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Neural injury


Understanding the mechanisms of spinal injury


We are interested in how the body’s tissues respond to mechanical forces, both as a part of normal function and in injury, such as in physical trauma or when a nerve is compressed.

A major part of our neural injury research involves understanding how injuries occur in road trauma, which is a leading cause of death and disabling injury in Australia, for both adults and children.

We are studying how these injuries occur, and how changes to the types and design of restraints used by children and passengers in the rear seat of cars can reduce serious injuries and death.


MEMOIR – a clinical trial for Complex Regional Pain Syndrome

Complex Regional Pain Syndrome (CRPS) is a serious health condition, affecting approximately 20,000 people in Australia. It is characterised by severe burning, stinging and stabbing pain. People with CRPS are unable to use their painful limb and their ability to work or participate in normal social activities is severely restricted. Currently, there are no effective treatments for CRPS.

A vast body of research has demonstrated changes in brain processes in CRPS. The MEMOIR trial will investigate the effectiveness of two novel brain-directed treatments to reduce pain and improve function in people with CRPS.

MEMOIR consolidates the expertise of scientists and clinicians from NeuRA (A/Prof James McAuley, A/Prof Sylvia Gustin, Mr Michael Ferraro), the University of South Australia (Prof Lorimer Moseley), the University of Sydney (Prof Andrew McLachlan), the University of Notre Dame Australia Fremantle (Prof Benedict Wand, Prof Eric Visser), the University of Exeter (Prof Sallie Lamb), Brunel University London (Dr Neil O’Connell) and the University of Oxford (Dr Hopin Lee).

Due to the COVID-19 global pandemic, the commencement of MEMOIR has been delayed. Recruitment for MEMOIR will commence in September 2020.

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Investigations into the firing behaviour of human motoneurones in health and after neurological inju

This basic science project aims to examine the behaviour of human motoneurones during sustained activation to reveal their mechanisms of recovery after activation. We will take the fundamental findings from this study and compare the behaviour of motoneurones innervating muscles affected by neurological injury such as spinal cord injury and stroke.

Control of coughing and expiratory muscles in spinal cord injury

Respiratory complications are the major cause of death for people with spinal cord injuries. People with a high level spinal cord injury are 150 times more likely to die from pneumonia than the general population. This is because after high level spinal cord injury, people have a reduced ability to cough and to clear secretions from the lungs. The major group of muscles that produce a cough are the abdominal muscles. If the abdominal muscles are paralysed after spinal cord injury then the strength of the cough will be severely reduced. In our lab, we are looking at ways to improve cough in people with spinal cord injury by using surface functional electrical stimulation of the abdominal muscles. We have shown that this type of stimulation can improve cough significantly. We are now looking for ways to further improve cough through muscle training as well as ways to develop a portable stimulator that would allow independent activation of a cough.

The effect of respiratory muscle training on respiratory health after spinal cord injury

After cervical spinal cord injury (SCI), the respiratory muscles are partly or completely paralysed. This has two major clinical consequences: a decreased ability to get air into the lungs and a decreased ability to cough and remove secretions. This results in a lifetime of recurrent respiratory tract infections (2/year/person) that often progress to pneumonia with frequent and extended hospital admissions. People with cervical SCI are 150 times more likely to die from respiratory complications than the general population, as many as 28% die within the first year after injury. For those that survive the first year, a cervical SCI has a lifetime cost of $9.5million, a large proportion of which is attributed to respiratory-related complications. A recent longitudinal study of people with cervical SCI showed that respiratory muscle weakness is associated with incidental pneumonia. Respiratory muscle weakness also causes dyspnoea (breathlessness) and sleep-disordered breathing, which is 4-10 times more prevalent in people with SCI than the able-bodied population. Therefore, there is an urgent need to identify a simple and cost-effective treatment for respiratory muscles weakness to prevent respiratory complications after SCI, improve quality of life and reduce the burden on the healthcare system.

Our primary aim is to determine definitively the effectiveness of training on respiratory muscle strength, respiratory physiology and health outcomes. To do this we will conduct a randomised controlled trial 2 times bigger than the largest previous study, of respiratory muscle resistive load training in individuals with acute and chronic cervical SCI. The project will provide critical new knowledge about the efficacy of a simple and inexpensive respiratory muscle training regime, which can be applied immediately in the hospital and community, to minimise respiratory morbidity in people with SCI. This project also provides a unique opportunity to investigate other consequential effects of long-term respiratory muscle training that have never been studied in people with SCI. These include effects on cough efficacy, sleep-disordered breathing, breathlessness, respiratory morbidity, respiratory health and neural drive to the diaphragm, as well as quality of life.


Syringomyelia is an enigmatic condition in which high pressure fluid-filled cysts form in the spinal cord, often after spinal cord injury or in congenital conditions where there is obstruction to cerebrospinal fluid flow near the brainstem. In collaboration with neurosurgeon Prof Marcus Stoodley, we are using magnetic resonance imaging, computational modelling and experimental models to understand how cerebrospinal fluid flow in the central nervous system is altered, and the mechanisms by which this gives rise to build-up of fluid in the spinal cord. • Honours and PhD projects are available to study the biomechanical and basic biological mechanisms of syringomyelia, using magnetic resonance imaging, experimental and computational modelling.

Defining the Causes and Developing New Treatments for People with Spinal Cord Injury and Sleep Apnoe

The prevalence of sleep apnoea in people with chronic quadriplegia is two to seven times higher than the general population. Optimal treatment approaches may also differ.

What else is happening in Neural injury research at NeuRA?