Category: Neurology

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Microbes May Hold the Key to the Brain’s Evolution

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First-of-its-kind study offers evidence that microbes from different primate species influence physiology in ways linked to brain size and function

Source: Pixabay

Humans have the largest relative brain size of any primate, but little is known about how mammals with larger brains evolved to meet the intense energy demands required to support brain growth and maintenance.

A new study from Northwestern University provides the first empirical data showing the direct role the gut microbiome plays in shaping differences in the way the brain functions across different primate species.

“Our study shows that microbes are acting on traits that are relevant to our understanding of evolution, and particularly the evolution of human brains,” said Katie Amato, associate professor of biological anthropology and principal investigator of the study, which was published in PNAS. 

The study builds upon previous findings from Amato’s lab that showed the microbes of larger-brained primates, when introduced in host mice,  produced more metabolic energy in the microbiome of the host – a prerequisite for larger brains, which are energetically costly to develop and function. This time, the researchers wanted to look at the brain itself to see if the microbes from different primates with different relative brain sizes would change how the brains of host mice functioned. 

What they found

In a controlled lab experiment, the researchers implanted gut microbes from two large-brain primate species (human and squirrel monkey) and one small-brain primate species (macaque) into microbe-free mice.  

Within eight weeks of making changes to the hosts’ microbiomes, they observed that the brains of mice with microbes from small-brain primates were indeed working differently than the brains of mice with microbes from large-brain primates. 

In the mice with large-brain primate microbes, the researchers found increased expression of genes associated with energy production and synaptic plasticity, the physical process of learning in the brain. In the mice with smaller-brain primate microbes, there was less expression of these processes. 

“What was super interesting is we were able to compare data we had from the brains of the host mice with data from actual macaque and human brains, and to our surprise, many of the patterns we saw in brain gene expression of the mice were the same patterns seen in the actual primates themselves,” Amato said. “In other words, we were able to make the brains of mice look like the brains of the actual primates the microbes came from.”

Another surprising discovery the researchers made was a pattern of gene expression associated with ADHD, schizophrenia, bipolar and autism in the genes of the mice with the microbes from smaller-brained primates. 

While there is existing evidence showing correlations between conditions like autism and the composition of the gut microbiome, there is a lack of data showing the gut microbes contribute to these conditions. 

“This study provides more evidence that microbes may causally contribute to these disorders —specifically, the gut microbiome is shaping brain function during development,” Amato said. “Based on our findings, we can speculate that if the human brain is exposed to the actions of the ‘wrong’ microbes, its development will change, and we will see symptoms of these disorders, i.e., if you don’t get exposed to the ‘right’ human microbes in early life, your brain will work differently, and this may lead to symptoms of these conditions.” 

Implications and next steps

Amato sees clinical implications for further exploration of the origins of some psychological disorders and for taking an evolutionary perspective on the way microbes affect brain physiology.

“It’s interesting to think about brain development in species and individuals and investigating whether we can look at cross-sectional, cross-species differences in patterns and discover rules for the way microbes are interacting with the brain, and whether the rules can be translated into development as well.

“Primate gut microbiota induce evolutionarily salient changes in mouse neurodevelopment” was published by the Proceedings of the National Academy of Sciences on Jan. 5.

Source: Northwestern University

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Post-stroke Injection of Nanomaterials Protects the Brain in Preclinical Study

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Ischaemic and haemorrhagic stroke. Credit: Scientific Animations CC4.0

When a person suffers a stroke, physicians must restore blood flow to the brain as quickly as possible to save their life. But, ironically, that life-saving rush of blood can also trigger a second wave of damage — killing brain cells, fuelling inflammation and increasing the odds of long-term disability.

Now, Northwestern University scientists have developed an injectable regenerative nanomaterial that helps protect the brain during this vulnerable window.

In a new preclinical study, the team delivered a single intravenous dose, immediately after restoring blood flow, in a mouse model of ischemic stroke, the most common type of stroke. The therapy successfully crossed the blood-brain barrier — a major challenge for most drugs — to reach and repair brain tissue. The material significantly reduced brain damage and showed no signs of side effects or organ toxicity.

Published in the journal Neurotherapeutics, the findings suggest the new therapy could eventually complement existing stroke treatments by limiting secondary brain injury and supporting recovery.

“Current clinical approaches are entirely focused on blood flow restoration,” said co-corresponding author Dr Ayush Batra, associate professor  at Northwestern and a neurocritical care physician with Northwestern Medicine. “Any treatment that facilitates neuronal recovery and minimises injury would be very powerful, but that holy grail doesn’t yet exist. This study is promising because it’s leading us down a pathway to develop these technologies and therapeutics for this unmet need.”

