Diagnosis and Treatment of Spinal Cord Injury

1st Edition - May 10, 2022
Editors: Rajkumar Rajendram, Victor R Preedy, Colin R Martin
Language: English
Hardback ISBN:
9 7 8 - 0 - 1 2 - 8 2 2 4 9 8 - 4
eBook ISBN:
9 7 8 - 0 - 1 2 - 8 2 2 4 9 9 - 1

Diagnosis and Treatment of Spinal Cord Injury will enhance readers’ understanding of the complexities of the diagnosis and management of spinal cord injuries. Featuring chapte… Read more

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Diagnosis and Treatment of Spinal Cord Injury will enhance readers’ understanding of the complexities of the diagnosis and management of spinal cord injuries. Featuring chapters on drug delivery, exercise, and rehabilitation, this volume discusses in detail the impact of the clinical features, diagnosis, management, and long-term prognosis of spinal cord injuries on the lives of those affected. The book has applicability for neuroscientists, neurologists, clinicians, and anyone working to better understand spinal cord injuries.

Cover image
Title page
Table of Contents
Copyright
Dedication
Contributors
Preface
Section A: Setting the scene: Introductory chapters
Chapter 1: Traumatic spinal cord injury and outcomes in low-resource settings
Abstract
Introduction
Epidemiology
Etiology
Diagnosis
Prehospital and acute management
Treatment strategies
Post-acute medical care and rehabilitation
Applications to other areas of neuroscience
Key facts of global traumatic spinal cord injury epidemiology and etiology
Summary points
References
Chapter 2: Biomechanics and patterns of spine injuries associated with spinal cord injury
Abstract
Introduction
Pathogenesis of TSCI: The critical role of spine biomechanics
Patterns of spine injuries associated with spinal cord injuries
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts
Summary points
References
Chapter 3: Body, action, and space representations in people affected by spinal cord injuries
Abstract
Introduction
The neuroplasticity following SCI and the networks involved in the body, space, and action representations
The body representations
The action representation
The space representation
The effects of rehabilitation on the body, action, and space representations
Conclusions
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of neuroplasticity following spinal cord injury
Summary points
References
Chapter 4: Methods for treating pain and painful syndromes in spinal cord injury: Medications, therapies, interventions, and neuromodulation
Abstract
Introduction
Application to other areas of neuroscience
Main narrative text
Mini-dictionary of terms
Key facts of pain after SCI
Summary points
References
Section B: Clinical features of spinal injury
Chapter 5: Factors contributing to pressure injuries in traumatic spinal cord injury
Abstract
Introduction
Pathophysiology of pressure injuries
Prevalence, impact, and cost of pressure injuries in patients with SCI
Structural and physiological changes following SCI
Risk assessment tools
Risk factors associated with pressure injuries in patients with traumatic spinal cord injury
Conclusion
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of pressure injuries
Summary points
References
Chapter 6: Venous thromboembolism in spinal cord injury—Prophylaxis, diagnosis and treatment
Abstract
Introduction
Epidemiology
Screening
Prophylaxis
Diagnosis
Treatment
Conclusion
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of venous thromboembolism in spinal cord injury
Summary points
References
Chapter 7: Osteoporosis-related fractures: What they are and how they occur following spinal cord injury
Abstract
Introduction
Physiopathology
Fractures
Risk factors
Diagnosis
Treatment
Conclusion
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of osteoporosis after spinal cord injury
Key facts of fragility fractures after spinal cord injury
Key facts of diagnosis of osteoporosis after spinal cord injury
Key facts of treatment for osteoporosis-related fractures after spinal cord injury
Summary points
References
Chapter 8: Understanding the effects of prolonged cervical spinal cord compression on the brain. Current knowledge and future challenges
Abstract
Introduction
Cervical spine compression causes brain atrophy
Cervical spine compression causes neural plasticity to preserve function
Cervical spine compression changes the functional connectivity of the brain
Cervical spine compression also damages the brain WM
Conclusion and future perspectives
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of spinal cord compression
Key facts of advanced MRI techniques
Summary points of cervical spine compression
References
Chapter 9: Spasticity in spinal cord injury
Abstract
Introduction
Pathophysiology of spasticity
Manifestations of spasticity in spinal injuries
Assessment of spasticity and its consequences
Treatment of spasticity
Modalities of treatment in spinal injury
Outcome measures after treatment
Management protocol for spasticity in spinal cord injury
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of “diagnosis of spasticity in spinal cord injury”
Key facts of “treatment of spasticity in spinal cord injury”
Summary points
References
