NAPS Consortium Site Spotlight: OHSU + VA Portland Health Care System (VAPORHCS)

Jun 2

Written By Kaleidoscope Management Group

Since observing high rates of REM sleep behavior disorder (RBD) among Veterans at the Portland VA Sleep Clinic, the team has shown great interest in the NAPS Consortium since 2018. They have reported that Veterans with traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) have significantly higher rates of RBD (Elliott, Lim et al., SLEEP, 2023). What sets our site apart is that it has the highest enrollment of Veterans among all NAPS sites, allowing us to investigate and compare neurotrauma-associated RBD (TBI/PTSD) with traditional RBD. Recently, the Portland team, together with other NAPS Consortium Investigators, published the first study based on the NAPS registry, which outlines the baseline characteristics of 361 participants with RBD (Elliott, Lim et al., ACTN, 2023).

Two institutions are involved for the Portland NAPS site:

OHSU

Oregon Health & Science University (OHSU) is a specialized health sciences institution located in Portland, Oregon. As the state's largest academic health sciences center, OHSU is dedicated to providing comprehensive services, including healthcare education, biomedical research, patient care, community outreach, and public service. It serves not only the entire state but also regions in southwest Washington, Idaho, Montana, Alaska, and northern California. OHSU Hospital is nationally recognized, ranking 29th according to US News & World Report.

With a robust research portfolio, OHSU ranks 25th among medical schools for NIH funding, securing nearly $500 million in research grants, with a focus on clinical trials receiving over $100 million. OHSU boasts over 1,200 Principal Investigators engaged in 4,000 research projects and offers more than 25 graduate programs for PhD and Masters students, including a combined MD/PhD program.

The OHSU School of Medicine supports a large academic community, with 2,180 faculty members, 1,433 students, and 668 residents and fellows across 27 departments. The Department of Neurology at OHSU comprises over 100 faculty members specializing in various areas such as sleep medicine, aging and Alzheimer's disease, movement disorders, multiple sclerosis, stroke, epilepsy, neuromuscular diseases, neuro-oncology, and neurocritical care. It is home to notable Centers including the Layton Aging & Alzheimer's Disease Center and the Parkinson Center of Oregon.

VA Portland Health Care System (VAPORHCS)

The VA Portland Health Care System (VAPORHCS) is a prominent clinical and research institution situated in Portland, Oregon. It enjoys a close affiliation with Oregon Health & Science University (OHSU). OHSU and VAPORHCS are located in close proximity on adjoining campuses, connected by an indoor skybridge that fosters collaboration and training opportunities. VAPORHCS has a rich history of conducting impactful research within its facilities, boasting a team of over 175 investigators and more than 570 active protocols. Approximately 5,750 Veterans participate as volunteers in these ongoing protocols. Recently, Portland VA scientists secured research grants totaling over $36 million from organizations such as the VA, NIH, DoD, NSF, and others. Additionally, there have been nearly 500 research publications stemming from their work. The research collaborations within VAPORHCS and between VAPORHCS and OHSU are notably robust and productive.

Our Team

From left to right: Mohini Bryant-Ekstrand, Anam Arik, Miranda Lim, MD PhD, Brittany Ligman, Cosette Olivo, Jon Elliott, PhD

Miranda M. Lim, MD, PhD

Principal Investigator

I am an Associate Professor in Neurology and Co-Director of the Oregon Alzheimer's Disease Research Center at OHSU. Additionally, I serve as a Staff Neurologist at the Portland VA and Associate Co-Director of Research and Education for the VA Veterans Integrated Services Network (VISN 20) Northwest Mental Illness Research, Education, and Clinical Center (NW MIRECC). Our research program, known as the Sleep & Health Applied Research Program (SHARP), focuses on basic and translational research supported by multiple federal agencies, including the VA, DoD, NSF, and NIH. Our goal is to unravel the mechanisms through which sleep contributes to brain health.

My journey with NAPS began during my neurology residency at Washington University in St. Louis, where I had the opportunity to work alongside Dr. Yo-El Ju, the Co-PI. It was during this time that our scientific team at WashU identified the significant role of sleep disruption in the progression of Alzheimer's disease, a groundbreaking finding (Kang, Lim et al., Science 2009). This experience ignited my fascination with sleep, leading me to pursue a clinical and research fellowship in Sleep Medicine at the University of Pennsylvania. Since then, I have dedicated my clinical and research endeavors to understanding the pivotal role that sleep plays, not only as a crucial window to assess brain health but also as a potential driver of disease.

