Day 1 :
The Royal London Hospital, UK
James Barber qualified with MB BS from University College London in 1999. He has been working in Neurosurgery since 2005, having been a Consultant in The Royal London Hospital for the past 2 years. His main areas of practice are: Neurotrauma (specifically the management of patients with prolonged post-traumatic disorders of consciousness), Neuromodulation (Epilepsy and Affective Disorder), Complex CSF-Flow Disorders and Craniofacial Reconstruction. He has published the first case series in the U.K. of the implantation of a wireless intracranial pressure monitor and is setting up a trial to look at the potential benefits of VNS in minimally conscious subjects.
Neurosurgery to modify behavior is known to have been in practice for thousands of years. It was more than likely that for the majority of this timespan the success of any such interventions were those for either space-occupying tumours or blood clots. In the 20th Century, the disastrous forays into disconnecting ‘aberrant circuits’ in the brain, although initially performed with the best of intentions, set back surgical modification of behaviour back to its neolithic roots. With the more recent advent of advanced imaging modalities, connectomics and methods for stimulating brain structures, neuromodulation has seen a resurgence in efficacy for treating cognitive disturbance, heralding a new era of highly specific therapies for refractory neuropsychological conditions. In this talk, we will be looking at the various treatments currently available and discuss potential techniques that could prove to be revolutionary in the decades to come.
Hull and East Yorkshire Hospitals NHS Trust, UK
Dr Philip McMillan is a Consultant in the NHS with over 23 years of medical expertise. His primary focus has been around Geriatrics and Neurological Rehabilitation and has developed unique perspectives on the capacity of the brain to recover from injuries and disease. Through international collaboration he has proposed a nutritional protocol for dementia reversal and has recently had a breakthrough theory on the pathology of dementia. His current aim is to lead the field of dementia to a new direction of research and treatment of this devastating disease.
The intricacies of dementia are explored in relation to varied studies on brain atrophy in multiple sclerosis and used to delineate the primary pathology of the latter.
The theory examines the high frequency of cognitive impairment (Jongen 2012) in Multiple Sclerosis and its early manifestation during the disease. The fact that there is associated brain atrophy cannot be explained by the degree of damage to neurons. (Carlos 2015) noted a 5 to 10 times greater rate of atrophy in Multiple Sclerosis.
The cognitive changes with Multiple Sclerosis are then correlated embryologically to the subependymal zone (Kazanis 2009) explaining the pathology of brain atrophy and why we have not made more progress through research.
Our understanding of the blood CSF barrier and the brain CSF interaction is poorly understood and probably holds the key to the symptoms of dementia (Erikson 2013). This interaction between the CSF and brain interstitial space is coordinated by the ependymal and subependymal zone of the brain.
This is a novel concept that will aim to explain the links of all forms of dementia, as well as directing fertile areas for research.