Annual Report
—2017 Dr Tracy Melzer — MRI Research Manager, NZBRI
New Zealand Brain Research Institute
Annual Report
—2017
Dr Tracy Melzer — MRI Research Manager, NZBRI
As the MRI Research Manager,
I oversee all magnetic resonance
imaging that occurs at the Institute.
This includes my primary research
focus — using multimodal MRI to
investigate cognition in Parkinson’s
disease — as well as facilitating
and collaborating on other projects
ranging from child development
to mild traumatic brain injury to
Alzheimer’s disease.
One of the main advantages
of the NZBRI is its multidisciplinary
nature; it promotes effective and
friendly collaboration between
experts in diverse fields from the
Universities of Otago and Canterbury,
as well as Christchurch Hospital
Annual Report 2017 1
Contents
Activity snapshot 02
Our people 10
Chair Report 12
Research Director Report 16
Statement of Service Performance 20
Clinical Director Report 36
Research Reports 40
— Neuroimaging at the NZBRI 40
— Dementia Research Report 44
Fundraising and the FBI 48
Published Articles 54
2017 NZBRI Completed Theses 56
Funding Impact 58
Acknowledgements 60
Financial Report 2017 62
2 New Zealand Brain Research Institute
Activity snapshot
17 papers published,
1001 research participant
visits, 3044 outpatient
assessments, 3 completed
theses, 14 ongoing theses,
19 public talks, 14 students
and 28 staff.
Annual Report 2017 3
17 papers published,
1001 research participant
visits, 3044 outpatient
assessments, 3 completed
theses, 14 ongoing theses,
19 public talks, 14 students
and 28 staff.
4 New Zealand Brain Research Institute
Countries represented
Belgium, Egypt, Germany,
India, Iran, New Zealand,
Pakistan, Saudi Arabia, South
Africa, United Kingdom, USA.
Annual Report 2017 5
Belgium, Egypt, Germany,
India, Iran, New Zealand,
Pakistan, Saudi Arabia, South
Africa, United Kingdom, USA.
6 New Zealand Brain Research Institute
Disciplines represented
Bioengineering, Mathematics
& Biostatistics, Medical
Physics, Neurology,
Neuroscience, Nursing,
Psychology, Radiography,
Radiology.
Annual Report 2017 7
Bioengineering, Mathematics
& Biostatistics, Medical
Physics, Neurology,
Neuroscience, Nursing,
Psychology, Radiography,
Radiology.
8 New Zealand Brain Research Institute
Legacy
Annual Report 2017 9
Legacy
10 New Zealand Brain Research Institute
Our People
Board
Dr Cheryl Doig Professor Professor Professor
Chairperson Ivan Donaldson David Murdoch Ian Wright
Virginia Spoors Richard Sudell Mike Stenhouse Simon Carey
CMRF Representative CMRF Representative
Annual Report 2017 11
Directors
Dr Michael MacAskill Professor Kate Russell Dr Tracy Melzer
Research Director Tim Anderson Commercial Director MRI Manager
Clinical Director
“Our work is of national significance in
considering the impact of brain health
on well-being and future resourcing
needs. This research is critical for the
benefit of all New Zealanders.”
Dr Cheryl Doig
Chairperson, NZBRI
12 New Zealand Brain Research Institute
Chair Report
Annual Report 2017 13
The New Zealand Brain Research
Institute (NZBRI) has continued to grow
its reputation as a major contributor to
research on the brain and neurological
disorders, both nationally and
internationally.
ur focus is to improve brain-health for our community
O through research, education and clinical practice. This work
is undertaken by an experienced and globally recognised team of
researchers and clinicians who have made major contributions to
conferences; supervised and undertaken research; and been involved
in collaboration through the Brain Research New Zealand Centre of
Research Excellence (CoRE) and through international connections.
Medical research is vitally important and the work of NZBRI
is especially so. Funding such research can be challenging and we
do appreciate the regular donations and generous bequests that
continue to make our work possible in an increasingly crowded
donor market.
The Friends of the NZBRI (FBI) continue to be champions for the
NZBRI cause, and we recognise their tremendous support in running
the NZBRI Golf Tournament and the Opera Meets Art. We also thank
Michael and Ivan Donaldson and the team from Pegasus Bay winery
for donating the proceeds of the inaugural Pegasus Bay Vine Run,
a total of $19,000, to NZBRI.
