About

Michael I. Miller is the Bessie Darling Massey Professor and director of the Department of Biomedical Engineering at Johns Hopkins University. He also serves as the director of the Center for Imaging Science and co-director of the Kavli Neuroscience Discovery Institute. As a biomedical engineer, Miller is pioneering cutting-edge technologies in computational medicine to understand and diagnose neurodegenerative diseases. His research focuses on the functional and structural characteristics of the human brain in health and disease, including Huntington’s disease, Alzheimer’s disease, dementia, bipolar disorder, schizophrenia, and epilepsy. By developing new tools derived from advanced medical imaging technologies to analyze patient brain scans, Miller aims to predict the risk of developing neurological disorders years before the onset of clinical symptoms. His lab is currently devising cloud-based methods to build and share libraries of brain images—and the algorithms used to understand them—associated with neuropsychiatric illness. Miller’s research is highly translational, and he has co-founded four start-up companies in the past decade. He has co-authored more than 200 peer-reviewed publications, as well as two highly cited textbooks on random point processes and computational anatomy. Miller earned his BS from the State University of New York at Stony Brook in 1976, and his MS and PhD in biomedical engineering from Johns Hopkins University in 1978 and 1983, respectively. He was the Newton R. and Sarah L. Wilson Professor in Biomedical Engineering at Washington University in St. Louis until joining Johns Hopkins University in 1998. He was named the Herschel and Ruth Seder Professor in Biomedical Engineering in 2003, before his appointment as the director of biomedical engineering in 2017.

Research topics

• Medicine
• Internal medicine

Selected publications

• The Ecological Relationship Between Food Access and Disease Activity in Canadian Children newly diagnosed with Juvenile Idiopathic Arthritis

  The Journal of Rheumatology · 2026-05-15

  article

  Objective A healthy diet may contribute to improved disease activity in JIA. In Canada, access to healthy food is variable. This study examined the relationship between food accessibility, disease activity measures, and weight in children with JIA. Methods Clinical data from children newly diagnosed with JIA (2017–2021) collected in the CAPRI registry were linked to neighborhood-level food accessibility measures using postal codes. Data were analyzed at enrollment and at 1-year follow-up. Associations were assessed using Spearman's rho correlations, Mann–Whitney U test (p < 0.05) and mixed effects linear regression. Results Among 641 JIA patients, 21.9% were overweight or obese (BMI >85th percentile) and lived in areas with less access to chain grocery stores (p = 0.02) compared with those with underweight or healthy BMI. At baseline, healthy-weight (p = 0.02) and overweight (p = 0.04) patients had lower disease activity (cJADAS10) than those with obesity; this association was not observed at 1-year follow-up. At baseline, a greater proportion of fast-food restaurants in the neighborhood was linked to fewer active joints (r s = –0.09, p = 0.04). At 1-year, higher densities of fast-food restaurants and convenience stores were associated with lower disease activity (r s = –0.14, p = 0.02). Conclusion Obesity was linked to higher disease activity and reduced access to healthy food in chain grocery stores. However, greater access to both healthy and unhealthy food was associated with lower disease activity, relationships that may reflect general benefits of urban living.

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• Tuning Human and Artificial Intelligence: The Theory of Communication Resonance & Intelligence Tuning (ToCRIT)

  Una Mens Homo et Machina · 2026-02-01

  articleOpen access1st authorCorresponding

  This paper introduces the Theory of Communication Resonance & Intelligence Tuning (ToCRIT), a novel framework that reconceptualizes intelligence as a dynamic, emergent property of attuned communication rather than solitary problem-solving. Developed through a recursive human–AI collaboration, ToCRIT bridges emotion science, communication theory, and artificial intelligence research. We argue that intelligent systems—whether biological or artificial—depend not on alignment alone, but on the capacity for resonant tuning: the real-time, adaptive management of emotional, semantic, and relational signals within an interaction. Central to the model is the Resonant 8va², a taxonomy of sixteen emotional waveforms that function as foundational tuning tools. Methodologically, we introduce the Resonance Collider Framework, an experimental approach that treats interaction itself as data, tracking phenomena such as signal drift, lucid/drag zones, and communicative “folds.” Findings from this approach reveal that miscommunication and rupture are not noise, but essential sites for resonant repair and insight generation. The paper concludes by presenting Nine Gates of Communication—thresholds of resonant difficulty—and proposes nanoethics as a micro-ethical framework for attuned interaction. ToCRIT offers a pathway toward more relational, emotionally intelligent artificial systems and a deeper understanding of the co-created nature of intelligence itself.

