NEWS

As the year draws to a close (oddly, since it was January only a couple of months ago), it is an opportunity to reflect on the year that’s now behind us. It has been a fairly chaotic one in the world of health services and systems, as the widespread consequences of the pandemic have revealed themselves in both expected and unexpected ways. During the pandemic, uncertainty about the future had a focused, crisis quality to it. That has now given way to uncertainty about the way in which our health, disability, social and education systems now operate. In these stormy seas, clarity about our values and guiding principles is all the more important for steering the ship.

One of the things I most love about ASSBI is that we are a community unswervingly guided by our values. In the recent revamp of our website (which is worth checking out – assbi.com.au), our home page now proudly states our Purpose, which is to improve the lives of people with conditions impacting the brain and their support networks; our Vision, to support maintenance and innovations in knowledge and practice to provide the best possible treatment and care; and our Mission, to support professional development, cross-disciplinary engagement, and strengthen the voice of lived experience. I believe our activities throughout 2023 have enacted these intentions, from the fabulous Darwin conference to our ever-growing suite of evidence-based resources, our BRAINSPaN community of practice, and developing plans for our lived experience sub-committee.

Our recent survey of 2023 conference attendees was informative in guiding some of the intentions we now have for 2024.  A majority of the attendees had been loyal attendees of ASSBI conferences for many years, which is wonderful, but we had fewer attendees in their early career. We are now brainstorming ways to encourage engagement with early career clinicians and researchers, and would love to hear your ideas about this. We hope to see plenty of you at the 2024 ASSBI Conference, to be held in Sydney from 2-4 May 2024 at the Four Seasons Hotel. The program is shaping up beautifully, including a reasonably priced conference dinner with DJ and dancefloor, which is always a personal highlight!

Plans for the Global Neuropsychology Congress in Porto, Portugal in mid-2024 (https://www.globalneuropsychology.org), which is jointly hosted by ASSBI, INS, FESN and SLAN, are also progressing well. There will be an excellent program of keynote and invited speakers, symposia and roundtables on a range of contemporary topics. Keep your eye out for the call for abstracts for oral and poster presentations, coming any day now.

I hope that you all have a relaxing festive season enjoying delicious food with family and friends. Let’s hope that we all start 2024 restored and ready for whatever the future brings.

Things have been busy at ASSBI, as usual. Planning is full steam ahead for the 2024 ASSBI Conference, to be held in Sydney from 2-4 May 2024 at the Four Seasons Hotel. Block out your calendars!

ASSBI are also partnering with several organisations including the Federation of European Societies of Neuropsychology (FESN), the International Neuropsychological Society (INS), and the Sociedad Latinoamericana de Neuropsicologia (SLAN), to host the Global Neuropsychology Congress from 3-5 July 2024 in beautiful Porto, Portugal. This congress will be an international meeting of minds, bringing together members of ASSBI, FESN, INS, and SLAN, as well as many other friends and colleagues from around the world. The congress will incorporate research and clinical practice topics relevant to neuropsychology and related fields, to ensure that everyone in our global community benefits from the very best neuropsychological science and practice.  See more in our Newsletter

I am delighted to be writing my very first “Words from our President”, having taken the reins from Prof Olivier Piguet at ASSBI’s AGM at the conference in Darwin on 5 May 2023. I feel incredibly honoured to lead such a vibrant, forward-thinking, impactful and inclusive organisation whose members care so deeply about working together to improve the lives of people living with brain conditions. ASSBI’s unique strength is its multidisciplinary, transdiagnostic scope, which allows rich exchange of knowledge and ideas amongst clinicians, researchers, students, policy makers, and people with lived experience of conditions affecting the brain.