On behalf of the Board, I would like to acknowledge the
huge contribution and commitment of the NZBRI team. Dr Michael
MacAskill (Research Director) and Professor Tim Anderson (Clinical
Director) provide the board with expert advice. Our researchers
and administrators illustrate the importance of international
relationships and the power of collaborative endeavours to make
a difference in the lives of the community they serve.
14 New Zealand Brain Research Institute
The achievements of individual researchers have been significant
and are detailed in the Research Director’s Report.
The CMRF administration team also plays a vital role in the
smooth running of NZBRI, with Kate Russell the General Manager
of CMRF also acting as the Commercial Manager for NZBRI.
Kate Russell, has continued to provide clear direction, strengthened
our operational practices and supported the development of
new relationships. Kate leaves us in June to take up a new role
at the Christchurch City Council and we wish to acknowledge
her contribution to NZBRI.
2017 has also seen some changes in our board composition.
Emeritus Professor Steve Weaver stepped down from his role as
an independent director once our two new independent directors
were appointed. His contribution to NZBRI was significant and we
thank him for staying on during this transition time. Our two new
independent directors joined us at the beginning of the financial
year. Virginia Spoors is Southern Regional Manager, Health and
Ability Services — St John of God Hauora Trust and Richard Sudell
is a consultant with a background in commercial, capital works
and transaction advisory services.
They join a strong team: Professor Ivan Donaldson,
independent director; Professor Ian Wright, Deputy Vice-Chancellor
(Research and Innovation) at University of Canterbury; Professor
David Murdoch, Dean and Head of Campus of the University
of Otago; Christchurch; Mike Stenhouse and Simon Carey,
CMRF representatives.
2017 has seen the board of NZBRI and CMRF continue
to work closely, with excellent support and relationships maintained
particularly through the CMRF representatives on our Board.
NZBRI operates under a financial structure, which is fully owned
by CMRF. Summarised financial and performance information
derived from the audited Performance Report for NZBRI for 2017
is included within this publication.
Annual Report 2017 15
In summary the net deficit for the 12 months was $41,747. The 2017
financial year saw income from research grants being higher than
budget reflecting the quality of the research program. Research
expenditure was slightly behind budget.
CMRF continued its support with an underwrite contribution
of $200,000 from its funds plus a further $150,000 drawdown
of capital from the van der Veer fund held by CMRF.
Income of $1,288,068 included a grant of $125,000 from the
CMRF parent to support our administrative function. This helps us
optimise the monies spent on the provision of research facilities,
personnel and research projects. You will read of the significant
work undertaken in the extensive reports that form part of this
Annual Report.
The new Board undertook a full review of our strategic direction
in late 2017, seeking input from staff and involving senior researchers
in our strategic workshop. Our focuses on growing and enhancing
our research programmes; extending our collaborative relationships
and projects; and nurturing and retaining talent aim to extend
our reputation. While NZBRI is already performing well, our new
strategic direction focuses on next steps in research, reputation
and financial sustainability.
Dr Cheryl Doig
Board Chair, NZBRI
16 New Zealand Brain Research Institute
Research Director
Report
Annual Report 2017 17
A large part of the Institute’s work is
devoted to Parkinson’s disease. Although
we have a lot of clinical and research
expertise in working directly with people
with this condition, surprisingly little had
been learned about the wider picture of
Parkinson’s in this country.
n 1966, at the beginning of their careers, distinguished neurologists
I Martin Pollock and Richard Hornabrook reported the first local
estimates of the epidemiology of Parkinson’s. This was a landmark
paper internationally, being one of the first to highlight the high
rate of dementia in what was previously thought to be solely a
movement disorder. The study was, however, restricted to residents
of Wellington, and the only Ma¯ori patients they identified were rural-
dwellers and hence were not included.
A later study in 1992 was similarly limited to the city of Dunedin.
An authoritative national estimate of the frequency of Parkinson’s
was sorely needed, as international estimates are unlikely to
generalise to our unique population. Dr Toni Pitcher has led this
research, collaborating closely with biostatistician, Dr Daniel Myall.
They applied a “big data” approach, analysing literally millions
of prescribing records over a decade, cross-referenced to other
national and regional data sources. They estimated for the first time
the national prevalence (the number of people with the disease:
191 per 100,000 people), and the incidence (the rate of new cases:
29 per 100,000 people per year).
