Clinical neuroimaging research at CUBRIC has three main aims:
Our research into the mechanisms of brain diseases draws on substantial synergies with the gene discovery work at the MRC Centre for Neuropsychiatric Gentics and Genomics (MRC CNGG), where substantial progress has been made over the last decade in identifying risk genes for neurodevelopmental disorders such as schizophrenia, bipolar disorder and autism, and neurodegenerative disorders such as Alzheimer’s disease and Parkinson’s disease. For many of these variants, the mechanisms by which they confer disease risk are not known, and we investigate the effects of these genetic variants (and their interaction with the environment) on brain structure and function and on behaviour. This work is supported by our growing genetic imaging cohort and several international collaborations.
Neuroimaging and neurophysiological methods available at CUBRIC are ideally suited to improve our understanding of psychiatric and neurological diseases. Examples from ongoing work include the investigation of the pathophysiology of damage and recovery in neuroinflammatory conditions such as multiple sclerosis (MS) [Figure 1], of the relationship between brain activation and performance on cognitive tasks (for an example from bipolar disorder see Figure 2), and of structural and functional variations in epilepsy [Figures 3 and 4]. This research can also contribute to the development of novel preventative or recovery-oriented therapeutic strategies.
2. To develop and evaluate imaging protocols for the monitoring of disease evolution and treatment effects
Neuroimaging methods at CUBRIC can help us develop protocols for improved monitoring of disease evolution, identification of predictors of treatment response and treatment effects. Because mechanisms underlying recovery are active also during normal learning, our scientific interests widen to include functional anatomy of the healthy brain and its changes with activities or learning [Figure 5]. Collaborations between clinicians and imaging scientists also contribute to the development of structural and functional neuroimaging for clinical applications such as MS [Figure 6] and presurgical evaluation of patients with treatment-refractory epilepsy [Figure 7].
3. To incorporate neuroimaging into new treatment programmes with a focus on mental health and neurorehabilitation
Neuroimaging and neurophysiological methods can also help us identify the neurobiological mechanisms of existing or new treatments. This work is not confined to the investigation of drug effects but includes psychological (for example cognitive training) and physical (for example exercise programmes) interventions. In this regard, we are also interested in the development of clinical neurofeedback. Neurofeedback is a technique by which patients can learn to self-regulate activity in specific brain areas or circuits while this activity is monitored by EEG, MEG or fMRI. CUBRIC researchers are coordinating a European consortium that develops and evaluates neurofeedback protocols for mental and behavioural disorders (BRAINTRAIN Project). For example, one potential target for neurofeedback is the hyperactivation of motivation areas of the brain in response to alcohol cues [Figure 8].
To further these aims we collaborate closely with the MRC Centre for Neuropsychiatric Genetics and Genomics (MRC CNGG), the Neuroscience and Mental Health Research Institute (NMHRI), the National Centre for Mental Health, the BRAIN Biomedical Research Unit, clinical academics in the Institute of Psychological Medicine and Clinical Neurosciences, and a network of clinical collaborators in neurology, psychiatry, clinical psychology, anaesthesiology and other disciplines across the Welsh NHS.