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• Histidine Supplementation Stabilizes Hearing and Vision and Improves Growth in <scp>HARS1</scp> ‐Related Autosomal Recessive Disorder Associated With Usher‐Like Symptoms

  American Journal of Medical Genetics Part A · 2026-05-19

  articleOpen access

  Autosomal recessive HARS1-related disorder (originally described as Usher syndrome type 3B) caused by a homozygous Y454S variant in the histidyl-tRNA synthetase gene (HARS1) is characterized by progressive sensorineural hearing and vision loss and respiratory deterioration with risk for sudden death following febrile illnesses. In-vitro studies have previously shown that histidine can rescue a humanized yeast model for pathogenic HARS alleles. Fourteen children homozygous for HARS Y454S were treated with supplemental oral histidine (50 mg/kg BID) and monitored with bloodwork and physical, visual, and audiometry assessments during a 3-year clinical trial, then followed for more than 4 years on histidine in the post-trial period. Patient fibroblasts were assessed for response to histidine. Hearing and vision remained stable, and growth improved significantly. Children remained healthy, with no severe deteriorations despite exposure to bacterial and viral infections, including COVID-19. Gains in growth were maintained in the post-trial period on varying levels of histidine supplementation. Daily oral histidine supplementation in children with autosomal recessive HARS1-related disorder can ameliorate or slow the progression of disease and is safe, inexpensive, and well tolerated. This study adds to the growing list of autosomal recessive ARSopathies (aminoacyl-tRNA synthetase disorders) that are amenable to amino acid supplementation.

  PublisherDOI

• Quantification of perforant path fiber degeneration using ex vivo 11.7T MRI along severities of neurofibrillary tangles in the entorhinal cortex

  Proceedings on CD-ROM - International Society for Magnetic Resonance in Medicine. Scientific Meeting and Exhibition/Proceedings of the International Society for Magnetic Resonance in Medicine, Scientific Meeting and Exhibition · 2025-09-16

  article

  Motivation: Degeneration of perforant path fibers is crucial in the process of Alzheimer's disease (AD) pathogenesis as it is functionally related to memory deterioration. Goal(s): This study aims to test whether the degeneration of perforant path fibers quantified by 11.7T MRI ex vivo is associated with neuropathological changes along the AD continuum. Approach: Twenty postmortem brain tissues were scanned with 11.7T MRI for three-dimensional T2-weighted imaging, diffusion tensor imaging, and tractography, and were cut for subsequent histological examinations of AD pathology. Results: Greater degeneration of perforant path fibers was observed in the group of higher severity of neurofibrillary tangles in the entorhinal cortex. Impact: Myeloarchitectonic features of the perforant pathway, identified using 11.7 MRI in postmortem human brain tissues, were associated with neuropathological changes along the AD continuum, reflecting neurodegeneration of early AD pathogenesis.

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• 67. Assessing General Pediatricians’ Comfort Level and Clinical Practice for Counselling and Prescribing Contraception to Adolescent Patients in Southwestern Ontario

  Journal of Adolescent Health · 2025-02-07

  articleOpen accessSenior author
  PublisherOA PDFDOI

• Benefit of icosapent ethyl across types and sizes of myocardial infarction in REDUCE-IT

