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ECTION AND N
OT
EU
PR
O
F THE SOCIE
NO
TY
IO
F
AT
ICITY • FO
AST
UN
PL
D
RO
FOUNDATION OF THE
SOCIETY FOR THE STUDY OF
NEUROPROTECTION AND
NEUROPLASTICITY
STUDY OF N
HE
EU
RT
R
O
Institute for Neurological
Research and Diagnostic
RoNeuro
5TH EUROPEAN TEACHING COURSE
on NEUROREHABILITATION
BRAIN DAYS
14TH CONGRESS OF EUROPEAN SOCIETY
for CLINICAL NEUROPHARMACOLOGY
JUNE 1-4, 2015 | CLUJ-NAPOCA | ROMANIA
www.roneuro.ro | www.ssnn.ro
WELCOME ADDRESS
This event is organized by the Foundation of the Society for the Study of Neuroprotection
and Neuroplasticity, together with the Romanian Society of Neurology and “Iuliu Hatieganu”
University of Medicine and Pharmacy, Cluj-Napoca, Romania, and is endorsed, as the previous
ones, by the World Federation of Neurorehabilitation (WFNR) and European Federation of
Neurorehabilitation Societies (EFNRS).
After three successful past events, the meeting in Cluj will again present a platform for
exchange of newest scientific information as well as providing space for teaching oriented
workshops. We try to reach an audience of all colleagues with an interest in this steadily
expanding and exciting field (physicians, nurses, therapists, basic scientists etc.)
A major topic will be to come to a resume where neurorehabilitation in Europe stands today
and where future perspectives in science and education as well as in optimizing services shall
go. The formats used in the meeting as well as the selected main thematic areas will certainly
have a chance to be of interest to a wide audience.
DAFIN F. MUREȘANU
Course Director
VOLKER HÖMBERG
HEINRICH BINDER
Program Chairman
Program Co-Chairman
President of the Romanian
Society of Neurology
EFNRS Secretary General
EFNRS Past President
WFNR Secretary General
SSNN President
3
SCIENTIFIC COMMITTEE & FACULTY
Silviu Albu /Romania
Mihaela Baciut /Romania
Ovidiu Bajenaru /Romania
Leontino Battistin /Italy
Heinrich Binder /Austria
Dana Boering /Germany
Angelo Bulboaca /Romania
Anca D. Buzoianu /Romania
Vitalie Chiosa /Republic of Moldova
Michael Chopp /USA
Lacramioara Perju Dumbrava /Romania
Daniela Efremova /Republic of Moldova
Alexandru Gasnas /Republic of Moldova
Mihail Gavriliuc /Republic of Moldova
Volodymyr Golyk /Ukarine
Stanislav Groppa /Republic of Moldova
Wolf Dieter Heiss /Austria
Dirk M. Hermann /Germany
Volker Hömberg /Germany
Peter Jenner /UK
Amos D. Korczyn /Israel
Vitalie Lisnic /Republic of Moldova
Albert Ludolph /Germany
Tudor Lupescu /Romania
Ion Moldovanu /Republic of Moldova
Dafin F. Mureşanu /Romania
Adriana Sarah Nica /Romania
Gelu Onose /Romania
Ioan Onac /Romania
Cristian Falup-Pecurariu /Romania
C. D. Popescu / Romania
Peter Riederer /Germany
Marina Sangheli /Republic of Moldova
Stephen Skaper /Italy
Johannes Thome /Germany
Ioan Veresiu / Romania
Johannes Vester /Germany
Aurel Popa-Wagner /Germany
Andreas Zwergal /Germany
4
LOCAL COMMITTEE
Mihaela Baciut /Romania
Grigore Baciut /Romania
Maria Balea /Romania
Angelo Bulboaca /Romania
Anca Buzoianu /Romania
Nicu Draghici /Romania
Lacramioara Perju Dumbrava /Romania
Ştefan Florian /Romania
Iuliana Gainariu /Romania
Ioan Marginean /Romania
Alina Nagy /Romania
Ioan Onac /Romania
Livia Popa /Romania
Ovidiu Selejan /Romania
Adina Stan /Romania
Dana Slavoaca /Romania
ORGANIZERS
Institute for Neurological
Research and Diagnostic
ECTION AND N
OT
EU
PR
O
F THE SOCIE
NO
TY
IO
F
AT
ICITY • FO
AST
UN
PL
D
RO
FOUNDATION OF THE
SOCIETY FOR THE STUDY OF
NEUROPROTECTION AND
NEUROPLASTICITY
5
STUDY OF N
HE
EU
RT
R
O
MEDIA PARTNERS
CLUJ
6
GENERAL
INFORMATION
7
GENERAL INFORMATION
COURSE VENUE
“IULIU HATIEGANU” Auditorium,
23 Gheorghe Marinescu Street
Cluj Napoca, Romania
“Iuliu Hatieganu” University of
Medicine and Pharmacy
Registration Desk
All materials and documentation will be available at
the registration desk located at SSNN booth.
The staff will be pleased to help you with all
enquiries regarding registration, materials and
program. Please do not hesitate to contact the staff
members if there is something they can do to make
your stay more enjoyable.
LOGISTIC PARTNER:
8
Scientific Secretariat
Contact Details
Foundation of the
Society for the Study of
Neuroprotection and
Neuroplasticity
37 Mircea Eliade Street, 400364,
Cluj-Napoca, Romania
Office phone: +40745255311
E-mail:[email protected]
Mrs. Doria Constantinescu,
mobile: +40757096111
[email protected]
Mrs. Diana Biris,
mobile: +40755080820
[email protected]
LANGUAGE
The official language is English.
Simultaneous translation will not be
provided.
CHANGES IN PROGRAM
The organizers cannot assume liability
for any changes in the program due to
external or unforeseen circumstances.
NAME BADGES
Participants are kindly requested to
wear their name badge at all times.
The badge enables admission to the
scientific sessions and dinners.
FINAL PROGRAM &
ABSTRACT BOOK
The participants documents include
the program and abstract book which
will be handed out at the registration
counter.
MOBILE PHONES
Participants are kindly requested to
keep their mobile phones turned off
while attending the scientific sessions
in the meeting rooms.
CURRENCY
The official currency in
Romania is RON.
ELECTRICITY
Electrical power is 220 volts, 50 Hz.
Two-prong plugs are standard.
TIME
The time in Romania is
Eastern European Time (GMT+2).
COFFEE BREAKS
Coffee, tea and water are served during
morning coffee breaks and are free of
charge to all registered participants.
9
SCIENTIFIC PROGRAM
10
RoNeuro
BRAIN DAYS
5TH EUROPEAN TEACHING COURSE
on NEUROREHABILITATION
14TH CONGRESS OF EUROPEAN SOCIETY
for CLINICAL NEUROPHARMACOLOGY
MONDAY, JUNE 1ST, 2015
08:50 – 09:00
Welcome address
WFNR and EFNRS activities update
Volker Homberg (Germany)
European curriculum for residency training in neurorehabilitation
Volker Homberg (Germany)
PRESIDENTIAL SESSION
___________________________________________
Chairpersons: Dafin Muresanu (Romania), Volker Homberg (Germany)
09:00 – 09:35
Sense and nonsense of using ICF in neurorehabilitation
Volker Homberg (Germany)
09:35 – 10:10
International Brain Research Organization (IBRO)
Special lecture
Promoting neurological recovery and brain plasticity in the ischemic brain: opportunities and challenges
Dirk M. Hermann (Germany)
10:10 – 10:45 Advances in neurorehabilitation fundamentals - an update
Dafin Muresanu (Romania)
10:45 – 10:55 Discussions
10:55 – 11:20 COFFEE BREAK
11
SESSION 1
___________________________________________
Chairpersons: Dirk M. Hermann (Germany), Andreas Zwergal (Germany)
11:20 – 11:50 The diabetic brain-neurovascular and cognitive dysfunction, and stroke in the diabetic brain-potential neurorestorative therapeutic approaches
Michael Chopp (USA)
11:50 – 12:20 Exosomes and microRNAs in mediating neurorestoration after stroke and neural injury
Michael Chopp (USA)
12:20 – 12:50 Co-ultramicronized palmitoylethanolamide/luteolin promotes maturation of rat cortical oligodendrocytes
Stephen Skaper (Italy)
12:50 – 13:00 Discussions
13:00 – 14:00 LUNCH
SESSION 2
___________________________________________
Chairpersons: Michael Chopp (USA), Albert Ludolph (Germany)
14:00 – 14:30 Neurootology update
Andreas Zwergal (Germany)
14:30 – 15:00 Motor rehabilitation: training techniques derived from motor learning knowledge
Volker Homberg (Germany)
15:00 – 15:30 Motor rehabilitation: physical therapy
Volker Homberg (Germany)
15:30 – 16:00 Robots in neurorehabilitation. Sense and nonsense
Volker Homberg (Germany)
12
16:00 – 16:10 Discussions
16:10 – 16:40
COFFEE BREAK
SESSION 3
___________________________________________
Chairpersons: Heinrich Binder (Austria), Stephen Skaper (Italy)
16:40 – 17:10
ALS genotypes and phenotypes
Albert Ludolph (Germany)
17:10 – 17:40
The forgotten autonomous system in early rehabilitation
Heinrich Binder (Austria)
17:40 – 18:10 What’s the meaning of early rehabilitation in neurodegenerative diseases?
Heinrich Binder (Austria)
18:10 – 18:20 Discussions
TUESDAY, JUNE 2ND, 2015
SESSION 4
___________________________________________
Chairpersons: Ovidiu Bajenaru (Romania), Amos Korczyn (Israel)
08:30 – 09:00
Management of dysphagia after stroke
Dana Boering (Germany)
09:00 – 09:30 Pressure ulcer prevention and management during
the early phase after stroke
Dana Boering (Germany)
09:30 – 10:00
Non-invasive brain stimulation in rehabilitation after stroke
Wolf Dieter Heiss (Germany)
10:00 – 10:10
Discussions
10:10 – 10:40
COFFEE BREAK
13
SESSION 5
___________________________________________
Chairpersons: Wolf Dieter Heiss (Germany), Peter Jenner (UK)
10:40 – 11:10 Neurorehabilitation strategy in patients with focal dystonia
Ovidiu Bajenaru (Romania)
11:10– 11:40
Vascular Parkinsonism
Amos Korczyn (Israel)
11:40 – 12:10 Pain and sleep disturbances in Parkinson’s disease
Cristian Falup Pecurariu (Romania)
12:10 – 12:20 Discussions
12:20 – 13:20 LUNCH
SESSION 6
___________________________________________
Chairpersons: Ioan Marginean (Romania), Johannes Vester (Germany)
13:20 – 13:50 Novel pharmacological approaches to the treatment of
Parkinson’s disease
Peter Jenner (UK)
13:50 – 14:20
Continuous drug delivery in early- and late-stage Parkinson’s disease.
Peter Jenner (UK)
14:20 – 14:50 Levodopa—carbidopa intestinal gel and brainstem auditory
evoked potentials in advanced Parkinson’s disease
C.D. Popescu (Romania)
14:50 – 15:00 Discussions 15:00 – 15:30
COFFEE BREAK
SESSION 7
___________________________________________
Chairpersons: C.D. Popescu (Romania), Volodymyr Golyk (Ukraine)
15:30 – 16:00 Medically unexplained symptoms in neurology
Amos Korczyn (Israel)
16:00 – 16:30 Principles of neurorehabilitation in vestibular system disorders
Volodymyr Golyk (Ukraine)
16:30 – 17:00
Is there a chance for clinical research in neurorehabilitation within the framework of evidenced-based medicine? Classic and new approaches
Johannes Vester (Germany)
14
17:00 – 17:10
Discussions
WEDNESDAY, JUNE 3RD, 2015
SESSION 8
___________________________________________
Chairpersons: Gelu Onose (Romania), Adriana Sarah Nica (Romania)
08:30 – 09:00
Propaedeutics for rehabilitation in the central nervous
system traumatology (postacute/ subchronic stages)
Gelu Onose (Romania)
09:00 – 09:30
Nutritional care of neurological disabled patients
Adriana Sarah Nica (Romania)
09:30 – 10:00 Combination of granulocyte colony-stimulating factor with and BM MSC and BM MNCs for stroke treatment in aged rats is not superior to G-CSF alone
Aurel Popa Wagner (Germany)
10:00 – 10:10 Discussions
10:10 – 10:40 COFFEE BREAK
SESSION 9
___________________________________________
Chairpersons: Aurel Popa Wagner (Germany), Vitalie Lisnic (Rep. Moldova)
10:40 – 11:10
Results from a large retrospective cohort trial in TBI
Dafin Muresanu (Romania)
11:10 – 11:40
The benefit of high-end neurological therapy in
maxillofacial surgery
Mihaela Baciut (Romania)
11:40 – 11:50
Discussions
15
SESSION 10
___________________________________________
Chairpersons: Tudor Lupescu (Romania), Ioan Veresiu (Romania)
11:50 – 12:20 Symptomatic treatment in diabetic neuropathy
Tudor Lupescu (Romania)
12:20 – 12:50 Impairment of the central nervous system in demyelinating polyneuropathies: neurophysiological, clinical and neuroimaging aspects
Vitalie Lisnic (Rep. Moldova)
12:50 – 13:20
Are there evidences for pathogenesis-based approach
of diabetic neuropathy?
Ioan Veresiu (Romania)
13:20 – 13:30
Discussions
13:30 – 14:30
LUNCH
14TH CONGRESS OF EUROPEAN SOCIETY
for CLINICAL NEUROPHARMACOLOGY
14:30 – 14:40
Welcome address
SECTION 1
___________________________________________
Chairpersons: Peter Riederer (Germany), Leontino Battistin (Italy)
14:40 – 15:10
Brain cholesterol: implications in the treatment of neurological diseases
Ovidiu Bajenaru (Romania)
15:10 – 15:40 Pharmacological support in traumatic brain and spinal cord injury
Dafin Muresanu (Romania)
15:40 – 16:10
Disease course modification in Parkinson’s disease
Amos Korczyn (Israel)
16
16:10 – 16:20
Discussions
16:20 – 16:50
COFFEE BREAK
SECTION 2
___________________________________________
Chairpersons: Anca Buzoianu (Romania), Cristian Falup Pecurariu (Romania)
16:50 – 17:20
Virus and Parkinsonism
Peter Riederer (Germany)
17:20 – 17:50
Therapeutic approaches to non-motor Parkinson’s disease
Leontino Battistin (Italy)
17:50 – 18:20 New aspects on glatiramer acetate mechanism
of action in MS
Anca Buzoianu (Romania)
18:20 – 18:50 Using CLOCK-gene related mechanisms in the treatment
of neuropsychiatric disorders
Johannes Thome (Germany)
18:50 – 19:00
Discussions
THURSDAY, JUNE 4TH, 2015
SESSION 11
___________________________________________
Chairpersons: Dafin Muresanu (Romania), Stanislav Groppa (Rep. Moldova)
08:30 – 09:00 The role of neurotrophic factors in brain protection and recovery after stroke
Dafin Muresanu (Romania)
09:00 – 09:30
Features of clinical polymorphism and etiology of seizures
Stanislav Groppa (Rep. Moldova)
09:30 – 10:00
The importance of high-density EEG in the detection of epileptiforminterictal changes and location of the epileptogenic foci
Vitalie Chiosa (Rep. Moldova)
10:00 – 10:10
Discussions
10:10 – 10:40
COFFEE BREAK
17
SESSION 12
___________________________________________
Chairpersons: Lacramioara Perju Dumbrava (Romania), Angelo Bulboaca (Romania)
10:40 – 11:10
Atypical forms of chronic inflammatory demyelinating polyneuropathy
Vitalie Lisnic (Rep. Moldova)
11:10 – 11:40
Visual symptoms as nonmotor phenomena in Parkinson’s disease
Lacramioara Perju Dumbrava (Romania)
11:40 – 12:10 Motor control and eye-hand coordination in neurorehabilitation
Angelo Bulboaca (Romania)
12:10 – 12:40
Clinical and therapeutic aspects in lumbar sciatica by disc herniation
Ioan Onac (Romania)
12:40 – 12:50
Discussions
12:50 – 13:50
LUNCH
SESSION 13
___________________________________________
Chairpersons: Ion Moldovanu (Rep. Moldova), Marina Sangheli (Rep. Moldova)
13:50 – 14:20 Phenomena of pre- and postischemic conditioning: theoretical,
experimental and clinical aspects
Mihail Gavrilciuc (Rep. Moldova)
14:20 – 14:50
Risk factors and secondary prevention of ischemic stroke in the population of Moldova
Daniela Efremova (Rep. Moldova)
14:50 – 15:20
Importance of motor and pharmacological interventions
in stroke rehabilitation
C.D. Popescu (Romania)
18
15:20 – 15:50
Transcranial Magnetic Stimulation (TMS) and results of connectivity studies in acute ischemic stroke
Alexandru Gasnas (Rep. Moldova)
15:50 – 16:00
Discussions
16:00 – 16:30
COFFEE BREAK
SESSION 14
___________________________________________
Chairpersons: Mihail Gavrilciuc (Rep. Moldova),
Alexandru Gasnas (Rep. Moldova)
16:30 – 17:00
Chronic migraine associated with autonomic disorders and other related comorbidities
Ion Moldovanu (Rep. Moldova)
17:00 – 17:30
Consciousness, altered states of consciousnessand brain plasticity: therapeutical perspectives
Ion Moldovanu (Rep. Moldova)
17:30 – 18:00
Epidemiological study of multiple sclerosis
in the Republic Of Moldova
Marina Sangheli (Rep. Moldova)
18:00 – 18:10
Discussions
19
ABSTRACTS
20
THE BENEFIT OF HIGH-END
NEUROLOGICAL THERAPY IN MAXILLOFACIAL SURGERY
Surgical procedures performed in maxillofacial surgery imply dissection in the immediate
vicinity of sensitive (trigeminal nerve) and motor (facial nerve) trunks or branches
frequently. The nerve function can suffer postoperatively, with severe consequences
altering the life quality of the patient.
In order to quantify the dysfunction, two major fields of maxillofacial surgery, parotid
tumor surgery and orthognathic surgery were analyzed. With the increasing number
of parotid gland tumors, this surgery has become a daily routine in our center. Various
branches of the facial nerve crossing the implied region can be involved in the tumor
and require surgical dissection or extirpation. Orthognathic surgery, on the other
hand, is performed increasingly for correction of maxillofacial deformities. It implies
osteotomies of the maxillary bones to correct their position and/or dimension in cases
of maxillofacial deformities. The branches of the trigeminal nerve can suffer from
intraoperative trauma or in the postoperative period.
During the healing period, progressive clinical improvement of the motoric dysfunctional
region and anesthetized region respectively is observed.
MIHAELA
BACIUT
Grigore Baciut,
Dafin Muresanu*,
Simion Bran,
Andreea Magdas
Department of
Maxillofacial Surgery
and Oral Implantology,
*Department of
Neurosciences
“Iuliu Hatieganu”
University of Medicine
and Pharmacy,
Cluj-Napoca, Romania
High-end neurological therapy modalities are evaluated in this study pertaining to their
regenerative neurological capacity in patients having undergone maxillofacial surgery
procedures.
21
BRAIN CHOLESTEROL:
IMPLICATIONS IN THE TREATMENT
OF NEUROLOGICAL DISEASES
Cholesterol is one of the most important structural chemical components of the CNS;
aproximatively 25% of the whole quantity of cholesterol in the human body is to be
found only in the CNS. The structural importance of cholesterol in the CNS is related
mainly to its major role in the normal function of the membranes, both cell membranes
and organelles’ membranes ( particularly in neurons ). The biological importance of the
lipid rafts containing cholesterol in membranes for the normal neuronal and synaptic
functions, could be also suggested by the fact that the CNS cholesterol is not produced
in the liver as for the rest of the tissues in the body, but inside the CNS itself, in particular
by astrocytes which have the whole enzymatic and proteic equipment for its synthesis,
metabolism and intercellular trafficking; more than this, the BBB does not allow the
passage of systemic cholesterol from the blood to the brain, but allows the transfer
of some of cholesterol derivatives from the CNS tissue to the blood, influencing the
cholesterol homeostasis in the brain. The careful understanding of the cholesterol role
and metabolism in the CNS has been related to different neuropathological conditions
such as Alzheimer’s disease, vascular cognitive impairment, depression and also to
some therapeutic particularities of statins not only for cerebro-vascular disorders, but
also for demential diseases and multiple sclerosis.
NEUROREHABILITATION STRATEGY
IN PATIENTS WITH FOCAL DYSTONIA
Primary dystonia is a complex pathophysiological condition which essentialy is
determined by synaptic abnormalities in the motor basal ganglia circuits connecting
these structures with the cortical areas related to motor control on one hand, and on the
other hand inducing a dysbalance in the supraspinal dyscharges on the peripheral motor
perycaria in the spinal cord and brainstem, which clinically manifest as chronic dystonic
movements. More than these, at the muscle level, abnormalities in the function of
the neuromuscular spindles are also present, and these abnormalities are enhanced
by their chronic overstimulation due to dystonia itself, which in turn determine
abnormal proprioceptive informations to the motor cortex. As a consequence, the
cortical representation of the dystonic muscles extends on the motor cortical maps
due to a maladaptive neuroplasticity, which final consequence is the presence of a
vicious circle manifesting as an overactivity in those motor circuits, perpetuating and
enhancing dystonia. The usual treatment of these disorders consists in periodic local
injections of botulinum toxin or in some cases stereotactically guided DBS in the basal
ganglia ( usually in GPi ), but these have to be just one component of the treatment of
these motor disorders, which have to be completed in a complementary manner by a
complex functional rehabilitation by kinesitherapy. Kinesitherapy procedures have to
take into account all these pathogenetic mechanisms, in order to facilitate the cortical
motor map reorganization to normal parameters and in the same time to evitate the
peripheral stimulation and overactivity in the muscle spindles local discharges to the
CNS, with the aim to bring to normal as much as possible the spinal and cortical afferent
proprioceptive information.
22
OVIDIU
BAJENARU
University of Medicine
and Pharmacy
“Carol Davila”,
Bucharest,
Romania
Director of the
Department of
Neurology,
Neurosurgery and
Psychiatry
Chairman and Head
of Dept. Neurology University Emergency
Hospital, Bucharest,
Romania
THERAPEUTIC APPROACHES
TO NON-MOTOR PARKINSON’S DISEASE
In recent years it has become increasingly evident that in Parkinson disease together
with the classic motor disability patients complain about a number of non-motor
symptoms (NMS) . While knowledge of NMS associated with PD is not new – James
Parkinson described such symptoms almost 200 years ago – it is the increasing
recognition of their diversity, prevalence and impact on patients’ health-related quality
of life that has led to a significant shift in diagnostic and therapeutic approaches to the
disease.
Almost all patients with PD suffer from NMS. NMS have a greater detrimental impact on
health related quality of life than motor symptoms and are frequently under-reported
by patients and under-recognised by physicians. Furthermore, little is known about
their progression, their response to dopaminergic medication and their occurrence in
the context of nonmotor fluctuations. The development of instruments for screening
and evaluation of NMS represents an important step forward in the recognition of these
disturbances, but they do not clearly establish the relationship with disease and the
response to treatment. The response of individual NMS to dopaminergic treatment
depends on the mechanism underlying its development. Indeed NMS may originate
from multiple causative processes, underpinned by predominant involvement of
non-dopaminergic circuits or even secondary to medications. Moreover concomitant
conditions could produce clinical features mimicking PD-related NMS, which will likely
be refractory to dopaminergic treatment.
