Meet Terry O'Brien, new Head of Monash's Neuroscience & Alfred's Brain departments

Professor Terence O’Brien with a patient in the new clinical trials centre
at Alfred Health. Prof O'Brien is Head, Departments of Neuroscience and
Medicine, Monash University; Program Director, Alfred Brain,
Director of Neurology, and Deputy Director of Research, Alfred Health.

by Anne Crawford

When Monash University and The Alfred Hospital decided to make brain diseases one of their strengths and create Australia’s first new university department dedicated to translational neuroscience, they approached a candidate tailor-made for the role of heading it.

Professor Terence O’Brien, one of Australia’s leading clinical and translational neuroscientists, is well-known for his ability to carry research from basic science through to treatment outcomes, and for having a focus on a collaborative approach.

Moreover, Prof. O’Brien has a reputation for growing departments, and for drawing together people and resources. At the time he was approached about heading the new Department of Neuroscience, Prof. O’Brien was the James Stewart Professor of Medicine, Royal Melbourne Hospital, University of Melbourne. In the 10 years previous he had led the Department of Medicine (RMH) to become the largest and most academically active department of its kind in Australia.

Prior to that Prof. O’Brien had headed the Royal Melbourne Hospital Epilepsy Program for a decade, building it to become one of the leading clinical academic epilepsy programs nationally and internationally.

Within six months of starting his new appointments at Monash University and Alfred Health last October, Prof. O’Brien had recruited more than 140 multidisciplinary staff and students, set up 20 groups researching different brain disease areas and begun overseeing more that 20 clinical trials.

In addition to his other leadership roles, he is overseeing the Epilepsy and Neuropharmacology Research Group, developing new treatment approaches for epilepsy and related areas, including traumatic brain injury and dementing disorders, building on his internationally-recognised research record in these areas.

Prof. O’Brien has published more than 395 peer-reviewed original papers in leading neurological, pharmacological and imaging journals and in more than 2000 abstracts. He is highly cited, with almost 14,000 citations on Google Scholar and 10,500 Scopus entries.

He has been principal investigator on more than 60 industry sponsored or investigator-initiated clinical trials and cohort studies and has had his research recognised in 17 awards from national and international scientific bodies, among them the Ambassador for Epilepsy Award from the International League Against Epilepsy (ILAE).

Prof. O’Brien cites as some of his proudest research contributions: developing a new imaging technique in his doctoral days to localise the seizure focus for epilepsy surgery; with Prof. Frank Vajda, establishing the Australia Register of Antiepileptic Drugs, publications from which have given women with epilepsy better information about minimising the risk of medication on their unborn child while maximising the chance of seizure control; and the development of new therapies for epilepsy that have gone from basic science into clinical trials. The clinical trials are for;

• PRAX-944, an oral tablet being tested in a Phase II, open-label study in adults with generalised epileptic syndromes with refractory absence seizures.

• Sodium selenate is a compound which has been found to stimulate the activity of a major tau enzyme (PP2A) in the brain. Selenium is an essential trace element in humans and sodium selenate is an another similar compound which has not been explored in terms of its potential therapeutic applications. Its safety and tolerability have been demonstrated in prostate cancer and mild-moderate Alzheimer's disease. Prof.O’Brien’s research group has demonstrated its effectiveness in animal models of neurodegenerative disease, and has now started clinical trials.

• Huperzine A is an NMDA-receptor antagonist and shows protection against seizures in animal models of epilepsy. Prof.O’Brien’s group is leading a Phase IIa first-in-disease study in patients with severe drug-resistant epilepsy utilising the Department’s new early phase clinical trial unit.

• Triheptanoin is a triglyceride, odd-chained medium fatty acid that has anticonvulsant effects in animal models of epilepsy. Prof O’Briens’ group has completed a Phase II randomised control study of its safety and effectiveness in patients with drug-resistant epilepsy.

His research has made exceptional insights into, and benefitted many people with epilepsy, traumatic brain injury, neurodegenerative diseases, brain tumours and stroke. Patients with drug-resistant epilepsy can now access more effective treatment options, including surgery, and gain a better understanding of the adverse effects of long-term medication use. A neurologist, he is a champion of putting the patient first in his work.

Prof. O’Brien said his research would continue to concentrate on understanding and treating the underlying causes of epilepsy rather than just the symptoms. “The fundamental goal of our research group is to try to understand the processes that cause these conditions and look for ways to intervene and reverse the condition manly around epilepsy but also beyond that,’’ he said.

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

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