  European Journal of Preventive Cardiology · 2025-09-20 · 2 citations

  articleOpen access

  AIMS: We studied the efficacy and safety of icosapent ethyl (IPE) 4g daily in reducing the risk of myocardial infarction (MI) across different MI subtypes and sizes, among REDUCE-IT high-risk patients with hypertriglyceridemia. METHODS: REDUCE-IT was a phase 3b, double-blind multicenter trial. Patients with established CVD or diabetes who were treated with statins and had moderate hypertriglyceridemia were randomized to receive IPE 4g daily or placebo. The current analysis focused on MI subtypes (fatal MI, nonfatal MI, ST-segment elevation MI (STEMI), non-STEMI (NSTEMI)), as well as MI size (measured by multiples of troponin upper limit of normal) and MI-related complications. Safety outcomes included treatment emergent adverse events (TEAEs), bleeding, atrial fibrillation, and flutter. RESULTS: At 5.7 years follow-up, MI incidence was lower with IPE compared with placebo (8.6% vs 12.0%), hazard ratio (HR) 0.69 (95% CI 0.58-0.81, P<0.0001). STEMI incidence was lower with IPE (2.7% vs 3.9%, HR 0.60, 95% CI 0.44-0.81, P=0.0008), as was NSTEMI incidence (5.9% vs 7.8%, HR 0.73, 95% CI 0.60-0.89, P=0.001). Fatal and nonfatal MIs were reduced with IPE (HR 0.55, 95% CI 0.30-1.01, P=0.05 and HR 0.70, 95% CI 0.59-0.82, P<0.0001, respectively). Stratification by size revealed IPE reduced most MIs, but the protective effect was higher for larger MIs (P<0.0001). Further analyses showed benefits in MI-related outcomes, including reductions in spontaneous MI and MI-related complications. Among patients who developed MI, safety outcomes showed no significant increase in serious bleeding, atrial fibrillation or flutter, or adverse events with IPE. CONCLUSION: IPE significantly reduced MI across most subtypes and sizes in statin-treated patients with elevated triglycerides at increased cardiovascular risk. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT01492361.

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• 102 Use of blood pressure trends to predict severity of hypotensive episodes in neonates

  Paediatrics & Child Health · 2025-12-01

  articleOpen access

  Abstract Background Hypotension leading to circulatory insufficiency is a serious morbidity in neonates admitted to Neonatal Intensive Care Unit (NICU). Early recognition, and timely and appropriate treatment are essential to prevent adverse consequences. However, currently there are no early tools to predict episode severity to allow triaging of patients to higher level of care or intervention. Objectives This study aimed to look at trends in vital signs 6 hours prior to use of vasoactive agent and analyzed the relationship between the early trends and episode severity and outcomes. Design/Methods This was a retrospective cohort study at a tertiary care NICU in Southwestern Ontario that included all neonates who needed inotropic support between Jan 1, 2018, to Dec 31, 2022. Data regarding physiological parameters in the 6 hours prior to inotropic agent start were collected. Details of the episodes including number of vasoactive agents, doses, vasoactive inotropic score (VIS) and outcomes such as mortality were collected. The relationship between changes in vital signs (systolic blood pressure [SBP], diastolic blood pressure [DBP], mean blood pressure [MBP], heart rate and oxygen saturation index [OSI]) and episode severity (VIS) and mortality were examined. Repeated measures analysis of variance models was used to examine trends over time between age groups, and logistic regression models were used to examine predictors of dichotomous outcomes. Results 154 neonates were included in the study. 50.6% of cohort were &amp;lt;28 weeks,14.9% were 28-34 weeks and 34.4% were &amp;gt;34 weeks. Baseline characteristics and underlying etiology for hypotension are summarized in Table 1. On analysis of blood pressure values 6 hours prior to initiation of vasoactive agents (6-0hrs), we detected a significant declining trend over time in SBP, DBP and MBP for all neonates (Figure 1). The changes in heart rate and oxygen requirement were not significant in that 6-hour window. The logistic regression analysis showed that, for every 1-unit drop in SBP 6-0hrs, DBP 6-0hrs and MBP 6-0hrs, VIS increased by 0.30 (95%CI=0.50, 0.10), p=0.003; 0.32 (95%CI=0.56, 0.07), p=0.012; and 0.26 (95%CI=0.51, 0.01), p=0.044 respectively. Similar findings were recorded during the period of 3hours prior to initiation of vasoactive agents (3-0hrs) . Assessment of indices of oxygenation demonstrated that for every 1-unit increase in OSI 3-0hrs, VIS increased by 1.07 (95%CI=0.34, 1.80), p=0.005. Vital sign trends did not show a relationship to mortality as shown in Table 2. Conclusion This study shows that blood pressure drops significantly in the 6 hours prior to actual initiation of vasoactive medications. The rate of drop could successfully predict episode severity. Integrating the rate of hourly change in BP within routine vital monitoring algorithms could be clinically useful in managing vulnerable neonates.