LEONTINO
BATTISTIN
Angelo Antonini
Department of
Neurosciences, Medical
School, University of
Padua, Italy
Neurorehabilitation
Scientific Hospital,
IRCSS San Camillo,
Venice, Italy
Available evidence shows that dopamine agonists can improve specific NMS. The most
recent results regard rotigotine , a non-ergoline dopamine receptor agonist administered
transdermally via a patch which demonstrated significant improvements in early
morning motor impairment and nocturnal sleep disturbances a double-blind, placebocontrolled trial. Pramipexole was also tested and demonstrated to be beneficial in PD
patients complaining about depression and apathy.
Finally, non-dopaminergic therapies however, remain the key therapeutic options for
many NMS such as excessive daytime sleepiness, constipation, dribbling of saliva,
insomnia and REM behavior disorders.
23
THE FORGOTTEN AUTONOMOUS SYSTEM
IN EARLY REHABILITATION
In early rehabilitation relevancy of respiration, cardiovascular circulation and excretory
functions as voiding and defaecation are neglected for the most part from neurological
side. There is nearly no acute occurring neurological disease without respiratory
disturbances. Therefore mechanical ventilation, tracheostomy, weaning and various
complications are common. Cardiovascular disturbances appear on the one side as
consequence of nervous lesions at various levels brain or spinal cord. On the other side
suffer 75% of stroke patients from a cardiac disease and one might argue that stroke
patients very often are far more disabled by their cardiac condition than by the stroke
itself. Not least inability to control voiding and defaecation pose a common problem.
Knowledge of pathophysiology, treatment and rehabilitation challenges regarding this
is mostly disregarded in neurorehabilitative education and therefore delegated.
WHAT’S THE MEANING OF EARLY REHABILITATION
IN NEURODEGENERATIVE DISEASES?
When does rehabilitation actually start? According to a type of chronological order,
curative medicine comes before rehabilitation. Rehabilitation is oriented according to
the biomedical model, which is exclusively aimed at the restoration of organ damage
and/or organ dysfunction. From the ontological point of view, organ damage and/or
organ dysfunction are the results of the course of an illness. According to this process
of illness, one has to regard three main points in early rehabilitation.
First, neurological diseases are mostly chronically progressing illnesses that have
started subclinically long before the first symptoms and discomfort are experienced.
This concerns particularly the so-called neurodegenerative diseases. These mostly
develop slowly so that one really cannot ascertain their very beginning.
Second, instead of improvement because of curative medicine, the illnesses are grossly
progressive. Therefore, they lead to an increase in symptoms or development of new
complaints.
Third, besides the nervous system, there is usually one or more organ systems affected.
This leads, finally, to a competition of causalities and interactions.
Early diagnosis is mandatory. To make a prognosis and to estimate expected
impairments is the next step. It is important to distinguish between first-order
impairments attributable to the differently afflicted nervous system and their negative
effects on different other organs. The neurorehabilitation task is support of adaptive
reconfiguration in the former and prevention in the latter case.
Binder H.: Neurorehabilitative interventions in the acute stage of diseases. Textbook of Neural Repair and
Rehabilitation 2e, eds. Michael E. Selzer, Stephanie Clarke, Leonardo G. Cohen, Gert Kwakkel, and Robert H.
Miller. Published by Cambridge University Press. © Cambridge University Press 2014
24
HEINRICH
BINDER
Landsteiner
Institute for
Neurorehabilitation
and Space Medicine
Vienna, Austria
MANAGEMENT OF DYSPHAGIA AFTER STROKE
Dysphagia affects more than 50% of stroke survivors and represents one of the first
hurdles on the path of recovery after stroke, leading to a 17% increase of pulmonary
infections and a 30% increase of mortality. Prompt evaluation and treatment of
swallowing disorders can therefore mitigate the development of further secondary
complications and foster social reintegration of stroke patients.
DANA
BOERING
St. Mauritius
Therapieklinik
Meerbusch, Germany
The talk will give an overview of swallowing physiology and neural control, of bedside
screening tests, of clinical and instrumental assessment methods, a brief insight in the
mechanisms of postlesional plasticity in poststroke dysphagia and in the nutritional
assessment and support of the patients. It will give a detailed presentation of the
different compensatory and rehabilitative techniques pointing out new trends in
dysphagia management and possible future developments of this rapidly evolving field.
PRESSURE ULCER PREVENTION AND MANAGEMENT
DURING THE EARLY PHASE AFTER STROKE
Pressure ulcers are painful, costly and often preventable complications during the early
phase after stroke. Their prevention and timely management is of great importance,
knowing that hospital lengths of stay, readmission rates, motor gains and average
hospital costs are greater in patients who develop pressure ulcer than in those who
don´t and that the Admission Norton Scale scores not only predict pressure ulcer
development, but also mortality a year after rehabilitation.
The talk will give an overview concerning NPUAP classification, pathophysiology, risk
assessment for pressure ulcer, including nutritional risk, skin assessment, preventive
strategies about nutrient intake management, skin care, repositioning, support surfaces
and prophylactic dressings. Further it will deepen aspects of pressure ulcer treatment
beginning with validated monitoring tools, special nutritional aspects, support surfaces,
cleansing, debridement, infection management, negative pressure wound therapy and
pain management.
25
NEW ASPECTS ON
GLATIRAMER ACETATE MECHANISM OF ACTION IN MS
Multiple sclerosis (MS) is a major health issue among young individuals, since it
is a debilitating disease which interrupts the most prolific period in a human’s life.
Glatiramer acetate (GA) is one of the most widely used disease-modifying drugs for the
treatment of relapsing-remitting multiple sclerosis, with increasingly promising long
term outcome, as follow-up studies are being carried out.However, there are still many
aspects not completely clarified regarding the mechanism of action of this molecule.
ANCA D.
BUZOIANU
As for a mechanism, it was widely thought that GA has an inductor effect on neurotrophic
factor expression. One of these neurotrophic factor systems is the brain-derived
neurotrophic factor (BDNF)/receptor tyrosine kinase B (TrkB) pathway. Peripheral blood
is thought to contain soluble BDNF, and some blood cells express TrkB.
Faculty of Medicine,
“Iuliu Hatieganu”
University of Medicine
and Pharmacy,
Cluj-Napoca, Romania
Our research was oriented towards outlining whether GA treatment leads to changes in
plasma BDNF levels and TrkB activation. We’ve hypothesized that such a phenomenon
might occur in relapsing-remitting multiple sclerosis patients treated with the drug.
Results showed the opposite: GA treatment, after one year of sustained therapy, is not
influencing peripheral BDNF levels, not from the point of view of total free BDNF nor
the phosphorylated TrkB. In spite of this, results also mirror that even if the present
treatment is not producing any quantifiable effect on the BDNF/TrkB system, a
considerable difference between the activity of the couple is seen when MS is compared
with healthy controls, the expression being significantly reduced.
26
Vitalie Vacaras,
Major Zoltan,
Dafin F. Muresanu
THE IMPORTANCE OF HIGH-DENSITY EEG IN THE
DETECTION OF EPILEPTIFORM INTERICTAL CHANGES AND
LOCATION OF THE EPILEPTOGENIC FOCI
High-density EEG is a method of electroencephalography recorded by 256 scalp
electrodes, evenly covering the whole surface of the head, contributing to more
accurate view of electrical source due to higher spatial and temporal resolution. The
high spatial resolution combined with magnetic resonance characteristics of brain can
provide the accurate information of epileptiform changes on EEG and localization of
epileptogenic foci (ESI - Electrical Source Imaging). Several studies have demonstrated
the clinical utility of the high-density EEG and ESI in the pre-surgical clinical evaluation
of pharmacoresistant epilepsy. Locating spike sites using high-density EEG has proven
to be more effective in predicting the seizure onset zone than other methods, including
PET, MRI and ictal SPECT.
Keywords: High-density EEG, pharmacoresistant epilepsy, nonlesional epilepsy,
Magnetic Resonance Imaging, Electrical Source Imaging.
VITALIE CHIOSA
Groppa St.
Gorincioi N.
Ciolac D.
Misina L.
Munteanu C.
Vataman A.
“Nicolae Testemitanu”
State University of
Medicine and Pharmacy
Chisinau, Republic of
Moldova
27
VISUAL SYMPTOMS AS NONMOTOR PHENOMENA
IN PARKINSON’S DISEASE
Along with the motor symptoms, Parkinson’s disease (PD) patients experience a wide
range of non-motor problems including visual disturbances. These are multifaceted,
but often under-reported as such. In a visual survey questionnaire, 78% PD patients
reported at least one problem related to vision or visuospatial functioning
The most frequent encountered problems are impaired contrast sensitivity, color
discrimination, visuospatial processing, ocular or eyelid movements and diplopia
followed by visual misperceptions and hallucinations. Some patients report dry eyes,
ocular pain or photophobia.
The pathophysiological basis of the visual disturbances is not completely understood.
Changes in the visual cortex were detected with functional MRI before the visual
symptoms were clinically evident. Further studies are necessary to determine how
these changes will contribute to development of visual symptoms in PD patients. The
possible role of retinal dopaminergic system is also considered to be responsible for
some of these symptoms, being known that dopamine is the major neurotransmitter in
the amacrine and interplexiform cells in the retina. Visual hallucinations are likely to be
a result of disruption across related yet diverse neural circuitry.
The therapy is only symptomatic and not always satisfactory. It includes ophthalmological
treatment, botulinum toxin for blepharospasm and specific treatment for hallucinations.
This work shows how complex the visual problems in PD patients can be and the
importance of a thorough and multidisciplinary approach.
28
LACRAMIOARA
PERJUDUMBRAVA
University of Medicine
and Pharmacy
“Iuliu Hatieganu”
Cluj-Napoca, Romania
THE DIABETIC BRAIN-NEUROVASCULAR
AND COGNITIVE DYSFUNCTION, AND STROKE IN THE
DIABETIC BRAIN-POTENTIAL NEURORESTORATIVE
THERAPEUTIC APPROACHES
Diabetes, particularly in the elderly contributes to cognitive and learning deficits. In
addition, diabetes is a major risk factor for stroke, and approximately one-third of all stroke
patients are diabetic. Here, I will describe our work on the neurovascular dysfunction
in the diabetic brain, first without stroke and then after stroke. Type 2 diabetes (T2DM)
in the older rat will be shown to induce neurovascular dysfunction and significant
cognitive loss compared with the non-diabetic aged–matched brain. The diabetic
brain exhibits increased loss of axons and oligodendrocytes, reduced myelination and
reduced spine density, as well as substantial fibrin deposition compared with the nondiabetic aged-matched brain. In addition, the T2DM aging brain exhibits an impaired
glymphatic system. Non-invasive MRI evaluation of the glymphatic system, providing
an index of interstitial solute clearance, demonstrates that glymphatic impairment is
highly correlated with cognitive loss. Stroke in the T2DM brain greatly exacerbates
neurovascular dysfunction and impaired neurological sequelae in the diabetic brain
compared with the non-diabetic brain. The diabetic brain post stroke exhibits increased
inflammation and axonal damage. Molecular mechanisms underlying the exacerbation
of neurological deficits and impaired neurovascular function after stroke in the T2DM
animal will be described, including the adverse effects of substantially reduced
angiopoietin 1 as well as microRNA-126, an important non-coding RNA which plays a
vital role in orchestrating neurovascular health. Restorative therapies, such as delayed
treatment of stroke in the diabetic animal with human umbilical cord blood cells which
enhance angiopoietin and miR-126, will be described.
MICHAEL
CHOPP1,2
1. Henry Ford Hospital,
Department of
Neurology, Detroit, MI,
USA
2. Oakland University,
Department of Physics,
Rochester, MI, USA
EXOSOMES AND MICRORNAS IN MEDIATING
NEURORESTORATION AFTER STROKE AND NEURAL INJURY
My lecture will primarily focus on the development of neurorestorative therapies
for stroke and traumatic brain injury (TBI). Historically, therapeutic approaches to
stroke have targeted neuroprotection, i.e. reduction of the ischemic lesion. However,
acutely applied neuroprotective agents for stroke have failed in clinical trials, and
thrombolysis with tPA is employed in fewer than 10% of all patients with ischemic
stroke. In contrast, neurorestorative strategies, designed to enhance neurovascular
remodeling of intact tissue, may be applied during the subacute and chronic phases
post stroke. Neurorestorative therapies are not hampered by a narrow therapeutic
window, a race against cell death, and potential adverse reactions associated with
thrombolysis, and therefore may be employed in all stroke patients. Post stroke and
TBI, there is evidence of neurovascular remodeling, which leads to modest and most
often inadequate recovery. However, with increased efforts to elucidate the biological
substrates underlying and driving plasticity in the CNS, we are able to amplify
endogenous neurorestorative processes and thereby enhance neurological recovery.
In this lecture, molecular and cellular neurorestorative therapeutic approaches will be
outlined, and novel neurorestorative directions including the use of non-coding RNAs
and nanomedicine as a means to amplify neurovascular remodeling and thereby to drive
neurological recovery post stroke and neural injury will be described. The potential roles
of non-coding RNAs, particularly, microRNAs, and their microvesicular nano-carriers,
exosomes, as potential therapeutic agents for stroke and TBI, will be discussed.
29
TRANSCRANIAL MAGNETIC STIMULATION (TMS)
AND RESULTS OF CONNECTIVITY STUDIES IN ACUTE
ISCHEMIC STROKE
Stroke is one of the leading causes of mortality and disability in modern countries. Clinical
manifestation of stroke is rapidly developing loss of brain function due to disturbance in
the blood supply to the brain. Neuroplasticity, also known as cortical mapping, challenges
the idea that brain functions are fixed in certain time. Neuroplasticity can act through
two possible mechanisms on stroke disability-prevention and treatment of neurological
deficit. Post-stroke recovery is based on plastic changes in the central nervous system
that can compensate the loss of activity in affected brain regions. In particular,
monohemispheric stroke is thought to result in disinhibition of the contralesional
unaffected hemisphere. Neurorehabilitation programs improve function partly by
enhancing cortical reorganization. Repetitive transcranial magnetic stimulation (rTMS)
is a non-invasive way of producing potent changes in cortical excitability. Therefore,
the application of rTMS is proposed to promote functional recovery in stroke patients,
owing to the induced neuroplasticity. Functional recovery might be obtained either
when rTMS is applied at low-frequency (around 1 Hz) over the disinhibited, unaffected
hemisphere in order to restore defective inhibition or when rTMS is applied at highfrequency (5 Hz or more) over the affected hemisphere in order to reactivate hypoactive
regions. Therefore, in the, acute or recent stroke might be a major indication of rTMS in
neurological practice. Repetitive transcranial magnetic stimulation has opened a new
field of investigation of the neural circuitry, and is developing into a therapeutic tool.
Keywords: cortico-spinal conduction, motor evoked potentials, electrophysiology,
neurophysiology,cortical silent period, Neuroplasticity
30
ALEXANDRU
GASNAS
Ciolac D.,
Pirtac I.,
Groppa St.
“Nicolae Testemitanu”
State University of
Medicine and Pharmacy
Chisinau, Republic of
Moldova
PHENOMENA OF PRE- AND POSTISCHEMIC
CONDITIONING: THEORETICAL, EXPERIMENTAL AND
CLINICAL ASPECTS
Reduction of ischaemia injury is the aim of most treatments for cerebrovascular
disease. Ischemic tolerance has been demonstrated in experimental models of
cerebral ischemic stroke induced by carotid occlusion. Although many strategies have
proven benefit in the experimental arena, few have translated to clinical practice.
We analysed endarterectomy results of 50 patients with established ischemic stroke
caused by carotid stenosis. Operations were performed under the general anesthesia.
Additionally, before surgical treatment in all pacients we executed remote ischemic
preconditioning that included five cycles of bilateral upper limbs 5/5 min of ischemia
and reperfusion alternation. Limb ischemia was induced by inflating tourniquets 200
mmHg. Despite the skeptic expectations our results prove the amelioration of cerebral
hemodynamics and also improvement of total neurological deficiency of the patients
according to the scale NIHSS. The tool research included: duplex scanning of extracranial arteries, CT- and conventional angiography and in some cases pre- , intra- ,
and postoperative neurophysiological monnitoring. Although the exact mechanism of
pre- and postischemic conditioning remains uncertain, its discovery merit to address
to further understanding the mecanism of endogenous neuroprotection and potential
new therapeutic strategies for neuroprotection in cases of brain injury. Ischaemic
preconditioning could be close to becoming a clinical technique.
MIHAIL
GAVRILIUC
Adrian Bodiu,
Alexandru Grumeza,
Rodica Vașchevici
Chairman Department
of Neurology,
State Medical and
Pharmaceutical
“Nicolae Testemitanu”
University, Chisinau,
Republic of Moldova
31
PRINCIPLES OF NEUROREHABILITATION
IN VESTIBULAR SYSTEM DISORDERS
Vertigo and dizziness are not unique disease entities. After headache, it are among
the most frequent presenting symptoms with lifetime prevalence around 30%.
Main components of vestibular dysfunction associated with affections of different
sites of the brain are: disorders of perception (vertigo/dizziness), gaze stabilization
(nystagmus), postural control (postural imbalance, falling tendency) and the vegetative
system (nausea/vomiting). The most frequent forms of vestibular vertigo according to
outpatient clinics data are benign paroxysmal positioning vertigo, Meniere`s disease
and vestibular neuritis accompanied by somatoform phobic postural vertigo, central
vestibular vertigo and vestibular migraine responsible for 73.9% admissions.
Vestibular system`s disorders rehabilitation is based on compensation of static and
dynamic deficits. First is based on plastic events in vestibular nuclei via neurobiological
mechanisms activation followed bilateral rebalance of nuclei activities and the later
switch on different behavioral mechanisms using specific substitutions strategies.
Practical issues of clinical applications for vestibular rehabilitation always balancing
between habituation featured “don`t respond” behavior accompanied with quantitative
variations and negative learning and adaptation using “different respond” activities with
qualitative variations and positive learning allowing the subject gain new responses
substituting for the lost functions (the best adapted to day life conditions). All strategies
based on specific physical therapy approaches both individually based and goal oriented
according to the type of vestibular disorder.
Keywords: vestibular disorder, vertigo, dizziness, balance, neurorehabilitation.
32
VOLODYMYR
GOLYK
State Institution
“Ukrainian State Institute
of Medical and Social
Problems of Disability
Ministry of Public Health
of Ukraine”;
Public Organization
“Ukrainian Society for
Neurorehabilitation”
Radyansky bstr. 1a, 49027,
Dnipropetrovs’k, Ukraine
FEATURES OF CLINICAL POLYMORPHISM
AND ETIOLOGY OF SEIZURES
This scientific work is based on video-EEG examination of the patients that took
place in the Laboratory of Neurobiology and Medical Genetics, Institute of Emergency
Medicine (Chisinau, Republic of Moldova). Video EEG monitoring (VEM) was made to
assess the differential diagnosis of seizures, to classify the epileptic seizures or epileptic
syndromes, localization of epileptic foci and antiepileptic drug selection. This study
was undertaken from June 2006 to March 2015. Video-EEG monitoring was performed
using a 21-channel Coherence system (Deltamed SA, Natus Medical Incorporated),
including the registration of single-channel oculogram, single-channel ECG, EMG,
recording of the respiratory movements of the chest. The duration of the monitoring
was determined individually for each patient, and averaged between 30 minutes for a
standard EEG recording, 4-8 hours for a daytime monitoring and 12-24-48-72 hours for
night and long-term monitoring.
Simultaneous recording with the current EEG provides indisputable diagnosis of
paroxysmal events. Confirmation of the correct diagnosis allows cancellation of the
unnecessary antiepileptic drugs and to choose the appropriate treatment.
In our study, among patients whose clinical manifestations were recorded, based on
the data obtained during the VEM, the preliminary diagnosis was changed in 39%
of patients. Of the total of patients at diagnosis was changed in 39% of cases. The
diagnosis changes in our patients regarding the type of epileptic seizures (partial or
generalized), the diagnosis of epilepsy, epileptic manifestations and the transition
from the category of unclassified seizures to classified. The diagnosis of non-epileptic
seizures has been documented by VEM.
STANISLAV
GROPPA
Department of
Neurology and
Neurosurgery, “Nicolae
Testemitanu” State
University of Medicine
and Pharmacy
Chisinau, Republic of
Moldova
Keywords: epilepsy, epileptic seizure, EEG, VEM.
33
NON-INVASIVE BRAIN STIMULATION
IN REHABILITATION AFTER STROKE
The functional deficit after a focal brain lesion is determined by the localization and the
extent of the tissue damage. Since destroyed tissue usually cannot be replaced in the
adult human brain, improvement or recovery of neurological deficits can be achieved
only by reactivation of functionally disturbed but morphologically preserved areas or by
recruitment of alternative pathways within the functional network. The visualization
of disturbed interaction in functional networks and of their reorganization in the
recovery after focal brain damage is the domain of functional imaging modalities such
as positron emission tomography (PET) and functional magnetic resonance imaging
(fMRI). Longitudinal assessments at rest and during activation tasks during the early
and later periods following a stroke can demonstrate recruitment and compensatory
mechanisms in the functional network responsible for complete or partial recovery
of disturbed functions. Imaging studies have shown that improvements after focal
cortical injury are represented over larger cortical territories, an effect which appears to
be dependent on the intensity of rehabilitative training. It has also been shown that the
unaffected hemisphere in some instances actually inhibits the recovery of ipsilateral
functional networks and this effect of transcallosal inhibition can be reduced by noninvasive brain stimutation.
Non-invasive brain stimulation (NIBS) can modulate the excitability and activity of
targeted cortical regions and thereby alter the interaction within pathologically affected
functional networks; this kind of intervention might promote the adaptive cortical
reorganization of functional networks after stroke. Non-invasive brain stimulation
(NIBS) uses direct current (DCS: excitation under the anode, inhibition under the
cathode) or repetitive transcranial magnetic stimulation (rTMS: excitatory at high
frequency, inhibitory at low frequency). Since recovery from poststroke deficits seems
to be more effective in patients who recover function in the ipsilateral perilesional area,
NIBS trials aimed to activate this region: this effect can be achieved by excitatory
NIBS (high frequency repetitive transcranial magnetic stimulation, rTMS; intermittent
theta burst stimulation, iTBS; anodal transcranial direct current stimulation, tDCS) to
reactivate the perilesional area or by inhibitory NIBS (low frequency rTMS or cathodal
tDCS) to reduce increased activities in the contralesional homologous areas.
DCS as well as rTMS were applied in combination with rehabilitative measures in order
to improve various symptoms after stroke, especially motor deficits and aphasia. In
both applications recovery was improved with combined treatment in comparison
to standard therapy without NIBS. All types of NIBS were used in rehabilitation of
motor deficits after stroke and positive effects on recovery were observed. Among the
different modalities low-frequency inhibitory stimulation of the motor cortex in the
contralateral non-affected hemisphere seems to be the most prominent approach, but
large controlled trials are still missing.
