2024 BRITL Brain Research, Innovation & Translation Laboratory
The Brain Research, Innovation & Translation Laboratory (BRITL) Neuroscience research program is part of the University of Hawaii John Burns School of Medicine MD5 MED 599 Neuroscience Research Course. University Hawaii medical students may sign up for elective credit while working at BRITL in MD5 MED 599 Neuroscience research credit.
BRITL is part of Hawaii Pacific Neuroscience’s robust clinical and academic research programs where we foster a culture of innovation and collaboration. Physicians and scientists work closely within and across centers, institutes, and schools to collaborate whether they are basic laboratory-based scientists, bio statisticians or clinicians to encourage cross disciplinary translation bench to bedside research. BRITL students work alongside and collaborate with at Hawaii Pacific Neuroscience Clinical Research Center whose ground breaking work is funded by NIH and other agencies and recognized nationally.
BRITL’s mission is to support our local medical students to pursue their passion in neuroscience, research and develop leadership in this field to make an impact in the local community. It provides students the opportunity to work in a team setting working with seasoned investigators, junior investigators, residents, senior student leaders and junior students. BRITL is proud to recognize exceptional medical students as “neuroscience academic scholars” and project leaders who have demonstrated exemplary academic abilities in neuroscience, leadership qualities, passion, and commitment to the pursue of excellence in research and a commitment to make a difference in the local and global community. See their Publications & International Presentations
Core Neurology/Neuroscience Faculty
Enrique Carrazana, MD
Publications Director,
Clinical Educator
Janette Abramowitz, MD,
Assistant Professor
Darren DuGas, MD
Neurology, Epilepsy, EEG
Natalia Gonzalez, MD
Neurology, Neuromuscular, MS & Neuroimmunology, EMG
Angeline Eojung Kim, MD
Neurology, Headache, Pain Disorders
Eliza Hagen, MD
Neurology
Nichoals Anderson, MD
Sleep Medicine
Alex (Andra) Takeyasu, MD
Psychiatry, Center for Psychiatric Neuroscience
Russell Woo, MD
Professor and Director of Medical Student Research
Lawrence Burgess, MD
Professor and Director of Student Affairs
Qi Zhi, DNP, MPH, FNP
Neurology
Chathura Siriwardhana, PhD
Biostatistics
2024 BRITL (Brain Research, Innovation & Tranlsational Lab) Didatics & Lectures
June 15th Sat 9AM-4PM
Spring Presentation & Summer Orientation
Introduction to Research
Kore Kai Liow, MD
Neuroscience Chair and BRITL DirectorClinical Professor Medicine (Neurology)
Clinical & Translational Research
Improving Outcomes for Infants with Biliary Atresia in Hawaii - Is It Time to Screen?
Russell Woo, MD
Professor & Associate Dean Clinical ProgramJune 18, 25 Tues 5:00-6:30PM
Research Bio Statistics I and II
Chathura Siriwardhana, PhD,
Assistant Professor,Biostatistics Core Facility,
Dept. Quantitative Health Services
July 13th Saturday 9AM-4PM
MID TERM Oral Presentation
July 16 Tues 5:00-6:00PM
Writing up Your Abstract and Poster
Enrique Carrazana, MD
Publication Director, Neurology, Hawaii Pacific Neuroscience, Clinical EducatorJuly 23, 30, Aug 5 -Tues 5:00-6:00PM
How to Get Your Posters Ready How to Submit to National Meetings How to Submit for Full length Publications
2024-25 Project Leaders
D-Dré Wright, MS2
Anita Cheung, MS2
Ryan Nakamura, MS2
Oct 19th Sat 9AM-4PM FINAL Poster Presentation
2024 Hawaii Neuroscience Symposium and Research Poster Competition
Full Program Information
Register Online
Native Hawaiian & Pacific Islanders Health Disparity
Keaweʻaimoku Kaholokula, PhD
Professor and Chair of Native Hawaiian Health, John A. Burns School of Medicine
Visiting Professor Keynote Speaker
Advances in Spasticity, Dystonia & Blepharospasm Treatments
Zoltan Mari, MD
Ruvo Family Chair for Parkinson’sDisease & Movement Disorders
Lou Ruvo Center for Brain Health, Cleveland Clinic
Presentation Research Award
2023 HI Neuroscience Best Posters Presentations
Lawrence Burgess, MD
Director, Student AffairsRussell Woo
MD Associate Director of Research
MID TERM Oral Presentation
Keynote Speakers
Jason Viereck, MD, PhD
Academic Director, BRITL,Clinical Assistant Professor of Med (Neurology)
2022-2023 Hawaii BRITL Project Leaders
Julia Jahansooz graduated from the University of California, Berkeley with a degree in Integrative Biology. She went on to earn her master’s degree in Clinical and Translational Research from the University of Hawai’i and is now a second year medical student at JABSOM. Julia believes research is the backbone of clinical practice and encourages everyone to participate in some level of research during their career. 