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• Abstract 4370601: Efficacy of Icosapent Ethyl for Cardiovascular Risk Reduction by Aspirin Use in REDUCE-IT

  Circulation · 2025-11-03

  article

  Background: Icosapent ethyl, a purified eicosapentaenoic acid, has demonstrated CV risk reduction. Emerging evidence suggests that the antiplatelet effects of icosapent ethyl may contribute to this CV benefit. Hypothesis: Clinical outcomes with icosapent ethyl among patients with or without aspirin use have not been reported. This is an important evidence gap given the potential overlapping antiplatelet effects. Methods: REDUCE-IT was a double-blind clinical trial randomizing patients to icosapent ethyl (2g twice per day) or placebo. Statin-treated patients with elevated triglycerides (135-499 mg/dL), controlled LDL-C (41-100 mg/dL), and increased CV risk were included. In this analysis, patients with or without aspirin use were included and evaluated by randomization group. Patients were assessed overall as well as among the primary and secondary (prior CV disease) prevention cohort. The primary composite endpoint included events of nonfatal MI, nonfatal stroke, coronary revascularization, hospitalization for unstable angina, or CV death. The key secondary endpoint included events of nonfatal MI, nonfatal stroke, or CV death. Results: Among 8179 patients, 6179 (75.5%) were with aspirin use. Icosapent ethyl significantly reduced the primary endpoint events compared with placebo (67.3 vs 99.1 events/1000 patient-years [p-y]; Rate Ratio (RR): 0.69 [95% CI: 0.61, 0.77]; P&lt;0.0001), with consistent effects among those with aspirin use (70.2 vs 109.4 events/1000 p-y; RR: 0.64 [95% CI: 0.56, 0.74]) or without (57.9 vs 67.2 events/1000 p-y; RR: 0.85 [95% CI: 0.65, 1.11]) (Pinteraction[int]=0.15) ( Figure ). Similar benefits were observed with icosapent ethyl for key secondary composite endpoint events (Pint=0.20). Findings were numerically similar in the primary prevention cohort, though not statistically significant. Among 5785 patients in the secondary prevention cohort, icosapent ethyl similarly reduced primary endpoint events (78.8 vs 120.8 events/1000 p-y; RR: 0.65 [95% CI: 0.57, 0.74]; P&lt;0.0001), with consistency among those with aspirin use (75.9 vs 123.7 events/1000 p-y; RR: 0.61 [95% CI: 0.53, 0.70]) or without (95.6 vs 104.8 events/1000 p-y; RR: 0.89 [95% CI: 0.64, 1.23]) (Pint=0.12). Conclusion: Among patients with elevated triglycerides, controlled LDL, and high CV risk, icosapent ethyl reduced CV outcomes irrespective of aspirin use. These findings suggest icosapent ethyl has CV benefit incremental to concomitant background therapy with statins plus aspirin.

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• Effectiveness over time of a primary series of the original monovalent COVID-19 vaccines in adults in the United States

  PLoS ONE · 2025-05-06 · 1 citations

  articleOpen access

  With data from 2 US claims databases (Optum, CVS Health) supplemented with Immunization Information System COVID-19 vaccine records, we evaluated overall and time-specific vaccine effectiveness (VE) of an initial primary series for 3 monovalent COVID-19 vaccines-BNT162b2, mRNA-1273, and JNJ-7836735-in adults (18-64 years). Vaccinated individuals were matched to unvaccinated comparators, and we estimated VE against any medically diagnosed COVID-19 and hospital/emergency department (ED)-diagnosed COVID-19. Additionally, we estimated VE by era of predominant variants, in subgroups, and compared across vaccine brands. The cohorts consisted of 341,097 (Optum) and 1,151,775 (CVS Health) matched pairs for BNT162b2; 201,604 (Optum) and 651,545 (CVS Health) for mRNA-1273; and 49,285 (Optum) and 149,813 (CVS Health) for JNJ-7836735. The study period began 11 December 2020 (date of first COVID-19 vaccine availability in the US) and ended 15 January 2022 in Optum and 31 March 2022 in CVS Health. Summary VE estimates from meta-analysis against hospital/ED-diagnosed COVID-19 were: BNT162b2, 77% (95% CI, 76%-78%); mRNA-1273, 84% (95% CI, 83%-85%), JNJ-7836735 66% (95% CI, 63%-68%). VE estimates were higher for hospital/ED-diagnosed COVID-19 than for medically diagnosed COVID-19, and VE estimates were highest in adults receiving mRNA-1273 for both outcomes. VE was sustained for approximately 7 months for medically diagnosed and up to 9 months for hospital/ED-diagnosed COVID-19. VE differed by brand and variant era. Ongoing real-world surveillance of COVID-19 vaccines using robust data sources and methodology is needed as new variants and recommendations for updated vaccines have evolved.

