In Context

www.thelancet.com/neurology Vol 11 April 2012 303

We all need our hobbies; something to take our minds off the daily grind. For some of us it’s stamp collecting, or poetry, or amateur dramatics. For Gregor Wenning it’s musing on the life of Saint Augustine. “I’m fascinated by this really interesting conversion from a rather loose type to a Bishop”, says Wenning, and it turns out he’s not the only one. “The current Pope is really very much infl uenced by Augustine”, he explains, “and actually, last year in June, I was received by the Pope and I gave him the three volumes that I’ve published on Saint Augustine. To many people it sounds a bit ridiculous, but to me it meant quite a bit. I fi nd philosophy interesting; it’s one of the things that helps to distract me a little bit”. All of which begs the question: if penning theological treatises is a welcome distraction from the day job, what on earth is the day job?

According to Clare Fowler, of the Institute of Neurology at Queen Square, University College London, UK, “Gregor is at the forefront in world understanding of multiple system atrophy (MSA).” As head of clinical neurobiology at the University of Innsbruck in Austria, “his personal eff orts have done a tremendous amount to get us to our current level of understanding about how the condition fi ts with other neurodegenerative diseases”, Fowler explains. No easy feat, considering the fi endish complexity of MSA. “It has so many clinical facets”, explains Wenning. “It’s not only the pathology that is diverse, but also the clinical presentation. It still happens many times that patients are misdiagnosed as having Parkinson’s disease, and they even have invasive therapies, but in the end it evolves into MSA”. Theological pursuits seem simple by comparison.

Born in 1964, in Horstmar, Germany, Wenning’s fi rst experience of neurodegenerative disease came in the most unfortunate of circumstances. “I entered the fi eld of neurodegeneration through my own family story, because my father actually died of motor neuron disease when I was 15”, he recalls. The family was contacted at the time by the eminent neurologist Albert Ludolph, who was just starting to study motor neurone disease at the nearby University of Münster. A few years later, Wenning would fi nd himself in Ludolph’s department studying for his MD, “looking into transcranial magnetic brain stimulation, which at that time [1985] was a very new and exciting tool.”

More excitement was to come when, in 1986, Wenning spent his fi rst clinical year in London at King’s College. “It was the fi rst time I met Niall Quinn and David Marsden, at the movement disorder clinic, and I actually saw my fi rst MSA patient there, presented by Niall Quinn. That was a turning point, and I decided I would really like to go into these movement disorders.” Quinn recalls his fi rst impressions of Wenning as someone who “stood out, as someone who

was very bright, and also naturally very inquisitive. He gave me his CV and a photo and said that if ever I was looking for a research fellow he would love to work for me”. It was an initiative that would later pay dividends.

After graduating from Münster in 1990, Wenning worked briefl y at the University of Tübingen in Germany researching ataxia, before being made an off er he couldn’t refuse. “Niall Quinn phoned me up and told me there was a job possibility at the UK Parkinson’s Disease Society to spend a 3-year PhD grant on MSA research, and would I be interested? And I just dropped everything—it was the chance of a lifetime”, he recalls with relish. “To have this exposure in Queen Square; to have all these brains around you; it really set off an enormous amount of activity; diff erent types of projects looking at MSA and working out animal models”. It was during this period that Wenning produced what he calls his “best personal paper”: a description of the clinical features and natural history of 100 patients diagnosed with MSA, published in Brain in 1994.

He also met his future wife, Roberta, during this period; and when the 3 year PhD period was up, the two of them started looking for posts together in Germany. Coincidentally, Werner Poewe had just become head of the department of Neurology at Innsbruck, and he was on the lookout for “youngish people to join him to build up the movement disorder unit”, Wenning recalls. “So my wife and I were off ered jobs at Innsbruck and we just decided that’s logic; we have to go there and we’ve been there ever since, 17 years now”.

Not a moment has been wasted. Wenning quickly secured European Union funding to establish a consortium for clinical studies of MSA: the European Multiple System Atrophy Study Group (EMSA-SG), and “his energy and thoroughness meant that the EMSA-SG has really produced a large number of important papers on the topic and clinicians and scientists in Europe forged connections”, says Fowler. Quinn agrees, and credits the EMSA-SG with producing some of the most “important multicentre studies on the clinical features, imaging, natural history of MSA, and also trials of potential disease-modifying treatments for the disease”. Under Wenning’s careful stewardship, his laboratory has now grown to a 20 person multidisciplinary team and continues to go from strength to strength. It will, he says, keep plugging away, looking for disease mechanisms, drug targets, and validating new treatment approaches for a disease that Wenning still describes as fascinating, but one that would test the patience of saints.

David Holmes

Profi leGregor Wenning: unravelling the mysteries of MSA

See Review page 361

For the 1994 paper see Brain 1994; 117: 835–45

For more on EMSA-SG see http://www.emsa-sg.org