34
WOLF-DIETER
HEISS
Max Planck Institute for
Neurological Research,
Cologne, Germany
In poststroke aphasia several studies attempted to restore perilesional neuronal activity
in the injured left inferior frontal gyrus by applying excitatory high frequency rTMS or iTBS
or anodal tDCS to small series of patients in the chronic stage: They showed favorable
effects in speech performance for several weeks to a few months. Only one study
coupled ipsilesional anodal tDCS to language therapy in chronic nonfluent aphasia and
observed improved speech / language performance for 1 week to 2 months. Most NIBS
studies in poststroke aphasia employed inhibitory low frequency rTMS for stimulation
of the contralesional pars triangularis of the right inferior frontal gyrus (BA 45) in order
to reduce right hemisphere hyperactivity and transcallosal inhibition on the left Broca’s
area. Most studies reported single cases or small case series with chronic poststroke
aphasia without any control condition and beneficial effects on speech performance
lasting for several months. Only a few controlled studies including sham stimulation
were performed in chronic stage after stroke. A controlled trial with inhibitory cathodal
tDCS stimulation of the non-dominant right Wernicke area in patients with subacute
global aphasia resulted in some improvement of comprehension in the treatment group.
In one controlled randomized study changes in PET activation pattern in the subacute
course were related to the clinical improvement. The shift of the activation pattern
to the dominant hemisphere induced by inhibitory rTMS over the right inferior frontal
gyrus could be demonstrated in the PET activation studies and correlated to improved
performance in aphasia tests. NIBS might be a treatment strategy which could improve
the effect of other rehabilitative efforts.
35
PROMOTING NEUROLOGICAL RECOVERY
AND BRAIN PLASTICITY IN THE ISCHEMIC BRAIN:
OPPORTUNITIES AND CHALLENGES
Recent laboratory findings suggest that it might be possible to promote cerebral
plasticity and neurological recovery after stroke by use of exogenous pharmacological
or cell-based treatments. Brain microvasculature and glial cells respond in concert
to ischaemic stressors and treatment, creating an environment in which successful
recovery can ensue. Neurons remote from and adjacent to the ischaemic lesion are
enabled to sprout, and neural precursor cells that accumulate with cerebral microvessels
in the perilesional tissue further stimulate brain plasticity and neurological recovery.
These factors interact in a highly dynamic way, facilitating temporally and spatially
orchestrated responses of brain networks. In view of the complexity of the systems
involved, stroke treatments that stimulate and amplify these endogenous restorative
mechanisms might also provoke unwanted side-effects. In experimental studies, adverse
effects have been identified when neurorestorative treatments were administered to
animals with severe associated illnesses, after thrombolysis with alteplase, and when
therapies were initiated outside appropriate time windows. Balancing the opportunities
and possible risks, suggestions for the translation of restorative therapies from the
laboratory to the clinic are provided.
36
DIRK M. HERMANN
Department of Neurology,
University Hospital Essen,
Germany
SENSE AND NONSENSE
OF USING ICF IN NEUROREHABILITATION
Medicine today uses a standardized international classification of diseases (ICD).
In acute medicine treatment and diagnoses of a particular disease entities,which are
defined nosologically are the most important points.
As already mentioned in module 1 in rehabilitation medicine the problem is some
different: Here in the foreground of interest of physicians and patients is the ability
of the patient to do particular things i.e. to find descriptors for the actual abilities,
function and chances of participation for the patient.
VOLKER
HÖMBERG
Heinrich Heine
University of Duesseldorf
SRH Health Center
Bad Wimpfen
Germany
To make also such a classification comparable on an international level and find sort of a
“micro language” to describe such differences in function and abilities the world health
organization (WHO) has suggested to use a standardized international classification
of function (ICF).
The ICF differentiates
1.
Body functions and structures
2.Activities
3.Participation
In the course of rehabilitation there is a transition from the acute medical treatment of
body structures and body functions towards a more functional activity and participation
related view. Within the ICF nine chapters of different activities can be differentiated
from elementary mobility to major live areas as social, civic and religious actvities.
Within each domain ( e.g. mobility) activities can be further sub defined into sub
categories:
It will be demonstrated how ICF classification can be institute to describe rehabilitation
process. Furthermore it is critically discussed in how far the micro language of ICF really
reflects the patients ambitions and needs in the rehabilitation process.
It is important to note to that the ICF tries to reflect a bio- psycho- social model of
disease rather than a pure biological understanding.
It will be critically discussed for what this ICF “language” is suitable or not.
The relative impact of working on impairments, disabilities or handicap in neurorehab
will be contrasted in the context of neurorehab as applied neuroscience.
37
MOTOR REHABILITATION: TRAINING TECHNIQUES DERIVED
FROM MOTOR LEARNING KNOWLEDGE
Within the last decade there was a dramatic change in paradigms in motor rehabilitation:
Physiotherapy is no longer understood as “hands on” treatment but concentrates more
on “hands off” and coaching activities. The traditional “school” oriented concepts
are more and more replaced by therapeutic procedures which are derived from
neurobiological and neurobehavioural knowledge and are evidence based.
VOLKER
HÖMBERG
To further stimulate progress in the field of motor rehabilitation a fast transfer from
basic neuro- and behavioural sciences into clinical practice is needed and appropriate
clinical study designs and service implementations have to be defined. Most of the
evidence based concepts are taking advantage from elementary rules for human motor
learning.
SRH Health Center
Bad Wimpfen
Germany
Several evidence based therapeutic procedures can be grouped into modules to
ascertain that every patient has a chance to be treated by a procedure likely to improve
his condition even on a limited length of stay. So a quality proven rehabilitative therapy
can be offered.
In the talk both neuroscientific principles of plasticity and motor learning as well as
examples of therapeutic modules will be demonstrated.
MOTOR REHABILITATION:PHYSICAL THERAPY
The classical “spa” concept from which neurorehabilitation historically has originated
,was based on the use of hot waters , massages and other physical means providing
elements of wellness along with presumptive healing effects.eg. reducing muscle
spasms, pain or paraethesiae.
This lecture will summarize the most important physical therapeutic technique
used in neurorehabilitation for improvement of motor function and reduction of
positive sensory symptoms and discuss their differential clinical usefulness for special
patients`problems.
This list will include the most useful electrical and magnetic stimulation methods,aspects
of hydrotherapy and application of heat and cold.
These techniques will also be classified according to their impact on neuromodulation
as a more modern concept of brain conditioning” in relation to motor learning therapy
strategies.
38
Heinrich Heine
University of Duesseldorf
ROBOTS IN NEUROREHABILITATION.
SENSE AND NONSENSE
Over the last decade intelligent mechanical training devices have been introduced into
day by day clinical practice in motor rehabilitation.
VOLKER
HÖMBERG
The term “robots” has been borrowed from machines ( may the be android or not)
designed to help man do hard work.
Heinrich Heine
University of Duesseldorf
Therefore the term “robots” is somewhat misleading when used in the neurorehab field:
These device are not designed to make therapists´s life easier or even getting rid of
them completely , but are a compelling and important addenda to our motor-therapist
armory which eventually will icrease productivity and effectiveness of therapists’ work.
“Robots “ can open new therapeutic windows especially in severely afected patients in
a very early stage of treatment, when conventional techniques are not usable ( e.g int
he completely hemiplegic patient)
SRH Health Center
Bad Wimpfen
Germany
This review lecture will delineate the advantages of “robot” assisted training in the
context of motor learning principles (high repetition rate, refined and augmented
feedback properties , automatic shaping etc.) and critically discuss there relative
contribution in modern evidence based motor rehab strategies.
39
NOVEL PHARMACOLOGICAL APPROACHES TO THE
TREATMENT OF PARKINSON’S DISEASE
The drug treatment of Parkinson’s disease (PD) has been based around dopamine replacement therapy for many decades. This improves motor function in early PD but
many problems remain that relate the long term complications of dopaminergic therapy, the progression of the disease process and the occurrence of non-motor symptoms
of PD. In essence the changes that are occurring in drug therapy can be divided in those
that affect the early stages of PD, those which are to be employed in the later more
complicated stages of the illness and those which might be disease modifying.
In early treatment, there has been a return to the use of L-dopa based on the results of
PD-MED and STRIDE-PD trials which shows that careful early use has the best clinical
efficacy and no long term disadvantage with respect to the appearance and severity of
motor complications and motor fluctuations in later disease. As a consequence novel
delivery forms of L-dopa are being developed along with new formulations of existing
dopamine agonists.
The only dopamine agonist drug that is distinguished from the others is apomorphine
as it exhibits clinical efficacy equivalent to that of L-dopa. The current administration
of apomorphine requires subcutaneous injection or infusion as a result of its poor oral
bioavailability. As a consequence, there is particular interest in developing new forms of
apomorphine to allow it to be used less invasively and to benefit from its proven clinical efficacy. Why apo morphine is the better dopamine agonist probably relates to its
ability to interact with both D-1 and D-2 receptors and its generally rich pharmacology
which needs to be explored further.
Longer acting forms of L-dopa and dopamine agonists are also being developed for the
treatment of ‘wearing off’ along with novel COMT inhibitors and reversible MAO-B inhibitors. Interesting new formulations of amantadine are being studied for suppressing
dyskinesia and other classes of glutamate antagonists are under investigation. However, it is the potential use of non-dopaminergic approaches to the treatment of ‘wearing
off’ and dyskinesia where most effort has gone but so far with little clinical translation.
One exception is the introduction of the adenosine A2a antagonist Istradephylline in to
the treatment of PD for the control of ‘wearing off’.
Lastly, the search for disease modifying/neuroprotective treatments continues despite
previous failures. Attacking the accumulation of α-synuclein is one such approach as is
the search for drugs that modify other components of the cell death cycle that are are
affected by gene defects detected in inherited forms of PD, such as parkin, LRRK2 and
GBA. treatment of non-motor symptoms of PD has become a priority with an ‘as needs’
symptomatic approach being used currently as the neuronal basis of many non-motor
symptoms is not clear. However, preclinical studies on cognition, sleep and autonomic change are starting to develop animal models in which novel pharmacological approaches can be tested. One interesting approach is the repositioning of drugs already
used in man for other indications but which have shown evidence for neuroprotection
in preclinical studies. These include drugs used to treat type II diabetes and calcium
channel blockers used in cardio-vascular disease.
40
PETER JENNER
NDRC, Institute
of Pharmaceutical
Sciences, Faculty of
Life Sciences and
Medicine, King’s
College, London UK
DISEASE COURSE MODIFICATION IN PARKINSON’S DISEASE
Personalized medicine is an emerging field that encompasses the use of risk algorithms,
molecular diagnostics, targeted therapies and pharmacogenomics in order to improve
health care. It is expected to impact the way drugs are developed and patients are
treated in many fields, including neurodegenerative diseases in the near future.
Parkinson’s disease (PD) is the second most common neurodegenerative disease in
man and its clinical hallmark is the motor parkinsonian features , namely rest tremor,
bradykinesia, rigidity and loss of postural reflexes; These symptoms, resulting from the
loss of dopaminergic neurons in the substantia nigra pars compacta, respond well to
dopamine replacement therapy; The limitation of dopaminergic therapy is that patients
soon develop motor fluctuations, shortening and loss of stability and predictability
of the response as well as drug-induced involuntary movements termed dyskinesias;
additionally they do not provide benefit for the multiple nonmotor symptoms affecting
most patients’ lives and decreasing patients’ quality of life. Moreover they do not
slow down disease progression with evolution of cumulative widespread neurological
disability.
Amos D. Korczyn
Sackler School of Medicine
Tel-Aviv University,
Ramat-Aviv 69978, Israel
In this review we will outline the applications of personalized medicine for the several
stages from at risk populations to full-blown advanced PD.
We expect to change the way we currently define PD with molecular diagnostics,
the use of DNA-, protein- or mRNA-based biological markers to predict the risk for
developing PD as well as the molecular phenotype of ongoing PD through its various
stages. Genomic analysis of diseases with homogeneous clinical phenotypes will unveil
distinct molecular entities that require different treatment strategies for optimal
outcomes. Furthermore molecular-targeted therapies that slow degeneration of both
dopaminergic and non-dopaminergic neurons will replace those that simply treat PD
symptoms, providing long-term disease course modification. Finally, pharmacogenomic
data that predicts therapy response and limitations in the individual patient based on
his genomic profile will accompany many drugs.
41
Medically unexplained symptoms in neurology
Medically unexplained symptoms in neurology (MUS) is a heterogeneous group of
disorders which lack identified biological basis and are assumed to have a psychological
origin. They are diagnosed by exclusion of an organic basis, as well as exclusion of
feigning. MUS symptoms can be either positive (such as “epileptic” seizures) or negative
(e.g. weakness). They can be accompanied by apathy (such as “la belle indifference”)
or extreme anxiety (PTSD). The assumptions that all “functional” symptoms are
psychogenic, and therefore can only respond to psychiatric therapy, has not been
validated.
The separation of “organic” from “psychogenic” symptoms parallels the philosophical
school of dualism (vs monism), implying that some processes are due to “mental”
processes which are not physical.
The diagnosis of MUS requires exclusion of malingering and factitious disorders. It
is almost impossible to prove the existence of feigning, and in many cases even a
“malingerer” may believe there is a justified source of the abnormality.
Treatment of MUS is disappointing.
Vascular Parkinsonism
Leucoaraiosis, or white matter disease of the brain, is a common affection in the
elderly, and can be easily demonstrated on MRI. In addition to age, risk factors for
white matter lesions (WML’s) are mainly cardiovascular ones. It is not always clear
what is the pathogenetic process underlying WML’s, although a primary suspect is
small vessel disease. The clinical correlates of WML’s include cognitive impairment,
gait abnormalities, depression and urinary incontinence. Although the same MRI
features can occur in normal elderly people, they are predictive of future appearance of
gait impairment and cognitive decline. No study has yet demonstrated different MRI
patterns in the different clinical syndromes.
The clinical syndrome of dementia associated with WML’s is attributed to Binswanger.
In addition to cognitive impairment, however, patients with Binswanger’s disease
frequenthy have gait impairment as well as urinary incontinence.
Lower body parkinsonism has also been assonciated with WML’s. This syndrome is
different from idiopathic Parkinson’s disease by not involving the face and upper limbs
(or only minimally), not responding to levodopa, and being predominantly symmetrical
in onset. Many patients with lower body parkinsonism have, or develop, cognitive
impairment and urinary incontinence.
Thus, Binswanger’s disease (BD) and lower body parkinsonism have strikingly
overlapping clinical features, risk factors and neuroimaging manifestations. Therefore
they could present different points on a spectrum. Long term follow-up studies of these
two groups of patients may lead to a common phenotype, combining features of both.
Prospective data are lacking to test this hypothesis.
42
Amos D.
Korczyn
Sackler School of
Medicine
Tel-Aviv University,
Ramat-Aviv 69978,
Israel
ATYPICAL FORMS OF CHRONIC INFLAMMATORY
DEMYELINATING POLYNEUROPATHY
Background
Chronic inflammatory demyelinating polyneuropathy (CIDP) is an aquired, demyelinating,
motor and sensory neuropathy that is presumed to be immune mediated. The classic
form of CIDP is fairly symmetric and motor involvement is greater than sensory. In
our study we examined atypical forms of CIDP which are more difficult to recognize
because of lack of unified diagnostic criteria.
Materials and methods
We studied 52 patients divided into 3 groups: 20 patients with typical CIDP, 20 patients
with atypical CIDP according to the EFN/PNS guideline (revised 2010) and 12 patients
with sensory CIDP according to the criteria of French CIDP study group.
Results
Our results suggest that in group of atypical CIDP prevail multifocal sensory- motor
forms called Lewis-Sumner Syndrome (LSS) -56% of cases. Upper limbs are first
involved in the clinical evolution of patients with LSS and not lower limbs as in typical
CIDP. NCS show conduction blocks mostly in median and ulnar nerves in patients with
LSS, but unaffected nerves are strictly normal. In typical CIDP NCS show evidence
of demyelination in all nerve trunks. Anti-ganglioside antibodies were positive only in
motor forms of CIDP. NCS is not a sensitive test to diagnose sensory CIDP, in 75%
cases motor conduction velocities were not affected. SSEP is a high sensitive test
to be used for underlying a possible CIDP from all sensory polyneuropathies. Overall
Neuropathy Limitation Scale and 9 hole peg test are the most efficient tests to evaluate
progression or regression of symptoms in patients with CIDP. Loss of myelin was the
most prominent finding on biopsy. Nerve biopsy is used mainly when other studies
fail to clearly establish the diagnosis of CIDP, particularly when electrophysiologic
criteria for demyelination are not met. Nerve biopsy should be considered in patients
with progressive, predominantly large fiber sensory neuropathy of otherwise unknown
etiology, as they may have sensory CIDP that responds to therapy.
Vitalie Lisnic
Eugeniu Gavriliuc,
Victor Nemțan,
Octavian Misic,
Olesea Odainic,
Pavel Gavriliuc
“Nicolae Testemitanu”
State University of
Medicine and Pharmacy
Chisinau, Republic of
Moldova
Conclusions
There is significant phenotypic variability in the clinical spectrum of CIDP suggesting
that there are differint immunopathological mechanisms at play. Future research is
needed to identify disease markers to improve diagnosis and to develop new therapeutic
strategies
43
Impairment of the central nervous system
in demyelinating polyneuropathies:
neurophysiological,
clinical and neuroimaging aspects
Various case series of patients with autoimmune demyelinating disease affecting
both the central and peripheral nervous system (CNS and PNS) have been reported
for decades. Frequently, demyelination starts within PNS, but later CNS pathology
develop, in some cases with a relapsing–remitting course. The potential mechanisms
of concomitant damage of the myelin from the PNS and CNS remain unclear.
We studied 80 patients with ‘’classical” PNS demyelination (25 with acute inflammatory
demyelinating polyneuropathy (AIDP) and 55 with chronic inflammatory demyelinating
polyneuropathy (CIDP)) and 80 with “classical” CNS demyelination – multiple sclerosis
(MS). The goal of the research was to study the clinical, electrophysiological and
neuroimaging interrelations of impairment of the central and peripheral nervous system
in diseases with pollard demyelinating manifestations: central and peripheral.
The research revealed the existence of a clinical-neurophysiological continuum of
central and peripheral demyelination. The extremes of this clinical-neurophysiological
continuum were occupied by AIDP and CIDP on one limit and MS on the other. The
intermediate part of the mentioned spectrum was occupied by a syndrome of combined
central and peripheral inflammatory demyelination.
The subclinical impairment of the CNS in demyelinating polyneuropathies could be
detected by means of electrophysiological and neuroimaging investigations. In cases
of AIDP subclinical signs of pyramidal tract impairment were established based on
conduction in the pyramidal pathway by means of motor evoked potentials (MEP). The
clinical impairment of the CNS was established within the CIDP pattern of symmetric
proximal and distal weakness (Dimachkie MM, Saperstein DS, 2014). This form develops
mainly in females, in remitting-relapsing course of the disease, with expressed degree
of the motor and sensory deficit, and resistant to conventional immunosuppression
treatment.
The study demonstrated that in a significant number of patients with MS subclinical
signs of peripheral nerve impairment occurred. The sensory fibers of the sural and motor
fibers of the peroneal nerves were more frequently involved.
44
Vitalie Lisnic
Eugeniu Gavriliuc,
Victor Nemțan,
Octavian Misic,
Olesea Odainic,
Pavel Gavriliuc
“Nicolae Testemitanu”
State University of
Medicine and Pharmacy
Chisinau, Republic of
Moldova
ALS genotypes and phenotypes
Our epidemiological data show that about 5% of ALS patients in Germany have a family
history. The majority carry the C9orf72 mutation (24%), next is the SOD mutation (13%),
TBK1, FUS and TDP-43 (each about 5%) follow. Most of these mutations do not only
encode mutations in the genome of ALS patients, but also of FTD patients. Therefore,
the phenotype – genotype relation is poorly understood.
Recent neuropathlogical findings emphazise that staging (“Braak Staging”) for ALS is
also possible. The results demonstrate that the pathology as shown by the molecular
marker TDP-43 spreads from the motor cortex into the direction of the gyrus rectus
and the orbitofrontal cortex. In a similar longitudinal fashion it affects the corticofugal
tracts, the corticospinal tract (stage 1). the tracts to the precerebellar nuclei (stage 2),
the corticostriatal tract (stage 3) and the perforant pathway (stage 4). These findings
include ALS in the group of diseases which are characterized by an “initiation and
propagation” pattern along anatomically defined pathways.
ALBERT
Ludolph
University of Ulm;
Department of
Neurology
Medical director,
Head of Department,
Ulm, Germany
The translation of these neuropathological findings into phenotypes are at their
beginning. However, measurement of fractional anisotropy by DTI shows that the
neuropathological staging is mirrored by affection of the respective tracts. Also,
spreading of the disease is a characteristic feature clinically and the predominant
affection of monosynaptically supplied muscles characterize the disease. Whether
these novel findings and these new concepts of ALS can be exploited therapeutically,
will be show in the future.
45
SYMPTOMATIC TREATMENT IN DIABETIC NEUROPATHY
The high incidence and prevalence of Diabetes Mellitus in the population represents
a real matter of public health. Among diabetic patients there is a high prevalence of
neuropathy. One of the most frequent symptoms encountered in this patients, and also
with an important impact on quality of life, is neuropathic pain. Thus, symptomatic
treatment in diabetic neuropathy is centered on management of pain. Pregabaline
and duloxetine are the two drugs approved by FDA and EAM for the treatment of
distal symmetric polyneuropathy. There are also other options too, including opioids,
trycilclic antidepressants, SSRIs, and antiepileptics. Alpha lipoic acid has also shown
pain relieving properties.
46
TUDOR
LUPESCU
Head of Neurology
Department, “Agrippa
Ionescu” Hospital,
Bucharest, Romania
CHRONIC MIGRAINE ASSOCIATED WITH AUTONOMIC
IMBALANCE AND OTHER RELATED COMORBIDITIES
Background:
Chronic migraine (CM) is a progressive disabling brain disease; different comorbidities
may influence the clinical presentation as well as some aspects of migraine pathogenesis.
Aim:
to study CM relations with autonomic imbalance and other comorbidities.
Material and methods:
The 4 types of comorbidities in CM were studied: autonomic imbalance (154 patients),
syncope (65 patients), arterial hypertension (60 patients) and residual lateral ventricles
asymmetry (62 patients). We used a large variety of methods: headache questionnaires
and diaries, anxiety/depression scores, heart rate variability (HRV), trigeminal evoked
potentials, tilt testing, ambulatory Holter blood pressure monitoring, pressure algometry
and MRI.
Ion
Moldovanu1,2
Stela Odobescu1, Lilia
Rotaru1, Galina Corcea1,
Oxana Grosu1, Violeta
Maticiuc 1
Institute of Neurology and Neurosurgery of
the Republic of Moldova,
2Medical and Pharmaceutical University „Nicolae
Testemiţanu” of the
Republic of Moldova
Results:
The study of 154 patients with CM by means of HRV analysis has shown that the
abnormal increased activity of brainstem vagal centers determines the autonomic
imbalance in these patients leading to its involvement in the pathogenesis of the CM
itself.
The combination of CM with syncope revealed the entity of syncopal migraine and
its frequent association with orthostatic intolerance syndrome as a manifestation
of autonomic failure. The relation between CM and arterial hypertension was due to
abnormal autonomic regulation of blood pressure diurnal changes in 60% of cases
(non-dipping patients). Asymmetry of lateral ventricles has proven to be a destabilizing
factor for the evolution and severity of CM.
