Opportunities for Hydrocephalus Research: Pathways to Better Outcomes

Westin Hotel, Seattle, WA

Opportunities in Hydrocephalus Research: Pathways to Better Outcomes was held in Seattle, Washington, July 9-11, 2012. The conference uniquely built upon the impressive success of the NIH-sponsored workshops “Hydrocephalus Myths, New Facts and Clear Directions” held in 2005 and “Improving Outcomes in Hydrocephalus: Bridging the Gap between Basic Science and Clinical Management” in 2009. The 2012 conference was unique in several important ways. First, our primary goal was to make the conference focused on the patient. To that end, we looked at hydrocephalus research from the patient perspective and collectively sought out areas of research that held early promise for improving patient care. Secondly, unlike most meetings, we were not going to have individual investigators comment solely on their own work. Instead recognized experts summarized the current state of their field of expertise and provided educated guidance on those areas of research that hold the most promise for early “winnable” achievements in improving patient care. Along these lines, we recognize that many important advancements will take longer and our experts identified the long-term goals that may lead to advanced treatment options or potential cures for hydrocephalus.

The majority of the presentations from the conference are below. To see the presentation, simply click on the presentation title.

Monday, July 9, 2012

07:00 Continental Breakfast and Registration

08:00 Introduction-Sponsor Acknowledgements
Dawn Mancuso, FASAE, CAE, Chief Executive Officer, Hydrocephalus Association

08:10 CAUSES OF HYDROCEPHALUS
Directors introduced by Pat McAllister, PhD; Department of Neurosurgery, Division of Pediatric Neurosurgery, University of Utah, Salt Lake City, UT

Plenary Session 1: GENETICS – Directed by Esteban Rodriguez, MD, PhD

08:10 Speaker: William B. Dobyns, MD; Seattle Children’s Research Institute & University of Washington, Seattle, WA
Title: The genetic basis of human hydrocephalus: hindbrain development, growth regulation and more Part I
The genetic basis of human hydrocephalus: hindbrain development, growth regulation and more Part II 

08:40 Director: Esteban Rodriguez, MD, PhD; Instituto de Histologia y Patología, Universidad Austral de Chile Valdivia, Chile
Title: Abnormal neurogenesis in foetal onset hydrocephalus in humans and animal models: opening the avenue for stem cell therapy

09:10 Speaker: Antonio J. Jimenez, PhD; Departamento de Biología Celular Genética y Fisiología, University of Malaga, Spain
Title: Repair mechanism of the disrupted ventricular zone in hydrocephalic animal models and humans

09:40 Discussion

10:00 Break

Plenary Session 2: PATHOPHYSIOLOGICAL MODIFICATIONS – Directed by Marc R. Del Bigio, MD, PhD

10:15 Director: Marc R. Del Bigio, MD, PhD; Department of Pathology & Canada Research Chair in Developmental Neuropathology, University of Manitoba, Winnipeg, Manitoba
Title: Mechanisms of cellular and axonal injury in hydrocephalus: hypoxia-ischemia in slow motion

10:45 Speaker: Stephen A. Back, MD, PhD; Departments of Pediatrics and Neurology, Oregon Health & Science University, Portland, OR
Title: Mechanisms and potential therapies for white matter injury: unexpected mechanisms of regeneration and repair

11:15 Speaker: Jerold Chun, MD, PhD; Department of Molecular Biology, Dorris Neuroscience Center, The Scripps Research Institute (TSRI), La Jolla, CA
Title: Lysophosphatidic acid (LPA) signaling in post-hemorrhagic hydrocephalus

11:45 Discussion

12:05 Lunch
Speaker:
J. Gordon McComb, MD; Children’s Hospital of Los Angeles, University Children’s Medical Group, Los Angeles, CA
Title: Funding for promising aspects of hydrocephalus research by the Rudi Schulte Research Institute, Santa Barbara, CA

13:00 KEYNOTE ADDRESS
Speaker: Marc Randolph; founder & first CEO of Netflix, Santa Cruz, CA
Title: “That will never work”: the role of failure in success – the founding of Netflix

13:45 DIAGNOSIS OF HYDROCEPHALUS
Directors introduced by Samuel R. Browd, MD, PhD; Department of Neurological Surgery Seattle Children’s Hospital and the University of Washington, Seattle, WA

Plenary Session 3: BIOMARKERSDirected by David D. Limbrick, MD, PhD

13:45 Director: David D. Limbrick, MD, PhD; St. Louis Children’s Hospital & Washington University School of Medicine, St. Louis, MO
Title: Introduction to biomarkers and brief review of post-hemorrhagic hydrocephalus

