Medical Specialties Commons^™

Durable Responses At 24 Months With High-Frequency Spinal Cord Stimulation For Nonsurgical Refractory Back Pain, Naresh P. Patel, Jessica Jameson, Curtis Johnson, Daniel Kloster, Aaron Calodney, Peter Kosek, Julie Pilitsis, Markus Bendel, Erika Petersen, Chengyuan Wu, Taissa Cherry, Shivanand Lad, Cong Yu, Dawood Sayed, Johnathan Goree, Mark K. Lyons, Andrew Sack, Diana Bruce, Manish Bharara, Rose Province-Azalde, David Caraway, Leonardo Kapural

Department of Neurosurgery Faculty Papers

OBJECTIVE: The objective of this study was to evaluate the 24-month durability of pain relief, function, quality of life, and safety outcomes for patients with nonsurgical refractory back pain (NSRBP) treated with high-frequency spinal cord stimulation (SCS) within a large, national, multicenter randomized controlled trial (RCT).

METHODS: Following the completion of an RCT comparing high-frequency SCS plus CMM with CMM alone for the treatment of NSRBP, patients gave additional consent for a follow-up extension to 24 months. Presented is the cohort analysis of all patients treated with high-frequency SCS following the optional crossover at 6 months. The outcomes assessed to …

Association Between Trigeminal Neuralgia And Degenerative Cervical Myelopathy: A Cross‐Sectional Study Using Us Data, Robert J. Trager

Faculty Scholarship

Background: Limited research has suggested that trigeminal neuralgia (TN), an often-idiopathic pain disorder affecting the face and head, may arise from compression of the cervical spinal cord due to involvement of the spinal trigeminal tract. We hypothesized that adults with TN would have a greater likelihood of concurrent degenerative cervical myelopathy (DCM) compared to matched adults without TN. Methods: We retrieved de-identified data from a US network (TriNetX, Inc.) including medical records of >113 million patients, with a query date of October 1, 2023, and data spanning the previous 20 years. We created two groups of adults (aged ≥18 years): …

Internet Analytics Of An Innovative Digital Educational Resource Of Type 1 Diabetes Hellotype1 In Local Languages For People Living With Diabetes Families And Healthcare Professionals In Southeast Asia, Sze May Ng, I V Malene, Thy Khue Nguyen, Khuong Le, Yang Xian Lucas Lim, Ngee Lek, Samantha Seal, Steffen Yun Tange, Azriyanti Anuar Zaini, Taninee Sahakitrungruang, Anne Charlotte Ficheroulle

Faculty, Staff and Student Publications

BACKGROUND: There is minimal data of health outcomes for Type 1 Diabetes (T1D) in Southeast Asia (SEA) where government funding of insulin and blood glucose monitoring either do not exist or is limited. The full impact of Covid-19 pandemic on the national economies of SEA remain unknown. In the midst of the pandemic, in 2021, HelloType1 was developed by Action4Diabetes (A4D), a non-government organisation charity in collaboration with Southeast Asia local healthcare professionals as an innovative digital educational resource platform of T1D in local languages. HelloType1 was launched in Cambodia, Vietnam, Thailand and Malaysia in 2021 to 2022 with Memorandums …

Indices Of Narrative Language Associated With Disability, Norah M Almubark, Gabriela Silva-Maceda, Matthew E Foster, Trina D Spencer

Faculty, Staff and Student Publications

Narratives skills are associated with long-term academic and social benefits. While students with disabilities often struggle to produce complete and complex narratives, it remains unclear which aspects of narrative language are most indicative of disability. In this study, we examined the association between a variety of narrative contents and form indices and disability. Methodology involved drawing 50 K-3 students with Individual Education Programs (IEP) and reported language concerns from a large diverse sample (n = 1074). Fifty typically developing (TD) students were matched to the former group using propensity score matching based on their age, gender, grade, mother’s education, …

Impaired Discourse Content In Aphasia Is Associated With Frontal White Matter Damage, Junhua Ding, Erica L. Middleton, Daniel Mirman

