Can you tell us the story of how Synapse was born? Cathy: At HRW, we’ve been working extensively in the neuroscience space for a long time- with the volume of the work that we’re doing in the area pushing around 15% of our projects. We realised we have loads of people with expertise in and passion for this this area, and it felt fitting to tie it all together within an expert unit to help us better interact with our clients, the industry, and the wider HRW team. Abi: Emma and I were inspired to start the process by HRW’s Innovation Challenge: we really pride ourselves on innovation and our idea of a therapy area hub for neuroscience was received positively, winning us the Auriga Award for client-facing innovations. Faye: We see ourselves as following in the footsteps of the ORBIT (Oncology Research Business Insights) and Shift (Behavioural Science) teams: expanding on areas of knowledge and skill that exist within our business, to create like a framework and offering that delivers on our clients’ and colleagues’ needs. It felt like a natural evolution considering our extensive past work in neuroscience. Why did you personally want to get involved? Vincent: I’ve been involved in quite a few mental health and psychiatry research projects before, and I enjoyed studying neurology and diseases of the nervous system at university- so I’ve always had a bit of a passion for it. I also feel connected to certain conditions due to the experiences of a few close friends and family members. Abi: Since joining HRW as a graduate, I’ve been consistently involved in psychiatry and neuroscience projects. There’s a history of mental health experiences in my family too, so it’s something that I have a personal interest in. I just get really excited when writing reports and running analysis in these areas! I love to learn about upcoming treatments, such as exploring the use of early phase clinical assets and more experimental therapies. Emma: I also have a long-standing interest in psychiatry, and specialized my Master’s in Philosophy of Psychiatry, where I explored how gender norms are baked into diagnostic categories in the DSM-5. I’m also part of our Behavioural Science team, HRW Shift, so I am intrigued by the prospect of establishing the synergies between behavioural science and neuroscience. Alex: I’ve just been fascinated with the brain for years, and I’ve been studying it from an applied neuroscience perspective during my PhD and now from a psychological one. Naturally, I jumped with joy when I could join this team of like-minded people, through which I can nurture my interest in neurodegenerative diseases and expand my expertise to cover mental health disorders. Cathy: I’ve worked extensively in neuroscience and psychiatry projects since starting in HRW about 10 years ago. Obviously “neuroscience” is a big word – it covers lots and lots of very diverse conditions! But what strikes me about all of them is that there’s a sort of complexity and nuance to them that means they’re always interesting. They always require careful thinking and discussion with our clients to get it right, because it’s not a one-size-fits-all sector. Faye: For me, it was a pretty great fit for my workload, in terms of the sorts projects that I’m already working on- in schizophrenia, PTSD, Parkinson’s Disease, migraine, Alzheimer’s and Borderline Personality Disorder. Cara: I wanted to join because of some personal experience with dementia in my family, and I’ve worked on quite a few projects in neuroscience, and I find the space to be really interesting. I’ve worked extensively within dementia, Alzheimer’s, borderline personality disorder and PTSD. Why does neuroscience need a special focus? Faye: The interesting thing about neuroscience is that there’s a few more challenges you have to overcome in these sorts of MR projects. For example, working with psychiatrists, who can be quite “savvy” in knowing what we’re trying to achieve with certain projective techniques- so we have to get creative in order to access reality! These areas can also pose challenges in speaking directly to patients, so again we must come up with different ways of gaining an insight into their experience. Cathy: I think a good parallel is oncology- it requires a huge amount of understanding of a vast number of different conditions, new and emerging therapies, and various mechanisms of action. It’s a similar story here. There’s lots of complex science behind why neurology conditions are treated the way that they are it’s a very difficult space to go into blind, for both researchers and clients. Vincent: The theme of “ambiguity” comes to mind for me: in other conditions, it’s quite evident if someone is experiencing them and the diagnosis will be clear: whereas some neurological or mental health disorders, are rarely clear cut and must be handled differently. Also, you’ve got the underlying pharmacology to think about: given that most molecules will have to enter the blood-brain barrier or the central nervous system, it makes it even more challenging to try and make sure those drugs work, and that they’re safe. Emma: Thinking about mental health in particular, it’s a completely different philosophy of medicine that underpins this area compared to classic medicine. The DSM-5 guidance for assessing and diagnosing mental health conditions is symptom-based, and