The injectable therapy is based on supramolecular therapeutic peptides (STPs), a platform developed by Northwestern’s Samuel I. Stupp. A study published in 2021 in the journal Science demonstrated the use of an STP technology — nicknamed “dancing molecules” — because of the highly dynamic nature of its therapeutic agents that could reverse paralysis and repair tissue in mice after a single injection at the site of severe spinal cord injury. The new study found scientists can administer similar dynamic assemblies of molecules intravenously, without requiring surgery or an invasive injection directly into the brain.

“One of the most promising aspects of this study is that we were able to show this therapeutic technology, which has shown incredible promise in spinal cord injury, can now begin to be applied in a stroke model and that it can be delivered systemically,” said Stupp, co-corresponding author. “This systemic delivery mechanism and the ability to cross the blood-brain barrier is a significant advance that could also be useful in treating traumatic brain injuries and neurodegenerative diseases such as ALS.”

Study mimicked real-world stroke treatment

Acute ischaemic stroke is a devastating condition and is one of the leading causes of morbidity and mortality worldwide, Batra said, severely impacting a patient’s quality of life and engagement in society.

“It has not only a significant personal and emotional burden on patients, but also a financial burden on families and communities,” he said. “Reducing this level of disability with a therapy that could potentially help in restoring function and minimising injury would really have a powerful long-term impact.”

The findings are highly relevant for future clinical applications because the scientists tested the approach in a mouse model that closely mimics real-world ischemic stroke treatment, Batra said. They first blocked blood flow to simulate a major ischaemic stroke and then restored it (a process called reperfusion), just as whem doctors restore blood flow acutely for ischaemic stroke patients.

The scientists monitored the mice for seven days and didn’t observe any significant side effects or biocompatibility issues such as toxicity or immune system rejection. They used advanced imaging techniques, such as real-time intravital intracranial microscopy seen in this video, to confirm the therapy localised to the stroke injury site. Compared to untreated mice, those treated with the “dancing molecules” had significantly less brain tissue damage, reduced signs of inflammation and reduced signs of excessive, damaging immune response.

Stupp said the therapy has pro-regenerative and anti-inflammatory properties, both of which contributed to the positive results.

“You get an accumulation of harmful molecules once the blockage occurs and then suddenly you remove the clot and all those ‘bad actors’ get released into the bloodstream, where they cause additional damage,” Stupp said. “But the dancing molecules carry with them some anti-inflammatory activity to counteract these effects and at the same time help repair neural networks.”

Dynamic ‘dancing molecules’ can be dialed down in concentration

The secret behind Stupp’s “dancing molecules” breakthrough therapeutic is tuning the collective motion of molecules, so they can find and properly engage constantly moving cellular receptors. The treatment sends signals that encourage nerve cells to repair themselves. For example, it can help nerve fibres (called axons) grow again and reconnect with other nerve cells, restoring lost communication through neural plasticity.

In previous studies, scientists injected the dancing molecules as a liquid, and when used to treat spinal cord injury, the therapy immediately gels into a complex network of nanofibres that mimic the dense, extracellular matrix of the spinal cord. By matching the matrix’s structure, mimicking the motion of biological molecules and incorporating signals for receptors, the synthetic materials are able to communicate with cells.

In the new study, the scientists dialled down the concentration of supramolecular peptide assemblies to prevent possible clotting as the therapy enters the bloodstream. Smaller aggregates of peptides easily crossed the blood-brain barrier. Once enough molecules cross, larger nanofibre assemblies can form in brain tissue to produce a more potent therapeutic effect, Stupp said.

“We chose for this stroke study one of the most dynamic therapies we had in terms of its molecular structure so that supramolecular assemblies would have a better probability of crossing the blood-brain barrier,” Stupp said.

Optimiaing therapeutic targeting

The fact that seemingly effective therapies cannot cross the blood-brain barrier has plagued the neuroscience field for decades, Batra said. This new therapy could change that.

When a physician acutely restores blood flow to a region of the brain in a stroke patient, the blood-brain barrier permeability is locally increased, naturally creating a transient opening and opportunity for therapeutic intervention, Batra said.

“Add to that a dynamic peptide that is able to cross more readily, and you’re really optimising the chances that your therapy is going where you want it to go,” Batra said.

Next steps

Further studies will need to assess whether this treatment can support longer-term, functional recovery, Batra said. For instance, many stroke patients suffer from significant cognitive decline throughout the subsequent year after a stroke. The new therapy is primed to address that secondary injury, Batra said, but the studies will require a longer follow-up period and more sophisticated behavioral testing.

