Pharmacology, Toxicology and Environmental Health Commons^™

With Love, ; An Interdisciplinary And Intersectional Look At Why Creativity Is Essential, Theo Starr Gardner

Whittier Scholars Program

My Whittier Scholars Program self-designed major, Teaching Creativity, is a mixture of Art, Literature, and Education classes. My research and praxis classes have been focused on the ‘how?’s and 'why?’s of creativity, so it felt only right that my project should be a constructivist, generative project. The project I have been working on throughout my time at Whittier, and that has just fully come to fruition on April 11th, 2024, was a solo art gallery/open mic event entitled ‘With Love,’. With Love, was conceptually inspired by the research I’ve conducted on creativity and creative arts education over the past few …

Toxicological Effects And Treatment Of Accidental Ingestion Of Simparica Trio® In Felis Catus: An Investigative Review, Aussia Stander

Honors Theses

Simparica TRIO^®, a canine endectocide manufactured by Zoetis, contains sarolaner, moxidectin, and pyrantel pamoate salt in an orally administered chewable tablet. These compounds are all toxic to both cats and dogs in sufficient amounts. As Simparica TRIO^® rises in popularity among pet owners, Felis catus (felines, cats) in multi-pet households (households with both cats and dogs) are at increased risk of overdosage and toxicosis from accidental ingestion of Simparica TRIO^® due to their smaller weight.

Simparica TRIO^® is not for feline use and little literature exists on the symptoms of and treatment for accidental ingestion …

The Revolutionary St. Louis Insane Asylum, Julia Talbert

Undergraduate Research Symposium

Even with its grand structure on Arsenal Street towering over the city below, few residents of St. Louis and surrounding areas are aware of the grand history or even existence of the St. Louis Insane Asylum. The building is over 150 years old and was a place of hope, failure, strife, and empathy. The asylum had a large impact on St. Louis and provided revolutionary outlooks, unique perspectives, and curious therapies.

Pediatric Beta Blocker Therapy: A Comprehensive Review Of Development And Genetic Variation To Guide Precision-Based Therapy In Children, Adolescents, And Young Adults., Mollie Walton, Jonathan B. Wagner

Manuscripts, Articles, Book Chapters and Other Papers

Beta adrenergic receptor antagonists, known as beta blockers, are one of the most prescribed medications in both pediatric and adult cardiology. Unfortunately, most of these agents utilized in the pediatric clinical setting are prescribed off-label. Despite regulatory efforts aimed at increasing pediatric drug labeling, a majority of pediatric cardiovascular drug agents continue to lack pediatric-specific data to inform precision dosing for children, adolescents, and young adults. Adding to this complexity is the contribution of development (ontogeny) and genetic variation towards the variability in drug disposition and response. In the absence of current prospective trials, the purpose of this comprehensive review …

Human Mitragynine And 7-Hydroxymitragynine Pharmacokinetics After Single And Multiple Daily Doses Of Oral Encapsulated Dried Kratom Leaf Powder, Marilyn A. Huestis, Martin A. Brett, John Bothmer, Ramsey Atallah

Institute of Emerging Health Professions Faculty Papers

Kratom leaves, consumed by millions worldwide as tea or ground leaf powder, contain multiple alkaloids, with mitragynine being the most abundant and responsible for most effects. Mitragynine is a partial µ-opioid receptor agonist and competitive antagonist at κ- and δ-opioid receptors; however, unlike morphine, it does not activate the β-arrestin-2 respiratory depression pathway. Due to few human mitragynine data, the largest randomized, between-subject, double-blind, placebo-controlled, dose-escalation study of 500–4000 mg dried kratom leaf powder (6.65–53.2 mg mitragynine) was conducted. LC-MS/MS mitragynine and 7-hydroxymitragynine plasma concentrations were obtained after single and 15 daily doses. Mitragynine and 7-hydroxymitragynine C_max increased dose …

Metabolic Stability And Metabolite Identification Of N-Ethyl Pentedrone Using Rat, Mouse And Human Liver Microsomes, Alexandre Barcia Godoi, Natalícia De Jesus Antunes, Kelly Francisco Cunha, Aline Franco Martins, Marilyn A. Huestis, Jose Luiz Costa

