Dr Sophie Binks – Neurology Registrar at the Nuffield Department of Clinical Neurosciences, University of Oxford

 

What or who inspired you to become a vet?

I’m not a vet – I’m a doctor specialising in neurology.  I was inspired to enter medicine as a graduate entrant after working in a related field and becoming fascinated by neurology. However, I am a great cat lover, and when I became aware of a chance to incorporate a feline-focussed strand into my research on autoimmune encephalitis, I jumped at it. I have a strong commitment to the ‘One Health’ approach and the idea that vets and human medics can work together for the benefit of all species.

What is your current job? Do you hold clinics as well as carrying out research?

At the time of writing, I am a clinical research fellow in the Oxford Autoimmune Neurology Group, studying for a PhD in this topic. I maintain clinical work including regular participation in an autoimmune neurology clinic with the group PI, Assistant Professor Sarosh Irani, who is a world leader in this field.

What drew you to your field of study and what motivates you to continue?

Autoimmune neurology in humans is a relatively new, exciting and rapidly evolving field, with lots of interesting science to be done, and the chance to really make a difference to patient outcomes, since most of these conditions are very treatable with immunotherapy.

Thanks to pioneering work done by emeritus group member Bethan Lang, and Dr Akos Pakozdy, a feline epilepsy expert at Vetmeduni Wien, I was aware of a parallel between one of our ‘human’ conditions, and a form of spontaneously-arising limbic encephalitis in pet cats sometimes known as ‘FEPSO’ (feline complex partial seizures with orofacial involvement). Both of these patient groups have autoantibodies to a brain protein known as leucine-rich, glioma-inactivated 1 (LGI1). In both cats and humans, this condition presents with acute to sub-acute onset of seizures, behavioural and cognitive change.

I am drawn to the potential to discover biological insights driving disease in both species, and to deliver improved outcomes for feline and human patients. Unfortunately, it is still sometimes the case that severely affected cats are euthanized if the seizures cannot be brought under control. I hope our research will help improve diagnosis and best medical care for these feline patients.

Discuss the impact your research has had on the profession. How have those in general or referral practice benefited from your research?

I hope that we are raising awareness of this potentially treatable cause of feline seizures among first opinion and referral practice.  With vet collaborators, I have done webinars via the RVC and the BVNS which have had really good attendance and feedback.  At present, we are able to offer testing for feline LGI1-autoantibodies free of charge as part of our research programme.  This offers the chance of a diagnosis and more guided treatment for cats with otherwise unknown causes of seizures.

Has your research served as the foundation for other studies or developments in the field, and what will happen after your study is complete?

The interest, enthusiasm and engagement from the veterinary community has been a real pleasure, and we are currently applying for further funding to carry on with our research. We are very excited to announce that, thanks to the continued support of BSAVA PetSavers, we have just been awarded full funding for a veterinary-qualified individual to join our research team to gain a Master’s Degree by Research. The successful candidate will study feline neuroimmunology in the beautiful city of Oxford with our multidisciplinary team. To apply please visit this link. At present we are planning publications and conference presentations to highlight our findings – at the time of doing this interview nearly 100 cats have been enrolled in our study and we should soon have the chance to publish some insightful results!

We have also recently launched an educational website, www.feline-encephalitis.org, which aims to offer a resource for clinicians and researchers to learn about this topic, as well as information on how to submit suspected cases to the study. There is also a video bank of cats with seizures and LGI1-autoantibodies, to help vets recognise the condition; the video bank is password protected as it is for professional visitors only, but the rest of the site is open access for all.

Tell us a little about your own experience. What does your research mean to you personally and what have you gained from it?

Research is the foundation of driving advances in medical and veterinary science and is important to me for continuous improvement of the care we can deliver to patients.  On a personal level I find it very enjoyable and intellectually stimulating. I feel very fortunate to be involved as it is like being paid to do my hobby.

What is your favourite aspect of your work, and what has been your most important/surprising finding?

I really enjoy translation from the clinic to the lab – meeting patients and clinical observations is so important to generating key research ideas and addressing the questions that matter.  This is just as true for feline as human patients!  With my ‘human’ hat on, one of the key findings has been the role of genetics in autoimmune encephalitis and this is something that we hope to bring to bear on the feline patients as well.

One favourite aspect is following the progress of patients and hearing of good progress is always so pleasing and motivating.  I am always delighted to hear back from vets about how the LGI1-antibody cats are doing, and finding out that a much-loved family pet is back at home, interacting and affectionate, is a great boost.

What does PetSavers offer the profession in your opinion?

I cannot speak as a vet, but as a researcher I am very grateful to have received the support to pursue this topic, and that PetSavers is open to working with cross-disciplinary teams which I believe brings innovation and energy to the field.

Away from the practice and bench, how do you spend your spare time?

I enjoy reading, walking, and classical music, and spending time with my own cats (and my husband).  Very sadly, our older feline girl died as I was doing this interview – she was my constant companion in my study as I analysed and wrote up research; an inspiration, and much missed.

What advice would you give to vets considering carrying out clinical research for the first time?

Sometimes it can feel a bit daunting but I do believe that hard work and a conscientious approach can go a long way.  It’s important to work well with and learn from others – I have been really fortunate to have really excellent mentors and I have really loved working with the vets on this project, Dr Pakozdy, and Dr Abbe Crawford and Dr Lucy Davison of the RVC, as well as other vets from across the UK and Europe who have contributed samples, and our feline geneticist Dr Lorna Kennedy.

It’s also key to pick a research field you enjoy and are passionate about and then it will never feel like work.  I can honestly say that every single moment spent on autoimmune encephalitis is a privilege and a pleasure and I hope I’ll be able to continue for a long time.