Baby with cap

Global Neurology Research Group

The Global Neurology Research Group, part of the Department of Neurology and the Neurological Clinical Research Institute, finds innovative solutions to improve the quality of neurological care in low- and middle- income countries.

Overview

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.

Highlights

Aleppo Presentation

Special Event: Medical Care Under Siege

This event, held in the Etherdome at Massachusetts General Hospital, provided attendees with the opportunity to learn firsthand about the struggles of medical providers working in Aleppo, Syria. The presentation was sponsored by the Massachusetts General Hospital Global Neurology Research Group and the Syrian-American Medical Society. Download the program


Big Brain Projects Urged to Aid Public Health

The Bhutan Epilepsy project was referenced in a recent article in Nature. "[Dr. Mateen's] study of 205 people with epilepsy in Bhutan, now in review at a journal, showed that the app could reliably detect this neural activity — allowing health-care workers with little training to identify the type of epilepsy someone has and which drug could best treat it."


Global Neurology Group Joins African Health and Aging Study

Africa Health Screening

The Global Neurology Research Group team is pleased to join the The Health and Aging Study in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) at the University of Witwatersrand in Agincourt, South Africa this month. Learn more about HAALSI


Study Suggests a Significant Amount of Epilespy in Bhutan is Preventable and Treatable

Congratulations to Kate Brizzi, Sonam Paydon, Tshokey, Damber Nirola, Lhab Tshering, and colleagues on their publication on neurocysticercosis among people with epilepsy in Bhutan. This study suggests a significant proportion of epilepsy in Bhutan is treatable and preventable.

It also guides the use of diagnostic tests for Taenia solium, a parasitic tapeworm, through research performed by the Neurocysticercosis Working Group referral lab in Lima with Professor Hugo Garcia and the Bhutanese medical laboratories in Thimphu.


Mateen Presents at Mexican Neurology Conference

Dr. Mateen presented a lecture on demyelinating diseases of the central nervous system at the Mexican Academy of Neurology on Oct. 31, 2016. Learn more


Image of Bhutan Wins Award in Mass General Photo Contest

Bhutan

Congratulations to Sara Grundy won 3rd place in this year’s MGH’s Got Talent Photo Contest for the ‘Places’ category! The picture was taken at a temple near Paro in Bhutan from our trip in August.


Mateen Seeks Creative Solutions for Global Neurology Challenges

Farrah Mateen, MD, PhD, divides her time between seeing patients at Massachusetts General Hospital and traveling across the globe researching innovative solutions for global neurological care.


Stories from the Field: Neurology Research in Bhutan

Clinical Research Coordinator Sara Grundy writes about her experiences working with clinical trial participants in Bhutan in this article from the Center for Global Health at Mass General.


Presentation at the 2016 ANA Meeting

Join us at the 2016 American Neurological Annual meeting in Baltimore: Off the Beaten Track: Roads Less Traveled  Early/Mid-Career Level Faculty Development Course on Monday October 17th! Download program


Global Neurology Group Presents at CME Forum in Bhutan

On August 20th, we held a continuing medical education open forum on epilepsy in Bhutan at the Khesar Gyalpo University of Medical Sciences of Bhutan in Thimphu, chaired by Bhutan's first modern psychiatrist, Dr. Chencho Dorji.

CME in Bhutan

CME in Bhutan


Epilepsy Project Reaches a Milestone

Bhutan Epilepsy Project

The Bhutan Epilepsy Project has recruited its 400th participant. The program is designed to provide mobile diagnosis for epilepsy in Bhutan, a country that has no practicing neurologists.


Epilepsy Project Featured on Yiga Radio

Epilepsy Project Featured on Yiga Radio

Congratulations to Lhab Tshering (pictured center) who was interviewed on epilepsy for Yiga Radio 94.7 Bhutan!

Group Members

Global Neurology Research staff members
Sarah Clark, Diederik Koelman, and Farrah Mateen, MD, PhD, outside of the MGH Neurological Clinical Research Institute entrance.

