Research shaping
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The Perron Institute’s Centre for Restorative Neurology includes Restorative Neurology Research and Clinical Psychology Research.

Restorative Neurology Research

The Centre for Restorative Neurology is a new initiative focusing on research to improve functional recovery of patients after neurological illness or injury including stroke, head injury, Parkinson’s disease and multiple sclerosis. Led by Clinical Professor Soumya Ghosh, this research is multidisciplinary and uses state-of-the-art methodologies, including robotic arm therapy, balance assessment and therapy, cognitive assessment and therapy and non-invasive brain stimulation.

Research Focus

The ultimate goal of the Centre – the first of its kind in Australia – is to develop multidisciplinary programs targeted at promoting recovery and functional improvement neurological patients.

Neurological disorders are one of the leading causes of disability in Australia. In spite of advances in prevention and acute care, a large proportion of patients with cerebrovascular, inflammatory and neurodegenerative disorders are left with significant deficits.

Recovery from neural injury is thought to occur through processes of “relearning” and “neuroplasticity”, and newer techniques such as computer-assisted robotic therapy, cognitive therapy and non-invasive brain stimulation are being increasingly trialed to hasten this relearning process and improve outcomes.

The Centre is active in developing appropriate clinical trials for evaluating newer therapies and understanding mechanisms of neuroplasticity. The Centre also routinely evaluates patients for recruitment into one of these clinical trials.

Members

Achievements

GRANTS

Neurotrauma Research Programme

Augmenting Stroke Rehabilitation with Non-invasive Brain Stimulation
Ghosh S, Thickbroom G and Cooper I ($76,245).

Princess Margaret Hospital Foundation

Understanding brain maturation in premature babies: the use of the standard video EEG to study electrical activity of the brain and neonatal seizures, and predict neurodevelopmental outcomes
Nagarajan L, Ghosh S et al. ($77,000)

MS Research Australia incubator grant

Enhancing balance and gait in patients with Multiple Sclerosis – combined use of balance training (using smart balance master) with non-invasive brain Stimulation
Ghosh S et al. ($25,000)

PUBLICATIONS

  • Lakshmi Nagarajan , Ashleigh Murch, Reimar Junckerstorff, Peter Shipman, Rex Henderson, Soumya Ghosh (2015) Child with a heterozygous deletion of 2 Mb that includes the DAG 1 gene, presenting as developmental delay.  Journal of Pediatric Neurology. (In Press)

Brain Plasticity

The Perron Institute’s Brain Plasticity Research, which includes non-invasive brain stimulation, is now led by Clinical Professor Soumya Ghosh and has been in operation for 25 years.

Brain plasticity refers to the ability of the brain to modify itself in order to respond to new circumstances and to learn new behaviours. The brain has multiple mechanisms that enable it to do this. In neurological disorders, brain plasticity is one of the cardinal methods whereby the brain responds to injury or to progressively developing conditions. An example of brain plasticity is when an uninjured part of the brain takes over a function that used to be performed by a part of the brain that has sustained an injury. For example, the language centres of the brain are normally located in the left hemisphere of the brain in right-handed individuals, but after a stroke that damages that hemisphere, the right hemisphere can acquire language-processing abilities.

Non-invasive brain stimulation is used to up-regulate brain plasticity, to encourage reorganisation in the brain that could lead to some functional improvement in neurological disorders.

The main form of brain stimulation is transcranial magnetic stimulation, which uses electromagnetic induction to stimulate brain cells painlessly and non-invasively using a stimulator coil placed outside the head. The Group has developed stimulation strategies that up-regulate or down-regulate the brain activity underlying the coil, and have shown that under some circumstances, this can lead to improvement in motor performance.

Transcranial direct current stimulation is also a technique used, which passes a very low DC current through the brain that can modulate brain-firing patterns. We are currently trialing this in combination with rehabilitation robotics in stroke, as part of the Restorative Neurology program.

As well as stimulating the brain, we have also recorded function in the brain with functional magnetic resonance imaging (fMRI). This has enabled us to study motor, sensory and language systems, and is used in clinical applications for neurosurgical planning.

Current research involves combining these brain stimulation methods with state-of-the-art rehabilitation tools such as rehabilitation robotics. The institute has acquired the first MIT-MANUS robot in Australia. The device, developed at the Massachusetts Institute of Technology, is used for upper limb rehabilitation after neurological illness or injury. This device has been given Category A approval by the American Heart Association for use in stroke rehabilitation. It will enable the Perron Institute to carry out highly reproducible physical therapy in combination with defined brain stimulation protocols, to endeavour to improve function in neurological disorders.