Ward Weldon graduated from Punahou Highschool and earned a Bachelor of Science in Biology at the Massachusetts Institute of Technology (MIT). He is currently a second year medical student at JABSOM. Ward recommends that interested medical students engage in research early in their careers, so they may develop the skills to lead meaningful research in the future as physicians. 2022-2023 Hawaii BRITL Student Editor
Anson Lee graduated from Punahou School and went on to earn a B.S. in Molecular and Cellular Biology, B.A. in Archaeology, and B.A. in Near Eastern Studies at Johns Hopkins University. Currently, he is a second-year medical student at the JABSOM. Anson believes that participating in research is the best way to improve patient care and lead the future of medical practice. 
Medical students: Janette Bow-Keola, “Yun Shwe-kya Pine, Daniel Vodak, Kai Moriyama
Assessing the Correlation Between Demographics, BEAM™, and MMSE
We aim to create a complete database of Alzheimer’s Disease patients receiving treatment at the Memory Center. Our data collection will include: demographics (age, race/ethnicity, education level) and diagnostic procedures (APOE/CSF, BEAM EEG). Current identification of Alzheimer’s Disease (AD) is limited to either invasive techniques of CSF and blood sampling or cost prohibitive PET imaging. Therefore, there exists a need for a novel, noninvasive biomarker for the detection and monitoring of AD.
Medical students: Justin Wong, students: Lauren Nguyen, Keao Kawaakoa, Lea Zoe el-Hage
Epidemiology of Diabetes Among Asian American, Native Hawaiian/Pacific Islander (AANHPI) Patients with Alzheimer Disease (AD)
Single center, retrospective study of patients with ICD-G30 codes identifying Alzheimer Disease
Demographic information, MMSE scores, comorbidities, age of onset of AD, and MRI reports were obtained from a total of 752 patients. MRI reports were used to obtain Fazekas and
Global Cortical Atrophy scale scores to assess the severity of AD. Diabetes increases the risk for AD by enhancing inflammatory signaling pathways, mitochondrial dysfunction, oxidative stress, and insulin resistance in the brain. In Hawaii, an estimated 11.7% of the population has diabetes, with 40.7% of diabetic individuals aged 65 and older, and 81.8% belonging to the AANHPI population. Current literature suggests that AD disproportionately affects specific racial groups, such as AANHPIs, more than others; however, further research is needed to confirm these differences. This study aims to investigate the diabetes rates among AD subjects overall and within common racial groups in Hawaii to better understand the risk factors associated AD. Diabetes, hypertension, and other comorbidities can contribute to structural changes in the brain, including white matter hyperintensities and cortical atrophy observed on MRI/CT scans, which are early signs of cognitive impairment and neurodegeneration. There is no literature investigating the AANHPI population and the severity of white matter hyperintensities and cortical atrophy among diabetic patients with AD. This study will also examine the risk factors and cognitive correlates of white matter hyperintensities and cortical atrophy in diabetic AD patients compared to non-diabetic AD patients.
