Professor Nigel Hoggard

My research interests remain primarily centred on the diagnostic applications of MR imaging in radiology with a particular emphasis on neuroscience and the cerebellum in particular. I work closely with Prof Marios Hadjivassiliou, we are part of the SIGReD group founded by Marios, a multi-disciplinary research group focussed on gluten related diseases. We have published numerous articles on gluten ataxia and brain imaging in gluten sensitivity.

The cerebellum is a small part of the brain that never the less contains over half of the neurons. It represents a highly compact system for combining and analysing information subconsciously for the rest of the brain, it can be thought of as the brain’s own supercomputer. It is designed to compare feedback information such as where is my hand in space to pre-existing models held in the cerebellum and then feed-forward into motor commands to ensure movements coordinated in real time such as would be required for catching a ball.The cerebellum not only helps the brain to control balance and coordination of movement but is now having its role in control of emotion, language and cognition gradually revealed. When it is damaged patients may be affected by falls and feel clumsy. They may lose the ability to walk, speak normally, use utensils or dress themselves and quite frequently may have to use a wheel chair as it becomes more severe.

The cerebellum is affected by a wide range of diseases including genetic conditions, degenerative conditions, alcohol and auto-immunity related diseases. There are new treatments being developed for diseases affecting the cerebellum but trials are hampered by the lack of suitable ways to measure their effectiveness. In dementia and MS many trial outcomes are based on MR imaging techniques as a well as clinical changes in the patients. But because the cerebellum’s activity is subconscious and represents feedback control beneath the surface it is difficult to measure clinically. Our group’s research is focussed on assessment of the cerebellum with advanced MR imaging based techniques. In particular, there is a need for measurements in the autoimmune cerebellar diseases and aggressive degenerative cerebellar disease such as MSA-C.

Gluten sensitivity, as well as causing ataxia, can be associated with accelerated white matter small vessel disease and imaging to assess this and the evaluation the blood brain barrier is an area of great interest to us in SIGReD. We recently published a paper demonstrating cognitive and structural brain changes in patients with coeliac ideas from the UK BioBank study in Gastroenterology. We have been recently funded by the Peter Sowerby Foundation to investigate the potential consequences of gluten possessing antibodies gliadins in the blood, which affects about 10% of the UK population, on brain structure and neuro-cognitive performance.

I have been heavily involved in the UK and European response to the evidence of the accumulation of gadolinium in the brain in patients after routine administration of gadolinium based contrast agents for MR scans.I co-chaired the PRAC which recommended to the Human Medicines agency to restrict the use of linear structure gadolinium based contrast agents in the European Union.