An Extended Follow-up Of Stroke Patients For Cognitive Impairment And Neuropsychiatric Disorders: Sydney Stroke Study
Funder
National Health and Medical Research Council
Funding Amount
$321,800.00
Summary
Vascular Dementia (VaD) is the second most common cause of dementia after Alzheimer's disease. In fact, it may be a preventable cause of dementia. Yet it has been relatively neglected by researchers until the last decade, which has seen an upsurge of interest in this disorder. There is no consensus on the criteria for dementia. The profile of early cognitive impairment due to vascular factors is still poorly understood, and the longitudinal course of VaD as defined by modern criteria has not bee ....Vascular Dementia (VaD) is the second most common cause of dementia after Alzheimer's disease. In fact, it may be a preventable cause of dementia. Yet it has been relatively neglected by researchers until the last decade, which has seen an upsurge of interest in this disorder. There is no consensus on the criteria for dementia. The profile of early cognitive impairment due to vascular factors is still poorly understood, and the longitudinal course of VaD as defined by modern criteria has not been studied. There have been few studies of the progressive changes in MRI in patients with cerebrovascular disease. The overlap of VaD and Alzheimer's disease (AD) remains a problem for taxonomists and clinicians. One approach to the study of VaD is to examine a high risk group of subjects longitudinally to determine the early features, the risk factors and progressive changes. With this in mind, we began studying a cohort of stroke patients who are at high risk of VaD, in 1997-1999, and are following them longitudinally. The follow-up is now in its third year, and three neuropsychological assessments and two MRI-MRS scans have been performed. We propose to extend the follow-up to 5 years, with repeat neuropsychiatric, neuropsychological and MRI-MRS investigations, and wherever possible to necropsy, to determine the nature of vascular pathology that underlies cognitive impairment. Our cohort of stroke patients is arguably the most comprehensively assessed such cohorts internationally, and presents an excellent opportunity for a long-term follow-up study.Read moreRead less
THE NATURAL HISTORY OF COGNITIVE IMPAIRMENT AND DEMENTIA IN A STROKE COHORT
Funder
National Health and Medical Research Council
Funding Amount
$290,747.00
Summary
In a current NHMRC-funded study, we have examined 200 stroke patients (and 100 control subjects) at 3 months after a stroke and one year later, and identified those who have impairment in memory and other cognitive functions. We have also studied these subjects in detail from a psychiatric perspective and performed brain scans on them using magentic resonance imaging. We find that many stroke patients have problems with their cognitive functioning which has a major impact on their lives. A large ....In a current NHMRC-funded study, we have examined 200 stroke patients (and 100 control subjects) at 3 months after a stroke and one year later, and identified those who have impairment in memory and other cognitive functions. We have also studied these subjects in detail from a psychiatric perspective and performed brain scans on them using magentic resonance imaging. We find that many stroke patients have problems with their cognitive functioning which has a major impact on their lives. A large number also become depressed. These consequences of stroke are not given sufficient importance by clinicians. The fact that stroke is a common problem in the elderly, and our society is aging, makes this a problem of major public health significance. In the new proposal, we plan to study these subjects up to 3 years with repeat neuropsychiatric assessments and brain scans to investigate the natural history of stroke-related cognitive impairment. We will determine whether further new cases of dementia develop in the period 1-3 years, what happens to the brain lesions picked up on brain scans, and how these deficiencies affect the patients' living status and their longevity. We will be able to determine the factors that lead to a good outcome, and suggest strategies that may be applicable to improve the functioning of these individuals.Read moreRead less
Delineating The Anatomical Correlates Of Neurocognitive And Psychomotor Dysfunction In Depression By FMRI
Funder
National Health and Medical Research Council
Funding Amount
$388,340.00
Summary
