Thinking Ahead Helping protect your mind and brain

Transcription

1 Thinking Ahead Helping protect your mind and brain

2 Contents Introduction 1 Motor disorders 2 Stroke & cerebral palsy 4 Child development 6 Epilepsy 8 Cognition 10 Mental health 12 Ophthalmic disorders 14 Supporting our work 16 There is no scientific study more vital to man than the study of his own brain. Our entire view of the universe depends on it. Francis Crick (winner of the Nobel Prize for determining the structure of DNA)

3 Thinking Ahead The Institute of Neuroscience at Newcastle is one of the UK s leading centres for research into disorders of the brain and nervous system. Our aims are to understand the fundamental biology of brain and behaviour, and to develop innovative treatments for disorders that affect our senses, movement and mental wellbeing. In partnership with the local health trusts, our clinical staff are involved in the day-to-day care of patients, and the knowledge gained from this direct contact is at the heart of our advances in research. Our research takes place in modern laboratory facilities, and recent investments mean that we have access to some of the latest technology. As well as government research grants obtained from the Medical Research Council (MRC) and National Institute of Health Research (NIHR), the Institute is supported by funding from a wide range of research charities, including The Wellcome Trust and The Royal Society. We are also a highly international Institute with staff and visitors drawn to Newcastle from across the globe. But while we are doing well, we can always do better. Funding pressures mean that we cannot always support good ideas and the fast pace of innovation means that we are constantly looking to introduce new approaches that will take us closer to treatment solutions. In this brochure, we hope to give you insight into some of our recent successes and the vital challenges we still face, and to inspire you to help us conquer these challenges. Professor Colin Ingram and Professor Anya Hurlbert Directors, Institute of Neuroscience 1 Thinking Ahead

4 Motor disorders Changes to movement are often the first sign of a nervous system disorder, such as Parkinson s disease, multiple sclerosis, or amyotrophic lateral sclerosis. Often these changes are first detected as instability, perhaps as a tremor or as an occasional fall. While not all instability is caused by a progressive disorder, many cases are, and at the Institute of Neuroscience we have been developing new methods to diagnose disorders so that treatments can be delivered earlier and to greater effect. Our work has examined the cause of tremor and other motor disorders, such as dystonia, in order that we can develop ways to lessen the burden of impairment and improve the quality of life. As a complement to therapies based on drug treatments, we have been developing novel electronic devices that can interact with the nervous system in order to overcome deficiencies and to help with the rehabilitation process. Alongside these progressive disorders are motor disorders arising from acute injury, such as lesions to the spinal cord which can leave a patient unable to move a limb due to damage to the nerve connections. At the Institute we have been developing new technology, based on cuttingedge electronics and decoding of brain signals, that will bridge the area of damage and help restore function to otherwise paralysed limbs. Such technology has the potential to one day replicate at least a small part of the complex nervous system which controls movement. I wobble quite a bit and I find it hard to walk. It has had a huge impact on my quality of life. It would be a great thing for me and those in the same position if they can come up with a way of treating my tremor. Norma Riley 2

5 Our novel electronic devices enable accurate measurement of neural activity during movement. Our work with patients takes place in the laboratory and outside. We have developed techniques to measure changes in muscle and nerve activity during normal daily living, so that we can assess effectiveness of treatments and quality of life. 3 Thinking Ahead

6 What excites me about Limbs Alive is that it looks at the long term rehabilitation of the stroke survivor and for the first time with a rehabilitation treatment I ve had a great deal of fun! Stephen Simpson 4

7 Stroke and cerebral palsy Disruption to the blood flow or oxygen and nutrient supply can very quickly lead to brain damage, as happens in cerebral palsy in children or stroke in adults. At the Institute of Neuroscience we are working on ways to reduce the impact of such events and to aid the process of recovery. In cases of stroke it is widely accepted that the sooner treatment is provided the better the outcome. At Newcastle we are investigating the effectiveness of a range of acute interventions to minimize brain damage. Our neurosurgical team leads important international studies to evaluate different approaches to reduce bleeding and its consequences, in order to improve the clinical management of patients. Yet however quickly treatment is provided, stroke will usually leave people with some impairment which is commonly seen as difficulties in movement on one side of the body (hemiparesis). Through studying the normal pattern of impairment, researchers at the Institute deduced that particular repetitive exercises would help recovery, especially for actions that require both hands, and invented a series of action video games to aid rehabilitation. The Limbs Alive project provides a highly motivating way to deliver therapy in the home and at the same time offers a way to monitor patient improvement. This form of therapy is particularly engaging for children with cerebral palsy. Over many years we have undertaken detailed studies of how the brain develops and adapts in children with brain injury, and we now have the exciting prospect of making a step change for movement recovery through this new rehabilitation approach. We have designed specific tasks to measure movements and brain activity, and used this knowledge to develop award winning video games to help rehabilitation. 5 Thinking Ahead

