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Research Tags

Ataxia BOTULINUM TOXIN DBS DYSTONIA FRIEDREICH'S ATAXIA PARKINSON'S DISEASE

Research Projects

Project Title

A shared-care model for deep brain stimulation in Irish patients with Parkinson's disease: a pilot cross- channel collaboration to improve access, efficiency and the patient experience

From

2014

2015

Summary

After Alzheimer's disease, Parkinson's disease (PD) is the 2nd most common neurodegenerative disorder, affecting approximately 1% to 2% of individuals over 60 years in our aging population. Deep brain stimulation (DBS) is an advanced surgical treatment option in patients for whom medication can no longer provide an adequate quality of life. Electrodes are implanted within the brain and then programmed over an intensive schedule of outpatient visits. Irish patients must travel to English centres for assessment, surgery and post-operative care as no Irish neuroscience unit has been able to provide the multidisciplinary team and expertise required for pre-operative assessment or the programming of implanted electrodes afterwards. We proposed an observational study of a unique collaborative, shared-care model between the Tallaght Movement Disorders Clinic and neurosurgical collaborators in the Institute of Neurology at the University of London. We will provide the required pre-operative radiological, neuropsychological and neuropsychiatric assessment of surgical candidates and weekly consultant-led post-operative programming of electrical stimulation, reducing patient and carer travel to a minimum. We assessed 40 candidates over two years and established stimulation in 10. All surgery was carried out in London as per the standard clinical practice. Outcome measures will included 1) improvement in motor symptoms compared with baseline and international norms, 2) patient rated change on a quality of life scale and 3) an economic analysis to cost this novel approach with the current standard of care. Patients referred but who are considered ineligible for surgery after screening will be managed with alternative advanced therapies within the multidisciplinary clinic.

Funding Agency

Meath Foundation

Project Type

Development of a Clinical Service - Pilot

Person Months

Representations

Details	Date
Member of an expert delegation that met with Minister Brendan Howlin on 1st December 2014 to develop a funding case for Deep Brain Stimulation for people with Parkinson's disease and related disorders in Ireland. Presentation and expert testimony to the Oireachtas Joint Committee on Health and Children 6th November 2014 on the Benefits of Deep Brain Stimulation as part of ongoing efforts to secure funding for a deep brain stimulation programme for the Ireland of Ireland.	1st December 2014
Presentation to TDs and Senators at a Dail Briefing in Leinster House to make a case for government funding for the Parkinson's Association of Ireland and expansion of neurology services for Parkinson's disease	10 April 2019

Details

Date

Member of an expert delegation that met with Minister Brendan Howlin on 1st December 2014 to develop a funding case for Deep Brain Stimulation for people with Parkinson's disease and related disorders in Ireland. Presentation and expert testimony to the Oireachtas Joint Committee on Health and Children 6th November 2014 on the Benefits of Deep Brain Stimulation as part of ongoing efforts to secure funding for a deep brain stimulation programme for the Ireland of Ireland.

1st December 2014

Presentation to TDs and Senators at a Dail Briefing in Leinster House to make a case for government funding for the Parkinson's Association of Ireland and expansion of neurology services for Parkinson's disease

10 April 2019

Languages

Language	Skill Reading	Skill Writing	Skill Speaking
English	Fluent	Fluent	Fluent
French	Fluent	Fluent	Fluent
German	Medium	Medium	Medium

Memberships

Membership of Professional Institutions, Associations, Societies

Details	Date From	Date To
Member of the Royal College of Physicians of Ireland	2005	2018
Fellow of the Royal College of Physicians of Ireland	2018	to date
Irish Institute of Clinical Neuroscience	2012	to date
International Parkinson and Movement Disorder Society	2005	to date
Parkinson's Association of Ireland	2012	to date

Publications and other Research Outputs

Stephen Murphy, Soon Tjin Lim, Justin Kinsella, Sean Tierney, Bridget Egan, T Martin Feeley, Sinead Murphy, Richard Walsh, Ronan Collins, Tara Coughlan, Desmond O'Neill, Sean O'Neill, Joseph Harbison, Prakash Madhavan, Mary Paula Colgan, Dermot Cox, Niamh Moran, George Hamilton, Dominick McCabe, On-treatment platelet reactivity' under both high and low shear stress conditions and relationship with cerebral micro-embolic signals in asymptomatic and symptomatic carotid stenosis: Results from the HaEmostasis In carotid STenosis(HEIST) study, Neurology, American Academy of Neurology, Philadelphia, May 4 - May 11 2019, 92, (Supp 15), 2019, Conference Paper, PUBLISHED

