Cooperation in São Paulo
Unicamp scientists help conceive and carry out Brazil’s most
ambitious brain research project ever; focus will be epilepsy

Álvaro Kassab

The State University of Campinas (Unicamp) has conceived and is going to coordinate the broadest multidisciplinary research program focused on brain mapping ever carried out in Brazil. Named CInAPCe (Cooperação Interinstitucional de Apoio à Pesquisa sobre o Cérebro, or Inter-Institutional Cooperation for the Support of Research on the Brain), the program will be funded by the State of São Paulo Research Foundation (Fundação de Amparo à Pesquisa do Estado de São Paulo). At least 150 researchers – professors, students and technicians – of nine Unicamp units will be involved in the project, whose thematic focus is epilepsy. Also in the project are the University of São Paulo (Universidade de São Paulo, USP), through units in its São Paulo, Ribeirão Preto and São Carlos campi, the Federal University of São Paulo (Universidade Federal de São Paulo, Unifesp) and São Paulo’s Albert Einstein Hospital. In the next four years, the program is expected to form and train at least 300 researchers – 30 post-doctors, 100 PhDs, 50 Masters’, 100 scientific initiation students and 20 technicians.

Before the end of the year Unicamp will receive a high field magnetic resonance machine. The US$ 2 million-worth equipment is going to be the platform for the creation, in the next few months, of the Multi-Modal Center of Neuro-Imaging for Studies in Epilepsy (Centro Multimodal de Neuroimagem para Estudos em Epilepsia). Three other similar devices will go to the Albert Einstein Hospital and to USP’s Medical Schools in São Paulo and Ribeirão Preto. The project is going to cost approximately US$ 10 million. The CInAPCe is expected to start operating in early 2007.

Slow start

Professor Roberto Covolan, of Unicamp’s Gleb Wataghin Physics Institute (Instituto de Física Gleb Wataghin, IFGW), one of the program’s coordinator, has been involved in the project from the start. He recalls that by the end of the 1990s Unicamp already had a multidisciplinary team structured for carrying out research in neuroscience, an area that experienced expressive growth in the past decade. The group was comprised of scientists from the School of Medical Sciences and from the Physics, Biology and Computing Institutes. In 2000, Professor Covolan, neurologist Li Li Min and Fernando Cendes, who heads the School of Medical Sciences’ Department of Neurology told then president of Fapesp’s Superior Board, physicist Carlos Henrique de Brito Cruz, about their interest in turning Unicamp into a sort of advanced laboratory for research in the area of neurosciences with the purchase of a high field resonance equipment. Cruz, who later became rector, supported the initiative but suggested not to limit it to Unicamp.

The project began to take form with a workshop held at Unicamp in December of 2000, when the idea of creating a multidisciplinary, inter-institutional statewide program was first presented. The proposal was accepted by groups of scientists specialized in brain dynamics. It was also decided then that researchers from the exact and technology sciences would be called to join in. The workshop’s most immediate results were the creation of work groups and the organization of further meetings.

“There was much debate before we reached the points of convergence,” recalls Professor Covolan. In 2001, the main points were presented to the Fapesp, which showed interest in supporting the project. The foreign exchange crisis of 2002 and the vicinity of presidential elections, however, stalled the process. It was only in May of 2004 that Fapesp promoted a workshop with the research groups and things stated to move again. An evaluation by international experts – Brian Meldrum, professor of experimental neurology at London’s King’s College; Bruce Pike, from Montreal’s McConnell Brain Imaging Centre; and Ana Nobre, from England’s Oxford University – indicated that it was worthwhile for the fostering agency to invest in the program. The selection of participants, made through an edict, consolidated the basis of the CInAPCe. Now there are only a few bureaucratic details left before the contract is signed, says Professor Covolan.

Specific focus

At first the CInAPCe’s goal was to study the nervous system as a whole. But along the way it was decided that the focus should be more specific. Professor Cendes, who coordinates the thematic project, explains that a number of reasons are behind the choice of epilepsy as the object of the research. For example, the fact that Unicamp already hosted a group whose priority was that pathology. In addition, the other institutions involved in the project already had background in the area and had significant production in terms of volume and quality.

Another important aspect is the clinical components of the disease, which scientists see as “a window for the comprehension of brain operation,” as professor Cendes defines. A large number of pathologies, he explains, have epileptic crises in common. “There are a number of diseases, among them cranial trauma, that can cause epilepsy,” he says. According to him, the advance of the neurosciences is directly linked to the studies on epilepsy, be them the mere observation of problems with memory, be it through medical procedures. He points out that the very representation of the brain’s movements was drawn and elaborated through surgeries performed on epilepsy patients, and that it is possible to understand, from behavior alterations caused by the disease, how the brain works and some of its manifestations, among them language abilities, movements and how memory organizes itself.

The focus on neuro-imaging, in such a context, will be essential for carrying out comparative studies between volunteers without the disease and epilepsy patients. That kind of analysis, argues Professor Cendes, is crucial for understanding why epilepsy patients have histories of loss of memory, depression and other associated symptoms. With this, he believes, it will be easier to detect the alterations and to study comprehensively the brain subsystems in which they take place. The most immediate effect of this analytical effort will be the advent of new approaches for treatment, diagnostics and thus prevention.

A public health problem

For Professor Cendes, the main goal of the scientists who work in this area, both clinically and experimentally, is to understand how the process that unleashes epilepsy works. The expectation is that the CInAPCe will provide enough subsidies to contribute to the clarification of those mechanisms and to the discovery of other components present in pathologies derived from epilepsy. “With this,” he says, “not only we will be able to understand the disease, but also to take steps to protect the brain of people who are exposed to the pathology, from birth or after a certain age.”

A pathology that, besides being confused with other diseases whose common symptom is the frequency of the crises, does not affect just human. Epilepsy is quite common among dogs, cats and small primates. That, according to Professor Cendes, makes possible to apply experimental models on animals so as to simulate certain types of epilepsy similar to those that affect humans, thus opening up a wide range of possibilities in the study of countless biological variables. “That’s where, for example, the groups of biology that work with neurophysiology, molecular biology and so on fit in,” he says. Professor Cendes points out that, in the case of experimental models, it is possible to study the dimension of the interference of the crisis, to carry out behavior analyses and to evaluate the damages to memory. “From the study with animals we will be able to come close to what happens with humans,” he hopes.

That is something that will benefit a lot of people. It is estimated that epilepsy affects 1 percent of the population worldwide. Inhabitants of developing countries are more susceptible to it, another factor that was also taken into consideration in the formulation of the program – the causes range from recurrent infections, common in poor countries, to accidents. In short, epilepsy is a public health problem.