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World Congress of ISPGR and Gait & Mental Function to Trondheim

Illustration(21.06.2012) The research group for mobility at INM and the research network for Human Motor Control at Medical technology, NTNU, are hosting this year's Joint World Congress of ISPGR and Gait & Mental Function in Trondheim on 24-28 June.

World Congress of ISPGR and Gait & Mental Function to Trondheim

Illustration(21.06.2012) The research group for mobility at INM and the research network for Human Motor Control at Medical technology, NTNU, are hosting this year's Joint World Congress of ISPGR and Gait & Mental Function in Trondheim on 24-28 June.

The theme of the congress is "Movement Analysis from Bench to Bedside".

Keynotes include:

  • "The interplay between posture, gait and mental function" – Professor Bastiaan Bloem, MD, University Medical Centre St Radboud, Nijmegen; Founder and Medical Director, Parkinson Centre Nijmegen. The Netherlands; and ISPGR's President.
  • "How does the brain create movement, and how can this be influenced with brain stimulation?" – Professor Mark Hallett, MD, NIH, USA.
  • "What is it with gait speed?" – Professor Stephanie Studenski, University of Pittsburgh, USA.
  • "Gait stability: to fall or not to fall, that is the question" – Professor Jaap van Dieën, VU University Amsterdam, The Netherlands.
  • "Cognition: motoric perspectives" – Professor Joe Verghese, MD, Albert Einstein College of Medicine, Bronx, USA.

Migraine among the most common causes of disability

The attention paid to migraine and other forms of headache is nowhere near what it should be, relative to the size of the problem. (Photo: iStockphoto)(04.03.2013) Migraine is the 7th most common specific cause of disability globally – and it affects rich and poor alike, according to the world wide study Global Burden of Disease 2010 (GBD 2010).

Migraine among the most common causes of disability

The attention paid to migraine and other forms of headache is nowhere near what it should be, relative to the size of the problem. (Photo: iStockphoto)(04.03.2013) Migraine is the 7th most common specific cause of disability globally – and it affects rich and poor alike, according to the world wide study Global Burden of Disease 2010 (GBD 2010).

The study also shows that tension headache and migraine are the most common illnesses in the world – only superseded by caries.

Not a rich-man's disease

The findings from the study build on the previous GBD which was carried out in 2000 under the auspices of the World Health Organization (WHO), but this time around most world regions have been included, and it confirms that migraine and headache is not only a Western complaint:

"The data set is much better – we have much more data from all over the world than before. Previously we had good data from perhaps Western-Europe, North-America and a few other regions. Now we have adequate data from more or less all regions. And they show that migraine is not a Western complaint among the rich. There is just as much migraine in many poor countries," explains Professor Lars Jacob Stovner at the Department of Neuroscience (INM) at NTNU, who has contributed to the research.

Headache is neglected

In light of the results from GBD 2010, Stovner thinks that the attention paid to migraine and other forms of headache is nowhere near what it should be, relative to the size of the problem.

"What we wish to highlight is that the resources allocated to migraine, both in terms of treatment and research, are much less than one would think considering their impact. This is a neglect of a big, worldwide health challenge."

Stovner wishes to put headache and migraine on the agenda of those who allocate resources to treatment and research:

"When it comes to priorities in the healthcare sector, these should perhaps to a larger degree be guided by objective measures such as this study and not just by traditions, powerful interest groups among patients and professionals, and by media agendas.

"The aim of the whole effort with Global Burden of Disease is that we should be able to prioritise resources correctly according to what actually affects people while they live, and what they die from," Stovner says.

An even more widespread problem

A weakness of the study is that it does not include the burden associated with the periods between headache attacks. It only measures disability in connection with actual attacks.

"Many of those suffering from these conditions feel rather restricted between headaches because they worry about the next attack – i.e. they feel anxiety and worry about attacks. Or they place restrictions on how they live their lives in order not to provoke attacks, and this has not been included," Stovner explains.

Publications and related links

Early MRI important after traumatic brain injury

Non-bleeding lesions: Axonal injury to hemisphere (yellow arrow), axonal injury to corpus callosum (red arrow), and axonal injury to the cerebellum and brainstem (green arrow). (Photo: INM/NTNU)(21.12.2012) Early MRI gives better diagnosis of head injuries, according to research from the Department of Neuroscience (INM) at NTNU and St. Olavs Hospital.

