27 Jun 2018

Monash-Alfred's Department of Neuroscience rising star

2018 O’Brien (epilepsy, neuropharmacology) group. Professor
Terry O'Brien in the back row on the far left.
by Anne Crawford

In late August a new force in Australian neuroscience will be officially launched - Monash University’s Department of Neuroscience will be the only department of its kind in an Australian university.

Partnered with Alfred Health, arguably Australia’s number one teaching hospital, the Department of Neuroscience has a team of more than 140 staff and students, and 19 groups researching different brain diseases, with a heavy focus on translational research. More than 20 clinical trials are already underway.

In excess of $40 million  has  been invested in infrastructure and personnel by Monash University and the Alfred Hospital.

Based in new offices in the Alfred Centre complex and coming under the banner of the Central Clinical School, the Department is headed by Professor Terence O’Brien, the Van Cleef Roet Professor of Medicine (Neurology) and Director of Neurology, Alfred Health.  “I see the Department as being the leading translational research centre in neuroscience in Australia, and one of the leading ones in the world.”

Professor O’Brien said it encompasses the “whole pipeline” of neuroscientific endeavour from generating knowledge through basic research, engineering and developing findings into treatments, clinical trials, making health evaluations, to assessing outcomes and the cost effectiveness of treatment.

“We’re not just interested in how synapses work for science’s sake – although that’s fundamental – but how synapses work to develop better treatments for people with neurological diseases,” Prof. O’Brien said. “Our goal is to improve human health.”

Brain disease, which accounts for one third of all diseases, is a huge burden on the health system and can be devastating to the people who have it, their families and people who love them. It is responsible for the greatest number of years lost to disability in older people (>55 years). “And that percentage is increasing as people get older,” he said.

The Department’s multidisciplinary staff include clinicians and researchers, neurologists, neuropsychiatrists, neuropsychologists, neurosurgeons, neuroradiologists and specialists in pre-clinical imaging.

Together they cover a broad range of neurological disease and disorders ranging from epilepsy, dementia including Alzheimer’s disease, other neurodegenerative diseases including Multiple Sclerosis and Parkinson’s disease, paediatric brain injury, neuroinflammatory conditions, neurocognitive and neuropsychiatric disorders, brain tumours, stroke and traumatic brain injury, including concussion.

The research will extend well beyond the Department with multidisciplinary collaborations within the precinct, for example with haematologists interested in treatments for stroke, cardiologists interested in connections between heart and brain disorders at the Baker Institute, psychiatrists interested in mental health comorbidities of neurological diseases at Monash-Alfred Psychiatry Research Centre, and engineers working to develop new devises to better diagnose and treat brain diseases from Monash Institute of Medical Engineering (MIME).

Prof. O’Brien, former head of the Department of Medicine at the University of Melbourne for 10 years, is known for his networking and team-building skills. The Department will maintain and enhance deep collaborations with clinical and basic neuroscience researchers at the University of Melbourne and The Florey.

“They were looking for an academic, someone who could bring a critical mass of people to work well together, work out what resources were needed, build infrastructure and support the work,” he said.

Prof. O’Brien said one of the strengths of his research career has been in preclinical translation.

Head of the Central Clinical School, Professor Stephen Jane said, “Until recently there have been virtually no disease-modifying treatments that slow down or reverse the course of largely progressive, disabling, and often ultimately fatal brain diseases.

“There is now exciting promise for the development of effective new therapies for many of these previously untreatable brain diseases. However, there has been a lack of advanced facilities and infrastructure in Australia, and globally, required to effectively translate these research advances into proven therapies for patients.”

Remarkably, Prof. O’Brien has created and assembled the Department of Neuroscience in little over eight months.

“It was a huge challenge for me. If you knew before where we would be now and what was needed to do it, you’d say ‘no thank you!’” he quipped. “We’ve had tremendous support from the University and Hospital.”

About a quarter of the staff he recruited had previously been involved with Prof. O’Brien’s own epilepsy research group. Others were already working as clinicians at the Alfred Hospital, perhaps teaching at Monash, were brought into the university department. The remainder of staff were recruited from institutions in Australia or internationally  with appointments from the University of Calgary in Canada and USC, in the USA.

New purpose-built state-of-the-art basic neuroscience laboratories, a preclinical imaging facility with technology leading equipment including PET-CT, FLECT, and a $4.5million 9.4T Tesla MRI, and a dedicated Neurological Clinical Trials Facility have been built this year, thanks to infrastructure investments by Monash University and Alfred Health.

The Clinical Trials Facility will be embedded in the Neurosciences Ward at The Alfred with capacity for overnight stays and a focus on early-stage trials. Prof. O’Brien is proud of the program, which he oversees. “We have a really outstanding group of trial co-ordinators,” he said.

The trials are aiming to develop treatments for diseases including; epilepsy, dementia, movement disorders including the Parkinson’s disease and progressive supranuclear palsy (PSP), a nasty form of migraine called cluster headache, stroke, traumatic brain injury and MS. One trial is investigating diagnostic markers for sports concussion in amateur footballers. Another is developing “wearable diagnostics” to diagnose when a person has had a seizure to provide better monitoring, and potentially, better alerts.

Investigations go beyond traditional neurobiology. Some of the trials are investigating alternative treatment programs including dietary therapy for conditions such as epilepsy. Novel deep brain stimulation approaches will be clinically tested for the treatment of neurological diseases including Parkinson’s and epilepsy. Imaging-based research will be conducted within neuropsychiatry.

Researchers are about to embark on a large, whole-genome study of epilepsy involving patients and researchers in China.

A six-bed unit Inpatient Epilepsy Monitoring unit has been built alongside the Neurology Clinical Trials centre, the most advanced unit with the largest capacity in Australia, Prof. O’Brien said. There is currently a “desperate shortage” of such units for Australian patients to access.

As well as running the Department, Prof. O’Brien heads a group investigating treatment for epilepsy.

“Epilepsy’s a symptom of many brain diseases,” he said. “For our group the holy grail is the development of disease-modifying treatment for epilepsy and also for other neurological diseases, to look for ways to reverse the condition, mainly around epilepsy but also beyond it.”

The Monash University Department of Neuroscience will be officially launched by the Honourable Greg Hunt MP, Minister for Health on 30 August 2018.

Department Mission Statement:
To undertake the highest quality, internationally significant, research across a broad range of basic and clinical neuroscience fields, and to translate these to improve treatment and outcomes of patients with neurological diseases.
Link: www.monash.edu/medicine/ccs/neuroscience/home

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