01 Tele-Stroke Programme02 Tele-Stroke Programme (cont’) Preventing Stroke 03 NNI-Aesculap Academy Thoracolumbar Approaches Course04 2nd Singapore International Neurocognitive Symposium 05 2nd Singapore International Neurocognitive Symposium (con’t) Regional Consortium for Neurocognitive Research and Training06 The ABCs of Empowering People with Parkinson’s (PWPs) Parkinson’s Disease - More than movement

07 Raising Expertise in Parkinson’s Disease Rehabilitation 08 3rd EEG-EMG-Autonomic Workshop 09 Levodopa and the Feedback Process

on Set-Shifting in Parkinson’s Disease 10 Multiple Awards for NNI Research Interns11 Mark Your Calendar • Upcoming Events: 11th Advanced NR Course • 13th Singapore Stroke Conference 12 Calendar of Events / Support Groups

Contents

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

Continued to page 2

TELE-STROKE PROGRAMME Harnessing Technology for Stroke Care

January - June 2011 Volume 13, No: 1

MICA (P) 092/06/2011

The National Neuroscience Institute (NNI) partnered Changi General Hospital (CGH) for the launch of the NNI Tele-Stroke Programme. This programme provides patients with immediate, 24/7 access to stroke care experts at NNI.

Telemedicine technology for stroke, known as “Tele-stroke’ was officially launched on 25 October 2010 as a pilot project by the NNI and its care partners - Singapore Health Services (SHS) and Changi General Hospital (CGH). It is an integrated effort to develop a technology-based system to allow the remote diagnosis and treatment for acute stroke patients. This technology will enable eligible patients to receive

the best possible care for stroke, in the quickest possible time.

Stroke is Singapore’s fourth most common cause of death, and the leading cause of chronic severe disability. Thousands of Singaporeans are admitted to hospitals each year because of stroke or its complications. Time is important in the treatment of acute ischemic stroke. To be eligible for treatment with the clot busting drug called recombinant tissue plasminogen activator (rtPA), the patient must seek medical treatment in the quickest possible time. The safe administration of this drug requires expertise which is not always available 24/7 at all hospitals.

Eligible patients who receive the drug within 3 hours (4 and a half hours in selected cases) of stroke onset may have reduced disability rates and improved post-stroke recovery. Working with NNI neurologists, Emergency Department doctors at CGH will be able to diagnose and treat eligible stroke patients within the three-hour window period. This gives patients the best chance of a good outcome. The computer assisted programme provides advanced web-conferencing technology that enables communication between the CGH Emergency Department doctors, NNI neurologists and the potential IV rtPA candidate.

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NNI

TELE-STROKE PROGRAMME

continued from page 1

More specifically this will enable NNI neurologists to do remote consultation of the stroke patient at CGH Emergency Department, review the patient’s CT scan of the brain and confirm eligibility of the patient for IV rtPA treatment.

Working together, the NNI neurologist and CGH emergency doctor would develop a care plan based on the established stroke protocols including, if appropriate, the administration of rtPA.

As explained by Dr Rajinder Singh, Project Leader and Consultant, Department of Neurology, NNI “Our aim in developing this programme is to allow us to complement the clinical skills with the most advanced technology for better clinical outcomes. Tele-stroke is part of our overall plan towards enhanced care. Importantly, this enables NNI to improve the level of co-ordinated care for our patients. We are now able to work with our care partners to facilitate earlier and faster diagnosis, so that appropriate treatment can be given promptly.”

Associate Professor Lee Kim En, Senior Consultant and Head, Department of Neurology, NNI, further added that, “Early treatment remains the cornerstone of acute ischemic stroke management and it is important patients must arrive at hospitals at the earliest time possible. “Time is brain” carries a new meaning as tele-stroke makes it possible to reduce the amount of time taken to identify and treat a patient with rtPA, thus improving patient outcomes. With Tele-stroke, it allows NNI an opportunity to extend this enhanced level of stroke care service to the patients.