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• Cardiovascular Outcomes With Icosapent Ethyl by Baseline Low‐Density Lipoprotein Cholesterol: A Secondary Analysis of the REDUCE‐IT Randomized Trial

  Journal of the American Heart Association · 2025-02-19 · 15 citations

  articleOpen access

  Background The efficacy of icosapent ethyl among patients with very well‐controlled baseline low‐density lipoprotein cholesterol (LDL‐C) is unknown. Methods In this post hoc analysis of the REDUCE‐IT (Reduction of Cardiovascular Events With Icosapent Ethyl–Intervention Trial) randomized clinical trial, statin‐treated patients with high cardiovascular risk, elevated triglycerides (135–499 mg/dL), and baseline LDL‐C of 41 to 100 mg/dL were included. Patients were randomized to icosapent ethyl (2 g twice daily) or placebo and then post hoc stratified by baseline LDL‐C (&lt;55 mg/dL versus ≥55 mg/dL). The primary composite end point included cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, coronary revascularization, or unstable angina. Results Among 8175 patients with baseline LDL‐C data, 7117 (87.1%) had LDL‐C ≥55 mg/dL and 1058 (12.9%) had LDL‐C &lt;55 mg/dL. In patients with LDL‐C &lt;55 mg/dL, the rate of the primary composite end point was lower in the icosapent ethyl group (16.2% versus 22.8%) than in the placebo group (hazard ratio [HR], 0.66 [95% CI, 0.50–0.87]; absolute risk reduction, 6.6%; P =0.003). Among patients with LDL‐C ≥55 mg/dL, a primary composite end point event occurred in a lower proportion of patients in the icosapent ethyl group (17.4% versus 21.9%) than in the placebo group (HR, 0.76 [95% CI, 0.69–0.85]; absolute risk reduction, 4.5%; P &lt;0.0001). No significant interaction was observed between baseline LDL‐C and treatment group ( P for interaction=0.40). Findings were consistent among secondary cardiovascular end points and in sensitivity analyses. Conclusions Among statin‐treated patients with elevated triglycerides and high cardiovascular risk, icosapent ethyl reduced the rate of cardiovascular end points irrespective of baseline LDL‐C, including among eligible patients with optimal LDL‐C control. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01492361.

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Recent grants

• NIH Grant R01HL061369

  NIH · $1.6M · 2006

• NIH Grant K07HL003926

  NIH · $789k · 2006

• NIH Grant I01CX000147

  NIH · 2014

• NIH Grant K07HL002263

  NIH · $524k · 1994

• NIH Grant R21HL094980

  NIH · $347k · 2011

Frequent coauthors

• Philippe Gabríel Steg

  Université Paris Cité

  195 shared

• Deepak L. Bhatt

  Cornell University

  115 shared

• Christie M. Ballantyne

  Baylor College of Medicine

  98 shared

• Jean‐Claude Tardif

  94 shared

• Eliot A. Brinton

  University of Colorado Denver

  82 shared

• Terry A. Jacobson

  Meridian Clinical Research

  80 shared

• Stephen S. Kroll

  74 shared

• Stephen Havas

  University of Maryland, Baltimore

  73 shared

Education

• MD

  Rutgers Robert Wood Johnson Medical School

  1983

Awards & honors

• IEEE Biomedical Engineering Thesis Award (1982)
• Johns Hopkins Paul Ehrlich Graduate Student Thesis Award (19…
• NSF Presidential Young Investigator Award (1986)
• Inaugural Johns Hopkins University Gilman Scholar (2011)
• Fellow of the American Institute for Medical and Biological…