Medical students: Lauren Kim, students: Zena Fadel, Connor Weldon
Analysis of Antidepressants in Alzheimer's Patients
Based on past studies, NHPI populations are diagnosed with PD, AD, or dementia at an earlier age, and that PD severity is positively associated with PD duration in Asians and NHPI. While treatments are focused on management of symptoms, there is more to be known on the effects of antidepressant agents on worsening of cognitive impairment, especially in NHPI patients. It is known that some anticholinergic drugs were linked to higher dementia risk, including those for the treatment of depression, bladder incontinence, and PD. However, there has been no evidence that medications for hayfever, travel sickness, or stomach cramps raise
risk of dementia. In fact, current Phase 3 trials are being done on repurposed antidepressants such as AXS-05, a combination of dextromethorphan and bupropion, along with the FDA-approved atypical antipsychotic drug Rexulti (brexpiprazole) for treating agitation associated with Alzheimer’s dementia. I will be analyzing the long-term effects of antidepressants with combined treatment for patients with cognitive decline (including AD, PD, and dementia patients).
Medical students: Kaela Iwai, Students: Rose Garcia, Hannah Miura, Andrew Mettias
CPAP Therapy Compliance in Obstructive Sleep Apnea Patients in Hawaii
Retrospective chart review using the eClinicalWorks medical record database. Patients treated at HPN and diagnosed with OSA. Findings: No significant association between patient characteristics and CPAP therapy CPAP adherence significantly associated with OSA severity. Investigate CPAP adherence and compliance of patients in Hawaiʻi diagnosed with OSA.
Medical students: Ryan Nishi, students: Ysabella Perez, Cadie Young
Exploring Carpal Tunnel Syndrome in Underserved Communities: A Focus on AANHPI Populations and Risk Factors
Carpal tunnel syndrome is a debilitating nerve compression condition. While carpal tunnel syndrome has been well studied, there is lack in the literature regarding the presentation of carpal tunnel in Asian American, Native Hawaiian and other Pacific Islander Populations. Through this project I hope to address the paucity of research on carpal tunnel in AANHPI populations to identify differences in clinical presentation, comorbidities, and treatment. I hope to achieve this by using retrospective chart review using the HPN database.
Medical students: Erin Kim, students: Princess Cacpal, Ethan Kimura
Analyzing Differences in Outcomes of Combination Medications for Treatment for Chronic Migraines
Previous research at headache center showed that there were racial/ethnic differences in demographics, clinical presentations & comorbidities among patients with chronic migraines. They found that NHPI patients were more likely to be diagnosed earlier than White patients, had higher BMIs, and had higher rates of hyperlipidemia, insomnia, diabetes, and polypharmacy.
We are investigating the classifications of treatment options that were prescribed (e.g. abortive, preventative, maintenance) were not noted for this population. Furthermore, there were no data showing the long-term effects of these medications in improving symptoms and the different types of treatments/medications to determine the potential efficacy of different combinations for patients with chronic migraines in Hawaii.
Medical students: Kylie Yamauchi, Nhat Danielle Vallo, Kenneth Lin, Bryan Chaleunxay
Utility of EEG biomarkers in the early identification of Alzheimer’s Disease: A systematic review
AD patients had lower accuracy compared to neurotypicals for the AO task P300 can be used as a biomarker to detect AD → larger P300 amplitudes are associated with better short-term and long-term memory. Current identification of Alzheimer’s Disease (AD) is limited to either invasive techniques of CSF and blood sampling or cost prohibitive PET imaging. Therefore, there exists a need for a novel, noninvasive biomarker for the detection and monitoring of AD.