“Tele-stroke is part of our overall plan towards enhanced care. Importantly, this enables NNI to improve the level of co-ordinated care for our patients.” – Dr Rajinder Singh, Project Leader and Consultant, Department of Neurology, NNI

“With Tele-stroke, it allows NNI an opportunity to extend this enhanced level of stroke care service to the patients.”– Associate Professor Lee Kim EnSenior Consultant and Head, Department of Neurology, NNI

Spine hands-on workshop where participants have the opportunity to try out latest instruments.

STROKE IS AN EMERGENCY. Recognise stroke symptoms and act F.A.S.T. Early treatment may limit the effects of stroke.

FACE - Facial droop. Uneven smile.

ARM - Arm numbness. Arm weakness.

SPEECH - Slurred speech. Difficulty in speaking or understanding.

TIME - Call 995 and get to the hospital immediately.

Act FAST

Preventing Stroke Signs and Symptoms

How Does Telestroke Work?Telestroke technology operates on a “hub and spoke” model, in which specialist neurologists at the ‘hub’ communicate with the ‘spoke’ hospital’s Emergency Departments (ED) via video-conference link. Working together, the stroke neurologist and the ED staff develop a care plan based on the established stroke protocols including, if appropriate, the administration of rtPA.

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NNI-Aesculap Academy Thoracolumbar Approaches Course

Dr Rajendra Tiruchelvarayan, Course Chairman, giving a lecture on the clinical anatomy of thoracolumbular region.

(Far left) Dr Danny Louange Thomas, from the department of Orthopaedic Surgery at Tan Tock Seng Hospital, guiding the trainees.

Trainees working on the cadaver.

The annual National Neuroscience Institute (NNI)-Aesculap Academy Thoracolumbar Approaches Course jointly organised with the Aesculap Academy was held on 9 and 10 May 2011, at the Post Graduate Medical Institute and Surgical Experimental Laboratory, Singapore General Hospital.

The course took a specialised approach this year with focus on ‘Surgery For Thoracolumbar Spine”. The previous years’ course coverage included keyhole neuroendoscopic surgery, skull base surgery and cervical spine.

The participants comprising local and regional neurosurgeons went through a morning of lectures, followed by a day and a half of hands-on workshop covering the thoracolumbar spine region. The hands-on workshop was led by a team of experienced neurosurgeons from NNI and orthopaedic surgeons from Tan Tock Seng Hospital. Feedback from the course trainees was good, and they were asking when the next course would be held.

Said Associate Professor Ivan Ng, Senior Consultant and Head, Department of Neurosurgery, NNI “The Course was a success and experts from the field gave the trainees a good series of lectures and guidance during the hands-on workshop.”

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2nd Singapore International Neurocognitive Symposium draws more than 300 regional healthcare professionals

The Singapore International Neurocognitive Symposium organised by National Neuroscience Institute (NNI) was held on 4 and 5 March 2011 at the Hilton Singapore Grand Ballroom.

The two-day conference comprised a faculty of 30 speakers from the various foreign and local hospitals. It attracted an audience of more than 300 regional healthcare professionals which included family physicians, specialists, nurses and therapists.

Singapore is one of the fastest ageing countries in the world. It was noted that by 2030, one fifth of Singapore’s population will be 65 years and older, making it among the ten fastest ageing countries in the world. With this, the number of Singaporeans suffering from dementia is likely to rise. It is expected that the number of persons with dementia will more than double from about 20,000 today to 45,000 by year 2020.

The conference provided a platform for regional professionals to exchange up-to-date information in the field of cognitive disorders, ranging from epidemiology, to practical clinical applications and management. A panel discussion was included to allow doctors from Southeast Asia discuss their local policies in managing the growing number of dementia patients in their countries.

‘I am confident that the academic sessions in this symposium will enrich our knowledge in the field of cognitive neuroscience and would lead to better care for our patients with cognitive disorders’, said Dr Nagaendran Kandiah, consultant from the department of neurology, NNI and the symposium organising chairman.

The organising commitee put together a programme comprising plenary sessions and workshops tailored for medical doctors and allied health professionals to better understand the advancement in dementia care and hence be able to provide a holistic care for patients with neurocognitive disorders.

