字體:
Symposium(1):Update in Neurology
范英琦 Ying-Chi Fan
MD
Attending physician
Department of Neurology, Chung Shan Medical University hospital
中山醫學大學神經內科總醫師
中山醫學大學神經內科住院醫師
專長:(1)腦中風(2)眩暈(3)周邊神經病變
fanyingchi@gmail.com

Lecture Abstract
Status epilepticus is one of the emergency neurological disease. Non-convulsive status epilepticus is difficult to diagnose because it’s unclear clinical manifestations. Treatment of non-convulsive status epilepticus patients is often delayed due to unclear diagnosis. The mortality rate increased significantly and sequela became more severe if we delay treatment for Non-convulsive status epilepticus patient.
Thus, we will introduce the presentation, evaluation and treatment of adult non-convulsive status epilepticus. We hope more neurologists can understand this disease and make the correct diagnosis and give treatment in time.


蔡孟翰 Meng-Han Tsai
MD, PhD
Director
Division of Epilepsy and Brain Function, Department of Neurology, Kaohsiung Chang Gung Memorial Hospital
menghan@cgmh.org.tw

Dr Meng-Han Tsai is currently the Director of Division of Epilepsy and Brian Function at Kaohsiung Chang Gung Memorial Hospital. He acquired his medical degree (MD) at Kaohsiung Medical University in 2003, subsequently started neurology residency training at Department of Neurology of Kaohsiung Chang Gung Memorial Hospital from 2003 to 2008). In 2009, Dr. Tsai jointed the research team at Epilepsy Research Center and Florey Neuroscience Institute, Melbourne, Australia. He also studied at University of Melbourne, Australia and obtained his PhD degree under the supervision of Prof. Samuel F. Berkovic, and Prof. Ingrid E. Scheffer in the field of “Genetics of Epilepsy”. After returning to Taiwan, Dr. Tsai continues his clinical and research interests in the field of epilepsy genetics and leading the epilepsy surgery team of KCGMH. He received research grants from Chang Gung Medical Research Found and Ministry of Science and Technology Research Project about genetics in epilepsy. 
Dr. Tsai has received several research awards and travel grants from Taiwan Neurology Society, Epilepsy Society of Australia, and Taiwan Epilepsy Society, American Epilepsy Society and International League against Epilepsy, including the Epilepsy Research Award of Taiwan Epilepsy Society in 2014, Best Research Article of Taiwan Epilepsy Society in 2013 and 2017.

Lecture Abstract
In the past decade, next generation sequencing and new imaging technology have greatly improved our ability to diagnose the underlying cause of epilepsies. The advance in our understanding of the cause of epilepsies also pave the way toward precision treatment. In this talk, I will discuss the recent progress of precision diagnosis using NGS and emerging precision treatment.


楊鈞百 Chun-Pai Yang
部定副教授
光田綜合醫院神經內科主任
neuralyung@gmail.com

光田綜合醫院神經內科主任
光田綜合醫院醫學研究部主任
光田綜合醫院睡眠醫學中心主任
弘光科技大學營養醫學研究所兼任副教授
專長
各種頭痛、頭暈(暈眩、耳鳴)、各種疼痛(疱疹後神經痛、糖尿病神經痛、坐骨神經痛、肩頸酸痛、骨刺、開刀後慢性疼痛、手麻腳麻、顏面神經麻痺)、睡眠障礙(疲倦、憂鬱失眠)、腦中風及其後遺症、失智症、動作障礙(巴金森氏症、不自主運動)、癲癇。


黃子洲 Tzu-Chou Huang
MD
副院長
活水神經內科診所
joetchuang@gmail.com

Dr Tzu-Chou graduated from China Medical College 1993 and got a master degree in 2011 from the Institute of Emergency and Critical Care Medicine in National Yang-Ming university. I am now a senior attending physician and chief at department of neurology, MMH. My study interest was stroke and neurocritical care.

Lecture Abstract
Clinicians are no strangers to patients with migraine symptoms and frequent dizziness. Several studies have found a close association between dizziness and migraine. Vestibular migraine(VM) is defined as a patient having recurrent vertigo with migrainous features such as migrainous headache, photo- and phono-phobia, or visual aura. It is now among the most common causes of recurrent vertigo in the general population. Despite its prevalence and high impact on healthcare cost and utilization, it has remained an under-recognized condition. Also, not all migraineurs with episodic vertigo are VM. Another newly defined vestibular disorder, persistent postural-perceptual dizziness(PPPD), refers to patients who have chronic persistent dizziness, and the symptoms could be exacerbated by upright posture, motion, or complex visual stimuli. About 20 % of PPPD is a consequence of VM so that it is also closely related to migraines. Besides, some other vestibular disorders such as benign paroxysmal positional vertigo, Meniere’s disease, mal de debarquement syndrome, and motion sickness are proved to be more prevalent in migraine patients than in the general population.


嚴成文
PhD
Professor
National Sun Yat-Sen University
cmurobot@gmail.com

台灣中山大學機械與機電工程系與高雄醫學大學物理治療系合聘教授
研究領域:醫療機電、機器學習、生理訊號處理、睡眠醫學、智慧診斷

Lecture Abstract
主題在於說明穿戴科技在睡眠醫學中的可能應用。 除了探討現今穿戴科技的限制之外,也會說明如何透過訊號的處理,多維感測器的應用,訊號收集時間的拉長以及機械學習的應用,來強化穿戴科技的功能。


柯立偉
國立交通大學電機與控制工程博士
lwko@nctu.edu.tw

計算神經科學,腦機介面,生醫訊號處理,機械學習,圖形識別與遠距照護系統


Symposium(2):Update in Neurology
陳柔賢 Rou-Shayn Chen
Associate Professor, M.D.
Attending Physician
Division of Movement Disorder,
Department of Neurology
Chang Gung Me
Taoyuan, Taiwan
cerebrum@ms13.hinet.net

陳柔賢醫師現任台灣林口長庚紀念醫院神經內科系動作障礙科主治醫師、帕金森治療中心召集人與神經科學研究中心臨床神經生理學組資深成員;並擔任台灣神經學學會理事,台灣動作障礙學會理事,台灣臨床神經生理學會常務理事。
陳醫師於2005年到2014年擔任神經內科系動作障礙科主任,完成了台灣第一個完整的帕金森病人豋錄系統,近七年來已經追蹤記錄多達1000為病人以上,無論就病情進程、病理生理、藥物治療、國際趨勢,都能提供許多臨床醫師與研究計劃具體的合作方向與建議。
陳柔賢醫師於2011-5月到2013-5月間擔任臺灣動作障礙學會理事長,於2013到2017擔任國際動作障礙學會亞太地區分會(AOS-MDS) 的執行理事。陳醫師創辦建立了兩個台灣的國際型大型會議:2013年的第一屆台灣帕金森氏病與動作障礙國際研討會,2015年的第一屆台灣國際神經醫學大會。其中台灣帕金森氏病與動作障礙國際研討會將於2018 年11月舉辦第四屆,而台灣國際神經醫學大會將於2019年五月舉辦第四屆,已經成為台灣最重要的兩個知名於國際的大型學術會議。
20多年的醫師生涯,陳柔賢醫師對於動作障礙疾病的臨床治療與致病機轉,持續保持高度的興趣:陳醫師很早就投入臨床電氣生理學的研究,對於肌張力不全症與寫字型痙攣症多所著墨;對於肉毒桿菌素治療半面肌肉痙攣症與偏頭痛也經驗豐富;多年來參與帕金森氏病友會的運作與活動,和許多病友有著深度的了解,也累積了非常豐富的帕金森氏病藥物治療實務經驗。目前與未來的研究方向主要在於動作障礙疾病的臨床治療,帕金森氏病與各種神經退化性疾病的解構與治療,並利用重複經顱核磁刺激技術嘗試大腦皮質的可塑性的調控。


張永義 Yung-Yee Chang
助理教授
高雄長庚 神經內科系 巴金森氏病中心主任
高雄長庚神經內科系一般神經科主治醫師
changyy7@gmail.com

學歷
高雄醫學大學醫學系學士
經歷
高醫附設醫院主治醫師
高醫附設醫院神經科總住院醫師
高醫附設醫院神經科住院醫師
專長:基礎神經學、臨床神經學、巴金森氏症


藍旻瑜 Min-Yu Lan
MD, MSc
Attending physician and Assistant Professor
myl@ksts.seed.net.tw

Dr. Min-Yu Lan is Assistant Professor of the Department of Neurology at Kaohsiung Chang Gung Memorial Hospital and Chang Gung University. He received his medical degree from the Kaohsiung Medical College and completed his residency in neurology and fellowship in Kaohsiung Medical College. He also completed an additional fellowship in the University of Columbia, New York, US, and a Master's degree in the Institute of Clinical Medicine at Kaohsiung Medical College.

