Dr. Dorina Papageorgiou Talks to TNH about Her Life and Work

Dr. Dorina Papageorgiou with the MRI machine in the background. Photo: Courtesy of Dr. Dorina Papageorgiou

HOUSTON, TX – Dr. Theodora Dorina Papageorgiou, Assistant Professor of Psychiatry & Behavioral Sciences and Physical Medicine & Rehabilitation at Baylor College of Medicine in Houston, Texas, always wanted to go into science, she told The National Herald on a recent visit to TNH’s offices in Long Island City. Born and raised in Athens, she now calls Houston home where she lives with her husband, attorney James Cargas, who recently ran for Congress.

He has been praised for his campaign by Republicans and Democrats alike for sticking to the issues. His wife, supportive throughout, is working on some of the most cutting-edge research in neuroscience. She recently received a grant from the McNair Medical Institute to continue her work focused on investigational targeted brain neuro-therapeutics, for the rehabilitation of speech/motor impairment, cortical blindness, and chronic pain as a result of traumatic brain injury, stroke, brain tumor, neuropathic disease, and pain syndromes.

Dr. Papageorgiou told TNH about this remarkable work which will undoubtedly change the way many patients are treated for specific neurological injuries and conditions. Her interest in science and medicine began early on. Her father, Dr. Vasilios Papageorgiou, is a physician with three specialties and a PhD as well. She credits her parents for instilling the passion for education and science in her and her sister, Dr. Angela Papageorgiou, who is a cancer biologist doing pancreatic cancer research at Harvard. Their mother, Olga Helmi-Papageorgiou, a published author, studied English literature at University College London and taught them the English alphabet before they started school. Her parents met at the Red Cross Hospital in Athens where her father was a physician and her mother was a volunteer. 

After passing the Greek University entrance exams, Papageorgiou said her mother asked if she wanted to study in the United States and she said yes. Accepted to the University of Georgia, she studied Psychology and Sociology, and then attended Johns Hopkins University Bloomberg School of Public Health earning a Master’s in Psychiatric Epidemiology. Her sister also attended the University of Georgia and went on to earn a PhD at The Uninversity of Texas – M.D. Anderson Cancer Center. Papageorgiou visited her sister there and was really impressed with the Texas Medical Center. “It’s an amazing place in terms of medicine and science,” she told TNH, “So I went there to the graduate school with a focus on neuroscience, and received my PhD degree which focused on human brain neuroimaging.”

Dr. Dorina Papageorgiou in her lab at Baylor College of Medicine in Houston, TX. Photo: Courtesy of Dr. Dorina Papageorgiou

Three fellowships followed, one at M.D. Anderson Cancer Center, two at Baylor College of Medicine, and Papageorgiou now has a primary appointment at Baylor College of Medicine and a secondary appointment at the Department of Electrical and Computer Engineering, Neuroengineering Research Program, at Rice University. Papageorgiou said “The Texas Medical Center is extremely diverse with people from all over the world. A great place to do science!”

About the focus of her research she explained, “We all know what an MRI is, it looks at the structures of the brain, functional MRI examines not only the structures but also the function of the brain. But what we’re doing in my lab, which very few investigators in the world are focusing on is called real-time functional MRI neurofeedback (rt-fMRI nFb). What this means is that in real time we read the activity in the patient’s brain and we feed it back- to re-circuit the brain. What my lab has developed is that the neurofeedback we deliver- with the goal to re-circuit and reorganize the brain- is accomplished in a very individualized and targeted treatment, which we apply to patients who have neurological disorders. 

“Using this technology, we are developing and continuously optimizing, capitalize on areas in the brain that are functionally associated with a lesioned area but are intact. This gives us the ability to reorganize pathways. This is feasible because there is a lot of redundancy in the brain, meaning there are a lot of copies in the brain. Specifically, we are looking at people with lower cranial nerve injury; basically the nerves that control tongue movement and sensation are lesioned. This has terrible complications because patients cannot swallow, cannot eat, and have speech problems. So we’re using the principle of redundancy to reorganize pathways and try to capitalize on those that still have some lingering function. Also in the pain area, we are starting a new study on patients who have chemotherapy-induced neuropathic pain as a result of cancer treatment. This pain unfortunately, lingers even after treatment. Our goal is to map the brain to see what happens after the pain treatments patients receive, and for those who are resistant to conventional pain treatments, and how can we eliminate pain using again the same technology.”

Papageorgiou also noted that another patient population “we focus on is patients who have been diagnosed with cortical blindness. The blindness these patients suffer from is very specific in that it is not the result of a retinal problem but rather of a lesion in the brain at the location of the brain responsible for vision as a result of a stroke or traumatic brain injury or tumor resection. We are finding that under specific, targeted, and individualized training, we can restore visual recovery for patients with specific visual injuries as a result of an injury in their brain. Somebody may wonder if these people are partially blind how can they see, but apparently the brain receives some messages and after a while there is this what I call purposeful and induced learning that occurs and can reorganize the brain and engage new areas to be a part of the visual perception- the way we visually experience the world.” 

“The lab has a development component, we’re developing the technology and, at the same time, we’re applying it to patients. The application of the technology to patients drives the development. We are also looking at healthy people to better understand these pathways and optimize our approach to patients” Papageorgiou noted.

She added that “this method is completely non-invasive, the same way someone lays supine in the MRI scanner, it’s the same thing but patients have to engage and perform a visual task, similar to a brain-machine interface.”

Papageorgiou noted that this treatment is “not one size fits all, it’s individualized and targeted.”

As the patient performs the task, repeatedly, data is being collected in real-time and precise computations are applied to give individualized and targeted neurofeedback to each patient. The results for some patients who return for treatments over time to maintain and improve their outcomes can be life-changing. And for Papageorgiou and her team, “it is ultimately rewarding to be able to witness improvements in patients’ lives, whether it is their visual recovery or improvement in their swallowing or speech.” Papageorgiou’s hope is that this experimental treatment will someday be transferred to the clinic.