Targeting dopamine to treat impaired memory consolidation in neurodegenerative disease

Our current study examines the role of a brain chemical called dopamine in storing memories overnight. Dopamine is commonly known as the 'reward chemical', but it also affects memory formation and storage, although the exact roles it plays are still being researched. We aim to see how dopamine during sleep affects the storage of different types of memory, and to see whether dopamine could be used to help treat memory problems.

Who can take part?

We are looking for volunteers who:

• are fluent in English;
• are aged 65+;
• do not have a diagnosis of memory impairment or dementia

What will happen if I take part?

If you are willing to take part you will be invited to four visits at the Clinical Research and Imaging Centre (CRIC Bristol) on St Michael’s Hill in Bristol. The first visit is a screening visit during which we ask you about your health to make sure it is safe for you to take part. You will also have a chance to get to know the research facility during this visit. The three other visits are overnight visits during which you will learn memory tasks. Before going to sleep, you will take a single dose of a medication or a placebo, and then your brainwaves will be recorded during sleep using sensors placed on your scalp. On one of the visits we will take a magnetic resonance image (MRI) of your brain. We also ask you to keep a sleep diary for a week before each overnight visit (3 weeks in total).

All our volunteers are given single doses of placebo and two types of medication, which both increase dopamine activity in the brain. We have a lot of experience in prescribing these medications; they are widely used and known to be well-tolerated.
We do not pay our volunteers, but we do cover all expenses. Does this sound like something you would like to do? If so, please get in touch with Hanna Isotalus or Dr Coulthard to find out more.

Telephone: 0117 414 8238

Email: elizabeth.coulthard@bristol.ac.uk or Hanna.isotalus@bristol.ac.uk

Sadly, despite our best efforts, not all our patients on Intensive Care will survive. We realise this is an extremely distressing time for relatives and friends and we want to assure you that we will do all we can to help if your loved one passes away.

In this situation, we can offer a memory box in which any items of personal significance, such as cards and locks of hair can be kept. We can also help with other keepsakes such as a handprint if this is something that you would like.

We will make sure you are given information for what happens next, with a bereavement leaflet containing contact details for the hospital bereavement service.

In addition, we aim to call you within a few days to offer our support. At this time, we will ask if you would like any further input from the wider medical and nursing team responsible for the care of your loved one. If you need to call us before this, please do not hesitate to contact us via the ICU Reception on 0117 414 1400.

Towards the end of the year, we hold an annual ICU memorial service to celebrate the lives of those that have died on our ICU. This is held in a venue close to the hospital, usually in December. All friends and family are very welcome to attend.

GMC Number: 6109278

Specialty: Upper Gastrointestinal, Bariatric and Metabolic Surgery

Secretary: Kate Hewings

Telephone: 0117 414 0837

Clinical interests: Surgical treatment of obesity and diabetes as part of multi-modal care. Laparoscopic (keyhole) gastrointestinal surgery, management of gallstone disease and gastro-oesophageal reflux. 

Research interests: Outcomes of bariatric/metabolic surgery beyond weight loss with a focus on obesity associated morbidity and cardiovascular risk.  Identification of how these operations work or how bariatric/metabolic surgery changes the way the gut talks to the brain. 

Dimitri Pournaras graduated from the Aristotle University of Thessaloniki, Greece and undertook all his postgraduate training in the UK. He was awarded Research Fellowship by the Royal College of Surgeons of England to conduct research on obesity, diabetes and metabolic surgery.  He completed his PhD in the Department of Investigative Medicine, Hammersmith Hospital, Imperial College London and then trained in all aspects of laparoscopic oesophagogastric surgery in Cambridge and Norwich. Following a Bariatric and Metabolic Surgery Fellowship approved by the Royal College of Surgeons, he was appointed as a Consultant in Bristol where he works as part of a multidisciplinary team.  He is on the editorial board of journals Obesity Surgery and Clinical Obesity and has authored more than 50 peer reviewed publications, including articles in the Lancet, the Annals of Surgery, the British Journal of Surgery and the British Medical Journal. He delivers more than 10 invited international lectures every year. 

