Research

Through our long-standing affiliation with the Melbourne Neuropsychiatry Centre, we have become internationally recognised for conducting leading and collaborative research into the diagnosis and treatment of neuropsychiatric, neurocognitive, neurodegenerative, and neurological disorders.

Research areas

Together, we can find new and better ways to prevent, detect and treat conditions of the brain and mind.

As a clinical and research team, we strive to find ways to improving health outcomes and the quality of life for patients and their loved ones – at the present day and for future generations.

Our areas of research interest include:

  • Differentiating severe mental illness from ‘organic disorders’
  • Younger onset dementia / rare / atypical dementias
  • Huntington’s disease and movement disorders
  • Metabolic Neuropsychiatry
  • Niemann Pick Type C
  • Deep brain stimulation in OCD
  • Neuropsychology in neuropsyciatry

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Research areas
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Current Studies

The MiND Study: a simple blood test to diagnose dementia quickly and accurately?

People with psychiatric, cognitive and/or neurological symptoms, and their clinicians such as psychiatrists, neuropsychologists, neurologists, and other specialists, often face the diagnostic dilemma of, “is this a primary psychiatric disorder, or is there something neurological or neurodegenerative going on”?

Despite gold-standard assessments, this question is not easily resolved. Timely and accurate diagnosis of dementia, especially younger-onset dementia, is challenging. Did you know that patients with younger-onset dementia frequently endure a “diagnostic odyssey” of over 3-5 years, associated with multiple assessments (seeing an average of three to five specialists) and repeated and costly investigations, misdiagnosis, inappropriate treatment, uncertainty and negative outcomes, and diagnostic delay (if a diagnosis is reached at all)?

The Markers in Neuropsychiatric Disorders (MiND) Study is a new five-year longitudinal study that hopes to solve some of these problems.

MiND is led by Professor Dennis Velakoulis (Director of Neuropsychiatry Royal Melbourne Hospital, and Clinical Director of Melbourne Neuropsychiatry Centre), Dr Dhamidhu Eratne (Neuropsychiatrist and PhD student), and the team at Neuropsychiatry, Royal Melbourne Hospital, Victoria, Australia.

MiND is exploring the blood biomarker of neuronal injury, neurofilament light (NfL), in the assessment of cognitive, neurological and psychiatric symptoms, in a wide range of people from broad settings. Our pilot study (Eratne et al. ANZJP 2020) showed great promise for NfL as a diagnostic screening test for psychiatrists, neurologists and GPs. The ultimate aim of MiND is clinical translation, and the availability of a simple, routinely available blood test (think of it as a ‘CRP or ‘PSA’ for the brain), to improve timely and accurate diagnosis, and subsequently enhance the quality-of-life and outcomes for patients, their families, their treating clinicians, and the healthcare system at large.

The Study, funded by MACH, MRFF and NHMRC grants, has a target of 500 patients, with recruitment planned across Neuropsychiatry, general practice, memory clinics, as well as public and private health services and specialists (e.g., psychiatrists, neurologists, geriatricians) across Victoria, and nationally. 

The MiND Study has partnered with national and international leaders, leading to an impressive MiND Study Group. Collaborations, just to name a few, include working closely with the Department of General Practice at the University of Melbourne, the Walter and Eliza Hall Institute of Medical Research, The Florey Institute of Neuroscience & Mental Health, and The University of Gothenburg and Lund University in Sweden.

If you would like to collaborate, or if you have a patient to refer to the Study, please visit: https://themindstudy.org

Enroll HD

Huntington’s disease (HD) is a progressive neurodegenerative condition that manifests with motor, cognitive and psychiatric symptoms.  It is a genetic disease which is autosomal dominant, meaning that there is a 50% risk of passing the gene from an affected person to the next generation.  There are currently no cures for HD but symptomatic treatments.  We are interested  the progression of the disease and how it affects a person’s mood, quality of life and other behaviours as well as the family member who lives and supports them (https://enroll-hd.org/) .  Currently our team, led by Professor Walterfang, we are investigating the phenotypical variation in HD by looking at whole genome sequencing, funded by the Bethlehem Griffith Research Foundation, in concert with Calvary Care Bethlehem.  We investigate neuroimaging, animal models and lab neurosciences in HD, with Monash University (Professors Julie Stout and Nellie Georgiou-Karistianis), the Florey Institute of Neurosciences and Mental Health (Professor Tony Hannan) and Bio21 (Professor Danny Hatters), respectively.

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Current Studies
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Currently recruiting

The MiND Study

If you would like to collaborate as a participant, or if you have a patient to refer to the Study, please visit: https://themindstudy.org/for-participants/ and/or https://themindstudy.org/for-healthcare-professionals/ Or reach out to the MiND Study Team: https://themindstudy.org/contact/ if you have any questions. 

Enroll HD Study

If you would like to participate in the Study please visit:https://enroll-hd.org/participate/ Please reach out to the Enroll HD Study Team at: https://enroll-hd.org/contact-us/

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Telehealth and younger onset dementia

Better Care Victoria BRIGHT-YOD Project

The Bridging Gaps in Health using Telehealth for people with Younger Onset Dementia (BRIGHT-YOD) Project was an innovation project supported by the Better Care Victoria Innovation Fund.