The symposium highlights included topics that interest many, such as genetics of dementia, epidemiology of dementia in Singapore, new insights into frontotemporal dementia and there were four concurrent workshops that focused on the different aspects of dementia.

Dr Nagaendran Kandiah, Organising Chairman of the Neurocognitive Symposium.

Guest of Honour, Mr Hawazi Daipi, Senior Parliamentary Secretary for Ministry of Health.

Dr Robin Hsiung from The University of British Columbia delivered a lecture on “Genetics of Dementia: Current Status and Future Role”.

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Judging the poster presentations.

Judging the poster presentations.

RegioNAl CoNSoRTiuM foR NEuROCOGNITIVE RESEARCH AND TRAINING

The National Neuroscience Institute (NNI) together with its partners, started a new initiative which hopes to help clinicians across Southeast Asia translate research into meaningful applications for managing patients with cognitive disorders.

The Neurocognitive Research and Training Consortium (NRTC), Southeast Asia (NRTC-SEA) was formed in recognition of the value of regional alliance in understanding and addressing the neurocognitive health needs of Southeast Asian populations. The Consortium aims to co-ordinate cognitive research in Southeast Asia and has several key research and training projects lined up for the coming years, said the chairman of the group’s steering committee, Dr Nagaendran Kandiah, consultant from the department of neurology at the NNI. Inaugurated during the 2nd Singapore International Neurocognitive Symposium on 4 March 2011, the NRTC-SEA is made up of six country-specific representatives from Brunei, Indonesia, Malaysia, the Philippines, Thailand and Singapore, and its activities are to be guided by steering and advisory committee of eminent neurologists from across the region.

Specific types of research projects the consortium is expected to engage in include dementia-related epidemiological studies, biomarker research and clinical trials.

OBJECTIVES of the NRTC-SEA

• To facilitate culturally-appropriate, multidisciplinary clinical and academic collaborative research in Southeast Asia.

• To establish a forum for lively intellectual exchange that leads to the generation of new knowledge in the area of cognition.

• To develop efficacious international collaborative research programmes that transform clinical assessment, treatment, and rehabilitation for individuals suffering from neurocognitive disorders in Southeast Asia.

• To maximise the use of regional resources for cognitive education through active co-operation in the form of inter-institutional training and combined conferences.

• To promote and conduct studies that raise the standards of care, help better the lives of patients, and improve the health status of patients with cognitive disorders in Southeast Asia.

Members of the NRTC-SEA with Mr Hawazi Daipi (centre), Senior Parliamentary Secretary for Ministry of Health (Singapore). From left to right: Dr Shahul Hameed (Singapore), Dr Irene Looi (Malaysia) , Dr Nagaendran Kandiah (Singapore), Dr Simeon Marasigan (Philippines), Dr Norazeida (Brunei) and Dr Paulus Anam Ong (Indonesia).

Workshops in session.

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The team with workshop director, Dr Au Wing Lok, Senior Consultant Neurologist from NNI (Far left)

Parkinson’s Disease – More Than Movement

The ABCs of Empowering People with Parkinson’s (PWPs)

Parkinson’s disease is usually considered to be a condition with significant movement problems characterised by tremor, slow movement and stiffness. Yet many people with Parkinson’s also experience non-motor symptoms like sleep, mood, constipation and memory problems.

These symptoms are frequently more troubling, and interfere more with daily life, than the motor problems. Recognising non-motor symptoms, understanding how they may affect the quality of life is an important step towards taking control of the health and learning to live well with Parkinson’s.

Learning how to cope with the non-motor symptoms of Parkinson’s was the focus of the public forum held on 9 April 2011. Both the English and Mandarin sessions were held concurrently at the TTSH Theatrette and attracted over 300 participants. The panel of speakers comprised neurologists, nurses, therapists and dieticians who shared with the audience the types of non-motor symptoms and its coping techniques.

The forum was organised by National Neuroscience Institute (NNI), together with Tan Tock Seng Hospital (TTSH) and the Parkinson’s Disease Society of Singapore and in conjunction with World Parkinson’s Day which fell on 12 April 2011.