Chapter 10: Fall circumstances, consequences, assessments, and interventions to manage fall risk among individuals living with spinal cord injury
Abstract
Introduction
Fall frequency
Fall circumstances
Consequences of falls
Assessment of fall risk
Intervention program to manage fall risk
Application to other areas of neuroscience
Mini-dictionary of terms
Key facts of fall frequency and fall circumstances
Key facts of consequences of falls
Summary points
References
Chapter 11: Infections and spinal cord injury: Covid-19 and beyond
Abstract
Introduction
Immunosuppression due to spinal cord injury
Leading infection diseases in spinal cord-injured patients
COVID-19 disease: A new infectious normality in spinal cord-injured patients?
Key facts of “infections and spinal cord injury: Covid-19 and beyond”
Summary points
References
Chapter 12: Sleep problems in spinal cord injury
Abstract
Introduction
Sleep-disordered breathing
Prevalence of sleep-disordered breathing after tetraplegia
Sleep-disordered breathing is an acute and direct consequence of cervical SCI
Sleep-disordered breathing after tetraplegia has clinically important impacts
Why do people with tetraplegia have sleep-disordered breathing, predominantly obstructive sleep apnea?
Clinical management of sleep-disordered breathing in people with SCI
How does SCI alter the circadian rhythm?
Periodic leg movements of sleep in SCI
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of sleep
Summary points
References
Further reading
Section C: Diagnosis and evaluation
Chapter 13: Biomarkers in spinal cord injury: A highlight on prognostic insights
Abstract
Acknowledgments
Introduction
Pathophysiology of SCI
Biomarkers of SCI
microRNAs as biomarkers
Exosomes
Conclusions
Mini-dictionary of terms
Key facts of biomarkers spinal cord injury
Summary points
References
Chapter 14: Quality of life tools for spinal cord–injured people
Abstract
Introduction
Definitions: Quality of life and health-related quality of life
Implementation in the study of quality of life in people with spinal cord injury
Integrative quality of life assessment instruments
Health-related quality of life assessment instruments for conditions resulting from spinal cord injury
Conclusions
Applications to other areas of neuroscience
Dictionary of terms
Key facts of measuring quality of life in sci people
Summary
References
Chapter 15: S100b in spinal cord injury
Abstract
Introduction
S100b characteristics
S100b and CNS pathology
Biomarkers in SCI
S100b and SCI
Limitations and perspectives
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of calcium-binding proteins
Summary points
References
Chapter 16: Assessment of postural control after spinal cord injury or disease: A narrative review
Abstract
Introduction
Chapter objectives
Comprehensive assessment of postural control
Current state of postural control assessment in clinical settings
Instrumented assessments of postural control
Individualized and comprehensive assessment of postural control after SCI/D
Wheelchair users: Assessment of postural control
Part-time ambulators: Assessment of postural control
Full-time ambulators: Assessment of postural control
Summary
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of postural control
Summary points
References
Section D: Treatments: Experimental and clinical
Chapter 17: Surgical management of acute spinal cord injury in emergency setting
Abstract
Introduction
Natural history of patients with acute cervical SCI
Natural history of patients with thoracic or thoracolumbar SCI
Surgical procedures
How to define early versus late surgery post SCI?
Which is the most efficacious threshold?
What threshold is feasible?
Does ESD offers the same benefit for all acute SCI?
Complete versus incomplete SCI
Effects of ESD on different neurological level of injury
The special case of Central Cord Syndrome
Conclusions
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of surgical treatment of spinal cord injury
Summary points
References
Chapter 18: Spinal cord epidural stimulation for autonomic nervous system control: A focus on improving bladder, bowel, and cardiovascular function
Abstract
Introduction
Future directions with scES and applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of autonomic dysfunction after SCI
Key facts of scES after SCI
Summary points
References
Chapter 19: Treating spinal cord injury with implanted spinal cord stimulators
Abstract
Introduction
Spinal cord stimulation
Spinal cord stimulators
Significance of SCS
Current limitations of the neurostimulators
Advanced neurostimulators
Prospects of the stimulation for spinal cord injury rehabilitation
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of spinal cord injury
Summary points
References
Chapter 20: Bowel dysfunction in spinal cord injury
Abstract
Introduction
Characteristics of neurogenic bowel in spinal cord injury
Clinical manifestations
Diagnosis
Conservative treatment of the neurogenic bowel
Surgical treatment of the neurogenic bowel
Conclusions
Applications to other areas of neuroscience
Dictionary of terms
Key facts of neurogenic bowel dysfunction
Summary points
References
Chapter 21: Management of neurogenic lower urinary tract dysfunction due to spinal cord injury
