My research has to date been in two general areas – central post-stroke pain (CPSP), and separately how the brain generates one’s body image. The central pain work has largely focused on a serendipitous observation of ours that stimulating the vestibular system in certain CPSP patients appears to transiently reduce pain intensity. In order to explain this observation I proposed a model whereby the parieto-insular vestibular cortex (PIVC) is better viewed as an extension of the wider interoceptive cortex that is known to lie in the dorsal posterior insula. This is in keeping with the leading theory on the pathogenesis of CPSP – the thermosensory disinhibition hypothesis, which postulates that central to the pathogenesis of this disorder is the disruption of the output from the dorsal posterior insula to the homeostatic centers in the brainstem – since the PIVC also activates these same centers.
I have also been engaged in several projects investigating body image and the parietal lobes. What I believe to be the most important of these projects involves a seemingly bizarre condition in which an otherwise sane and rational individual requests the amputation of a perfectly healthy limb. Until now this has been explained largely on psychological grounds. However, we have obtained functional brain imaging data suggesting that the desire, in fact, arises from dysfunction of the right parietal lobe: an area known to be vital in creating body image. Although I have currently returned to full-time clinical work I continue to be actively involved with the lab, and have an ongoing role in two entirely new projects.