ktp-nni integrated neuroscience...

The Khoo Teck Puat (KTP)-National Neuroscience Institute (NNI) Integrated Neuroscience Centre located at the Singapore General Hospital (SGH) is the first of its kind to provide the full range of treatment options in highly complex surgical procedures such as neurosurgery.

Driven by neuroscience expertise from the NNI, this SingHealth collaboration with BrainLAB AG, a German medical technology company offers a comprehensive range of the latest technology to provide clinicians with effective access and improved management of digital medical information. From diagnostics to treatment, the Centre will provide clinicians with timely information and more treatment options. This results in better informed medical decisions made and a seamless combination of multiple treatments.

01 KTP-NNI Integrated Neuroscience Centre 03 1st Asian Australasian Advanced Course in Paediatric

Neurosurgery04 Neurosurgical Approaches Course into its 2nd Year05 Gifts of love for Brain Damage Research Endowment Fund06 Interventional Neuroradiology 07 Neurointerventional Nursing

08 NEW! Motor Control Laboratory for PD patients09 Clearing The Misconceptions of Brain Injury10 Award for NNI Researcher at Prestigious Gordon

Research Conference11 Black Tea Could Lower Parkinson’s Risk12 Calendar Of Events

Contents

Centre for the care of the Brain, Spine, Nerve and Muscle

January-March2008Volume10,No:1

MICA (P) 224/07/2007

KTP-NNI INTEGRATED NEUROSCIENCE CENTREThe world’s first digitally integrated neuroscience centre

Thiscomprehensiveall-in-onefacilitywillbeabletoenhanceaneurosurgeon’ssurgicalplanningandexplorationexperience,especiallyforcomplexneurosurgicaloperations,whichmakesup50%ofallcasesseenatNNI.Itwillallowthesurgeonstolookatthepreciseimagesofapatient’sbrainbefore,duringandrightaftersurgery.Thisallowsustodecidewhetherfurtherproceduresarerequiredandtranslatestobetteroutcomesforpatients.

AssociateProfessorIvanNgSeniorConsultant&HeadofNeurosurgeryDepartment,NNI

The Centre will set the new standard for the comprehensive approach to neurosurgery as well as cancer care, otolaryngology (ear, nose and throat) and orthopaedic surgery in terms of clinical results and overall cost effectiveness. With real-time high quality intra-operative Magnetic Resonance Imaging (iMRI), Computed Tomography (iCT) scanning, and advanced image-guidance navigation system capabilities, surgeons will be able to intra-operatively monitor a patient’s progress and perform more complicated surgeries with less time required and improved patient outcomes.

BrainSUITEiCTThe BrainSUITE iCT is an integrated operating theatre that combines sky navigation with the intra-operative CT scanner and radiolucent operating table. Unique BrainLAB technology makes it possible to automatically register images taken intra-operatively.

In combination with Brainlab Cranial VectorVision, it further enhances the precision of sterotactic neurosurgery. With versatile patient positioning possibilities via an adjustable operating table and extra large scanner gantry bore, it ensures that most patients can be treated.

The iCT is ideal for various neurosurgery subspecialities such as • Functional Neurosurgery• Neuro-oncology• Neurovascular• Skull Base• Spinal• Trauma

NovalisShapedBeamRadiosurgeryThe Novalis® Shaped Beam Surgery system, an integrated radiotherapy/radiosurgery system, adds the option of highly precise radiosurgery and radiotherapy, providing patients with the best possible treatment outcomes and improved quality of life. The system forms part of the world’s first digitally integrated neuroscience centre.

