NeuroAIDS Program

Hope. It is our driving force. The Mount Sinai NeuroAIDS Program is committed to developing safe and effective treatments for the neurological complications of HIV infection, which can affect all aspects of the nervous system from the brain, to the spinal cord, to the peripheral nerves. We are striving to expand the knowledge base on mechanisms responsible for these disorders.

Our approach today continues to be inspired by this original vision: to integrate clinical research with patient care, education, and community outreach in order to improve the lives of people living with neurologic complications of HIV. Our team's expertise includes neurology with program director David Simpson, MD, and Jessica Robinson-Papp, MD, MS; neuropsychology with David Dorfman, PhD; and health psychology with Mary Catherine George, MM.  We are closely allied with the Manhattan HIV Brain Bank research program and the Clark Neuropsychology Laboratory, which add additional expertise in neuropathology and neuroimaging.

Clinical Research

Our team is currently addressing the neurologic problems faced by people living with chronic HIV, focusing on peripheral neuropathies and chronic pain. We have a long, rich history of breaking new ground in NeuroAIDS research, contributing broadly to the field. These contributions include some of the earliest descriptions of the neurologic complications of HIV, including neurocognitive impairment, myelopathy, peripheral neuropathies, myopathy, and more. 

With today’s widespread use of combination antiretroviral therapy, our work has turned toward the neurologic problems faced by people living with chronic HIV, including peripheral neurpoathy and chronic pain. We have several ongoing clinical research protocols.

Autonomic neuropathy, gastrointestinal motility, and inflammation in HIV (ANGI)

This NIH-funded project examines relationships between autonomic neuropathy and gastrointestinal dysmotility in HIV. We believe that slowed gastrointestinal transit time due to HIV-associated autonomic neuropathy is a cause of small intestinal bacterial overgrowth (SIBO), which could contribute to chronic inflammation in HIV. Priniciple Investigator - Jessica Robinson-Papp, MD, MS.

Peripheral Neuropathy Registry Research Protocol

The purpose of this natural history study is to develop a multi-center cohort of well-characterized peripheral neuropathy patients, including those with HIV-associated neuropathy. Priniciple Investigator - David Simpson, MD.

Double-blind controlled study of Intravenous Immunoglobulin for HIV-associated myelopathy

The goal of this study is to determine the safety and efficacy of the use of IVIG for the treatment of HIV-associated myelopathy. Priniciple Investigator - David Simpson, MD 

Recently completed research protocols

We have also completed a number of important research projects from which we build on.

HIV-associated Neuropathy: Ethnic Disparities and Pathogenesis

This study examined the role of ethnicity in the development of HIV-associated neuropathies. Principle Investigator - Jessica Robinson-Papp, MD, MS.

Understanding and Relieving HIV Symptoms Using Mindful Modulation

In this study we examined the effects of Mindfulness Based Stress Reduction (MBSR) on chronic pain and autonomic function in people living with HIV. Principle Investigator - Jessica Robinson-Papp, MD, MS.

The Experience of Chronic Pain in Neuropathic Pain and Back Pain:  A Focus Group Approach

The goal of this study was to compare the similar and dissimilar language used by three different pain disorders (HIV-associated neuropathy, diabetic neuropathy, and chronic low back pain) to determine the usefulness of pain scales. Principle Investigator - David Simpson, MD.

Patient Care

We provide compassionate, comprehensive care to HIV-positive patients who are experiencing any number of neurologic disorders. These conditions include dementia, neuropathy, brain infections, and disorders of the spinal cord and muscle. Dr. Simpson sees patients in the Mount Sinai Faculty Practice in the Department of Neurology. Dr. Robinson-Papp is the attending neurologist for the Jack Martin Clinic, which is a member of the Institute for Advanced Medicine; this is a network of clinics devoted to providing comprehensive care to individuals and families in need of primary care, HIV services, specialty care, supportive services, trauma related treatment, transgender health care, and other conditions that impact the overall well-being of the community.

Education

The Mount Sinai NeuroAIDS Program is actively involved in the education of health care providers, patients, and the general community in issues surrounding AIDS and the nervous system. These activities are performed at the local, national, and international levels. Dr. Simpson lectures extensively throughout the world on NeuroAIDS and conducts teleconference lectures as well.

Dr. Robinson-Papp is a lecturer and consultant for the AIDS Education and Training Center (AETC), providing education to health care providers on the neurologic complications of HIV. She also hosts visiting primary care and infectious disease physicians from the U.S. and abroad, for NeuroAIDS training in the Jack Martin Clinic. Some of our attendees include scholars from programs such as the Arthur Ashe Endowment International Healthcare Worker Training Program and the Mount Sinai Institute for NeuroAIDS Disparities.

Community Outreach

We understand that HIV research has deep roots in advocacy and in the HIV community. We are committed to honoring this rich tradition. To this end our team maintains relationships with a variety of neighborhood and community organizations such as the Manhattan HIV Care Network. Through these relationships we are able to collaborate with community members to design research that is responsive to their needs.