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Teva Pharmaceuticals Ltd are leading the way in improving the lives of people with multiple sclerosis and Parkinson’s disease.
Further information on our patient support services can be obtained directly from Teva Pharmaceuticals Ltd.
Telephone 01296 719768 or email: [email protected]
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The road to recovery: The new treatments and therapies available for neurological conditions
HOPE FOR THE FUTURE
NEUROLOGICAL DEVELOPMENT
PHOTO: PRIVATE
Novel approachThe surgery that could decrease the effect of Parkinson’s
Assisting recoveryUsing music and light to help brain function after injury
PRIVATE THE ROYAL HOSPITAL FOR NEURO-DISABILITY
No.1/Mar ’11A SUPPLEMENT BY MEDIAPLANET DISTRIBUTED WITHIN THE INDEPENDENT
REPORTON BRAIN
CONDITIONS
A SPECIAL
Donns LLP is recognised as one of the leading specialist personal injury law firms in the UK, at the forefront of personal litigation dealing with claims both in the UK and with claim facilities in the USA. Our clients come to us from all areas of the UK and we regularly visit them where this is necessary. Our aim is to provide expert legal advice in all areas of personal injury, particularly serious Brain injuries. Whilst more serious injuries take time to reach settlement, Donns will ensure that clients will be properly looked after. This is to ensure their future by securing the maximum compensation they will require to help them live as normal a life as possible. Our aim is to work closely with clients and their families, to reduce the stress and worry experi-enced that such injuries cause. We deliver exceptional levels of cli-ent service from our highly trained
and experienced legal professionals. We have a strong history with 40 years experience in the personal in-jury marketplace and have achieved great success for many of our cli-ents, claiming millions of pounds for them.An example of the firms’ success is demonstrated by recent settlements achieved by the firms Member Part-ner and Head of Litigation, Gillian Lakes.Mrs Lakes advises of a case she set-tled this year in respect of a young man, 17 years of age at the time of accident, who suffered an extremely serious brain injury. Her client was involved in an accident on a motor-cycle in which he was not to blame. Mrs Lakes client was air lifted from the accident scene to hospital where he remained unconscious for 2 days. A difficult period was to follow for both the client, the medical practi-tioners and the family of the injured
man. Through the expertise of Mrs Lakes and her legal counsel, a sub-stantial settlement award, worth over £6 million pounds throughout his lifetime, was achieved.Mrs Lakes describes how cases such as this and the relationship that is built with the client and their fami-lies spur her on to ensure only the very best outcome is achieved for the people she represents, in what are very difficult circumstances. It is often the case that individuals do not realise the true effect of their in-juries and that it is only after speak-ing with significant individuals such as family members, that the true pic-ture becomes apparent. In another case involving a mo-torcyclist, Mrs Lakes describes a further settlement achieved of over £1million pounds. A 37 year old man suffered a serious brain injury, in addition to other serious inju-ries, resulting in the break-up of his
marriage. A settlement award was achieved to ensure that all of his care needs were met for the future. In some cases Mrs Lakes also de-scribes how injuries can be so se-vere that the client may not have the capacity to deal with the matter so she acts as Deputy for those injured clients protecting their position.Claims such as this can derive from road traffic accidents, military claims or accidents at work and its paramount the right advice is sought from the outset.
As a means of underpinning Donns commitment to providing a high quality service to clients the firm has achieved, the Investors In Peo-ple standard and The Law Society’s practice management standardLEXCEL Accreditation for quality.
The first step towards making an accident compensa-tion claim is often the scariest and hardest of all, espe-cially if you worry about the cost of making a claim.
‘To establish whether or not you have a claim we pro-vide advice on the best way to progress the compensa-tion claim. We offer a completely free initial enquiry.
Funding your claim will clearly be of major impor-tance, and we endeavor to ensure that any cost to you, if any, is kept to a minimum. There are three main ways in which you may be able to arrange payment of the legal costs; Legal Aid, Legal Expenses Insurance or a ‘No Win-No Fee’ agreement. Please contact us and we will discuss the best options for you.
