Transcript Research Activities in a nutshell

Neuroepidemiolgy in a nutshell
Christina Wolfson
What is neuroepidemiology?
Domains of inquiry?
Selected topics
Funding opps
Neuroepidemiology
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– that branch of epi dealing with the study of neurological
disease
• Journal NEUROEPIDEMIOLOGY (founded in 1982)
• Few neuroepidemiologists in Canada
– SER 2005 Symposium on neurological diseases
Domains of Enquiry
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GENETIC
PHARMACO
GLOBAL
INFECTIOUS
CLINICAL
SURVEILLANCE
METHODOLOGY
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PERINATAL
LIFECOURSE
WOMEN'S
ENVIRO
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MENTAL
BIOSTATISTICS
What?
• Epidemiology of
Neurodegenerative
disorders
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Design
Detection
Distribution
Determinants
Prevention
Prognosis
• Multiple Sclerosis
• Amyotrophic Lateral
Sclerosis
• Parkinson’s Disease
• Alzheimer’s disease
With whom?
Neurologists, Neuropsychologists,
Economists, Statisticians, Physiotherapists,
Nutritionists, Family Docs, Sociologists,
Ethicists, Lawyers, Engineers,
Kinesiologists, Clinical biochemists,
Immunologists, Virologists, Geneticists, ......
How?
Whatever is needed!
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Case control
Cohort
Case crossover
Clinical Trial
Prevalence
Statistical methods
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Systematic reviews
Databases
Face to face interviews
Telephone interviews
Self administered
questionnaires
• Physical assessments
• Biological samples
• Focus Groups
Some pending questions
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What is the prevalence of
– MS in Canada?
– ALS in Canada?
– Parkinson’s disease in Canada?
How do we identify MS, ALS, PD in population based studies without a full neuro
assessment?
What is the best tool to identify cognitive impairment in a population based study?
How do we identify participants who do not have the capacity to consent to research?
Is the incidence of MS increasing in women but not in men? If so, why and what etiological
clues might it provide?
How do we fold pediatric multiple sclerosis into what we thought we knew about the
susceptibility period of MS (adolescence)? Can pediatric MS provide clues to the etiology of
adult onset MS?
What are our best strategies to conduct risk factor studies on ALS, a rare, rapidly fatal
disease?
Is the incidence of ALS really increased in deployed Gulf War Veterans? How can we study
this? What is the optimal comparison group?
Has survival with MS increased over the past 50 years?
How has the presence of length bias (lack of adjustment) influenced what we believe about
survival with neurological disorders?
Selected projects (1)
• International case control study of MS risk factors
– Norway, Italy, Sweden, Serbia, and Canada
• Risk factors: Smoking, Vit D through Diet; Sun exposure,
Early life infections
• 4,000 cases – 16,000 controls
• Pilot work – MSc thesis project
• MS Latitude Project
– Feasibility study for a prevalence study of MS in Qc
using capture-recapture methodology
– Survey of physician preferences for the care of
individuals with MS
Selected projects (2)
• Profile of Neurological Diseases in Canada (POND)
– Systematic review and knowledge synthesis
• Prevalence and correlates of successful health care
transition in young adults with chronic neurological
disorders
– MSc Thesis Topic – student generated
• The Epidemiology & Impact of Comorbidity on
Multiple Sclerosis in Canada
– New emerging team
Selected topics (3)
• Program in Epidemiology Targeting Amyotrophic
Lateral Sclerosis (PETALS)
– Development and testing of risk factor questionnaires
– Implementation of a database including risk factor info
– Setting the stage for epidemiological research in Canada
• Validation of diagnostic algorithms for Parkinson’s
disease
• Neurological/neurocognitive outcomes in Gulf War
veterans
• Canadian Longitudinal Study on Aging
Trainee Topics in Neuroepi
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MSc (EBOH and Math/Stat)
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Impact of misclassified exposure to
infectious agents in case-control studies of
multiple-sclerosis (thesis)
Measures of change in cognition on AD
(Thesis)
*Seasonal variation in Parkinson’s disease
risk (Thesis)
*Successful health care transition in young
adults with chronic neurological disorders
(Thesis)
Lifestyle risk factors & AD (project)
Frequency & correlates of behaviour
disturbance in AD (project)
Age at onset of AD – correlates (project)
Methods to study the natural history of
MS (thesis Math/Stat)
A new capture-recapture model selection
criteria (thesis Math/Stat)
MS prognosis: A review of statistical
modelling approaches (thesis Math/Stat)
Validity of the Markov assumption in
economic studies of AD medications
(thesis Math/Stat
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Postdocs
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PhD students (EBOH)
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Mental incapacity & long term participation in
observational research
*Satisfaction with assistive technologies in MS
Delirium in elderly post surgical patients
Spatial statistics & their application to
neuroimaging studies of MS patients
(Biostatistics)
Fully Bayesian mapping models to identify high
risk areas with an application to MS in Sardinia
(Biostatistics)
*Physican & caregiver preferences for treatment
options in AD
Neurology residents/clinical fellows
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MS in Canada
Epstein Barr Virus and MS
Quality of Life in MS
MS in the Middle East
Lead exposure and ALS
Canine Distemper Virus & MS
Surgical resection of brain tumours and survival
• In 2009 Successfully lobbied the government to commit
$15million to epidemiological research into neurological
disorders
• Prevalence/incidence/burden/risk factors/treatment
Funding Opps
• CIHR, FRSQ, disease specific societies
– MS, PD, ALS etc.
• CIHR Neuroinflammation Training Grant
(McGill- U de M – Laval consortium)
• EndMS Research and Training Network
– $20 million initiative to recruit, retain and train
student/researchers interested in MS related
research
– Studentships, summer schools etc.
Questions?
[email protected]