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The document discusses research into neurological diseases like Alzheimer's, Parkinson's, and MS, outlining challenges like developing treatments to slow neurodegeneration and maintaining private sector funding. It also explores promising areas of research like ketogenic diets for epilepsy and stem cell therapy for MS. Revolutionary developments are giving hope to millions with neurological conditions, but continued research is still needed.

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NEUROLOGY neurologicalhealth.co.uk RESEARCH IS THE KEY TO PREVENTION PHOTO:THINKSTOCK SPORT-RELATED HEAD INJURIES Looking at the link between concussion and neurodegenerative diseases PARKINSON’S DISEASE The future offensive to slow or reverse this debilitating condition A spotlight on AN INDEPENDENT SUPPLEMENT DISTRIBUTED WITHIN THE GUARDIAN ON BEHALF OF MEDIAPLANET WHO TAKE SOLE RESPONSIBILITY FOR ITS CONTENTS Revolutionary developments intreatmentaregiving hopetomillionswithneurologicaldiseases
2 · neurologicalhealth.co.uk AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET Perception,prevention andthechallengesahead INNOVATIVE RESEARCHinfo@neuro-sys.fr www.neuro-sys.fr @sysneuro INNOVATIVE DRUG DISCOVERY FROM PLANTS Neuro-Sys is a successful neuro-pharmacological company specialised in neurodegenerative diseases such as ALZHEIMER’S, PARKINSON’S, HUNTINGTON’S and the AMYOTROPHIC LATERAL SCLEROSIS. Fuel your research with exclusive new compounds! Void of inspiration? With the support of its innovative green-extraction and medicinal plants. Bespoke pharmacological platforms available to the industry Thanks to its strong expertize and a cutting-edge automated equipment, Neuro-Sys develops and proposes to clients (biotech and pharmaceutical companies) innovative preclinical models of CNS diseases to achieve high- From medicinal plants To molecular compounds ..... ..... ..... Welloverhalfofuswillatsomestageofourlivesexperienceeither depression,dementia,astroke,headinjury,migraine,epilepsy, Parkinson’sdisease,schizophrenia,multiplesclerosisoranyoneof severalhundredotherdiseasesofthebrain. N eurological and psychiatric dis- eases account for about 10 per cent of the world’s over- all disease burden, and the annual cost to the European Union alone approaches€1trillion. During much of the 20th centu- ry, neurological progress consist- ed mainly of describing an ever- increasing number of ways that brain function could be deranged, with scant regard to treating pa- tients. As for psychiatric disease, this remained fertile ground for speculation, little of which led to rational treatments. Our under- standing of brain disease has re- cently been revolutionised by careful neuropathology,advances in fundamental neuroscience and genetics, and by the invention of CT and MRI scans and electrical recordings to see inside the skull. Even for diseases where these methods are of limited use, well- designed clinical trials are lead- ing to improved treatments,albeit mainly for symptom control. A major challenge is to devel- op ways of arresting the progres- sive loss of neurons that occurs in many brain diseases, including Alzheimer’s, Parkinson’s disease, ALS (motor neuron disease) and multiple sclerosis. Although some treatments have been shown to work in animal models, clinical translation is slow and expensive. Another challenge is to maintain engagement from the pharmaceu- tical industry to invest in diseases where discoveries may take many years to emerge.Worryingly,sever- al big pharmaceutical companies have moved their research and de- velopmentoutoftheUK,citinghos- tility to animal experimentation amongreasonstodoso.Othershave pulled out of psychiatric disease completely,following unsuccessful clinicaltrials. The British Neuroscience As- sociation supports this campaign in its aim of raising awareness of the various neurological diseases, the in-depth research carried out by the experts and the treatment optionsavailable. CHALLENGES Is rugby a safe sport? New research explores the dangers p10 EDITOR’S PICK NEUROLOGY 3RD EDITION, MARCH 2015 Managing Director: Carl Soderblom Content and Production Manager: Cary Hastings Business Developer: Alex Williams Responsible for this issue Project Manager: Sam Ayerst E-mail: sam.ayerst@mediaplanet.com Phone: 07789 986 427 Mediaplanet contact information: Phone: +44 (0) 203 642 0737 E-mail: info.uk@mediaplanet.com FOR EXTENDED, INTERACTIVE AND EXCLUSIVE CONTENT VISIT MEDIAPLANET UK #neurohealth neurologicalhealth.co.uk Dimitri Kullmann Professor of Neurology, University College London
neurologicalhealth.co.uk · 3AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET INSPIRATION Meeting the dementia research funding challenge A t the G8 leader’s meeting in De- cember 2013 the leaders of the eight nations agreed on a set of key goals to tack- le the growing problem of demen- tia. Since then, Alzheimer’s Re- search UK has been working to- wards two aims in particular: im- proving the quality of life of peo- ple with Alzheimer’s,and finding a treatment that either cures or slows down the progression of the disease by 2025. In the past,Alzheimer’s and oth- erdementiashavesufferedthrough what Hilary Evans, director of ex- ternal affairs at Alzheimer’s Re- search UK,says has been a “chronic lack of investment in research”,but things are now improving.“There’s beenaproblemwiththelackofpro- gresstofindanycuresornewtreat- ments, but this is now being ad- dressed”,shesays. The goal is to encourage fund- ing for research and collaborations between the charity,academic re- searchers, drug companies and the UK government, says Dr Si- mon Ridley, head of research at Alzheimer’s Research UK. “We need to explore differ- ent approaches, and new ther- apeutic avenues, and novel as well as traditional methods of looking for funding. The gov- ernment has provided support but we really need to ramp up the amount of funding from the private sources for academic research. So we’re trying to look for investment from the pri- vate sector through a number of mechanisms.” New collaborations These include the £30 million Drug Discovery Alliance, backed by the charity,which will fund three new drugdiscoveryinstitutesattheuni- versities of Oxford and Cambridge and University College London. There’s also the Dementia Consor- tium,a partnershipwith drug com- panies Lilly, Eisai and drug devel- opment specialists MRC Technol- ogy, and a research centre in the University of Cambridge for stem cellresearch. “This will allow work to flour- ish,and close the gaps between ac- ademia and industry”, Ridley says. The work could also benefit from a global fund for early-stage clinical trials,which the charity hopes will fund promising new drugs and act asacatalystforresearch. Seeing the benefits Evans is hopeful that these newpro- jectswillmakearealdifferenceinthe future.“There’s been an increase in spendingonresearchandsohopeful- lywewillseethebenefitsofthatsoon. Whatwe’redoingisencouragingthe industry to work with academic, NGOs and the government,because there’sgoingtohavetobeaunitedef- forttomakeprogress,”Evanssays. It’s also important to raise public awareness ofAlzheimer’s,which Ev- ans says is still “relativelylow” com- pared with other diseases like can- cerandheartdisease.“Alzheimer’sis a disease,it’s not just a consequence ofgettingold,andAlzheimer’sisone type of dementia - dementias are differentdiseases.” Question:WhataresomeofthekeygoalsforresearchintoAlzheimer’sdisease? Answer:Exploringnewavenuesoffundingfornewtreatmentsfordementiaand improvingpeople’squalityoflife. Alzheimer’s Research UK is the world’s leading dedicated dementia research charity. Only research has the power to solve our greatest medical challenge and we are leading the charge for new treatments. Find out more about our blueprint to defeat dementia and join the fight at www.alzheimersresearchuk.org Charity numbers 1077089 & SC042474 Dr Simon Ridley Head of research, Alzheimer’s Research UK LILIAN ANEKWE info.uk@mediaplanet.com