Early MRI important after traumatic brain injury

Non-bleeding lesions: Axonal injury to hemisphere (yellow arrow), axonal injury to corpus callosum (red arrow), and axonal injury to the cerebellum and brainstem (green arrow). (Photo: INM/NTNU)(21.12.2012) Early MRI gives better diagnosis of head injuries, according to research from the Department of Neuroscience (INM) at NTNU and St. Olavs Hospital.

"The clinical relevance of the study is that MRI should be performed in the first weeks after a brain injury as important information could be lost if the MRI examination is performed too late," says medical doctor and PhD candidate Kent Gøran Moen at INM and the Department of Neurosurgery.

"CT is the most common imaging diagnostics tool for head injury, but the injury in the brain tissue is not shown very well by CT since only the ‘tip of the iceberg' is visible."

In a study based on 58 patients with moderate to severe head injuries admitted to St. Olavs Hospital over a three-year period, the researchers found that traumatic axonal injury gradually becomes less visible the longer one waits before MRI examination. The grade of the injury and localisation could have a great impact on a patient's prognosis and thereby on their continued treatment and rehabilitation.

Neuron (Photo: INM/NTNU)Axon: Branch of a nerve cell (neuron) sending signals from the nucleus to other neurons. They are the main communications channel between nerve cells.

Traumatic axonal injury: Damage to the axon (lesion) which usually takes place just below the nucleus. This injury is often initiated at the time of the head injury as the axon is stretched. Many axons will then, after a few hours or days, be split in two and die, whereas other axons will only sustain reversible damage.

Lesion: Damage to tissue or parts of tissue. MRI can identify indirect signs of damage to axons due to visible lesions. The lesions are caused by swelling of the brain tissue and damage to small blood vessels (micro-haemorrhages).

Good diagnosis important for rehabilitation

The results found by Moen and his research team could be very useful in relation to rehabilitation of these patients, the largest part of whom were aged 20-40 with many years still to live:

"There have been cases where brain injury patients for example have started having problems at school or at work without us being able to identify why, as CT examinations have not shown any damage to the brain tissue. With early MRI we could perhaps have found lesions which could have predicted and explained these problems.

"A previous study from our research team has shown that patients with axonal injury in the brainstem have a poorer prognosis. To identify such lesions is therefore very important both in terms of predicting a prognosis, and to estimate the length of the rehabilitation period."

As early as possible

There are certain challenges to using MRI at an early stage after a head injury as the patients are often still in intensive care. MRI devices are not mobile and the patient has to be able to lie completely still for half an hour to achieve good quality MR images.

Nevertheless, based on the findings of the study, Moen recommends a routine for using MRI as early as reasonably possible, to obtain more information about the injuries to the brain tissue.

Visible and non-visible lesions

In the study, MRI was used on average a week after the initial injury, and then again after three and 12 months. The aim was to see how bleeding (so-called micro-haemorrhages) and non-bleeding traumatic axonal lesions develop over time.

"Previously it has been common to use MRI relatively late. But we have had a certain suspicion that we have missed parts of the injuries because they ‘disappear' from the MR images over time," Moen explains.

"In particular we saw that the non-bleeding lesions disappeared. Many of the lesions had disappeared at the three-month examination, whereas the bleeding lesions started to disappear at the 12-month examination.

Moen and his colleagues are now conducting a study involving 128 patients looking at the impact of visible traumatic axonal lesions on patient prognosis, and also plan studies in which non-visible lesions, which can be measured using the technique diffusion-MRI, are mapped. One of the goals is to investigate which lesions have the greatest impact on the outcome of head injuries.

Publication

Two new Centres of Excellence at the Faculty of Medicine

Norwegian Centre of Excellence logo(12.11.2012) The Research Council of Norway has given 13 research groups status as Centre of Excellence (SFF) from 2013. Two of these belong to the Faculty of Medicine (DMF): The Centre of Molecular Inflammation Research (CEMIR) and Centre for Neural Computation (CNC).

Two new Centres of Excellence at the Faculty of Medicine

Norwegian Centre of Excellence logo(12.11.2012) The Research Council of Norway has given 13 research groups status as Centre of Excellence (SFF) from 2013. Two of these belong to the Faculty of Medicine (DMF): The Centre of Molecular Inflammation Research (CEMIR) and Centre for Neural Computation (CNC).