Conclusions:
Different type of comorbidities may have a different impact on CM. The autonomic
imbalance, syncope and arterial hypertension appear to be involved even in the
pathogenesis of CM. Residual lateral ventricles asymmetry influence the severity of the
painful phenomenon only.
47
CONSCIOUSNESS, ALTERED STATES OF CONSCIOUSNESS
AND BRAIN PLASTICITY: THERAPEUTIC PERSPECTIVES
The study of the phenomenon of consciousness (Cs) appears to be more heuristic for the
analysis not only of the form of “ordinary consciousness” (subjectivity, intentionality,
self-consciousness and will), but mostly of different forms of Cs as altered states of
consciousness (ASC).
In ASC arise such exceptional opportunities of human beings as abolition of pain, increase
of physical and mental performance, modification of the emotional perception, certain
creativity insights, etc. that can be explained by a “reset” of special neurodynamic,
psychophysiological and neuroplasticity processes (Moldovanu I., Vovc V., 2012, 2013).
Consciousness influence brain neuroplasticity during both wakefulness and sleep. This
means that Cs indeed activates synaptic flow, brain structures changes and functional
organization (Askenasy J. and J. Lehmann, 2013). In recent years to explain the
phenomenon of Cs some concepts of quantum physics are used (Hameroff S., Penrose
R, 2014).
Our goal is to present a novel approach for research of the phenomenon of Cs based on
several important strategic issues:
a) to study certain forms of Cs - ASC.
b) to quantify the phenomenological structure of consciousness in ASC (Pekala
R., 1991, Dittrich A et al. 2005).
c) ASC will be induced by various ways using neurostimulation techniques (as
binaural sound stimulation, transcranial electrical stimulation, etc.).
d) plasticity and neuroprotection study will be an essential component of our
research.
So, altered states of consciousness appear to be an “interface” between ordinary
consciousness and unconsciousness of the human being and it seems to have major
therapeutic potential.
48
Ion
Moldovanu1,2
Victor Vovc2 1, Alexandru
Cernei1, Oleg Arnăut1
Institute of Neurology
and Neurosurgery of the
Republic of Moldova,
2Medical and Pharmaceutical University „Nicolae Testemiţanu” of the
Republic of Moldova.
ADVANCES IN NEUROREHABILITATION FUNDAMENTALS
- AN UPDATE
Brain damage have a negative impact on all three levels of structural and functional
organization: cellular and molecular level, circuitries level and dynamic network level
and launches an endogenous continuous brain defense response which consists in
neuroprotection (the immediate response) and neurorecovery (a later response).
Endogenous neuromodulation represents at the cellular and molecular level the
optimization of common biological processes that could potentially generate cell
death or promote neurodegeneration. At the circuitries and dynamic network levels,
it represents the tendency in reinbalancing of functional connectivity in resting-state
netwoks.
In the last years, there has been a substantial effort in understanding the brain functioning
and how to enhance endogenous neuromodulation and neurorehabilitation in general,
by using a large spectrum of neurotechnologies such as imaging techniques (functional
magnetic resonance imaging, ligant-based positron emission tomography, diffusiontensor imaging), quantitative electroencephalogram, magnetoencephalography, eye
tracking, optogenetics, transcranial magnetic stimulation, transcranial direct current
simulation, deep brain simulation, computational neuroscience and brain-computer
interfaces. The combination between these technologies provide valuable information
about the structure-function relationship underling resting-state networks, about the
dynamic cross-talk between networks and about the abnormalities in the functional
connectivity in different pathologies.
DAFIN F.
MUREȘANU
Chairman
Department of Clinical
Neurosciences,
University of Medicine
and Pharmacy
“Iuliu Hatieganu”,
Cluj-Napoca, Romania
49
RESULTS FROM A LARGE RETROSPECTIVE
COHORT TRIAL IN TBI
TBI is a field with many unmet needs in medicine and public health. It is a major cause
of death and disability and also leads to huge direct and indirect costs to society.
Currently the incidence of TBI is increasing.
DAFIN F.
MUREȘANU
TBI populations are heterogeneous in terms of mechanism of disease, baseline
prognostic risk factors, clinical severity and evolution. This heterogeneity generates
complex challenges.
Chairman
Department of Clinical
Neurosciences,
University of Medicine
and Pharmacy
“Iuliu Hatieganu”,
Cluj-Napoca, Romania
New pharmacological approach together with more basic and clinical research is needed
for better targeting TBI therapy to the individuals.
The frequent progression of contusive brain injury indicates that this may constitute a
subpopulation of TBI more likely to benefit from acute neuroprotection (in the classic
sense) by limiting processes involved in secondary brain damage.
Other mechanisms, and consequently different approaches may be more relevant in
patients with diffuse axonal injury, and neuroprotection in a more broad sense also
includes strategies and therapies aimed at promoting regeneration or replacement
of lost neuronal and glial cells, neuronal circuits, and stimulation of neuroplasticity
(neurorecovery).
The primary goal of pharmacological support in TBI is to reduce secondary damage
(neuroprotection) and to enhance repair (neurorecovery).
The current presentation will highlight the limits of monomodal drugs, the advantages of
multimodal drugs and the results of a large retrospective cohort trial with Cerebrolysin
in traumatic brain injury.
50
THE ROLE OF NEUROTROPHIC FACTORS IN BRAIN
PROTECTION AND RECOVERY AFTER STROKE
This presentation briefly reviews some of the mechanisms involved in the pathogenesis
of neurological diseases, i.e. damage mechanisms, and their interactions and overlap
with protection and reparatory processes (i.e., endogenous defense activities). A
relationship between damage mechanism (DM) and endogenous defense activity (EDA)
regarding therapy principles will also be described.
Currently, it is difficult to find the correct therapeutic approach for brain protection
and recovery, especially because we do not fully understand all of the endogenous
neurobiological processes, the complete nature of the pathophysiological mechanisms
and the links between these two categories. Moreover, we continue to use a simplistic
and reductionist approach in this respect.
DAFIN F.
MUREȘANU
Chairman
Department of Clinical
Neurosciences,
University of Medicine
and Pharmacy
“Iuliu Hatieganu”,
Cluj-Napoca, Romania
Endogenous neurobiological processes, such as neurotrophicity, neuroprotection,
neuroplasticity and neurogenesis, are central to protection and recovery and represent
the background of EDA.
The biological reality of the nervous system is far more complex. In fact, there is an
endogenous holistic process of neuroprotection and neurorecovery that should be
approached therapeutically in an integrated way.
The current tendency to exclusively frame drug activity in terms of single mechanisms
and single focus effect might distract from other paradigms with greater explanatory
power and hinder the development of more effective treatment strategies. A change of
concept is required in pharmacological brain protection and recovery. Some prospective
considerations including an integrated pharmacological approach, focusing on drugs
with multimodal activity and pleiotropic neuroprotective effect which are biological
drugs, rather than single mechanism drugs, which usually are chemical drugs will be
highlighted.
Biological agents (e.g., neurotrophic factors and related molecules) with modulating
and multimodal effects are better pharmacological agents for brain protection and
recovery, because they usually have also pleiotropic neuroprotective effect. That is why
they are capable of pharmacologically bridging acute neuroprotective processes with
the long-term recovery processes in stroke, TBI and neurodegenerative disorders.
This presentation will also focus on important therapeutic results of Cerebrolysin
treatment in stroke and TBI.
51
NUTRITIONAL CARE OF
NEUROLOGICAL DISABLED PATIENTS
There is an increasing number of neurological patients (stroke, MS, ALS) with impaired
nutrition which can exist before the appearance of disease or during the rehabilitation
period, this issue is central to the evolution of the patient.
Consequences registered by raising morbidity and mortality from cardiovascular
diseases (hypertension, diabetes, decreased insulin resistance) showed that the
program of prevention and treatment respectively in those situations are closely linked
to nutrition, especially for inpatient neurological rehabilitation.
Monitoring and evaluation of obesity, malnutrition, energy and fluid intake are essential
directions in therapeutic rehabilitation program and patient education.
In the presentation are reviewed patient’s evaluations for clinical and anthropometric
indices, classification of obesity, disorders malnutrition-type. At the same time
are presented therapeutic aspects related to changes in weight, diet and nutrition
principles, elements on the functional capabilities and physical consequences such
as muscle changes, edema, trophic disorders. This paper presents the justification for
importance of energy and fluid intake and enteral nutrition.
In the center of the presentation, the emphasis is on neurological disabled patient
education practices on diet, nutrition, individual adaptations in various psychobehavioral aspects. Also an important aspect represents education of caregivers
regarding nutrition principles, taking into account that many neurological patients
depend on them for conducting daily activity living.
52
ADRIANA SARAH
NICA
Head of Neurology
Head of Rehabilitation
Department,
University of Medicine
“Carol Davila”
Bucharest, Romania
CLINICAL AND THERAPEUTIC ASPECTS IN LUMBAR
SCIATICA BY DISC HERNIATION
Lumbar sciatica represents a form of clinical manifestation of a peripheral motor neuron
syndrome in the low back pain, most frequently having a mechanic disc etiology,
characterized by dermatome distribution aggravated by flexion and Valsalva maneuver,
with monoradicular neurologic deficit in 50% of cases. Annual costs of treatments are
impressive, ranging at billions of Euros/US dollars annually. Properly treated it has a
high healing potential within 3 month from beginning (60-80%), untreated it is prone
to chronic pain. Severe forms with ponytail syndrome require neurosurgical treatment.
Current guidelines recommend positive diagnosis of sciatica in the presence of a typical
radicular pain, lower limb irradiated and at least one neurological test (sign) indicating
nerve root damage or characteristic neurological deficit, excluding warning signs (“ red
flags “) , both anamnesis and physical examination.
IOAN ONAC
Chair of Balneophysical
Therapy and Medical
Rehabilitation,
University of Medicine
and Pharmacy
“Iuliu Hatieganu”,
Cluj-Napoca, Romania
Computer tomography (CT) and magnetic resonance imaging (MRI) have both the
needed accuracy for the diagnosis of disc herniation.
Initial treatment is conservative, with a major focus on patient education (see the clinic
guide of the Dutch College of General Practitioners). It recommends relative rest with
continuing normal activity, combined with drug therapy (NSAIDs, analgesics, muscle
relaxants, general corticotherapy or paravertebral , epidural, infiltration, sedatives).
Surgical treatment (discectomy ‘the golden standard’ in the herniated disc) is reserved
for severe cases with ponytail syndrome or if clinical symptoms persist after 6-8 weeks
of treatment.
Regarding the optimal treatment and application timing, no definite conclusion was
reached yet.
No significant differences appeared in the evolution of patients treated surgically
compared with those treated conservatively, on the long term of 1-2 years.
53
PROPAEDEUTICS FOR REHABILITATION
IN THE CENTRAL NERVOUS SYSTEM TRAUMATOLOGY
(POSTACUTE/ SUBCHRONIC STAGES)
Central nervous system (CNS) traumatology provides, likewise all the severe CNS
lesions – mainly because currently there is no cure for them – devastating consequent
conditions/ sequels, often including with most serious/ life-long disabilities [mainly
of the following kinds: motor/ neural-muscle (tone and/or trophicity), coordination,
balance, sphincter/s control, sensitive and/or sensory/al (especially for some brain
ailments), swallowing, cognitive/ consciousness, and/or communication, respectively
emotional/ behavioral] thus being a harsh burden – but at the same time, challenge
– for the affected individuals, their kin and/or care takers, and for the society, as well.
The modern clinical management of patients with postacute/ subchronic conditions
following severe CNS – including traumatic – lesions, is complex, entailing (in addition
to neurosurgical and/or of intensive care type intervention/s, if necessary) endeavors
for balanced: pharmacological, physical-kinesiological (including rehabilitation nursing),
speech and/or cognitive-behavioral, therapies.
In order to reach as consistent as possible neurorehabilitative and neurorestorative
outcomes, professionals who work in this very difficult domain must get, and have
constantly up-dated, (including) solid preliminary/ propaedeutical
knowledge
on: definitions and epidemiologic data regarding CNS traumas, major consequent
conditions and dysfunctions/ disabilities, morph-/phys-pathological underlying lesions’
mechanisms (including as intimate therapeutic, rehabilitative targets), instruments for
clinical/ para-clinical and functional evaluation – used to identify neurorehabilitative
related indications, respectively to assume prognostic estimations, to set specific,
realistic/ appropriate goals and/or to assess the results obtained.
In this work/ invited lecture, the above mentioned subject matters will be systematically
and integratively approached.
Keywords: propaedeutics, CNS traumatology,
neurorehabilitation, postacute/ subchronic stages
54
serious/
life-long
disabilities,
GELU ONOSE
The University of
Medicine and Pharmacy
”Carol Davila” –
Bucharest, Romania
The Teaching
Emergency Hospital
”Bagdasar-Arseni” –
Bucharest, Romania
PAIN AND SLEEP DISTURBANCES
IN PARKINSON’S DISEASE
Pain is a frequent non-motor symptom. The prevalence varies between studies because
of the criteria and definitions used. There were many attempts for pain classification in
PD. The pathophysiology involves basal ganglia in nociceptive pathways, the corticalbasal ganglia-thalamic circuit in modulation of pain. The major categories of pain are:
musculoskeletal, dystonic, neuropathic, central. There are data that pain is one of the
most bothersome PD related symptom/condition in early and also advanced PD. Frozen
shoulder, radicular and nonradicular back pain are more frequent encountered in PD.
Treatment involves a complex approach with pharmacological treatment, physical
therapy, injections of botulinum toxin.
CRISTIAN
FALUP-PECURARIU
Department of Neurology,
County Emergency Clinic
Hospital, Faculty of
Medicine, Transilvania
University Brașov,
Romania
Sleep disturbances in Parkinson’s disease (PD) are: insomnia, REM sleep behavior disorder,
restless legs syndrome, excessive daytime sleepiness. All sleep disturbances have
higher prevalence comparing with normal control groups. Insomnia is more prevalent in
advanced disease comparative with early disease. However, large epidemiologic studies
suggested that insomnia is more prevalent as pre-motor symptom. Excessive daytime
sleepiness (EDS) has been shown in cross sectional studies to be present in 30-50% of
the PD patients. The prevalence is increasing in longitudinal studies. There are multiple
factors involved in EDS: intrinsic to PD, effects of drugs, nocturnal sleep disorders. REM
sleep behavior disorder with abnormal dreams, dream-enacting behaviors, could be a
premotor feature or could appear during the evolution of PD.
55
IMPORTANCE OF MOTOR AND PHARMACOLOGICAL
INTERVENTIONS IN STROKE REHABILITATION
Stroke can have devastating effects on neurological function and is often the cause of
persistent disability. Recovery is incomplete in many cases, and long term intervention
is needed. The fundaments of functional recovery are neuroplastic processes - they are
triggered both by the inbalance caused by the stroke and by the attempts to move and
to regain control over the affected limbs. Rehabilitation aims to enhance and optimize
natural processes that occur in the injured brain. Neuroplasticity is an active process
and is can be identified on all structural levels of the brain – starting from the mollecular
layer and culminating with the functional networks and regions. Both motor learning and
pharmacologic intervention have the potential to modulate neuroplasticity. Cortical
function can be evaluated through transcranian magnetic stimulation. To illustrate
the impact of pharmacologic intervention on cortical dynamics in stroke we present the
added effect of Cerebrolysin (a neurotrophic factor) to conventional rehabilitation on
18 subjects with recent middle cerebral artery ischemic stroke (2-12 weeks). Patients
that have received Cerebrolysin for 10 days have significantly larger amplitudes of the
motor evoked potential and diminished treshold values on the lesioned hemisphere, as
well as a more important enlargement of the hand projection area as compared with
the control group. This prooves a potentiating effect of the pharmacologic intervention
on the cortical mechanisms involved in rehabilitation.
56
CRISTIAN DINU
POPESCU1
D. Muresanu2
C. Bohotin1
V. Bohotin3
1. “Grigore T. Popa”
University of Medicine
and Pharmacy, Iasi,
Romania
2. “Iuliu Hatieganu”
University of Medicine
and Pharmacy Cluj
Napoca
3. Service de
Neurologie, Les
Hôpitaux des Chartres“
LEVODOPA—CARBIDOPA INTESTINAL GEL AND
BRAINSTEM AUDITORY EVOKED POTENTIALS IN
ADVANCED PARKINSON’S DISEASE
The aim of this paper is to analyze the influence of continuous dopaminergic stimulation
on functional connectivity in brainstem evaluated by auditory evoked potentials in
patients with advanced Parkinson’s disease.
Material and methods. The paper is a prospective study of 25 patients with Parkinson’s
disease, two of them in stage Hoehn and Yahr 3 and the others 23 in stage 4. The
evaluations was done before and after 10 days of treatment with with levodopa/
carbidopa intestinal gel.
Results. Inspection of the absolute values of waves I, III, and V finds that the patients
in OFF state before L-dopa/carbidopa gel infusion present significant increases in waves
III and V that occur at 4.26 and 6.30 msec while wave I is normal at 1.75 msec. The
latencies after duodopa therapy are well within normal limits at 1.76, 3.80 and 5.62 ms
Conclusion. Our results indicate that functional connectivity in brainstem showed a
significant increase possibly due to the dopaminergic continuous stimulation action
on dysfunctional communication within the motor network in Parkinson’s disease.
CRISTIAN DINU
POPESCU1,2
D. Alexa1,2
D. Baltag2
Cristina Grosu1,2
1. Student Physician,
University of Medicine
and Farmacy
“Grigore T.Popa”- Iasi,
Faculty of Medicine
2. Neurology Clinic,
Rehabilitation Hospital
Iasi
57
VIRUS AND PARKINSONISM
Although the interaction of viral infections with brain structures is well known
and explicit since the pandemic influenza some 90 years ago which gave rise to
postencephalitic parkinsonism, the interaction of virus at the level of transmitters is
not fully understood. Although there is a lack of virus particles in cases of encephalitis
lethargica, more recent experimental data with H5N1 virus infected C57BL/6J mice
indicate virus transport from peripheral nervous system to CNS, α-Synuclein aggregation
and microglia activation, classical signs of PD.
Loss of neurons in the Substantia nigra (SN) has been initiated by H5N1 and in other
experimental studies using simian immunodeficiency (SIV), a rhesus monkey model for
HIV parkinsonism. Interestingly enough, L-Dopa and selegiline restored the dopamine
deficiency but aggravated the SIV-induced pathology. As a consequence, treatment
strategies for HIV-infected patients with parkinsonism must be reconsidered if the
need for antiparkinsonian treatment is indicated.
58
PETER RIEDERER
University of
Würzburg, Medical
School, Germany
EPIDEMIOLOGICAL STUDY OF
MULTIPLE SCLEROSIS IN THE REPUBLIC OF MOLDOVA
Background:
Multiple sclerosis (MS) is the most common cause of neurological disability in young
adults worldwide and about half of those affected are from Europe. The geographical
distribution of MS is heterogeneous, but it is well known that the disease is more
prevalent in temperate zones than in the tropics, with significant variations between
regions of the same latitude, even within the same country. An interaction of
environmental and genetic factors is thought to trigger the development of MS.
Aim:
To investigate epidemiological and clinical data of multiple sclerosis in the Republic of
Moldova, including gender and age specific trends, taking into account the fact that the
natural evolution of the disease is not yet influenced by the use of disease-modifying
drugs.
Methods:
747 MS patients were included in the study. McDonalds’ Criteria (2010) was used
to establish the diagnosis. All data from the different epidemiological sources was
incorporated into a single dataset. The demographic and clinical data collections were
performed using a paper form of questionnaires completed by a retrospective analysis
of hospital records.
MARINA
SANGHELI1,2
Marina Sangheli1,2
Vitalie Lisnic1,2
Mihail Gavriliuc1,2
Olesea Odainic2
Larisa Chetrari2
Svetlana Pleșca2
Cristina Marcoci1,2
Anna Belenciuc1,2
1. Department of
Neurology, State
University of Medicine
and Pharmacy “Nicolae
Testemitanu”,
Republic of Moldova
2. Institute of Neurology
and Neurosurgery,
Republic of Moldova
Results:
On December 31st 2012, 747 patients were residing in the study area. Of 724 prevalent
patients, 460 (63,5%) were female, mean age of 42.1±11.9 years and 264 (36,5%) were
male, mean age 40.8±12.8 years. The crude onset-adjusted prevalence was 21.0 per
100,000 (95%CI: 14.8-27.1) and the standardized prevalence 20.2. A higher number of
MS patients was recorded for the rural (72.6%) than in the urban area (27.4%) as well as
for the administrative area of the North (33.8%) in comparison with the South (11.1%).
Conclusion:
This study supplies a wide picture of the age and gender-specific prevalence of MS
throughout the Republic of Moldova, standardized to European population. The higher
frequency of all manifestations on 31st December 2012 reflects the worsening of the
disease, which proves the disease progression and necessity of disease-modifying
therapy.
59
CO-ULTRAMICRONIZED PALMITOYLETHANOLAMIDE/
LUTEOLIN PROMOTES MATURATION OF RAT CORTICAL
OLIGODENDROCYTES
Oligodendrocytes are the myelin-producing cells of the central nervous system
responsible for ensheathment of axons. Oligodendrocytes have limited ability to repair
the damage to themselves or to other nerve cells, as seen in demyelinating diseases,
such as multiple sclerosis (MS). MS lesions are characterized by the presence of
undifferentiated oligodendrocyte precursor cells (OPCs), highlighting their inability to
mature into myelin-producing oligodendrocytes. Thus, an important strategy may be
to replace the lost oligodendrocytes and/or promote their maturation or proliferation.
N-palmitoylethanolamine (PEA) is an endogenous fatty acid amide belonging to
the N-acylethanolamines family. Studies demonstrate PEA to possess analgesic,
anti-inflammatory, and neuroprotective actions. More recently, a composite of coultramicronized PEA and the flavonoid luteolin (co-ultraPEA/Lut, 10:1 by mass) was
shown to be more efficacious that PEA alone in improving outcome in experimental
models of spinal cord injury and traumatic brain injury. Here, we examined the ability
of co-ultraPEA/Lut to promote progression of OPCs into a differentiated phenotype.
OPCs were prepared from newborn rat cortical mixed glial cell cultures as described,
and treated the following day with 10 μM co-ultraPEA/Lut. Cells were collected 1,
4 and 8 days later and analyzed for expression of myelin basic protein (MBP). RealTime Polymerase Chain Reaction and Western blot analyses revealed a time-dependent
increase in expression of both mRNA for MBP and MBP content by immunoblotting.
Treatment with either ultramicronized PEA or luteolin was ineffective. Co-ultraPEA/Lut
also promoted morphological development of OPCs. Co-ultraPEA/Lut may represent a
novel pharmacological strategy to promote OPC maturation.
Supported by MIUR, PON ‘Ricerca e Competitività 2007 - 2013’ (PON01_02512)
60
STEPHEN D.