In addition, the team is interested in testing whether additional regenerative signals could be incorporated into the therapeutic peptides to produce even better results.

Source: Northwestern University

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Dopamine Cells Work a Night Shift to Strengthen Skills

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Photo by Cottonbro on Pexels

Dopamine neurons, the cells that drive reward and motivation while we’re awake, become surprisingly active during nonrapid eye movement sleep right after we learn something new.

According to a new University of Michigan study, this night surge that is synchronised with memory-boosting sleep spindles, helps strengthen motor memories and improves motor skills.

The findings challenge long-held assumptions about dopamine’s role in the brain, showing that these neurons don’t just support learning during the day – they actively help lock in new skills while we sleep, said study co-author Ada Eban-Rothschild, U-M associate professor of psychology.

“As alterations in dopamine signalling are associated with neurodegenerative diseases that also involve motor deficits and sleep disturbances, understanding these links could pave the way for improved therapeutics and advancements in human health,” she said.

The study focused on specific midbrain dopamine neurons that become active after learning, but only during nonrapid eye movement, or NREM, sleep. This burst of activity helps the brain fine-tune and reinforce newly learned movements, contributing to more precise motor performance once awake.

Understanding how dopamine supports motor learning at night also sheds light on the broader importance of sleep in shaping behavior, said Eban-Rothschild and colleagues.

“The findings highlight that sleep is an active biological period during which key neural circuits strengthen the skills and patterns we rely on every day,” she said.

By revealing how dopamine helps consolidate motor memories during sleep, the researchers say the findings open a new window into brain health: It may eventually guide the development of therapies that target both sleep and dopamine pathways, offering new hope for improving motor function and quality of life in affected individuals.

The study was published in the Journal Science Advances. In addition to Eban-Rothschild, the study’s authors are Bibi Alika Sulaman, Eric Chen, Aaron Crane, Sangjin Lee and Gideon Rothschild

Source: University of Michigan

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How the Nervous System Activates Repair After a Spinal Cord Injury

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View of the spinal cord. Credit: Scientific Animations CC4.0

After a spinal cord injury, cells in the brain and spinal cord change to cope with stress and repair tissue. A new study from Karolinska Institutet, published in Nature Neuroscience, shows that this response is controlled by specific DNA sequences. This knowledge could help develop more targeted treatments.

When the central nervous system is damaged – for example, in a spinal cord injury – many cells become reactive. This means they change their function and activate genes that protect and repair tissue. However, how this process is regulated has long been unclear.

Researchers at Karolinska Institutet have now mapped thousands of so-called enhancers; small DNA sequences that act like “switches” for genes, turning them on or boosting their activity. By analysing individual cell nuclei from mice with spinal cord injuries using AI models, the researchers discovered that these genetic switches are activated after injury and instruct specific cell types to respond. The main cells affected were glial cells such as astrocytes and ependymal cells – support cells that help protect and repair the nervous system.

New opportunities for precision treatments 

“We have shown how cells read these instructions through a code that tells them how to react to injury. This code combines signals from general stress factors with the cell’s own identity,” explains Enric Llorens-Bobadilla, researcher at the Department of Cell and Molecular Biology at Karolinska Institutet.

“This opens up the possibility of using the code to target treatments specifically to the cells affected by the injury,” says Margherita Zamboni, researcher at the same department and first author of the study.

The study is a collaboration between researchers at Karolinska Institutet and SciLifeLab, supported by the European Research Council (ERC), the Swedish Research Council, and the Swedish Foundation for Strategic Research. Some researchers have reported consultancy roles and patent applications related to the technology.

Source: Karolinska Institutet

Categories : Environmental Effects NeurologyTags :

Five Ways Microplastics May Harm the Brain

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A new study highlights five ways microplastics can trigger inflammation and damage in the brain.

Photo by FLY:D on Unsplash

Microplastics could be fuelling neurodegenerative diseases like Alzheimer’s and Parkinson’s, with a new study highlighting five ways microplastics can trigger inflammation and damage in the brain.

More than 57 million people live with dementia, and cases of Alzheimer’s and Parkinson’s are projected to rise sharply. The possibility that microplastics could aggravate or accelerate these brain diseases is a major public health concern.

Pharmaceutical scientist Associate Professor Kamal Dua, from the University of Technology Sydney, said it is estimated that adults are consuming 250 grams of microplastics every year – enough to cover a dinner plate.

