In our sixth 'Meet the researcher' post, we meet Dr Alison Yarnall, one of our NIHR Newcastle BRC-funded researchers. She recently supervised a PhD student to complete research on sarcopenia and frailty in prodromal dementia and led the Muscle and Ageing in Science Study – Parkinson’s disease, funded by NIHR Newcastle BRC.

Can you give us an overview of your role and research area?

I am an academic geriatrician and NIHR Newcastle BRC Intermediate Clinical Fellow, working from Newcastle University and Newcastle Hospitals. I am also Deputy Director of the Clinical Ageing Research Unit (CARU). A key focus of my research is how it applies to everyday practice with patients.

My main research area is in Parkinson’s and other neurodegenerative disease. Within Parkinson’s, my principal areas of interest are cognitive function, gait (including digital mobility) and falls; and I am primarily interested in the neurobiological underpinning of these conditions.

I am also an active member of the Older People’s Medicine department within Newcastle Hospitals, and I run a specialist clinic for older adults with Parkinson’s and complex health needs, in addition to a general medical memory clinic.

Working in the landscape I do, within partnerships between the University, Trusts and NIHR allows me to contribute to the translation of research directly to patient benefit.

What led you to focus on Parkinson’s research?

As part of my clinical training in geriatrics, I spent time working in Parkinson’s clinics and could see the significant impact of cognition and falls in the disease. I also saw the frequent hospital admissions in people with Parkinson’s due to both motor and non-motor symptoms.

Can you tell us about the development of your research career so far?

I am very grateful to have had early career support from the Newcastle BRC in training and development opportunities. This has allowed me to move forwards in my research career. From PhD to early career researcher, the NIHR and Newcastle BRC have provided several training and development opportunities. Not only has this supported me personally, but I know that my research knowledge can be translated into patient benefit too.

What research are you currently focussing on?

I work across the Dementia and the Ageing Syndromes themes within the Newcastle BRC. This includes research related to cognition, gait, falls and sarcopenia within neurodegenerative disease.

One of my main research areas is the prevention of falls in older people, which is also a public health priority. Gait disorders are a primary driver of falls and are common manifestations in ageing and associated conditions such as Parkinson’s disease (PD). Changes in gait and falls also contribute to, and are consequences of, ageing syndromes such as sarcopenia and frailty. The burden of gait impairments and falls risk is greatest in people with PD. This was highlighted by people with PD who contributed to a recent James Lind Alliance and Parkinson’s UK priority setting exercise.

I have recently been given funding from both Parkinson’s UK and Dunhill Medical Trust to investigate the use of non-invasive vagus nerve stimulation in Parkinson’s. We hope to determine if this is safe and acceptable, and whether it improves measures of gait.

I also have a key role in the €50 million IMI MOBILISE-D project; a consortium of over 150 professionals from 34 participating universities, hospitals and industry partners, working together to reach the common goal of validating health care technology.

Most recently, I have been successful in securing funding from Dunhill Medical Trust on a pilot intervention study to improve gait parameters (and thus reduce falls risk) in Parkinson’s disease using non-invasive vagus nerve stimulation entitled Adjunctive Vagus Nerve Stimulation for Improving Neural control of Gait in Parkinson’s Disease (AdVaNSING-PD).

What role does industry play in your research?

Industry links have been fundamental to the following:

• The AdVaNSING-PD study
• Within a novel study that we are due to start, which looks at drug repurposing
• As part of the aforementioned MOBILISE-D study.

Industry partners are important to ensure that a common goal of advances in disease management is met.

How valuable is the role of patients and the public in your research?

The role of patients and public is invaluable in research. It is particularly important in Parkinson’s research. I actively engage with patients and patient groups, which helps to ensure that our research is appropriate and applicable to people who need it the most.

What do you see as being the next breakthrough in Parkinson’s research?

Over the past 25 years, the global burden of PD has more than doubled due to increasing numbers of older people, longer disease duration and environmental factors. This has been associated with an increase in disability-adjusted-life-years.

The Newcastle BRC’s objective is to understand the mechanisms behind ageing and treating age-related diseases, and is exploring a novel mechanism and potential non-pharmacological treatment for gait disorder in PD. Targeting specific gait characteristics which underpin falls risk could conceivably reduce the morbidity and mortality associated with falls in PD, with wider implications for other ageing conditions if efficacy is demonstrated. Our Adjunctive Vagus Nerve Stimulation for Improving Neural control of Gait in Parkinson’s Disease (AdVaNSING-PD) study will hopefully contribute to this.

More widely in the field of PD research, there are a number of studies which focus on disease modification. The prospect of potentially halting the pathological process as part of these studies is hugely exciting and an area of interest in the coming years.