The Department of Neurology issues a quarterly newsletter highlighting it's research efforts. This newsletter is intended to inform staff about research initiatives being conducted by neurology colleagues and to stimulate recruitment into current trials. To preview Lahey's current Hospital & Medical Center Department of Neurology Research Newsletter, click here.
Diana Apetauerova, MD (Director of Movement Disorders Center) and Janet Zani, MS, APRN, BC were awarded a grant from the Robert E. Wise Research and Education Institute for their project, "Effects of subthalamic nucleus stimulation on striatal dopaminergic transmission in patients with Parkinsons disease- A pilot study".
This study will look at dopamine activity before and after deep brain stimulation (DBS) surgery to see if, what, changes occur in the brain. DBS surgery is an established treatment option for Parkinsons disease (PD) that directly changes brain activity with reversible effects. The mechanism or underlying principles by which DBS surgery benefits patients with PD, however, remains unclear. PD is caused by loss of dopamine-secreting neurons (nerve cells) in the part of the brain that affects movement. Medications used to treat the symptoms of PD are generally those that are targeted to replace this dopamine loss. DaTscan™ (Ioflupane I 123 Injection) in brain SPECT imaging is an FDA approved screening test which helps differentiate between PD and other similar movement disorders and it permits us to measure and see dopamine’s activity in the brain. The effectiveness of DaTscan™ for monitoring disease progression or response to therapy, such as DBS, has not yet been established. If you would like to find out more about this study, click here.
Kiron Thomas, MD along with colleagues Kinan Hreib, MD, PhD (Director of Stroke Services) and Matthew Tilem, MD were awarded a grant from the Robert E. Wise Research and Education Institute for their project, "Dynamic Contrast Enhanced (DCE) MR Permeability Maps: Clinical application to acute ischemic stroke – A pilot study."
This research project will evaluate a new additional imaging approach also called MR permeability imaging during a routine brain MRI which will be performed as standard of care for patients who have experienced a stroke. In stroke we know that small brain vessels may have a small amount of leakage for water and other small compounds such as the MRI contrast agent. If such a leakage is present patients may have a higher risk of having bleeding into the brain area affected by the stroke. This study will assess if the additional imaging technique is capable of quantifying such leaks and if the presence of a leak may predict later bleeding in the brain.
Randall Davis PhD (MIT) and Dana Penney, PhD ABN were awarded a $250,000 grant from the Defense Advanced Research Agency (DARPA) for their revolutionary digital Clock Drawing Test assessment system project. The project involves investigating how neuropsychological testing can be reconceived in light of newly available technology, potentially enabling it to be far more sensitive in detecting, monitoring, and analyzing subtle changes in cognitive capability. Initial efforts have focused on the Clock Drawing Test, whereby a digitizing ballpoint pen is used to capture very detailed information about pen position and timing and to detect and analyze both the drawing and the process that produced it. Together with the Lahey sponsored ClockSketch Consortium (eight cooperating clinics around the country that are administering the test using the digitizing pens and their software), Drs Penney and Davis are gathering and analyzing an extensive database of neuropsychological information.
Funds from the DARPA grant will enable expansion of this effort to include assessing subtle cognitive impairment associated with mild traumatic brain injury (mTBI). mTBI is a risk factor for early dementia and the addition of this clinical group to the current research will help advance work on detecting cognitive markers for incident dementia.
Dana Penney, PhD ABN., Randall Davis PhD (MIT) and colleagues were selected as a finalist for the Janssen, Pfizer & Geoffrey Beene Gives Back Alzheimer’s Initiative Alzheimer’s Challenge 2012. Their concept, the Digital Clock Drawing Test (dCDT): Detecting and assessing cognitive change across the Alzheimer’s disease spectrum from presymptomatic to dementia, is based on innovative software developed jointly by Lahey and MIT and was selected from more than 100 submissions.
Dr. Penney’s ClockSketch team presented their concept to industry judges in Washington DC on June 21. As a finalist she was the recipient of awards totaling $30,000.
The Alzheimer’s Challenge 2012 was a contest seeking the development of simple, cost-effective, consistent tools that could be easily used to assess memory, mood, thinking and activity level over time to help improve diagnosis and monitoring of people with Alzheimer’s disease. The grand prize winner received $175,000.
Dr. Penney’s concept integrates digital ink technology and inventive software with the familiar Clock Drawing Test, producing an innovative digital Clock Drawing Test (dCDT) assessment system that has potential to identify and measure early cognitive markers of dementia years earlier. Digital ink technology enables, among other things, capture of the drawing process (e.g., pauses, hesitations), and analysis of information processing speed (e.g., patients working harder/longer for a correct result), in addition to the standard final drawing. A consortium of 8 participating clinics are currently undertaking this project allowing an accumulation of a large body of normative data, and examination of dCDT performance across a spectrum of ages.
For complete information on this challenge, visit the Alzheimer’s Research Forum: http://www.alzforum.org/new/detail.asp?id=3352
Diana Apetauerova, MD presented results of her project, “Chronic Parkinsonism Associated With Liver Cirrhosis.” at the 137th Annual Meeting of the American Neurological Association in Boston, MA. Results of this presentation was highlighted on DocGuide.com in October 2012.
DocGuide is “an independent news organization that publishes medical content online from peer-reviewed, Medline-indexed journals and major medical conferences. The purpose is to serve the information needs of physicians worldwide and to build a community amongst these physicians that exchanges views on medical advances and developments.” (http://www.docguide.com/faq, accessed 1/8/13)
The author describes the study results in detail. To access the complete article, click here
Netter's Neurology, 2nd edition (Philadelphia, PA, Elsevier/Saunders, 2011, IBSN-13:978-1-4377-0273-6) edited by Lahey Neurologists H. Royden Jones, Jr., MD, Jayashri Srinivasan, MD, Ph.D. FRCP, Gregory Allam, MD and Diagnostic Neuroradiologist Richard Baker, MD was recently named on the Choice Outstanding Academic Titles List 2012. Choice subject editors recognize the most significant titles reviewed during the calendar year by compiling the Outstanding Academic Titles list, which is published each January. Published by the American Library Association, the Choice "uses criteria such as overall excellence in presentation and scholarship, importance relative to other literature in the field, distinction as a first treatment of a given subject in book or electronic form, originality or uniqueness of treatment, value to undergraduate students and importance in building undergraduate library collections.”(Retrieved March 6, 2013, from "www.CRO2.org”)
On September 12, 2012 Netter’s Neurology was also a First Prize Winner, in the Illustrated Book Category by the British Medical Association 2012 Medical Book Competition. It’s reviewer commented that “it communicates often very difficult areas of neurology quite simply, and builds on basics to advanced understanding. I've never seen such well–thought–out and informative illustrations with such detail in another neurology book of this type. It does not take long to ascertain that this is a high quality book with not only content to a high standard but also the way it is presented to a learner. I have not seen any others which can compete.” (Retrieved March 6, 2013 from "www.BMA.org")
RESEARCH IN NEUROLOGY
The American Heart Association/American Stroke Association's Get With The Guidelines program has again awarded Lahey Clinic’s stroke service the Stroke Gold Performance Achievement Award.