The risk of Parkinson’s increases dramatically with age, although
most previous studies have not directly examined beyond the age of
85. By being able to cover an entire national population, we could
give reliable rates up to age 100, and produced strong confirmation
18 New Zealand Brain Research Institute
of previous hints that the risk of Parkinson’s actually begins to
markedly decline in the oldest-old (those more than 85 years of age).
This has important implications for our understanding of the disease:
it is related to old age, but not necessarily the ageing process itself.
Toni and Daniel are continuing this research, into a number of
questions of national and international interest.
During 2017, we had a healthy success rate for attracting
competitive research grant funding. NZBRI researchers submitted
23 research grant applications. Of those, ten were successful and
five were unsuccessful, while one was withdrawn due to success of
a similar application to another funding body. The outcomes of seven
others were still awaited. In total, $1.23 million of external funding
was attracted to support our research projects.
The Brain Research New Zealand/Rangahau Roro Aotearoa
national centre of research excellence was the most significant
external funder of our research in 2017. Through its national
competitive funding process, it invested in a number of our projects
to assess brain health (using sophisticated measures of MRI, EEG,
and brain proteins in blood samples). They also funded our follow-
up nation-wide epidemiology study, to investigate the effects of
rural living and of ethnicity and financial deprivation on rates of
Parkinson’s disease.
This external funding was in addition to the Institute’s
application of its own resources into research. Most particularly,
we acknowledge the value of the Orr Family Estate donation, which
has been sustaining our substantial Parkinson’s longitudinal research
for the past four years. That generous investment has enabled us to
maintain our team of skilled neuropsychological assessors, who have
an ongoing and close relationship with our large cohort of Parkinson’s
research volunteers and their families. Over the past four years, as
part of a project examining the decline of cognitive functioning in
at-risk patients, we have needed to step up our usual two-yearly
Annual Report 2017 19
assessments to a 6-monthly cycle. It has only been with the support
of the Orr family that we have been able to maintain that intensive
level of contact with our patients and their caregivers.
Once again, it has been a pleasure to work this year with such
a talented and passionate group of researchers, clinicians, support
staff and graduate students. Please refer to the “Statement of Service
Performance” (SSP), attached to our financial report, to get a more
comprehensive account of their research, clinical, and educational
achievements in 2017. None of this would be possible, however,
without the continued generous devotion of time and energy from
our research volunteers and their families.
Michael R. MacAskill
PhD, Research Director, NZBRI
20 New Zealand Brain Research Institute
NZBRI 2017 Statement of Service Performance
The New Zealand Brain
Research Institute
(NZBRI) has three main
charitable aims:
Annual Report 2017 21
NZBRI 2017 Statement of Service Performance
The New Zealand Brain — Reveal new knowledge about
the brain and its dysfunction
Research Institute — Improve the standard of care for
(NZBRI) has three main people with neurological disorders,
locally, nationally, and globally
charitable aims: — Educate clinicians, scientists, and
the public on brain research findings
and techniques.
22 New Zealand Brain Research Institute
NZBRI 2017 Statement of Service Performance
Reveal new knowledge about the
brain and its dysfunction
Output
Publish research outputs in peer-reviewed journals. The primary
output of a research institution is publication of papers in peer-
reviewed scientific and clinical journals.
Performance Measures Performance
Quantity At least 20 papers published per year 85%
(17 papers published)
Quality Publish in international journals, 100%
unless compelling reason to
disseminate locally
Evidence Publications viewable on our public website:
nzbri.org/labs/publications
Note that the numbers above do not include published research abstracts or brief reply letters.
Outcome NZBRI research papers will be cited widely in the academic literature
The primary outcome of a successful research paper is influence upon
scientific and clinical thought, as measured by the number of times that
paper is cited by other research groups
Evidence We report on the citations generated only from the most influential papers
generated from NZBRI (those with ≥ 100 citations). The annual number of
citations for each of those papers can be verified by finding a record for
that paper in a publicly-available Google Scholar page associated with
one of its authors. Due to the algorithm used by Google Scholar to measure
citations, values might fluctuate slightly from those generated at the time
of this report.
