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Paul Nyquist, M.D., M.P.H.

Paul Alan Nyquist, M.D., M.P.H.

Photo of Dr. Paul Nyquist, M.D., M.P.H.

Co-Director, Johns Hopkins Bayview Neurocritical Care Unit

Associate Professor of Neurology

Male

Expertise: Neurological Critical Care, Neurology, Stroke

Research Interests: Acute Brain Injury; White Matter Disease; Subarachnoid Hemorrhage; Stroke Genetics; Intracranial Hemorrhage

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Locations

The Johns Hopkins Hospital
Appointment Phone: 410-955-5000

600 N. Wolfe Street
Meyer Building 8-138
Baltimore, MD 21287 map
Phone: 410-955-2611
Fax: 410-614-7903

Background

At Johns Hopkins, Dr. Paul Nyquist has two roles as an attending physician in the neurocritical care unit (NCCU) and as a member of the cerebrovascular team. His research goal is to bridge the gap between clinical trials and bench top innovations. He has embraced a research strategy characterized by two features. The first is an ongoing interest in any translational research projects that incorporate well founded biological models into patient care in brain injury. He has a theoretical focus which emphasizes the role of inflammation in cerebrovascular disease with particular attention to the effects of inflammation on endothelial activation. His goal is to develop acute interventions that will improve outcomes in patients with acute brain injury of any type.

Dr. Paul Nyquist received his medical degree and masters of public health degree from the George Washington University. After medical school, Dr. Nyquist completed his internal medicine internship at the National Naval Medical Center in Bethesda, Maryland. Upon completion, he was trained as a Navy Second Class Deep Sea Diver, radiation health specialist and an Undersea Medical Officer. Dr. Nyquist was part of the United States Naval world wide dive watch and rendered on call medical advice for diving and decompression related injuries for the United States Navy.

His clinical neurological training includes a neurology residency at the Mayo Clinic in Rochester, Minnesota as well as a senior staff clinical fellowship at the National Institutes of Health in the National Institutes of Neurological Diseases and Stroke in Bethesda, Maryland. He was a critical care medicine fellow in the ACGME accredited National Institutes of Health Critical Care Medicine program for 16 months. Dr. Nyquist then served as director of the stroke program at Inova Fairfax Hospital, assistant professor of Neurology at Virginia Commonwealth University Medical School, and clinical assistant professor of Psychiatry at Georgetown University Medical School. He completed his Neurocritical care fellowship training at Johns Hopkins and is now an Associate Professor of Neurology, Neurosurgery and Anesthesiology/Critical Care at the Johns Hopkins University School of Medicine.
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Titles

  • Co-Director, Johns Hopkins Bayview Neurocritical Care Unit
  • Associate Professor of Neurology
  • Associate Professor of Anesthesiology and Critical Care Medicine
  • Associate Professor of Medicine
  • Associate Professor of Neurosurgery

Education

Degrees

  • MD, George Washington University School of Medicine (1992)

Residencies

  • Mayo Clinic Medical School College of Medicine / Neurology (1999)

Fellowships

  • NIH - HCPS - NINDS (2001)
  • Johns Hopkins University School of Medicine / Rotator (2002)
  • National Institutes of Health / Critical Care Medicine (2002)

Board Certifications

  • American Board of Psychiatry & Neurology / Neurology (2000, 2010)

Research & Publications

Research Summary

Dr. Paul Nyquist has an ongoing interest in any translational research project that incorporates well-founded biologic models into patient care in brain injury. He has been involved in a number of clinical trials that have been at the forefront of new technologic innovations in brain injury and has extensive experience in clinical trials in both military and civilian settings. These trials often have involved protocols with high clinical impact on those enrolled.

Dr. Nyquist also has a theoretical focus that emphasizes the role of inflammation in cerebrovascular disease, with particular attention to the effects of inflammation on endothelial activation. He is interested in how inflammation and endothelial activation affect the neurovascular unit. To that end, he is investigating the role of genetic variation on the proclivity of the endothelium to become transformed into a procoagulant state in carotid atherosclerosis.

