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Mobile MRI Scanning Facility |
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The MRN Mobile Imaging system is a custom designed one-of-a-kind facility. The heart of the mobile system is a Siemens’ 1.5T Avanto MRI. The Avanto is the most advanced 1.5T system in the Siemens product line.
The Avanto is a ultrashort 150cm (4’11’’) long, whole body superconductive 1.5T magnet with 5th generation active shielding (AS) technology with counter coils, External Interference Shielding (E.I.S.) and excellent homogeneity (based on 24 plane plot, 50 cm DSV type. 0.8 ppm). The system comes equipped with a 12-element Matrix head coil capable of ultra-fast parallel acquisition in either 4-channel (CP Mode), 8-channel (Dual Mode) or 12-channel (Triple Mode) settings. The SQ-engine gradients are the most advanced product on the Siemens’ platform. The SQ-engine gradients have a maximum amplitude of 45 mT/m for the longitudinal direction and 40 mT/m for horizontal and vertical direction. The gradient slew rate is 200 T/m/s with a minimal rise time of 200 µs (from 0-40 mT/m amplitude). The Avanto is also equipped with AudioComfort - an acoustic noise buffer that leads to a 30dB attenuation of gradient noise compared to other conventional systems that leads to a reduction of 97% in sound pressure. This latter sound reduction is of great benefit to functional imaging studies. The MR system comes completely integrated into a trailer, which also houses a 72-channel Biosemi EEG/ERP data collection system for brain potential studies. The mobile trailer was built by Medical Coaches, Inc. http://www.medcoach.com/ . MIND Mobile Core Director, Dr. Kent Kiehl, custom designed the mobile coach to optimize the system for functional imaging. A few of the modifications included a ventilated and shielded rear-projection box to the back wall of the trailer to house the high-resolution video projector for fMRI studies. The video image is projected thru a six inch waveguide and is redirected to the rear of the bore using a high resolution mirror. The projected image is displayed on a rear-projection screen at the back of the magnet bore. The participant views this image using a standard mirror system attached to the head coil. Three custom waveguides were installed between the control room and the magnet room for fiber-optic response devices, peripheral devices (skin conductance, heart rate) and passage of cables to the rear-projection box mounted on the back wall of the trailer. These, and other, modifications have enable the system to be optimized for collection of functional neuroimaging protocols. Example functional MRI data from the mobile MRI is provided in the Figures below.
Results (left image) from the mobile MRI scanner of inmates (n=25) during commission of an error during a Go/No Go study (p < .001). Areas associated with error-monitoring include rostral and caudal anterior cingulate, thalamus, posterior cingulate, fusiform, and parietal cortex – repliciating results of prior studies (Kiehl et al., 2000). These data illustrate that the mobile MRI system is capable of collecting robust fMRI data. Results (right image) from the mobile MRI scanner of inmates (n=54) during target detection of an auditory ‘oddball’ task (p < .001). These data replicate previous results from our laboratory (Kiehl et al., 2005) and illustrate that the mobile imaging system is capable of collecting clean data in small, susceptibility-prone areas (i.e., right amygdala).
The mobile MRI system is also capable of collecting high resolution Diffusion Tensor Imaging (DTI). An example of the color coded DTI (FA) image collected from the mobile 1.5T scanner is shown at left. Colors are coded based on the direction of the fibers (red is left/right; green is superior/inferior; blue is anterior/posterior). Stability performance – one of the most critical developments of MRI technology in the last few years has been improvements in the temporal stability characteristics of MRI systems. The Siemens’ Avanto system was selected because our preliminary tests indicated that their systems provide very robust temporal stability – an essential component necessary for long time-series functional imaging data. The mobile MRI system has exceeded performance expectations in this regard – system specifications call for less than 1% peak-to-peak noise – average measurement has been less than 0.4% peak-to-peak – see figure below (based on the MGH stability sequence).
