UH neurologist receives $421,313 grant to develop novel imaging technique in HIV dementia

University of Hawaiʻi at Mānoa
Tina M Shelton, (808) 692-0897
Director of Communications, Office of Dean of Medicine
Posted: Feb 16, 2016

Dr. Beau Nakamoto
Dr. Beau Nakamoto
An MRI image of the brain before (A) and after (B) novel MRI dye infused. Magnified image (C) after the MRI dye is infused demonstrates accumul
An MRI image of the brain before (A) and after (B) novel MRI dye infused. Magnified image (C) after the MRI dye is infused demonstrates accumul

Neurologist Beau Nakamoto recalls it as though it was just yesterday. A friend confided that he was infected with HIV. He shared how frustrated he was that although the virus was controlled with medication, his ability to think just wasn’t the same.

Very soon after that encounter, Dr. Nakamoto met Cecilia Shikuma, MD, and Bruce Shiramizu, MD, scientists who are studying HIV-associated dementia at the University of Hawaiʻi Center for AIDS. Suddenly, a door opened on an opportunity to make a difference in the lives of people, who like Dr. Nakamotoʻs friend, were struggling with cognitive decline.

Dr. Nakamoto has received a two-year, $421,313 grant from the National Institute of Neurological Disorders and Stroke (National Institutes of Health) to examine whether a new Magnetic Resonant Imaging (MRI) “contrast dye” can be used to detect the inflammation that is believed to signal decline in memory and thinking. The contrast dye that Dr. Nakamoto will be studying will specifically target the immune system’s white blood cells, which are believed to play a key role in the development of HIV-associated cognitive impairment.

About 2,900 people in Hawaiʻi live with HIV/AIDS, and there continue to be new cases every year. In the last two decades, as people live longer under a daily regimen of anti-viral HIV-fighting medicine, the Hawaiʻi Center for AIDS has noticed that HIV patients are suffering dementia at rates greater than people without the virus. While severe HIV dementia is uncommon with effective combination antiretroviral therapies, milder degrees of cognitive impairment continues to affect up to 50% of HIV-infected individuals. Even mild cognitive impairment can have a big impact on important parts of a person’s daily life. Employment difficulties arise because of fatigue, driving is difficult or dangerous and people forget to take their medications (without daily doses of life-sustaining HIV antivirals, HIV patients will die).

Nakamoto, an Associate Professor of Medicine and a Neurologist at Straub Clinic & Hospital, is a member of an elite team of researchers at the Hawaiʻi Center for AIDS who suspect one of the main types of cells that protect the body against infection also play a key role in causing HIV-associated dementia. It is believed that once these infection-fighting cells (monocytes) have switched on to battle HIV, an unintended consequence is the production of toxic chemicals in the brain that cause uncontrolled inflammation and ultimately cognitive impairment.

Dr. Nakamoto is one of few researchers in the nation to utilize novel MRI contrast agents to track those infection-fighting cells in the brains of HIV-infected patients. If successful, this technique could potentially be used in future clinical trials aimed at targeting the HIV-infection fighting monocytes with the hope of finding a treatment for HIV-associated dementia.

Dr. Nakamoto is a 1999 graduate of the University of Hawai’i MD program, and also holds a PhD in Clinical Research.

Health Disparities
There are differences in how diseases affect different groups of people, particularly in the state of Hawaiʻi. HIV is just one of these diseases. The John A. Burns School of Medicine (JABSOM) has a special focus on research programs to address these differences with the goal of improving heath care in Hawaiʻi. Dr. Jerris Hedges, Dean of JABSOM, has been supporting programs, such as the Master’s and Doctorate Programs in Clinical Research, and building a research infrastructure to invest in local talent such as Dr. Nakamoto. Furthermore, Dr. Hedges is encouraging partnerships between academic clinicians, basic scientists, and community stakeholders to ensure discoveries from laboratory and clinical studies are applied to improving heath care in Hawaiʻi.

About RMATRIX I and II
JABSOM is one of five U.S. academic institutions funded through the NIH/NIMHD to develop an infrastructure to encourage translational research (i.e., research which bridges the gap from laboratory findings to clinical practice and visa versa) into disorders involving Aging and Neurocognitive decline, Cancer, Cardiovascular disease, Nutrition & Metabolic diseases, Respiratory illnesses and Perinatal & Growth Development differences among minority populations. He was a 2011-2012 recipient of the Pilot Project Program Award from the Research Centers in Minority Institutions (RCMI) Multidisciplinary And Translational Research Infrastructure EXpansion (RMATRIX; NIMHD grant #U54MD007584)
program, which provided preliminary data for his recently awarded RMATRIX-2 R21 National Institutes of Health (NIH) grant through the National Institute of Neurological Disorders and Stroke (NINDS).

Leading the way at the University of Hawaiʻi are RMATRIX Co-Principal Investigators, Jerris Hedges, MD, Dean of the John A. Burns School of Medicine and Dr. Noreen Mokuau, Dean of the Myron B. Thompson School of Social Work.

“We are so pleased by Dr. Nakamoto’s funding award, especially given how keen the competition has been for resources from the National Institutes of Health. This grant shows that RMATRIX is doing what it is intended to do, providing our faculty and community members with a foundation from which to successfully compete for external funding,” said Dr. Hedges.

About the JABSOM Master’s and Doctorate Programs in Clinical Research
The goal of this program is to provide high quality training for doctoral and post-doctoral candidates to increase the critical mass of clinical researchers at JABSOM in addition to facilitating career development and research collaborations. Since this program’s inception in
2003 under the leadership of Dr. Rosanne Harrigan, Professor and Chair of the Department of Complementary and Alternative Medicine, 32 Masters and 20 Doctoral students have graduated.

“Dr. Nakamoto is one example of the high quality of clinician researchers that our program is capable of producing,” said Dr. Harrigan.

For more information about the Masters and Doctorate Programs in Clinical Research at JABSOM, visit:
http://mscr.hawaii.edu, about RMATRIX, visit http://rmatrix.jabsom.hawaii.edu/,

About other JABSOM research programs focusing on improving healthcare in Hawaiʻi, visit:

For more information, visit: http://jabsom.hawaii.edu/news-media/uh-med-now/