Neurology Commons^™

Quick! Which Scanner Should The Patient Go To?, Nicholas Johnson, Farnaz Norozian

School of Medicine Research Poster Showcase

Introduction Rarely does a pediatric patient have a stroke, but when they do what imaging modality is best suited? EMS tele comes in activating a stroke alert. An 11 year old otherwise healthy male presented with 10 hours of left sided sensation changes, waking up with dense left hemiparesis.14 days prior he had been on amusement park rides resulting in headache with vomiting since resolved. On arrival, slight hypertension for age otherwise hemodynamically stable, glucose normal, EKG demonstrated sinus rhythm. No history of genetic blood or clotting disorder. PICU and ER attendings discussion resulted in MRI as the initial imaging …

A Comparison Of Spinal Reflex Function And Morphological Adaptations Of The Achilles Tendon Between Individuals Chronically Post-Stroke And Healthy Controls, Migi Contreras, Mira Seekins, Johanna Mendez, Trevor Diez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: The hallmark gait deviation in individuals with post-stroke hemiparesis is slow walking speed. Reduction in gait speed after stroke is influenced by decreased propulsive forces, which may likely be related to impaired spinal circuit function and spasticity of the paretic plantarflexors. Chronic muscle tone maladaptations in paretic ankle plantarflexors can result in altered Achilles tendon (AT) morphology, therefore leading to altered mechanical properties, force transmission capabilities and subsequent insufficient propulsive forces during walking. The purpose of this study is to characterize the chronic maladaptations in both the spinal Ia afferent loop excitability and AT morphology after stroke lesions in …

Brain Functional Topology Differs By Sex In Cognitively Normal Older Adults, Zhengshi Yang, Filippo Cieri, Jefferson W. Kinney, Jeffrey L. Cummings, Dietmar Cordes, Jessica Z K Caldwell

Brain Health Faculty Research

Introduction: Late onset Alzheimer’s disease (AD) is the most common form of dementia, in which almost 70% of patients are women. Hypothesis: We hypothesized that women show worse global FC metrics compared to men, and further hypothesized a sex-specific positive correlation between FC metrics and cognitive scores in women. Methods: We studied cognitively healthy individuals from the Alzheimer’s Disease Neuroimaging Initiative cohort, with resting-state functional Magnetic Resonance Imaging. Metrics derived from graph theoretical analysis and functional connectomics were used to assess the global/regional sex differences in terms of functional integration and segregation, considering the amyloid status and the contributions of …

The Rey Auditory Verbal Learning Test: Cross-Validation Of Mayo Normative Studies (Mns) Demographically Corrected Norms With Confidence Interval Estimates, David W. Loring, Jessica L. Saurman, Samantha E. John, Stephen C. Bowden, James J. Lah, Felicia C. Goldstein

Brain Health Faculty Research

Objective: The Mayo Normative Studies (MNS) represents a robust dataset that provides demographically corrected norms for the Rey Auditory Verbal Learning Test. We report MNS application to an independent cohort to evaluate whether MNS norms accurately adjust for age, sex, and education differences in subjects from a different geographic region of the country. As secondary goals, we examined item-level patterns, recognition benefit compared to delayed free recall, and derived Auditory Verbal Learning Test (AVLT) confidence intervals (CIs) to facilitate clinical performance characterization. Method: Participants from the Emory Healthy Brain Study (463 women, 200 men) who were administered the AVL were …

Mechanisms Of Memory Updating: State Dependency Vs. Reconsolidation, Christopher Kiley, Colleen M. Parks

Psychology Faculty Research

Reactivating a memory trace has been argued to put it in a fragile state where it must undergo a stabilization process known as reconsolidation. During this process, memories are thought to be susceptible to interference and can be updated with new information. In the spatial context paradigm, memory updating has been shown to occur when new information is presented in the same spatial context as old information, an effect attributed to a reconsolidation process. However, the integration concept holds that memory change can only occur when reactivation and test states are the same, similar to a state-dependent effect. Thus, in …

Developing Methods To Detect And Diagnose Chronic Traumatic Encephalopathy During Life: Rationale, Design, And Methodology For The Diagnose Cte Research Project, Jeffrey Cummings, Numerous Authors, See Full List Below

