A partnership between the Universities of Brighton and Sussex with the NHS

 

neuroscience

Name: Dr Andrew Dilley PhD

Academic position: Lecturer in Anatomy

Research: Pain, peripheral neuropathies and inflammation

Contact details:

Brighton and Sussex Medical School
University of Sussex
Falmer
Brighton BN1 9PX
UK

Tel: +44 (0)1273 877094
Fax: +44 (0)1273 877576

E-mail:

Biography:

• BSc (Anatomy and Developmental Biology) University College London, 1993
• PhD (Neurophysiology) Kings College London, 2000
• Postdoctoral Research Fellow (Physiology), University College London, 2000-5
• Instructor in Anaesthesia, Harvard Medical School, 2005-7

Teaching focus:

Functional/structural anatomy and neurophysiology

Research focus:

• Mechanisms underlying the development of altered excitability of peripheral nerve axons in painful neuropathies
• Ultrasound imaging as a tool to examine the peripheral nervous system

 

Laboratory members:

• Dr Jane Greening
• Natalie Richards

 

Current funding:

Current work is funded by a grant from the Pain Relief Foundation and a BSMS PhD Studentship that is funding Natalie Richards.

Current research:

With an expanding role for inflammation in neuropathic conditions, I am particularly interested in how inflammation and minor nerve injury can affect the properties of peripheral axons, especially changes in axonal excitability. At sites of local nerve inflammation, intact, through-conducting axons develop the ability to respond to mechanical stimulation. Current research is focused on understanding the mechanisms underlying the development of this inflammation-induced axonal mechanical sensitivity. Such changes in axonal properties are likely to play a major role in symptom production in patients with common painful conditions such as back pain, repetitive strain injuries (non-specific arm pain), compressive neuropathies, and complex regional pain syndrome. In these conditions, painful symptoms are often reproduced by limb movements that mechanically tension the affected nerve or by digital pressure applied over the affected peripheral nerve.

Changes in axonal excitability are associated with a variety of other conditions that affect the peripheral nervous system. Of particular interest is the autoimmune neuropathy, Guillain-Barré syndrome. This debilitating condition is mainly characterised by a loss of motor function due to the demyelination of peripheral nerve axons. Despite a loss of axonal function, symptoms of pain are frequently reported by these patients, suggesting an altered excitability of peripheral afferent neurons.

This research uses a range of techniques, both laboratory- and clinically-based. Most of the laboratory studies use extracellular recording techniques to record from isolated unmyelinated (C-) and myelinated (A-) axons in models of peripheral nerve inflammation. These experiments are also combined with behavioural, immunohistochemical and histological studies.

Human studies explore the use of imaging techniques to examine peripheral nerves in patients with painful conditions. I am particularly interested in ultrasound and real time imaging of tissue dynamics, especially the sliding and stretching of peripheral nerves during joint movements. Part of this research is an examination of peripheral nerve sliding in patients with painful conditions, in an attempt to further understand the mechanisms of symptom production.

 

Key/recent publications:

Bove GM, Dilley A (2009) The conundrum of sensitization when recording from nociceptors. Journal of Neuroscience Methods (In Press)

Dilley A, Greening J (2009) Peripheral nerve inflammation in a case of non-specific arm pain. Clinical Journal of Pain (Submitted)

Erel E, Dilley A, Kumar P, Bhatti W, Lees, VC. (2009) Sonographic measurements of longitudinal median nerve sliding in patients following nerve repair. Muscle and Nerve

Reeve A, Dilley A. (2009) Effects of posture on the thickness of transverse abdominus in pain-free subjects. Manual Therapy [Epub ahead of print]

Coppieters M, Hough A, Dilley A. (2009) Different nerve gliding exercises induce different magnitudes of nerve movement. An in vivo study using dynamic ultrasound imaging. Journal of Orthopaedic & Sports Physical Therapy 39(3): 164-171