Funding your claim
Legal Advice From The Expert
To discuss your situation and possible claim please contact us on 0800-612-9609 or e-mail [email protected]
Donns LLP Solicitors ∙ City Wharf ∙ New Bailey Street ∙ Manchester ∙ M60 1DZ
Gillian LakesHead of Litigation, Donns LLP
Accidents at School Accidents at Work Accidents in Public Places Compensation for Victims of Crimes of Violence Cycle Accidents Fatal Accidents Head Injuries Holiday and Travel Disasters Military Accident Motorcycle Accidents Pedestrian Accidents Road Traffic Accidents Slips Trips and Falls Spinal Injury Sports Related Injury Whiplash Injury Other type of InjuryFinancial Redress Claims
No Win No FeeNo Up Front FeesNo Call Centres40 Years ExperienceDedicated Solicitors
2 · MARCH 2011 A SUPPLEMENT BY MEDIAPLANET DISTRIBUTED WITHIN THE INDEPENDENT
Better understanding gives new hope
Disorders of the brain are the largest single burden of ill health in the developed world, exceeding those of all other illnesses combined. Some reflect an abnormal development of the brain whereas others result from progressive damage to brain tissue.
“For some unknown reason women are three times as likely to be affected”
Professor David BatesEmeritus Professor at Newcastle University discusses multiple sclerosis
WE RECOMMEND
PAGE 10
Recovering from injury p. 71. How Dominic Hurley still enjoys a full life after his crash as a teenager
New Parkinson’s hope p. 8 2. How dedicated research has created future treatment hope
NEUROLOGICAL DEVELOPMENT, 1ST EDITION, MARCH 2011
Managing Director: Willem De GeerEditorial Manager: Katherine WoodleyBusiness Development Manager: Christopher Emberson
Project Manager: Faye GodfreyPhone: 020 7665 4411E-mail: [email protected]
Distributed with: The Independent, March 2011Print: The Independent
Mediaplanet contact information: Phone: 0207 665 4400Fax: 0207 665 4419E-mail: [email protected]
Mediaplanet takes full responsibility for the contents of this supplement
We make our readers succeed!
It is encouraging that both abnor-mal development and progres-sive damage to brain tissue disor-ders are amenable to study in the diseased human brain and in an-imal models using cutting edge
neuroscience techniques honed in the laboratory.
Disorders of neurodegeneration are especially relevant at present. We have an ageing population which means that more and more peo-ple will live long enough to develop such illnesses.
The current supplement demon-strates recent advances that have been made, particularly in relation to these neurodegenerative disorders. We have access to brain tissue from affected humans so the underlying pathological changes at death are well established. These have already led to targeted treatments, such as dopamine replacement in Parkin-son’s and acetylcholine therapy in Alzheimer’s disease, which do have significant clinical benefit.
However, these are end stage changes and are unlikely to be caus-ative of the illnesses. The field has
therefore moved on to explore the mechanisms underlying the neuro-degeneration in each with a view to treating before the damage is done.
Treatment advancesIn Alzheimer’s disease there are clear pathological chang-
es such as plaques and tangles and massive accumulation of amyloid protein. Preventing this build-up offers a new means of intervention. Treatment approaches include vac-cination against amyloid, which has been shown to clear the protein from the human brain, and enzyme inhibitors that prevent the cleavage of the pre-protein. These latter drugs are in trials at present.
Both these illnesses have been sig-nificantly helped by the discovery of (rare) genetic mutations that predis-pose to the illness. In Alzheimer’s disease these have been found to be in amyloid processing and have al-lowed specific mouse models to be made that display some of the char-acteristics of the human disease. These models demonstrate altera-tions in brain processes underlying
memory formation and provide an experimental model for developing new treatments in the “test-tube”.
Another exciting area of re-search is the role that neuroin-flammation might play in aggra-vating an underlying pathological change and so turning it into a dis-ease process. Markers of neuroin-flammation are increased in most neurological disorders.
The neuroinflammatory pathways offer a new target for intervention since work with inflammatory dis-eases outside the body has provided a considerable data base of process-es and treatments. They are also po-tential targets for imaging so we are nearing the time when we can mon-itor changes in neuroinflammation non-invasively using positron emis-sion tomography (PET) brain scan-ning techniques.
