Millions of Americans are now living with HIV with the aid of a multitude of antiretroviral drugs. Fordham student Elizabeth Breen is one of many researchers working to make sure they get the neurological attention they need.

This fall, the Fordham College at Lincoln Center senior learned that the paper “Medical Outcomes Study HIV Health Survey (MOS-HIV) Subscales and Neurocognition Among Latinx People with HIV” has been accepted for presentation at the International Neuropsychological Society’s annual meeting, which takes place in February virtually.

The paper details the results of an analysis that Breen and nine others conducted of surveys on medical outcomes that 105 people with HIV took in 2014.

The group was 74% Latinx and had an average age of 46. The goal was to get a better understanding of what aspects of their mental health had the greatest effect on their neurological health. As part of the survey, they were asked to perform tasks such as listening to a list of words and then repeating them back to an interviewer or thinking of as many words as they could that started with the letter T in 60 seconds.

“Everyone that we work with does well in some areas and struggles in others. That’s just how our brains work. But overall, once we collect that data, we get a pretty good estimate of how good people’s psychological capabilities are at the time of testing,” she said.

“We really haven’t had the opportunity to investigate how a chronic condition like HIV could affect people as they age. Maybe it’s not even the HIV. Maybe it’s the medication they’re taking.”

Findings

The survey found that the Latinx participants had better physical health than the non-Latinx white participants, and there was a direct correlation between their neurocognitive abilities and their mental health. More specifically, when mental health was broken down into different categories, the categories of energy and social functioning were found to correlate the most with healthy neurocognition.

“These are the specific areas in which if you’re doing really well in, then you’re probably going to be doing better in your neurocognition as well,” she said.

Knowing that these areas are important to this demographic is important because like Black patients, the Latinx population has historically received treatment inferior to their non-Latinx white peers. Findings such as these can help researchers better tailor future treatments that are conscious of those differences.

“Brain health specifically has huge disparities in the rate of diagnosis, so it’s an important factor to be aware of when you have dementia or cognitive decline among these culturally diverse populations,” she said.

The research is being conducted under the supervision of Monica Rivera-Mindt, Ph.D., professor of psychology.

Although the pandemic interrupted the study and halted the collection of in-person survey data, Breen, who is majoring in neuroscience and theology and is on track to earn a master’s in ethics, has been able to return to research.

Under Rivera-Mindt’s supervision, researchers such as Breen are collecting similar data connected to neurological health from a wider set of participants. Black, white, and Latinx participants are being interviewed, as are patients both with and without HIV. Breen conducts interviews over the phone; for in-person aspects of the survey, participants visit Mount Sinai Hospital. It’s that personal interaction that drew Breen to the research.

“I’m a huge proponent of equitable health care in general and given the disparities that we’re seeing in the recent diagnoses among people of color for Alzheimer’s and other dementias, it’s just starting,” she said, adding that her work in this area has been very rewarding.

“To be able to get involved in clinical neuropsychology research, and to be able to meet new people and build these relationships has been so fulfilling for me.”

Devin Rocks is still at least a year away from earning his Ph.D. in biology. But the Rockaway Park, Queens, native is already making a splash in the academic world, thanks to his work examining the role that fluctuating sex hormones can have on mental disorders such as anxiety and depression.

This spring, the Organization for the Study of Sex Differences honored Rocks with the Elizabeth Young New Investigator Award, and the Society for Behavioral Neuroendocrinology awarded him its Welcome Initiative Award. In January, the Society for Neuroscience bestowed upon him the Trainee Professional Development Award.

The awards recognize both the promise that Rocks has as a scientist and the work he’s conducted at Fordham under the guidance of Marija Kundakovic, Ph.D., assistant professor of biology. Kundakovic’s lab has been focused on an acute problem: Women are twice as likely to have anxiety and depression than men, but little research has been done on the molecular level to figure out why—until now. In January, Kundakovic was awarded nearly $1.9 million in grant funding from the National Institute of Mental Health for her research.

Rocks, who graduated from Fordham College Rose Hill in 2017 with a B.S. in integrative neuroscience and is on track to earn a Ph.D. in biological sciences in 2022, has been a part of the research from the beginning. He was one of five co-authors of a 2019 paper published in the prestigious journal Nature Communications that showed how a microscopic cell component called chromatin changes its shape during the mouse ovarian cycle—especially when females experience a change in estrogen. Because the changes occur inside the brain area implicated in anxiety and depression, it may affect women’s vulnerability to an increased risk for these disorders.

“The chromatin is basically the packaging material of the DNA. The chromatin can either be open, which allows the genes to be turned on, or it can be closed, in which case the genes are turned off,” he said.

“The studies showed that, over the rodent estrous cycle, which is the rodent equivalent of the menstrual cycle, the fluctuating sex hormones are affecting whether this chromatin is open or closed and affecting certain genes.”

It’s not known exactly how the opening or closing of chromatin causes depression or anxiety, but connecting the two events together is an important step in the research.

Since that 2019 paper was published, Rocks has been conducting follow-up research that involves introducing a gene known as Egr1 into the brains of laboratory mice to mimic the changes that normally only happen during the estrous cycle. The results will be published as part of his dissertation.

“We can give mice extra copies of this gene in the brain region that we study, the ventral hippocampus, and this can mimic the effect you’d see from the fluctuating hormones. This gene seems to be playing an important master regulatory role,” he said.

Kundakovic, who joined Fordham in 2015 and began working with Rocks when he was in his junior undergraduate year, said “functional” studies that rely on live animals are vital to verifying studies that use computational analysis to predict whether one change (a change in estrogen) is connected to something happening in the brain (a change in chromatin structure) and behavior.

“You can do a big data-computational type analysis, and say, ‘Give me the predicted regulator of these chromatin changes that we are seeing.’ [In 2019], we did that, and we found a really good candidate in Egr1,” she said.

“What Devin did was he took the candidate that we have, and he was able to do a manipulation of the animals in which he could functionally relate the changes and say, ‘This is the regulator of the behavior.’”

Rocks still has more research to do. Now that he knows that introducing Egr1 into mouse brains can change their behavior, he’s planning to conduct experiments that show exactly how Egr1 affects chromatin.

“We want to see which changes in chromatin and gene expression that we see happening in normal animals over their estrous cycle are being regulated directly by Egr1,” said Rocks, who also teaches techniques in molecular biology to first-year graduate students.

The awards he received are gratifying, he said, given that he’s still completing his education.

“It’s an indication that the community is welcoming me as someone who will contribute to the field in the future and will continue to grow as a scientist, and so I’m really grateful for all of them,” he said.

The most challenging aspect of the research has been utilizing the full spectrum of research techniques required.

“A lot of labs will just do one of the techniques we do, like the genome-wide experiments. Learning how to do them and analyze all that data that comes out of it using bioinformatics analysis, and then also learning how to do animal surgeries—we combine so many different disciplines and techniques,” he said.

“It’s definitely been a challenge to keep up with all of that. It’s also really exciting though. Learning new things is one of my favorite parts of the job.”

Kundakovic was quick to note that when it was announced that Rocks had won the Elizabeth Young New Investigator Award, he was introduced as a “future leader in the field.”

“As someone who’s been working with him for the past five years, since he was an undergraduate, it’s really been my privilege to watch him grow as a person and a scientist,” she said.

“His dedication to his work, his passion; it’s just paid off really well. I think he’s on a really good path.”