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Novalis Shaped Beam Radiosurgery is a new cancer radiation treatment with millimeter precision where tumours of the brain and other parts of the body such as the head and neck, spine, lung, liver and prostate can be treated with high precision, while harm to surrounding tissue is significantly reduced. All these offer faster treatment with possibly shorter hospital stay. The Novalis system offers : • faster treatment with possibly shorter

hospital stay due to greater degree of precision

• the higher precision also minimizes damage to healthy tissue surrounding the tumour as well as allowing for high doses of radiation to be safely administered

• Patients will benefit from frameless therapy, often allowing them to return home the same day

TheadditionofNovaliswillallowustotreatmanymorepatientswithstereotacticradiosurgery.Itcanbeusedtotreattumoursthatareinoperableorininstanceswhereopensurgeryofferstoohigharisk.Theshapedbeamtechnologyhelpstoachievemaximumtumourscelldeathwithminimalsideeffects,andhealthytissuesurroundingthetumoursispreventedfromdamagetoaverylargeextentexplainedAssociateProfessorIvanNg,SeniorConsultant&HeadofNeurosurgeryDepartment,NNI.

Neus-linkCentre for the Brain, Spine, Nerve and Muscle

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BrainSUITEiMRIiMRI is the combination of neurosurgical technologies all in one operating theatre. Together with the latest in neuroimaging such as iPLAN BOLD imaging, DTI fiber tracking, it allows the finest work in neurosurgical microsurgery with better patient outcome and results.

The BrainSUITE iMRI aims to improve patient care in a wide range of clinical applications. The neurosurgical applications include

• Biopsy with and without a frame• Complicated tumour resection• Epilepsy surgery• Functional imaging

• Glioma resection• Intra-cranial cyst surgery• Pituitary tumor surgery• Vascular surgery

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1st Asian Australasian Advanced Course in Paediatric Neurosurgery– 1st Part of 2nd Cycle

The 1st part of the 2nd cycle of the Asian Australasian Advanced Course in Paediatric Neurosurgery (AAACPN), organised by National Neuroscience Institute (NNI), was held in Singapore from 4-8 December 2007. More than 40 neurosurgeons around the Asia-Pacific region convened at the Nanyang Executive Centre, Nanyang Technological University for an intensive live-in 5 days programme.

The AAACPN is the Asian Australasian equivalent of the European Course in Paediatric Neurosurgery, which has been successfully organised by the European Society for Paediatric Neurosurgery for over 20 years. A similar course has been started in Latin America since 2004.

Renowned teaching faculty from Australia, England, France, India, Italy, Japan, Korea, Taiwan and USA shared with participants on

Course Chairman, Dr Seow Wan Tew (extreme left) and faculty members.

The faculty and participants.

the various neurosurgical diseases in children and surgical techniques. Besides didactic lectures, the course also included hands-on training as well as video-discussion sessions. The highly participative sessions had allowed participants to interact with lecturers and facilitated exchange of ideas and information during the course.

“It is important to train neurosurgeons to become competent paediatric neurosurgeons

as the paediatric population in the Asian region is growing rapidly and along with this, is increasing demand from children with neurosurgical diseases.” said Dr Seow Wan Tew, course chairman on the need to train neurosurgeons in the field of paediatric neurosurgery.

The next AAACPN will be held in Taipei, Taiwan. For more information, please visit www.aaacpn.com.

A trainee practising on an animal saw-bone under the guidance of faculty member.

Into its second installment this year, the successful National Neuroscience Institute (NNI)-Aesculap Academy Neurosurgical Approaches Course was held from 14 – 16 February 2008 at Singapore General Hospital Experimental Laboratory.

Positive feedback from the previous year’s course participants propelled the team to spearhead their sophomore effort for 2008, opening up registrations for 40 participants to partake in the intensive 3-day workshop-based practicum in neurosurgical techniques that featured guest faculty Professor Axel Perneczky of Mainz University, Germany and Dr Peter Hwang from the Alfred Neurosurgical Unit, Melbourne.

Course chairman, Associate Professor Ivan Ng said, “The turnout is amazing. We received more than 40 registrations from Taiwan, Pakistan, as well as Southeast Asian countries, for this year’s course. There are very few cadaveric courses in neurosurgery in the region so this adds to the value of our course and its draw to international neurosurgeons.”

The course commenced on Thursday, 14 February 2008 beginning with a series of comprehensive lectures on endoscopic techniques and common neurosurgical approaches. During workshop sessions, participants worked with cadaveric models to simulate neurosurgical scenarios like aneurysm surgery, endoscopic third ventriculostomies and transphenoidal surgery.