14:15 Speaker: Laurence Watkins, MD; Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London
Title: Biomarkers of NPH – molecules and other predictors of outcome

14:45 Speaker: Richard S. Morrison, PhD; Department of Neurological Surgery, Centers on Human Development and Disability & Proteomics, Intellectual and Developmental Disabilities Research Center, University of Washington School of Medicine, Seattle, WA
Title: Proteomic characterization of human ventricular cerebrospinal fluid from patients with hydrocephalus

15:15 Discussion

15:35 Break

Plenary Session 4: NEUROIMAGING- Directed by Mark Wagshul, PhD

15:50 Speaker: William G. Bradley, MD, PhD; Department of Radiology, University of California, San Diego, CA
Title: MRI of hydrocephalus with thoughts on the etiology of Idiopathic NPH

16:20 Speaker: Norman Relkin, MD, PhD; Cornell Memory Disorders Program & Departments of Clinical Neurology and Neuroscience, New York Presbyterian Hospital/Weill Cornell Medical College, New York, NY
Title: Quantitative MRI techniques for improved differential diagnosis and treatment of NPH

16:50 Director: Mark Wagshul, PhD; Department of Radiology and Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Bronx, NY
Title: Mechanisms in hydrocephalus revealed by neuroimaging

17:20 Discussion

17:40 Adjourn

 

Tuesday, July 10, 2012

07:00 Continental Breakfast and Registration

08:00 TREATMENT OF HYDROCEPHALUS – Directors introduced by Jill A. Morris, PhD; Program Director in Neurogenetics, NIH/NINDS, Bethesda, MD

Plenary Session 5: BIOENGINEERING ADVANCES- Directed by Samuel R. Browd, MD, PhD and Barry Lutz, PhD

08:00 Director: Samuel R. Browd, MD, PhD and Barry Lutz, PhD; Departments of Neurological Surgery and Bioengineering, Seattle Children’s Hospital and the University of Washington, Seattle, WA
Title: Overview of bioengineering and hydrocephalus: 50 years in 30 minutes

08:30 Speaker: Thomas J. Clement, MS; Cardiac Insight, Inc./Aqueduct Neurosciences, Inc., Seattle, Washington
Title: Roadmap for commercialization: from idea to product

09:00 Speaker: David A. Watson; Dave Watson Engineering, San Jose, California
Title: Risks and misdirection: critical areas to focus shunt technology development

09:30 Discussion

09:50 Break

Plenary Session 6: SURGICAL TREATMENTS – Directed by Jay Riva-Cambrin, MD

10:10 Director: Jay Riva-Cambrin, MD; Primary Children’s Medical Center and the University of Utah, Salt Lake City, UT
Title: Methodology for critical assessment of new techniques, the impact of surgical adjuncts in shunt placement and revisions, and novel advances in infection prevention

10:40 Speaker: Benjamin Warf, MD; Children’s Hospital Boston, Boston, MA
Title: The expanding role of combined endoscopic third ventriculostomy and choroid plexus cauterization (ETV/CPC) as the primary treatment for infant hydrocephalus

11:10 Speaker: Richard J. Edwards, MD; Department of Neurosurgery, Frenchay Hospital, Bristol, UK
Title: Strategies to reduce proximal catheter revision rates

11:40 Discussion

12:00 Lunch

13:00 OUTCOME IN HYDROCEPHALUS – directors introduced by Paul Gross; Chairman, Hydrocephalus Association

Plenary Session 7: NEUROPSYCHOLOGICAL OUTCOMES – Directed by Jack M. Fletcher, PhD

13:00 Director: Jack M. Fletcher, PhD; Department of Psychology, University of Houston, Houston, TX
Title: Hydrocephalus: Why is there variability in neuropsychological outcomes?

13:20 Speaker: Andrew Zabel, PhD; Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD
Title: Spina bifida and hydrocephalus across the lifespan: Part I – Children

13:45 Speaker: Maureen Dennis, PhD; Program in Neurosciences and Mental Health and Department of Surgery, The Hospital for Sick Children and the University of Toronto, Toronto, Ontario
Title: Spina bifida and hydrocephalus across the lifespan: Part 2 – Adults

14:10 Speaker: Michael A. Williams, MD; The Sandra and Malcolm Berman Brain & Spine Institute, Sinai Hospital, Baltimore, MD
Title: Redeeming Salomon’s Prophesy – Reversible neuropsychological deficits of INPH

14:35 Discussion

14:50 Break

Plenary Session 8: NEUROLOGICAL OUTCOMES AND QUALITY OF LIFE – Directed by Abhaya V. Kulkarni, MD, PhD

