Clinical Neurophysiology and Neural Engineering
(Dr. Bahman Nasseroleslami, Mr. Stefan Dukic, Ms. Roisin Mc Mackin and Dr. Amina Coffey)
Clinical Neurophysiology and Neural Engineering projects investigate novel biomarkers of disease onset, progression, and stratification that can be used in the clinical trials of new therapeutics, and eventually enabling a precision/personalised medicine approach towards neurodegeneration. This search for novel disease biomarkers heavily relies on a fundamental understanding of the disease mechanisms and pathophysiology, for which several neurophysiological techniques are employed to study the disease. The research seeks to recalibrate our view of ALS as a disorder of motor and non-motor networks as opposed to focal degeneration of neurons, and to develop novel and inexpensive biomarkers that will segregate patient groups based on differential network disruption.
There have been exciting new findings using non-invasive surface electroencephalographic (EEG) recordings from over scalp in resting-state and during cognitive processing: the alterations in the neural activity and communication (e.g. increased functional connectivity) shows disruptions in several brain networks in ALS and these changes correlate with structural degeneration in MRI scans. Furthermore, the EEG signatures of cognitive impairment reflect the behavioural performance degradation as evidenced by neuropsychological assessments.
The ongoing research and future objective is to further characterise the disruption in motor and non-motor networks and how they change as the disease progresses by employing additional techniques: non-invasive transcranial magnetic stimulation (TMS) generates small short-lasting electrical pulses in the brain whose consequent response in muscles can characterise the alteration in various motor networks. The other technique that can characterise and “image” the motor networks during natural ongoing real movements, is electrical source imaging (ESI) using EEG and electromyographic (EMG) recordings during functional motor tasks. These emerging techniques, in combination with more established methods in clinical neurophysiology (e.g. Motor Unit Number Index, MUNIX, that reflects the progressive loss of lower motor neurons) shall bring new insights on the disruptions of various motor (and non-motor) systems in ALS subphenotypes and in neurodegeneration at large. This work is directed by Prof. Hardiman as PI of the lab and conducted by a small team of PhD students and research assistants led by Senior Research Fellow Dr. Bahman Nasseroleslami.
The projects benefit from extensive collaboration with PI’s in Trinity (Prof. Richard Carson) and University College Dublin (Prof. Madeleine Lowery) in Ireland as well as the University of Rochester, USA (Dr E.C. Lalor), the University of Sydney, Australia (Prof. M. Kiernan & S. Vucic), UMC Utrech, the Netherlands (Prof. L. van den Berg), University of Mainz, Germany (Prof. M. Muthuraman), University of Strathclyde, Scotland, UK (Prof. B.A. Conway & Dr H. Lakany), University of York, England, UK (Dr David M. Halliday) to bring together various levels of expertise to understand the underlying disease mechanisms and move towards the development of new biomarkers that can be used in the clinic to help separate patients into new and meaningful subgroups, and that can be used to measure disease progression over time in clinical trials.