He is one of the main contributors to the research of hereditary neurological diseases, including hereditary spastic paraplegia, leukodystrophy, cerebral cavernous malformation and lipid storage myopathy, in Taiwan. His clinical and research interests focus on genetics and pathogenic mechanisms of hereditary and degenerative neurological diseases.

Lecture Abstract
Hereditary spastic paraplegia (HSP) and hereditary cerebellar ataxia (HCA) are traditionally designed as two disparate groups of inherited neurodegenerative disorders. With the main clinical manifestations related with degeneration of the corticospinal tract and the cerebellar circuit respectively, each of them encompasses an ever-expanding list of causative genes. However, the presence of ataxia is a hallmark for some of HSPs and, conversely, the occurrence of spasticity is common in some HCAs. With the advents of the new generation sequencing and genomic studies in the last decade, the intersections between HSP and HCA has been increasingly recognized. Moreover, it is also the case that spastic ataxia is related with disease genes which classically belong to other disease categories, such as leukodystrophy, familial Parkinson’s disease, neurodegeneration with brain iron accumulation (NBIA), etc. More and more frequently, these diseases have been considered jointly as the ataxia-spasticity spectrum diseases (ASSD), which present a phenotypic continuum— with spasticity at one extreme and ataxia at the other.

In face of the clinical and genetic complexities, several extensible lists of etiologies and genes for ASSD have been proposed in the literature. We have been studying familial and sporadic cases of ASSD, excluded for acquired conditions, in the Taiwanese population. Except for spastic paraparesis and cerebellar ataxia, it is frequent that the cases presented additional neurological and systemic manifestations and distinctive neuroimaging abnormalities. By using a strategy of combined phenotype-guided gene test, prevalent gene screening and whole exome sequencing, a diverse categories of diseases, including complicated HSP, spinocerebellar ataxia, spastic ataxia and NBIA, have been identified in this cohort. In light of the heterogeneous genetic basis of ASSD, we suggest incorporation of mode of inheritance, clinical and neuroimaging phenotypes and disease prevalence and continual updating of genetic and genomic information to improve efficiency of diagnostic workup.

ASSD genes are linked to various cellular functions, including endoplasmic reticulum morphology, autophagy-lysosomal activity, phospholipid and fatty acid metabolism, myelination and mitochondrial function. Based on the affected functions, disease-specific biomarkers have been developed in a small numbers of ASSD for disease diagnosis, treatment and activity surveillance. Notably, the recent progress in molecular pathology leads to the introduction of a new nosology for neurodegenerative diseases, moving from the traditional, phenotype-based classification to the molecular pathway-driven categories. The phenotypic overlap of ASSD might reflex common underlying pathogenic mechanisms, to which the corticospinal tract and the cerebellar neuron circuits are selectively vulnerable. Improvement in knowledge regarding biological functions shared by ASSD genes might open the way of molecular pathway-directed therapeutic approaches, which, by targeting a handful of dysregulated cellular pathways instead of single gene or disease symptoms, might offer the potential to overcome the barrier of ASSD treatment.


郭育呈 Yuh-Cherng Guo
MD
Attending physician
cmtpmp22@gmail.com

Dr. Guo was graduated from Department of Medicine, Kaohsiung Medical University and completed master degree from Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University. He has finished the training of resident, chief resident and research fellow at Department of Neurology, Neurological Institute, Taipei Veterans General Hospital. Then he moved to Department of Neurology, Kaohsiung Medical University Hospital as an attending physician. Now he is an attending physician and the director of neurophysiological examination section at Department of Neurology, China Medical University Hospital, Taichung. Dr. Guo has interest in the field of neuroimmunology, pathology of nerve and muscle and genetics. He has been working at the diagnosis and management of multiple sclerosis, autoimmune encephalitis, dysimmune neuropathies, inherited neuropathies and myopathies.

Lecture Abstract
The field of gene therapy is striving more than ever to define a path to the clinic and the market. Twenty gene therapy products have already been approved and over two thousand human gene therapy clinical trials have been reported worldwide. These advances raise great hope to treat devastating rare and inherited diseases as well as incurable illnesses. Here we review several gene therapies approved for neuromuscular inherited diseases.
Spinal muscular atrophy (SMA) is one of the most common inherited neuromuscular disorders. Several phase 1-3 studies have demonstrated the efficacy of different approaches including gene replacement, antisense oligonucleotides, and splicing modifiers. Early treatment is essential for the maximum efficacy of the newly available treatments. Nusinersen, an antisense oligonucleotide designed to modify pre-messenger RNA splicing of the SMN2 gene product, results in an increase in the inclusion of exon 7 and, thus, production of full-length survival motor neuron protein. Nusinersen is administered intrathecally and is a life-long treatment, requiring three lumbar punctures per year in the maintenance phase.
Duchenne muscular dystrophy (DMD) is the most common and most severe type of muscular dystrophy. Stop-codon read-through utilizes certain drugs or chemicals to selectively induce ribosomal read-through of premature stop codons, which represent up to 10% of all DMD cases. Exon skipping, targeting exons with anti-sense oligonucleotides (AONs) to produce a shorter but working version of dystrophin, can treat 55% of DMD patients. Gene therapy combined with cell transplantation and tissue engineering has the potential to lead to life-changing therapy for DMD.
Disease-modifying agents for transthyretin (TTR)-related familial amyloid polyneuropathy (FAP) have become available in the last decade. Tetramer stabilizers as Tafamidis and a NSAID-Diflunisal, Patisiran (a small interfering RNA, siRNA, silencing the TTR gene) and Inotersen (an antisense oligonucleotide that selectively binds TTR mRNA and decreases TTR production) have shown different efficacies, outcomes and functional prognosis.
Despite considerable efforts in gene therapy, only a few of the approved gene and cell-based gene therapy products were translated into the clinic. Development of viral delivery systems emerge as effective tools for gene manipulation and gene therapy approaches.


陳景欣 Gin-Shin Chen
PhD
Institute of Biomedical Engineering and Nanomedicine / National Health Research Institutes
gschen@nhri.edu.tw

陳博士目前擔任國衛院/醫工奈米所的(正)研究員一職,他專精於聚焦超音波醫療器材的開發,以及超音波對組織的生物效應,其中對於超音波周邊神經調節的研究已經有10年之久,發表多篇論文於知名國際期刊,例如Journal of Neural Engineering、IEEE UFFC、IEEE TBME、British Journal of Anaesthesia等。

Lecture Abstract
Pain evoked by diabetic peripheral neuropathy or migraine can degrade the patient’s quality of life and increase economic burden. However, medication analgesia or transcranial magnetic stimulation is only effective for some patients. We hypothesized that FUS treatment could modulate/block peripheral nerve conduction temporarily, resulting in pain alleviation. Diabetes was induced in Sprague-Dawley rats using streptozotocin injections. Diabetic neuropathy was confirmed by animal behavior tests. The in vitro and in vivo studies showed that the FUS thermal effects temporarily suppressed the partial action potentials of the sciatic nerves in normal and diabetic neuropathic rats. Follow-up action potential measurements and histological analyses indirectly verified the safety of the FUS-induced blockade technique. We further studied how to cure the diabetic peripheral neuropathy or repair the sensory function in diabetic rats. This is an important issue because none of medication based on pathogenetic therapies have gained approval from the US Food and Drug Administration or European Medicines Agency until now. We performed the animal study. Experimental results showed that two-consecutive-week FUS treatment can increase the upstream arterial blood flow in diabetic feet, ameliorate downstream microvessel perfusion and restore peripheral sensory function. Therefore, Noninvasive FUS treatment potentiates the alleviation of neuropathic pain and/or the prevention of diabetic foot ulcers. For the migraine study, the greater occipital nerve (GON) related to migraine pain was the treated target. A cortical spreading depression model was established as a migraine model in Sprague-Dawley rats. The in vitro and in vivo results showed that the FUS mechanical effects also inhibited the action potentials of the GONs reversibly. Moreover, the duration of the cortical spreading depression was reduced significantly by GON block, implying potential treatment efficacy on migraine pain. This study is the first to investigate the use of FUS for nerve conduction blocks in GONs, laying the groundwork for the potential use of FUS as a pain relief tool in patients with migraine.


