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STOP-AUST: The Spot Sign And Tranexamic Acid On Preventing Intracerebral Haemorrhage Growth – AUStralasia Trial
Funder
National Health and Medical Research Council
Funding Amount
$764,621.00
Summary
The STOP-AUST study is a randomized controlled trial with the aim of testing whether the medication tranexamic acid when given early within 4.5 hours of symptom onset is superior to standard care alone in stopping intracerebral haemorrhage (ICH, a bleeding into the brain) growth. Total 100 to 150 patients will be enrolled into the study.
Discovery To Therapy Implementation In Acute Stroke
Funder
National Health and Medical Research Council
Funding Amount
$585,269.00
Summary
Advances in acute stroke therapies are occurring rapidly but challenges remain in their safe and effective delivery to stroke sufferers. This research focuses on testing a potentially superior ‘clot busting’ drug therapy for acute stroke and on identifying reasons why one of the most widely used current therapies carries a risk of significant harm due to bleeding into the brain. The work also investigates how to better implement the newest form of acute therapy, mechanical blood clot extraction.
Short Duration Hypothermia To Prevent Subsequent Intracranial Pressure Rise.
Funder
National Health and Medical Research Council
Funding Amount
$436,453.00
Summary
Elevated brain pressure after stroke or other forms of brain injury can cause further injury and death. Body cooling to 32-33 C (hypothermia) for 12-24 hours saves lives after some forms of brain injury, but may have major side effects. We found that 2 hours hypothermia has a long-lasting effect preventing pressure elevation. We will determine the best temperature and duration of hypothermia in a stroke model and use imaging to confirm findings in patients, with a view to later human trials.
A New Paradigm To Prevent Intracranial Hypertension
Funder
National Health and Medical Research Council
Funding Amount
$408,388.00
Summary
Increasing brain pressure after stroke or other forms of brain injury can cause further injury and death. Body cooling by 4-5 0C (hypothermia) for 12-24 hours saves lives after some forms of brain injury, but may have major side effects. We found that 2 hour hypothermia has a long-lasting effect preventing pressure elevation. We will determine the best temperature and duration of hypothermia in a stroke model and use imaging to confirm findings in patients, with a view to later human trials.
Does Coeliac Disease Cause Ataxia Or Cognitive Impairment?
Funder
National Health and Medical Research Council
Funding Amount
$606,013.00
Summary
Coeliac disease (CD) is due to an allergy to a protein (gluten) found in wheat, barley and rye. It classically causes disease of the small bowel, resulting in impaired absorption of important nutrients, and is treated by a restrictive diet eliminating foods containing extracts of these grains. However, it has recently been found that CD is much commoner than previously thought (about 1 in 100-200), and often causes only non-specific symptoms. Two important conditions linked to CD by some, but no ....Coeliac disease (CD) is due to an allergy to a protein (gluten) found in wheat, barley and rye. It classically causes disease of the small bowel, resulting in impaired absorption of important nutrients, and is treated by a restrictive diet eliminating foods containing extracts of these grains. However, it has recently been found that CD is much commoner than previously thought (about 1 in 100-200), and often causes only non-specific symptoms. Two important conditions linked to CD by some, but not all, researchers are ataxia (incoordination) and impairment of thinking and memory. The problem is that many normal people (12% of the population) have antibodies to gluten, so that studies suggesting that sensitivity to gluten, as determined by the presence of antibodies, causes these brain disorders are not conclusive. That is, this could be a chance association. Furthermore, there is some evidence that damage to the coordination part of the brain (the cerebellum) from other causes may also cause antibodies to gluten. It is quite possible that antibodies to the cerebellum can cross-react with gluten, and vice versa. In this case, treating patients with ataxia and antibodies to gluten with the restrictive diet may be treating the result rather than the cause of the disorder. This project will study patients with CD (proven on small bowel biopsy) with sensitive, objective methods, including MRI, electronic measures of coordination, and psychological tests of thinking and memory, to see whether CD really is associated with these two problems. It will also study coordination and brain structure in a mouse model of CD. If the associations are proven, all patients with these disorders will need to be tested for CD, and treated with the restrictive diet if found to be positive. If not, clinicians will be confident that testing for anti-gluten antibodies would be irrelevant and misleading in these two situations.Read moreRead less
Acute Stroke: Imaging The Ischaemic Penumbra With Perfusion CT
Funder
National Health and Medical Research Council
Funding Amount
$243,000.00
Summary