Cervical spine approaches, and fusion instrumentation were also covered.

Participants listening attentively to a neuronavigation topic.

Injecting some fun after some serious work.


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NeurosurgicalApproachesCourseintoits2ndYear

Participants also familiarized themselves with the latest surgical tools such as neuronavigation platforms, endoscopes and powered dissection tools. “This course provides regional participants with good hands-on exposure to endoscopes, microscopes and cervical spine complex instrumentation which will improve their neurosurgical techniques” said Course Director Dr Rajendra Tiruchelvarayan. We look forward to the next neurosurgical course planned for 2009.

Course chairman, A/Prof Ivan Ng showing participants the supraorbital approach for aneurysms.

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NNIBrainDamageResearchEndowmentFund

In contrast to other organs of the body, brain damage is particularly poignant as it can cause not just physical handicaps but also changes in the patient’s personality and ability to think and reason, destroying the soul of the patient. The family also suffers greatly, not merely from financial and physical burden of caring for the patient, but also the emotional distress that the family member they know and love so well is now a “different” person.

Brain damage can occur from many different causes, the most common being trauma, stroke, infections, and neurodegenerative diseases such as Alzheimer’s or Parkinson’s disease. Since its inception, the NNI has been intimately involved in the immediate care and management of these patients.

It has also contributed extensively towards scientific research to improve our understanding of the causes of brain damage, and to developing potentially meaningful therapies to aid recovery and prevent further brain damage.

These research programmes span the entire spectrum, from optimized acute traumatic brain care to improve outcomes, to designing novel neuro-rehabilitative regimens to help brain damaged survivors integrate back into society. Planned research themes also include innovative research into regeneration of the damaged nervous system using new molecular and cellular therapies.

The Brain Damage Research Endowment Fund aims to help Singapore carry out relevant and ground-breaking research that will one day improve the outcome of these patients.

Gifts Of Love

for Brain Damage Research Endowment Fund

Talented potters, Mrs Mavis Oei, Chairman of the Goodwood Park Hotel Group and Ms Jaqueline Low, Pottery Teacher came together with a group of friends to produce 200 pottery pieces for Gifts of Love, a pottery exhibition-sale organised in December 2007 to raise funds for the NNI Brain Damage Research Endowment Fund. This fund will enable research in the areas of trauma of the nervous system and the design of novel neuro-rehabilitative regimens for brain-damaged survivors. Associate Professor Lee Wei Ling, Director of the National Neuroscience Institute specially commissioned two glazed plates, titled “A glance is worth a thousand kisses”, as a moving tribute to the love and support that her parents have given to each other in the course of their marriage.

Interventional NeuroradiologyEnhancingCareUsingAdvancedTechnology


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EnquiriesNational Neuroscience Institute Neuroradiology Department Tel: (65) 6357 7022 Fax: (65) 6357 7039Website : www.nni.com.sg

Procedures commonly performed by the neurointerventional team include the following:

1. Embolization of intracranial aneurysm

2. Transarterial and transvenous embolization of cranial and spinal dural arteriovenous fistulas, including caroticocavernous fistula

3. Transarterial embolization of cerebral and spinal arteriovenous malformations (AVMs)

4. Intracranial (e.g. internal carotid, middle cerebral, vertebrobasilar arteries) percutaneous transluminal angioplasty (PTA) and stenting

5. Extracranial PTA and stenting (e.g. common and internal carotid and vertebral arteries)

6. Acute thromboembolic stroke management using intra-arterial chemical thrombolysis and mechanical thrombectomy device

7. Chemical and mechanical angioplasty of intracranial vasospasm

8. Direct puncture sclerotherapy of head and neck low flow vascular malformation

Whatisinterventionalneuroradiology?Interventional Neuroradiology is a minimally invasive approach in the treatment of vascular diseases of the central nervous system. As opposed to open surgery that involves opening of the skull bone to reach the target for surgical repair, interventional neuroradiology uses endovascular techniques that treat vascular diseases from within the lumen of the blood vessel. Tubes known as catheters are inserted (mostly via large blood vessel in the groin) and using a series of gradually decreasing caliber catheters within each, the smallest catheter is then navigated into the target diseased blood vessel of the brain, within which materials and devices can be introduced to perform the treatment.

