Dr Jonathan Coles University positionLecturer Dr Jonathan Coles is pleased to consider applications from prospective PhD students. DepartmentsInstitutesHome pagehttp://www.medschl.cam.ac.uk/anaesth... Research ThemeInterestsAs a clinician specialising within Neurointensive care my research interests are focused on describing the pathophysiology of head injury and optimising patient outcome. Using the combined facilities of the Wolfson Brain Imaging and Neurosciences Critical Care Unit at Addenbrooke's Hospital patients undergo structural and functional imaging studies using positron emission tomography and magnetic resonance imaging. I have used such imaging tools to define the incidence, temporal evolution and impact on outcome of cerebral ischaemia following head injury. Other work has addressed the impact of clinical interventions aimed at controlling intracranial pressure such as hyperventilation and elevation of cerebral perfusion pressure. Current research is aimed at using imaging techniques to define the temporal pattern and metabolic correlates of neuronal loss after human head injury. Such data will be crucial in the development and implementation of successful neuroprotective therapies.  PET imaging of cerebral ischaemia following head injury. X-ray CT, PET cerebral blood flow (CBF), oxygen extraction fraction (OEF), oxygen metabolism (CMRO2) and glucose metabolism (CMRgluc) images obtained following evacuation of a subdural haematoma. Note the small amount of residual subdural blood with minimal midline shift. The cerebral hemisphere underlying the evacuated subdural haematoma displays a marked reduction in CBF, slight fall in CMRO2 and large increase in OEF suggestive of cerebral ischaemia. In addition, the substantial increase in CMRgluc implies a switch to non-oxidative metabolism of glucose in order to meet underlying metabolic need. View image full-size (3961x1136 pixels) Research Focus
EquipmentComputational modelling Computerised tomography Electroencephalography (EEG) Electrophysiological recording techniques Haemodynamic monitoring Magnetic resonance imaging (MRI) Neuropsychological testing Positron Emission Tomography (PET) Collaborators
Associated News ItemsKey publicationsColes JP, Fryer TD (2007), “Hyperventilation following head injury: effect on ischemic burden and cerebral oxidative metabolism” Critical Care Medicine 35(2):568-78 Details Coles JP, Fryer TD (2004), “Incidence and mechanisms of cerebral ischemia in early clinical head injury” Journal of Cerebral Blood Flow and Metabolism 24(2):202-11 Details Coles JP, Steiner LA (2004), “Does induced hypertension reduce cerebral ischaemia within the traumatized human brain?” Brain 127(11):2479-90 Details Publications2014Hong YT, Veenith T, Dewar D, Outtrim JG, Mani V, Williams C, Pimlott S, Hutchinson PJ, Tavares A, Canales R, Mathis CA, Klunk WE, Aigbirhio FI, Coles JP, Baron JC, Pickard JD, Fryer TD, Stewart W, Menon DK (2014), “Amyloid imaging with carbon 11-labeled Pittsburgh compound B for traumatic brain injury.” JAMA Neurol 71(1):23-31 Details Veenith TV, Carter EL, Grossac J, Newcombe VF, Outtrim JG, Nallapareddy S, Lupson V, Correia MM, Mada MM, Williams GB, Menon DK, Coles JP (2014), “Use of diffusion tensor imaging to assess the impact of normobaric hyperoxia within at-risk pericontusional tissue after traumatic brain injury.” J Cereb Blood Flow Metab Details 2013Carter EL, Newcombe VF, Hawkes RC, Coles JP (2013), “Magnetic resonance imaging and thermal injury.” J Neurosurg 119(4):1082-4 Details Newcombe VF, Williams GB, Outtrim JG, Chatfield D, Gulia Abate M, Geeraerts T, Manktelow A, Room H, Mariappen L, Hutchinson PJ, Coles JP, Menon DK (2013), “Microstructural basis of contusion expansion in traumatic brain injury: insights from diffusion tensor imaging.” J Cereb Blood Flow Metab 33(6):855-62 Details Veenith TV, Carter E, Grossac J, Newcombe VF, Outtrim