The burden of stroke is large. Clot-dissolving medication (thrombolysis) may dramatically improve the outcome of many patients with severe stroke by unblocking the affected brain artery. However, very few patients receive this medication, as the current approval is restricted to treatment within 3 hours of stroke onset. The major aim of thrombolysis is to rescue brain tissue with reduced blood flow (the ischaemic penumbra) from becoming irreversibly damaged (infarcted). The penumbra progressivel ....The burden of stroke is large. Clot-dissolving medication (thrombolysis) may dramatically improve the outcome of many patients with severe stroke by unblocking the affected brain artery. However, very few patients receive this medication, as the current approval is restricted to treatment within 3 hours of stroke onset. The major aim of thrombolysis is to rescue brain tissue with reduced blood flow (the ischaemic penumbra) from becoming irreversibly damaged (infarcted). The penumbra progressively becomes infarcted over the next 48 hours if blood flow is not restored by the blood clot in the brain artery being dissolved. Penumbral brain tissue cannot be identified with clinical assessment or standard CT scanning. New generation CT scanners are capable of assessing brain blood flow. Perfusion CT imaging (CTP) is well tolerated and time-efficient, and can be integrated into the brain CT scanning process performed on all stroke patients. Preliminary evidence suggests that CTP can distinguish between tissue that represents the ischaemic penumbra, and tissue that is already permanently injured. This project aims to validate the use of CTP in imaging the ischaemic penumbra. This will be based on testing the accuracy of CTP tissue signatures of the penumbra in predicting clinical outcome and final stroke size. This is the only national collaborative study planned worldwide for this relatively new but increasingly accessible imaging technique. The ability to rapidly identify under-perfused but still viable brain with CTP would add new and exciting management options to the routine emergency assessment of stroke patients. The results of this unique study could have a significant impact on the management of acute stroke worldwide. If validated, it is anticipated that CTP would be widely used to improve patient selection for stroke thrombolysis, especially in safely extending the time window so that a greater number of patients can be treated with better outcomes.Read moreRead less
Structural And Functional Networks In The Human Brain: Disturbance In Disease And Influence Of Genes.
Funder
National Health and Medical Research Council
Funding Amount
$568,892.00
Summary
Professor Graeme Jackson is a Neurologist at the Austin Hospital whose research is dedicated to the problem of understanding how epilepsy occurs and devising strategies for successful treatment. He is Deputy Director and head of the epilepsy division of the Florey Neuroscience Institutes which has research dedicated advanced MR imaging systems and physics support largely dedicated to solving these problems in epilepsy. He has 170 plus papers, 10 cited over 200 times. Career citations exceed 6000 ....Professor Graeme Jackson is a Neurologist at the Austin Hospital whose research is dedicated to the problem of understanding how epilepsy occurs and devising strategies for successful treatment. He is Deputy Director and head of the epilepsy division of the Florey Neuroscience Institutes which has research dedicated advanced MR imaging systems and physics support largely dedicated to solving these problems in epilepsy. He has 170 plus papers, 10 cited over 200 times. Career citations exceed 6000.Read moreRead less
Structural Connectomes In Traumatic Brain Injury: Can Secondary Disease Progression Be Stopped And Cognitive Deficits Be Reversed?
Funder
National Health and Medical Research Council
Funding Amount
$431,000.00
Summary
Many people with traumatic brain injury (TBI) experience cognitive problems, including poor memory and concentration. TBI is often referred to as a ‘hidden disability’ because the overwhelming majority of patients with TBI show no abnormalities on standard MRI or CT scans. In my project, I will delineate the mechanisms of secondary injury in finer detail through enhanced neuroimaging techniques, resulting in new assessment and treatment modalities for individuals with TBI.
Implementation Of Quality Use Of Advanced CT Imaging In Acute Stroke
Funder
National Health and Medical Research Council
Funding Amount
$1,128,594.00
Summary
Many centres now use advanced CT scanning techniques to assess stroke patient suitability for clot-dissolving treatment. However, there is major variation across Australia in the clinical application of advanced CT scanning techniques, which is a barrier to the delivery of this treatment. This project addresses the variation in CT imaging techniques by developing, piloting and evaluating the implementation of a standardised advanced CT scanning strategy for acute stroke patients.
Helping Stroke Physicians Choose Who To Thrombolyse - The Targeting Optimal Thrombolysis Outcomes (TOTO) Study
Funder
National Health and Medical Research Council
Funding Amount
$1,073,140.00
Summary
Thrombolysis using alteplase is one of the most effective treatments for stroke but is currently used in only 5% of stroke cases. A major barrier is a lack of tools to identify who will benefit from treatment, or who might have a major adverse event. In this study we will develop a clinical decision rule based on clinical data, advanced CT imaging, and blood biomarkers to help identify those who will benefit and those likely to bleed, to encourage wider use of this treatment in acute stroke.