SKAPER
Massimo Barbierato,
Carla Marinelli,
Laura Facci,
Pietro Giusti
Department of
Scienze del Farmaco,
Università degli
Studi di Padova,
Italy
USING CLOCK-GENE RELATED MECHANISMS IN THE
TREATMENT OF NEUROPSYCHIATRIC DISORDERS
Rhythmical circadian alteration of physical functions, including those involved in
neural activity and behaviour, is a universal phenomenon whose underlying cellular
and molecular basis is regulated by so-called CLOCKgenes. In principle, these CLOCK
genes are able to regulate the expression of other genes in a strictly non-random,
time-dependent, repetitive manner. While knowledge about the exact mechanisms of
CLOCK-gene effects is rapidly increasing, more and more neuropsychiatric disorders
are identified which coincide with profound pathological alterations of sleep, circadian
rhythmicity and CLOCK-gene regulation. Therfore, targeting CLOCK-gene related
mechanisms is a promising strategy in order to develop innovative and effective
treatment options for such widespread and devastating conditions as dementia and
neurodevelopmental disorders (ADHD, ASD) and other neuropsychiatric disorders.
JOHANNES
THOME
University
Medicine of Rostock,
Rostock, Germany
61
ARE THERE EVIDENCES FOR PATHOGENESIS-BASED
APPROACH OF DIABETIC NEUROPATHY?
Diabetic neuropathy (DN) is considered as the most frequent chronic complication of
diabetes. In a recent study (Veresiu IA et al, Journal of Diabetes Complications, 2015 ),
we have sown that more than two thirds of the patients from our country declare about
themselves that they have this complication with an important impact on their quality
of life. Peripheral DN is also the most important risk factor for foot ulcerations and
lower limb non-traumatic amputations and autonomic DN is an important predictor
for early mortality. In spite of fact that we have several options for the symptomatic
treatment of painful DN, the “disease modifying” strategy continues to challenge the
researchers and the practitioner also. One by one, the different hypothesis, as the
aldose reductase inhibition for blocking excessive polyol production, inhibition of some
potentially harmful fatty acid synthesis (e.g. gamma-linolenic acid), protein kinase C
inhibition and some nerve growth factors manipulation, failed to fulfill expectations.
Probably the very complex interplay of many metabolic and vascular mechanisms
involved in the DN pathogensis, and the lack of reliable targets for different therapeutic
interventions, are some of the explanations of this situation. A very tempting hypothesis
is that proposed (and experimentally proved) by Brownlee M et al (Nature 414:813820, 2001), the so called “unifying mechanisms”, based on transketolase activation
effect of benfothiamine and redirection of harmful glycolitic products to pentosophosphate pathway. A well done, double blind, placebo-controlled study (Stracke H
et al, Exp Clin Endocrinol Diab, 116, 600-605, 2008) showed significant improvement
on some symptoms of peripheral DN. Another “disease modifying” approach is based
on powerful antioxidant effect of alpha-lipoic acid. There is a published meta-analysis
of the studies with alpha-lipoic acid (Ziegler D et al, Diabet Med 21:114-121, 2004)
showing symptomatic benefits of these treatment. The good risk-benefit and costbenefit ratios are also in the favour of these two strategies.
62
IOAN VERESIU
“Iuliu Hatieganu”
University of Med and
Pharm Cluj-Napoca.
Department of Diabetes,
Nutrition and Metabolic
Diseases,
Romania
IS THERE A CHANCE FOR CLINICAL RESEARCH IN
NEUROREHABILITATION WITHIN THE FRAMEWORK OF
EVIDENCED-BASED MEDICINE?
CLASSIC AND NEW APPROACHES
Evidence-based practice knocks on the door of clinical research in neurorehabilitation.
The clinical trial is the mechanism for comparing and testing therapeutic interventions
to determine their effect in human subjects and thus their value in rehabilitation
practice (Terrin, 2003, Behrman 2013). But how are the chances to improve therapeutic
concepts within the demanding framework of evidenced-based medicine? Classic
approaches based on the single criterion paradigm and modern approaches based on
the multidimensional approach are discussed with examples from different fields of
neurorehabiliation.
JOHANNES C.
VESTER
Senior Consultant
Biometry and
Clinical Research
idv - Data Analysis and
Study Planning,
Germany
63
COMBINATION OF GRANULOCYTE COLONY-STIMULATING
FACTOR WITH AND BM MSC AND BM MNCS
FOR STROKE TREATMENT IN AGED RATS IS NOT SUPERIOR
TO G-CSF ALONE
Attractive therapeutic strategies to enhance post-stroke recovery of aged brains include
methods of cellular therapy that can enhance the endogenous restorative mechanisms
of the injured brain. The translational failure of experimental therapies might hence
at least partially be related to monotherapeutic approaches, not ideally addressing
potential counter-mechanisms to their full extent or within the best time window. For
example, therapeutic effect relying on stem/progenitor cell mobilization by granulocytecolony stimulating factor (G-CSF) require about a week to become manifest, which is
potentially beyond the optimal timing. Here, we tested the hypothesis that treating
post-stroke aged rats with the combination of bone marrow-derived mononuclear cells
(BM MNC) or bone marrow-derived mesenchymal cells BM MSC and G-CSF improves
the long term (56 days) functional outcome by compensating the delay before G-CSF
comes to full effect.
To this end, 1x106 syngeneic BM MSC and BM MNC per kg bodyweight (BW) in
combination with G-CSF (50µg/kg, continued for 28 days) were administered via
the jugular vein to Sprague-Dawley rats six hours post-stroke. Infarct volume was
measured by magnetic resonance imaging 3 and 48 days post-stroke and additionally
by immunhistochemistry at day 56. Functional recovery was tested during the entire
recovery period. Daily G-CSF treatment led to robust and consistent improvement of
neurological function, but did not alter final infarct volumes. The combination of G-CSF
and BM MNC, did not further improve post-stroke recovery. The lack of an additional
benefit may be due to an hitherto not well investigated interaction between both
approaches and, to a minor extent, to the insensitivity of the aged brains to regenerative
mechanisms.
Also considering recent findings on other tandem approaches involving G-CSF
in animal models featuring relevant co-morbidities, we conclude that such combination
therapies are not the optimal approach to treat the acutely injured aged brain.
64
AUREL
POPA-WAGNER
Department of
Psychiatry, University
Medicine of Rostock,
Rostock, Germany
RISK FACTORS AND SECONDARY PREVENTION
OF ISCHEMIC STROKE IN THE POPULATION OF MOLDOVA
Stroke is one of the leading causes of morbidity and mortality worldwide. In the Republic
of Moldova stroke mortality rate remains one of the leaders in Europe. Stroke incidence
rate increased from 20.4 in 2000 to 28.19 in 2008 to 100.000 population. Stroke is the
first cause of disability among adults in the Republic of Moldova, 13% of stroke patients
being of working age. Also it is the second cause of dementia and the most common
cause of epilepsy in the elderly, as well as a fairly frequent cause of depression. The
importance of the problem is determined by social and economic impact caused by
stroke.
Each year 800 persons in a population of 1 million suffer recurrent stroke (33% of all
strokes). At least 1 in 3 people who’ve had a TIA will have a stroke within 5 years. All
these are potentially avoidable by effective management of risk factors and secodary
prevention. Also recurrent strokes are more likely than initial strokes to result in disability
and death. Study rezults will permit elaboration of secondary prevention strategies with
the purpose to minimize stroke impact on the population of the Republic of Moldova.
DANIELA
EFREMOVA
Eremei Zota,
Daniela Efremova,
Chiforişina V,
Groppa. St
Neurologist at
Neurology Department
of National Scientific
Practice Center of
Medical Emergencies.
Chisinau, Moldova
Keywords: Stroke , secondary prevention, management
65
NEUROOTOLGY UPDATE
Over the last years the insight into pathophysiology and treatment of the most frequent
vestibular disorders has markedly increased. However, the diagnostic criteria are still
not standardized and prospective treatment trials are still lacking.
Peripheral vestibular disorders are the most common cause for vertigo and dizziness.
Bilateral vestibulopathy can be reliably diagnosed by the head-impulse test, caloric
irrigation, and vestibular-evoked myogenic potentials. A new frequent subtype has
been described: cerebellar ataxia, neuropathy, and vestibular areflexia syndrome.
Benign paroxysmal positioning vertigo (BPPV) can be easily diagnosed and effectively
treated. Vitamin D deficiency may be a risk factor for recurrent BPPV. Vestibular
neuritis is most likely caused by the reactivation of a herpes simplex type 1 infection;
the inferior vestibular nerve subtype is now well established. More evidence is needed
that the recovery can be improved by corticosteroids. Symptomatic treatment with
antiemetic drugs in vestibular neuritis should be given on demand and for a short time.
Endolymphatic hydrops in Menière’s disease can be depicted by high-resolution MRI
after transtympanic gadolinium injection; a high-dosage and long-term prophylactic
treatment with betahistine is evidently effective. Its mechanism of action is most likely
an increase in the inner-ear blood flow. Vestibular paroxysmia is now a well established
entity; carbamazepine is the treatment of first choice. Superior canal dehiscence
syndrome can be reliably diagnosed; the best current treatment option is canal plugging.
Central lesions can also induce vertigo, dizziness and balance disorders. An acute lesion
in the entrance zone of the vestibular nerve, the vestibular nucleus or cerebellum
may mimick peripheral lesions and can only be differentiated by an exact neuroopthalmological exam including testing for skew deviation, gaze-evoked nystagmus
and head impulse pathology. Chronic cerebellar degeneration may induce ocular motor
disorders like downbeat nystagmus (DBN) and dysfunction of posture and gait. DBN is
generally caused by a bilaterally impaired function of the cerebellar floccular lobe due
to neurodegenerative disorders. A randomized double-blind cross-over trial of 4-AP in
DBN showed a reduction in slow phase velocity of DBN by half and an improvement of
visual acuity at a dosage of 5mg 4-AP four times a day.
Vestibular migraine is the most common cause of central recurrent attacks of vertigo.
Characteristic features include recurrent attacks of various combinations of vertigo,
ataxia of stance and gait, visual disorders, and other brainstem symptoms accompanied
or followed by occipitally located head pressure, pain, nausea, or vomiting. Treatment is
the same as for migraine with aura, i.e., for prophylactic therapy the use of betablockers
(metoprolol or propranol), valproic acid or topiramate for at least six months. There is
an on-going a placebo-controlled multi-center trial (metoprolol 95 mg per day versus
placebo; the PROVEMIG- trial).
Although progress has been made in the diagnosis and treatment of most vestibular
disorders, more state-of-the-art trials are needed e.g. on the treatment of bilateral
vestibulopathy to prove the efficacy of balance training, of vestibular neuritis (in terms
of recovery of peripheral vestibular function and central compensation), of vestibular
paroxysmia to prove the effects of carbamazepine, and of Menière’s disease to find the
optimal dosage of betahistine. Recently, a European Network for Vertigo and Balance
Research, called DIZZYNET, was established to run these multicenter prospective
clinical trials.
66
ANDREAS
ZWERGAL
Department of Neurology,
German Center for Vertigo
and Balance Disorders
and Institute for Clinical
Neurosciences, University
Hospital Munich,
Germany
CURRICULUM VITAE
67
MIHAELA BACIUT
/Romania
University studies
➢
1990: Faculty of Dental Medicine, „Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca
➢
1999: Faculty of Medicine, „Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca
Postgraduate specialization
➢
Oral and maxillofacial surgery
Postgraduate training
➢
Oral Implantology, 1994
➢
Microsurgery, 1994
➢
International Cancer Management Course, 1998
➢
Competence course in maxillo-dental radiodiagnostic
➢Ultrasonography
➢
Orthognathic surgery
➢Lasertherapy
PhD degree
➢
„Value of ultrasonography in maxillofacial surgery”,
University of Medicine and Pharmacy Cluj-Napoca, 2003
Position held
➢
Professor, Department of Maxillofacial Surgery and Implantology,
Faculty of Dental Medicine, University of Medicine and Pharmacy Cluj-Napoca since 2007
Scientific and professional societies
➢
Founding member of the Romanian Society of Reconstructive Microsurgery
➢
Vicepresident of the Romanian Society of Oral and Maxillofacial Surgery (SRCOMF)
➢Member:
•
Romanian Society of Angiology and Vascular Surgery 1991
•
International Association of Oral and Maxillofacial Surgeons (IAOMS) 1994
•
European Association of Cranio-Maxillofacial Surgery (EACMFS) 1994
•
Association of Transylvanian Dermatologists 1996
•
Romanian Society of Plastic and Esthetic Surgery 2001
•
Romanian Society of Ultrasonography in Medicine and Biology 1998
•
Romanian Society of Oral Implantology and Biomaterials 2000
•
Romanian Society of Lasers in Dentistry 2003
Scientific activity
•
Scientific articles and studies - 190 papers
•
Books and textbooks - 10 books authored and coauthored
•
Papers communicated in conferences – 71 papers
68
Other professional activities
➢
Member of the Editorial Board Journal of Cranio-Maxillofacial Surgery –
the official journal of the European Association of Cranio-Maxillofacial Surgery
➢
Member of the editorial boards:
•
Dento-Medica (Sibiu, Romanian – French Dental Association,
“Victor Papilian” Faculty of Medicine 1996
•
Quo Vadis (Cluj-Napoca, Humanitarian Foundation “Hipocrate” 1997
•
Romanian Journal of Ultrasonography 1999
•
Transilvania Stomatologică 2001
Other positions held
Member in 15 scientific committees
Domains of research and interest
➢
Stem cell based regeneration
➢
Craniofacial surgery of complex congenital malformations
➢
Orthognathic surgery of facial deformities and asymmetry
➢
Oral implantology
➢Biomaterials
➢
Medical rapid prototyping and medical imaging to optimize healthcare systems
➢
Craniofacial bone reconstruction and regeneration
➢
Osteogenesis using callus distraction
➢Lasertherapy
➢
Craniofacial ultrasonography
Research projects – national and international - 22
69
OVIDIU BAJENARU
/Romania
1983
1983-1985
1985- 1989
1985
1989
1993
1994 - 1999
1999 (since)
2006:
2011
2013 ( since)
: M.D. at the Faculty of Medecine of University of Medecine and Pharmacy
“Carol Davila” Bucharest
: post graduate hospital stagium in University Hospital of Emergency Bucharest
: resident of neurology
: assistant professor – University of Medicine and Pharmacy “Carol Davila”
Bucharest- Department of Neurology of the University Hospital of Emergency Bucharest
: specialist in neurology, confirmed by the Ministery of Health of Romania
: Ph.D. at the University of Medecine and Pharmacy “Carol Davila” Bucharest
- senior lecturer of neurology
- Head of Department and Medical Chief (University Hospital of Emergency, Bucharest
: Associate Professor of Neurology
: Professor of Neurology at the University of Medicine and Pharmacy
” Carol Davila” Bucharest and Chairman of the Neurology Department of the
University Hospital of Emergency Bucharest
: Doctor Honoris Causa - University „Ovidius” – Constanta ( Romania )
: Director of Department of Clinical Neurosciences - University of Medicine and
Pharmacy ” Carol Davila” Bucharest
: Corresponding member of the Romanian Academy of Medical Sciences
Other professional activities :
2000-2004 2001-2013
2013(since)
2003-2009
2005-2009
2011 (since)
: Vice-Dean of the Faculty of Medecine - University of Medecine and Pharmacy
“ Carol Davila” Bucharest
: President(founder) of the Romanian Society of Neurology
: Honorary President ad vitam of the Romanian Society of Neurology
: member of the Scientific Committee of ECTRIMS
: member of the Executive Committee of the European Society of Neurology
: member of the National Committee of Habilitation of the Romanian Ministery
of Education for PhD accreditation and high academic degrees
Post graduate training :
1992 - 1994
1996
1997
2009, 2011 70
: post graduate training in clinical neurology and functional investigations of the nervous system at University “ Rene Descartes”(Paris) : C.H.U. Sainte-Anne (Neurology) and C.H.U. Cochin – Port Royal (Functional Investigations of the Nervous System) and training in neuroendocrinology
: second medical competence (confirmed by the Ministery of Health of Romania) in “Diagnosis in Neurological Diseases by MRI”.
: assistant of clinical research in pharmaco-clinical trials (Paris)
: International training for methodology in clinical research
Fields of interest for the scientific research
•
dementia and neurodegenerative diseases ( in particular Parkinson’s disease )
•
multiple sclerosis
•
stroke
•
experimental and clinical study of sleep disturbances in the neurological and neuroendocrinologic
diseases
-
more than 450 scientific papers published and reported in different national and international
scientific meetings
•
ISI Web of Science: h-index : 8
-
5 medical books and monographies ( published in Romania )
-
co-author ( 1 chapter ) to the “International Neurology - A Clinical Approach”
( eds. ROBERT P. LISAK, DANIEL D. TRUONG, WILLIAM CARROLL, ROONGROJ BHIDAYASIRI ),
Wiley-Blackwell , 2009
-
Country Principal Investigator – in more than 20 international, multicentric clinical trials
-
Principal Investigator of the research site – in more than 30 international and
national multicentic trials
-
Member of the Steering Committee of PRECISE trial
Other activities:
- coordinator of the Continuous Medical Education ( EMC ) national program of the Romanian Society of Neurology for neurologists in Romania
- coordinator and author of the Guidelines for diagnosis and treatment of neurological diseases ( agreed
by the College of Medecins of Romania )→main author of the national guidelines for Parkinson’s disease,
Multiple Sclerosis and Dementia
- coordinator of the National Program of the National House of Insurance and Ministery of Health, for treatment of patients with neurological diseases (2000 - 2015)
- coordinator of the first medical team in Romania for DBS in Parkinson’s disease.
- chief-editor of Romanian Journal of Neurology ( the official journal of the Romanian Society of Neurology )
Scientific affiliation :
•
Romanian Society of Neurology ( Honoray President ad vitam)
•
UEMS – European Board of Neurology ( Secretary General – elected in 2010 )
•
European Neurological Society ( ENS ) – member of the Executive Committee between 2005 – 2009
•
European Stroke Organization
•
European Federation of Neurological Societies (EFNS) and European Academy of Neurolgy (since 2014)
•
American Academy of Neurology ( cooresponding member )
•
Danube Neurological Association ( Vice-Secretary General – elected in 2011 )
•
ECTRIMS ( member of the Scientific Council 2003-2009 )
•
New York Academy of Sciences
•
American Academy for Advancement in Science
•
Movement Disorders Society
•
Romanian Association for the Study of Pain
•
Romanian Society for the Study of Neuroplasticity (founder president of honour)
2005, 2006, 2010, 2011: awarded by the Prize of Excelence in Neurology for the scientific activity in Romania
( decided by a National Jury organized by the Health Chamber of the Romanian Parliament )
2008: awarded by the Romanian Society of Internal Medicine for the best scientific activity in a related medical
speciality
2014: awarded by the International Brain Foundation and Romanian Academy of Medical Sciences, for excellency in the development of management of patients with multiple sclerosis in Romania
Investigator in an International Program of Research for genetic factors in stroke patients; Country Principal Investigator – in more than 30 international, multicentric clinical trials; Principal Investigator of the research site – in more than 30 international and national multicentic trials
71
LEONTINO BATTISTIN
/Italy
Graduated in Medicine at the University of Padova Medical School in 1963; Specialist in Neurology in 1967.
During the years 1967-1970 he was Research Fellow at the Institute for Neurochemistry, Columbia University,
New York, USA.
Full Professor of Neurology from 1980 and then Director of the Department of Neurosciences of the Medical
School of the University of Padova from 1989 to 2009. He is the Scientific Director of the Research Hospital for
Neurorehabilitation, IRCCS San Camillo, Venice, from 2005.
He has been member of the Executive Council of the Italian Society of Neurology and the President of the Italian Society for Parkinson’s Disease; he is member of the Executive Committee on Extrapiramidal Disorders and
of the one on Dementia of the World Federation of Neurology and Chairman of the Research Group for Organization and Delivery of Neurological Services; he has been Vice-President for Europe of the World Federation of
Neurology during the years 2001-2005, and he is the President of the European Society for Clinical Neuropharmacology during the years 2000-2008; he is a member of numerous International Scientific Societies, and Fellow of the American Academy of Neurology. He is also a member of the Editorial Board of international journals
of neuroscience and clinical neurology.
He has organized various International Symposia on specific themes of neuroscience; he was also the President
of the 11th World Congress on Parkinson’s Disease that was held for the first time in Italy in 1994.
He has published more than 250 papers in various international and national journals and edited ten volumes on
specific arguments of neurology; his main scientific interests have always been cerebral metabolism and function expecially in degenerative diseases of the nervous system, like Parkinson’s and Alzheimer’s disease, as well
as in cerebrovascular diseases and in neurorehabilitation.
72
HEINRICH BINDER
/Austria
EDUCATION:
1965 - 1972
Faculty of Medicine at the University Vienna
MD since (promotion on) 1972, June 6th
1972 - 1978
University Hospital for Neurology,
graduated in Medical Specialist for Neurology and Psychiatry
9/1982
Docent for neurology, a title corresponding to PhD
since 1988 Professor for Neurology, University Vienna
founding member of the Austrian Society for
Neurorehabilitation
5/1989
Head of the Neurological Hospital
“Maria Theresien-Schlössel”
1994-2007
Head of Ludwig Boltzmann Insitute for Restorative Neurology and Neuromodulation
Since 2008
Deputy Head of Landsteiner Institute for
Neurorehabilitation and Space Medicine
since 2002
Head of the Neurological Center, Otto Wagner Hospital,
Vienna.
Main focus: Patients with severe neurological/
neuropsychological deficits and invasive neurorehabilitation methods
currently
President of
•
Austrian Society for Neurorehabilitation (OEGNR)
•
European Federation NeuroRehabilitation Societies (EFNRS)
Member of
•
Management Committee of the World Federation NeuroRehabilitation (WFNR)
•
Managing Board of the International Danube Symposium
•
Editorial Board of ”Journal of Medicine and Life”:
Chairman of
•
Special Interest Group/WFNR “Spinal Cord Injury”
•
Special Interest Group/WFNR “Early Rehabilitation”
•
Scientific panel/EFNS “Brain recovery and Rehabilitation”
•
Special Branch / International Danube Symposium: “NeuroRehabilitation”
Main topic of research: Neurorehabilitation, brain injury, spinal cord injury, vegetative state/ apallic syndrome
(more than 140 publications)
73
DANA BOERING
/Germany
Education:
1. Secondary School I. Slavici Arad, Romania
2. Medical School: Facultatea de medicina si Farmacie I.M.F. Cluj- Napoca, Romania
Academical qualifications:
1. Dr. medic : I.M.F. Cluj Napoca 1981
2. German acknowledgement as Dr. med. 1987
3. Specialty qualification: Neurologist 1994
4. Further specialty qualification: Neurorehabilitationist 2001, Neurophysiologist 2002
Employment:
St. Mauritius Therapieklinik Meerbusch since 2002
Professional appointments, scientifical activities:
1994-2002 Collaboration with the University of Essen in the field of plasticity after stroke, with an emphasis
on the role of theerebellum in motoric learning tasks
Since 2002 Collaboration with the University of Düsseldorf in the field of plasticity after stroke
2009 Collaboration with the Coma Science Group Liege/Belgium
2010 Collaboration with the Neuroradiology of the Wake University Winson- Salem U.S.A. in a study on network properties of DOC patients
74
ANCA BUZOIANU
/Romania
Anca Dana Buzoianu, MD, PhD, is Professor of Clinical Pharmacology, Senior Clinical Pharmacologist, Senior
Pediatrician, Dean of the Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu” ClujNapoca, President of the Romanian Association of the Medical School’s Deans, General Executive Secretary of
the Romanian Society for Pharmacology, Therapeutics and Clinical Toxicology. She is also member of 8 scientific
international Societies, and 4 national one.