The MIND mobile imaging system was designed to serve to under-represented communities (e.g., rural areas) and/or special needs facilities. Specific projects include:
Increasing Understanding of the Mental Processes Underlying Substance Abuse, severe Impulsivity, and Antisocial/Psychopathic Behavior The societal cost of crime in the United States is estimated to be $1.33 Trillion dollars a year (Anderson, 1999). That translates to nearly $4400 per year for every child, adolescent and adult in the United States. For the State of New Mexico our portion of that cost is estimated to be $8.87 billion dollars per year. And the cost of crime is growing. More than 200 new jail cells are built every day in the United States. New Mexico’s incarcerated population (jails and prisons) has doubled in the last 10 years to over 10,000 inmates. Much of crime is related to alcohol and substance abuse. The mobile imaging system is currently being used to assess the efficacy of how different treatments work to prevent relapses to methamphetamine, heroin and cocaine addiction and which treatments work best for different individuals. Personality disorders, such as psychopathy, also have strong links to criminal behavior. Individuals with psychopathy have elevated risk for prison violations, parole violations, substance abuse, and general, violent, or sexually violent recidivism, in both males and females. The mobile MRI system is being used to study these conditions with the goal of translating the brain imaging findings into effective treatment protocols. For some individuals, behavioral problems begin at a very early age. The mobile MRI system is being used to study the environmental, cognitive, and behavioral characteristics of high-risk youth who are involved with the criminal justice system. The mobile MRI system will help delineate the developmental pathways that contribute to severe adolescent disruptive disorders. By studying these pathways we will gain insight into the variables that lead to disruptive disorders. We can utilize this research to develop optimized treatment protocols tailored to the specific needs of each youth. BENEFITS TO STATE and SOCIETY AT LARGE • Development of intervention strategies for the highest risk adolescents • Improvement of alcohol and substance dependence treatment • Over the long term, reduction of recidivism rates for juvenile and adult offenders This one-of-a-kind mobile MRI unit is being driven from site to site and located inside the grounds of men’s and women’s correctional facilities and juvenile detention centers. Understanding the mental processes behind high-risk behaviors is the first step in providing better treatment for inmates in order to reduce recidivism rates and decrease the cost of criminal behavior to society. This research would not be possible without the generous support from the New Mexico Department of Corrections http://corrections.state.nm.us/ and the Children, Youth and Families Department (CYFD) http://www.cyfd.org/ . We all share the vision of using the best science to help develop the most effective management strategies and treatment protocols for criminal justice involved populations. For more information about the Mobile MRI Core/Clinical Neuroscience Laboratory and it's Director, Dr. Kent Kiehl |
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Neuroinformatics is a hybrid field of neuroscience and computer science disciplines whose major goal is to produce databases and software for data acquisition, data management and data exploration (http://www.neurovia.umn.edu/IGERT). The hallmark of neuroinformatics software is that it helps investigators integrate all neuroscience research information sources collected within a research study--such as integration of genetic information with clinical assessments scales and brain morphometry measures. Neuroinformatics tools are targeted towards scientists that collect, summarize and use neuroscience research data in analyses so that these investigators can focus on understanding the function of the brain in healthy and disease populations rather than getting bogged down by data use and integration issues.
The Neuroinformatics Core (NIC) is located at the Mind Research Network (MRN) in Albuquerque. The MRN has extensive experience in the design, conduct and analysis of single and multi-centered clinical trials. This includes the MIND Clinical Imaging Consortium, which generates data from more than 400 human research volunteers across four sites (University of New Mexico, The University of Iowa, University of Minnesota, and Harvard University) that have had comprehensive neuroimaging (MR spectroscopy, fMRI, DTI, MEG), genetic, clinical, socio-demographic, and neuropsychological assessments. The neuroinformatics core is responsible for all aspects of data management for this project including data security, querying, reporting, analyzing, summarizing, and archiving. Other ongoing projects that the NIC participates in are the Biomedical Informatics Research Network (BIRN), as well as the National Alliance for Medical Imaging Computing (NA-MIC).
Organization Mr. Jeremy Bockholt has had 16 years of experience in neuroscience research and software development and has lead neuroinformatics support and centralized morphometric analysis efforts at the MRN for the past four years. Mr. Bockholt is an experienced project manager, database manager, software engineer, and anatomical imaging analysis practioneer. Mr. Bockholt currently leads a team of software engineers at the MRN whose mission is to develop state of the art neuroinformatics tools. Mr Bockholt leads the NIC and oversees all aspects of data management from all project investigators. The NIC team will work with the study investigators to finalize the study data collection forms and build a computerized SQL database system. Having the NIC in the same location where the MR, MEG, EEG analysis occurs, in addition to where a statistician is located, facilitates communication and coordination of data related issues. In addition, the core directors and scientific director participate in semi-monthly meetings with Mr Bockholt to discuss issues related to the NIC (forms design, database development, database management, quality control procedures, recruitment issues, etc.). Minutes of the meetings, as well as data collection forms, recruitment reports, etc. will be posted to an intranet and will be available to all study investigators (password protected).
