Related Research

As author of this Blog; "Bloody Wishful Thinking", I don't necessarily endorse any of 
these resources. But, on the other-hand I think they're a bloody good read and there's
some great ideas out there! Further, if you have an idea worth sharing, then I invite you
to please let us know. My email is;  :-)

What other research is being done?

Within the (U.S)-Federal Government, the National Institute of Neurological Disorders and 
Stroke (NINDS), one of the National Institutes of Health (NIH), has primary responsibility for 
conducting and supporting research on spinal cord disorders and demyelinating 
diseases such as transverse myelitis. The NINDS conducts research in its laboratories at 
the NIH and also supports studies through grants to major medical institutions across the country.

NINDS researchers seek to clarify the role of the immune system in the pathogenesis of 
demyelination in autoimmune diseases or disorders. Other work focuses on strategies
to repair demyelinated spinal cords including approaches using cell transplantation. The 
knowledge gained from such research should lead to a greater knowledge of the mechanisms 
responsible for demyelination in transverse myelitis and may ultimately provide a means to 
prevent and treat this disorder.
The NINDS also funds researchers who are using animal models of spinal cord injury to study
strategies for replacement or regeneration of spinal cord nerve cells. The ultimate goals of these
studies are to encourage the same regeneration in humans and to restore function to paralyzed
patients. Scientists are also developing neural prostheses to help patients with spinal cord
damage compensate for lost function. These sophisticated electrical and mechanical devices
connect with the nervous system to supplement or replace lost motor and sensory function.
Neural prostheses for spinal cord injured patients are being tested in humans.

 Where can I get more information?
For more information on neurological disorders or research programs funded by the National 
Institute of Neurological Disorders and Stroke, contact the Institute's Brain Resources and 
Information Network (BRAIN) at:
P.O. Box 5801
Bethesda, MD 20824
(800) 352-9424

Other News

Pain Management education for health professionals to be delivered through 
Medicare Locals
The Australian Medicare Locals Alliance will be facilitating the development and delivery of 
pain management education for healthcare professionals, to be delivered through Medicare 

ADEM - "..Acute Disseminated Encephalo-Myelitis.."

Some good info here;

Drug allows morphine to relieve pain without addiction | New Scientist

"A potential new treatment to prevent morphine addiction is at hand. Researchers have 
identified an immune receptor involved in addiction to the drug, and found a way to block this 
receptor without affecting pain relief." 

Back Pain Choices - National Prescribing Service

An online tool that has been developed to assist in the diagnosis and management of lower 
back pain (LBP) by primary care clinicians.
Chronic Pain and Sleep Webinar - Canadian Institute for the Relief of Pain and Disability
Information about how the sleep cycle works, what recent research says about how sleep and 
chronic pain interact and some practical strategies to get your sleep cycle back on track. 
Mindhealthconnect is a new national e-mental health online portal, developed by the 
Commonwealth Government. The portal provides access to information and treatment as an 
alternative to 
traditional face-to-face services, as well as information on high prevalence conditions such as 
depression and anxiety. Find out more...

Some "SCIs" - Facts & Stats...

In Queensland, around 90 spinal cord injuries are sustained every year. • Most spinal cord injuries happen to people under the age of 35. • More than 70% of spinal cord injuries are sustained by men. • The main causes of traumatic spinal cord injuries are road trauma, falls and water related accidents. • In 2010-11, 40 % of SCIs resulted in quadriplegia, and 60% in paraplegia. Source: Princess Alexandra Hospital’s Spinal Injuries Unit 2012. • More than 10,000 people in Australia have a spinal cord injury. Source: Spinal Cord Injury Network 2011. • The proportion of people with disabilities globally is rising and now stands at 1 billion, accounting for 15 per cent of the world’s population, according to the first official global report on disability. Read moreSource: World Report on Disability by the World Health Organisation 2011. • The lifetime cost per incidence of paraplegia is estimated to be $5 million. • The lifetime cost per incidence of quadriplegia is estimated to be $9.5 million. • The total cost of spinal cord injury in Australia is estimated to be $2 billion annually. Source: Access Economics 2009. • If just 10% of carers were able to return to the workforce because their family member with a disability had appropriate personal support, there would be a $3 billion boost into the economy. • If just 2% of people with a disability could come off the pension to work because they had appropriate employment training, then there would be an injection of $2.5 billion into the economy. Source: National Disability Services 2010.

The Facts - Transverse Myelitis is a neurological disorder caused by inflammation across both sides of one level, or segment, of the spinal cord. Attacks of inflammation can damage or destroy myelin, the fatty insulating substance that covers nerve cell fibers. This damage causes nervous system scars that interrupt communications between the nerves in the spinal cord and the rest of the body.

Researchers at UQ's Queensland Brain Institute (QBI) have discovered a new brain mechanism that plays an important role in regulating how we experience pain. Scientists from QBI's synaptic plasticity laboratory discovered the new mechanism while studying the amygdala – the part of the brain that deals with our emotional responses. 

QBI has one of the relatively few laboratories around the world currently looking at how the amygdala deals with pain inputs. According to QBI's Dr Andrew Delaney, there are essentially two aspects to pain. “You have a sensory component that tells you where you are hurting and what sort of hurt you've had, and there's the emotional response you have to that event,” he said. 