4 · neurologicalhealth.co.uk AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET be awayto specificallytarget tumours,es- pecially those of neurological origin.Evi- dence is mainly from animal studies but growinginterestinusingketogenicthera- pytotreatbraincancershasledtodevelop- ment of clinical trials of the diet alongside conventional cancer treatments.The en- hancement of mitochondrial function in- ducedbytheketoticstatemayalsobeben- eficial in disorders of neuro-degeneration such as Parkinson’s disease, Alzheimer’s disease and myotrophic lateral sclerosis. Limited evidence also suggests a protec- tiveroleintraumaandischaemia,withthe injuredbrainpreferringtouseketonesasa fuel.Futureclinicaluseofketogenicthera- pyincancerandwiderneurologicalcondi- tionsmustbeledbywelldesignedresearch trials in order to clarifywhowould benefit from this type of treatment and how best it should be implemented.But at almost a century old,the outlook for the ketogenic dietremainsverypositive;itisclearlyhere tostaywithanexcitingfutureaheadofit. “The potential of ketogenic therapy to treat disorders beyond epilepsy is gaining recognition” Elizabeth Neal, Ketogenic diet research dietician T hese diets are designed to induce a similar metabol- ic response to starvation, with ketone bodies be- coming the primary ener- gy substrate for brain and other metabolically active tissues in the absence of adequate glucose supply. Worldwide scientific research on the ketogenic diet has expanded consid- erably over the past two decades and es- tablished it as a proven therapy. This plac- es it firmly alongside other treatment op- tions for intractable childhood epilepsy. Newer and more liberal variants of the di- et,the lowglycaemic index treatment and the modified Atkins diet, have also been used with success. Despite considerable international and UK-wide variation in the availability of these ketogenic thera- pies,their clinical use is continuing to ex- pand to other age groups, with on-going research into the dietarytreatment of epi- lepsy in young infants and adults with re- fractoryseizures. Ketogenic therapy should always be implemented with specialist medcal and dietetic supervision to ensure it is an appropriate and safe treatment choice. This requires nutritional supplementa- tion,regular clinical monitoring and on- going dietary adjustments; aiming to maximise efficacy and minimise side ef- fects. If successful, the benefits can ex- tend beyond seizure control; anticon- vulsant medications can frequently be reduced or discontinued and improve- ments in behaviour, cognition and qual- ity of life are commonly reported.The ef- fects of the diets can be long lasting and some who have seen benefit can return to a normal diet without resumption of seizureactivity. Extended benefits Thepotentialofketogenictherapytotreat disorders beyond epilepsy is gaining rec- ognition.Alreadyestablishedasafirst-line treatment choice for the neurometabolic diseases glucose transporter type one de- ficiencysyndromeandpyruvatedehydro- genasedeficiency,emergingevidencesug- gestswiderapplications.Thepreferenceof malignant cancer cells for glucose as an energy source suggests that this low-car- bohydrate, high-fat dietary regime could Theketogenicdietisahighfat,restrictedcarbohydrate regimewhichhasbeenusedasasuccessfulepilepsy treatmentforalmost100years. NUTRICIA, SUPPORTING PATIENTS ON A KETOGENIC DIET FOR OVER 10 YEARS For many years Nutricia has worked with dietitians, carers and the charity Matthews Friends, to help patients with intractable epilepsy and their families manage the ketogenic diet. We are committed to providing the most advanced ketogenic products and bringing the highest possible standards to epilepsy care in children. Nutricia understands the highs and lows of caring for a child on the ketogenic diet. So to support families and carers in the little ways that matter, we offer a home delivery service to ensure the right product gets to the patient at the right time. Nutricia Ltd. White Horse Business Park, Newmarket Avenue, Trowbridge, Wiltshire, BA14 0XQ T: 01225 751098 www.nutricia.co.uk Ketogenic diets and their impact on neurological diseases INSIGHT ELIZABETH NEAL, KETOGENIC DIET RESEARCH DIETICIAN info.uk@mediaplanet.com
neurologicalhealth.co.uk · 5AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET MIRACLE FOOD Ketogenic diets are becoming recognised as a serious treatment method for neurological disorders PHOTO: THINKSTOCK Matthew’s Friends, the Ketogenic Diet charity in the UK, founded in 2004, supports NHS ketogenic teams as well as their patients with comprehensive Ketogenic information and resources, which is approved by our Medical Board and Clinical Staff. Treatment is also provided at Matthew’s Friends Clinics for children and adults with Epilepsy and Glut 1DS and adults with Brain Tumour. The charity and clinic also supports further research into new applications for Ketogenic dietary therapy. As hosts of the 2014 Global Symposium for Ketogenic Dietary Therapies, we are inspired by the breadth of new research and interest worldwide, broadening the scope conditions, in addition to the known success in the treatment of refractory epilepsy. Matthews Friends @Young Epilepsy MainTelephone Number: 01342 836571 www.matthewsfriends.org NEWS Despite being the most common serious neurological condition in the UK, epilepsy is still misunderstood. Those with the condition face a postcodelotteryofcare.Therecently publishednationalEpilepsy12audit revealed that although there have been some improvements in paedi- atricservices,thereremainongoing concerns that children are not get- ting access to the right health pro- fessionals at the right time. Only just over half of the children in the audithadbeenreferredtoanepilep- syspecialistnurseand57percentof children needing further specialist input from a paediatric neurologist werenotreferredon. The World Health Organisation launched a global campaign to im- prove the epilepsytreatment gap in February2015.‘Epilepsy:Treatit.De- featit.’highlightsthatmorethan50 million people worldwide live with the condition.But the issues that it addresses are not limited to devel- oping countries.They are the same issues that people with epilepsy faceintheUKtoday. Epilepsyin thespotlight YOUNG EPILEPSY info.uk@mediaplanet.com Epilepsy training for health, education and care professionals across the UK, including masterclasses for specialists hosted by Professor Helen Cross, The Prince of Wales’s Chair of Childhood Epilepsy. Bespoke packages including emergency medication training for schools/care homes. For details visit youngepilepsy.org.uk Call 01342 832243 ext 296 Email epilepsytraining@youngepilepsy.org.uk Got a question or need some support? Call our helpline on 01342 831342 Young Epilepsy is the national charity working exclusively to support the 112,000 children and young people in the UK with epilepsy. Young Epilepsy is the operating name of NCYPE (National Centre for Young People with Epilepsy) Registered Charity No. 311877 (England and Wales)
6 · neurologicalhealth.co.uk AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET “The challenge is to wake up the cells that otherwise just sitting there dormant” Dr Alasdair Coles, senior lecturer, department of clinical neurosciences, University of Cambridge MS comes in two forms: the relapsing- remitting form and a progressive form. Around 80 per cent of people who have MS have the relapsing-remitting form, and have periodic flare-ups of symptoms that affect their nervous system.The oth- er20percenthaveprogressiveformsofMS, whichcauseaslowandgraduallossoftheir abilitytodothings. The two different forms have different causes.Althoughwe still don’t fullyunder- stand these differences,it appears that — putsimply—therelapsing-remittingform is caused by inflammation in the brain, whereas the progressive form is caused by the slowdamage and then death of nerves. This happens when a protective coat of a substance called myelin which normally protectsthenervesfromdamage,islost. “Inthelast20yearswehavemadereally good strides with relapsing-remitting MS, but not for progressive MS,and the reason whyislinkedtotheirdifferentcauses”,says DrAlasdair Coles,senior lecturer in the de- partment of clinical neurosciences at the University of Cambridge.“But we do have anadvantage,becausethetwoformsofMS aren’t entirely connected.This means we canadopttwoapproaches:earlytreatment andexperimentalapproaches.” Safe treatment Earlyand aggressive treatments for relaps- ing-remitting MS means using the strong- est drugs as soon as people are diagnosed. Thisapproachiscontroversialandthere’sa genuinelackofconsensusaboutwhetherit issafe.ButtheNationalInstituteforHealth andCareExcellence,whichpublishedguid- ance on howto treat MS in October 2014,is that people can be treated with stronger drugseveniftheyhaveearlyMS. Colessays:“Wecanuseearlyandaggres- sivetreatmenttostoppeople’snervesfrom being stripped of their myelin.It’s still not standard treatment and the conservative position,whichIunderstand,istousemild- er drugs for people early on in the disease. Atthemomentthere’slittleevidencetosay thatthisapproachstopstheprogressionof MS over the long-term,but that’s because wehavenothadthedrugsforverylong.” LILIAN ANEKWE info.uk@mediaplanet.com Doctors’knowledgeofthedifferentcausesofmultiplesclerosisisleadingtonew potentialfortreatmentandresearch,accordingtoleadingUniversityofCambridge expert,DrAlasdairColes. What does the future hold for MS research? NEWS Anotherapproachwouldbetolookatthe possiblepotentialofgivingpeoplewithMS drugsthatcanrestorethemyelinthatdam- aged nerve cells have lost.“There’s promis- ing lines of research,although nothingyet that’sintheclinic”,Colessays. “We know there are stem cells in the brain that are capable of being remyelinat- ed.So the challenge is to wake up the cells that that otherwise just sitting there dor- mant” says Coles, who is conducting an early-stage trial looking at using existing MSdrugsinthisway. So the current research efforts in MS mean that in the future people with MS could benefit from a combination ap- proach, to combat the inflammation and to regenerate stem cells and repair the nerves — and possibly leading to better managementofMS.
