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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Abdominal muscle stimulation to improve bowel function in spinal cord injury

Bowel complications, resulting from impaired bowel function, are common for people living with a spinal cord injury (SCI). As a result, people with a SCI have high rates of bowel related illness, even compared with those with other neurological disorders. This includes high rates of abdominal pain, constipation, faecal incontinence and bloating. These problems lower the quality of life of people with a SCI and place a financial burden on the health system. A treatment that improves bowel function for people with a SCI should reduce illness, improve quality of life and lead to a large cost saving for health care providers. Bowel problems have traditionally been managed with manual and pharmacological interventions, such as digital rectal stimulation, enemas, and suppositories. These solutions are usually only partially effective, highlighting the need for improved interventions. The abdominal muscles are one of the major muscle groups used during defecation. Training the abdominal muscles should improve bowel function by increasing abdominal pressure. During our previous Abdominal FES research with people with a SCI, we observed that Abdominal FES appeared to lead to more consistent and effective bowel motion. However, this evidence remains anecdotal. As such, we are going to undertake a large randomised controlled trial to investigate the effectiveness of Abdominal FES to improve the bowel function of people with a SCI. This study will make use of a novel measurement system (SmartPill, Medtronic) that can be swallowed to measure whole gut and colonic transit time. We will also assess whether Abdominal FES can change constipation-related quality of life and the use of laxatives and manual procedures, as well as the frequency of defecation and the time taken. A positive outcome from this study is likely to lead to the rapid clinical translation of this technology for people living with a SCI.
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