Embedding imaging and analysis tools for risk identification, diagnosis, prediction, and treatment targeting
Main location of work
Why the work is important
Despite the UK’s outstanding international profile in brain imaging, the work has delivered only modest patient benefit. The NHS Long Term Plan acknowledges that ‘capacity in diagnostic services has not kept pace with the growth in demand’ and there is a need to ‘improve accuracy and turnaround time on scans.’ The NHS Framework for Mental Health Research flags the current lack of routine brain scanning in mental health as a ‘lost opportunity.’
Building on the previous BRC Neuroimaging and Cognitive Neuroscience Theme, the Brain Technologies Theme will focus on the scientific/clinical interface to create and test accurate tools for measuring brain structure and function to improve risk identification, early diagnosis, outcome prediction and treatment targeting.
What work will be carried out
Research projects being undertaken in this theme include:
- New markers of brain health
Brain-imaging and neurophysiology measures will be validated and refined to assess brain health through iterative testing in clinical settings.
Innovations will be introduced in brain-imaging and neurophysiology methods to develop and improve neurological, psychiatric, and psychological biomarkers. Brain-imaging methods will include MRI, CT, and retinal Imaging; Neurophysiology methods will include MEG and EEG. Methods will be applied to multiple clinical research cohorts and routinely acquired NHS imaging data available for experimental testing through local and national partnerships.
- New analytic tools
New analytic tools will be developed that can be used reliably in individual patients and across varied real-world settings. Methods will focus on establishing population norms and charting individual variation by mining population datasets (eg UK Biobank) to facilitate comparisons between individual patients.
Building on leading roles in population neuroimaging initiatives, the team will harmonise MRI and CT acquisition across hardware and sites to enable quantitative measures in clinical settings, transforming clinical readings of images, currently done ‘by eye.’ Collaborators in Manchester will access brain scanners from three major vendors in clinics across the city with the aim of creating a standard output from all clinical settings.
Knowledge from both of these research projects will allow translation of technological innovations into both the clinic and the home.
- Brain reporting software for healthcare settings
Novel image-reporting software for healthcare settings for treatment trials and routine clinical practice (FSL-clinical) will be introduced, co-designed with clinicians, and build on our highly successful and openly available analytical tools for brain-imaging research.
FSL-clinical will provide a comprehensive and intuitive platform that overcomes current usability barriers of commercially available software. Diagnostic accuracy, feasibility, and co-effectiveness will be tested with other Oxford Health Themes (Dementia, Pain, Depression Therapeutics), Oxford BRC Themes (Imaging, Preventative Neurology), and the Health Economics Research Centre. For maximal clinic utility, the aim is integration with the NHS image-reporting system (PACS), toward which the work will take advantage of Greater Manchester’s unified PACS system.
- Home technologies for brain monitoring and modulation
Innovations in EEG, retinal imaging, and brain-stimulation methods will be applied to develop home technologies that provide a window on neurological and systemic health.
A variety of avenues will be explored for developing portable and affordable markers of brain health (eg EEG measures of synaptic health for prevention and treatment of neurodegeneration and mood disorder, home-based EEG for early detection of neurodegeneration, retinal imaging for diagnosing brain conditions that could be administered during an annual high-street eye test). Partners at the University of Surrey will collaborate to develop portable methods for recording and modulating activity directly from the brain for treating neurological conditions.
Patient and public involvement, engagement and participation
The patient and carer experience are at the heart of all the work in the BrainTechnologies Theme, building on the award-winning public engagement programmes at the Wellcome Centre for Integrative Neuroimaging (WIN).
Home-based projects which form part of the Home technologies for brain monitoring and modulation research project are geographically unconstrained and allow recruitment nationwide, targeting areas of greatest need.
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Increasing research capacity and critical mass
The Brain Technologies Theme builds on a strong foundation and track record in building research capacity, supporting career development, fostering a positive research culture, stimulating public engagement with research, and promoting open science established by the previous Neuroimaging Theme and WIN. The team have successfully delivered brain-imaging training courses (eg FSL course) for over 10 years and has started piloting clinically oriented training programmes for health professionals to build capacity in brain imaging.