UCL Institute of Neurology

24 December 2010: New hope for cluster headache sufferers

The pain of cluster headaches (CH) is notoriously excruciating and usually described as one of the most distressing conditions known to mankind. Female patients describe attacks as worse than childbirth and patients are occasionally driven to suicide. Attacks last between 15 minutes and three hours and can occur up to eight times a day.

For a small group of CH patients there has been no solution. Until now.

The treatment, known as deep brain stimulation, is already used to treat other neurological conditions such as Parkinson’s disease and dystonia. In CH patients, it is used to target a part of the brain (the posterior hypothalamus) which is overactive during the headaches. An electrode is inserted into the brain and linked to a stimulator under the chest. When the stimulator is switched on, an electric current passes into the brain, blocking the damaging signals that cause cluster headaches.

This new method of treating cluster headaches follows on from pioneering research at Queen Square, where the NHNN and the nearby Institute of Neurology at UCL are housed.

The research, which goes back a decade, pinpointed a particular region of the brain (the posterior hypothalamus) and studies revealed the presence of increased blood flow in this region during a cluster headache attack, a sure sign of increased activity.

Early pilot results of DBS in a small number of patients with unremitting chronic cluster headaches were very encouraging and this led two consultants, neurologist Manjit Matharu and neurosurgeon Ludvic Zrinzo to introduce the procedure at the NHNN.

Mr Matharu and Mr Zrinzo said: “We are really excited about the early indications from using DBS in this way. Patients who suffer from this excruciating condition come to us at their wits’ end and for many of them we are a last resort. Unless you have experienced cluster headaches you cannot underestimate the impact they have on the lives of sufferers and their families. If we can help them in any way it’s immensely rewarding,” they said.

read more >> UCLH News | BBC News including film footage

24 December 2010: IoN Student wins Santander Formula One Scholarship

Martin, who is Argentinian, says he was surprised and delighted to receive this prestigious scholarship, established to mark the bicentennial celebrations of Argentina, Chile, Colombia and Mexico.

The scholarships are awarded to the academically best candidate accepted for study at UCL from each of the ten Santander network countries.

The MSc Clinical Neurology programme is an intense one year academic course based in Queen Square for clinicians from around the world.

read more >> Santander Master's Scholarships | MSc in Clinical Neurology

22 December 2010: Alzheimer’s changes detectable in healthy elderly

The approach could allow scientists to test treatments or preventions far earlier in the disease, when experts believe they could be more effective.

The findings of the study are published online this week in Annals of Neurology.

The researchers studied 105 cognitively normal individuals from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). They split this group into those with high and low levels of cerebrospinal fluid (CSF) amyloid, a protein which is typically reduced in the CSF of patients with Alzheimer’s disease.

MRI scan measurements over 12 months were used to calculate the brain shrinkage rate. The team also checked other characteristics such as the presence of known Alzheimer’s risk gene APOE4.

The results revealed that the brains of those normal individuals with low CSF levels of amyloid (38% of the group), shrank twice as quickly as the other group. They were also five times more likely to possess the APOE4 risk gene and had higher levels of another culprit Alzheimer’s protein, tau.

Study lead author Dr Jonathan Schott from the Dementia Research Centre (UCL Institute of Neurology) said: “In this study of healthy people in their 70s and 80s we found that about one in three had a spinal fluid profile consistent with Alzheimer’s disease. Using MRI scanning, we showed that these individuals also had increased brain shrinkage over the following year.

“The significance of these findings will only be clear with longer clinical follow-up, but may suggest that these individuals are at increased risk of developing dementia. If so these results add to a growing body of work suggesting that Alzheimer’s disease starts many years before the onset of symptoms.”

Rebecca Wood, Chief Executive of the Alzheimer’s Research Trust, the leading UK dementia research charity, said: “We are hamstrung by our inability to accurately detect Alzheimer’s, but these findings could prove to be pivotal. Spotting Alzheimer’s early is essential to the global research effort to beat the disease. We know that treatments for many diseases can be more successful if given early and this is likely to be true for Alzheimer’s. It will be crucial to keep following the study group to see how many develop Alzheimer’s, and to expand the research to test the approach further.

“Findings like these underline the importance of research, but detecting Alzheimer’s is only the first step. If we are to defeat the disease, we must invest in research into preventions and treatments now before our dementia crisis spirals out of control.” More...

