Nerve centre for combined ops

Claire Sanders visits a new interdisciplinary neuroscience centre that aims to advance our minimal understanding of the brain.

Researchers at the Institute of Psychiatry's new neuroscience centre are the first to admit how little they know about the brain. "Our ignorance is fundamental," says director Nigel Leigh. "We have only just begun to scratch the surface."

Trying to understand exactly where the new centre fits into the complex relationship between the institute, King's College school of medicine and dentistry and King's College hospital, brings on a similar feeling of humility.

Professor Leigh draws the centre as a black blob in the grey area where the institute, on one side of the road, meets with the hospital on the other. It has a regional clinical service based at the hospital and an academic element staffed by the institute and the school of medicine. Both the institute and the school are part of King's College, London, which is due to merge with the United Medical and Dental Schools of Guy's and St Thomas's hospitals later this year.

"With the merger we will have the resource of the largest medical school in the country," says Professor Leigh. Already 300 NHS and academic staff are engaged at the centre.

The complex arrangement means the centre can draw on the specialist psychiatric expertise of the institute and the clinical and research strengths of the school of medicine.

Interdisciplinarity flourishes in this environment. The institute has ten interdisciplinary research groups whose work focuses on tackling the mental health issues identified in The Health of the Nation, the health white paper. King's medical school also has IRGs working in general medicine. The groups integrate basic and clinical science and researchers from several disciplines. Some joint IRGs have been established between the institute and the school, including one in clinical neuroscience.

Professor Leigh heads the clinical neuroscience IRG, a role which he says overlaps with his new job as director of the neuroscience centre, which in turn he describes as the "nerve centre" for the IRG.

The aim of the new centre is to help those suffering from disorders such as Alzheimer's disease, Parkinson's, stroke and motor neurone disease (MND).

"The disorders we work with are highly complex in their causes and mechanisms," says Professor Leigh. "By bringing together advanced brain imaging, molecular biology and genetics, epidemiology and clinical care, we are on the threshold of a new opportunity for understanding and delivering the best possible treatments."

"The opportunity for direct access to patients," says Hugh Markus, reader in neurology, is one of the great advantages of the new centre.

King's College Hospital serves over three million people in the Southeast of England and for researchers studying a disease as rare as MND this provides an invaluable resource. There are 5,000 victims of MND in the UK and about 10 per cent will receive treatment at the new centre.

The centre plans to use brain imaging to understand the process of neuronal degeneration. This will also advance understanding of other degenerative disorders such as Parkinson's and Alzheimer's.

Professor Leigh has work with the MND Association as a central part of his strategy. He argues that a good relationship with patients is essential not only for proper care, but also for research. "Many of these patients become incredibly well-informed about their condition," he says. "The MND holds annual national and international conferences which clinicians, scientists and patients attend." The development of new drugs found to have an impact on MND has also provided opportunities for funding. And because the disease progresses quickly, with most patients dying within three to five years of diagnosis, any small advance in treatment is immediately measurable.

Funding for the centre is as complex as the interdisciplinary structure underlying it. The academic building was funded by a grant of Pounds 2.5 million from the Higher Education Funding Council for England. The fact that the institute received a 5 rating in the 1992 Research Assessment Exercise (and a 5* in the 1996 exercise), was key to the decision to place the centre at the institute.

Work is under way to bring the latest technology into neuropsychological studies, including the use of virtual reality to create "virtual spatial environments" where the effect of damage to the brain can be measured. The centre is also planning a large international study to look at how blood clots travel to the brain, and the subsequent likelihood of a stroke, using ultrasound techniques. "We have an international reputation to keep up," says Professor Leigh. "The centre will enable us to stay ahead."