neurologicalhealth.co.uk · 7AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET RESEARCH IS KEY Understanding the causes behind this unpredictable disease will prove key in treating it. PHOTO: THINKSTOCK FACTS ON MS 5 1 There are more than 100,000 people in the UKcurrentlylivingwithMS. 2 Symptoms usually start in your 20s and 30s and it affects almost three times as manywomen asmen. 3 It affects the central nervous system — the brain and spinal cord nerves whichcontrolbodilyfunctions. The immune system attacks the myelin coating which protectsnervefibres,damaging the nerves and causing them tomalfunction. 4 MS is an unpredictable condition and symptomsincludeproblems with mobility and balance, vision and dizziness,fatigue, bladder problems, muscle stiffnessanddepression. 5 TheMSSocietyistheUK’s leading MS charity; we provide information and can help people – call our helpline on 0808 800 8000 or visit www.mssociety.org.uk MS SOCIETY info.uk@mediaplanet.com
8 · neurologicalhealth.co.uk AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET “When we also consider the fami- lies of people struggling with the disease this means Parkinson’s di- rectly affects 20-40 million people. Parkinson’s also affects govern- ments and healthcare systems be- causeitisaverycomplexcondition to treat as each person has their own combination of symptoms”, DrWyse,says. The Cure Parkinson’s Trust is working with neurology experts worldwide,andhasidentifiedmore than 70 potentially disease-modi- fying’ treatments.TheTrust has al- ready prioritised more than 20 of these radical new treatment ap- proachestobetestedinPDpatients in specialist neurology hospitals aroundtheworld. Dr Wyse explains: “The first of these trials,involving repurposing of an anti-diabetic drug,was com- pleted last year with extremely promising results suggesting we may have already intercepted de- clineinPDpatients.” A second line of new treatments involves several ‘mitochondrial’ targeteddrugs. “Wearestartingtomovetowards developing personalised medicine for PD patients,with future thera- pies matched to their genetics,bi- ochemistry, and their symptoms”. As such they have identified po- tential treatments targeting awide range of biochemical pathways which now need to be proven in clinicaltrials. Regenerative medicine Another key area is regenerative medicine, focusing on re-grow- ing and replacing the cells that have died as Parkinson’s progress- es. “Surgical trials of transplanta- tion of neural tissue, and of long- term infusions of a natural brain growth factor,GDNF,are underway in Cambridge and Bristol,and offer huge promise.” The neurodegen- erative disease named after James Parkinsonwhodiscovereditin1817, includes a range of crippling mo- torandnon-motorsymptomssuch as shaking,slowness of movement, gutproblemsanddisturbedsleep. According to Dr Wyse,the main causes of Parkinson’s are environ- mental,such as exposure to pesti- cides or in manganese mines; ge- netic(about10percentπofpatients have genetic forms of PD),and for othersit’striggeredbyheadtrauma, as in the case of the famous boxer MuhammedAli. All current treatments just fo- cus on managing daily symptoms. Since some people are diagnosed with the disease in their 30s or 40s they can be afflicted with the diseasefor40to50years. Dr Wyse and his colleagues are working hard on finding a cure be- yond symptomatic treatments. He says: “While money is current- ly needed to test many innova- tive new disease-modifying treat- mentsintheclinicwebelievethere really is hope that in the near fu- ture we can slow, stop and even reverseParkinson’s. DIANE PRIESTLEY info.uk@mediaplanet.com Dr Richard Wyse Director of research and development, The Cure Parkinson’s Trust INSPIRATION Real promise for 10 million people living with Parkinson’s DrRichardWyse,directorofresearchanddevelopmentatTheCureParkinson’sTrust,believes that“scientifically,nowmorethanever,thereisconsiderablehopeaboutfuturetherapiestoslow, stoporreverseParkinson’s.” BritanniaP h a r m a c e u t i c a l s L t d BRITANNIA PHARMACEUTICALS IS PROUD TO SUPPORT MEDIAPLANET ON PARKINSON‘S Whatarethemostpromising newapproachesthatarehelping researcherstobetterunderstand theeffectsofParkinson’s disease(PD)?ProfessorRoger Barker,whoworksatthe UniversityofCambridge’scentre forbrainrepair,explains. “Threeareasofcomplimentaryresearch arecontributingtoresearchersgaininga betterunderstandingofPDandtheright treatmentsfordifferentpeople”, Barkersays. “Atthemomentwedon’treallyunder- standwhysomepeopledowellformany yearswhile others quite quicklydevelop seriouseffects.We’retryingtolearnwhy from looking at the genetic makeup of peoplewhohavemoreaggressivediseas- es.Wecantaketheirskincellsandrepro- gram them in the lab and convert them into nerve cells. Then we can discover newtargetsforresearchandtreatments.” “Thefuturewillcomewhenweareable totakeembryoniccellsandturnthemin- to new nerve cells,and inject them into the brains of people with PD.It won’t be a cure but it couldvastlyimprove symp- tomsfor10oreven20years.There’ssome research now in mice that is promising, and I hope to see results in the next five years.There’sfocusonaproteincalledal- phasynuclein,whichbuildsupinsidethe braincellsofpeoplewithPDandspreads outsideofthebrain.It’sacompletelynew idea,butifprovenwemightbeabletode- velopavaccinetostopthesymptoms.” Newapproachesto Parkinson’sresearch LILIAN ANEKWE info.uk@mediaplanet.com
neurologicalhealth.co.uk · 9AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET NEWS Revolutionary treatment for brain tumours P rofessor Lars Leksell, who wanted to emu- late the surgical pre- cision of a scalpel with beams of radia- tion, first developed thetool40yearsago. He developed the Gamma Knife as a dedicated tool, able to deliver a highly accurate therapeutic dose of radiation to the brain with little ornoharmtothepatient,andithas becomethegoldstandardofstereo- tacticradiosurgery(SRS). Professor Christer Lindquist, Consultant Neurosurgeon at the BUPA Cromwell Hospi- tal Gamma Knife Centre in Lon- don worked with the late Prof Leksell in research and develop- ment of the Gamma Knife and has the longest experience with the deviceworldwide. He says: “The Gamma Knife was a quantum leap for the treatment of many inoperable brain tumours and other conditions when it was firstintroduced. “A very high dose of radiation is delivered in one single treatment session, and the patient can be treatedasanoutpatientorstayonly onenightinthehospital. “The high dose is,however,tox- ic not only to the treatment ob- ject but it may also be injurious to normal brain. It is therefore essential that the radiation vol- ume is “tailor-made” to the ob- ject to be treated.” Salvage therapy Prof Lindquist came to London in 1998 from the Karolinska Hospi- tal in Stockholm, where he was the Director of the Skull Base Surgery Program and the Gamma Knife Center in the Department of Neurosurgery and has pub- lished some 100 scientific papers in neurosurgery. He says: “Whole Brain Radia- tion Therapy (WBRT) is the most common type of radiation still used in the UK to treat brain me- tastases. In my opinion it should now only be used as salvage ther- apy. Side effects such as memo- ry deficits, dementia and epilep- tic seizures are not acceptable when modern radiosurgery is a better treatment.” The Leksell Gamma Knife can be used to treat primary and sec- ondary brain tumours, and some cases of Parkinson’s Disease,epi- lepsy and Obsessive Compulsive Disorder (OCD). The one-day non-invasive treatment means patients can usually receive treatment in a single day and return to normal lifestyle the day after treatment. More than 800,000 patients have been treated with the gamma knife throughout the world. Peoplewithbraintumourscannowbetreatedwithagentleralternative tosurgerywitharemarkable‘gammaknife’. Dedicated. Leksell Gamma Knife® is the only system designed specifically for brain radiosurgery. Optimized to spare healthy tissue where it matters most, it allows you treatment of the most challenging cases with confidence. 