What is it like to have advanced dementia? Using remote measurement of EEG and physiological markers of sleep, arousal and awareness in people with advanced Alzheimer's disease. MRC GW4 BioMed DTP PhD studentship 2025/26 Entry, Department of Neuroscience Ref: 5237

Supervisors

Lead Supervisor: Associate Clinical Professor Jonathan Huntley, University of Exeter, Department of Neuroscience

CO-Supervisor: 

Professor Elizabeth Coulthard, Universsity of Bristol, Department of Bristol Medical School

Professor Marc Goodfellow, University of Exeter, Department of Mathematics and Statistics

Dr Ravi Poorun, University of Exeter, Medical School

The GW4 BioMed2 MRC DTP is offering up to 21 funded studentships across a range of biomedical disciplines, with a start date of October 2025.

These four-year studentships provide funding for fees and stipend at the rate set by the UK Research Councils, as well as other research training and support costs, and are available to UK and International students.

About the GW4 BioMed2 Doctoral Training Partnership

The partnership brings together the Universities of Bath, Bristol, Cardiff (lead) and Exeter to develop the next generation of biomedical researchers. Students will have access to the combined research strengths, training expertise and resources of the four research-intensive universities, with opportunities to participate in interdisciplinary and 'team science'. The DTP already has over 90 studentships over 6 cohorts in its first phase, along with 58 students over 3 cohorts in its second phase.

The 120 projects available for application, are aligned to the following themes;

• Infection, Immunity, Antimicrobial Resistance and Repair

• Neuroscience and Mental Health

• Population Health Sciences

 

Applications open on 10th September 2024 and close at 5.00pm on 4th November 2024.

Studentships will be 4 years full time.  Part time study is also available.

Project Information

Research Theme: Neuroscience & Mental Health

Project Summary: What is it like to have advanced dementia? How do changes in sleep and awareness impact the behaviour and quality of life of people living with advanced dementia? How can we be sure that our interventions are making a genuinely positive difference? This PhD project will address these fundamental questions by translating recent breakthroughs in cognitive neuroscience to improve understanding of sleep disturbance, awareness, and the care needs of people with advanced dementia. It will use state-of-the-art EEG, physiological and behavioural biomarkers of sleep, awareness, and emotional response to provide a unique understanding of advanced dementia.

Project Description: 

BACKGROUND: Sleep disturbance and fluctuations in awareness and arousal are common in dementia, particularly in advanced dementia. These include excessive daytime sleepiness, sleep fragmentation, sundowning, apparent fluctuations in consciousness and disrupted circadian rhythms. Sleep disturbance causes significant challenges and distress to patients and carers. It is associated with behavioural and psychological symptoms (BPSD) including agitation, apathy and wandering, and reduced function and compliance with activities of daily living. It can be very challenging for carers to manage sleep disturbance, with night-time wandering and daytime apathy associated with the need for people with dementia to move into residential care.

Unfortunately, people with advanced dementia living in care homes are often under stimulated, spending large periods of time in their rooms with limited social contact or engagement. In communal areas people are often left to sleep in chairs and this may even be encouraged as it may reduce demands on under resourced and overworked carers. However, does this represent good care, or good quality of life and wellbeing for people with dementia?

A number of fundamental questions require urgent answers:
• Is sleep disturbance an inevitable feature of advanced dementia?
• Are changes in level of arousal simply related to sleep or are epileptic phenomena being routinely missed?
• Is there variability and precipitating and perpetuating factors that could be the target of interventions to manage sleep disturbance, BPSD, and improve quality of care and quality of life and wellbeing for people with dementia and their carers?
• It is also unclear why and how changes in sleep occur with progression of dementia into the severe and end of life stages, and whether sleep markers could be used to personalise care, predict end of life or BPSD and measure sleep interventions.

It is not feasible to investigate sleep formally in an in-laboratory polysomnographic study, as many people living with advanced dementia in care homes may be bed-bound or housebound and may find the experience of a lab investigation disorientating and distressing. Recent development of portable, wireless EEG devices now allow high quality EEG recordings to be made in a real world setting, and many of these devices are specifically designed to be comfortable, unobtrusive and worn to measure sleep. This now allows an accurate assessment of macro-architectural parameters, sleep staging and identification of micro-architectural measures of sleep in care homes. In a pilot study we have demonstrated that the use of simple wireless EEG monitoring is feasible and acceptable to people with advanced dementia, families and professional caregivers. In addition, advances in wireless technology allow data to be captured remotely in real time and time series analyses enable sophisticated measurement not only of sleep architecture, but markers of neuronal complexity and awareness.

There is now potential to use these devices for the first time to answer crucial clinical questions about the nature and extent of sleep disturbance and awareness in people with advanced dementia in care homes.

AIMS AND IMPORTANCE: This exciting, novel and clinically important PhD project will translate state of the art remote EEG recording and data analysis to answer fundamental clinical questions in people with advanced dementia.

