Mild traumatic brain injury (TBI) is a leading cause of death and disability in Australia, especially in young populations. Although many patients recover uneventfully following mild TBI, complications such as prolonged symptoms, depression and cognitive deterioration may occur. With considerable advancements in neuroimaging and cognitive assessment in recent years, newer techniques may provide a window to directly observe changes that accompany mild TBI.
Mild Traumatic Brain Injury And The Risk Of Long-term Neurodegenerative And Neurobehavioural Disease
Funder
National Health and Medical Research Council
Funding Amount
$585,269.00
Summary
Considerable media attention surrounds the potential for long-term problems in individuals with high exposure to head impacts such as seen in sporting, civilian and/or military contexts. This study examines the long-term effects of mild traumatic brain injury (mTBI) and helps close the current knowledge gap of the impact of this disorder on individuals. There are no long term trials to answer the critical question of whether mild TBI causes long term problems in the brain.
Proteases And Protease-inhibitor Complexes As Modulators Of Traumatic Brain Injury Severity
Funder
National Health and Medical Research Council
Funding Amount
$613,311.00
Summary
Traumatic brain injury (TBI) is a significant cause of mortality and morbidity in Australia, affecting approximately 21,800 Australians annually. A large number of survivors have permanent neurological deficits, causing adverse effects on lifestyle and family relationships and placing a significant burden on the health system. In this project we will address a novel means to improve TBI outcome by targeting two linked enzyme systems that together have been shown to be deleterious in this conditi ....Traumatic brain injury (TBI) is a significant cause of mortality and morbidity in Australia, affecting approximately 21,800 Australians annually. A large number of survivors have permanent neurological deficits, causing adverse effects on lifestyle and family relationships and placing a significant burden on the health system. In this project we will address a novel means to improve TBI outcome by targeting two linked enzyme systems that together have been shown to be deleterious in this condition.Read moreRead less
Multi-centre Randomised Trial Of Early Decompressive Craniectomy In Patients With Severe Traumatic Brain Injury
Funder
National Health and Medical Research Council
Funding Amount
$490,500.00
Summary
Despite optimal neurosurgical and intensive care therapy, many trauma patients with severe brain injury (typically young males) have very poor long term neurological outcomes. Current knowledge suggests that a key contributor to secondary brain damage which occurs after injury and to poor neurological outcomes is brain swelling and subsequent increase in brain pressure. Present intensive care therapies to control brain pressure are often not effective, and favourable neurological outcomes occur ....Despite optimal neurosurgical and intensive care therapy, many trauma patients with severe brain injury (typically young males) have very poor long term neurological outcomes. Current knowledge suggests that a key contributor to secondary brain damage which occurs after injury and to poor neurological outcomes is brain swelling and subsequent increase in brain pressure. Present intensive care therapies to control brain pressure are often not effective, and favourable neurological outcomes occur in only 20-30% of these patients. Small studies suggest that a surgical operation called decompressive craniectomy (DC) may decrease brain pressure and improve neurological outcomes in these patients. DC involves temporarily surgically removing a piece of skull bone (during the swelling period) and replacing it when the swelling has subsided. DC is done under general anaesthetic in unconscious patients and is used occasionally at present, although due to insufficient research the benefits are controversial. The proposed study is a multi-centre randomised controlled study of best current therapies plus early decompressive craniectomy vs best current therapies alone in selected unconscious patients with severe head injury. The study outcome is patient neurological function measured 6 months after the injury. A study of this type is required before early DC could become a routine therapy in Australia. Next of kin will sign informed consent for the study and then also for the surgery if patients are randomised to surgery. The study will be managed at the Alfred Hospital-Monash University in Melbourne and includes fifteen collaborating ANZ neurotrauma centres over 3.0 years. There are >200 patients in Australia annually in this category with potential for DC to increase favourable outcomes in >40 patients annually. Lifetime costs for these patients with severe disability are > $2.4 million, so there may be substantial economic and social impact.Read moreRead less
A New Map Of The Human Cerebral Cortex To Assist The Interpretation Of FMRI And PET Studies
Funder
National Health and Medical Research Council
Funding Amount
$264,307.00
Summary
