Interview: Brain research resonates for BRI scientist

Tucked away in the corner of the Austin and Repatriation Medical Centre campus in Melbourne suburb of Heidelberg is the Brain Research Institute (BRI), devoted to research into epilepsy and other neural disorders, as well as the function of the healthy brain.

Swiss neurologist Dr Regula Briellman is the BRI's research coordinator, responsible for managing the many collaborations that institute scientists are involved in, as well as the in-house projects. Originally coming to Australia for postdoctoral work, she has now been here for six years.

"I initially planned to go back, but it proved to be so interesting that I stayed on," Briellman said.

One of the big drawcards was the three Tesla magnetic resonance scanner (3T MRI) at the Institute, the only one in Australia. This scanner offers far more resolution than the 1.5T MRIs used for most clinical applications. It can also be used for functional MRI, which uses parameters such as increased blood flow to localise areas of activity in the brain.

Another technique used by the researchers is magnetic resonance spectroscopy, which allows examination of various metabolites in the brain. Briellman said that while drugs often affected metabolites, research in this area was not yet at a point where the effect of a drug on a particular condition could be monitored.

As well as the clinical projects, the BRI is also actively involved in developing new techniques, including software and hardware development for 3T MRI.

Briellman coordinates a wide range of projects at the BRI, but focuses mainly on epilepsy, which is the main clinical focus at the institute. Her main areas of interest are neuroprotection, neurodegeneration and neuroplasticity.

"The more you discover, the more you are astonished," she said.

One research project Briellman was involved in looked at the occurrence of spikes, abnormal brainwaves that happen in between seizures that localise to the epileptic focus. BRI researchers have developed a technique using a combination of EEG, which records brainwaves, and functional MRI to pinpoint the origins of the spikes.

"In many cases, we can't actually see the lesion or abnormality, so it's difficult to offer an operation to treat or cure the epilepsy. EEG and functional MRI can help localise the area so that we can treat it," Briellman explained. She noted that the technique was still in the experimental phases of development.

Another application of the functional MRI technique used by Briellman and her co-workers is to look at the relationship between the epileptic seizure focus and brain function. She said that this was important for planning surgery to treat the epilepsy to reduce the possibility of causing brain damage.

A study that Briellman is about to begin working on involves discordant identical twins, where one has epilepsy and the other does not. A prior study of 13 sets of twins showed that there was an explanation, usually a lesion, for the majority of cases of discordant twins, but in a couple of cases this wasn't the case.

Of interest to Briellman and her fellow researchers is the fact that the epileptic twin in these unexplained cases had a slightly larger brain than the non-epileptic twin. The new study will look at that aspect more closely.

Briellman said that epilepsy research not only had clinical benefits to patients in the form of better patient management and improved neurosurgical treatment options, but it also provided a lot of information about the workings of the brain.

In addition to clinically-focused research, Briellman is also interested in how the brain works. One of her recent studies examined how brain function related to language use in multi-lingual people. Functional MRI was used to monitor the brain function in the Swiss volunteers as they performed simple word exercises in four languages.

She found that the subjects used less of their brain when working in their most fluent languages, in these patient's cases usually German and English. In contrast, working in the less fluent languages required more of the brain, although the same regions of the brain were used.

According to Briellman, the mix of clinical research and basic neurological research was what has made working at the BRI so attractive.

"The combination here of clinical research and technical support is really unique. You can really do clinical research which is relevant," Briellman said. "The research environment I have here, I wouldn't get in Switzerland and that's why I am here."