A vital branch of our Acute Care Department, the Intensive Care Clinical Research Team deliver national and international multi-centre studies in Intensive Care Medicine and related specialities, working to advance the care that we give to our patients.

The team also work closely with colleagues across the Trust and beyond to develop new and innovative research ideas that test new treatments especially in the fields of major trauma and neurosciences.

Please speak to the person treating you to find out if there is a research study that may be able to help you.

Current Studies:

UK-ROX

Statins for Improving Organ Outcome in Transplantation (SIGNET)

Airways-3

SciL

GENOMICC

MARCH

Paused Studies:

Ketogenic diet in traumatic brain injury

Southmead Hospital ICU has a well-established FICE (Focused Intensive Care Echocardiography) service, with 10 FICE-accredited consultants and 6 FICE mentors.

We hold quarterly FICE governance and echocardiography update meetings, which are open to all who are interested and we have previously hosted a FICE training course. We actively encourage ICM trainees to participate in FICE training during their time with us and have helped a number of trainees to achieve FICE accreditation.

FICE scans performed on the unit are archived to our hospital PACS system and we are well-supported by the echocardiography department in Southmead Hospital.

New Meeting topic 18/12/2017: ‘Pearls and pitfalls in Intensive Care Echocardiography’

FICE CPD Meeting Topics 2018:

• 12/03/2018: EDEC and Extended FICE

FICE CPD Meeting Topics 2017:

• 19/12/2016 Pericardial effusions and tamponade
• 27/03/2017 TTE to predict fluid-responsiveness
• 19/06/2017 Diastolic heart failure on the ICU
• 18/09/2017 Topic TBC

Southmead ICU is a part of the Southwest Critical Care Network. 

The South West Critical Care Network (started in 2014) aims to promote excellence of care for critically ill patients; support critical care providers and commissioners to ensure an integrated approach to the planning and delivery of critical care, and to support continual quality improvements.

Patients on our Intensive Care Unit are cared for by a highly skilled, specialist multi-disciplinary team of over 300 staff. This includes 27 Intensive Care Consultants, resident doctors, advanced practitioners, specialty medical and surgical teams, nursing staff, physiotherapists, dieticians, speech and language therapists and pharmacists.

ICU Leadership Team 

• Dr Chris Newell (Clinical Lead for ICU)
• Dr Andy Ray (Deputy Clinical Lead for ICU)
• Valentien Crook-Jones (Lead Nurse Critical Care)
• Mo Maddock (ICU Matron)
• Jay Parry (ICU Manager)

ICU Administrator

• Chantelle Stephens 

ICU Consultants

• Dr Charis Banks
• Dr Jules Brown
• Dr Kristina Birch
• Dr John Cameron
• Dr Kate Crewdson
• Dr Keith Davies
• Dr Scott Grier
• Dr Dominic Janssen
• Dr Rachel Jones
• Dr Anne Kendall
• Professor David Lockey
• Dr Aidan Marsh
• Dr Skylar Paulich
• Dr Cathy Ross
• Dr Matt Rowe
• Dr Liam Scott
• Dr Aggie Skorko
• Dr Reston Smith
• Professor Jas Soar
• Dr Ian Thomas
• Dr Matt Thomas
• Dr Julian Thompson
• Dr Ben Walton
• Dr Stephen West
• Dr Chris Williams

Allied Healthcare Professionals – ICU Clinical Leads

• Susan Harrison, Zoe Stone, Emma Wickman (Clinical Lead Physiotherapists).
• Lucy Holmes (Highly Specialised Intensive Care and Theatres Pharmacist).
• Lynsey Francey (ICU Dietitian Team Leader).
• Melissa Varia (Speech and Language Therapy Pathway Lead).
• Emma Bailey (Speech and Language Therapy Team Lead).     
• Dr Nicholas Ambler (Consultant Clinical Psychologist).

We recognise that having someone close to you in Intensive Care can be distressing. Southmead ICU is a large unit and visiting can feel overwhelming. We are all here to help and support you. Please feel free to ask questions at any time.