Success is likely to take many years but work is taking place on a global scale. Given the huge capabili-ties of UK neuroscience we can pre-dict that we will be playing a key role in these development as the current supplement indicates.
CHALLENGES
“We have an aging population which means that more and more people will live long enough to develop such illnesses”
David NuttBritish Neuroscience Association President-elect
Trevor RobbinsBritish Neuroscience Association President
4 · MARCH 2011 A SUPPLEMENT BY MEDIAPLANET DISTRIBUTED WITHIN THE INDEPENDENT
Question: With medical advances helping to control the symptoms of Parkinson’s why would doctors consider brain surgery?Answer: There are limits to current medicines and, according to Professor Tipu Aziz, implanted electrodes are offering new hope
Novel brain surgery looks promisingWhen Professor Tipu Aziz was looking to develop his interest in surgery’s role in alleviating the symptoms of Parkin-son’s, he had doors slammed in his face, he remembers. Today the Professor of Neurosurgery at Oxford’s John Radcliffe hospital is on the verge of pioneering a new procedure he hopes will bring back mobility to patients suffering from rig-id legs.
Since the introduction of the drug lev-odopa, 50 years ago, doctors had swayed so strongly in favour of treating the con-dition with medicine that many surgi-cal techniques had, wrongly in Aziz’s mind, been sidelined.
His new surgical technique uses elec-trodes to stimulate the pedunculopon-tine nucleus (PPN) area of the brain. It is suited to those who may have respond-ed well to levodopa, and so have reduced upper body tremors, yet still have lower body rigidity.
“We have carried out the operation on seven people in Oxford with no prob-lems and we’re working with colleagues in Australia who’ve carried it out 15 times,” he says.
“Around the world it’s been carried out roughly a hundred times and we believe that when the data is collected it will show it’s a successful operation which could alleviate symptoms in peo-ple who have no or very little lower body movement and so they can hardly get up and if they try to walk they will often fall over.”
Deep brain stimulationIn the operation tiny electrodes are pushed in to the PPN, deep inside the brain, from the top of the head. These have a pacemaker device attached to them which fires at a low rate of 20Hz. This Aziz believes is just enough to encourage the brain to become active and transmit sig-nals to the legs which, due to Parkinson’s, are not currently being fired properly.
The operation is similar, in principle, to a procedure already widely adopted around the globe in which the subthal-mic nucleas (STN) region of the brain is stimulated with implanted electrodes. It is normally used for patients who have developed a reaction to levodopa called dyskinesia, which causes pronounced involuntary movements far worse than the tremor for which the drug would have previously been prescribed.
However, in this operation the im-plants work at a higher rate than the PPN operation. This, Aziz explains, is to slow down the part of the brain, by bombarding it with signals, so fewer signals to move are transmitted and, hopefully, the involuntary movements are curtailed.
Hence, the theory Aziz expects to be accepted, along with the new PPN pro-cedure, is that an electric signal which fires at a low rate can boost brain sig-nals, and help with rigidity, whereas a higher rate can down-regulate signals
and so help with excess movement. “It’s still early days for the PPN procedure and surgeons and neurologists will have to examine the data and decide if it is a procedure they want to see used more regularly,” he says.
“I’m hopeful it will be adopted and it will help show that doctors were far too quick to turn their backs on surgery in the latter half of the last century once we got medicines they believed could treat Parkinson’s. It meant a long histo-ry of surgical developments was nearly lost, and I think we’re showing here at Oxford that surgery has an important part to play in alleviating the symptoms of Parkinson’s.”
Nevertheless, Aziz accepts that brain surgery is not without its risks and sur-geons and neurologists will have to ex-amine the data carefully and progress with caution.
