Progress in paediatric neurosciences is proceeding rapidly, and we are entering an era in which technologies will allow for a greater knowledge and understanding of normal and abnormal brain development. Because of our improved diagnostic abilities, it is now possible to identify even subtle brain abnormalities early on, thus allowing for early intervention. However, in certain areas of the world, many children do not benefit from this progress because of the shortage of child neurologists and adequately equipped medical centers.
In recent years, this progress in diagnostic and therapeutic capabilities and the growing necessity for advanced technology to diagnose CNS disorders have greatly increased the divide between developed and developing countries. In addition, child neurologists from developing countries are hampered by the lack of professional networks that could provide continuous education and updates on new developments in the specialty.
About 70% of children with disablities live in resource-poor countries, and most of them have neurological diseases. Protein-energy malnutrition, dietary micronutrient deficiencies, environmental toxins and a lack of early sensory stimulation may contribute to the high prevalence of neurodevelopmental disabilities in these countries. Access to up-to-date imaging and genetic and biochemical testing is limited in some regions, which is particularly problematic because delaying diagnosis and treatennt can have deleterious effects on a child's development.
There is an urgent need to identify regional centers and reference labd to improve diagnosis of neurological disease in children in developing countries. In Central Asia, the number of qualified child neurologists has increased in recent years, but they are not equally distributed between urban and rural areas, with about 95% of them concentrated in the countries' capital cities. The situation is worse in Africa, where many countries have no child neurologists at all.
Education is one of the primary goals and purposes of the International Child Neurology Association (ICNA). The ICNA Education Committee has organized numerous programs for improving participants' knowledge of paediatric neurological disorders at the primary care level and for promoting clinical research interest in child neurology and have been organized in several countries, including Egypt, Estonia, Guatemala, India, Kazakhstan, Kenya, Peru, Ukraine, and Uruguay. The main goals of these events were to improve the use of relevant diagnostic measures and management in paediatric neurological care, and enrich the teaching and academic skills of local trainers.
Under the ICNA educational programmes, a number of different strategies have been adopted to promote education in emerging countries. Among these was for the ICNA executive board to hold it's annual meeting in conjunction with local or regional child neurology organizations, and for the association to provide speakers and scientific support to local conferences. In doing these things, ICNA has had a significant impact on the development of regional child neurology associations in Asia, Africa, Eastern Europe, the Middle East, and South America.
In 2002, my administration established research as the top prerogative of our society. Not surprisingly, ICNA's primary research priority is to document and define the causes of neurological handicaps in children in various geographic regions so that approaches to prevention and treatment can be tailored to a region's specific needs.
We urgently need to build this research capacity in emerging countries through international cooperation so that we are united against the devastating neurological disorders that affect millions of children worldwide. ICNA has a unique role in improving international cooperation and promoting clinical and scientific research byneproviding a medium through which physician can exchange opinions at an international level for the advancement of paediatric neurosciences.
The Internet is the key to coordinating global education in paediatric neurology. ICNA supports a Web site, www.icnapedia.org, that provides access to pertinent papers, clinical guidelines, consensus statements,and management protocols. The association is deeply committed to providing innovative, educational and training programs for all professional involved in the care of children with neurological disorders. Its International Education committee plans to develop a distance learning course in paediatric neurology for those who are not able to travel to attend courses and conferences in person.
ICNA is uniquely qualified and well positioned to remedy this deficit by reducing the gap and increasing the level of child neurology care all around the world. To accomplish this ambitions goal, ICNA should work with the World Federation of Neurology and World Health Organization. This international cooperation is more important than ever to promote brain health globally.
Part of this article is adapted from a paper by Prof Curatolo which appeared in the Journal of Child Neurology (2010;25:1444-9)
- Details
- Dr Paolo Curatolo
- News
- Hits: 750
The abstract submission deadline for Autism Spectrum Disorders: From Mechanisms to Therapies is July 29, 2011. We encourage you to submit your research for presentation and hope you will join us, our co-organizers, and leading researchers in Arlington, USA from November 9-11, 2011.
The abstract submission deadline for Autism Spectrum Disorders: From Mechanisms to Therapies is July 29, 2011. We encourage you to submit your research for presentation and hope you will join us, our co-organizers, and leading researchers in Arlington, USA from November 9-11, 2011.