100% Leksell Gamma Knife® Perfexion™ Preferred for cranial radiosurgery For more information, visit gammaknife.com Submillimetric accuracy Largest clinical evidence base Convenient for patients 1516053.00 Professor Christer Lindquist Consultant neurosurgeon, BUPA Cromwell Hospital, Gamma Knife Centre, London DIANE PRIESTLEY info.uk@mediaplanet.com PHOTO:THINKSTOCK RADIATION TREATMENT Patients can receive the gamma knife treatment and return to normal life the next day.
10 · neurologicalhealth.co.uk Physical exercise helps keep brains healthy but acute concussion, a brain injurythat can go undetected, can be fatal. Repeated concussions are known to cause neurodegener- ative disease in boxers.Could rugby playerssufferinthesameway? To find out Professor Damian Bailey of the Neurovascular Re- search Laboratory at the Univer- sity of South Wales has developed tests that focus on the brain’s con- trol of it’s own blood flow and oxy- gen.Bailey says: “Understanding of the causes and long-term brain ef- fectsofconcussionsispoor.Concus- sions can be hard to spot,do not re- quire a direct blow to the head and in 90 per cent of cases do not lead tounconsciousness. “Wehavefoundevidenceofaccel- erated brain ageing leading to im- paired mental agility and dementia symptomsinretiredrugbyplayers.” Bailey has put over 250 rugby players through tests designed to challenge the brain. Putting the brain under pressure through novel types of exercise, high-fat meals and changes in oxygen/car- bon dioxide has detected subtle and enduring signs of brain injury. Study participants were matched against non-rugby playing con- trols of similar age and fitness.The findings are being submitted for scientificpublication. “Our research could change the way rugby is played and even the game’s rules,so accurate results are essential,” says Bailey. “We believe that our battery of lab tests can pick up subtle effects and provide a more scientific means of determining when the brain has fully recovered - or not,as we have seen in some of thesedentaryretiredplayers.Ourap- proaches include electron paramag- netic resonance spectroscopy and ozone-based chemiluminescence to measure blood levels of free radicals, tiny molecules that in excess can damage the brain and impair blood flowandoxygendelivery.” The lab also uses high-performance data acquisition hardware to cap- ture a wide varie- ty of signals from the brain, heart, lungs and mus- cles.Thisincludes blood flow and oxy- genation,blood pressure, heart rate, ventilation and the composition of expiredgases. Bailey says: “If my re- search confirms there is a clear risk of brain injury from concussions I hope it willbeusedtoinformreturn to play decisions and help prevent some of the more damaging long-term chang- es to the brain that can oc- curwhenplayersretire.” LINDA WHITNEY info.uk@mediaplanet.com Scientistsareusingnewtechniquestostudytheeffectsof concussioninrugbyplayerswhichcouldmakethesport saferandgiveinsightsintoneurodegenerativediseases. One in six people in the UK suffer from a neurological disorder. This can be from birth, through a slowly developing illness or through brain injury. The National Brain Appeal is the charity dedicated to raising much-needed funds for The National Hospital for Neurology and Neurosurgery. We rely on your donations to fund vital research and projects. www.nationalbrainappeal.org Registered charity no: 290173 IS RUGBY A SAFE SPORT? NEW STUDIES ARE HELPING RESEARCHERS FIND OUT INSPIRATION AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET PHOTO:THINKSTOCK
www.braintumourresearch.org Tel: 01296 733011 | info@braintumourresearch.org BRAIN TUMOURS KILL MORE CHILDREN AND ADULTS UNDER THE AGE OF 40 THAN ANY OTHER CANCER Please mention this publication when responding Let’s connect Each day of research costs £2,740 Brain tumours receive just 1%of national spend on cancer Registered charity number 1153487 (England and Wales) HELP US FUND THE FIGHT. Sponsor days of research at ground-breaking Centres of Excellence. A small charity can make a big difference. We know. When you are diagnosed with a brain tumour, you need someone who understands.We know. Get in touch today, for 24/7 help on 01983 292 405, email hello@brainstrust.org.uk or visit www.brainstrust.org.uk With your donation we will help more people with a brain tumour feel less afraid, less alone and more in control in the face of a terrifying diagnosis.Text LIVE12 £5 to 70070 or call 01983 292 405 to support brainstrust today. brainstrust is a registered charity in England and Wales (1114634), and Scotland (SC044642) NEUROLOGICAL CONDITIONS ARE A SERIOUS PROBLEM IN THE UK www.brt.org.uk/donate We fund world-leading research 12.5 million people in the UK live with a form of brain disease Brain Research Trust Dutch House 307-308 High Holborn London WC1V 7LL Tel 020 7404 9982 Registered Charity in England & Wales No. 1137560. Registered Company Limited by Guarantee No. 7345516
Feed your mind Feed your mind Neurozan® is certified by pioneering charity FOOD FOR THE BRAIN. www.foodforthebrain.org From ,chemists,Waitrose,Holland & Barrett,health stores & www.neurozan.com *IRI value data.52 w/e 2 November 13. Neurozan® is an advanced,comprehensive formula to help safeguard your daily intake of essential vitamins and minerals. Including iron,zinc and iodine which help to maintain normal cognitive function and pantothenic acid which supports normal mental performance. Neurozan® Original contains a specially developed combination of nutrients and is certified by FoodForTheBrain. Neurozan® Plus dual pack provides even greater nutritional support with high purity Omega-3 from Norway. DHA helps to maintain normal brain function. So if you’re looking for a supplement that’s different,keep Neurozan® in mind. ORIGINAL DUAL PACK WITH DHA ADNEUCONP27-06-14E Micronutrients with iron,zinc & iodine, which contribute to normal cognitive function

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Neuro PDF

  • 1.