The National Neuroscience Institute Community Care Partners Programme (NNI-CCPP) Workshop this year was conducted on the 16 April 2011, and saw many nurses and medical social workers attending.

Into its fifth run, the aim of this NNI-CCPP workshop was “The ABCs of Empowering PWPs”.

The team of trainers were Ms Li Wei, Advance Practice Nurse from NNI, Ms Alisa Tan, Ms Janet Chua and Ms Regina Huang, Medical Social Workers from Tan Tock Seng Hospital. Ms Alisa Tan and the team provided the participants with a very lively and practical approach to applying the ABCs to their day-to-day interaction with patients with Parkinson’s.

Participants were taught how to assess patients using the Hoehn and Yahr’s scale. The Hoehn and Yahr scale is a commonly used system for describing how the symptoms of Parkinson’s disease progress. They were also taught how to conduct a family assessment using the genogram and genomap. Other topics included psycho-education, how to do a resource map, and resources available in the hospital and community.

In between lectures, they were given multiple choice questions to apply what they had just

learned. Using the Auto Response System (ARS), answers from participants are instantly generated via hand-sized ARS clickers, and reflected live onto the presentation slides.

Participants were then given case studies and had to present their discussions. The interactive format made it very useful for them to apply their knowledge of the ABCs.

ABCs of Empowering PWPs

A for Access needs

B for Broaden knowledge

C for Connect to resources

Primary Symptoms

• Shakingofarmsorlegsatrest• Stiffnessofarms,legsorbody• Slownessofmovementandwalking• Stabilityproblemswhenwalkingor standing Secondary Symptoms • Constipation• Difficultyswallowing• Constipation• Difficultyswallowing• Choking,coughing,ordrooling• Excessivesalivation• Excessivesweating• Lossofboweland/orbladdercontrol • Lossofintellectualcapacity• Anxiety,depression,isolation• Scaling,dryskinonthefaceorscalp• Slowresponsetoquestions

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HMDP Visiting Expert in

RAISING EXPERTISE IN PARKINSON’S DISEASE REHABILITATION

Dr Au Wing Lok, Senior Consultant Neurologist from NNI giving an overview of the NNI-Community Care Partners Programme.

HMDP visiting expert, Ms Margarita Makoutonina.

Margarita Makoutonina, a lecturer from Australia’s Royal Melbourne Institute of Technology (RMIT) University and Mayfield Education Institute, and acting manager of Allied Health Department in Elsternwick Private Hospital presented a talk on Parkinson’s disease rehabilitation on 15 January 2011, as part of the Health Manpower Development Programme (HMDP).

Ms Makoutonina is the senior clinician and occupational therapist in the Victorian Comprehensive Parkinson Program (VCPP), National Centre of Excellence in Melbourne, Australia. For the past 12 years, she has worked closely with neurologists to develop a specific rehabilitation programme and also with multidisciplinary teams to provide a tailored approach to the overall management of people with Parkinson’s disease. Ms Makoutonina’s talk covered various areas of Parkinson’s disease

rehabilitation and how it enhances the lives of people with Parkinson’s disease. Topics covered included needs of the patients, caregiver related issues, financial considerations, relationships issues, provision of care and service access. She also shared her knowledge on the latest in Parkinson’s rehabilitation, including ideas on standards of care in Australia.

The talk held at the Tan Tock Seng Hospital theatrette was well attended by over 200 allied health professionals from around Singapore. It was organised by the National Neuroscience Institute, Tan Tock Seng Hospital and Parkinson’s Disease Society of Singapore (PDSS). The visit provided excellent opportunities for the HMDP expert to share her expertise and experience with the local community, doctors, nurses and the allied health professionals.

(Second from right) HMDP expert Ms Margarita Makoutonina with (from left) Dr Au Wing Lok, Senior Consultant Neurologist from NNI, Ms Julie Lau, President of PDSS and Mr David Zhang, Senior Occupational Therapist from Tan Tock Seng Hospital.