8 Child development The development of the brain from a cluster of cells to an intricately-structured, multi-function organ is one of nature s most amazing achievements. Scientists are only just beginning to appreciate the complex processes that occur in development and the myriad ways in which the normal pattern can be disrupted. At the Institute of Neuroscience we are studying both typical development as well as developmental disorders that mould children for life. Through our work in studying behaviour and cognitive abilities during development, we are able to identify the early signs of conditions such as bipolar disorder, which are known to start during childhood and adolescence. One major focus has been on autistic spectrum disorders, which are typified by impaired social interactions and communication. We are delineating particular behaviours and cognitive processes at the core of this syndrome. We have contrasted these deficits with typical behaviour, and with another developmental disorder, Williams syndrome, which is typified by highly verbal and sociable behaviour. We have learned that the differences in the way these children look at faces may explain their differences in detecting social cues. In other work, we are exploring whether increased anxiety underlies repetitive behaviours. The Institute also hosts the International Molecular Genetic Study of Autism databases and DNA samples which are aiding our understanding of the genetic basis of autism spectrum disorders. Such genetic information informs our studies on how particular genes are expressed during early life and whether they contribute to differences in brain development. Working in the laboratory, in schools, and in the home environment, our researchers have developed new ways to assess how children think and acquire new skills. 6

9 It is fascinating to work with young children and discover more about the way they learn and develop. Whilst it can sometimes be a challenge to get them to cooperate with an experiment, that can also be a part of the rewarding experience! Dr. Debbie Riby Children engage with experiments that are designed to seem like play. 7 Thinking Ahead

10 I can spend time with my children without worrying that I ll have a seizure, thanks to getting the best treatment possible from my Newcastle doctors. Kim Armstrong 8

11 Epilepsy Most of us will know someone who has suffered an epileptic seizure - a relatively brief event when a wave of activity spreads across the brain causing involuntary movement and loss of consciousness. These seizures may be mild or major, and occur infrequently or, for a small number of people, every few hours. In all cases they affect people s lives. Fortunately, for most people epileptic seizures can be controlled by drugs and at the Institute of Neuroscience we are working to develop new treatments. We are also working to uncover the underlying causes of epilepsy. In some cases, these may be changes to energy pathways (metabolism) or the appearance of specific types of antibodies. Although drugs are effective, in some instances the only cure is to remove surgically the small area of brain that triggers the seizure activity. This is a major operation but one that is usually successful. In Newcastle many of the patients undergoing this procedure have given permission for us to study the abnormal tissue that is removed. Thus we have the unique opportunity to probe the abnormal tissue straight from the brain, and we apply state-of-the-art electrical recording techniques, alongside anatomical and molecular methods, to find out what has gone wrong. We are one of a very few places in the world undertaking this type of research, and our pioneering collaboration between basic scientists and surgeons will help define new treatments to lessen the impact of epilepsy and improve the quality of life. Our researchers use some of the latest recording techniques to study seizure activity both in the clinic and in the laboratory. 9 Thinking Ahead

12 Cognition It is easy to take for granted the multitude of things the brain does all of the time. Its teeming activity makes images out of light and music out of sound; it creates language, memories, and the power to decide. But when this activity falters, the disturbance goes to the core of being human and cannot be ignored. Using a variety of techniques, including magnetic resonance imaging (MRI) and electroencephalography (EEG), members of the Institute of Neuroscience are working to understand how the brain achieves complex cognitive abilities. We also want to understand how and why these abilities sometimes go wrong. For example, we have demonstrated that appreciating music involves areas of the brain specialised for pitch, timbre, and rhythm, and that dysfunction in these can lead to conditions like tone deafness or an inability to follow a simple beat. We are also exploring why is it that people sometimes perceive something that is not really there, as in tinnitus or visual hallucinations. Such cognitive disorders become more disabling when they affect the ability to comprehend language or to understand the social or emotional meaning of everyday things, such as laughter or interjections. These perceptual deficits can have major impact on health. For example, changes to the way that people perceive body shape may underlie such devastating conditions as anorexia. By shedding light on complex cognitive processes, we hope our research will offer new ways to tackle debilitating disorders of the mind and brain. Our researchers are world leaders in cognitive neuroscience and employ some of the latest techniques to examine how the brain is activated during cognition. 10