SEAN HARGRAVE
CHANGE “Doctors were far too quick to turn their backs on surgery in the latter half of the last century once we got medicines they believed could treat Parkinson’s”Professor Tipu Aziz, Professor of Neurosurgery, John Radcliffe hospital, Oxford
The University of Bristol offers superb teaching and training in neuroscience. You will learn from internationally recognised experts to acquire the techniques, skills and knowledge to study how the brain works - in health and disease, from molecular biology to cognitive psychology, and from fundamental science to technological and clinical applications. Students are well-supported and fully integrated into what is one of the UK’s largest neuroscience communities. Its state-of-the-art facilities, programme of talks by world-leading neuroscientists, public engagement events, student activities, and biennial Bristol-Cardiff Young Neuroscientists’ Day all enhance your experience at Bristol and equip you for being one of the neuroscientists of the future. bristol.ac.uk/neuroscience/students
Undergraduate courses: Postgraduate taught courses:
Postgraduate research programmes:
from synapses to systems in health and disease’
Biological Sciences, Clinical Sciences, the Bristol Institute of Clinical Neurosciences, and the Laboratories for Integrative
see bristol.ac.uk/neuroscience/students/phds
INSPIRATION
MARCH 2011 · 5A SUPPLEMENT BY MEDIAPLANET DISTRIBUTED WITHIN THE INDEPENDENT
ROYAL APPROVALProfessor Aziz (centre) and neurosurgery colleague, Richard Kerr, presented the John Radcliffe hospital’s deep brain stimulation work to the Queen in 2008PHOTO: PRIVATE
Neuro Specialists, Realising Potential, Changing Lives
Krysalis specialises in Occupational Therapy rehabilitation of adults and children with acquired brain injury. We have extensive experience and expertise allowing us to offer a specialist approach. Krysalis has coverage throughout the entire UK.
01373 826252 [email protected]
www.krysalisconsultancy.co.uk
FACTS
Drying eye dropsOne of the earliest Victorian medicines given for Parkin-
son’s was belladonna drops which dancers in the Moulin Rouge took to make their eyes appear whiter. It also made their mouths dry and French doctors caught on to the idea in combating excess saliva and drooling in Parkinson’s patients.
Less invasiveWhile surgeons today use electric implants to uprate
or downrate activity in the brain their counterparts in the last cen-tury, and earlier, would often make lesions on the brain to reduce ex-cess activity. The results were largely promising although there was a risk of stroke or even death. This still exists but is reduced to a very low level by less invasive electric implants.
Better powerOne of the biggest advances has come through recharge-
able batteries which power im-plants. These now have a lifespan of a decade. Implants come with a regulator the patient can use to increase or decrease current, de-pending on how their symptoms are. These normally progress dur-ing the day requiring a lower sig-nal to be increased.
6 · MARCH 2011 A SUPPLEMENT BY MEDIAPLANET DISTRIBUTED WITHIN THE INDEPENDENT
Advances in technology and treat-ments are offering greater hope for people living with acquired brain injuries.
These improvements are under-lining that brain injuries are not al-ways permanent and there is always room for people to regain some cog-nitive and motor function, explains Sally Light, Director of Rehabilita-tion at the The Royal Hospital for Neuro-Disability.
“The brain does have the ability to recover to a certain extent; injuries are not always permanent,” she says. “We focus on providing a wide range of care to help people get back and develop some cognitive function, in-cluding physiotherapy and speech thereapy, and we’re also getting great results from music therapy.”
Technology in treatmentIt is important to get as much cog-nitive function and movement as possible because as long as a per-son can move a part of their body, the team at the hospital in Putney, London, will endeavour to shape technology around them so they can communicate.
“As long as they can move a part of their body, it may be just to blink or to move a single finger, we can build a switch to enable them to select words and phrases on a com-puter so they can communicate,” says Light.
“At the same time, we also work hard to ensure that physiothera-py and nutrition maximise their ability and don’t suffer from the secondary complaints you can get
from a brain injury, such as bed sores caused by immobility.”
Checking awarenessTechnology is also coming to the aid of those patients who appear to be in a vegetative state but may actually have some cognitive func-tion. By avoiding misdiagnosis, the team can treat such patients and, where possible, be enabled to use technology to communicate, such as an eye gaze system which allows words and sentences to be formed by staring at letters on a computer screen.
“We’ve developed a sensory test here, called SMART, which has been very successful for testing awareness,” Light says.
“There’s also a new test being de-veloped, using the functional MRI scan, which can look for activity in the brain. We’re correlating our SMART results with those from the scans and they seem to be backing one another up so far and enabling patients who have some awareness to be given treatment.”
