Professor Fenella Jane Kirkham MB BChir, MD Cantab, FRCPCH
Professor of Paediatric Neurology
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Professor Fenella Kirkham is a clinical academic at University of Southampton (UoS) and University hospital Southampton (UHS) NHS Foundation Trust.
She has a longstanding interest in the prevention of brain damage in children, including those with sickle cell disease, sleep disordered breathing, head injury and congenital heart disease. She runs treatment trials in patients with sickle cell disease with MRI, cognitive and pain endpoints in collaboration with colleagues in the UoS School of Psychology. She is about to run a pilot trial of early mobilisation and rehabilitation in children in intensive care at UHS. She has international collaborators in Africa, India, Europe and the USA. She also holds a professorial post at UCL, where her MRI students are based.
Professor Fenella Kirkham undertakes transcranial Doppler (TCD) clinics in children with sickle cell disease (SCD) for the NHS (@crescentkids) and trains teams in TCD virtually across the World. She has run randomised controlled trials of auto-adjusting continuous positive airways pressure (APAP) to prevent hypoxia (low oxygen) in children and adults with SCD and sleep disordered breathing. Based on previous work in a collaboration over 15 years with colleagues, including Prof Christina Liossi and Dr Alexandra Hogan, at the University of Southampton School of Psychology, the endpoints chosen have been processing speed, pain and quantitative MRI as well as safety and acceptibility. The phase 1 pilot (ISRCTN29004071), funded by the Stroke Association, recruited and retained 24 children for 6 weeks and demonstrated safety and improvement in cancellation, a measure of attention and processing speed (PMC2704312). A feasibility Phase 2 randomised crossover trial (ISRCTN46078697) comparing overnight oxygen with APAP, designed with the Research Development Service in Southampton, sponsored by University hospital Southampton and funded by the National Institute for Health Research (NIHR) Research for Patient Benefit funding stream, found that patient preference was for APAP (PMC6637584). A novel pain measure, the Index of Pain Experience in Sickle Cell Anaemia (IPESCA), was used (10.1111/bjh.15841) in the full Phase 2 randomised controlled trial (ISRCTN46012373; PMC5778753). Baseline results showed an association between oxygen content, quantitative MRI and processing speed, an important factor in IQ (PMC5993179).
As a clinical paediatric neurologist, Fenella’s focus is on epilepsy and she randomised Wessex patients into trials of vagal nerve stimulation and Eslicarbazepine (10.1016/j.yebeh.2020.106962) for intractable seizures as well as Steroids vs Vigabatrin for infantile spasms (10.1016/S2352-4642(18)30244-X).
Fenella maintains her interest in neurological emergency and intensive care, specifically for paediatric stroke and non-traumatic coma. She was a co-applicant and local Principal Investigator for the Stroke Association funded Outcome for Childhood Stroke in the South of England (PMID:24304598, 26928665). She continues her collaboration with International colleagues in North America, India and Africa. With Julie Makani and Mboka Jacob DOI: 10.1161/STROKEAHA.119.027097) in Tanzania, and Samson Gwer in Nairobi, whose PhDs she co-supervised (PMC5357619), and who trained in the UK, in part at University hospital Southampton, she continues to work to improve outcomes for SCD, malaria and epilepsy in Africa. Current projects involving University hospital Southampton include the Paediatric Early Rehabilitation/Mobilisation during InTensive care (PERMIT) pilot study, for which she is a co-PI on a grant funded by the NIHR Health Technology Assessment (HTA;17/21/06).