Institute of Emerging Health Professions Faculty Papers

New Psychoactive Substances (NPSs) are defined as a group of substances produced from molecular modifications of traditional drugs. These molecules represent a public health problem since information about their metabolites and toxicity is poorly understood. N-ethyl pentedrone (NEP) is an NPS that was identified in the illicit market for the first time in the mid-2010s, with four intoxication cases later described in the literature. This study aims to evaluate the metabolic stability of NEP as well as to identify its metabolites using three liver microsomes models. To investigate metabolic stability, NEP was incubated with rat (RLM), mouse (MLM) and human …

The Effect Of Caffeine On Bee Behavior: A Progressive Ratio Study, Kayle Cohen, Becky Hansis-O'Neill, Aimee Dunlap Dr

Undergraduate Research Symposium

This presentation focuses on the effect of caffeine on bee behavior using behavioral pharmacology methodologies. Researchers trained bumblebees to drink out of artificial flowers, then administered sucrose nectar or caffeinated sucrose nectar during a schedule of progressive and fixed ratios. The finding suggests that caffeine did increase the number of rewards during the fixed ratio, but not in the progressive ratio. However, research is still ongoing as bees continue to be tested..

Lake Water Chemistry And Local Adaptation Shape Nacl Toxicity In Daphnia Ambigua, Mary Alta Rogalski, Elizabeth S. Baker, Clara M. Benadon

Biology Faculty Publications

Increasing application of road deicing agents (e.g., NaCl) has caused widespread salinization of freshwater environments. Chronic exposure to toxic NaCl levels can impact freshwater biota at genome to ecosystem scales, yet the degree of harm caused by road salt pollution is likely to vary among habitats and populations. The background ion chemistry of freshwater environments may strongly impact NaCl toxicity, with greater harm occurring in ion-poor, soft water conditions. In addition, populations exposed to salinization may evolve increased NaCl tolerance. Notably, if organisms are adapted to their natal lake water chemistry, toxicity responses may also vary among populations in a …

Lead Bioaccessibility And Commonly Measured Soil Characteristics (Detroit, Mi, Usa) – Phase 1, Sabrina R. Good, Allison R. Harris, Patrick Crouch, Conor T. Gowan, William D. Shuster, Shawn P. Mcelmurry

Open Data at Wayne State

Contaminated urban soil is one of the major contributors to child Pb exposure. To gain a better understanding of Pb risk in urban areas, composite samples were collected from 142 residential, privately owned, parcels in Detroit, Hamtramck, and Highland Park, Michigan, with approval from the property owners. The proximity of soil sampling and former smelter locations were also reported. Sample were collected from areas covered with turf grass. Four samples were collected, one from each cardinal direction (north, south, east, and west), 20 cm from an aluminum tent stake driven into the center of the sampling site. Soils were collected …

Photoluminescence Switching In Quantum Dots Connected With Fluorinated And Hydrogenated Photochromic Molecules, Ephraiem S. Sarabamoun, Jonathan M. Bietsch, Pramod Aryal, Amelia G. Reid, Maurice Curran, Grayson Johnson, Esther H. R. Tsai, Charles W. Machan, Guijun Wang, Joshua J. Choi

Chemistry & Biochemistry Faculty Publications

We investigate switching of photoluminescence (PL) from PbS quantum dots (QDs) crosslinked with two different types of photochromic diarylethene molecules, 4,4'-(1-cyclopentene-1,2-diyl)bis[5-methyl-2-thiophenecarboxylic acid] (1H) and 4,4'-(1-perfluorocyclopentene-1,2-diyl)bis[5-methyl-2-thiophenecarboxylic acid] (2F). Our results show that the QDs crosslinked with the hydrogenated molecule (1H) exhibit a greater amount of switching in photoluminescence intensity compared to QDs crosslinked with the fluorinated molecule (2F). With a combination of differential pulse voltammetry and density functional theory, we attribute the different amount of PL switching to the different energy levels between 1H and 2F molecules which result in different potential barrier …

Kinome Profiling Identifies Mark3 And Stk10 As Potential Therapeutic Targets In Uveal Melanoma, Usman Baqai, Alison M. Kurimchak, Isabella Trachtenberg, Timothy J. Purwin, Jelan I. Haj, Anna Han, Kristine Luo, Nikole Fandino Pachon, Angela Jeon, Vivian Chua, Michael A. Davies, J Silvio Gutkind, Jeffrey L. Benovic, James S. Duncan, Andrew E. Aplin