The cortex is the brain structure most intimately involved in cognition, motivation and emotion. It is thought to be the principal area affected in diseases such as schizophrenia, and Alzheimer's disease. An enormous and costly effort is expended in functional neuroimaging with PET and fMRI to establish the relation between cortical regions and neurologic and psychiatric dysfunction. Unfortunately due to the unavailability of an accurate map of the human cortex, the researcher is left only with ....The cortex is the brain structure most intimately involved in cognition, motivation and emotion. It is thought to be the principal area affected in diseases such as schizophrenia, and Alzheimer's disease. An enormous and costly effort is expended in functional neuroimaging with PET and fMRI to establish the relation between cortical regions and neurologic and psychiatric dysfunction. Unfortunately due to the unavailability of an accurate map of the human cortex, the researcher is left only with crude estimates of the location of normal and abnormal cortical activity. Further, there is limited ability to relate the human data to the wealth of knowledge available on non-human primate brains. Conversely, researchers using animal models of human cortical pathology cannot readily relate their data to humans because the similarities between the brains of experimental animals and humans have not yet been comprehensively established. The present project will establish the similarities between the cortex of humans and rhesus monkeys. By revealing comprehensively the location of cortical areas this project will provide the context within which hypotheses of cortical function and dysfunction can be tested. The applicants were the first to use the distribution of chemical substances in the brain to construct a comprehensive map of the rat brain. This work is the only Australian publication ranked amongst the 50 most cited items in the history of science. They wish to apply similar techniques to study the least understood part of the human brain, the cortex. The research proposed herein will not examine human tissue from individuals who suffered from depression, anxiety, schizophrenia, Alzheimer's disease, or Parkinson's disease. However, the outcomes of the proposed research will be of assistance to virtually everyone who studies the relation between these diseases and the brain.Read moreRead less
In this Fellowship I will capitalise on my role as Professor of Surgery and Public Health at Monash University, Director of the National Trauma Research Institute, and a surgeon at The Alfred Hospital, to lead a program of research that improves our understanding of what works in trauma care and trauma systems, uses scientific strategies to ensure research makes a difference to practice and policy, and supports further research that seeks to understand how research can best be used to improve in ....In this Fellowship I will capitalise on my role as Professor of Surgery and Public Health at Monash University, Director of the National Trauma Research Institute, and a surgeon at The Alfred Hospital, to lead a program of research that improves our understanding of what works in trauma care and trauma systems, uses scientific strategies to ensure research makes a difference to practice and policy, and supports further research that seeks to understand how research can best be used to improve injured peoples' lives.Read moreRead less
Hypertonic Saline (HTS) In Head Injured Patients - A Multicentre, Prehospital, Prospective Randomised Clinical Trial
Funder
National Health and Medical Research Council
Funding Amount
$247,269.00
Summary
Head injury is common in patients with major trauma, many of whom are young adults. The extent of head injury has a major influence on patient outcome. Low blood pressure after trauma worsens the extent of brain injury by decreasing its blood supply at a critical stage. Much of this secondary brain injury occurs before the patient reaches hospital. Hypertonic saline (HTS) is an intravenous salt solution which has been used in intensive care patients for many years to decrease brain swelling in h ....Head injury is common in patients with major trauma, many of whom are young adults. The extent of head injury has a major influence on patient outcome. Low blood pressure after trauma worsens the extent of brain injury by decreasing its blood supply at a critical stage. Much of this secondary brain injury occurs before the patient reaches hospital. Hypertonic saline (HTS) is an intravenous salt solution which has been used in intensive care patients for many years to decrease brain swelling in head injured patients. We know that HTS can be given to patients before they reach hospital, is safe, and acts by rapidly increasing blood pressure and decreasing brain swelling. Accordingly HTS may minimise secondary brain injury and lead to increased survival. Importantly, HTS is likely to dramatically improve neurological function of survivors without any significant risk of side effects. This study is designed to determine the effectiveness of prehospital HTS in head injured trauma patients with traumatic coma and low blood pressure.Read moreRead less
Newborn babies are at risk of becoming short of oxygen during delivery and sustaining brain damage. Seizures may cause further damage to the brain because they release damaging chemicals or make extra energy demands on the brain that cannot be met. To detect seizures, it is necessary to measure the EEG, the tiny electrical signals from the brain. We are proposing to automatically detect and count seizures, building upon 8 years of fundamental EEG signal processing research work we have undertake ....Newborn babies are at risk of becoming short of oxygen during delivery and sustaining brain damage. Seizures may cause further damage to the brain because they release damaging chemicals or make extra energy demands on the brain that cannot be met. To detect seizures, it is necessary to measure the EEG, the tiny electrical signals from the brain. We are proposing to automatically detect and count seizures, building upon 8 years of fundamental EEG signal processing research work we have undertaken. We anticipate that the product will be of major commercial interest. We will further explore what is a rapidly expanding marketplace and ensure we maximize the commercial return on this product.Read moreRead less