Overview
Our laboratory uses molecular biology, cell culture, and animal modeling techniques to examine the CNS response to acute injury. In particular, our laboratory examines the role of microglial activation and the endogenous CNS inflammatory response in exacerbating secondary injury following acute brain insult. Much of the in vitro work in this laboratory is dedicated to elucidating cellular responses to injury with the ultimate goal of exploring new therapeutic interventions in the clinical setting of stroke, intracranial hemorrhage, and closed head injury.
In conjunction with the Multidisciplinary Neuroprotection Laboratories, we also focus on clinically relevant small animal models of acute CNS injury. For example, we have recently characterized murine models of closed head injury, subarachnoid hemorrhage, intracranial hemorrhage and perinatal hypoxia-ischemia, in addition to the standard rodent models of focal stroke and transient forebrain ischemia. Recently we have adapted several of these models from the rat to the mouse to take advantage of murine transgenic technology. The objective of these studies are two-fold: to gain better insight into the cellular responses and pathophysiology of acute brain injury, and to test novel therapeutic strategies for clinical translation. In both cell culture systems and animal models, our primary focus is on examining the role of oxidative stress and inflammatory mechanism in mediating brain injury following acute brain insult, and examining the neuroprotective effects of endogenous apolipoprotein E in the injured mammalian central nervous system.
Our laboratory is committed to translational research, and has several active clinical research protocols, which are designed to bring the research performed in the Multidisciplinary Research Laboratories to the clinical arena. These protocols are centered around patients following stroke and acute brain injury, and are primarily based out of the Emergency Room and Neurocritical Care Unit. For example, we are currently examining the role of inflammatory mediators for use as a point-of-care diagnostic marker following stroke, intracranial hemorrhage, and closed head injury. We have recently translated a novel apoE mimetic from the preclinical setting to a multi center Phase 2 trial evaluating efficacy in intracranial hemorrhage. We are also examining the functional role of different polymorphisms of of inflammatory cytokines in the setting of acute brain injury and neurological dysfunction following cardiopulmonary bypass.
In conjunction with the Multidisciplinary Neuroprotection Laboratories, we also focus on clinically relevant small animal models of acute CNS injury. For example, we have recently characterized murine models of closed head injury, subarachnoid hemorrhage, intracranial hemorrhage and perinatal hypoxia-ischemia, in addition to the standard rodent models of focal stroke and transient forebrain ischemia. Recently we have adapted several of these models from the rat to the mouse to take advantage of murine transgenic technology. The objective of these studies are two-fold: to gain better insight into the cellular responses and pathophysiology of acute brain injury, and to test novel therapeutic strategies for clinical translation. In both cell culture systems and animal models, our primary focus is on examining the role of oxidative stress and inflammatory mechanism in mediating brain injury following acute brain insult, and examining the neuroprotective effects of endogenous apolipoprotein E in the injured mammalian central nervous system.
Our laboratory is committed to translational research, and has several active clinical research protocols, which are designed to bring the research performed in the Multidisciplinary Research Laboratories to the clinical arena. These protocols are centered around patients following stroke and acute brain injury, and are primarily based out of the Emergency Room and Neurocritical Care Unit. For example, we are currently examining the role of inflammatory mediators for use as a point-of-care diagnostic marker following stroke, intracranial hemorrhage, and closed head injury. We have recently translated a novel apoE mimetic from the preclinical setting to a multi center Phase 2 trial evaluating efficacy in intracranial hemorrhage. We are also examining the functional role of different polymorphisms of of inflammatory cytokines in the setting of acute brain injury and neurological dysfunction following cardiopulmonary bypass.
Current Appointments & Affiliations
Professor of Neurology
·
2012 - Present
Neurology, Neurocritical Care,
Neurology
Vice Chair for Academic Affairs in the Department of Neurology
·
2013 - Present
Neurology,
Clinical Science Departments
Director, Duke Clinical Research Institute in the Department of Neurology
·
2016 - Present
Neurology,
Clinical Science Departments
Assistant Dean for Scholarly Education
·
2024 - Present
Medical Education,
School of Medicine
Professor in Neurobiology
·
2012 - Present
Neurobiology,
Basic Science Departments
Professor in Anesthesiology
·
2012 - Present
Anesthesiology,
Clinical Science Departments
Professor in Neurosurgery
·
2016 - Present
Neurosurgery,
Neurosurgery
Affiliate, Duke Global Health Institute
·
2010 - Present
Duke Global Health Institute,
University Institutes and Centers
Member in the Duke Clinical Research Institute
·
2016 - Present
Duke Clinical Research Institute,
Institutes and Centers
Associate of the Duke Initiative for Science & Society
·
2017 - Present
Duke Science & Society,
University Initiatives & Academic Support Units
Recent Publications
Association of blood pressure variability with clinical and biomarker outcomes in moderate to severe TBI: A TRACK-TBI study.
Journal Article J Clin Neurosci · July 2026 INTRODUCTION: Traumatic brain injury (TBI) represents a significant global health burden and often results in functional impairment. Blood pressure variability (BPV), a surrogate marker of autonomic dysfunction, has been shown to influence outcomes in pati ... Full text Link to item CiteAssociation of Preinjury Beta-Blocker Exposure With Brain Injury Biomarkers Following Traumatic Brain Injury.
Journal Article J Neurosurg Anesthesiol · April 1, 2026 OBJECTIVE: Beta-blockers have been studied for their impact on traumatic brain injury (TBI). We aimed to examine the association of preinjury beta-blocker exposure with early brain injury biomarker levels and outcomes following TBI. METHODS: We retrospecti ... Full text Open Access Link to item CiteApolipoprotein E Mimetic Peptide CN-105 and Postoperative Delirium in Older Patients: The Phase 2 MARBLE Randomized Clinical Trial.
Journal Article JAMA Netw Open · April 1, 2026 IMPORTANCE: The apolipoprotein E (APOE) gene ε4 allele leads to increased Alzheimer disease risk and neuroinflammation and is also believed to play a role in postoperative delirium. However, the safety and feasibility of modulating apoE protein signaling t ... Full text Link to item CiteRecent Grants
Impact of Autonomic Dysfunction on Multi-Organ Dysfunction following Severe TBI: The AUTO-BOOST Study
ResearchCo Investigator · Awarded by National Institute of Neurological Disorders and Stroke · 2023 - 2028A Risk Stratification Model for Health and Academic Outcomes in Children with Concussion Based on Novel Symptom Trajectory Typologies
ResearchSignificant Contributor · Awarded by National Institute of Neurological Disorders and Stroke · 2023 - 2028Targeting Apolipoprotein-E to Improve Recovery after Spinal Cord Injury
ResearchPrincipal Investigator · Awarded by University of Maryland, Baltimore · 2025 - 2027View All Grants
Education
Duke University ·
1991
M.D.