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Dr Axel Petzold
Appointment
  • Honorary Associate Professor
  • UCL Queen Square Institute of Neurology
  • Faculty of Brain Sciences
Role
UCL Subsidiary Supervisor
Biography

I graduated from the Medical University of Freiburg (Germany). I received my MD (summa cum laude) in Experimental Ophthalmology with Ted Sharpe (University of Freiburg) and my PhD in Biochemistry with Ed Thompson (University College London). I trained as a neurologist in France (Lyon), Germany (Munich) and the United Kingdom (London). 


I am employed as a consultant neurologist jointly by Moorfields Eye Hospital (MEH), City Road and The National Hospital for Neurology and Neurosurgery (UCLH NHNN), Queen Square, London, UK.


I am also employed as a consultant neurologist jointly by the Departments of Neurology and Ophthalmology at the Amsterdam University Medical Centre (AUMC) where I am the Director of the Dutch Expertise Centre for Neuro-ophthalmology.


I am the chairman for neuro-ophthalmology of the European Reference Networks (ERN) for Rare Diseases (RD), ERN-EYE (www.ern-eye.eu).


I am an honorary Senior Lecturer at the Department of Molecular Neurosciences,  UCL Institute of Neurology, Queen Square, London, UK.


My primary research interest is on the recognition, prevention and treatment of axonal degeneration and demyelination in optic neuropathies and internuclear ophthalmoplegia. The disease spectrum covers Multiple Sclerosis, Optic Neuritis (MSON) and other optic neuropathies (ION, RION, CRION, NMO-ON, MOG-ON).


I am also interested in other diseases and models I can learn from and contribute facilitating research in these areas.


Research Themes
Research Summary

Neuronal death and axonal degeneration are the key pathological processes disrupting the function of the nervous system. In contrast to demyelination and conduction block, axonal degeneration in the CNS is frequently irreversible and therefore a major cause of permanent disability. My first line research is focused on the detection, quantification and monitoring of neuronal cell death and axonal degeneration in vivo and in vitro.


The methods I originally developed and which are now used globally are based on protein biomarkers as a surrogate for neuronal death and axonal degeneration. These protein biomarkers are not only relevant to clinical treatment trials, for monitoring of disease progression, but also a valuable tool for archaeology and in basic science.

The pioneering work at UCL ranged from method development to validation strategies. This has contributed to formation of an international network, training of many key researchers from around the world who now hold prestigious chairs, commercialisation and high throughput research.

A key limitation of contemporary protein biomarker research is that, in longitudinal studies, quantification of progression of atrophy will require complementary techniques. An ideal tool to this purpose is optical coherence tomography (OCT). I have contributed to integrating OCT in existing research lines. One focus remained reproducibility and validation which over the time have matured into internationally endorsed quality control criteria (OSCAR-IB) and reporting guidelines (APOSTEL). The role of this approach for AI driven OCT research on quality of big data has been recognised. We are addressing these issues within several big data projects. Functional imaging with OCT using visual adaptation tasks and OCT angiography (OCTA) are emerging techniques in the field. The role of OCT as a highly precise structural imaging biomarker has opened many avenues for exciting research.

There is one more limitation neither of above two research lines permit to quantify: demyelination and conduction block. A novel model to assess this non-invasive, in vivo, in patients is infrared oculography. We have developed, validated and made openly available algorithms for assessment of saccadic eye movements (DEMoNS). Demyelination slows axonal conduction resulting in an internuclear ophthalmoplegia. We demonstrated in a successful double-blind randomised controlled trial that blocking potassium channels promoted conduction in demyelinated axons and enhanced saccadic speed.

Taken together we are now in a position to combine above three approaches in clinical trials focused on remyelination and neuroprotection. Elegant combination of these methods permits to minimise the risk of trial failure by means of rigorous exclusion criteria, functional treatment response prediction models and validated, quantitative, structural and functional outcome measures with a rigorous quality control pipeline. We are using two clinical models, optic neuritis and internuclear ophthalmolplegia.