An official 2011 SFN satellite meeting, Autism Spectrum Disorders: From Mechanisms to Therapies, will focus on recent advances in understanding the neural basis of autism spectrum disorders (ASD).
The aim of this meeting is to bring together key researchers working on autism spectrum disorders at multiple levels, with a specific goal of considering how current basic research findings and candidate mechanisms can be directed towards therapies and treatments.
The topics that will be discussed include:
- Autism Genetics
- From Animal Models to Mechanisms
- Synaptic Mechanisms
- Circuit Mechanisms
- Cognitive Mechanisms
- From Models to Potential Therapeutics
Abstracts are now being accepted on the above topics.Abstract Submission Deadline: July 29, 2011
Read More
- Details
- ICNA
- News
- Hits: 656
It is my distinct honor, on behalf of the International Child Neurology Association, to invite you to register for the 12th International Child Neurology Congress to be held in Brisbane, Australia during May 2012.
The Congress will be held jointly with the 11th Asian and Oceanian Congress of Child Neurology, and promises to attract a large international audience. As in the past congresses, the Scientific Program will be of the highest caliber, emphasizing not only the latest developments and advances in child neurology, but also a review of current standard of care in the practice of child neurology. Participants from all over the world will be able to engage in collegial exchange of ideas in a friendly and warm atmosphere.
An attractive socio-cultural program is also being planned, and participants and their families will be able to enjoy both the diversity and uniqueness that Australia has to offer. Therefore, it is with great enthusiasm that we urge you to join us in Brisbane, May 2012 in what we anticipate to be a memorable scientific, academic and social experience.
Harry T. Chugani, M.D.
President, The International Child Neurology Association (ICNA)
Bruce and Rosalie Rosen Professor of Pediatrics and Neurology
Director, Positron Emission Tomography Center
Children's Hospital of Michigan, Detroit Medical Center
Wayne State University School of Medicine, Detroit, Michigan, USA
Read More
- Details
- Harry Chugani
- News
- Hits: 585
Use of newer-generation antiepileptic drugs, which are also prescribed for bipolar mood disorders and migraine headaches, during the first trimester of pregnancy was not associated with an increased risk of major birth defects in the first year of life among infants in Denmark, according to a study in the May 18 issue of JAMA. Older-generation antiepileptic drugs are associated with an increased risk of birth defects.
"Epilepsy during pregnancy is a therapeutic challenge. Since the 1990s, the number of licensed antiepileptic drugs has substantially increased, but safety data on first-trimester use of newer-generation antiepileptic drugs and birth defects are limited," according to background information in the article.
Ditte Molgaard-Nielsen, M.Sc., and Anders Hviid, M.Sc., Dr.Med.Sci., of the Statens Serum Institut, Copenhagen, Denmark, conducted a study to analyze the association between the use of lamotrigine, oxcarbazepine, topiramate, gabapentin, and levetiracetam (newer-generation antiepileptic drugs) during the first trimester of pregnancy and the risk of any major birth defects. The study included data on 837,795 live-born infants in Denmark from January 1996 through September 2008. Individual-level information on dispensed antiepileptic drugs to mothers, birth defect diagnoses, and potential confounders (factors that can influence outcomes) were ascertained from nationwide health registries.
Among the live births included in the study (837,795), 19,960 were diagnosed with a major birth defect (2.4 percent) during the first year of life. Among 1,532 pregnancies exposed to lamotrigine, oxcarbazepine, topiramate, gabapentin, or levetiracetam at any time during the first trimester, 49 infants were diagnosed with a major birth defect (3.2 percent) compared with 19,911 infants (2.4 percent) among 836,263 unexposed pregnancies. After adjusting for various factors, the authors found that exposure to lamotrigine, oxcarbazepine, topiramate, gabapentin, or levetiracetam at any time during the first trimester was not associated with an increased risk of major birth defects. Gabapentin and levetiracetam exposure during the first trimester was uncommon.
The prevalence odds ratios for any major birth defects after exposure to any newer-generation antiepileptic drugs during the first trimester were not statistically different for mothers with epilepsy, mood affective disorder or migraine, or without a diagnosis.