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Most uveal melanoma cases harbor activating mutations in either GNAQ or GNA11. Despite activation of the mitogen-activated protein kinase (MAPK) signaling pathway downstream of Gαq/11, there are no effective targeted kinase therapies for metastatic uveal melanoma. The human genome encodes numerous understudied kinases, also called the "dark kinome". Identifying additional kinases regulated by Gαq/11 may uncover novel therapeutic targets for uveal melanoma. In this study, we treated GNAQ-mutant uveal melanoma cell lines with a Gαq/11 inhibitor, YM-254890, and conducted a kinase signaling proteomic screen using multiplexed-kinase inhibitors followed by mass spectrometry. We observed downregulated expression and/or activity of 22 kinases. …

Socioeconomic Geographies And Municipal Decision Making Of New York's Climate Smart Communities Program, Stephen Corbisiero

Digital and Data Studies Student Scholarship

Nearly all of New York’s residents live in a municipality designated as a Climate Smart Community, but few are familiar with one of the state’s major legislative accomplishments. The initiative allows municipalities to earn points toward a climate smart certification by implementing sustainable technologies in their communities, which in turn makes them eligible for increased grant funding from New York State. As climate change begins to have a greater impact on human and natural life, investing in green infrastructure has never been more important. New York’s Climate Smart Communities program is widespread, but adoption rates vary greatly throughout the state …

Enteroendocrine Cell Regulation Of The Gut-Brain Axis, Joshua Barton, Annie Londregan, Tyler Alexander, Ariana Entezari, Manuel Covarrubias, Scott Waldman

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Enteroendocrine cells (EECs) are an essential interface between the gut and brain that communicate signals about nutrients, pain, and even information from our microbiome. EECs are hormone-producing cells expressed throughout the gastrointestinal epithelium and have been leveraged by pharmaceuticals like semaglutide (Ozempic, Wegovy), terzepatide (Mounjaro), and retatrutide (Phase 2) for diabetes and weight control, and linaclotide (Linzess) to treat irritable bowel syndrome (IBS) and visceral pain. This review focuses on role of intestinal EECs to communicate signals from the gut lumen to the brain. Canonically, EECs communicate information about the intestinal environment through a variety of hormones, dividing EECs into …

Analyzing The Ramifications Of Climate Change On Mental Health, Salvatore A. Medori

Student Publications

When thinking about the vast array of impacts that the climate crisis has on humanity, there are many things that come to mind, but mental health impacts are likely not one of them. Even though research demonstrates that mental effects from any form of disaster far exceed the physical health implications mental health impacts of the largest disaster facing humanity since the Second World War are rarely considered at all, let alone when solutions are being created. This has led to a hidden crisis emerging underneath an even larger crisis, with serious consequences for most individuals across the globe. The …

Inequality Of Air Quality?: A Study Of Air Quality Within Housing Price Brackets In Gettysburg, Pa, Jess G. Schaefer, Alexis J. Jones, Arden H. Dowd

Student Publications

With the rise of cars and other motorized vehicles has come the rise of air pollution, which tends to have disproportionate environmental and health impacts on low-income and communities of color. This study analyzes car presence and air quality on a transect within Gettysburg, PA to determine if there is a relationship between air pollution and vehicle presence, and if there is a difference in air quality between higher price bracket housing compared to campus, commercial, and lower price bracket housing. To test our research questions, we identified nine sampling locations along a transect where we measured air pollutants, including …

Clean Water Saves Lives: Improving Clean Water Access In Yeakpee Town, Liberia, Mishael F. Ohanwadi

Student Publications

Civil unrest in Liberia, a West Coast African nation, has caused the destruction of essential infrastructure, particularly water, sanitation, and hygiene (WASH) systems. As a result, there is a high reliance on unsafe water sources and prevalence of waterborne diseases and health issues, particularly in the Yeakpee Town Community. Inadequate funding has hindered progress, and there are connections between gender inequalities and limited access to clean water. The Clean Water Save Lives project, launched in 2020, aimed to provide sustainable access to clean water in Yeakpee Town community by constructing a water pump with a filtration system. The project aimed …