Murphy SJX, Lim ST, Kinsella JA, Tierney S, Egan B, Feeley TM, Murphy SM, Walsh RA, Collins DR, Coughlan T, O'Neill D, Harbison JA, Madhavan P, O'Neill SM, Colgan MP, Cox D, Moran N, Hamilton G, McCabe DJH., Increased Leucocyte-Platelet Complex Formation in Recently Symptomatic versus Asymptomatic Carotid Stenosis Patients and in Micro-emboli Negative Subgroups., 2019, pepub ahead of print , Journal Article, PUBLISHED DOI URL

Stephen Murphy, Soon Tjin Lim, Justin Kinsella, Helen Enright, Dymphna Murphy, Sean Tierney, Bridget Egan, Martin Feeley, Sinead Murphy, Richard Walsh, Ronan Collins, Tara Coughlan, Desmond O'Neill, Joseph Harbison, Prakash Madhavan, Sean O'Neill, Mary Pat Colgan, Dermot Cox, Niamh Moran, George Hamilton, Dominick McCabe, Profile of Reticulated Platelets and Red Cell Reticulocytes in Patients With Recently Symptomatic versus Asymptomatic Carotid Stenosis, Stroke, International Stroke Conference, Los Angeles, Jan 23-Jan 26, 49, (Supp 1), 2018, Conference Paper, PUBLISHED

Stephen Murphy, Soon Tjin Lim, Justin Kinsella, Sean Tierney, Bridget Egan, Martin Feeley, Sinead Murphy, Richard Walsh, Ronan Collins, Tara Coughlan, Desmond O'Neill, Joseph Harbison, Prakash Madhavan, Sean O'Neill, Mary Pat Colgan, Dermot Cox, Niamh Moran, George Hamilton, Dominick McCabe, Evidence of Ongoing Platelet Activation in Micro-emboli Negative Recently Symptomatic versus Asymptomatic Carotid Stenosis, 2018, Conference Paper, PUBLISHED

Renaud, M., Moreira, M.-C., Monga, B.B., Rodriguez, D., Debs, R., Charles, P., Chaouch, M., Ferrat, F., Laurencin, C., Vercueil, L., Mallaret, M., M"Zahem, A., Pacha, L.A., Tazir, M., Tilikete, C., Ollagnon, E., Ochsner, F., Kuntzer, T., Jung, H.H., Beis, J.-M., Netter, J.-C., Djamshidian, A., Bower, M., Bottani, A., Walsh, R., Murphy, S., Reiley, T., Bieth, É., Roelens, F., Poll-The, B.T., Lourenço, C.M., Jardim, L.B., Straussberg, R., Landrieu, P., Roze, E., Thobois, S., Pouget, J., Guissart, C., Goizet, C., Dürr, A., Tranchant, C., Koenig, M., Anheim, M., Clinical, biomarker, and molecular delineations and genotype-Phenotype correlations of ataxia with oculomotor apraxia type 1, JAMA Neurology, 75, (4), 2018, p495-502 , Journal Article, PUBLISHED

Murphy SJX, Lim ST, Kinsella JA, Murphy D, Enright HM, McCabe DJH, for the HEIST study group, Increased platelet count and reticulated platelets in recently symptomatic versus asymptomatic carotid artery stenosis and in cerebral microembolic signal-negative patient subgroups: Results from the HaEmostasis In carotid STenosis (HEIST) Study., J Neurol, 265, (5), 2018, p1037 - 1049, Journal Article, PUBLISHED DOI URL

D'Alton M, Coughlan T, Cogan N, Greene S, McCabe DJH, McCarthy A, Murphy S, Walsh R, O'Neill D, Kennelly S, Ryan D, Collins R, Patterns of Mortality in Modern Stroke Care, Ir Med J, 111, (5), 2018, pP750 , Journal Article, PUBLISHED URL

Petya Mihaylova, Neil Austin, Michael Alexander, Lorraine Cassidy, Raymond Murphy, Richard Walsh, Sinéad Murphy, Ddhd2-associated autosomal recessive spastic ataxia in an irish family, J Neurol Neurosurg Psychiatry, Association of British Neurologists, Liverpool, 3-5 May, 2017, Conference Paper, PUBLISHED

Petya Mihaylova, Sinéad Murphy, Richard Walsh, Spg7-related ataxia in the irish national ataxia clinic cohort, J Neurol Neurosurg Psychiatry, Association of British Neurologists, Liverpool, May 3-5, 88, (Supp 1), BMJ Publishing Group Ltd, 2017, Conference Paper, PUBLISHED

J Panicker, M Lad, M Parkinson, M Rai, M Pandolfo, P Mihaylova-Bogdanova, RA Walsh, S Murphy, A Emmanuel, P Giunti, Lower urinary tract, bowel and sexual dysfunction in Friedreich's ataxia, Journal of the Neurological Sciences, World Congress of Neurology, 381, Elsevier, 2017, pp891-892 , Conference Paper, PUBLISHED