Annual Report 2017 23
NZBRI 2017 Statement of Service Performance
The most highly cited papers
from the NZBRI (those with Paper Total citations
>100 citations)
Dalrymple-Alford 2010 373
The figure across shows the 14
most-highly cited papers published Trenkwalder 2011 305
by Institute researchers since the Stott 2005 297
Institute was founded in 2004 (i.e. Heitger 2009 192
the 14 papers that have been cited
more than 100 times). In terms Melzer 2012 158
of citations by researchers in the McKinlay 2008 138
field, these papers (in addition
to the Institute’s body of other Leow 2010 120
publications) continued to be McKinlay 2010 118
influential in 2017. Anderson 2006 117
Dalrymple-Alford 2011 113
Heitger 2004 110
Heitger 2006 108
Huckabee 2005 107
Mitchell 2005 103
24 New Zealand Brain Research Institute
NZBRI 2017 Statement of Service Performance
Reveal new knowledge about the
brain and its dysfunction
Output
Submit high-quality funding applications to competitive funding rounds
at external research funding bodies.
The Institute’s research activity is primarily funded by grants from external
sources. Any funds awarded are as the result of a competitive process, and the
quality of the work is assessed by national and international peer reviewers.
These measures were not reported in previous SSPs.
Performance Measures Performance
Quantity Numbers of grants submitted 23
Quality Numbers of grants successful or otherwise 10 successful
5 unsucessful
7 awaiting a decision
1 withdrawn (due to success
of application to antoher body)
Outcome Funding received to enable research activity, by providing for
research costs and maintaining employment stability for externally-
funded research staff.
Most external research income is not directly awarded to the Institute and
hence does not appear explicitly in its Financial Statements. This is because
most of its research staff must apply for funding through their affiliated
university as the host organisation. Thus the Institute generates much more
research income than is apparent from its own Financial Statements.
Annual Report 2017 25
NZBRI 2017 Statement of Service Performance
Performance Measures Performance
Quantity Total funding awarded $1,229,153.00
Details of $378,108 — Brain Research NZ
successful Patterns of MRI brain ageing to assess brain health
grants
$248,644 — Brain Research NZ
Plasma alpha synuclein, AB and tau in Parkinson’s and Alzheimer’s.
$166,347 — Brain Research NZ
EEG Biomarkers for cognition in Parkinson’s
$136,925 — NZ Dementia Prevention Trust
Christchurch-based Dementia Prevention Research Clinic
$114,920 — Brain Research NZ
Does rural living or deprivation contribute to the risk
of Parkinson’s in New Zealand?
$100,000 — Brain Research NZ
Novel MRI methods and genetics in mild cognitive
impairment and mild Alzheimer’s.
$57,209 — University of Otago
Amyloid, brain volume, and the risk of future
cognitive decline in Parkinson’s.
$12,000 — University of Otago
MacGibbon Fellowship.
$10,000 — University of Canterbury
Predictors of poor outcomes in older people with dementia.
$5,000 — University of Otago
CMRF-funded summer studentship.
Evidence The Institute maintains a register of all grant applications submitted by
its researchers. Funding bodies also often make details of their awarded
grants (but generally not the unsuccessful applications) publicly available.
26 New Zealand Brain Research Institute
NZBRI 2017 Statement of Service Performance
Reveal new knowledge about the brain
and its dysfunction
Output
Assess new and existing participants in research studies
Performance Measures Performance
Quantity Follow-up existing participants in primary 198 participants assessed
longitudinal and imaging Parkinson’s studies across ~904 visits, 14%
fewer than 2016
Quantity Gather blood samples for Parkinson’s 160 samples drawn and
and control participants for extracting processed.
DNA and other biomarkers.
Quantity Continue assessment of participants in 70 participants completed
study of cognitive enrichment in Parkinson’s the protocol. An additional
(recruitment commenced in 2015) follow-up study will be
conducted.
Quantity Commence study to use a new PET tracer Not achieved, 0 of 56
to detect tau protein in Parkinson’s disease. patients recruited (due
Total patients required 70, goal to recruit to international supplier
56 in 2016 being unable to provide
the radioactive PET tracer)
Quantity Assess participants in other independent Study of voluntary
sub-studies in Parkinson’s suppression of tremor in
Parkinson’s disease. Study
commenced and completed
in 2017: recruited 39
patients and completed
assessments for 37 (92.5%
of planned target of 40).
