Dr. Sukhvir Wright at Aston University Institute for Health and Neurodevelopment (IHN), and honorary consultant neurologist at Birmingham Children's Hospital (BCH), has been awarded a £3.4m Career Development Award from Wellcome to research autoimmune encephalitis (AE), an inflammatory brain condition, in children.
Every minute, someone in the world is diagnosed with encephalitis, which can be caused by an infection or have an autoimmune cause, where the body's own immune system starts attacking the brain. AE accounts for around a third of cases, with patients experiencing seizures, cognitive and sleep dysfunction and movement disorders. Although medical professionals are getting better at recognising and treating AE earlier, the long-term outcomes remain frustratingly poor, particularly in children under five.
Some symptoms of the disease, such as seizures, can resolve but others, such as problems with learning and memory, behavioral change and sleep disorders, can become chronic. Why some of these symptoms get better and others persist is not well understood.
Dr. Wright carried out a world-first preliminary study in a group of children with AE at least 18 months after they first developed the condition, using magnetoencephalography (MEG) brain scans. She found distinct long-term brain structure and network changes and believes that these brain changes are responsible for the chronic symptoms of the disease.
During this Career Development Award, Dr Wright will use laboratory models to characterise the mechanisms causing the chronic symptoms, examining the underlying changes from single brain cells to whole brain networks. She will also examine longitudinal brain network changes in children immediately following the acute attack of AE and for up to eight years afterwards using a new optically pumped magnetometer (OPM) MEG scanner.
IHN is an ideal location for the research project, as it houses the UK's only paediatric clinical and research Wellcome Trust MEG laboratory. The MAG4Health OPM MEG scanner that will be used by Dr Wright was installed in 2024 following a Medical Research Council (MRC) equipment grant for £800,000 led by Aston University's Dr. Caroline Witton in partnership with Birmingham Children's Hospital (BCH). The Aston-BCH OPM MEG uses an adjustable cap with sensors which is placed on the patient's head, which allows some degree of movement and is therefore more acceptable for children.
Combining the data from the laboratory models and human patients will enable Dr Wright and her research team to identify common pathophysiological targets, mechanisms and predictive biomarkers to reduce the adverse effects of AE and improve long-term outcomes.
Dr. Wright is part of the neuroimmunology team at BCH, led by paediatric neurology consultant Professor Evangeline Wassmer. The AE research project will involve Professor Wassmer's team, the BCH Psychology department led by Dr. Jo Horton, Professor Stefano Seri (neurophysiology) and Dr Laavanya Damodaran (liaison psychiatry).
Children and families with lived experience of AE will be directly involved with all aspects of the research to ensure it is answering questions that matter to them, including the family of one of the first AE patients ever treated by the neurology team at BCH. This patient and family involvement will be facilitated by the Epilepsy Research Institute's Shape Network and Encephalitis International, two charities with which Dr Wright has strong links.
Dr. Wright said:
"We hope that this project will transform outcomes and optimise brain health in paediatric autoimmune encephalitis and beyond by delivering a significant shift in understanding the acute and long-term effects that autoimmune encephalitis has on children and young people."
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