Whoisitfor?Patients with conditions such as aneurysms, vascular malformations or tumours of the brain, spine including head and neck can be considered for treatment by using endovascular techniques. Interventional techniques such as thrombolysis (‘clot-busting’) and clot retrieval devices can also be used for the urgent management of patients with acute ischemic stroke.

OURSERVICESOur dedicated neurointerventional team comprises experienced doctors qualified in the treatment of neurovascular disorders, highly trained nurses and radiographers specialized in assisting neurointerventional procedures on a 24-hours basis.

Cerebralaneurysm

Brain

Bloodvessels

The National Neuroscience Institute (NNI) neuroradiology interventional service is supported by a group of dedicated Nurse Specialists. Besides providing important liaison between doctors, patients and their families, they possess subspecialised skills in assisting interventional procedures for the treatment of neurovascular diseases.

Neurointerventional Nursing is a nursing speciality unique to NNI. In this highly subspecialised field of interventional neuroradiology, these nurses are an integral part of the team, working along side doctors during each interventional procedure, and applying their special brand of nursing expertise to ensure the procedures are successful.

“Our work covers a wide spectrum of duties. Together with the doctors and technologists, we are trained to take care of patients in different modalities of imaging from computed tomography (CT) to magnetic resonance imaging (MRI) and importantly, we are a rare breed of nurses highly trained in the field of neurovascular interventional work.” says Nurse Manager Low Hwee Huang, who manages the department’s nursing team. “The work is tireless but never boring. A procedure can last from 2 hours to more than 8 hours, not forgetting bearing the weight of our 1.5 kg radiation protection apron.” “Being a neurointerventionally trained nurse

has its challenges” says Senior Staff Nurse Rozana Othman. “We see patients of all ages, and I remember the youngest patient I assisted in treatment was a three days old neonate with congenital vascular malformation of the brain. At times, the interventional team has to be activated at odd hours of the day to tend to urgent cases like massive bleeding from the head and neck region that needs to

be embolized immediately.”

Apart from assisting the doctors, patient education and counseling are important roles of the interventional nurses. Dispensing post procedural care advice and financial counselling are also part of the job.

Chan Wai Yee, senior staff nurse says, “I have been working in neuroradiology for 9 years now. It is a definitely a challenging field because we have to keep up with the newest techniques and procedures.”

“I find my role as a neuroradiology nurse more challenging as the procedures get more complex,” says Fam Su Rong, a staff nurse of the team. “I also get to interact and understand the patients better as compared to my previous attachment in the general nursing ward.”

“With rapid advances in neurointerventional techniques, there is a need for experienced nurses trained in this field. Patient care can be complex as many patients with neurovascular diseases are acutely ill,” says Dr Wickly Lee, consultant and neurointerventionalist specialist. “That’s why having nurses on your team who have the right experience counts towards successful patient management.”

Neurointerventional Nursing

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From left, SSN Chan Wai Yee, SN Fam Su Rong, SSN Rozana Othman and NM Low Hwee Huang in their scrub suits and protective aprons.

The nurses with Dr Francis Hui (extreme left)

Head of Department (Neuroradiology) and

James Tan, Sr Radiographer and Tan Jau Tsair,

Assistant Manager/CT In-charge (far right).

As a value-added service, the Motor Control Laboratory was set up in January 2008 for patients with Parkinson’s disease and movement disorders. The laboratory provides diagnostic evaluation of movement disorders through various methods of quantitative measures and electrophysiological studies. Quantification of movement disorders is useful for the monitoring of disease progression and treatment response, especially in the context of akinetic-rigid disorders and tremor disorders. This service is provided by the Parkinson’s Disease and Movement Disorders Centre of the National Neuroscience Institute (NNI), as part of our continuing effort to improve the care and management of Parkinson’s disease.