it’s deliberately agnostic about what causes these symptom clusters- mainly because we just don’t have that understanding yet. In standard medicine, what you’re (hopefully) treating is the cause of the symptoms. In psychiatry, it’s a really different way of approaching treatment and that comes with a completely different set of decision-making dynamics; such as a strong role for Risk Aversion, and personalization discourse (a preference for treating each patient case as completely unique). What developments in neuroscience are you most excited about? Abi: I am SO excited about upcoming developments in the use of psychoactive drugs (dissociatives and psychedelics) in psychiatry. These compounds represent such a departure from established medicines, and I’ve been reading about how disruptive and revolutionary they are likely to be within psychiatric medicine. There are many challenges and barriers to consider- including the wider societal context- how will society’s perceptions and pre-conceptions around these compounds impact their uptake? But there’s huge potential- some estimates I’ve read predict the psychedelics market will be worth $7 billion within the next ten years! Alex: I’m very excited because we’re now finding out more about the role of the immune system of the brain and of glial cells in neurodegenerative diseases including Alzheimer’s, Parkinson’s, and ALS, and I find that truly fascinating! Even Alois Alzheimer, who discovered Alzheimer’s disease, noticed the inflammation in the brain but this was simply labelled as a by-product and we’re now starting to find out how important these cells are. I am interested in any development in this area as we can apply that to several different diseases. It can affect how we formulate drugs to normalize the activity of those cells, and I’ve been reading about the nanofabrication of systems to carry those drugs through the blood and brain barrier. Vincent: We’re seeing fascinating stuff in MS around that too: the role of microglia, for example, in the development of this condition, and the role of B-cells- we’re looking at technology to help B-cells reduce some of the inflammation. It’s great to see research looking at a condition from a different angle, and also thinking ahead to how we can help HCPs becoming educated on these developments. What can clients expect from Synapse? Alex: We’ll be offering tailored consultancy stemming from an expert background and supporting your core research team. We’ll be hand-picking the right people for the job to help clients and our wider HRW team navigate the therapy area in question- helping them understand the context, the competitive space, and the patient experience, and how to tailor the research approach accordingly. Vincent: We’ll be able to help clients who might be very new to the disease area: we have that level of insight and knowledge to help guide them through material design and beyond. It can even be small things, like how to frame a question in a discussion guide, the techniques selected for certain stakeholders, putting the findings from that project into the much wider context or landscape in terms of what’s happened before, and what’s going to be happening in the future. Cathy: It applies across both qual and quant. For example, we’re here to make sure that the codes that we put in front of people within a survey make sense in the context of how complex these spaces can be, so that we’re accurately reflecting the competitive set and allowing polypharmacy where appropriate, and recognizing that there might not be clean “lines” of therapy- but rather cycling between different approaches in certain conditions and also recognizing when certain therapies might be saved for later line. What can we expect from Synapse this year? Cara: We have some great things in store for this year! Aside from our official launch this month, we’re planning to run two webinars; the first will be around the use of psychedelics in psychiatric medicine, which will take place around the Summer; and the second will explore developments in Alzheimer’s, which we’re hoping to run in Autumn. We’re also planning to attend the FENS Conference, and the European Conference on Mental Health. Vincent: Yeah, it really is an exciting year for Synapse. We’ll also be running a number of podcasts working with our Behavioural Science team, and have some super insightful blogs lined up including a piece on Digital Medicine in Psychiatry, and several interviews with expert physicians on the topics of MS, PTSD, and beyond. We have honestly done so much work in the neuroscience space so it’s just great to see our expertise packaged up and ready to help more and more of our clients. What does this mean for HRW’s expertise in other areas? Cara:. We’ve many “pockets” of expertise throughout our business and work in hundreds of different therapy areas, so we always try and make sure we take advantage of that on each project. Our clients can expect to see more of these expert hubs popping up in different areas in the future, allowing us to celebrate and cement our expertise across therapeutic landscapes. Abi: If anyone has a therapy area they’re interested in, or if you’re curious as to whether we work in a particular space, it’s always best just to ask! Chances are we’ve “been there, done that!” By Team Synapse Apply Now!