Medical Specialties Commons^™

The Correlation Between The Microbiome And Neurodegenerative Disorders Such As Alzheimer Disease, Aurora Mokris

Honors Theses

Recent studies suggest that there are 1.3 times as many microbial cells as human cells in the body (Abbot, 2016). Another study claims that the combined genomes of this microbiota is 150 times that of the human genome (Zhuang & Shen, 2018). If you have ever had the feeling that you are not alone in an empty room you are most certainly correct. Your body is teeming with millions of organisms living in mutualistic symbiosis with you and surrounding microbes, but at times, this seemingly harmonious relationship can be disturbed, resulting in serious physical and psychological changes to the human …

Body Mass Index In Multiple Sclerosis Modulates Ceramide-Induced Dna Methylation And Disease Course, Kamilah Castro, Achilles Ntranos, Mario Amatruda, Maria Petracca, Peter Kosa, Emily Y. Chen, Johannes Morstein, Dirk Trauner, Corey T. Watson, Michael A. Kiebish, Bibiana Bielekova, Matilde Inglese, Ilana Katz Sand, Patricia Casaccia

Advanced Science Research Center

Background: Multiple Sclerosis (MS) results from genetic predisposition and environmental variables, including elevated Body Mass Index (BMI) in early life. This study addresses the effect of BMI on the epigenome of monocytes and disease course in MS.

Methods: Fifty-four therapy-naive Relapsing Remitting (RR) MS patients with high and normal BMI received clinical and MRI evaluation. Blood samples were immunophenotyped, and processed for unbiased plasma lipidomic profiling and genome-wide DNA methylation analysis of circulating monocytes. The main findings at baseline were validated in an independent cohort of 91 therapy-naïve RRMS patients. Disease course was evaluated by a two-year longitudinal follow up …

Diffuse Low-Grade Glioma - Changing Concepts In Diagnosis And Management: A Review, Rashid Jooma, Muhammad Waqas, Inamullah Khan

Section of Neurosurgery

Though diffuse low-grade gliomas (dLGGs) represent only 15% of gliomas, they have been receiving increasing attention in the past decade. Significant advances in knowledge of the natural history and clinical diversity have been documented, and an improved pathological classification of gliomas that integrates histological features with molecular markers has been issued by the WHO. Advances in the radiological assessment of dLGG, particularly new magnetic resonance imaging scanning sequences, allow improved diagnostic and prognostic information. The management paradigms are evolving from "wait and watch" of the past to more active interventional therapy to obviate the risk of malignant transformation. New surgical …

Role Of Surgery In Spinal Metastases, Altaf Ali Laghari, Humza Faisal Siddiqui, Muhammad Shahzad Shamim

Section of Cardiology

Spinal metastases constitute two-third of all cases of bone metastases. Surgical intervention in these tumours has been recommended in highly selective cases, for confirming diagnosis, stabilizing the spine, and decompressing nerves or spinal cord for alleviation of pain and preservation of function.In this article,the authors have reviewed available evidence on role of surgery in spinal metastases and have presented results of selected papers on this vast topic.

Rationale And Methods For A Multicenter Clinical Trial Assessing Exercise And Intensive Vascular Risk Reduction In Preventing Dementia (Rrad Study), Amanda N. Szabo-Reed, Eric Vidoni, Ellen F. Binder, Jeffrey Burns, C. Munro Cullum, William P. Gahan, Aditi Gupta, Linda S. Hynan, Diana R. Kerwin, Heidi Rossetti, Ann M. Stowe, Wanpen Vongpatanasin, David C. Zhu, Rong Zhang, Jeffrey N. Keller

Neurology Faculty Publications

Alzheimer's Disease (AD) is an age-related disease with modifiable risk factors such as hypertension, hypercholesterolemia, obesity, and physical inactivity influencing the onset and progression. There is however, no direct evidence that reducing these risk factors prevents or slows AD. The Risk Reduction for Alzheimer's Disease (rrAD) trial is designed to study the independent and combined effects of intensive pharmacological control of blood pressure and cholesterol and exercise training on neurocognitive function. Six hundred and forty cognitively normal older adults age 60 to 85 years with hypertension and increased risk for dementia will be enrolled. Participants are randomized into one of …

Maximum Iv Tpa Dose For Obese Patients Is Associated With Greater Likelihood Of Hemorrhagic Conversion And Worse Functional Outcome At Discharge, Amy Starosciak, Felipe De Los Rios La Rosa

All Publications

No abstract provided.

