DrDipankarNandi

Summary

Dipankar Nandi studied medicine in the All India Institute of Medical Sciences, New Delhi (AIIMS), arguably the premier medical educational and research establishment in South Asia. He went on to complete his residency in General Surgery and then Neurosurgery in AIIMS and was appointed to the Faculty in 1996. He came to the UK on the INLAKS Foundation Scholarship and engaged in research into the mechanisms of akinesia in advanced Parkinson's disease for a D. Phil. (Neuroscience, Pembroke College) in the University Laboratory of Physiology, Oxford (Professors Tipu Aziz and John Stein) on the Norman Collison Foundation Fellowship.

Dipankar then completed his higher specialist training in neurosurgery in the Radcliffe Infirmary, Oxford (MRCS Ed, FRCS (SN)) and is now a Consultant neurosurgeon in the Charing Cross Hospital.

His clinical and research interests lie in the fascinating confluence of stereotactic functional neurosurgery (deep brain stimulation, DBS), the neurophysiology (local field potentials) of movement disorders (PD, essential tremor, MS tremor, dystonia), treatment resistant depression and chronic central pain (post-stroke pain, cluster headaches, other intractable neuropathic pain syndromes) and the electrical-brain interface generated by the DBS electrode in vivo.

Another area of clinical and research interest is the difficult field of primary malignant brain tumours. These tumours have resisted long years of extensive basic science and clinical studies aimed at improving the duration of survival and neurological functional outcome; the median survival after diagnosis of a primary high grade glial brain tumour today is about 12 - 15 months in spite of a combination of resective cranial surgery, radiotherapy and anti-neoplastic chemotherapy. The last three decades of scientific and technical sophistication have managed to enhance survival by barely 3-6 months. Dipankar is working on using the safer and highly accurate minimally-invasive deep intra-cerebral access provided by his functional stereotactic neurosurgical skills, to target deep-seated brain tumors and deliver anti-neoplastic agents locally within the tumour at concentrations not possible to achieve by systemic means. The tools which are expected to come into play in the forseeable future include individual tumour-tailored chemotherapy, multi-agent therapy, viral-vector delivery and sustained brachytherapy.

The general neurosurgical service that Dipankar runs offers microsurgical decompressive operations for common spinal problems like back and neck radicular pain, carpal tunnel syndrome etc. arising from a variable combination of degenerative spinal disease, trauma and poor physical habits. Brain tumours, malignant and benign, are the other major neurological problems managed regularly in this service. There is an acute on-call service with mainly head and spinal trauma and neurovascular admissions. Neurosurgical residents are trained in this wide range of clinical conditions with special emphasis on functional and stereotactic neurosurgery. 

Recently, Dipankar (PI) and the Imperial College Neuromodulation Group (ICNG) have been awarded an MRC Research Grant to perform a clinical study that looks at the effect of DBS of a brainstem nucleus (the pedunculopontine nucleus - PPN) on axial motor symptoms in Parkinson's disease (such as gait and postural control dysfunction). This could help in the treatment of these particularly difficult and debilitating problems of some patients with PD. The MRC award is further supplemented by an award from the Medtronic European Research Board that will provide some free hardware for the study for clinical use. 

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