Neurology Commons^™

Response Of Astrocyte Subpopulations Following Spinal Cord Injury., R Vivian Allahyari, Nicolette M Heinsinger, Daniel Hwang, David A Jaffe, Javad Rasouli, Stephanie Shiers, Samantha J Thomas, Theodore J Price, Abdolmohamad Rostami, Angelo C Lepore

Farber Institute for Neuroscience Faculty Papers

There is growing appreciation for astrocyte heterogeneity both across and within central nervous system (CNS) regions, as well as between intact and diseased states. Recent work identified multiple astrocyte subpopulations in mature brain. Interestingly, one subpopulation (Population C) was shown to possess significantly enhanced synaptogenic properties in vitro, as compared with other astrocyte subpopulations of adult cortex and spinal cord. Following spinal cord injury (SCI), damaged neurons lose synaptic connections with neuronal partners, resulting in persistent functional loss. We determined whether SCI induces an enhanced synaptomodulatory astrocyte phenotype by shifting toward a greater proportion of Population C cells and/or increasing …

Challenges And Opportunities For Immunotherapeutic Intervention Against Myeloid Immunosuppression In Glioblastoma, Mark A Exley, Samantha Garcia, Amelia Zellander, Jenny Zilberberg, David W. Andrews

Department of Neurosurgery Faculty Papers

Glioblastoma multiforme (GBM), the most common and deadly brain cancer, exemplifies the paradigm that cancers grow with help from an immunosuppressive tumor microenvironment (TME). In general, TME includes a large contribution from various myeloid lineage-derived cell types, including (in the brain) altered pathogenic microglia as well as monocyte-macrophages (Macs), myeloid-derived suppressor cells (MDSC) and dendritic cell (DC) populations. Each can have protective roles, but has, by definition, been coopted by the tumor in patients with progressive disease. However, evidence demonstrates that myeloid immunosuppressive activities can be reversed in different ways, leading to enthusiasm for this therapeutic approach, both alone and …

Treatment Of Nonsurgical Refractory Back Pain With High-Frequency Spinal Cord Stimulation At 10 Khz: 12-Month Results Of A Pragmatic, Multicenter, Randomized Controlled Trial., Leonardo Kapural, Jessica Jameson, Curtis Johnson, Daniel Kloster, Aaron Calodney, Peter Kosek, Julie Pilitsis, Markus Bendel, Erika Petersen, Chengyuan Wu, Taissa Cherry, Shivanand P Lad, Cong Yu, Dawood Sayed, Johnathan Goree, Mark K Lyons, Andrew Sack, Diana Bruce, Frances Rubenstein, Rose Province-Azalde, David Caraway, Naresh P Patel

Department of Neurosurgery Faculty Papers

Objective: Spinal cord stimulation (SCS) at 10 kHz (10-kHz SCS) is a safe and effective therapy for treatment of chronic low-back pain. However, it is unclear from existing evidence whether these findings can be generalized to patients with chronic back pain that is refractory to conventional medical management (CMM) and who have no history of spine surgery and are not acceptable candidates for spine surgery. The authors have termed this condition "nonsurgical refractory back pain" (NSRBP) and conducted a multicenter, randomized controlled trial to compare CMM with and without 10-kHz SCS in this population.

Methods: Patients with NSRBP, as defined …

Optimizing The Application Of Surgery For Degenerative Cervical Myelopathy [Ao Spine Recode-Dcm Research Priority Number 10], Ricardo Rodrigues-Pinto, Thiago Montenegro, Benjamin M Davies, So Kato, Yoshiharu Kawaguchi, Manabu Ito, Mehmet Zileli, Brian K Kwon, Michael G Fehlings, Paul A Koljonen, Shekar N Kurpad, James D Guest, Bizhan Aarabi, Vafa Rahimi-Movaghar, Jefferson R Wilson, Mark R N Kotter, James Harrop

Department of Neurosurgery Faculty Papers

Study design: Literature Review (Narrative).

Objective: To introduce the number 10 research priority for Degenerative Cervical Myelopathy: Individualizing Surgery.

