Working Group 5
Brainstem Clinic (overview brainstem in clinical conditions & new targets for therapies)
Key objectives of the Working Group
a) provide an overview of our current knowledge on the brainstem in clinical conditions,
b) identify new targets for methods development as well as interventions to improve brainstem-related clinical conditions,
c) establish a network of researchers and cohorts for multi-site brainstem MRI and brainstem interventions,
d) foster contacts with policymakers to promote the relevance of brainstem MRI in clinical assessments and therapies.
Current projects
WP1: Overview of the clinicopathological landscape of primary human brainstem disorders.
Brainstem disorders are vast – In the first instance I would suggest aiming for a structured review that attempts to parse this universe and provide a focus on primary disorders of adulthood (something similar). The idea is this would avoid “lesional” syndromes or simple visual diagnostics, instead provide a clinical backdrop for the advanced/bespoke imaging methods the Action is focussing on. Clearly prodromal neurodegeneration is a hot topic here, but should also include things like sleep, psychiatric, autonomic, movement, auditory processing etc., Needs quite some thought about how best to structure/collate, and input from lots of different clinical domain expertise. Opportunity to maybe create some structural probability disorder maps from atlases (if feasible)
Primary output:
Paper - Overview of the clinicopathological landscape of primary human brainstem disorders
Teaching content for clinical research update training symposium/session
WP2: Practical steps in setting up studies in brainstem populations
The brainstem is a challenging structure to study. Relying on ‘out of the box’ standard sequences are unlikely to work. It is critical that when planning a study, if brainstem structures are going to be regions of interest, this should be factored in. The idea here is brainstorm these and create a simple outline for any would-be researcher, using the classic “ten simple rule” format
Primary output:
Paper -Ten simple rules for studying brainstem disorders using MRI
Teaching content for clinical research update training symposium/session
WP3: Summarise current methods and open challenges for studying brainstem disease in vivo.
There are already a number of dedicated imaging acquisitions, methods and analysis techniques for studying the brainstem in vivo. The idea here is to provide a structured overview of this for a more clinically orientated research audience. The relative pros and cons for the different techniques will need appraising, and in doing so current gaps or open challenges be identified (e.g. contending with movement/noise, smoothing and effect size discrepancies in small structures, ill-defined boundaries etc.,). Will involve working closely with WG1 and WG3. Requires expertise using different packages/pipelines/modalities
Primary output:
Paper - Current methods and open challenges for studying brainstem disease in vivo
Teaching content for clinical research update training symposium/session
Feed-back between WG1, WG3 and WG5
WP4: Brainstem clinical research network
All clinical facing methods/research critically hinge on being able to cross centres/sites/countries, and often these are key requisites in large grants (e.g. EU Horizon). Furthermore, there is value in being able to pool existing expertise and/or resources. Finally, there are many other existing organisational entities that may value in the outputs from the initiative or other avenues we could use to promote and disseminate the work (e.g. conferences). How best to achieve this needs to be defined by the WP4 team.
Primary output:
Brainstem clinical research network
Multisite linked cohorts/capabilities
Directory of resources
Opportunities to deliver output to broader audience