About the Project
Motor neurone disease (MND), is a progressive degenerative disorder of the upper and lower motor neurones, causing weakness and wasting of muscles controlling limb movement, speech, swallowing, and breathing, leading to eventual death, usually from respiratory complications.
Malnutrition and weight loss are common in patients with MND (pwMND) and are associated with increased morbidity, disability and mortality. The nutritional management of pwMND is very important and equally challenging. The aim is to maintain an optimal nutritional intake and minimise the effects of weight loss, either by preventing its occurrence or by compensating for any loss that has already taken place. Several strategies exist following the diagnosis and during the early stages of the disease (e.g., dietary advice, food fortification and provision of oral nutritional support) as well as when, with disease progression, pwMND lose the ability to safely maintain a sufficient oral intake (e.g., enteral feeding, via a gastrostomy).
However, there is a dearth of evidence on the efficacy of these interventions and their effect on a key outcome, such as nutritional status, is not well understood. In clinical practice, self-reported food diaries and anthropometry (e.g., weight, body mass index, mid-upper arm muscle circumference and triceps skinfold thickness) are currently broadly used to assess nutritional intake and status. These methods, although informative to some extent, are prone to a number of limitations, biases and measurement errors (e.g., weight measurements are practically difficult or impossible in severely disabled pwMND and food diaries are subject to recall bias). There is currently a need to establish an objective measure of nutritional intake/status for pwMND to inform clinical practice and optimise care. Evidence in the field of nutritional epidemiology suggests that a number of dietary biomarkers could be reliably used as surrogate indicators.
This PhD proposal provides an excellent opportunity to undertake high quality research within a stimulating multi-disciplinary context in a state of the art facility. The PhD candidate will be responsible for the set-up, and day-to-day running of the study, and benefit from collaborating with colleagues from the University of Leeds and developing protocols for bio-sample collection, storage and analysis. The PhD candidate will be attending regular clinical research and lab group meetings, seminar series and other research meetings within the department and the Faculty; and will be encouraged to attend national/international conferences and publish research findings in high-quality, international journals.
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