Teaching Summary

Students

  1. Mr J Sen 'Extracellular fluid surrogate markers in acute brain injury: a longitudinal microdialysis study' MSc 2002. The project received a distinction. 
  2. Ms C Maduakor 'Intracerebral microdialysis of S100B and nitric oxide metabolites: clinico-pathological correlations in traumatic brain injury' MSc 2003. The project received a distinction.
  3. Mr R Afinofi 'In vivo biomarker recovery study of 20 & 100 kDa cut-off cerebral microdialysis catheters'. MSc 2004.
  4. Dr ET Lim 'Search for potential surrogate markers in neuroinflammatory disorders, in particular multiple sclerosis' MD 2005. Now Consultant Neurologist.
  5. Ms S McLernon 'Cross-validation of methods for quantification of biomarkers in neurocritical care' MSc 2006. Ms McLernon is now a Senior Lecturer (Neuroscience) for Post-Registration Nursing at Imperial College London.
  6. Mr M Tisdall 'Non-invasive optical measurement of cerebral oxygenation, perfusion and cellular energy status: an opportunity to identify windows for targeted neuroprotection in traumatic brain injury?'. MD 2009 (UCL). Now Consultant Neurosurgeon at GOS.
  7. Mr A Tarnaris 'Biomarkers in idiopathic normal pressure hydrocephalus' MD (in progress). Now locum Consultant Neurosurgeon at the Southampton University.
  8. Mr A Patel 'Biochemical markers of acute stroke and their correlation with physiolgocial variables” MSc 2006.
  9. Mr Kolias 'Extracellular fluid glial biomarkers' MSc (2007). Mr Costas continued this research line at Cambridge where he completed his PhD in 2013. Now an Academic Consultant Neuro-surgeon at Addenbrooks, Cambridge.
  10.  Ching-Hua Lu 'Disease biomarkers in a SOD1-G93A mouse model of amyotrophic lateral sclerosis and their translational potential in human disease'. PhD 2013 (UCL). Dr Lu is now a consultant neurologist in Taipee.
  11. Dr Lisanne Balk 'Optical Coherence tomography, a window to the brain' PhD 2014 (Amsterdam UMC). Dr Balk has now a permanent position as a senior researcher at the Dutch Mulier Institute in Utrecht.
  12. Dr Jenny Nij Bijvank 'Shifting the point of view: perspectives on eye-movements in multiple sclerosis' PhD 2020 (Amsterdam UMC). Dr Nij Bijvank is now a post-doctoral researcher at the Amsterdam UMC.
  13. Dr Danko Coric 'Structural and functional relationships in the anterior visual pathway in a large Dutch MS cohort' PhD (Amsterdam UMC ongoing)
  14. Ms Iris Kleerekooper 'Functional OCT for quantification of mitochondrial dysfunction in optic neuritis' PhD (UCL ongoing) 
  15. Mr Siegfried Wagner 'AI and OCT in the AlzEYE cohort' PhD (UCL ongoing).

Visiting research fellows

  1. Prof. Konrad Rejdank (Poland),  Chair of Neurology, Lublin
  2. Mr Andrew Kay (UK), neurosurgeon
  3. Dr Phlip Mas (France), MD, Toulouse
  4. Prof. Ales Bartos (Czech Republic),  Chair of Neurology, Prague II
  5. Dr Judith Eikelenboom (Netherlands), neurologist Westfriesgasthuis
  6. Prof. Zhannat Idrissova (Russia),  Chair of Neurology at the KazNMU University of Kazakhstan
  7. Dr Eva Houzvickova (Czech Republic), Neurologist, Prague V
  8. Prof Maria Villar (Spain), Chair Neuroimmunology, Madrid
  9. Prof Charlotte Teunissen (Netherlands), Chair and Head of the CSF lab Amsterdam UMC
  10. Dr Frank Karmin (Germany), Neurologist, Germany.
  11. Dr Michael Stock (Germany)
  12. Dr Mathilda Degn Vinther (Denmark), Senior Researcher, Glostrup Research Institute
  13. Prof Yevgeni Trufanov (Ukraine), Chair of Neurology, Kiev
  14. Prof Jens Kuhle (Switzerland), Chair of MS Centre Basel
  15. Dr Paulus Romner (Austria), Associate Professor in Neurology, Vienna
  16. PD Dr Paulus Ehler (Germany), Associate Professor ITU, Rostock
  17. Dr Patrick Altmann (Austria), Neurologist in training, Vienna

Appointments
01-OCT-2014 Consultant Neurologist Neuro-Ophthalmology Moorfields Eye Hospital & UCLH NHNN, United Kingdom
01-APR-2009 Consultant Neurologist Locatie VUmc Amsterdam UMC, Netherlands
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