Welcome to the Clinical Neurology Research Group Website
Purpose of the CNRG website
The main function of this website is to promote greater patient, professional, and public awareness of the CNRG’s work.
About Us
The Clinical Neurology Research Group (CNRG) was established in 2000 with the aim of improving treatments for people with chronic neurological disease, particularly multiple sclerosis (MS). We are located in the ITTC Building, Tamar Science Park (pictured above), near Derriford Hospital, Plymouth, UK.
In order to develop better treatments, with the ultimate goal of curing common neurological conditions such as MS, Parkinson’s disease (PD), Alzheimer’s disease (AD), Huntington’s disease (HD) and Motor Neurone disease (MND), we need better methods of testing whether specific medicines work. The best way to test treatments is by using clinical trials, in which people with a particular condition are assigned to one or more treatments or a control group. These are known as randomised controlled trials or RCTs.
One of the reasons that we do not yet have major breakthroughs in treatments to slow progression in most of the chronic neurological conditions is that we do not have good ways to measure how severe any disease is, or what impact that disease is having on people with the condition and their carers. We have therefore developed a strategy to improve methodology of clinical trials by firstly improving how we measure the impact of particular diseases (Outcome Measures Research) and then using these newer methods to test treatments in clinical trials. In order to understand fully how newer measurements change over the course of time in any particular condition, we also need to carry out epidemiological research, often called natural history studies. The relatively stable population means that Devon and Cornwall is a good place to carry out such research, as well as being a lovely place to live!
Clinical Trials
One of our largest and most recent clinical trials was the Cannabinoids in MS (CAMS) study. This was coordinated by the CNRG with the help of 33 neurology and rehabilitation centres around the UK, which recruited 667 people with MS to take part. Our more recent CUPID study (Cannabinoid Use in Progressive Inflammatory brain Disease) builds on the results from the CAMS study, the long-term phase of which found evidence of cannabinoids slowing disease progression in some progressive MS patients. The three year CUPID study will further examine this finding over a longer treatment period and incorporate a number of both clinical and patient-based outcome measures well validated by previous research. The trial commenced in 2006 and is due to finish in 2012.
Outcome Measures Research
Improving the reliability and validity of outcome measures to enable better assessment of symptoms and treatments is an important part of the CNRG’s work. Qualitative research methods (focus groups, semi-structured interviews) help us to develop a better understanding of how people’s functioning is affected by symptoms or treatments. This is then applied to constructing quantitative instruments (questionnaires) with items that are clinically meaningful, whilst still accurately reflecting patient experiences. Rasch methodology is then used to test the scientific nature of the items (mapping each item’s ‘difficulty’ and predictability of how patients respond to them). From this analysis the questionnaire can then be revised and retested, until it is deemed both reliable (according to the Rasch statistics), and valid (accurately represents the thing it is supposed to measure).
Long-term goals of the CNRG
Our overall goal is to continue making significant contributions to the knowledge,
understanding, and treatment of chronic neurological conditions by maintaining
our interests in cutting edge theory and research, and continuing to apply
rigorous research methods to evaluate them.