    NEUROLOGY neurologicalhealth.co.uk RESEARCH IS THE KEYTO PREVENTION PHOTO:THINKSTOCK SPORT-RELATED HEAD INJURIES Looking at the link between concussion and neurodegenerative diseases PARKINSON’S DISEASE The future offensive to slow or reverse this debilitating condition A spotlight on AN INDEPENDENT SUPPLEMENT DISTRIBUTED WITHIN THE GUARDIAN ON BEHALF OF MEDIAPLANET WHO TAKE SOLE RESPONSIBILITY FOR ITS CONTENTS Revolutionary developments intreatmentaregiving hopetomillionswithneurologicaldiseases
  • 2.
    2 · neurologicalhealth.co.ukAN INDEPENDENT SUPPLEMENT BY MEDIAPLANET Perception,prevention andthechallengesahead INNOVATIVE RESEARCHinfo@neuro-sys.fr www.neuro-sys.fr @sysneuro INNOVATIVE DRUG DISCOVERY FROM PLANTS Neuro-Sys is a successful neuro-pharmacological company specialised in neurodegenerative diseases such as ALZHEIMER’S, PARKINSON’S, HUNTINGTON’S and the AMYOTROPHIC LATERAL SCLEROSIS. Fuel your research with exclusive new compounds! Void of inspiration? With the support of its innovative green-extraction and medicinal plants. Bespoke pharmacological platforms available to the industry Thanks to its strong expertize and a cutting-edge automated equipment, Neuro-Sys develops and proposes to clients (biotech and pharmaceutical companies) innovative preclinical models of CNS diseases to achieve high- From medicinal plants To molecular compounds ..... ..... ..... Welloverhalfofuswillatsomestageofourlivesexperienceeither depression,dementia,astroke,headinjury,migraine,epilepsy, Parkinson’sdisease,schizophrenia,multiplesclerosisoranyoneof severalhundredotherdiseasesofthebrain. N eurological and psychiatric dis- eases account for about 10 per cent of the world’s over- all disease burden, and the annual cost to the European Union alone approaches€1trillion. During much of the 20th centu- ry, neurological progress consist- ed mainly of describing an ever- increasing number of ways that brain function could be deranged, with scant regard to treating pa- tients. As for psychiatric disease, this remained fertile ground for speculation, little of which led to rational treatments. Our under- standing of brain disease has re- cently been revolutionised by careful neuropathology,advances in fundamental neuroscience and genetics, and by the invention of CT and MRI scans and electrical recordings to see inside the skull. Even for diseases where these methods are of limited use, well- designed clinical trials are lead- ing to improved treatments,albeit mainly for symptom control. A major challenge is to devel- op ways of arresting the progres- sive loss of neurons that occurs in many brain diseases, including Alzheimer’s, Parkinson’s disease, ALS (motor neuron disease) and multiple sclerosis. Although some treatments have been shown to work in animal models, clinical translation is slow and expensive. Another challenge is to maintain engagement from the pharmaceu- tical industry to invest in diseases where discoveries may take many years to emerge.Worryingly,sever- al big pharmaceutical companies have moved their research and de- velopmentoutoftheUK,citinghos- tility to animal experimentation amongreasonstodoso.Othershave pulled out of psychiatric disease completely,following unsuccessful clinicaltrials. The British Neuroscience As- sociation supports this campaign in its aim of raising awareness of the various neurological diseases, the in-depth research carried out by the experts and the treatment optionsavailable. CHALLENGES Is rugby a safe sport? New research explores the dangers p10 EDITOR’S PICK NEUROLOGY 3RD EDITION, MARCH 2015 Managing Director: Carl Soderblom Content and Production Manager: Cary Hastings Business Developer: Alex Williams Responsible for this issue Project Manager: Sam Ayerst E-mail: sam.ayerst@mediaplanet.com Phone: 07789 986 427 Mediaplanet contact information: Phone: +44 (0) 203 642 0737 E-mail: info.uk@mediaplanet.com FOR EXTENDED, INTERACTIVE AND EXCLUSIVE CONTENT VISIT MEDIAPLANET UK #neurohealth neurologicalhealth.co.uk Dimitri Kullmann Professor of Neurology, University College London
  • 3.
    neurologicalhealth.co.uk · 3ANINDEPENDENT SUPPLEMENT BY MEDIAPLANET INSPIRATION Meeting the dementia research funding challenge A t the G8 leader’s meeting in De- cember 2013 the leaders of the eight nations agreed on a set of key goals to tack- le the growing problem of demen- tia. Since then, Alzheimer’s Re- search UK has been working to- wards two aims in particular: im- proving the quality of life of peo- ple with Alzheimer’s,and finding a treatment that either cures or slows down the progression of the disease by 2025. In the past,Alzheimer’s and oth- erdementiashavesufferedthrough what Hilary Evans, director of ex- ternal affairs at Alzheimer’s Re- search UK,says has been a “chronic lack of investment in research”,but things are now improving.“There’s beenaproblemwiththelackofpro- gresstofindanycuresornewtreat- ments, but this is now being ad- dressed”,shesays. The goal is to encourage fund- ing for research and collaborations between the charity,academic re- searchers, drug companies and the UK government, says Dr Si- mon Ridley, head of research at Alzheimer’s Research UK. “We need to explore differ- ent approaches, and new ther- apeutic avenues, and novel as well as traditional methods of looking for funding. The gov- ernment has provided support but we really need to ramp up the amount of funding from the private sources for academic research. So we’re trying to look for investment from the pri- vate sector through a number of mechanisms.” New collaborations These include the £30 million Drug Discovery Alliance, backed by the charity,which will fund three new drugdiscoveryinstitutesattheuni- versities of Oxford and Cambridge and University College London. There’s also the Dementia Consor- tium,a partnershipwith drug com- panies Lilly, Eisai and drug devel- opment specialists MRC Technol- ogy, and a research centre in the University of Cambridge for stem cellresearch. “This will allow work to flour- ish,and close the gaps between ac- ademia and industry”, Ridley says. The work could also benefit from a global fund for early-stage clinical trials,which the charity hopes will fund promising new drugs and act asacatalystforresearch. Seeing the benefits Evans is hopeful that these newpro- jectswillmakearealdifferenceinthe future.“There’s been an increase in spendingonresearchandsohopeful- lywewillseethebenefitsofthatsoon. Whatwe’redoingisencouragingthe industry to work with academic, NGOs and the government,because there’sgoingtohavetobeaunitedef- forttomakeprogress,”Evanssays. It’s also important to raise public awareness ofAlzheimer’s,which Ev- ans says is still “relativelylow” com- pared with other diseases like can- cerandheartdisease.“Alzheimer’sis a disease,it’s not just a consequence ofgettingold,andAlzheimer’sisone type of dementia - dementias are differentdiseases.” Question:WhataresomeofthekeygoalsforresearchintoAlzheimer’sdisease? Answer:Exploringnewavenuesoffundingfornewtreatmentsfordementiaand improvingpeople’squalityoflife. Alzheimer’s Research UK is the world’s leading dedicated dementia research charity. Only research has the power to solve our greatest medical challenge and we are leading the charge for new treatments. Find out more about our blueprint to defeat dementia and join the fight at www.alzheimersresearchuk.org Charity numbers 1077089 & SC042474 Dr Simon Ridley Head of research, Alzheimer’s Research UK LILIAN ANEKWE info.uk@mediaplanet.com
  • 4.
