By placing the patient at the heart of its concerns, Paris Brain Institute is pursuing a goal: to develop innovative therapeutic solutions that revolutionize the treatment of neurological and psychiatric diseases.
Bringing fondamental research and clinical research closer together to maximize the chances of a discovery becoming a treatment is therefore essential and an integral part of the Institute’s model. It is with this clear perspective that the unique iCRIN model was created. The objective of these structures is to develop the sharing of expertise between Pitié-Salpêtrière Hospital’s caregivers and Paris Brain Institute’s research teams.
Stroke, Alzheimer’s and Parkinson’s diseases, neurogenetics, neuro-oncology… Organized around 13 key themes exploring all areas of the fight against brain diseases, the iCRINs are a success gas pedal for the many clinical research projects of the Brain Institute’s ecosystem of care services.
In collaboration with Institut de la Mémoire et de la Maladie d’Alzheimer (IM2A), this project aims to: identify new cognitive markers and group specific populations of patients with Alzheimer’s disease; develop clinical applications, increasing preclinical and clinical trials, and proof of concept studies. To this end, iCRIN is building and monitoring cohorts of patients suffering from neurodegenerative diseases, whose clinical, biological and neuroimaging data will be organized in a database.
PARKINSON’S DISEASE AND MOVEMENT DISORDERS
The iCRIN dedicated to Parkinson’s disease and movement disorders benefits from the synergies between the team of Olga Corti and Jean-Christophe Corvol and that of Marie Vidailhet and Stéphane Lehéricy. Its two main objectives are to identify biomarkers of disease severity, progression and response to treatment, and to decipher the pathophysiological mechanisms underlying behavior and motor control disorders in rare movement disorders.
AMYTROPHIC LATERAL SCLEROSIS (ALS)
The ALS center in Paris is one of the most important in Europe, both in terms of new patients and patients followed. It collaborates with several members of Séverine Boillée’s team at the Institut du Cerveau. The iCRIN ALS is composed of four axes: to elucidate the onset of Amyotrophic Lateral Sclerosis (ALS or Charcot disease) and identify biomarkers; to understand the propagation of motor neuron dysfunction; to discover why innervation compensation mechanisms are maintained in some patients; to study the effect of opening the blood-brain barrier by focused ultrasound in ALS.
NEUROLOGICAL INTENSIVE CARE
The neurological intensive care unit is a very experienced structure in the acute care of patients with peripheral and/or central nervous system disorders. Its activity is focused on four main pathologies: categorization and follow-up of consciousness disorders in collaboration with Lionel Naccache’s team; diagnosis and therapy of status epilepticus with Stéphane Charpier and Vincent Navarro’s team; early diagnosis of encephalitis; creation of a large clinical database in myasthenia.
Almost all the clinical activities of the neurosurgery department have research programs with teams and platforms of the Brain Institute. The iCRIN aims to ensure the development of multimodal databases for future clinical trials. Five major research areas: identification of predictive factors of morbidity and mortality in cohorts of patients with brain tumors and in patients with aneurysms; new targets for deep brain stimulation and brain-maze interfaces; opening of the blood-brain barrier in various neurological pathologies; new therapeutic approaches for meningiomas; ex vivo human tissue for cellular electrophysiology.
The NEUROLOP clinical research center, including the actors of the Rare Disease Reference Centers of the Genetics Department of the Hospital and the Brain Institute, aims at deciphering the phenotypes associated with the genes involved in neurogenetic pathologies such as spinocerebellar ataxias or Huntington’s disease, from birth to adulthood; the search for clinical, imaging, biological and genetic biomarkers; innovative therapeutic trials in small cohorts of rare diseases; the transition from neurodevelopmental defects to programmed neuronal loss in adulthood in neurogenetic diseases in conjunction with basic research.
The association of the neuro-oncology department with a dedicated research team, led by Marc Sanson and Emmanuelle Huillard at the Brain Institute, a unique tumor bank (Onconeurotek), a preclinical therapeutic research group (GlioTex, led by Ahmed Idbaih), and a National Cancer Institute certification for early phase clinical trials and innovative therapies allow us to aim at the following objectives accelerate the transfer of the laboratory’s innovations into clinical applications, by identifying new biomarkers and testing innovative therapies, particularly in areas that have not yet been explored.
iCRIN Stroke aims to: participate in/coordinate randomized controlled trials, use Big Data to build a dynamic prognostic model of stroke outcome; identify new structural and functional markers of stroke consequences; develop innovative therapeutic approaches in rehabilitation, such as non-invasive brain stimulation techniques, innovative and playful rehabilitation strategies (serious games, neurofeedback) or pharmacological treatments
The clinical project of the Pitié-Salpêtrière orthopedic department focuses on three main themes: the genetic etiology of idiopathic scoliosis, in collaboration with Claire Wyart’s team at the Institut du Cerveau; the implementation of a systematic registry of neurological status before and after surgery for all patients in the spine unit; and the development of various prospective analysis protocols linking neuroscience to sports surgery or spinal cord trauma.
iCRIN Psychiatry proposes a multi-modal approach combining brain stimulation with pharmacotherapy or psychotherapy. It represents a strong interface between the clinical services and the Brain Institute, more particularly with Philippe Fossati and Liane Schmidt’s team. Two lines of research are currently being explored: the development of pragmatic trials in disorders related to stress dysregulation, such as post-traumatic stress; the exploration of neuromodulation of networks in psychiatry and drug use disorders.
TRAUMATIC BRAIN INJURY
New approaches to integrate multimodal data are crucial for tracking brain vulnerability, individual trajectories, and the evolution of traumatic brain injury (TBI). This iCRIN aims to structure and develop a large prospective cohort of individuals affected by traumatic brain injury explored in a multimodal manner (clinical, radiology, physiology), and to develop modeling of the results, including using statistical learning techniques.
The iCRIN Multiple Sclerosis aims at the translational development of remyelination strategies to prevent the progression of disability; the development of new imaging tools to evaluate repair strategies in patients with Multiple Sclerosis (MS); the development of therapies targeting the immune system; the detection and understanding of the pathophysiology of certain symptoms of multiple sclerosis, such as respiratory symptoms, and the development of new connected tools for more accurate assessment of disability progression.
In the rapidly evolving field of sleep physiology and medicine, this iCRIN focuses on a better description of the semiology of these disorders, their genetics, and neurophysiological and brain imaging markers and their optimal treatment. It also aims to understand the mechanisms of normal sleep and dreaming; to determine whether certain brain functions (e.g., memory or emotions) are related to REM sleep or not; to study preclinical neurodegeneration and to test neuroprotective treatments in patients with Parkinson’s disease and dementia with Lewy bodies