I have been a member of ASSBI since I was a bright-eyed clinical neuropsychology student in the early 2000s. I have always loved ASSBI conferences and events, for both the high-quality, clinically meaningful content, and the top-notch social program which reliably features dance floor delights! This was never truer than in Darwin, at ASSBI’s first in-person/hybrid conference since 2019. I am still buzzing from the fun of it all. A full conference report will follow in the next newsletter, but for now – thank you and congratulations to Barbra Zupan and Lizzie Beadle for their superb job as convenors, the student team led by Aishani Desai for all of their crucial contributions, all our keynote speakers and presenters who beautifully showcased the diverse and important work that is happening in our field, and of course the inimitable Margaret and Matt Eagers, without whom we really would all flounder.

I’m also proud of ASSBI’s focus on supporting students through our student teams and ambassadors, events, awards, and other initiatives. I spent several years as the Student Liaison Officer on the ASSBI executive committee, which was a very rewarding role, and indeed quite easy given the amazing competence and innovative spirit of our student team and members. The next generation of clinicians and researchers in the brain impairment field are truly remarkable.

I would like to give an enormous thank you to Olivier Piguet for all his hard work during his two years as President. Olivier had the tough gig of leading ASSBI through the thick of the pandemic, and consequently gave his two Presidential Addresses online rather than in-person, thereby missing the rewards of a live audience. He was nevertheless unflappable, capable, and determined. He was instrumental in developing ASSBI’s 5-year strategic plan and ensuring our plans for the first year were successfully implemented. It has also been wonderful to have a dementia expert at the helm of ASSBI, which has been important for ensuring our scope includes all brain conditions, not just brain injury.

Enormous thanks must go to Emeritus Professor Robyn Tate, who is stepping down from the ASSBI committee as part of her attempts to “retire”. Robyn has been instrumental to ASSBI right from the beginning, and in fact was part of the birth of ASSBI in 1976, at the same time as I was busy being born. It is hard to put into words the phenomenal contributions that Robyn has made to ASSBI and to our field broadly. She has such a rigorous, careful, considered approach to everything she puts her mind to. Special thanks to you Robyn for all you have given, and for asking me to step into your shoes as President.

Congratulations also to our new President-Elect, A/Prof Barbra Zupan. In line with our aim to ensure multidisciplinary engagement with ASSBI goes from strength to strength, it will be wonderful to have a speech pathologist at the helm to give everyone a break from us neuropsychologists! Barbra is very active, positive, and hard-working and will undoubtedly be a fantastic President when she takes over in 2025.

In the second year of ASSBI’s 5-year strategic plan, there is a strong focus on growing and re-imagining the ways in which ASSBI engages with people with lived experience. This is a really important task and one which is very close all our hearts. The executive committee would welcome all your ideas about this, and how ASSBI can best complement the work of other organisations focused on advocacy for people living with brain conditions.

It'll be a busy couple of years ahead. It’s just as well we have such a strong committee and membership to share the work – and have some fun along the way.

WORDS FROM OUR PRESIDENT

Short story: A 10-year-old boy falls off his bike. By all accounts, his fall is mild. Following this incident, however, he starts experiencing seizures which become increasingly frequent, often several times a day. These seizures cannot be controlled by medications, and the boy becomes increasingly incapacitated, dropping out of school and later unable to hold a job. The boy’s name was Henry Molaison, or HM as he became to be better known.

Seventy years ago - on the 1^st of September 1953 - at the age of 27, Henry underwent a pioneering brain operation to remove what was thought to be the origin of his seizures. William Scoville removed Henry’s both hippocampi. As neurosurgeons often say, “the operation was a success, the patient survived”. Indeed, Henry did survive but also became densely amnesic, unable to remember any new information for more than a few second unless it was continuously rehearsed. Scoville, together with Brenda Milner reported the case of Henry in 1957 in a seminal article published in the Journal of Neurology, Neurosurgery and Psychiatry.

