Department of Neuroscience projects

Projects: 

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.