An integrative approach to understanding brain-related medical disorders Multidisciplinary The Brain Dynamics Centre consists of a team of multidisciplinary researchers based at the Department of Psychological Medicine, Westmead Hospital. The centre has links spanning three Universities and seven departments, to create an integrated research team. We have 5 International collaborations. There will be 25 PhD students linked to this centre, in 2001. Using Computerized Brain Imaging Technologies to explore the timing of brain function and where and when the activity occurs, we have developed a number of entirely new ways to analyse and model patterns of brain dysfunction. Brain disorders - impact on our community Forty percent of people are likely to experience a brain-related illness during their lifetime. At any one time, one in 15 adults or children you meet will be experiencing some form of brain disorder or mental health problem. This equates to 1.25 million Australians, and 400 million people world wide. Of all people who turn to the medical and health services for help, at least one is troubled by these disorders - which are often not correctly diagnosed or effectively treated. Neuropsychiatric (brain-related) disorders represent 11.5% of the worldwide burden of disease. World Health Organization statistics (http://www.who.int/mental_health In Australia, brain disorders are the third largest group in terms of health costs - $3 billion or 9.6% per annum of total health expenditure. Australian Institute of Health and Welfare report, 2000 Unlike physical illnesses, brain-related illnesses are a problem of the young. Brain disorders commonly reflect disturbances at critical points in the development of young individuals. They often remain as a life-long impairment, that disrupts essential areas of life functioning, including motivation and emotion. A focus on Neuropsychiatric disorders of Motivation and Emotion The Brain Dynamics Centre is focusing on disorders of the brain systems that regulate motivation and emotion. Given the importance of emotion and motivation to our everyday functioning, breakdowns in these brain systems can produce neuropsychiatric disorders that disrupt critical aspects of interpersonal communication, concentration and attention, emotional regulation, and the ability to integrate thoughts and emotions. We translate information about the brain and brain disorders into clinical practice and treatment by bringing together neuroscience researchers from a range of disciplines with clinical doctors who are involved in treating neuropsychiatric disorders. The disorders we focus on, and the predictions we are researching, are: ADHD - 3-5% of children have an ADHD diagnosis, and 35% of child referrals to mental health services are for ADHD. The primary symptoms are inattention, hyperactivity and impulsive behaviour. Our central prediction: ADHD reflects a failure of frontal brain inhibition of appropriate responses. Schizophrenia - We focus in particular on the early episodes of psychosis. 20,000 young Australians aged 15-24 could develop schizophrenia psychosis by their 25th birthday (Health. Dept.). Over 2,000 babies are born each year who go on to develop schizophrenia. It is the greatest single contributor to youth suicide, and responsible for more deaths than AIDS, SIDS, multiple schlerosis and melanoma combined. Core symptoms include hearing internal voices, believing others are intending to harm or control them, disordered thought and emotion, and social withdrawal. Psychosis is often associated with substance use, possibly as a means of self-medication. Our central prediction: Schizophrenia is a breakdown in the integrative brain function - the failure to integrate thoughts and emotions produces misattributions about the context of incoming information (e.g.., irrelevant information is processed as relevant, the emotional intentions of others are misinterpreted), and a lack of goal-directed motivation. PTSD - follows traumatic events such as childhood abuse, assault, and severe accidents (conservatively, 5% of children and adolescents are exposed to these traumas, and at risk of PTSD). Common symptoms are emotional disturbances, intrusive and distressing memories of trauma, nightmares, avoidance of anything related to the trauma, sleep problems, hypervigilance and excessive arousal/anxiety. Our central prediction: Hypervigilance in PTSD is due to overarousal of the nervous systems and overreactivity to trauma-related stimuli reflects excessive activity of the brain's limbic (emotion) system. Social phobia - Up to 10% of people experience social phobia. It is the most common of all the anxiety disorders, and is the third most common mental disorder. Social Phobia is characterised by severe anxiety in social situations, with excessive fear of negative evaluation by others. There has been extremely little research into social phobia, despite its huge impact on social and interpersonal functioning. Our central prediction: In social phobia, there is a cognitive bias and hypervigilance towards social threat, reflected in hyperarousal and attentional avoidance of sources of threat (e.g. avoidance of eye gaze). Borderline Personality Disorder - Borderline Personality may reflect the effects of serious abuse at a critical point of brain development (up to 70% have a history of chronic childhood abuse). BPD symptoms include emotional disturbance, dissociation and a fragmented personal identity. BPD is linked to high risk for addictive behaviours (including substance dependence, problem