School of Medicine Faculty Research

Background: Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease that has been neuropathologically diagnosed in brain donors exposed to repetitive head impacts, including boxers and American football, soccer, ice hockey, and rugby players. CTE cannot yet be diagnosed during life. In December 2015, the National Institute of Neurological Disorders and Stroke awarded a seven-year grant (U01NS093334) to fund the “Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of Chronic Traumatic Encephalopathy (DIAGNOSE CTE) Research Project.” The objectives of this multicenter project are to: develop in vivo fluid and neuroimaging biomarkers for CTE; characterize its clinical presentation; refine …

Trial Of Pimavanserin In Dementia-Related Psychosis, Pierre N. Tariot, Jeffrey L. Cummings, Maria E. Soto-Martin, Clive Ballard, Deniz E. Erten-Lyons, David L. Sultzer, Davangere P. Devanand, Daniel Weintraub, Bradley Mcevoy, James M. Youakim, Srdjan Stankovic, Erin P. Foff

School of Medicine Faculty Research

BACKGROUND Patients with dementia due to neurodegenerative disease can have dementia-related psychosis. The effects of the oral 5-HT2A inverse agonist and antagonist pimavanserin on psychosis related to various causes of dementia are not clear. METHODS We conducted a phase 3, double-blind, randomized, placebo-controlled discontinuation trial involving patients with psychosis related to Alzheimer's disease, Parkinson's disease dementia, dementia with Lewy bodies, frontotemporal dementia, or vascular dementia. Patients received open-label pimavanserin for 12 weeks. Those who had a reduction from baseline of at least 30% in the score on the Scale for the Assessment of Positive Symptoms-Hallucinations and Delusions (SAPS-H+D, with higher …

Aducanumab: Appropriate Use Recommendations, Jeffrey Cummings, P. Aisen, L. G. Apostolova, A. Atri, S. Salloway, M. Weiner

School of Medicine Faculty Research

Aducanumab has been approved by the US Food and Drug Administration for treatment of Alzheimer’s disease (AD). Clinicians require guidance on the appropriate use of this new therapy. An Expert Panel was assembled to construct Appropriate Use Recommendations based on the participant populations, conduct of the pivotal trials of aducanumab, updated Prescribing Information, and expert consensus. Aducanumab is an amyloid-targeting monoclonal antibody delivered by monthly intravenous infusions. The pivotal trials included patients with early AD (mild cognitive impairment due to AD and mild AD dementia) who had confirmed brain amyloid using amyloid positron tomography. The Expert Panel recommends that use …

Assessing Clinical Change In Individuals Exposed To Repetitive Head Impacts: The Repetitive Head Impact Composite Index, Charles Bernick, Guogen Shan, Lauren Bennett, Jay Alberts, Jeffrey Cummings

School of Public Health Faculty Research

Background: There is a current lack of any composite measure for the effective tracking and monitoring of clinical change in individuals exposed to repetitive head impacts (RHI). The aim of this study is to create a composite instrument for the purposes of detecting change over time in cognitive and behavioral function in individuals exposed to RHI. Methods: The data to derive the composite instrument came from the Professional Fighters Brain Health Study (PFBHS), a longitudinal study of active and retired professional fighters [boxers and mixed martial arts (MMA) fighters] and healthy controls. Participants in the PFBHS underwent assessment on an …

Chronic Traumatic Encephalopathy And The Built Environment, Dak Kopec, Kendall Marsh

Architecture Faculty Research

© 2020, Faculty of Engineering, Universitas Indonesia. All rights reserved. Traumatic Brain Injuries (TBIs) are often connected to the development of Chronic Traumatic Encephalopathy (CTE), a degenerative brain disease commonly found in athletes, military veterans, and others that have a history of repetitive brain trauma. This formative exploratory study looked at person-centred design techniques for a person with CTE. The person-centred design method used for this study was based on a two-tiered reductionist approach; the first tier was to identify common symptoms and concerns associated with CTE from the literature. This information provided specific symptoms that were addressed through brainstorming …

Longitudinal Change In Regional Brain Volumes With Exposure To Repetitive Head Impacts, Charles Bernick, Guogen Shan, Henrik Zetterberg, Sarah Banks, Virendra R. Mishra, Lynn Bekris, James B. Leverenz, Kaj Blennow