Methods: This article summarizes the current recommendations and indications for surgery, including how known prognostic factors such as injury time, age, disease severity, and associated comorbidities impact surgical outcome. It also considers key areas of uncertainty that should be the focus of future research.

Results: While a small proportion of conservatively managed patients may remain stable, the majority will deteriorate over time. To date, surgical decompression is the mainstay of treatment, able to halt disease progression and improve neurologic function and …

Establishing Diagnostic Criteria For Degenerative Cervical Myelopathy [Ao Spine Recode-Dcm Research Priority Number 3], Bryn Hilton, Emma L Gardner, Zhilin Jiang, Lindsay Tetreault, Jamie R F Wilson, Carl Moritz Zipser, K Daniel Riew, James D Guest, James Harrop, Michael G Fehlings, Ricardo Rodrigues-Pinto, Vafa Rahimi-Movaghar, Bizhan Aarabi, Paul A Koljonen, Mark R N Kotter, Benjamin M Davies, Brian K Kwon

Department of Neurosurgery Faculty Papers

Study design: Narrative review.

Objectives: To discuss the importance of establishing diagnostic criteria in Degenerative Cervical Myelopathy (DCM), including factors that must be taken into account and challenges that must be overcome in this process.

Methods: Literature review summarising current evidence of establishing diagnostic criteria for DCM.

Results: Degenerative Cervical Myelopathy (DCM) is characterised by a degenerative process of the cervical spine resulting in chronic spinal cord dysfunction and subsequent neurological disability. Diagnostic delays lead to progressive neurological decline with associated reduction in quality of life for patients. Surgical decompression may halt neurologic worsening and, in many cases, improves function. …

Developing Novel Therapies For Degenerative Cervical Myelopathy [Ao Spine Recode-Dcm Research Priority Number 7]: Opportunities From Restorative Neurobiology., Aref-Ali Gharooni, Brian K Kwon, Michael G Fehlings, Timothy F Boerger, Ricardo Rodrigues-Pinto, Paul Aarne Koljonen, Shekar N Kurpad, James Harrop, Bizhan Aarabi, Vafa Rahimi-Movaghar, Jefferson R Wilson, Benjamin M Davies, Mark R N Kotter, James D Guest

Department of Neurosurgery Faculty Papers

Study design: Narrative review.

Objectives: To provide an overview of contemporary therapies for the James Lind Alliance priority setting partnership for degenerative cervical myelopathy (DCM) question: 'Can novel therapies, including stem-cell, gene, pharmacological and neuroprotective therapies, be identified to improve the health and wellbeing of people living with DCM and slow down disease progression?'

Methods: A review of the literature was conducted to outline the pathophysiology of DCM and present contemporary therapies that may hold therapeutic value in 3 broad categories of neuroprotection, neuroregeneration, and neuromodulation.

Results: Chronic spinal cord compression leads to ischaemia, neuroinflammation, demyelination, and neuronal loss. Surgical …

Degenerative Cervical Myelopathy: Development And Natural History [Ao Spine Recode-Dcm Research Priority Number 2]., Aria Nouri, Enrico Tessitore, Granit Molliqaj, Torstein Meling, Karl Schaller, Hiroaki Nakashima, Yasutsugu Yukawa, Josef Bednarik, Allan R Martin, Peter Vajkoczy, Joseph S Cheng, Brian K Kwon, Shekar N Kurpad, Michael G Fehlings, James S Harrop, Bizhan Aarabi, Vafa Rahimi-Movaghar, James D Guest, Benjamin M Davies, Mark R N Kotter, Jefferson R Wilson

Department of Neurosurgery Faculty Papers

Study design: Narrative review.

Objectives: To discuss the current understanding of the natural history of degenerative cervical myelopathy (DCM).

Methods: Literature review summarizing current evidence pertaining to the natural history and risk factors of DCM.

