ANNUAL REVIEW master Final3a - St Vincent's University Hospital

St. Vincent’s Healthcare Group Limited - Annual Review 2007
Education & Research
To achieve this, of course, close co-operation is required with the clinical team. Dr. Lisa Costelloe was doing
an MD in this area at the Dept of Neurology. Drs. Roisin Lonergan (MS research) and David Bradley
(Dystonia) joined us in July 2007. A new clinic was set up in 2005 specifically for people with MS. In 18
months, almost 500 patients with MS and 150 control subjects have been recruited. Lisa Costelloe, Roisin
Lonergan, Niall Tubridy and Michael Hutchinson assess the patients clinically and document the disease
phenotype in each individual seen. This is done in the course of ‘normal’ clinical care. The work of Katie Doyle,
MS Research Nurse, Sinead Jordan, Research Nurse, and Marguerite Duggan, MS Specialist Nurse, has
been integral to the smooth running of this project and the ongoing care our patients.
We have also undertaken work in collaboration with Dr. Margaret O’Brien looking at OAS in MS and plan
further studies in vitamin D receptor genes in 2008.
In addition to immunological research, we have a long-standing interest in the evaluation of clinical outcome
measures for MS drug trials. In particular, the health related quality of life of MS patients and its quantification
is being examined longitudinally in a large MS cohort attending this hospital. We have established a clinically
useful and psychometrically valid “minimal change score” for one of the widely used MS self–report
instruments. Doctor reported MS rating scales are also being evaluated for clinimetric characteristics that
would make them effective outcome measures for RCTs).
In 2007 and 2008 we plan a large scale study of the epidemiology of MS in Ireland based in Dublin, Donegal
and Wexford. We aim to look at immunological, genetic and vitamin D markers in a large cohort of people
with MS and controls in Ireland.
Current MS Clinical Research Projects of the Neurology Research group
1. Diffusion Tensor Imaging (DTI) of the Medial Longitudinal Fasiculus in Multiple Sclerosis patients
with Internuclear Ophthalmoplegia
To investigate the specificity of DTI, a novel MRI technique that provides information about the direction of
white matter tracts, compared to conventional MRI for detecting disruption of the medial longitudina
fasiculus in MS.
Clinically, superior visualisation of new lesions and axonal loss may be of prognostic value and may
enable us to monitor response to therapy in longitudinal studies.
In collaboration with Jonathan Mc Nulty (Lecturer in Diagnostic Imaging, UCD), Professor Patrick Brennan,
UCD, Professor Powderly, UCD, Dr. Risteard O’Laoide, SVUH
2 Cognitive Functioning in Multiple Sclerosis: a longitudinal ERP analysis to quantify the degree of
mpairment due to MS
In collaboration with Dr. Robert Whelan, PhD Research Fellow Departments of Psychiatry and
Neurology, SVUH.
Cognitive impairment (CI) in MS represents a balance between destruction, repair and
adaptivefunctional reorganisation. Contrast-enhanced MRI often fails to detect diffuse pathological
changes in normal appearing brain tissue. Event Related Potentials (ERP), small fluctuations of the EEG
related to the processing of a relevant stimulus, measure information-processing speed and are the
most robust and sensitive markers of CI in MS. They are sensitive to subtle CI, which influences daily
activities and quality of life, work performance, independent coping skills
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