Neuroscience projects

Projects: 

Automation of the collateral history in the memory Assessment pathway

Main Supervisor

Dr Dan Blackburn (d.blackburn@sheffield.ac.uk)

Second Supervisor

Dr Ronan O'Malley (r.omalley@sheffield.ac.uk)

Aim and Objectives

1. Adapting the computerised doctor to receive responses from care partner
a. Developing a survey based in existing tools that the care-partner can complete to provide a more complete assessment of cognition and function.
b. Investigate automation of the pen and paper assessment of Anosagnosia
c. Investigating automated analysis of the Cambridge behavioural Inventory

Research Methodology

1. Adapt existing tools to take a semi-structured format to collect data from care-partners. Current tools include the Cambridge Behavioural Inventory and the Informant Interview of the GPCOG Screening Test.
2. Investigate anosognosia using a discrepancy between self- and informant-evaluations of cognitive and functional performance. This can be conducted using standardised forms which the student will incorporate into a automated tool
3. Investigate the the Cambridge Behavioural inventory into an automated form within the MyPathway system
 

Expected Outcome

Correlation of CBI with established diagnosis of AD, DLB, MCI with positive biomarker
Correlation of Anosagnosia scores on a cohort of 30 people with MCi or early AD with positive CSF biomarkers of AD (ptau, total tau, Amyloid ratio).

Type of Project

Clinical project - based in the clinical environment with patients/including service evaluation

Additional Training

• Interdisciplinary skills (in between engineering/computational and clinical (cognitive neurology).
• Co-design technology development with pwMCI (including those from ethnic minority groups) and clinicians will ensure accptability and scalability of tool.

• Working with an industrial partner will provide a bussiness approach to medical software development.

• Quantitative skills (computation, data analytics and informatics and developing digital and technology excellence as the student will experience web design and large scale data collection.

Motor neuron disease/amyotrophic lateral sclerosis: Immunity and trauma

Main Supervisor

Dr Robin Highley (robin.highley@sheffield.ac.uk)

Second Supervisor

Dr Johnathan Cooper-Knock (j.cooper-knock@sheffield.ac.uk)

Other Supervisors

Dr Bridget Ashford

Aim and Objectives

Assess immunity using several markers in post mortem brains of individuals with MND/ALS.
Examine the relationship of this with pathological indices of brain trauma (chronic traumatic encephalopathy) and severity of disease.

Research Methodology

1) Access existing slides that have undergone immunohistochemistry (labelling of proteins with antibodies for visualisation on a microscope) for a variety of immune markers.
2) Perform additional immunohistochemistry for additional markers on additional regions.
Analyse these
3) Use digital image analysis to quantify the amoung of labelling (from immunohistochemistry in steps 1 and 2)
4) Take quantificaiton data from 3) and compare patients with and without pathological evidence of chronic traumatic encephalopathy.
5) Take quantification data from 3) and copare patients with short and long survival.

Expected Outcome

Answer the question of whether the degree of neuroinflammation affects MND disease severity and if this is involved in the response to trauma, thereby potentially explaining some sporadic disease.

Type of Project

Lab/Bench Project - primarily working in a lab environment

Additional Training

The student will gain skills in literature review, "wet" laboratory skills, image and data handling and analysis, scientific writing and project management.

Investigating the impact of ethnicity on disease outcomes in FSHD

Main Supervisor

Dr Channa Hewamadduma (chewamadduma1@sheffield.ac.uk)

Second Supervisor

Mr Jon Street (jon.street@sheffield.ac.uk)

Aim and Objectives

1. Identify the key issues experienced by members of the BAME community in the UK with FSHD in the UK

2. Identify any differences in disease severity reported by white and non-white individuals with FSHD in the UK

3. Identify differences in quality of life measures of white and non-white individuals with FSHD in the UK

Research Methodology

The UK FSHD Registry has over 900 participants. Participants are sent questionnaires to complete every every year - these include information about their usual level of mobility, their arm function, their pain, quality of life, and demographic information.

We intend to use data supplied by the registry to analyse the quality of life (as measured by SF-36), disease severity (as measured by reported mobility and arm restrictions), and pain (as measured with the McGill pain questionnaire) of individuals on the registry who identify as non-white. We will use this information to help determine if there is any difference between the experiences of non-white individuals with FSHD in the UK, as compared with white individuals.

Expected Outcome

Population studies in Iran, Japan, China and South Korea have presented evidence of reduced disease penetrance in these populations. We therefore expect to uncover differences in both disease severity and lived experience of BAME individuals living with FSHD as compared with white individuals living with the disease.

Type of Project

Medical Humanities

Additional Training

Students will be supported in analysing and interpreting quality of life data from SF-36 using SF-6D methodology. These methods are applicable to many other conditions where quality of life measures are used in medical research.