Annual Report 2017 27
NZBRI 2017 Statement of Service Performance
Performance Measures Performance
Quantity Recruit participants to study of effect During 2017, 23 more
of CPAP on cerebral bloodflow and participants recruited. As
cognition in sleep apnoea 15 were recruited in 2016,
a further 7 are required to
complete the study design
of 45 participants.
Evidence Internal records maintained by individual principal investigators
or study coordinators responsible for each project.
28 New Zealand Brain Research Institute
NZBRI 2017 Statement of Service Performance
Improve the standard of care for people
with neurological disorders
Output
Establish Christchurch branch of the national Dementia Prevention
Research Clinic (DPRC).
The DPRC provides for intensive medical, neuropsychological, neuroimaging,
and other assessments for patients at risk of progression to dementia. This clinic
provides a comprehensive clinical service for this group of patients that would not
exist without this research funding (provided by the Brain Research New Zealand
national centre of research excellence).
Performance Measures Performance
Quantity Number of patients assessed 5 patients assessed (Clinic
established in August 2017 and first
patients recruited in October.
Evidence Internal records maintained by research nurse co-ordinator.
Annual Report 2017 29
NZBRI 2017 Statement of Service Performance
Output
Provide clinic facility for neurological outpatient assessments
Performance Measures Performance
Quantity Number of Canterbury DHB 3044 outpatient visits
outpatient visits hosted (13% increase from 2016) conducted
onsite by CDHB neurologists,
attending to 2260 patients.)
Evidence Data supplied upon a confidential request to the Decision Support unit
at Canterbury District Health Board
30 New Zealand Brain Research Institute
NZBRI 2017 Statement of Service Performance
Output
Canterbury people will receive improved care or levels of assessment by
involvement in pharmaceutical trials or international observational studies
Performance Measures Performance
Quantity Number of Canterbury DHB 3044 outpatient visits
outpatient visits hosted (13% increase from 2016) conducted
onsite by CDHB neurologists,
attending to 2260 patients.)
Number of STAR 1 trial — Double-blind study of cannabidiol for partial onset
patients epilepsy. Study continued in 2017. 9 patients were assessed over 31 visits.
active STAR 2 trial — Open-label study of cannabidiol transdermal gel for
involved in partial onset epilepsy. Study commenced in 2017. 5 patients assessed
studies
over 62 visits.
Duodopa study — Open-label study of levodopa/carbidopa
intestinal gel for Parkinson’s patients: one patient, 3 visits.
Study ended in September 2017
STEADFAST study — Double-blind study of azeliragon for
mild Alzheimer’s. Study continued in 2017, with 7 patients assessed
over 21 visits.
ENROLL HD — Observational study of families with Huntington’s.
Ongoing longitudinal study, with 100th patient recruited in 2017.
As some previously recruited patients have died or did not attend
follow-up, 80 patients were assessed over 80 sessions.
Daybreak study — Five-year trial of ozanimod in people with relapsing
multiple sclerosis. Recruitment closed. Two participants.
Endorse study — Twelve-year trial of tecfidera in people with relapsing
multiple sclerosis. Recruitment closed. Two participants remaining.
ESTEEM study — Observational study of people with relapsing multiple
sclerosis taking tecfidera for the first time. Four participants recruited.
Annual Report 2017 31
NZBRI 2017 Statement of Service Performance
Number of N-Momentum — Four-year trial of MEDI-551 in people with active
patients neuromyelitis optica. Recruitment ongoing. Zero participants to date
active PREVANZ study — Trial of vitamin D supplementation in clinically isolated
involved in syndrome. Recruitment ongoing. 16 participants.
studies
CompANZ — Online questionnaire on Lifestyle and Medical History
Survey and the Cost Diary of people with multiple sclerosis.
Recruitment ongoing. 233 participants.
TASTE — Acute Stroke study comparing alteplase and tenecteplase.
Recruitment ongoing. 3 participants.
EXTEND-IA TNK — Acute Stroke study comparing alteplase and
tenecteplase with clot retrieval. Recruitment closed. 3 participants.
Evidence Internal records maintained by study coordinators
responsible for each project
32 New Zealand Brain Research Institute
NZBRI 2017 Statement of Service Performance
Educate clinicians, scientists, and the public
on brain research findings and techniques
Output
Provide opportunities for students to complete graduate
qualifications in brain research
Performance Measures Performance
Quantity Number of PhD completions One doctorate awarded
(Dr Yassar Alamri, University of
Otago, ‘Biological and behavioural
markers of Parkinson’s disease’)
Four other doctoral theses
submitted in 2017 but
examination process is
ongoing. (Canterbury:
K. Hornse, R. Shooranghiz.
Otago: M. Almuqbel, S. Feng.)
