Issue 15 Summer 2015

magazine

theNeuRANeuroscience Research Australia • neura.edu.au

STUDY: kids on quad bikes

iFOCUS prevents falls

2

4

5BRAIN INFLAMMATION

& schizophrenia

A new BOOST

for DEMENTIA RESEARCH

3page

‘What’s the fuss?’ A new community-led campaign to promote the Medical Research Future Fund (MRFF) and the importance of research to our future. Around Australia, celebrities, community and business leaders, patients and researchers explained ‘What’s the fuss?’ about many diseases and conditions. As I hope you will see on the television commercial, the fuss is that Australian medical research provides hope for new discoveries leading to better treatments and potential cures.

I have previously spoken about the importance of the MRFF, it is the investment that Australia needs. As a perpetual endowment fund, the MRFF will lead to many more medical discoveries and help make our health system more effective and efficient. The fuss is for all of us, for our future, and for the important role the MRFF will play. Please visit the website, whatsthefuss.org.au, listen to the stories, share the link, and share your personal stories as to ‘why medical research is important to you’.

NeuRA’s researchers have a proud history of accomplishments and our scientists continue to be acknowledged as recipients of impressive awards that value their achievements:

• Prof George Paxinos received the 2015 NSW Premier’s Prize for Science & Engineering for ‘Excellence in Medical Biological Sciences’ Prize for outstanding impact. George’s groundbreaking work on mapping the brain has, and continues to be used by most scientists working on the relationship between the brain and the diseases that affect it.

• Prof Glenda Halliday has been awarded the Elizabeth Blackburn Fellowship by the NHMRC for the highest ranked female applicant in the clinical category of the Research Fellowship scheme. NHMRC Research Fellowships provides the career support for our most outstanding researchers and we are delighted to have someone of Glenda’s calibre leading the team which is identifying factors that lead to degeneration of the brain in dementia patients. Read more about her research leadership in this publication.

As we approach the end of 2015, I’d like to wish you a wonderful festive season and thank you for your generous support this year. I look forward to sharing more of our news with you in 2016.

Message from our EXECUTIVE DIRECTOR

welcome

Neuroscience Research Australia (NeuRA) is a not-for-profit research institute based in Sydney, Australia. Our goal is to prevent, treat and cure diseases, disorders and injuries of the brain and nervous system through medical research. Find out more at neura.edu.au or call 02 9399 1000.

About NeuRA

Prof Peter R Schofield FAAHMS PhD DSc Executive Director and CEO

CAUSE OF EATING DISORDERS IN YOUNGER-ONSET DEMENTIA FOUND

A new study by Dr Rebekah Ahmed has revealed that abnormally high levels of a protein, called agouti-related

protein, are associated with an increased risk of developing an eating disorder in people with younger-onset dementia. A striking feature of frontotemporal dementia (FTD) is the

presence of an abnormal eating behaviour, where patients eat large amounts, develop strong preferences for sweet food and become rigid in their food choices. “Our study confirms that changes in dementia are not simply limited to memory

and cognition as previously thought,” says Dr Ahmed. “It not only highlights the potential key role of this protein in eating

changes in FTD, it also provides a potential target for treatment to modify the disease progression.”

03

01

TEACHING THE NEXT GENERATIONIn October Dr Lee Walsh worked with Sans Souci Public School

to run four science enrichment sessions. Eighty students of all grades performed a scientific investigation including

forming a hypothesis, collecting data, analysing their results and then sharing their findings with other students. Dr Walsh

provided scientific and technical support for the teachers and led discussions with students on the scientific method,

data analysis and interpretation.

02

If you would like to subscribe to our magazine, go to neura.edu.au/subscribe/mag. You can also email your details to magazine@neura.edu.au or call 02 9399 1000.