Ellis R, Hing W, Dilley A, McNair P. (2008) The reliability of measuring sciatic nerve movement, during neural mobilisation, using diagnostic ultrasound. Ultrasound in Medicine and Biology 34(8): 1209:1216

Dilley A, Bove GM. (2008) Disruption of axoplasmic transport induces mechanical sensitivity in intact rat C-fibre nociceptor axons. Journal of Physiology 586.2: 593-604

Dilley A, Bove GM. (2008) Recovery of inflammatory induced axonal mechanical sensitivity and conduction slowing in C-fiber nociceptors. Journal of Pain 9:185-92

Dilley A, Odeyinde S, Greening J, Lynn B. (2008) Longitudinal sliding of the median nerve in patients with non-specific arm pain. Manual Therapy 13: 536-43

Dilley A, Summerhayes C, Lynn B (2007) An in vivo investigation of ulnar nerve sliding during upper limb movements. Clinical Biomechanics 22:774-779.

Dilley A, Lynn B, Pang SJ. (2005) Pressure and stretch mechanosensitivity of peripheral nerve fibres following local inflammation of the nerve trunk. Pain 117:462-472.

Greening J, Dilley A, Lynn B. (2005) In vivo study of nerve movement and mechanosensitivity of the median nerve in whiplash and non-specific arm pain patients. Pain 115: 248-253.

Julius A, Lees R, Dilley A, Lynn B. (2004) Shoulder posture and median nerve sliding. BMC Musculoskeletal disorders 5: 23

Dilley A, Gregson NA, Hadden RDM, Smith KJ. (2003) Effects on axonal conduction of anti-ganglioside sera and sera from patients with Guillain-Barré syndrome. Journal of Neuroimmunology 139(1-2): 133-40

Dilley A, Lynn B, Greening J, DeLeon N. (2003) Quantitative in vivo studies of median nerve sliding in response to wrist, elbow, shoulder and neck movements. Clinical Biomechanics 18(10): 899-907.

Erel E, Dilley A, Lynn B, Greening J, Morris V. (2003) Longitudinal sliding of the median nerve in patients with carpal tunnel syndrome. Journal of Hand Surgery [Br] 28(5): 439-43

Dilley A, Greening J, Lynn B, Leary R, Morris V. (2001) The use of cross-correlation analysis between high-frequency ultrasound images to measure longitudinal median nerve movement. Ultrasound in Medicine and Biology 27(9):1211-8

 

Book Chapters

Greening J & Dilley A. Peripheral mechanisms of chronic upper limb pain: nerve dynamics, inflammation and neurophysiology: Evidence-informed screening, diagnosis and management in manual therapy (In press)

 

Selected meeting abstracts

Dilley A, Bove GM. (2007) Axoplasmic flow blockers are sufficient to induce mechanical sensitivity in nociceptor axons. Society for Neuroscience 124.9, San Diego, USA..

Greening J, Dilley A, Lynn B. (2007) Nerve movement mechanosensitivity and sensory function in patients with non-specific arm pain. Sixth International Scientific Conference on
Prevention of Work-Related Musculoskeletal Disorders, Boston, USA.

Lynn B, Barbe MF, Dilley A, Littlejohn G. (2005) Pain due to work-related upper limb disorders. Abstracts of the 11th World Congress on pain, Sydney, Australia.

Dilley A, Lynn B, Pang SJ. (2005) The effects of nerve trunk inflammation on the conduction properties of locally mechanosensitive A- and C- fibres and on activating transcription factor 3 (ATF3) levels in cell bodies. Abstracts of the 11th World Congress on Pain, Sydney, Australia

Active collaborations:

• Dr Geoffrey Bove, Harvard Medical School, Boston, USA
• Professor Bruce Lynn, Department of Physiology, University College London
• Dr Jane Greening, Department of Physiology, University College London
• Dr Michel Coppieters, University of Queensland, Australia
• Dr Wayne Hing, Auckland University of Technology, New Zealand