15 December 2010: Fighter pilots' brains are ‘more sensitive

The study, published today in the Journal of Neuroscience, compares the cognitive performance of 11 front-line RAF (Royal Air Force) Tornado fighter pilots to a control group of a similar IQ with no previous experience of piloting aircraft. All the participants completed two ‘cognitive control’ tasks which were used to investigate rapid decision making. Diffusion tensor imaging (DTI), a type of MRI brain scan, was then used to examine the structure of white matter connections between brain regions associated with cognitive control.

The researchers found that fighter pilots have superior cognitive control, showing significantly greater accuracy on one of the cognitive tasks, despite being more sensitive to irrelevant, distracting information. The MRI scans revealed differences between pilots and controls in the microstructure of white matter in the right hemisphere of the brain.

Senior author Professor Masud Husain, UCL Institute of Neurology (Department of Brain Repair and Rehabilitation) and UCL Institute of Cognitive Neuroscience, said: “We were interested in the pilots because they’re often operating at the limits of human cognitive capability – they are an expert group making precision choices at high speed.

“Our findings show that optimal cognitive control may surprisingly be mediated by enhanced responses to both relevant and irrelevant stimuli, and that such control is accompanied by structural alterations in the brain. This has implications beyond simple distinctions between fighter pilots and the rest of us because it suggests expertise in certain aspects of cognition are associated with changes in the connections between brain areas. So, it’s not just that the relevant areas of the brain are larger – but that the connections between key areas are different. Whether people are born with these differences or develop them is currently not known.”

The study tasks were designed to assess the influence of distracting information and the ability to update a response plan in the presence of conflicting visual information. In the first task, participants had to press a right or left arrow key in response to the direction of an arrow on a screen in front of them, which was flanked by other distracting arrows pointing in different directions. In the second task, they had to respond as quickly as possible to a ‘go’ signal, unless they were instructed to change their plan before they had even made a response.

The results of the first task showed that the expert pilots were more accurate than age-matched volunteers, with no significant difference in reaction time – so, the pilots were able to perform the task at the same speed but with significantly higher accuracy. In the second task, there was no significant difference between the pilots and volunteers, which the authors say suggests that expertise in cognitive control may be highly specialised, highly particular to specific tasks and not simply associated with overall enhanced performance.

These findings suggest that in humans some types of expert cognitive control may be mediated by enhanced response gain to both relevant and irrelevant stimuli, and is accompanied by structural alterations in the white matter of the brain.

The research was supported by funding from the Wellcome Trust, the Medical Research Council and the NIHR Specialist Biomedical Centre at UCL/UCLH NHS Trust
More...

10 December 2010: World-leading scientist secures funding for gene research

Professor John Hardy FRS and his team at the UCL Institute of Neurology (Department of Molecular Neuroscience) , are beginning an ambitious new study that will see them attempt to identify genes that increase the risk of developing Alzheimer’s.

Funded by a £346,000 grant from the Alzheimer’s Research Trust, Prof Hardy plans to sequence every gene in 500 people with Alzheimer’s, and will compare them with the genes of healthy people.

Their work will reveal the genetic changes responsible for Alzheimer’s, giving doctors a better chance of predicting who is at risk of developing the disease.

Prof Hardy said: “Britain has played a leading role in research into the genetics of Alzheimer’s disease, and already we are beginning to make real progress. This study should give us a much greater understanding of the causes of Alzheimer’s, and should also tell us more about how we can intervene and stop the disease progressing.”

read more >>  Alzheimer's Research Trust press release

3 December 2010: New brain imaging tests to track Huntington’s

29 November 2010: 2010-11 IoN PhD Studentship Round Now Open

14 October 2010: Parkinson's UK Fellowship Award

8 October 2010: Study results consistent with earlier estimates of vCJD prion prevalence in Britain

8 October 2010: IoN scientist lands £329k funding boost from dementia research charity.

20 September 2010: Scientists identify link between introspection and brain structure

13 September 2010: Stents may double the risk of stroke in patients over 70

10 September 2010: Epilepsy prizes

10 September 2010: Developing a cell library resource for dementia research

27 August 2010: Lizard venom offers hope for Parkinson’s disease patients

27 August 2010: Research shows that two heads are better than one

9 August 2010: Win for IoN at Shape of Science Symposium

29 July 2010: Wellcome Success

18 June 2010: Brain study reveals that agreement is rewarding

17 June 2010: Queen's Birthday Honours

14 June 2010: New website to help stroke survivors learn to read again

6 May 2010: Elections to the Academy of Medical Sciences Fellowships announced

28 April 2010: St Peter's Medal for Professor Clare Fowler

23 April 2010: Researchers to study how the brain 'rewires itself'

23 April 2010: Robot trainer to benefit stroke patients