“We ingest microplastics from a wide range of sources including contaminated seafood, salt, processed foods, tea bags, plastic chopping boards, drinks in plastic bottles and food grown in contaminated soil, as well as plastic fibres from carpets, dust and synthetic clothing.”

“Common plastics include polyethylene, polypropylene, polystyrene and polyethylene terephthalate or PET. The majority of these microplastics are cleared from our bodies, however studies show they do accumulate in our organs, including our brains.”

The systematic review, recently published in Molecular and Cellular Biochemistry, was an international collaboration led by researchers from the University of Technology Sydney and Auburn University in the US.

The researchers highlighted five main pathways through which microplastics can cause harm to the brain, including triggering immune cell activity, generating oxidative stress, disrupting the blood–brain barrier, impairing mitochondria and damaging neurons.

“Microplastics actually weaken the blood–brain barrier, making it leaky. Once that happens, immune cells and inflammatory molecules are activated, which then causes even more damage to the barrier’s cells,” said Associate Professor Dua.

“The body treats microplastics as foreign intruders, which prompts the brain’s immune cells to attack them. When the brain is stressed by factors like toxins or environmental pollutants this also causes oxidative stress,” he said.

Microplastics cause oxidative stress in two main ways: they increase the amount of “reactive oxygen species” or unstable molecules that can damage cells, and they weaken the body’s antioxidant systems, which normally help keep those molecules in check.

“Microplastics also interfere with the way mitochondria produce energy, reducing the supply of ATP, or adenosine triphosphate, which is the fuel cells need to function. This energy shortfall weakens neuron activity and can ultimately damage brain cells,” said Associate Professor Dua.

“All these pathways interact with each other to increase damage in the brain.”

The paper also explores specific ways in which microplastics could contribute to Alzheimer’s, including triggering increased buildup of beta-amyloid and tau; and in Parkinson’s through aggregation of α-Synuclein and damage to dopaminergic neurons.

First author UTS Master of Pharmacy student Alexander Chi Wang Siu is a currently working in the lab of Professor Murali Dhanasekaran at Auburn University, in collaboration with Associate Professor Dua, Dr Keshav Raj Paudel and Distinguished Professor Brian Oliver from UTS, to better understand how microplastics affect brain cell function. 

Previous UTS research has examined how microplastics are inhaled and where they are deposited in the lungs. Dr Paudel, a visiting scholar in the UTS Faculty of Engineering, is also currently investigating the impact of microplastic inhalation on lung health.

While evidence suggests microplastics could worsen diseases like Alzheimer’s and Parkinson’s, the authors emphasise that more research is needed to prove a direct link. However, they recommend taking steps to reduce microplastic exposure.

“We need to change our habits and use less plastic. Steer clear of plastic containers and plastic cutting boards, don’t use the dryer, choose natural fibres instead of synthetic ones and eat less processed and packaged foods,” said Dr Paudel.

The researchers hope the current findings will help shape environmental policies to cut plastic production, improve waste management and reduce long-term public health risks posed by this ubiquitous environmental pollutant.

Source: University of Technology Sydney

Categories : NeurologyTags :

Headache Disorders Affect Nearly One in Every Three People

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Photo by Kindel Media

Headache disorders affected almost 3 billion people worldwide in 2023 – nearly one in every three people, a figure unchanged since 1990 – and ranked sixth among causes of health loss, according to new research published in The Lancet Neurology. The analysis is part of the Global Burden of Disease (GBD) 2023 study and estimated health loss from migraine, tension-type headache, and medication-overuse headache from 1990 through 2023.

The study, led by researchers at IHME and the Norwegian University of Science and Technology (NTNU), examined the health loss resulting from headache disorders, and how long people have headache across different ages and sexes. Health loss was measured in years lived with disability (YLDs), which captures the total time people spend living with health conditions that limit daily activities and overall well-being. Drawing on population-based studies worldwide, the analysis provides the most comprehensive picture to date of how headache disorders affect daily life and overall health.

Headache disorders rank among the world’s most disabling conditions, disproportionately affecting women

In 2023, headache disorders accounted for an age-standardised rate of 541.9 YLDs per 100 000 people, ranking sixth among all causes of disability globally. The burden of headache disorders was more than twice as high among women as men, with rates of 739.9 and 346.1 YLDs per 100 000, respectively. Across every age group, women consistently spent more time experiencing headache symptoms than men.

“Our analysis shows that headache disorders have remained unchanged in three decades,” said Yvonne Xu, co-author and research scientist at IHME. “And women experience significantly higher levels of headache-related disability because they have headaches more frequently and for longer durations than men. Recognizing this is essential for improving how we prevent and manage headache disorders worldwide.”

