The Zeiss confocal microscope in the Young-Pearse lab is used to capture images of neurons. Young-Pearse is one of many principal investigators who will be moving into the new building.

When the new building at 60 Fenwood Road opens in fall 2016, it will be a hub for state-of-the-art labs, outpatient clinical space and advanced imaging facilities. It will also be home to researchers and clinicians from across many disciplines with a shared vision for collaboration, acceleration and translation of laboratory discoveries into novel treatments for patients. In the months leading up to the opening, this series has featured several major research areas that will be brought together in the new space. The story below highlights what the building will mean for clinicians and researchers in the departments of Neurology, Neurosurgery and Psychiatry.

Smarter clinical trials. Advanced care for patients. Sophisticated imaging technologies. And bridges – both literal and figurative – to other departments and research areas. Members of BWH’s Neurosciences Center have all this and more to look forward to when the new building opens its doors this fall at 60 Fenwood Rd.

Martin A. Samuels

“The nervous system disciplines at BWH have never had a place that we can all truly call home,” said Martin A. Samuels, MD, chair of the Department of Neurology and director of the Neurosciences Center. The BWH Neurosciences Center is the umbrella entity that facilitates all forms of collaboration (clinical care, research and education) within the neurosciences at BWH.

“BWH is unique in that nine of the hospital’s clinical department chairs have a deep interest in disorders of the nervous system,” said Samuels.  “These include the core departments solely dedicated to diseases of the nervous system – Neurology, Neurosurgery and Psychiatry – in addition to six other departments around the hospital.”

These departments are Pathology, led by Jeffrey Golden, MD, a neuropathologist; Radiation Oncology, led by Daphne Haas-Kogan, MD, a neuro-radiation oncologist; Anesthesiology, Perioperative and Pain Medicine, led by James Rathmell, MD, a pain specialist; Pediatric Newborn Medicine, led by Terrie Inder, MBCHB, a pediatric neurologist; Orthopaedic Surgery, led by James Kang, MD, a spinal surgeon; and Physical Medicine and Rehabilitation, led by Ross Zafonte, DO, a neurophysiatrist interested in head injury. There are numerous other divisions and programs with an interest in nervous system medicine. These include sleep medicine, neuroendocrinology, neurourology, neurootology and others. These divisions and programs are currently scattered across BWH’s campus, a challenge that has emphasized their separation.

“We all work in different locations, which doesn’t facilitate collaboration and communication,” Samuels said.

Once the new building opens, the three core departments of the Neurosciences Center will physically come together. The close proximity of the clinicians, researchers and staff working in the new building will provide connections among colleagues, patients and ideas.

“Though no single building can hold all that we are doing at the Brigham in the neurosciences, our hope is that the new building will act as a focal point for all clinical and research areas that are a part of the Neurosciences Center,” said Adrian Ivinson, PhD, the Neurosciences Center’s executive director.

“The new building represents our overarching strategy for reducing suffering caused by nervous system disorders. In it, researchers, clinicians and trainees will work together to solve some of the biggest neurosciences problems of the 21^st century including Alzheimer’s disease, ALS, Parkinson disease, stroke, dementia, epilepsy, brain tumor, depression, anxiety, multiple sclerosis, paralysis and pain, making concrete the concept of translational biomedical science,” said Samuels.

David Silbersweig

The new building will also allow members of the Neurosciences Center to strengthen another pillar of the center’s mission: educating the next generation of researchers and clinicians. David Silbersweig, MD, chair of Psychiatry, notes that having multiple neurosciences-related departments in one building will strengthen BWH’s neuropsychiatry program and its brain-circuit-based approach to psychiatry, giving rise to new education and training opportunities.

“Trainees from different departments can receive cross-departmental training,” said Silbersweig. “They can all share ideas and work together, which we think will have a positive effect on our patients and the quality of their care.”

The Translational Bridge

Patients will be seen in the Neurosciences Clinical Center on the new building’s first floor; clinical trials will unfold on the third floor; and basic and translational research will take place in the labs on the eighth, ninth and tenth floors of the building. The close proximity of clinical space and research space will accelerate the translation of treatments from the laboratory to the patient.

An artistic rendering of the brain. The right cerebral hemisphere has been removed revealing the cerebral nuclei and brainstem.

Clinical trials provide researchers and clinicians with crucial information to develop new therapies. Neuroscience researchers are beginning to understand the underlying mechanisms of many diseases. Building on these insights about the biology and genetics of diseases, researchers will be able to identify and then enroll patients with genetic backgrounds that make them more likely to respond to a drug. This will allow small-scale but precise clinical trials to be undertaken that can lay a foundation for larger-scale trials to be conducted in partnership with industry.

“These are critical data,” said Ivinson. “Crossing the translation bridge, which spans the gap between the laboratory and the clinic, is the key to creating personalized medicine. This is how you bridge the gap between research discoveries and clinical implementation.”