Wearable multi-sensor device for assessing the hand in motor neurone disease

Main Supervisor

Dr James Alix (j.alix@sheffield.ac.uk)

Second Supervisor

Dr Jamie Healey (jamie.healey@nhs.net)

Aim and Objectives

1). To assess the reliability of measurements made with the glove in healthy volunteers and patients with motor neurone disease.
2). To ascertain if the glove measurements can differentiate between healthy volunteers and patients with dementia.
3). To investigate the correlation between glove measurements and other standard assessments.

Research Methodology

We have developed a multi-modal sensing glove using 3D printing technology (Paterson et al., Flex. Print. Electron., 7 035003, 2022). The new design will capture several different types of data. These will include: surface electromyography, electrical impedance myography, force and hand/finger motion.

The student will: recruit patients, undertake measurements with the glove and analyse data.

Expected Outcome

We will perform recordings twice with each participant - this will enable us to assess reliability (e.g. using intra-class correlation coefficient).

We will compare the different measurements between patients and healthy volunteers to ascertain if the recordings are significantly different between the two groups (e.g. t-tests with false discovery rate correction).

We will correlate readings with traditional measures of hand function in ALS such as symptom scores, the spit hand index and grip strength (e.g. Pearson correlation).

The students work will contribute to our understanding of how well our new technology can capture the effects of motor neurone disease upon the hand.

Type of Project

Clinical project - based in the clinical environment with patients/including service evaluation

Additional Training

Training on how recruit and consent patients will be provided. Training on collecting data (e.g.the glove measurements and other data), operate relevant software etc will be provided. My (J Alix) experience is that the intercalated statistics course provides sufficient training for the planned analyses, providing the student applies what they have learnt. More advanced statistical training (e.g. multivariate statistics) can be provided and some previous students have undertaken such analyses.

The development and implementation of innovative technology enabled care in motor neuron disease.

Main Supervisor

Dr Esther Hobson (e.hobson@sheffield.ac.uk)

Second Supervisor

Dr Liam Knox (l.knox@sheffield.ac.uk)

Other Supervisors

Professor Chris McDermott, Dr Elizabeth Coates

Aim and Objectives

To synthesise the evidence on the technology enabled care services used in MND using a rapid systematic review technique.

To identify the factors that improve technology provider collaborations when designing digital health interventions by conducting semi-structured interviews +/- questionnaires with technology providers and the customers with whom them work.

Research Methodology

Standard systematic review methodology will be employed, using search terms and engines to identify and retrieve articles. A thematic synthesis will be carried out and findings presented qualitatively. The aim will be to publish this review and use the information to design the second stage of the project.

Qualitative interviews +/- questionnaires will be conducted with staff from technology development organisations and people with whom they interact. These can be face-to-face or online and be audio-recorded. Transcripts will be analysed using framework analysis. This work will also be published and feed into a publicly available toolkit to help NHS staff interact with technology companies.

Expected Outcome

The systematic review will highlight what is known regarding digital health for people with MND and identify gaps in the current knowledge. Findings can also be used to better define future digital technologies and adherence to these interventions. The student will be supported to help them publish this review in a high impact journal and present their findings at the International ALS/MNS symposium.

Results from the qualitative interviews will provide information for future digital intervention commissioners and aid them to work with technology companies. This represents a large gap in the current literature and therefore the student will also be supported to publish/present this separately to the review.

Type of Project

Qualitative Project/non-lab based - primarily using qualitative methods

Additional Training

Training on qualitative interview techniques, qualitative analysis and questionnaire design will be provided. As the interviewees will be healthy participants, this represents an easier opportunity for students who have no experience of qualitative research methods. Systematic review techniques will also be taught during the process. The student will be encouraged to present at interferences conferences and to different audiences.

The student will also be expected to embed themselves within the large research team conducting research headed by Professor McDermott. This forms part of a prestigious NIHR funded fellowship "Better Care in MND" as well as part of the £50 million pound government commitment to research to find a cure for MND. The student's role will be to follow the increasingly expanding technology enabled care in MND programme. This will include attending clinics and MND consultations, weekly research meetings and shadowing and working with other members of staff.

Digital diagnosis of cognitive impairment using CognoSpeak

Main Supervisor

Dr Dan Blackburn (d.blackburn@sheffield.ac.uk)

Second Supervisor

Dr Ronan O'Malley (r.omalley@sheffield.ac.uk)

Aim and Objectives

Undertake a literature review of current best neuropsychological screening tools used in to detect cognitive dysfunction in Parkinson’s disease plus any language biomarkers for Parkinson’s disease will be undertaken.

Recruit 20 people with Parkinson’s disease to interact with the CognoSpeak

Research Methodology

This project will adapt CognoSpeak for use in screening for cognitive impairment in people with Parkinson’s disease and people with Dementia with Lewy Bodies.

