In this blog, Dr Ayodele Sasegbon – 2019 Turner-Warwick lecturer for the North Western region and overall winner for 2019 – speaks about his experiences with the RCP lecturer scheme and how it helped him finish his PhD thesis and beyond.
I heard about the Turner-Warwick lecturer scheme during my PhD and jumped at the chance to apply. While I had presented my work before, it was to clinicians in the same (admittedly rather niche) field. I felt, and still feel, very passionate about the work I am involved in and relished the opportunity to speak about dysphagia, its importance and the future of treatment to a wider audience of clinicians.
My work has predominantly focused on the neurological processes which control and coordinate swallowing, neurogenic dysphagia and neuromodulation. Dysphagia can be caused by numerous disease processes that affect different parts of the swallowing sensorimotor pathway. Take strokes as an example, damage to cortical or subcortical areas that control swallowing, cause decompensation and dysphagia.
Over 2 decades ago, the Manchester Dysphagia Group discovered that, with respect to swallowing, cortical motor areas are asymmetrically represented. In essence, there is a more active or ‘dominant’ motor area and a less active or ‘non-dominant’ area. Not all patients who have strokes suffer from lasting dysphagia. A proportion of them never become dysphagic while others suffer from a transient swallowing impairment.
As I said then, I knew how excited I felt about the work I was doing but if a person is closeted away for long enough in a neurophysiological laboratory, anything can seem interesting. I was glad others felt the same.
In those patients with hemispheric strokes who lose and later regain their ability to swallow safely, there is a reduction in cortical activity over the swallowing motor area of the damaged hemisphere with preserved activity over its hemispheric partner. As time progresses and their ability to swallow recovers, there is an increase in activity over the undamaged hemispheric area. This is thought to represent neuroplastic compensation. In patients who become dysphagic but do not recover, this process of compensation is not observed.
The question then emerges: ‘Can compensation be induced where no natural compensation has occurred?’ In short, yes. There are several techniques such as repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (TDCS) and pharyngeal electrical stimulation (PES), that can alter activity within the brain. Meta-analyses have shown rTMS, TDCS and PES are effective in improving post-stroke dysphagia. The purpose of my research is to further develop these techniques and apply them to patients with neurogenic dysphagia, to induce compensation and restore swallowing function.
I was delighted and humbled to be awarded the Turner-Warwick lecturer prize for the North Western region and later the inaugural national prize. As I said then, I knew how excited I felt about the work I was doing but if a person is closeted away for long enough in a neurophysiological laboratory, anything can seem interesting. I was glad others felt the same.
Winning the Turner-Warwick lecturer prize gave me more confidence to speak in public, as well as during my PhD viva. Knowing my work was appreciated gave me a little boost when defending my thesis
Presenting to the North Western region was nerve-wracking, as was preparing to present at the RCP’s annual conference.
Since being named a Turner-Warwick lecturer, I completed my PhD. I am now an academic clinical lecturer in the north west and am shortly to head back to the same neurophysiological lab.
Winning the Turner-Warwick lecturer prize gave me more confidence to speak in public, as well as during my PhD viva. Knowing my work was appreciated gave me a little boost when defending my thesis, a boost which may have prevented me from becoming too nervous and jelly-like.
My experience with the scheme also helped me when I applied for my next academic step and I would recommend the scheme wholeheartedly to any trainee who may be interested.