Results: DCM is a common condition in which progressive arthritic disease of the cervical spine leads to spinal cord compression resulting in a constellation of neurological symptoms, in particular upper extremity dysfunction and gait impairment. Anatomical factors including cord-canal mismatch, congenitally fused vertebrae and genetic factors may increase individuals' risk for DCM development. Non-myelopathic spinal cord compression (NMSCC) is a common phenomenon with a prevalence …

Developing Peri-Operative Rehabilitation In Degenerative Cervical Myelopathy [Ao Spine Recode-Dcm Research Priority Number 6]: An Unexplored Opportunity?, Timothy F Boerger, Allison S Hyngstrom, Julio C Furlan, Sukhvinder Kalsi-Ryan, Armin Curt, Brian K Kwon, Shekar N Kurpad, Michael G Fehlings, James Harrop, Bizhan Aarabi, Vafa Rahimi-Movaghar, James D Guest, Jefferson R Wilson, Benjamin M Davies, Mark R N Kotter, Paul A Koljonen

Department of Neurosurgery Faculty Papers

Study design: Narrative review.

Objective: Degenerative cervical myelopathy is one of the most frequent impairments of the spinal cord encountered internationally in adults. Currently, surgical decompression is the recommended treatment for people with DCM (PwCM) presenting with moderate to severe symptoms or neurological deficits. However, despite surgical intervention, not all patients make a complete recovery due to the irreversible tissue damage within the spinal cord. The objective of this review is to describe the state and gaps in the current literature on rehabilitation for PwCM and possible innovative rehabilitation strategies.

Methods: Literature search.

Results: In other neurological disorders such as …

A New Framework For Investigating The Biological Basis Of Degenerative Cervical Myelopathy [Ao Spine Recode-Dcm Research Priority Number 5]: Mechanical Stress, Vulnerability And Time, Benjamin M Davies, Oliver Mowforth, Aref-Ali Gharooni, Lindsay Tetreault, Aria Nouri, Rana S Dhillon, Josef Bednarik, Allan R Martin, Adam Young, Hitoshi Takahashi, Timothy F Boerger, Virginia Fj Newcombe, Carl Moritz Zipser, Patrick Freund, Paul Aarne Koljonen, Ricardo Rodrigues-Pinto, Vafa Rahimi-Movaghar, Jefferson R Wilson, Shekar N Kurpad, Michael G Fehlings, Brian K Kwon, James Harrop, James D Guest, Armin Curt, Mark R N Kotter

Department of Neurosurgery Faculty Papers

Study design: Literature Review (Narrative).

Objective: To propose a new framework, to support the investigation and understanding of the pathobiology of DCM, AO Spine RECODE-DCM research priority number 5.

Methods: Degenerative cervical myelopathy is a common and disabling spinal cord disorder. In this perspective, we review key knowledge gaps between the clinical phenotype and our biological models. We then propose a reappraisal of the key driving forces behind DCM and an individual's susceptibility, including the proposal of a new framework.

Results: Present pathobiological and mechanistic knowledge does not adequately explain the disease phenotype; why only a subset of patients with …

James Lind Alliance Priority Setting Partnership For Degenerative Cervical Myelopathy [Ao Spine Recode-Dcm]: An Overview Of The Methodology Used To Process And Short-List Research Uncertainties, Lindsay Tetreault, Oliver Mowforth, Danyal Z Khan, Toto Gronlund, Philip Garwood, Olesja Hazenbiller, James S Harrop, Bizhan Aarabi, Vafa Rahimi-Movaghar, Shekar N Kurpad, James D Guest, Jefferson R Wilson, Brian K Kwon, Michael G Fehlings, Benjamin M Davies, Mark R N Kotter

Department of Neurosurgery Faculty Papers

Study design: Overview of the methods used for a James Lind Alliance (JLA) Priority Setting Partnership (PSP).

Objectives: The objectives of this article are to (i) provide a brief overview of the JLA-facilitated PSP process; (ii) outline how research uncertainties were initially processed in the AO Spine RECODE-DCM PSP; and (iii) delineate the methods for interim prioritization and the priority setting workshop.

