Submitted by acs95 on Mon, 22/12/2025 - 15:44
Name: Elizabeth McKiernan
Research group: Old Age Group, Department of Psychiatry
Supervisor: Professor John O’Brien
Advisor: Professor Li Su
Title of your PhD: A study of ultra-high field strength structural and spectroscopic MR imaging in dementia with Lewy bodies and Alzheimer’s disease.
Can you give us a short background into what your PhD/MPhil was about?
Despite its position as the second commonest form of neurodegenerative dementia, dementia with Lewy Bodies (DLB) is relatively poorly understood, with little research focusing on its pathophysiology or symptomatology in comparison with Alzheimer’s disease (AD) or Parkinson’s disease (PD), to which it is closely related. In contrast to AD, which typically presents with amnesic cognitive deficits, DLB more commonly presents with complex neuropsychiatric symptoms, including complex visual hallucinations, cognitive fluctuations, rapid eye movement (REM) sleep behaviour disorder (RBD), and parkinsonism. In my PhD thesis I present a detailed investigation of neuroimaging changes found in DLB compared to in AD, in comparison to cognitively healthy older adults, using ultra-high field, 7 tesla (7T), brain magnetic resonance imaging (MRI) and single voxel proton magnetic resonance spectroscopy (MRS).
How would you sum up your main findings?
My analysis of 7T structural data concentrated on the measurement of subfield volumes in the hippocampus, amygdala, and thalamus. I found that, in mild to moderate DLB, pronounced amygdala subfield atrophy is present (compared to controls), is almost as marked as in AD, and is associated with measures of cognition and visual hallucinations. I also found that widespread hippocampal subfield atrophy is present in DLB (compared to controls), and though it is less pronounced than in AD, it is more extensive than has previously been described at lower MR field strengths. My 7T spectroscopy data, from voxels placed in the left occipital lobe and left thalamic region showing that myoInositol (a putative marker of neuroinflammation) is higher in patients compared to controls. I also found limited evidence that changes in concentrations of gamma-aminobutyric acid (GABA) and glutamate (the primary inhibitory and excitatory neurotransmitters in the brain) may be related to visual hallucinations and cognitive fluctuations, though these analyses were exploratory and findings tentative.
What made you want to do a PhD?
A range of things including interest in the topic and desire to add something to our understanding of these diseases. I also enjoy studying for its own sake so the opportunity to spend a longer period of time focusing on a specific research question was a pleasure.
What was your best day during your PhD?
I was extremely proud when I completed data collection for the cohort as there had been many challenges to overcome including the challenges of continuing the study during the COVID pandemic and recruitment to a 7T imaging study (for which the safety screening is more stringent than at lower field strengths. I was privileged to work with the generous participants who gave their time to the study.
What was your worst day during your PhD?
During the COVID pandemic my study was briefly put on hold, and I had a lot of concerns about the future of the project.
Do you have any words of advice to future PhD/MPhil students in Psychiatry?
Remember that it is a marathon, not a sprint and it is a good idea to take your time and really think about what you are doing and why. Also, life outside the PhD is as important (usually more important) than life within it; try not to neglect yourself and your family/ friends.
What do you hope to do next?
I am now happy to be working as a Research Associate within the same group, continuing with the work started during my PhD as well as other projects.