The Neurovascular Research Laboratory is predominately interested in the vascular adaptations that occur with physical activity, aging, healthy eating and high-altitude adaptation.
Our current research areas include:
The neuroprotective benefits of high-intensity interval training
Concussion and head injury in sport
The control of cerebral blood flow at high altitude and during space flight
Cardiopulmonary exercise testing and post-operative outcome
Post-prandial hyperlipidaemia, antioxidants and vascular function
Haemostasis and its interaction with vascular disease
Chronic spinal pain and cognitive health
The group continues to lead the way in terms of research outputs having published in some of the highest impact-factor journals leading the molecular-vascular science specialist fields.
The impact of its work is further demonstrated nationally and internationally through invited presentations, media coverage and successful grant applications.
In 2016, the international research team Global Research Expedition on Altitude Related Chronic Health (Global REACH) was established and executed a high-altitude research expedition to Nepal. The team consists of ∼45 students, principal investigators and physicians with the common objective of conducting experiments focused on high altitude adaptation in lowlanders and in highlanders with lifelong exposure to high altitude.
In 2018, Global REACH travelled to Peru, where they performed a series of experiments on lowlanders following acclimatisation and in the Andean highlanders who have resided at high-altitude for ~7,000 to ~10,000 years. Alongside Visiting Professor Phillip Ainslie of the University of British Columbia-Okanagan, Professor Damian Bailey (Professor of Physiology and Biochemistry) and Benjamin Stacey (Lecturer in Clinical Science) of the Neurovascular Research Laboratory, University of South Wales aimed to further their previous research examining the impact of high-altitude on the molecular determinants that control the regulation of brain blood flow in both healthy lowlanders, healthy highlanders and maladapted highlanders with chronic mountain sickness (Video 1). A detailed overview of this expedition has been published in Experimental Physiology.
The lab in action in Cerro De Pasco, Peru
It is estimated 5–10% of high altitude dwellers are at risk of developing chronic mountain sickness which is a public health concern primarily in the Andes, but also in Kyrgyzstan, Northern India, and among migrants to high altitude in Tibet and the USA. This is clinically relevant given that nearly a third (11 million) of Peru's population and more than 140 million people worldwide, live at high altitude (>2500m), often in areas that are either poor, such as Ethiopia, Ecuador and Bolivia, or highly controlled, such as Tibet. Among the highest reported prevalence is in the mining city of Cerro de Pasco, Peru (Video 2), where 15% of men aged 30–39 years and 34% aged 60–69 years present with chronic mountain sickness.
Cerro De Pasco panorama
In low- and middle-income countries, cardiovascular disease and cerebrovascular disease are rapidly becoming the leading causes of morbidity and mortality for both women and men, mainly due to changes in established risk factors. At high-altitude, in Cerro de Pasco, Peru (4340 m), at least 15-20% of deaths are caused by cardiovascular disease and 4.6% caused by cerebrovascular disease. Recent evidence from our group has provided a molecular basis to explain why individuals with chronic mountain sickness present with increased risk of cardiovascular-cerebrovascular disease risk, namely attributable to significantly high blood viscosity, a disruption imbalance of oxidants and anti-oxidants and lower resting brain blood flow which has been associated with cognitive decline and depression in this unique population.
Research on high altitude physiology offers complementary insight into biological adaptation to high-altitude. The ways in which results from these expeditions can be applied are multifaceted, with implications for military deployment to high-altitude (e.g. Afghanistan), for the growing numbers (>1 million) of lowlanders taking vacations at high altitude destinations, and for commercial flight personnel, who experience low levels of oxygen during flight. These data can have direct translational impact for patients in critical care and in other clinical situations of arterial hypoxemia (e.g. lung disease, heart failure, circulatory shock). Importantly, these research expeditions give us new insight into the current physiological status of local highlanders (Tibetan, Peruvian and Ethiopian), which might lead to related health benefits in these populations. The results from this expedition will be a valuable step towards effective treatments for the cardiovascular and cerebrovascular disease and ultimately help inform government policies to provide adequate healthcare to high-altitude inhabitants.
The aged population is growing rapidly, which is associated with an increase in the burden of cognitive decline, dementia and stroke. Currently, there are no curative treatments available and therefore focus is being directed towards preventative measures. One of these preventative measures is physical activity, which has been shown be highly beneficial to brain health.
Unfortunately, the time burden associated with physical activity is a major barrier to participation. In order to address this a novel exercise paradigm, high-intensity interval training (HIIT), has emerged in recent years. However, the effect of HIIT on brain function remains to be established.
Resultantly, we are conducting studies to assess the short-term and long-term effects of HIIT on physiological and cognitive function within the brain. This helps us to understand the potential benefits of HIIT and promote it as a valuable public health intervention with the aim of preventing neurodegenerative disease.
There is growing concern that the repetitive impact of heading the ball in football may cause sub-concussive trauma and lead to accelerated cognitive decline/early onset dementia in later-life.