林宙晴 Chou-Ching Lin
Prof
Application of OCT for peripheral nerves
Neurology, National Cheng Kung University
clin45@gmail.com

Chou-Ching K. Lin received a Bachelor degree of Medicine from National Yang-Ming University, Taipei, Taiwan in 1988 and an MSc and PhD in biomedical engineering from Case Western Reserve University, Cleveland, OH, USA in 1994 and 1997, respectively. He is a professor and chairman in Department of Neurology and an adjunct professor in Department of Biomedical Engineering, National Cheng Kung University. His areas of interest include functional MRI, brain-computer interface (BCI), brain stimulation, and neural network modelling of natural intelligence and artificial intelligence (AI).
Lecture Abstract
Optical coherence tomography (OCT) is a new technology for in vivo scanning of live tissues. Currently, the best known clinical application is for retina. Doppler OCT uses the principle of Doppler shift to estimate the moving rate of objects in the scanned area, most likely blood flow in the biological samples. There were only rare studies on application of OCT to nervous system. Our group has been working on the biomechanics of peripheral nerves for decades. OCT allows us to study a peripheral nerve in situ and the Doppler function enables the estimation of blood flow within a nerve. In this talk, I will summarize and describe our past studies on biomechanics of nerves and the application of OCT in this field.

Key words: Doppler optical coherence tomography, biomechanics, peripheral nerve, vasa nervorum, diabetic neuropathy, finite element method


Plenary Session

President Lecture

Eric Edward Smith
MD, MPH
Professor
University of Calgary, Canada
eesmith@ucalgary.ca

Dr. Eric Smith is Professor of Neurology, Radiology, and Community Health Sciences at the University of Calgary, and the holder of the endowed Katthy Taylor Chair in Vascular Dementia. He is the Medical Director of the Cognitive Neurosciences Clinic and a member of the Calgary Stroke Program. Dr. Smith graduated from McGill University, trained in Neurology in teaching hospitals of Harvard Medical School, and was Assistant Professor of Neurology at Harvard University before being recruited to Calgary in 2008. He Chairs the Brain Health Science Subcommittee of the American Heart Association. Dr. Smith’s research team investigates how cerebral small vessel diseases cause cognitive impairment and dementia.

Lecture Abstract
Cerebral small vessel diseases are the second most important contributor to risk of dementia, and the cause of one quarter of all strokes. In most cases, the underlying vascular pathology is arteriosclerosis or cerebral amyloid angiopathy. Despite advances in primary and secondary prevention for stroke, vascular brain injury from age-related cerebral small vessel disease remains extremely common. The therapies that have been effective at reducing the risk of stroke from large artery atherosclerotic disease and cardioembolism may not be as effective against small vessel disease. This lecture will review the pathophysiology, diagnosis, and treatment of cerebral small vessel diseases. Current guideline-based management and new therapeutic approaches in clinical trials will be discussed


Chun-Jen Shin Lecture

John Walter Dunne
MBBS(hons), FRACP, FRCP
Professor
School of Medicine, University of Western Australia
Head, EEG and Clinical Neurophysiology Laboratories,
Royal Perth and Sir Charles Gairdner Hospitals, Perth, Western Australia
Secretary General
International League against Epilepsy – Asia Oceania
john.dunne@uwa.edu.au

Clinical Professor, Department of Medicine, University of Western Australia Secretary General, ILAE – Asia Oceania (Commission on Asian and Oceanian Affairs) Australian delegate to the International Federation of Clinical Neurophysiology Chairman, EEG and Clinical Neurophysiology Committee, Australian and New Zealand Association of Neurologists Member of Epilepsy Society of Australia national executive and other committees Involved in epilepsy and clinical neurophysiology teaching throughout the Asian and Oceanian region.

Lecture Abstract
Major advances are occurring in our understanding and treatment of epilepsy.
The underlying mechanisms of some epilepsies have been clarified by epilepsy genetics, imaging and the exploration of brain networks; providing possible targets for prevention and specific treatment.
Ever increasing numbers of antiseizure medicines are available. Diagnostic techniques are rapidly evolving. Digital video-EEG has been revolutionary, with inpatient and now in-home monitoring possible. Post-acquisition digital EEG processing, wideband EEG and machine learning are emerging as clinical tools rather than research methods. More precise invasive presurgical EEG monitoring has revealed new information on seizure semiology, and emerging ultra long subscalp EEG monitoring techniques have potential roles in diagnosis and possibly seizure prediction.
Structural and functional imaging techniques are also rapidly developing, with coregistration and hybrid forms of the different modalities assisting in diagnosis, epilepsy surgery and exploration of the nature of epilepsy.
However, for many reasons I believe the single most important technological advance in epilepsy is the smartphone, both for diagnosis and management. Smartphones provide an opportunity to improve medical care for individual patients and to improve public health and education, including in developing countries since uptake is relatively high even in lowincome countries.
Despite these exciting changes, the foundation of epilepsy diagnosis remains a careful and accurate history, followed by appropriate investigations when needed. A good history requires skill and time, and unfortunately ordering tests is easier than taking a good history.
The misdiagnosis of epilepsy remains common, and the future progress of epilepsy must be based on accurate clinical assessment, listening to our patients and their families, having realistic goals, and ongoing care and support. Individually tailored treatment options are possible, and we hope to increasing move from control of symptoms to strategies for prevention and cure.


TsuPei Hung Lecture

Ian McKeith
MD, FRC Psych, FRSB, F MedSci
Professor
Old Age Psychiatry , Newcastle University, UK
i.g.mckeith@ncl.ac.uk

Ian McKeith is Professor of Old Age Psychiatry at Newcastle University. His dementia research career has included clinico-pathological brain banking studies, population based epidemiology, biomarker development and clinical trials. His current work based in the Newcastle Biomedical Research Centre in Age Related Diseases has a focus on diagnostics and novel therapeutics for Lewy Body dementia. From 2005-2015 he was Director of the UK National Dementias and Neurodegenerative Diseases Research Network (DeNDRoN). He is an NIHR Senior Investigator, founding President of the Lewy Body Society national charity and a member of several international editorial and advisory boards. He has received Lifetime Achievement Awards from the UK Royal College of Psychiatrists in 2008, and from the American Alzheimer’s Association International Conference (AAIC) in 2015. In 2018 he received the European Grand Prix from the French Alzheimer Research Foundation.

Lecture Abstract
Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementia in older people, with a prevalence estimated at between 7.5% (clinical) and 15% (pathological) of all cases. Much of this variability is probably related to overlapping Lewy and Alzheimer disease. Consensus criteria for DLB diagnosis were updated in 2017 and recognize four core clinical features (fluctuating cognition with pronounced variations in attention and alertness.; recurrent visual hallucinations that are typically well formed and detailed; REM sleep behavior disorder, which may precede cognitive decline, and one or more spontaneous cardinal features of parkinsonism). Three indicative biomarkers were also described; (reduced dopamine transporter uptake in basal ganglia demonstrated by SPECT or PET; abnormal (low uptake) 123iodine-MIBG myocardial scintigraphy, and polysomnographic confirmation of REM sleep without atonia).
The Diamond-Lewy programme was a five year study based in Newcastle upon Tyne and Cambridge, UK, designed to improve the DIAgnosis and Management Of Neurodegenerative Dementia of Lewy body type. Five work packages were included. The first assessed the frequency of Lewy body dementia diagnosis in UK NHS clinics and the second identified barriers and facilitators to diagnosing and managing LBD. Work package three systematically reviewed the published evidence about best ways of managing LBD and developed a best practice management guideline. Work package four developed an assessment toolkit to aid clinicians in their diagnostic practice. Finally in work package five the feasibility of undertaking a cluster randomized study of the introduction of the management toolkit was assessed using the outcomes for patients and carers as secondary measures. In this plenary talk the main outputs of DiamoND-Lewy will be presented.


