Meet The Researcher

When I am not working in the clinic or researching MS I can be found mountain biking on the trails around Melbourne (usually not breaking too many bones!).

As a clinical neuropsychologist, I have often consulted with people with MS who have concerns about their cognition. Unfortunately, for many of these patients, the path to cognitive diagnosis before seeing me was not a smooth one. This was due partially to a lack of a coherent model of clinical cognitive impairment in MS. This inspired me to get involved in MS research to improve our ability to diagnose, explain, and manage cognitive concerns in people with MS.

From a clinical perspective, the availability of effective disease modifying therapies is the most exciting development in recent times. This has completely changed the outlook for people with MS. A a neuropsychologist, my challenge is to ensure that the cognitive, psychological, and psychiatric aspects of MS are just as optimally managed as the physical symptoms.

The overall aim of my project is to develop a clinically translatable model of MS. By this I mean a framework for describing all of the cognitive symptoms experienced by people with MS and linking them to organic changes happening in the brain. At the moment, most cognitive research is focussed narrowly on scores derived from simple psychometric instruments, such as processing speed tests. While these tests are important, they are of little help for a person with MS who experiences more nuanced or complex difficulties, such as problems with forming sentences, forgetting details from conversations, or walking into a room and forgetting why they went there. My project will formally test a model that encapsulates these difficulties by dividing cognitive impairment in MS into two distinct classes: fundamental versus instrumental cognitive impairment. It will also incorporate other factors known to affect cognition, such as pain, fatigue, and poor sleep. I will validate this using psychometric methods in people with and without MS.

At the moment there is no unified model for describing cognitive impairment in MS, particularly in patients who might experience cognitive difficulties but who have normal cognitive test scores. If successful, our model will provide a common language for patients, clinicians, and family members to communicate findings of cognitive impairment. This will help patients understand why they are experiencing specific difficulties, and provide direction regarding what can be done to improve cognitive function.

As a clinican-researcher, my lab is really the outpatients clinic at the Royal Melbourne Hospital. The best thing about this is working directly with patients who will hopefully benefit from my research. This keeps my research relevant and also provides me with an endless list of potential research questions! The biggest challenge is that we are always limited by time. In a busy clinic we have to help as many patients as possible, which means working out new ways of practicing efficiently.