Moss-Magee Rehabilitation Papers

Aphasia is a common consequence of stroke with severe impacts on employability, social interactions and quality of life. Producing discourse-relevant information in a real-world setting is the most important aspect of recovery because it is critical to successful communication. This study sought to identify the lesion correlates of impaired production of relevant information in spoken discourse in a large, unselected sample of participants with post-stroke aphasia. Spoken discourse (n = 80) and structural brain scans (n = 66) from participants with aphasia following left hemisphere stroke were analysed. Each participant provided 10 samples of spoken discourse elicited in three different …

Cavernous Malformations Of The Central Nervous System: An International Consensus Statement, Anastasia Tasiou, Alexandros G. Brotis, Adamantios Kalogeras, Christos Tzerefos, Cargill H. Alleyne, Alexandros Andreou, Andreas K. Demetriades, Nikolaos Foroglou, Robert M. Friedlander, Bengt Karlsson, Neil Kitchen, Torstein R. Meling, Aristotelis Mitsos, Vasilios Panagiotopoulos, Themistoklis Papasilekas, Giacomo Pavesi, Lukas Rasulic, Alejandro N. Santos, Robert F. Spetxler, Ulrich Sure, Stavropoula Tjoumakaris, Christos M. Tolias, Peter Vajkoczy, Kostas N. Fountas

Department of Neurosurgery Faculty Papers

Introduction: Cavernous malformations (CM) of the central nervous system constitute rare vascular lesions. They are usually asymptomatic, which has allowed their management to become quite debatable. Even when they become symptomatic their optimal mode and timing of treatment remains controversial.

Research question: A consensus may navigate neurosurgeons through the decision-making process of selecting the optimal treatment for asymptomatic and symptomatic CMs.

Material and methods: A 17-item questionnaire was developed to address controversial issues in relation to aspects of the treatment, surgical planning, optimal surgical strategy for specific age groups, the role of stereotactic radiosurgery, as well as a follow-up pattern. …

Deep Histopathology Genotype-Phenotype Analysis Of Focal Cortical Dysplasia Type Ii Differentiates Between The Gator1-Altered Autophagocytic Subtype Iia And Mtor-Altered Migration Deficient Subtype Iib, Jonas Honke, Lucas Hoffmann, Roland Coras, Katja Kobow, Costin Leu, Tom Pieper, Till Hartlieb, Christian G Bien, Friedrich Woermann, Thomas Cloppenborg, Thilo Kalbhenn, Ahmed Gaballa, Hajo Hamer, Sebastian Brandner, Karl Rössler, Arnd Dörfler, Stefan Rampp, Johannes R Lemke, Sara Baldassari, Stéphanie Baulac, Dennis Lal, Peter Nürnberg, Ingmar Blümcke

Faculty, Staff and Student Publications

Focal cortical dysplasia type II (FCDII) is the most common cause of drug-resistant focal epilepsy in children. Herein, we performed a deep histopathology-based genotype–phenotype analysis to further elucidate the clinico-pathological and genetic presentation of FCDIIa compared to FCDIIb. Seventeen individuals with histopathologically confirmed diagnosis of FCD ILAE Type II and a pathogenic variant detected in brain derived DNA whole-exome sequencing or mTOR gene panel sequencing were included in this study. Clinical data were directly available from each contributing centre. Histopathological analyses were performed from formalin-fixed, paraffin-embedded tissue samples using haematoxylin–eosin and immunohistochemistry for NF-SMI32, NeuN, pS6, p62, and vimentin. Ten …

Profiles Of Resting State Functional Connectivity In Temporal Lobe Epilepsy Associated With Post-Laser Interstitial Thermal Therapy Seizure Outcomes And Semiologies, Mashaal Syed, Jingya Miao, Anish Sathe, Kichang Kang, Arichena Manmatharayan, Michael Kogan, Caio M. Matias, Ashwini Sharan, Mahdi Alizadeh

Farber Institute for Neuroscience Staff Papers and Presentations

Introduction: It is now understood that in focal epilepsy, impacted neural regions are not limited to the epileptogenic zone. As such, further investigation into the underlying functional connectivity (FC) patterns in those enduring Temporal Lobe Epilepsy (TLE) with Mesial Temporal Sclerosis (MTS) is imperative to understanding the intricacies of the disease.