13 Advanced imaging techniques help us to reveal the brain networks that underlie cognitive processes, such as how hearing and seeing interact in understanding language. 11 Thinking Ahead

14 Mental health Mental health disorders are the most common disorders of the nervous system, but often some of the hardest to recognise and treat. The Institute of Neuroscience is investigating the brain processes that underlie major mental disorders, particularly affective disorders (depression and bipolar), anxiety, and schizophrenia. Our work also overlaps with colleagues in the Institute for Ageing and Health in tackling dementia. At Newcastle we have a long and successful history of research into depression and bipolar disorder, and in recent years have focussed on how these affective disorders disrupt the abilities to think straight and make decisions. Using MR imaging and EEG we are able to explore how these cognitive functions are affected even when the person feels well. These cognitive impairments are some of the things that those who suffer say have the biggest impact on their daily living, and we aim to target the things that matter to the patient. To this end, we are exploring the effectiveness and potential for new drug treatments as well as developing cognitive behavioural therapies. Alongside our clinical work we have a large programme of research on the brain mechanisms that might lead to mental health disorders and the way in which drugs are able to target specific deficiencies. This work involves evaluating how existing drug treatments work, such as lithium for mood stabilization, and looking at developing new drugs or novel ways that existing drugs may be used. Magnetic resonance imaging is one of the ways we are gaining greater insight into the relationship between brain changes and mental wellbeing. 12

15 I have taken part in research over many years and will continue to do so. The knowledge that I, in some small way, may help with the management of bipolar disorder in the future brings many benefits, not least of which is a great feeling of self-worth Gill Moore Our work investigates how psychiatric disorders can affect specific thought processes and whether new drugs can help recovery. 13 Thinking Ahead

16 The Institute is undertaking important work to determine the best way to treat children with squint (exotropia), whether that requires surgery, patching, or simply leaving the eye to correct itself. Working closely with the Ophthalmology Department in the Royal Victoria Infirmary, researchers in the Institute tackle disorders affecting the retina and eye movements. 14

17 Ophthalmic disorders More of the human brain is devoted to vision than to any other sense, and seeing is more than just the formation of images. Vision guides actions and helps to bind the other senses together, and in so doing forms the basis for knowledge. Research on vision at the Institute of Neuroscience covers the full range of the visual system, from what happens in the eye to how the brain interprets images and constructs an understanding of the world. Disorders of vision can affect both the young and the old. Our work in children has particularly targeted squint (exotropia), in clinical studies to determine the most effective treatment and in basic science studies of how the brain handles having two slightly different images of the world. This research also addresses the fundamental ability to use two eyes to see in depth. From our work it has also become clear that people don t all see things the same. For example, the perception of colour has been shown to vary both for normally sighted individuals and for those who carry genetic defects in photoreceptors. While the latter typically leads to colour blindness, surprisingly for a small number of people it can also lead to enhanced colour perception. However good the brain is at compensating for different views on the world, loss of function in the eye will lead to blindness. This can happen due to genetic disorders (retinitis pigmentosa) or ageing (macular degeneration). At the Institute we are working on novel approaches to overcome this blindness, including electronic implants that might replace the photoreceptors or stem cells that can restore lost cells. Colour blindness and colour perception are important topics in our work on vision and ophthalmic disorders. 15 Thinking Ahead

18 Supporting our work You can make a difference too Much of our work would not be possible without the support we receive from the public. As well as the patients who agree to let us study their conditions, many other people volunteer to be subjects for our studies. It is a chance to get some first-hand experience of research and we try to make the experience informative and fun. If you are interested in volunteering please visit our Get Involved web page ( Our work is also supported by generous financial donations to help run experiments, pay for research staff and students, and even to buy key equipment and refurbish laboratories to keep our work at the cutting edge. All donations, large or small, can make a big difference to what we can achieve. As examples, new research laboratories for studies of schizophrenia were enabled by funds from the Lena Teague Bequest, while a donation from the parent of a child with bipolar disorder provided much-needed funds to to help a PhD student complete his research. If you would like to discuss how your donation can make a difference you can do so by contacting the External Liaison Coordinator at the Institute of Neuroscience, Medical School, Newcastle University. Telephone: ion@ncl.ac.uk 16

19 Each year the members of the Institute are involved in a wide variety of activities to raise public awareness of neuroscience and research on brain disorders. These include activities in schools, public exhibitions, lectures, Science-Art activities, and many more. If you are interested in finding out more please contact us. 17 Thinking Ahead

20 Institute of Neuroscience Medical School Newcastle University Framlington Place Newcastle upon Tyne NE2 4HH United Kingdom Telephone: +44 (0) /5731 Fax: +44 (0)