Environmental & Global Health Faculty Research

Objective This study tests the hypothesis that certain MRI-based regional brain volumes will show reductions over time in a cohort exposed to repetitive head impacts (RHI). Methods Participants were drawn from the Professional Fighters Brain Health Study, a longitudinal observational study of professional fighters and controls. Participants underwent annual 3T brain MRI, computerized cognitive testing, and blood sampling for determination of neurofilament light (NfL) and tau levels. Yearly change in regional brain volume was calculated for several predetermined cortical and subcortical brain volumes and the relationship with NfL and tau levels determined. Results A total of 204 participants who had …

Outcomes In Patients With Gunshot Wounds To The Brain, Leigh Anna Robinson, Lauren M. Turco, Bryce Robinson, Joshua G. Corsa, Michael Mount, Amy V. Hamrick, John Berne, Dalier R. Mederos, Allison G. Mcnickle, Paul J. Chestovich, Jason Weinberger, Areg Grigorian, Jeffry Nahmias, Jane K. Lee, Kevin L. Chow, Erik J. Olson, Jose L. Pascual, Rachele Solomon, Danielle A. Pigneri, Husayn A. Ladhani, Joanne Fraifogl, Terry Curry, Todd W. Costantini, Manasnun Kongwibulwut, Haytham Kaafarani, Janika San Roman, Craig Schreiber, Anna Goldenberg-Sandau, Parker Hu, Patrick Bosarge, Rindi Uhlich

School of Medicine Faculty Research

Introduction: Gunshot wounds to the brain (GSWB) confer high lethality and uncertain recovery. It is unclear which patients benefit from aggressive resuscitation, and furthermore whether patients with GSWB undergoing cardiopulmonary resuscitation (CPR) have potential for survival or organ donation. Therefore, we sought to determine the rates of survival and organ donation, as well as identify factors associated with both outcomes in patients with GSWB undergoing CPR. Methods: We performed a retrospective, multicenter study at 25 US trauma centers including dates between June 1, 2011 and December 31, 2017. Patients were included if they suffered isolated GSWB and required CPR at …

A 24-Week Double-Blind Placebo-Controlled Study Of The Efficacy And Safety Of The Ampa Modulator S47445 In Patients With Mild To Moderate Alzheimer's Disease And Depressive Symptoms, Eileen M. Bulger, Sylvie Gouttefangeas, Sylvie Bretin, Stéphanie Galtier, Philippe Robert, Vjera Holthoff-Detto, Jeffrey Cummings, Maria Pueyo

School of Medicine Faculty Research

Introduction S47445 is a novel positive allosteric modulator of alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid receptors that may emerge as a favorable candidate for the symptomatic treatment of cognitive and depressive disorders in patients suffering from Alzheimer's disease (AD) of mild to moderate severity and with depressive symptoms. Methods For this double-blind, placebo-controlled 24-week phase II trial, 520 outpatients aged between 55 and 85 years, with probable AD at mild to moderate stages (a Mini-Mental State Examination score of 24-15 inclusive) and exhibiting depressive symptoms (Cornell Scale for Depression in Dementia [CSDD] ≥ 8) were recruited in twelve countries and randomized to 3 doses …

Asymmetric Crying Facies Syndrome, Kai-Yu Ho Pt, Phd, Jing Nong Liang Pt, Phd

Physical Therapy Faculty Research

A female infant, born vaginally at 40 weeks of gestation with a birthweight of 3260 g had an Apgar score of 10 at 1 and 5 minutes. She presented with an asymmetric facial expression when crying, with the right side of her mouth deviating inferior-laterally (Figure, A and Video[available at www.jpeds.com]). At rest, her facial expression was symmetric and a thinner left lower lip was noted (Figure, B). A pediatricneurologist noted intact motor, reflex, and cranial nerve functions, and she was diagnosed with asymmetric crying facies, likely because of hypoplasia of the left depressor angularis oris muscle. Asymmetric crying facies …

Treatment Combinations For Alzheimer’S Disease: Current And Future Pharmacotherapy Options, Jeffrey L. Cummings, Gary Tong, Clive Ballard

Integrated Health Sciences Faculty Research

Although Alzheimer’s disease (AD) is the world’s leading cause of dementia and the population of patients with AD continues to grow, no new therapies have been approved in more than a decade. Many clinical trials of single-agent therapies have failed to affect disease progression or symptoms compared with placebo. The complex pathophysiology of AD may necessitate combination treatments rather than monotherapy. The goal of this narrative literature review is to describe types of combination therapy, review the current clinical evidence for combination therapy regimens (both symptomatic and disease-modifying) in the treatment of AD, describe innovative clinical trial study designs that …