JG, Lupson V, Williams GB, Menon DK, Coles JP (2013), “Inter subject variability and reproducibility of diffusion tensor imaging within and between different imaging sessions.” PLoS One 8(6):e65941 Details 2012Carter E, Coles JP (2012), “Imaging in the diagnosis and prognosis of traumatic brain injury.” Expert Opin Med Diagn 6(6):541-54 Details 2011Geeraerts T, Coles JP, Aigbirhio FI, Pickard JD, Menon DK, Fryer TD, Hong YT (2011), “Validation of reference tissue modelling for [11C]flumazenil positron emission tomography following head injury.” Ann Nucl Med 25(6):396-405 Details Newcombe V, Chatfield D, Outtrim J, Vowler S, Manktelow A, Cross J, Scoffings D, Coleman M, Hutchinson P, Coles J, Carpenter TA, Pickard J, Williams G, Menon D (2011), “Mapping traumatic axonal injury using diffusion tensor imaging: correlations with functional outcome.” PLoS One 6(5):e19214 Details Newcombe VF, Outtrim JG, Chatfield DA, Manktelow A, Hutchinson PJ, Coles JP, Williams GB, Sahakian BJ, Menon DK (2011), “Parcellating the neuroanatomical basis of impaired decision-making in traumatic brain injury.” Brain 134(Pt 3):759-68 Details Veenith T, Coles JP (2011), “Anaesthesia for magnetic resonance imaging and positron emission tomography.” Curr Opin Anaesthesiol 24(4):451-8 Details 2009Coles JP, Cunningham AS, Salvador R, Chatfield DA, Carpenter A, Pickard JD, Menon DK (2009), “Early metabolic characteristics of lesion and nonlesion tissue after head injury.” J Cereb Blood Flow Metab 29(5):965-75 Details Hutchinson PJ, O'Connell MT, Seal A, Nortje J, Timofeev I, Al-Rawi PG, Coles JP, Fryer TD, Menon DK, Pickard JD, Carpenter KL (2009), “A combined microdialysis and FDG-PET study of glucose metabolism in head injury.” Acta Neurochir (Wien) 151(1):51-61; discussion 61 Details Trivedi M, Coles JP (2009), “Blood pressure management in acute head injury.” J Intensive Care Med 24(2):96-107 Details 2008Abate MG, Trivedi M, Fryer TD, Smielewski P, Chatfield DA, Williams GB, Aigbirhio F, Carpenter TA, Pickard JD, Menon DK, Coles JP (2008), “Early derangements in oxygen and glucose metabolism following head injury: the ischemic penumbra and pathophysiological heterogeneity.” Neurocrit Care 9(3):319-25 Details Geeraerts T, Newcombe VF, Coles JP, Abate MG, Perkes IE, Hutchinson PJ, Outtrim JG, Chatfield DA, Menon DK (2008), “Use of T2-weighted magnetic resonance imaging of the optic nerve sheath to detect raised intracranial pressure.” Crit Care 12(5):R114 Details Newcombe VF, Hawkes RC, Harding SG, Willcox R, Brock S, Hutchinson PJ, Menon DK, Carpenter TA, Coles JP (2008), “Potential heating caused by intraparenchymal intracranial pressure transducers in a 3-tesla magnetic resonance imaging system using a body radiofrequency resonator: assessment of the Codman MicroSensor Transducer.” J Neurosurg 109(1):159-64 Details Newcombe VF, Williams GB, Nortje J, Bradley PG, Chatfield DA, Outtrim JG, Harding SG, Coles JP, Maiya B, Gillard JH, Hutchinson PJ, Pickard JD, Carpenter TA, Menon DK (2008), “Concordant biology underlies discordant imaging findings: diffusivity behaves differently in grey and white matter post acute neurotrauma.” Acta Neurochir Suppl 102:247-51 Details Nortje J, Coles JP, Timofeev I, Fryer TD, Aigbirhio FI, Smielewski P, Outtrim JG, Chatfield DA, Pickard JD, Hutchinson PJ, Gupta AK, Menon DK (2008), “Effect of hyperoxia on regional oxygenation and metabolism after severe traumatic brain injury: preliminary findings.” Crit Care Med 36(1):273-81 Details 2007Coles JP (2007), “Imaging after brain injury.” Br J Anaesth 99(1):49-60 Details Mannion RJ, Cross J, Bradley P, Coles JP, Chatfield D, Carpenter A, Pickard JD, Menon DK, Hutchinson PJ (2007), “Mechanism-based MRI classification of traumatic brainstem injury and its relationship to outcome.” J Neurotrauma 24(1):128-35 Details Newcombe VF, Williams GB, Nortje J, Bradley PG, Harding SG, Smielewski P, Coles