Henry’s unfortunate outcome was a critical milestone in our understanding of the biological bases of human cognition. Scoville and Milner’s article, cited nearly 10,000 times, demonstrated the importance of the hippocampus to episodic memory functions, and has led to over 13,000 scientific articles on the topic of episodic memory since 1968! HM himself participated in many of these studies, first with Brenda Milner in Montreal, then with Suzanne Corkin at MIT, the last time in 2006, only a couple of years before he passed away¹. Remarkably, seventy years later, the mechanisms by which new memories are organised, laid down and later retrieved are still incompletely understood. Similarly, although the role of the hippocampus in memory is not under debate, its exact functions still are, as are the contributions of other brain regions towards this function.

Fascination for memory by the scientific and clinical community is not entirely surprising. Memory is a wonderful thing! In addition to allowing us to reminisce about the past, it is intimately linked to our survival. It allows us to navigate the world, solve problems and acquire knowledge, create social networks and have meaningful relationships. It is also linked to creativity, allowing us to project ourselves in the future, and therefore plan future actions that will contribute to our quality of life. But what this story also demonstrates is the importance of single-case experiments in understanding human behaviour. Although a lot is being said about experimental design, power calculation and sample size, many breakthroughs have come about from careful examinations of single patients. This highlights the importance for clinicians to remain curious: you never know where your next patient will lead to.

I am telling you all this because I have been reminiscing about my tenure as President of ASSBI. Indeed, I am sad to announce that this will be my last ‘words from the President’ as I will be handing over the reins of the Presidency to Dana Wong at the Annual General Meeting in May. In spite of the challenging times, this has been a privilege to serve ASSBI during these past two years. I want to thank the members of the Executive Committee for helping me during this time and for their continuing contribution to making ASSBI such a wonderful and welcoming association. I also want to thank Margaret Eagers for her help and support during that time. As I bid you farewell, fear not: I will still be around for the foreseeable future and I hope to see many of you in Darwin at the ASSBI Annual Conference.

Until next time, stay well and stay safe.
Olivier Piguet, President, ASSBI
¹ Corkin S. (2013). Permanent present tense. The man with no memory and what he taught the world. Allen Lane.

WORDS FROM OUR PRESIDENT

 As many of you know, I work in the dementia space, running FRONTIER, the clinical research group on frontotemporal dementia and related younger-onset dementias at the Brain and Mind Centre of the University of Sydney. We see primarily people who exhibit changes in behaviour, personality and cognition in their 40s or 50s. Indeed, dementia is not just a disease of old age with 10% of individuals living with dementia being younger than 65 years. Not surprisingly, dementia in that age group is associated with challenges that are different to a dementia diagnosis later in life, affecting families in their working life, and often with young children. 

I have just returned from the International Conference on Frontotemporal Dementias, which was held in Lille, in Northern France in early November. The excitement among delegates and speakers of the conference was palpable. For many – myself included – it was their first international conference since 2019. Being able to reconnect with friends and colleagues face to face was a real treat. Many new projects and international collaborations were discussed during the few days of the conference! This enthusiasm demonstrates the importance of direct contact in social interactions and the limitations of virtual meetings. Indeed, many of these new ideas were hatched on the sideline of the program, either in between sessions or during the many social events that took place during the week.

Aside from this conference, it has also been exciting to see the progress made in the field of pharmacological treatments for dementia. Results from a clinical trial for Alzheimer’s disease were recently reported. The drug, Lecanemab, is a monoclonal antibody that has been demonstrated to reduce the amount of beta-Amyloid in the brain, one of the two toxic proteins involved in Alzheimer’s disease. Whilst definite evidence for a clinical impact of the drug is still pending, this new drug is promising and gives hope to thousands of people living with the most common form of dementia around the world.

In the field of frontotemporal dementia, the field is not as advanced, in part because of the multiple causes and different biological mechanisms involved in this type of dementia. Nevertheless, at the Lille conference, no fewer than 9 pharmaceutical companies presented preliminary data or outlined proposals for clinical trials to test novel compounds in frontotemporal dementia. When we organised the last conference on frontotemporal dementia in Sydney in 2018 (the 2020 meeting was cancelled because of COVID), only one pharmaceutical company was present. In addition, this company was focusing on symptom management, rather than on disease-modifying treatment. 

