Dr Matthew Silsby

Dr Silsby is a neurologist and neurophysiologist at Westmead Hospital. He graduated Sydney Medical School with Honours in 2011 and completed neurology training at Concord, RPA, and Westmead hospitals. He undertook the Neuromuscular and Neuroimmunology fellowship at Concord Hospital in 2018, with a particular emphasis on neuromuscular medicine and clinical neurophysiology. He is also the Unit Coordinator for the Master of Medicine (Clinical Neurophysiology) unit “Applied Clinical Neurophysiology” at the University of Sydney.

His current research focuses on understanding the pathophysiology of movement disorders in patients with acquired inflammatory and inherited neuropathies, with a focus on the development of tremor and how it relates to poor balance. This forms the basis of his PhD at Westmead Clinical School (University of Sydney) as part of the Neuromuscular Research Group at Westmead. This has included comprehensive neurophysiological tremor studies which have shown potential for uncovering the mechanism of neuropathic tremor. The team is also developing a novel approach to assessing balance in neuropathies, and how this changes with treatment, through the use of posturography.

Forefront Group: Neurodegenerative and Neuromuscular Diseases Research Group at the Westmead Institute

Supervisors:

Prof Steve Vucic, A/Prof Victor Fung, Prof Matthew Kiernan, Prof Con Yiannikas

Expertise:

  • Neurophysiology
  • Neuromuscular
  • Movement Disorders

Affiliate Organisations

Sydney University, Westmead Clinical School, Westmead Hospital

Neurodegeneration of interest:

Neuromuscular disorders, Motor Neuron Disease

Specific Skills:

  • Medical Doctor
  • Neurophysiologist
  • Clinical Researcher
  • nerve conduction studies
  • tremor studies
  • posturography

Project - Characterisation of movement disorders in neuropathy: understanding their pathophysiology and role in disability

Disease area:

NA

Research Project Description

Neuropathy leads to dysfunction of peripheral nerves causing loss of sensation and weakness. This frequently leads to poor balance, and in some cases the development of movement disorders. The commonest movement disorder is tremor, referred to as neuropathic tremor. Both imbalance and tremor are debilitating symptoms, although both are underdiagnosed. Even when they are recognised, there is no consensus on treatment and most options are only somewhat effective. This may be because the underlying pathophysiology of imbalance and tremor in neuropathies is not well understood. The prevailing hypothesis is that tremor is caused by distorted peripheral inputs from damaged nerves, causing the brain to misinterpret the incoming sensory information and thus causing abnormal movements. It is possible that a similar mechanism plays a key role in imbalance.

This research will aim to explore the hypothesis that imbalance and neuropathic tremor are a result of distorted peripheral inputs confusing the relevant central processors. It will also explore whether neuropathic tremor is directly responsible for imbalance in those patients in whom both is present. The role that these disorders have on disability and quality of life will also be established. Extensive neurophysiological evaluations will be performed including peripheral nerve conduction studies and tremor studies. Techniques that have previously been applied to primary tremor disorders, but not to neuropathic tremor, will also be used. Balance and sway will be assessed with the use of posturography and correlations between tremor disorders and neuropathies will be examined. These assessments aim to provide insight into the pathogenesis of disability in neuropathy, thus allowing more targeted therapy aimed at improving outcomes in this disabling condition.