    4 · neurologicalhealth.co.ukAN INDEPENDENT SUPPLEMENT BY MEDIAPLANET be awayto specificallytarget tumours,es- pecially those of neurological origin.Evi- dence is mainly from animal studies but growinginterestinusingketogenicthera- pytotreatbraincancershasledtodevelop- ment of clinical trials of the diet alongside conventional cancer treatments.The en- hancement of mitochondrial function in- ducedbytheketoticstatemayalsobeben- eficial in disorders of neuro-degeneration such as Parkinson’s disease, Alzheimer’s disease and myotrophic lateral sclerosis. Limited evidence also suggests a protec- tiveroleintraumaandischaemia,withthe injuredbrainpreferringtouseketonesasa fuel.Futureclinicaluseofketogenicthera- pyincancerandwiderneurologicalcondi- tionsmustbeledbywelldesignedresearch trials in order to clarifywhowould benefit from this type of treatment and how best it should be implemented.But at almost a century old,the outlook for the ketogenic dietremainsverypositive;itisclearlyhere tostaywithanexcitingfutureaheadofit. “The potential of ketogenic therapy to treat disorders beyond epilepsy is gaining recognition” Elizabeth Neal, Ketogenic diet research dietician T hese diets are designed to induce a similar metabol- ic response to starvation, with ketone bodies be- coming the primary ener- gy substrate for brain and other metabolically active tissues in the absence of adequate glucose supply. Worldwide scientific research on the ketogenic diet has expanded consid- erably over the past two decades and es- tablished it as a proven therapy. This plac- es it firmly alongside other treatment op- tions for intractable childhood epilepsy. Newer and more liberal variants of the di- et,the lowglycaemic index treatment and the modified Atkins diet, have also been used with success. Despite considerable international and UK-wide variation in the availability of these ketogenic thera- pies,their clinical use is continuing to ex- pand to other age groups, with on-going research into the dietarytreatment of epi- lepsy in young infants and adults with re- fractoryseizures. Ketogenic therapy should always be implemented with specialist medcal and dietetic supervision to ensure it is an appropriate and safe treatment choice. This requires nutritional supplementa- tion,regular clinical monitoring and on- going dietary adjustments; aiming to maximise efficacy and minimise side ef- fects. If successful, the benefits can ex- tend beyond seizure control; anticon- vulsant medications can frequently be reduced or discontinued and improve- ments in behaviour, cognition and qual- ity of life are commonly reported.The ef- fects of the diets can be long lasting and some who have seen benefit can return to a normal diet without resumption of seizureactivity. Extended benefits Thepotentialofketogenictherapytotreat disorders beyond epilepsy is gaining rec- ognition.Alreadyestablishedasafirst-line treatment choice for the neurometabolic diseases glucose transporter type one de- ficiencysyndromeandpyruvatedehydro- genasedeficiency,emergingevidencesug- gestswiderapplications.Thepreferenceof malignant cancer cells for glucose as an energy source suggests that this low-car- bohydrate, high-fat dietary regime could Theketogenicdietisahighfat,restrictedcarbohydrate regimewhichhasbeenusedasasuccessfulepilepsy treatmentforalmost100years. NUTRICIA, SUPPORTING PATIENTS ON A KETOGENIC DIET FOR OVER 10 YEARS For many years Nutricia has worked with dietitians, carers and the charity Matthews Friends, to help patients with intractable epilepsy and their families manage the ketogenic diet. We are committed to providing the most advanced ketogenic products and bringing the highest possible standards to epilepsy care in children. Nutricia understands the highs and lows of caring for a child on the ketogenic diet. So to support families and carers in the little ways that matter, we offer a home delivery service to ensure the right product gets to the patient at the right time. Nutricia Ltd. White Horse Business Park, Newmarket Avenue, Trowbridge, Wiltshire, BA14 0XQ T: 01225 751098 www.nutricia.co.uk Ketogenic diets and their impact on neurological diseases INSIGHT ELIZABETH NEAL, KETOGENIC DIET RESEARCH DIETICIAN info.uk@mediaplanet.com
  • 5.
    neurologicalhealth.co.uk · 5ANINDEPENDENT SUPPLEMENT BY MEDIAPLANET MIRACLE FOOD Ketogenic diets are becoming recognised as a serious treatment method for neurological disorders PHOTO: THINKSTOCK Matthew’s Friends, the Ketogenic Diet charity in the UK, founded in 2004, supports NHS ketogenic teams as well as their patients with comprehensive Ketogenic information and resources, which is approved by our Medical Board and Clinical Staff. Treatment is also provided at Matthew’s Friends Clinics for children and adults with Epilepsy and Glut 1DS and adults with Brain Tumour. The charity and clinic also supports further research into new applications for Ketogenic dietary therapy. As hosts of the 2014 Global Symposium for Ketogenic Dietary Therapies, we are inspired by the breadth of new research and interest worldwide, broadening the scope conditions, in addition to the known success in the treatment of refractory epilepsy. Matthews Friends @Young Epilepsy MainTelephone Number: 01342 836571 www.matthewsfriends.org NEWS Despite being the most common serious neurological condition in the UK, epilepsy is still misunderstood. Those with the condition face a postcodelotteryofcare.Therecently publishednationalEpilepsy12audit revealed that although there have been some improvements in paedi- atricservices,thereremainongoing concerns that children are not get- ting access to the right health pro- fessionals at the right time. Only just over half of the children in the audithadbeenreferredtoanepilep- syspecialistnurseand57percentof children needing further specialist input from a paediatric neurologist werenotreferredon. The World Health Organisation launched a global campaign to im- prove the epilepsytreatment gap in February2015.‘Epilepsy:Treatit.De- featit.’highlightsthatmorethan50 million people worldwide live with the condition.But the issues that it addresses are not limited to devel- oping countries.They are the same issues that people with epilepsy faceintheUKtoday. Epilepsyin thespotlight YOUNG EPILEPSY info.uk@mediaplanet.com Epilepsy training for health, education and care professionals across the UK, including masterclasses for specialists hosted by Professor Helen Cross, The Prince of Wales’s Chair of Childhood Epilepsy. Bespoke packages including emergency medication training for schools/care homes. For details visit youngepilepsy.org.uk Call 01342 832243 ext 296 Email epilepsytraining@youngepilepsy.org.uk Got a question or need some support? Call our helpline on 01342 831342 Young Epilepsy is the national charity working exclusively to support the 112,000 children and young people in the UK with epilepsy. Young Epilepsy is the operating name of NCYPE (National Centre for Young People with Epilepsy) Registered Charity No. 311877 (England and Wales)
  • 6.