Postgraduate specialization. Professor Anca Buzoianu is senior clinical pharmacologist and also senior
pediatrician. She is the Head of the Department of Pharmacology at Medical Faculty of Cluj, and the leader
of a dynamic research team of the department, and member of the Neuroscience Research Center of the
Iuliu Hatieganu University of Cluj-Napoca. Professor Anca Buzoianu and her colleagues are actually involved
in Pharmacogenetics studies regarding the metabolizing status of some drugs such the oral anticoagulants,
antiepileptic drugs, biologic products etc. Other research themes are the therapeutic approach of multiple
sclerosis and stroke, pharmacogenetics of the drugs used in dermatological diseases, the effects of some new
compounds in pain and inflammation etc. Professor Buzoianu has conducted 8 national grants, 1 international
educational project and participated in the research team in another 16 research projects.
Professor Buzoianu has a valuable expertise in Academic Leadership and Management, also in the Management
of the Health Care System (Master in the Health Care Management 2009), and in the Quality Assurance
evaluation process, being evaluator for the Higher Education for several years. She is President of the Clinical
Pharmacology and Toxicology Committee of the Romanian Health Ministry, President of the Pharmacology
Committee of the Romanian Physician College, member of the Institutional Evaluation Committee of the
Romanian Agency for Quality Assurance in Higher Education.
Scientific and professional societies
•
CIDMEF – Conference Internationale de Doyens et de Facultes de Medicine d’Expresion Francaise - member de Bureau Permanent,
•
European Association of Clinical Pharmacology and Therapeutics,
•
International Association for Medical Education,
•
International Association of Medical School,
•
The Society for the Study of Neuroprotection and Neuroplasticity
•
European College of Neuropsychopharmacology
•
International Advisory Board - European Society of Clinical Neuropharmacology
•
Balkan Medical Union.
•
Romanian Association of the Medical Faculties Deans - president
•
General Executive Secretary of the Romanian Society for Pharmacology, Therapeutics and Clinical Toxicology
•
Romanian Association for the Study of Pain
•
Romanian Society of Addiction and Pharmacovigilence,
Scientific activity
• Articles and studies - 80 papers indexed ISI and in other international data bases
• Books and chapter in books - 12
75
Prizes
Professor Anca Dana Buzoianu has been honored with the “Victor Papilian” prize of the Cluj Medical Faculty in
2006 for her first volume of “Pharmacology” textbook. In 2007 she received the great “Iuliu Hatieganu” Award
for her contribution to the development of a novel domain of academic learning in the frame of the Doctoral
School.
In 2011 Professor Anca Dana Buzoianu has received the honorary medal of the National Council of the Physicians
of the National Order of Doctors de France
In 2012 Professor Buzoianu Anca has been honored with the Excellence Award for Academic Management “Dean of the year” with the occasion of the “Health Gala” - offered by the Romanian Ministry of Education and
Health Ministry
In 2013 she won again the great Prize “Iuliu Hatieganu” of the University of Medicine and Pharmacy for her
contribution for the obtaining of the quality certificate “Label CIDMEF” by the Medical Faculty of Cluj-Napoca.
76
LACRAMIOARA PERJU-DUMBRAVA
/Romania
Lăcrămioara Perju-Dumbravă, MD, PhD is Professor of Neurology within the Neurosciences Department,
Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, Chairman of the First
Neurology University Clinic, Cluj-Napoca, Romania. Her academic status includes her position as member of
the Board of the Faculty of Medicine and of the University’s Senate, as well as Doctorate coordinator in the field
of MEDICINE. Her prestigious activity includes: publishing of 3 monographs, co-authorship in other 7 speciality
books, 192 scientific papers published in medical journals, chairman and speaker at annual national congresses
and conferences, international conferences and membership in editing committees and professional societies,
involvement in several clinical studies, her expertise being sought by national medical councils and committees.
77
MICHAEL CHOPP
/USA
Michael Chopp, PhD, joined the Henry Ford Health System in Detroit in 1983. He was appointed Vice Chairman
for Research of the Department of Neurology in 1991, Scientific Director of the Henry Ford Neuroscience
Institute in 1999, and is the Zoltan J. Kovacs Chair in Neuroscience Research. Dr. Chopp is also Distinguished
Professor of Physics at Oakland University in Rochester, MI.
He received his MS and doctorate degrees in Mathematical and Solid State Physics from New York University.
After nearly 10 years of working as a Physicist and as a Professor of Physics, Dr. Chopp made a career change
and turned his interest to translational research in neuroscience Dr. Chopp’s research has primarily focused
on: 1) cellular and molecular biology of ischemic cell injury, 2) the pathophysiology of stroke, traumatic brain
injury, peripheral neuropathy, multiple sclerosis, and glioma, 3) combination thrombolytic and neuro and
vascular protective therapies for stroke, 4) mechanisms of neuroprotection, 5) cell-based and pharmacological
neuro-restorative therapies for stroke, traumatic brain injury and neurodegenerative disease, 6) molecular and
cellular mechanisms underlying neurogenesis and angiogenesis and the induction of brain plasticity leading
to functional and behavioral recovery after neural injury, 7) treatment of glioma, 8) exosomes/ microRNA for
treatment of neurological injury and disease, and 9) magnetic resonance imaging. Dr. Chopp has over 600 peer
reviewed publications and has given 397 plenary lectures and invited presentations. He has chaired National
Institutes of Health (NIH) study sections and has often served as a consultant to government agencies, the U.S.
National Institutes of Health, and the pharmaceutical industry.
78
DANIELA EFREMOVA
/Republic of Moldova
II.
Education: currently working as a neurologist in training (post graduate scholarship)
Institution:
State University of Medicine and Pharmacy “Nicolae Testemitanu”
of the Republic of Moldova, Department of Neurology
Date: from(month/year): November, 2012
to (month/year): Ongoing
Degree(s) or Diploma(s): Post graduate studies in neurology (Speciality: Neurologist)
Language of the Program:Romanian
Institution:
Date: from(month/year):
to (month/year):
State University of Medicine and Pharmacy “Nicolae Testemitanu”
of the Republic of Moldova, General Medicine Faculty
September, 2006
June, 2012
Degree(s) or Diploma(s): Medical Doctor. Speciality: General Medicine.
Final grade at the State examinations: 97.2%.
Language of the Program:Romanian
Institution:
Date: from(month/year):
To (month/year):
Degree(s) or Diploma(s):
Language(s) of subjects:
School no.°62 (currently Lyceum “Minerva”)
September, 1995
June, 2006
Graduation certificate, with grade: 95%
Romanian, English, Russian, German
III.Internships:
30 March- 24 April, 2015. Observership in Neurology. Salzburg, Austria.
July, 2010
Exchange of Experience in Iasi, Romania. Subject matter: Obstetrics,
Genecology and Surgery
IV.
Language Proficiency:
Englishexcellent
Russian, Romanian native speaker
Germanbeginner level
V.
Professional Record:
February, 2010- August, 2014
Medical assistant by plurality of offices at Theoretic Evening Lyceum no.°1, Chisinau Municipality,
(Republic of Moldova)
VI.
2015
2014
Publications / written works:
Neuromyelitis optica - a case report.
Archives of the Balkan Medical Union. 04/2014Chisinau, 49(1): 143-146. ISSN 0041-6940.
79
2014
Modern aspects on the problem of acute pain and strategies for its treatment. Archives of the Balkan Medical Union. 04/2014Chisinau, 49(1):51-56. ISSN 0041-6940.
2012
“Clinical Morphopathological Diagnostics and Treatment Issues of Trophoblast Tumours”
(“Scientific Annals of the State University of Medicine and Pharmacy “Nicolae Testemitanu”
of the Republic of Moldova”, Vol. 4, 2012 [Ed. XIII])
2012
“The Algorithm of Application of the Method of Tissue Expansion in Plastic Surgery of PostCombustion and Post-Traumatic Sequelae” (“Scientific Annals of the State University of
Medicine and Pharmacy “Nicolae Testemitanu” of the Republic of Moldova”,
Vol. 4, 2012 [Ed. XIII])
2011
“Bioethical Aspects of Abortion” (“Scientific Annals of the State University of Medicine and
Pharmacy “Nicolae Testemitanu” of the Republic of Moldova”, Vol. 2, 2011 [Ed. XII])
2009
“Ovarian Cancer” (“Scientific Annals of the State University of Medicine and Pharmacy
“Nicolae Testemitanu” of the Republic of Moldova”, Vol. 1, 2009 [Ed. X])
VII.
Other diplomas, certificates, distinctions:
2012
Participant’s Diploma at the National Congress of Young Doctors and Students
(Bucharest, Romania)
2011
Participant’s Diploma at the Annual University Conference by the State University of
Medicine and Pharmacy “Nicolae Testemitanu” of the Republic of Moldova
2011
Participant’s Diploma at the National Congress of Young Doctors and Students
(Bucharest, Romania)
2010
Volunteer’s Certificate. Project by the State University of Medicine and Pharmacy
“Nicolae Testemitanu” of the Republic of Moldova: Healthy Way of Life
2009
Participant’s Diploma at the Annual University Conference by the State University of
Medicine and Pharmacy “Nicolae Testemitanu” of the Republic of Moldova
X.
Seminars, conferences attended:
28-29 November, 2014. Teaching Course on Movement Disorders. Chisinau, Republic of Moldova.
11-13 June 2014. Еst-European Course of Epilepsy - Cheile Gradistei, România.
2-8 March, 2014. Salzburg Weill Cornell Seminar in Neurology. Salzburg, Austria.
September, 2013. Balkan Medical Union’s Congress Chisinau, Republic of Moldova.
80
MIHAIL GAVRILIUC
/Republic of Moldova
1987-1991
: Neurologist at the Republican Clinical Hospital, Chisinau
1991-1996
: Assistant professor of the Department of Neurology and Neurosurgery at the State University of Medicine and Pharmacy “Nicolae Testemitanu” Chisinau
1996-2001
: Docent of the Department of Neurology and Neurosurgery at the State University of Medicine and Pharmacy “Nicolae Testemitanu” Chisinau
2001-2010
: Deputy Director of the Institute of Neurology and Neurosurgery, Chisinau
2010 (since)
: Professor of Neurology, Chairman of the Neurology Department at the State University of Medicine and Pharmacy “Nicolae Testemitanu” Chisinau
2010-2012
: Dean of the Faculty of Medicine 2 - State University of Medicine and Pharmacy “Nicolae Testemitanu” Chisinau
2012 (since)
: Vice-rector for International Relations - State University of Medicine and Pharmacy “Nicolae Testemitanu” Chisinau
Fields of special interests: ischemic tolerance of the nervous system, vascular cerebral and spinal cord diseases,
and encephalitis.
81
VOLODYMYR GOLYK
/Ukraine
Education
September 1, 1988 – June 24, 1994 Dnipropetrovs’k Medical Institute c. Dnipropetrovs’k, Ukraine.
Medical Doctor, Honors Diploma, Specialty- general medicine.
Residency:
August 1, 1994 – June 28, 1996 Dnipropetrovs’k State Medical Academy, Neurology & Neurosurgery Department,
Dnipropetrovs’k, Ukraine.
Doctor – specialist, Specialty – neurology
Clinical fellowship:
September 1, 1996 – August 31, 1998
Dnipropetrovs’k State Medical Academy, Neurology & Neurosurgery Department, Dnipropetrovs’k,
Ukraine.
Cerebrovascular neurology
PhD program – Neurology
April 1999-May 2003,
Kharkiv Medical Academy of Postgraduate education
Ph.D., Speciality – Neurology
Internship – Neurology (Alberto Vilar Internship)
March 02-24, 2004
Christian Doppler Landeskliniken Neurology, Salzburg, Austria
Training – Expert Spasticity Management training course
July 19-20, 2010,
University Hospital of North Staffordshire, North Staffordshire Rehabilitation Centre,
Stoke on Trent, UK
Training – Update on Management of Vertigo and Vestibular Disorders
May 19-20, 2011
University of Provence, Marseille, France
Training – Vestibular Disorders and Vertigo Treatment Masterclass
June 16, 2012
Maastricht University Medical Centre, Maastricht, Netherlands
Publications 210 scientific publications
Professional Affiliation
Member,
European Neurological Society (1999),
Movement Disorders Society (2007)
Ukrainian Anti-Stroke Association (2007),
Regional Society of Clinical Neurology, Dnipropetrovs’k Region, Ukraine.
82
DIRK M. HERMANN
/Germany
Carrier formation
Since 2008
2011
2008
2002-2007
2007
2002 2001
1998-2001
1995-1998 1995
1995
1994-1995 1993
1990/1991
since 1990
1987-1994
1987
1980-1987
1974-1980
Full professor of Neurology, University Hospital Essen, Germany
Geriatrics board, Bezirksärztekammer Nordrhein
Pain therapy board, Bezirksärztekammer Nordrhein
Associate professor, Department of Neurology, University Hospital Zurich,
Switzerland (Prof. Dr. C. Bassetti)
Sleep medicine board, Bezirksärztekammer Südwürttemberg
State doctorate, University of Tübingen, Germany
Neurology board, Bezirksärztekammer Südwürttemberg
Resident, Department of Neurology, University of Tübingen,
Germany (Prof. Dr. J. Dichgans)
Research associate, Max Planck Institute (MPI) for Neurological
Research, Cologne, Germany (Prof. Dr. K.-A. Hossmann)
Approbation” (medical licensure)
M.D. University of Gießen, Germany: ‘Afferent and efferent
projections of raphe magnus and pallidus nuclei’ at Physiological
Institute, University of Gießen, Germany
“Arzt im Praktikum”/ resident, Max-Planck-Institute of
Psychiatry, Munich, Germany (Prof. Dr. Dr. F. Holsboer)
Practical year
MD thesis studies Department of Expt. Medicine, Lyon,
France (Prof. Dr. M. Jouvet)
Fellow of “Studienstiftung des Deutschen Volkes”
Studies of Human Medicine at University of Gießen, Germany
“Abitur” (German high school diploma: Grade 1,0)
High School: Justus-Liebig-Schule Gießen, Germany
Elementary School: Ludwig-Uhland-Schule Gießen, Germany
83
WOLF DIETER HEISS
/Austria
Wolf-Dieter Heiss, born 31.12.1939 in Zell am See, Austria, graduated in medicine from the University of Vienna,
Austria, in 1965. He achieved his training in neurology, neurophysiology, psychiatry and nuclear medicine at
the University hospital in Vienna and spent research fellowships at the MIT, Cambridge, USA, the Physiological
Institute in Stockholm, Sweden, the Department of Physiology of SUNY, Buffalo, NY and the Department
of Neurology of the University of Minnesota, Minneapolis, USA. 1976 he was appointed associate professor
at the Department of Neurology of the University of Vienna. In 1978 he became director of the Center for
Cerebrovascular Research of the Max Planck Institute for Brain Research and of the Department of Neurology
of the City Hospital Cologne-Merheim, Germany. 1981 he was appointed as director at the Max Planck Institute
for Neurological Research. 1985 – 2005 he was professor of neurology and chairman of the Department of
Neurology of the University of Cologne and director of the Department of General Neurology at the MPI in
Cologne. He was president of the International Stroke Society 1992-96, was on the board of directors of the
Society for Cerebral Blood Flow and Metabolism, deputy editor of the Journal of Cerebral Blood Flow and
Metabolism and at present is associate editor of the Journal of Nuclear Medicine and section editor of Stroke.
He was chairman of the program committee of the European Federation of Neurological Societies (EFNS) 1998 2001 and was president of the EFNS 2001 – 2005. Since 2005 he is Visiting Professor at the Danube University
in Krems, Austria, and since 2009 Adjunct Professor at the McGill University in Montreal, Canada.
His significant portfolio of scientific articles includes 617 papers indexed on Web of Knowledge-ISI, rating a
Hirsch index of 63.
In 2013 he became Associated Professor of the Department of Neurosciences, Faculty of Medicine, University
of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, Romania.
84
VOLKER HÖMBERG
/Germany
MEDICAL DIRECTOR
St. Mauritius Therapy Hospital Meerbusch
PERSONAL DATA
Born 25 July 1954
Married to Priv.-Doz. Dr. Kristina Müller, paediatric neurologist
MEDICAL CAREER
1973 - 1980 School, Universities of Düsseldorf and Freiburg; Elective in Neurology at
Boston City Hospital, Boston, Mass.; National Hospital
for Nervous Diseases, London
since 1975
Junior researcher in the Department of Neuropsychology at the
C. & O. Vogt Institute for Brain Research, Düsseldorf and the Department of Neurology, Freiburg (Prof. R. Jung)
1980 - 1981 Research fellow in the Department of Neuropsychology (Prof. G.
Grünewald) at the C. & O. Vogt Institute for Brain Research,
Düsseldorf
since 1981 Clinical training in the Department of Neurology (Prof. H.-J. Freund),
Heinrich- Heine-University Düsseldorf
since 1985 Senior registrar in the Department of Neurology, Heinrich-HeineUniversity Düsseldorf
since 1987 Senior investigator for the German Research Council Special Task
Force in Neurology at Heinrich-Heine-University
(SFB 200 and SFB 194)
1987-2005 Medical director of the Neurological Therapy Center (NTC),
Heinrich-Heine-University Düsseldorf
since 1988 Board examiner for Neurology at the local examination board
(Ärztekammer Nordrhein)
1989-1997 Vice president of the German Society for Neurological Rehabilitation
1993 Habilitation in Neurology, Heinrich-Heine-University Düsseldorf
since 1995 Board examiner for physical medicine and rehabilitation
(Ärztekammer Nordrhein)
1997-2005 Medical director of the Neurological Therapy Center, Cologne
1998-2004
President of the German Society for Neurological Rehabilitation
since 2000
Medical director and head of neurology, St. Mauritius Therapy
Hospital, Meerbusch
since 2003 Secretary General World Federation for NeuroRehabilitation (WFNR)
since 10/2004 Vice president of the German Society for Neurological Rehabilitation
since 2005 Panel-Chairman Neurorehabilitation for European Federation
Neurological Societies (EFNS)
85
PETER JENNER
/UK
Date of Birth:
6th July 1946
Place of Birth:
Gravesend, Kent
Education:
1956-1964Gravesend Grammar School
1964-1972
Chelsea College, University of London
Degrees and Diplomas:
1964-1967:
1967-1970:
1972:
1987:
1994:
2005:
2006:
2008:
2011:
B. Pharm(Hons) 2:1, Chelsea College, University of London
Ph.D., Chelsea College, University of London
Membership of the Royal Pharmaceutical Society of Great Britain
D.Sc., University of London
Fellow of the Royal Pharmaceutical Society of Great Britain
Fellow of the British Pharmacological Society
Fellow of King’s College London
Emeritus Professor of Pharmacology, King’s College London
Fellow of the Royal Society of Medicine
Honours and Achievements:
- Elected Fellow of the British Pharmacological Society
- Elected Fellow of King’s College London
- ISI Most Cited Author in Neuroscience – Ranked in top 0.5% of all neuroscience authors in the world
- Scientific Impact – Hirsch Index 72 (Admission to National Academy of Sciences USA average 52)
- Winner THES Spinout of the Year 2005 – National Award for the most successful company formed in academia
- Rated in Top Ten Entrepreneurial Academics in the UK – THES/Independent
- National Parkinson’s Foundation Centre of Excellence for ‘gold standard’ research excellence in Parkinson’s
disease 2005
- International Movement Disorder Society – Extraordinary Contribution to Movement Disorders (Honorary
Membership)
Appointments:
1970-1972
1972-1978
1978-1985
1983-1985
1985-1989
86
Postdoctoral Fellow in the Department of Pharmacy, Chelsea College, University of London
Lecturer in Biochemistry, University Department of Neurology, Institute of Psychiatry
Senior Lecturer in the above Department
Honorary Senior Lecturer, King’s College Hospital Medical School
Reader in Neurochemical Pharmacology, University Department of Neurology, Institute of Psychiatry and King’s College Hospital
Medical School
1988-2000
1989-1998
1993-
1998-2004
2005
2005-2010
2008
Honorary Senior Lecturer, Institute of Neurology
Professor of Pharmacology and Head of Department, King’s College London
Director, Neurodegenerative Diseases Research Centre, King’s College London
Head of Division of Pharmacology and Therapeutics, Guy’s, King’s and St. Thomas’ School of Biomedical Sciences, King’s College London
Professor of Pharmacology, Guy’s, King’s and St. Thomas’ School of Biomedical Sciences, King’s College London
Director of Proximagen Ltd
Emeritus Professor of Pharmacology, King’s College London
Editorial Boards:
Journal of Pharmacy and Pharmacology
Polish Journal of Pharmacology
Journal of Neural Transmission (Handling Editor)
Neuropharmacology (Handling Editor 2002 - )
Synapse (European Editor 1990 - )
International Review of Neurobiology (Series Editor)
Past Activities:
Director, Parkinson’s Disease Society Experimental Research Laboratories (1988-1999)
Elected Member of Council, Parkinson’s Disease Society (1993-1999)
Member of Medical Advisory Panel, Parkinson’s Disease Society (1993-1999)
Member of Biochemical Society - Molecular and Cellular Pharmacology Group Committee (until 2000)
President of Watford Branch of Parkinson’s Disease Society 2000
Secretary of Basal Ganglia Club
Member of Board of Management, Institute of Epileptology, King’s College London
Member of Medical Advisory Board of Bachman-Strauss Foundation, New York 2000-2005
Journal of Neurochemistry (Handling Editor 1998-2008)
Vice-President of European Society for Clinical Pharmacology 2001-2008
Current Activities:
Consultant to the Pharmaceutical Industry
Referee for research grant applications from:
Royal Pharmaceutical Society
Medical Research Council
Wellcome Trust
Parkinson’s Disease Society
INSERM, France
87
AMOS KORCZYN
/Israel
Professor Korczyn graduated from the Hebrew University – Hadassah Medical School in Jerusalem in 1966
(MD), where he also received an MSc degree in pharmacology (cum laude) in 1966. He trained in neurology
at Beilinson Hospital and at the National Hospital for Nervous Diseases, Queen Square, London. He was the
Chairman of the Department of Neurology at the Tel-Aviv Medical Center since 1981 until 2002, and the
incumbent of the Sieratzki Chair of Neurology at Tel-Aviv University, 1995-2010. Professor Korczyn has a
particular interest in neurodegenerative diseases. He has authored or co-authored over 600 articles in peerreviewed journals, as well as chapters in books, etc. He edited several books and Special Issues in Journals,
and is co-Editor of the Journal of the Israeli Neurological Association (JINA) since 2009. He is or has been an
Editorial Board member of 20 international journals, and organized several neurological conferences, mainly
in the field of dementia, Parkinson’s disease and other degenerative brain disorders, as well as CONy – the
International Congress on Controversies in Neurology. Professor Korczyn also served on advisory boards in
several drug discovery programs.
Professor Korczyn is the Chairman of the Scientific Administrative Board of the Israeli Alzheimer’s disease
association (EMDA), and member of the SAB of Alzheimer Disease International, and has been the chairman of
the WFN Research Committee for Neuropharmacology.
