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46 47 > Research Report // AR 2006
is highly effective in reducing PTSD symptoms. Importantly,
both cognitive therapy and exposure-based therapies are
highly successful in reducing PTSD symptoms compared to a
wait-list control, but PE has greater treatment gains than CR.
Markers of PTSD
The research team is continuing to explore the relationships
between autonomic arousal and neural function in response
to emotional signals and in the context of cognitive tasks.
They have pioneered new integrative analysis techniques
for SCR-fMRI data. They are also examining responses to
positive facial signals in PTSD to explore the integrity of
the reward/approach systems in PTSD. We are examining
structural MRI data to identify specific impairments in brain
regions (particularly anterior cingulate and hippocampus) in
PTSD. Finally, we are integrating autonomic, genetic, spatial
and temporal neural measures (fMRI and EEG) to examine
integrative theoretical models of PTSD.
Depression - objective markers for depression
In Australia, it has been estimated that depression costs
our economy $3.3billion in lost productivity each year,
highlighting the urgent need for valid markers of the illness
and successful treatment. This research, funded by NHMRC
and ARC, is focused on using measures of emotion,
cognition and brain function to identify objective markers
of depression and response to anti-depressant treatment.
Results to date identify distinct brain changes that predict
development of depression.
Pfizer fellowship and NISAD: “Missing links: connectivity
and schizophrenia”
The Centre has focused on young people who have recently
experienced their first-episode of psychosis. The ultimate aim
is to identify the causes of the disorder, and how it might be
prevented or better treated in the future. The project
of normal connectivity revealed in the project reported
under the Cognitive Neuroscience Unit. Schizophrenia
patients showed a reversal of the normal connectivity
between amygdala-frontal networks for processing
stimulus significance.
The inability to ‘bind’ perceptions and cognitions into
a coherent whole in schizophrenia may involve the
networks for determining significance. The findings
support the Centre’s model of schizophrenia as a disorder
of neural connectivity.
Structural brain alterations in schizophrenia
This is a PhD research project which used high-resolution
(~1mm3) images of the brain provided by structural MRI
(sMRI). The same first episode group was studied to provide
a means to link information across projects.
First episode schizophrenia patients showed a loss of grey
matter in the frontal, parietal and temporal cortices, as well
as cerebellum, at the time of their first presentation to mental
health services, relative to matched healthy controls.
In addition, these reductions in grey matter followed a
different pattern of relationship to neural activity to that in
healthy controls. In healthy subjects, grey matter declined
slightly (consistent with neural pruning) and EEG activity
(indexing neural activity) followed a similar pattern. In
schizophrenia, however, there was a preservation or even
increase of EEG activity, particularly for the slow wave Theta
band. This dissociation in schizophrenia is consistent with a
disorganization of pruning, and may be a factor in the cause of
schizophrenia in late adolescence. The increase in EEG activity
may reflect increases in synchronized activity in particular.
Centre for Vision Research
The Blue Mountains eye study
The Blue Mountains Eye Study is a benchmark populationbased
study in ophthalmology. As well as defining the
prevalence, incidence and risk factors for eye diseases, many
novel systemic associations have been explored. The 10-
year mortality and cause of death information from this
Blue Mountains population has been explored in relation
to information derived from grading photographs taken of
the retina at the back of the eye. Retinal vessels may carry
information about the circulation system in the brain and
in other end organs of the body. Our data have shown
that retinal photographs provide information on structural
changes in small vessels of the retina. These signs may
be independent sub clinical markers for vascular disease,
predicting subjects at higher risk of future vascular events,
including the development of stroke, stroke-related death,
cardio-vascular death and high blood pressure in older
people. The Centre has also led to data analyses pooling Blue
Mountains Eye Study and Beaver Dam Eye Study (USA)
data to investigate less frequent retinal vascular lesions such as
retinal emboli and retinal vein occlusion.
Retinal vessel signs in acute stroke patients
This multi-centre clinical cohort study has recruited acute
stroke patients from three centres (stroke units at Westmead
Hospital, Royal Melbourne Hospital and Singapore General
Hospital) to assess whether retinal vessel signs can help to
determine the prognosis for different clinical stroke subtypes,
in collaboration with the Retinal Vascular Imaging Centre
(RetVIC) in Melbourne and stroke specialists in Singapore.
So far, more than 1300 patients have been recruited
following acute stroke. Retinal photographs were taken and
the assessment of these signs is currently underway.
Cataract surgery and risk of age-related macular Degeneration
Age-related Macular Degeneration (AMD) is the leading
cause of blindness in older people. Previous populationbased
studies have suggested at least a 3-fold higher risk of
progression to late-stage AMD in eyes after cataract surgery.
This project aims to confirm these findings in a much larger
sample of older people having cataract surgery and also to
look at cataract surgery outcomes, including the impact on
quality of life.
Almost 2,000 patients undergoing cataract surgery at
Westmead Hospital and from private ophthalmologist rooms
have been recruited, with over 1200 patients being reexamined
6 months post-operatively. We plan to follow these
patients for up to 5 years to assess both short-term (2-3 years)
and long-term risks of AMD after cataract surgery.
The Sydney childhood eye study
This project has assessed the frequency and risk factors
associated with myopia and other common eye conditions
in school children aged 6 or 12 years. The project examined
1740 6-year-old and 2353 12-year-old children from almost
60 primary and secondary schools across Sydney.
Reports from this study have identified that reduced outdoor
activity, rather than increased close work, may predict
myopia (short-sightedness). The study also showed that other
common childhood eye conditions like amblyopia (reduced
vision in one eye) and strabismus (squint) are relatively well
detected at present, but identified new risk factors, particularly
modest levels of lower birth weight or prematurity.
The new phase (Sydney Paediatric Eye Disease Study) is now
examining a large sample of children aged less than 6 years
to determine factors associated with the development of
amblyopia and its detection in very young children.
compared first episode schizophrenia patients to the pattern