Keynote Speech

林靜嫻 Chin-Hsien Lin
MD, PhD
Department of Neurology, National Taiwan University Hospital
chlin@ntu.edu.tw

Dr. Chin-Hsien Lin graduated from College of Medicine, National Taiwan University, and received her neurological residency training in National Taiwan University Hospital (NTUH). She received her PhD training from Institute of Molecular Biology, Academia Sinica, and investigated the molecular mechanisms of LRRK2 mutations in neurons by using a Drosophila model system. She received post-doctoral fellowship training in University of British Columbia, Canada.
Dr. Lin is now a clinical professor in Department of Neurology, National Taiwan University Hospital. Her main academic interests include genetic and molecular biology studies of Parkinson’s disease and related neurodegenerative disorders. She investigated the molecular mechanisms of mutations of Parkinson’s disease or dystonia causative genes in neuronal degeneration by using cellular and animal model systems. She is now an executive member of Taiwan Movement Disorders Society (MDS) and also a representative member of the leadership program of international MDS. She is also committee members of educational committee of the MDS-AOS section and active member of evidence-based medicine (EMB) and basic neuroscience committees of international Movement Disorders Society.

Lecture Abstract
Parkinson’s disease (PD) is a common neurodegenerative disorder and the etiology comes from an interplay between genetic and environmental risk factors. The recent identification of a growing list of causative genes linking to familial forms of PD has led to a better understanding of disease-linked protein networks and provides key biological insights into underlying disease processes, including mitochondria and lysosomal dysfunction, impaired intracellular trafficking and alpha-synuclein dyshomeostasis. In recent years, numerous clinical trials for disease modification in PD have failed, possibly because of a “one-size-fits all” approach. More attention should be paid to the symptomatic and pathological differences between patients. We propose that patients belong to distinct nodes or clusters, which are defined by clinical, pathological, genetic and molecular features of the disease are needed. Given that the advent of genetic progress in the field of PD, we now have far more representative animal models of the disease, and we can be inspired by the early successes of others using antisense oligonucleotide and vaccination approaches in other neurodegenerative diseases. In this talk, Alternatively, a tailor medicine approach, which customizes treatments based on patients’ individual genotype and pathology findings, may help reach the goal of disease modification.


Symposium(3):Advanced in patient care and clinical practice
郭博昭
MD, PhD
國立陽明大學 腦科學研究所
tbjkuo@ym.edu.tw

原創各式腦科學研究相關技術,範圍包括各式軟、硬體技術並進行產學合作,另建立遙控刺激進行各式行為及認知等研究,近年全力推廣雲端保健技術應用。2017年完成全球首創之多點無線同步多頻道睡眠記錄系統。Medical AI相關研發目前正在雙和醫院進行“加護病房穿戴式腦波與心電監測系統”、“醫護人員心率變異人工智慧健康管理系統”及“社區睡眠呼吸中止篩檢系統”三大原創者提出的臨床試驗,都是成功整合8大醫療人工智慧項目的開發案。

Lecture Abstract
醫學是最古老的行業之一,時至今日也是最晚自動化的行業。目前的醫療服務仍以醫師親自看診為主,但隨著老年人口的逐漸增加,這種模式勢必無法滿足未來的需求。另一方面,資訊科技已經引領了一系列的產業革命,許多原本需要靠人服務的項目都逐漸轉由資訊系統自動化,遠距健康照護已經成為相當熱門的著眼點。
透過醫療物聯網與人工智慧進行雲端健康管理,就是最近一波利用資訊科技的能力將醫療自動化的變革。郭博昭教授將以醫師與工程師雙重身份,用原創的器材與實驗,從醫學技術、電資技術及服務模式三個方面,來分享人工智慧物聯網AIoT的臨床案例。


石富元 Fu-Yuan Shih
Associate Professor, M.D.
Attending Physician
Department of Neurosurgery
Chang Gung Memorial Hospi
8902055@cgmh.org.tw

石富元醫師現任台灣高雄長庚紀念醫院神經外科主治醫師、神經外科加護病房專責醫師、北美神經重症醫學會會員、高雄長庚帕金森治療中心成員;並擔任台灣功能性神經外科醫學會秘書長。
於2014年至今擔任神經外科加護病房專責醫師,致力於神經重症病患照護,無論就病情進程、神經重症監測、手術治療、藥物治療、目標體溫控制治療、國際趨勢,都能提供許多臨床醫師相關的討論與建議。
石富元醫師對於神經重症的臨床監測與治療,持續保持高度的興趣,也擔任急救加護醫學會與神經創傷醫學會共同舉辦的急性腦損傷課程講師;石醫師亦專研於深腦部刺激術、癲癇手術及術中監測。目前與未來的研究方向主要在深腦部刺激術用於帕金森是病的治療、急性腦損傷之症監測與治療及急性腦損傷的癲癇研究。

Lecture Abstract
Acute brain injury (ABI) includes traumatic brain injury, hemorrhagic stroke, infarction stroke, aneurysmal subarachnoid hemorrhage, hypoxic encephalopathy, and central nervous system infection. Acute brain injury can range from brain concussion to brain death. Multimodality monitoring allows the neurocritical care clinician to collect vast amounts of data including intracranial pressure, electroencephalograms, hemodynamics, ventilation, body temperature, serial neurological examinations, fluid intake-output, and other neurophysiologic parameters. Multimodality monitoring allowed artificial intelligence to utilize this information and manage basic patient care. Early signs of neurological deterioration could be detected more promptly and appropriate measures taken more quickly, thereby improving patient outcomes. We will discuss about the artificial intelligence for neurocritical care in acute brain injury.


林雅如 Ya-Ju Lin
MD, Msc
Senior attending physician and Chief
Department of Neurology, MacKay Memorial Hospital , Taipei
yjl5824@gmail.com

Dr Ya-Ju Lin graduated from China Medical College 1993 and got a master degree in 2011 from the Institute of Emergency and Critical Care Medicine in National Yang-Ming university. I am now a senior attending physician and chief at department of neurology, MMH. My study interest was stroke and neurocritical care.

Lecture Abstract
Clinicians are no strangers to patients with migraine symptoms and frequent dizziness. Several studies have found a close association between dizziness and migraine. Vestibular migraine(VM) is defined as a patient having recurrent vertigo with migrainous features such as migrainous headache, photo- and phono-phobia, or visual aura. It is now among the most common causes of recurrent vertigo in the general population. Despite its prevalence and high impact on healthcare cost and utilization, it has remained an under-recognized condition. Also, not all migraineurs with episodic vertigo are VM. Another newly defined vestibular disorder, persistent postural-perceptual dizziness(PPPD), refers to patients who have chronic persistent dizziness, and the symptoms could be exacerbated by upright posture, motion, or complex visual stimuli. About 20 % of PPPD is a consequence of VM so that it is also closely related to migraines. Besides, some other vestibular disorders such as benign paroxysmal positional vertigo, Meniere’s disease, mal de debarquement syndrome, and motion sickness are proved to be more prevalent in migraine patients than in the general population.


