The NIHR is the nation's largest funder of health and care research and provides the people, facilities and technology that enable research to thrive. We work in partnership with the NHS, universities, local government, other research funders (including industry and charities), patients and the public to improve the health and wealth of the nation.
In 2017-18, the NIHR spent £20 million on neurology research studies. The NIHR Clinical Research Network (CRN) supported 254 neurological disorders studies, 76 of which were new studies, and recruited 18,225 patients to studies in this area last year (2018/19).
This case study looks at the impact that the MS-STAT phase 2 trial has had on advancing the development of a possible treatment for secondary progressive multiple sclerosis (SPMS). The trial took place between 2008-11 and was led by chief investigator Dr Jeremy Chataway, FRCP Consultant Neurologist, University College London (UCL) Institute of Neurology. As a result of the MS-STAT study, a much larger phase 3 trial (MS-STAT2) has now begun.
The ‘Golden Hour’ study, supported by the NIHR Surgical Reconstruction and Microbiology Research Centre (SRMRC), is assessing what happens to the immune system within the first 60 minutes from the moment of traumatic injury.
The study found that traumatic injury resulted in immediate immune dysfunction, with both immune activation and suppression detected within minutes across many immune cells and molecules. Some of the immune changes recorded immediately after trauma were no longer present several hours later.
A team supported by the NIHR Cambridge Biomedical Research Centre have carried out a study using MRI to measure changes in brain oxygen levels in participants carrying out a card matching task.
The researchers found that the ‘default mode network’ (DMN) in the brain, previously associated with daydreaming, plays an important role in allowing us to perform tasks on autopilot.
The most interesting difference in brain activity was found when comparing the stage at which participants were learning the rules of the task and the stage at which participants applied these rules - the latter was when DMN was more active. They found that in those with a stronger relationship between activity in the DMN and regions of the brain associated with memory during the stage of applying task rules, the more accurately they performed the task.
A phase 3 trial funded by the NIHR Health Technology Assessment (HTA) Programme is investigating whether statins could become a treatment for people with multiple sclerosis (MS).
The trial is testing simvastatin, a cheap cholesterol lowering drug, in people with the secondary progressive form of MS. There are currently no licensed treatments that can slow or stop disability progression in people with this type of MS.
The NIHR Clinical Research Network (CRN) Neurological Disorders Specialty is supporting the MElatonin in children with Neurodevelopmental Disorders and impaired Sleep: a randomised, double blind, placebo-controlled, parallel study (MENDS).
A great example of our commitment to widen access to patients is the MENDS study
Community paediatricians identified children in care or being looked after by their extended family. This required working with local authorities, social services and the children’s families to gain consent but it was a valuable approach to widening access to a very difficult to reach patient population.
You can find out more about neurological disorders studies in your area through the Be Part of Research website.
We provide world-class health service infrastructure - research support staff such as clinical research nurses, and research support services such as pharmacy, pathology and radiology - to support organisations seeking to conduct clinical research in the NHS in England. Some of this research is funded by the NIHR, but most of it is funded by NHS non-commercial partners and industry.
We support the set up and delivery of clinical research in the NHS through our Study Support Service and our Research Design Service helps researchers develop proposals to secure funding from our research programmes.
The neurological disorders specialty supports the set up and delivery of clinical research in the NHS in epilepsy, multiple sclerosis, headache, neuro-muscular disease, neurological infections such as encephalitis and the normal development of the nervous system. By promoting high quality clinical research we aim to increase the understanding of the causes of these conditions, and improve the prevention, detection, care and treatment for people suffering from them.
Our local teams of research staff are specialists in facilitating the set up and recruitment to neurological disorders studies in England. We have substantial experience of supporting all types of research studies including complex and multi-centre clinical interventions.
We also work closely with the Dementias and Neurodegeneration Specialty (DeNDRoN) - which covers dementias, Parkinson’s disease, motor neurone disease and Huntington’s disease - to deliver high quality collaborative research.
Each of our 15 Local Clinical Research Networks has at least one nominated local Clinical Specialty Research Lead for Neurological Disorders. These clinicians lead research groups to promote and support related research within the NHS trusts in their area.
At a national level the local leads come together to manage the national neurological disorders clinical research portfolio. This involves regularly reviewing the progress of studies, identifying barriers to recruitment, and coming up with solutions and strategies to help overcome those barriers. Our National Specialty Group of clinical experts offer advice and support to commercial and non-commercial customers looking to conduct research in the NHS.
Find out about what our Neurological Disorders specialty can offer the life-sciences industry and why you should place your study in England.
We have strong links with disorder-focused national charities such as the Migraine Trust, Epilepsy Action, and The Multiple Sclerosis Society and Multiple Sclerosis Trust. In addition we work with the Neurological Alliance, an umbrella group for neurological charities, to ensure even rarer conditions can be represented in our research portfolio. As an example, the National Lead has attended Migraine Trust patient update days, speaking about the disorder, explaining how the CRN helps studies in this area and fielding questions about how to get involved in research from participants. As a result the number of commercial studies now on portfolio, in part because the charity is supporting participation, has quadrupled in the last year.
We also work with stakeholders including the MS Clinical Trials Network Steering Group and the UK Epilepsy Research Network, and patient support organisations such as Age UK, the Guillain Barré Syndrome Support Group UK and the MS Society to promote the successful delivery of research studies in the NHS that will address patients needs.
The NIHR provides the support and facilities the NHS needs for first-class research by funding a range of infrastructure.
NIHR Biomedical Research Centres (BRCs), partnerships between England’s leading NHS organisations and universities, conduct translational research to transform scientific breakthroughs into life-saving treatments. The following BRCs undertake research in neurological disorders:
NIHR Medtech and In vitro diagnostics Co-operatives (MICs) build expertise and capacity in the NHS to develop new medical technologies and provide evidence on commercially-supplied in vitro diagnostic tests. The following MICs undertake research in neurological disorders:
The NIHR Surgical Reconstruction and Microbiology Research Centre (SRMRC) is a national centre for trauma, surgery and infection research, taking discoveries from the military frontline to improve outcomes for all patients.
All of the NIHR facilities and centres are opening to working with the public, charities, industry and other partners. If you are interested in collaborating with the NIHR please contact the NIHR Office for Clinical Research infrastructure: firstname.lastname@example.org
The NIHR funds and supports world-class experts in the field of neurological disorders. In addition, our experts in the NIHR Clinical Research Network (National Specialty Leads) can advise on delivering your neurological disorders study in the NHS.
Professor Peter Goadsby is the NIHR Clinical Research Network National Specialty Lead for Neurological Disorders.
He was appointed a Wellcome Senior Research Fellow at the Institute of Neurology, University College London in 1995. He was Professor of Clinical Neurology and Honorary Consultant Neurologist at the National Hospital for Neurology and Neurosurgery, Queen Square, London until 2007.
He has been Professor of Neurology, Department of Neurology, University of California, San Francisco since 2007. He has been an Honorary Consultant Neurologist at the Hospital for Sick Children, Great Ormond St, London since 1998.
In 2013 he was appointed Director, NIHR-Wellcome Trust King’s Clinical Research Facility, King’s College Hospital, Professor of Neurology at King’s College London and Honorary Consultant Neurologist, King’s College Hospital.
His major research interests are in the basic mechanisms of primary headache disorders, such as migraine and cluster headache, in both experimental and clinical settings, and translating these insights into their better management.
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