Low-Cost Pm2.5 Sensors Can Help Identify Driving Factors Of Poor Air Quality And Benefit Communities, Tim Keyes, Rea Domingo, Samantha Dynowski, Royal Graves, Martha Klein, Melissa Leonard, John Pilgrim, Alison Sanchirico, Kate Trinkaus

WCBT Faculty Publications

Air quality is critical for public health. Residents rely chiefly on government agencies such as the Environmental Protection Agency (EPA) in the United States to establish standards for the measurement of harmful contaminants including ozone, sulfur dioxide, carbon monoxide, volatile organic chemicals (VOCs), and fine particulate matter at or below 2.5 μm. According to the California Air Resources Board [1], “short-term PM2.5 exposure (up to 24-h duration) has been associated with premature mortality, increased hospital admissions for heart or lung causes, acute and chronic bronchitis, asthma attacks, emergency room visits, respiratory symptoms, and restricted activity days”. While public agency resources …

Modeling Biphasic, Non-Sigmoidal Dose-Response Relationships: Comparison Of Brain- Cousens And Cedergreen Models For A Biochemical Dataset, Venkat D. Abbaraju, Tamaraty L. Robinson, Brian P. Weiser

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Biphasic, non-sigmoidal dose-response relationships are frequently observed in biochemistry and pharmacology, but they are not always analyzed with appropriate statistical methods. Here, we examine curve fitting methods for “hormetic” dose-response relationships where low and high doses of an effector produce opposite responses. We provide the full dataset used for modeling, and we provide the code for analyzing the dataset in SAS using two established mathematical models of hormesis, the Brain-Cousens model and the Cedergreen model. We show how to obtain and interpret curve parameters such as the ED50 that arise from modeling, and we discuss how curve parameters might change …

Coal Ash Dumps In The Mountain West, Julia Salangsang, Nicole Diaz Del Valle, Zachary Billot, Caitlin J. Saladino, William E. Brown Jr.

Environment

This fact sheet presents data on coal ash dumps, their management, and the pollutants that exist at each site in the Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah. The original report includes data on coal ash dumping sites for all 50 states.

Developing A National-Scale Exposure Index For Combined Environmental Hazards And Social Stressors And Applications To The Environmental Influences On Child Health Outcomes (Echo) Cohort., Sheena E. Martenies, Mingyu Zhang, Anne E. Corrigan, Anton Kvit, Timothy Shields, William Wheaton, Deana Around Him, Judy Aschner, Maria M. Talavera-Barber, Emily S. Barrett, Theresa M. Bastain, Casper Bendixsen, Carrie V. Breton, Nicole R. Bush, Ferdinand Cacho, Carlos A. Camargo, Kecia N. Carroll, Brian S. Carter, Andrea E. Cassidy-Bushrow, Whitney Cowell, Lisa A. Croen, Dana Dabelea, Cristiane S. Duarte, Anne L. Dunlop, Todd M. Everson, Rima Habre, Tina V. Hartert, Jennifer B. Helderman, Alison E. Hipwell, Margaret R. Karagas, Barry M. Lester, Kaja Z. Lewinn, Sheryl Magzamen, Rachel Morello-Frosch, Thomas G. O'Connor, Amy M. Padula, Michael Petriello, Sheela Sathyanarayana, Joseph B. Stanford, Tracey J. Woodruff, Rosalind J. Wright, Amii M. Kress, Program Collaborators For Environmental Influences On Child Health Outcomes

Manuscripts, Articles, Book Chapters and Other Papers

Tools for assessing multiple exposures across several domains (e.g., physical, chemical, and social) are of growing importance in social and environmental epidemiology because of their value in uncovering disparities and their impact on health outcomes. Here we describe work done within the Environmental influences on Child Health Outcomes (ECHO)-wide Cohort Study to build a combined exposure index. Our index considered both environmental hazards and social stressors simultaneously with national coverage for a 10-year period. Our goal was to build this index and demonstrate its utility for assessing differences in exposure for pregnancies enrolled in the ECHO-wide Cohort Study. Our unitless …

Self-Administered Intranasal Etripamil Using A Symptom-Prompted, Repeat-Dose Regimen For Atrioventricular-Nodal-Dependent Supraventricular Tachycardia (Rapid): A Multicentre, Randomised Trial, Bruce S Stambler, A John Camm, Marco Alings, Paul Dorian, Hein Heidbuchel, Jaco Houtgraaf, Peter R. Kowey, Jose L Merino, Blandine Mondésert, Jonathan P Piccini, Sean D Pokorney, Philip T Sager, Atul Verma, J Marcus Wharton, David B Bharucha, Francis Plat, Silvia Shardonofsky, Michael Chen, James E Ip

