Your brain is precious.
And that's what drives the work of Susan Margulies.
When Margulies arrived at Georgia Tech and Emory University in August 2017, our state had landed one of the world’s foremost experts in traumatic brain injury.
Margulies was recruited as a GRA Eminent Scholar to head the top-ranked Wallace H. Coulter Department of Biomedical Engineering, a joint department of the two universities. Throughout her 35-year career, she has broken new ground in biomedical research, earned a reputation as a collaborator and blazed a few trails for women in science.
On a spring morning in April, she sat down to share her thoughts on kids and brain injuries, scientific discovery and the unique department she’s now leading.
What’s the most common cause of traumatic brain injury in children?
In a young child, under the age of 2, it’s falls and abusive head trauma. In teens, it’s going to be motor vehicles and sports-associated injuries.
What will it take to minimize sports-related brain injuries?
I was part of a commission that issued a landmark report in 2014 through the Institute of Medicine. It was a partnership of the NCAA, Department of Defense, NIH, CDC and the National Association of Athletic Trainers. Since this report, we’ve seen some change in culture – there’s a far greater awareness of concussions in children. Many major hospitals, like CHOA, have a concussion awareness program to get information to children of all ages and to parents and coaches and organizers of club sports. We want them to understand the grave implications of ignoring the science of concussion.
Going forward, where could further investment in research best be made to prevent concussions?
Improving the science associated with the condition. Historically, most traumatic brain injury research in animals has centered on severe injuries. Now we know that, by far, the largest number of traumatic brain injuries – over 90 percent – are mild injuries.
Accumulated exposure to mild traumatic brain injuries is one under-studied area of great concern. Anybody who has a sprained ankle and repeatedly sprains it is aware that you’re more likely to sprain the ankle again, not because you trip more easily, but because that injured tissue does not respond to the next exposure in the same way as never-injured tissue. We’re learning that the brain is similar. Once it’s been injured, it has a different response to subsequent injury. In the same way we have this well-developed mindset about a sprained ankle, we need to have the same mindset about our brains.
What’s an example of an innovation needed to help children with brain injuries?
The youngest children can’t tell us that they have a brain injury. So there’s a real need for diagnostics based on saliva, blood or some other type of non-invasive method. It could even be looking at pupillary responses or brain waves or electro encephalograms.
Interestingly, the same types of non-invasive metrics we develop for a child could also be used in adults. That could be a real advantage, because you wouldn’t need the cooperation of a player who really wants to play in the big game next weekend. We’d actually have something that is as definitive as, say, an X-ray of a leg to say, ‘you have to sit out.’ That would be wonderful.
Is that something scientists in the Coulter Department are working on right now?
Yes. We have an NIH grant to develop these objective measurements, so we’re looking at blood and serum biomarkers. Others are looking at saliva. We’re looking at eye-tracking. We’re looking at balance, sleep cycles and activity levels during night and day. These are all things we can measure with minimal cooperation from the subject.
What’s the story of how you came to Georgia?
I had been at the University of Pennsylvania for 24 years, quite happy really. The opportunity to come to Georgia was an opportunity to move my research into directions that are really driven by engineering innovation. There’s a group of faculty at Emory, Georgia Tech and Children’s Healthcare of Atlanta who are focused on the injured brain, and who are at the interface of technology, medicine and neuroscience. And, of course, the opportunity to come to the Coulter Department of Biomedical Engineering.
A highly respected program.
Yes, number one in the nation, and the only department of its kind housed inside a public and a private university.
What’s that like day to day? Do you have an office on both campuses?
I do. And soon, I’ll have a lab on both campuses. I think of it as one research group on two campuses. That [duality] allows me to understand the challenges and opportunities of both places, and to understand the needs of both as they look to the other as a partner.
What about the Coulter Department would surprise people?
Emory has a well-developed brand of thinking about cures for diseases like HIV and cancer – Emory is well known for that. But they’re not as well known for some of what our BME faculty are engaged in, like imaging modalities or innovative drug delivery systems or antibiotic resistance. On the Georgia Tech side, people think of Tech as innovating in biomedical engineering, but many don’t how involved Tech is in the translation of that innovation to patient care. It goes from a prototype device all the way to breakthroughs in medicine.
What does the collaboration with CHOA look like?
There’s a pediatric technology consortium between CHOA, Georgia Tech and Emory, with funding for innovation and partnership. My goal is to make that a broader partnership.
Broader in what sense?
Mostly innovating for children who are patients. Through my research over the last 35 years, I’ve seen that what’s been discovered to help an adult can’t always be applied to the child. The child is actually a unique setting, from an engineering perspective and a biological perspective. For example, when we think about treating a brain injury in children, we have to think about more than the fact that they have smaller heads. Their tissues are of different properties, and their response to the deformation of tissues in the brain are different. So the treatments have to be different.
Georgia has a reputation for scientists working across universities. Do you see opportunities to work with fellow GRA Eminent Scholars and other scientists?
Steve Stice at the University of Georgia is one. He and I look forward to collaborating – he reached out to me during my recruitment. My lab is still in the process of moving. I’m also serving on a committee that involves Georgia State, Emory and Georgia Tech creating a single campus to study brain health. The vision is to study human subjects from a range of perspectives. Wearable technology, big data analysis, imaging, psychiatry, neurology and other areas, all coming together on emerging science that can be learned through patients.
Your undergraduate degree is in aerospace engineering and mechanical engineering.
But I always wanted to be in biomedical engineering.
Why is that?
I really wanted to really make a difference in medicine. I grew up in Rochester, Minnesota, home of the Mayo Clinic and felt there was a role for math, science and engineering in making a difference in medicine. As an undergraduate, I realized through a series of research experiences that I really wanted to be a biomedical engineer. That was going to be the path most impactful for me. I’m delighted to be able to speak two languages, engineering and biomedical science.
For me, the important piece is identifying important questions in medicine that benefit from engineering knowledge and approaches to improve the diagnosis and treatment of patients. So I’m always looking to serve as not just a bridge, but as a meeting place for people in different disciplines to come together to share expertise.
Is there anything in your background that inspired that?
Like being a middle child? (Laughs) I like bringing people together. I think I have a talent for seeing opportunities that others might not appreciate and understanding the culture of different institutions.
What do you think needs to be done to get more women to pursue STEM fields?
It’s a matter of having role models and understanding how math and science can make a difference in the world. We have the largest number of women in our undergraduate and graduate programs engineering – 57% of our freshman class are women, and 52% of our total enrollment. We have 24% under-represented minorities in our freshman class, 17% overall. We’re a very diverse population.
Who inspired you when you were younger?
One person is my maternal grandmother. She came to Canada in her 20s from Russia. She had been teaching math in a school in a ghetto in Russia. She was always very math savvy. She was widowed in her early 40s, with two young girls, and had to take over my grandfather’s business. He was a leather wholesaler, which is not exactly a woman’s world. As a working woman in her 40s with two girls, she was in business, and her knowledge of math helped her thrive.