李孟 Meng Lee
副教授
嘉義長庚腦血管暨一般神經科副科主任
b8101099@gmail.com

學歷
台北醫學大學醫學系
經歷
嘉義長庚神經內科主治醫師
林口長庚神經內科住院醫師
專長:腦中風、高血壓、高血脂


王文甫 Wen-Fu Wang
MD
Director of long term care center at Changhua Christian Hospital
w4239.tw@gmail.com

王文甫醫師畢業於中國醫藥學院醫學系, 並在中國醫藥大學附設醫院完成住院醫師訓練並擔任主治醫師。 目前是彰化基督教醫院長期照護中心和失智症中心主任。也任教於明道大學休閒保健系。 同時也是台灣臨床失智症協會理事,以及彰化戀戀半線失智症協會常務理事。
王文甫醫師的主要臨床和學術興趣包括失智症,神經退行性疾病,中風和長期照護。他的團隊參加了許多阿茲海默氏症治療的三期臨床試驗。目前主要從事失智症的診斷,治療,和長期照護的研究議題。

Lecture Abstract
神經科疾病常導致急性失能(如中風)和慢性失能(如失智症,巴金森氏症和其他神經退化疾病)。
長照2.0中,出院準備,居家醫療,居家復能,以及失智創新服務等皆與神經科疾病關係密切。
本演講將介紹長照2.0與神經科相關的服務內容,分享神經科醫師在臨床實務中,如何連結長照2.0,協助病患後續醫療照護,並探討神經科醫師在長照2.0中的角色及藍海。


張谷州 Ku-Chou Chang
MD
Director, Long-term care center; Division of Cerebrovascular Diseases
Chang Gung Memorial Hospital, Kaohsiung, Taiwan
kcchang@cgmh.org.tw

張谷州醫師,高雄長庚紀念醫院長期照護服務中心主任及腦血管科主任,長庚大學醫學院醫學系副教授,台灣腦中風學會常務理事及台灣神經學會理事,高雄市政府長期照護推動小組委員。健保署「建立腦中風急性後期照護模式之專業訓練及實地輔導計畫」主持人。執行屏東縣緊急腦中風轉診通訊諮詢。配合「居家醫療照護整合計畫」以「出院準備服務長期成效研究及資訊平台建立」計畫及「推動長照10年計畫2.0」建構台灣神經會專屬失能服務。

Lecture Abstract
出院準備服務由緊急醫療處置、到院第一時間開始,置入長照2.0服務,協助失能病患連結社會服務資源,執行雙向轉診分級醫療。
腦血管疾病治療持續突破,血栓溶解加血栓移除緊急治療後,中風90天後:30-40%恢復良好,20%死亡。恢復良好控制血壓血糖血脂抗凝血藥物預防腦梗塞再發;嚴重案例接受安寧緩和治療。40-50%嚴重神經缺損,有恢復潛力轉入急性後期處置;數障礙持續案例由長期照護體系接手。
100年健保署規劃腦中風急性後期照護,104年拓展至六項疾病,105年出院準備服務管理費,出院準備服務具象化;推動居家醫療,行動不便就醫困難案例,進到行動醫療。
人口持續老化,勞動人口持續降低,衛福部長期照護,107年各院積極推動居家復能服務,配合長照四包錢,由出院準備服務及社區轉介,衛生局主導積極布建服務據點完整網絡。
對健康,亞健康,失智/失能,重病/末期,到臨終生命過程,藉健康促進,出院準備服務,到居家醫療的健康照護體系,執行慢性病管理到人生終末安寧療護,融入急性醫療擴展服務面向。
台灣醫療由緊急處置到急性後期銜接長期照護,107年再藉由復能多元服務試辦計畫,對醫療服務產生另一個層次的重大質與量的變化。
高雄長庚醫院92年起,基於病患連續性照護需求,整合失能照護需求高專科,配合完備出院後服務,在主管機關鑑訪查及服務品質考核下,持續提升出院準備服務讓病人獲得合適照顧。


Symposium(4):Advanced in patient care and clinical practice
宋家瑩 Jia-Ying Sung
PhD, MD
Associate Professor / Director and Clinical physician
Taipei Medical University / Taipei Municipal WanFang Hospital
sung.jiaying@gmail.com

Dr. Jia-Ying Sung has extensively studied on peripheral neuropathy and clinical neurophysiology for over ten years. She has special experiences on nerve excitability measurement of patients and has published her research topics about neuromuscular diseases such as diabetes polyneuropathy, inflammatory demyelinating polyneuropathy of peers reviewed articles in the journals of SCI, such as JNNP & Brain.

Lecture Abstract
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is the most common treatable neuropathy and a spectrum disorder. Autoimmune response toward the peripheral nerves is supposed as the pathogenesis and makes myelin or axon damage secondarily; however, the exact mechanisms underlying the development of immunopathology remain to be defined. The clinical presentation is variable because the targets of immune response are multiple. Furthermore
sometimes the treatment response is also unpredictable. In this section, we will summarize clinical assessment tools, including neurophysiological studies, serological and image studies of CIDP in recent years. We hope to establish a comprehensive evaluation of all patients with polyneuropathy to help patients receive correct and effective treatments in the future.


黃至誠 Chih-Cheng Huang
助理教授
高雄巿立鳳山醫院神經科主治醫師
高雄長庚神經內科系神經肌肉疾病科主治醫師
hjc2828@gmail.com

學歷
成功大學醫學工程研究所博士
高雄醫學大學醫學系
經歷
美國Mayo Clinic神經科研究員
高雄縣阿蓮鄉長佑醫院主治醫師
高醫附設醫院神經科總醫師
專長:自律神經疾病、周邊神經及肌肉疾病、醫學工程、神經電生理


林衛邑 Wey-Yil Lin
MD.
Director, Department of Neurology
Director, Department of Quality Management
Landseed International Hospital, Taoyuan
gortexlin@gmail.com

Dr. Wey-Yil Lin graduated from Taipei Medical University in 2001, and completed the neurologist training in Chang Gung Memorial Hospital, Linkou. Dr. Lin was the General Secretary of Taiwan Movement Disorder Society during 2011 and 2013, and the attending physician and assistant professor in the Division of Movement Disorder, Department of Neurology, Chang Gung Memorial Hospital, Linkou during 2009 and 2017. His fields of interest are neuroimaging, neurophysiology and epidemiology of Parkinson’s disease and other movement disorders. He also has practical experience of deep brain stimulation and botulinum toxin injection for the treatment of movement disorders.

Lecture Abstract
The autonomic nervous system (ANS) includes multiple components: sympathetic noradrenergic, sympathetic cholinergic, parasympathetic cholinergic, enteric, and adrenomedullary. Involvement of ANS is not uncommon in the neurodegenerative disease, especially in the synucleinopathies. The patients with impaired ANS may have various manifestations, e.g. orthostatic hypotension, urinary symptoms, dysphagia, gastroparesis, constipation, or hyperhidrosis. The talk will give a brief overview about the studies and tests for cardiac sympathetic dysfunction, delayed gastric emptying and gastrointestinal transit, and urinary dysfunction in the neurodegenerative disease. Some of the clinical rating scales for autonomic dysfunction may be useful for the clinicians, and they will be reviewed in the talk.


林哲偉
助理教授
國立成功大學 醫工系 助理教授
lincw@mail.ncku.edu.tw

國立交通大學電機與控制工程系學士
義大利米蘭大學資訊科技學系碩士
國立成功大學電機工程學系博士
國立成功大學醫工系 助理教授
國立成功大學電機系助理研究員
國立成功大學電機系博士後研究員
專長:生醫訊號處理、慣性訊號處理、穿戴式載具設計、嵌入式系統設計


黃立楷
Li-Kai Huang
MD.
Attending Physician
Department of Neurology Taipei Medical University Shuang-Ho Hospital New New Taipei City , Taiwan
greatoriole@gmail.com

黃立楷醫師現任衛生福利部立雙和醫院神經內科主治醫師,失智症中心成員,台灣臨床失智症學會副秘書長。黃立楷醫師對於認知行為神經學,失智症照護,以及道德研究保持高度的興趣,並持續參與大腦意識損傷研究,追蹤家訪數十位植物狀態及微意識狀態患者,並在台北醫學大學醫學人文研究所碩士班及神經再生博士學位學程就讀中。


王培寧 Pei Ning Wang
Professor, Department of Neurology,
School of Medicine, National Yang-Ming University
Director of Dementia treatment and research Center,
Taipei Veterans General Hospital
Attending Physician, Division of General Neurology,
Department of Neurological Institute,
Taipei Veterans General Hospital,
Taipei, Taiwan
linda2860@gmail.com

