Conferences and symposia are a crucial part of the research world – not only for the amount of knowledge that is communicated to large audiences but also for the exchange of ideas on a more inter-personal level. Novel ideas are created there as well establishment of collaborations that might lead to new research projects and clinical trials – all in all, putting a bunch of researchers in a venue with a projector, coffee and biscuits can only lead to good things!
One of the recent events that I had the pleasure to attend was a small-scale conference – the Mini-Symposium on generic disease mechanisms in MND and other neurodegenerative disorders. Held at the Brighton and Sussex Medical School in late June, this event was a precursor to the inauguration of a new MND Care and Research Centre for Sussex, directed by Prof Nigel Leigh.
The whole day was filled with excitement and friendly atmosphere from the very beginning, when all attendees gathered in the lobby for registration and had a chance greet their colleagues from other institutions, all the way to the very end. Throughout the day, we heard a number of interesting talks, ranging from transport mechanisms within cells, models of MND to development of medicine strategies. The string of talks was concluded by the final talk from Prof Dame Pamela Shaw, who took us on the MND journey so far and the future therapeutic prospects.
As scientific conferences are usually full of scientific jargon that might often seem as encrypted code language, I decided to explain to you some of the exciting research that I heard at the Mini-Symposium in a more ‘user-friendly’ language.
How things flow in a motor neurone (aka ‘Intercellular transport and trafficking’)
Dr Majid Hafezparast started the first session of talks by introducing what we already know about the different ways that cell nutrients are carried along motor neurones. This can either be from the cell body along the axon, a long neuronal projection, to the cell ending (ie anterograde movement) or the other direction (ie retrograde movement). Both kinds of transport are crucial for healthy functioning of the cell and for some reason, the retrograde movement is affected in MND. Studies done on mice, conducted by Dr Hafezparast and his colleagues, showed that this defective retrograde transport is present long before any symptoms can be observed, similarly to other neurodegenerative disease such as frontotemporal dementia, Alzheimer’s or Parkinson’s disease. Repairing this glitch in axonal transport might therefore be the next focus of pharmacological studies in order to develop new therapeutic strategies.
Using measures of cognitive and behavioural changes as MND biomarkers
While I get excited about all kinds of research topics, neuropsychological research is the one that has a special place in heart. It is perhaps the connection between various tests that look at person’s cognitive (ie thinking) skills and behavioural patterns and what is actually happening in the brain on a cell basis (this is usually investigated using imaging methods, such as electroencephalogram; EEG, or magnetic resonance imaging; MRI) that makes me so excited about this area of research.
The talk by Dr Marwa Elamin focused on the importance of neuropsychological testing as a way to help predict disease progression in MND patients. She highlighted that, aside from the motor system, MND is also associated with changes in behaviour and cognition in up to 50% of people living with the disorder. These changes are mainly decreases in executive functioning, which includes impaired decision-making, reasoning or abstract thinking. Building on this knowledge, Dr Elamin and her colleagues from Trinity College Dublin reviewed neuropsychological test results of a large number of people with MND, to see if there are differences in the way people with MND process certain tasks. Their results showed specific patterns of cognitive and behavioural changes for different groups of MND patients (eg people with slow vs fast progressing MND), which means that clinicians could use a series of simple neuropsychological tests early on after diagnosis to reliably predict a patient’s prognosis (ie how the disease will progress). This is a very exciting finding as MND tends to be very unpredictable in the way that it progresses – neuropsychological testing could act as a kind of a biomarker that will make this prediction easier.
You can read the original research paper here, or for information on cognitive change, read our booklet on Cognitive change, frontotemporal dementia and MND or our information sheet How do I support someone if the way they think is affected?.
We believe in MIROCALS
One talk that was a must at this Mini-Symposium was that by Prof Nigel Leigh, the UK project leader of the clinical trial MIROCALS (Modifying Immune Responses and Outcomes in ALS). This long-awaiting clinical trial has recently recruited its first patient and Prof Leigh took us through the rationale of the trial and the recruitment process. We have already put together an information sheet informing about the mechanisms of the trial, which you can view here. One of the ways this clinical trial differs from others is the need for the participants to not have previously or currently been taking riluzole and only a recent onset of MND (within 24 months). The reason for this criterion is so that we can observe changes in biomarkers in the blood and cerebrospinal fluid (CSF) in response to riluzole, providing more insight into the beneficial effects of this treatment (riluzole will be provided to the participants at the start of the trial).
The clinical trial will also involve a secondary study that will look closely on biomarkers that we can obtain using magnetic resonance imaging (MRI). The aim of this study is to increase our understanding of how and why brain cells become damaged in ALS, and especially look at the importance of neuroinflammation in the development and progression of the disease.
MND – the story so far…
In the final talk of the mini-Symposium, Prof Dame Pamela Shaw from the Sheffield Institute of Translational Neuroscience (SITraN) gave an overview of the current and prospective therapeutic strategies to help us tackle MND, summarising the focus of many studies on the role of supportive glial cells – astrocytes – in the death of motor neurones, as these have been shown to be potentially toxic in SOD1 and C9ORF72-related MND.
Even though the mini-Symposium itself was not podcasted, you can view Prof Shaw’s earlier talk at the MND Association Annual General Meeting 2016 here.