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Riding on the success of the 2nd EEG-EMG Workshop in 2008, Associate Professor T. Umapathi, Organising Chairman, continued with the tradition of interactive teaching for the 3rd EEG-EMG-Autonomic Workshop held from 25 to 27 March 2011.

The interactive teaching course covered a half day workshop on EEG with packed sessions over the weekend on EMG updates as well as interactive bedside tutorials. A new segment on Autonomic Function Tests was introduced this year. Tests include measurement of RR interval during respiration and heart rate/blood pressure variability during the Valsalva manoeuvre.

The faculty, comprising neurologists from National Neuroscience Institute (NNI), National University Hospital and in private practice, and assisted by medical technologists from the NNI’s Neurodiagnostic Laboratory, provided comprehensive coverage of the theme. The faculty discussed and covered a wide spectrum of neurological disorders and the different aspects of EEG interpretation, using actual EEG tracings to illustrate examples of normal variants, abnormal EEG patterns, epileptiforms

3rd EEG-EMG-Autonomic Workshop

discharges and ictal EEG tracings. Participants were given sets of multiple choice questions to apply what they had learned. Using the Auto Response System (ARS), answers from participants were instantly generated via hand-sized ARS clickers and reflected live onto the presentation slides.

During the EMG sessions, the teaching faculty members demonstrated various techniques used in the electrodiagnosis of these disorders through live electrodiagnostic evaluations on patients with various neurological complaints such as weakness, numbness and fatigue. Audio visual aids were used to allow the participants to closely observe the range of tests, which included specialised techniques such as single fiber EMG, transcranial magnetic stimulation and blink reflex.

Participants were later divided into small groups for the hands-on sessions, where they were given ample opportunity to interact real time with the faculty and patient during the practical sessions conducted at the Neurodiagnostic Laboratory.

An Interactive Teaching Course with Live Demonstrations and Hands-on Tutorials

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“Executive functioning is impaired in PD patients, even in early stages of the disease. In particular, the ability to shift a mental set in response to the changing environment is affected in PD patients. Using functional magnetic resonance imaging, we aim to identify the brain areas that are implicated in set-shifting. A total of 13 PD patients and 17 normal subjects underwent functional magnetic resonance imaging while they performed a modified card sorting task, a neuropsychological assessment tool to evaluate set-shifting.

Dr Au et al observed differences in set-shift task performance and brain activation patterns across subject groups, modulated by the dopamine status of the subjects and also the types of feedback cues provided. Our study showed that the corticostriatal loops (medial prefrontal cortex, supplementary motor area, caudate nucleus) were activated during internal feedback learning, whereas the mesocortical substrates (dorsolateral prefrontal cortex, cingulate cortex, insula) were activated in the presence of external feedback cues. The authors found PD subjects had impaired set-shifting during ‘off’ medication when learning was through positive outcomes, and this deficit was mediated via reduced lateral prefrontal cortex activations. Levodopa replacement improved the activations in the right dorsolateral prefrontal cortex, and hence improved the cognitive processing time through positive outcomes. The authors also observed that the ability to set-shift through negative feedback was not affected in PD subjects (both during ‘off’ and ‘on’ medications), possibly due to compensatory changes outside

the nigrostriatal dopaminergic pathway, as shown by the increased activations in the temporo-parieto-occipital lobe in PD patients compared to normal subjects.”

In Summary:a. PD subjects showed executive dysfunction, early in the course of the disease.b. They have difficulties in learning through positive outcomes, but may compensate by learning through negative feedback.c. Learning through negative feedback is mediated via compensatory changes outside the nigrostriatal dopaminergic pathway.

Implications:When designing rehabilitative and coping strategies for PD subjects, we need to consider the dopamine status and the types of feedback cues provided. The use of external feedback cues and negative feedback may help PD subjects to learn a new task more effectively. Levodopa replacement does not always improve the cognitive functioning in PD subjects.

Human Brain Mapping 2011 March 24 [Epub ahead of print].