Page 1 of 7

Richard Walsh Robertus de Bie Susan Fox, Movement Disorders , Second, Europe and US, Oxford University Press, 2017, Book, PUBLISHED

Parkinson's Disease in, editor(s)Hardiman, O., Doherty, C.P., Elamin, M., Bede, P. , Neurodegenerative Disorders, 2016, pp85 - 115, [ Olszewska, Diana A., Fahn, S, Walsh R and Lynch T], Book Chapter, PUBLISHED

Richard Walsh Robertus de Bie Susan Fox, Movement Disorders , First, Europe and US, Oxford University Press, 2013, Book, PUBLISHED

Parkinson's Disease: Advanced Disease, Motor Complications, and Management in, editor(s)David Burn , Oxford Textbook of Movement Disorders, Europe , Oxford University Press, 2013, [Susan H. Fox, Binit Shah, Richard Walsh, and Anthony Lang], Book Chapter, PUBLISHED

Parkinson's Disease in, editor(s)Hardiman, Orla, Doherty, Colin P. , Neurodegenerative Disorders, Europe, Springer, 2011, [Richard Walsh, Timothy Lynch, Stanley Fahn], Book Chapter, PUBLISHED

Other Movement Disorders in, editor(s)Editor: Goldman, Lee. Video editing; R Walsh , Goldman's Cecil Medicine, North America, Saunders, 2011, [Anthony Lang], Book Chapter, PUBLISHED

RA Walsh, R Whelan, JP O'Dwyer, S O'Riordan, S Hutchinson, R O'Laoide, K Malone, R Reilly, M Hutchinson., Bilateral cortical grey matter changes support the sensory endophenotype hypothesis in familial adult onset primary torsion dystonia, Neurology, American Academy of Neurology, Chicago, 70, (Supp 1), 2008, ppA433-, Poster, PUBLISHED

Awards and Honours

Award	Date
McGrath Medal in Pathology UCD	2001
Uschi Tschabitscher Young Neurologist Award, Clinical Research, European Federation of Neurological Societies	2006
Mater Misericordiae Clinical Grand Rounds Annual Silver Medal	2009
47,400 Meath Foundation Clinical Improvement Project Award
10,000 Lundbeck Neuroscience Bursary for clinical research in dystonia	2010
$50,000 Parkinson Society Clinical Research Bursary	2010
10,000 Travel Bursary Irish Institute of Clinical Neurosciences & Glaxo Smith Kline	2010
$50,000 Edmond J. Safra Clinical Fellowship Bursary in Movement Disorders	2011
22,000 Dystonia Ireland Clinical Research Grant	2006
40,000 Unrestricted Development Award (Novartis) for purchase of an ocular coherence tomography for ataxia phenotyping project	2014

Research Interests

Description Of Research Interests

My primary research interest is in the field of movement disorders, incorporating parkinsonian syndromes, inherited ataxic syndromes and dystonia. I have had a particular interest in genotyping and clinical phenotyping. This has included an MD thesis on the role of endophenotypes in the pursuit of a genetic cause of familial dystonia, the ongoing genotyping of the ataxia population in Ireland and description of the role and cost effectiveness of next generation sequencing in the diagnostic process. I await ethics approval for participation as local PI in a multicentre genotyping study of Parkinson's disease in Ireland sponsored by Genomic Medicine Ireland for which I have been involved in protocol development for the national project. Along with my colleague Dr. Sinead Murphy, I am a co-supervisors of an MD thesis candidate in Trinity College Dr. Petya Bogdanova with whom we are looking at ocular phenotypes in hereditary ataxia. We have also been successful in 2019 in establishing Dublin as a new European Friedreich's Ataxia Consortium for Translational Studies study site. This phenotyping natural history study will provide useful clinic data for future therapeutic trials. I have published on pharmacological and surgical therapies for movement disorders. This has included studies looking at therapeutics in dystonia using botulinum toxin and deep brain stimulation of the globus pallidus in cervical dystonia. I have in addition participated as an investigator in therapeutic studies of pump therapy in advanced Parkinson's disease (local PI in the Observe Study and sub-investigator in the pivotal north American open phase III trial of levodopa-carbidopa intestinal gel). I have been active as the only Irish neurologist providing a clinical service for deep brain stimulation programming and this has facilitated collaboration with neural engineering, for which ethics approval is awaited, to allow the study of surface muscle biomarkers of deep brain stimulation.

Trinity College Dublin, The University of Dublin

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Dr. Richard Walsh