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Research by Professors John Stein and Tipu Aziz at the University of Oxford has had a significant impact on advanced Parkinson's disease patients affected by freezing of gait and loss of balance. Since 2008 deep brain stimulation of the pedunculopontine nucleus has resulted in major improvements in both gait and posture in Parkinson's disease patients who have been treated with dopaminergic drugs for several years, but who had suffered the return of severely disabling movement problems. Around two hundred patients have been successfully treated worldwide through this pioneering surgery, with associated improvements in quality of life.
Recent advances in MRI brain scanning developed at the UCL Institute of Neurology have underpinned major improvements in the surgical treatment of epilepsy. Information about the location of critical brain structures, such as the optic radiation that carries visual signals, and language areas of the brain, are used to identify the risks of neurosurgery in specific individuals. This helps to inform patient choice and to reduce the risk of loss of any part of the visual field or language when performing the surgery. UCL's pioneering use of these imaging techniques during surgery, with correction of the movement of the brain that occurs during surgery, showed that this approach reduced the occurrence of serious loss of vision to zero. This information is now used in epilepsy surgery every week at the National Hospital for Neurology and Neurosurgery and is being rolled out to other centres.
The capacity for cognitive function may be missed by clinical examination in severely disabled survivors of acquired brain injuries, resulting in individuals being mislabelled as being in the vegetative state (VS). Work from David Menon and John Pickard has shown that functional brain imaging provides a more consistent and less observer-dependent means of detecting and quantifying such cognitive capacity. As a result of this work, the use of functional imaging has been integrated into clinical protocols as the basis for: identifying patients with such covert cognition; prognosticating on outcome; defining a rational framework for patient selection in clinical trials; and exploring the use of brain-machine interfaces to improve communication with such patients.
Research by Professor Karl Friston at UCL has led to the development of Statistical Parametric Mapping (SPM), a statistical framework and software package. By providing a way to analyse signals measured from the human brain in MRI scanners, SPM triggered the creation of an entirely new field of imaging neuroscience. Beneficiaries include: commercial manufacturers who provide imaging equipment; healthcare practitioners and patients, where SPM is used to deliver new treatments; pharmaceutical industries using SPM to deliver clinical trials; the IT industry developing new software based on SPM; and entirely new industries such as neuromarketing that could only have been created once SPM had been invented.
The Cybernetics team at the University of Reading works at the frontier of human-machine interaction. The group carries out research on therapy and human enhancement in collaboration with medical professionals, to research new therapeutic treatments for patients with paralysis. Our work has led to the first human implantation of BrainGate, an intelligent deep brain stimulator, and the culturing of neurons within a robot body. Our work has been used by neurosurgeons in experimental human trials with the aim to enhance the standard of living of paralysed individuals. This ground breaking, and sometimes controversial work, has sparked widespread discussion and debate in the public sphere, within the media and at the government level, on the use of machines to enhance humans and vice versa.
Our research on alternatives to medication in the treatment of childhood epilepsy has resulted in increasing rates of surgery with better outcomes, and a new clinical service — the national Children's Epilepsy Surgery Service (CESS) — being commissioned in England and Wales. We have also developed an evidence base for ketogenic dietary therapy, resulting in an increase in service provision. Many more patients are benefiting from this therapy, which is now recommended in NICE guidelines. Throughout our programme of research we have engaged with charities and patient groups to disseminate the results of our research as widely as possible.
Research conducted by Glasgow Caledonian University (GCU) has changed the way power cables and motors are monitored in EDF Energy's nuclear power stations in the UK and Wuhan Electrical Power Company, China, providing the companies with innovative techniques enabling them to identify insulation defects and improve their maintenance programme. Application of the research output has helped the companies to enhance practice in PD testing, reduce maintenance and repair costs by millions of pounds whilst reliably supplying over 20% of the UK's power generation, and an area with over 10 million people in China.
Condition monitoring instrumentation for high voltage plant has been developed at GCU under contract research for Doble Engineering (Headquarters in MA, USA), a global service provider for the electric power industry. The instruments are an important new line of products for Doble providing increased sales revenue and service provision. The instruments have been widely adopted by Doble's global client base to provide improved asset management. Other beneficiaries of the work include global contract electronic manufacturing companies. In 2012 Doble invested £1.2 million in an Innovation Centre at GCU to support their product development road map.
More than 240,000 people with kidney failure are treated with peritoneal dialysis (PD) worldwide. Cardiff University pioneered novel test methods that identified deleterious dialysis solution components, leading directly to manufacturers introducing more biocompatible dialysis fluids that improve patient outcomes. Cardiff investigators designed and ran the early clinical studies on these new fluids, which now lead the PD solutions market worldwide, and are recommended in European clinical guidelines. Recent evidence suggests that their use reduces peritonitis severity, decreases peritonitis incidence by 40% and mortality by 30%, resulting in reduced hospitilsation and significant healthcare savings.
Novel methods of measurement developed by Marek Czosnyka, Peter Hutchinson, David Menon and John Pickard have provided new insights into the pathophysiology of brain injury, led to commercial applications, and influenced patient care in terms of improved outcome for clinical trials. Multimodality brain monitoring of intracranial pressure (ICP), brain oxygen and microdialysis; PET/MRI imaging of critically ill patients; and computerised CSF infusion tests for shunt function in hydrocephalus have each impacted on the clinical practice and the ability to evaluate novel treatments and interventions in brain injury. This work has led directly to the establishment of a National Institute for Health Research (NIHR) Health Technology Cooperative for Brain Injury.