Using extensive clinical testing for commonly detected risk factors in cerebral vascular disease, Dr. Nyquist is exploring how cerebrovascular small-vessel disease in patients who are predisposed to atherosclerosis may be influenced by inflammation and genetic history. He is also investigating how biomarkers may be used to detect damage in each compartment of the neurovascular unit in the settings of vasospasm and cerebral salt wasting in patients with subarachnoid hemorrhage.

Dr. Nyquist believes that an interrelationship exists between small-vessel disease of the brain and small-vessel disease of the heart and that a number of potential genes may predispose to both. In a study that he conducted in a group of patients who had asymptomatic small-vessel disease of the heart, he found a cross-correlation with silent small-vessel strokes in the brain. His goal is to identify the genes that are associated with cerebral vascular disease in the hopes of developing new treatments for this condition that afflicts millions worldwide.

 

Lab

Clinical Trial Keywords

Intracranial Hemorrhage, Subarachnoid Hemorrhage, Stroke

Selected Publications

Extramural Funding

NIH/NINDS RO-1, Funded, Principal Investigator 1R01NS062059-01A1, GRANT00431125, Occult Small Vessel Cerebrovascular Disease in High Risk Families.

Investigator / Inteventional Management of Stroke (IMS) III NIH Sponsored Clinical Trial

Principal Investigator/ Clinical Trial of rFVIIa (Novoseven) in Patients with
Intracerebral Hemorrhage at Johns Hopkins University, Sponsored by NOVONORDISK

Principal Investigator/ Desmotaplase in Acute Stroke at Johns Hopkins University (DIAS), Sponsored by Forest Pharmaceuticals

Investigator, CLEAR, Use of rt-PA for the Resolution of Clot in Intra-
ventricular Hemorrhage, Sponsored by FDA Orphan Drug Program

Investigator / CREST, Carotid Revascularization Endarterectomy vs. Stent Trial, NIH Sponsored Clinical Trial

Principal Investigator/ Siblings with Ischemic Stroke Study Stroke, INOVA Fairfax Hospital


Department of Defense Sponsored Research Projects
Principle Investigator, Project Officer-1993-1996: Complement Levels in Experimental Divers Before and After Dives with a High Predicted Risk of Decompression Sickness.

Project Officer, Principle Investigator -1994-1996: Desmopressin in Submersion Diueresis in Dives of Long Duration.
Project Officer-1995 - 1997: Human Decompression Trial with 1.3 ATA Oxygen in Helium.63713N.M0099.01A.1510.
Medical Monitor-1995 - 1997: Hyperbarcia Recognition and Thermal Status of Exercising Divers Exposed to Cold Water and Elevated PCO2. 63713N.M0099.01B.1428.

Publications:

Paul A. Nyquist MD, MPH , Cherie A. Winkler, PhD , Louise M. McKenzie, PhD , Lisa R. Yanek, MPH , Lewis C. Becker, MD , Diane M. Becker, ScD, MPH Single Nucleotide Polymorphisms in Monocyte Chemoattractant Protein-1 and its Receptor Act Synergistically to Increase the Risk of Carotid Atherosclerosis, Cerebrovascular Disease, accepted.

Paul A Nyquist, Wityck R., Lisa R. Yanek, David Yousem, Lewis C. Becker, Diane M. Becker, High Prevalence of Silent Small Vessel Cerebrovascular Disease and Co-occurrence with Occult Coronary Disease in Healthy Individuals from High Risk Families. Neuroepidemiology accepted

Nyquist P, Stevens RD, Mirski MA. Neurologic injury and mechanical ventilation.
Neurocrit Care. 2008;9(3):400-8. Epub 2008 Aug 12

Stevens RD, Nyquist PA.Types of brain dysfunction in critical illness. Neurol Clin. 2008 May;26(2):469-86, ix

Naval NS, Nyquist PA, Carhuapoma JR.Management of spontaneous intracerebral hemorrhage. Neurol Clin. 2008 May;26(2):373-84, vii.