Quantity Number of Masters degree completions Two theses submitted
and awarded (Jamie Small,
University of Canterbury, MMedSc,
‘Mild traumatic brain injury and
advanced magnetic resonance
imaging techniques’, Dr Sharon
Jay, University of Otago, MMedSc,
‘Mild traumatic brain injury and
advanced magnetic resonance
imaging techniques’.
Quality Pass external national/international 100% of those that have
expert examination completed the process.
Evidence Publicly-viewable thesis databases of the respective universities (for theses
that have completed the submission, examination, and awarding process).
Annual Report 2017 33
NZBRI 2017 Statement of Service Performance
Output
Provide public education opportunities for brain research
Performance Measures Performance
Quantity Number of presentations given 18 (2 × Probus, 1 × U3A, 1 × Canterbury
by researchers and management MS & Parkinson’s Society, various
Rotary, Lions, Zonta, Kiwanis clubs,
to community service and
Commonwealth Society.)
education groups
Quantity Number of public talks given 1 (Student presentation to University of Otago,
Christchurch public lecture)
Quantity Number of interviews 4 (TVNZ One News, Radio New Zealand,
in public media The Senior Citizen newspaper,
Ara Broadcasting School.
Quantity Number of other Various online news coverage
appearances in media arising from above interviews, 2 ×
Christchurch Press articles, 1 ×
Listener article.
Quantity Other public outreach events 2 (Staff and students manning a stand
at local malls to raise public awareness
of brain research.)
34 New Zealand Brain Research Institute
“NZBRI brings together
researchers from diverse
backgrounds and provides
a collegial environment
fostering collaboration and
knowledge transfer.”
Dr Toni Pitcher
Research Fellow, University of Otago, Christchurch & NZBRI
Annual Report 2017 35
“NZBRI brings together
researchers from diverse
backgrounds and provides
a collegial environment
fostering collaboration and
knowledge transfer.”
Dr Toni Pitcher
Research Fellow, University of Otago, Christchurch & NZBRI
36 New Zealand Brain Research Institute
Clinical Director
Report
Annual Report 2017 37
An exciting initiative during 2017 has
been the establishment of our Dementia
Prevention Research Clinics (DPRCs) in
mid-2017 as part of our involvement in the
national collaboration, Brain Research
New Zealand (BRNZ) Centre of Research
Excellence.
his clinic is based at the NZBRI and is recruiting people with
T mild cognitive impairment (MCI). People with MCI have a
50% risk of ultimately developing dementia, especially Alzheimer’s
Dementia. Participants in this research clinic undergo extensive
assessment, including detailed cognition testing, MRI and amyloid
PET brain scans, and have blood samples stored in a biobank for
later analysis and, we hope, discovery of new markers.
Our clinic volunteers are then reassessed regularly for any
changes in thinking and memory, and follow-up brain scans and
blood tests. The aim of these DPRCs is to find and test new therapies
to help prevent and treat dementia. The multidisciplinary clinic is
staffed by nurse coordinator Marie Goulden RN, Neuropsychologist
Dr Karelia Levin, Psychologist Prof John Dalrymple-Alford,
Geriatrician Dr John Elliot, Neurology Fellow Dr Purwa Joshi,
and Neurologist Prof Tim Anderson, along with Dr Toni Pitcher
responsible for blood sampling and Dr Tracy Melzer for the MRI and
PET brain scans. We have just farewelled Dr Joshi but are pleased
to welcome Neurologist Dr Campbell Le Heron onto the clinic team.
We already have over ten people participating in our clinic with an
expected number of some fifty recruited per year.
The NZBRI is excited to host two young and energetic research-
minded neurologists who have joined the CDHB Neurology
Department. Dr Teddy Wu arrived early in 2017. Teddy has special
expertise and research interests in Stroke and undertook his PhD
38 New Zealand Brain Research Institute
thesis work in Melbourne on cerebral haemorrhage (bleeding
in the brain). He will be furthering his Stroke research under the
auspices of the NZBRI.