Brain tumour patients live longer with early surgery

MR of a low-grade glioma in the temple lobe.(05.11.2012) Patients with brain tumour of diffuse low-grade glioma (LGG) type have a 14 percentage point greater chance of being alive after 5 years if they receive early surgery, according to a study at the Department of neurology (INM) at NTNU and St. Olavs Hospital, compared with a strategy of wait-and-see. 

Brain tumour patients live longer with early surgery

MR of a low-grade glioma in the temple lobe.(05.11.2012) Patients with brain tumour of diffuse low-grade glioma (LGG) type have a 14 percentage point greater chance of being alive after 5 years if they receive early surgery, according to a study at the Department of neurology (INM) at NTNU and St. Olavs Hospital, compared with a strategy of wait-and-see. 

"This is an important study in brain surgery because there has been a controversy over what is the best treatment for this type of tumours. Treatment practice has therefore varied greatly both nationally and internationally," says last author Ole Solheim.

Glioma

Glioma is a tumour which arises among cells that make up the connective tissue of the nervous system. It is very similar to normal brain tissue, which makes it hard to see during surgery.

Brain surgeons are often supported by modern technology to find the tumour, and to avoid removing tissue that is not part of the tumour. Surgeons may use the imaging technology MRI before surgery, and during surgery may for example use intraoperative MRI or intraoperative ultrasound.

The study, which involved 153 patients of an average age of around 40 with newly diagnosed diffuse LGG, was divided between two health regions in Norway. Patients at hospital A were followed-up with monitoring of the brain tumour, while patients in hospital B received early surgical treatment where possible.

The patients were followed over time, and the results show that after 5 years, 60% of the patients at hospital A were still alive, whereas 74% of patients at hospital B survived – this constitutes a difference of 14 percentage points. This remarkable difference has led to the acceptance of the study in the renowned Journal of the American Medical Association (JAMA).

International recognition

"This is the first comparative study of this patient group. Although it isn't a large study, the patients are young – and we're talking about a substantial gain in life years. This is probably the reason why it has been accepted in such a reputable journal as JAMA – the treatment effect is great," Solheim explains.

The study has already gained national and international recognition, and received great attention at the recent annual congress of the European Association of Neurological Societies (EANS).

Changed practice

The recommendation for early surgical treatment in patients with this type of brain tumours has already been acknowledged by hospital A in Norway, which has changed its practice.

What about quality of life?

"What we plan to do next is to look at morbidity and quality of life. We have looked at survival, and we now wish to look at how the survivors are doing," Solheim says.

The researchers have already begun interviewing surviving patients, both those being actively treated with surgery and those being monitored, on their quality of life.

Publication

The study was supported in part by the National Centre of Competence for Ultrasound and Image-Guided Therapy, which is a partnership between St. Olavs Hopsital, NTNU and Sintef.

Regenerative medicine at NTNU

Regenerative medicine is a field of medicine combining ‘traditional' medical research with advanced imaging technology, nanotechnology and biomaterials science. (25.09.2012) Regenerative medicine is a hot topic in medical research as it could lead to treatments for conditions and diseases that today are incurable. On 3 October, 11 international speakers come to NTNU to discuss the latest developments in an open, one-day seminar.

Regenerative medicine at NTNU

Regenerative medicine is a field of medicine combining ‘traditional' medical research with advanced imaging technology, nanotechnology and biomaterials science. (25.09.2012) Regenerative medicine is a hot topic in medical research as it could lead to treatments for conditions and diseases that today are incurable. On 3 October, 11 international speakers come to NTNU to discuss the latest developments in an open, one-day seminar.

Health information security prize to NSEP’s Gunnar Klein

Gunnar Klein was awarded the ASSIS 2012 prize on 8. September.(12.09.2012) A prize for secure health information systems in Europe has been awarded to NSEP Professor Gunnar Klein at the Department of Neuroscience (INM), NTNU.

Health information security prize to NSEP’s Gunnar Klein

Gunnar Klein was awarded the ASSIS 2012 prize on 8. September.(12.09.2012) A prize for secure health information systems in Europe has been awarded to NSEP Professor Gunnar Klein at the Department of Neuroscience (INM), NTNU.