Methods: The rsfMRIs of 17 healthy participants, 10 left-sided TLE-MTS patients with a pre-operative history of focal impaired awareness seizures (FIA), and 13 left-sided TLE-MTS patients with a pre-operative history of focal aware seizures (FA) were compared to determine the existence of distinct FC patterns with respect to seizure …

Surgical Evacuation For Chronic Subdural Hematoma: Predictors Of Reoperation And Functional Outcomes, Georgios S. Sioutas, Ahmad Sweid, Md, Ching-Jen Chen, Andrea Becerril Gaitán, Fadi Al-Saiegh, Kareem El Naamani, Rawad Abbas, Abdelaziz Amllay, Lyena Birkenstock, Rachel E. Cain, Ramon L. Ruiz, Michael Buxbaum, David Nauheim, Bryan Renslo, Jonathan Bassig, Michael Reid Gooch, Nabeel Herial, Pascal Jabbour, Robert H. Rosenwasswer, Stavropoula I. Tjoumakaris

Department of Neurosurgery Faculty Papers

Background

Although chronic subdural hematoma (CSDH) incidence has increased, there is limited evidence to guide patient management after surgical evacuation.

Objective

To identify predictors of reoperation and functional outcome after CSDH surgical evacuation.

Methods

We identified all patients with CSDH between 2010 and 2018. Clinical and radiographic variables were collected from the medical records. Outcomes included reoperation within 90 days and poor (3–6) modified Rankin Scale score at 3 months.

Results

We identified 461 surgically treated CSDH cases (396 patients). The mean age was 70.1 years, 29.7 % were females, 298 (64.6 %) underwent burr hole evacuation, 152 (33.0 %) …

An Uncommon Diagnosis Of Necrotizing Mastoiditis Presenting As Bell’S Palsy: A Case Report, Parker Maddox, Claire Abramoff

Student Papers, Posters & Projects

Introduction: The benign nature of Bell’s palsy has led to a lack of a standardized work-up, and dangerous underlying mimics are at risk of being missed. Case

Report: An 84-year-old female with a history of vertigo presented to the emergency department with a left-sided facial droop consistent with Bell’s palsy. After further work-up, the patient was diagnosed with bilateral necrotizing mastoiditis.

Conclusion: Unilateral facial weakness involving the forehead and palpebral fissures is often diagnosed as idiopathic Bell’s palsy. Various pathologies can present with unilateral facial weakness, and the differential needs to remain broad.

Identifying The White Matter Pathways Involved In Multiple Sclerosis-Related Tremor Using Diffusion Tensor Imaging, Ahmed Bayoumi, Khader M Hasan, Jorge Patino, Zafer Keser, Joseph A Thomas, Refaat E Gabr, Claudia Pedroza, Arash Kamali, Mya C Schiess, Jerry S Wolinsky, John A Lincoln

Faculty, Staff and Student Publications

Background

Tremor affects up to 45% of patients with Multiple Sclerosis (PwMS). Current understanding is based on insights from other neurological disorders, thus, not fully addressing the distinctive aspects of MS pathology.

Objective

To characterize the brain white matter (WM) correlates of MS-related tremor using diffusion tensor imaging (DTI).

Methods

In a prospective case-control study, PwMS with tremor were assessed for tremor severity and underwent MRI scans including DTI. PwMS without tremor served as matched controls. After tract selection and segmentation, the resulting diffusivity measures were used to calculate group differences and correlations with tremor severity.

Results

This study included …

Advances In Deep Brain Stimulation: From Mechanisms To Applications, Stephanie S Sandoval-Pistorius, Mallory L Hacker, Allison C Waters, Jing Wang, Nicole R Provenza, Coralie De Hemptinne, Kara A Johnson, Melanie A Morrison, Stephanie Cernera

Faculty, Staff and Students Publications

Deep brain stimulation (DBS) is an effective therapy for various neurologic and neuropsychiatric disorders, involving chronic implantation of electrodes into target brain regions for electrical stimulation delivery. Despite its safety and efficacy, DBS remains an underutilized therapy. Advances in the field of DBS, including in technology, mechanistic understanding, and applications have the potential to expand access and use of DBS, while also improving clinical outcomes. Developments in DBS technology, such as MRI compatibility and bidirectional DBS systems capable of sensing neural activity while providing therapeutic stimulation, have enabled advances in our understanding of DBS mechanisms and its application. In this …

Botulinum Toxin Type A Injections For Refractory Abdominal Dystonia: A Case Report, William J. Naber Ii, Jodi M. Wilhelm, Kurt A. Kuhlman, Gabriel Howard

