Dr Alexander Marsh

Research

Epilepsy

Dr Marsh has an interest in the evaluation and lateralisation of cognitive function in epilepsy using functional MR neuroimaging methods, both in task-based and resting state fMRI, with particular emphasis on pre-operative evaluation for resective surgery. His doctoral thesis focussed on the comparative validity of resting-state and task-based fMRI for lateralising language function in epilepsy surgery. 

Dr Marsh has on ongoing interest in evaluating the efficacy of using task-based fMRI paradigms (some novel), resting-state fMRI and diffusion tensor imaging in predicting post-operative cognitive risk of resective surgery.

PKU

Dr Marsh is currently a Research Psychologist on a phase 4 open-label, single-cohort study of the long-term neurocognitive outcomes in 4 to 5 year-old children with phenylketonuria treated with sapropterin dihydrochloride (kuvan®) for 7 years. His role is to conduct assessments of intellectual functioning and he has consulted on the monitoring of development using psychometeric methods and techniques. 

Traumatic Brain Injury

Dr Marsh is interested in the detetction of Post-Traumatic Amnesia (PTA) and its prognostic use in ongoing cognitive sequelae. He has been involved in developing guidance on the assessment and management of PTA in two major trauma centres and regional rehabilitation units. Dr Marsh has also been involved in projects developing new protocols for assessing the ongoing risk of PTA.

Dr Marsh is engaged with research in the behavioural assessment and detection of cognitive sequelae of traumatic brain injury. He has been involved in developing a cognitive screening tool for children and presented this as a paper at the International Neuropsychological Society Conference (2016).

Dr Marsh has been involved to a lesser degree in research and guidance in neurorehabilitation of traumatic brain injury, with respect to the rehabilitation of working memory (Phase II - RCT), guidelines for management challenging behaviour, assessment and mamangement of prolonged disorders of consciousness (NCHC NHS Trust) and most recently (2017) advice in promoting exerercise following TBI to improve recovery.

Tuberous Sclerosis Complex (TS)

Dr Marsh is a clinical researcher and trial co-ordinator for an NIHR randomised control trial of Acceptance and Commitment Therapy (ACT) for TSC. The study aims to assess the feasibility and acceptability of the DNA-V model of ACT as a psychological treatment to improve quality of life among adolescents and young adults with TSC. The intervention is delivered remotely via secure video-conferencing software and will therefore also assess the feasibility and acceptability of remote delivery of ACT. As a secondary aim, the study will also assess initial clinical and cost effectiveness of ACT as a means of improving quality of life among adolescent and young with TSC. 

Teaching

DClinPsy Teaching Delivered:

• Paediatric Neuropsychology
• Neuropsychology practice in paediatric epilepsy
• Role of Trainee Clinical Psychologist
• Facilitating Case Workshops (co-facilitated with Dr Cathy Harding)

Professional Development Sessions Delivered:

• Introduction to Clinical Neuropsychology
• Professional boundaries and dilemmas in clinical psychology (co-facilitated with Dr Loyal)
• Pre-operative evaluation of cognition with fMRI for neurosurgery
• Phytochemical supplementation for cognition 
• Novel approach of pre-operative visual memory fMRI assessment for resective neurosurgery
• Introduction to neurodevelopment: the growing brain and clinical implications 

Biography

Dr Alex Marsh is a Specialist Clinical Psychologist in Paediatric Neuropsychology. He is a Registered Practitioner Psychologist with the Healthcare Professionals Council, a Member of the British Psychological Society and Association of Clinical Psychologist-UK, a Full Member of the Royal Society of Biology, and Full Member of the British Neuroscience Association. His undergraduate training was carried out at Aston University and he completed his Doctorate in Clinical Psychology with Cardiff University, where his thesis focussed on understanding how structural and resting state functional magnetic resonance neuroimaging can support pre-operative cognitive evaluation in neurosurgery. He has undertaken additional post-graduate study (with distinction) in molecular medicine at the University of Bath.

Dr Marsh's current clinical post is in the Paediatric Neurosciences Centre at Bristol Royal Hospital for Children. He has previously worked at several neuroscience centres and other NHS services across the country including:

• Tier 1 Regional Rehabilitation Service at the Colman Centre for Specialist Rehabilitation
• The Institute of Neurosciences at North Bristol NHS Trust
• The Department of Paediatric Neuropsychology at Bristol Royal Hospital for Children
• The Department of Health Psychology at Aneurin Bevan UHB
• The Department of Paediatric Neuropsychology at The Noah's Ark Children's Hospital for Wales.

Whilst in these posts, he has a number of notable achievements, including:

• Leading in the development of a Regional Paediatric Neuropsychology pathway for Young Persons with Epilepsy
• Participating in a regional working group for the development of a clinical pathway and guidance for the assessment and management of patients presenting with behaviours that challenge due to neurological injury
• Contributing to guidance and pathway development of a newly designated Major Trauma Centre
• Participating in a regional working group for the development of a clinical pathway and guidance for the assessment and management of patients in Prolonged Disorders of Consciousness
• Supporting in the development of a new protocol for the assessment of Post-Traumatic Amnesia

Dr Marsh has also held a number of academic positions, relating to teaching and researching psychology and neurosciences:

• Learning Development Associate, Aston University
• Research Associate, University of Exeter
• Honorary Teaching Associate, University of Bristol
• Research Psychologist, Bristol Royal Hospital for Children
• Honorary Senior Teaching Associate, University of Bristol
• Visiting Lecturer, University of Bristol

During this time, he has supervised a number of post-graduate students. He has worked on several clinical trials, including a trial examining the rehabilitation of childhood memory disorders and the use of the drug Tetrahydrobiopterin to improve neurodevelopmental outcomes in children with Phenylketonuria. His research also includes work in functional neuroimaging, neurocognitive tool development, interventions and treatment for neurocognitive disorders, and neurodegeneration. He has presented his work at regional, national and international conferences, including the British Neuroscience Association – Association of British Neurologists Joint symposium: 'Meeting of Minds', and the International Neuropsychology Society Annual Conference; and within peer-reviewed journals.

Dr Marsh is also active in various activities supporting the profession of Clinical Psychology, including:

• Former Membership of the Board of Directors for the Association of Clinical Psychologists, UK; as Director for Trainees
• Membership of the South Wales Doctor of Clinical Psychology Therapies Committee & Academic and Curriculum Planning Subcommittee
• Invited Membership of the South Wales Doctor of Clinical Psychology Neuropsychology Practice Committee
• Invited Membership of the South Wales Doctor of Clinical Psychology Neuropsychology Training Task and Finishing Group
• Membership of the British Psychological Society Assistant Psychologist Practice Guidance Task Force
• Former Membership of the Quality Assurance and Enhancement Committee, South Wales Doctor of Clinical Psychology Course
• Founding member and Former Chair of the South Wales Clinical Training in Neuropsychology Group
• Welsh National Representative for Trainees, Association of Clinical Psychologists, UK
• Founding member of the UK Training in Clinical Psychology Collaboration Group

During these activities, Dr Marsh has founded a national professional trainee network and written a number of national guidance documents for the training of clinical psychologists.

Professional memberships

• Healthcare Professions Council (HCPC)
• British Psychology Society (BPS)
• Association of Clinical Psychologists-UK (ACP-UK)
• British Neuroscience Association (BNA)
• Royal Society of Biology (MRSB)
• British Neuropsychological Society (BNS)

Supervisions

Please get in touch if you are a post-graduate student interested in undertaking research in the areas of clinical neuropsychology.