THE NATURAL HISTORY OF COGNITIVE IMPAIRMENT AND DEMENTIA IN A STROKE COHORT
Funder
National Health and Medical Research Council
Funding Amount
$290,747.00
Summary
In a current NHMRC-funded study, we have examined 200 stroke patients (and 100 control subjects) at 3 months after a stroke and one year later, and identified those who have impairment in memory and other cognitive functions. We have also studied these subjects in detail from a psychiatric perspective and performed brain scans on them using magentic resonance imaging. We find that many stroke patients have problems with their cognitive functioning which has a major impact on their lives. A large ....In a current NHMRC-funded study, we have examined 200 stroke patients (and 100 control subjects) at 3 months after a stroke and one year later, and identified those who have impairment in memory and other cognitive functions. We have also studied these subjects in detail from a psychiatric perspective and performed brain scans on them using magentic resonance imaging. We find that many stroke patients have problems with their cognitive functioning which has a major impact on their lives. A large number also become depressed. These consequences of stroke are not given sufficient importance by clinicians. The fact that stroke is a common problem in the elderly, and our society is aging, makes this a problem of major public health significance. In the new proposal, we plan to study these subjects up to 3 years with repeat neuropsychiatric assessments and brain scans to investigate the natural history of stroke-related cognitive impairment. We will determine whether further new cases of dementia develop in the period 1-3 years, what happens to the brain lesions picked up on brain scans, and how these deficiencies affect the patients' living status and their longevity. We will be able to determine the factors that lead to a good outcome, and suggest strategies that may be applicable to improve the functioning of these individuals.Read moreRead less
THE EFFECTS OF TRANSCRANIAL MAGNETIC STIMULATION (TMS) ON RAT MODELS OF DEPRESSION
Funder
National Health and Medical Research Council
Funding Amount
$204,274.00
Summary
Repetitive Transcranial Magnetic Stimulation (rTMS) is the direct stimulation of the brain by using high field magnetic pulses. It is a new technique that has been demonstrated to have some potential as a treatment of depressive illness and possibly other neuropsychiatric disorders. At this early stage of its investigation, the parameters of stimulation that are most likely to be therapeutic, and its mechanisms of action, are not known. Published studies vary in the frequency, duration and exten ....Repetitive Transcranial Magnetic Stimulation (rTMS) is the direct stimulation of the brain by using high field magnetic pulses. It is a new technique that has been demonstrated to have some potential as a treatment of depressive illness and possibly other neuropsychiatric disorders. At this early stage of its investigation, the parameters of stimulation that are most likely to be therapeutic, and its mechanisms of action, are not known. Published studies vary in the frequency, duration and extent of stimulation, with no firm guidelines about optimal parameters. Empirical study of the relative effects of stimulation at different frequencies, at different numbers of stimuli and for different durations is therefore important for the future development of this treatment. Such an investigation is best carried out in an animal model of depression for both ethical and practical reasons, as such studies in patients would possibly take many years and be extremely difficult to conduct. We propose such a study in rat models of depression which have demonstrated validity and utility in drug research. Rat models have a long track record in developing psychiatric treatments and are cost-effective and of proven value. We also plan to investigate the neuroanatomy of the immediate-early genes induced by TMS and compare it with electroconvulsive shock (ECS) and a tricyclic antidepressant, two established treatments of depression. The results will have implications for future human studies in guiding us toward the optimal parameters for therapeutic effects. They will also enhance our understanding of the mechanism of action of TMS in depression.Read moreRead less
Transdermal Testosterone Therapy: A Potential Treatment For Selective Serotonin Reuptake Inhibitor (SSRI)-associated Sexual Dysfunction In Women
Funder
National Health and Medical Research Council
Funding Amount
$241,351.00
Summary
Female sexual dysfunction (FSD) is frequently reported with selective serotonin reuptake inhibitor (SSRI) therapy and venlafaxine, these being the most common antidepressants used by Australian women. We have shown that testosterone therapy significantly improves sexual function in women with FSD. However SSRI-users have been excluded from these past studies. The aim of this study is to assess the efficacy of transdermal testosterone therapy for treatment of sexual dysfunction associated with SS ....Female sexual dysfunction (FSD) is frequently reported with selective serotonin reuptake inhibitor (SSRI) therapy and venlafaxine, these being the most common antidepressants used by Australian women. We have shown that testosterone therapy significantly improves sexual function in women with FSD. However SSRI-users have been excluded from these past studies. The aim of this study is to assess the efficacy of transdermal testosterone therapy for treatment of sexual dysfunction associated with SSRI therapy.Read moreRead less
Healthy, Wealthy And Wise: The Long-term Effectiveness Of An Online Universal Program To Prevent Substance Use And Mental Health Problems Among Australian Youth
Funder
National Health and Medical Research Council
Funding Amount
$1,472,709.00
Summary
The proposed study represents a unique opportunity to build on the NHMRC funded Climate Schools Combined (CSC) study, a world-first trial of a combined, internet-delivered school-based approach to preventing substance use, anxiety and depression. Having successfully implemented this trial and followed these students for 3 years, we propose to extend follow-up of this large trial cohort over the critical transition from secondary school into early adulthood.