Sally LightDirector of Rehabilitation The Royal Hospital for Neuro-Disability
SMART TECHNOLOGY AND TREATMENTS AID RECOVERY
SEAN HARGRAVE
Question: Can people
who have suffered brain injury
recover enough to lead a
fulfilling life?
Answer: Given the right care
patients who have suffered
even severe injuries can start
to recover and, thanks to
technology, interact with friends
and their surroundings
NEWS
MARCH 2011 · 7A SUPPLEMENT BY MEDIAPLANET DISTRIBUTED WITHIN THE INDEPENDENT
In recent years, however, Hurley’s sponsored cycling events have raised more than £51,000 for good causes, including the acquired brain injury charity, Headway, and he has made it into the GB Paral-ympic cycling team squad.
Having already completed 12-, 24- and 48-hour cycling marathons he last year replicated every stage of the Tour de France on an exer-cise bike in his local Asda super-market in Rotherham, clocking up 2,261 miles in the two-day “Tour de Asda”.
To Hurley it is proof that people can lead a full and fulfi lling life af-ter receiving a brain injury.
“You mustn’t moan, you’ve got
to focus on what you can do rather than what you can’t,” he says.
“I was a student when I had my accident, so I was left with very little memory of my childhood. I’ve made a pretty good recovery, though the use of my right arm and leg is restricted so I can’t do a lot of sports. We chanced on cy-cling when my, now, wife and I de-cided to hire a pair of bikes to cy-cle round a park. I loved it and I’ve never looked back.”
GB teamFor the future Hurley is hoping to put his graphic design qualifi ca-tions to use in his home town of Rotherham and is actively seek-ing sponsorship for the training re-gime he hopes will propel him from the current GB Paralympic cycling squad into the team that will com-pete against the best of the world in September 2012.
He will also continue to advo-cate the use of helmets when cy-cling, having recently walked away unharmed from a training crash where his helmet took so much force, it smashed.
Dominic HurleyCyclist
When Dominic Hurley came off a moped on holiday in Cyprus 16 years ago, his family was told as he came out of a three-month coma he would be unlikely to ever walk or talk again
NEW THERAPYHelen Gill-Thwaites created the ‘Smart’ test at the Neuro-Disability hospital to assess a patient’s level of awarenessPHOTO: THE ROYAL HOSPITAL
FOR NEURO-DISABILITY
Making Headway going for cycling gold
SEAN HARGRAVE
For over 25 years, we have been
providing leading diagnostics
healthcare in the UK. We understand
the needs of clinicians and patients
to provide quality diagnostic images.
Last year we carried out almost
500,000 procedures and provide
over 10 different types of diagnostic
imaging including MRI, CT and
Ultrasound.
When it comes to diagnostic scans, you can
depend on InHealth to deliver quality results.
To arrange a referral, find out more about InHealth, our people and our
vision visit www.inhealthgroup.com
Together, delivering excellence in healthcare
What is encephalitis and how
is it diagnosed?
!Encephalitis is inflamma-tion of the brain caused by
infection or auto-immune re-sponse. Diagnosis is very diffi cult in the initial stages but brain scans and testing of the cerebral spinal fl uid provide important ev-idence of infl ammation or infec-tion, as does the presentation of altered consciousness.
What advances are giving
doctors cause for hope?
!Recent research has suggest-ed that with in-depth labora-
tory testing we can reduce the number of unknown causes of en-cephalitis from 50-60 per cent to in the region of 35 per cent.
We are still identifying new forms of encephalitis and this means we can improve diagno-sis and treatment. Mortality is high and those who survive may sustain an injury to the brain. Some people may make a good re-covery, but for others encepha-litis can present complex and diffi cult problems.
QUESTION & ANSWER
Ava EastonChief Executive Offi cer, Encephalitis Society
8 · MARCH 2011 A SUPPLEMENT BY MEDIAPLANET DISTRIBUTED WITHIN THE INDEPENDENT
David Burn is adamant that within the next five years, or a decade at the outside, there will be new, improved medicines available to offer hope to those living with Parkinson’s.
The Clinical Director of the Ageing and Health Unit at Newcastle Univer-sity believes drugs currently show-ing promise, through exploring new disease-fighting pathways, could well lead to new combinations of medicines to treat patients designed around symptoms as well as hold back the progress of the disease.
