Five areas of neurosciences research that could shape the future
King’s Health Partners Neurosciences share five examples of their current research focused on improving the lives of people living with neurological conditions.
It’s currently estimated that one in six people have one or more neurological conditions, with around 16.5 million cases in England. With the Maurice Wohl Clinical Neuroscience Institute, the National Institute for Health Research (NIHR)-Wellcome Trust King’s Clinical Research Facility, the Medical Research Council (MRC) Centre for Neurodevelopmental Disorders and the UK Dementia Research Institute at King’s College London, King’s Health Partners Neurosciences is well equipped to improve outcomes for people with neurological conditions.
When the Research Excellence Framework was carried out in 2014, there were a number of strong examples put forward to demonstrate the impact of research at King’s Health Partners Neurosciences. These include improved patient outcomes through the establishment of dedicated specialist units for stroke patients; the treatment of non-motor symptoms of Parkinson’s disease and widespread adoption of genetic testing for motor neuron disease.
Looking to the future, King’s Health Partners Neurosciences is on the cusp of forging more medical breakthroughs and has the potential to significantly improve lives for people with neurological conditions.
Prof Mark Richardson [pictured above,right], Joint Director for King’s Health Partners Neurosciences, has chosen five ground-breaking examples from the Institute to demonstrate the future impact of King’s Health Partners Neurosciences’ research.
1. Deeper understanding of brain disorders
Epilepsy, autistic spectrum disorders (ASD) and schizophrenia are three large groups of disorders caused by abnormal brain development, which can cause long-term effects and are very difficult to treat.
The MRC Centre for Neurodevelopmental Disorders, directed by Prof Oscar Marin, King’s Health Partners Neurosciences, brings together world leading researchers across King’s College London, with the mission to identify the underlying biological mechanisms in developmental brain disorders.
Currently treatments for brain disorders are based on symptoms, and the maximum response rate is 50%. Identifying disease mechanisms, such as cellular defects or network abnormalities, helps researchers to understand the cause of the disorder and develop targeted treatments. This knowledge has the potential to develop new treatments to change the lives of those living with epilepsy, ASD and schizophrenia.
2. Curing migraines
Data from the Migraine Trust estimates that the UK population loses 25 million days from work or school each year from migraines which is calculated to a cost of £2.25 billion per year. A King’s Health Partners Neurosciences team led by Prof Peter J Goadsby, developed a world-first treatment for migraine.
The team discovered calcitonin gene–related peptide (CGRP) plays a key role in migraine. It affects patients by modifying the transmission of pain signals in brain systems involved in migraine. During spontaneous migraine attacks CGRP is released from the trigeminal nerve, which is responsible for pain experienced in the head. Based on this discovery they worked with pharmaceutical companies to design a monoclonal antibody, and to develop an oral drug for this target, and then tested their efficacy through leading international multi-centre trials, which were published in the New Medical Journal of Medicine in 2017 and 2019.
Building on this bench to bedside research, several monoclonal antibodies have now been approved by the European Medicines Agency and the Food and Drug Administration in America for the treatment of headache disorders.
This research has the potential for high impact, as headache disorders are ranked globally as the second most disabling disease, and migraine is the leading cause of disability among all neurological disorders.
3. Repairing spinal cord injuries
A King’s Health Partners Neurosciences team, led by Prof Elizabeth Bradbury, runs pre-clinical research into spinal injuries. Recent research found that following initial spinal injury, structural molecules of the normal spinal cord (chondroitin sulfate proteoglycans) hinder spinal repair and cause inflammation.
Using a specially modified virus to deliver an enzyme called chondroitinase ABC, they found that the enzyme successfully broke down chondroitin sulfate proteoglycans, reducing secondary damage to the spinal cord.
If these promising findings successfully translate into humans, this would be a revolutionary for treating patients with spinal cord injuries in future. Spinal cord injuries result in loss of movement and sensation, and charities estimate that there are currently 50,000 people living with a spinal cord injury in the UK. This research could have a significant impact for tetraplegic individuals, for example, for whom recovery of hand function is an important determinant of independence.
4. Understanding genetic mutations in motor neuron disease (MND)
Prof Chris Shaw, from King’s Health Partners Neurosciences, leads work on the development of gene therapy for MND and frontotemporal dementia (FTD).
This study is built on the research he pioneered in understanding genetic mutations that cause MND and FTD.
While not all symptoms are shared between the two diseases, there is significant overlap in their genetic causes and underlying biology. His gene therapy programme will be based on the development of a modified virus that delivers the gene therapy.
Presently there are no treatments that cure such conditions, only treatments to relieve the symptoms, and it is estimated that MND affects up to 5,000 adults in the UK at any one time.
If successful at the pre-clinical stage, this therapy could pave the way to first human experimental studies and wider application for treatments for currently incurable neurodegenerative conditions.
5. Using AI to spot brain abnormalities
Dr Thomas Booth is leading research across teams at King’s Health Partners on developing an AI decision-making tool that identifies abnormalities on magnetic resonance imaging (MRI) brain scans.
The algorithm being trained in the study will use the wealth of existing neuroimaging data from King’s Health Partners.
We expect clinicians will be able to make faster and more accurate decisions and diagnoses about patients living with neurological conditions, for example more accurately monitoring the progress of a brain tumour following treatment, thanks to AI.
Prof Mark Richardson, Joint Director of King’s Health Partners Neurosciences, said:
King’s Health Partners Neurosciences is really well positioned in terms of the forward-thinking research ideas and methods it continues to innovate.
The unique research techniques we champion across our partnership, just like these five examples of superb work from my colleagues, will continue to enhance the experience of those at the heart of what we do in research – our patients.”
To discover more about how King’s Health Partners Neurosciences delivers outstanding research and education, and drive excellence in care and equity for patients with neurological conditions, visit the Institute’s webpages.