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NeuRA Magazine #22

5 minutes with…

ASSOCIATE PROFESSOR MELISSA GREEN

Assoc Prof Melissa Green is leading research to discover how stress-related mechanisms disrupt brain maturation early in life, setting off a cascade of effects which impede normal cognitive and emotional development.

Her research uses neuroscience methods to examine the biological effects of stress among adults with severe mental disorders, as well as complementary methods from epidemiology to understand the mechanisms of mental disorder in developing children.

Victims of early childhood maltreatment are among those at highest risk of developing mental disorders. Assoc Prof Green’s newly funded project, conducted in collaboration with the NSW Government Department of Family and Community Services (FACS), will determine dynamic states of ‘risk’ and ‘resilience’ for mental disorders among children who have been maltreated before the age of 5 years.

Assoc Prof Green said, “The first few years of life represent the most rapid period of brain development, with increased plasticity of the brain making it highly sensitive to prolonged stress. Exposure to stress at this stage in the life-course may critically influence brain development in ways which put children at risk of developing mental disorders in later life.”

The new project was funded by the Australian Rotary Health’s ‘Mental Health of Young Australians’ scheme and is embedded within the NSW Child Development Study (NSW-CDS), led by Prof Vaughan Carr (UNSW and NeuRA).

This study uses repeated waves of longitudinal record linkage to follow a population cohort of approximately 87,000 children as they develop through middle childhood, adolescence, and into young adulthood.

The Rotary funded project will continue to use this routinely collected government data alongside cross-sectional surveys that were administered to the NSW-CDS child cohort at age 5 and 11 years, to determine patterns of ‘risk’ and ‘resilience’ which are evident in childhood competencies or developmental vulnerabilities. Childhood competencies will include social and emotional functioning, as well as cognitive achievements, for which normative skill levels can be determined in the general population.

The team are particularly interested in determining protective factors
(e.g. availability of family and school supports) which are associated with ‘resilience’ profiles among maltreated children, in contrast to factors which confer this persistent risk profile across early and middle years of childhood. Findings from the study will be used to make policy recommendations regarding the earliest detection of children at risk of mental disorder, and will determine targets for timely interventions to promote life-long resilience in children who are subjected to early-life adversity.

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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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