To give a picture of medicine’s cur-rent response to Parkinson’s, he lik-ens the depletion of dopamine in the brain, which allows signals to be sent with speed around the brain, to the problem many a motorist will be all familiar with.
“Parkinson’s is a bit like an oil leak too. You get a dripping away of dopamine over a long period of time until the pistons seize up,” he says.
“We can treat people for the various symptoms and move up to prescribing
levodopa to stimulate the production of more dopamine in the brain but it’s a little like pouring a tin of oil in the top of the engine; it’s frustrating, but you still can’t do much about the leak deep down at the bottom of the engine.”
Beyond movementHence doctors share a patient’s frus-tration over there being no cure for the disease, merely drugs which can attempt to make up for the loss of dopamine and other chemi-cals in the brain, which Parkinson’s
restricts, causing far more than the movement problems with which the condition is most readily associated.
“Typically people with Parkin-son’s will have a tremor, which could be down to many other con-ditions which need to be consid-ered before a diagnosis is made,” he says.
“However, it’s not just a motor disease, it’s not just about move-ment. A lot of people will have suf-fered a reduced sensation of smell and they will often have disturbed sleep patterns with lots of violent involuntary movements during the night.”
Also, unfortunately, something like four in five people living with Parkinson’s are likely to develop de-mentia, according to Burn, and so the disease involves far more than involuntary movements.
One silver lining, apart from the expected arrival of new drugs, is a recently developed scan for Parkin-son’s which reveals when dopamine depletion is taking place. Burn be-lieves this can help patients for whom a diagnosis is proving diffi-cult he also thinks it could be offered to those in doubt who would like to have their diagnosis speeded up.
New medicines offer hope to those with Parkinson’s
RESEARCH AND DEVELOPMENT The continued effort of scientists may bring new treatment for Parkinson’s according to Burn PHOTO: DAVIDBGRAY/ISTOCKPHOTO
SEAN HARGRAVE
Question: What hope is there
for Parkinson’s patients? Are
new developments on the way?
Answer: Although there is no
cure in the offing, new medicines
which combat Parkinson’s
symptoms in innovative ways
could soon get approval
NEWS
Parkinson’s ‘double whammy’ for patientsIs Parkinson’s one disease, or is it two conditions? Or perhaps one condition with two different manifestations?
This is a contentious point doc-tors will debate but all would probably agree that it does at least appear to have two differ-ent stages.
Doug MacMahon, Director of the Parkinson’s Academy, cer-tainly points out that there would appear to be two distinct faces of Parkinson’s.
“There’s the involuntary movement, or tremors, that one often sees in the patients who are diagnosed earlier in life and then there’s the stiffness, a lack of movement, which we often see in people who are diagnosed later in life,” he says.
“Middle-aged people who get diagnosed will often have lost their sense of smell too. All Par-kinson’s sufferers, though, have the possibility of the same ‘dou-ble whammy’ later on in life of having a higher risk of develop-ing dementia. So you have prob-lems with mobility, or immobili-ty, as well as cognitive function.”
FACTS
Roughly one in every 500 peo-
ple in the UK has Parkinson’s which
equates to around 120,000 people
It is normally first diagnosed in
people over the age of 50, although
one in twenty people living with the
condition will be affected under the
age of 40
The disease is caused by nerve
cells dying, leading to dopamine de-
pletion. This chemical enables signals
to pass around the brain quickly and
when levels are low movement disor-
ders can ensue
Parkinson’s is not just a move-
ment disorder. It has many addition-
al symptoms including loss of smell,
sleep disturbance, bladder and di-
gestive issues, fatigue and depres-
sion. People living with the disease
are more likely than normal to develop
dementia.
...Teva and Lundbeck are committed to improving the lives of
people with Parkinson’s disease. Through continued research
and development, we aim to improve understanding of the
condition and, with effective treatments, help people with
Parkinson’s enjoy life.
Parkinson’s is a progressive neurological condition that is characterised by problems with movement and other associated symptoms. Today, Parkinson’s affects around 120,000 people in the UK, and as the population ages, the number of people affected is expected to keep increasing.