Toung TJ, Nyquist P, Mirski MA. Effect of hypertonic saline concentration on cerebral and visceral organ water in an uninjured rodent model. Crit Care Med. 2007 Oct 23;

Nyquist P, LeDroux S, Geocadin R. Thrombolytics in intraventricular hemorrhage. Curr Neurol Neurosci Rep. 2007 Nov;7(6):522-8.

Nyquist P, Ball R, Sheridan MJ, Complement levels before and after dives with a high risk of DCS,Undersea Hyperbaric Medicine, UHM 2007, 34(3), 191.

Stevens RD, Nyquist PA. Coma, delirium, and cognitive dysfunction in critical illness.
Crit Care Clin. 2006 Oct;22(4):787-804;

Nyquist PA, Ball R, Sheridan MJ. Complement levels before and after dives with a high predicted risk of decompression sickness. Naval Medical Research Center, Silver Spring, MD. Technical report No. 2006-001; June 2006.

Nyquist P.A., Buttolph T, Dick C., "Detection of leukocyte activation in pigs with neurologic decompression sickness", Aviat Space Environ Med. 2004 Mar;75(3):211-4.

Lattimore SU, Chalela J, Davis L, Degraba T, Ezzeddine M, Haymore J, Nyquist P, Baird AE, Hallenbeck J, Warach S, Impact of establishing a primary stroke center at a community hospital on the use of thrombolytic therapy: the NINDS Suburban Hospital Stroke Center experience. Stroke. 2003 Jun;34(6): 2003 May 15

Worrall BB, Azhar S, Nyquist PA, Ackerman RH, Hamm TL, DeGraba TJ. Interleukin-1 receptor antagonist gene polymorphisms in carotid atherosclerosis. Stroke. 2003 Mar;34(3):790-3

Nyquist PA, Cascino GD, McClelland RL, Annegers JF, Rodriguez M. Incidence of seizures in patients with multiple sclerosis: a population-based study. Mayo Clin. Proc. 2002 Sep;77(9):910-2.

Nyquist PA, Cascino GD, Rodriguez M. Seizures in patients with multiple sclerosis seen at Mayo Clinic, Rochester, Minn., 1990-1998. Mayo Clin. Proc. 2001 Oct;76(10):983-6.

Nyquist P.A., R.D. Brown, Jr., D.O. Wiebers, C.S. Crowson, and W.M. OFallon Circadian and seasonal occurrence of subarachnoid and intracerebral hemorrhage
Neurology. 2001 56: 190-193.

Nyquist P, Laws ER, Elliot E, Novel features of tumors that secrete both growth hormone and prolactin in acromegally, Neurosurgery. Vol. 35, No. 2, 179-185, 1995.

Activities & Honors

Honors

  • United Nations Humans Rights Community Award 2003, United Nations Association of The National Capital Area: For the care of the victims of torture in the Washington D.C. Capital area., 2003
  • General Loan Repayment Program, National Institute of Health, 2000 - 2003
  • American Neurological Association, travel fellow award, 2001
  • American Epilepsy Society, Young Investigators Award, 1999
  • Navy and Marine Corps Commendation Medal, 1996
  • GWU Medical School: Graduated with Distinction, AOA, 1992
  • Navy Health Professional Scholarship, 1989
  • University of Michigan: Graduated distinction overall, with High-Honors from the Honors College, 1986
  • Western Michigan University Phi Eta Sigma, Freshman Honors Society, 1981

Memberships

  • Maryland Society for the Rheumatic Diseases
    President
  • The American College of Rheumatology
    Fellow
  • The Myositis Association
    Board Member

Professional Activities

  • American Academy of Neurology, 1996
  • Society of Critical Care Medicine, 2002
  • Neuro Critical Care Society, 2003
  • Stroke Council, 2003
  • The Johns Hopkins Medical Surgical Society, 2005
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