Migraine and medication overuse drive most of the global burden from headache disorders

Although tension-type headache is nearly twice as prevalent as migraine, migraine accounts for about 90% of headache-attributed YLDs. In 2023, migraine alone caused an estimated 40.9 million YLDs globally, with an age-standardised rate of 487.5 YLDs per 100 000. Tension-type headache accounted for 54.4 YLDs per 100 000, showing that migraine, though less common, is far more disabling and drives most of the overall burden of headache disorders. While the highest rates of disability from migraine were seen in North Africa and the Middle East, closely followed by high-income regions such as Europe and North America, the burden remains high worldwide.

Medication-overuse headache, defined as the worsening of an existing headache due to excessive use of medication (e.g., pain medication) mainly used to treat migraine or tension-type headache, further amplifies this burden. While this condition affects relatively few, its impact on population-level disability is substantial because of the high individual burden. For migraine, medication overuse accounted for 22.6% of YLDs in men and 14.1% in women, while for tension-type headache, it contributed 58.9% and 56.1%, respectively. Overall, medication overuse was responsible for more than one-fifth of all headache-related disability globally. 

“Our findings show that a large part of the global headache burden is preventable,” said Andreas Kattem Husøy, lead author and post-doctoral fellow in the Department of Neuromedicine and Movement Science at NTNU and Norwegian Centre for Headache Research (NorHead). “Integrating headache services into primary care, especially in low- and middle-income countries where effective treatments remain scarce, could reduce lost productivity and improve quality of life for hundreds of millions.”

Improved care and education are key to reducing the global burden of headache disorders.

Headache disorders remain one of the most common and disabling health conditions worldwide. The burden is unevenly distributed by sex and further intensified by overuse of pain medication, a preventable cause of long-term pain and disability. Although effective and affordable treatments are available, access to appropriate care and education on safe medication use remain limited in many settings.

The findings highlight an urgent need to strengthen prevention, management, and access to care for headache disorders worldwide. With greater awareness and coordinated action, much of the global burden of headache disorders can be prevented.

Source: Institute for Health Metrics and Evaluation

Categories : Neurology Regenerative MedicineTags :

Study Reveals the Dual Role for a Protein Critical for Healing Nerve Damage

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Sarm1 appears to be essential for regeneration

Source: CC0

Nerve damage can be an unfortunate side effect from an accident, illness or even certain treatments, like chemotherapy. Fortunately, the peripheral nervous system can heal itself to a certain extent, albeit very slowly. Researchers are still trying to understand this natural healing process in order to improve it. A recent study published in Science Translational Medicine sheds new light on this.

This mouse-based study from the University of Michigan adds to the evidence regarding a specific protein inside of the nerves, called Sarm1, that seems key for regeneration. Previous studies have revealed that when Sarm1 is activated, it sets off the degenerative process in nerves. The thinking has been that for conditions like chemotherapy induced peripheral neuropathy, diabetes, or nerve trauma, blocking Sarm1 would beneficially block the breakdown of nerves.

But what else would blocking Sarm1 effect?

“We know that nerve breakdown after an injury is quite efficient, and the breakdown is what Sarm1 controls. So, there must be a biological reason for this breakdown to be so quick and efficient,” said Ligia B. Schmitd, PhD, of the Department of Cell and Developmental Biology, lead author of the study.

Schmidt is a research fellow in the lab of Roman Giger, PhD, co-senior author with Ashley Kalinski of the University of South Carolina.

Using mice bred to lack Sarm1 and subjecting them to peripheral nerve injury, the team could observe drastic changes to the distal nerve environment, including fewer blood-borne immune cells resulting in reduced nerve inflammation.

“These cells are important because they have to enter the injured nerve to clean up all of the debris,” said Schmitd.

More importantly, their study revealed a critical effect on Schwann cells, which line and support the peripheral nerves.

Normally following an injury, Schwann cells will convert to a repair state in which they express different genes and proteins to migrate and proliferate in order to regrow the axon, the long projecting portion of the neuron.

But without Sarm1, “the Schwann cells are just stuck there,” said Schmitd.

In essence, Sarm1 controls both nerve degeneration and regeneration through its effect on Schwann cells.

The team also noted that a lack of Sarm1 seemed to boost the nerve’s efforts to regrow, but without activating the repair Schwann cells, these efforts were much less efficient.