Klein has been recognized for his contribution to information security in the health sector.

Amongst his achievements, is his work to introduce cryptographic methods using public key infrastructure (PKI) and smart cards, which since have become international standards for the secure identification of health personnel, and for the secure sharing of sensitive patient information.

He has also lead the work on an international standardization of information security over many years, which has resulted in a series of standards that are now used to guide the health sector's own work on information security.

The €5000 prize was awarded by the Royal Academy of Medicine in Brussels, on behalf of the Association pour la sécurité des systèmes d'information de santé (ASSIS), on 8. September.

Smart technology against falls

Recording gait at NTNU. Photo: Geir Mogen(28.06.2012) Elderly people across Europe will test everyday-use of smart technology in a three-year project where movement sensor carried on the body will record how the elderly stand, walk – and fall.

Smart technology against falls

Recording gait at NTNU. Photo: Geir Mogen(28.06.2012) Elderly people across Europe will test everyday-use of smart technology in a three-year project where movement sensor carried on the body will record how the elderly stand, walk – and fall.

The aim of the fall-project is to develop better alarms, and to tailor treatment and exercise regimes for the elderly to minimize the risk for falls and serious fractures.

The elderly will use the movement sensors over time so that researchers can monitor balance, gait, and risk and tendency to fall. The sensors can be carried around the wrist, above and below joints, on the head, or in a belt with the sensor in the back. The technology can also be integrated into smart phones.

INM's Jorunn Helbostad, who is responsible for the project in Trondheim, explains:

"The technology is already available. Accelerometers and angle meters are used in smart phones – mobile phones that can be used horizontally or vertically – you only need to tilt the phone."

The FARSEEING project involves 11 partners across 7 EU-countries researching the prevention and notification of falls among the elderly using smart phone technology.

This article is a summary from Forskning.no (in Norwegian).

Education Prize awarded to Menno Witter and Ingrid Riphagen

Professor Menno Witter. Photo: Geir Mogen(15.06.2012) The Faculty of Medicine's annual education prize («Studieseksjonens undervisningspris») for 2012 is awarded to Professor Menno Witter (Centre for the Biology of Memory) and Adviser Ingrid Riphagen (Unit for Applied Clinical Research) for their inspiring work on developing and implementing the project «Information Literacy – A Modular Approach for Master's Students».

Education Prize awarded to Menno Witter and Ingrid Riphagen

Professor Menno Witter. Photo: Geir Mogen(15.06.2012) The Faculty of Medicine's annual education prize («Studieseksjonens undervisningspris») for 2012 is awarded to Professor Menno Witter (Centre for the Biology of Memory) and Adviser Ingrid Riphagen (Unit for Applied Clinical Research) for their inspiring work on developing and implementing the project «Information Literacy – A Modular Approach for Master's Students».

The prize is a diploma and a travel grant (NOK 20 000), and was awarded during the graduation ceremony for the medical doctor students today.

The Faculty of Medicine has offered a two-year Master of Science (MSc) degree in Neuroscience for almost ten years. According to the learning objectives of the master's programme, the graduated candidates should be able to formulate a research question based on relevant information sources and adequate insight into current knowledge, and to report outcomes of research and defend interpretations and conclusions in a coherent way both orally and in writing.

New educational models

Until 2010 there were no organized, systematic learning activities to improve the students' knowledge and skills in these areas, but interviews with the students and their supervisors identified a need for this. A project to improve the students' information literacy was initiated by Menno Witter, who is the programme coordinator of the MSc in Neuroscience, and Ingrid Riphagen, who is a medical information specialist.

Four different modules were developed. These are integrated in the four compulsory courses that the students take in their first academic year. Each module comprises two seminars with practical learning activities. For each module the students need to write an essay. The feedback on the essay is given in two ways. First, general issues like common mistakes or problems are taken together and discussed through an interactive exchange between the course coordinator and all students. Specific suggestions on what is not correct, how to amend this, what individual students need to pay attention to etc., is provided to each student in writing, as comments embedded in their essay.

Successful project

The results so far show that the project has been a success. The teachers have observed an improvement in the quality of the students' written works. The students have also been more aware on issues like copyright, citation and plagiarism, and better skilled in information search and selection strategies and writing in English.

We congratulate Menno Witter and Ingrid Riphagen with the award!

 

Contact INM

Telephone:
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