Dr Campbell Le Heron joined us in April this year after
completing his PhD thesis research at the University of Oxford (UK)
on apathy in neurological disorders. Campbell is passionate about
research and his expertise and interests are in cognitive disorders
such as dementia, and movement disorders (e.g. Parkinson’s and
Huntington’s). We are pleased to host Teddy and Campbell and
grateful to the CDHB Neurology Department for facilitating their
research interests at NZBRI.
We have continued to host the CDHB Neurology Department
outpatient clinics at our clinical facility at 40 Stewart Street
on almost a daily basis. These clinics provide opportunities for
patients to participate in the NZBRI clinical research activities
and for teaching medical students from the University of Otago,
Christchurch medical school. Dr Debbie Mason has specialized
multiple sclerosis (MS) clinics and leads research and trials of
new therapies in MS, Dr Rod Duncan offers specialised epilepsy
expertise, whilst Drs Fink and Reimers have subspecialty interest
in stroke and nerve and muscle disorders.
Beyond these special areas, the Neurology clinics see people
with the full gamut of common neurological problems including
headache, dizziness, gait disorders etc. The NZBRI clinical
facility also hosts three specialised neurological nurses Helen
Skene (Parkinson’s), Jane Eagle and Jessica Deacon (MS) and
Movement Disorders research coordinator Dr Laura Paermentier;
they are critical in supporting the NZBRI clinical research and
pharmaceutical studies and overseeing advanced treatments
for Parkinson’s and MS.
I continue to conduct two specialised Parkinson’s and Movement
Disorders clinics, as well as a botulinum toxin treatment clinic
Annual Report 2017 39
for people with various forms of muscle spasm. With Dr Sandy
MacLeod, Psychiatrist, and other members of a multidisciplinary
team I run regular Huntington’s disease (HD) clinics at the Institute.
We also continue to participate in the large international HD-Enroll
research study for those with, or at risk of HD, and have some 100
participants from Canterbury and other parts of the South Island.
We were pleased to host a Summer Student, medical student
William Muller who undertook a project on eye movements
in Huntington’s analyzing the eye movement data from many
thousands of people with, or at risk of, Huntington’s. The results
of William’s work will be presented in a poster at a major
conference in Hong Kong later in the year.
We are already well into another busy and productive year at the
NZBRI. At the heart of our endeavours is the desire to improve the
outlook for our patients with neurological disorders.
Professor Tim Anderson
Clinical Director, NZBRI
40 New Zealand Brain Research Institute
Research Reports
Neuroimaging
at the NZBRI
Annual Report 2017 41
Research Reports
As in previous years, brain imaging
remains a key aspect of the research
we conduct at the NZBRI.
e continue to have studies that utilize both Magnetic
W Resonance Imaging (MRI) and Positron Emission Tomography
(PET) imaging to investigate many topics, ranging from child
development through to diseases of the elderly, and beyond.
2017 was an exciting year in terms of imaging hardware. Pacific
Radiology Group (PRG) installed a new research grade 3T MRI
scanner at St. George’s Hospital in early 2017. This state-of-the-art
facility will facilitate cutting edge research. Researchers from the
NZBRI have already begun to utilise this resource, with three new
studies commencing in 2017. The 3T GE scanner that we have used
since its installation in 2006 was moved from its previous home at
Hagley Radiology to a new private hospital, Forte Health. We carried
out quality assurance tests before and after the move, with studies
continuing to utilise the scanner in its new location.
In 2017, we performed 154 hours of MRI scanning and an
additional 26 amyloid PET scans on the GE PET scanner at Southern
Cross Hospital. This amounts to less scanning than in prior years,
however this can be attributed to the completion of the amyloid
PET study, the ‘down time’ associated with the scanner move, and
the delay in starting new studies on the new St. George’s scanner
(commissioned in February 2017). In total, 8 different studies utilized
imaging in their research.