Professor Wang obtained her medical degree from National Yang-Ming University and completed a residency in neurology at the Neurological Institute, of VGH Taipei. She also completed a behavioral neurology fellowship at the University of California San Francisco’s Memory and Aging Center. In addition to neurology she has board certification for geriatric medicine and dementia.
Professor Wang has multiple research interests including Alzheimer’s disease, neuroimaging, cognition, behavioral neurology, geriatric neurology and frailty. Her research investigated the biomarkers of dementia and cognitive frailty. Prof. Wang made efforts on establish the validity of the Chinese-version neuropsychological tests to make a accurate early diagnosis of mild AD and mild cognitive impairment (MCI). In the recent years, Prof. Wang concentrate to the trajectory of different biomarkers from preclinical AD, MCI due to AD, to dementia due to AD. Her aim is to explore the biomarkers for early diagnosis of Alzheimer’s disease and prediction the progress from aging to mild cognitive impairment and dementia.
Besides dementia, Prof. Wang extended her research interest to the relationship between frailty, brain and cognition. Her teams found reduced cerebellar gray matter is a neural signature of physical frailty. Even without subjective cognitive complaints, higher risk of cognitive impairment is presented. in the prefrail and frail individuals. Community-based longitudinal cohort is ongoing to evaluate the nature course of cognitive frailty.

Lecture Abstract
Dementia is a global public health priority. Currently available treatment options, including acetylcholinesterase inhibitors and memantine, only have symptomatic effects and no drugs with disease-modifying properties are available. Research on the amyloid cascade indicates that amyloid-β (Aβ) clearance from the brain may be the main pathophysiological change in late-onset AD and the key driver of neurodegeneration, which ultimately results in progressive cognitive deterioration and dementia. Most new AD drug candidates target different aspects of Aβ clearance, eg, using passive anti-Aβ immunization, but so far, all efforts to develop more effective drugs have failed. Therefore, prevention has been highlighted as a pivotal component in managing the dementia epidemic. Modifiable risk factors of dementia and AD include lifestyle-related factors, vascular and metabolic disorders, and psychosocial factors. Nonpharmacological prevention trials are being conducted to modify dementia risk associated with known epidemiological risk factors. Given the complex, multifactorial, and heterogeneous nature of late-onset AD and dementia, interventions targeting several risk factors and mechanisms simultaneously may be required for optimal preventive effects. In the past few years, three large multidomain trials (FINGER, MAPT and PreDIVA) have been completed. The FINGER trial showed that a multidomain lifestyle intervention can benefit cognition in elderly people with an elevated risk of dementia. The primary results from the other trials did not show a statistically significant benefit of preventive interventions, but additional analyses among participants at risk of dementia showed beneficial effects of intervention. Overall, results from these three trials suggest that targeting of preventive interventions to at-risk individuals is an effective strategy. This talk will discuss the current knowledge of lifestyle-related risk factors and results from novel trials aiming to prevent cognitive decline and dementia.


Case-base learning
林浚仁 Chun-Jen Lin
MD, PhD
Attending physician
Taipei Veterans General Hospital
zenlin1981@hotmail.com

Dr. Chun-Jen Lin is an attending vascular neurologist at Taipei Veterans General Hospital and an assistant professor at National Yang-Ming University. His clinical services include endovascular thrombectomy for acute ischemic stroke, prevention and management of stroke, and diagnosis and treatment of dizziness. His research focus on the cognitive impact of severe carotid stenosis and its associated disruption of functional connectivity. He also does studies about clinical data analysis as well as meta-analysis of cerebrovascular diseases.

Lecture Abstract
Reperfusion therapy for acute ischemic stroke including IV thrombolysis and endovascular thrombectomy (EVT) within time windows has been applied as standard treatment worldwide. Recently, several studies indicated that reperfusion therapy still worked if the clinicians were able to identify the presence of salvageable tissue based on advanced brain imaging. Perfusion parameters or DWI of MRI were generally needed to confirm the infarct core volumes, in order to estimate the clinico/infarct or hypoperfusion/infarct mismatch. Therefore, this is an era that tissue-based selection for reperfusion therapy is possible.
In this talk, I will present cases receiving EVT in an extended time window (≥6 hours) based on advanced imaging including fast-MR or CT perfusion. I will share the decision making process and the outcomes of the treatment.


朱海瑞 Hai-Jui Chu
MD
attending physician
Attending Physician, Dept. of Neurology, ECK Hospital, Taiwan
raybay619@hotmail.com

學經歷
輔仁大學醫學系畢業
University of California, Irvine, Stem Cell Research Center研究醫師
美國UCLA Ronald Reagan醫學中心 中風神經科、腦血管介入科 研究醫師
Treating M2 occlusion with mechanical thrombectomy, comparing to proximal large vessel occlusions such as the ICA or the M1 may need to pass through longer and more tortuous routes. Also, the diameter of M2 is much smaller that needs to be managed more delicately. On the other hand, is suction thrombectomy or stent retriever thrombectomy the better strategy for M2 occlusion? In our series, M2 occlusions account for 19.6% among all EVT series. Some cases will be demostrated.


黃虹瑜 Hung-Yu Huang
中國醫藥大學附設醫院 神經部 備任主治醫師
fisher8577@hmotmail.com

中國醫藥大學 中(西)醫學系 醫學士
中國醫藥大學附設醫院 神經部 住院醫師
神經放射科學會顱內血管取栓術認證
神經重症專科醫師
專長:腦中風急性治療與相關慢性疾病控制、失智、運動障礙疾病


蔣漢琳 Han-Lin Chiang
M.D.
Attending Physician
Department of Neurology
Neurological Institute
Taipei Veterans General Hospital
Taipei, Taiwan
/td>
yorkiego@gmail.com

Dr. Chiang was graduated from Taipei Medical University and received her neurology residency training in Chang Gung Memorial Hospital, Lin Kuo. She became an attending neurologist in the Neurology Department of Taipei Tzu Chi General Hospital from 2009 to 2018 and was shifted to Taipei Veterans General Hospital since 2018/8. She was trained as a clinical fellow in the Movement Disorder Unit of Westmead Hospital, Australia with Prof. Victor Fung. She received her master’s degree from National Taiwan University College of Medicine under the supervision of Prof. Chin-Hsien Lin. Her major interest focuses on Gut-Brain Axis in Parkinson’s disease.

Lecture Abstract
Chorea is a hyperkinetic movement disorder characterized by irregular, flow-like, unpredictable movements with a wide range of etiologies. The etiologies include many secondary causes that are possibly treatable, such as autoimmune disorders or thyrotoxicosis, as well as genetic causes, which are rapidly expanding. A shotgun-like approach is often infeasible. In this talk, I’ll try to summarize the way to approach such patients in a systemic way and to give a brief update on newly discovered diseases with chorea and treatment options.


陳凱翔 Kai-Hsiang Chen
MD
Head of the Neurology Department
National Taiwan University Hospital Hsinchu branch
stanleychen1230@gmail.com

Dr. Chen graduated from Taipei Medical University and received his neurological resident training in National Taiwan University Hospital, Taiwan. He has served as an attending physician in the Department of Neurology, National Taiwan University Hospital Hsinchu Branch since 2012. He built up deep brain stimulation team for Parkinson's disease treatment in Hsinchu since 2015. In addition to the clinical experience, he completed his research fellowship in Professor Robert Chen’s lab in Krembil Brain Institute, University of Toronto. Dr. Chen’s major interests include neuromodulation and electrophysiological assessment in movement disorders through deep brain stimulation (DBS) and transcranial magnetic stimulation (TMS) and focused ultrasound (FUS). Dr. Chen is currently the chairman of Department of Neurology, National Taiwan University Hospital Hsinchu Branch.