Young onset dementia (YOD) – dementia that occurs in people under 65 years of age – affects more than 25,000 Australians, making up almost 10 per cent of all dementia diagnoses.

It is a life-limiting illness that can cause those affected to lose up to 20 years of their life. They can also experience multiple, complex symptoms that require specific expertise for diagnosis and care.

People experiencing YOD, as well as their families and carers, experience several barriers to receiving the care they need. These can include significant diagnostic delays, navigating multiple different medical specialties, using support services designed for the elderly, and living with unmet practical, psychological ,and financial support needs.

The Melbourne Young Onset Dementia (MYOD) service in Neuropsychiatry at the Royal Melbourne Hospital is one of the few services nationally that can provide tailored, flexible, and expert services to those affected by this condition.

The Neuropsychiatry Service at the Royal Melbourne Hospital harnessed telehealth technology to give more patients access to its MYOD service and reduce the personal and economic costs for those requiring care in rural and regional Victoria.

In December 2020, the Royal Melbourne Hospital secured recurrent state government funding to continue the Melbourne Young Onset Dementia telehealth service. The BRIGHT-YOD project also received a high commendation in December 2019 in the Chief Executive Healthcare Innovation Award category of The Royal Melbourne Hospital’s Celebrating Excellence Awards.

For more information about the Project, including methodology, outcomes, learnings, please visit the Better Care Victoria website here

Better Care Victoria BRIGHT-YOD Project Logos

Media stories

Dementia prevention

Pushing back against dementia

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Movement disorders

Huntington’s Disease

Huntington’s disease (HD) is a progressive neurodegenerative condition that manifests with motor, cognitive and psychiatric symptoms.  It is a genetic disease which is autosomal dominant, meaning that there is a 50% risk of passing the gene from an affected person to the next generation.  There are currently no cures for HD but symptomatic treatments.  We are interested  the progression of the disease and how it affects a person’s mood, quality of life and other behaviours as well as the family member who lives and supports them (https://enroll-hd.org/) .  Currently our team, led by Professor Walterfang, we are investigating the phenotypical variation in HD by looking at whole genome sequencing, funded by the Bethlehem Griffith Research Foundation, in concert with Calvary Care Bethlehem.  We investigate neuroimaging, animal models and lab neurosciences in HD, with Monash University (Professors Julie Stout and Nellie Georgiou-Karistianis), the Florey Institute of Neurosciences and Mental Health (Professor Tony Hannan) and Bio21 (Professor Danny Hatters), respectively.

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Movement disorders
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Metabolic Disorders

Niemann-pick Type C Disease

Brain changes in Niemann-pick Type C Disease

Professor Walterfang has been involved in more than two decades of work and research in the adult-onset neurometabolic and neurodegenerative disorder, Niemann Pick type C disease (NPC), a recessive genetic illness that often presents with psychiatric illness such as schizophrenia prior to  the onset of ataxia, dystonia and cognitive decline. We have published not only the standard reference reviews on neuropsychiatric and cognitive aspects of NPC (https://pubmed.ncbi.nlm.nih.gov/16720792, https://pubmed.ncbi.nlm.nih.gov/30632019), but undertook the first group structural neuroimaging studies utilizing magnetic resonance imaging (MRI) in the disorder, showing that brain changes in vivo largely matched those seen in animal models and human neuropathological studies (https://pubmed.ncbi.nlm.nih.gov/20484681, https://pubmed.ncbi.nlm.nih.gov/23237858). More recently, we have undertaken a suite of positron emission tomography (PET) imaging studies in the disorder, showing a characteristic signal of metabolic, inflammatory and tauopathic changes in the disease (https://pubmed.ncbi.nlm.nih.gov/32209649, https://pubmed.ncbi.nlm.nih.gov/30690666, https://pubmed.ncbi.nlm.nih.gov/33830335). We are further examining more sophisticated imaging techniques involving the cerebellum and other brain regions, and novel neuroimaging techniques examining the role of iron changes in the NPC brain, and have active research ongoing in cognitive and other motor changes seen in NPC patients.

Additionally, we have characterized and demonstrated the clinical utility of ocular-motor biomarkers in the disease (https://pubmed.ncbi.nlm.nih.gov/23226429, https://pubmed.ncbi.nlm.nih.gov/19307542), in addition to the role of swallowing biomarkers (https://pubmed.ncbi.nlm.nih.gov/32562141), whilst also showing how the novel therapy miglustat slows changes in brain and ocular-motor indices in the disease (https://pubmed.ncbi.nlm.nih.gov/28710748, https://pubmed.ncbi.nlm.nih.gov/26691656, https://pubmed.ncbi.nlm.nih.gov/26092521). With colleagues at the Florey Institute of Neuroscience and Mental Health we have examined the role of biometal perturbations in NPC in mice and humans (https://pubmed.ncbi.nlm.nih.gov/24343124), and also shown how mouse carriers may have an attenuated form of the illness (https://pubmed.ncbi.nlm.nih.gov/26942423).