Subscribe

Editor: Chelsea Hunter Writers: Chelsea Hunter, Anne Graham

Photography: Anne Graham Designer: Kristian Molloy

Credits

STUDY AIMS TO PREVENT CHILDHOOD INJURIES OR DEATHDoctors are calling for children who ride motorbikes, quads and other off-road vehicles to participate in a new study aimed at preventing crashes and serious injury. The research follows on from a recent Queensland Coroner’s findings into quad bike deaths, which highlighted the potential risks of children riding motorbikes and quads. Dr Christopher Mulligan explains that, “unlike adults, children riding motorcycles and quads sometimes don’t have the physical strength, developmental or cognitive skills needed to safely operate large vehicles.” By taking a quick survey, parents can help us identify the biggest risk factors for crashing and the areas where we can prevent the most injuries. The survey can be found at www.neura.edu.au/offroad

COO JOINS NEURA NeuRA staff were pleased to welcome new Chief Operating Officer Nicola Ware to the executive ranks in July. Nicola brings over ten years management experience in medical research having been General Manager at the Melanoma Institute Australia since 2008 and previously Operations Manager at the Victor Chang Cardiac Research Institute from 2006-8.

NEW SCREENING TEST DEVELOPED FOR DEMENTIA A new bedside screening test will help doctors and clinicians to determine whether a dementia patient has Alzheimer’s disease (AD) or behavioural-variant frontotemporal dementia (bvFTD). The two disorders share clinical features and as a result bvFTD is often misdiagnosed as AD. However, the two dementias affect different brain regions and require vastly different management approaches. The FRONTIER Executive Screen (FES), developed by Assoc Prof Olivier Piguet gives medical professionals the confidence to make early, accurate diagnoses in a short time-frame. Rather than focusing on memory, the FES measures the integrity of complex thinking abilities, or ‘executive functions’, which can be measured in around 10 minutes by clinical staff, providing faster, more accurate diagnoses and more treatment management options.

04

0605

news

IN BRIEF

Cover Prof Glenda Halliday

01 Prof Peter Schofield

02 Dr Lee Walsh

03 Dr Rebekah Ahmed

04 Quad Bike Study

05 Assoc Prof Olivier Piguet

06 Nicola Ware

02

feature story

03

With more than 330,000 Australians currently living with dementia, there continues to be an urgent need to better understand this complex disease. Fortunately, this is an exciting time to be a researcher working on developing innovative ways to diagnose and treat the various dementias.

“Right now, as a group, we’re in a good position to make a real difference,” says Prof Glenda Halliday.

THE FUTURE OF DEMENTIA RESEARCH

As part of the Federal Government’s Boosting Dementia Research Initiative, Prof Hallliday and the team she leads have been awarded one of six Dementia Research Team Grants. These five-year grants, will provide support for teams of researchers to pursue collaborative research, promote effective translation of research, and develop capacity under a dementia research priority framework.

Prof Halliday is looking specifically at the non-Alzheimer’s disease dementias, such as frontotemporal dementia and

dementia with Lewy bodies, which are often not correctly diagnosed. “If you have a dementia syndrome, people are more likely to call it Alzheimer’s disease,” she says, and estimates that for every 1000 patients clinically diagnosed with Alzheimer’s disease, just over half have the tissue pathology of Alzheimer’s disease and about a third have a non-Alzheimer dementia.

This is a figure that can only be arrived at via autopsy, so it is critical to find a way to accurately differentiate and diagnose the dementias earlier to ensure that the best treatment is provided.

“The interesting thing with Alzheimer’s disease is that its progression is very slow and the majority of people will get it late in life. With non-Alzheimer’s dementias, people get it earlier on in life and its progression is fast. So we really do need to develop a way to identify a dementia earlier for those people.”

The number of Australians with dementia is predicted to grow to more than one million people in the next 40 years. NeuRA researcher Professor Glenda Halliday believes we’re in a better position than ever before to discover how to diagnose the many different dementias and reduce the number of people who will be affected in the future.

T H E

differenceb e t w e e n t h e

dementias

01

To achieve this goal, Prof Halliday will lead a collaborative group of ten teams from five different organisations as they study families with non-Alzheimer’s disease dementias for the next five years. Their aim is to identify the genes involved, possible biomarkers to aid in diagnosis, and the different pathways each disease takes as it progresses.

