Neuropsychiatry

Alzheimer's Autralia Summit

In May 2015, Alzheimer’s Australia held a two day Summit in Melbourne, the first of its kind, offering an environment for all of the Young Onset Dementia Key Workers from around Australia to network, and provided an opportunity for members of the Neuropsychiatry Team to meet interstate workers with whom they have been consulting via teleconference. In addition to strengthening the collaboration by having face-to face contact, the Neuropsychiatry clinicians were invited to present to the Key Workers. Dr Kelso launched the release of the updated Quality Dementia Care Series Five booklet: Younger Onset Dementia: A Practical Guide. This guide is a resource for families and consumers, which she was involved in developing in Sydney in 2008, and has now taken the lead role in editing in 2015.  (See link below). JoAnne Bevilacqua presented a summary of the Clinical Consultation outcomes to date. Both presentations were well received, and a “wish list” of outcomes identified has been endorsed by Alzheimer’s Australia. These include flying Neuropsychiatry outpatient clinicians interstate quarterly to provide face-to-face clinical consultations in light of the significant shortage of specialised services in the state. The first visit will be to Tasmania in October 2015.
https://fightdementia.org.au/sites/default/files/20090200_Nat_QDC_QDC5YODPracGuide.pdf

4th Neuropsychiatry and Behavioural Neurology Conference

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The RANZCP Section of Neuropsychiatry and the ANZAN Section of Behavioural Neurology, supported by the University of Melbourne, and in collaboration with theAustralian Consortium of Centres for Clinical Cognitive Research (AC4R) are pleased to announce the 2015 annual Neuropsychiatry and Behavioural Neurology Conference.

The programme is below, and registration can be done through the
conference website.

Friday 6 November 2015 09.00 - 19:00
Registration open
Welcome
Theme Session: Schizophrenia Dr Ramon Mocellin  — TBC Professor Christos Pantelis  — The present: Schizophrenia: State of the Art. Neuroprogression and the role of stress,  drugs and neuroinflammation
Morning Tea
Keynote Session Schizophrenia: The Future Professor John McGrath: Expectations for the future of schizophrenia research - from the prosaic to the grandiose
Lunch
Theme Session: Nucleotide repeats and Lewy bodies Dr Samantha Loi – Huntingtons disease - the past Professor Elsdon Storey – Molecular biology of repeat disorders Dr Rosie Watson - Dementia with Lewy Bodies
Afternoon Tea 
Theme session: Epilepsy
Professor Harry McConnell – The past:
Epilepsy through the Ages, a neuropsychiatric perspective Professor Terry O’Brien – The present: Treatment for Epilepsy: The Current State of Play Professor Mark Cook – The future: Title TBC
Trainee Session Trainee case presentations and judging
Conference Dinner Guest Speaker Associate Professor Steve Ellen
  Saturday 7 November 2015  08:45 – 12:00

Registration open
Neuroimaging workshop
Neuroimaging Teaching Session Dr Frank Gaillard -
Understanding MRI
Morning Tea

Neurocogitive case workshop: Associate Professor David Darby
 
Conference Close

Radiopedia - a Growing Resource

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Dr Frank Gaillard is a consultant neuroradiologist at the Royal Melbourne Hospital with interests in brain tumour imaging, multiple sclerosis, neurodegenerative diseases and computer assisted image interpretation.  He is the founder and CEO of Radiopaedia.org, the largest collaborative online  radiology resource, dedicated to effecting global change through open radiology education and resources.  Dr Gaillard works collaboratively with the Neuropsychiatry Unit to review cases and provide teaching. 
 
Dr Gaillard started radiopaedia in 2005, as a way of keeping interesting films while completing his radiology training.  Ten years later, in 2015, Radiopaedia attracted 7 million hits a month from 2 million unique users and represented every country in the world.  As of January 2015, Radiopaedia had a total of 17,660 cases uploaded to the site from radiologists around the world.
"To be able to give radiologists or doctors in third world nations, who don't have the teaching, or the expertise, or the hardware that we do, the ability to see some of these cases and better treat and diagnose their patients is probably what gives me the greatest sense of satisfaction on a day-to-day basis."