Graduate Medical Education Research Journal

Background: A 58-year-old male with chronic bilateral treatment resistant abdominal spasms secondary complications of ascites/ alcoholic cirrhosis. Spasms would occur 4-5 times/day, lasting minutes to hours despite a 2-year course of therapeutic and pharmacological interventions. Due to treatment refraction, 6 uniformly spaced botulinum toxin type A (BTX-A) injections were placed per side, using electromyography for audible intramuscular syringe placement confirmation, while visual confirmation was made via ultrasound. During the initial trial, 6 evenly spaced injections were performed bilaterally, uniformly distributing 80U/side. Injections began bilaterally just medial to the junction of the inferior rib cage border/ anterior axillary line and progressed …

Endovascular Embolization For Epistaxis: A Single Center Experience And Meta-Analysis, Kareem El Naamani, Charles Morse, Marc Ghanem, Julie Barbera, Abdelaziz Amllay, Grace Severance, Ramon Ruiz, Ahmad Sweid, Michael Gooch, Nabeel Herial, Pascal Jabbour, Robert Rosenwasswer, Gurston Nyquist, Stavropoula Tjoumakaris

Department of Neurosurgery Faculty Papers

The optimal treatment for intractable epistaxis is still controversial. Various studies have demonstrated high success rates and low complication rates for endovascular embolization. Herein, the authors report an institutional experience and meta-analysis in terms of efficacy and safety of endovascular embolization of intractable epistaxis. This was a retrospective observational study of 35 patients with epistaxis who underwent 40 embolization procedures between 2010 and 2023. The primary outcome was immediate success defined by immediate cessation of epistaxis at the end of the procedure. Immediate success was achieved in most of the procedures (39, 97.5%). During follow-up, three (7.5%) patients experienced a …

A Drosophila Model Relevant To Chemotherapy-Related Cognitive Impairment, Matthew Torre, Hassan Bukhari, Vanitha Nithianandam, Camila A Zanella, Douglas A Mata, Mel B Feany

Duncan NRI Faculty and Staff Publications

Chemotherapy-related cognitive impairment (CRCI) is a common adverse effect of treatment and is characterized by deficits involving multiple cognitive domains including memory. Despite the significant morbidity of CRCI and the expected increase in cancer survivors over the coming decades, the pathophysiology of CRCI remains incompletely understood, highlighting the need for new model systems to study CRCI. Given the powerful array of genetic approaches and facile high throughput screening ability in Drosophila, our goal was to validate a Drosophila model relevant to CRCI. We administered the chemotherapeutic agents cisplatin, cyclophosphamide, and doxorubicin to adult Drosophila. Neurologic deficits were observed with all …

Idiopathic Intracranial Hypertension: A Case Report, Christopher Bugajski Od

Optometric Clinical Practice

Background: Optic nerve head edema is a serious finding for which multiple etiologies need to be considered. When optic nerve head edema is observed bilaterally, among the top differentials is idiopathic intracranial hypertension (IIH), also known as primary pseudotumor cerebri. An emergent magnetic resonance image with and without contrast as well as venography and lumbar puncture with opening pressure measurement must be performed to diagnose and determine management. Case Report: This case specifically features a 30-year-old Caucasian female with bilateral optic disc edema secondary to IIH. In addition to discussing the details regarding this patient’s case, this report …

Tfeb And Tfe3 Control Glucose Homeostasis By Regulating Insulin Gene Expression, Adrien Pasquier, Nunzia Pastore, Luca D'Orsi, Rita Colonna, Alessandra Esposito, Veronica Maffia, Rossella De Cegli, Margherita Mutarelli, Susanna Ambrosio, Gennaro Tufano, Antonio Grimaldi, Marcella Cesana, Davide Cacchiarelli, Nathalie Delalleau, Gennaro Napolitano, Andrea Ballabio

Duncan NRI Faculty and Staff Publications

To fulfill their function, pancreatic beta cells require precise nutrient-sensing mechanisms that control insulin production. Transcription factor EB (TFEB) and its homolog TFE3 have emerged as crucial regulators of the adaptive response of cell metabolism to environmental cues. Here, we show that TFEB and TFE3 regulate beta-cell function and insulin gene expression in response to variations in nutrient availability. We found that nutrient deprivation in beta cells promoted TFEB/TFE3 activation, which resulted in suppression of insulin gene expression. TFEB overexpression was sufficient to inhibit insulin transcription, whereas beta cells depleted of both TFEB and TFE3 failed to suppress insulin gene …

