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Postgraduate Research Students

Jennifer Williams

Dr. Williams qualified from the UCD school of Medicine in 2006. Having completed her intern year and BST in Medicine she went on to obtain her higher medical specialist training in Clinical Neurology and was awarded her CCST from the Royal College of Physicians of Ireland in 2015. She has worked in several neurology tertiary referral centres and teaching hospitals including Beaumont, the Mater Misericordiae, Tallaght and St.James’s hospitals. She is interested in all aspects of neurology but her specialist area of interest is Epilepsy.

Current Research

Having enrolled in a PhD programme with the Academic Unit of Neurology her current projects include evaluating the use of advanced neuroimaging techniques in the acute peri-ictal period , and investigating the implementation of evidence based care for seizures in the emergency department. Her work includes longitudinal neuroimaging follow-up of patients post seizure and examination of several neuroanatomical regions of interest thought to be important in seizure initiation and propagation. This novel work gives unique insight into neuronal networks utilising diffusor tensor imaging.
The second aspect of her work examines pre-defined patient outcome metrics in those that present to the emergency department with a diagnosis of seizure. She is investigating the differences in care received by over 500 emergency seizure presentations to a tertiary referral centre, and assessing the impact of an evidence based seizure care pathway on patient care. Her work also includes looking at the barriers to implementing evidence based guidelines in the emergency department and puts forward recommended solutions for overcoming the barriers identified.

Publications

Title: The Spectrum of peri-ictal MRI changes; four illustrative cases
Accepted for publication in Seizure: The European Journal of Epilepsy
Authors: Jennifer Williams1,2, Gerard Mullins 3, Norman Delanty 4,5, Bede Peter1,2, Colin P Doherty1,2

1 Department of Neurology, St.James’s Hospital, James’s Street, Dublin 8, Ireland.Seizure: The European Journal of Epilepsy. 2017 May 31;50:19-32. doi: 10.1016/j.seizure.2017.05.005. [Epub ahead of print]
An exploration of the spectrum of peri-ictal MRI change; a comprehensive literature review.
Williams JA1, Bede P2, Doherty CP2.
Author information
1
Department of Neurology,St. James's Hospital, James's Street, Dublin 8, Ireland; Academic Unit of Neurology, Trinity Biomedical Science Institute, Trinity College,152-160 Pearse Street, Dublin 2, Ireland. Electronic address: williaj7@tcd.ie.
2
Department of Neurology,St. James's Hospital, James's Street, Dublin 8, Ireland; Academic Unit of Neurology, Trinity Biomedical Science Institute, Trinity College,152-160 Pearse Street, Dublin 2, Ireland.

 

Epilepsy and Behavior. 2017 May 30;72:72-77. doi: 10.1016/j.yebeh.2017.04.022. [Epub ahead of print]
Moving evidence based guidelines for seizures into practice in the emergency department: What's stopping us?
Williams J1, Petrov G2, Kennedy U3, Halpenny J3, Doherty CP4.
Author information
1
Department of Neurology, St. James's Hospital, James's Street, Dublin 8, Ireland; Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, 152-160 Pearse Street, Dublin 2, Ireland. Electronic address: williaj7@tcd.ie.
2
Department of Neurology, St. James's Hospital, James's Street, Dublin 8, Ireland.
3
Department of Emergency Medicine, St. James's Hospital, James's Street, Dublin 8, Ireland.
4
Department of Neurology, St. James's Hospital, James's Street, Dublin 8, Ireland; Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, 152-160 Pearse Street, Dublin 2, Ireland.

Journal of Neurological Science. 2017 Jun 15;377:227-233. doi: 10.1016/j.jns.2017.04.014. Epub 2017 Apr 12.
Clinical outcomes and a high prevalence of abnormalities on comprehensive arterial and venous thrombophilia screening in TIA or ischaemic stroke patients with a patent foramen ovale, an inter-atrial septal aneurysm or both.
Lim ST1, Murphy SJX1, Smith DR2, Williams J3, Navarro SG3, McCabe J3, Moore DP4, McHugh J5, McCabe DJH6.
Author information
1
Department of Neurology, The Adelaide and Meath Hospital, incorporating The National Children's Hospital, Dublin, Ireland; Stroke Service, The Adelaide and Meath Hospital, incorporating The National Children's Hospital, Dublin, Ireland.
2
Vascular Neurology Research Foundation, The Adelaide and Meath Hospital, incorporating The National Children's Hospital, Dublin, Ireland.
3
Department of Neurology, The Adelaide and Meath Hospital, incorporating The National Children's Hospital, Dublin, Ireland.
4
Department of Cardiology, The Adelaide and Meath Hospital, incorporating The National Children's Hospital, Dublin, Ireland.
5
Department of Haematology, The Adelaide and Meath Hospital, incorporating The National Children's Hospital, Dublin, Ireland.
6
Department of Neurology, The Adelaide and Meath Hospital, incorporating The National Children's Hospital, Dublin, Ireland; Stroke Service, The Adelaide and Meath Hospital, incorporating The National Children's Hospital, Dublin, Ireland; Vascular Neurology Research Foundation, The Adelaide and Meath Hospital, incorporating The National Children's Hospital, Dublin, Ireland; Department of Clinical Neurosciences, Royal Free Campus, UCL Institute of Neurology, London, UK; Academic Unit of Neurology, School of Medicine, Trinity College, Dublin, Ireland. Electronic address: dominick.mccabe@amnch.ie.