JP, Maiya B, Gillard JH, Hutchinson PJ, Pickard JD, Carpenter TA, Menon DK (2007), “Analysis of acute traumatic axonal injury using diffusion tensor imaging.” Br J Neurosurg 21(4):340-8 Details 2006Coles JP (2006), “Imaging of cerebral blood flow and metabolism.” Curr Opin Anaesthesiol 19(5):473-80 Details Coles JP, Fryer TD, Bradley PG, Nortje J, Smielewski P, Rice K, Clark JC, Pickard JD, Menon DK (2006), “Intersubject variability and reproducibility of 15O PET studies.” J Cereb Blood Flow Metab 26(1):48-57 Details 2005Cunningham AS, Salvador R, Coles JP, Chatfield DA, Bradley PG, Johnston AJ, Steiner LA, Fryer TD, Aigbirhio FI, Smielewski P, Williams GB, Carpenter TA, Gillard JH, Pickard JD, Menon DK (2005), “Physiological thresholds for irreversible tissue damage in contusional regions following traumatic brain injury.” Brain 128(Pt 8):1931-42 Details Johnston AJ, Steiner LA, Coles JP, Chatfield DA, Fryer TD, Smielewski P, Hutchinson PJ, O'Connell MT, Al-Rawi PG, Aigbirihio FI, Clark JC, Pickard JD, Gupta AK, Menon DK (2005), “Effect of cerebral perfusion pressure augmentation on regional oxygenation and metabolism after head injury.” Crit Care Med 33(1):189-95; discussion 255-7 Details O'Connell MT, Seal A, Nortje J, Al-Rawi PG, Coles JP, Fryer TD, Menon DK, Pickard JD, Hutchinson PJ (2005), “Glucose metabolism in traumatic brain injury: a combined microdialysis and [18F]-2-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET) study.” Acta Neurochir Suppl 95:165-8 Details Pickard JD, Hutchinson PJ, Coles JP, Steiner LA, Johnston AJ, Fryer TD, Coleman MR, Smielewski P, Chatfield DA, Aigbirhio F, Williams GB, Rice K, Clark JC, Salmond CH, Sahakian BJ, Bradley PG, Carpenter TA, Salvador R, Pena A, Gillard JH, Cunningham AS, Piechnik S, Czosnyka M, Menon DK (2005), “Imaging of cerebral blood flow and metabolism in brain injury in the ICU.” Acta Neurochir Suppl 95:459-64 Details Steiner LA, Balestreri M, Johnston AJ, Coles JP, Chatfield DA, Pickard JD, Menon DK, Czosnyka M (2005), “Effects of moderate hyperventilation on cerebrovascular pressure-reactivity after head injury.” Acta Neurochir Suppl 95:17-20 Details Steiner LA, Balestreri M, Johnston AJ, Coles JP, Smielewski P, Pickard JD, Menon DK, Czosnyka M (2005), “Predicting the response of intracranial pressure to moderate hyperventilation.” Acta Neurochir (Wien) 147(5):477-83; discussion 483 Details 2004Coles JP (2004), “Regional ischemia after head injury.” Curr Opin Crit Care 10(2):120-5 Details Coles JP, Fryer TD, Smielewski P, Rice K, Clark JC, Pickard JD, Menon DK (2004), “Defining ischemic burden after traumatic brain injury using 15O PET imaging of cerebral physiology.” J Cereb Blood Flow Metab 24(2):191-201 Details Johnston AJ, Steiner LA, Chatfield DA, Coles JP, Hutchinson PJ, Al-Rawi PG, Menon DK, Gupta AK (2004), “Effect of cerebral perfusion pressure augmentation with dopamine and norepinephrine on global and focal brain oxygenation after traumatic brain injury.” Intensive Care Med 30(5):791-7 Details Menon DK, Coles JP, Gupta AK, Fryer TD, Smielewski P, Chatfield DA, Aigbirhio F, Skepper JN, Minhas PS, Hutchinson PJ, Carpenter TA, Clark JC, Pickard JD (2004), “Diffusion limited oxygen delivery following head injury.” Crit Care Med 32(6):1384-90 Details Owler BK, Momjian S, Czosnyka Z, Czosnyka M, Péna A, Harris NG, Smielewski P, Fryer T, Donovan T, Coles J, Carpenter A, Pickard JD (2004), “Normal pressure hydrocephalus and cerebral blood flow: a PET study of baseline values.” J Cereb Blood Flow Metab 24(1):17-23 Details Steiner LA, Balestreri M, Johnston AJ, Czosnyka M, Coles JP, Chatfield DA, Smielewski P, Pickard JD, Menon DK (2004), “Sustained moderate reductions in arterial CO2 after brain trauma time-course of cerebral blood flow velocity and intracranial pressure.” Intensive Care Med 30(12):2180-7 Details Steiner LA, Johnston AJ, Czosnyka M, Chatfield DA, Salvador