Evidence-Based Intervention To Improve Assessment Of Headache Pain And Its Functional Capacity, Mavjuda Saydazamova

Doctoral Projects

Introduction: Headache is a chronic pain that is challenging to properly assess in clinical practice, as it is based almost entirely on the ability of the clinician and patient to communicate. This communication is based on pain scale tools. To assess patients’ disability and pain intensity, the selected organization uses the Migraine Disability Assessment (MIDAS) screening tool. Pain intensity is measured with a Numeric Pain Scale within the MIDAS. Measuring chronic headache pain accurately, while using a very subjective and inadequate pain scale to measure chronic pain was an issue. The literature review supported replacing the Numeric Pain Scale with …

Neuroprotective Activity Of Leukemia Inhibitory Factor Is Relayed Through Myeloid Zinc Finger-1 In A Rat Model Of Stroke, Stephanie M. Davis, Lisa A. Collier, Elspeth A. Foran, Christopher C. Leonardo, Craig T. Ajmo Jr., Keith R. Pennypacker

Neurology Faculty Publications

The aim of this study was to determine whether leukemia inhibitory factor (LIF) exerts its neuroprotective effects through signal transduction of the transcription factor myeloid zinc finger-1 (MZF-1). According to the hypothesis of this study, MZF-1 mediates LIF-induced neuroprotective signaling during ELVO through increased expression and transcriptional activity. To determine the in vivo role of MZF-1 in LIF-induced neuroprotection, we used Genomatix software was used to MZF-1 sites in the promoter region of the rat superoxide dismutase 3 (SOD3) gene. Stroke was induced via middle cerebral artery occlusion, and animals were administered PBS or 125 μg/kg LIF at …

Predictors Of Good Functional Outcome At Discharge In Stroke Patients With Depression In The Fl-Pr Collaboration To Reduce Stroke Disparities, Amy Starosciak

All Publications

No abstract provided.

The Acute Effects Of Melatonin On Striatal Dopamine Release: Progressive Electrochemical Analysis In An Ex Vivo Mouse Model Utilizing Fast Scan Cyclic Voltammetry, Kevin D. Hughes

Masters Theses

The caudate putamen is a sub region of the basal ganglia, containing neural tracts important for cognition, reward learning, and voluntary motor function. Dopamine (DA) signaling received from the dopaminergic neurons of the substantia nigra pars compacta mediate locomotion, degradation of which is the characteristic neuropathology for Parkinson’s disease (PD). PD is an initially neurovegetative motor disorder but can progress to include cognitive impairments as well. Sundowner’s syndrome (SS) has been observed in patient populations with neurodegenerative diseases, characterized by the decline of cognition into evening hours. Due to the circadian influence which the hormone melatonin has on the sleep-wake …

Rare Variant Of Guillain-Barré Syndrome After Chikungunya Viral Fever, Sajid Hameed, Sara Khan

Section of Neurology

Chikungunya (CHIK) viral fever is a self-limiting illness that presents with severe debilitating arthralgia, myalgia, fever and rash. Neurological complications are rare. We present a case of a 36-year-old woman who presented with acute onset progressive difficulty swallowing and left arm weakness. She was diagnosed with CHIK viral fever 4 weeks prior to admission. After investigations, she was diagnosed with a pharyngeal-cervical-brachial variant of Guillain-Barré syndrome. In hospital, she required ventilator support. Her condition improved after five sessions of intravenous immunoglobulin with almost complete resolution within 6 months of symptom onset. With frequent CHIK outbreaks, the neurological complications are increasingly …

Tobacco Smoking And Dementia In A Kentucky Cohort: A Competing Risk Analysis, Erin L. Abner, Peter T. Nelson, Gregory A. Jicha, Gregory E. Cooper, David W. Fardo, Frederick A. Schmitt, Richard J. Kryscio

Epidemiology and Environmental Health Faculty Publications

Tobacco smoking was examined as a risk for dementia and neuropathological burden in 531 initially cognitively normal older adults followed longitudinally at the University of Kentucky’s Alzheimer’s Disease Center. The cohort was followed for an average of 11.5 years; 111 (20.9%) participants were diagnosed with dementia, while 242 (45.6%) died without dementia. At baseline, 49 (9.2%) participants reported current smoking (median pack-years = 47.3) and 231 (43.5%) former smoking (median pack-years = 24.5). The hazard ratio (HR) for dementia for former smokers versus never smokers based on the Cox model was 1.64 (95% CI: 1.09, 2.46), while the HR for …