“We’re looking at families because researchers studying Alzheimer’s disease have been able to identify early indicators so that we can treat people before the disease has an effect on the brain,” says Prof Halliday. “We’d like to achieve the same outcome for other dementias. Certainly over the next five years we’ll know more about what differentiates non-Alzheimer’s dementias from Alzheimer’s.”

CELEBRATING WOMEN IN RESEARCH

Prof Halliday was also recognised with the award of the Elizabeth Blackburn Research Fellowship. This annual prize acknowledges the research accomplishments and potential of top female scientists in the clinical, public health and biomedical sciences, while taking into account their international profile and the mentoring they provide to junior researchers. The fellowship, which has been named in honour of Australian Nobel Laureate Professor Elizabeth Blackburn, is the only national research award for women.

The NHMRC Elizabeth Blackburn Fellowships were first introduced in 2011 to foster the career development of female scientists, a move that Prof Halliday endorses.

“In a career, women usually have to take time out for having families and that means their career doesn’t have a normal trajectory. So when they come back in, their compatriots look like they’re streets ahead,” she explains.

By highlighting the career paths of women such as Prof Halliday, it is hoped that younger female scientists will be inspired to remain working in research. “The NHMRC knows that a lot of women are lost to the scientific workforce,” she agrees, “and there are more female PhD students than male, but not as many women use their PhD in the senior workforce for a variety of reasons. Creating this award helps provide role models so that women are reminded to keep pursuing their career path.”

Building on participants’ cognitive strengths and abilities is the innovative approach the iFOCIS research team is using to tackle falls prevention for people with dementia. In this group of people, falling occurs twice as often as those without dementia and the impact can be significantly worse: fractures are up to three times more common, 26% of admissions to hospital for people with dementia are fall related. Despite the need for intervention to prevent falls in this group of people in the community, there are no proven effective strategies known to date.

John is a retired public servant who has joined the iFOCIS study. He has vascular dementia and recently fell while walking down the stairs at the movies. Luckily he did not sustain any injuries, but he decided that falls prevention research was a good idea. John saw the occupational therapist (OT) who identified his cognitive strengths and developed a tailored exercise program that matched his physical abilities. It was taught in a way that John was easily able to understand. The OT assessed John’s home to identify any fall hazards and the physical therapist upgraded John’s exercises as his strength and balance improved.

Finally, John’s friend who helps out with the exercises, also has a session with the OT to talk about practical ways to manage living with dementia and to encourage John to complete his exercises. All visits are in John’s home so it makes it easier for him to participate over the 12-month randomised controlled trial.

John’s individual program is typical of what people allocated to the intervention group receive. Exercises are tailored to physical abilities and the way the program is delivered is based on cognitive abilities. The latter is the novel approach that the trial is investigating, and means that people with very different stages of dementia can be enrolled in the study. Both the intervention group and the control group record any falls in a monthly calendar and the two groups will be compared to determine if the intervention is successful in reducing falls.

To the following researchers whose continued dementia research has been supported by the award of NHMRC-ARC Dementia Research Development Fellowships. NeuRA was successful in attracting 1 in 10 of these highly competitive awards.

• Dr Surabhi Bhatia• Dr Rachel Tan• Dr Fiona Kumfor• Dr Cristian Leyton

• Dr Adam Martin• Dr Sivaraman Purushothuman• Dr Kylie Radford• Dr Morag Taylor

01 Prof Glenda Halliday with Dr Nic Dzamko

03 Jackie Wesson with trial participant John

02 Prof Glenda Halliday

04

02

newsA focus on PREVENTING FALLS

Congratulations

“Right now, as a group, we’re in a good position to make a real difference.”

03

The book details how her quick descent into psychotic-like symptoms was reversed once she was treated with anti-inflammatories. Susannah’s ‘cure’ provided extra incentive for Dr Weickert to keep exploring this idea.

