This year’s BNPA Annual Meeting took place on the 11th of March. Due to the novel coronavirus, this was our very first virtual BNPA Annual Meeting. However, the silver lining of this online format was that it enabled delegates from all over the world to attend – from trainees and students to established clinicians and professors.
The meeting opened with the BNPA Medal Lecture from our former President, Professor Eileen Joyce, Professor of Neuropsychiatry at the Institute of Neurology, University College London. Professor Joyce spoke about ‘Neurosurgery for Severe OCD: The Past, Present and Future’, including her recent UCL-MRC clinical trial of deep brain stimulation (DBS) for treatment-refractory obsessive-compulsive disorder. A key message throughout her talk was the direct application of neuroscience for clinical treatment and to improve our understanding of treatment mechanisms, including which patients respond best to which interventions (a theme throughout the meeting).
The topic of personalised medicine continued in the next session on neurostimulation and neurorestoration. First, we heard from Dr Katherine Scagos (Assistant Professor at the University of California, San Francisco, Department of Psychiatry), who spoke about ‘Personalised closed-loop neurostimulation for depression’, outlining how individualised target selection, biomarker-driven stimulation, and continuous neural sensing might improve clinical efficacy of DBS for depression, by optimising the particular DBS parameters for a given patient. Next, Dr Michael Fox (Director of the Centre for Brain Circuit Therapeutics at Brigham and Women’s Hospital and Associate Professor of Neurology at Harvard Medical School) spoke about the utility of circuit neuroscience for localising target sites with non-invasive brain stimulation. In particular, Dr Fox outlined how although lesions that cause depression do not anatomically overlap on a single region, many lesions have substantial connectivity overlap with the dorsolateral prefrontal cortex, a putative hub for depression symptoms. Finally, Dr Leigh Hochberg (Professor of Engineering, School of Engineering & Carney Institute for Brain Science, Brown University; Director, VA RR&D Center for Neurorestoration & Neurotechnology) spoke about his extraordinary neurorestoration work using intracortically-based Brain-Computer Interfaces (iBCIs), which record and decode the brain’s neural activity to restore the ability to move or communicate to patients with motor neurone disease (ALS), stroke, or spinal cord injury.
The second session on Global Neuropsychiatry began with a riveting talk from Dr Robert Bartholomew (Honorary Senior Lecturer, Department of Psychological Medicine, University of Auckland) entitled ‘Sex, Bugs & Microwave Attacks: How Bad Science, Mating Insects & Psychogenic Illness Created an International Incident with Cuba’. The talk covered the scientific evidence behind what were initially termed ‘sonic attacks’ on American and Canadian diplomats in Cuba; evidence suggests the symptoms patients described may have been ‘psychogenic’ in nature.
Next, Dr Anthony Feinstein (Professor of Psychiatry at the University of Toronto) spoke about his extensive work on post-traumatic stress disorder (PTSD) in war-zone journalists, who have a lifetime prevalence of PTSD similar to frontline combat veterans. Finally, in a joint session run by BNPA Board Member Dr Timothy Nicholson (Clinical Senior Lecturer, Neuropsychiatry Research and Education Group, Institute of Psychiatry Psychology & Neuroscience, King’s College London) and Dr Benedict Michael (Senior Clinician Scientist Fellow, University of Liverpool and NIHR HPRU for Emerging and Zoonotic Infection), we heard the emerging science on neurological, neuropsychiatry, and psychiatric complications from COVID-19. They encouraged people to continue submitting cases to CoroNerve, a UK-wide surveillance system for clinicians to briefly notify cases and later provide full clinical details.
After short lunch break, we resumed for the poster ‘Data Blitz’ session, where presenters gave 3-minute talks on the topic of their posters. The topics covered were broad and fascinating, ranging from non-epileptic attacks to Huntington’s disease to aphantasia.
Following the presentations, we heard from Harriet Sharp, Dr Harriet Ball, and Dr Luis Manssuer in the Lishman Prize presentations. Harriet Sharp spoke about the role of interoception in myalgic encephalomyelitic/Chronic Fatigue Syndrome (ME/CFS) and fibromyalgia. Dr Ball spoke about subjective cognitive decline as a potential marker of susceptibility to functional cognitive disorder. Finally, Dr Manssuer spoke about reward and risk processing in the amygdala.
The Clinical Update this year was given by Professor Alasdair MacLullich (Professor of Geriatric Medicine, Usher Institute, University of Edinburgh). Professor MacLullich presented our current understanding of delirium pathophysiology, including the relationship between delirium and dementia, and clinical care for delirium including detection, treatment, and prevention.
The closing speaker of the Annual Meeting was Professor Masud Husain (Professor of Neurology & Cognitive Neuroscience at the University of Oxford and Wellcome Trust Principal Research Fellow), who gave the 2021 JNNP Lecture, ‘When the spark goes out: the neurology of apathy and motivation’. Professor Husain put forward a conceptual framework of apathy, focusing on the cognitive components of motivation, such as the ability to generate options for behaviour, and effort-based decision making for rewards. Evidence suggests these processes may be impaired in apathy, and potentially improved by dopaminergic medication.
Following the evening AGM, we presented a video of tributes to and memories of the late Professor Alwyn Lishman. Professor Maria Ron and Dr Jonathan Bird introduced the video, and we were very pleased that Professor Lishman’s daughter was able to join us. The BNPA Annual Meeting 2021 was such a success that many members wrote to us to ask for combined online/in-person versions of the meeting in future.
We are delighted to have been able to provide this meeting in our changed circumstances, and certainly hope in the future to find a hybrid style that would suit both virtual and in-person attendance at the Meeting. We are grateful to all our wonderful delegates and speakers for such an inspiring meeting on the exciting present and promising future of neuropsychiatry.