Principal Investigator

Farrah Mateen, MD, PhD
Associate Professor of Neurology, Harvard Medical School

Research Staff

Sarah Clark, BSc
Project Manager, Massachusetts General Hospital, Boston, MA, US

Sara Grundy, BA
Project Manager, Massachusetts General Hospital, Boston, MA, USA

Lhab Tshering, BSc
Research Coordinator, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan


Graduate Students

Gladia Hotan, PhD candidate
Neuroscience, Massachusetts Institute of Technology, Cambridge, MA, USA

Diederik Koelman, BSc
Master's Student, Academic Medical Center, Amsterdam, The Netherlands

Leah Wibecan, BSc
MPH student, Harvard T.H. Chan School of Public Health, Boston, MA, USA


EEG Technicians

Joe Cohen, BSc
Chief EEG Technician, Massachusetts General Hospital, Boston, MA, USA

Jo Mantia
EEG Technician, Sunnybrook Hospital, Toronto, Canada


Residents/Fellows

Aline Herlopian, MD
Clinical Neurophysiology/Epilepsy Fellow, Massachusetts General Hospital, Boston, MA, USA

Natalie Cornay Manalo, MD
Advanced General and Autoimmune Neurology Fellow, Massachusetts General Hospital, Boston, MA, USA

Mahmoud AbdelRazek, MD
Neurology Fellow, Massachusetts General Hospital, Boston, MA, US

Altaf Saadi, MD
Neurology Resident, Brigham and Women's Hospital & Massachusetts General Hospital, Boston, MA, USA

Brian Wong, MD
Pediatric Neurology Fellow, University of Southern California, Los Angeles, CA, USA


Alumni

Kate Brizzi, MD
Advanced General Neurology Fellow, Massachusetts General Hospital, Boston, MA, USA

Veronica Bruno, MD
MPH student, Harvard T.H. Chan School of Public Health, Boston, MA, USA

Sonam Deki, BComm
Research Coordinator, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan

Megan Diamond, SM
Massachusetts General Hospital, Boston, MA, USA

Alice Lam, MD
Epilepsy Fellow, Massachusetts General Hospital, Boston, MA, USA

Tullia Leib
Co-op Student, Northeastern University, Boston, MA, USA

Erica McKenzie, BSc
Medical Student, Queen's University, Ontario, Canada

Bryan Patenaude, MA
PhD Candidate, Harvard T.H. Chan School of Public Health, Boston, MA, USA

Lance Shaull, BA
Associate Coordinator, Massachusetts General Hospital, Division of Global Health and Human Rights

Tali Sorets
High School Student, Buckingham, Brown & Nichols, Cambridge, MA, USA

Michael P.H. Stanley, BA
Medical Student, Tufts University School of Medicine, Boston, MA, USA

Stanley Wanjala, MA
Sagam Community Hospital, Sagam, Kenya

Emma Wolper, BA
Research Assistant, Lesley University, Cambridge, MA, USA

Janice Wong, MD
Neurology Resident, Brigham and Women's Hospital & Massachusetts General Hospital, Boston, MA, USA

Rodrigo Zepeda, MD
Epilepsy Fellow, Massachusetts General Hospital, Boston, MA, USA



Global Neurology Staff Working in Bhutan

Damber and Farrah Erica and Tali
Dr. Damber Nirola and Dr. Farrah Mateen Erica McKenzie and Tali Sorets enrolling patients.
Sonam and Lhab Jo in the clinic
Research coordinators Sonam and Lhab in Thimphu, Bhutan. EEG Technician Jo Mantia performs a stationary EEG in the clinic in Bhutan. 

Research Projects

Testing out the smartphone-based EEG

Testing the smartphone-based EEG in Bhutan.

Research Projects

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 (which is funded by the Government of Canada and dedicated to supporting Bold Ideas with Big Impact in global health).

Resources:

Articles:


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.

Educational Resources

Epilepsy and Microeconomics Survey

This is the survey form that we have developed to conduct intake surveys with epilepsy study participants in Bhutan. The survey is designed to collect important data for those with epilepsy in resource-limited settings. Please feel free to download the survey and modify for use in other countries as needed.