Methods: A steering group was created to define the scope for the PSP, organize its activities, and establish protocols for decision-making. A survey was created asking what questions on the diagnosis, treatment, and long-term management of DCM should …

Pathogenic Tnf-Α Drives Peripheral Nerve Inflammation In An Aire-Deficient Model Of Autoimmunity, Yan Wang, Lily Guo, Xihui Yin, Ethan C Mccarthy, Mandy I Cheng, Aline T Hoang, Ho-Chung Chen, Anushi Y Patel, Denise Allard Trout, Erin Xu, Natalie Yakobian, Willy Hugo, James F Howard, Katherine M Sheu, Alexander Hoffmann, Melissa G Lechner, Maureen A Su

Department of Neurology Faculty Papers

Immune cells infiltrate the peripheral nervous system (PNS) after injury and with autoimmunity, but their net effect is divergent. After injury, immune cells are reparative, while in inflammatory neuropathies (e.g., Guillain Barré Syndrome and chronic inflammatory demyelinating polyneuropathy), immune cells are proinflammatory and promote autoimmune demyelination. An understanding of immune cell phenotypes that distinguish these conditions may, therefore, reveal new therapeutic targets for switching immune cells from an inflammatory role to a reparative state. In an autoimmune regulator (Aire)-deficient mouse model of inflammatory neuropathy, we used single-cell RNA sequencing of sciatic nerves to discover a transcriptionally heterogeneous cellular landscape, including …

A Taxonomy Of Childhood Pedal Cyclist Injuries From Latent Class Analysis: Associations With Factors Pertinent To Prevention, Joseph Piatt

Department of Neurosurgery Faculty Papers

Background: Studies of pedal cyclist injuries have largely focused on individual injury categories, but every region of the cyclist's body is exposed to potential trauma. Real-world injury patterns can be complex, and isolated injuries to one body part are uncommon among casualties requiring hospitalization. Latent class analysis (LCA) may identify important patterns in heterogeneous samples of qualitative data.

Methods: Data were taken from the Trauma Quality Improvement Program of the American College of Surgeons for 2017. Inclusion criteria were age 18 years or less and an external cause of injury code for pedal cyclist. Injuries were characterized by Abbreviated Injury …

Atypical Ataxia Presentation In Variant Ataxia Telangiectasia: Iranian Case-Series And Review Of The Literature, Tannaz Moeini Shad, Reza Yazdani, Parisa Amirifar, Samaneh Delavari, Marzieh Heidarzadeh Arani, Seyed Alireza Mahdaviani, Mahnaz Sadeghi-Shabestari, Asghar Aghamohammadi, Nima Rezaei, Hassan Abolhassani

Department of Neurology Faculty Papers

Ataxia-telangiectasia (AT) is a rare autosomal recessive neurodegenerative multisystem disorder. A minority of AT patients can present late-onset atypical presentations due to unknown mechanisms. The demographic, clinical, immunological and genetic data were collected by direct interview and examining the Iranian AT patients with late-onset manifestations. We also conducted a systematic literature review for reported atypical AT patients. We identified three Iranian AT patients (3/249, 1.2% of total registry) with later age at ataxia onset and slower neurologic progression despite elevated alpha-fetoprotein levels, history of respiratory infections, and immunological features of the syndrome. Of note, all patients developed autoimmunity in which …

The Relationship Between Malignant Tumors And Ischemic Stroke: Ii. Chronology Of Diagnoses And Treatment Of Strokes, Nóra Hajnóczky, Dániel Bereczki

Department of Medicine Faculty Papers

Összefoglaló. A malignus daganatok és a stroke együttesen gyakran fordulnak elő a stroke tradicionális rizikófaktoraival (magas vérnyomás, hyperlipidaemia, cukorbetegség, elhízás, dohányzás) rendelkező betegekben. Az elmúlt évtized kutatási eredményei alátámasztották, hogy a rosszindulatú daganatban szenvedő betegekben szignifikánsan nagyobb a stroke kockázata. A malignus daganatokhoz társuló stroke a leggyakrabban a malignus daganat diagnózisát követő fél-egy év során jelentkezik. A kapcsolat a másik irányban is létezik: stroke-betegek követése során malignus daganat szignifikánsan gyakrabban jelent meg, mint a stroke-mentes kontrollcsoportban. A daganatot a leginkább a stroke utáni első hat hónapban diagnosztizálják. A korábban nem ismert rosszindulatú daganat időnként az akut stroke kezelése során derül …

