Advancing Neurological Care Worldwide
Neurological disorders such as epilepsy, stroke, dementia and traumatic brain injuries are more common in low- and middle income countries, where 86% of the world’s population is concentrated.
These neurological disorders can be disabling both physically and mentally, and there is a high human and economic cost associated with them. Many of these diseases come with a stigma attached since they are often misunderstood.
Compounding this problem is that many of these diseases are not well diagnosed or treated due to a lack of trained neurologists and limited access to medical care in these settings.
When last studied, there were 12 African countries with no neurologists, and an additional 23 countries with a ratio of one neurologist to more than five million people in the population.
The Global Neurology Research Group at Mass General works on projects designed to improve the diagnosis, care and treatment of neurological diseases in these resource-limited settings.
Page updated: February 6, 2015
Farrah Mateen, MD PhD
Sarah Clark, BSc, Senior Clinical Research Coordinator
Diederik Koelman, BSc, Master's student, Academic Medical Center, Amsterdam, The Netherlands
Emma Wolper, Research Assistant, Lesley University, Boston, USA
Erica McKenzie, BSc, Medical Student, Queen's University, Ontario, Canada
Mia Borzello, BA, Research Assistant, Cash Laboratory, Harvard Medical School/Massachusetts General Hospital, Boston, USA
Tali Sorets, High school student
Staff in Bhutan
Sonam Deki, BComm, Research Assistant, affiliated with Jigme Dorji Wangchuck National Referral Hospital
Lhab Tshering, BSc, Research Assistant, affiliated with Jigme Dorji Wangchuck National Referral Hospital
Smartphone EEG in Bhutan- the group is conducting a clinical study to test the feasibility of using a smartphone-based electroencephalograph (EEG) system to diagnose patients with epilepsy in Bhutan, a small, land-locked country between China and India. Funded by Grand Challenges Canada.
Optical Coherence Tomography (OCT) to Assess Brain Development in Infants in Sub-Saharan Africa- Preliminary data suggest that retinal nerve fiber layer measurements may be surrogate markers of early life cortical development. Embryologically, the retina shares derivation with the cerebral cortex, but unlike the cortex, can be visualized noninvasively through a new technology, optical coherence tomography (OCT). OCT is a portable, affordable, painless, noninvasive medical instrument and has supportive scientific evidence as a surrogate marker of gross measures of neurodevelopment in specific disease states. Interpretation of RNFL thicknesses are automated and colorized so that lay community health care workers can be trained to make basic readings in the field.
We aim to determine whether handheld, noninvasive OCT equipment can reliably assess brain development through measurements of retinal nerve fiber layers in early life and be an effective screening test for some forms of abnormal early life brain development.
Mateen 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;82:1274–1276
Fugate JE, Lyons JL, Thakur KT, Smith BR, Hedley-Whyte ET, Mateen FJ. Infectious causes of stroke. Lancet Infect Dis 2014;14:869-80.
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