Data Core Specific Aims 1) finalizing the study protocol in collaboration with the study investigators, 2) collaborating with the study investigators in the development of the forms for recording data as well as 3) development of the method for transmission of data to the NIC, 4) collaboration with the study investigators in developing the detailed Manual of Procedures, 5) development of a web-based database, 6) managing the database, 7) running SAS quality-control program checks, 8) maintaining the Master Database with appropriate backups and security checks, 9) monitoring subject recruitment and distributing monthly enrollment reports, 10) producing reports summarizing the status of data acquisition by subject, distributions and summary statistics for the primary variables.
Additional NIC Activities Further responsibilities of the NIC include: providing an organized network with a ³user friendly² interface, defining and building the public vs. secure (private) sections, providing public website features (including an overview of network and study information, background and responsibilities of key personnel, news items, conference information and announcements, information for potential study subjects), and providing secure website features (to include: access to the Manual of Procedures, reports to the steering committee and supporting foundations, minutes of conference calls with study investigators, reports and updates on recruitment status, reports to the Data Monitoring and Safety Committee.
System Information, Data Entry/Verification, and Quality Assurance Multiple RDBMS database servers running Oracle 9i instances will be maintained to provide separate development, integration, and production environments. When necessary, the production environment can be rolled over to the integration environment such that data access down-time is minimized during hardware maintenance or failure. At the same time, enhancements to the system are ongoing in the development environment, get thoroughly tested in the integration environment and are scheduled for migration into the production environment in a way that minimizes loss of data access. A middleware tier will be used to provide web applications to the end users using desktop web browsers over secure HTTP connections. Multiple web-application servers running PHP 4.3 and Apache 2.0 will be utilized to provide separate development, integration, and production environments. Thus permitting the same system development and maintenance cycle outlined in the RDBMS section above.
Quality Assurance Any pen and paper assessments will be data-entered twice (by separate entry operators) and screened for entry errors. Study site coordinators can resolve entry conflicts and review logical errors made at the time of acquisition according to a data dictionary defining the type and range of each item relevant to the clinical instrument and protocol. A comprehensive data dictionary from previous studies that used similar clinical instruments will be used at the onset to develop a real-time quality assurance program for the study under review. To ensure maximal data quality, raters will be notified immediately when assessment values lie outside the ranges identified by the data dictionary for each item that is entered. Over the course of the study, the data dictionary will be optimized for the population being studied. Data will be checked for integrity and verification. An audit trail will be maintained when resolution of outliers lead to either a formal documented change in the data point or confirmation that the data point represents extreme but normal biological variation. An error report page (when errors occur) will be interactively returned to the user. The database will track who made the transaction and the time and date of the transaction for each successful data submission. Every successful submission of a transaction will be recorded in on-line archive tables, thus providing a complete audit trail of the database. That is, the database can be recreated to any point in time. Every six months, protocol review will be performed by relevant principal investigators to include audits of informed consent documentation and data accuracy. Reports will be prepared on the following elements: timeliness and completeness of data submission; eligibility and compliance; and accrual information.