The sensory part of pain is quite well understood but until now very little had been done to look at the emotional part of pain.” QBI scientists used an anatomical technique which involved labelling the neurons in what is essentially the brain's pain-relay station (the parabrachial nucleus) to identify target cells in the amygdala that receive inputs during pain. 

Researchers were able to record electrical responses in the amygdala when the pain inputs were stimulated electrically. “People have long thought there's a connection between your experience of pain and the emotional state that you're in,” Dr Delaney said. 

Historically, this has been borne out by first-hand reports from people who have suffered a traumatic injury during the height of combat and yet gone on to all but ignore their injury for some time. A similar phenomenon happens on the sporting field where, during the game's emotional zenith, a player injures a knee or ankle but manages to finish the play or walk off. 

For many years, this was thought to be a spinal cord effect, whereby the release of hormones during heightened emotions inhibit the transmission of pain – sometimes called the "gate theory" of pain. “Our findings indicate that there is also an interaction between the stress pathways in the brain and the pain pathway that targets the amygdala,” Dr Delaney said. 

"This seems to indicate that during times of stress, our emotional response to pain may also be modulated, perhaps reducing the emotional impact of a painful experience.” QBI scientists have shown, for the first time, that the stress hormone noradrenaline acts as a fast modulatory transmitter in the brain and that the way this transmitter works at these pain synapses was by scaling down the size of the pain inputs. 

Such a mechanism had not previously been identified in the brain and it is one which is ideally suited to providing strong control over the activation of the emotional response, even when strong painful input activates the pathway to the amygdala. 

According to QBI's Head of Synaptic Plasticity, Professor Pankaj Sah, people who suffer chronic pain have higher incidence of anxiety disorders, conditions known to involve dysfunctional processing in the amygdala. “This study reveals an important site for interaction between the pain and emotional systems of the brain, potentially offering a key connection to how this might be occurring,” he said. 

Ultimately understanding how these systems interact at the synaptic level might reveal the nature of these dysfunctional states and offer an insight into how we might better treat such conditions.” The research – "Noradrenaline Modulates Transmission at a Central Synapse by a Presynaptic Mechanism" – is published in the journal Neuron and is downloadable here.


For more information, please contact: QBI Communications Office Tel: +61 7 3346 6434

Notes to the Editor


The Queensland Brain Institute was formed in 2003 as part of the Queensland Government’s Smart State Initiative, building on a long history of neuroscience at The University of Queensland.  QBI is dedicated to understanding the molecular basis of brain function and applying this knowledge to the development of new therapeutics to treat brain and mental health disorders.

Stem Cell Research and the Rare Neuroimmunologic Disorders

Dr. Michael Levy
Assistant Professor of Neurology
Transverse Myelitis Center
Johns Hopkins Medical Center

Stem cells offer the best hope of neu-rologic recovery in transverse myelitis, acute disseminated encephalomyelitis, neuromyelitis optica and optic neuritis.

Stem cells are defined as an immature cell that has the potential to develop into a mature, functioning cell. In the developing embryo, for example, all cells are initially stem cells. As the embryo begins to grow tissues, those stem cells mature into functional cells that make organs like the liver, kidney and brain (Figure 1 next page - Mike Jones [CC-BY-SA-2.5], via Wiki-media Commons). There are many steps cells take in their development between the early embryonic stem cell stage and the final mature cell stage. At each point in their development, they become more and more special-ized toward their fate. The goal of us-ing stem cells for clinical benefit is to take advantage of their potential to grow into cells that are missing from the patient or need to be replaced. In the case of transverse myelitis, the goal is to regenerate spinal cord cells that were lost due to inflammation.

The classic teaching in neurology is that once you destroy neurologic tissue from disease, infection or trauma, there is no regeneration. In this way, the spinal cord is very different from other organs such as the kidney, liver and bone marrow which have a re-markable capacity to regenerate. We now recognize that there is some re-covery by endogenous mechanisms in the spinal cord. Endogenous regenera-tion refers to the ability of the patient’s own stem cells to migrate to the site of the damage and initiate repair. These stem cells originate deep in the brain and can travel down to the spinal cord when needed. But in the majority of spinal cord damage in humans, the stem cells that arrive mysteriously do not mediate repair and eventually die off. There is an effort to understand this potential repair mechanism and enhance it (see Biogen’s new drug in development: anti-Lingo antibody) and that is the subject of another review article.

There are other stem cell trials taking place in diseases related to transverse myelitis, but they do not focus on re-generation. Rather, these “stem cells” which come from the bone marrow, are used to modulate the immune system in patients who have recur-rent inflammatory disease, such as multiple sclerosis, neuromyelitis optica, or recurrent transverse myelitis. The bone marrow contains two types of stem cells, those that will become immune cells and the rest are called mesenchymal stem cells.

Immune stem cells are being studied for their ability to reboot the immune system in patients with recurrent disease. The approach is similar to a bone marrow transplant in which a small number of the patient’s healthy immune stem cells are harvested and stored in the lab while chemotherapy drugs are used to wipe out the rest of the immune system. Then the healthy

immune stem cells are replaced and the immune system reboots entirely from those healthy immune stem cells. This approach is not useful for patients who have monophasic, idiopathic transverse myelitis because those pa-tients do not have an aberrant immune system; rather, those patients have a healthy immune system that made one devastating mistake in the past.

(to be continued)...