Having trained as a neurologist with broad experience in general neurology, I have specialist experience in neurorehabilitation, complex spasticity management and multiple sclerosis.
I completed a PhD investigating disease modifying treatments for multiple sclerosis (MS) in the Division of Neuroimmunology (Department of Neuroinflammation) at the UCL Institute of Neurology. After completing a fellowship in neurorehabilitation at the National Hospital for Neurology and Neurosurgery (NHNN), I was appointed as a consultant and have gained considerable experience in both neurorehabilitation and complex spasticity management, including treatments using EMG guided botulinum toxin, intrathecal baclofen and phenol.
Current research interests focus on developing a spasticity research programme to complement the clinical service focusing on (i) investigation of novel therapeutic agents for spasticity and (ii) improve outcome measurements.
Ongoing studies include the 'ITB cognition study' to evaluate the cognitive benefits of intrathecal treatment over oral agents in subjects with MS. As a sub-study we are collecting CSF and blood samples to evaluate biomarkers of disability and cognition.
The research for which I was awarded my PhD from UCL focused on biological therapies for MS. I developed and validated a novel assay to detect neutralising antibodies (NAbs) to Interferon beta, the most commonly prescribed drug for MS. This work was supported by an EU consortium (EU framework 6) grant to develop guidelines and tests for monitoring of people with MS on immuno-modulatory treatments (NABINMS). My work has shown that patients with high titres of NAbs are more likely to fail treatment with Interferon beta and alternative treatments should be considered. The respective assay which I developed during my PhD is now a routine assay in the Neuroimmunologiy laboratory, IoN, serving the majority of the UK.
Other research interests build on the expertise I developed during my PhD. These interests include the investigation of environmental risk factors for MS, particularly the role of EBV as (i) a potential trigger of MS and (ii) a modulator of disease activity in established MS. My work has shown that the immune response to EBV could potentially be used as a biomarker of disease activity. I am currently leading a study to evaluate whether the serological response to EBV can help predicting the conversion from relapsing-remitting to secondary progressive MS.
- Farrell RA, Marta MM, Gaeguta A, Giovannoni G, Creeke P. Development of resistance to biological therapies with reference to interferon beta. Rheumatology 2012 Feb 3
- Dalton C, Farrell RA, De Souza A, Wujanto E, Thompson S, Liu C, Greenwood RJ. Patient inclusion in goal setting during early inpatient rehabilitation after acquired brain injury. Clinical Rehabil 2012 Feb;26(2):165-73
- Farrell RA, Espasandin M, Lakdawala N, Marshall C, Creeke PI, Worthington V, Giovannoni G. Incorporation of an Interferon beta neutralizing antibody assay into routine clinical practice. Multiple Sclerosis 2011 Nov;17(11):1333-40.
- Farrell RA and Giovannoni G. Current and future role of Interferon beta in therapy of Multiple Sclerosis. J Int Cyt Res 2010 Oct;30(10):715-26.
- Farrell RA, Antony D, Wall GR, Clark DA, Fisniku L, Swanton J, Khaleeli Z, Schmierer K, Miller DH, Giovannoni G. Humoral immune response to EBV in multiple sclerosis is associated with disease activity on MRI. Neurology 2009 Jul 7;73(1):32-8.
- Farrell RA, Lam R , Aziz T, Gibbs E, Giovannoni G, Grossberg S, Oger J. Validating parameters of a luciferase reporter gene assay to measure neutralizing antibodies to IFN beta in multiple sclerosis patients. J Immunol Methods 2008 Jul 31;336(2):113-8.
- Farrell RA, Kapoor R, Leary S, Rudge P, Thompson A, Miller D, Giovannoni G. Neutralizing anti-interferon beta antibodies are associated with reduced side effects and delayed impact on efficacy of Interferon-beta. Mult Scler 2008 Mar;14 (2):212-8.
- Farrell RA, Giovannoni G. Measuring and management of anti-interferon beta antibodies in subjects with multiple sclerosis. Mult Scler 2007 Jun;13(5):567-77
- Farrell RA, Heaney D, Giovannoni G. Emerging therapies in multiple sclerosis. Expert Opin Emerg Drugs 2005 Nov;10 (4):797-816.