Upstate Medical University Assistant Professor of Pharmacology David Auerbach, PhD, loves that the spaces in which he used to take classes are now home to the ground-breaking neuro-cardiac research he’s directing and conducting.

Auerbach was a graduate student in the department of pharmacology at Upstate from 2004 to 2011. He later worked at the University of Michigan Medical School and most recently the University of Rochester Medical Center. When the opportunity to return to Upstate arose, Auerbach said he jumped on it and joined the pharmacology faculty in April 2019.

“Upstate New York is a hotbed for cardiac electrophysiology research, particularly research into the mechanisms of arrhythmias and electrical disturbances of the heart. It’s great to come back to Central New York as there are so many pioneer investigators here including several at Upstate,” said Auerbach, whose specialty is investigating the susceptibility and mechanisms for electrical disturbances in the brain and heart. He is focusing on why Long QT Syndrome (LQTS), a rare inherited cardiac abnormality, can lead to electrical disturbances in the heart in the form of arrhythmias and in the brain in the form of seizures.

Auerbach generated a novel and clinically relevant model of LQTS with an inherited mutation that is associated with a high prevalence of arrhythmias and seizures. Development and validation of his new LQTS model has the potential to be a “game-changer” as it could provide a powerful model for future mechanistic and drug/device safety studies.

“Previous studies demonstrated that this inherited disease leads to cardiac arrhythmias. We are investigating whether this same mutant channel also causes chaotic electrical function in the brain, in the form of seizures,” he said. Auerbach published a study that demonstrated that LQTS patients are at a high risk of experiencing dangerous seizures when compared to their unaffected family members.

“We’re studying this model at all levels from molecular to cellular to organ to whole body. Our goal is to understand the underlying mechanism for these neuro-cardiac electrical abnormalities,” Auerbach said. Another tool he is using is a database of 21,000 people, which includes LQTS patients and their unaffected family members. He is making connections between disturbances in the heart and in the brain. “Once we know the mechanisms, we can take that back to the patient level to further verify the results and eventually develop novel therapies to prevent arrhythmias, seizures and sudden death.”

Auerbach is also launching another project – this one involving wearable technology to detect cardiac arrhythmia markers in epilepsy patients who are at risk for Sudden Unexpected Death in Epilepsy (SUDEP). While likely an underestimate, each year about one in every 1,000 patients with epilepsy die of SUDEP; Disney star Cameron Boyce’s death in July 2019 was attributed to SUDEP.

Traditional epilepsy monitoring involves a multi-day stay in the hospital. As this is only a short period of time, sometimes the patient does not develop a seizure during the recording. Using wearable technology, Auerbach’s team will capture the multi-system changes surrounding seizures, and validate a wearable recording device for potential future long-term, outpatient recordings. The goal is to develop effective strategies to predict the risk and ultimately prevent SUDEP.

Auerbach said that while cardiac abnormalities have always been his primary focus, his new research opportunities “outside the classic organ of interest” at Upstate are exciting. He is also energized by Upstate’s commitment to expanding the Upstate Heart Institute and cardiology services in the last year, including adding eight cardiologists to the Upstate faculty in late 2019.

“I am excited by the great opportunities at Upstate to grow my research program through access to great facilities, forming new collaborations and hiring a great group of people to work on these projects.”

 

Caption: Assistant Professor of Pharmacology David Auerbach, PhD, in a lab in Weiskotten Hall.