Disorders of Consciousness (DOC)

The diagnosis of patients in Vegetative States (VS) and related conditions is currently made solely on the basis of subjectively observed behaviour, with a known error rate of over 40%. We work to develop objective structural MRI markers that can be used in the clinical settings, with the final goal of reducing misdianosis in this population. In parallel, we aim to identify early prognostic biomakers that can assist the clinician when making important decisions about allocation of resources, and continuation (or otherwise) of medical care. 

Mild Traumatic Brain Injury (mTBI)

Mild traumatic brain injury (mTBI), often referred to as concussion, can result in long-term disability due to persistent headaches, imbalance, memory disturbance, and poor mental health, and ~30% of patients are not able to return to work or sport after 12 months. We are co-leading the MRI and cognition workstreams of mTBI-PREDICT, a long-term study that aims to identify the most accurate, reproducible and clinically practical biomarkers to better identify those at risk of long-term health issues after mTBI. 

We are also working to better understand differences in clinical outcomes between men and women. 

DOC

There are currently no therapies or treatments available to improve outcomes in VS patients. We are assessing the potential for several non-invasive brain stimulation techniques (namely, transcranial direct current stimulation –tDCS- and focused ultrasound stimulation -FUS-) to provide VS patients with a degree of control over their external behaviour, which would give them a physical means of interacting with the world for the first time since their injuries. This line has been funded by MRC, and HCA Healthcare (RAINDROP trial). 

Paediatric Acquired Brain Injury

Cognitive fatigue is one of the most debilitating chronic sequelae after acquired brain injury in children and young people. Fatigue interferes with the children and young people's school performance and social relationships and has a huge impact in their quality of life. We are developing a home-based therapy using non-invasive brain stimulation to help manage fatigue in these patients.

We are interested in the functional and structural bases of consciousness and its disorders. We use magnetic resonance imaging (MRI) and combine diffusion weighted imaging and functional MRI to study how damage to specific regions of the brain can generate the particular patterns of impaired or preserved cognitive function each DOC patient exhibits. Finally, we use tDCS and FUS to establish causal links between specific brain networks and awareness. This line has received funding from MRC and BBSRC.