Abstract
Introduction
Physiology of storage and emptying
Pathophysiology of NLUTD due to SCI
Overview of management of patients with NLUTD due to SCI
Basic and optional assessments
Urinary management (Table 3)
Pharmacological treatment
Assessment of clinical outcomes (periodic follow-up)
Surgical treatment
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of catheters for clean intermittent catheterization
Summary points
References
Chapter 22: Bed support surfaces for preventing pressure injuries after spinal cord injury
Abstract
Introduction
Pressure injuries (PI): Definition, epidemiology and impacts
Pathogenesis of pressure injuries following spinal cord injury
Support surfaces: An approach for prevention and treatment of pressure injuries
Conclusion
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of pressure injuries after spinal cord injury
Summary points
References
Chapter 23: Nerve and tendon transfers in tetraplegia: A new narrative
Abstract
Introduction
Classifications
Indications and timing
Group 0
Group 1
Group 2
Group 3
Group 4
Group 5
Group 6
Group 7
Group 8
Group 9
Conclusions
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of nerve and tendon transfers in tetraplegia: A new narrative
Summary points
References
Chapter 24: GEMINI-supported spinal cord transplantation for the treatment of chronic spinal paralysis: Overview and initial clinical translation
Abstract
Introduction
The GEMINI spinal cord fusion protocol: Overview
GEMINI: Fusogens
GEMINI: Electrical stimulation
Clinical translation
Current human trial
Conclusion
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of the GEMINI spinal cord fusion protocol for spinal cord injury
Summary points
References
Chapter 25: Chondroitinase ABC I as a novel candidate for reducing damage in spinal cord injury
Abstract
Molecular perspectives
Glycosaminoglycan degrading enzymes: A brief description
Chondroitinase ABC I and spinal cord injury
Chondroitinase ABC I for enzyme therapy: Challenges and perspectives
Combinatorial therapy with chondroitinase ABC I
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of chondroitinase ABC I
Key facts of the therapeutic potential of chondroitinase ABC I
Summary points
References
Chapter 26: Phenol neurolysis for spasticity management in people with spinal cord injury
Abstract
Introduction
Phenol or alcohol neurolysis history
Mechanism of action
Phenol neurolysis technique and dose
Adverse effects
Case study
Conclusion/summary
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of phenol
Summary points
References
Chapter 27: Anti-repulsive guidance molecule: An antibody treatment in spinal cord injury
Abstract
Introduction
Characteristics of RGMa
RGMa in spinal cord injury (SCI)
Clinical studies
RGMa in other CNS disorders
Conclusions
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of axonal sprouting
Summary points
References
Chapter 28: Mitochondrial biogenesis for the treatment of spinal cord injury
Abstract
Introduction
Mitochondrial dysfunction
Mitochondrial biogenesis
Cell type-specific mitochondrial dysfunction and MB
Mitochondrial biogenesis mediates consequences of SCI
Limitations of MB
Mini-dictionary
Key facts
Summary points
References
Chapter 29: Exploring the exogenous and endogenous effects of melatonin on spinal cord injury
Abstract
Introduction
Effects of exogenous melatonin on secondary injury after spinal cord injury
Combination treatment strategy for spinal cord injury
Role of endogenous melatonin in spinal cord injury
Clinical application of melatonin in spinal cord injury
Conclusion
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts
Summary points
References
Chapter 30: High-intensity interval training in individuals with spinal cord injury
Abstract
Introduction
Section 1: Background and overview
Section 2: Cardiometabolic comorbidities associated with SCI
Section 3: SCI exercise benefits, guidelines, and participation
Section 4: Health benefits of high-intensity interval training
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of SCI and exercise
Summary points
References
Chapter 31: Stem cells and chronic spinal cord injury: Overview
Abstract
Introduction
Pathophysiology of SCI
Stem cells: A brief overview
Embryonic stem cells—An overview of pre-clinical findings
Toward autologous transplantation: Mesenchymal stem cells
Cellular reprogramming: Induced pluripotent stem cells
Translation to the bedside
The role of immunity
Applications to other areas of neuroscience
Conclusion
Mini-dictionary of terms
Key facts for stem cells
Key facts for spinal cord injury
Summary points
References
Chapter 32: Viral vector gene therapy approaches for regeneration and repair in spinal cord injury
Abstract
Introduction
Viral vector approaches
Routes of administration
Viral vector approaches for therapeutic delivery
Other approaches
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of viral vectors and spinal cord injury
Summary points
References
Chapter 33: Curcumin usage for inflammation and spinal cord injury
Abstract
Introduction
Structure, pharmacology, and biological targets
Anti-inflammatory effects
Anti-oxidant effects
Stem cell and progenitor cell proliferation