Data and Safety Monitoring, Adverse Event Data Collection and Reporting The MRN NI tools facilitate a Data and Safety Monitoring Plan, which monitors the well-being of study participants and ensures scientific integrity of the project can also. During the course of a study, adverse events can be immediately entered into the data base and communicated to site directors; any serious adverse events will be formally reported to the IRB within five days. A cumulative adverse event-reporting table can be completed for annual continuing review. A monthly report that includes a written description of any potential adverse events is also available. Monitoring criteria include: number of subjects screened, number of subjects enrolled, number of drop outs, any complaints or adverse events. |
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Traumatic Brain Injury Research |
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The symptoms of Traumatic Brain Injury (TBI) can range from severe physical and mental disability to subtle problems with attention, concentration, or emotional control. Patients with TBI often have persisting, disabling cognitive and emotional problems that impact their work and family lives and limit their ability to seek appropriate care. The pathology underlying more moderate to severe TBI include lesions, contusions and hemorrhages that are readily diagnosed with conventional scanning methods such as magnetic resonance imaging (MRI); however, there may also be other pathology in healthy appearing tissue. Similarly, the identification of the pathology underlying mild TBI is often more subtle and complicated. TBI Resources TBI Research Team TBI Publications In the United States alone there are approximately 1.2 million mild TBI cases per year that result in an estimated cost of $56 billion dollars. In the majority (60-70%) of these cases, clinical findings are absent on standard CT scans. Although MRI scans are more sensitive than CT for diagnosing mild TBI injuries such as small petechial lesions, approximately 43-68% of mild TBI cases have normal MRI scans. The fact that traditional imaging modalities may be insensitive to differences between normal and mild/moderate TBI in the majority of cases suggests that the diagnostic utility and predictive validity of more research-based neuroimaging techniques, such as functional magnetic resonance imaging (fMRI), magnetic resonance spectroscopy (MRS), magnetoencephalography (MEG) and diffusion tensor imaging (DTI) needs to be explored.
Nowhere is the problem of TBI more dramatic than with our returning veterans from Iraq and Afghanistan. Specifically, two-thirds suffer from brain injuries or mental health problems, a rate much higher than that seen in prior conflicts. In fact, mild TBI is the most common injury in returning veterans and may be undiagnosed or misdiagnosed as either post-traumatic stress disorder (PTSD), depression, or as an attention deficit disorder. The nature of the brain injuries in recently returning veterans is also different – blast injuries predominate over acceleration and deceleration injuries, which are much better understood. Importantly, for unknown reasons, soldiers injured in a blast are more likely to have symptoms of an acute stress reaction or PTSD in addition to a TBI. This combination of factors renders the differential diagnosis of PTSD and TBI extremely challenging for care providers.
The first step for successful treatment is to better understand the pathophysiology underlying TBI, and to develop biomarkers sensitive to neuronal injury and recovery. This ensures that best care practices will be used when diagnosing and treating patients with TBI. We are currently seeking to identify biomarkers in brain images that 1) improve the ability to differentiate TBI from other diagnoses, 2) correlate with measures of functional outcome, and 3) correlate with cognitive dysfunction, especially in the area of attentional control.
Another primary obstacle is accessibility of care. This is especially true in New Mexico, which is a largely rural state with only a few population centers. Many individuals with TBI return to the medically under-served communities where access to care is more difficult. With our mobile MRI, The MRN unit can uniquely address the needs of this under-served population in New Mexico and adjoining states, establishing a model of diagnostic service for other rural locations in the United States.
MISSION STATEMENT The MRN will utilize advanced multimodal imaging in combination with comprehensive neurocognitive and psychiatric assessments to further understand the changes in brain function that occur over time as a consequence of TBI. When necessary, we will bring our mobile imaging laboratories to rural populations where access to care is often a burden. Our ultimate goal is to use state-of-the-art neuroimaging technology to help those afflicted with TBI by 1) providing accurate and rapid diagnosis, 2) selecting appropriate therapy for patients, and 3) individualize therapy to optimize functional outcome.
Please see our list of publications for additional information regarding this MRS work and other findings from our TBI team. |
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The Solution for Subject-Response Testing in a Magnetic Environment Testing subjects in a magnetic environment is a challenge, particularly if the test requires manual switching and/or transmission of a signal. The device used must be completely non-magnetic and preferably non-metallic to reduce unwanted signal noise that would need to be filtered. It must restrain the wrist to limit unwanted movement, while keeping the fingers comfortably positioned on the response switches. In short, it must be comfortable, robust and reliable.