ABC News - Link

NUCOG Now Available on the iPad

The NUCOG, the Neuropsychiatry Unit’s cognitive screening instrument - first developed in 2000 and validated in a number of neurological and psychiatric disorders, as well as in multiple languages - is now available on the iPad. The initial version comes with English, simplified Chinese and Spanish language versions built-in right off the bat. The iPad NUCOG also comes with a built-in manual (English only).
The iPad version of the
NUCOG combines its world-leading versatility, breadth and brevity with the advantages of an App, including the capacity to resume testing, print and email results, have patients write directly on the screen, and use the iPad camera to capture patient data.
Get the iPad NUCOG here via iTunes. Or, for more information on the tool, visit the NUCOG website here.
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Neuropsychiatry of Movement Disorders

The unit’s 2013 Neuroimaging Fellow, Dr Brad Hayhow, has published an illustrated summary of how typical movement disorders associated with chorea, dystonia and ataxia are associated with neuropsychiatric illness. This review paper has been published in the new Columbia University movement disorders journal, Tremor.
The paper can be viewed in full here, and contains high-quality illustrations about frontal-subcortical circuits whose disruption can lead to psychiatric illness. One of the images can be found below.

NEUROPSYCHIATRY OF MOVEMENT DISORDERS
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Prototypical frontostriatal circuit.

Neuropsychiatry and Behavioural Neurology Conference Programme

PROGRAMME FOR 2ND NEUROPSYCHIATRY AND BEHAVIOURAL NEUROLOGY CONFERENCE

The full programme for the 2nd NP/BN Conference is now available. As per last year’s conference, Friday provides a rich set of clinical updates in neuropsychiatry and behavioural neurology, with a Saturday morning teaching session focussing on clinical teaching: neuroradiology and movement disorders.

Please register at the conference website:
http://www.npbn2013.com/


Dr Jenny Torr - Intellectual Disability

Dr John Kwok -
The Neurogenetics of dementia

Dr Andrew Evans -
Parkinsons plus syndromes

Dr Martin Jackson - Acquired brain injury and substance abuse

Professor Colleen Loo - ECT

Professor Paul Fitzgerald -
TMS

Professor Nicola Lautenschläger -
Exercise and neurostimulation

A/ Professor Michael Fahey - Dementia in the very young

A/Professor Elsdon Storey -
Dementia plus movement disorders

Dr Jo Fielding -
Dementia plus eye movement disorders

Neuropsychiatry and Behavioural Neurology Education and Training



A/Professor David Darby - Prodromal Dementia Concepts

Dr Karyn Boundy -
Current Therapeutics of Alzheimers Disease

Professor Dennis Velakoulis -
Therapeutics of FTD

A/Professor Michael Woodward - Landscape of Clinical Trials in Australia and the World

Dr Karyn Boundy - How to enter the Clinical Trials Market Place, “What do you need to start up a clinical trial centre”
Friday 8 November 2013
0900 – 1630 hours
Registration open
0930 – 1130 hours
Themed Session: Clinical updates and insights
1130 – 1230 hours
Keynote Session
1230 – 1330 hours
Lunch
1330 – 1530 hours
Themed Session: Neurostimulation in psychiatry and neurology
1530 – 1730 hours
Themed Session: Dementia “plus”
1730 – 1800 hours
Trainees Meeting:
1730 – 1900 hours
Conference Dinner
1900 – 2100 hours
Themed Session: Australian Consortium of Centres for Clinical Cognitive Research (AC4R)


Saturday 9 November 2013

Dr Frank Gaillard and Dr Brad Hayhow -
Understanding MRI

Understanding movement disorders
0845 – 1200 hours
Registration open
0900 – 1030 hours
Neuroimaging Teaching Session
1030 – 1115 hours
Dr Andrew Evans -
1115 – 1130 hours
Morning Tea
1130 hours
Conference Close

2nd Neuropsychiatry and Behavioural Neurology Conference

SAVE THE DATE!! 2nd Neuropsychiatry and Behavioural Neurology Conference

On November 8th and 9th 2013, the 2nd Neuropsychiatry and Behavioural Neurology Conference will be held in Melbourne, following on from the success of the inaugural conference in 2012.

A joint initiative between the Section of Neuropsychiatry from the RANZCP and the ANZAN Section of Behavioural Neurology, the conference will present a broad selection of topics relevant to psychiatrists and neurologists alike.

Watch this space for first formal conference announcements!