Severe depression is characterised by slowing of mental and motor abilities. Previous research by our group indicates the role of small frontal and basal brain regions in the regulation of these abilities. This research will extend our previous studies by providing new information detailing the underlying physiology of behavioural and structural abnormalities in patients with severe depression. Emerging research by our group and others suggest that some types of severe depression in later life a ....Severe depression is characterised by slowing of mental and motor abilities. Previous research by our group indicates the role of small frontal and basal brain regions in the regulation of these abilities. This research will extend our previous studies by providing new information detailing the underlying physiology of behavioural and structural abnormalities in patients with severe depression. Emerging research by our group and others suggest that some types of severe depression in later life are due to undetected forms of cerebrovascular disease. If we are able to demonstrate that the key features of severe depression of this type (psychomotor, attentional, memory and executive disturbance and global disability) are related to such brain changes this may lead to a major breakthrough in the prevention and treatment of these disorders. A new type of brain imaging technology called 'functional Magnetic Resonance Imaging' (fMRI) permits simultaneous investigation of the structure and function of small areas of the brain. As the technique does not use radiation and can be performed while the patient is completing mental tasks, it can be used in repeated experiments. Consequently, it permits description of brain changes (areas of activation) that occur during specific mental tasks. Therefore, if we are now able to use this technique to extend our previous clinical and imaging studies we will be able to test whether some forms of late-life depression are due to undetected brain changes.Read moreRead less
A Randomised Control Trial Of A Group-Based Intervention For Substance Abuse In Psychosis.
Funder
National Health and Medical Research Council
Funding Amount
$345,250.00
Summary
The use of alcohol and illicit substances is common amongst people with psychotic illnesses, and is associated with a poor outcome in terms of severity of symptoms, treatment adherence, work-studies, family cohesion, aggression and quality of life. All this adds significantly to the cost of mental health services and society more broadly. The proposed study aims to refine, pilot, and rigorously evaluate a group-based intervention that targets substance use in such individuals at different stages ....The use of alcohol and illicit substances is common amongst people with psychotic illnesses, and is associated with a poor outcome in terms of severity of symptoms, treatment adherence, work-studies, family cohesion, aggression and quality of life. All this adds significantly to the cost of mental health services and society more broadly. The proposed study aims to refine, pilot, and rigorously evaluate a group-based intervention that targets substance use in such individuals at different stages of their illness, and within a number of different treatment settings. The intervention will be informed by an enhanced understanding of the motivations for substance use in people with psychotic illnesses The specific aims are to: Refine, implement and evaluate, using a controlled experimental design, a novel group-based intervention for reducing substance abuse comorbidity in people with psychotic disorders; Determine reasons for substance use by these individuals, to inform the intervention procedures; Pilot the intervention in a series of different treatment settings, including early episode and rehabilitation programs, and non-government organisations dealing with people with psychotic disorders, to ensure generalisability, adaptability, and acceptability; Augment case managers' knowledge and skills in dealing with comorbid drug and alcohol use Enhance detection, motivation to change, ongoing monitoring and relapse prevention of substance misuse in clients with psychotic disorders. It will also be possible, once the treatment intervention is finalised and evaluated, to expand its use to patients with non-psychotic mental illnesses.Read moreRead less
Memory, Synaptic Plasticity And Gene Networks In Schizophrenia
Funder
National Health and Medical Research Council
Funding Amount
$1,142,138.00
Summary
Schizophrenia affects about 1% of the population. Its typical progression over a lifetime leads to long-term impairment of cognition, reality distortion, and an impoverished quality of life. Most likely, multiple genes, interacting together or with environmental factors, are involved. Using a novel approach to its partition, WA researchers aim to unravel complex networks of genes affecting memory and brain function in a cognitive deficit subtype of schizophrenia they have identified recently.
Ocular Motility In Autism And Asperger S Disorder: Dissociation Of Motor Deficits.
Funder
National Health and Medical Research Council
Funding Amount
$131,235.00
Summary
We will use ocular motor technology to investigate motor dysfunction in autism and Asperger's disorder, to advance our understanding of the neurobiological bases of these disorders. This will help clarify whether neural networks are differentially disrupted in these disorders, as our previous clinical research suggests. This dissociation and the subsequent development of an ocular motor clincal screen may improve diagnosis, and potentially treatment, of these devastating conditions.