JAMA Neurology.2016 Feb;73(2):234-5. doi: 10.1001/jamaneurol.2015.2201.
Striking Central Pontine Myelinolysis in a Patient With Alcohol Dependence Syndrome Without Hyponatremia.
McNamara PH1, Williams J1, McCabe DJ2, Walsh RA1.
Author information
1
Department of Neurology, Movement Disorders Unit, and Stroke Service, The Adelaide and Meath Hospital and Trinity College, Dublin, incorporating the National Children's Hospital, Dublin, Ireland.
2
Academic Unit of Neurology, School of Medicine, Trinity College, Dublin, Ireland3Department of Clinical Neurosciences, Royal Free Campus, UCL Institute of Neurology, London, England.

Parkinsonism and Related Disorders.2015 Jul;21(7):823-4. doi: 10.1016/j.parkreldis.2015.04.026. Epub 2015 May 2.
Speech myoclonus due to probable pregabalin adverse drug-reaction.
Olszewska DA1, Chalissery AJ1, Williams J1, Lynch T1, Smyth S2.
Author information
1
Department of Neurology at the Dublin Neurological Institute, Mater Misericordiae University Hospital, Dublin, Ireland.
2
Department of Neurology at the Dublin Neurological Institute, Mater Misericordiae University Hospital, Dublin, Ireland. Electronic address: ssmyth@mater.ie.

Parames Iyer

Dr. Parameswaran Mahadeva Iyer completed his MD in 1997 from Kerala University , India. He cleared MRCPI in 2007 and his currently a final year Specialist Registrar in Neurology.

Current Research

: Study to develop biomarkers for ALS based on novel neurophysiologic techniques
Hypothesis: Resting state and activated spectral EEG can be used to identify altered neural networks in ALS that can be developed as biomarkers of disease phenotype and progression
Introduction
Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disease, characterized primarily by motor system degeneration.  There is increasing evidence of cognitive impairment in ALS. Over 100 new ALS patients are diagnosed each year, of who over 80% are followed by the Irish ALS Research Group at Beaumont Hospital. The mean life expectancy for ALS is 3 years from diagnosis.  There is an urgent need for new biomarkers of disease onset and progression. Evolving data has pointed to altered functional connectivity in ALS compared to controls.  The aim of this project is to explore novel  neurophysiologic techniques to assess alterations in functional connectivity in the brains of ALS patients compared to healthy controls, and to determine whether ALS with cognitive impairment exhibits a distinct pattern compared to those with intact cognition
Neurophysiology: Spectral EEG
Electroencephalogram (EEG) gives information about brain status and activity.   EEG spectral analysis has been used to evaluate functional connectivity in other neuro degenerative conditions.
Aims
To compare the functional connectivity in brains of ALS patients with controls, and also with ALS patients with cognitive impairment.
To evolve patterns of functional connectivity among these groups
To assess whether that could be used as a biomarker in predicting disease progression in ALS group
To assess whether the derived patterns could be projected on to control group so as to predict the probability of developing ALS and ALS with cognitive impairment in a healthy population in the community.
Goal
 To generate pilot  spectral EEG data to assess changes in functional connectivity and neural networking and in ALS compared to controls using a well characterized patient cohort based at Beaumont Hospital.
Methods
Patients are recruited from the ALS Clinic at Beaumont Hospital. All patients undergo full clinical and neuropsychological evaluation, and donate DNA for banking. and 128 channel EEG will be performed in the Dept. Geriatric Medicine, St.James Hospital .
These spectral EEG and fMRI data would be processed in collaboration with Engineering department in Trnity College Dublin, to develop mathematical models of prediction for disease progression in ALS group and disease probability in control group , there by developing a biomarker for ALS.
Conclusion
The project aims to develop biomarkers for ALS and ALS with cognitive impairment to assess the trends of progression and to project the model into healthy control to assess the probability of developing ALS or ALS with cognitive impairment among healthy controls.

Christina Schuster

2014 – 2017 Ph.D., Clinical Medicine, Trinity College Dublin, Ireland.
2011 – 2014 Research Associate, German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Germany.
2009 – 2011 Research Master in Cognitive and Clinical Neuroscience, Specialisation: Neuropsychology, Maastricht University, Netherlands.
2006 – 2009 Bachelor of Science in Psychology, Université du Luxembourg, Luxembourg.

Research Interests

Ms. Christina Schuster’s research interests are focused on the vulnerability profiles of different brain areas and their relation to neurodegenerative conditions and healthy ageing. She is interested in how research findings can be applied in a clinical setting (e.g. as a diagnostic biomarker) and be of benefit to the patients.

Title PhD
Evaluation of Neuroimaging Biomarkers in Amyotrophic Lateral Sclerosis

Synopsis
Objective, accurate and validated biomarkers are urgently needed for diagnostic applications, disease-monitoring and as prognostic indicators. The aim of my PhD thesis is to evaluate the role of magnetic resonance imaging (MRI) as a potential biomarker of ALS.
To this aim, I evaluated cross-sectionally and longitudinally ALS-associated structural brain changes. The results were used in diagnostic and prognostic models to assess the biomarker potential of MRI metrics. The multimodal analyses relied on complementary grey and white matter measures based on T1-weighted and diffusion-weighted images. The methods included voxel-based morphometry, vertex-based cortical thickness analyses and track-based analyses of fractional anisotropy, mean -, radial - and axial diffusivity indices.