The answers to recent and remote memory questions, along with measures of lexical and semantic complexity will be compared to existing database of healthy controls and those with AD

Expected Outcome

Feasibility of recruiting people with Parkinson's disease to undertake digital cognitive assessment both in person and remotely

Comparison of semantic and language complexity versus HC and people with AD

Acoustic features will also be explored

Type of Project

Clinical project - based in the clinical environment with patients/including service evaluation

Additional Training

Clinical research methodology

Remote Ischaemic Conditioning for Secondary Stroke Prevention (RIC-prevent) - A pilot randomised controlled trial

Main Supervisor

Dr Ali Ali (ali.ali@sheffield.ac.uk)

Second Supervisor

Dr Sheharyar Baig (sheharyar.baig@nhs.net)

Aim and Objectives

To assess this we aim to recruit 34 patients with minor stroke or TIA in a 1:1 randomised manor to undertake either true RIC or ‘sham’ RIC for 8 weeks and evaluate the following primary outcomes:
• Safety – adverse event profiles
• Feasibility & compliance – treatment log of number of completed treatments
• Tolerability – Likert scales of comfort

Research Methodology

Eligible patients will be randomised (1:1) to either RIC (BP cuff inflation around the upper arm at 200 mmHg for 5 minutes followed by 5 minutes of deflation), or sham (inflation pressure 20 mmHg), repeated 4 times, daily for 8 weeks. Patients will need to complete training on the intervention delivered by the MSc student and supervised by clinicians (AA). Weekly telephone calls will ensure treatment log completion (assessing feasibility, compliance and tolerability) and detection of adverse events (safety). Secondary outcomes (BP,HR, functional measures, EQ-5D) will be measured at baseline and 8 weeks.

Expected Outcome

Primary outcomes will be reported in descriptive terms. Secondary outcome measures will be reported descriptively and statistical tests for between group differences will occur according to data distribution (parametric statistics for normally distributed data and non-parametric statistics for non-normally distributed data).

Type of Project

Clinical project - based in the clinical environment with patients/including service evaluation

Additional Training

Student will receive training in delivery of the intervention, on how to take blood samples and prepare serum and plasma for storage, training on outcome measure assessment and undertaking a clinical study.

Role of Remote Ischaemic Preconditioning (RIPC) on Activity, Fatigue and Gait in people with Multiple Sclerosis.

Main Supervisor

Dr Krishnan Padmakumari Sivaraman Nair (siva.nair@nhs.net)

Second Supervisor

Dr David Paling (david.paling@nhs.net)

Aim and Objectives

Primary Aims
1) To assess whether RIPC can increase activity in people with MS
2) To assess whether RIPC can reduce fatigue in people with MS
3) To assess whether RIPC can improve gait in people with MS
Secondary Aims
1) To assess whether RIPC can reduce the impact of MS on people’s life.
2) To assess whether RIPC can improve the quality of life in people with MS.

Research Methodology

Participants will be randomised to receive either RIPC or a sham intervention (sham). They will not be told which group they are in. Participants and their carer will be taught how to perform the relevant intervention and be asked to do so at home every day for six weeks. Physical activity, gait and fatigue will be compared before and after the intervention period. Participants will be asked to wear an activity monitor at home for 1 week before and after the intervention to measure levels of activity. To assess gait, participants will complete the 6 minute walk test wearing inertial sensors which measure gait and distance walked. The modified fatigue impact scale will be completed before and after the intervention and levels of exertion recorded after each 6 minute walk test.

Expected Outcome

Primary analysis will focus on the comparison of the outcome measures at baseline and after the 6 week home intervention period. As a secondary analysis, the outcome measures will be compared before and after the intervention within the visit.

Type of Project

Clinical project - based in the clinical environment with patients/including service evaluation

Additional Training

Progress in new technologies has given rise to devices and techniques which allow more objective evaluation of activity, gait and fatigue. This reduces the error margin caused by subjective techniques [4] and potentially shortens the time needed to detect changes resulting from an intervention. Among these technologies, the currently most adopted are wearable sensors and pressure insoles, dynamometry (DYN), and surface electromyography (sEMG). The INSIGNEO biomechanics laboratory, recently established as part of the NIHR Sheffield Biomedical Research Centre (BRC), is now equipped with all the state of the art sensors needed to perform the above type of assessments.

Wearable sensor systems (e.g. pressure and bend sensors, accelerometers and gyroscopes, heart rate monitors) allow for recording and characterisation of walking “out of the laboratory”, for example, in patient’s homes, at clinic visits, and during the course of their everyday lives. Their most common application is in the analysis of a patient’s motor performance, as recorded while the patient is performing traditionally established tests such as the six-minute walk, 10-minute walk, or timed up and go (the participant is asked to rise from a chair, walk seven metres, turn around, walk back to the chair, and sit down). In addition, wearable sensors can be used to monitor a patient’s gait and physical activity patterns for prolonged periods of time, such as while at home or at work. Wearable sensors allow the recording of several parameters, such as step and stride duration and frequency, gait speed, balance, symmetry and joint angles.

We aim to utilise the above technologies to assess whether RIPC can improve activity, gait and fatigue in people with Multiple Sclerosis. Using validated patient reported outcome measures we will also assess whether RIPC can reduce the impact of MS on people’s life and improve the quality of life in people with MS.