Retinal Vascular Signs As Risk Markers For Incident Stroke Or Cerebrovascular Death: A Population-based Assessment
Funder
National Health and Medical Research Council
Funding Amount
$410,199.00
Summary
Stroke remains a major cause of disability and death in Australia. Preliminary data from the Blue Mountains Eye Study suggest that blood vessel changes observed in the retina at the back of the eye may provide signs of an increased risk of stroke or death from stroke. Importantly, although stroke is strongly associated with elevated blood pressure, the risk associated with these blood vessel signs seems to be independent of blood pressure. The proposed study will conduct a detailed re-grading of ....Stroke remains a major cause of disability and death in Australia. Preliminary data from the Blue Mountains Eye Study suggest that blood vessel changes observed in the retina at the back of the eye may provide signs of an increased risk of stroke or death from stroke. Importantly, although stroke is strongly associated with elevated blood pressure, the risk associated with these blood vessel signs seems to be independent of blood pressure. The proposed study will conduct a detailed re-grading of retinal photographs taken on people who attended the Eye Study during 1992-4 and 5-year follow-up exams during 1997-9. We will grade these photographs manually (using a stereo-viewer), and with computer assistance to measure changes in the diameter of small arteries in the retina and other signs. By closely matching our grading technique to that used in a large American Study, we hope to develop reliable grading for these signs and will be able to compare our findings internationally. Our aim is to assess the frequency of abnormal retinal vessel changes in people of different age groups as well as the development and progression of these signs over time. Their relationship to well known vascular risk factors like smoking, blood pressure, obesity, diabetes and cholesterol will also be investigated. We hope to be able to discriminate those changes associated with an increased stroke risk from those due to normal ageing. We expect that the increased stroke risk associated with abnormal retinal vessel changes may be greater than shown in our early data. If confirmed, then these findings may provide a more sensitive and objective measure of stroke risk than relying on traditional risk factors, which are difficult to quantify and change with time. We may be able to develop simple rules so that doctors using an ophthalmoscope or examining a retinal photograph could identify high risk patients. These people could benefit from interventions to reduce their risk.Read moreRead less
Evaluating The Effectiveness Of Therapy For Word Production Impairments In Aphasia.
Funder
National Health and Medical Research Council
Funding Amount
$231,500.00
Summary
This project addresses the remediation of language disorders following brain damage (aphasia). It targets the difficulties people with aphasia have in retrieving and accurately producing the words they need to communicate. These word production impairments are an extremely common symptom of aphasia and may be of different types. They are often severe but can be improved with treatment. However, there is no one task that is effective for every person with word production impairments in aphasia. U ....This project addresses the remediation of language disorders following brain damage (aphasia). It targets the difficulties people with aphasia have in retrieving and accurately producing the words they need to communicate. These word production impairments are an extremely common symptom of aphasia and may be of different types. They are often severe but can be improved with treatment. However, there is no one task that is effective for every person with word production impairments in aphasia. Unfortunately, to date research has failed to investigate adequately the relationship between the type of word production disorder and the appropriate treatment task to successfully remediate it - matching treatment to impairment remains a process of 'trial and error'. As therapy is a time consuming (and hence costly) process, it is clearly desirable to be able to select the best treatment as quickly as possible. This project aims to address this issue. We will investigate the effectiveness of two tasks which are commonly used by speech pathologists in their treatment of people with word retrieval impairments: answering a question regarding the meaning of a word (e.g. Does a cat purr?), and naming a picture with the help of the first sound of the word (e.g. the sound kuh' to help name a picture of a cat). We will determine if after treatment with these tasks, word retrieval and conversation skills improve; and in particular if one task is more effective for one type of word retrieval problem (e.g. retrieving the sounds of the word) than for another (e.g. impaired word meanings). The results of this study will enable Speech Pathologists to select the correct treatment with more accuracy than is currently possible, providing benefits in terms of increased communication ability for aphasic individuals (and hence greater social participation, quality of life, and reduced depression) and benefiting the Health Service Providers through more cost effective service delivery.Read moreRead less
A RCT Of Power Training And Treadmill Training To Improve Walking Ability In Sub-acute Stroke Patients.
Funder
National Health and Medical Research Council
Funding Amount
$403,041.00
Summary
Stroke causes weakness, incoordination, and reduced aerobic fitness, all of which impact significantly on walking ability and other related functions, such as balance. The current management of stroke patients is inadequate in improving patients' walking ability to a level that promotes independence in the community, as it does not address the impairments at the physiological level necessary to implement significant change. A relatively new approach to walking following stroke is the use of trea ....Stroke causes weakness, incoordination, and reduced aerobic fitness, all of which impact significantly on walking ability and other related functions, such as balance. The current management of stroke patients is inadequate in improving patients' walking ability to a level that promotes independence in the community, as it does not address the impairments at the physiological level necessary to implement significant change. A relatively new approach to walking following stroke is the use of treadmill walking. However, this form of training does not address the weakness following stroke. Therefore we propose to demonstrate the efficacy of a relatively new modality 'treadmill training with power training', at higher intensity over a greater number of sessions than would be received currently with 'usual care' or treadmill training only. To ensure that persons continue to maintain the level of improvement from an intensive exercise program, we will also implement a behavioural change for long-term maintenance of exercise behaviour in a less supervised environment. A randomized, single-blinded, control trial will be used. Subjects will be randomly allocated to 'treadmill training + power training', 'treadmill training', or usual care (i.e. control). Subjects in the two training groups will also receive 'usual care'. Subjects in the treadmill and treadmill + power training groups will attend training sessions for 10 weeks, with 3 sessions per week. Subjects will then be provided with a home exercise package to continue with their exercises. The findings from this study are critical in identifying whether, by addressing the 3 major impairments following stroke at doses which are known to produce physiological change in other frail populations, the stroke patient can achieve independence in walking and walk sufficient distances, both of which are important to the stroke patient.Read moreRead less
The Effect Of Smoking On The Exacerbation Of Stroke: Oxidative Stress Involvement And Cerebrovascular Response.