Lecture Abstract
In daily clinical practice, neurologists usually diagnosed a neurological disease through a patient's clinical manifestation, biochemical data, or genetic survey etc. However, one of the most important method is electrophysiological assessment. There are lots of equipments we can utilize, including surface EMG, needle EMG, nerve stimulation, EEG, and transcranial magnetic stimulation (TMS), etc. Each of these methods had its own advantage to let clinical physicians get closer to the correct diagnosis. For example, we can use surface EMG to record many kinds of hyperkinetic involuntary movements, or try to differentiate organic or functional tremor. We can apply TMS to obtain the central conduction time or measure cortical excitability in patients. Besides, clinical physicians can conduct these studies periodically as long term outcome measurements. Certainly, there are limitations in every electrophysiological assessment. Not to over-explain test results is another key point that all physicians should pay attention to. In this talk, we will discuss how to utilize or integrate these methods to approach different kind of movement disorder patients.


戴逸承 Yi-Cheng Tai
MD
Attending Physician
E-DA Hospital / I-Shou Univeristy
b88401074@ntu.edu.tw

Dr. Tai obtained his M.D. degree from National Taiwan University (NTU) in 2006. He finished the residency program in the Department of Neurology at National Taiwan University Hospital (NTUH) (2008-2012). He was an attending physician in the Department of Neurology, E-DA Hospital from 2013-2014. He started his fellowship in movement disorders in the Department of Neurology, Westmead Hospital and Sydney Medical School, University of Sydney, Australia under Dr. Victor Fung’s supervision in 2015. He is now an attending neurologist in E-DA Hospital and a clinical lecturer in the School of Chinese Medicine for Post Baccalaureate, I-Shou University.
Dr. Tai is a member of International Parkinson and Movement Disorder Society and Taiwan Movement Disorders Society. Dr. Tai has clinical and research interests in electrophysiological analysis of movement disorders and deep brain stimulation.

Lecture Abstract
This is an introduction of clinical application of DBS to patients with advanced Parkinson’s disease. The lecture will focus on the patient selection, time point and target for DBS surgery, surgery preparation, intra-operative monitoring, and post-operation medication adjustment. It will also give a rough coverage about the principle of DBS parameter adjustments and possible side effects after DBS surgery. The lecture will mainly be conducted by following the time-line of a typical DBS case accompanied by some evident data.


Case-base learning
鄭美雲 Mei-Yun Cheng
MD, PhD
Assistant Prof
Chang Gung Memorial Hospital, Linkou t
cheng-mei-yun@yahoo.com.tw

Education:
1996-2003, Chung Shan Medical University, Taiwan
2010~ 2017 Doctoral degree in the Institue of Molecular Medicine, National Tsing Hua University, Taiwan

Employment Record:
2008, Attending, Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan
2013, Asistant Professor, Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan
2019 Director, Section of Functional Neurology and Epilepsy, Chang Gung Memorial Hospital, Linkou, Taiwan

Research Interests:
1. Epilepsy (treatment, surgical evaluation, basic study)
2. Autoimmune encephalitis
3. Spinal cord infarction
4. Multiple sclerosis (treatment and basic study) e.

Lecture Abstract
Epilepsy is the fourth most common neurological disease. In Taiwan, one of 26 people accounts for nearly 130,000 people have epilepsy, of which about 40,000 are drug-refractory epilepsy. In epilepsy patients in adult, about 60% of them have temporal lobe epilepsy. Although anti-seizure medications (ASM) are still an important basis for treatment, there are about a quarter of patients who cannot achieve good control with drugs. In addition to ASM, epilepsy surgery is one of the treatment options for patients with medically refractory epilepsy. The epilepsy surgery include conventional resection/lobectomy, neuromodulation (deep brain stimulation, vagal nerve stimulation, responsive neurostimulation, hippocampal stimulation or cortical stimulation) and minimally invasive epilepsy surgery (stereotactic radiofrequency thermocoagulation, laser-induced thermal therapy, stereotactic radiosurgery and MRI-guided focus ultrasound ablation)
I will introduce the application of minimally invasive surgery, radiofrequency thermocoagulation (RFTC), to patients with temporal lobe epilepsy. The content will include pre-operative evaluation, selection of suitable patients, intraoperative monitoring, surgical methods and postoperative follow-up.


周建成 Chien-Chen Chou
臺北榮民總醫院神經醫學中心 癲癇科主治醫師
igorugo@gmail.com

中山醫學大學 醫學士
陽明大學腦科學研究所 碩士
經歷
臺北榮民總醫院神經醫學中心 神經內科 住院醫師
臺北榮民總醫院神經醫學中心 神經內科 總醫師
臺北榮民總醫院癲癇科研修醫師
國際期刊International Journal of Neurological Disorders and Therapy編輯委員
義大利米蘭尼瓜爾達醫院癲癇手術中心研修醫師
專長:癲癇相關之臨床診治與研究、腦電波與腦磁波之訊號分、暈厥、頭痛、睡眠障礙

Lecture Abstract
Surgery is a reliable treatment for drug-resistant focal epilepsies associated with structural lesions. However, when there is no lesion detectable in high resolution MRI, intracerebral neurophysiological information combined with semiology of seizures is needed to identify and localize the brain area to be resected to achieve post-surgical seizure freedom.
Today, I would like to introduce a 26 year-old man with focal drug-resistant epilepsy. He suffered from epileptic seizures since he was 17 years old. Recurrent seizures were controlled well by antiepileptic drugs (AEDs, including phenytoin and levetiracetam). However, seizure freedom only lasted for 2 years and seizures recurred, which were poor responsive to AEDs even adding with zonisamide and perampanel. His brain MRI showed no structure lesions.
In this talk, I will focus on the questions as follows:
(1) How to analyze the information between his semiology, findings of video-electroencephalography (VEEG) and other non-invasive presurgical evaluation?
(2) How to combine the data of presurgical evaluation and then to propose the hypotheses of his seizure network and to plan his stereo-EEG implantation?
(3) How to analyze the interictal and ictal periods of stereo-EEG and to perform the cortical mapping by stereo-EEG?


李旭東 Lee-SD Kao
副教授
台中榮總 腦腫瘤神經外科 科主任
leesd2001@hotmail.com

國防醫學院醫學系畢業
國防醫學院醫學科學研究所博士班畢業
台中榮總 神經外科 總醫師
台中榮總 神經外科 主治醫師
美國約翰霍普金斯大學醫院神經外科 主治醫師,研究員
美國約翰霍普金斯大學醫院藍茲功能性神經實驗室研究員
專長:
1..帕金森症及頑固型疼痛之治療
2.癲癇手術及電刺激治療
3.腦中風,顱內動脈瘤及動靜脈畸形手術
4.內視鏡腦下垂體腫瘤手術
5.三叉神經痛及顏面神經痙攣
6.脊椎神經手術
7.內視鏡脊椎手術
8.脊椎高頻熱凝療法手術
9.脊椎骨水泥灌漿手術
10.椎間盤突出微創手術
11.頸內-頸外動脈吻合手術


王嚴鋒 Yen-Feng Wang
MD, PhD
Attending physician
Taipei Veterans General Hosptial
yfwang851106@gmail.com

Dr. Yen-Feng Wang was graduated from National Yang-Ming University (NYMH). After completing his residency training in the Department of Neurology of Taipei Veterans General Hospital (VGHTPE), he did his fellowship in headache medicine with Professors Shuu-Jiun Wang and Jong-Ling Fuh. He earned his PhD degree from the Institute of Clinical Medicine of NYMU. He served as an attending physician at the Department of Neurology of VGHTPE. His major clinical and research interests focus on headache disorders.

Lecture Abstract
In the past decade, next generation sequencing and new imaging technology have greatly improved our ability to diagnose the underlying cause of epilepsies. The advance in our understanding of the cause of epilepsies also pave the way toward precision treatment. In this talk, I will discuss the recent progress of precision diagnosis using NGS and emerging precision treatment.