David Wolfe, MD, MPH, director of Research for the Depression Center, and his team are currently working on three clinical trials, one of which just began a few weeks ago. They are collaborating with colleagues in Neurology and Rheumatology to study the effects of novel anti-inflammatory medications to treat major depression.

“We hope that this move will provide a better experience for patients, allowing them to transition more easily between clinical and research settings,” said Wolfe. “The building will be a ‘one-stop shop,’ making scheduling, testing and patient care easier to coordinate and execute.”

Setting Sights on Neurological Diseases

Image of neurons in the hippocampus region of the brain captured using a Zeiss confocal microscope in the Young-Pearse lab. Image shows astrocytes (red), nuclei (blue) and microglia (green). Astrocyte and microglia can help protect the brain from toxic factors (such as amyloid beta in Alzheimer’s disease).

The core research laboratories of the Ann Romney Center for Neurologic Diseases will be located in the new building, where researchers will pursue new treatment strategies for five neurologic diseases: multiple sclerosis (MS), Alzheimer’s disease, ALS (Lou Gehrig’s disease), Parkinson disease and brain tumors. Co-directed by neurologists Howard Weiner, MD, and Dennis Selkoe, MD, the center aims to bring together investigators both within the Brigham and outside of it who work across all five disease areas to accelerate the pace of discovery.

Tracy Young-Pearse, PhD, who started her independent research laboratory at BWH in 2010, uses molecular approaches to study the functions of genes involved in Alzheimer’s disease, schizophrenia and related neurodevelopmental diseases. Her lab, which is currently on the Harvard Medical School campus, will be one of the first to move into the new building in late September.

“This move will create an incredibly exciting new frontier for the work of our lab,” said Young-Pearse. “We currently work with many other labs in Neurology and Psychiatry to explore the underlying causes of Alzheimer’s disease and related disorders. In the new space, we will be able to work directly adjacent to these labs in a fluid and interactive research space as well as be in close proximity to our clinical colleagues, who work to diagnose and treat these diseases every day.”

Technological Advances

Ennio Chiocca

The new building will also provide the neurosciences with access to cutting-edge technology that will support and propel translational research forward. In 2017, a Magnetom Terra 7.0 Tesla MRI will be moved into the building; the “Tesla” is the newest and most powerful MRI machine available and the first to be installed in a clinical setting in North America. The machine will be used to visualize extremely detailed images of pathways in the brain and provide insight into otherwise unseen processes.

Ennio Chiocca, MD, PhD, chair of Neurosurgery, studies the progression of malignant brain tumors and immunotherapy treatments. He looks forward to using this technology in his area of research.

Alexandra Golby

“Many neurosurgeons have research labs,” said Chiocca. “Being able to visualize the brain’s structure and function will be invaluable in the clinical as well as the research setting.”

Alexandra Golby, MD, a neurosurgeon and principal investigator, looks forward to having advanced imaging technology closer to her research lab.

“This is the first time we will have a space that is completely dedicated

to the neurosciences and supplemented by advanced imaging technology,” said Golby, whose research relies heavily on data collected from advanced MRI, including functional MRI  and diffusion imaging, to perform individualized brain mapping for neurosurgical patients.

Strengthening Connections

Moving into the new facility will allow physicians and researchers from different areas of expertise who are working on addressing a common health problem to come together.

“Pain is an example of a truly interdisciplinary problem that involves experts from many departments including Psychiatry, Rheumatology, Orthopaedics, Oncology and Neurology,” said Samuels. “It is a problem that we are able to approach effectively because we aren’t limiting ourselves to working with only those in our respective fields.”

The building is physically connected by bridges to Dana-Farber Cancer Institute, the Shapiro Cardiovascular Center and the main hospital, where neuroscience collaborations can continue to blossom.

“Within the neurosciences, we have a deep interest in cancer as well as neurological infectious diseases, such as encephalitis, and cerebrovascular diseases, such as stroke,” Samuels said. “Neurosciences research encompasses the brain, the spinal cord, the nerves and the muscles which, in turn, affect the entire body. It is inherently multidisciplinary.”

Building toward the Future

An fMRI map showing the relationship of critical brain structures in relation to a brain tumor.

Ivinson hopes that the new building will be a model for the future of research and clinical care.

“We have the opportunity to create entirely new initiatives, share knowledge and explore new developments with institutions around the world,” Ivinson said.

Samuels adds that the timing of the new building’s opening helps herald a new century of discovery and progress in understanding and treating nervous system diseases.

“To our knowledge, there is no other place on earth that will have a building like this with a neurosciences center of this magnitude,” said Samuels. “This is the century of the brain, and we’re hoping to witness monumental progress made in advancing research and patient care.”