More recently, Neuropsychiatry was a key site in the international phase 2B/3 trial of intrathecal cyclodextrin in NPC (https://clinicaltrials.gov/ct2/show/NCT02534844), and is involved in examining a range of other therapies in the disorder, including novel molecules and therapies with our colleagues Professor Bush and Dr Hung at the Florey.

Ongoing pre-clinical work includes an examination of the role of “killer” immune cells in NPC with A/Prof Voskoboinik at the Peter Mac, and the role of genetic modifiers in adult and pediatric patients with NPC with Dr Andrew Muncaksi in Wellington, NZ.

Neuropsychiatry Of  Phenylketonuria

Professor Walterfang sees a number of patients with  phenylketonuria (PKU), a genetic disorder of amino acid metabolism that results in a toxic buildup of the amino acid phenylalanine in the brain and, although now treated with dietary modification, often presents with neuropsychiatric and cognitivie symptoms across the lifespan. After publishing the definitive review of psychiatric and cognitive issues in PKU (https://pubmed.ncbi.nlm.nih.gov/31551819), we have also shown that untreated adults who return to diet show significant reductions in depression and anxiety in addition to cognitive symptoms (https://pubmed.ncbi.nlm.nih.gov/33461585). We are finalizing a number of neuroimaging studies in PKU and also  looking at further studies on brain function in PKU adults, in addition to participation in upcoming therapeutic trials including gene therapy in the disorder.

Brain Shape In Neurodegenerative Disorders

Beginning with a highly successful neuroimaging collaboration with A/Professor Looi from ANU, Professors Walterfang and Velakoulis have undertaken a number of studies examining the role  of shape of brain structures in neurodegenerative  disorders that allow clinicians and radiologists to more reliably separate these disorders from eachother in the diagnostic process. Initially examining subcortical structures disorders in the rare movement disorder neuroacanthocytosis (https://pubmed.ncbi.nlm.nih.gov/21377843), we then examined the role of brain shape changes in the striatum, hippocampus, corpus callosum and thalamus as biomarkers in frontotemporal dementia  (https://pubmed.ncbi.nlm.nih.gov/20156566, https://pubmed.ncbi.nlm.nih.gov/21237621, https://pubmed.ncbi.nlm.nih.gov/24531157, https://pubmed.ncbi.nlm.nih.gov/26075893), progressive supranuclear palsy (https://pubmed.ncbi.nlm.nih.gov/28550719, https://pubmed.ncbi.nlm.nih.gov/21899988), Alzheimer’s disease  (https://pubmed.ncbi.nlm.nih.gov/20156566,  https://pubmed.ncbi.nlm.nih.gov/22414571, https://pubmed.ncbi.nlm.nih.gov/22990433), Huntington’s disease (https://pubmed.ncbi.nlm.nih.gov/22990433, https://pubmed.ncbi.nlm.nih.gov/28031992, https://pubmed.ncbi.nlm.nih.gov/31330407), vascular dementia (https://pubmed.ncbi.nlm.nih.gov/23916546)  and Parkinson’s disease (https://pubmed.ncbi.nlm.nih.gov/29555381, https://pubmed.ncbi.nlm.nih.gov/31483847). Ongoing work continues examining the role of shape as a biomarker, involving a  range of novel neuroimaging techniques  continues across a range of neurodegenerative disorders.

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Metabolic Disorders
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Technology

The utility of technology can play a multiple roles in neuropsychiatric disorders, in inpatient settings, in the community and in residential care.  These can range from very simple techniques such as utilising touchscreen technology (iPads etc) as a tool for engagement and learning (PubMed Article), a strategy to address neuropsychiatric symptoms associated with dementia (PubMed Article), to more complex technology such as socially-assistive robots (more here and here), which we collaborated with Latrobe University.  In addition, the monitoring of neuropsychiatric symptoms is essential in order to design appropriate non-pharmacological and pharmacological interventions and a real-time method, the Symptom Assessment Manager (www.cerescape.com/sam) was successfully trialled at Neuropsychiatry (Reseach Paper).

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Research leads

Albeit a small team, we have published over 600 articles in reputable national and international journals.  We have received over 10 million dollars’ worth of research funding from State and Federal Governments, and many generous private benefactors.  For a complete list of our publications, please visit PubMed via this link.

Meet the team

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Our publications

Did you know that…

  • 11% of our publications are in the top 10% cited worldwide over.
  • 40% of our publications are in the top 10% of journals.
  • Just under 42% of our publications are with international collaborations.
  • 54% of our publications are with national collaborations.

For a comprehensive list of the teams' 600+ publications: visit PubMed via this link.

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Our research collaborations

We are fortunate to work with leading organisations around the globe.

 

Are you a patient/carer, student, researcher, or organisation, who would like to learn more about our research work, please contact us via email at: neuropsychiatry@mh.org.au

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Our research collaborations
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