Care Gaps And Recommendations In Vestibular Migraine: An Expert Panel Summit, Monica P Mallampalli, Habib G Rizk, Amir Kheradmand, Shin C Beh, Mehdi Abouzari, Alaina M Bassett, James Buskirk, Claire E J Ceriani, Matthew G Crowson, Hamid Djalilian, Joel A Goebel, Jeffery J Kuhn, Anne E Luebke, Marco Mandalà, Magdalena Nowaczewska, Nicole Spare, Roberto Teggi, Maurizio Versino, Hsiangkuo Yuan, Ashley Zaleski-King, Michael Teixido, Frederick Godley

Department of Neurology Faculty Papers

Vestibular migraine (VM) is an increasingly recognized pathology yet remains as an underdiagnosed cause of vestibular disorders. While current diagnostic criteria are codified in the 2012 Barany Society document and included in the third edition of the international classification of headache disorders, the pathophysiology of this disorder is still elusive. The Association for Migraine Disorders hosted a multidisciplinary, international expert workshop in October 2020 and identified seven current care gaps that the scientific community needs to resolve, including a better understanding of the range of symptoms and phenotypes of VM, the lack of a diagnostic marker, a better understanding of …

Krabbe Disease: A Personal Perspective And Hypothesis, Mohammad Rafi

Department of Neurology Faculty Papers

Introduction: Krabbe disease (KD) or globoid cell leukodystrophy (GLD) is one of the lysosomal disorders affecting central and peripheral nervous systems (CNS and PNS). It is caused by mutations on the galactocerebrosidase (GALC) gene. Affected individuals accumulate undegraded substrates and suffer from neuroinflammation. Methods: Hematopoietic stem cell transplantation (HSCT) has been partially successful in treating patients with KD when accomplished prior to the onset of symptoms. The success is credited to the ability of the hematopoietic stem cells in providing some GALC enzyme to the CNS and eradicating potential neuroinflammation. Combination of the HSCT with some other GALC-providing strategies has …

Reduced Risk Of Reoperations With Modern Deep Brain Stimulator Systems: Big Data Analysis From A United States Claims Database, Chengyuan Wu, Sean J Nagel, Rahul Agarwal, Monika Pötter-Nerger, Wolfgang Hamel, Ashwini Sharan, Allison T Connolly, Binith Cheeran, Paul S Larson

Department of Neurosurgery Faculty Papers

Objective: There have been significant improvements in the design and manufacturing of deep brain stimulation (DBS) systems, but no study has considered the impact of modern systems on complications. We sought to compare the relative occurrence of reoperations after de novo implantation of modern and traditional DBS systems in patients with Parkinson's disease (PD) or essential tremor (ET) in the United States.

Design: Retrospective, contemporaneous cohort study.

Setting: Multicenter data from the United States Centers for Medicare and Medicaid Services administrative claims database between 2016 and 2018.

Participants: This population-based sample consisted of 5,998 patients implanted with a DBS system, …

Outcomes Of Mechanical Thrombectomy For Patients With Stroke Presenting With Low Alberta Stroke Program Early Computed Tomography Score In The Early And Extended Window, Eyad Almallouhi, Sami Al Kasab, Zachary Hubbard, Eric C Bass, Guilherme Porto, Ali Alawieh, Reda Chalhoub, Pascal Jabbour, Robert M Starke, Stacey Q Wolfe, Adam S Arthur, Edgar Samaniego, Ilko Maier, Brian M Howard, Ansaar Rai, Min S Park, Justin Mascitelli, Marios Psychogios, Reade De Leacy, Travis Dumont, Michael R Levitt, Adam Polifka, Joshua Osbun, Roberto Crosa, Joon-Tae Kim, Walter Casagrande, Shinichi Yoshimura, Charles Matouk, Peter T Kan, Richard W Williamson, Benjamin Gory, Maxim Mokin, Isabel Fragata, Osama Zaidat, Albert J Yoo, Alejandro M Spiotta

Department of Neurosurgery Faculty Papers

Importance: Limited data are available about the outcomes of mechanical thrombectomy (MT) for real-world patients with stroke presenting with a large core infarct.

Objective: To investigate the safety and effectiveness of MT for patients with large vessel occlusion and an Alberta Stroke Program Early Computed Tomography Score (ASPECTS) of 2 to 5.