Our Intensive Care team has a large number of staff including:

• Doctors
• Nurses
• Critical Care Practitioners
• Allied Healthcare Professionals
• Administrative and support staff 

The ICU is divided into four separate areas know as pods, each containing 12 beds. 

• Pod A beds 1-12.
• Pod B beds 13-24.
• Pod C beds 25-36.
• Pod D beds 37-48.

When your loved one is admitted to the ICU you will be told their Pod and room number. You will also be given a phone number to call directly to that room. You may be asked to set up a password to allow staff to confirm who you are. This makes sure your loved one's privacy and confidentiality is always maintained. You can phone us any time, day or night. We will always try to answer calls to the bedside straight away. Sometimes when we are providing patient care we may not be able to do this. If we do not answer the phone, please do not worry - we ask you to try again in 15 minutes. 

Our ICU reception is open:

• Monday to Friday, 08:00 to 20:00.
• Saturday, Sunday, and bank holidays, 08:00to 19:00.

Outside these hours we have an intercom system which links directly to the Pods. Sometimes the clinical areas may be busy so do not be concerned if we do not answer straight away. Please try again in a few minutes. 

Visiting ICU

Our ICU is located at Gate 37 on Level 2 of the Brunel Building. Our reception can be contacted directly on: 0117 414 1400

For information about how to find us visit Southmead Hospital | North Bristol NHS Trust

ICU visiting times are from 11:00 to 19:00.

We have a limit of two visitors at the bedside at any one time. This is in line with the overall Trust visiting policy. This ensures safety on the unit and respects the privacy of other patients and their families. We can allow children to visit when appropriate but please discuss this with one of our senior nurses beforehand.

There may be times when we ask you to leave the room whilst we provide essential patient care. You may wait in the reception waiting area until you are called back in. The rooms at the entrance of the pods are reserved for private discussions so we ask you to keep these rooms free.

Patient rooms

Each patient room has an ‘About me’ board. You can use this to display photographs or information about your loved one that you would like to share with us. This can include things like their favourite music or radio station which can help us to provide personalised care.

Around each bed there is a lot of essential equipment which helps us look after your loved one. Please try not to focus on this and concentrate on spending time with your relative or friend.  They will be supported and encouraged by you being there. You can hold their hand, comfort and talk to them. Familiar faces and voices may help to orientate them and reassure them, even if they cannot respond at the time.

Updates

When a patient is admitted, we may need to perform urgent investigations and procedures. This can take some time and may mean that it is more than an hour before we can update you. We will always update you as soon as possible after your loved one is admitted. 

We record contact details for the patient’s closest family and friends to keep you updated. It is helpful for us to have one member of the family as a point of contact. It is difficult for us to keep multiple relatives updated separately, so we ask to communicate mainly with those closest to the patient. We aim to update you regularly and certainly if there are major changes in your loved one’s condition. If you would like an update directly from the medical team or have any concerns about your loved one’s condition or their care, please let us know. 

Accommodation

For visitors who come from further away we have limited accommodation for up to 48 hours. If accommodation is needed for longer, we can give you details of locally available options.

ICU Garden

We are very fortunate to have a dedicated garden space between Pods B and C in the ICU. This is a fantastic outdoor space which was made possible by support from the ICU charitable fund. It allows us to take patients outside during their recovery and rehabilitation. 

Visiting the garden may not be appropriate for all patients, but will be considered on a case-by-case basis. This depends on each patient’s clinical condition and the treatment they are receiving at that time. If you think your loved one would enjoy or benefit from time in the garden, please discuss this with the nurse looking after them. 

GMC Number: 6053268

Specialty: Medicine for Older People

GMC Number: 6165975

Year of first qualification: 2008, University of Edinburgh

Specialty: Rheumatology

Clinical interests: General rheumatology, inflammatory arthritis and temporal arteritis

Secretary: Caroline Reed

Telephone: 0117 340 8510

Dr Villar is involved in all aspects of rheumatology but has a particular interest in inflammatory arthritis and temporal arteritis. She also enjoys teaching and is training in musculoskeletal ultrasound.  

Dr Villar is a member of the British Society of Rheumatology and Royal College of Physicians.