Professor Korczyn is an honorary member of the neurological societies of Israel, Serbia, Poland and Russia.
Professor Korczyn’s H-index is 39.
88
VITALIE LISNIC
/Republic of Moldova
Dr. Vitalie Lisnic is a Professor of Neurology at Department of Neurology of the State University of Medicine
and Pharmacy „Nicolae Testemitanu”, Chisinau, Republic of Moldova. He is a consultant in the Department of
Vertebroneurology and Neuropathies, responsible for electromyographic examinations at the Institute of Neurology and Neurosurgery in Chisinau.
Dr. Lisnic graduated the Faculty of General Medicine of the Chisinau State Medical Institute in 1989. He passed
internships in Neurology and Neurophysiology in Moscow (Russian Federation) in 1993, Charles University,
Pilsen (Czech Republic) in 1994, Landesnervenklinik of Salzburg (Austria) in 1999, Emory University, Atlanta
(USA) in 2002 and 2003, Vienna University (Austria) in 2008. In 2003 obtained a clinical attachment in neuropathies at the National Institute of Neurology, Queen’s Square, London, UK. In 2003-2004 he was the Principal Investigator of the Moldovan team of the grant of the Moldovan Research and Development Association
and U.S. Civilian Research and Development Foundation.
Dr. Lisnic other important responsibilities include the following:
•
President of the Moldovan Neurological Association
•
Member of the Education Committee of the European Academy of Neurology
•
Delegate of the Republic of Moldova in World Federation of Neurology and
European Academy of Neurology
•
Member of the American Academy of Neurology
•
Member of Movement Disorders Society
•
Member of editorial board of 2 Moldovan and one Ukrainian medical journals
Dr. Vitalie Lisnic is the author of more than 150 scientific publications in Moldovan and International biomedical
journals. Under his guidance were defended 4 Ph.D theses.
89
ALBERT LUDOLPH
/Germany
Professional Experience:
1979 - 1984
Resident, Board Neurology and Psychiatry (Department of Neurology and Psychiatry, University of Münster FRG)
(Prof. G. Brune, Prof. R. Tölle)
1984 - 1985
Stipend, Deutsche Forschungsgemeinschaft: Institute of Neurotoxicology, Albert Einstein College of Medicine, Bronx, New York (Prof. P.S. Spencer, Prof. H.H. Schaumburg)
1985 - 1989
Staff, Department of Neurology, University of Münster
(Prof. G. Brune)
1987
Habilitation, Faculty of Medicine, University of Münster, C2 Professor of Neurology
1990 - 1992
Staff Scientist, Visiting Assoc. Prof., Center for Research on Occupational and
Environmental Toxicology, Portland (Oregon)
1992
Staff, Department of Epileptology, University of Bonn
(Prof. C.E. Elger)
1993 - 1996
C3 Professor of Neurology, Vice Chairman, Department of Neurology,
Humboldt University Berlin (Prof. K.-M. Einhäupl)
1996
C4 Professor of Neurology, Chair, Department of Neurology, University of Ulm
2003 -
Chair (elected) Academic Neuroscience Center, University of Ulm
2005 – 2009 Deputy Chair and Chair (elected), European ALS-MND-Group
2008 - Chair, Scientific Council of Deutsche Stiftung Querschnittlähmung (DSQ)
2008 - 2012
Chair Scientific Council Deutsche Gesellschaft für Muskelkranke
2009 – Chair (elected), World Federation of Neurology, ALS Research Group
2009 – Member of the Fachkollegium Neurowissenschaften der deutschen
Forschungsgemeinschft (DFG) (elected)
2010 – Vice Dean oft the Medical Faculty oft the University of Ulm
2014 - Board, Scientific Board Stifterverband für die Wissenschaften
Chair (reelected), World Federation of Neurology ALS Research Group
2014 -
Delegate of the German Society of Neurology to the World Federation of Neurology
90
TUDOR LUPESCU
/Romania
Tudor Lupescu obtained his medical degree from “Carol Davila” University of Medicine in Bucharest, in 1989.
After 3 years of training at Colentina Clinical Hospital he became Specialist in Neurology in 1994. Since 2006 he
is running the Neurology Department al Agrippa Ionescu Hospital in Bucharest. 1998, he qualified as Consultant
Neurologist. Since his early years of training in Neurology, Tudor Lupescu has shown a special interest in Clinical
Neurophysiology. In 2000 he earned a Competence in Clinical Neurophysiology (EEG, EMG, and Evoked Potentials). 1997 he was the first to use Transcranial Magnetic Stimulation in Romania. This was also the subject of
his PhD thesis presented in 2005. Since 2008, Tudor Lupescu is President of ASNER – Romanian Society of
Electrodiagnostic Neurophysiology. He is also founding member and vicepresident of the the Romanian Society
of Diabetic Neuropathy.
Dr Tudor Lupescu is associate member of the American Academy of Neurology, and associate member
of the American Association of Neuromuscular and Electrodiagnostic Medicine. Between 2008 and 2013 he was
also member of the Neurophysiology Subcommittee of ENS.
91
ION VASILE MOLDOVANU
/Republic of Moldova
Ion Vasile Moldovanu, Republic of Moldova (RM) citizen, MD, PhD., Professor of Neurology, specialist in chronic
pain (especially primary and secondary headaches), autonomic nervous system and movement disorders.
He holds a PhD-1 and PhD-2 thesis in Neurology from Medical Institute “I. M. Secenov”, Moscow (Russia) in
1983 and 1991 respectively. He became Professor in 1996.
For many years professor Moldovanu develops the concept of the Functional Neurology using different models
of functional and organic neurological pathologies. Currently he is concerned with the study of the phenomenon of consciousness and altered states of consciousness (in collaboration with specialists in the field of
physiology, biophysics and quantum physics) in order to develop a novel therapeutic non-pharmacological approach by means of neurostimulation techniques.
Professor Ion Moldovanu is currently working in the Neurology Department of Medical and Pharmaceutical University “Nicolae Testemitanu” of the Republic of Moldova and in the Institute of Neurology and Neurosurgery
as senior researcher.
Academic positions:
Director of the Institute of Neurology and Neurosurgery (2009-2013).
Head of the Department of Neurology of Medical and Pharmaceutical University “Nicolae Testemitanu” of the
Republic of Moldova (1998-2009).
Researcher at the Neurology department of the Moscow Medical Institute “I. M. Secenov” in Russia (19831991).
He founded and is actually President of the Society of Headache and Pain of the RM, vice President of Neurological Society of the RM, honorary member of the French Society of Neurology, the founder and President of
the Association of Psychoanalysis and Psychosomatic in Moldova.
International cooperation: scientifically research program in movement disorders at the Premontre Hospital
(France) in connection with Salpetriere Clinic (Paris, France) – 1991-1993, visiting Professor at the University
“Joseph Fourier” (Grenoble, France, 1996), at the Institute of Neuroscience from the Paris VI University (Paris,
France, 1997), Fulbright clinical and scientifically research Program in the Mayo Clinic Headache Center (Scottsdale, Arizona, USA, 2002-2003), practical clinical training in the Headache Emergency Center of the Lariboisiere Hospital (Paris, France, 2006), etc.
He was responsible for many international projects, as the Epidemiology of primary headaches in the RM supported and guided by the International Headache Society (2005), the Non-pharmacological treatment of acute
and chronic headaches by transcranial electrical stimulation (BMBF project Moldova-Germany 2010-2011, bilateral Moldovan-Ukrainian-European project 2007-2010).
Author of about 350 scientific papers, co-author of 2 books, 3 monographs, 1 compendium, 3 patents, scientific coordinator of the International Classification of Headache Disorders translation from English into Romanian (2004, 2015). He trained 12 doctors in medical science and is currently leading 9 MD thesis in progress.
For many years professor Ion Moldovanu was a member of the board of the International Headache Society and
European Headache Federation.
92
DAFIN F. MUREŞANU
/Romania
Professor of Neurology, Senior Neurologist, Chairman of the Neurosciences Department, Faculty of Medicine,
University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, President of the Romanian Society of
Neurology, President of the Society for the Study of Neuroprotection and Neuroplasticity (SSNN), member of
the Academy of Medical Sciences, Romania, secretary of its Cluj Branch. He is also member of 13 scientific
international societies (being member of the American Neurological Association (ANA) - Fellow of ANA (FANA)
since 2012) and 7 national ones, being part of the executive board of most. Professor Dafin F. Muresanu is a
specialist in Leadership and Management of Research and Health Care Systems (specialization in Management
and Leadership, Arthur Anderson Institute, Illinois, USA, 1998 and several international courses and training
stages in Neurology, research, management and leadership). Professor Dafin F. Muresanu is coordinator in
international educational programs of European Master (i.e. European Master in Stroke Medicine, University
of Krems), organizer and co-organizer of many educational projects: European and international schools
and courses (International School of Neurology, European Stroke Organisation summer School, Danubian
Neurological Society Teaching Courses, Seminars - Department of Neurosciences, European Teaching Courses
on Neurorehabilitation) and scientific events: congresses, conferences, symposia (International Congresses
of the Society for the Study of Neuroprotection and Neuroplasticity (SSNN), International Association of
Neurorestoratology (IANR) & Global College for Neuroprotection and Neuroregeneration (GCNN) Conferences,
Vascular Dementia Congresses (VaD), World Congresses on Controversies in Neurology (CONy), Danube Society
Neurology Congresses, World Academy for Multidisciplinary Neurotraumatolgy (AMN) Congresses, Congresses
of European Society for Clinical Neuropharmacology, European Congresses of Neurorehabilitation). His activity
includes involvement in many national and international clinical studies and research projects, over 200 scientific
participations in the last 7 years as “invited speaker” in national and international scientific events, a significant
portfolio of scientific articles (113 papers indexed on Web of Science-ISI, H-index: 14) as well as contributions in
monographs and books published by prestigious international publishing houses. Prof. Dr. Dafin F. Muresanu has
been honoured with: the Academy of Romanian Scientists, “Carol Davila Award for Medical Sciences / 2011”, for
the contribution to the Neurosurgery book “Tratat de Neurochirurgie” (vol.2), Editura Medicala, Bucuresti, 2011;
the Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca “Octavian Fodor
Award” for the best scientific activity of the year 2010 and the 2009 Romanian Academy of Medical Sciences
“Gheorghe Marinescu Award” for advanced contributions in Neuroprotection and Neuroplasticity.
93
ADRIANA SARAH NICA
/Romania
Current position
-
Professor in Physical Medicine, Rehabilitation and Balneoclimatology at the University of Medicine “Carol Davila”, Bucharest
-
Head of Rehabilitation Department - University of Medicine “Carol Davila”, Bucharest
-PhD
-
Chief of University Rehabilitation Department III – National Institute of Rehabilitation, Physical Medicine and Balneoclimatology
-
European Board certified in PRM
-
EFIC Councilor for Romania
-
Senior consultant in Physical Medicine and Rehabilitation
Medical Career
1978 – MD at the Faculty of Medicine – University of Medicine “Carol Davila”, Bucharest
1982 – University assistant and resident doctor – Balneoclimatology, Sport Medicine and Physical Medicine –
University of Medicine “Carol Davila”, Bucharest
1985 – Specialist in Balneoclimatology, Sport Medicine and Physical Medicine – University of Medicine
“Carol Davila”, Bucharest, confirmed by the Ministery of Health of Romania
1992 – Lecturer – Balneoclimatology, Sport Medicine and Physical Medicine – University of Medicine
“Carol Davila”, Bucharest
1997 – PhD at the University of Medicine “Carol Davila”, Bucharest
1998 – Ass. Professor of Balneoclimatology, Sport Medicine and Physical Medicine – University of Medicine
“Carol Davila”, Bucharest
2002 – 2004 – Medical Director of National Institute of Rehabilitation, Physical Medicine, Balneoclimatology,
Bucharest, Romania
2003 – Professor of Rehabilitation, Physical Medicine and Balneoclimatology
Post-graduated training and fields of interest in scientific research
1.
ICF Workshop –Oct. 2011, Notvill, Switzerland
2.
Speaker at the Neuro-rehabilitation School of SSNN-from 2012
3.
Musculoskeletal Ultrasound Course, October 10-12, 2008, Bucharest
4.
Project “Postgraduate Training in Romania; Competence in Public Health Administration and Management”, Bucharest, 22.06.2007
5.
“4th Symposium - Discussion Platform for Pain, Surgery and Rehabilitation Aspects”, Bodrum, Turkey, 30.04-3.05.2007
6.
“ISCD Bone Densitometry Course & Workshop”, Bucharest, March 1-3, 2007
7.
“Project Management in Clinical Research”, Wien, February 19-21, 2007
8.
“Introduction to Good Clinical Practice”, Wien, December 12-13, 2006
9.
“ EMG Course”, “UMF Carol Davila”, Bucharest, 2006
10.
“Research in Robotics Technology and Virtual Reality Applyed in Physiotherapy”, Bucharest,
October 3, 2006
11.
“Hospital Management”, Bucharest, September 18.- November 17, 2006
12.
The Second International Course for Hand Surgery and Hand Therapy”,
Cluj-Napoca, September 22-24, 2006
13.
“35th Congress of the International Society of Medical Hydrology and Climatology”,
Istanbul Turkey, June 6-10, 2006
14.
External Auditory Course - Sistem of Quality Management SR EN ISO 9001/2001,
SR EN ISO 19011/2003”, Bucharest – SIMTEX, february 6-10 2006
15.
“The First International Course for Hand Surgery and Hand Therapy”, Cluj-Napoca,
September 23-25 , 2005
16.
“Electrostimulation of the innervated and denervated skeletal muscle”, during the
14th European Congress of Physical and Rehabilitation Medecine, Wien, Austria, May 12-15, 2004
17.
”Management of Educational Project”, Ministry of Health– CNPPMFA, June 9-13, 2003
94
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
“Training Trainers and Evaluators for Testing and Checking Laboratories”, 16-20 June 2003 –
Certificate of Training RENAR
ERASMUS Program – “Actualities in Biomecanic and Gate Analysis”,
European School Marseille, France, June 1-11 2003
“4th Congress of Hand Surgery”, “5th National Congress of Reconstructive Micro Surgery”,
15-16.10.2002, Bucharest
“International Workshop for Hand Rehabilitation”, Bucharest, 15-16 .10.2002
“Course of General Echography”, Competence in Ecography, UMF Carol Davila, June 28, 2002, Bucuresti
“Course for Training Trainers” – Diploma of Instructor Trainer in Rehabilitation,
Physical Medicine and Balneoclimatology , Ministry of Health, May 2002
“5th ESRA WORKSHOP “NEURAL BLOCKADES ON CADAVERS” – Institute of Anatomy,
University of Innsbruck / Austria, February 21-23, 2002
,, Electromyography Testing, Evoked Potentials and EEG”, UMF ,,Carol Davila”, March 6-31, 2001
Competence in Pain Therapy”- National Institute for Traing of Pyisicians and Pharmacists, 4.12.2001
,,Paliative Medicine – An Compulsory Part of Today’s Medicine” -International Course of Romanian Society of Paliative Medicine and Tanatology”, Sinaia, oct 28-30, 1999
Building a Strong Foundation in Medical Rehabilitation, May 31–June 2, 1999, CARF –
The Rehab. Accreditation Commission LUND, Sweden
Competence in Biostimulation of Laser Therapy
Competence in Pain Therapy
« Reeducation Fonctionelle » Postgraduate training in Rehab, December 1991 – March 1992,
Secretariat d’Etat Aux Handicapes et Accidentes de la Vie, Nancy, France
“New Priorities for Health Care”– Management in Heath Sciences, Salzburg, June 1991
“Homeopathy” (1986-1988), “Acupuncture” (1983)
Scientific activity
Author of 4 books
Chapters in published books - 9 chapters
Author or coauthor of more than 200 papers published in national and international issues
Research: project manager in 6 national projects, partner in 1 international project
Keynote speaker in international congresses and conferences: Verona (1995), Florence (2008), Bucharest (2007,
2008)
Delegate of ISPRM WRD Commitee for ICF, 2011
Affiliation
- Romanian Association of Physical Medicine and Rehabilitation ISPRM (International Society of Physical &
Rehabilitation Medicine (Board member since 2010)
- Romanian Association for the Study of Pain (Past President)
- Romanian Rheumatological Association
- Romanian Association for Osteoporosis
- Romanian Association for Laser
- Romanian Association for Psycho-neuro-endocrinology
- Romanian Association for Geriatry
- I.A.S.P.
- Fellow of Seminar Salzburg Society
- EFIC (Councellar of the Board of European Federation International Corner Committee for Romania – 2006
- 2012)
- Romanian Termography Medical Association (President)
- Member of the PRM Commision in the Ministry of Health
95
IOAN ONAC
/Romania
Education:
Oct 1974 – June 1980 UMF “Iuliu Haţieganu”-Cluj, General practitioner
1982 – prezent UMF “Iuliu Haţieganu”-Cluj, Project Manager, physician on rehabilitation, physi-cal medicine,
balneology
Degree : Doctor of Medicine Degree, Project Manager
Working experience: 24 years
1982 – present Chair of Balneophysical Therapy and Medical Rehabilitation, UMF “Iuliu Haţieganu”-Cluj,
Lecturer
1982 – present Rehabilitation and Physical Medicine department, Clinical Rehabilitation Hospital, Head of
Department
Present working status and position: Clinical Rehabilitation Hospital, General Director, Head of Department
Experience in medical field : 22 years;
Elaborated and/ or published research: most important projects:
5 scientific projects: VIASAN, project participant, no. 128/2004
BOOKS, MONOGRAPHIES
1.Alexandrina Nicu, I. Onac, Luminiţa Pop, Rodica Ungur, Laszlo Irsay, Liviu Pop/ sub redacţia Conf. Dr. Liviu
Pop: Evaluare clinică articulară şi musculară, University Medical Publishing House „Iuliu Haţieganu” – Cluj,
2002.173 pages, B5 format, ISBN 973-8385-39-3
2.L. Irsay, L. Pop: Masajul medical clasic, suport DVD, ISBN 973-693-127-7, DACIN SARA 1060/2005, University
Medical Publishing House „Iuliu Haţieganu” – Cluj, 2005
3.I.Onac: Masajul medical, University Medical Publishing House „Iuliu Hatieganu” Cluj-Napoca, 2009.
13. Member of profesional associations: Romanian Society of Physical and Rehabilitation Medi-cine, European
Society of Physical and Rehabilitation Medicine .
14. Language knowledge: english, french.
15. Other core copetences:
16. Specialisation and qualification: physician, rehabilitation, physical medicine, balneology
17. Cumulated experience other national/international programmes:
Active grants:
1.PN-II-ID-PCE-2008-2 Grant, no.ID- 2623 /2008
Studiul efectelor ultrasonoterapiei asupra balantei oxidanti/antioxidanti la pacientii artrozici
Role : Member
Past grants:
1.VIASAN Grant no.362/2004,2005-2006: Eficientizarea tratamentului artrozelor prin demonstrarea utilitatii
condroprotectoarelor pe plan clinico-functional, biologic si radiologic Role: Member
2.CNCSIS Grant no. 1415/2006, 2006-2008: Ameliorarea calitatii vietii femeilor cu osteoporoza prin asocierea
la medicatia osteoporotica a metodelor balneofizioterapeutice si a unor practici de management, marketing
social Role:Member
96
GELU ONOSE
/Romania
Dr. Gelu Onose - 58 years (born: the 20th of December,1956); graduated, in 1982, from the
Faculty of General Medicine, within the Institute of Medicine and Pharmacy, in Bucharest, Romania
- Professor at the (State) University of Medicine and Pharmacy (UMP) “Carol Davila”, in Bucharest
- Doctoral/ Post-Graduate Tutor - at the (State) University of Medicine and Pharmacy ”Carol Davila” (UMPCD),
in Bucharest
- MD; - PhD; - MSc
- Senior Physician of : - Physical & Rehabilitation Medicine (PRM) and
- Gerontology & Geriatrics (G-G)
Competences in : - General Ultrasonograpy
- Management of sanitary services
- Chief of the of the UMPCD PRM Discipline and of the P(neural-muscular)RM Clinic Division - the National
Reference Center for NeuroRehabilitation - and of its RDI Nucleus, at theTeaching Emergency Hospital“BagdasarArseni” (TEHBA), in Bucharest
- President Co-Founder of the Romanian Society for Neurorehabilitation (RoSNeRa) - affiliated to the World
Federation for NeuroRehabilitation (WFNR) - member of the Management Committee - and respectively,
of the Romanian Society for Spinal Cord Pathology, Therapy and Rehabilitation (RoSCoS) - affiliated to the
International Spinal Cord Society (ISCoS) and to European Spinal Cord Injury Federation (ESCIF)
- A member of the Scientific Committee – proposed Co-ordinator for SCI researches (2014) – afferent to the
Prezidium of the world Academy for Multidisciplinary Neurotraumatology (AMN)
- Selected and invited - as among ”Highly-specialized scholars” - by Thomson Reuters to participate in the
invitation-only ”Academic Reputation Survey”, within its related partnership with Times Higher Education’s
influential World University Rankings: 2010, 2011, 2012
- Invitated Peer-Reviewer (March 2010) by the “Journal of Molecular Histology” and (March, 2012) by the
”Spinal Cord” journal (both ISI Thomson Reuters rated)
- Contributing member/ (2011-2012) to the achievement of the imposing educational project: ”E-Learning for
Spinal Cord Injury Health Professionals”, of the International Spinal Cord society (ISCoS) - including/ specifically,
în 4 modules/ submodules of it: (Clinical Assessment of Patients with SCI; Assistive Technology Module and
Mobility & seating sub-module; Management of neurogenic bladder; Physiotherapy Module and Physical therapy
perspectives on rehabilitation sub-module
- Gest Editor within its Special Issues: Second Edition, Vol. 4, 2011 and Vol. V, Third Edition, 2012
- Founder Member of the Honorary Editorial Board of the Journal of Neurorestoratology (since 2013)
- Senior Expert (since 2012) within, and Chairman (since 2013), of the Active and Healthy Ageing - Working
Group (WG), and also Rapporteur (since 2013) on Chronic Conditions Management of the Comité Permanent/
Standing Committee of the European Doctors (CPME)
- Invited lecturer to all – since the first – European Teaching Courses on Neuro-Rehabilitation, with training
conference presentations (in 2011, 2013, 2015) and to the organization (in 2012), contributions
97
- Invited Professor to deliver two extended lectures to the Symposium: ”BEYOND TBI
(Optimizing Management in TBIs)”, held in August, 2013, in Mumbai, India, within an
International Educational Program of McCann-Erickson Healthcare Complete Medical
- 8 published medical books - one of them : “The Spondyloarthropathies” received, in 2002, the “Iuliu Hatieganu”
Award of The Romanian Academy)
- 4 chapters within medical books
- Over 200 scientific works, papers – communicated within national and international scientific meetings and/
or published in peer-reviewed or non peer-reviewed medical journals – and professional interviews/ articles, in
mass-media
- 3 Patents/ Invention Certificates (plus 2 Utility Models), appointed by the State Office for Inventions and
Marks (SOIM/ OSIM)
- Main awards: the “Iuliu Hatieganu” Award of The Romanian Academy (2002); the Award of the (Romanian)
National Authority for Scientific Research for the RDI project acronymed ”ACTUAT” (2006); the Gold Medal at
the International Saloon of Inventions, Geneve/ Switzerland for the RDI project acronymed ”MOD” (2008)
- A member of the Scientific Council/ Editorial Board of medical journals:
- ”Journal of Medicine and Life” (rated in Index Medicus, Medline)
- “Infomedica”
- (Romanian) “Rehabilitation, Physical Medicine and Balneology“
- “Romanian Neurosurgery”
- ”Industria Textila” (ISI Thomson rated journal)
- Founder Member of the Honorary Editorial Board of the ”Journal of
Neurorestoratology”
- A member of the (scientific societies):
- Romanian Medical Association (RMA)
- Romanian Society of Physical and Rehabilitation Medicine (PRM) Including of its Board
- Romanian Society of Neurosurgery (RSN)
- Romanian Society of Biomaterials (RSB)
- Balkan Medical Union (BMU),
- International Society of Hydrothermal Technique (SITH - the
National Council of the Romanian Section SITH - RS)
- British Society of Gerontology (BSG)
- International Spinal Cord Society (ISCoS)
- European Spinal Cord Injury Federation (ESCIF)
- World Academy for Multidisciplinary Neurotraumatology (AMN)
- World Federation For Neurorehabiliation (WFNR) - a member
of the Council/ Management Committee
- International Society of Physical and Rehabilitation Medicine (ISPRM)
98
CRISTIAN FALUP-PECURARIU
/Romania
Cristian Falup-Pecurariu received his medical degree from the University of Medicine and Pharmacy “Iuliu
Haţieganu” from Cluj-Napoca. He hold a 1 year fellowship of the European Neurological Society in movement
disorders and sleep medicine at Hospital Clinic, University of Barcelona, Spain.
