Professor John T O’Brien is Professor of Old Age Psychiatry in the Department of Psychiatry, having previously been Professor of Old Age Psychiatry at Newcastle University, and leads the Old Age Psychiatry research team at the University of Cambridge. He is also a National Institute for Health Research Senior Investigator and a Fellow of the Academy of Medical Sciences.
His research interests include: the application of neuroimaging in old age psychiatry; dementia with Lewy bodies; the role of vascular factors in dementia and depression and clinical trials. He has published over 400 peer reviewed papers on these topics and is a member of the National Institute for Health and Clinical Excellence (NICE), British Association of Psychopharmacology and the European Federation of Neurological Sciences (EFNS) Dementia Guideline groups. He is Past President of the International College for Geriatric Psychoneuropharmacology (ICGP).
His other current roles include being Deputy Editor of International Psychogeriatrics, the National Specialty Dementia lead for the Dementias and Neurodegenerative Diseases (DeNDRoN) research network and Treasurer of the International Vas-Cog Society.
Old Age Psychiatry Researchers
Improving the diagnosis and management of neurodegenerative dementia of Lewy body type in the NHS
Dementia is a national priority, both in relation to research and clinical service development. Central to improving patient care in those with dementia is the accurate recognition and diagnosis of sub-types of dementia and ensuring appropriate management. This programme focuses on Lewy body dementia (LBD), which includes two related disorders: dementia with Lewy bodies (DLB) and Parkinson’s disease dementia. The signs and symptoms of LBD are often difficult to detect, and probably only a minority of those with DLB are correctly diagnosed; as a result, many patients with LBD do not receive the best possible management.
This programme will deliver an assessment toolkit suitable for routine NHS use in secondary care, where dementia assessment and assessment of Parkinson’s disease occurs, and will produce a clinically relevant, evidence-based management pathway to guide clinicians. We anticipate a doubling of the numbers of those with Lewy body dementia being recognised, and therefore appropriately managed. Since most Lewy body dementias are misdiagnosed for Alzheimer’s disease, improving the accuracy of Lewy body dementia diagnosis will consequently improve the accuracy for other dementia diagnoses, including Alzheimer’s disease.
The programme’s ambition is the wider dissemination of the assessment and management tool throughout the NHS, with subsequent wide impact in terms of improving patient care for those with Lewy body dementia.
Funded by Lewy Body Society, Addenbrooke’s Charitable Trust and Alzheimer’s Research UK, and led by Drs Li Su and John O’Brien, the Multimodal Imaging in Lewy Body Disorders (MILOS) project aims to detect the damage to brain structure and function associated with Lewy Body Disorder.
We combine multiple state-of-the-art neuroimaging and computational techniques in this three years project in the University of Cambridge. First, we use Magnetoencephalography (MEG), to detect and measure electrical activity in the brain. Second, magnetic resonance imaging (MRI) is used to measure changes in brain structure. Third, Positron Emission Tomography (PET) will be used to detect damaged protein (amyloid beta using the well-established PIB radioligand) in living brains that are indicative of pathology associated with Alzheimer’s disease.
The findings will further our understanding on how DLB affects the patient’s brain, in particular the causes of cognitive decline and psychiatric symptoms, and how to detect this condition and treat it in the future.
Determining the predictors and outcomes of people with dementia with Lewy bodies using the Clinical Record Interactive Search (CRIS) system to improve diagnosis and management (LEWY-CRIS)
[T]he researchers will use anonymised records from two NHS trusts, increasing the number of records in the database to more than 2000. They will search the records for cases of dementia with Lewy bodies and compare them to records for people that do not have dementia with Lewy bodies. . This will help them to find out whether there are patterns or early factors that may help to diagnose dementia with Lewy bodies early. This will help to improve the key words used in their database searches and also improve the criteria that clinicians use to diagnose dementia with Lewy bodies. They will ensure that all of their results are validated by a clinical expert.
The researchers will also develop and test an app that can repeat this work in an automated way. This would allow a large number of records to be searched quickly and repeatedly to identify those people who may fulfil the clinical criteria but have not yet been diagnosed.
This project will help to improve how dementia with Lewy bodies is diagnosed. This has the potential to lead to increased rates of diagnosis and at earlier stages of the condition. Early diagnosis is vital to ensuring people gain access to services and support, but also helps to better plan how relevant services can best help people in a particular area.
Source: Alzheimer’s Society