Levodopa and the Feedback Process on Set-Shifting in Parkinson’s DiseaseA team of neurologists led by Dr Au Wing Lok, Senior Consultant from the department of neurology of National Neuroscience Institute (NNI) published a paper to study the interaction between levodopa and the feedback process on set-shifting in Parkinson’s disease (PD). Members of the NNI team included Associate Professor Louis Tan, Senior Consultant, department of neurology, Dr Paulito Palmes, from the department of research and Dr Sitoh Yih Yian, Senior Consultant from the department of neuroradiology.

The rest of the team included researchers from the Bioinformatics Research Centre, Nanyang Technological University.

In the paper, the authors observed the following.

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Bryce Tan Wei Quan – A JC2 student from NUS High School, Bryce did a project entitled “The Effect of Nitric Oxide on Protein Homeostasis: Implications for Parkinson’s disease” under the supervision of A/Prof Soong Tuck Wah, Adjunct Senior Research Scientist at NNI Research. For his efforts, Bryce was awarded a Gold Award at the 2011 SSEF. This is Bryce’s second SSEF Gold Award. He had earned his first gold at last year’s SSEF for a related project also under A/Prof Soong.

Rebekah Lee Jian Jia – The youngest amongst the current group of NNI research interns, Rebekah was a secondary 3 student from Raffles Girls’ Secondary when she conducted her research work in the laboratory of A/Prof Lim Kah Leong, Adjunct Senior Research Scientist at NNI Research. At the 2011 SSEF, Rebekah clinched a silver award for her project entitled “Endogenous and Exogenous Modulators of Parkinson’s Disease-linked Mutant LRRK2-induced Neurotoxicity”. Notably, Rebekah’s project has also received a Merit Award at an earlier science fair, i.e. 2010 Youth Science Conference. Despite her young age, Rebekah has apparently done a great job. Many at NNI might recognise Rebekah, as she often comes to visit her father, A/Prof Lee Kim En (Head of NNI Neurology Department) at his office.

Multiple Awards for NNI Research Interns As with their predecessors, research interns from National Neuroscience Institute (NNI) were handsomely rewarded for their research work at the 2011 Singapore Science and Engineering Fair (SSEF), which was held in the Singapore Science Center from 9 - 10 March 2011. SSEF is affiliated to the prestigious Intel International Science and Engineering Fair, otherwise known as the “Olympics of science competitions”. A total of 265 projects from various schools and junior colleges were shortlisted for competition at SSEF this year. Among these were four projects from NNI that bagged one gold, two silvers and one bronze award respectively. The winners and their mentors are as follows:

Congratulations to all the winners for their stellar performance and thanks for flying the NNI flag high!

Jin Chentian – Chentian is currently a JC2 student at Raffles Institution, and also the son of Ms Chen Yan (Senior Medical Technologist at NNI Neuromuscular Laboratory). Chentian walked away with a silver award at the 2011 SSEF for his project related to ion channel dysfunction that was conducted under the mentorship of Dr Liao Ping, Research Scientist at NNI Research. Adding a feather to his cap, Chentian also emerged as the second prize at the affiliated A*STAR Talent Search Programme, whose panel of judges consists of distinguished scientists from local and international universities, as well as A*STAR research institutes and a Nobel Laureate.

Cleo Chiong Xiao-Ying and Desmond Lim Shi Wei – This pair of JC1 students from NUS High School were looking for drugs that might mitigate neuronal death in Alzheimer’s disease (AD) in the laboratory of A/Prof Lim Kah Leong. Within a few months, they found that antioxidants derived from green tea and red wine are rather effective in protecting primary mouse cortical neurons against the toxic effects of beta amyloid, widely accepted as the pathogenic culprit of AD. For their work, Cleo and Desmond took the Bronze Award at 2011 SSEF. They had earlier also presented their project at the annual Ritsumeikan Super Science Fair in Japan as part of their exchange programme.