Funder
National Health and Medical Research Council
Funding Amount
$292,216.00
Summary
This grant addresses whether smoking contributes to the severity of stroke outcome. The studies outlined in this proposal will contribute significantly in our understanding of how smoking contributes to the progression of stroke. The understanding of the involvement of smoking in the progression of stroke will be of great benefit in the development of improved stroke patient management.
The Impact Of CPAP Treatment On Carotid Artery Atherosclerosis In Heavy Snoring And Mild Sleep Disordered Breathing
Funder
National Health and Medical Research Council
Funding Amount
$697,512.00
Summary
Mild sleep disordered breathing, including habitual snoring, is a very common problem in the adult population, with a prevalence of between 20-40%. Increasingly it is now recognised that habitual snoring may be an independent risk factor for the development of stroke. In this proposal we will explore the hypothesis that treatment for snoring will slow or stop the development of carotid artery atherosclerosis.
The NanoNautilus : A Breakthrough In The Successful Treatment Of Strokes And Other Cerebrovascular Diseases
Funder
National Health and Medical Research Council
Funding Amount
$187,212.00
Summary
Strokes are one of the biggest killers of Australians and are becoming increasingly so every year. Bleeding from the brain involves extremely delicate and dangerous medical treatments. The development of NanoNautilus [TM]---a remote-controlled steerable microcatheterusing world-first miniaturization technology---will revolutionise current practises and greatly reduce the current risk with medical intervention.
The Role Of Snoring Vibrations In The Pathogenesis Of Early Carotid Artery Atherosclerosis
Funder
National Health and Medical Research Council
Funding Amount
$593,833.00
Summary
Habitual snoring is a very common problem in the adult population, with a prevalence of between 20-40%. Increasingly it is now recognised that snoring may be an independent risk factor for the development of stroke. In this proposal, we will explore the hypothesis that chronic snoring transmits a pressure wave through the tissues of the neck to the carotid artery which may damage the artery wall and subsequently lead to stroke. This may lead to new strategies to treat habitual snoring.
A Study Of Mechanisms Of Cognitive Decline In Type 2 Diabetes Mellitus
Funder
National Health and Medical Research Council
Funding Amount
$510,222.00
Summary
Diabetes mellitus and dementia are major public health problems. Diabetes may increase the risk of dementia. This study aims to uncover the mechanism by which diabetes may increase dementia risk. This may lead to finding new ways to prevent or treat diabetes-related dementia and thus reduce the public health burden of dementia.
Targeting Aldosterone Receptors In Cerebrovascular Disease
Funder
National Health and Medical Research Council
Funding Amount
$857,712.00
Summary
Stroke represents a major health (accounting for 6% of all deaths) and economic (costs Australia $2.14 billion per year) burden on society, thus clearly more effective treatments are needed. This project will investigate the role of two substances produced in the body – angiotensin II and aldosterone – in stroke outcome, and whether targeting their receptor(s) may prevent poor outcomes following stroke.
THE VASCULAR CONSEQUENCES OF SNORING AND OBSTRUCTIVE SLEEP APNOEA
Funder
National Health and Medical Research Council
Funding Amount
$476,052.00
Summary
Snoring refers to a condition where the throat narrows significantly during sleep, and allows the soft tissues which surround this part of the airway to vibrate and create the typical snoring noise. Habitual snoring is a very common problem in the adult population, with a prevalence of between 20-40%. More severe forms of snoring are associated with the obstructive sleep apnoea syndrome, which is a condition in which the throat completely blocks behind the tongue and palate during sleep leading ....Snoring refers to a condition where the throat narrows significantly during sleep, and allows the soft tissues which surround this part of the airway to vibrate and create the typical snoring noise. Habitual snoring is a very common problem in the adult population, with a prevalence of between 20-40%. More severe forms of snoring are associated with the obstructive sleep apnoea syndrome, which is a condition in which the throat completely blocks behind the tongue and palate during sleep leading to cessation of breathing for short periods of time. Sleep apnoea is among the commonest chronic disorders of adult males occurring in 5% of men over the age of 45 years. Increasingly, it is now recognised that snoring, without sleep apnoea, may be an independent risk factor for the development of both of these very common and significant medical disorders. However, there have been no studies exploring the mechanisms by which snoring might contribute to the development of stroke and hypertension. In this proposal, we will explore the hypothesis that chronic snoring transmits a pressure wave through the tissues of the neck to the carotid artery which is the main blood supply to the brain. We propose that the chronic vibration of this artery leads to disease such as atherosclerosis and hypertension. Our studies will help to prove that this is a common mechanism whereby both snoring and sleep apnoea may contribute to the development of important vascular diseases. Studies will also establish the prevalence of carotid atherosclerosis in snorers (with and without OSA), and the prevalence of habitual snoring and OSA in patients at risk of developoing completed stroke. The recognition of snoring as an independent risk factor for vascular disease will clearly have important and wide ranging implications for the future management of snoring in the prevention of stroke and hypertension.Read moreRead less