There is currently no cure for Parkinson’s, but much progress has recently been made in identifying the disease in its early stages. Compared to just 10 years ago, there is now a range of effective treatments suitable for people in the early stages of their disease. To get the best out of treatment it is important that Parkinson’s is diagnosed as early as possible. If you, or someone you care for, would like some more information about Parkinson’s speak to your doctor.
About Teva/Lundbeck:
Teva Pharmaceutical Industries Ltd., headquartered in Israel, is among the top 20 pharmaceutical companies and among the largest generic pharmaceutical companies in the world. Teva’s innovative research and development focuses on developing novel drugs for diseases of the central nervous system.
Lundbeck is an international pharmaceutical company engaged in the research and development, production, marketing and sale of drugs for the treatment of psychiatric and neurological disorders.
Working together...
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10 · MARCH 2011 A SUPPLEMENT BY MEDIAPLANET DISTRIBUTED WITHIN THE INDEPENDENT
Doctors await new medicines
Doctors are hoping the first oral medicines for multiple sclero-sis will begin to become available from the end of the year.
The pills are expected to be used for patients who are not re-sponding well to monthly admin-istered injections, or daily self-in-jected medicines, and it is hoped that they may give doctors anoth-er way of slowing down the dam-age to the central nervous system caused by multiple sclerosis. The pill that is likely to become avail-able first, called fingolimod, works by attempting to send aggressive T cells, which have been attacking the central nervous system, to the body’s lymph nodes.
Extra optionsProfessor David Bates, Emeritus Professor at Newcastle University, believes it is a positive step to have
additional options. Today’s treat-ments cascade down from offering relief from immediate symptoms to trying to regulate the T cells in the body’s immune system which, for some unknown reason, have turned on the myelin lining of the body’s central nervous system.
The reason why the body turns on itself in this way, and the trigger which sets the process off, are still unknown. It gives rise to symp-toms which are too general to im-mediately pin down to MS, Profes-sor Bates explains.
“MS is caused by an immune re-
sponse as the aggressive T cells cross the blood brain barrier and cause damaging to the lining of nerves,” he says.
“The major symptom this first causes is painful blindness in one eye or severe visual impairment that lasts a while before eventual-ly getting better. Other symptoms can be weakness or numbness in the legs or periods of dizziness and a lack of coordination. These are not isolated to MS so there are many conditions that have to be eliminated first.
“The symptoms tend to first be noticed by people in their twenties or thirties and, for some unknown reason, women are three times as likely to be affected.”
The latest thinking is that a pos-sible trigger could be the EB virus which causes, among many dis-eases, glandular fever, which is prevalent in teenagers. Although more than nine in 10 people will have had the virus at some time, almost everyone with MS has had the virus.
“The symptoms tend to first be noticed by people in their twenties or thirties”
Professor David BatesEmeritus Professor at Newcastle University
SEAN HARGRAVE
Question: What new hope
is there for people living with
multiple sclerosis?
Answer: New medicines
which tackle the disease in novel
ways are expected to become
available over the next few years
NEW TREATMENTSFor the first time oral treatments will be available for multiple sclerosisPHOTO: JAKUB PAVLINEC
/SHUTTERSTOCK
NEWS
FACTS
Multiple sclerosis is the most
common central nervous system dis-
order to affect young people. It is
caused by an auto-immune response
in which the myelin layer around nerve
fibres is attacked
MS is not directly inherited but it is
believed that some genes which are
passed on could make people more
susceptible to the disease
The disease normally strikes
when people are in their twenties or
thirties. The cause is unknown but it
is believed to be a combination of en-
vironment and genetics. It is thought
some people who are susceptible to
the disease may have it triggered by
a virus. The EB virus, which causes
glandular fever, is the most likely sus-
pect, doctors believe
Making headlines despite MSNeurological pain can sometimes leave Channel 4 News’ technology correspondent, Ben Cohen, feeling like his head is several times larger, it can also cause electric shocks in his limbs and often makes him feel like staying in bed for the day
Having lived with MS since be-ing diagnosed in his early twen-ties, however, has come to ac-cept that a positive mental atti-tude is the only way forward.