Heading is already banned for younger players in the USA. However, until more research is conducted on both the short- and long-term effects of heading the ball, as well as the underlying physiological mechanisms that may underpin these changes in cognition, it is difficult to determine whether other countries should follow suit.
Therefore, we are currently embarking on studies that will help address these concerns in both male and female footballers.
Sports-related concussion (SRC) represents a significant and growing public health concern, yet remains one of the least understood injuries facing the sports medicine community. There is increasing concern that prior recurrent concussion may contribute to long-term neurologic consequences in later-life and the development of neurodegenerative diseases, including dementia and chronic traumatic encephalopathy (CTE).
Our research has implemented a functionally integrated translational model which sought to determine the metabolic, cerebral-haemodynamic and clinical implications of prior recurrent concussion across the lifespan of rugby union players. Two large scale projects have been conducted to date including, 1) a longitudinal observation of professional rugby union players across one season and, 2) a cross sectional comparison of retired rugby union players with a non-concussed control group. The findings of the studies suggest that sports related concussion serves as a model of accelerated brain ageing and may increase a person’s trajectory towards neurodegenerative disease in later life.
Physical exercise is known to improve fitness and decrease all-cause mortality across the human age continuum. However, with time demands proving a barrier to participation, High Intensity Interval Training (HIIT), is emerging as a potential exercise regimen that can give great cardiorespiratory benefits, but also increase the risk of thrombophilic (clot-related) complications.
The Neurovascular Research Laboratory is currently undertaking research designed to assess the safety of High Intensity Interval Training as a method of exercise rehabilitation.
Specifically, we are interested in the impact it may or may not have on the activation of the blood coagulation system. The aim of this research is to explore the mechanisms that underpin exercise’s influence on blood clotting.
Understanding how the brain defends oxygen delivery to itself is of significant clinical importance given that many brain disorders, such as stroke, Alzheimer’s disease and associated dementias are characterised by an impairment in oxygen and nutrient delivery to the brain.
The Neurovascular Research Laboratory is currently researching the molecular mechanisms that underpin the regulation of cerebrovascular (brain) function during exposure to low oxygen levels (hypoxia) in lowlander and high-altitude natives.
New research is focusing on the relationship between spinal pain, physical activity levels and the onset of cognitive decline and possibly dementia as a working hypothesis.
Previous studies have established an association between spinal pain and physical activity levels and between physical activity and cognitive decline.
However, to date, investigations have failed to determine the potential association between spinal pain and accelerated cognitive decline and to what extent this association is affected by physical activity levels. In order to explore these relationships we have gained access to the Danish Twins Registry (DTR), which is the second largest twins database in the world through an important collaboration between USW and Southern Denmark University.
We are currently investigating both cross sectional and longitudinal analyses of the Longitudinal Study of Aging Danish Twins (LSADT), which is contained within the DTR and collected over four specific waves in 1995, 1997, 1999 and 2001 with two-year follow up interviews up to and including 2005.
The research will look specifically at the impact of spinal pain and cognitive change matched against a number of covariates including standard demographics (age, gender, education and socioeconomic status, physical activity levels and other comorbidities.
This part of the research will inform the second phase of the research which will explore the mechanistic aspects of this relationship measuring various molecular, haemodynamic and clinical factors in a randomized trial conducted within the Welsh Institute of Chiropractic.
This is a very exciting project through the Neurovascular Lab led by Professor Damian Bailey and Professor David Byfield at USW and our collaborator Professor Jan Hartvigsen at Southern Denmark University along with colleagues at the DTR.
We are currently exploring the link between preoperative cardiorespiratory fitness and postoperative survival in patients undergoing major surgery. In collaboration with the University Hospital of Wales, Cardiff, Department of Anaesthetics, this work has helped optimise the identification of patients at high risk of postoperative complications and mortality, which supports patient care decisions.
The use of exercise training prior to surgery is becoming widely acknowledged as an integral part of multimodal “prehabilitation” strategies, as the stress of undergoing major surgery is much akin to that of running a marathon! Importantly, (low) cardiorespiratory fitness is a modifiable risk factor, and our work here is helping assess the feasibility and efficacy of preoperative exercise interventions designed to improve postoperative outcomes.
Furthermore, we are also providing the South Wales (exercise) intervention arm for the CHALLENGE-UK trial (a phase III study of the impact of a physical activity programme on disease-free survival in patients with high risk stage II or stage III colon cancer: a randomised controlled trial).
Chronic Mountain Sickness (CMS) or ‘Monge’s Disease’ as it was first described by Dr Carlos Monge in 1925 is one of the conditions that affects ≈5% of the population in Bolivia and is recognised by the World Health Organisation as a major public health problem for Andean countries since several million Altiplano residents may be at risk.
Our study aims to explore the relationship between endothelial function, cognitive performance and dietary antioxidants in hypoxic [diseased (CMS+) and non-diseased (CMS-)] and non-hypoxic age matched lowlander controls.
It aims to determine if a link exists between inadequate intake of dietary antioxidants (naturally found in foods), endothelial function and cognition in CMS+ patients.