Parkinson’s disease is one of the most common neurodegenerative diseases, affecting three per 1000 individuals aged 50 and above in Singapore. It is a chronic debilitating illness, presenting with slowing of movement (bradykinesia), stiffness (rigidity), shaking of

NEW! Motor Control Laboratory for PD patients

limbs (tremor), and falls (postural instability). Of these symptoms, bradykinesia is the most consistent and disabling symptom. Fortunately, there are effective medications to control these symptoms so that patients may remain active in the community.

One of the challenges in the management of parkinsonism is to determine the level of response to treatment, which is used as a supportive criteria to diagnose Parkinson’s disease. The specialist uses a clinical rating scale which is subjective and requires training of raters to ensure inter-rater consistency. Patients with Parkinson’s disease and related disorders may be on follow-up by primary physicians, geriatricians, and general physicians, who may not be familiar with the clinical rating scales. The Motor Control Laboratory will provide objective measures of motor performance, so that physicians may use these quantitative data to monitor disease progression and to evaluate treatment response.

OurServicesThe Motor Control Laboratory uses various techniques to quantitate motor disability so that physicians may have objective markers to monitor disease progression and treatment response in parkinsonism. The laboratory is run by a team of movement disorders specialists, nurse clinicians and technicians. Three services are currently offered:

1) Motor-time testing 2) On-off evaluation 3) Deep Brain Stimulation (DBS) programming and evaluation

The services are open to all doctors who manage patients with Parkinson’s disease and related disorders.

MotorControlLaboratoryNeurodiagnostic Service Laboratory, Level 1National Neuroscience Institute (Tan Tock Seng Hospital Campus)

MakinganAppointment&EnquiriesTel : (65) 6357 7070 Fax: (65) 6357 7069

OperatingHours8:00am to 5:30pm (Mon-Wed, Fri)8:00am to 5:00pm (Thurs)CLOSED on Saturdays, Sundays and Public Holidays

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Clearing The Misconceptions of Brain InjuryIf you enter a room full of people, would you be able to identify those who have had suffered a brain injury? Are two head injuries better than one? Does the mind overrule everything?

MisconceptionsaboutTraumaticBrainInjury(TBI)TBI is a major public health problem accounting for one-half of trauma related deaths in Singapore and a further unquantified proportion of severe and permanently disabled survivors especially in the under 35-year-old age group. Over the past decades, scientific and technological advancement in the field of brain injury have led to increased survival from injuries which would have been fatal previously. Following all grades of brain injury, it is not uncommon to have temporary or permanent consequences affecting the behaviour, concentration, cognition, memory, personality, and physical abilities of a person.

Brain injury is often called the invisible disability. TBI patients with no visible disabilities were commonly referred to as the “walking

wounded” as the complexity of TBI and the effects of often subtle brain damage may make people difficult to be aware of the existence and often misidentify persons with TBI as learning disabled or mentally ill.

There are many popular misconceptions about the effects and recovery after a TBI, which may result in part from our daily experiences, inaccurate portrayals in books, movies, and television and affect the successful reintegration of brain injured survivors into society. This article highlights some of the common misconceptions identified in a survey conducted on 100 mild TBI patients and their immediate families in the National Neuroscience Institute.

Alittlebraindamagedoesnotmattermuch,sincepeopleonlyuseapartoftheirbrainsanyway.Reality: Thebraincontrolsandco-ordinateseverythingwedo–thinking,walking,talking,swallowing,breathing,feelinghungryandthirsty,andfeelingangryorsad.Damagetoarelativelysmallarea,butcriticalregioninthebrainmaycausedevastatingdisabilities.

Asimpleknockorbumpontheheadwillnotcausebraindamagesolongasthepersonisnotknockedout.Reality:Headinjuriescancauseslowandsubtlebleedingbetweenthebrainandtheskull,andthesignsofsuchbleedingmightnotbeapparentforseveralhours.Minorheadtrauma,evenwithoutdirectheadimpact,orlossofconsciousness,orabnormalitiesevidencedinMRIorCTscans,canresultinlong-termproblemsaffectingthecognition,concentration,behaviour,personalityandmemoryofaperson.

