Each tile includes a summary and discussion of the aims of current research projects at NeuRA.
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This project aims to deliver the most comprehensive, detailed and stereotaxically accurate MRI atlas of the canonical human brain.
In human neuroscience, researchers and clinicians almost always investigate images obtained from living individuals. Yet, there is no satisfactory MRI atlas of the human brain in vivo or post-mortem. There are some population-based atlases, which valiantly solve a number of problems, but they fail to address major needs. Most problematically, they segment only a small number of brain structures, typically about 50, and they are of limited value for the interpretation of a single subject/patient.
In contrast to population-based approaches, the present project will investigate normal, living subjects in detail. We aim to define approximately 800 structures, as in the histological atlas of Mai, Majtanik and Paxinos (2016), and, thus, provide a “gold standard” for science and clinical practice. We will do this by obtaining high-resolution MRI at 3T and 7T of twelve subjects through a collaboration with Markus Barth from the Centre for Advanced Imaging at the University of Queensland (UQ). The limited number of subjects will allow us to image each for longer periods, obtaining higher resolution and contrast, and to invest the required time to produce unprecedented detail in segmentation.
We will produce an electronic atlas for interpreting MR images, both as a tablet application and as an online web service. The tablet application will provide a convenient and powerful exegesis of brain anatomy for researchers and clinicians. The open access web service will additionally provide images, segmentation and anatomical templates to be used with most common MR-analysis packages (e.g., SPM, FSL, MINC, BrainVoyager). This will be hosted in collaboration with UQ, supporting and complementing their population-based atlas.
Researchers from NeuRA, the University of New South Wales the University of Sydney, and HammondCare have found surviving sensory spinal nerve connections in 50 per cent of people living with complete thoracic spinal cord injuries.
The study, which is part of a decade-long collaboration between the researchers, used cutting-edge functional MRI (fMRI) technology to record neural response to touch. It was Dr Sylvia Gustin who analysed the fMRI images to identify the moment the patient’s brain registered the touch.
“Seeing the brain light up to touch shows that despite the complete injury to the thoracic spine, somatosensory pathways have been preserved,” explains Dr Gustin.
“It’s fascinating that although the patients did not ‘feel’ the big toe stimulation in the experiment, we were able to detect a significant signal in response to the touch in the brain’s primary and secondary somatosensory cortices, the thalamus, and the cerebellum.”
For those living with a complete spinal cord injury this means, despite previously believing the communication to the brain had been severed in the injury, messages are still being received. Dr Gustin describes this new category of spinal cord injury as ‘discomplete’
“The current classification system is flawed. It only contains two types of spinal cord injury – complete and incomplete,” says Dr Gustin.
“It is important we acknowledge there is a third category – the ‘discomplete’ injury, only then we can provide better treatment regimens for the many sufferers of a complete spinal cord injury.”
For those newly classified as ‘discomplete’, this discovery opens up new opportunities to identify those people living with a spinal cord injury that are more likely to benefit from treatments aimed at improving sensation and movement. Because of this study, research participant, James Stanley, now knows he belongs to a new category.
“It is exciting to know that there is a connection there, that my toe is trying to say hello to my brain,” says James.
“If medical professionals can work to identify people like me with a ‘discomplete’ injury earlier, perhaps they can find new treatments and rehabilitation techniques.
“The thought that one day I might be able to feel the sand between my toes again, or the waves wash over my feet gives me hope. It’s something Dr Gustin’s discovery has made possible.”
The Caring for Spirit project is focused on providing a centralised online source of evidence-based resources and information that are culturally appropriate and appealing to Aboriginal and Torres Strait Islander communities. The team is translating the results of current research into culturally relevant and accessible information, education and training for people living with dementia, their families and carers, as well as for Aboriginal Health Workers.
We have engaged the services of Aboriginal staff, consultants, and graphic and website designers to achieve the appropriate look and feel. Community engagement and approval is essential and we are working with our Aboriginal community partners across NSW, as well as through our diverse networks to ensure national impact. Advice and feedback from these partners will be used to refine the resources. Growing old well is something we all want for our communities, but we also know that many things happen in our lives that could influence this process. A diagnosis of dementia can have an influence on our mind, body and spirit. This project is focused on translating the results of current research to keep our mind, body and spirit well, through education and training. This is important for people living with dementia, their families and carers, as well as for Aboriginal Health Workers. It is anticipated that these resources will contribute to enhancing the lives of Aboriginal and Torres Strait Islander people and their carers who are living with dementia, and contribute to alleviating the high burden of dementia in this population.
The project, Sharing the Wisdom of Our Elders, comes in response to research highlighting the limited awareness of ageing and dementia across Aboriginal communities and requests from partnering communities (as part of the Koori Growing Old Well Study) for a strengths-focused and Aboriginal specific teaching resource to increase community knowledge of dementia prevention. This project acknowledges the central role that Elders have in the health and wellbeing of Aboriginal Communities, and the role that art has in representing their stories and traditions.
This project is funded by The Lowitja Institute (2018-2019), and focuses on the theme of Strong Elders and responds to the question: “what is good and healthy ageing for Aboriginal and Torres Strait Islander people?” In the Koori Growing Old Well Study, participants were asked to described what they have learnt, throughout their lifetime and diverse experiences, is important for growing old well. This project will represent the responses of Elders in artwork and stories.
It is estimated that 1.2 million Australians are currently caring for someone with dementia. Caring for somebody with dementia can become more complicated by the presence of behavioural problems (e.g. depression, anxiety, apathy, aggression) in the person with dementia. These behavioural problems can contribute significantly to carer burden and distress. This study aims to improve our understanding of how interactions between the carer and the care-recipient affect behavioural problems in dementia. A better understanding of these interactions will help us develop programmes which can be used to assist the carer and those suffering from dementia to minimise the negative impact of problem behaviours in dementia.
Rates of behavioural and psychological symptoms of dementia (BPSD) amongst people living in residential aged care facilities (RACF) are high. Over 90% of Australian aged care residents exhibit clinically significant BPSD. Physical aggression, agitation and disinhibition, especially when severe, are difficult to manage and can put patients, carers and other residents at risk. Management of BPSD has recently become a focus of attention for the Australian Government, especially in relation to inappropriate overprescribing of antipsychotics. The discrepancy between international and national recommendations and the continued over-prescription of medication to manage BPSD must be addressed. Australia urgently needs better programs to support RACF to implement non-pharmacological, cost-effective management programs.