In this early-career researcher interview, we talk to Lianne Reus who is PhD candidate at the Alzheimercentrum Amsterdam, Amsterdam UMC, supervised by Prof. Pieter Jelle Visser, Prof. Brenda Penninx and Yolande Pijnenburg. Her research focuses on social withdrawal in schizophrenia, depression and the early stage of Alzheimer’s disease.
She has been working on the PRISM project for the last 3 years. PRISM is a major European research project that brings together researchers from different laboratories, clinics, universities and scientists from industry. The project goal is to investigate the biological substrate underlying social withdrawal.
We asked her to tell us about her research, career path as well as experiences in working on such a big public-private research collaboration.
Can you tell us a bit about your work?
PRISM represents an apt exemplar of the principles developed in the RDoC framework (Research Domain Criteria). Instead of looking at single diseases in isolation, we are looking across 2-3 different diseases, trying to understand the biological basis of common symptoms across these diseases.
PRISM focusses on schizophrenia and Alzheimer’s disease (AD). There is also the possibility of a subsequent project phase in which we are hoping to expand these studies to also encompass major depression. Each participant is seen over two to three days, attending six hours of testing per day.
During these intensive days, participants answer questionnaires related to social functioning and undergo neuropsychological assessments. In addition, they also provide blood samples and participate in brain imaging (MRI & EEG). Since this testing is so extensive, we refer to it as “deep phenotyping”.
What is your role in these studies?
When patients attend our clinic at the Alzheimercentrum Amsterdam, they are offered the opportunity to participate in the PRISM study. For those interested, I am called to the clinical offices and provide them with further information on the study.
If they agree to participate, I help with the assessment of questionnaires, neuropsychological tests, MRI and EEG. MRI and EEG imaging involves two out of three days of the study visit. Besides that, I also analyse the participant data that is generated from the PRISM study as part of my PhD.
Can you tell us about your career path?
I did a bachelor’s degree in psychobiology at the University of Amsterdam, including internships in different institutions. I then did a Master in Neurosciences at Vrije Universiteit Amsterdam. During that time, I also did an internship in Edinburgh, where I worked with Prof. Andrew McIntosh – looking at the relationships between genetic predispositions for psychiatric illnesses and brain structure.
What made you decide to do a PhD?
I’ve always been interested in the brain. When choosing my undergraduate degree, I looked at programmes like psychology, neurosciences and biology. During that time, I became more and more interested in why people have different personalities and behaviours, but also why they develop mood disorders in particular. With this curiosity in mind, doing a PhD seemed like the natural thing for me to do.
Given my special interest in the overlap between dementia and psychiatry and the possibility to try to understand how symptoms work, I was especially keen to work on the PRISM project.
The PRISM project links researchers from pharmaceutical companies and academic institutions. As an early-career researcher, how did you feel about these interactions?
The PRISM project has shown me how important it is to link academic research to industry. By doing so, we can identify new targets for potential drugs; it also gives us the power to do very interesting data analyses. As a young researcher, I found it valuable to learn how bench research and clinical trials happen in different environments as well as how this work can be brought together.
You will be finishing your PhD in 2020. Where do you see your career progressing after that?
I really enjoy my work! I love that we are working towards helping patients, such as by identifying new drug targets or by better stratifying patients and clinical trial participants. Therefore, I hope to continue academic research after my PhD, perhaps by working as a postdoc.
The PRISM project has helped develop an application called “BEHAPP”. Could you tell us a bit more about this tool?
BEHAPP is a smartphone application that has been developed by the University of Groningen, an academic institution that is the coordinator of the PRISM project. The app is used to passively monitor daily social functioning.
Behavioural endpoints for social functioning are based on a variety of smartphone measures, such as travelling to see friends, making phone calls and sending messages. These social behaviours have previously been very hard to analyse, as researchers and clinicians have often relied on reporting by caregivers and patients. BEHAPP is installed on the smartphones of participants during their PRISM study visit, which allows us to measure their social behaviours as estimated with the app for the duration of the study.
It is important to assess social behaviours. Since social withdrawal is a symptom of neurodegenerative diseases and mood disorders, monitoring social behaviours can help diagnose or monitor the progression of these conditions.
What has excited you the most during your time working on the PRISM project?
Social withdrawal is one of the first symptoms of AD, but clinicians often don’t consider this during their interactions with patients. It was fantastic to work with a platform that aims to more reliably measure social behaviour, and could therefore really help with the diagnostic workup for people with AD.
What are some of the challenges and highlights of your work?
It can be quite demoralising to receive paper rejections, or when data analyses don’t work out as planned. However, working closely with other researchers is a great experience, I love brainstorming about research, coming up with new questions and ways in which to answer them.
A real highlight of my working day is the moment when I am knee-deep in data analysis and start to see a pattern emerge, a clear answer to a question I was trying to address. I also love the fact that working at the Alzheimercentrum Amsterdam means that I have direct contact with study participants.
Any final thoughts?
I have always found it strange that researchers and clinicians from psychiatry and neurology are often very distant, working in separate silos although both disciplines are looking at brain abnormalities. The great thing about working on PRISM is to see that it brings together these different specialities and research areas: so, in a sense, PRISM is bridging the gap between psychiatric and neurodegenerative disorders.
The Alzheimercentrum Amsterdam website is found at: https://www.alzheimercentrum.nl/
The PRISM website is found at: https://prism-project.eu/en/prism-study/
Information on BEHAPP is found at: https://behapp.org/