“For a long time, we’ve thought that simply preventing nerve breakdown would be a good thing. What our study now shows is that this early breakdown also sends powerful signals to Schwann cells and immune cells that are needed for efficient repair, so any future therapy that targets Sarm1 will have to preserve that delicate balance between protection and regeneration,” said Giger, professor in the Department of Cell and Developmental Biology.

Schmitd notes that the study needs to be done in other animal models and with other proteins involved in nerve repair, “but if this proves to be an important mechanism for triggering the repair Schwann cell state, then down the road, fixing this response could help humans regenerate peripheral nerves.”

Source: University of Michigan Medicine

Categories : Cancer NeurologyTags :

Study Links Food Insecurity to Tumour Growth in Paediatric Neuroblastoma

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How food insecurity may biologically intensify neuroblastoma growth, bridging social determinants of health and cancer biology 

Image Credit: Justine Ross, Michigan Medicine

Neuroblastoma remains one of the deadliest childhood malignancies, accounting for a disproportionate number of paediatric cancer deaths worldwide.

Despite major therapeutic advances, survival rates remain lower for children from socioeconomically disadvantaged families, a pattern long observed and poorly understood at the biological level.

Extending earlier National Institute of Health’s Children’s Oncology Group findings that linked poverty to poorer survival in paediatric cancers, investigators at University of Michigan Health C.S. Mott Children’s Hospital set out to develop the first experimental model to test how social determinants might influence tumour biology itself.

The team led by Erika Newman, MD, Section Head of Pediatric Surgery and Associate Director for Health Equity at the Rogel Comprehensive Cancer Center developed an innovative murine cancer model that simulated food insecurity by intermittently varying chow access, mirroring the unpredictable nutrition many families experience.

The study, recently published in Communications Biology, used established neuroblastoma validated xenograft models to observe how this stressor affected tumour growth and biologic responses.

The results were striking: the experimental group exposed to food insecurity developed significantly larger and bulkier tumours, accompanied by persistent elevation of stress hormones (corticosterone) and activation of tumour survival pathways.

“Our work builds on decades of clinical evidence linking poverty and food insecurity to poorer cancer outcomes,” said Newman.

“We set out to define the biology behind those disparities, to show how social conditions can become embedded in the body and influence how tumours grow.”

The work provides a translational framework linking social determinants of health to molecular pathways of cancer progression, paving the future for studies that explore how interventions addressing nutrition and stress might improve treatment response.

“This model gives us a scientific bridge between social context and cancer biology,” stated Newman.

“It shows that the environments our patients live in, access to food, stability, and safety are not background conditions. They are part of the biology we must confront if we want equitable outcomes.”

The research arrives at a moment of renewed concern over federal nutrition programs, with potential SNAP benefit interruptions amid government budget negotiations.

Newman emphasises that these findings reinforce the urgency of policies ensuring consistent food access for vulnerable children and families.

Newman stresses that health care must account for the realities in which families live.

She calls for systematic screening of social determinants like food insecurity and economic strain within paediatric and oncology practices, ensuring that medical care addresses both biologic and social drivers of outcome disparities.

Source: University of Michigan Medicine

Categories : NeurologyTags :

Better Brain Health: UP Neurosurgeon Develops Non-invasive, Eye-based Method to Measure Intracranial Pressure

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Prof Llewellyn Padayachy is pioneering work in non-invasive techniques to assess and measure raised pressure inside the skull.

Paediatric neurosurgeon Professor Llewellyn Padayachy, Head of the Department of Neurosurgery at the University of Pretoria’s (UP) Steve Biko Academic Hospital, is redefining how brain-related diseases are diagnosed and treated, especially in low-resource settings. He’s at the forefront of pioneering work in non-invasive techniques to assess and measure raised pressure inside the skull, known as intracranial pressure (ICP).

As part of his PhD 15 years ago, Prof Padayachy set out to find safer methods for earlier diagnosis of brain tumours in children, a patient group that often presented far too late, with tumours already dangerously large. This trend of delayed diagnosis shifted his research focus to detecting raised ICP, pressure within the skull – a critical marker when diagnosing life-threatening neurological conditions. Traditionally, assessing this pressure involves invasive procedures and highly specialised equipment, resources that are often unavailable in rural or primary care settings.

“Ultimately, this non-invasive system offers a ‘thermometer for the brain’ – a simple yet powerful diagnostic tool that enables earlier treatment, better outcomes and more equitable healthcare access,” Prof Padayachy explains. “This research provides a lifesaving bridge between innovation and accessibility, especially on a continent where neurosurgery is severely under-resourced.”

