Altered Imaging

Brain scanning is one of the most dynamic fields in medical research. And thanks to Joanna Wardlaw, the University is continuing to set the pace.

Professor Joanna Wardlaw
Professor Joanna Wardlaw

Strange to think it, but when Professor Joanna Wardlaw contemplated applying to university, she swithered between art and science. As it turned out, she plumped for medicine at the University of Edinburgh and got the best of both worlds. Now, as one of the world’s leading neuroradiologists and clinical scientists, she gets to contemplate the staggering beauty of the human brain every day.

Art’s loss is the health system’s gain. Professor Wardlaw’s story begins in 1990 when she worked with a cardiologist who was exploring the then controversial idea of using drugs to get rid of blood clots in the heart. If the principle turned out to be true for the heart, she wondered, could it also be true for the brain? After all, when someone has a stroke, it’s generally because a blood vessel has blocked an artery in much the same way.

Her first research project was to see if the same clot-busting drugs could be used to treat stroke patients. Today, thanks to her pioneering work, every one of us has a much better chance of recovery from a stroke. “A couple of years ago, we finished the largest ever trial, with just over 3,000 patients, and we were able to show reasonably conclusively that the drug is very beneficial,” she says when we meet in the Clinical Research Imaging Centre next to Edinburgh’s Royal Infirmary. “If you get the drug within four-and-a-half hours, you are much more likely to live independent of help in activities like being able to brush your teeth, play your guitar, go to the shop or make your bed.”

Now, as director of the Brain Research Imaging Centre, which she set up in 1998, Professor Wardlaw is at the forefront of research into the prevention and cure of strokes. For the past decade, she’s been paying particular attention to the sizeable sub-set of patients, many of them elderly, whose strokes can lead to cognitive impairment and dementia, even though they often go unnoticed.

“People can go on accumulating this damage in their brain without really realising it’s happening,” she says. “You might just feel you’re slowing down a bit and that it’s normal to slow down when you’re older. With very detailed scanning, you can unpick how good the flow to the brain is, see structural abnormalities and look at the subtleties of how well the fibre connections are working.”

To take her research to the next level, she is raising funds for an MRI scanner which will be installed at Edinburgh’s Royal Infirmary in 2015. Every development in computer technology has brought improvements in imaging quality, speed and analytical capacity, opening up exciting possibilities for medical researchers and patients alike. The new machine promises to be no different.

“As well as giving us powerful statistical information, the replacement scanner will provide information that is useful to the individual patient,” she says. “Our work goes from pure science, trying to understand these complicated pathological processes, through to translating our knowledge into something that improves services for patients on a day to day basis. That is one of the areas where Edinburgh has particular strengths.”

Generous support for the £1.8m scanner has come from the Wellcome Trust, the Edinburgh and Lothians Health Foundation and others, but there are still opportunities to support the project – every donation is welcome and none is too small.

“For our first research scanner at the Western General Hospital, some of the most important donations were relatively small but they came from really enthusiastic individuals,” says Professor Wardlaw, who is supported by the Row Fogo Trust. “Even relatively modest donations are morale-boosting. They make everyone involved feel they’re doing something worthwhile.”