Large Vessel Occlusion Prediction Scale Thresholds That Are Sensitive For Dawn Trial Patients., Kevin J Keenan, Wade S Smith, Ashutosh P Jadhav, Diogo C Haussen, Ronald F Budzik, Alain Bonafé, Parita Bhuva, Dileep R Yavagal, Marc Ribò, Christophe Cognard, Ricardo A Hanel, Ameer E Hassan, Cathy A Sila, Jeffrey L Saver, David S Liebeskind, Tudor G Jovin, Raul G Nogueira

Neuroscience Articles

BACKGROUND: Large vessel occlusion (LVO) prediction scales are used to triage prehospital suspected stroke patients with a high probability of LVO stroke to endovascular therapy centers. The sensitivities of these scales in the 6-to-24-h time window are unknown. Higher scale score thresholds are typically less sensitive and more specific. Knowing the highest scale score thresholds that remain sensitive could inform threshold selection for clinical use. Sensitivities may also vary between left and right-sided LVOs.

METHODS: LVO prediction scale scores were retrospectively calculated using the National Institutes of Health Stroke Scale (NIHSS) scores of patients enrolled in the DAWN Trial. All …

The Atoh1-Cre Knock-In Allele Ectopically Labels A Subpopulation Of Amacrine Cells And Bipolar Cells In Mouse Retina, Sih-Rong Wu, Huda Y Zoghbi

Duncan NRI Faculty and Staff Publications

The retina has diverse neuronal cell types derived from a common pool of retinal progenitors. Many molecular drivers, mostly transcription factors, have been identified to promote different cell fates. In Drosophila, atonal is required for specifying photoreceptors. In mice, there are two closely related atonal homologs, Atoh1 and Atoh7. While Atoh7 is known to promote the genesis of retinal ganglion cells, there is no study on the function of Atoh1 in retinal development. Here, we crossed Atoh1^Cre/+ mice to mice carrying a Cre-dependent TdTomato reporter to track potential Atoh1-lineage neurons in retinas. We characterized a heterogeneous …

Dicarboxylic Acylcarnitine Biomarkers In Peroxisome Biogenesis Disorders, Michael F Wangler, Barbara Lesko, Rejwi Dahal, Sharayu Jangam, Pradnya Bhadane, Theodore E Wilson, Molly Mcpheron, Marcus J Miller

Duncan NRI Faculty and Staff Publications

The peroxisome is an essential eukaryotic organelle with diverse metabolic functions. Inherited peroxisomal disorders are associated with a wide spectrum of clinical outcomes and are broadly divided into two classes, those impacting peroxisome biogenesis (PBD) and those impacting specific peroxisomal factors. Prior studies have indicated a role for acylcarnitine testing in the diagnosis of some peroxisomal diseases through the detection of long chain dicarboxylic acylcarnitine abnormalities (C16-DC and C18-DC). However, there remains limited independent corroboration of these initial findings and acylcarnitine testing for peroxisomal diseases has not been widely adopted in clinical laboratories. To explore the utility of acylcarnitine testing …

Optogenetic Stimulation Of Ca1 Pyramidal Neurons At Theta Enhances Recognition Memory In Brain Injured Animals, John I Broussard, John B Redell, Jing Zhao, Rebecca West, Ryota Homma, Pramod K Dash

Faculty, Staff and Student Publications

The hippocampus plays a prominent role in learning and memory formation. The functional integrity of this structure is often compromised after traumatic brain injury (TBI), resulting in lasting cognitive dysfunction. The activity of hippocampal neurons, particularly place cells, is coordinated by local theta oscillations. Previous studies aimed at examining hippocampal theta oscillations after experimental TBI have reported disparate findings. Using a diffuse brain injury model, the lateral fluid percussion injury (FPI; 2.0 atm), we report a significant reduction in hippocampal theta power that persists for at least three weeks after injury. We questioned whether the behavioral deficit associated with this …

