Dr Coco Newton on what navigation and virtual reality tests reveal about dementia
Dr Coco Newton is a neuroscientist at the UCL Institute of Cognitive Neuroscience who focuses on finding ways to detect dementia earlier.
Dr Newton’s earliest ambition was to be an architect, but she was swayed towards neuroscience by an inspirational biology teacher at school. Later, an opportunity to do a year in industry during her biomedical science degree steered her career in an unexpected direction. Instead of working in a pharmaceutical company, Dr Newton decided to gain experience as an academic. Interested in how to combine her lifelong interest in architecture with her studies in neuroscience, she became intrigued by the field of navigation and how we orient ourselves in space.
This led her to work as a research assistant with Professor Hugo Spiers from UCL’s Division of Psychology and Language Sciences. One of Professor Spiers’s projects involved studying London taxi drivers’ brains to uncover clues that might help understand Alzheimer’s disease.
Dr Newton began to investigate a region of the brain known as the hippocampus. The hippocampus plays a key role in spatial memory, enabling us to navigate and remember directions. More importantly, it could also shed light on the earliest stages of Alzheimer’s disease.
Dr Newton explains that the hippocampus appears to be an area of the brain where neurodegeneration first begins to develop – long before the onset of symptoms. She first designed mazes to test navigation in rats, and then shifted the focus to people. Taxi drivers, given their expertise in dealing with the cognitive demands of navigating complex street layouts, were an obvious choice for human studies.
Detecting Alzheimer’s early is critical to the future success of treatments that could delay, or ultimately even prevent, the condition.
“Early diagnosis has always been important since we realised that the pathology of dementia begins many years before symptoms start to develop,” Dr Newton explains. “But it’s only in the six months or so that this has become critical because we've recently had clinical trials that have shown that certain drugs might actually be able to slow down the disease if people receive them early enough.”
One tool that proved to be transformative is virtual reality. Dr Newton says that with the advent of wearable technology and digital health, it’s becoming easier to measure people in their everyday lives. This helps researchers understand how our brains interact with our environments, and spot when things go wrong.
Professor Dennis Chan from the UCL Institute of Cognitive Neuroscience specialises in using virtual reality to understand how to recognise early symptoms of dementia. Dr Newton undertook her PhD with Professor Chan, and they worked on a project using virtual reality to show that people at risk of Alzheimer’s disease have impaired spatial navigation prior to problems with other cognitive functions.
They found that it was a specific type of navigation behaviour that is impaired in dementia. Dr Newton explains that key to this is our ability to remember a location only using ourselves as “self-motion information”. She explains: “Imagine walking around in a desert and it's completely featureless. After taking a series of turns you need to try and walk the shortest path back to where you started by integrating the previous paths you’ve taken into a ‘homing signal’. That's the type of behaviour that we're testing.”
“The reason why we used virtual reality is because if you think about navigation as behaviour, it's a functional everyday behaviour. We have to walk around to get to places. It's very different from current clinical tests where you need to make people sit down with a pen and paper.”
She adds: “This really brought our research to life because we had in essence a test that could pick up on the clinical changes in people much earlier than these gold standard pen-and-paper tests.”
Virtual reality environment: photo by Dr Andrea Castegnaro
Now holding an interdisciplinary Schmidt Science Fellowship, Dr Newton has recently started to look at how we can transform our health systems, which she feels are unprepared to deal with the growing problem of dementia in an ageing population. A big challenge, she says, is getting people into the clinic in the first place. She believes there’s a huge need for better public health awareness. Helping people recognise early symptoms and removing some of the stigma and fear could lead to earlier diagnosis and hopefully better outcomes.
Another area of interest is spinning out research in dementia diagnostics and therapeutics. “Publishing research is all well and good, but it’s not actually going to make a difference to people if no one does anything with it,” she explains.
Dr Newton believes a holistic approach is ultimately what we need to tackle the challenge of dementia. “If you really want to advance dementia research, you have to approach it from multiple angles. Combining the neuroscience approach and the health systems approach and the entrepreneurship approach is important, as is thinking about the role of digital technology. I think that harnessing all these elements in one research group is how we stand the best chance of making progress.”
