Inflammation has a potential key role in the development of Alzheimer’s disease (AD); midlife rheumatoid arthritis (RA) appears to increase the risk of future cognitive impairment and AD. Our primary hypothesis is: TNFα inhibitors (TNFi) reduce the rate of cognitive decline in RA patients with amnestic mild cognitive impairment (aMCI) compared to RA patients with aMCI on traditional Disease Modifying Anti-Rheumatic Drugs (DMARDs). Aims are:  Do TNFi reduce the rate of cognitive decline in RA participants with aMCI, independent to changes in mood or rheumatological disease stage? . Are rates of cognitive decline in aMCI RA subjects related to their peripheral inflammatory cytokine profile?
We have compelling retrospective data that suggests RA patients on TNFi are at reduced risk of AD but there are confounding factors not accounted for. We propose an 18 month longitudinal observation study comparing cognitive decline in aMCI RA participants on a TNFi to those on traditional DMARDs. Participants will be recruited from rheumatology day centres in Belfast, Antrim and Southampton. Cognitive tests will be carried out at baseline and 6 monthly along with validated tests of mood, function, pain, quality of life and disease activity by the PhD student in Northern Ireland sites in conjunction with research nurses from the NICRN Dementia Clinical Research Group. Bloods will be analysed for cytokines and genetics.
This study will provide extremely valuable longitudinal data on the potential utility of TNFi in cognitive protection; it represents a cost-effective platform to test the hypothesis; the multi-disciplinary research team will then be in a position to commit to further evaluation via an international Phase 3 Randomised Placebo Controlled Trial.
This project will involve Regulated Activity (working with children and/or vulnerable groups).
The successful applicant will be required to supply their details to the School Postgraduate Office in order for a criminal history check to be undertaken (Enhanced Disclosure Checks). The project will be conditional on the successful applicant being issued with a satisfactory Enhanced Disclosure Certificate.
Candidates should have or expect to obtain a 2:1 or higher Honours degree or equivalent in a relevant biomedical or life sciences subject.
Candidates applying from countries where the first language is not English should produce evidence of their competence through a qualification such as IELTS or TOEFL score.
The minimum recommended score for the School of Medicine, Dentistry and Biomedical Science is:
• IELTS score of 6.0 with not less than 5.5 in each of the four component elements of listening, reading, speaking and writing taken within the last 2 years;
• TOEFL score of 80+ (internet basted test), taken within the last 2 years, with minimum component scores of; Listening 17, Reading 18, Speaking 20, Writing 17);
• A valid Certificate of Proficiency in English grade A or B;
• A valid Certificate of Advanced English grade A; or
• A first or upper second class honours degree from a university based in the UK, Republic of Ireland or other suitably quality assured location in a country deemed by the UK Border Agency to be majority English speaking.
For a list of English Language qualifications also accepted by the School and University please see the following link: http://www.qub.ac.uk/home/International/International-students/Applying/English-language-requirements/
The English Language Unit (ELU) offers both pre-sessional and in-sessional courses in English for academic purposes and study skills. Courses vary in length and full information can be obtained from the ELU http://www.qub.ac.uk/tefl/