The MIND Input Device is specifically designed for use in an fMRI or MEG (magnetoencephalography) environment. It is a complete system with response cast, optical amplifiers, and interface boxes. The response cast consists of 100-percent plastic and fiber-optic parts, making it magnetically and RF inert. Five optical buttons are inside the thermoplastic cast that is secured to the forearm by a Velcro strap. A 50-foot optical cable connects the cast to amplifiers placed outside of the magnet room, keeping the testing and the signal free of any interference. Designed and used at The Mind Institute, one of the nation’s premier neuroscience research facilities, the device is currently in service at the Center for Magnetic Resonance Research at the University of Minnesota, Martinos Center for Biomedical Imaging at Massachusetts General Hospital, and Mental Health Clinical Research Center at University of Iowa. • LEDs provide instant visual feedback to the experimenter to ensure that the subject is responding correctly • Compatible with E-Prime, MEL Professional NBS Presentation and other leading stimulus-delivery software packages • Compatible with external data-acquisition systems like PowerLab, BioPac, LabVIEW etc. • MRI-compatible/MRI-safe for fMRI and MEG applications • Non Magnetic/Non-Metallic • No RF interference, no RF Filters needed • Printable Brochure
Addtional specifications available, please contact Michael Doty
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BabySQUID® for Human Brain Development Research |
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Magnetoencephalography (MEG) is a neuroimaging technique that has extremely good temporal resolution (<1 ms) and good spatial resolution (0.5 cm). MEG (http://en.wikipedia.org/wiki/Magnetoencephalography) and EEG (http://en.wikipedia.org/wiki/Electroencephalography) are completely noninvasive neuroimaging techniques. This means that both techniques are passive (no external signal is applied to the brain) and are simply measuring activity that naturally occurs either in the resting state or in response to some sensory stimulus. While MEG and EEG provide similar information, there are technical and practical advantages of using MEG to monitor brain activity in young children. First, the immature skull of infants and children contain features including the sutures and fontanels that distort the EEG signal, while the MEG signal is unaffected by these skull features. This allows for direct comparison of MEG signals across subjects with differing skull structures without concern that the external skull features are influencing any difference in the neuronal signal, providing a significant technical advantage over EEG in neurodevelopment studies. A significant practical advantage is that, unlike EEG, it is not necessary to attach electrodes directly to the head. Instead, the infant or toddler can simply lay on the babySQUID® cart with their head resting on the MEG sensor array to obtain good quality data.
The prototype babySQUID® MEG system was designed by Dr. Yoshio Okada, Professor, Department of Neurology, University of New Mexico, and Tristan Technologies, inc., San Diego, CA, and built by Tristan. This is the only MEG system in the world to be designed specifically for measuring MEG signals from the infant/toddler. The system has two primary advantages over the currently available commercial adult MEG systems. First, the sensors are spaced more closely to account for the smaller head size of infants. Second, the sensors are located closer to the surface of the head rest allowing for increased sensitivity to neuronal activity. The system has 76 first-order gradiometers and 10 reference channels laid out in a hemispherical design that allows the baby to lie down during data collection. The sensors are 12-14 mm apart and are located approximately 6 mm below the surface of the dewar. The data acquisition system can collect data at rates up to 10 kHz. The data can currently be exported to two widely available MEG software analysis tools including BESA and Brainstorm, with additional development ongoing. Policies and Procedures  The use of the babySQUID® is free to all the users interested in collaborating with the Mind Research Network (MRN). Interested users should contact Dr. Julia Stephen, Ph.D., Research Scientist, at the MRN. Before starting each study, the user must have a human research protocol approved by the sponsoring institution. Also, each user is responsible for the data acquisition and analysis and costs of the study, including subject recruitment and reimbursement. The MRN and UNM scientists are available for the training of the research personnel. Scheduling The scheduling should be done in consultation with Dr. Stephen of the MRN
Request Pilot Scans The policy for pilot scans is the same as for the collaborative studies described under MR Core Policies and Procedures.
Additional Resources
The babySQUID® study can be carried out along with MRI studies for identifying brain regions active in a given task. Please see MR Core Facilities for the use of the MRN MRI facilities. Safety All studies must follow the safety procedures approved by the MRN and the Human Research Review Committee of the University of New Mexico. |
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Functional Imaging for Research and Schizophrenia Treatment A Program for Assessment, Treatment and Imaging Studies Schizophrenia is an enigmatic illness that affects 1% of the world’s population. Understanding of this illness requires a well-controlled research program with a large number of patients and controls. The Mind Research Network (MRN) has addressed this severe mental illness by forming the Mind Clinical Imaging Consortium (MCIC). Under this program we have studied 178 patients and 170 healthy controls thus far. We have established a large data bank containing anatomical and functional MRI, MEG and immortalized cell lines for genetic data. We have developed a cross-site calibration of MRI and MEG and methods for unifying the analysis of MEG data across three different platforms that are installed in three MRN partner sites. The FIRST Program is an extension of the MCIC with a focus on early diagnosis of schizophrenia. Early detection will be important in understanding the development of this illness and in providing more effective care of these patients. The Mind Research Network, through its partnerships with Massachusetts General Hospital, the University of Minnesota and the University of New Mexico, has launched the Functional Imaging for Research and Schizophrenia Treatment (FIRST) Program. Through this collaboration we hope to gain a better understanding of serious mental illnesses. We anticipate that the knowledge gained from these studies will improve the treatment and prognosis of schizophrenia and other psychoses.