Design, setting, and participants: This retrospective cohort study used data from the Stroke Thrombectomy and Aneurysm Registry (STAR), which combines the prospectively maintained databases of 28 thrombectomy-capable stroke centers in the US, Europe, and Asia. The study included 2345 patients presenting with an occlusion in the internal carotid …

Clinical Applications Of Magnetic Resonance Imaging Based Functional And Structural Connectivity, Chengyuan Wu, Francisca Ferreira, Michael Fox, Noam Harel, Jona Hattangadi-Gluth, Andreas Horn, Saad Jbabdi, Joshua Kahan, Ashwini Oswal, Sameer A Sheth, Yanmei Tie, Vejay Vakharia, Ludvic Zrinzo, Harith Akram

Department of Neurosurgery Faculty Papers

Advances in computational neuroimaging techniques have expanded the armamentarium of imaging tools available for clinical applications in clinical neuroscience. Non-invasive, in vivo brain MRI structural and functional network mapping has been used to identify therapeutic targets, define eloquent brain regions to preserve, and gain insight into pathological processes and treatments as well as prognostic biomarkers. These tools have the real potential to inform patient-specific treatment strategies. Nevertheless, a realistic appraisal of clinical utility is needed that balances the growing excitement and interest in the field with important limitations associated with these techniques. Quality of the raw data, minutiae of the …

Augmentation Of Pedicle Screws Using Bone Grafting In Patients With Spinal Osteoporosis, Andrey Evgenievich Bokov, Anatoliy Bulkin, I S. Bratsev, Svetlana Ya Kalinina, Sergey G. Mlyavykh, David G. Anderson

Department of Neurosurgery Faculty Papers

The aim of the study was to develop a new method of vertebral augmentation based on autologous and allogeneic bone chips to be used in pedicle screw fixation and to compare this method with the technique based on polymethyl methacrylate (PMMA). Materials and Methods. This prospective non-randomized study included 164 patients with degenerative pathologies or traumatic injuries of the lumbar spine and transitional thoracolumbar segments; 153 of the operated patients were followed up for 18 months. In these patients, radiodensity of the cancellous bone tissue was below 110 HU by the Hounsfield scale. Patients with degenerative spinal disorders underwent pedicle …

Igg4-Mediated Neurologic Autoimmunities: Understanding The Pathogenicity Of Igg4, Ineffectiveness Of Ivig, And Long-Lasting Benefits Of Anti-B Cell Therapies, Marinos Dalakas

Department of Neurology Faculty Papers

Background and objectives: Describe the unique functions of immunoglobulin G4 (IgG4) in IgG4-neurologic disorders (IgG4-ND) and explain why, in contrast to their IgG1-counterparts, they respond poorly to intravenous immune globulin (IVIg) but effectively to anti-B cell therapies.

Methods: The IgG4 structure and isotype switch, B cells and plasmablasts relevant to IgG4 production, and IgG4-induced disruption of the targeted antigens are reviewed and compared with IgG1-mediated autoimmune ND, where IVIg inhibits IgG1-triggered inflammatory effects.

Results: The main IgG4-ND include muscle-specific kinase myasthenia; nodal/paranodal chronic inflammatory demyelinating polyradiculoneuropathy with antibodies to neurofascin-155, contactin-1/caspr-1, or pan-neurofascins; antileucine-rich, glioma-inactivated-1 and contactin-associated protein-like 2 associated-limbic …

Spect Functional Neuroimaging Distinguishes Adult Attention Deficit Hyperactivity Disorder From Healthy Controls In Big Data Imaging Cohorts, Daniel G Amen, Theodore A Henderson, Andrew Newberg

Marcus Institute of Integrative Health Faculty Papers

Background: The diagnosis of attention deficit hyperactivity disorder (ADHD) relies on history and observation, as no reliable biomarkers have been identified. In this study, we compared a large single diagnosis group of patients with ADHD (combined, inattentive, and hyperactive) to healthy controls using brain perfusion single-photon emission computed tomography (SPECT) imaging to determine specific brain regions which could serve as potential biomarkers to reliably distinguish ADHD. Methods: In a retrospective analysis, subjects (n = 1,135) were obtained from a large multisite psychiatric database, where resting state (baseline) and on-task SPECT scans were obtained. Only baseline scans were analyzed in …

