Global Brain Group

Global Brain Group

The Global Brain Group is a multidisciplinary group of investigators at the University of Washington, Seattle Children’s and the University of Nairobi. Our mission is to serve infants, children, and adolescents in resource poor settings by conducting research to understand risk factors and mechanisms for neuroimpairment and generating evidence to support best practices for optimizing neurodevelopment and social and emotional well being. The Global Brain Group provides a forum for peer mentorship, sharing ideas, synergy and collaboration between researchers at academic institutions and non-profit organizations. We meet on a monthly basis for peer mentorship meetings, and journal clubs.


Sarah Benki-Nugent
Dr. Benki-Nugent received her PhD (Microbiology) and MS (Epidemiology) from the University of Washington. She has been involved in HIV research in Kenya since 2000. Her research objective is to define best practices for optimizing growth and development in children in resource poor settings, particularly children affected by HIV, malnutrition and environmental toxins.

Claudia Crowell
Claudia S. Crowell, MD MPH joined the Division of Pediatric Infectious Diseases at Seattle Children’s Hospital in 2013. She earned a medical doctorate degree with honors from the University of Washington in 2006, followed by pediatric residency and pediatric infectious disease fellowship training at Northwestern University. Dr. Crowell’s primary research interests are management of pediatric HIV, and prevention and treatment of complications of HIV and its treatment.

Cecilia Breinbauer, MD, MPH
Dr. Breinbauer is an experienced Child and Adolescent Psychiatrist and expert on Global Mental Health who joined our faculty on in 2014. She has a joint appointment in the Department of Global Health and the Department of Psychiatry and Behavioral Sciences, where she will contribute to develop a new Center of Excellence in Maternal and Child Mental Health with both local and global projects. Dr. Breinbauer moved from Chile, her native country, to Washington DC where she collaborated with internationally renowned experts on child and young adolescent development and mental health at the Pan American Health Organization (PAHO), the Inter-American Development Bank (IADB), UNICEF, and various other nonprofit organizations.

Manasi Kumar, PhD, AFBPsS
Dr. Kumar is a Senior Lecturer in the Department of Psychiatry at the University of Nairobi. She is a clinical psychologist by training with interest in critical developmental psychology and psychoanalysis. Kumar is engaged in many issues around neurodevelopment in vulnerable children, including exploring tools for assessing neurodevelopment impairments in children in extreme poverty and with HIV, understanding psycho-social correlates of development in conditions of abject poverty and social inequalities, and how mainstream psychotherapies could incorporate neurocognitive stimulation and an understanding of neurodevelopmental vulnerabilities in children from resource deprived settings.

Meeting Schedule

The HIV Neuropathogenesis Journal Club provides a forum for discussion of seminal papers and cutting-edge research in mechanisms of neuropathogenesis in adult and pediatric HIV, biomarkers for neuro-impairment, and strategies for intervention. The journal club meets bimonthly and is lead by:

Christina M. Marra, MD, Professor, Neurology, Vice Chair (Academic Affairs), Neurology, Adjunct Professor, Medicine (Infectious Diseases), UW

Claudia Crowell, MD, Assistant Professor, Pediatrics, UW

Sarah Benki-Nugent, MS, PhD, Acting Assistant Professor, Global Health, UW

Our next Journal Club will be November 30th at 9:00 AM at 908 Jefferson Street, 13th floor, room 1362.

Articles for Discussion

A lipid storage-like disorder contributes to cognitive decline in HIV-infected subjects. – Veera Venkata Ratnam Bandaru, PhD, Michelle M. Mielke PhD, Ned Sacktor, MD, Justin C. McArthur MBBS, Igor Grant MD, Scott Letendre MD, Linda Chang MD, Valerie Wojna MD, Carlos Pardo MD, Peter Calabresi MD, Sody Munsaka PhD, Norman J. Haughley PhD. Neurology. 2013 Oct 22;81(17):1492-9. doi: 10.1212/WNL.0b013e3182a9565e. Epub 2013 Sep 11

Cerebrospinal fluid metabolomics implicate bioenergetic adaptation as a neural mechanism regulating shifts in cognitive states of HIV-infected patients – Alex M. Dickens, Daniel C. Anthony, Reena Deutsch, Michelle M. Mielke, Timothy D.W. Claridge, Igor Grant, Donald Franklin, Debra Rosario, Thomas Marcotte, Scott Letendre, Justin C. McArthur and Norman J. Haughey. AIDS. 2015 Mar 13;29(5):559-69. doi: 10.1097/QAD.0000000000000580.

A Biological Perspective of CSF Lipids as Surrogate Markers for Cognitive Status in HIV – Norman J. Haughey, Zhu Xiaomao, and Veera Venkata Ratnam Bandaru. J Neuroimmune Pharmacol. 2013 Dec;8(5):1136-46. doi: 10.1007/s11481-013-9506-0. Epub 2013 Nov 8.

Past Articles

September 21st

Tiraboschi JM, Muñoz-Moreno JA, Puertas MC, Alonso-Villaverde C, Prats A, Ferrer E, Rozas N, Maso M, Ouchi D, Martinez-Picado J, Podzamczer D.Viral and inflammatory markers in cerebrospinal fluid of patients with HIV-1-associated neurocognitive impairment during antiretroviral treatment switch. HIV Med. 2015 Jul;16(6):388-92. doi: 10.1111/hiv.12243. Epub 2015 Feb 27.

