Stroke and Brain Injury

The Brain Injury Research Group centred in Academic Neurosurgery led by Mr Christos Tolias have established their new laboratory and secured funding from the KMRCT and “Headfirst” (£130,000) for an in vitro investigation of the cellular and subcellular mechanisms of normobaric hyperoxia in brain injury. A stretch model of injury on primary brain cell cultures will be used for this project. In collaboration with Steven Minger (Senior Lecturer, Stem Cell Biology Laboratory/Translational Neuroscience Group, Wolfson Centre) they have gained Ethics approval for a feasibility study on establishing adult, human, neural stem cell lines from samples of brain tissue retrieved at the end of endoscopic ventriculostomies. We have already enrolled four patients and have successfully cultured the first human neural stem cells, although no cell lines have been established as yet. A parallel project is being organised to compare a human stem cell culture injury model with the validated animal one, in effect a combination of the two previously described projects.

Professor Anthony Strong has commenced a long term experimental collaboration with the Max Planck Institute for Neurological Research (Professor R.Graf) in Cologne. King’s continues to lead the COSBID collaboration (Co-operative Study of Brain Injury Depolarisations: www.cosbid.org ). King’s has played a leading role in what is now a substantial transatlantic collaboration involving some 14 centres in COSBID. An important body of data is now accumulating for patients with serious head injury, with subarachnoid haemorrhage, and with major stroke, and in all of these, recurrent transient depolarisation is prominent. The group believes that the results are leading to a paradigm shift in concepts of the mechanisms, and potential treatment, of acute brain injury. Related to this project, Mr Robin Bhatia, has completed his PhD benchwork, developing a highly effective method for monitoring potassium concentration in the micro-dialysate from the cerebral cortex, thus providing direct chemical verification of depolarisation events in the injured human brain, and allowing clear assessment of the metabolic correlates of depolarisation events.

Mr Richard Selway is involved in collaboration with the epilepsy group in developing new neurophysiological tests to optimise epilepsy surgery, and with the movement disorder group in the development of techniques for service delivery of complex movement disorders surgery. Particularly productive has been the work on paediatric movement disorders such as on children with the PANK2 mutation, in whom implantation of deep brain stimulators has produced excellent clinical improvement.