The progress made in the past four years in this field has been truly outstanding and is indicating that real changes are on the horizon for the 400,000 people living with dementia in Australia and their families, although treatments are still likely some years away. Until then, we need to make sure that effort continues towards the development of appropriate services, support, and infrastructures that are still lacking.

As this is the last ‘words from the President’ for 2022, I would like to take this opportunity to wish you all a merry Christmas and a healthy and prosperous 2023.

Until next time, stay well and stay safe.
Olivier Piguet, President, ASSBI

ASSBI is in the process of refreshing and improving our website. As a result, you might come across pages that are still in development (i.e. not fully functioning yet) , or find that some existing pages are temporarily unavailable. We thank you for your patience over this interim period and will endeavour to complete the updates as quickly as possible.

NEW PUBLISHED ARTICLE
Sense of Self after Brain Injury 

Acquired brain injury (ABI) can affect virtually any aspect of a person’s functioning. At the deepest level, it can alter sense of self or the unique and persisting qualities that define who we are. Understanding changes to self after brain injury can be challenging for the person, family members, clinicians and researchers. 

Dr Julia Schmidt (The University of British Columbia) and Professor Tamara Ownsworth (The Hopkins Centre, Griffith University) have recently edited a special issue on the topic of Self after Brain Injury for the journal Neuropsychological Rehabilitation (Volume 32, Issue 8). This edited volume comprises 19 articles from authors around the world. The articles cover theories, clinical frameworks, strategies and interventions relevant to understanding and managing changes to self after ABI in childhood and adulthood.  

NEW PUBLISHED ARTICLE
Utility of the Addenbrooke’s Cognitive Examination-III online calculator to differentiate the primary progressive aphasia variants

David Foxe†, Anne Hu†, Sau Chi Cheung, Rebekah M. Ahmed, Nicholas J. Cordato, Emma Devenney, Yun Tae Hwang, Glenda M. Halliday, Nicole Mueller, Cristian E. Leyton, John R. Hodges, James R. Burrell, Muireann Irish, Olivier Piguet

Brain Communications https://doi.org/10.1093/braincomms/fcac161 Abstract video: https://youtu.be/RRAMxKJ6A4E

† These authors contributed equally to the work.

What the study is about
Primary progressive aphasias (PPA) are rare younger-onset dementias that primarily affect speech and language functions. Recent findings suggest that the three variants of PPA (logopenic: lv-PPA; non-fluent: nfv-PPA; semantic variant: sv-PPA) can be distinguished based on their distinct profiles on the subdomain scores of a widely used general cognitive screening test, the Addenbrooke’s Cognitive Examination-III (ACE-III) (Foxe et al. 2021; Leyton et al. 2013). In this study, we investigated the utility of the ACE-III to differentiate the PPA variants based on their item-by-item performance profiles on this test. From these results, we created an interactive ACE-III PPA online calculator which predicts the variant based on a patient’s unique ACE-III item-by-item profile.

What we did
We conducted multinomial regression analyses to establish performance profiles among groups, and R Shiny from RStudio was used to create the interactive ACE-III PPA diagnostic calculator. To verify its accuracy, probability values of the regression model were derived based on a 5-fold cross validation of cases. The calculator’s accuracy was then verified in an independent sample of PPA patients who had completed the ACE-Revised (ACE-R: an older version of this test) and had in vivo amyloid-PET imaging and/or brain autopsy pathological confirmation.

What we found
Our ACE-III PPA diagnostic calculator demonstrates sound accuracy in differentiating the variants based on an item-by-item ACE-III profile. The calculator is freely for clinicians and is suitable for most clinical settings http://shiny.maths.usyd.edu.au/PPA_diagnostic_calc/