Michelle Farrar FRACP PhD

Axonal excitability in spinal muscular atrophy: providing insight into pathophysiology and a potential biomarker for clinical trials

Michelle Farrar was trained at Sydney Children’s Hospital and also did 12 months in the neurophysiology lab at Prince of Wales Hospital learning peripheral nerve electrophysiology. Michelle completed her PhD in 2013 and recently accepted an appointment as Senior Lecturer in paediatric neurology at University of New South Wales, based at Sydney Children’s Hospital.

Interview by Russell Dale, 20 November 2013


Thanks Michelle for finding time for a chat. Congratulations on your new job as senior lecturer! Could you start by telling us about you PhD experience which was successfully examined in 2012.

Thanks Russell. I was fortunate to cut my teeth as a ‘lab rat’ in the neurophysiology laboratory with Matthew Kiernan and this kindled my interest in axonal excitability and its applicability to paediatric disease. My PhD combined clinical and neurophysiological studies, and focussed mainly on spinal muscular atrophy. I first examined the natural history of the disease with a retrospective study of patients with spinal muscular atrophy and their outcomes. I then applied novel neurophysiological studies, axonal excitability testing, to further understand pathophysiology. In SMA, I was able to show that these electrophysiological techniques are useful measures of degeneration and may be useful as biomarkers for clinical trials. My studies also showed that there is evidence of plasticity and adaptation in spinal muscular atrophy which may explain why there is plateauing of disease in the childhood and adult variants. It was exciting for me to use these techniques for the first time in paediatrics and demonstrate their feasibility, as they have been widely applied in adults to understand nerve function in health and disease. More recently axonal excitability studies are proving useful in CNS disease.


Your work was published in Brain- that’s terrific, and what do you hope to achieve over the next 5 years?

I am excited that the axonal excitability electrophysiology can provide important insight into understanding CNS disease, as well as peripheral nerve disease. I am keen to undertake further studies in order to further understand disease mechanisms and develop axonal excitability as a potential biomarker for future collaborative clinical trials in this area.


Who are your key collaborators?

I have some great collaborators here and internationally, with Prof Matthew Kiernan (USYD), A/Prof Steve Vucic (USYD), A/Prof Cindy Lin (UNSW), Prof Hugh Bostock (University College London) and Dr Manoj Menezes (USYD).


If a potential trainee comes to ask you about research, what would you advise them are the most important factors for successful research?

The things I have learnt that are important are the need to have ‘time to think’ during research activity, and the importance of being part of a research team. The other piece of advice I would give the student is to plan ahead, as there is a long ‘leading time’ for research. It takes time to develop research ideas, create a research plan and organise ethics. I would also advise potential PhD students to get a ‘taster’ of research in clinical training and writing a case report. It is important to build a track record early if you wish to be successful when applying for PhD scholarships. Having a publication, a poster and conference presentation is important if you wish to be successful in scholarship applications. Preparation is key …


Thanks Michelle. Any other things you would tell a potential ‘future clinical researcher’?

One of the main things I have learnt is that research is not done on your own. Collaboration is essential, in fact being part of a team is actually the most enjoyable part of research, to share the pain, and share the joy, when it comes!


Thanks Michelle, and good luck with your plans.