Professor Sylvia Gustin (PhD, BPsych, MPsych) is Founding Director of the NeuroRecovery Research Hub at the University of New South Wales and Director of the Centre for Pain IMPACT (*investigating pain mechanisms to advance clinical translation) at Neuroscience Research Australia. She received her PhD in Neuroscience from the University of Tubingen, Germany, in 2006. Prof Gustin has been using multimodal neuroimaging techniques to investigate the central circuits underlying chronic pain, spinal cord injury neuropathic pain and rehabilitation. Her program of research forms a translational pipeline where her basic science research informs the development of novel therapeutic interventions that are translated to improve the lives of people with a disorder affecting the brain and spine. She develops and tests new technology treatments (e.g., Virtual Reality Walking and gamified Brain-Computer Interface Neuromodulation) to ameliorate chronic pain, for example neuropathic pain after spinal cord injury, phantom pain after amputation or orofacial pain. Her research also focuses on developing and testing novel haptic virtual reality walking treatments/interfaces to offer restoration of somatosensory perception among individuals previously classified as having total sensorimotor loss. Her research is funded by the Rebecca L. Cooper Medical Research Foundation, the Australian National Health and Medical Research Council (NHMRC), the Medical Research Future Fund (MRFF), International Association for the Study of Pain (IASP), US Department of Defence (DoD), NSW Defence Innovation Network and NSW Health.
Research
THE AVATAR PROGRAM: SPINAL CORD INJURY AND RELATED DISORDERS: DISCOVERY TO CURE
Around 350 Australians are affected by a spinal cord injury (SCI) each year, many of them at a young age. The effects of a spinal cord injury are major: they can impair many critical functions that are easily taken for granted. Movement, sensation, blood pressure control as well as bowel, bladder and sexual function can all be affected. Complete spinal cord injury (SCI) is associated with total loss of sensorimotor function below the level of injury. However, in a 2018 breakthrough finding A/Prof Gustin revealed that half of all people suffering from a complete SCI still have surviving spinal somatosensory nerve fibres. This finding has received significant attention from the global science and SCI community because it reflects a paradigmatic shift in science and culture – for the first time, individuals who thought they could not move or feel below the site of injury have the potential to feel again. However, currently, there are no effective pharmacological/biological interventions to promote or restore touch perception after SCI. Consequently, there is an urgent need to develop new therapies to promote/restore touch perception after complete SCI.
Although loss of mobility is often considered the most serious consequence of SCI, people with SCI consistently rate pain as one of the most difficult problems to deal with. SCI neuropathic pain is experienced below the zone of injury and is described as sharp, burning, unbearable and terrifying. Critically, SCI neuropathic pain remains minimally responsive to existing pharmacologic and non-pharmacologic treatment. Although pharmacological agents (e.g., opioids and antiepileptics) are treatment mainstays, most provide only a third of patients 30% pain reduction and are associated with numerous negative side effects, e.g. toxicity, addiction and abuse. Consequently there is an urgent need to develop new SCI pain therapies.
The Avatar Program will address these urgent needs by developing and evaluating interventions that can provide touch restoration and pain amelioration via the primary source of touch and pain: the human brain. Over the last 13 years A/Prof Gustin has undertaken fundamental research to unravel the critical neurochemical, structural and functional brain changes that underlie SCI Rehabilitation and SCI neuropathic pain. Firstly, she has identified thalamic ‘biomarkers’ of spinal cord injury neuropathic pain and delivered the thalamocortical model for the development and chronification of neuropathic pain following SCI. Secondly, she has provided the first objective evidence that 50% of people with a complete SCI still have intact nerve fibres which can likely still influence perception and performance. In her AVATAR program, Prof Gustin aims to translate the gained knowledge of her fundamental research into treatment.
Prof Gustin has developed two new approaches that target the neurochemical and functional thalamic alterations which her research previously revealed to ultimately treat SCI neuropathic pain. (1) Gamified Brain-Computer Interface Neuromodulation (gBCI-N) intervention teaches individuals to gain control over their brain activity via EEG biofeedback in a way that reduces their pain. (2) Virtual reality walking (VRWalk) therapy targets cortical and sub-cortical disruption associated with SCI neuropathic pain by reinstating sensorimotor input using visual illusion and thereby reducing pain. (3) Lastly, drawing on her recent discovery and innovations in virtual reality (VR) embodiment technology, she will develop an entirely novel intervention to restore touch perception among individuals previously classified as having complete perceptual loss. Virtual Reality Haptic Walking (VRHapticWalk) intervention simultaneously enhances surviving somatosensory spinal nerve fibres and somatosensory (touch) signals in the brain in an effort to restore touch perception among people previously classified as having complete perceptual loss.
If you want to know more about Prof Gustin’s research, please visit her website: www.neurorecoveryresearch.com