Schizophrenia, a potentially devastating mental illness, affects one percent of the population. The disease, which often develops a in person’s late teens or early twenties, can affect all aspects of life–from career and education, to relationships with others. The longer a psychotic illness is left untreated, the greater the disruption to the person’s life. Some research suggests that delays in treatment can lead to a slower and/or less complete recovery. However, through a combination of medication and psychosocial treatments, symptoms can often be controlled in about 80 percent of patients.
Clinicians and scientists at the Mind Research Network are actively working to improve the lives of people with schizophrenia. Our mission is to:
Improve the psychiatric and medical care of individuals with schizophrenia by providing: • confidential consultation for accurate diagnosis and early detection • expert evaluation, including structured interviews, medication and treatment evaluation, and neurocognitive testing • ongoing assessment, including symptom monitoring and resource utilization
Educate patients, family members, the public, and fellow health professionals about treatments through: • educational support groups for family members to improve skills for interacting with loved ones diagnosed with schizophrenia and related illnesses • social and support groups for patients (education,smoking cessation, weight management) • lectures for mental health care professionals and academics on schizophrenia and its treatment
Research the causes of schizophrenia and early diagnosis and prognosis through our: • brain imaging program–sophisticated imaging techniques used to pinpoint brain regions that may be overactive or underactive in patients with schizophrenia • genetics program–investigating possible links between genes and schizophrenia
What is the purpose of this research? FIRST is a clinical research program designed to provide assistance to individuals who are experiencing early symptoms of psychosis or schizophrenia. The research specializes in the early diagnosis and treatment of individuals struggling with changes in their thoughts, behavior, and emotions that may be indicative of developing a serious mental illness.
What are some of the study procedures? Participants in all our studies will be asked to complete a thorough assessment process, which will include a set of interviews, cognitive testing, genetic testing, as well as a brief medical and neurological exam. Neuroimaging participants will undergo non-invasive procedures involving MRI, MRS, and DTI technology.
Who is eligible to participate? • People between the ages of 15 and 40 years who have experienced psychotic symptoms, which were not drug-induced, or who have been diagnosed with a psychotic illness, such as schizophrenia or schizoaffective disorder for less than two years • We are also enrolling emotionally and physically healthy participants to serve as controls in our research
Additional Information • Participation in all studies is strictly voluntary and can be discontinued at any time • Participants generally incur no cost for study procedures and will be reimbursed for their time • Participants who require immediate psychiatric attention will receive priority scheduling
Many of the services provided in the FIRST Program are made possible solely or partially through charitable contributions. We welcome and appreciate gifts of any size to help us continue to pursue cutting-edge research and offer patents and families the most advanced and effective care.
FIRST Investigators
Mind Research Network • Jeremy Bockholt • Vince Calhoun, PhD • Vince Clark, PhD • Chuck Gasparovic, PhD • Kent Kiehl, PhD • Jody Roberts, MS
Massachusetts General Hospital • Elfar Alalsteinsson, PhD • Corinne Cather, PhD • Oliver Freudenreich, MD • Don Goff, MD • Daphne Holt M.D. PhD • Bruce Jenkins, MD
University of Minnesota • Dan Hanson, MD, PhD • Sanjiv Kumra, MD • Kelvin Lim, MD • Chuck Schulz, MD • Tonya White, MD
University of New Mexico • Tara Biehl, MS • Juan Bustillo, MD • John Lauriello, MD • Nora Perrone-Bizzozero, PhD For medical questions or information about becoming a research participant, please contact: Massachusetts General Hospital 617-912-7891 The University of Minnesota 612-627-4890 The University of New Mexico 505-272-9544 For more information about the FIRST Program, please contact: The Mind Research Network Jody Roberts, Program Manager jroberts@mrn.org 505-272-3171
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