His current clinical trial aims to identify people with schizophrenia who have signs of inflammation markers in their blood. It is thought that an anti-inflammatory treatment may reduce their symptom severity and restore thinking skills.

His research may even have benefits for people with depression or bipolar disorder.

IS THE LINK BETWEEN SCHIZOPHRENIA AND INFLAMMATION IN THE BRAIN BEING DISCUSSED MUCH IN ACADEMIC CIRCLES?It is being presented more and more often at conferences and meetings, with whole sessions devoted to the topic.

There are also many more articles published in scientific journals. However, the idea of inflammation being relevant to people with schizophrenia is also very controversial since there is debate as to whether the inflammation is causative of schizophrenia or simply a by-product of the illness.

The answer is presently unknown, but I think it could be both. It could be causative in some people but a by-product of the illness in others. Either way, it would be treatable.

WAS THE IDEA OF A LINK A GRADUAL ONE OR A ‘LIGHTBULB MOMENT’ FOR YOU?

It was a bit of both due to the research reporting that inflammation may be a factor in schizophrenia, as well findings from our labs of inflammation in schizophrenia and this book which showed that inflammation may cause psychotic symptoms in at least some people and that it was not only treatable but there could actually be a cure for some people.

WHO ELSE MIGHT BENEFIT FROM THIS KIND OF RESEARCH?

It could also be beneficial to people suffering from schizoaffective disorder, bipolar disorder, (anyone with psychosis) and depression.

As is so often the case for many people with mental illness, the cause is usually uncertain and the diagnosis can change over time, which is what happened to Susannah Cahalan in Brain on Fire.

I think this often happens because our diagnostic system for mental illness doesn’t tap into the cause of the illness.

By performing a more extensive and thorough biological assessment that includes testing for measures of inflammation, we may be able to find more appropriate and therefore, beneficial treatments for some people suffering from psychotic symptoms and depression.

HAVE THESE FINDINGS REGARDING INFLAMMATION IN SCHIZOPHRENIA INFLUENCED THE DESIGN OF YOUR NEW TRIAL? Our new treatment trial is unique in that it screens participants to identify which people have inflammation markers in their blood samples. If found, these people can then enter the trial in which they may receive the specific “designer” treatment aimed at blocking the markers of inflammation, which has been shown to reduce symptoms of other immune-related illnesses.

HOW MIGHT THIS CHANGE THE WAY WE TREAT SCHIZOPHRENIA?

It could completely revolutionise the treatment of schizophrenia. Instead of targeting the so-called fast-acting neurotransmitter molecules such as dopamine, this new treatment targets part of the immune system response (a cytokine receptor) which may be overactive in some people with schizophrenia and would cause damage to the brain.

So, ideally, all people with schizophrenia could be screened using a blood test for these elevated inflammation markers and if the elevated markers are present then the person could be treated with this inflammation-reducing treatment, which could substantially reduce or possibly even eliminate symptoms and restore thinking abilities in some people with schizophrenia.

DR TOM WEICKERT5

minutes with

01

05

Dr Tom Weickert had already started to research the link between psychosis and inflammation of the brain when he came across Susannah Cahalan’s memoir, Brain on Fire: My Month of Madness.

Your support this year, whether it be donating, running a marathon, cycling through Cambodia, playing Bridge, deciding to leave a gift in your will or signing up to See it Through to a Cure, has allowed great research to continue.

One of the areas where your donations have had the greatest impact, is in supporting our best and brightest PhD students with scholarships. This support allows them the freedom to spend all their time on research and less on worrying about ‘how to pay the bills’.

PhD students form an integral part of the research community at NeuRA, and are tomorrow’s leaders in brain and nervous system research. We currently have students studying under the supervision of a NeuRA faculty member in almost every research group covering many disease areas including: dementia, Parkinson’s, schizophrenia, autism, falls prevention, sleep apnoea and stroke rehabilitation to name a few.