He is Head of the Department of Neurology, County Emergency Clinic Hospital from Brasov, and is Lecturer of
Neurology at the Transilvania University from Braşov.
During his career Cristian Falup-Pecurariu was President of the European Association of Young Neurologists and
Trainees (EAYNT), EAYNT Liasion Officer with World Federation of Neurological Society, co-representative of
Europe on the International Working Group for Young Neurologists and Trainees (World Federation of Neurology), Secretary of the EFNS/MDS-ES Panel on Movement Disorders and currently is member of the Educational
Committee of MDS-ES and MDS Leadership Task Force.
His research focuses on non-motor aspects of Parkinson’s diseases and restless legs syndrome.
99
CRISTIAN DINU POPESCU
/Romania
Cristian Dinu POPESCU is a professor of Neurology at the University of Medicine and Pharmacy “Gr. T. Popa”
Iasi. He graduated from the same University in 1975 and holds a PhD from 1991.
He is the head of the Neurology Clinic in The Clinical Rehabilitation Hospital in Iasi, Romania, where he conducts
his clinical and scientific activity.
Since 2008 he is chief of the Neurology Department and also the chief of the VI th Medical Chair of the Iasi
Medical University.
He is a member of national and international professional associations (vice president of the Romanian Society
of Neurology, member of the Society for Study of Neuroprotection and Neuroplasticity, Society of Parkinson’s
Disease and Movement Disorders, European Council of Neurological Rehabilitation, Balcanian Medical Union).
He was an invited speaker in most of the important national neurology scientific events during the last years.
He is a local coordinator for MS immunomodulatory treatment. He initiated and coordinated the organization
of the National Multiple Sclerosis Conferences during the last 5 years.
He has authored or coordinated 5 books and took part in writing of 12 other books as coautohor, and more than
150 papers.
His main fields of interest have been aging of the brain and its vascular system, multiple sclerosis, rehabilitation
in stroke and other neurological diseases. Neurorehabilitation and neuroplasticity are among the main topics of
concern, both in current clinical practice and regarding the research activities.
His group was among the first to use functional electrical stimulation in Romania - current research targets
applications and effects of FES in stroke, MS and Parkinson’s disease.
He is the coordinator of one of the first groups in our contry to use transcranian magnetic stimulation in neurology
– both in clinical practice (diagnostic and therapeuthical TMS) and for research (cortical neuroplasticity and
neuromodulation)
100
PETER RIEDERER
/Germany
since 2010 Senior Professor at the University of Würzburg, Medical School, Germany
1986 - 2010 University-Professor (University Würzburg); Head, Clinical Neurochemistry, Department of Psychiatry, Psychosomatics and Psychotherapy at the University of Würzburg, Medical
School, Germany
1983 titl. a. o. University-Professor (TU Vienna)
1979 Associate Professor (University-Dozent) TU Vienna
1971 - 1986 Head, Clinical Neurochemistry, Ludwig Boltzmann Institute (LBI) for
Neurochemistry (1971 - 1975) and LBI Clinical Neurobiology (1976 - 1986), Lainz-Hospital, Vienna, Austria
1970 Doctor techn. Degree
1969 - 1971 Assistant Professor
Honors and awarded memberships (selection)
2013 2012 2011 2008 2007 2006 2005 2004 1991 1986 Honorary Member, Austrian Society for Parkinson’s Disease
Edit. Board Member, International Association of Neurorestoretology (IANR)
WFN - Association of Parkinson Disease Related Disorder- Lifetime Award
Honorary Dr. degree International University Catalunya, Barcelona, Spain
Honorary Member of the Hungarian Academy of Sciences;
Member of the Deutsche Akademie der Naturforscher Leopoldina;
Honorary President of the German Society for Parkinson’s Disease
Honorary membership of the German Society of Biological Psychiatry
Honorary membership of the Austrian Alzheimer Society
Most cited chemist in the field of medicine
AGNP - Award, Award for psychopharmagological research
Senator Dr. Franz Burda-Award
Project coordination, membership in collaborative research projects (selection)
current disease
(Gifu),
2004 - 2011 Alzheimer’s
2002 - 2012 2002 - 2008 2002 - 2008 2000 - 2012 1999 - 2012 1991-1998 International joint project in the field of clinical and experimental studies on Parkinson’s
and dementia of Alzheimer type with: M.B.H. Youdim (Haifa), T. Nagatsu (Aichi), M. Naoi
W. Maruyama (Aichi), Z. Lackovic, M. Salkovic (Zagreb) and E. Grünblatt (Zürich)
DAAD-Stability Pact Project : Establishing the role of diabetes type II as risk factor for
disease (with S. Hoyer, M. Salkovic, E. Sofic, E. Grünblatt)
Brain Net Europe II: Standardization of human post-mortem brain studies at an European level
(Europen FP 7 project)
BMBF Kompetenznetz HIV/AIDS
DFG-project “Benzodiazepines”
VITA - Project (Vienna Transdanube Aging Study): A prospective longitudinal aging study to
elaborate risk factors for AD
Head of the Brain Bank Center (BBC) Würzburg of the National Brain-Net, Germany
BMBF Schwerpunkt “Parkinson”
More than 1.100 publications in the field of Neuroscience
101
MARINA SANGHELI
/Republic of Moldova
Current titles and positions:
a. Academic activity:
since 2003 - Associate Professor, Department of Neurology, State University of Medicine and Pharmacy
“Nicolae Testemiţanu” Chisinau, Republic of Moldova
b. Clinical activity:
since 1994 - Consultant Neurologist at the Institute of Neurology and Neurosurgery in Moldova
Previous academic and professional work:
1997-2003 – Assistant professor Department of Neurology, State University of Medicine and Pharmacy
“Nicolae Testemiţanu” Chisinau, Republic of Moldova
Undergraduate and graduate studies:
1986 - 1992 State University of Medicine Chisinau, Moldova
Postgraduate Studies:
2014 - Salzburg Cornell Seminars “Palliative Care in Neurology”, Austria
2012 - 1st International Course of Neuroepidemiology in Eastern Europe, Chisinau, Republic of Moldova.
2010 - Regional educational course of EFNS Chisinau, Moldova.
2010 - Internship in Neurology, Medical University of Craiova, Romania.
2005 - Education Course of World Federation of Neurosurgical Societies, Chisinau, Republic of Moldova.
2003 - Salzburg Cornell Seminars in Neurology, Austria
2003 - Clinical internship program of EFNS “Department to Department “, Hamersmith Hospital, London, UK.
2001 - Clinical Internship Medical University, Iasi, Romania.
2000 - Internship at the Department of Manual Therapy, Stavropol, Russia.
1994-1997 - PhD studies in the Department of Neurology and Neurosurgery, State University of Medicine and
Pharmacy “Nicolae Testemiţanu” Chisinau, Republic of Moldova
1992-1994 - Residency in Neurology, Department of Neurology and Neurosurgery, State University of Medicine
and Pharmacy “Nicolae Testemiţanu” Chisinau, Republic of Moldova
Grants:
2003-2004 –Grant CRDF - MRDA MB-3037 ”Demyelination of nerve fibers and axonal degeneration in the
central and peripheral nervous system in neuropathy (similarities and differences) “. Investigator.
Projects:
Multicenter, Double-blind, Randomized, Parallel-group, Monotherapy, Active-control Study to Determine the
Efficacy and Safety of Daclizumab High Yield Process (DAC HYP) versus Avonex® (Interferon β 1a) in Patients
with Relapsing-Remitting Multiple Sclerosis. Sub-investigator (study coordinator)
Memberships
Moldovan Neurological Society
European Neurological Society
Moldovan Society for the Study of Pain
European Pain Federation
102
STEPHEN SKAPER
/Italy
STUDIES: B.S. (chemistry) Illinois Institute of Technology (1969); Ph.D. (biochemistry) University of South
Dakota (1973); Laurea in chemistry, University of Padua (1990)
CAREER: NIH Postdoctoral Fellow, Department of Medicine, University of California, San Diego (1973-1976);
Fellow in Human Genetics, Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio
(1977); Postgraduate Research Biologist, Department of Biology, University of California, San Diego (1978);
Assistant Research Biologist, Department of Biology, University of California, San Diego (1979-1982); Associate
Research Biologist, Department of Biology, University of California, San Diego (1983-1987); Head, Laboratory
of Neuropharmacology, Neuroscience Research Laboratories, Fidia S.p.A. - Abano Terme, Italy (1987-1993);
Principal Scientist and Head, Laboratory of Cell Biology, Researchlife S.c.p.A. (a Lifegroup Company), Biomedical
Research Center, St. Thomas Hospital, Castelfranco Veneto (TV), Italy (1993-1996); Visiting Professor,
Department of Pharmacology, University of Padova, Padova, Italy (1997); Assistant Director, Molecular
Neurobiology Research, SmithKline Beecham Pharmaceuticals, New Frontiers Science Park, Harlow, United
Kingdom (1998-2001); Senior Team Leader, Migraine and Stroke Research, Neurology & GI Centre of Excellence
for Drug Discovery, GlaxoSmithKline R & D Limited, Harlow, United Kingdom (2002-2003); Senior Team Leader,
Neuro Cell Sciences/Neurodegeneration Research, Neurology & GI Centre of Excellence for Drug Discovery,
GlaxoSmithKline R & D Limited, Harlow, United Kingdom (2004-2007); Senior Team Leader, Target Validation
Dept (Cognition and Pain), Centre of Excellence for Drug Discovery, GlaxoSmithKline R&D Limited, Harlow,
United Kingdom (2008); Adjunct Professor, Department of Pharmacology and Anesthesiology, University of
Padua, Faculty of Medicine, Padua, Italy (2009-present).
PROFESSIONAL MEMBERSHIPS: Sigma ΧI (The Scientific Research Society); Phi Lambda Upsilon (honorary
chemistry society); Alpha Chi Sigma (professional society in chemistry/chemical engineering); Society for
Neuroscience; International Society for Cerebral Blood Flow and Metabolism
JOURNALS EDITED: Editor-in-Chief, CNS & Neurological Disorders – Drug Targets; Associate Editor, American
Journal of Neuroprotection and Neuroregeneration; Editorial Board Member, Nature Scientific Reports
(Neuroscience); Councilor, International Association of Neurorestoratology
REVIEW PANELS: The Wellcome Trust (UK), Biotechnology and Biological Sciences Research Council (BBSRC)
(UK), Austrian Science Fund (ad hoc review panel to evaluate interdisciplinary doctoral programmes in
neuroscience)
RESEARCH INTERESTS: Molecular biology and cellular mechanisms of cell death in CNS aging, neurodegenerative
disorders and neuroinflammation, astrocyte-microglia interactions, oligodendrocyte biology and diseases of
demyelination. Track record of drug discovery project leadership in kinases, ion channels, G-protein-coupled
receptors, DNA repair enzymes, growth factors, identification and optimization of tools for target validation
studies, utilising RNAi, conditional and viral knockdown\outs\ins, transcriptomics, proteomics and in vitro cellbased disease or mechanism relevant assays in rodent systems.
PUBLICATIONS: OVER 290 publications in the neurosciences, including book chapters and symposia proceedings.
PATENTS: Pharmaceutical compositions containing monosialoganglioside GM1 or derivative thereof suitable
for the treatment of Parkinson’s disease (Patent No.: US 6,620,792 B1), use of CRF receptor agonists for the
treatment or prophylaxis of diseases, for example neurodegenerative diseases (US 2003/0186867 A1), treatment
of conditions with a need of GSK-3 inhibition (PCT WO 02/062387 A1), use of CRF receptor agonists for the
treatment or prophylaxis of diseases, for example neurodegenerative diseases (PCT WO 01/72326 A1), use of
monosialoganglioside GM1 or N-dichloro-acetyl-lyso-GM1 for preventing or reversing neuronal degeneration
induced by long term treatment with L-DOPA in the therapy of Parkinson’s disease (EP 0 770 389 A1)
REVIEWER FOR JOURNALS: Journal of Neuroscience, PNAS, Nature Reviews, The FASEB Journal, Journal of
Neuroinflammation, Neurobiology of Disease, Neurobiology of Aging, Glia, Neuroscience, Apoptosis, PLoS
One Biology, Journal of Pharmacology and Experimental Therapeutics, British Journal of Pharmacology,
Neuropharmacology, European Journal of Pharmacology, Journal of Neurological Sciences
103
JOHANNES THOME
/Germany
Johannes Thome studied medicine, philosophy and social psychology and obtained his MD/PhD degrees from
Saarland University. After his training as a resident in Psychiatry and Neurology at the University of Wurzburg,
he moved to the USA where he became a Postdoctoral Associate at Yale University. After two years of intensive
and highly successful research in the area of molecular neuroscience and psychopharmacology, he returned
to his native Germany and worked as Consultant Psychiatrist and Senior Scientist at the Central Institute of
Mental Health Mannheim, University of Heidelberg. In 2004, Johannes moved to Wales and settled in Swansea,
where he was the Professor of Psychiatry at the University of Wales Swansea. In 2010, he accepted the Chair
of Psychiatry at the University of Rostock.
104
IOAN VERESIU
/Romania
• Actual position
Associate Professor, Department of Diabetes, Nutrition and Metabolic Diseases “Iuliu Hatieganu“ Medicine and
Pharmacy University, Cluj-Napoca;
Head of Diabetes, Nutrition and Metabolic Diseases Department, County Emergency Hospital Cluj-Napoca .
• Work experience
1.10.2004 - present
Associate Professor, MD, PhD
1.10.2010-present
Teaching the Diabetes, Nutrition and Metabolic Disorders Module (4th year School of General Medicine)
Teaching the Therapeutic Nutrition Class (3rd year School of Nutrition and Dietetics)
Coordinator of student`s scientific activities and graduation theses
Coordinator and evaluator of student`s practical activities
Editor of students’ readers.
“Iuliu Hatieganu“ Medicine and Pharmacy University, Cluj-Napoca.
8 Victor Babes St, 400012 Cluj-Napoca.
Website: www.umfcluj.ro
Teaching, research and medical assistance activities regarding Diabetes, Nutrition and Metabolic Disorders field.
1.10.1995 - 30.09.2004
Lecturer, MD, PhD
Teaching the Diabetes, Nutrition and Metabolic Disorders Module (4th year School of General Medicine)
Coordinator of the Residency program in Diabetes, Nutrition and Metabolic Disorders
Coordinator of student`s scientific activities and graduation theses
Coordinator and evaluator of student`s practical activities
Editor of students’ readers.
“Iuliu Hatieganu“ Medicine and Pharmacy University
8 Victor Babes St, 400012 Cluj-Napoca.
Website: www.umfcluj.ro
Teaching, research and medical assistance activities regarding Diabetes, Nutrition and Metabolic Disorders
field.
1981-1995
Assistant professor, Medical Semiology Department
Supervising practical activities for the 3rd year School of General Medicine students.
Editor of students’ readers
Coordinator of graduation theses
Development of scientific research in diabetes risk, dyslipidemia.
“Iuliu Hatieganu“ Medicine and Pharmacy University
8 Victor Babes St, 400012 Cluj-Napoca.
Teaching, research and medical assistance activities in Internal Medicine specialty.
105
1980-1981
MD General Medicine
Primary Care Assistance for adults and children.
Asuaju de Sus Primary Care Facility, Maramures County
1977-1980
Intern MD
Health care providing activities, scientific research
Oncological Institute, Cluj-Napoca.
• Education and Training
1997
PhD in Medical Sciences
Diabetes, Nutrition and Metabolic Diseases
“Carol Davila” Medicine and Pharmacy University, Bucharest
National Council of Attestation of Titles, Diplomas and Academic Certifications, 30-Oct 31st 1997, Confirmation no. 5347/20.11.1997
1996
Attending Specialist MD
Diabetes, Nutrition and Metabolic Diseases
National Council of Attestation of Titles, Diplomas and Academic Certifications, confirmation no. 862/17.04.1996
1986
Specialist MD
Cardiology
National Council of Attestation of Titles, Diplomas and Academic Certifications, confirmation no. 56/12.02.1986
1984
Attending Specialist MD
Internal Medicine
National Council of Attestation of Titles, Diplomas and Academic Certifications, confirmation no. 459/12.12.1984
• Organization Membership
European Association for the Study of Diabetes (EASD)
Diabetic Foot Study Group (part of EASD)
American Diabetes Association (ADA)
Foot Care Study Group (part of ADA)
Romanian Society of Diabetes, Nutrition and Metabolic Disorders
Romanian Federation of Diabetes, Nutrition and Metabolic Disorders, Chair since 2010
International Task Force for Diabetic Foot of IDF (national representative)
International Task Force for Diabetes Experts Panel from Accessing Countries (DEPAC), since 2009
Romanian Society of Diabetic Neuropathy, Chair since 2013
Honorary Member of the Hungarian Diabetes Society, 2014
106
JOHANNES VESTER
/Germany
Born, 1952, he specialized in Veterinary Medicine between 1971 and 1974 at the University in Munich, then
changed to the University in Cologne in 1974 and specialized in Human Medicine from 1974 to 1980. In 1976
to 1979, he additionally studied biometric methods for pharmacology and clinical research at the Institute for
Data Analysis and Study Planning in Munich.
While studying human medicine, he completed research work on pattern recognition in the visual brain and
developed a pharmacodynamic Neuron Simulation Model at the Institute for Medical Documentation and Statistics of the University at Cologne.
From 1985 to 1995, he was member of the Ultrahigh Dexamethasone Head Injury Study Group and leading
biometrician of the German GUDHIS Study.
Since 1982 he holds advanced training courses on biometry for professionals in clinical research and university
establishments. His work also involves human engineering of biometric software and GCP-compliant tutorials
for biometric appraisal of clinical studies.
Since 1995 he cooperates closely with the Institute for Data Analysis and Study Planning as Senior Consultant
for Biometry & Clinical Research. He planned and evaluated about 150 randomized clinical studies worldwide
and is member of various international advisory boards including participation as biometric expert in regulatory
authority panels and in FDA, EMEA, and BfArM hearings.
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AUREL POPA-WAGNER
/Germany
Nationality: Romanian; German
Education:
2012-present Professor of Experimental Neurology at the Department of Psychiatry and Head of the Research
Molecular Psychiatry, University of Medicine Rostock
2008-present: Professor of Pathobiochemistry, University of Medicine and Pharmacy, Craiova, Romania.
2004-2012 Professor of Experimental Neurology at the Department of Neurology and Head of the Research
Department Ernst-Moritz-Arndt University
2004 Habilitation in Internal Medicine and Experimental Neurology, Medical Faculties of Erlangen-Nuerenberg and Greifswald.
2004 Associate Professor, Clinic of Neurology Ernst-Moritz-Arndt University, Greifswald. 1996-1998 Laboratory Head, Clinic of Neurology, Ernst-Moritz-Arndt University, Greifswald
1991 Post-graduate: Post-doctoral training at Ethel Percy Andrus Gerontology Center, University of Southern California
1990 Graduate: PhD in Biochemistry Institute of Biochemistry, University of Karlsruhe, Germany
Present academic position
Professor of Experimental Neurology at the Department of Psychiatry and Head of the Research Molecular
Psychiatry, University of Medicine Rostock.
Main Domain of Research
•
Aging, Stroke, Molecular Rehabilitation, Mood disorders, preclinical and clinical research, therapeutic
strategies: drugs, stem cells
•
Expertise: aged animals models of cerebral ischemia; behavioral analysis; recording of EEG and various
physiological parameters by telemetric measurements; MRI for small animals; immunohistochemical procedures, proteomics, genomics.
Honours
Rene Schubert Prize for Research on Ageing
Recent GRANTS: 7
Amount: 6,7 millions Euros
2007-2008
BMWT: Automatisiertes Immunhistologisches Analysegerät (Development of an automatic immunostaining device for floating tissue sections).
Grant agreement no: 03ESFMV022
Grant money: 70.000 Euro
2008-2011
BMBF: Neuroprotective effecst of hypothermia. An MRI study.
Grant agreement no: 0314107
Grant money: 3,05 millions Euro
2009-2012
FP7: Improvement of the research competitiveness in neuroscience
at the Ernst Moritz Arndt University of
Greifswald
Acronym: ImpactG
Grant agreement no.: 229750
Grant money: 1,05 millions Euro
108
2009-2012
BMBF: Multimodal Approaches for Regenerative Stroke Therapies. Therapeutic benefit of bone marrow stem
cells administered to aged rats after stroke.
Acronym: MARS
Grant agreement no: 01GN0982
Grant money: 760.000 Euro
2010-2013
FP7: Improvement of the research competitiveness in molecular imaging at the Ernst Moritz Arndt University
of Greifswald
Acronym: EnVision
Grant agreement no.: 264143
Grant money: 2,15 millions Euro
2011-2012
BMBF: Systemic regulatory mechanisms to cope with persistent energy excess in aging systems.
Grant agreement no: MOE 10/73
Grant money: 24.000 EURO
2011-2014
UEFISCDI: Age-related deterioration of biological pathways and their significance for brain tissue regeneration
and functional recuperation after stroke
Acronym: Regeneratome
Grant agreement no: PN-II-ID-PCE-2011-3-0848
Grant money: 410.000 Euro
2012-2015
UEFISCDI: Cellular therapy of stroke
Acronym: CELEST
Grant agreement no: PN-II-ID-PCCA 80/2012
Grant money: 410.000 Euro
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SPONSORS
Romania
110
www.ssnn.ro
‘‘RoNeuro’’
Institute for Neurological Research and Diagnostic,
Cluj-Napoca, Romania
Tel.: 0374 46.22.22
str. Mircea Eliade nr. 37, 400364 Cluj-Napoca, România
Fax: 0374.461.674; Email: [email protected]
www.roneuro.ro