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MSWA Bulletin Magazine Spring 2021

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What is assistive technology and how can it help you? | Good health monitoring practices | Pain and pain management series: Part 2 | Farewell Marcus Stafford

RESEARCH FROM

RESEARCH FROM NEUROSCIENCE RESEARCH AUSTRALIA (NEURA) Read more at: neura.edu.au The physiology of improved functional movement with Wii therapy; Dr Penelope McNulty Successful rehabilitation after stroke is limited by many factors including trained personnel, equipment, time, and money. “One of the biggest impediments in rehabilitation is patient compliance and motivation. We have developed a novel rehabilitation strategy using the Nintendo Wii; it’s fun, cheap, and can be used in patients’ homes.” This intense but flexible program can be adapted to the individual patient’s needs and can be used for patients with good upper limb function and those with poor function. “Now that we know Wii therapy works, we need to understand how and why it works. This will allow us to further refine and develop Wii therapy so that more patients can benefit from post-stroke rehabilitation.” FROM STROKE ASSOCIATION UK Read more at stroke.org.uk Can automated stroke diagnosis help reduce its effects? University of Edinburgh, Dr Grant Mair. Stroke strikes every five minutes in the UK and it’s crucial that stroke patients are treated quickly and effectively to reduce the likelihood of death and severe disability. In very busy hospitals, there may be delays and scans can be hard to interpret even for the most experienced professionals. Artificial intelligence (AI) computer software can assist humans to interpret brain scans and they are increasingly available for use in healthcare. More research that is also independent of the companies producing the software is needed to ensure that they do increase the accuracy and speed of diagnosis, they are safe and good value for money. The researchers tested an AI software, called e-ASPECTS, developed by Brainomix Ltd Oxford UK to understand if it should be used for diagnosis of stroke in hospitals. The team looked at how well the software can identify and quantify damage to the brain caused by stroke compared to a human expert, as well as how well it identifies underlying causes of stroke symptoms eg, stroke caused by blood clot vs a bleed in the brain. They also looked at if certain clinical (eg, patient age, stroke severity) or imaging characteristics (eg, stroke type, position of patient in the scanner) have an effect on differences between the software and human diagnoses. The team will determine if using the software can save time in diagnosis of stroke compared to various types of clinicians involved in stroke care and using the software increases confidence of clinicians and influences their decisions in diagnosing stroke. The researchers collated over 4000 patient brain scans from nine studies, making this the biggest ever analysis of this software. The final results for software accuracy will be published soon. Testing with professionals is ongoing. This research sets a precedent for independent testing of AI software in stroke, which can improve stroke care by ensuring the best software is used. The results of this research and similar studies will help NHS trusts and other organisations make informed decisions when purchasing AI software. FROM HUNTINGTON’S VICTORIA Read more at: huntingtonsvic.org.au/research Targeting the Huntington’s Disease Gut Microbiome; Yifat Glikmann- Johnston. Research Duration: January 2021 – December 2022 Recruitment Dates: April 2021 – September 22 Many people with Huntington’s disease (HD) lose weight unintentionally and experience gastrointestinal disturbances, which affect their quality of life. As people with HD struggle with symptoms that lack adequate treatments, there is a critical need to understand how nonpharmacological interventions such as lifestyle factors (eg, diet, exercise, sleep) can be used to enhance quality of life until appropriate pharmacological treatments are found. 10

This research project is investigating the bacteria within the gut and the relationship between gut health and clinical indicators of HD such as mood, weight, and thinking and memory. “Our study is completely remote, meaning that participants can do the study from home. We use online questionnaires, cognitive tasks via mobile app and telehealth, and ask for a faecal sample to be sent by post. Results of this research will provide the knowledge we need about the HD gut to make lifestyle recommendations and inform other interventions that can help with gastrointestinal symptoms (eg, change in diet, taking supplements such as probiotics).” This research project is funded by the Huntington’s Disease Society of America HD Human Biology Project Fellowship awarded to Dr Yifat Glikmann-Johnston. FROM MND AUSTRALIA Read more at: mndaustralia.org.au Phase 2/3 of the Copper-ATSM clinical trial will soon commence at Macquarie University, Sydney and then at other sites across Australia. The first clinical trial of copper-ATSM as a potential treatment option for motor neurone disease (MND) started recruiting in November 2016. Copper-ATSM therapy was developed in Australia. Research has shown copper-ATSM can protect motor neurones in the spinal cord, improve MND-like symptoms, and extend the lifespan of mice with a mutated form of SOD1. It is more effective in mutant SOD1 mice than riluzole (the only approved treatment for MND). Phase 1 of the study, conducted at two sites in Australia, identified a safe dosage of copper-ATSM. The phase 2/3 trial will commence initially at Macquarie University in Sydney and then at other sites across Australia. Anyone interested in taking part in the trial will need to contact their neurologist to discuss suitability and eligibility. Phase 1 of the study recruited participants who have been diagnosed with sporadic or familial amyotrophic lateral sclerosis. Research to date has been conducted on familial MND animal models. There is no animal model for sporadic MND. However, in 2015 Peter Crouch and colleagues at The University of Melbourne and the Florey Institute found MND-affected tissues obtained from people who died because of sporadic MND had important similarities to mice that responded to copper-ATSM. This suggests that copper-ATSM may have activity in both sporadic and familial MND. A possible treatment resulting from these studies is many years away. Phase 1 determined a safe dose of copper-ATSM. Data from this trial guided researchers in setting up the next phase of the trial. The Phase 2 Cu-ATSM clinical trial will involve 80 participants and evaluate efficacy (whether the compound works as intended) and further evaluate safety. Patients involved in this phase of the trial will be randomly assigned Cu-ATSM or a placebo for 6x28 day cycles. Motor Neurone Disease Research Australia has invested more than .2 million to support three projects that aim to assist developing copper-ATSM as a potential therapeutic for MND. WOULD YOU PREFER TO RECEIVE BULLETIN ONLINE? If you would like to opt-out of receiving a paper copy of this publication, please contact communications@mswa.org.au to sign up to the e-magazine. 11

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