Nov 22 2010 By Jane Harrison
Neurologist Dr Matthew Williams with a slide of the Cerebellum which regulates mobility. Charing Cross Hospital. Hammersmith.
A brain collection, started in Essex more than 50 years ago to try and unlock the causes of mental illness, is now in the hands of the West London Mental Health NHS Trust. Expanded to include the brains of a variety of patients, the Corsellis collection is still being used world-wide to try and combat current illness. As modern techniques emerge its potential is enormous. Jane Harrison went to see this wonder of science.
TUCKED away on the St Bernard's hospital site is one of the most incredible and unlikely collections you can imagine – over 6,000 brains dating back to the 1950s, perfectly preserved in what looks like small, round Tupperwares.
Some are whole, while others are small slices – they look like beautiful segments of coloured broccoli when stained on slides – and the formalin (salt buffered formaldehyde)they are swimming in is slightly cloudy, a relief for the squeamish.
This meticulously documented piece of history is the Corsellis brain collection, the first in this country, and magnet for medical experts across the globe.
They were originally collected by Prof Corsellis, a consultant pathologist at Runwell Hospital in Essex, a long-stay mental hospital where he worked, in 1950. When the Runwell patients died a post mortem was almost always carried out for diagnostic reasons by Dr Corsellis, who instead of disposing of them after examination, kept those that interested him.
Most brains were from the patients but a few neurological cases were received from nearby Southend General Hospital and later over 300 epilepsy specimens from the Maudsley Hospital and gradually, as his reputation grew, from all over the country.
After he died the collection was taken over by Dr Clive Bruton and the collection included cases of Parkinson's disease, depression and Creutzfeldt Jacob disease and when he died the collection was transferred to the West London Mental Health NHS Trust in 1997 at St Bernard's hospital, Uxbridge Road, Southall.
It is now in the capable hands of its curator Dr Michael Maier, consultant psychiatrist and honorary lecturer at Imperial College and its manager Dr Matthew Williams, research associate at Imperial College. Dr Corsellis' work is not only the blue-print for other brain collections or banks, but has become a vital research tool world-wide.
Dr Maier said: "Prof Corsellis started collecting to gain research and became famous because of his more interesting results. He was sent brains to report on from around the world including dementia, epilepsy and tumours. His work showed dementia pugilistica, or punch drunk: the damage to the brains of boxers. The evidence from his study changed legislation. In amateur boxing boxers now have to wear headgear and they've changed the number of rounds in professional fights. He also did some seminal work on Alzheimer's."
He said the Trust made a bid for the collection when Runwell had to sell of some of its land, beating off interest from abroad.
He said: "We wanted to keep the collection intact, particularly because it contained a variety of disorders. Nowadays collections tend to focus on particular disorders, such as MS. The Corsellis collection also has a large number of 'control' brains across the ages, which makes it very easy to use. It has been used for research around the world ever since."
They now send slides of stained slices, rather than part of or the whole brain, which can be examined under a microscope when they get requests from hospitals or academic institutions. Dr Williams said: "I am contacted and asked what we have. For example there was a study in Australia where they wanted to look at brain tumours. We look at the data base which fits their criteria and if it is a good project I send the information. We have had people wanting to look at the collection purely out of curiosity. We send slides now. We used to send whole brains, but we never got them back."
While the answer to some conditions are still a long way off, the collection also has great potential as modern science continues to evolve. Dr Maier said: "This collection was used to survey dementia cases going back to the 1950s. We understand the basic problems with the disease as it takes its course, but not the early manifestations.
"We need to understand more about epilepsy which affects a large proportion of people. Disorders of the brain have been the last area to take off. Collections like this add to that body of knowledge but we are still a long way to understanding the causes of schizophrenia, which affects the brain throughout life. No one person is going to get the magic cure. It's all about accumulation of knowledge. If we didn't have collections like this we would be very impoverished."
"In the past there was much less treatment than now so we could see the progression of the disease more easily. In modern medicine we intervene very quickly. Before doctors would watch an illness as it progresses. Treatment changes an illness. We will be able to use new techniques as they become available."
People are as fascinated by the collection as they are in the way the brain works.
The collection started 11 years before the Human Tissue Act (1961) and the procedure for collecting brains 50 years ago were consistent with medical and legal requirements at the time. It was reviewed by the home office in 2002 under the guidance of Jamie Metters, who was later the forerunner of the Human Tissue Authority. The Trust was granted a licence in 2007 which ensures the collection is being kept in a sound environment.
Dr Maier said: "We have records for all the cases, coroners' reports and who gave permission for tissue to be retained. The archival collection stopped in 1998 and there are no plans to add to it."
So while there are still many questions surrounding disease the scope for the future is tremendous. Research on brain collections and archives will be the only way to find out if an apparently new disease is really new and the potential of DNA research on the brain has yet to be explored.
Dr Maier said: "One of our most exciting events is our link to Brain UK last year making the collection available to the research community. In the past no one had access to large collections. The bigger the study the clearer the answer."