    6 · neurologicalhealth.co.ukAN INDEPENDENT SUPPLEMENT BY MEDIAPLANET “The challenge is to wake up the cells that otherwise just sitting there dormant” Dr Alasdair Coles, senior lecturer, department of clinical neurosciences, University of Cambridge MS comes in two forms: the relapsing- remitting form and a progressive form. Around 80 per cent of people who have MS have the relapsing-remitting form, and have periodic flare-ups of symptoms that affect their nervous system.The oth- er20percenthaveprogressiveformsofMS, whichcauseaslowandgraduallossoftheir abilitytodothings. The two different forms have different causes.Althoughwe still don’t fullyunder- stand these differences,it appears that — putsimply—therelapsing-remittingform is caused by inflammation in the brain, whereas the progressive form is caused by the slowdamage and then death of nerves. This happens when a protective coat of a substance called myelin which normally protectsthenervesfromdamage,islost. “Inthelast20yearswehavemadereally good strides with relapsing-remitting MS, but not for progressive MS,and the reason whyislinkedtotheirdifferentcauses”,says DrAlasdair Coles,senior lecturer in the de- partment of clinical neurosciences at the University of Cambridge.“But we do have anadvantage,becausethetwoformsofMS aren’t entirely connected.This means we canadopttwoapproaches:earlytreatment andexperimentalapproaches.” Safe treatment Earlyand aggressive treatments for relaps- ing-remitting MS means using the strong- est drugs as soon as people are diagnosed. Thisapproachiscontroversialandthere’sa genuinelackofconsensusaboutwhetherit issafe.ButtheNationalInstituteforHealth andCareExcellence,whichpublishedguid- ance on howto treat MS in October 2014,is that people can be treated with stronger drugseveniftheyhaveearlyMS. Colessays:“Wecanuseearlyandaggres- sivetreatmenttostoppeople’snervesfrom being stripped of their myelin.It’s still not standard treatment and the conservative position,whichIunderstand,istousemild- er drugs for people early on in the disease. Atthemomentthere’slittleevidencetosay thatthisapproachstopstheprogressionof MS over the long-term,but that’s because wehavenothadthedrugsforverylong.” LILIAN ANEKWE info.uk@mediaplanet.com Doctors’knowledgeofthedifferentcausesofmultiplesclerosisisleadingtonew potentialfortreatmentandresearch,accordingtoleadingUniversityofCambridge expert,DrAlasdairColes. What does the future hold for MS research? NEWS Anotherapproachwouldbetolookatthe possiblepotentialofgivingpeoplewithMS drugsthatcanrestorethemyelinthatdam- aged nerve cells have lost.“There’s promis- ing lines of research,although nothingyet that’sintheclinic”,Colessays. “We know there are stem cells in the brain that are capable of being remyelinat- ed.So the challenge is to wake up the cells that that otherwise just sitting there dor- mant” says Coles, who is conducting an early-stage trial looking at using existing MSdrugsinthisway. So the current research efforts in MS mean that in the future people with MS could benefit from a combination ap- proach, to combat the inflammation and to regenerate stem cells and repair the nerves — and possibly leading to better managementofMS.
  • 7.
    neurologicalhealth.co.uk · 7ANINDEPENDENT SUPPLEMENT BY MEDIAPLANET RESEARCH IS KEY Understanding the causes behind this unpredictable disease will prove key in treating it. PHOTO: THINKSTOCK FACTS ON MS 5 1 There are more than 100,000 people in the UKcurrentlylivingwithMS. 2 Symptoms usually start in your 20s and 30s and it affects almost three times as manywomen asmen. 3 It affects the central nervous system — the brain and spinal cord nerves whichcontrolbodilyfunctions. The immune system attacks the myelin coating which protectsnervefibres,damaging the nerves and causing them tomalfunction. 4 MS is an unpredictable condition and symptomsincludeproblems with mobility and balance, vision and dizziness,fatigue, bladder problems, muscle stiffnessanddepression. 5 TheMSSocietyistheUK’s leading MS charity; we provide information and can help people – call our helpline on 0808 800 8000 or visit www.mssociety.org.uk MS SOCIETY info.uk@mediaplanet.com
  • 8.
    8 · neurologicalhealth.co.ukAN INDEPENDENT SUPPLEMENT BY MEDIAPLANET “When we also consider the fami- lies of people struggling with the disease this means Parkinson’s di- rectly affects 20-40 million people. Parkinson’s also affects govern- ments and healthcare systems be- causeitisaverycomplexcondition to treat as each person has their own combination of symptoms”, DrWyse,says. The Cure Parkinson’s Trust is working with neurology experts worldwide,andhasidentifiedmore than 70 potentially disease-modi- fying’ treatments.TheTrust has al- ready prioritised more than 20 of these radical new treatment ap- proachestobetestedinPDpatients in specialist neurology hospitals aroundtheworld. Dr Wyse explains: “The first of these trials,involving repurposing of an anti-diabetic drug,was com- pleted last year with extremely promising results suggesting we may have already intercepted de- clineinPDpatients.” A second line of new treatments involves several ‘mitochondrial’ targeteddrugs. “Wearestartingtomovetowards developing personalised medicine for PD patients,with future thera- pies matched to their genetics,bi- ochemistry, and their symptoms”. As such they have identified po- tential treatments targeting awide range of biochemical pathways which now need to be proven in clinicaltrials. Regenerative medicine Another key area is regenerative medicine, focusing on re-grow- ing and replacing the cells that have died as Parkinson’s progress- es. “Surgical trials of transplanta- tion of neural tissue, and of long- term infusions of a natural brain growth factor,GDNF,are underway in Cambridge and Bristol,and offer huge promise.” The neurodegen- erative disease named after James Parkinsonwhodiscovereditin1817, includes a range of crippling mo- torandnon-motorsymptomssuch as shaking,slowness of movement, gutproblemsanddisturbedsleep. According to Dr Wyse,the main causes of Parkinson’s are environ- mental,such as exposure to pesti- cides or in manganese mines; ge- netic(about10percentπofpatients have genetic forms of PD),and for othersit’striggeredbyheadtrauma, as in the case of the famous boxer MuhammedAli. All current treatments just fo- cus on managing daily symptoms. Since some people are diagnosed with the disease in their 30s or 40s they can be afflicted with the diseasefor40to50years. Dr Wyse and his colleagues are working hard on finding a cure be- yond symptomatic treatments. He says: “While money is current- ly needed to test many innova- tive new disease-modifying treat- mentsintheclinicwebelievethere really is hope that in the near fu- ture we can slow, stop and even reverseParkinson’s. DIANE PRIESTLEY info.uk@mediaplanet.com Dr Richard Wyse Director of research and development, The Cure Parkinson’s Trust INSPIRATION Real promise for 10 million people living with Parkinson’s DrRichardWyse,directorofresearchanddevelopmentatTheCureParkinson’sTrust,believes that“scientifically,nowmorethanever,thereisconsiderablehopeaboutfuturetherapiestoslow, stoporreverseParkinson’s.” BritanniaP h a r m a c e u t i c a l s L t d BRITANNIA PHARMACEUTICALS IS PROUD TO SUPPORT MEDIAPLANET ON PARKINSON‘S Whatarethemostpromising newapproachesthatarehelping researcherstobetterunderstand theeffectsofParkinson’s disease(PD)?ProfessorRoger Barker,whoworksatthe UniversityofCambridge’scentre forbrainrepair,explains. “Threeareasofcomplimentaryresearch arecontributingtoresearchersgaininga betterunderstandingofPDandtheright treatmentsfordifferentpeople”, Barkersays. “Atthemomentwedon’treallyunder- standwhysomepeopledowellformany yearswhile others quite quicklydevelop seriouseffects.We’retryingtolearnwhy from looking at the genetic makeup of peoplewhohavemoreaggressivediseas- es.Wecantaketheirskincellsandrepro- gram them in the lab and convert them into nerve cells. Then we can discover newtargetsforresearchandtreatments.” “Thefuturewillcomewhenweareable totakeembryoniccellsandturnthemin- to new nerve cells,and inject them into the brains of people with PD.It won’t be a cure but it couldvastlyimprove symp- tomsfor10oreven20years.There’ssome research now in mice that is promising, and I hope to see results in the next five years.There’sfocusonaproteincalledal- phasynuclein,whichbuildsupinsidethe braincellsofpeoplewithPDandspreads outsideofthebrain.It’sacompletelynew idea,butifprovenwemightbeabletode- velopavaccinetostopthesymptoms.” Newapproachesto Parkinson’sresearch LILIAN ANEKWE info.uk@mediaplanet.com
  • 9.
