Dr Sara Leddy from Queen Square Institute of Neurology discusses her research project investigating the effects of climate change on people with neurological diseases and what attracted her to this area.

On a personal level I have been worried about climate change for a long time, but as a doctor I wasn’t quite sure how best I could help, and often felt caught up with clinical work. It wasn’t until the beginning of the pandemic, that I realised what a powerful and essential role healthcare and other individuals can play in a global health crisis and how relevant this was to the crisis which we are now facing caused by climate change.

This inspired me to get involved in my previous trust’s sustainability group as well as local activism groups, and ultimately led to me to hear about the inspiring work that Professor Sisodiya, Deputy Director, Sustainability and Climate Change, UCL Queen Square Institute of Neurology, has been leading in this field. I have been very fortunate to have the opportunity to combine my interests in neurology and climate change and am undertaking a PhD supervised by Professor Sisodiya, which started in September this year.

My research project seeks to characterise the effects of climate change on people with neurological diseases. There is currently limited evidence for a link between climate change and other neurological diseases.

However, when considered in its entirety, with its pervasive consequences, it is very likely to affect this vulnerable patient group in a number of ways. For example, weather-related disasters, which are increasing in frequency have led, in other countries, to disruption of supply chains responsible for medicines and health provision. Hotter temperatures at night during heat waves lead to disturbed sleep which can significantly lower the seizure threshold of an individual with epilepsy.

Certain genetic epilepsy syndromes are temperature-sensitive, and anecdotally patients and their carers have reported a deterioration of seizure control during the heatwaves of recent years. This has been noted by several neurologists in different countries looking after this complex group of patients.

Other neurological conditions such as multiple sclerosis, Parkinson’s disease and dementia are likely to have negative outcomes in extreme temperatures. Those diseases with features of autonomic or thermoregulatory dysfunction, such as Huntington’s disease, MSA, primary autonomic failure, certain peripheral neuropathies, and spinal cord injuries are also likely to be adversely affected.

Guidelines on the management of these diseases under extremes of temperature are yet to be developed and may significantly improve the quality of life for these individuals, in addition to preventing hospital admissions and additional harm during future heatwaves.

With large-scale validated surveys, my project hopes to provide evidence about the concerns of individuals with neurological disease and their families about climate change, to delineate what they are experiencing and to learn from their current adaptation strategies.

By using temperature and humidity monitors in certain clinical sites and in the homes of people with selected neurological conditions, in addition to recruiting individuals to take part in experiments using climate chambers, we seek to identify the direct effects of real-world temperature and humidity profiles on validated symptom, cognitive and clinical outcome measures, and on thermal comfort in this vulnerable cohort. I also plan to explore the effects of heatwave-simulated temperatures on medicines which are commonly used to treat neurological diseases, as this may give us further information on how best to store these drugs in future heatwaves.

Understanding the role of thermoregulation and its dysfunction in these conditions, alongside the effects of climate change, may give a further understanding of the disease itself, leading to additional novel avenues for future research, but most importantly it will allow us to prepare for the unpredictable climates which both we and our patients now face.

As clinicians and researchers, we have the opportunity and obligation to advocate for, and protect, patients from the difficulties that climate change will bring. I hope that my project will shine a light on how much we can and need to do for people with neurological diseases and inspire others to get involved! I am very grateful to the National Brain Appeal and the Epilepsy Society for funding this work.

If anyone would like to learn more about the project, please feel free to contact me (s.leddy@ucl.ac.uk) or come along to the workshop organised by Professor Sisodiya and Professor Helene Plun-Favreau on 24 January at 3pm in Room 412, 40 Bernard St, London WC1N 1LE.

“This event is a chance for early career researchers, students and technical staff to start a conversation around climate change and sustainability. What concerns you? What would you like to see change at UCL? How would you like to get involved? With input from a number of colleagues working on sustainability, and plenty of space for discussion, this is a great chance to start generating change.”

For further reading please see a recent article in Practical Neurology, with practical climate advice for neurologists.

Find out more about sustainability at UCL Queen Square Institute of Neurology.