Efficacy And Safety Of Fremanezumab In Clinical Trial Participants Aged ≥60 Years With Episodic Or Chronic Migraine: Pooled Results From 3 Randomized, Double-Blind, Placebo-Controlled Phase 3 Studies, Stephanie J. Nahas, Steffen Naegel, Joshua M Cohen, Xiaoping Ning, Lindsay Janka, Verena Ramirez Campos, Lynda J Krasenbaum, Dagny Holle-Lee, David Kudrow, Christian Lampl

Department of Neurology Faculty Papers

Background: Although migraine is less common in older people, preventive treatment of migraine in these individuals may be more challenging due to the presence of multiple comorbidities and polypharmacy. Additionally, evidence for migraine treatment efficacy, safety, and tolerability is limited in this population. We evaluated efficacy, safety, and tolerability of fremanezumab, a fully humanized monoclonal antibody (IgG2Δa) that selectively targets calcitonin gene-related peptide (CGRP), in clinical trial participants aged ≥60 years with episodic migraine (EM) or chronic migraine (CM).

Methods: This analysis included data from 3 randomized, double-blind, placebo-controlled phase 3 studies: the HALO EM study, HALO CM study, and …

Accuracy Of High-Frequency Oscillations Recorded Intraoperatively For Classification Of Epileptogenic Regions., Shennan A Weiss, Richard J Staba, Ashwini Sharan, Chengyuan Wu, Daniel Y. Rubinstein, Sandhitsu Das, Zachary J. Waldman, Iren Orosz, Gregory Worrell, Jerome Engel, Michael R Sperling

Department of Neurology Faculty Papers

To see whether acute intraoperative recordings using stereo EEG (SEEG) electrodes can replace prolonged interictal intracranial EEG (iEEG) recording, making the process more efficient and safer, 10 min of iEEG were recorded following electrode implantation in 16 anesthetized patients, and 1–2 days later during non-rapid eye movement (REM) sleep. Ripples on oscillations (RonO, 80–250 Hz), ripples on spikes (RonS), sharp-spikes, fast RonO (fRonO, 250–600 Hz), and fast RonS (fRonS) were semi-automatically detected. HFO power and frequency were compared between the conditions using a generalized linear mixed-effects model. HFO rates were compared using a two-way repeated measures ANOVA with anesthesia type …

Risk Factors Associated With Long Covid Syndrome: A Retrospective Study, A A Asadi-Pooya, Ali Akbari, Amir Emami, Mehrzad Lotfi, Mahtab Rostamihosseinkhani, Hamid Nemati, Zohreh Barzegar, Maryam Kabiri, Zahra Zeraatpisheh, Mohsen Farjoud-Kouhanjani, Anahita Jafari, Fateme Sasannia, Shayan Ashrafi, Masoume Nazeri, Sara Nasiri, Mina Shahisavandi

Department of Neurology Faculty Papers

Background: Recently, people have recognized the post-acute phase symptoms of the COVID-19. We investigated the long-term symptoms associated with COVID-19, (Long COVID Syndrome), and the risk factors associated with it. Methods: This was a retrospective observational study. All the consecutive adult patients referred to the healthcare facilities anywhere in Fars province from 19 February 2020 until 20 November 2020 were included. All the patients had a confirmed COVID-19 diagnosis. In a phone call to the patients, at least three months after their discharge from the hospital, we obtained their current information. The IBM SPSS Statistics (version 25.0) was used. Pearson …

Temozolomide Rechallenge In Patients With Recurrent High-Grade Glioma Treated With Re-Irradiation, Mustafa Basree, Ayesha Ali, Shivank Garg, Jonathan Glass, Lyndon Kim, Christopher J Farrell, James J. Evans, Kevin Judy, David W. Andrews, Wenyin Shi, Maria Werner-Wasik, Joshua Palmer

