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Research (neurological physics)

Clinical applications for Southampton TMD analyser

The department is internationally recognised for pioneering an understanding of the complex brain pressure waves emitted from the ear. Southampton was the first to prove an open fluid pressure communication between the brain and inner ear. This has clinical significance for providing a non-surgical method of assessing brain pressure and abnormal brain pressure waves. We use the Southampton tympanic membrane displacement (TMD) method and the cerebral and cochlear fluid pressure (CCFP) analyser to detect tiny intra-aural pressure waves.

Our research is published in peer-reviewed medical journals. It demonstrates that baseline brain pressure and pressure wave abnormalities are detectable in patients with head trauma and are associated with cognitive decline. NASA has published this data using the CCFP analyser on the International Space Station to track changes in brain pressure in space.

A principal objective is to understand and decipher these complex aural pressure waves, as we believe they contain information pertinent to neurogenerative disease. We have published research that shows a combination of intracranial and arterial pulses. Our recent discovery is that a significant component appears to be a cerebral venous drainage wave. Brain venous drainage is not easily measured and needs to be better understood. It is crucial in several neurodegenerative diseases with obscure or unknown causes. To assist us in our understanding, we have developed a mathematical model of the head, neck and heart to test our hypothesis that impaired cerebral venous drainage will increase brain pulsatility.

University of Southampton research collaboration

Thoracic pressure and respiration significantly affect venous drainage from the brain. We are working with the School of Electronics and Computer Science, University of Southampton, and supervising a PhD student who has invented a device that assists breathing according to a predefined pattern. This device should allow cerebral venous drainage to be controlled and measured with our TMD device in a clinical setting.

Looking ahead - opportunities and challenges

Our research on non-surgical detection of brain pressure using the tympanic membrane displacement (TMD) analyser has led us to an intriguing finding. We have observed that variations in pulsatility, both smaller and larger than usual, may be associated with cognitive decline. In our pilot study on patients with idiopathic normal pressure hydrocephalus (iNPH), we gathered preliminary data supporting our hypothesis: large pressure waves are associated with iNPH and are detectable as abnormal aural pressure waves using the TMD analyser.

The disease, iNPH, is fascinating since it is one of the few dementias that can be halted or even reversed if detected early. Our Southampton TMD technique may offer a non-invasive, simple screening method to revolutionize early detection before significant cognitive decline becomes established. We will seek research funding to investigate whether these abnormal aural pressure waves are a biomarker of iNPH and further validate the potential of our TMD technique.

Links to other websites that report our research

UHS Careers website: Explore New Frontiers

CSF Leak Association: Intracranial Pressure Monitoring Using Non-invasive Technique

The Press and Journal: British Astronaut Heads for the International Space Station.

ENT and Audiology News: Neurological idiopathic disease: a shared journey for NASA and medicine. By Robert Marchbanks