Stochastic Modeling Of Radiation-Induced Dendritic Damage On In Silico Mouse Hippocampal Neurons, Eliedonna Cacao, Vipan K. Parihar, Charles L. Limoli, Francis A. Cucinotta

Health Physics and Diagnostic Sciences Faculty Research

Cognitive dysfunction associated with radiotherapy for cancer treatment has been correlated to several factors, one of which is changes to the dendritic morphology of neuronal cells. Alterations in dendritic geometry and branching patterns are often accompanied by deficits that impact learning and memory. The purpose of this study is to develop a novel predictive model of neuronal dendritic damages caused by exposure to low linear energy transfer (LET) radiation, such as X-rays, gamma-rays and high-energy protons. We established in silico representations of mouse hippocampal dentate granule cell layer (GCL) and CA1 pyramidal neurons, which are frequently examined in radiation-induced cognitive …

Biomarker And Clinical Trial Design Support For Disease-Modifying Therapies: Report Of A Survey Of The Eu/Us: Alzheimer's Disease Task Force, Jeffrey Cummings, Nick Fox, Bruno Vellas, Paul Aisen, Guogen Shan

Environmental & Global Health Faculty Research

BACKGROUND: Disease-modifying therapies are urgently needed for the treatment of Alzheimer’s disease (AD). The European Union/United States (EU/US) Task Force represents a broad range of stakeholders including biopharma industry personnel, academicians, and regulatory authorities. OBJECTIVES: The EU/US Task Force represents a community of knowledgeable individuals who can inform views of evidence supporting disease modification and the development of disease-modifying therapies (DMTs). We queried their attitudes toward clinical trial design and biomarkers in support of DMTs. DESIGN/SETTING/PARTICIANTS: A survey of members of the EU/US Alzheimer’s Disease Task Force was conducted. Ninety-three members (87%) responded. The details were analyzed to understand what …

Stroke Quality Measures In Mexican Americans And Non-Hispanic Whites, Darin B. Zahuranec, Lynda D. Lisabeth, Jonggyu Baek, Eric E. Adelman, Nelda M. Garcia, Erin C. Case, Morgan S. Campbell, Lewis Morgenstern

Journal of Health Disparities Research and Practice

Mexican Americans (MAs) have been shown to have worse outcomes after stroke than non-Hispanic Whites (NHWs), but it is unknown if ethnic differences in stroke quality of care may contribute to these worse outcomes. We investigated ethnic differences in the quality of inpatient stroke care between MAs and NHWs within the population-based prospective Brain Attack Surveillance in Corpus Christi (BASIC) Project (February 2009- June 2012). Quality measures for inpatient stroke care, based on the 2008 Joint Commission Primary Stroke Center definitions were assessed from the medical record by a trained abstractor. Two summary measure of overall quality were also created …

Sex Disparities In Access To Acute Stroke Care: Can Telemedicine Mitigate This Effect?, Catherine Wolff, Amelia K. Boehme, Karen Albright, Tzu-Ching Wu, Michael Mullen, Sean Savitz, Charles Branas, James Grotta, Brendan Carr

Journal of Health Disparities Research and Practice

Background: Women have more frequent and severe ischemic strokes than men, and are less likely to receive treatment for acute stroke. Primary stroke centers (PSCs) have been shown to utilize treatment more frequently. Further, as telemedicine (TM) has expanded access to acute stroke care we sought to investigate the association between PSC, TM and access to acute stroke care in the state of Texas.

Methods: Texas hospitals and resources were identified from the 2009 American Hospital Association Annual Survey. Hospitals were categorized as: (1) stand-alone PSCs not using telemedicine for acute stroke care, (2) PSCs using telemedicine for acute stroke …

Factor Structure Of The Cpt-Ii, Mary Vertinski

UNLV Theses, Dissertations, Professional Papers, and Capstones

The current study investigates the factor structure of the Conners' Continuous Performance Test-II (CPT-II) in four pediatric samples of participants: (a) patients with traumatic brain injury, (b) healthy controls, (c) patients with various clinical diagnoses, and (d) all of the previously mentioned subjects combined. Confirmatory factor analyses (CFA) were used to investigate a one-, three- and four-factor model fit of the data. None of the models examined were an adequate fit for the data; however, it appears that the four-factor model seemed to be the best fitting of the models examined. Failure to find reasonably adequate fit precluded further analyses.