Department of Neurosurgery Faculty Papers

PURPOSE/OBJECTIVE(S): To evaluate the clinical role of temozolomide rechallenge (TMZ) in patients with recurrent high-grade glioma (HGG) treated with re-irradiation (re-RT) regardless of surgical status. MATERIALS/METHODS: Single-center retrospective review of patients with a primary diagnosis of World Health Organization (WHO) Grade III anaplastic astrocytoma or Grade IV GBM treated from 2008 to 2016 for disease recurrence with re-RT (35 Gy in 10 fractions) with and without temozolomide rechallenge. Baseline characteristics were analyzed with pairwise tests. OS/PFS were assessed with the Kaplan-Meier method and multivariable cox regression models for OS. RESULTS: Two hundred and thirty patients were treated with re-irradiation (n …

Contributions Of Iranian Journal Of Medical Sciences (Ijms) During The Covid-19 Pandemic., A A Asadi-Pooya, Mohsen Farazdaghi, Marzieh Rostaminejad, Manica Negahdaripour

Department of Neurology Faculty Papers

No abstract provided.

Relationship Of Age, Atherosclerosis And Angiographic Stenosis Using Artificial Intelligence, Rebecca Jonas, James Earls, Hugo Marques, Hyuk-Jae Chang, Jung Hyun Choi, Joon-Hyung Doh, Ae-Young Her, Bon Kwon Koo, Chang-Wook Nam, Hyung-Bok Park, Sanghoon Shin, Jason Cole, Alessia Gimelli, Muhammad Akram Khan, Bin Lu, Yang Gao, Faisal Nabi, Ryo Nakazato, U Joseph Schoepf, Roel S Driessen, Michiel J Bom, Randall C Thompson, James J Jang, Michael Ridner, Chris Rowan, Erick Avelar, Philippe Généreux, Paul Knaapen, Guus A De Waard, Gianluca Pontone, Daniele Andreini, Mouaz H Al-Mallah, Robert Jennings, Tami R Crabtree, Todd C Villines, James K Min, Andrew D Choi

Department of Neurosurgery Faculty Papers

Objective: The study evaluates the relationship of coronary stenosis, atherosclerotic plaque characteristics (APCs) and age using artificial intelligence enabled quantitative coronary computed tomographic angiography (AI-QCT).

Methods: This is a post-hoc analysis of data from 303 subjects enrolled in the CREDENCE (Computed TomogRaphic Evaluation of Atherosclerotic Determinants of Myocardial IsChEmia) trial who were referred for invasive coronary angiography and subsequently underwent coronary computed tomographic angiography (CCTA). In this study, a blinded core laboratory analysing quantitative coronary angiography images classified lesions as obstructive (≥50%) or non-obstructive (<50%) while AI software quantified APCs including plaque volume (PV), low-density non-calcified plaque (LD-NCP), non-calcified plaque (NCP), calcified plaque (CP), lesion length on a per-patient and per-lesion basis based on CCTA imaging. Plaque measurements were normalised for vessel volume and reported as % percent atheroma volume (%PAV) for all relevant plaque components. Data were subsequently stratified by age <65 and ≥65 years.

Results: The cohort was 64.4±10.2 years and 29% women. Overall, patients >65 had more PV …

Electroencephalography In Patients With Autism Spectrum Disorder, A A Asadi-Pooya

Department of Neurology Faculty Papers

No abstract provided.

Multiple-Brain Systems Dynamically Interact During Tonic And Phasic States To Support Language Integrity In Temporal Lobe Epilepsy, Shilpi Modi, Xiaosong He, Kapil Chaudhary, Walter Hinds, Andrew Crow, Ashithkumar Beloor-Suresh, Michael R Sperling, Joseph I Tracy

Department of Neurology Faculty Papers

An epileptogenic focus in the dominant temporal lobe can result in the reorganization of language systems in order to compensate for compromised functions. We studied the compensatory reorganization of language in the setting of left temporal lobe epilepsy (TLE), taking into account the interaction of language (L) with key non-language (NL) networks such as dorsal attention (DAN), fronto-parietal (FPN) and cingulo-opercular (COpN), with these systems providing cognitive resources helpful for successful language performance. We applied tools from dynamic network neuroscience to functional MRI data collected from 23 TLE patients and 23 matched healthy controls during the resting state (RS) and …