Exploring Metabolic Neuropsychiatry with Professor Anthony Vernon

Q: What was the purpose of the Ernst Strüngmann Forum and the resulting publication Metabolic Neuropsychiatry?
A: The forum aimed to create a space for researchers from diverse backgrounds to explore how brain metabolism contributes to the neurobiology of neurological and psychiatric disorders. It was titled “metabolic neuropsychiatry” as we examined metabolic abnormalities in both neurological and psychiatric conditions. The goal was to integrate fundamental knowledge of brain metabolism with clinical and experimental data, and to identify gaps in our understanding. The book was designed to raise awareness of the importance of this field.

Q: What was the structure of the forum?
A: The forum happened for a whole week. Participants were divided into working groups, each tackling different aspects of brain metabolism across different scales. Groups rotated to observe each other’s conversations, which helped broaden perspectives. Topics ranged from very fundamental principles such as the physical constraints of blood supply to the brain to computational models of energy flow.

Q: Discussions in the forum included data usage and sharing. Is there a problem with how existing data is used in this field?
A: Yes, and it’s twofold. First, we often lack the right kind of data—especially longitudinal and transdiagnostic studies. Second, even when data exists, it’s not always analysed effectively. We need more studies that probe brain metabolism in healthy individuals under controlled conditions to understand behavioural and neural effects. There’s also a need to better integrate increasingly available “big data” with experimental approaches.

Q: Can you give an example of how big data is being used in this field?
A: One compelling example comes from Manu Goyal’s chapter, which discusses integrating brain metabolism with big data and neuroimaging. Using resources like the Allen Brain Atlas, researchers can correlate imaging signals with gene expression data. This approach, called imaging transcriptomics, helps identify metabolic and synaptic pathways involved in brain function. It’s not causal, but it allows for hypothesis generation and targeted experimental studies

Q: How can these insights be translated into interventions for neuropsychiatric illnesses?
A: There are promising examples:

• Ketogenic diet: Used to treat drug-resistant epilepsy, it demonstrates how dietary changes can affect brain function. If similar energy imbalances underlie other disorders, this approach might be extended, with caveats.
• GLP-1 receptor drugs (e.g., semaglutide): These drugs have been evaluated for thier effectiveness at managing weight gain in patients with schizophrenia. There are complex, bi-directional interactions between central (brain) and peripheral (body) pathways involved here, including insulin signalling. Further research is needed to understand then if GLP-1R targeting drugs could have beneficial effects beyond management of weight gain through normalisation of these pathway

Q: What’s the broader significance of understanding brain metabolism?
A: Understanding how the brain and body use energy could be transformative. Martin Picard’s work, for instance, conceptualises behaviour through energy flow and resistance. If we use these conceptual approaches to help guide our investigation of fundamental processes of how the brain and body use energy, this could enable development of biomarkers, and further our understanding of when and how things go wrong with metabolism in neuropsychiatric conditions.

Q: Do you think King’s has the expertise to work together to move this field forward?
A: Absolutely. King’s has strengths across several relevant domains:

• Clinical expertise, for example Toby Pillinger who was also at the forum, studies peripheral metabolic features and their relation to brain function.
• Fundamental metabolic research, supported by nearby institutes like the Roger Williams Institute for Liver Studies and the Cardiometabolic group at the Sir James Black Centre Experts at the Neuroimaging departments at Denmark Hill and St Thomas’ Hospital, with various research developing fine-grained methods to probe brain metabolism.
• Molecular and biochemical research, including cellular models.
• Computational approaches, though scaling lab findings to population-level insights remains a challenge.

This also relates to what Federico Turkheimer talked about in his feature Bottom-up and top-down neuroscience, that we often approach our research questions from one perspective, but we need to expand our understanding by looking at them from a different side and collaborate.

Q: What was your personal takeaway from the forum?
A: The forum reinforced the importance of interdisciplinary collaboration. Despite initial challenges—like entrenched views or abstract concepts—participants managed to align on a shared model of brain energy capacity. This model became a foundation for designing potential studies and simulations. It was gratifying to see diverse experts come together and agree on a way forward.

Q: Who should read the publication?
A: It’s relevant for anyone working in neuroscience, psychiatry, neuroimaging, metabolism, or computational biology. Researchers often still work in silos, and this publication encourages cross-disciplinary thinking. For example, biochemical experts might benefit from understanding metabolic constraints using computational approaches, while clinicians could consider metabolic features as potential intervention targets and/or biomarkers.

Q: What’s next for this initiative? Are there plans for follow-up?
A: Discussions at the forum involved future collaborations and follow-up papers. At King’s, there’s potential to replicate the forum internally, which may foster internal collaborations to help push this field forward, leveraging the unique clusters of expertise at King’s in relation to “metabolic neuropsychiatry”.

Q: Would you support a King’s-specific version of the forum?
A: Absolutely. This initiative (the ES forum) was a collective effort, and any reflections I share are just one perspective among many. The forum showed that interdisciplinary collaboration is not only possible but essential. If we can build a community around metabolic neuropsychiatry, we might finally start answering some of the big questions in brain health.