A Unicamp created and will coordinate the broadest multidisciplinary research program aimed at brain mapping carried out in the country. Entitled CInAPCe (Interinstitutional Cooperation to Support Research on the Brain), the program will be funded by Fapesp. At least 150 researchers – including teachers, students and technicians – from nine Unicamp units will be involved in the project, whose thematic focus is epilepsy. In addition to Unicamp, USP (campuses in São Paulo, Ribeirão Preto and São Carlos), Unifesp and Hospital Albert Einstein are participating.

Three units from USP, Unifesp and Albert Einstein participate in the program

Unicamp will receive, later this year, a high-field magnetic resonance machine. The equipment, valued at US$2 million, will serve as a platform for the installation at the University, in the coming months, of the Multimodal Neuroimaging Center for Epilepsy Studies (read text on page 5). Three other similar pieces of equipment will be installed at the Albert Einstein Hospital, in the capital, and at the USP Medical Schools in São Paulo and Ribeirão Preto. The entire project is budgeted at around US$10 million.

The forecast is that CInAPCe will start operating at the beginning of 2007. Its history, however, began to be written by researchers from Unicamp at the turn of the millennium. Roberto Covolan, professor at the “Gleb Wataghin” Physics Institute (IFGW) and one of the program coordinators, witnessed and was one of the protagonists in the birth of the embryo of the project that should train and train, over the next four years, at least 300 researchers – of which, according to the coordinators' document, 30 post-doctors, 100 doctors, 50 masters, 100 scientific initiation students and 20 technicians.
Covolan reveals that, at the end of the 90s, Unicamp already had a multidisciplinary team structured to carry out research in the area of ​​neuroscience, a field that experienced unparalleled growth in the past decade. The group had been formed following an internal call from the University for strategic projects. The team included scientists from the Faculty of Medical Sciences and the Institutes of Physics, Biology and Computing. Unicamp's tradition in multidisciplinary studies made things easier.

In 2000, Covolan, neurologist Li Li Min and Fernando Cendes, head of the Department of Neurology at FCM, expressed to the then president of the Superior Council of Fapesp, physicist Carlos Henrique de Brito Cruz, their interest in transforming Unicamp into a kind of advanced laboratory for research in the area of ​​neurosciences through the acquisition of high-field resonance equipment. Brito, who was also serving his second term as head of IFGW and would later become rector of Unicamp, supported the initiative but suggested that the program not be restricted to the University. In the assessment made at the time by the then president of Fapesp, the project had enough capacity to exceed intra-wall limits.

The Lightning - From then on, Cendes Li Min and Covolan, creators of the initiative, decided to expand the scope of the program. While the former made contacts with different research groups, Li Min and Covolan toured laboratories to explain the initiative's guidelines. The starting point of the project was the holding of a workshop at Unicamp, in December 2000. At the meeting, recalls Covolan, the idea of ​​creating a multidisciplinary and interinstitutional program with statewide coverage was launched. The proposal was taken up by groups of scientists specialized in brain dynamics. It was also decided, at the event, that researchers from the exact and technological areas would be incorporated into the scope of the program, joining the biomedical and biological staff.

The most immediate results of the workshop were the creation of working groups and the organization of similar events. The project focus and methodology were not immediately established. “There was a lot of debate until we reached points of convergence,” says Covolan. The maturity of the idea was materialized in a document sent to Fapesp in 2001, in which the main points of the program were set out. The development agency signaled favorably. However, when preparing to begin the usual understandings, the story began to come and go, leaving it at the mercy of the situation. The biggest event was the 2002 currency crisis. The rise in the dollar stalled research lines, paralyzing dozens of projects, mainly due to the price of imported inputs. The presidential elections were approaching and were, in the same way, another complicating factor.

