Conference Report for Movement Disorders Working Group
British Neuropsychiatry Association 27th AGM, Institute of Child Health, London 2014 on 27 and 28th
of February 2014
Ashish Pathak ST5, South Essex Partnership Foundation NHS Trust
Vijay Harbishettar* ST5, South Essex Partnership Foundation NHS Trust
*corresponding author: vijaykumar.harbishettar@sept.nhs.uk
The British Neuropsychiatry Association (BNPA) AGM was held on 27 and 28th of February 2014 at
the Institute of Child Health, London and attended by delegates from UK, Europe, USA and even as
far as Australia.
Day one witnessed a packed lecture theatre with many speakers. The initial focus of presentation
was on social cognition in autism, followed by neurodevelopment in schizophrenia. Later discussions
on primary and secondary prevention measures in Alzheimer’s disease (AD) seemed to gain
attention.
The first day began with theme ‘New development in Cognition’ chaired by Peter Halligan, who
welcomed the delegates. The first talk was given by Child Psychiatrist Professor David Skuse, who
emphasised needs for standardised objective measures of social development. He gave a summary
of his work on oxytocin hormone and receptors in social cognition, which left the delegates
wondering whether oxytocin has a role in autism treatment. Dr Roland Zahn took us through the
neuropsychiatry of social knowledge and moral motivation. He discussed the fMRI findings in frontotemporal dementia patients and showed that it is possible to map brain areas related to emotions.
After a break, we had the pleasure of listening to three more interesting talks. Professor Sarah-Jayne
Blackmore presented experimental findings on increased risk taking behaviours in adolescence. It is
known that 75% of the adult mental illness has its onset before 24 years of age. The important
finding was that brain development correlated with level of pubertal hormones better than the
chronology predicted by age. Following on from this, Professor Eileen Joyce suggested that cognitive
impairment may be a fundamental part of the schizophrenia syndrome, and showed data to suggest
the cognitive decline occurred prior to patients presenting with psychotic symptoms. Then we had a
lecture by neuropathologist, Professor James Nicholl, who discussed pathogenesis of AD and
mechanism of action of vaccines. He discussed his vaccine trial and role of immunotherapy in AD. It
was helpful to listen to a pathologist discussing stages of amyloid plaque formation and tau
accumulations.
The afternoon session began with a lecture delivered by Professor Nick Fox, chaired by Dr Alan
Carson. Professor Fox presented findings that substantiated the current need for earlier
identification of AD processes, possibly by using combined techniques such as serial structural
imaging, amyloid imaging and tau imaging.
During the afternoon session, there were three short platform presentations. The topics included
gene variants in AD, post-ictal psychosis and association of joint hyper-mobility with autonomic
hyperactivity with a possible link to neurodevelopmental disorders.
The late afternoon session was on the theme of a ‘Neuropsychiatry research update’. Dr David Okai’s
talk was on ‘Impulse Control Behaviours’ in Parkinson’s disease where he discussed findings of their
group’s unique CBT trial to treat those behaviours. Day one ended after Dr Hugh Rickard’s
presentation on ‘Do cholinesterase inhibitors work?’ He took us through systematic review evidence
and suggested that they may benefit but “only a little bit”. The key message seemed to be that there
is a need for better validated instruments in dementia.
On Day two, the programme started with a talk on ‘Recognising and diagnosing inflammatory brain
disease’ by Professor Neil Scolding. He informed the audience that inflammatory brain diseases are
uncommon, that they may be under-diagnosed or over-diagnosed and discussed their clinical
features and management .
This was followed by Dr Jeremy Rees talking about Paraneoplastic neurological disorders. He started
with their definition and mentioned their milestones, the possible antigens involved and highlighted
the importance of paraneoplastic syndromes. The key point was that neurological symptoms may
precede malignancy.
After a break, there was lecture on ‘Infectious encephalitis’ with psychiatric presentations by
Professor Tom Solomon. He presented a case series of six patients and discussed the symptoms
which may have alerted the psychiatrist to make a referral to a neurologist at an earlier stage of the
disease process.
The BNPA medal lecture on ‘autoimmune encephalitis’ was given by Professor Angela Vincent. She
spoke about antibody mediated diseases and immunotherapy.
In the late afternoon session, the chair Peter White announced prize winners of platform and poster
presentations. The administrative staff members of BPNA were thanked.
The chair then introduced the Wellcome Trust Debate. The topic of the debate was “This house
believes that neurology and psychiatry should be one medical discipline”. Professor Gerraint Rees
along with a clinical fellow in neurology spoke in favour of the motion while Professor Sir Simon
Wessely and a psychiatry trainee spoke against the motion. Each speaker had 10 minutes followed
by question and answers, the meeting concluded with closing remarks by the chair. When voting
was conducted, the majority voted in favour of the motion that neurology and psychiatry should be
one medical discipline.
Ample time for breaks gave opportunity for delegates to network with colleagues, view poster
presentations and purchase various neuropsychiatric textbooks.