Subcortical Morphology in Niemann Pick Type C

Striatal, hippocampal, thalamic and cerebellar MRI changes characterise NPC

In two recent papers, we have shown that Niemann-Pick type C (NPC) in adults is characterised by significant subcortical volumetric changes that correlate with various illness variables including cognition, ataxia and ocular-motor functioning. This expands on our suite of neuroimaging papers in NPC, the only group neuroimaging studies in this disorder, by further clarifying the relationships between brain changes and behaviour in this disorder. We have shown that volumetric changes are greatest in those regions that carry the largest neurofibrillary tangle burden and/or ganglioside excess based on neuropathological studies, and that these changes correlate with illness stage, cognition, ataxia measures and key ocular-motor saccadic measures. The first paper involved collaborating with Brian Patenaude (author of the FIRST toolbox in FSL, from the Oxford FMRIB group); the second utilised Freesurfer methodology to parcellate the cerebellum.

These two papers can be found
here and here.

Walterfang et al. Subcortical volumetric reductions in adult Niemann-Pick type C: a cross-sectional study.
Am J Neuroradiol in press.

Walterfang et al. Cerebellar volume correlates with saccadic gain and ataxia in adult Niemann-Pick type C.
Mol Genet Metab 108: 85-89, 2013.

Basal Ganglia Morphology Distinguishes Dementia Subtypes

Putaminal Morphology Reveals Frontostriatal “Axis” in FTD

With collaborators from the Australian National University and the University of California (Los Angeles), we have shown that, like the hippocampus, the putamen in the striatum can be used as a possible biomarker for dementia subtype. In comparing a well-characterised group of patients with frontotemporal dementia, Huntington’s disease Alzheimer’s disease and matched healthy controls, and using sophisticated shape analysis methodology from Paul Thompson’s group at UCLA, we showed that there are distinct atrophy “signatures” that occur in the putamen, a key grey matter structure in the basal ganglia. These signatures may be useful in aiding diagnosis, and for better understanding of some of the cognitive and behavioural disturbances that occur in these degenerative disorders.

The research also shows that, compared to a more typical basal ganglia disorder and a cortical disorder, frontotemporal dementia shares characteristics of both, adding to our previous work proposing a frontostriatal axis for many of the features of this illness.

The paper can be found
here.

Looi et al. Differential putaminal morphology in Huntington’s disease, frontotemporal dementia and Alzheimer’s disease.
Aust NZ J Psychiatry 46: 1145-1158, 2012.

Dennis Velakoulis awarded Full Professorship

Chair in Neuropsychiatry Awarded to Dennis Velakoulis

The director of the Neuropsychiatry Unit, Professor Dennis Velakoulis, has been awarded a full professorship at the University of Melbourne. He joins Professor Christos Pantelis as the University’s second Professor of Neuropsychiatry.

Professors Velakoulis and Pantelis formed the Melbourne Neuropsychiatry Centre, a joint initiative between the University of Melbourne and Melbourne Health, uniting clinical and research Neuropsychiatry. This centre has been one of the most productive neuropsychiatric research centres in the world in the last decade, and utilises the co-location and research synergy between the Royal Melbourne Hospital and the University of Melbourne, Australia’s leading-ranked University.


Neuropsychiatry and Behavioural Neurology Conference

Neuropsychiatry and Behavioural Neurology Conference

The RANZCP Section of Neuropsychiatry and the ANZAN section of Behavioural Neurology, supported by  the University of Melbourne, are pleased to announce a one day congress on October 19th and half day training workshop on October 20th, 2012.The congress venue will be at the Melbourne Brain Centre, Kenneth Myer Building, Parkville.

A major aim of this 2 day event is to highlight clinically relevant scientific advances across a range of disorders and we have attracted outstanding international and national speakers. Themes will include young onset dementia, rapidly progressive dementia, movement disorders and deep brain stimulation, and workshops will cover bedside cognitive testing and neuroimaging.

Our keynote speakers will be Professor Inga Zerr, from Gottingen in Germany, presenting on CJD; Professor John Hodges, from UNSW in Sydney, presenting on frontotemporal dementia; and Professor Christopher Rowe, from the Austin Hospital in Melbourne, presenting on functional imaging in the dementias.

For more information go to the
Conference website.

Brain Shape Analysis May Differentiate Alzheimer's from FTD

BRAIN SHAPE ANALYSIS DIFFERENTIATES ALZHEIMER’S DISEASE FROM FRONTOTEMPORAL DEMENTIA

A/Prof Mark Walterfang and Dr Dennis Velakoulis, with colleagues from ANU and the Karolinska Institute in Sweden, have shown how analysis of the shape of the hippocampus, one of the key brain regions involved in memory, can differentiate Alzheimer’s disease (AD) from another key type of dementia, fronto-temporal dementia (FTD).