Itisobviousthatsomeonehasbraindamagebecausetheylookdifferent.Reality: Manybraininjuredpeopleshownooutwardphysicalsignsofdisability,andcontinuetosuffercognitive,memory,andbehaviouralproblems.

Apersonwithabraininjurymayhavetroublerememberingeventsthathappenedbeforetheinjury,butusuallydoesnothavetroublelearningnewthings.Reality: Posttraumaticamnesiaiscommonafteraheadinjuryanddeficitsinthelearningandretentionofnewinformationareoftenseenintheearlystagesofrecoveryandsometimespermanent.Manybraininjuredpeopleexperiencesignificantdifficultiesintakinginnewinformation,makingmanyeverydaytasksextremelydifficult.

WorldHeadInjuryAwarenessDayThis was celebrated on 20 March 2008. This ‘celebration’ bears specific significance especially in India, which has the largest annual incidences of head injuries. Every day, almost 500,000 people are reported to suffer a head injury in some form or the other and it is the sixth most common cause of death, in the country.

BRAININJURYSUPPORTGROUPATNNIThe journey after a TBI can be very long. Joining a support group open up opportunities for TBI survivors and their carers to meet for mutual support and assist in re-integration into the society. Call tel : 6357 7545 for more information.

#1:

#4:

#5:

#2:

Sometimesasecondblowtotheheadcanhelpapersonrememberthingsthatwereforgotten.Reality: Itishighlyunlikelythatasevereblowtotheheadwillproduceamiraculous,oftenimmediate,recoveryfromamnesia.

#3:

Myths and Realities of Brain injury

Howquicklyapersonrecoversafterabraininjurydependsmainlyonhowhardheorsheworksatrecovering.Reality: Notwobraininjuriesarealike,soistherecovery.Recoveryafterabraininjuryoccursinanorderlyfashion.Outcomeisprimarilydeterminedbythelocation,extentandseverityofbraininjuryasopposedtopurelypersonalmotivationandhardwork.Rehabilitationisaprocessthataimstorestorethebrain-injuredpersontohis/herhighestfunctionalstatuspossibleandaidreintegrationbackintothefamilyandcommunity.

#6:

Dr Esther Wong (Extreme Right) with conference chair, Dr Ana Maria Cuervo (2nd from right), and delegates from other countries.


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Award for NNI Researcher at PrestigiousGordonResearchConference

References1. Wong, E.S.P. Tan, M.M.J. et al., (2008)

Autophagy-mediated clearance of aggresomes is not a universal phenomenon. Gordon Research Conference on Autophagy in Stress, Development and Disease. California, USA.

2. Tan, M.M.J*., Wong E.S.P*, et al., (2008) Lysine 63-linked ubiquitination promotes the formation and autophagic clearance of protein inclusions associated with neurodegenerative diseases. Human Molecular Genetics., 17, 431-439 (IF 8.1) (*Equal contribution)

3. Tan, M.M.J., Wong E.S.P, (2008) Lysine 63 polyubiquitin potentially partners with p62 to promote the clearance of protein inclusions by autophagy. Autophagy., 4(2), 251-253 (IF 6.7)

Dr Esther Wong, a postdoctoral fellow affiliated to the NNI Neurodegeneration Research Laboratory (PI: Dr Lim Kah Leong), won a cash (travel) award in a poster competition at the prestigious Gordon Research Conference on Autophagy in Stress, Development and Disease held in California early this year. According to the conference chair, Dr Ana Maria Cuervo, the Poster1 presented by Dr Wong has received numerous votes from the delegates and was ranked highest in the list of runner-ups at the competition. Dr Wong has presented the work done in Dr Lim’s laboratory demonstrating that protein aggregates associated with various neurodegenerative diseases are cleared differently by the cell’s bulk degradation machinery (otherwise known as autophagy).

Their result has important implications for the use of autophagy induction as a therapeutic strategy for diseases caused by cellular mismanagement of aggregation-prone proteins. Notably, Dr Lim’s laboratory has recently identified a novel signal that facilitates the clearance of disease-associated aggregates by autophagy2,3 , a discovery that Dr Wong has also helped contributed.

