An interview with Professor Alan Thompson

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In commemoration of World Brain Day 2021, News-Medical spoke to renowned neurology expert Professor Alan Thompson of University College London about his incredible career in brain research.

Can you introduce yourself and tell us what inspired your incredible career in brain research?

My name is Alan Thompson and I am Professor of Neurology and Neurorehabilitation at the UCL Queen Square Institute of Neurology and the National Hospital of Neurology and Neurosurgery. I was also dean of the faculty of brain sciences at UCL and pro vice-rector for London.

I was drawn into my career in brain research by my fascination with multiple sclerosis, a disease common in Ireland, and the perhaps naive belief that I could make a difference in our understanding of the disease, developing thus effective treatments and better management for people with MS, improving their quality of life and well-being.

I was fortunate to have two excellent mentors, Professor Michael Hutchinson in Dublin and Professor Ian McDonald in London, who supported and guided me during the critical early stages of this journey.

World Brain Day is celebrated annually around the world. This year, it is dedicated to multiple sclerosis (MS), a neurological disease affecting 2.8 million people worldwide. Can you tell us more about multiple sclerosis and why it affects so many people?

Multiple sclerosis is a complex and crippling neurological disease that involves a number of processes, including inflammation, demyelination, and axonal damage and loss. The precise cause of MS is unclear, but it is a complex mix of genetic and environmental factors. MS tends to affect young people in their prime and is one of the most common disabling neurological conditions affecting this age group.

In the majority of those affected, the disease begins with seizures or episodes (called relapses) after the initial episode called clinically isolated syndrome. Common initial episodes involve the optic nerve and the sensory and motor pathways. The majority of those affected enter a progressive and more disabling phase of the disease after a variable period.

Multiple sclerosis. Image Credit: Miriam Doerr Martin Frommherz / Shutterstock.com

There are treatments for multiple sclerosis, but access to this drug is still not available in many parts of the world. Why is this and what can be done to help improve access for all?

Few neurological conditions have seen therapeutic advances such as multiple sclerosis – especially for the early relapse / remission phase of the condition (around 20 treatments now available).

However, there is a very wide range of access facilities and it can be very low in middle and low income countries – mainly due to the cost and the limited health services available. It takes a concerted international effort to make that change one day.

This year’s key messages for World Brain Day 2021 are disability, prevalence, education, access to treatment and advocacy. What can people, governments and organizations do to help increase awareness of multiple sclerosis and its symptoms?

A collaborative global approach is needed and umbrella organizations such as the International MS Federation and the International Progressive MS Alliance are well placed to help coordinate and lead this endeavor.

Much of your research throughout your career has focused on multiple sclerosis. Why did you find it to be such an important part of your job?

As a young doctor, I was struck by how little we could do to help people with MS (at the time there was no effective treatment) – we just seemed to see them deteriorate.

I felt there was a real opportunity to improve our understanding of MS, and I was particularly struck in the early 1980s by the information that magnetic resonance imaging (MRI) could provide – in it. ‘investigation, diagnosis and as important biomarkers in clinical trials. I particularly focused on exploring the mechanisms of disability using this constantly evolving tool.

MRI

MRI. Image Credit: Shidlovski / Shutterstock.com

What areas of brain research are you currently focusing on?

I am involved in a number of areas – on the clinical side, improving diagnosis and working on phenotypes alongside participating in clinical trials, while on the research side I have focused more on the exploration of the mechanisms of disability – particularly with regard to the spinal cord and the focus on progressive forms of MS.

However, it is in my role as Chairman of the Scientific Steering Committee of the Progressive MS Alliance that I feel I have the most impact. It has been exciting and very rewarding to see how this (relatively established) organization brought together researchers, clinicians, people affected by MS and industry colleagues to raise the profile and drive the MS research agenda. progressive.

How has the current COVID-19 pandemic affected your research?

Inevitably, this delayed my own imaging research, but also delayed the work of the Alliance’s international networks for the past 18 months.

However, it also brought out the determination, resilience and collaboration of our community and it is remarkable to see how all of our activities have picked up with renewed energy and enthusiasm.

COVID-19 has also been the subject of a huge amount of research over the past year with many scientists and organizations working together to develop effective treatment strategies. How could this level of collaboration be used to develop effective treatment strategies to stop the progression of multiple sclerosis?

It is a great model of concerted collegial activity – which has made it possible to progress at high speed, to overcome long-standing obstacles, to approach in an innovative way. This is especially relevant when we think about how we test in MS and how we can speed up our processes for effective treatments in progressive MS.

In your incredible career as a researcher, what has been the moment that you are most proud of?

I would have said my findings around the MRI model of abnormalities in primary progressive MS were my proudest moment, but now I would be more inclined to the work of the Progressive MS Alliance which has had a real impact – and of course, I received the Charcot prize. last month, which really reflects all the work my colleagues and my team have done over the past 30 years.

Finally, do you think that with continued research and increased awareness, we could help slow, and eventually stop, the progression of multiple sclerosis?

Absolutely – I think we’re already on our way to slowing down – and will eventually stop the progression – probably long before we understand enough about MS to prevent it.

Where can readers find more information?

Articles related to multiple sclerosis:

  1. Thompson AJ, Banwell BL, Barkhof F… Cohen J. Diagnosis of Multiple Sclerosis: 2017 Revisions of the McDonald Criteria. Lancet Neurology 2018; 17: 162-173. (SI 30.039). Quotes: 980. Link: https://www.sciencedirect.com/science/article/pii/S1474442217304702
  2. Montalban X, Gold R, Thompson AJ et al. ECTRIMS / EAN Guideline for the Pharmacological Treatment of People with Multiple Sclerosis. Multiple Sclerosis Journal, online 20 January 2018 (IF 5.412); European Journal of Neurology 2018; 25: 215-237 (SI 4.516). Quotes: 72. Link: https://journals.sagepub.com/doi/full/10.1177/1352458517751049
  3. Thompson AJ, Baranzini S, Geurts JJ, Hemmer B, Ciccarelli O. Multiple sclerosis. The Lancet 2018; 391 (10130): 1622-1636 (SI 60,392). Quotes: 41. Link: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30481-1/fulltext
  4. Ontaneda D, Thompson AJ, Fox RJ, Cohen JA. Progressive multiple sclerosis: perspectives for the treatment of disease, repair and restoration of function. The Lancet 2017; 389: 1357: 1366. (IF 60.392) Quotes: 77. Link: https://www.sciencedirect.com/science/article/pii/S0140673616313204

Regarding the work on the WHO essential drugs list:

About Professor Alan Thompson

I am currently a consultant neurologist at Queen Square and professor of neurology and neurorehabilitation at UCL. I am the Dean of the Faculty of Brain Sciences at UCL – one of the largest and most successful faculties in UCL, and I have, in addition, the exciting role of Pro Vice-Provost London. I’m the editor-in-chief of the growing Multiple Sclerosis Journal and, of course, I chair the Scientific Steering Committee of the Progressive MS Alliance. Professor Alan Thompson

I went into the field of multiple sclerosis in the hopes of being able to make a difference and it has been wonderful to see how it has gone from an incurable disease to a treatable disease over the past twenty years – and it will be. great to see the same pattern evolve for people with the progressive form of the disease.


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