Facilitation of neurologic function recovery
Conclusion and future direction
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of curcumin
Summary points
References
Chapter 34: Use of (−)-epigallocatechin-3-gallate on spinal cord injury
Abstract
Introduction
In vivo studies
In vitro studies
Applications to other areas of neuroscience
Conclusion
Mini-dictionary of terms
Key facts of EGCG
Summary points
References
Chapter 35: Vitamin D and spinal cord injury
Abstract
Introduction
Vitamin D recommendations: Intake, sources, and status
Function and physiology
Vitamin D status of active individuals with SCI
Conclusion
Application to other areas of neuroscience (200–750 words)
Mini-dictionary of terms
Key facts of vitamin D and spinal cord injury
Summary points
References
Chapter 36: Corticospinal tract regeneration after spinal cord injury: Implications for treatment and recovery
Abstract
Introduction
CST development
Spinal cord injury induced spontaneous sprouting of CST
Promotion of CST regenerative sprouting
Robust CST regeneration into caudalized NPC graft after SCI
Reconnect injured spinal cord through neuronal relays
Future prospective
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of corticospinal tract regeneration after spinal cord injury
Summary points
References
Chapter 37: Trophic factors in patients with spinal cord injury
Abstract
Introduction
Role of neurotrophic factors in human neural plasticity after SCI
Different environments enhance trophic factors delivery
Therapeutic potential of trophic factors
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of spinal cord injury
Key facts therapeutic approaches
Summary points
References
Section E: Rehabilitation in spinal injury
Chapter 38: Spinal cord injury: Multiple family group (MFG) education and support
Abstract
Introduction
Epidemiology of spinal cord injury
Life impact and medical support
Spinal cord injury after-effects
Impacts of SCI on family caregivers
Impact of multiple family groups (MFG) on psychiatric outcomes
Adapting multiple family group treatment for brain and spinal cord injury
Comparison of MFG to educational control (EC)
Implementation and dissemination opportunities and barriers
Conclusion
Summary points
References
Chapter 39: Spinal cord injury rehabilitation: Linking service delivery and community integration
Abstract
Introduction
Prioritizing community integration
Interplay between health condition, person factors, and environmental factors
Models and approaches to community integration
Assistive technology, transport, housing
Leisure and social participation
The role of peer mentors in community integration
Return to work
Self-management, education and health literacy
Summary
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of spinal cord injury community integration
Summary points
References
Chapter 40: Rehabilitation in spinal cord injury: Exercise and testing for cardiorespiratory endurance and musculoskeletal fitness
Abstract
Introduction
Exercise and persons with a spinal cord injury
Exercise testing for persons with a spinal cord injury
Cardiorespiratory endurance testing
Musculoskeletal fitness testing
Application to other areas in neuroscience
Mini-dictionary of terms
Key facts of rehabilitation in spinal cord injury: Exercise and testing for cardiorespiratory endurance and musculoskeletal fitness
Summary points
References
Chapter 41: Community-based activity-based therapy for spinal cord injuries rehabilitation
Abstract
Introduction
Recovery after spinal cord injuries
Conventional rehabilitation after spinal cord injuries
Activity-based therapies
Applications to other areas of neuroscience
Mini dictionary of terms:
Key facts of activity-based therapy in the community
Summary points
References
Chapter 42: Mobile health apps and self-management for spinal cord injury rehabilitation
Abstract
Introduction
Chronic disease management
Traditional SCI self-management interventions
eHealth technology and mHealth apps
mHealth app needs among individuals with SCI
Development and pilot implementation of mHealth apps for SCI self-management
Clinical interventions on mHealth apps for SCI self-management
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of spinal cord injury
Key facts of eHealth
Summary points
References
Chapter 43: Biomaterials, spinal cord injury, and rehabilitation: A new narrative
Abstract
Introduction
Hydrogels and scaffolds
Nanomaterials
Case study: Agarose–carbomer-based hydrogels
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of “Biomaterials, spinal cord injury, and rehabilitation: A new narrative”
Summary points
References
Chapter 44: Support in spinal cord injury: A focus on robotics
Abstract
Introduction
Upper limb robots
Stationary lower limb robots
Ambulatory exoskeletons
Applications to other areas of neuroscience
Mini-dictionary of terms
Key facts of functional recovery
Summary points
References
Section F: Resources
Chapter 45: Recommended resources and sites for the neuroscience of spinal cord injury
Abstract
Acknowledgements (in alphabetical order)
Introduction
Resources
Application to other areas of neuroscience
Mini-dictionary of terms
Key facts of spinal cord injury
Summary points
References
Index