Six-Month Outcome Of Transient Ischemic Attack And Its Mimics, Alireza Sadighi, Vida Abedi, Alia C. Stanciu, Nada El Andary, Mihai Banciu, Neil Holland, Ramin Zand

Faculty Journal Articles

Background and Objective: Although the risk of recurrent cerebral ischemia is higher after a transient ischemic attack (TIA), there is limited data on the outcome of TIA mimics. The goal of this study is to compare the 6-month outcome of patients with negative and positive diffusion-weighted imaging (DWI) TIAs (DWI-neg TIA vs. DWI-pos TIA) and also TIA mimics.

Methods: We prospectively studied consecutive patients with an initial diagnosis of TIA in our tertiary stroke centers in a 2-year period. Every included patient had an initial magnetic resonance (MR) with DWI and one-, three-, and six-month follow-up visits. The primary outcome …

Effects Of Altered Gravity On The Central Nervous System Of Drosophila Melanogaster, Amber M. Paul, Siddhita Mhatre, Janani Iyer, Jhony A. Zavaleta, Ravikumar Hosamani

Publications

A comprehensive understanding of the effects of spaceflight and altered gravity on human physiology is necessary for continued human space exploration and long-term space habitation. Spaceflight includes multiple factors such as microgravity, hyper gravity, ionizing radiation, physiological stress, and disrupted circadian rhythms and these have been shown to contribute to pathophysiological responses that target immunity, bone and muscle integrity, cardiovascular and nervous systems. In terrestrial conditions, some of these factors can lead to cancer and neuroimmunological disorders. In this study, we used a well-established spaceflight model organism, Drosophila melanogaster, to assess spaceflight-associated changes in the nervous system. We hypothesize that …

Evidence Doesn’T Change Prescribing Patterns…So What Does?, Ali Rida, Anthony Brooks

Clinical Research in Practice: The Journal of Team Hippocrates

The authors write in support of critical analysis of clinical research, as a corrective to the physician's urge to "do something" even when no evidence of benefit exists.

Endovascular Coiling Versus Neurosurgical Clipping For Aneurysmal Subarachnoid Hemorrhage: A Systematic Review And Meta-Analysis, Syed Ijlal Ahmed, Gohar Javed, Syeda Beenish Bareeqa, Syeda Sana Samar, Ali Shah, Arwa Giani, Zainab Azam, Abeer Tasleem, Syed Hasham Humayun

Section of Neurosurgery

Background: Aneurysmal subarachnoid hemorrhage is a frequently devastating condition with a reported incidence of between 10 and 15 people per 100,000 in the United States. Currently, according to the best of our knowledge, there are not enough meta-analyses available in the medical literature of the last five years which compare the risks and benefits of endovascular coiling with neurosurgical clipping.
Methods: Twenty-two studies were selected out of the short-listed studies. The studies were selected on the basis of relevance to the topic, sample size, sampling technique, and randomization. Data were analyzed on Revman software.
Results: Mortality was found to be …

The Myth Of "It's All In Your Head"

DePaul Magazine

Researchers at DePaul's Center for Community Research are mapping the brain to uncover the causes of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). Psychologist Leonard Jason has been carrying out community-based epidemiology prevalence studies that show that about one million Americans, many of them from ethnic minorities, are afflicted with the condition.

Efficacy Of Leukemia Inhibitory Factor As A Therapeutic For Permanent Large Vessel Stroke Differs Among Aged Male And Female Rats, Stephanie M. Davis, Lisa A. Collier, Sarah J. Goodwin, Douglas E. Lukins, David K. Powell, Keith R. Pennypacker

Neurology Faculty Publications

Preclinical studies using rodent models of stroke have had difficulty in translating their results to human patients. One possible factor behind this inability is the lack of studies utilizing aged rodents of both sexes. Previously, this lab showed that leukemia inhibitory factor (LIF) promoted recovery after stroke through antioxidant enzyme upregulation. This study examined whether LIF promotes neuroprotection in aged rats of both sexes. LIF did not reduce tissue damage in aged animals, but LIF-treated female rats showed partial motor skill recovery. The LIF receptor (LIFR) showed membrane localization in young male and aged rats of both sexes after stroke. …

Prefrontal Corticotropin-Releasing Factor (Crf) Neurons Act Locally To Modulate Frontostriatal Cognition And Circuit Function., Sofiya Hupalo, Andrea J Martin, Rebecca K Green, David M Devilbiss, Craig W Berridge

