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Contribution Of Disturbed Blood Flow And Cerebral Metabolism To White Matter Damage In The Perinatal Brain
Funder
National Health and Medical Research Council
Funding Amount
$369,375.00
Summary
It has been known for some time that the white matter regions of the developing brain are particularly vulnerable to damage. These regions are deep in the brain near the ventricles, and are rich in myelin sheaths wrapped around the nerve fibres running from cell-rich areas in the outer layers of the brain to other regions, and down into the spinal cord. Damage to white matter usually leads to behavioural, learning and motor problems in the newborn infant - in its severest form, seen as cerebral ....It has been known for some time that the white matter regions of the developing brain are particularly vulnerable to damage. These regions are deep in the brain near the ventricles, and are rich in myelin sheaths wrapped around the nerve fibres running from cell-rich areas in the outer layers of the brain to other regions, and down into the spinal cord. Damage to white matter usually leads to behavioural, learning and motor problems in the newborn infant - in its severest form, seen as cerebral palsy. Such outcomes are often associated with the presence of asphyxia and infection during pregnancy, leading to the belief that the damage first arises while the baby is still in utero. In this application we suggest that asphyxia and-or infection during pregnancy cause prolonged disturbances in the regulation of blood flow and integrity of the blood-brain barrier in the developing brain, together with changes in metabolism that result in accumulation of prostaglandins and the toxic hydroxyl radical, leading irreversibly to cell death. If this series of events proves to be true, we have suggested and will test several protocols for protecting the fetal brain, which should be readily translatable to clinical practice.Read moreRead less
Sympathetic Control Of Cutaneous Blood Flow And Blood Pressure In Human Spinal Cord Injury
Funder
National Health and Medical Research Council
Funding Amount
$242,002.00
Summary
While spinal cord injury can cause devastating changes in the nervous system paralysis and loss of sensation relatively little is known about changes to the sympathetic nervous system. The sympathetic nervous system is intimately involved in the ongoing control of blood pressure, blood flow and temperature control. Loss of sympathetic control can occur following spinal cord injury. Interruption of descending pathways can result in partial or complete loss of sympathetic outflow from the thoracol ....While spinal cord injury can cause devastating changes in the nervous system paralysis and loss of sensation relatively little is known about changes to the sympathetic nervous system. The sympathetic nervous system is intimately involved in the ongoing control of blood pressure, blood flow and temperature control. Loss of sympathetic control can occur following spinal cord injury. Interruption of descending pathways can result in partial or complete loss of sympathetic outflow from the thoracolumbar segments. Complete decentralization can result in autonomic dysreflexia (autonomic hyperreflexia), in which sensory stimuli originating below the lesion evoke a reflex increase in sympathetic drive to the blood vessels, causing them to constrict. Because of this, blood pressure may rise suddenly and remain at such high levels that stroke and (occassionally) cardiac arrest may occur. This phenomenon, autonomic dysreflexia, is considered a medical emergency. The typical subjective signs of autonomic dysreflexia include a throbbing headache, tingling in the head or nasal congestion; sweating and flushing above the lesion are clinical signs that prompt medical staff to measure blood pressure and to locate the source of sensory irritation (usually a distended bladder or impacted colon, sometimes a pressure sore or ingrown toenail). Commonly, however, subclinical episodes go undetected, and this phenomenon of silent dysreflexia is of increasing concern. This project will develop means of assessing the integrity and state of the sympathetic nervous system below a lesion in patients with spinal cord injury and characterize the firing properties of reflexly activated sympathetic neurones.Read moreRead less
Shared Team Approach Between Nurses And Doctors For Improved Risk Factor Management (STAND FIRM)
Funder
National Health and Medical Research Council
Funding Amount
$1,945,676.00
Summary
There are many proven treatments for preventing people with stroke from having a recurrent event, e.g. maintaining blood pressure at acceptable levels. However, uptake of therapies is poor. We will assess whether patients receiving individualised management plans, prepared and administered by both doctors and nurses will have risk factors controlled better than those receiving usual care. The plan includes education of patients to help them have more control over their own care.
The Claustrum Enigma: Unlocking The Role Of The Last Unknown Area Of The Primate Brain
Funder
National Health and Medical Research Council
Funding Amount
$558,364.00
Summary
Despite nearly 200 years of study, the function of the claustrum remains unclear. Interest in this brain structure has recently been revived by findings showing damage to the claustrum in several major diseases, and by the suggestion that the claustrum may have a role in consciousness. Here we propose a series of experiments to test the novel hypothesis that the claustrum is part of the default mode network, a group of brain areas that act together when we aren't thinking about anything in parti ....Despite nearly 200 years of study, the function of the claustrum remains unclear. Interest in this brain structure has recently been revived by findings showing damage to the claustrum in several major diseases, and by the suggestion that the claustrum may have a role in consciousness. Here we propose a series of experiments to test the novel hypothesis that the claustrum is part of the default mode network, a group of brain areas that act together when we aren't thinking about anything in particular, that is- most of the time.Read moreRead less
A Centre For Research Excellence In Cerebral Palsy (CRE-CP)
Funder
National Health and Medical Research Council
Funding Amount
$2,622,042.00
Summary
Cerebral palsy is the most common physical disability in childhood. Our objective is to bring about a radical improvement in the treatment of individuals with cerebral palsy, both children and adults, and to determine better ways to assist their families. Emphasis will be placed on early detection of health issues and rigorous evaluation of management options. We will train more researchers and ensure that all the knowledge generated is made available to families and health care professionals.
Selective Isolation And In Vivo Properties Of Dopamine Neurons Generated From Embryonic Stem Cells.
Funder
National Health and Medical Research Council
Funding Amount
$505,389.00
Summary
This research aims to develop a procedure that allows for the safe and effective use of stem cells as a therapy for Parkinson’s disease. It is based on the concept that new dopamine neurons, generated from stem cells, can be implanted into the brain of the patients in order to replace those lost to the disease, thereby improving motor function.
HABIT-ILE: A Randomised Trial Of Hand Arm Bimanual Intensive Training Including Lower Extremity Training For Children With Bilateral Cerebral Palsy
Funder
National Health and Medical Research Council
Funding Amount
$1,100,903.00
Summary
In Australia, 35,000 people have cerebral palsy, and between 60-70% experience difficulties with movement on both sides of their body. There are currently no effective interventions for children with bilateral CP to improve their ability to use their hands, walk and perform daily life tasks. We have promising data about a new intervention, called HABIT-ILE, which we will test in 80 children with cerebral palsy and compare results to usual care.
New And Improved Treatment Strategies For Neonatal Seizures
Funder
National Health and Medical Research Council
Funding Amount
$883,209.00
Summary
Around 10% of neonates in Australia are diagnosed with seizures each year. Seizures worsen neurodevelopmental outcome following hypoxic brain injury. Despite evidence of the limited effectiveness and potential neurotoxicity of current anti-seizure medication, treatment has not changed for many decades. The objective of this study is to optimise treatment of neonatal seizures with a compound that is effective and does not cause harm, or indeed provides neuroprotection for the compromised brain.
Harnessing Neuroplasticity To Improve Motor Performance In Infants With Cerebral Palsy: A Pragmatic Randomized Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$2,736,349.00
Summary
Every 15 hours an Australian baby is born with cerebral palsy. Despite confidence in early intervention, 50% don't receive intervention before their first birthday while awaiting diagnosis, and 8 of 10 previous trials have not produced any physical gains over and above natural development. We have promising data about a new brain training intervention that harnesses neuroplasticity and improves movement. Our trial will treat 300 infants with early training comparing results to Standard Care.