To celebrate World Brain Day 2021, News-Medical spoke with renowned neuroscience professor Alan Thompson of University College London about his incredible career in brain research.
Would you please introduce yourself and tell us about what inspired your incredible brain research career?
My name is Alan Thompson and I am Professor of Neurology and Neuro-Rehabilitation at UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery. I was also Rector of the UCL School of Brain Science and Pro Vice-Provost for London.
They brought me into my career in Brain Research through my fascination with multiple sclerosis, a common condition in Ireland and the perhaps naive belief that I could make a difference in understanding the condition, thus developing effective treatments and improved management for those who had MS, improving their quality of life and well-being.
I was very lucky to have two great mentors, Professor Michael Hutchinson in Dublin, and Professor Ian McDonald in London, who supported and guided me through the first critical stages of this journey.
World Brain Day is celebrated around the world every year. This year is dedicated to multiple sclerosis (MS), a neurological disease that affects 2.8 million people worldwide. Could you tell us more about multiple sclerosis and why it affects so many people?
Multiple sclerosis is a complex, inactive neurological condition that involves a number of processes such as inflammation, demyelination, and axial damage and loss. The exact cause of multiple sclerosis is not clear, but it is a complex combination of genetic and environmental factors. Multiple sclerosis tends to affect young people early in life and is one of the most common neurological diseases affecting this age group.
In the majority of patients, the condition begins with attacks or episodes (called relapses) after the initial episode called clinically isolated syndrome. Common initial episodes include the optic nerve and sensory and motor pathways. The majority of those affected enter a progressive and more inactive phase of the situation after a variable period.
Multiple sclerosis. Credit Image: Miriam Doerr Martin Frommherz / Shutterstock.com
There are treatments available for multiple sclerosis, but access to this drug is not yet available in many parts of the world. Why is this and what can be done to improve access for all?
Few neurological conditions have seen such therapeutic developments as Multiple Sclerosis – especially for the previous relapsing / decongestant phase of the condition (about 20 treatments are now available).
However, there is a very wide range of accessibility and it can be very poor in middle and low income countries – mainly due to costs and limited health services available. It takes a concerted international effort to never change.
The key messages this year for World Brain Day 2021 are disability, prevalence, education, access to treatment and defense. What can people, governments and organizations do to raise awareness about MS and its symptoms?
A collaborative global approach is needed and umbrella organizations such as the International MS Federation and the International Progressive MS Alliance are well placed to contribute to coordinating and promoting this effort.
Much of your research throughout your career has been on multiple sclerosis. Why did you consider it such an important part of your job?
As a junior doctor, I was impressed by how little we could do to help people with multiple sclerosis (there was no effective treatment at the time) – it just seemed to be getting worse.
I felt there was a real opportunity to improve our understanding of MS and I was particularly impressed in the early 1980s by the information that MRI could offer – in research, diagnosis and as important biomarkers in clinical tests. I have particularly focused on exploring disability mechanisms using this ever-evolving tool.
MRI scan. Credit Image: Shidlovski / Shutterstock.com
What areas of brain research are you currently focusing on?
I participate in various fields – from the clinical point of view, improving the diagnosis and I work on phenotypes in parallel with the involvement in clinical trials, while from the research side I focused more on exploring mechanisms of disability – especially in relation to the spinal cord and the focus on progressive MS formats.
However, it is in my role as chairman of the Scientific Steering Committee of the Progressive Alliance for the Member States that I believe I have the greatest impact. It was fascinating and very enjoyable to see how this (relatively newly established) organization brought together researchers, clinicians, people with multiple sclerosis and industry colleagues to raise their profile and guide the Progressive Research Agenda. MS.
How did the current COVID-19 pandemic affect your research?
It inevitably delayed my own imaging search, but it also delayed the work of the Alliance’s international networks for the last 18 months.
However, it has also highlighted the determination, resilience and cooperation of our community and it is remarkable to see how all our activities have resumed with renewed vigor and enthusiasm.
COVID-19 has also undertaken vast research over the past year with many scientists and organizations working together to develop effective treatment strategies. How could this level of collaboration be used to develop effective treatment strategies to stop the progression of multiple sclerosis?
It is an excellent model of coordinated, collective activity – resulting in rapid progress, long-distance obstacle navigation, innovative approaches. This is especially important when thinking about how we are testing in the Member States and how we can speed up our procedures for effective treatments for progressive multiple sclerosis.
In all your incredible research career, what was your proudest moment?
I would say that my findings on the pattern of MRI abnormalities in primary progressive multiple sclerosis were my proudest moment, but now I will be more inclined towards the work of the Progressive MS Alliance that had a real impact – and of course the Charcot Award last month – which really reflects all the work my colleagues and team have done over the last 30 years.
Finally, do you think that with continuous research and further awareness, we could help slow down, and ultimately stop, the development of multiple sclerosis?
Absolutely – I think we are already well on the road to slowing down – and we will eventually stop evolving – probably long before the Member States understand enough to prevent it.
Where can readers find more information?
Multiple Sclerosis Documents:
- Thompson AJ, Banwell BL, Barkhof F… Cohen J. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurology 2018; 17: 162-173. (EA 30.039) References: 980. Link: https://www.sciencedirect.com/science/article/pii/S1474442217304702
- Montalban X, Gold R, Thompson AJ et al. ECTRIMS / EAN Directive on the pharmacological treatment of people with multiple sclerosis. Multiple sclerosis magazine, online 20 January 2018 (IF 5.412); European Journal of Neurology 2018; 25: 215-237 (IF 4,516). References: 72. Link: https://journals.sagepub.com/doi/full/10.1177/1352458517751049
- Thompson AJ, Baranzini S, Geurts JJ, Hemmer B, Ciccarelli O. Multiple Sclerosis. The scalpel 2018; 391 (10130): 1622-1636 (IF 60.392). References: 41. Link: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30481-1/fulltext
- Ontaneda D, Thompson AJ, Fox RJ, Cohen JA. Progressive multiple sclerosis: prospects for disease treatment, rehabilitation and restoration of function. The scalpel 2017; 389: 1357: 1366. (IF 60.392) References: 77. Link: https://www.sciencedirect.com/science/article/pii/S0140673616313204
Regarding the work of the WHO Essential Medicines List:
About Professor Alan Thompson
I am currently a Consultant Neurologist at Queen Square and Professor of Neurology and Neuro-Rehabilitation at UCL. I am Rector of the UCL School of Brain Science – one of the largest and most successful UCL Schools and I also have the exciting role of Pro Vice-Provost London. I am the editor-in-chief of the Multiple Sclerosis Journal, which goes from strength to strength, and, of course, I chair the scientific steering committee of the MS Progressive Alliance.
I went into Multiple Sclerosis in the hope that I could make a difference and it was great to see how it has gone from an incurable to a treatable situation in the last twenty years – and it would be great to see the same pattern evolve for those in the progressive form of the situation.