Our 2020 Faculty of Neuropsychiatry annual conference was held online for the first time. Given the COVID-19 crisis, our original plans for a two-day face-to-face programme had to be radically modified to accommodate the ‘new normal’. As a Faculty, we were determined not to let colleagues down and worked hard to deliver a high quality conference that would support colleagues’ education and maintain the success that has been built up over recent years. Despite the complications that came with the COVID-19 pandemic, the Faculty was also keen to turn some of the challenges into real opportunities and extend our audience base to include even more countries from around the world. We had 283 delegates from the UK and overseas including Australia, Bulgaria, Canada, Egypt, Ethiopia, Greece, India, Malta, Nigeria, South Africa, Tanzania and Zimbabwe. Being one of the first College Faculties to run a virtual conference, we believe we curated a highly educational and stimulating day.
Following a warm welcome from Dr Mike Dilley, our Faculty Chair, the day was opened by an address from Dr Adrian James, the President of our Royal College. This was followed swiftly by a plenary session on Autism Spectrum Disorder (ASD) chaired by Dr George El-Nimr, Academic Secretary. The session consisted of a talk by Dr Quinton Deeley who discussed psychiatric co-morbidity in people with ASD. This was of particular clinical relevance to our audience who were keen to ask many relevant questions. Dr Michael Craig then gave a presentation on ASD in females. The talk highlighted that ASD is a complex neurodevelopmental condition that is 2-5 times more common in males than in females. It is still poorly understood what causes the ‘male-biased’ prevalence of ASD. However, aetiological models suggest that the biological female phenotype in general displays a lower vulnerability to ASD than the male phenotype.
The second plenary session addressed ‘Novel Neuroimaging Markers’. Professor Federico Turkheimer gave a talk entitled ‘Positron Emission Tomography studies on peripheral and central immunity in healthy volunteers and clinically depressed cohorts’. The relationship between peripheral and central immunity and how these ultimately may cause depressed behaviour has been the focus of a number of imaging studies conducted with Positron Emission Tomography (PET). These studies aimed at testing the immune-mediated model of depression that proposes a direct effect of peripheral cytokines and immune cells on the brain to elicit a neuro-inflammatory response via a leaky blood-brain barrier and ultimately depression. In his talk, Professor Mitul Mehta then highlighted that Pharmacodynamic effect of drugs can be assessed in vivo in humans with neuroimaging. Numerous examples exist to demonstrate the success and future potential of MRI methodologies in the drug development process, which, if correctly applied, can provide a principled basis for some treatment options over others, accelerating the delivery of novel therapeutics for those in need.
Following on from this, a plenary session addressed ‘Neuropsychiatry of Parkinson’s Disease (PD)’ where Dr Rimona Weil delivered a talk on ‘Understanding dementia and hallucinations in PD’. The talk presented recent work using advanced neuroimaging to detect early changes in Parkinson’s dementia and shed light onto mechanisms for hallucinations in PD. Professor Eileen Joyce then talked about mood, psychosis, impulse control and deep brain stimulation in relation to PD. The fact that Parkinson’s disease is now recognised as a neuropsychiatric syndrome and not only a mere movement disorder, was emphasised. The presentation provided an update on the neuropsychiatric presentations of PD and their management. Outstanding gaps in service provision were also discussed.
The interesting topic of ‘The Science of Human Decision Making’ was the focus of the last plenary session of the day. Professor Jeffrey Dalley indicated that compulsion is a core component of addiction, defined by drug seeking and use that persists despite growing personal harm. However, for reasons that are not well understood, only a small proportion of individuals exposed to addictive substances develop compulsive drug use. This talk considered a broader translational approach to investigate neural vulnerability mechanisms in addiction, including high resolution magnetic resonance imaging in rodents, behavioural genetics, and computational neuroscience. The readiness potential in the debate about conscious free will, was the subject of the subsequent talk by Dr Aaron Schurger. The readiness potential (RP) is a slow build-up of neural activity in pre-motor areas that precedes the onset of a self-initiated movement by up to one second or more. Contemporary neuroscientific accounts of human volition lean heavily on the RP as a temporal marker of the brain processes leading up to movement onset, even though the precise nature of the RP remains unclear. Libet (1983) used the RP to argue against the possibility of conscious free will because the RP is apparently hundreds of milliseconds before subjects report having been aware of the conscious decision to act. Although the precise relationship between the RP and conscious volition remains highly controversial, the interpretation of the RP as a signature of “planning and preparation of volitional acts” has held strong for decades. However, recent evidence has begun to cast doubt on that interpretation and at least one alternative account of the RP has begun to gain traction. Dr Schurger discussed this alternative account of the RP, and its impact on our understanding of human volition.
In addition to individual talks, posters were available to view online and delegates were encouraged to view them during the breaks. Best Poster Awards were granted to trainees and medical students. Alexa Zhang, Core Trainee won the best trainee / SAS poster: “Vitamin D screening in neuropsychiatry: results from a service evaluation in an inpatient unit”. Jakov Tiefenbach, Medical Student won the best Medical Student / Foundation Doctor poster: “Understanding functional seizures: Are functional/dissociative seizures “dependent on idea”?
This year’s two-day virtual conference for our Faculty has already earned its place in the diary of colleagues and trainees. This will take place on 9 and 10 September 2021. We look forward to welcoming you then. See more here.