World Maps

My Thinking Cap is a coloring book about epilepsy, a brain disorder that affects people of any age. It is a fun and easy way to help kids and their families begin to understand more about epilepsy. This book can be especially useful for children in countries where epilepsy remains misunderstood. Stigma towards people with epilepsy persists everywhere.

Download by Language

Arabic

Arabic
Download booklet


 

Chichewa

Chichewa
Download booklet


 

English

English
Download booklet


 

French

French
Download booklet


 

Haitian Creole

Haitian Creole
Download booklet


 

Italian

Italian
Download booklet


 

Portugeuse

Portuguese
Download booklet


 

Russian

Russian
Download booklet


 

Spanish

Spanish
Download booklet


 

Tagalog

Tagalog
Download booklet


Publications

Koelman DL, Benkeser DC, Xu Y, Neo SX, Tan K, Katsuno M, Sobue G, Natsume J, Chahin S, Mar SS, Venkatesan A, Chitnis T, Hoganson GM, Yeshokumar AK, Barreras P, Majmudar B, Carone M, Mateen FJ. Acute disseminated encephalomyelitis in China, Singapore and Japan: a comparison with the USA. Eur J Neurol. 2016 [Epub ahead of print].


Saadi A, Patenaude B, Mateen FJ. Quality of life in epilepsy-31 inventory (QOLIE-31) scores: A global comparison. Epilepsy Behav. 2016 Dec;65:13-17 Review.


Brizzi K, Pelden S, Tshokey T, Nirola DK, Diamond MB, Klein JP, Tshering L, Deki S, Nidup D, Bruno V, Dorny P, Garcia HH, Mateen FJ; Bhutan Epilepsy Project. Neurocysticercosis in Bhutan: a cross-sectional study in people with epilepsy.Trans R Soc Trop Med Hyg. 2016 Sep;110(9):517-526.


Saadi A, Patenaude B, Nirola DK, Deki S, Tshering L, Clark S, Shuall L, Sorets T, Fink G, Mateen F. Quality of life in epilepsy in Bhutan. Seizure. 2016 Jul;39:44-8.


Koelman DL, Chahin S, Mar SS, Venkatesan A, Hoganson GM, Yeshokumar AK, Barreras P, Majmudar B, Klein JP, Chitnis T, Benkeser DC, Carone M, Mateen FJ. Acute disseminated encephalomyelitis in 228 patients: A retrospective, multicenter US study. Neurology. 2016 May;86(22):2085-93.


Brizzi K, Deki S, Tshering L, Clark SJ, Nirola DK, Patenaude BN, McKenzie ED, McLane HC, Cash SS, Dorji C, Mateen FJ. Knowledge, attitudes and practices regarding epilepsy in the Kingdom of Bhutan. Int Health. 2016 Jul;8(4):286-91.


McKenzie ED, Nirola DK, Deki S, Tshering L, Patenaude B, Clark SJ, Cash SS, Thibert R, Zepeda R, Leung EC, Lam AD, Lim AS, Mantia J, Cohen J, Cole AJ, Mateen FJ. Medication prescribing and patient-reported outcome measures in people with epilepsy in Bhutan. Epilepsy Behav. 2016;59:122–7.  


McLane HC, Berkowitz AL, Patenaude BN, McKenzie ED, Wolper E, Wahlster S, Fink G, Mateen FJ. Availability, accessibility, and affordability of neurodiagnostic tests in 37 countries. Neurology. 2015;85(18):1614–22.


Koelman DLH, Mateen FJ. Acute disseminated encephalomyelitis: current controversies in diagnosis and outcome. J Neurol. 2015 Sep;262(9):2013–24.


Sorets TR, Mateen FJ. Mandatory CPR Training in US High Schools. Mayo Clin Proc. 2015 Jun;90(6):710–2.


Saadi A, Mateen FJ. The internationalization of the American Academy of Neurology. Neurology. 2015 Feb;84(8):856–8.


McKenzie ED, Spiegel P, Khalifa A, Mateen FJ. Neuropsychiatric disorders among Syrian and Iraqi refugees in Jordan: a retrospective cohort study 2012-2013. Confl Health. 2015;9:10.

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