Department of Medicine Faculty Papers

BACKGROUND: Etripamil is a fast-acting, intranasally administered calcium-channel blocker in development for on-demand therapy outside a health-care setting for paroxysmal supraventricular tachycardia. We aimed to evaluate the efficacy and safety of etripamil 70 mg nasal spray using a symptom-prompted, repeat-dose regimen for acute conversion of atrioventricular-nodal-dependent paroxysmal supraventricular tachycardia to sinus rhythm within 30 min.

METHODS: RAPID was a multicentre, randomised, placebo-controlled, event-driven trial, conducted at 160 sites in North America and Europe as part 2 of the NODE-301 study. Eligible patients were aged at least 18 years and had a history of paroxysmal supraventricular tachycardia with sustained, symptomatic episodes …

Pharmacogenetic Testing For The Pediatric Gastroenterologist: Actionable Drug-Gene Pairs To Know., Tracy L. Sandritter, Rachel Chevalier, Rebecca Abt, Valentina Shakhnovich

Manuscripts, Articles, Book Chapters and Other Papers

Gastroenterologists represent some of the earlier adopters of precision medicine through pharmacogenetic testing by embracing upfront genotyping for thiopurine S-methyltransferase nucleotide diphosphatase (TPMT) before prescribing 6-mercaptopurine or azathioprine for the treatment of inflammatory bowel disease. Over the last two decades, pharmacogenetic testing has become more readily available for other genes relevant to drug dose individualization. Common medications prescribed by gastroenterologists for conditions other than inflammatory bowel disease now have actionable guidelines, which can improve medication efficacy and safety; however, a clear understanding of how to interpret the results remains a challenge for many clinicians, precluding wide implementation of …

Climate Change Imperils Pediatric Health: Child Advocacy Through Fossil Fuel Divestment., Sandra H. Jee, Elizabeth Friedman, Ruth A. Etzel, Vi T. Nguyen, Todd L. Sack, Kathi J. Kemper

Manuscripts, Articles, Book Chapters and Other Papers

Climate change poses an existential threat to children's health. Divestment of ownership stakes in fossil fuel companies is one tool available to pediatricians to address climate change. Pediatricians are trusted messengers regarding children's health and therefore bear a unique responsibility to advocate for climate and health policies that affect children. Among the impacts of climate change on pediatric patients are allergic rhinitis and asthma; heat-related illnesses; premature birth; injuries from severe storms and fires; vector-borne diseases; and mental illnesses. Children are disproportionately affected as well by climate-related displacement of populations, drought, water shortages, and famine. The human-generated burning of fossil …

Rapid & Sensitive Detection Of Antibiotic Resistance Genes By Utilizing New Diagnostic Probe Tales With 2d-Nanosheet Graphene Oxide, Jihye Kang

Masters Theses & Specialist Projects

As antibiotic resistance is one of the major health concerns in infectious diseases because of reducing the efficacy of antibiotics, rapid and sensitive detection of antibiotic resistance genes is critical for the effective treatment of infectious diseases. Polymerase chain reaction (PCR) is widely used to detect nucleic acids, but it requires additional steps involved in DNA denaturation and subsequent hybridization. A new class of DNA-binding domains called transcriptional activator-like effectors (TALEs) provide a novel scaffold for designing versatile DNA-binding proteins due to their modularity and predictability. Here, we developed a simple, rapid, and sensitive system for detecting antibiotic resistance genes …

Selenium Removal By Sediments And Plants At The Constructed Pariette Wetlands, Utah (Usa), Colleen P. Jones, Michael Amacher, Paul R. Grossl, Astrid R. Jacobson

Plants, Soils, and Climate Faculty Publications

Selenium (Se) contamination of public lands and water is a result of irrigated agriculture and mining activities in areas rich in Se geologic deposits. Pariette Draw is part of the northern Colorado Plateau and is an area of concern for Se contamination in the Pariette Wetlands. Pariette Wetlands, a wetland built in the 1970s to provide wildlife habitat, is distinguished by its arid climate and a short growing season of hot dry summers followed by cold winters with several months below freezing. An understanding of how Se is mobilized and removed within the wetland will provide management strategies that minimize …