R, Coles JP, Gupta AK, Pickard JD, Menon DK (2004), “Direct comparison of cerebrovascular effects of norepinephrine and dopamine in head-injured patients.” Crit Care Med 32(4):1049-54 Details 2003Coles JP, Steiner LA, Martin J, Donovan T, Hutchinson PJ, Carpenter TA, Menon DK (2003), “Assessment of the Ventrix parenchymal intracranial pressure monitoring probe (NL950-P) and Monitor (NL950-100) in a 3 Tesla magnetic resonance scanner.” Anaesthesia 58(2):143-8 Details Johnston AJ, Steiner LA, Chatfield DA, Coleman MR, Coles JP, Al-Rawi PG, Menon DK, Gupta AK (2003), “Effects of propofol on cerebral oxygenation and metabolism after head injury.” Br J Anaesth 91(6):781-6 Details Steiner LA, Coles JP, Czosnyka M, Minhas PS, Fryer TD, Aigbirhio FI, Clark JC, Smielewski P, Chatfield DA, Donovan T, Pickard JD, Menon DK (2003), “Cerebrovascular pressure reactivity is related to global cerebral oxygen metabolism after head injury.” J Neurol Neurosurg Psychiatry 74(6):765-70 Details Steiner LA, Coles JP, Johnston AJ, Chatfield DA, Smielewski P, Fryer TD, Aigbirhio FI, Clark JC, Pickard JD, Menon DK, Czosnyka M (2003), “Assessment of cerebrovascular autoregulation in head-injured patients: a validation study.” Stroke 34(10):2404-9 Details Steiner LA, Coles JP, Johnston AJ, Czosnyka M, Fryer TD, Smielewski P, Chatfield DA, Salvador R, Aigbirhio FI, Clark JC, Menon DK, Pickard JD (2003), “Responses of posttraumatic pericontusional cerebral blood flow and blood volume to an increase in cerebral perfusion pressure.” J Cereb Blood Flow Metab 23(11):1371-7 Details Steiner LA, Johnston AJ, Chatfield DA, Czosnyka M, Coleman MR, Coles JP, Gupta AK, Pickard JD, Menon DK (2003), “The effects of large-dose propofol on cerebrovascular pressure autoregulation in head-injured patients.” Anesth Analg 97(2):572-6, table of contents Details 2002Coles JP, Minhas PS, Fryer TD, Smielewski P, Aigbirihio F, Donovan T, Downey SP, Williams G, Chatfield D, Matthews JC, Gupta AK, Carpenter TA, Clark JC, Pickard JD, Menon DK (2002), “Effect of hyperventilation on cerebral blood flow in traumatic head injury: clinical relevance and monitoring correlates.” Crit Care Med 30(9):1950-9 Details Hutchinson PJ, Gupta AK, Fryer TF, Al-Rawi PG, Chatfield DA, Coles JP, O'Connell MT, Kett-White R, Minhas PS, Aigbirhio FI, Clark JC, Kirkpatrick PJ, Menon DK, Pickard JD (2002), “Correlation between cerebral blood flow, substrate delivery, and metabolism in head injury: a combined microdialysis and triple oxygen positron emission tomography study.” J Cereb Blood Flow Metab 22(6):735-45 Details Hutchinson PJ, O'Connell MT, Coles JP, Chatfield DA, Coleman MR, Al-Rawi PG, Kett-White CR, Gupta AK, Menon DK, Boniface SJ, Heazell M, Kirkpatrick PJ, Pickard JD (2002), “Investigation of the effect of chlormethiazole on cerebral chemistry in neurosurgical patients: a combined study of microdialysis and a neuroprotective agent.” Br J Clin Pharmacol 53(3):275-83 Details Smielewski P, Coles JP, Fryer TD, Minhas PS, Menon DK, Pickard JD (2002), “Integrated image analysis solutions for PET datasets in damaged brain.” J Clin Monit Comput 17(7-8):427-40 Details Steiner LA, Chatfield DA, Donovan T, Coles JP, Menon DK (2002), “Assessment of the Caradyne WhisperFlow for administration of continuous positive airway pressure in a 3 Tesla magnetic resonance scanner.” Anaesthesia 57(5):470-4 Details 2001Doyle PW, Coles JP, Leary TM, Brazier P, Gupta AK (2001), “A comparison of remifentanil and fentanyl in patients undergoing carotid endarterectomy.” Eur J Anaesthesiol 18(1):13-9 Details 2000Coles JP, Leary TS, Monteiro JN, Brazier P, Summors A, Doyle P, Matta BF, Gupta AK (2000), “Propofol anesthesia for craniotomy: a double-blind comparison of remifentanil, alfentanil, and fentanyl.” J Neurosurg Anesthesiol 12(1):15-20 Details 1999Coles JP, Menon DK (1999), “Things are not as they seem.” Anaesthesia 54(1):100 Details |
