We have a specific interest in peripheral neuropathy that occurs in the context of diseases of high global prevalence including diabetes, kidney failure, obesity and cancer. Our research is patient focused and interdisciplinary. We have a diverse range of expertise in areas such as neurology, neurophysiology, vision science, metabolic medicine and mathematical modelling.
Our novel multidisciplinary program of research in multiple sclerosis (MS), focuses on exploring the basis of common MS symptoms such as vision changes, fatigue and sleep disturbance. We have recently commenced studies to develop new ways of monitoring inflammation in MS patients, analysing the impact of disease modifying treatments through confocal imaging of the cornea in people with MS and analysis of neuropeptide levels in the tear film.
Our vision science programme has recently expanded to migraine, focusing on ocular surface changes. In the world, migraine is the eighth leading cause of disability years lost, and the leading cause of disability days lost among people under 50. The crosstalk between migraine processes and those affecting the ocular surface is not well understood, but physiological pathways may overlap. To better monitor and manage chronic migraine, we aim to expand our understanding of the connection between ocular surface disease and migraine.
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, including chemotherapeutic agents. 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.
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 neurophysiological and morphological techniques to identify early nerve dysfunction in patients with diabetes. 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.
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:
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.
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
MBBS, PhD, FRACP
Specific Research Keywords:
Neurology, Neurophysiology, Ion Channels, Corneal Confocal microscopy, Cancer, Multiple Sclerosis, Renal Disease, Diabetes and Endocrinology