An Extended Follow-up Of Stroke Patients For Cognitive Impairment And Neuropsychiatric Disorders: Sydney Stroke Study
Funder
National Health and Medical Research Council
Funding Amount
$321,800.00
Summary
Vascular Dementia (VaD) is the second most common cause of dementia after Alzheimer's disease. In fact, it may be a preventable cause of dementia. Yet it has been relatively neglected by researchers until the last decade, which has seen an upsurge of interest in this disorder. There is no consensus on the criteria for dementia. The profile of early cognitive impairment due to vascular factors is still poorly understood, and the longitudinal course of VaD as defined by modern criteria has not bee ....Vascular Dementia (VaD) is the second most common cause of dementia after Alzheimer's disease. In fact, it may be a preventable cause of dementia. Yet it has been relatively neglected by researchers until the last decade, which has seen an upsurge of interest in this disorder. There is no consensus on the criteria for dementia. The profile of early cognitive impairment due to vascular factors is still poorly understood, and the longitudinal course of VaD as defined by modern criteria has not been studied. There have been few studies of the progressive changes in MRI in patients with cerebrovascular disease. The overlap of VaD and Alzheimer's disease (AD) remains a problem for taxonomists and clinicians. One approach to the study of VaD is to examine a high risk group of subjects longitudinally to determine the early features, the risk factors and progressive changes. With this in mind, we began studying a cohort of stroke patients who are at high risk of VaD, in 1997-1999, and are following them longitudinally. The follow-up is now in its third year, and three neuropsychological assessments and two MRI-MRS scans have been performed. We propose to extend the follow-up to 5 years, with repeat neuropsychiatric, neuropsychological and MRI-MRS investigations, and wherever possible to necropsy, to determine the nature of vascular pathology that underlies cognitive impairment. Our cohort of stroke patients is arguably the most comprehensively assessed such cohorts internationally, and presents an excellent opportunity for a long-term follow-up study.Read moreRead less
Using Reward-based Biomarkers To Improve The Early Detection Of Bipolar Disorder In Individuals Seeking Treatment For Depression
Funder
National Health and Medical Research Council
Funding Amount
$366,252.00
Summary
Bipolar disorder is often misdiagnosed as unipolar major depression, which can have disastrous clinical consequences. Emerging evidence indicates that individuals with bipolar disorder show particular dysfunctions within brain regions involved in processing reward. This research will use cutting-edge neuroscience methodologies to investigate reward processing in these two disorders, with the objective of identifying biological markers that help distinguish bipolar from unipolar depression.
Brain Connectivity Imaging Markers To Confirm Diagnosis For Bipolar Vs. Unipolar Depression – A Connectome Approach.
Funder
National Health and Medical Research Council
Funding Amount
$434,369.00
Summary
Differentiating Bipolar disorders from Unipolar Depression is a major clinical challenge. This misdiagnosis hinders optimal clinical care and has many deleterious consequences such self-harm, increased chances of suicide, poor prognosis, and greater health care costs related to this disorder. This project will provide urgently-needed advance in accurate identification of Bipolar disorders using Magnetic Resonance Imaging and remove one of the key obstacles to accurate diagnosis.
A Cluster RCT Of A Novel Psychological Intervention To Reduce Depression Among At-risk Older Adults Transitioning To Residential Aged Care
Funder
National Health and Medical Research Council
Funding Amount
$893,152.00
Summary
Depression is common in aged care facilities, with many older adults finding the transition extremely difficult. We have developed a simple intervention to help new residents, including those with dementia, to adjust to life in aged care. This program focuses on key aspects of psychological wellbeing, and is designed for widespread use in aged care. We will evaluate the intervention to determine if it is superior to current care approaches in reducing depression and improving quality of life.
Preventing Anxiety, Depression And Substance Use In Adolescents.
Funder
National Health and Medical Research Council
Funding Amount
$1,709,988.00
Summary
Anxiety, depressive and substance use disorders account for three quarters of the disability attributed to mental disorders. Yet we have few models of well-implemented prevention programs for these common disorders. The current proposal addresses this gap by evaluating an innovative internet-based approach to preventing mental health and substance use problems in Australian adolescents.