Current research

Prof. Marios Papadopoulos is the academic neurosurgeon at St. George’s. He is also the Head of the Neurosciences Centre within St. George’s University of London. There are several research fellows and graduate students in the department.

Current research projects include:

Novel monitoring to optimize the early management of patients with severe spinal cord injury

In collaboration with Dr. Argyro Zoumprouli (intensive care) and Prof. Marek Czosnyka’s group in Cambridge, Prof. Papadopoulos has developed techniques to monitor intraspinal pressure and spinal cord perfusion pressure after spinal cord injury. This is analogous to monitoring intracranial pressure and cerebral perfusion pressure after brain injury.

For further details see Monitoring of Spinal Cord Perfusion Pressure in Acute Spinal Cord Injury Initial Findings of the Injured Spinal Cord Pressure Evaluation Study

Blood flow in injured human spinal cord

Prof. Marios Papadopoulos: Blood flow in injured human spinal cord. Indocyanine Green fluorescence at 5, 10, 15 and 20 seconds. Spinal cord blood flow was assessed at spinal cord perfusion pressure (SCPP) 71 and 60 mmHg.

Developing novel surgical techniques to improve outcome after spinal cord injury

Prof. Papadopoulos’ group has developed a novel surgical technique termed expansion duroplasty, which redcues the pressure on the injured spinal cord after injury.

Duroplasty technique

Duroplasty technique. A. (left) Exposed dura after laminectomy. (middle) Durotomy held open with forceps showing injured spinal cord and pressure probe. (right) Sutured dural patch. B. Pre-operative MRI showing injured cord. C. Post-operative (left) CT showing pressure probe and (right) MRI showing duroplasty.

 

Spinal cord regeneration

Prof. Geoffrey Raisman has recently been appointed to help develop surgical techniques to implant olfactory ensheathing cells into the damaged spinal cord to promote regeneration. Prof. Raisman has developed this technique and has recently shown that it works in humans. This was the subject of a recent BBC Panorama programme.

For further details see Functional regeneration of supraspinal connections in a patient with transected spinal cord following transplantation of bulbar olfactory ensheathing cells with peripheral nerve bridging

 

MR spectroscopy of brain tumours

Prof. Franklyn Howe has developed MRI-based techniques to help diagnose brain tumours non-invasively. Some of these techniques are used clinically, e.g. to target the most aggressive part of a glioma for biopsy.

Prof. Franklyn Howe: MR Spectroscopy of brain tumours.

Prof. Franklyn Howe: MR Spectroscopy of brain tumours. Low grade glioma and infiltrative regions in the high grade tumours appear green, the necrotic core of the high-grade tumour appears red and normal brain tissue blue.

 

Diffusion-weighted MR of brain

Dr. Thomas Barrick uses diffusion-weighted MRI to map out the white matter tracts in the brain. Some of these techniques are used clinically e.g. to define the relationship between a brain lesion and associated white matter tracts.

Dr. Thomas Barrick: Brain pathways. A colored 3-D MRI scan of the brain's white matter pathways traces connections between cells in the cerebrum and the brainstem.

Dr. Thomas Barrick: Brain pathways. A colored 3-D MRI scan of the brain’s white matter pathways traces connections between cells in the cerebrum and the brainstem.

 

Basic science

Prof. Papadopoulos’ laboratory investigates the roles of aquaporin water channels in the brain and spinal cord. In collaboration with Alan Verkan in San Francisco, they have characterized the role of aquaporins in brain oedema and cell migration.  A major goal of his laboratory is to understand the role of aquaporin-4 in neuromelitis optical and develop novel treatments. For further information see Treatment of neuromyelitis optica state-of-the-art and emerging therapies

The sequence of aquaporin-4

The sequence of aquaporin-4, the main water channel found in the brain and spinal cord

 

Clinical neurosurgical trials

The neurosurgery unit has contributed patients in multiple national and international clinical neurosurgical trials including STICH, STICH2, STITCH, RESCUEicp, STASH, GOSH and others.