Dr Walterfang undertook computerised shape analysis techniques on magnetic resonance imaging (MRI) scans to demonstrate that the head of the hippocampus is preferentially affected in FTD, whereas it is relatively spared in AD, which tends to affect the rest of the hippocampal structure.

The paper can be found
here.

Lindberg et al. Hippocampal shape analysis in Alzheimer’s disease and frontotemporal dementia subtypes. J Alzheimers Dis 30: 355-365, 2012.

Pontine to midbrain ratio: useful in NPC

THE PONTINE TO MIDBRAIN RATIO: USEFUL IN NPC, TOO

Niemann-Pick type C (NPC) disease is a rare autosomal recessive disorder that presents in adults with cognitive and motor disturbance, psychosis, and highly prominent vertical gaze palsy. We aimed to see if a validated measure in other disorders that demonstrate midbrain atrophy and have vertical gaze impairments was also useful in NPC. By examining a group of adult NPC patients and a larger group of matched controls, we showed that the pontine to midbrain ratio (PMR) - which, when elevated, reflects midbrain atrophy and consequent impairment of saccadic burst neurons that control eye gaze. We showed that this ratio is increased in NPC, although not to the same degree seen in other disorders such as progressive supranuclear palsy. However, this ratio was highly correlated to duration of illness and a range of measures of illness severity, including cognitive and ocular-motor functioning. The PMR may thus be a useful diagnostic and illness marker in NPC.

The paper can be found here.
Walterfang et al.
Pontine-to-midbrain ratio indexes ocular-motor function and illness stage in adult Niemann–Pick disease type C. Eur J Neurol, in press 2011.

AAV Professional Development Seminar

Dr Wendy Kelso will be presenting at an Alzheimer’s Australia (Victoria) professional development seminar on 23rd of November 2011, on Cognitive Assessment in Dementia. These seminars train staff from AAV in various aspects of dementia care, to facilitate their delivery of service to dementia patients and their families in the community.

Neuropsychiatry Spring Lecture Series


The Neuropsychiatry Unit , Royal Melbourne Hospital, in conjunction with Melbourne Neuropsychiatry Centre and the University of Melbourne present the Spring Lecture Series in Clinical Neuropsychiatry. This is a series of 10 lectures covering a broad group of Neuropsychiatric topics with a strong clinical focus. These lectures combine a small amount of didactic information with a large amount of clinical material where audience participation is encouraged.
These lectures are available to psychiatrists and psychiatry trainees.
Registration
: Psychiatrists $250, Trainees $150.

This popular series is frequently oversubscribed, so we would suggest RSVP as soon as possible to secure your attendance.

VENUE
: LECTURE THEATRE 2 ALAN GILBERT BUILDING
THE UNIVERSITY OF MELBOURNE

TIME : THURSDAY EVENINGS 5.30 PM – 8.00 PM

Lecture 1 5.30 – 6.30 pm
Refreshments 6.30 – 7.00 pm
Lecture 2 7.00 – 8.00 pm

DATES : 3/11 – 1/12

SPEAKERS: Dr Dennis Velakoulis, Dr Ramon Mocellin,
Dr Mark Walterfang, Dr Sophia Adams, Dr Andrew Evans

REGISTRATION: Dr Ramon Mocellin
03 9342 8750
Ramon.Mocellin@mh.org.au

Brain Changes in Adult NPC


Utilising methodology developed by Professor David Reutens, now at the Queensland Brian Institute, Dr Amanda Wood, from the University of Birmingham, and Drs Larry Abel and Elizabeth Bowman from the University of Melbourne’s Department of Optometry and Vision Sciences, we followed up our landmark MRI study in adults with Niemann-Pick disease type C (NPC) with a shape analysis of the corpus callosum (CC), the brain’s largest white matter fibre bundle, which connects the brain’s two hemispheres. This study demonstrated that the CC in NPC is globally thinned, but disproportionately thinned in regions similar to those seen in established schizophrenia, and may go some way to explaining the increased rate of psychosis in adults with NPC.

This paper can be found here.
Walterfang et al. Size and shape of the corpus callosum in adult Niemann-Pick type C reflects state and trait illness variables. American Journal of Neuroradiology 32: 1340-1346, 2011.