Ndhlovu LC1, Umaki T, Chew GM, Chow DC, Agsalda M, Kallianpur KJ, Paul R, Zhang G, Ho E, Hanks N, Nakamoto B, Shiramizu BT, Shikuma CM.Treatment intensification with maraviroc (CCR5 antagonist) leads to declines in CD16-expressing monocytes in cART-suppressed chronic HIV-infected subjects and is associated with improvements in neurocognitive test performance: implications for HIV-associated neurocognitive disease (HAND). J Neurovirol. 2014 Dec;20(6):571-82. doi: 10.1007/s13365-014-0279-x. Epub 2014 Sep 17.

Melica G, Canestri A, Peytavin G, et al. Maraviroc-containing regimen suppresses HIV replication in the cerebrospinal fluid of patients with neurological symptoms. AIDS. 2010 Aug 24;24(13):2130-3.

Impact of HIV on Neurodevelopment in Kenya (INK)

The Impact of HIV on Neurodevelopment in Kenya (INK) is an observational cohort study of child neurocognitive impairment in HIV-1-infected children with HIV-uninfected children as a comparison group. This study will involve 2 years of follow-up with annual neurocognitive assessments, and will be based in Nairobi Kenya. The INK Study will estimate the impact of ART on neurocognitive deficits in HIV-infected early-(infancy) and late-treated school-aged children. Separately, we will determine the relative impact of pre-ART HIV disease, response to ART, ART regimen, and immune activation on type and severity of neurocognitive deficits.
NINDS 1K01NS080637
“Impact of HIV, immune activation, and ART on child neurodevelopment in Kenya”
Time Period: 08/01/2012 – 07/31/2017
PI: Sarah Benki-Nugent

Mediational Intervention for Sensitizing Caregivers in Kenya (MISCK)

Pediatric HIV infection is associated with an increased risk of neurodevelopmental deficits. The Mediational Intervention for Sensitizing Caregivers (MISC), an early childhood intervention aimed at improving caregiver-child interactions by facilitating caregiver directed mediated learning, has been shown to improve neurodevelopment. The MISC has been studied extensively as an individual-based intervention administered in the home; however, home-based interventions are time intensive, expensive and difficult to implement on a large-scale. In contrast, group-based interventions are less time-intensive, less costly and provide an extended support network. We hypothesize that implementation of the group-based MISC will be associated with improved neurodevelopment comparable to the individual-based MISC in HIV-infected children ages 1-3 years. We also hypothesize that the group-based MISC will be associated with better caregiver attitudes, improved caregiver mental health and better child HIV-related health outcomes similar to the individual-based MISC. We plan to test these conducting a three-arm pilot randomized control trial of the individual-based MISC versus the group-based MISC versus controls in Nairobi,Kenya. We anticipate that both intervention arms will have improved outcomes compared to the controls. We anticipate the group MISC is a feasible approach that can be evaluated in larger future studies and potentially scaled for programmatic implementation.
Clinical Research Scholar’s Program Seattle Children’s Hospital
Title: Improving Neurodevelopmental Outcomes of HIV-Infected Children in Kenya
PI: Claudia Crowell
Time Period: 7/1/2014 – 6/30/2016
Center for Clinical and Translational Research Pediatric Pilot Award
Title: A Pilot Study of the Effect of the Mediational Intervention of Sensitizing Caregivers (MISC) on Neurodevelopment in HIV-infected Children in Kenya
PI: Claudia Crowell
Time Period: 10/1/2013 – 9/30/2014

INK Neurocognitive Assessment Training
In April 2013, the INK study team carried out a training in Nairobi, Kenya. In January 2014, the INK study team went through further training on validated neurocogntitive tests facilitated by Michael Boivin, PhD, MPH and Global Health Uganda. The training focused on the Bruininks-Oseretsky Test of Motor Proficiency (BOT) and the Kaufman Assessment Battery for Children (KABC), which measures cognitive ability.

MDAT Training
In 2013, Dr. Claudia Crowell, MD facilitated a skype training on the adapted Malawi Developmental Assessment Tool (MDAT) for the Nairobi and Kisumu study teams.

MISC Training
Mediational Intervention for Sensitizing Caregivers (MISC) Training: In January 2013, the MISCK study team traveled to Tororo, Uganda to attend a MISC training facilitated Deborah Givon and Cilly Shohet of the late Pnina Klein’s group at the Bar Ilan University, Israel.

Abby Renolds, Dartmouth University, 2018, BA, Engineering and Global Health Minor, BE, Biomedical Engineering

Lauren Gomez

Ira Martopuollo

The Regional Voice for Vulnerable Children

The Regional Inter-agency Task Team on Children and AIDS in Eastern and Southern Africa is a network of organisations working together to influence global, regional and national policy formulation and implementation for children and their families. Through advocacy and knowledge management, we work on the three priority areas below to improve the care and support for children.


The Consultative Group on Early Childhood Care and Development (CGECCD)

A global inter-agency consortium with strong links to regional networks and a track record of advocacy and knowledge generation and dissemination at an international level. Established in 1984 by a small group of donor funding agencies, it has evolved into a well-respected global network with committed partner agencies, institutions and professionals involved in the field of ECCD at all levels. The focus on young children (0 to 8yrs), their families and communities remains highly relevant in 2013 when taking into account the very large numbers of young children living in difficult and resource-poor contexts and the effects this has on their overall physical, social and cognitive development and well-being.

Coalition for Children affected by HIV/AIDS

The Coalition brings funders and technical experts together to advocate for the best policy, research, and programs for children because children are a vulnerable population that has too often been overlooked.