The project aims to:
1) Measure characteristics of sleep and physiological rhythms in individuals with advanced AD, particularly micro-architectural measures of sleep, relationship between sleep parameters, physiological rhythms, wellbeing and BPSD, including apathy and agitation.
2) Monitor the micro-architecture of fluctuations in arousal seen during the day? Can these fluctuations be predicted?
3) Identify whether external stimuli (e.g. music, spending time with others, environmental factors) are associated with changes in sleep and arousal in order to identify potential targets for interventions.

METHODS: The study will recruit 60 people with dementia living in care homes. Thirty people will be at the mild stage of dementia (sMMSE >18; GDS 1- 2) and thirty will be at the advanced stage of dementia (sMMSE < 10; GDS 5-7).

Participants will wear a small, portable, wireless EEG headband for 24 hours. They will also be asked to wear a watch that will measure physiological data including heart rate, galvanic skin response and actigraphy.

During the 24 hour period, there will be two 1 hour sessions of observation and introducing various stimuli including enjoyable music and activities.

Of note, the study will enable a highly novel and rich EEG and physiological data set to be collected from people with advanced dementia. There will be flexibility for the student to follow their own research interests and adapt the design of the observation and stimulation sessions, or consider additional data collection and analyses under supervision, and this will be a highly collaborative study enabling the student to learn a range of clinical, data analytic and neuroscience skills.

Funding

This studentship is funded through GW4BioMed2 MRC Doctoral Training Partnership. It consists of UK tuition fees, as well as a Doctoral Stipend matching UK Research Council National Minimum (£19,237 p.a. for 2024/25, updated each year).

Additional research training and support funding of up to £5,000 per annum is also available.

Eligibility

Residency:

The GW4 BioMed2 MRC DTP studentships are available to UK and International applicants. Following Brexit, the UKRI now classifies EU students as international unless they have rights under the EU Settlement Scheme. The GW4 partners have agreed to cover the difference in costs between home and international tuition fees. This means that international candidates will not be expected to cover this cost and will be fully funded but need to be aware that they will be required to cover the cost of their student visa, healthcare surcharge and other costs of moving to the UK to do a PhD.  All studentships will be competitively awarded and there is a limit to the number of International students that we can accept into our programme (up to 30% cap across our partners per annum).

Academic criteria:

Applicants for a studentship must have obtained, or be about to obtain, a first or upper second-class UK honours degree, or the equivalent qualification gained outside the UK, in an appropriate area of medical sciences, computing, mathematics or the physical sciences.  Applicants with a lower second class will only be considered if they also have a Master’s degree. Please check the entry requirements of the home institution for each project of interest before completing an application. Academic qualifications are considered alongside significant relevant non-academic experience.

English requirements:

If English is not your first language you will need to meet the English language requirements of the university that will host your PhD by the start of the programme. Please refer to the details in the following web page for further information https://www.exeter.ac.uk/study/englishlanguagerequirements/

Data Protection

If you are applying for a place on a collaborative programme of doctoral training provided by Cardiff University and other universities, research organisations and/or partners please be aware that your personal data will be used and disclosed for the purposes set out below.

Your personal data will always be processed in accordance with the General Data Protection Regulations of 2018. Cardiff University (“University”) will remain a data controller for the personal data it holds, and other universities, research organisations and/or partners (“HEIs”) may also become data controllers for the relevant personal data they receive as a result of their participation in the collaborative programme of doctoral training (“Programme”).

Further Information

For an overview of the MRC GW4 BioMed programme please see the website www.gw4biomed.ac.uk

Entry requirements

Academic Requirements

Applicants for a studentship must have obtained, or be about to obtain, a first or upper second-class UK honours degree, or the equivalent qualification gained outside the UK, in an appropriate area of medical sciences, computing, mathematics or the physical sciences. Applicants with a lower second class will only be considered if they also have a Master’s degree. Please check the entry requirements of the home institution for each project of interest before completing an application. Academic qualifications are considered alongside significant relevant non-academic experience.

English Language Requirements

If English is not your first language you will need to meet the English language requirements of the university that will host your PhD by the start of the programme. Please refer to the relevant university website for further information.  This will be at least 6.5 in IELTS or an acceptable equivalent.  Please refer to the English Language requirements web page for further information.

How to apply

A list of all the projects and how to apply is available on the DTP’s website at gw4biomed.ac.uk.  You may apply for up to 2 projects and submit one application per candidate only.

Please complete an application to the GW4 BioMed2 MRC DTP for an ‘offer of funding’.  If successful, you will also need to make an application for an 'offer to study' to your chosen institution.

Please complete the online application form linked from our website by 5.00pm on Monday, 4th November 2024.  If you are shortlisted for interview, you will be notified from Friday, 20th December 2024.  Interviews will be held virtually on 23rd and 24th January 2025.

Further Information

For informal enquiries, please contact GW4BioMed@cardiff.ac.uk

For project related queries, please contact the respective supervisors listed on the project descriptions on our website.

Summary