Professor Arun Vishwanathan Krishnan

PERIPHERAL NEUROPATHY RESEARCH

Our major area of interest is in peripheral nerve disease. We undertake detailed studies using neurophysiological techniques that provide novel insights into the causes of peripheral nerve injury that are of highest global prevalence. This includes nerve injury due to diabetes, renal impairment and toxin exposure, particularly chemotherapeutic agents. We also have an interest in understanding the causes of facial nerve and intra-operative nerve injury. Our studies of neuropathy focus on the development of novel biomarkers that can detect nerve injury at an early stage. We are also undertaking a number of clinical trials of neuroprotective agents that may help prevent or treat nerve injury. These strategies have been developed using data generated from our own studies of disease pathophysiology.

Diabetic neuropathy

Diabetes affects approximately 1.2 million Australians and is frequently complicated by a debilitating form of neuropathy termed diabetic neuropathy. Diabetic neuropathy typically begins with symptoms such as pain, tingling and numbness and can lead to ulceration and in more severe cases amputation. At present there is no cure and standard clinical neurological assessments are unsatisfactory for detecting early changes. Our studies have focused on biomarkers of nerve dysfunction in this cohort. We have utilised novel neurophysiological techniques and identified early nerve dysfunction in patients with diabetes in the absence of clinical signs and symptoms of neuropathy. Further to this, our investigations have indicated that in type 1 diabetes, the form of insulin administration may have an impact on neuropathy development. We are building upon these studies by undertaking a clinical trial of neuroprotective treatments for diabetes in addition to uncovering new therapeutic targets for prevention of complications.

Neuropathy in chronic kidney disease

Chronic kidney disease (CKD) is a serious condition that affects 1.7 million Australians. Our studies have demonstrated that nerve injury (neuropathy) occurs in ~80% of CKD patients. We have identified that high levels of potassium cause nerve injury in CKD and that dietary potassium restriction may help prevent neuropathy progression. We also are investigating the effects of renal transplantation on neurological function and the impact of cognitive impairment on functional outcomes in CKD.

Chemotherapy-induced peripheral neuropathy

Chemotherapy-induced peripheral neuropathy (CIPN) is a major side effect in the treatment of cancer, affecting up to 40% of cancer survivors. This can impose limitations on the patient to perform common ADLs and reduce their quality of life.

Common symptoms of CIPN include:

• Numbness
• Tingling, ‘pins and needles’ or electric shock-like sensations
• Burning sensations, sharp or stabbing pain
• Balance problems

We are currently conducting studies that investigate the impact of CIPN on cancer survivors. These studies utilise new methods and techniques used to assess and diagnose the impact of CIPN, with an emphasis on nerve function, sensation and dexterity.

Facial and intraoperative nerve injury

We have a significant interest in understanding the mechanisms of facial nerve injury due to many different causes, including traumatic and inflammatory aetiologies. We also undertake studies aimed at reducing the impact of intra-operative nerve injury, which occurs as an adverse effect of many surgical procedures. We also work with industry on the advancement of nerve monitoring technology and collaborate broadly with molecular biology and biomedical engineering teams to create new technologies to prevent and treat nerve injury. 

MULTIPLE SCLEROSIS RESEARCH

We have an extensive programme of clinical research in multiple sclerosis (MS), which is the most prevalent cause of non-traumatic neurological disability in young Australians. We are currently investigating the causes of fatigue in MS and have ongoing studies that explore the potential utility of novel medications for motor fatigue in MS. We are also involved in research that investigates the potential contribution of sleep-disordered breathing to fatigue in MS. 

Broad Research Areas:
Neurology, Neuroscience, Clinical Research, Diabetes, Renal Disease, Multiple Sclerosis, Cancer

Qualifications:
MBBS, PhD, FRACP

Specific Research Keywords:
Neurology, Neurophysiology, Ion Channels, Cancer, Multiple Sclerosis, Renal Disease, Diabetes and Endocrinology