"Our study, to our knowledge, is the largest analytic cohort study on this topic and provides comprehensive safety information on a class of drugs commonly used during pregnancy. The use of lamotrigine and oxcarbazepine during the first trimester was not associated with moderate or greater risks of major birth defects like the older-generation antiepileptic drugs, but our study cannot exclude a minor excess in risk of major birth defects or risks of specific birth defects. Topiramate, gabapentin, and levetiracetam do not appear to be major teratogens [an agent that can cause malformations in an embryo or fetus], but our study cannot exclude minor to moderate risks of major birth defects," the authors conclude.
JAMA. 2011;305[19]1996-2002.
Abstract: http://jama.ama-assn.org/content/305/19/1996.short
Note:
In 2008, a 200-patient study in Neurology found that topiramate in the first trimester of pregnancy carries a higher-than-usual rate of congenital malformations — especially when taken with valproate. [Article link: http://www.neurology.org/content/71/4/272.abstract ]
In March 2011, the FDA warned against use of topiramate during pregnancy because of its association with cleft lip and cleft palate; the FDA had classified topiramate in pregnancy category D. [FDA MedWatch alert]
Read More
- Details
- ICNA
- News
- Hits: 652
Researchers including members from the Niels Bohr Institute at the University of Copenhagen have developed a new method for making detailed X-ray images of brain cells. The method, called SAXS-CT, can map the myelin sheaths of nerve cells, which are important for conditions such as multiple sclerosis and Alzheimer's disease. The results have been published in the scientific journal, NeuroImage.
The myelin sheaths of nerve cells are lamellar membranes surrounding the neuronal axons. The myelin layers are important to the central nervous system as they ensure the rapid and uninterrupted communication of signals along the neuronal axons. Changes in the myelin layers are associated with a number of neurodegenerative disorders such as cerebral malaria, multiple sclerosis, and Alzheimer's disease.
The development of these diseases are still not fully understood, but are thought to be related to the damage of the myelin layers, so that messages from the brain reach the various parts of the body poorly or not at all. It is like an electric cord where the insulating material has been damaged and the current short circuits. In order to find methods to prevent or treat the diseases it is important to understand the connection between the diseases and the changes in the myelin.
Getting 3-D X-ray images
"We have combined two well-known medical examination methods: SAXS (Small-Angle X-ray Scattering) and CT-scanning (computed tomography scanning). Combined with a specially developed programme for data processing, we have been able to examine the variations of the myelin sheaths in a rat brain all the way down to the molecular level without surgery", explains PhD Torben Haugaard Jensen, Niels Bohr Institute at the University of Copenhagen. The method is called 'Molecular X-ray CT', because you use X-ray CT to study myelin at the molecular level.
The research has been carried out in collaboration with researchers in Switzerland, France and Germany. The experiments took place at the Paul Scherrer Institute in Switzerland, where they have a powerful X-ray source that can measure Small-Angle X-Ray Scattering, SAXS at a high resolution. Normally such experiments would give two-dimensional X-ray images that are sharp and precise, but without information on depth. But by incorporating the method from CT-scanning, where you image from different angles, the researchers have managed to get 3D X-ray images.
This has not only required the development of new X-ray methods and experiments, but has also required the development of new methods for processing data. The extremely detailed measurements of cross sections from different angles meant that there were 800,000 images to be analysed. So the researchers have also developed an image-processing programme for the SAXS-CT method. The result is that they can see all of the detailed information from SAXS in spatially resolved.
From point samples to total samples
"We can see the myelin sheaths of the neuronal axons and we can distinguish the layers which have a thickness of 17.6 nanometers", explains Torben Haugaard Jensen. "Up until now, you had to cut out a little sample in order to examine the layers in one area and get a single measuring point. With the new method we can examine 250,000 points at once without cutting into the sample. We can get a complete overview over the concentration and thickness of the myelin and this gives of the ability to determine whether the destruction of the myelin is occurring in spots or across the entire sample", he explains.
The research provides new opportunities for collaboration with doctors at Copenhagen University Hospital and the Panum Institute, who they already have close contact with. The method cannot be used to diagnose living persons. But the doctors can obtain new knowledge about the diseases, what kind of damage is taking place? - and where? They will be able to follow the development of the diseases and find out how the brain is being attacked. This knowledge could perhaps be used to develop a treatment.
Source:
Gertie Skaarup
University of Copenhagen
Read More
- Details
- ICNA
- News
- Hits: 645