When you think about treating diseases, medicines are probably the first line of defence. But recently, it is the humble cup of black tea that is making the headlines since the press conference on 18 January at the National Neuroscience Institute (NNI) revealed some extraordinary findings.

In a study led by Dr Louis Tan, senior consultant neurologist and lead researcher with other neurologists from the NNI and Dr Koh Woon Puay, assistant professor from Yong Loo Lin School of Medicine of National University of Singapore (NUS), they discovered that those who drink 23 cups of black tea a month are 71 per cent less likely to develop Parkinson’s disease (PD). The researchers postulate that black tea may contain neuro-protective agents that contribute to its health benefits against Parkinson’s disease.

The benefits of the beverage were not linked to the caffeine content, as revealed in the results of the study of about 63,000 men and women between ages 45 - 74. The findings were first published in the online issue of the American Journal of Epidemiology in December 2007.

While caffeine was associated with a protective effect, the benefits of black tea were not affected by the caffeine content. When adjusted for the caffeine level in black tea, the results were almost the same. This proved ”there’s something in black tea other than caffeine that protects,” said Dr Koh.

About 3 people out of 1,000 suffer from Parkinson’s disease, a degenerative disorder of the brain. Parkinson’s disease is a degenerative condition affecting movement and balance in men and women of late middle age. The number of people suffering from Parkinson’s disease is increasing with 300 new cases diagnosed each year, added Dr Louis Tan.

However, as with all things, everything must be done in moderation. Do not start to drink tea excessively. The important things are to know your limit and eat wisely and healthy.

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Black Tea Could Lower Parkinson’s Risk

Dr Koh Woon Puay and Dr Louis Tan. The other NNI researchers; (left) Dr Au Wing Lok, consultant neurologist and Dr Tan Eng King, senior consultant neurologist.

AdvisorA/Prof Lee Wei Ling

EditorDr Ang Beng Ti

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EditorialTeam

CALENDAROFEVENTSEnquiriesandRegistration Tel : (65) 6357 7152 / 6357 7163Fax : (65) 6256 4755Email : [email protected] : www.nni.com.sg

SUPPORTGROUPSParkinson’sDiseaseSupportGroupNNI@TanTockSengHospitalFirst Thursday of the month from 4 pm – 5:30 pm Neuroscience Clinic (Level 1), Tan Tock Seng HospitalTel: 6357 7060

NNI@SingaporeGeneralHospitalFirst Monday of the month from 11:00am to 1:00pmRehabilitation Centre (Education Resource Room, Block 1, Level 1) Tel : 8125 3543

AddressNational Neuroscience Institute 11 Jalan Tan Tock SengSingapore 308433Tel : (65) 6357 7153 Fax : (65) 6256 4755

[email protected]

Websitehttp://www.nni.com.sg


ThearticlesprovidedinNeuslinkareforinformationonlyanddoesnotreplacemedicaladvicefromyourdoctor.ContentsarenottobequotedorreproducedwithoutthepermissionfromtheCorporateDevelopmentDepartmentofNationalNeuroscienceInstitute.

BrainTumourSupportGroupEvery Wednesday of the month from 6.45 - 8.00pmNeuroscience Clinic (Level 1), Tan Tock Seng HospitalTel : 6357 7507 / 6357 8232

BrainInjurySupportGroupEvery 3rd week of even monthsNeuroscience Clinic (Level 1), Tan Tock Seng HospitalTel : 6357 7545

10 May GP Seminar – Movement Disorders and Dementia

5 July GP Seminar - Stroke

23 August Community Care Partners Programme Workshop 2 –

A Nursing Perspective

31 October - 2 November 10th Singapore Stroke Conference

13 - 14 November 8th Advanced Neuroradiology Course

28 - 30 November EEG/EMG Workshop

CommitteeMembersDr Wickly LeeDr Lim Kah LeongDr Kamal VermaDr Ernest WangMs Christina Wee (Co-ordinator)

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