gambling) and chronic depression. BPD is a major cause of Emergency Dept. and mental health service use due to self-harm, and 10-15% of sufferers commit suicide. Our central prediction: BPD is due to a subtle, chronic dissociative instability of limbic-frontal brain connections that follows early trauma. Depression - Major depression is the most prevalent of all neuropsychiatric disorders, and the World Health Organization reports that it is associated with the greatest disability (including disruptions to vocational, social, and interpersonal functioning). We are focusing in particular on evaluating new treatments for depression. Our central prediction: Depression reflects a breakdown in the regulation of the emotional brain (limbic structures) and the 'fight and flight' reflex (adrenocortical system) - and that the new treatments will target this breakdown. Parkinsons disease - Parkinsons Disease affects a large number of older people, and significantly impairs their control of movement and actions. Attention is now being given to the associated cognitive impairments, and the links between basal ganglia (movement dysfunctions) and limbic system (emotions). Our central prediction: Parkinsons disease disturbances are due to a failure of brain synchronization of self generated motor functions, resulting in secondary cognitive and emotional changes. Traumatic Brain Injury - Brain injuries caused by traumas (such as severe car accidents) are a major cause of neuropsychiatric and neurological impairment. The Brain Dynamics Centre team is using an integrative brain imaging approach to test each prediction. We are also focusing on identifying appropriate treatments for specific brain dysfunctions, and the objective evaluation of new treatments. Epilepsy - Our research into epilepsy currently focuses on developing a numerical brain model that predicts neural states which are indicative for epileptic seizures. We are hoping that our outcomes may one-day assist in providing objective and accurate diagnosis of subtypes of epilepsy. Integrative brain imaging and analysis approach The Brain Dynamics Centre has 10 project leaders (senior scientists) and 24 postgraduate students. It is a world leader in developing an integrative approach to imaging the brain, and analysing brain data. The new insights provided by this approach are applied to understanding neuropsychiatric disorders of motivation and emotion. The integrative approach is outlined in the book edited by our Director, Dr Evian Gordon ("Integrative Neuroscience: Bringing together biological, psychological and clinical models of the human brain", Harwood, London, 2000). In essence, integrative neuroscience is achieved by: bringing together different disciplines to provide complementary insights into central questions - our Centre covers psychiatry, psychology, neuroscience, physics, mathematics, computer science, extracting core information from the huge number of existing brain models to develop fundamental predictions about each disorder, simultaneously recording different aspects of brain and body function (rather than focusing on a single index), developing new analytical tools for examining detailed brain-body interactions and dynamics, (rather than simple averages). These developments include the first numerical simulation of whole-brain mechanisms. Our integrative brain imaging techniques include measures of: "Where" brain activity happens: MRI and fMRI Functional Magnetic Resonance Imaging (fMRI) shows us the location of different areas of activation (reflected in blood flow) in the brain that respond to different information. We are the first group to simultaneously record and analyse fMRI with body responses (e.g., arousal).   "When" brain activity happens: EEG and ERP Naturally occuring electrical activity in the brain provides a window onto how quickly we process information. We examine both the spontaneous ongoing activity (Electroencephalogram; EEG) and the specific changes in response to different information (Event Related Potentials; ERPs). We are the first to simultaneously record electrical activity and body functions (heart rate and arousal.   "How" brain activity relates to behaviour, symptoms and mechanisms The simultaneous body measures tell us how the brain is affected by our body (e.g.. how stress/anxiety/arousal changes our brain function). We also conduct clinical and psychological tests to measure neuropsychiatric symptoms, behaviour and outcomes, so we can relate brain function directly to these important clinical variables. The numerical brain simulation developed by our physicists allows us to examine directly the mechanisms underlying brain function changes in particular neuropsychiatric disorders.   'What' we attend to: Eyemovement recording We use a corneal reflection technique to record eye movement patterns as an objective, real-time index of attention. This technique enables us to relate brain function and clinical measures to cognitive performance. How can you help us? Currently, the research funding available for neuropsychiatric disorders is extremely limited. It is far less than that available for physical illnesses, and does not reflect the burden of disease on the individual, family and community that results from neuropsychiatric disorders. We value the support we currently receive from our sponsors and grant bodies - please see navigate the menu bar labelled "help us", for more information on helping us beat the diseases.

INDUSTRY PARTNER: The Brain Resource Company

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