Neurocritical Care Researchers and the
Road to Career Development Awards
By Lauren Koffman
This is the first installment in a Currents
series that will feature neurocritical
researchers who have been awarded career
development awards, or K awards. Each
person was asked to describe their research
background, experience with the
application process and a bit about their
research project.
Jonathan Elmer, MD, is at the University of
Pittsburgh Medical Center and says that
writing the first draft of the grant was a
learning experience but fun. Dusting the
application off a year later to revise and
respond to the pink sheet was painful. The
novelty had worn off and the novel science
already felt a bit like old news. He started
dabbling with clinical research as a resident
with a grant from the Emergency Medicine Foundation.
“I wasn’t good at it and didn’t like it. As a fellow, I completed a
master’s degree in clinical research and discovered that research was
a lot more fun when done right. I transitioned from my fellowship
program onto an institutional K12 from NHLBI, which was really
instrumental in allowing me the time to develop both my science
and me to a point where both were ready for an independent K.”
His grant explores quantitative EEG after cardiac arrest. “We’re
working to develop new analytical tools capable of transforming
this complex, longitudinal data into clinically actionable
knowledge. In Aim 1, we’re trying to identify non-invasive qEEG
signatures of secondary brain injury, validated against invasive
multimodality monitoring as our gold standard. In Aim 2, we’re
developing multidimensional trajectory models of qEEG over time
and testing whether these models shorten the time to an accurate
prognosis when added to conventional methods.”
Christopher Anderson, MD, practices at
Massachusetts General Hospital and recently
pursued a K-R transition. “The K23
application process was straightforward but
requires attention to detail, particularly as it
pertains to the interaction between your
research plan and your career development
plan. A first-rate mentor is a key component,
and the more developed their track record in
academic mentorship, the better. K awards are really about the
PI-mentor team, and I think one mistake people make is paying
too much attention to their research strategy rather than the other
critical components of the application.”
He completed a formal research fellowship at Massachusetts
General Hospital and the Broad Institute between residency and
a critical care fellowship. “A dedicated post-doctoral fellowship
was critical to my funding success. Following my critical care
fellowship, I received an AAN CRTF, followed by my K23 and
some institutional awards. During my K23, I also obtained a
master’s degree in translational investigation from Harvard
Medical School and performed a second post-doctoral research
fellowship at Biogen Inc. I received my first R01 in the fourth
year of my K23. I am also a PI of an AHA Strategically Focused
Research Network in Atrial Fibrillation, studying the utility of
polygenic risk scores in clinical practice for stratification of
atrial fibrillation risk in cryptogenic stroke.”
His research program is based on the population genetics
of ischemic and hemorrhagic stroke. His AAN award
studied genetic variants involved in the pathways serving
mitochondrial bioenergetics and their associations with
small vessel ischemic stroke and non-lobar intracerebral
hemorrhage. “My K23 built on my track record in
pathway-based genome wide analyses, focusing on genetic
influences on lipid levels and their role in intracerebral
hemorrhage risk and recurrence. In my R01, I am studying
whole genome sequencing data to perform fine-mapping of
genome wide association study signals, with gene-editing of
leading signals to identify cellular phenotypes.”
Raj Dhar, MD, from Washington
University School of Medicine says he did
not apply in his first few years as
neurocritical care faculty until was able to
obtain permanent U.S. residency (after
training in Canada) but was able to obtain
AHA grant in the interim (as well as
foundation award) to start a research career.
“Persistence pays off. I had prior K23 application on a different
project and with a different mentor that was not funded and
started work in a new area with a new mentor, which led
to an institutional KL2 grant for two years.” He obtained
preliminary data prior to successful submission of K23
grant about two years ago but describes it as a long journey.
Resubmission was required as the first application did
not reach a fundable score, but was he able to respond to
critiques including more relevant training and improving
the focus on mechanisms (genetics) rather than clinical
(prediction). He had no formal research training prior
to or during fellowship, but the KL2 grant included
significant research training including a focus on genomics
(which was related to his research project), ultimately
leading to Master of Science in clinical investigation degree
at Washington University in St. Louis.
The overall goal of his project is to identify genetic markers
that explain variability in rate of cerebral edema formation
after ischemic stroke. The primary aim is to create and validate
an imaging endophenotype that captures the dynamic change
in edema formation over the first few days after stroke. “We are
integrating automated image analysis (using machine learning on
thousands of serial head CTs) to measure rate of edema formation
with genomic data on this same large cohort of stroke patients
to identify which genetic variants explain the heterogeneity in
cerebral edema. This will both aid in the early prediction of
malignant cerebral edema as well as identify potential targets for
drug development to prevent or minimize edema formation.”
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