Medical student: Anna Gan, students: Jamie Pak, Bailey Wong, Claudia Seiler
Exploring Psychosocial Risk Factors In Parkinson’s Disease: A Closer Look At Marital Status
Recent studies have found a link between psychosocial factors such as marital status and social isolation, on the presentation, progression, and prognosis of various neurological disorders, including Alzheimer’s, ALS, Epilepsy, dementia, and MS. No study has looked directly at how marital status may influence the presentation and progression of Parkinson’s Disease. Does marital status affect the presentation and progression of
Parkinson’s Disease? What is the association between marital status and mood disorders (i.e depression, anxiety), behavioral factors (i.e smoking, alcohol, drug use), and sociodemographic factors in
patients with Parkinson’s disease?
Medical students: Matthew Kao, students: Michael Lima, Chloe Andres, Sidney Sario
Evaluating risk factors for back pain in Native Hawaiian and other Pacific Islanders
Risk factors for back pain have been described as being “multidimensional” with a wide range of factors having an influence, such as physical traits and socioeconomic traits. Research has been done on back pain and varying prevalence based on race in a sample of military service members. In addition, there has been research on low back pain prevalence and risk factors among Saudi adult patients. Seeing previous HPN research on risk factors associated with other primary diagnoses such as ischemic stroke among Native Hawaiian and other Pacific Islander patients, I would like to explore potential risk factors for back pain in Native Hawaiian and other Pacific Islander patients. With there being research already confirming a racial difference in terms of prevalence and research focusing on other ethnic groups, I hope to be able to uncover risk factors that may be more specifically associated with back pain within the Native Hawaiian and other Pacific Islander patient population that we see in Hawaii.
Examining potential modulating factors in the association between back pain and depression
It is well known that chronic back pain is a debilitating diagnosis that manifests in multiple facets of patients’ lives. With what is often a chronic and functionally impeding diagnosis, it is logical that one could develop related, subsequent mental health diagnoses such as depression. It has already been established that there is a bidirectional association between depression and back pain (meaning those with initial back pain had a positive association with subsequent development of depression and vice versa). However, with this established association comes questions regarding what possible variables could be modulating this association between back pain and depression. Thus, I hope to explore this association to see if there are any other possible variables (i.e., socioeconomic factors, comorbidities, etc.) that modulate or are related to this already established association between back pain and depression.
Medical students: Sarah Bellati, James Romero, Students: Sofia Muniz, Ethan Chang,
Novel Retrospective Analysis of Spinal Cord Involvement in Multiple Sclerosis Patients of Native Hawaiian/Pacific Islander (NHPI) Descent
Sclerosis (MS) is a devastating autoimmune attack on the white matter of the central nervous system. The diverse location of lesions can leave patients with various neurological deficits. Prior detection of spinal cord lesions by Magnetic Resonance Imaging (MRI) has strongly suggested that the presence of T2 hyperintensities and degree of spinal atrophy is correlated with level of disability in MS patients, as measured by the expanded disability status scale (EDSS) (Honig & Sheremata, 1989; Moccia et al., 2019). Thus, spinal MRI could be a useful tool in both MS diagnosis and prognosis, but differences in spinal cord lesions based on race/ethnicity have yet to be explored (Lassmann, 2015). Amezcua and colleagues performed a cross-sectional study of spinal lesions and disability in MS patients of hispanic heritage, and found associations similar to what has been described in caucasian populations (Amezcua et al., 2013). However, there is no existing literature characterizing spinal cord lesions in MS patients of NHPI descent.
Medical students: Tyrone John Sumibcay, students: Sara Ireland, Qu (Emily) Sonia Ukai,
Characterizing Epilepsy in Native Hawaiian and Pacific Islander Populations
- Characterize the severity of epilepsy in NHPI population, treatment course and outcomes
- How do NHPI patients with epilepsy present?
