To catalyze research in low-income settings to improve the care of people with nervous system disorders in locations around the world by building research capacity and awareness of neurological disorders.
Global Health Initiatives
The MGH Neurology faculty have active collaborations with researchers in several countries, focusing on priority neurological diseases including epilepsy, dementia, and neuromuscular diseases.
Faculty, residents, and fellows also participate in teaching and clinical care in several countries through partnerships with many universities and organizations worldwide.
Your donation will help provide care for people with neurological disorders in resource-limited settings in Africa and Asia, including epilepsy, stroke, and paralysis. Donations will go towards an EEG to diagnose seizures (30 dollars=one EEG) and medications for stroke (5 dollars per person per month), and research to help people with brain disorders in refugee and post-conflict zones. Please consider a donation today.
AAN Global Health Section
Connect With Mass General Neurology
The Bhutan Epilepsy Project
In the Kingdom of Bhutan, a least-developed, landlocked Himalayan country, there are no neurologists. People with epilepsy in Bhutan are treated by one of the country’s two psychiatrists. More than 1,000 patients are seen per year in the only tertiary care center. Approximately 8,000-10,000 people are estimated to have epilepsy in Bhutan, most of whom are undiagnosed.
Through the support of Grand Challenges Canada and the Thrasher Research Foundation, we will use the Smartphone Brain Scanner framework recently developed by Arkadiusz Stopczynski, MSc, Technical University of Denmark and Massachusetts Institute of Technology and colleagues.
This is a multi-platform, real-time, and portable electroencephalogram system consisting of software and hardware, compatible with multiple commercially-available, off-the-shelf mobile devices, such as Android mobile phones and tablets.
The device has several advantages for lower-income settings including (1) portability of the software to be used with multiple mobile technologies including smartphones, tablets, and computers, (2) software compatibility with existing mobile devices, (3) use of consumer-grade EEG headsets that are low cost (~300 dollars), (4) no need for paper tracings or ink, (5) no need for an expert operator, targeting the end-user such that any person can take the EEG recording on a patient with minimal training, (6) storage and electronic transmission of large amounts of data, including EEG tracings lasting for 12 hours or longer, and (7) battery operated mobile devices and EEG headsets, allowing for operation with limited electricity access.
Brain Disorders in Humanitarian Emergencies and Post-conflict States
Brain disorders are an under-appreciated health problem in settings of humanitarian conflict and in states emerging from conflict. We have been actively engaged in work with the United Nations High Commissioner for Refugees and related organizations to improve the advocacy, data collection, and treatment of neurological disorders among Syrian and Iraqi refugees as well as health systems approaches to improving neurological care in fragile states such as Timor-Leste.
The FLAMES Study for Africa: Fluoxetine for Stroke Recovery
Sixteen million people suffer a first-ever stroke each year worldwide. Of these, 5.7 million die and 5 million survivors remain disabled. Stroke is a leading cause of death and disability globally and accounts for more deaths than HIV/AIDS, malaria, and tuberculosis combined.
In the United States, a person suffers a stroke every 40 seconds and dies of stroke every 4 minutes. However, the incidence of stroke is even higher in low- and middle income countries, where 85% of all strokes occur.
Currently, there are no pharmacological treatment options for motor recovery after stroke proven to be efficacious. One recent phase III clinical trial of fluoxetine, a selective serotonin reuptake inhibitor (SSRI), showed improved motor recovery among 118 ischemic stroke survivors in France (FLAME Study).
Larger studies are needed, particularly in resource-limited settings and among HIV-infected stroke populations where the drug has not been studied.
A prospective, double-blinded, randomized, 1:1 placebo-controlled study of fluoxetine and its effect on motor recovery at 90 days will be performed, including acute ischemic stroke patients aged 18-80 years old with moderate to severe motor deficits at enrollment.
Research papersMateen FJ, Carone M, Haskew C, Spiegel P. Reportable neurologic diseases in refugee camps in 19 countries. Neurology 2012;79:937-40.
Mateen FJ, Niu J, Gao S, Li S, Carone M, Wijdicks EF, Xu WH. Persistent vegetative state: a comparative study at a Chinese and U.S. referral hospital. Neurocrit Care 2013;18:266-70.
Mateen FJ, Bahl S, Khera A, Sutter RW. Diphtheritic polyneuropathy as detected by acute flaccid paralysis surveillance, India. Emerging Infect Dis 2013;19:1368-73.
Berkowitz AL, Mittal M, McLane HC, Shen GC, Muralidharan R, Lyons JL, Shinohara RT, Shuaib A, Mateen FJ. Worldwide reported use of IV-tissue plasminogen activator for acute ischemic stroke. Int J Stroke 2014;9:349-55.
Mateen FJ, Post WS, Sacktor N, Abraham AG, Becker JT, Smith BR, Detels R, Martin E, Phair JP, Shinohara RT; for the Multi-Center AIDS Cohort Study (MACS) Investigators. Long-term predictive value of the Framingham risk score for stroke in HIV-infected vs. HIV-uninfected men. Neurology 2013;81:2094-102.
Schwamm LH. Telehealth: seven strategies to successfully implement disruptive technology and transform health care. Health Aff (Millwood). 2014;33:200-6.
Lyons JL, Coleman M, Engstrom JW, Mateen FJ. International electives in neurology training: a survey of U.S. and Canadian program directors. Neurology 2014;82:119-25.
Bucheli ME, Calderón A, Chicaiza D, Franco C, López R, Digga E, Atassi N, Salameh J, Berry JD. Feedback interaction of research, advocacy, and clinical care applied to ALS research in South America. Neurology 2013;81:1959-61.
Mateen FJ, Martins N. A health systems constraints analysis for neurological diseases: the example of Timor-Leste. Neurology 2014. In press
Fugate JE, Lyons JL, Thakur KT, Smith BR, Hedley-Whyte ET, Mateen FJ. Infectious causes of stroke. Lancet Infect Dis 2014;Epub May 30, 2014