Associate Professor Sylvia Gustin

Medicines for Back Pain

The No Worries Trial

Researchers: Associate Professor Sylvia Gustin, Nell-Norman-Nott, Dr Negin Hesam- Shariati, Dr. Chelsey Wilks (University of Washington).

Emerging evidence has shown that negative emotional states play a key role in the development and maintenance of chronic pain. The No Worries Trial will evaluate the effectiveness of a four-week internet-delivered Dialectical Behaviour Therapy (DBT) skills training to help chronic pain sufferers cope with painful, fearful, worrisome, anxious, and negative thoughts and emotions. Moreover, by having the DBT skills training online it is more accessible to those in remote communities, to those with restricted mobility, and more broadly it adds to the knowledge of internet-delivered therapies at a time when online is increasingly necessary to deliver treatment due to COVID-19.

MEMOIR – a clinical trial for Complex Regional Pain Syndrome

Complex Regional Pain Syndrome (CRPS) is a serious health condition, affecting approximately 20,000 people in Australia. It is characterised by severe burning, stinging and stabbing pain. People with CRPS are unable to use their painful limb and their ability to work or participate in normal social activities is severely restricted. Currently, there are no effective treatments for CRPS.

A vast body of research has demonstrated changes in brain processes in CRPS. The MEMOIR trial will investigate the effectiveness of two novel brain-directed treatments to reduce pain and improve function in people with CRPS.

MEMOIR consolidates the expertise of scientists and clinicians from NeuRA (A/Prof James McAuley, A/Prof Sylvia Gustin, Mr Michael Ferraro), the University of South Australia (Prof Lorimer Moseley), the University of Sydney (Prof Andrew McLachlan), the University of Notre Dame Australia Fremantle (Prof Benedict Wand, Prof Eric Visser), the University of Exeter (Prof Sallie Lamb), Brunel University London (Dr Neil O’Connell) and the University of Oxford (Dr Hopin Lee).

Due to the COVID-19 global pandemic, the commencement of MEMOIR has been delayed. Recruitment for MEMOIR will commence in September 2020.

If you are interested in being contacted about our CRPS research, please leave your details below and we will be in touch once recruitment begins. 

Spinal Cord Injury Breakthrough

Associate Professor Sylvia Gustin, Associate Professor Paul Wrigley and Professor Philip Siddall.

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 Avatar Project – Virtual Reality Intervention

The STOPain Study: Using brain-computer-interface intervention for people with neuropathic pain

Chronic pain is a significant problem worldwide affecting nearly 8 million Australians. Unfortunately, despite the availability of analgesics and other pain therapies, no treatment has been found that benefits the majority of individuals, and most of the available treatments have significant side effects or risks for serious adverse events, e.g. kidney failure.

Unravelling the link between chronic pain and mental health disorders

Chronic pain is a significant problem worldwide that results in enormous suffering and costs to affected individuals, their loved ones, and society. The experience of chronic pain is so much more than a sensation. Chronic pain impacts our emotions, cognition and social life.

A Multi-Site Randomized Clinical Trial to Examine the Efficacy and Mechanisms of Immersive Virtual W

Chronic neuropathic pain (NP) can be a debilitating secondary condition for persons with spinal cord injury (SCI) and effective pharmacological and non-pharmacological treatments remain elusive. This project brings together international experts in basic science and clinical approaches to SCI NP for a rigorous multisite randomized clinical trial to examine the efficacy and mechanisms of an advanced interactive virtual reality (VR) walking intervention (VRWalk).

RESOLVE Trial for Chronic Low Back Pain

For people with long term back pain that is not getting better. We are testing two pain treatment programs that target the brain, for people with chronic low back pain.

PREVENT

For people with a new low back pain episode. We are testing early intervention to reduce the risk of developing chronic low back pain.

SLEEPain

For people with back pain who are having trouble with their sleep. We are testing whether a simple sleep tablet will help people reduce their pain and sleep better.