At the heart of this innovation is the concept of the eye as a window to the brain. Initially using ultrasound imaging to measure the optic nerve sheath – along with technologies like optical coherence tomography (which uses light waves to take cross-sectional images of eye tissue), intraocular tonometry (to measure pressure inside the eye) and retinal scanning – his team has refined methods for non-invasively assessing ICP, without radiation or surgical intervention. This offers a faster, safer and more portable method for diagnosing neurological diseases.

Prof Padayachy’s initial work has since expanded to include adult patients, and now plays a crucial role in
identifying a range of central nervous system disorders, including brain tumours, hydrocephalus, infections and intracranial bleeding, conditions where early detection is essential for effective treatment.
This non-invasive approach has major benefits for both patients and health systems.

Early detection of conditions like brain tumours and hydrocephalus allows for intervention when symptoms are still mild and treatment is most effective. Detecting tumours earlier is the best modifier of outcome.

This eye-based technique is designed for point-of-care diagnosis. It is a simple, rapid method that can be employed in GP practices, rural clinics or by assistant nurse, with minimal training. By analysing high volumes of data using machine-learning algorithms, a “traffic light” system has been developed to streamline diagnosis: green for normal, orange for uncertain and red for urgent intervention.

The reduced risk and cost of this approach eliminates the dangers of invasive testing and reliance on expensive imaging tools like magnetic resonance imaging (MRI) and computed tomography (CT) scans, which are often unavailable in rural areas.


It can support broader disease management by aiding in the diagnosis of not just tumours but various central nervous system disorders, including bleeds, infection, strokes and traumatic brain injuries. This technology is also being tested in countries like Norway and Germany, and is applicable to astronauts who experience raised intracranial pressure in microgravity.

A solution for Africa, with global impact

According to the World Health Organization (WHO), more than two billion people around the world lack access to safe surgical care, with low- and middle-income countries carrying the greatest burden. Africa faces immense challenges in neurosurgery, such as severe underfunding, a lack of training positions and a high burden of disease.

There is one neurosurgeon per four million people, far below the WHO’s recommendation of one per 200 000. This shortage, compounded by the lack of a central brain tumour registry and limited access to diagnostics, severely impacts patient outcomes. In South Africa alone, limited infrastructure and only a handful of neurosurgical training posts mean that even the brightest medical talent can be lost in the system.

“We have more than 70 applicants for a single registrar training post,” Prof Padayachy says. “This is completely inadequate. This research demonstrates how innovation born out of necessity can help us overcome these hurdles.”

This non-invasive technique isn’t just capable of transforming care in Africa; its application in diagnosing visual impairment due to raised intracranial pressure in astronauts, where a conventional tool like lumbar puncture is difficult to use, highlights its versatility. Ultrasound, which is portable and radiation-free, is the only imaging modality suitable for space. The same “thermometer for the brain” now being tested in orbit began in the clinics of South Africa.

“With the right support, we can create a self-sustaining model for research in Africa, by Africans,” Prof Padayachy says. “We certainly have the talent, and we can develop the tools to lead the world in non-invasive brain diagnostics.”

Categories : Neurology Surgeries & ProceduresTags :

Surgeons Perform ‘Miraculous’ Reattachment of 2-year-old’s Severed Spinal Cord

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Oliver Staub, 2, smiles while recovering from two complex spinal cord surgeries at UChicago Medicine Comer Children’s Hospital that reattached his head to his spinal cord. Image credit: University of Chicago Medicine

With monitors quietly beeping and multiple tubes going into his small body, Oliver Staub lay in a hospital bed as his parents tearfully started saying goodbye.

On April 17, an armoured car going 70mph (112kph) slammed into the family’s minivan during their vacation in Mexico. Everyone in the car was injured, but no one more than Oliver.

The impact disconnected the 2-year-old’s head from his spine, resulting in a transection of his spinal cord.

Doctors offered a grim prognosis. They told Oliver’s parents, Laura and Stefan, that their son’s neck was broken, he was a quadriplegic, brain dead and would die in a matter of days.

But following a surreal turn of events – which included support from German soccer star Toni Kroos, viral Instagram posts, and traveling more than 2,000 miles for two risky spinal cord surgeries at the University of Chicago Medicine Comer Children’s Hospital — Oliver is now talking, laughing, smiling, moving his fingers and toes and starting to breathe on his own.

“To see someone survive an injury like this? Nothing like this has ever been reported in neurosurgery or spinal cord injuries,” said Mohamad Bydon, MD, Chair of the Department of Neurological Surgery at UChicago Medicine and health system leader for Neurological Surgery, who performed Oliver’s surgeries in July with a multidisciplinary team of surgeons.