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Organised by:

11th advanced neurOradiOlOgy cOurse

6 – 7 OcTOber 2011TTsH Theatrette (level 1)

Tan Tock seng Hospital, singapore

ENQUIRY AND SECRETARIATCourse Secretariat11th ADVANCED NEURORADIOLOGY COURSEc/o Department of NeuroradiologyNational Neuroscience Institute11 Jalan Tan Tock Seng, Singapore 308433

Tel: (65) 6357 7033 / 6357 7018 Fax: (65) 6358 1259E-mail: haslindah_salim@nni.com.sg

CoURSE HIgHlIgHTS- Neuro-interventional updates

- Imaging cerebrovascular reserve

- Paediatric spine : Development, imaging and neurosurgical perspective

- Fetal MRI

- Sellar and parasellar imaging and pathology

- Head and neck imagingREgISTRATIoN FEES (payable in Singapore Dollars and inclusive of GST)

Participants On or before 01 sep 11 after 01 sep 11

doctors s$250 s$280

Other Healthcare Professionals s$180 s$210

Singapore Radiological Society

College of Radiologists Singapore

nOminal sPOnsOrs:

Mark Your Calendar

12

CALENDAR OF EVENTS(July – December 2011)

SuPPORT GROuPS

Enquiries and Registration

Tel: (65) 6357 7152 / 6357 7163 Fax: (65) 6256 4755Email: nni_secretariat@nni.com.sgWebsite: http://www.nni.com.sg

AdvisorsProfessor Lee Wei LingDr Francis HuiMr Steven Sobak

EditorChristina Wee

Editorial Committee

The articles published in Neus-link are meant for information and should not be used as substitute for medical diagnosis or treatment. Please seek your doctor’s advice before starting any treatment or if you have any questions related to your health or medical condition. Contents in Neus-link are not to be quoted or reproduced without the permission from the Corporate Communications Department of National Neuroscience Institute (NNI).

Members, Editorial BoardA/Prof Lim Kah Leong Dr Lishya Liauw Dr Kamal VermaDr Ernest Wang

AddressNeus-link c/o Corporate Communications National Neuroscience Institute 11 Jalan Tan Tock SengSingapore 308433Tel : (65) 6357 7153 Fax : (65) 6256 4755

Emailnni_enquiry@nni.com.sg

Websitehttp://www.nni.com.sg

Epilepsy Support Groupc/o Singapore Epilepsy Foundation149 Rochor Road, #04-07 Fu Lu Shou ComplexSingapore 188425Tel: 6334 4302 Website: http://www.epilepsy.com.sg

Multiple Sclerosis Support Group c/o MS Care Tel : 6835 9916 Email : info@chcsa.org.sg

Muscular Dystrophy Support Group c/o Muscular Dystrophy Association (Singapore)Tel: 6259 6933 Website: http://www.mdas.org.sg

Neurovascular Befriender Servicesc/o National Neuroscience InstituteDepartment of Neurosurgery Tel : 6357 7545

Parkinson’s Disease Support GroupNNI at Tan Tock Seng Hospital c/o National Neuroscience InstituteNeuroscience Specialists Outpatient Clinics (Level 1)Tel: 6357 7605

Parkinson’s Disease Support GroupNNI at Singapore General Hospitalc/o National Neuroscience Institute (SGH Campus) Rehabilitation Centre (Education Resource Room, Block 1, Level 1) Tel : 8125 3543

Stroke Support Group c/o Singapore National Stroke Association26 Dunearn Road, Singapore 309423Tel: 6358 4138 Website: http://www.snsa.org.sg

For more information on Support Groups, visit our website at www.nni.com.sg

•1stNNI-NTUResearchWorkshop (8 July)

•4thCongressofthePan-AsianCommittee Treatment and Research in Multiple Sclerosis (28 – 30 August)

•NeuroscienceSeminarsforFamilyPhysicians

– Movement Disorders and Dementia (9 July 2011)

– Epilepsy and Sleep Disorders (20 August 2011)- Stroke

(10 September 2011)

•11thAdvancedNeuroradiologyCourse (6 – 7 October)

•13thSingaporeStrokeConference

(21- 22 October 2011)

•ImprovingCognitiveAwarenessandDementia Public Forum (19 November 2011)

* Dates subject to change.