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Faculty Profile: Igor Koralnik, MD, the Archibald Church Professor of Neurology and chief of Neuro-infectious Disease and Global Neurology in the Ken and Ruth Davee Department of Neurology

Michael Ison, MD, MS

Igor Koralnik, MD, is the Archibald Church Professor of Neurology and chief of Neuro-infectious Disease and Global Neurology in the Ken and Ruth Davee Department of Neurology. He is also director of the Program for Global Neurology at the Institute for Global Health and oversees the Neuro COVID-19 Clinic in Northwestern Medicine’s Comprehensive COVID-19 Center. His research focuses on determining better methods to diagnosis, manage and treat of viral infections of the nervous system, particularly how the SARS-CoV-2 virus causes neurological complications in different patient populations who currently have or had COVID-19, and improving this process overall in areas with limited resources.

What are your research interests? 

My research focuses on two major and interconnected areas: infections of the nervous system and global neurology. In particular, we want to understand how SARS-CoV-2 causes neurologic complications in two very distinct populations. The first includes hospitalized patients with severe COVID-19 pneumonia who develop encephalopathy, which is an alteration of mental function that goes from mild confusion all the way to coma. The second consists of the “long-haulers” who had a mild COVID-19 and never required hospitalization yet develop thereafter persistent and debilitating neurologic symptoms including brain fog, headache, dizziness, alteration of smell and taste, as well as intense fatigue.

 Another area of interest of my laboratory is to understand the role of the human virome in degenerative and autoimmune diseases of the nervous system. We have developed a novel assay called ViroFind, which allows us to detect every virus known to infect humans – more than 500 species — in clinical samples, identify viral variants and, potentially, novel viruses. We are currently using this assay in samples from patients with Alzheimer’s, Parkinson’s, ALS and Multiple Sclerosis.

Finally, we have helped create a Global Neurology Program in Lusaka, Zambia, where we are investigating how infections of the nervous system can be best diagnosed and treated in resource-limited settings.

What is the ultimate goal of your research?

The goal of our research is to find the best way to diagnose, manage and treat viral infections of the nervous system. We also want to determine whether viruses can act as triggers, causal factors or even biomarkers in degenerative or autoimmune diseases of the nervous system.

Our Global Neurology Program aims to improve neurologic health worldwide and provide neurological care, research and education to underserved populations. We strive to bridge the gap between resource-rich and resource-limited settings, and provide neurological care where it is needed the most. For example, together with colleagues we provided for the first time in-country neurologic education to Zambian physicians and trained them to become neurologists. In addition, we mentor Zambian investigators to become neuroscientists. We also provide unique exposure to our U.S. neurology trainees in global neurology and neuro-infectious diseases.

How did you become interested in this area of research?

I became interested in the field of neuro-infectious diseases when I was a medical student in Switzerland in the early ‘80s at the beginning of the HIV epidemic. At that time, HIV had just been discovered as the cause of AIDS. During my first clinical rotations, I saw many young people developing opportunistic infections of the nervous system that were unheard of at the time in the setting of immunosuppression. One of them was triggered by a reactivation of Human polyomavirus 2, or the JC virus, which is innocuous in healthy people but causes progressive multifocal leukoencephalopathy (PML), a devastating disease of the brain in patients with AIDS. I decided to do my medical doctorate thesis on how HIV affects the nervous system, and I was lucky to have the opportunity to come to the U.S. for a postdoctoral fellowship at the NIH thereafter, and to stay in the U.S. for neurology training.

I developed my interested in global neurology while mentoring residents, fellows and junior faculty at our Global Neurology Program in Zambia. It started as a one-person operation 15 years ago and has now evolved in a multi-institution effort called the Zambia Institute for Neurologic Care, Research and Education (ZINCARE). 

In view of my background in neurovirology and neuroimmunology, I was naturally interested in the neurological complications of COVID-19, and we opened one of the first dedicated neuro-COVID-19 clinics in the country in May 2020.

What types of collaborations are you engaged in across campus (and beyond)?

I have been at Northwestern for only about a year and a half, but I have already been blessed to meet great collaborators inside and outside of the Neurology department. My neuro-COVID research is done in collaboration with Drs. Ayush Batra and Eric Liotta in Stroke and Neuro-Critical Care, Dr Josh Cahan in Behavioral Neurology, and Drs. Phyllis Zee and Matthew Maas in Sleep Medicine

In addition, 10 neurologists in other divisions of our department have agreed to see some patients in the Neuro-COVID-19 clinic to meet a very high demand for appointments, and they therefore participate in both the clinical care and the research done at the clinic. I have also initiated collaborations in the departments of Ophthalmology, Psychiatry and Behavioral Sciences and Neurosurgery at Northwestern, as well as Physical Medicine and Rehabilitation at the Shirley Ryan AbilityLab, on various aspects of COVID-19 research. 

Our research and unique patient population has also triggered a broad interest in the biotech and pharmaceutical industries, and many companies have been reaching out to us to discuss collaborations on biomarkers and therapeutic interventions for neurologic manifestations of COVID-19. Of course, I also interact with the many members of the Comprehensive COVID-19 Center in the Department of Medicine, a multi-disciplinary clinic dedicated to the total care of post-acute COVID-19 patients at Northwestern. Finally, I am the director of the Global Neurology Program, and collaborate with other members of the Institute for Global Health.

How is your research funded?

Our research is funded through a number of approaches. We have been funded for more than two decades by various institutes at the NIH. In addition, we are funded by different foundations for disease-specific projects. Furthermore, some of our projects are sponsored by industry. Finally, we also benefit from the philanthropic support of generous donors who have decided to join the fight against COVID-19.

Who inspires you?

I was fortunate to have many great role models during my formative years in clinical and basic science research in neurology, infectious diseases, virology and immunology both in Switzerland and in the U.S. However, those who inspire me the most are all the young people, the undergraduate, medical and PhD students, residents, fellows and junior faculty who are working with us. They have a tremendous amount of enthusiasm and they are really driving the field of neurovirology and COVID-19 research. Those people are the future, and it is always inspiring to witness all their contributions and see them blossom.