The Intersection Of Herbicide Policy, Exposure, And Health At The University Of Connecticut, Katherine Hayward

Honors Scholar Theses

Pesticides play an extremely complicated role in our everyday lives. From the water you use to make your coffee, to the breastmilk your neighbor provides for their child, to the lake your dog swims in, chemical pesticides or their byproducts have been found in nearly every corner of our lives. The chemicals used in synthetic herbicides, a subcategory of pesticides, have far reaching negative impacts on human health, biodiversity, and water quality. Despite there being numerous published studies on the relationships between pesticide exposures and health, there is still ongoing discord and controversy surrounding their role in our lives. After …

Cats Of Unl: An Investigation Into The Human-Feral Cat Relationships On A University Campus In Nebraska, Jacey Skoda

Honors Theses

At the University of Nebraska-Lincoln (UNL), there exists a population of feral cats that is monitored and cared for by a group known as Husker Cats. As the cats wander the sidewalks and gardens of the university, they may appear non-threatening and pleasant to have around. However, a feral cat presence could have detrimental impacts on the surrounding ecosystem, property, and community. The first component of this project, a survey of individuals on UNL campus, ultimately seeks to understand what those in the UNL community know about the feral cats, how they feel about the feral cats, and how they …

Metal Composition And Contamination Assessment Of Urban Roadway Dusts On The Abu Dhabi-Liwa Highway, Uae, Ahmed A. Al-Taani, Yousef Nazzal, Fares M. Howari, Jibran Iqbal, Muhammad Naseem, Manish Sharma, Cijo Xavier, Dimitrios Papandreou, Lina Maloukh, Lakshmi Ambika, Imen Ben Salem, Abeer Al Bsoul, Haitham M. Farok

All Works

The metal composition of road-deposited dust along the Abu Dhabi-Liwa Highway was investigated to provide insight into the contamination profile and levels of road dust. The average concentrations of metals decreased in the order Al (28668 ± 4631 mg/kg)> Fe (21461 ± 2594 mg/kg) > Mn (711.8 ± 76.3 mg/kg) > Zn (210.6 ± 51.6 mg/kg) > Cu (94.9 ± 15.8 mg/kg) > Pb (83.6 ± 5.3 mg/kg) > Cd (75.1 ± 1.6 mg/kg) > Co (62.6 ± 6.4 mg/kg) > As (4.7 ± 2.9 mg/kg) > Ni (0.10 ± 0.19 mg/kg) > Cr (0.08 ± 0.06 mg/kg). The spatial variations of metals suggest different sources and contributing factors …

Development, Optimization, And In Vitro/In Vivo Evaluation Of Azelaic Acid Transethosomal Gel For Antidermatophyte Activity, Ali Nasr, Noha Badawi, Yasmine Tartor, Nader Sobhy, Ali Nasr

Pharmacy

Treatment of dermatophytosis is quite challenging. This work aims to investigate the antidermatophyte action of Azelaic acid (AzA) and evaluate its efficacy upon entrapment into transethosomes (TEs) and incorporation into a gel to enhance its application. Optimization of formulation variables of TEs was carried out after preparation using the thin film hydration technique. The antidermatophyte activity of AzA-TEs was first evaluated in vitro. In addition, two guinea pig infection models with Trichophyton (T.) mentagrophytes and Microsporum (M.) canis were established for the in vivo assessment. The optimized formula showed a mean particle size of 219.8 ± 4.7 nm and a …

Neurological-Type Wilson Disease: Epidemiology, Clinical Manifestations, Diagnosis, And Management, Nathaniel Kipker, Kaitlyn Alessi, Marko Bojkovic, Inderbir Padda, Mayur S. Parmar

HPD Articles

Wilson disease (WD) is a complex metabolic disorder caused by disruptions to copper regulation within the body, leading to an unregulated accumulation of copper within various tissues. A less understood organ affected by the collection of copper is the brain, which further leads to the generation of oxygen-free radicals and resultant demyelination. Healthcare providers must keep the neurological form of WD in their list of differentials when patients present with diverse neurological manifestations. The initial step to diagnosis will be to distinguish the characteristic disease presentation with a thorough history and physical and neurological examination. A high clinical disease suspicion …