The new imaging facility at St. George’s hospital hosted three
new research projects in 2017, including:
1. Voluntary tremor suppression in Parkinson’s disease (PI: Dr
Rebekah Blakemore, Medicine, University of Otago, Christchurch)
2. The Dementia Prevention Research Clinics (PIs: Prof John
Dalrymple-Alford, Psychology, University of Canterbury, and
42 New Zealand Brain Research Institute
Associate Professor Lynette Tippett, Psychology, University of
Auckland)
3. Unravelling the neural mechanisms of speech production: insights
from EEG and fMRI in people who stutter (PI: Dr Catherine Theys,
Communication Disorders, University of Canterbury)
A number of ongoing studies continued on the scanner that moved
from Hagley Radiology to Forte Health. The Parkinson’s disease
research group continues to be the largest user of imaging,
specifically using MRI to (1) track disease progression over time as
part of an ongoing longitudinal study, (2) investigate mild cognitive
impairment in Parkinson’s disease, and (3) test whether a programme
of physical and cognitive enrichment can alter the trajectory of
the disease. Two additional studies scanned participants on this
scanner:
1. Blood flow in Obstructive sleep apnoea (PIs: Richard Jones and
Carrie Innes)
2. Magnesium sulphate at 30-34 weeks gestational age
(MagNUM—PI: Prof Caroline Crowther, Liggins Institute, University
of Auckland)
Amyloid PET scanning completed recruitment in 2017 (actually Jan
2018), with two complementary studies acquiring data:
1. Amyloid deposition in PD with Mild Cognitive Impairment (PIs:
Tim Anderson & John Dalrymple-Alford)
2. Amyloid deposition in PD (excluding MCI—PI: Tracy Melzer)
Staff and Students:
Research Fellows Dr Toni Pitcher, Dr Daniel Myall, Dr Rebekah
Blakemore, and Dr Tracy Melzer were all directly involved in imaging
research, as were 7 students: 4 PhD students (Mustafa Almuqbel,
Annual Report 2017 43
Dr Simon Feng, and Ms Megan Stark, Medicine, Otago; Katherina
Russell, Lincoln), 3 Master’s students (Jamie Small & Mildred Tan,
Medical Physics, Canterbury; Dr Sharon Jay, Medicine, Otago),
and 1 research assistant (Maddie Pascoe, NZBRI). These students
represent three institutions, across multiple departments.
Dr Tracy Melzer
MRI Research Manager, NZBRI
44 New Zealand Brain Research Institute
Research Reports
Dementia
Research Report
Annual Report 2017 45
Research Reports
Excellent progress was made during 2017,
most especially the continuation of data
collection for the Parkinson’s disease
progression study, student postgraduate
completions and grant successes.
ur progression study is becoming an extremely valuable source
Oof varied and complex longitudinal datasets on Parkinson’s
disease patients; it continues to cement our place within the
international consortium on cognitive changes in Parkinson’s, for
which Dr Daniel Myall is now taking a leading role in setting up an
international resource.
The longitudinal study also includes work towards completion of
our current Health Research Council (HRC) project (Genetics, brain
imaging and cognitive decline in Parkinson’s disease; Co-PIs Tim
Anderson and John Dalrymple-Alford).
Of several new grant applications, perhaps the most significant
is our latest HRC project application, Plasma a-synuclein as a
biomarker of cognitive impairment in Parkinson’s disease (Co-PIs Tim
Anderson and John Dalrymple-Alford); we await the final outcome
of this application in May /June. Related projects also await an
outcome (MJ Fox Foundation, submitted in Jan 2018), but we have
already had success with Lottery Health.
In other work, we are nearing the completion of our “cognitive
and physical exercise” intervention study in patients with
Parkinson’s; we await some follow up data to assess the impact of
this intervention.
Of particular note is a new development to examine
electroencephalography (EEG) as a biomarker for cognition in
Parkinson’s disease and its extension to Alzheimer’s disease. In
that regards, we achieved grant success from Brain Research New
Zealand, which includes two-years part-time funding for Reza
46 New Zealand Brain Research Institute
“We are nearing the
completion of our
cognitive and physical
exercise intervention
study in patients with
Parkinson’s.”
Annual Report 2017 47
Shoorangiz, who recently completed his PhD at the NZBRI.
Among other success with the NZBRI was a full-time post-
doctoral fellowship for Kyla Horne (nee Wood) to begin new
MRI analyses, a new direction that stems from her important
contributions to the longitudinal progression study.
In addition, the Dementia Prevention Research Clinic (funded
by Brain Research New Zealand) commenced operations during
late 2017, with the appointment of a research coordinator (Marie
Goulden) and clinical neuropsychologist (Karelia Levin), and
a formal opening anticipated in August 2018.
Professor John Dalrymple-Alford
Professor of Psychology, NZBRI
48 New Zealand Brain Research Institute
Fundraising
and the FBI
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