Arginase Deficiency Masked By Cerebral Palsy And Coagulopathy-Three Varied Presentations Of Latin American Origin, Shelby L Mills, Paige Roberts, Myla Ashfaq, Kathryn Leal, Hope Northrup, Deborah L Brown, David Rodriguez-Buritica, Laura S Farach

Faculty, Staff and Student Publications

Arginase deficiency (ARG1‐D) is an autosomal recessive inborn error of metabolism that is often misdiagnosed. Classic presentation of ARG1‐D includes progressive symptoms of spasticity, delayed development, cognitive impairment, protein avoidance, and seizures. Patients who present atypically may evade diagnosis and require a thoughtful diagnostic workup. Here, we discuss three females of Latin American origin with differing clinical presentations, but who all have the same intronic pathogenic variant in ARG1. Importantly, we found that each case included elevated coagulopathy on laboratory testing and discussed one case in particular with manifestation of bleeding. When diagnosed early, treatment is favorable and can …

Importance Of Health Policy And Systems Research For Strengthening Rehabilitation In Health Systems: A Call To Action To Accelerate Progress, Walter R Frontera, Wouter Degroote, Abdul Ghaffar, Health Policy & Systems Research For Rehabilitation Group

Faculty, Staff and Student Publications

No abstract provided.

Use Of Term Reference Infants In Assessing The Developmental Outcome Of Extremely Preterm Infants: Lessons Learned In A Multicenter Study, Charles E Green, Jon E Tyson, Roy J Heyne, Susan R Hintz, Betty R Vohr, Carla M Bann, Abhik Das, Edward F Bell, Sana Boral Debsareea, Emily Stephens, Marie G Gantz, Carolyn M Petrie Huitema, Karen J Johnson, Kristi L Watterberg, Ricardo Mosquera, Myriam Peralta-Carcelen, Deanne E Wilson-Costello, Tarah T Colaizy, Nathalie L Maitre, Stephanie L Merhar, Ira Adams-Chapman, Janell Fuller, Michelle E Hartley-Mcandrew, William F Malcolm, Sarah Winter, Andrea F Duncan, Gary J Myer, Stephen D Kicklighter, Myra H Wyckoff, Sara B Demauro, Anna Maria Hibbs, Barbara J Stoll, Waldemar A Carlo, Krisa P Van Meurs, Matthew A Rysavy, Ravi M Patel, Pablo J Sánchez, Abbot R Laptook, C Michael Cotten, Carl T D'Angio, Michele C Walsh, Human Development Neonatal Research Network

Faculty, Staff and Student Publications

OBJECTIVE: Extremely preterm (EP) impairment rates are likely underestimated using the Bayley III norm-based thresholds scores and may be better assessed relative to concurrent healthy term reference (TR) infants born in the same hospital.

STUDY DESIGN: Blinded, certified examiners in the Neonatal Research Network (NRN) evaluated EP survivors and a sample of healthy TR infants recruited near the 2-year assessment age.

RESULTS: We assessed 1452 EP infants and 183 TR infants. TR-based thresholds showed higher overall EP impairment than Bayley norm-based thresholds (O.R. = 1.86; [95% CI 1.56-2.23], especially for severe impairment (36% vs. 24%; p ≤ 0.001). Difficulty recruiting …

Automated Large Vessel Occlusion Detection Software And Thrombectomy Treatment Times: A Cluster Randomized Clinical Trial, Juan Carlos Martinez-Gutierrez, Youngran Kim, Sergio Salazar-Marioni, Muhammad Bilal Tariq, Rania Abdelkhaleq, Arash Niktabe, Anjan N Ballekere, Ananya S Iyyangar, Mai Le, Hussain Azeem, Charles C Miller, Jon E Tyson, Sandi Shaw, Peri Smith, Mallory Cowan, Isabel Gonzales, Louise D Mccullough, Andrew D Barreto, Luca Giancardo, Sunil A Sheth

Faculty, Staff and Student Publications

Importance

The benefit of endovascular stroke therapy (EVT) in large vessel occlusion (LVO) ischemic stroke is highly time dependent. Process improvements to accelerate in-hospital workflows are critical.

Objective

To determine whether automated computed tomography (CT) angiogram interpretation coupled with secure group messaging can improve in-hospital EVT workflows.