賴資賢 Tzu-Hsien Lai
助理教授
亞東紀念醫院 11G病房主任
亞東紀念醫院 神經醫學部主治醫師
laitzuhsien@gmail.com

國立陽明大學 神經科學研究所博士
台北醫學大學 醫學系學士
國立陽明大學 醫學系講師
台北榮總 神經醫學中心特約醫師
馬偕紀念醫院 神經科主治醫師
員山榮民醫院 神經科主治醫師
台北榮總 神經醫學中心住院醫師
馬偕紀念醫院 神經科住院醫師
專長:頭痛、失智症、腦中風、一般神經疾病


楊富吉 Fu-Chi Yang
M.D., Ph.D.
Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
fuji-yang@yahoo.com.twfujiyang88@gmail.com

Dr. Fu-Chi Yang is currently an Associate Professor, Ward Chief, and Attending Physician at the Department of Neurology, Tri-Service General Hospital, National Defense Medical Center in Taiwan. He is also a director of the Taiwan Headache Society and headache specialist. Dr. Yang graduated from the National Defense Medical Center in Taiwan. He completed his residency in neurology and received fellowship training at the Tri-Service General Hospital in Taiwan. Dr. Yang received his Ph.D. degree from the Brain Science Institute at National Yang-Ming University in Taiwan. His primary research focused on headache, pain, cognition, and advanced neuroimaging with their applications. He dedicated himself in advanced MR neuroimaging and biomarker research to decipher the pathophysiology of migraine, cluster headache and cognition disorders.

Lecture Abstract
Trigeminal autonomic cephalalgias (TACs) comprise primary headache disorders with shared characteristics of unilateral headache and occasional ipsilateral cranial autonomic symptoms. TACs include cluster headache (CH), paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT), short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA), and hemicrania continua. CH, the most common TAC, shows more male prevalence, with typical onset at 20-40 years of age. Most patients have episodic CH; approximately 15% have chronic CH, which greatly impairs their quality of life. The episodes often exhibit circadian and seasonal rhythm. The pathophysiology of CH remains unclear. Anatomical connections between the hypothalamus, trigeminovascular system, and parasympathetic nervous system have been implicated in the pathophysiology of CH. Trigeminovascular activation involves several neuropeptides; however, current evidence limits their reliability as biomarkers of CH. Existing treatment targets trigger avoidance, and includes abortive therapies, prophylaxis during the cluster period, and long-term therapy in patients with chronic CH. Development of effective therapeutics for episodic attacks, and prophylactics, including invasive and non-invasive neuromodulation modalities, has seen remarkable progress. The first-line therapeutics for TACs have not changed in recent years; paroxysmal hemicrania and hemicrania continua are managed with indomethacin, and SUNCT and SUNA, with lamotrigine. Proper treatment warrants proper diagnosis of TACs.


倫理課程
李佳儒 Chia-Ju Lee
MD, MSc
Attending neurologist
Changhua Christian Hospital
cch170476@gmail.com

台北醫學大學醫學系畢業
英國倫敦大學學院臨床神經科學碩士 (MSc in Clinical Neuroscience, UCL Queen Square Institute of Neurology, UK)
彰化基督教醫院神經醫學部住院醫師、總醫師
彰化基督教醫院神經醫學部主治醫師
台東基督教醫院神經科主治醫師

Lecture Abstract
醫療決策的模式隨著時間演進,逐漸形成強調雙向溝通的「醫病共享決策」(Shared Decision Making,SDM),協助病人了解病情和治療選擇。希望藉由降低無效溝通並提升醫療品質,以便能夠建立更好的醫病關係。SDM能選用的工具有許多種:介紹美國AHRQ提倡的SHARE模式,以及彰基使用SDM設計協助神經科醫師臨床使用,有效減少急性腦中風靜脈溶栓治療時家屬猶豫時間,進而達到降低「Door-to-needle Times」的經驗。


李介元 Jie-Yuan Li
MD
Attending Physician
義大醫院
jeffli2035@gmail.com

Dr. Jie-Yuan Li graduated from National Yang- Ming University and trained in Internal Medicine and Neurology at Kaohsiung Veterans General Hospital. He undertook Research Fellowship training in Movement Disorders (mentored by Dr. Anthony Lang) and in Human Motor Physiology (mentored by Dr. Robert Chen) at Toronto Western Hospital in Toronto, Canada from year 2001 to 2003. In 2016, he moved to E-Da hospital and soon started the first deep brain stimulation surgery in Parkinson’s disease in collaboration with neurosurgeon in E-Da hospital.

Lecture Abstract
依據108年1月6日公布的「病人自主權利法」內文之第8至第13條提及「預立醫療決定Advance Decision;AD」,係事先立下之書面意思表示,指明處於五大特定臨床條件時,希望接受或拒絕維持生命治療、人工營養及流體餵養或其他與醫療照護、善終等相關意願之決定。
五大「特定臨床條件」包括末期病人、不可逆轉昏迷、永久植物人、極重度失智、以及其他經中央主管機關公告之重症。啟動預立醫療決定時機應為特定臨床條件發生之時,由病人/家屬/醫療委任代理人/醫療團隊發現後,需先經兩位專科醫師確診,符合特定臨床條件,再經由緩和醫療團隊至少2次照會確認,即可依照「預立醫療決定」中接受或拒絕之項目執行,接受緩和醫療照護或尊嚴善終。
在簽立「預立醫療決策書」前,需由病人、親屬、醫療服務提供者或其他相關人士,其中包括: 醫師、護理人員、個管師、社工師、見證人、醫療委任代理人進行溝通,商討當病人處於特定臨床條件、意識昏迷或無法清楚表達意願時,對病人應提供之適當照護方式以及病人得接受或拒絕之維持生命治療與人工營養及流體餵養,此過程稱為「預立醫療照護諮商Advance Care Planning;ACP」,現在我國提供「預立醫療照護諮商」之機構共有77家醫院。


林祖功 Tsu-Kung Lin
副教授
高雄長庚醫院神經內科主治醫師
長庚大學臨床兼任副教授
正修科技大學兼任副教授
tklin@adm.cgmh.org.tw

紐西蘭奧塔哥大學生物化學系博士, Ph.D
臺北醫學院醫學士, MD
經歷
高雄長庚醫院,神經內科主治醫師
專長:神經退化疾病、神經及肌肉疾病、神經電生理、老化及氧化壓力、巴金森氏症、運動障礙、粒線體疾病


劉嘉為 Chia-Wei Liou
Director of Stroke Center
Division of Cerebrovascular Disease
Department of Neurology
Kaohsiung Chang Gung Memorial Hospital
Kaohsiung, Taiwan
cwliou@ms22.hinet.net

Professor Liou was graduated from Taipei Medical University. He acquired his Board of Neurologist then continued medical work since 1989. He is now the Director of Stroke Center at KCGMH, and Professor of Neurology at Chang Gung University. He is also the leader of the Mitochondrial Research Group for Medicine at Kaohsiung Chang Gung Memorial Hospital. He is interested in contribution of mitochondrial genome polymorphisms to diabetes, stroke and neurodegenerative disease and has many related publications in the past years.


陳彥宇 Yen-Yu Chen
MD
Attending Physician
Changhua Christian Hospital
107281@cch.org.tw

陳彥宇醫師現任彰化基督教醫院神經醫學部主治醫師,並主要負責神經醫學部住院醫師與實習醫學生之教學行政工作、腦血管超音波檢查室之行政業務。另負責彰基受試者保護辦公室業務,安排人體試驗與研究倫理相關教育訓練與宣導課程及執行人體研究品質改善計畫與遵從性監測、擔任人體試驗委員會之委員及標準作業程序工作小組成員,及負責研究教學與流病中心,協調相關教育課程與咨詢服務工作。

Lecture Abstract
每個人有權決定自己的生活,病人有權決定自己的醫療處置,這是毫無疑問的。
然而實際上,卻可能因急緊狀況、病人失去自主能力、病人處在不可逆轉的重病狀況或痛苦難以忍受,家屬與醫師均面臨了是否持續維持生命治療措施的兩難處境:感同身受病人的痛苦,但又須面對與承擔做決定的艱難。病人自主權利法提供了明確的法律指引,藉由預立醫療、訂定得依其預立醫療決定終止、撤除或不施行維持生命治療等的規定,讓病人能有了解病情與決定醫療處置的權利。
病人自主權利法裡規定的五種臨床條件,其中第二條"處於不可逆轉之昏迷狀況",第三條"永久植物人狀態"與第四條"極重度失智"等臨床情況,屬神經科的範圍,因此希望藉由此課程,讓更多的神經科醫師參與及了解。