NeuRA Magazine #22

LEAVING A LEGACY OF DISCOVERY

Keith and Lucille had never considered how medical research could benefit from the donation of a brain until their world came crashing down. After noticing changes
in her husband, it was revealed that Keith was living with frontotemporal dementia. About one year later, he was also diagnosed with Parkinson’s disease. They desperately wanted to help future generations, and decided together that the best way to do that was through brain donation. They knew their precious gift would not only be of tremendous value to researchers now, but that it would create a legacy of discovery for years to come. After Keith’s passing and subsequent donation, an examination of his brain revealed that he was in fact not living with Parkinson’s disease, but had lived with both frontotemporal dementia and the early stages of Alzheimer’s disease. These types of findings are crucial in helping researchers and clinicians better diagnose and treat a wide range of brain diseases and is an key part of the reason why Lucille and Keith thought it important to bequest their brains to science at the Sydney Brain Bank.

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FEEL THE BUZZ IN THE AIR? US TOO.

Abdominal Functional Electrical Stimulation for Orthostatic Hypotension in Spinal Cord Injury

Spinal cord injury (SCI) results in the loss of function to not only voluntary motor control, but also to the regulatory systems that control bodily processes. Orthostatic (postural) hypotension (OH) is a common clinical feature in SCI patients, affecting up to 73% of patients with cervical spine and upper thoracic spine injuries during mobilisation and postural changes. This often results in symptoms of dizziness, light-headedness, fatigue and confusion, in turn limiting individual participation in physical rehabilitation and restricting progress towards regaining function and independence. Therapeutic interventions are centred around ameliorating symptoms of OH; however, options for patients remain limited. Non-pharmacological treatments have had little success at treating hypotension in the long-term, while pharmacological interventions are used only when necessary as they may contribute to hypertension and even worsen episodes of autonomic dysreflexia, a life-threatening condition. Functional Electrical Stimulation (FES) is one of the only interventions that has been shown to display some benefit in improving OH. Recently, stimulation of the lower limbs has been shown to acutely increase blood pressure in patients with SCI. Our recent projects have involved the use of FES applied over the abdominal muscles, termed abdominal FES, for SCI patients at risk of respiratory complications with promising results. As this same population is at risk of orthostatic hypotension, this study aims to determine whether abdominal stimulation can also be used to help this condition. Based on our previous research, we believe that abdominal FES will increase blood pressure acutely during an orthostatic challenge in individuals with acute spinal cord injury, allowing for a longer time spent in a standing position. This will facilitate more effective rehabilitation, therefore improving quality of life and decreasing associated medical complications.
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