04 December 2023
In this month’s eLearning spotlight, we spoke to Michelle Barraclough a research fellow at The University of Manchester. She talks us through her research in examining compensatory brain mechanisms in those with cognitive dysfunction and how this may affect cognitive fatigue in SLE (systemic lupus erythematosus).
Can you tell us a bit about your background?
I completed my undergraduate in psychology and was heading for a career in clinical psychology before finding my true passion was in research.
I have been part of some amazing research teams studying different aspects relating to psychology, from a behavioural neuroscience department in the US to an older age psychiatry department in the NHS. In the latter, as part of Prof Iracema Leroi’s team, I was researching Parkinson’s disease and impulsivity using functional magnetic resonance imaging (fMRI). It was this research and the connections I made during it that led to research within the complex field of lupus.
Due to my experience with fMRI a new PhD opportunity was highlighted to me with Prof Rebecca Elliott who is the Chair in affective neuroscience at UoM and Prof Ian Bruce, Honorary Consultant Rheumatologist at Manchester University Hospitals NHS Foundation Trust. This PhD aimed to examine neurocognitive function in SLE.
I initially had no knowledge about lupus. I don’t have a medical background, so it was a steep learning curve for me, especially given how complex this disease is. I completed my PhD and have now been researching cognitive dysfunction in SLE for over 10 years.
How do you recruit, is it mainly through clinicians referring people on for your studies?
Yes, the studies I’m involved in are usually for or with a rheumatologist and are often based at the Kellgren Centre for Rheumatology at MFT.
Currently, I don’t have any active studies in Manchester, but have submitted multiple grant applications recently. We’re hoping to undertake studies looking at the blood-brain barrier and the impact of physical exercise on cognitive fatigue.
You recently went to Toronto for research, can you tell me about this?
In science, you're encouraged to move away from your PhD supervisor to help you develop as an independent researcher. This doesn’t necessarily mean moving organisations, but I had an opportunity to do this and it was amazing. I was lucky as my young family were very supportive and happy to be uprooted for a year in Toronto.
With the support of my supervisor, I reached out to Dr Zahi Touma (Rheumatologist and clinician scientist in Toronto), who I had met at a previous ACR conference, and joined his team. My year there was extended to 18 months and now I am back in the UK we are still working together.
I would encourage anyone who is sceptical to reach out to colleagues and make connections as you never know what could happen. This experience has made me feel more comfortable and confident in reaching out to people. I also gained new skills and a larger network to further our knowledge in the field of cognitive function in SLE.
Can you tell us about the main research you’re working on from your recent trip to Toronto?
It's a continuation from my PhD which was looking at neurocognitive function in lupus and we’re looking at different brain mechanisms.
We know that in lupus people are more likely to have problems with cognitive function and when we measure that objectively it's around 40% of people who have some form of cognitive impairment.
In the clinic, patients who report brain fog, which we often think about as subjective or self-reported cognitive impairment are likely much higher than 40%. There’s a disconnect between those with objective and subjective cognitive impairment. Why we have the disconnect is something I’m interested in and the work I’m currently focused on.
What are the main things that rheumatologists should be asking our lupus patients?
You need to look at the whole person and all the different areas that could be interfering with their cognition as there are lots of factors that can affect them, such as pain, medication, and mood. For example, we know depression is a big factor that can affect cognition and it can also affect some of the functional differences in the brain, but it is not the full picture. There is something specific to lupus that affects cognition.
It's important not to be frightened to ask the question because then you can rule out other things that might be affecting cognitive function. You can then possibly access appropriate treatments for those factors until a better understanding of the mechanisms involved in cognitive dysfunction in SLE can be determined and other suitable treatments proposed.