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NeuRA Magazine #20

UNDERSTANDING SOFT TISSUE CHANGES IN CHILDREN

Dr Lauriane Jugé with a device used as part of the study

When human tissue, such as muscles or some organs, are affected by disease, they can become stiffer than surrounding muscle tissue. Traditionally, medical practitioners have used the palpation technique – using their hands to determine the firmness of tissue, for instance around the abdomen – to feel for changes in tissue stiffness in order to diagnose illness or disease.

While this is an effective technique, not all tissue is accessible to a physician’s hand. In these cases magnetic resonance elastography (MRE), a non-invasive medical imaging technique, has been developed to assess the stiffness of tissue such as the brain.

Prof Lynne Bilston’s team, which includes Dr Lauriane Jugé is particularly interested in changes in tissue stiffness in the brain and muscles and how this changes in neurological and muscle disorders. During their research they came to realise that while there is a lot of data on stiffness in adult tissue, there was little to none when it came to children. To answer this they are working on new methods to measure the properties of tissue when it is in use or under stress, either as a result of accident or disease.

One of the areas they are particularly interested in studying involves keeping children safe during car accidents. Current injury criteria and anthropomorphic test dummies, for example, are based on scaling adult anatomy to match children’s anatomy. Despite this, the dummies use adult tissue properties, even thought there is evidence that this can result in flawed injury criteria that cannot predict injury outcome in real children.

One of their current studies involves using MRE and diffusion tension imaging to find a more accurate way to assess and measure soft tissue changes in children. In doing this they hope to be able to quantify the mechanical properties and microstructure of tissues in healthy children in order to better predict the responses of these tissues in situations such as car accidents or disease. They’re confident that they will be able to fill in the critical gap in knowledge to so they can create accurate computational models of the body for use in child injury prevention, and other medically-related fields.

See what’s going on at NeuRA

FEEL THE BUZZ IN THE AIR? US TOO.

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 (s.gustin@unsw.edu.au) 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).
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