Dr Spence’s current research focuses on the integration of clinical, histopathological (tissue markers) and multi-omics (genetic, metabolite and protein level) datasets to investigate the role of TDP-43 and heavy metal dysregulation in the physical biology of ALS and other neurodegenerative diseases. Dr Spence utilises brain imaging technologies, immunohistochemistry and multi-omics analyses, with the aim of improving precision medicine by developing paired biomarker and treatment target strategies for specific endophenotype of ALS.

Dr Spence completed her PhD in 2023 demonstrating links between regional brain iron detected via MRI and cognitive performance. Following this, Dr Spence worked an NIH funded post-doctoral project in the Gregory Lab focusing on development of biomarkers and their relation to the physical biology of ALS. In 2026, Dr Spence was awarded the MND Association Lady Edith Wolfson Junior Non-Clinical Fellowship to identify stratification tools for ALS.