15:10 Director: Abhaya V. Kulkarni, MD, PhD; Departments of Neurosurgery and Neurology, Toronto Hospital for Sick Children, Toronto, Ontario,
Title: Quality of life in children with hydrocephalus

15:40 Speaker: Paige T. Church; MD, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario,
Title: Troubled waters: hydrocephalus and the preterm infant

16:10 Speaker: Mohit Bhandari, MD; Canada Research Chair, Department of Surgery and Clinical Epidemiology, McMaster University, Hamilton, Ontario
Title: Advantages of evidence-based treatments: changing the philosophy of a field and identifying good research

16:40 Discussion

17:00 Adjourn

18:00 – 19:00 Reception in the Pine Room, Westin Seattle

Wednesday, July 11, 2012

07:00 Continental Breakfast

08:00 Closing Day Welcome
Dr. Richard G. Ellenbogen M.D, Professor and Chair of Neurological Surgery, Theodore S. Roberts Endowed Chair of Pediatric Neurological Surgery, University of Washington

08:05 HYDROCEPHALUS ASSOCIATION LECTURE
Speaker: Paul Gross; Chair, Board of Directors, Hydrocephalus Association
Title: Insights into NIH funding

Discussion

GROUP DISCUSSIONS

These sessions are intended to provide a consensus on each of the main focus areas with substantial audience interaction. Initial emphasis will be on the critical issues facing future research as identified in the plenary sessions.

08:45 CAUSES OF HYDROCEPHALUS

Moderator: Pat McAllister, PhD; Primary Children’s Medical Center and the University of Utah, Salt Lake City, UT
Panelists: Esteban Rodriguez, MD, PhD; William Dobyns, MD; Antonio Jimenez, PhD; Marc Del Bigio, MD, PhD; Stephen Back, MD, PhD; Jerold Chun, PhD

09:45 Break

10:00 DIAGNOSIS OF HYDROCEPHALUS

Moderator: Norman Relkin, MD, PhD; Department of Neurology, Weill Cornell Medical College, New York, NY
Panelists: David Limbrick, MD, PhD; Laurence Watkins, MD; Richard Morrison, PhD; Mark Wagshul, PhD; William Bradley, MD, PhD

11:00 TREATMENT OF HYDROCEPHALUS

Moderator: Marion (Jack) Walker, MD; Department of Neurosurgery, Division of Pediatric Neurosurgery, University of Utah, Salt Lake City, UT
Panelists: Sam Browd, MD, PhD; Tom Clement; David Watson; Jay Riva-Cambrin, MD; Benjamin Warf, MD; Richard Edwards, MD; Richard G. Ellenbogen, M.D.

12:00 Lunch

13:00 OUTCOME IN HYDROCEPHALUS
Moderator: Michael A. Williams, MD; The Sandra and Malcolm Berman Brain & Spine Institute, Sinai Hospital, Baltimore, MD
Panelists: Jack Fletcher, PhD; Andrew Zabel, PhD; Maureen Dennis, PhD; Abhaya Kulkarni, MD, PhD; Paige Church, MD

14:00 CRITICAL SUMMARY OF THE SYMPOSIUM and WHERE WE SHOULD BE IN 3 YEARS

Basic Science
Pat McAllister, PhD; Department of Neurosurgery, Division of Pediatric Neurosurgery, University of Utah, Salt Lake City, UT

Bioengineering
Samuel R. Browd, MD, PhD; Department of Neurological Surgery, Seattle Children’s Hospital and the University of Washington, Seattle, WA

Clinical
John R.W. Kestle, MD, MSc; Department of Neurosurgery, Division of Pediatric Neurosurgery, University of Utah, Salt Lake City, UT

14:45 Closing Remarks – Paul Gross

15:00 Adjourn

 16:10 Speaker: Mohit Bhandari, MD; Canada Research Chair, Department of Surgery and Clinical Epidemiology, McMaster University, Hamilton, Ontario

Title: Advantages of evidence-based treatments: changing the philosophy of a field and identifying good research

Evidence-based medicine has recently been termed one of the top 10 discoveries in medicine. Changing the paradigm from ‘eminence-based’ to ‘evidence-based’ care requires a focus on the value of high quality evidence and its impact on patient care. This talk will highlight the advantages of EBM, the challenges of conducting high quality research, and the opportunities for surgeons and researchers to lead a major shift in paradigm in Neurosurgery.

 16:40 Discussion

17:00 Adjourn

18:00 – 19:00 Reception in the Pine Room, Westin Seattle

 

We would like to thank our sponsors:


Platinum Sponsors

Medtronic logo

Gold Sponsors

Rudi Schulti Research Institute

Silver Sponsors

Integra Codman Logo

 

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