Rowan-Virtua School of Osteopathic Medicine Departmental Research

The PFC and extended frontostriatal circuitry support higher cognitive processes that guide goal-directed behavior. PFC-dependent cognitive dysfunction is a core feature of multiple psychiatric disorders. Unfortunately, a major limiting factor in the development of treatments for PFC cognitive dysfunction is our limited understanding of the neural mechanisms underlying PFC-dependent cognition. We recently demonstrated that activation of corticotropin-releasing factor (CRF) receptors in the caudal dorsomedial PFC (dmPFC) impairs higher cognitive function, as measured in a working memory task. Currently, there remains much unknown about CRF-dependent regulation of cognition, including the source of CRF for cognition-modulating receptors and the output pathways modulated …

Lewy Body Dementia Association's Research Centers Of Excellence Program: Inaugural Meeting Proceedings., Bethany Peterson, Melissa Armstrong, Douglas Galasko, James E. Galvin, Jennifer Goldman, David Irwin, Henry Paulson, Daniel Kaufer, James Leverenz, Angela Lunde, Ian G. Mckeith, Andrew Siderowf, Angela Taylor, Katherine Amodeo, Matt Barrett, Kimiko Domoto-Reilly, John Duda, Stephen Gomperts, Neill Graff-Radford, Samantha Holden, Lawrence Honig, Daniel Huddleston, Carol Lippa, Irene Litvan, Carol Manning, Karen Marder, Charbel Moussa, Chiadi Onyike, Fernando Pagan, Alexander Pantelyat, Victoria Pelak, Kathleen Poston, Joseph Quinn, Irene Richard, Liana S. Rosenthal, Marwan Sabbagh, Douglas Scharre, Sharon Sha, Holly Shill, Yasar Torres-Yaghi, Tina Christie, Todd Graham, Ian Richards, Mike Koehler, Brad Boeve

Department of Neurology Faculty Papers

The first Lewy Body Dementia Association (LBDA) Research Centers of Excellence (RCOE) Investigator's meeting was held on December 14, 2017, in New Orleans. The program was established to increase patient access to clinical experts on Lewy body dementia (LBD), which includes dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), and to create a clinical trials-ready network. Four working groups (WG) were created to pursue the LBDA RCOE aims: (1) increase access to high-quality clinical care, (2) increase access to support for people living with LBD and their caregivers, (3) increase knowledge of LBD among medical and allied (or …

Systematic Literature Review Of Quetiapine For The Treatment Of Psychosis In Patients With Parkinsonism, Jack J. Chen, Henry Hua, Lilian Massihi, Ivan Portillo, Azita Alipour, William Ondo, Khashayar Dashtipour

Library Articles and Research

Objective:

The purpose of this article was to determine the efficacy and tolerability of quetiapine compared with placebo or other interventions for psychosis in parkinsonism.

Methods:

Participants with a diagnosis of parkinsonism participated in randomized controlled trials (RCTs) investigating the efficacy and tolerability of quetiapine for psychotic symptoms within a defined follow-up period. The authors conducted searches on PubMed, Cochrane Controlled Register of Trials, and EMBASE for articles published from January 1991 to October 2017. Study methodology and patient- and treatment-level data were independently extracted and summarized by using descriptive statistics. Studies underwent quality assessment for risk of bias.

Results: …

Human Verbal Memory Encoding Is Hierarchically Distributed In A Continuous Processing Stream., Michal T. Kucewicz, Krishnakant Saboo, Brent M. Berry, Vaclav Kremen, Laura R. Miller, Fatemeh Khadjevand, Cory S. Inman, Paul Wanda, Michael R. Sperling, Richard Gorniak, Kathryn A. Davis, Barbara C. Jobst, Bradley Lega, Sameer A. Sheth, Daniel S. Rizzuto, Ravishankar K. Iyer, Michael J. Kahana, Gregory A. Worrell

Department of Neurology Faculty Papers

Processing of memory is supported by coordinated activity in a network of sensory, association, and motor brain regions. It remains a major challenge to determine where memory is encoded for later retrieval. Here, we used direct intracranial brain recordings from epilepsy patients performing free recall tasks to determine the temporal pattern and anatomical distribution of verbal memory encoding across the entire human cortex. High γ frequency activity (65-115 Hz) showed consistent power responses during encoding of subsequently recalled and forgotten words on a subset of electrodes localized in 16 distinct cortical areas activated in the tasks. More of the high …

Current Situation And Future Recommendations For Neurophysiology Services In Pakistan, Imran Ahmad, Farooq Azam Rathore

Pakistan Journal of Neurological Sciences (PJNS)

Clinical neurophysiology is defined as “a medical specialty that studies the central and peripheral nervous systems through the recording of bioelectrical activity, whether spontaneous or stimulated”.1 There are different models of practice for clinical neurophysiology around the world. In some countries it is considered to be an independent specialty, while in other countries it is integrated with neurology.