    neurologicalhealth.co.uk · 9ANINDEPENDENT SUPPLEMENT BY MEDIAPLANET NEWS Revolutionary treatment for brain tumours P rofessor Lars Leksell, who wanted to emu- late the surgical pre- cision of a scalpel with beams of radia- tion, first developed thetool40yearsago. He developed the Gamma Knife as a dedicated tool, able to deliver a highly accurate therapeutic dose of radiation to the brain with little ornoharmtothepatient,andithas becomethegoldstandardofstereo- tacticradiosurgery(SRS). Professor Christer Lindquist, Consultant Neurosurgeon at the BUPA Cromwell Hospi- tal Gamma Knife Centre in Lon- don worked with the late Prof Leksell in research and develop- ment of the Gamma Knife and has the longest experience with the deviceworldwide. He says: “The Gamma Knife was a quantum leap for the treatment of many inoperable brain tumours and other conditions when it was firstintroduced. “A very high dose of radiation is delivered in one single treatment session, and the patient can be treatedasanoutpatientorstayonly onenightinthehospital. “The high dose is,however,tox- ic not only to the treatment ob- ject but it may also be injurious to normal brain. It is therefore essential that the radiation vol- ume is “tailor-made” to the ob- ject to be treated.” Salvage therapy Prof Lindquist came to London in 1998 from the Karolinska Hospi- tal in Stockholm, where he was the Director of the Skull Base Surgery Program and the Gamma Knife Center in the Department of Neurosurgery and has pub- lished some 100 scientific papers in neurosurgery. He says: “Whole Brain Radia- tion Therapy (WBRT) is the most common type of radiation still used in the UK to treat brain me- tastases. In my opinion it should now only be used as salvage ther- apy. Side effects such as memo- ry deficits, dementia and epilep- tic seizures are not acceptable when modern radiosurgery is a better treatment.” The Leksell Gamma Knife can be used to treat primary and sec- ondary brain tumours, and some cases of Parkinson’s Disease,epi- lepsy and Obsessive Compulsive Disorder (OCD). The one-day non-invasive treatment means patients can usually receive treatment in a single day and return to normal lifestyle the day after treatment. More than 800,000 patients have been treated with the gamma knife throughout the world. Peoplewithbraintumourscannowbetreatedwithagentleralternative tosurgerywitharemarkable‘gammaknife’. Dedicated. Leksell Gamma Knife® is the only system designed specifically for brain radiosurgery. Optimized to spare healthy tissue where it matters most, it allows you treatment of the most challenging cases with confidence. 100% Leksell Gamma Knife® Perfexion™ Preferred for cranial radiosurgery For more information, visit gammaknife.com Submillimetric accuracy Largest clinical evidence base Convenient for patients 1516053.00 Professor Christer Lindquist Consultant neurosurgeon, BUPA Cromwell Hospital, Gamma Knife Centre, London DIANE PRIESTLEY info.uk@mediaplanet.com PHOTO:THINKSTOCK RADIATION TREATMENT Patients can receive the gamma knife treatment and return to normal life the next day.
  • 10.
    10 · neurologicalhealth.co.uk Physicalexercise helps keep brains healthy but acute concussion, a brain injurythat can go undetected, can be fatal. Repeated concussions are known to cause neurodegener- ative disease in boxers.Could rugby playerssufferinthesameway? To find out Professor Damian Bailey of the Neurovascular Re- search Laboratory at the Univer- sity of South Wales has developed tests that focus on the brain’s con- trol of it’s own blood flow and oxy- gen.Bailey says: “Understanding of the causes and long-term brain ef- fectsofconcussionsispoor.Concus- sions can be hard to spot,do not re- quire a direct blow to the head and in 90 per cent of cases do not lead tounconsciousness. “Wehavefoundevidenceofaccel- erated brain ageing leading to im- paired mental agility and dementia symptomsinretiredrugbyplayers.” Bailey has put over 250 rugby players through tests designed to challenge the brain. Putting the brain under pressure through novel types of exercise, high-fat meals and changes in oxygen/car- bon dioxide has detected subtle and enduring signs of brain injury. Study participants were matched against non-rugby playing con- trols of similar age and fitness.The findings are being submitted for scientificpublication. “Our research could change the way rugby is played and even the game’s rules,so accurate results are essential,” says Bailey. “We believe that our battery of lab tests can pick up subtle effects and provide a more scientific means of determining when the brain has fully recovered - or not,as we have seen in some of thesedentaryretiredplayers.Ourap- proaches include electron paramag- netic resonance spectroscopy and ozone-based chemiluminescence to measure blood levels of free radicals, tiny molecules that in excess can damage the brain and impair blood flowandoxygendelivery.” The lab also uses high-performance data acquisition hardware to cap- ture a wide varie- ty of signals from the brain, heart, lungs and mus- cles.Thisincludes blood flow and oxy- genation,blood pressure, heart rate, ventilation and the composition of expiredgases. Bailey says: “If my re- search confirms there is a clear risk of brain injury from concussions I hope it willbeusedtoinformreturn to play decisions and help prevent some of the more damaging long-term chang- es to the brain that can oc- curwhenplayersretire.” LINDA WHITNEY info.uk@mediaplanet.com Scientistsareusingnewtechniquestostudytheeffectsof concussioninrugbyplayerswhichcouldmakethesport saferandgiveinsightsintoneurodegenerativediseases. One in six people in the UK suffer from a neurological disorder. This can be from birth, through a slowly developing illness or through brain injury. The National Brain Appeal is the charity dedicated to raising much-needed funds for The National Hospital for Neurology and Neurosurgery. We rely on your donations to fund vital research and projects. www.nationalbrainappeal.org Registered charity no: 290173 IS RUGBY A SAFE SPORT? NEW STUDIES ARE HELPING RESEARCHERS FIND OUT INSPIRATION AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET PHOTO:THINKSTOCK
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    www.braintumourresearch.org Tel: 01296 733011| info@braintumourresearch.org BRAIN TUMOURS KILL MORE CHILDREN AND ADULTS UNDER THE AGE OF 40 THAN ANY OTHER CANCER Please mention this publication when responding Let’s connect Each day of research costs £2,740 Brain tumours receive just 1%of national spend on cancer Registered charity number 1153487 (England and Wales) HELP US FUND THE FIGHT. Sponsor days of research at ground-breaking Centres of Excellence. A small charity can make a big difference. We know. When you are diagnosed with a brain tumour, you need someone who understands.We know. Get in touch today, for 24/7 help on 01983 292 405, email hello@brainstrust.org.uk or visit www.brainstrust.org.uk With your donation we will help more people with a brain tumour feel less afraid, less alone and more in control in the face of a terrifying diagnosis.Text LIVE12 £5 to 70070 or call 01983 292 405 to support brainstrust today. brainstrust is a registered charity in England and Wales (1114634), and Scotland (SC044642) NEUROLOGICAL CONDITIONS ARE A SERIOUS PROBLEM IN THE UK www.brt.org.uk/donate We fund world-leading research 12.5 million people in the UK live with a form of brain disease Brain Research Trust Dutch House 307-308 High Holborn London WC1V 7LL Tel 020 7404 9982 Registered Charity in England & Wales No. 1137560. Registered Company Limited by Guarantee No. 7345516
  • 12.
    Feed your mind Feed your mind Neurozan® is certifiedby pioneering charity FOOD FOR THE BRAIN. www.foodforthebrain.org From ,chemists,Waitrose,Holland & Barrett,health stores & www.neurozan.com *IRI value data.52 w/e 2 November 13. Neurozan® is an advanced,comprehensive formula to help safeguard your daily intake of essential vitamins and minerals. Including iron,zinc and iodine which help to maintain normal cognitive function and pantothenic acid which supports normal mental performance. Neurozan® Original contains a specially developed combination of nutrients and is certified by FoodForTheBrain. Neurozan® Plus dual pack provides even greater nutritional support with high purity Omega-3 from Norway. DHA helps to maintain normal brain function. So if you’re looking for a supplement that’s different,keep Neurozan® in mind. ORIGINAL DUAL PACK WITH DHA ADNEUCONP27-06-14E Micronutrients with iron,zinc & iodine, which contribute to normal cognitive function