Waking up to the science of sleep

Ben Goodwin reports on a major international collaboration using novel neuroimaging techniques.

Dr Bagshaw’s research interest centres on developing and applying non-invasive neuroimaging methods to questions in clinical and behavioural neuroscience. His current work focuses on using multimodal neuroimaging to measure simultaneously electrical activity and blood flow in the brain. Dr Bagshaw is pioneering this technique, known as EEG–fMRI, to shed light on how sleep and epilepsy affect the brain.

‘The way we sleep changes as we develop, with old age often seeing fragmented sleep patterns. It has been suggested that this might contribute to some of the cognitive changes that occur with advancing age. ‘Furthermore, in epilepsy sufferers, we know that more seizures occur if a person has less sleep and they are more likely to happen during particular stages of sleep. So while sleep is known to becrucial for optimal brain function, and there are some clear links between sleep and neurological disorders like epilepsy, how and why these issues are connected remains unclear.

‘By examining what happens in the brain during sleep and by comparing individuals’ sleep patterns with their waking behaviour and brain function, I am interested to find out what the brain is supposed to be doing during sleep. We can then use these methods to understand how those processes are affected by epilepsy, to better understand both phenomena.’

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Dr Bagshaw is Director of the Birmingham University Imaging Centre (BUIC), a world-class interdisciplinary research centre dedicated to the study of the human brain. The Centre is a collaboration between the Schools of Psychology, Medicine, and Sport, Exercise and Rehabilitation Sciences. BUIC incorporates academics from a range of disciplines, from physics to physiology and psychology, who are all involved in studying the relationships between brain activity, blood flow and behaviour.

Simultaneously, the treatment of epilepsy in Brazil is noted as being among the best in the world, with strong research at institutions such as the State University of Campinas (UNICAMP) feeding into clinical practice. It was this bench-to-bedside approach that caught the eye of Dr Bagshaw back in BUIC.

‘I had been particularly interested in the work of neurologist Professor Fernando Cendes at UNICAMP for some time.Professor Cendes is based in the university’s teaching hospital, where he is converging imaging methods to determine both the type and the severity of epilepsy within his patients, and to plan treatment. Although he is responsible for a relatively large number of patients, Professor Cendes is using these new approaches to help create tailored treatment for those in his care.

‘With BUIC a leading centre for EEG–fMRI techniques and UNICAMP boasting an existing research infrastructure within its own hospital, it seemed that we had much to offer each other in terms of furthering knowledge within the field. We are both working towards an overall common goal that leads to better treatment for all patients with neurological and other brain disorders.’

This is by no means the first time BUIC has collaborated outside the University, with Birmingham academics already enjoying a strong partnership with the University of Nottingham. Nottingham is home to the Sir Peter Mansfield Magnetic Resonance Centre, named after the Nobel Prize-winning physicist who pioneered magnetic resonance techniques therein the mid-1970s.

Today, using the Birmingham–Nottingham Strategic Collaboration Fund, this alliance between the two Midlands universities benefits from the expertise in psychology and brain disorders at BUIC, which is able to inform Nottingham academics on how their future development work on imaging equipment might be applied. ‘Speaking with physicists at Nottingham, they were keen to collaborate with Professor Cendes, as well as their counterparts at the University of São Paulo (USP) and staff working within Brazil’s Inter-institutional Cooperation in Support of Brain Research Program (CInAPCe). It was at this point that we realised we had the basis for a much larger collaboration.’

As part of the international strategy of both Birmingham and Nottingham universities, the two institutions have invested £4 million over the last three years in Brazil. This has led to increased academic and student exchanges, as well as more jointly authored papers between the two universities and Brazilian partners. Part of this funding included an agreement with the São Paulo Research Foundation (FAPESP), where nearly £500,000 was made available by the three partners to encourage greater academic collaborations between the Brazilian state, Birmingham and Nottingham. ‘Once we had secured a FAPESP grant’, says Dr Bagshaw, ‘we were quick off the mark to begin working together, with a series of delegations visiting partner institutions both here in the UK and in São Paulo state.’

‘Most of my time in Brazil was spent working with Professor Cendes at UNICAMP, collecting neuroimaging data using EEG–fMRI from 15 of his epilepsy patients and focusing on brain activity associated with sleep and its link with their condition. ’UNICAMP uses the same scanner as at the University of Birmingham, ensuring the consistency of data in both countries.

‘Back here in the UK, we are now analysing this data, with the aim of trying to understand the relationship between sleep and epilepsy. Ultimately, we are using innovative imaging techniques to spot abnormal brain networks and isolate those that are most specific to the problems experienced by patients. This will lead to a better understanding of the disorder, which is a prerequisite if more specific and individualised treatments are to be developed.

‘Taking things further, we are hoping to compare these results with other conditions that are exacerbated by sleep disturbances, such as depression, dementia and psychosis. One of the schools of thought we’ll be exploring is whether they could all be different behavioural manifestations of the same processes within the brain.’

Linking all the various strands of this major collaboration, a workshop was held in São Paulo earlier last year. ‘Both the UK and Brazilian teams had the chance to present their work together, as well as their research interests outside the ones covered in our grant proposal. This certainly whetted the appetite for more joint projects in the future.

‘We also hope our groundwork will see an increasing exchange of PhD and postdoctoral students between both sides. In the meantime, we expect joint papers between Birmingham and UNICAMP and Nottingham and USP to be published later this year, which will clearly document the valuable work we have achieved so far.’

Andrew Bagshaw is Reader in Imaging Neuroscience at the University of Birmingham.