Choice Of Therapeutic Anti-Seizure Medication In Patients With Brain Tumour, Altaf Ali Laghari, Syed Ijlal Ahmed, Namra Qadeer, Muhammad Shahzad Shamim

Section of Neurosurgery

Seizures are common in patients with brain tumours, even though prophylactic anti-seizure treatment for all patients with brain tumours is not recommended. Newer anti-epileptic drugs have shown benefits that outweigh the side effects of treatment and can also be given in combination with traditional anti-epileptic drugs. The authors have reviewed the literature on the various combinations of anti-epileptics in patients with seizures and brain tumours.

Management Of Non-Epileptic Seizures Through Hypnosis: A Case Study, Muhammad Rafiq, Sana Zaheer

Pakistan Journal of Neurological Sciences (PJNS)

Conversion disorder is associated with diverse somatic complaints including visual deficiency, psychogenic nonepileptic seizures, lethargy, paralyses etc. Studies have revealed that in addition to pharmacological treatment, psychological intervention including hypnosis has a significant impact in the management of conversion disorder. The current case study was focused to see any effect of unique hypnotic technique, Circle Therapy for the management of conversion disorder. The patient A.J. was referred for the evaluation and psychological management ofnon-epileptic seizures. After a complete physical and psychological observation and interview, stressors were identified a n d the patient underwent brief hypnotic session and it was suggested …

Multiple Sclerosis In Pakistan And Need For Multiple Sclerosis Registry, Haris Majid Rajput, Mohammad Wasay, Mazhar Badshah, Muhammad Hassan

Pakistan Journal of Neurological Sciences (PJNS)

Multiple sclerosis(MS) is an acquired chronic demyelinating disease of central nervous system is a leading cause of non-traumatic disability in young with significant socioeconomic impact. The aim of this study was to provide a comprehensive review of all available data of MS in Pakistan.

Report Of An Inferior Rectal Nerve Variant Arising From The S3 Ventral Ramus., Graham Dupont, Joe Iwanaga, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

In surgical approaches to the perineum in general and anal region specifically, considering the possible variations of the inferior rectal nerve is important for the surgeon. Normally, the inferior rectal nerve originates as a branch of the pudendal nerve. However, during routine dissection, a variant of the inferior rectal nerve was found where it arose directly from the third sacral nerve ventral ramus (S3). Many cases have described the inferior rectal nerve arising independently from the sacral plexus, most commonly from the fourth sacral nerve root (S4); however, few cases have reported the inferior rectal nerve arising from S3. Herein, …

Variant Anatomy Of The Buccal Nerve., Mayank Patel, Joe Iwanaga, Shogo Kikuta, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

Knowledge of the anatomy and variations of the nerves of the oral cavity is important to surgeons who operate this region. Herein, we report a rare case of a buccal nerve with two distinct roots. The anatomy of this case and its clinical applications is discussed.

Value Of Periodic Transcutaneous Daytime Carbon Dioxide Monitoring In Screening For Respiratory Failure In Patients With Amyotrophic Lateral Sclerosis, Muhammad K Rafiq

Pakistan Journal of Neurological Sciences (PJNS)

There is no single test currently available, which can predict respiratory failure in patients with amyotrophic lateral sclerosis (ALS) with high sensitivity and specificity. This study explores the potential use of transcutaneous carbon dioxide (PtcCO2) monitoring in early detection of respiratory failure in ALS.

Prevalence Of Stress And Depression Among University Students Of Karachi, Nida Naseem, Lubna Naz, Nazneen Zehra

Pakistan Journal of Neurological Sciences (PJNS)

Stress is an all-time concerned issue in undergraduate students. Stress levels are high due to workload, pressure of academic and extra-curricular activities and unhealthy lifestyle. Though stress can be beneficial for academic growth but increased magnitude can be harmful for physiological, psychological and social aspects.