Neural injury


Understanding the mechanisms of spinal injury


About our research

Led by Prof Lynne Bilston, key research is directed towards understanding the mechanisms of spinal injury in children, and improving child restraints used in cars.

Problems include whether children use restraints correctly and whether they use restraints that are appropriate for their size, and whether the rear seat restraints perform as well as those for front seat passengers.

Fundamental to this work is understanding the differences between injuries in children and in adults. We are investigating how their body tissues are different, including their size, how much load they can tolerate, how stiff they are, and how these factors, along with developmental changes, affect the types of injury that children sustain.

We use MRI techniques, such as magnetic resonance elastography, to measure the stiffness of body tissues in live human subjects in ways that have previously been impossible. This technique also has applications beyond road trauma research; there are also changes in tissue stiffness in some diseases, such as cancer, which is what allows us to detect breast cancer lumps, for example. We are using this technique to examine changes in brain tissue in brain cancer, in a condition called hydrocephalus (fluid accumulation in the brain) and also in muscles after injury.

What we have discovered

  • Many injuries to children in car crashes are preventable by using a restraint that is the right size for the child, and using the restraint correctly.
  • Children are not big enough to fit properly into adult car seats and belts until about 11 years of age.
  • Differences in spinal cord injury between adults and children may be related to differences in the stiffness of their spinal column and responses to forces that occur during injury.

Current projects

Magnetic Resonance Elastography

We are using this new MRI technique to measure the stiffness of the brain, muscles and other tissues. This method uses an external vibration in the tissue, the propagation of which is measured with the MRI scanner to estimate the stiffness and viscosity of the tissue. The stiffness changes with age and in some diseases, so this research may help us develop better methods of diagnosis of diseases of the brain and muscle, such as hydrocephalus, sleep apnoea, and muscle injury.

Effects of mechanical loads on the nervous system

We are studying how mechanical forces affect the tissues of the human nervous system. This research ranges from spinal cord and peripheral nerve injury to chronic conditions such as syringomyelia and hydrocephalus. Recent work on the mechanical factors in spinal cord injury has shown that the difference in spinal cord injury incidence and severity between adults and children is influenced both by fundamental differences in the spinal column flexibility and stiffness, and differences in intrinsic spinal cord tissue responses to mechanical loading.

Upper airway biomechanics

We are studying the mechanical properties and motion of muscles that surround the upper airway and how these change in people with sleep apnoea.

See what’s going on at NeuRA


The RESTORE Trial: Immersive Virtual Reality Treatment for Restoring Touch Perception in People with Discomplete Paraplegia

Chief Investigators: Associate Professor Sylvia Gustin, Prof James Middleton, A/Prof Zina Trost, Prof Ashley Craig, Prof Jim Elliott, Dr Negin Hesam-Shariati, Corey Shum and James Stanley While recognition of surviving pathways in complete injuries has tremendous implications for SCI rehabilitation, currently no effective treatments exist to promote or restore touch perception among those with discomplete SCI. The proposed study will address this need by developing and testing a novel intervention that can provide touch restoration via the primary source of sensory perception: the brain.Complete spinal cord injury (SCI) is associated with a complete loss of function such as mobility or sensation. In a recent discovery we revealed that 50% of people with complete SCI still have surviving somatosensory nerve fibres at the level of the spine. For those with complete SCI this is hopeful news as it means -- contrary to previous belief that communication to the brain had been severed by injury -- that the brain is still receiving messages. This new SCI type is labelled “discomplete SCI” -- a SCI person who cannot feel touch, but touch information is still forwarded from the foot to the brain. The project will use virtual reality (VR) in a way it has never been used before. We will develop the first immersive VR interface that simultaneously enhances surviving spinal somatosensory nerve fibres and touch signals in the brain in an effort to restore touch perception in people with discomplete SCI. In other words, immersive VR is being used to re-train the brain to identify the distorted signals from toe to head as sensation (touch). For example, participants will receive touch simulation in the real world (e.g., their toe) while at the same time receiving corresponding multisensory touch stimuli in the virtual world (e.g., experiencing walking up to kick a ball). This project is the first effort worldwide to restore touch sensation in 50% of individuals with complete injuries. The outcomes to be achieved from the current study will represent a cultural and scientific paradigmatic shift in terms of what can be expected from life with a spinal cord injury. In addition, the project allows potential identification of brain mechanisms that may ultimately represent direct targets for acute discomplete SCI rehabilitation, including efforts to preserve rather than restore touch perception following SCI. RESTORE consolidates the expertise of scientists, clinicians, VR developers and stakeholders from NeuRA and UNSW School of Psychology (A/Prof Sylvia Gustin, Dr Negin Hesam-Shariati), John Walsh Centre for Rehabilitation Research, Kolling Institute and University of Sydney (Prof James Middleton, Prof Ashley Craig and Prof Jim Elliott), Virginia Commonwealth University (A/Prof Zina Trost), Immersive Experience Laboratories LLC (Director Corey Shum) and James Stanley. If you are interested in being contacted about the RESTORE trial, please email A/Prof Sylvia Gustin ( and include your name, phone number, address, type of SCI (e.g., complete or incomplete), level of injury (e.g., T12) and duration of SCI (e.g., 5 years).