Their youthful enthusiasm injects a new source of energy into the projects that they are involved in and their fresh outlook often challenges their superiors, which ultimately enhances the quality of our research.

Your support means that NeuRA can currently award 32 PhD students with either full or supplementary scholarships. One of the recipients who currently receives a supplementary scholarship is Rosi Hutchings.

Rosi is in her first year as a PhD student, and is fascinated with ageing and dementia. Her PhD, Face processing in frontotemporal dementia (FTD), is investigating the causes of why some people with FTD show impaired recognition of facial expressions. Understanding more about this will help provide better health outcomes for patients living with the illness.

01 Dr Tom Weickert 02 PhD student Rosi Hutchings

01

02

06

Your donations AT WORKWhat you have done for NeuRA in 2015 is amazing!

making a

difference

P

• Mail this coupon in the reply paid envelope

• Call us on 1300 888 019 to make a donation over the phone

• Make a secure online donation at neura.edu.au/donate

• Fax this form (02) 9399 1082

Thank you for generously supporting our research into diseases of the brain and nervous system.

Bes

Visa Mastercard American Express Diners

$50 $100 $250 or

Step 2: My gift:

Step 3: How to make a donation

card

Step 1: How I choose to give my gift:

A message from the NeuRA Foundation: The NeuRA Foundation may co-operate with other like-minded reputable Australian charities to promote our work to our respective donors. If you’d prefer that NeuRA does not share your information with other charities, please phone us on1300 888 019, email us at foundation@neura.edu.au or write to us using the enclosed envelope.

DONATION & RESEARCH VOLUNTEER FORM

P

• Mail this coupon in the reply paid envelope

• Call us on 1300 888 019 to make a donation over the phone

• Make a secure online donation at neura.edu.au/donate

• Fax this form (02) 9399 1082

Thank you for generously supporting our research into diseases of the brain and nervous system.

Bes

Visa Mastercard American Express Diners

$50 $100 $250 or

Step 2: My gift:

Step 3: How to make a donation

card

Step 1: How I choose to give my gift:

A message from the NeuRA Foundation: The NeuRA Foundation may co-operate with other like-minded reputable Australian charities to promote our work to our respective donors. If you’d prefer that NeuRA does not share your information with other charities, please phone us on1300 888 019, email us at foundation@neura.edu.au or write to us using the enclosed envelope.

DONATION & RESEARCH VOLUNTEER FORM

Click on the icons on our website to view.Neuroscience Research Australia, Margarete Ainsworth Building, Barker Street, Randwick NSW 2031

Phone: 02 9399 1000 Email: info@neura.edu.au Website: neura.edu.auTo make a donation in support of our research, call 1300 888 019 or go to neura.edu.au/donate

Scientists discovered some time ago that they

could use magnetic resonance imaging (MRI) to map brain

activity when a person was repetitively

performing a task, such as looking at flashing lights or doing serial

math calculations.

More recently, they found that these MRI signals provide useful information when the scanned subject was not doing anything. They called these signals ‘resting state’ signals.

These signals come from consistent areas of the brain that are co-activated by tasks, suggesting a functional organisation. Brain function information could be quickly extracted with little input from the patient. The potential for use as a diagnostic and therapeutic monitoring technique, as well as a research tool, is huge.

However, the data consist of time series obtained from multiple ‘voxels’ in the brain - there are millions of data points with both spatial and temporal components. Extracting coherent information from this mass of data is a challenge.

This new analysis approach for resting state data uniquely provides repeatable, reliable results from single scanning sessions.

To better visualise the data, Prof Caroline Rae and team, with Prof Paul Bourke from the UNSW EPICenter, have constructed 3D brain representations of brain networks with the link repeatability indicated by the colour (red means more repeatable) and thickness (the thicker, the more repeatable) of the links.

The volume of individual brain parcels is indicated by the size of the sphere. They are now developing methods for network comparison and applying new approaches across a targeted range of patient data.

FUNCTIONAL networks in the brain

in focus