American Indian, Alaskan Native, Asian Pacific Islander, Native Hawaiians, and Other Pacific Islanders had the longest period between initial seizure and epilepsy diagnosis. To expand on the current literature for NHPI and Asian American populations. Hawaii’s ethnic diversity allows us to characterize epilepsy in these
minority groups
Medical students: Michaela Kop, students: Gabrielle Sarmiento, Jill Morimoto, Andrew Kai
Characterizing Fall Risk in Patients with Mild Cognitive Impairment
Assessing fall risk in older adults has long guided both patient and provider in implementing interventions to prevent falls. People living with dementia (PLWD) are at a much higher risk of falling than the general older adult population with an annual fall rate of 60–80% compared to approximately 30% in the general older adult community-dwelling population (Canadian Institute for Health Information, 2018). About 15% of emergency department visits by PLWD are fall-related, compared to 9% among older adults who do not have cognitive impairment (Ryan et al. 2011; LaMantia et al. 2016). Although dementia is thought to be a purely cognitive pathology causing deficits to one’s memory, attention, cognitive function, etc. there seems to be an increased rate of falls in patients with cognitive impairment, who seemingly, do not have any known motor deficits. This study seeks to assess the incidence of falls in patients with dementia and identify potential risk factors associated with higher incidences of falls in this population.
Medical students: Nina Krupa, students: Kaelyn Pacpaco, Kylie Herndon
Native Hawaiian and Pacific Islander Participation in Alzheimer's Disease Clinical Trials
Previous research done at HPN demonstrates that Asian and Native Hawaiian patients were less likely than White patients to participate in AD clinical trials The goal of this study is to determine what percentage of AD clinical trial participants are Native Hawaiian and Pacific Islander (NHPI). While NHPI make up about 28% of the population in Hawaii, we predict that less than 10% of AD clinical trial participants will be NHPI.
Medical students: Megan Kawamura, students: Amelia Lopez, Salina Li
Progression From Acute to Chronic Migraines: Differences in Patient Characteristics
Previous research at headache center showed that there were racial/ethnic differences in demographics, clinical presentations & comorbidities among patients with chronic migraines. They found that NHPI patients were more likely to be diagnosed earlier than White patients, had higher BMIs, and had higher rates of hyperlipidemia, insomnia, diabetes, and polypharmacy.
We will be investigating whether there are any demographic, comorbidity, or ethnic differences to explain a potential difference in duration between an acute & chronic migraine diagnosis among patients in Hawaii including factors mediating the speed of migraine progression (acute to chronic) has not been studied in this population.
Medical students: Jiwoo Kim, students: Krystalyn Edwards-Calma, Tiana Graessle
Exploring the Connection of OSA and Parkinson’s Disease
OSA is statistically more prevalent in PD population, 20-70% compared to 2-14% of the general population
Patients with OSA had a significantly higher risk of PD in their 5 year follow up OSA may precede PD
Relationship is bidirectional. To identify the prevalence of OSA in patients with PD. To identify a connection to other sleep disorders in patients with Parkinson’s Disease. To identify if NHPI (specific underrepresented demographic) communities are at greater risk. To identify if there is a significant disparity in the intensity of the issue. To identify specific comorbidities within those demographics that may predispose them to OSA
Medical students: Michael Read, Queenie Dyan Abarcar, Jayden-Joseph Acoba, Caitlin Palacio
Investigating Neural Networks using EEG and additional parameters for monitoring the progression of Alzheimer’s Disease
Current identification of Alzheimer’s Disease (AD) is limited to either invasive techniques of CSF and blood sampling or cost prohibitive PET imaging. Therefore, there exists a need for a novel, noninvasive biomarker for the detection and monitoring of AD. We propose that the use of EEG as a surrogate biomarker is as sufficient as current standards. We aim to collect additional patient data: neurovascular disease, medication reconciliation, CSF amyloid status, and APOE status. This adjunct information will be utilized to determine the efficacy of Advanced Brain Monitoring’s BEAM EEG monitoring software and its applicability to a diverse ethnic population.
