I had been pursuing research alongside clinical training for some time, and I wanted dedicated time in order to complete a more substantial piece of work.
I want to understand how systemic inflammation affects the brain. This is relevant to healthy individuals, but especially to those with brain disease. The clinical correlate is seen every day, in the acute decompensation of chronic brain disease which is frequently seen to accompany systemic inflammation, usually infection. My focus is on multiple sclerosis. My hypothesis is that the blood-brain barrier becomes leaky during systemic inflammation, leading to brain dysfunction, and that the diseased blood-brain barrier in multiple sclerosis is especially susceptible to this. I am exploring this hypothesis in humans using an advanced quantitative neuroimaging technique called dynamic contrast-enhanced magnetic resonance imaging.
I had 9 months of protected research time which enabled me to develop an international collaboration, set up and validate the imaging protocol, publish a review article, present at a number of conferences, and – importantly – develop a funding proposal for a fellowship. I was also able to take part in a number of other research studies in our group.
The disease exacerbations which accompany systemic inflammation are a major source of morbidity and mortality in multiple sclerosis, as well as in other chronic brain diseases. Systemic inflammation may also drive progression in the primary disease process. Understanding the mechanism for communication between the periphery and the brain will provide novel targets for new treatments.