Professor Siobhan Hutchinson

  ALZHEIMER'S DEMENTIA   APHASIA   BEHAVIOURAL SYMPTOMS   Clinical neurology   COGNITIVE IMPAIRMENT   DEMENTIA   DEMENTIA, NEURODEGENERATIVE   Dementia/ Alzheimer's Disease   EARLY ONSET DEMENTIA   FRONTOTEMPORAL DYSFUNCTION   MEMORY CLINICS   MEMORY IMPAIRMENT   MOTOR CONTROL   neurodegeneration   Primary Progressive Aphasia

Neuroplasticity: motor skill acquisition and motor recovery after brain injury. During my elective in Harvard Medical School Neurology Residency I joined the lab of Gottfried Schlaug, Director of the Neuroimaging Laboratory who was investigating the effects of skill learning, particularly musical skill learning, on the brain and demonstrated using imaging techniques, changes in brain structure and function previously unexpected in adults - neuroplasticity. My initial project was to examine the differences in brain volume between a large cohort of professional musicians, non-professional musicians and non-musicians. I found significant differences in cerebellar volume that correlated with practice time between these groups - this work is one of the first descriptions of plasticity in musicians - it has been cited often since. Through this research I became very interested in the mechanisms of motor skill acquisition, the ability of the adult brain to change with practice and wondered about the similarity of this plasticity to the mechanisms of motor recovery following brain injury. I proposed that we investigate motor recovery in our stroke patients using functional MRI comparing them to age-matched controls. (Notably in normals we found significant age-related differences in functional MRI during simple motor activity - an unexpected finding but very relevant to our proposed fMRI study). Functional imaging had shown a diffuse network of activity in stroke recovery including ipsilateral motor cortex. The innovative part of my proposal was that we planned to use transcranial magnetic stimulation to investigate the connectivity and excitability of these diffuse regions of activity. With collaboration between the clinical expertise of Michael Alexander, Neurorehabilitaion, Gottfried Schlaug's Neuroimaging Lab, and Alvaro Pacual Leone's, TMS Lab, I was awarded the Harvard Medical School's Clinical Investigators Training Program. Our data obtained in stroke subjects and normals revealed novel effects between the hemispheres in both groups. I left the Neuroimaging Laboratory, and newly founded Stroke Recovery division supported with an RO1 program grant, to return to Ireland in 2003 for family reasons. Dystonia Research Group, SVUH On returning to Ireland, I joined with a group of clinicians and scientists in the Dystonia Research Group in St. Vincent's Hospital under Michael Hutchinson PI, who are investigating the phenotype-genotype relationship in primary dystonia. I worked in a clinician in the Dystonia Clinic - characterising the clinical phenotypes. We have demonstrated clinical sensory deficits in affected and unaffected members and found correlation between the extent of the sensory deficit and function of various brain regions. Notably in the Schlaug Lab researchers had demonstrated aberrant motor activity maps in people with task-specific dystonia, musician's cramp. The Dystonia Group in SVUH have developed that theme. Neuroimaging biomarkers of Frontotemporal Dementia Through the development of the Cognitive clinic in St. James's Hospital we have a significant cohort of young dementia patients - opening up many avenues for research. Currently two research fellows develop clinical expertise under my supervision in this clinic, through collaboration with Peter Bede and Orla Hardiman. We are interested in deep clinical phenotyping of these patients - primarily using imaging. This collaboration has focused on the FTD-MND population, but also FTD and MND sub-types - currently we are characterising the Primary Progressive Aphasia cohort. Collaboration Through my expertise in Cognitive Neurology I have collaborated with others in this field - previously with Brian Lawlor in the Memory Clinic in MISA, currently with Aoibhinn Lynch and Sean O'Dowd in supervision of research fellows and notably in the newly awarded Dementia Trials Ireland Clinical Trials Network directed by Iracema Leroi.