Once the problems were overcome – the exchange rate was stabilized and the consequent return of investments –, Fapesp signaled that it was interested in financing the program. It invited interested parties through a notice in 2004 and promoted, together with the research groups, an internal workshop. An evaluation carried out by international reviewers showed the funding agency that it would be worth investing in the program. In addition to participating in the internal evaluation, Brian Meldrum, professor of experimental neurology at King's College, London; Bruce Pike of the McConnell Brain Imaging Center in Montreal; and Ana Nobre, from the University of Oxford, gave suggestions about how the project would work. The selection of those invited, made by notice, would consolidate the bases of CInAPCe. At the moment, says Covolan, there are only a few bureaucratic details left to sign the contract.

Focus - In principle, the objective of CInAPCe was to study the central nervous system as a whole. However, over the course of the negotiations, the objective changed. The idea that a very broad focus would only make things more difficult, compromising the project as a whole due to its diffuse nature, became consensual. Therefore, the choice of epilepsy as the object of the program was not random, as revealed by Fernando Cendes, professor at FCM at Unicamp and coordinator of the thematic project. Some factors listed by the professor contributed to the convergence around the disease.

The first, fundamental in the scope of the choice, was the fact that Unicamp already houses a group whose priority was pathology; Furthermore, the other institutions involved in the project also had a background in the area, having significant production in quality and volume. A Fapesp survey carried out in institutions in the field of neuroscience – including its sub-areas – corroborated this thesis by showing the predominance of studies related to epilepsy. The reasoning, therefore, would follow a logic: it would be more productive to work with something specific and already known than to go into areas that are little explored, if not unknown.

Another aspect, no less important, are the clinical components of the disease, invariably seen by scientists as “a window to understanding brain functioning”, as defined by Cendes himself. A countless number of pathologies, explains the teacher, have epileptic seizures in common. “We have a group of diseases, including head trauma, that can cause epilepsy. It is, therefore, a situation of several situations and disorders of the nervous system”, he teaches.

According to the neurologist, the advancement of neuroscience is directly linked to studies on epilepsy, whether through the mere observation of problems such as memory impairment, or through medical procedures. Cendes recalls that the representation of the brain's movements itself was designed and elaborated based on surgeries for the pathology, making it possible, based on the behavioral changes caused by the disease, to understand the functioning of the brain and its manifestations, including language and movements and the fabric of memory.

The focus on neuroimaging, in this context, will be fundamental to carry out comparative studies between normal people (volunteers) and patients affected by the disease. This type of analysis, reinforces the doctor, will be decisive in understanding why people with epilepsy have a history of problems such as memory loss, depression or other associated symptoms.

With this, Cendes believes, the task of detecting the change and scrutinizing the subsystem of the brain where it occurs will be made easier. The most immediate effect of this analytical effort will be the advent of new approaches to treatment, diagnosis and, consequently, prevention.

Puzzle - In Cendes' opinion, the main objective of scientists working in this area, both clinically and experimentally, is to understand how the process that triggers epilepsy works. The expectation is that CInAPCe will provide sufficient information to contribute to the unraveling of these mechanisms, and the discovery of other components present in pathologies derived from epilepsy. In this context, highlights the expert, it is necessary to put the puzzle together. “With this, we will not only be able to understand the plasticity of the disease, but also adopt measures that protect the brain of people subject to the pathology, from birth or after a certain age.”

A pathology that, in addition to being confused with other diseases whose common symptom is the frequent repetition of crises, does not only affect humans. Epilepsy is very common, for example, in dogs, cats and small non-human primates. This allows, says Cendes, that experimental models applied to animals lead to simulations of certain types of epilepsy that resemble those that affect humans, opening up a range of possibilities in the study of countless biological variables. “This is where, for example, biology groups that work with neurophysiology, molecular biology and so on fit in,” says Cendes. The expert recalls that it is possible, among other things, in the case of experimental models, to study the extent of crisis interference, carry out behavioral analyzes and evaluate the damage caused to memory. “Based on animal studies, we will be able to get closer to what is happening with humans.”

It's not little. Estimates indicate that, in the Campinas region, the disease affects at least 1% of the population, the same average recorded on a global scale. Inhabitants of developing countries are more susceptible, another factor also taken into account when formulating the program. The causes range from recurring infections, common in poor countries, to accidents caused by different reasons. In short: this is a public health problem.

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