“If you live with MS you can’t let it rule your life, you’ve got to still get out there, because if you just stay at home complaining you’d end up feeling worse,” he says.
“I’m generally responding well to treatment. I only have minor attacks at the moment, although I had a relapse in 2007 brought on, I believe, by a bout of food poisoning.
“The main thing I’ve learned through MS is that you need to remain upbeat. But you have to accept it is likely to shorten your working life so you have to make sure you get the most from every day and ensure you’re do-ing something you’re passion-ate about.”
Similar to many young pro-fessionals living with MS, Co-hen believes the trigger for the disease could have been hav-ing glandular fever in his teens. When he continued to experi-ence poor health doctors initial-ly diagnosed ME but later gave a diagnosis of MS.
“I had all the classic MS signs, so I certainly didn’t have ME,” he says.
“My symptoms are mainly sensory, I can’t feel my feet and have neuropathic pain in my hands, neck and face.”
Fortunately, the symptoms have been mostly manageable since a relapse four year ago. Al-though like others living with the condition, Cohen does not know whether to ascribe this to the sporadic nature of the disease, or the efficacy of treat-ment, or even a little bit of both.
The prescription is only the startTeva are leading the way in improving the lives of people with multiple sclerosis and Parkinson’s disease.
Our focus is continued support for patients by working in tandem with the NHS. In MS we offer a bespoke service to patients on our therapy, this may include initial training, a help-line and follow-up visits at either the centre or the patient’s home.
Further information on our patient support services can be obtained directly from Teva Pharmaceuticals Ltd: telephone 01296 719768 or email [email protected]
C0311/681 Date of preparation: March 2011
The Walton Centre NHS Foundation Trust is the only specialist Trust in the UK providing comprehensive neurology, neurosurgery, spinal and pain management services.
The Trust was formed in 1992 and in 1998 we moved to our current purpose-built site in Fazakerly, Liverpool.
We provide services to a population of 3.5 million people across Merseyside, Cheshire, Lancashire, the Isle of Man and North Wales.
This is achieved via a ‘hub and spoke’ system. We have partnerships with 13 district general hospitals across the area we serve. This satellite model of care for neurology and neurosurgery means that many patients are able to access outpatient consultants and some inpatient treatments closer to home.
We also accept referrals from people who live further away, based on their clinical need.
The range of conditions we treat includes Parkinson’s Disease, multiple sclerosis, brain and spinal tumours, spinal trauma, neuro-rehabilitation, epilepsy, head injuries, motor neurone disease, TIA, myasthenia gravis, hydrocephalus, headache and migraine.
We are what is known as a tertiary healthcare provider. This means that, unlike district general hospitals with accident and emergency departments, patients are referred to us from other hospitals as well as their GPs. This is because the type of services we off er and the conditions we treat are highly specialised.
For further details contact: The Walton Centre Tel 0151 529 5500 Or contact us via our website www.thewaltonentre.nhs.uk
New Stereotactic Brain RadiosurgeryThe Walton Centre are delighted to be working in partnership with Clatterbridge Centre for Oncology NHS Foundation Trust , who have a satellite radiotherapy centre based adjacent to our hospital.
The Centre houses three linac machines, one of which is the UK’s fi rst Novalis Txtreatment machine which benefi ts cancer care both locally and nationally by off eringpowerful and advanced radiation therapy. It has the ability to perform precise and painless brain tumour treatments in a single patient visit - treating previously inoperable brain tumours.Treatment is also patient-friendly through the use of an advanced technique known asframeless radio surgery; an alternative to the historical practice that requires immobilisation with an invasive head ring affi xed to the skull.
In its fi rst year of operation the Novalis Tx is expected to treat over 800 cancer patients at Clatterbridge Cancer Centre Liverpool. >It is estimated that 150 of these patients will be priority brain tumour patients where precise, non-invasive treatment is particularly eff ective. Clatterbridge has worked in partnership with The Walton Centre to bring this revolutionary treatment option to the North West and treatment with Novalis Tx will be considered for any patient in the UK for whom their doctor feels suitable. It may also be applied to certain types of benign tumours inside the head ad to some blood vessel abnormalities (some arteriovenous malformations).
All such treatments involve close collaborations between specialised neurosurgeons and oncologists.
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