Lee Neilson, MD

Co-Investigator

I am an Assistant Professor in Neurology at OHSU, where I also serve as a Staff Neurologist at the Parkinson's Disease Research, Education, and Clinical Center (PADRECC). Additionally, I have the privilege of co-directing the Movement Disorders Fellowship at the Portland VA. My ongoing research, supported by the VA, focuses on two main areas. Firstly, I am dedicated to improving our understanding of the prodromal Parkinson's disease (PD) population, aiming to characterize this group more comprehensively. Secondly, I am involved in evaluating biomarkers that can provide valuable insights into disease progression, with the ultimate goal of facilitating interventional trials.

I am delighted to be part of the NAPS Consortium of investigators, as it provides a tremendous opportunity to engage with the target population and advance our knowledge in the field of Parkinson's disease.

Anam Arik, MSc

Lead CRC

In addition to my role as a lead CRC for the NAPS study, I hold positions as a Lab Manager for the Sleep & Health Applied Research Program at the Portland VA and as a Sr. CRA in the Department of Neurology at OHSU. The NAPS study holds a special place for me because it is a longitudinal study, allowing me to have annual interactions with our participants. It brings me great pride to be involved in this remarkable consortium comprising multiple sites that collaborate to provide support for patients with RBD, while also working towards a better understanding of the progression of Parkinson's disease and related disorders.

Jonathan E. Elliott, PhD

Co-Investigator

I am an Assistant Professor in Neurology at OHSU and also serve as a Research Physiologist at the Portland VA. Furthermore, I co-direct the Sleep & Health Applied Research Program (SHARP). Our primary research focus within SHARP is to enhance our understanding of the relationship between disrupted sleep and long-term neurodegeneration. One notable example of this is our investigation into REM sleep behavior disorder (RBD) as a potential early indicator of synucleinopathies.

Our overarching objective is to conduct research that has tangible clinical implications, aiming to make a real-world impact. We strongly believe in the power of collaboration and teamwork, recognizing that scientific progress thrives on collective effort rather than isolated endeavors. Participating in the NAPS consortium aligns perfectly with these principles and provides us with an excellent platform for collaboration, support, and the pursuit of scientific advancement.

Kevin Duff, PhD

Neuropsychologist

I am a Professor in Neurology and serve as the senior neuropsychologist for the NIA-Layton Oregon Alzheimer's Disease Research Center at OHSU. Throughout my career, I have dedicated my research efforts to identifying early cognitive changes in various neurological conditions, such as Alzheimer's disease, Huntington's disease, and Parkinson's disease. My work in this field has been supported by the NIH since 2007.

Joining the NAPS Consortium is a natural extension of my long-standing interest in studying conditions that give rise to cognitive, motor, and psychiatric symptoms in patients. It provides a valuable opportunity to further explore and contribute to the understanding of these complex disorders.

Isabella Montano

Research Assistant

As an undergraduate student, I have the privilege of assisting in conducting neuropsychological and motor exams with the participants of the NAPS study. Choosing to work on NAPS was driven by my genuine interest in its cause, as well as my aspirations to pursue research and medicine in this specific area after graduation. One of the most captivating aspects of being involved in NAPS is the opportunity to meet new people and listen to the stories they willingly share during the breaks between tests. It adds a personal and meaningful touch to the research experience, further fueling my passion for this field.

Recent Highlights

SLEEP 2023 (June 2023)

NAPS investigator, Dr. Miranda Lim, gave an invited lecture on "Sleep in Animal Models of Neurodevelopmental Conditions," alongside other clinical researchers and physicians dedicated to studying sleep and the brain at SLEEP 2023.

Dr. Lim and her team also ignited audience interest in the NAPS Consortium through poster presentations by answering questions about findings with their peers.

Pictured L-R: Miranda Lim, Mohini Bryant-Ekstrand, and Isabella Montano

“Trauma-Associated Sleep Disorder” | White Noise: A Sleep Medicine Podcast (March 2023)

NAPS investigator, Miranda Lim, MD, PhD was recently interviewed for The White Noise: A Sleep Medicine Podcast, outlining trauma-related sleep disorder while having a little fun along the way.

The aim of this sleep medicine podcast is to provide health care professionals who deal with sleep related issues with the most up to date clinical information. The hosts feature expert interviews with leaders in the field of sleep medicine to help guide learning and grow clinical practice.

🎧 Listen to the episode here.

OHSU feature on OHSU-VA Partnership (Veterans Day 2021)

On Veterans Day, we salute all who served and who continue to do so through participation in medical research that benefits generations to come.