Rajkumar Rajendram

Dr Rajkumar Rajendram is a clinician scientist with a focus on internal medicine, anaesthesia, intensive care and peri-operative medicine. He graduated with distinctions from Guy’s, King’s and St. Thomas Medical School, King’s College London in 2001. As an undergraduate he was awarded several prizes, merits and distinctions in pre-clinical and clinical subjects.

Dr Rajendram began his post-graduate medical training in general medicine and intensive care in Oxford. He attained membership of the Royal College of Physicians (MRCP) in 2004 and completed specialist training in acute and general medicine in Oxford in 2010. Dr Rajendram subsequently practiced as a Consultant in Acute General Medicine at the John Radcliffe Hospital, Oxford.

Dr Rajendram also trained in anaesthesia and intensive care in London and was awarded a fellowship of the Royal College of Anaesthetists (FRCA) in 2009. He completed advanced training in regional anaesthesia and intensive care. He was awarded a fellowship of the Faculty of Intensive Care Medicine (FFICM) in 2013 and obtained the European diploma of intensive care medicine (EDIC) in 2014. He then moved to the Royal Free London Hospitals as a Consultant in Intensive Care, Anaesthesia and Peri-operative Medicine. He has been a fellow of the Royal College of Physicians of Edinburgh (FRCP Edin) and the Royal College of Physicians of London (FRCP Lond) since 2017 and 2019 respectively. He is currently a Consultant in Internal Medicine at King Abdulaziz Medical City, National Guard Heath Affairs, Riyadh, Saudi Arabia.

Dr Rajendram’s focus on improving outcomes from Coronavirus Disease 2019 (COVID-19) has involved research on point of care ultrasound and phenotypes of COVID-19. Dr Rajendram also recognises that nutritional support is a fundamental aspect of medical care. This is particularly important for patients with COVID-19. As a clinician scientist he has therefore devoted significant time and effort into nutritional science research and education. He is an affiliated member of the Nutritional Sciences Research Division of King’s College London and has published over 400 textbook chapters, review articles, peer-reviewed papers and abstracts.