“We didn’t think he’d ever be able to move, and now he’s moving all four limbs,” Bydon said. “This is a unique and special case. It’s beyond our wildest expectations.”

‘We have a reason to fight’

As family members gathered at the Mexico City hospital to say goodbye, something incredible happened: Oliver began to show signs of recovery.

His eyes would follow his parents when they were in the room. Stefan and Laura raised the issue with his doctors, who ultimately determined that their son did, in fact, have brain function. They kept his life-sustaining ventilator on.

“It was at that moment that I thought, ‘We have a reason to fight,’” Laura said. “My son was there.”

When doctors could do nothing more for Oliver, they trained his parents on how to care for him and operate his ventilator. Wearing a neck collar and vest to stabilise his head – which, internally, was not connected to his body – Oliver was moved to his grandparents’ home eight hours away, near Morelia, Mexico.

With help from a daily nurse visit, Oliver survived for two months without moving and once having an incident of cardiac arrest. Bydon finds this astounding, given how unlikely it is that someone with an unstable, transected spine could survive at all, much less under the care of his parents.

“If Oliver’s parents and caretakers had made one wrong move in those two months, it could have resulted in death,” Bydon said.

A journey to Chicago

Stefan and Laura researched treatments for severe spinal cord injuries, hoping to provide a better life for their son. They contacted top spinal cord specialists around the world, including Bydon, whose groundbreaking stem cell therapy research impressed them.

They were repeatedly told that surgery, and the travel involved, would be too risky. But Bydon saw hope, in part because Oliver had survived this long.

“You should never count out a 2-year-old. They can surprise you,” Bydon said. “But it would require a complex multidisciplinary team, which is where the University of Chicago could help.”

The surgery needed to be done as soon and safely as possible, Bydon told them.

But travel to the United States for the surgery would be difficult and expensive. The Staubs received aid from family, friends and charities, but were still far short of what they needed.

Global outreach and support

A friend encouraged them to write to the Toni Kroos Foundation, the soccer player’s charity which helps seriously ill children. Stefan and Laura knew it was a long shot.

Two days later, the phone rang at midnight. It was foundation director Claudia Bartz. She’d seen Oliver’s journey on Instagram and was so moved by his story, she decided the foundation would cover the cost of Oliver’s surgery and transport to Chicago.

“We cried and cried. We couldn’t believe it,” Laura said, adding that they only posted on Instagram to keep their friends and family updated on Oliver. “None of this would have been possible without Toni Kroos.”

Oliver soon became a top-trending news story in Germany and their Instagram account blew up, going from a few hundred followers to more than 100 000. Strangers across the world continue to hold fundraisers and prayer vigils, sending the family encouraging messages and donations for his medical expenses.

“We would gladly trade all of this to go back to our normal life,” said Laura, who still has large scars on her head from the accident. “What I’m seeing here? It’s miraculous. We call it ‘The Oliver Effect.’ This is bigger than us.”

‘Harrowing’ surgery, major recovery

When Oliver arrived at Comer in July via medical jet, Bydon performed the first surgery, an occipital cervical fusion, with a team of UChicago Medicine surgeons.

This surgery for a 2-year-old is risky, not only because of how long it is, but also because a toddler cannot tolerate blood loss.

The surgery involved reconstructing Oliver’s spine, repairing his spinal cord and stabilising the back of his head to his cervical spine using titanium rods and screws.

The second surgery, two days later, stabilised the front of his spinal cord and repaired a spinal cord herniation.

“Those first few days after the surgeries were harrowing,” Bydon said. “His heart stopped at one point, and he had swelling in the brain.”

But about five days later, Oliver was making progress and smiled for the first time since the accident. One month later, he was able to grab his mom’s hand, push someone away and recognise the sensation that he needs to urinate. Most impressively, Bydon said, he can now take breaths on his own.

“We know the spine is communicating with the brain and body again,” Bydon said.

Moving forward with family

Oliver was discharged from Comer Children’s on August 15. The family will permanently move from Germany to Mexico, near Laura’s family, and now have hope for the future.

Oliver will have regular physical therapy and take medications for inflammation. In about six months, he’ll be able to remove his neck brace, Bydon said.

Laura and Stefan plan to return to Comer in spring 2026, when Bydon may be able to use novel stem cell therapy clinical trials to improve Oliver’s physical functions, pending special FDA approval.

Stefan and Laura said they’ll always be grateful to Bydon and UChicago Medicine.

“He didn’t promise us a miracle,” Laura said, “but he delivered one.”

Source: University of Chicago Medicine