Design, Setting, and Participants

This cluster randomized stepped-wedge clinical trial took place from January 1, 2021, through February 27, 2022, at 4 comprehensive stroke centers (CSCs) in the greater Houston, Texas, area. All 443 participants with LVO stroke who presented through the emergency department were treated with EVT at the 4 CSCs. Exclusion …

Stratification Of Alpha Ganglion Cells And On/Off Directionally Selective Ganglion Cells In The Rabbit Retina, Xinruo Zhang, Katherine Brind'amour, Kelly E King, Susan Hartmaier, Katherine Harris, David A Weinstein, Cynthia J Girman

Faculty, Staff and Student Publications

Introduction

Neurodegenerative diseases cause developmental delays and loss of milestones in infants and children. However, scalable outcome measures that quantify features meaningful to parents/caregivers (P/CGs) and have regulatory precedence are lacking for assessing the effectiveness of treatments in clinical trials of neurodegenerative disorders. To address this gap, we developed an innovative, blinded strategy for single-arm trials with external controls using expert panel review of home video.

Method

We identified meaningful, observable, and objective developmental milestones from iterative interviews with P/CGs and clinical experts. Subsequently, we standardized video recording procedures and instructions to ensure consistency in how P/CGs solicited each activity. …

The Need For Space To Plan The Future For Spondyloarthritis, Louise D Mccullough

Faculty, Staff and Student Publications

A new study indicates that although men and women are equally likely to experience cognitive impairment after acute ischaemic stroke, there are sex differences in particular cognitive domains. Whether these differences are directly linked to biological sex is uncertain, as many factors, including age and pre-stroke factors, could contribute to cognitive outcomes.

The Development, Content And Response Process Validation Of A Caregiver-Reported Severity Measure For Cdkl5 Deficiency Disorder, Sonja I Ziniel, Alexandra Mackie, Jacinta Saldaris, Helen Leonard, Peter Jacoby, Eric D Marsh, Bernhard Suter, Elia Pestana-Knight, Heather E Olson, Dana Price, Judith Weisenberg, Rajsekar Rajaraman, Gina Vanderveen, Tim A Benke, Jenny Downs, Scott Demarest

Faculty, Staff and Students Publications

BACKGROUND: CDKL5 Deficiency Disorder (CDD) is a severe X-linked developmental and epileptic encephalopathy. Existing developmental outcome measures have floor effects and cannot capture incremental changes in symptoms. We modified the caregiver portion of a CDD clinical severity assessment (CCSA) and assessed content and response-process validity.

METHODS: We conducted cognitive interviews with 15 parent caregivers of 1-39-year-old children with CDD. Caregivers discussed their understanding and concerns regarding appropriateness of both questions and answer options. Item wording and questionnaire structure were adjusted iteratively to ensure questions were understood as intended.

RESULTS: The CCSA was refined during three rounds of cognitive interviews into …

Prevalent Distribution Of Conscious Processes On Either Side Of The Brain, Sohail Adnan, Mubasher Shah, Muhammad Fateen Rashed, Sadaf Nawab

Journal of Mind and Medical Sciences

Objectives. The brain has an intrinsic tendency for the lateralization of its functions. For instance, the left hemisphere assists in the comprehension and motor expression of language. What remains uncertain is whether conscious processes are also more prevalent in one hemisphere of the brain than the other. The epistemic goal of this research was to address this particular issue. Materials and Methods. We observed the rare pathological event of proximal occlusion of the middle cerebral artery (MCA), which halts blood flow to the central two-thirds of a hemisphere, and examined its effects on consciousness. We aggregated individual scores for eyes-opening …

From Covid-19 To Long Covid; The Forms Of The Neurological Manifestations, Sana Ahuja, Sufian Zaheer

Journal of Mind and Medical Sciences

Ever since the SARS-CoV-2 infection was declared a global pandemic in 2020, numerous multisystemic manifestations have been discovered. The COVID-19 is known to cause a wide spectrum of neurological symptoms like fatigue, headache, brain fog, stroke, smell and taste disorders, encephalopathy and neurodegenerative disorders. The neurological manifestations are more prevalent in the post-COVID syndrome or long COVID. The National Institute for Health and Care Excellence and WHO defined Ongoing Symptomatic COVID as 4-12 weeks post infection and post COVID-19 syndrome as persistence of symptoms beyond 12 weeks. So far there are limited data available regarding the pathophysiology of neurological symptoms …