Affiliations and expertise

Consultant in Internal Medicine, King Abdulaziz Medical City, National Guard Heath Affairs, Riyadh, Saudi Arabia

Victor R Preedy

Victor R. Preedy BSc, PhD, DSc, FRSB, FRSPH, FRSC, FRCPath graduated with an Honours Degree in Biology and Physiology with Pharmacology. After gaining his University of London PhD, he received his Membership of the Royal College of Pathologists. He was later awarded his second doctorate (DSc), for his contribution to protein metabolism in health and disease. He is Professor of Clinical Biochemistry (Hon) at King’s College Hospital and Emeritus Professor of Nutritional Biochemistry at King’s College London. He has Honorary Professorships at the University of Hull, and the University of Suffolk. Professor Preedy was the Founding Director and then long-term Director of the Genomics Centre at King’s College London from 2006 to 2020. Professor Preedy has been awarded fellowships of the Royal Society of Biology, the Royal College of Pathologists, the Royal Society for the Promotion of Health, the Royal Institute of Public Health, the Royal Society for Public Health, the Royal Society of Chemistry and the Royal Society of Medicine. He carried out research when attached to the National Heart Hospital (part of Imperial College London), The School of Pharmacy (now part of University College London) and the MRC Centre at Northwick Park Hospital. He has collaborated with international research groups in Finland, Japan, Australia, USA, and Germany. To his credit, Professor Preedy has published over 750 articles, which includes peer-reviewed manuscripts based on original research, abstracts and symposium presentations, reviews and edited books.

Affiliations and expertise

Professor, Department of Clinical Biochemistry, King’s College Hospital, London, UK; Emeritus Professor, Faculty of Life Sciences and Medicine, King’s College London, UK Visiting Professor, University of Hull, UK

Colin R Martin

Colin R. Martin RN, BSc, MSc, PhD, MBA, YCAP, FHEA, C.Psychol, AFBPsS, C.Sci is Professor of Clinical Psychobiology and Applied Psychoneuroimmunology and Clinical Director of the Institute of Health and Wellbeing at the University of Suffolk, UK. He is a Chartered Health Psychologist and a Chartered Scientist. He also trained in analytical biochemistry, this aspect reflecting the psychobiological focus of much of his research within mental health. He has published or has in press well over 300 research papers and book chapters. He is a keen book author and editor having written and/or edited more than 50 books. These outputs include the prophetic insight into the treatment of neurological disease, Handbook of Behavior, Food and Nutrition (2011), Nanomedicine and the Nervous System (2012), Oxidative Stress and Dietary Antioxidants in Neurological Disease (2020), Zika Virus Impact, Diagnosis, Control and Models (2021), Factors Affecting Neurodevelopment: Genetics, Neurology, Behavior and Diet (2021), Diagnosis and Treatment of Spinal Cord Injury (2022), The Neurobiology, Physiology, and Psychology of Pain (2022) and The Handbook of Lifespan Cognitive Behavioral Therapy: Childhood, Adolescence, Pregnancy, Adulthood, and Aging (2023). Professor Martin is particularly interested in all aspects of the relationship between underlying physiological substrates and behavior, particularly in how these relationships manifest in both acute and chronic psychiatric disorder. He has published original research germane to significant mental health disorders including the areas of schizophrenia, anxiety, depression, self-esteem, alcohol and drug dependency, high secure forensic mental health and personality disorder. He has a keen interest in the impact of postviral illness and is actively involved in clinical research post-Covid pandemic and in particular, the impact of Long Covid on psychological, neurological, physiological and social functioning. He is involved in collaborative International research with many European and Non-European countries.

Affiliations and expertise

Professor of Clinical Psychobiology and Applied Psychoneuroimmunology and Clinical Director: Institute for Health and Wellbeing, University of Suffolk, Ipswich, UK

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Diagnosis and Treatment of Spinal Cord Injury

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Rajkumar Rajendram

Victor R Preedy

Colin R Martin