Exercise-Induced Neuroprotection In A Hemiparkinsonian 6-Hydroxydopamine Rat Model, Merrill Russen Landers

UNLV Theses, Dissertations, Professional Papers, and Capstones

Outside of finding a cure, one of the preeminent goals of research in Parkinson's disease (PD) is finding a neuroprotective treatment that when applied prior to the onset of the disease will decrease the risk and severity of the subsequent disease. One such treatment that has potential as a neuroprotective agent in PD is exercise. Several studies have found forced exercise to be protective of Parkinson's disease in adult rodent models; however, few of these studies have used a design wherein voluntary exercise was evaluated. Moreover, no study has used a true neuroprotective design in which exercise was applied prior …

Program Evaluation Of Stroke In Rural Nevada Hospital, Starla Cheri Ricks

UNLV Theses, Dissertations, Professional Papers, and Capstones

The overall goal of this Doctor of Nursing Practice (DNP) scholarly project is to complete a program evaluation using the Centers of Disease Control (CDC) Framework for Program Evaluation to measure the effectiveness of a stroke protocol in a rural Nevada hospital. This (DNP) scholarly project evaluates program strategies over third and fourth quarters of 2010 as well as the first, second, and third quarters of 2011, that have been initiated to reduce the burden of neurological disease with the application of a stroke protocol that complies with defined evidence-based strategies for assessment and management of stroke victims. As part …

Effects Of Hyperthermia On Photochemical Internalization-Mediated Delivery Of Bleomycin, Christina Schlazer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Standard treatment protocols for high-grade gliomas, such as glioblastoma multiforme (GBM), are highly ineffective due to their inability to eradicate infiltrating tumor cells. Improvements in overall survival are likely to be realized only with the development of more effective localized therapies capable of eradicating tumor cells in the surgical resection margin and beyond. Photochemical internalization (PCI) is a localized light-based therapeutic modality that enhances the efficacy of therapeutic macromolecules including chemotherapeutic agents such as bleomycin. A number of studies have shown that this photodynamic therapy (PDT) - based modality may prove effective in the treatment of high-grade gliomas.

Three-dimensional multicell …

Electrical & Magnetic Stimulation And Health, Yiyan Li

College of Engineering: Graduate Celebration Programs

1, Introduction Most of the patients with neural diseases such as Parkinson’s disease, Stroke and Depression, cannot be cured by taking pills or conducting surgery. In contrast to the conventional therapies, physical therapies such as TMS (transcranial magnetic stimulation) (Fig. 1) and tDCS (transcranial direct current stimulation) (Fig. 2) are the most popular methods in treating neural disorders with a non-invasive way. TMS employs electromagnetic (1-3 Tesla) induction generates an Electric field suitable for neural stimulation; tDCS employs a weak current (1-2 mA) to modulate neuronal excitabilities.

The Effect Of Spiritualism On The Neuropsychological Function Of Memory, Carla Farcello

McNair Poster Presentations

The amount of physiological-neurological research performed over the past few years has dramatically increased due to our ability to view the structure and function of the brain in living human beings. The use of imaging tools has resulted in huge strides forward in unlocking some of the mysteries of the 3 pound universe-the human brain. One of the more unique neural processes being recently addressed is the affect of belief and spiritualism-the sense of being connected to something larger than oneself-on the human brain. This study hypothesized that better memory will be documented among the experimental group who report being …

Y-Aminobutyric Acid Inhibits Synergistic Interleukin-6 Release And Increases Intracellular Cytokine Content In C6 Astrocytoma Cells In Vitro, Daniella Sandoval, Becky M. Hess, Bryan L. Spangelo

Undergraduate Research Opportunities Program (UROP)

Alzheimer’s disease (AD) is a neurodegenerative disorder that is characterized by memory loss and is the most common cause of dementia. It is has been hypothesized that pro-inflammatory cytokines induce the inflammation that is believed to be the cause of the neuronal death that is associated with AD. γ-aminobutyric acid (GABA) is a major inhibitory neurotransmitter in the Central Nervous System possessing membrane hyperpolarization or depolarization activities. A decline in GABA may enhance cytokine release in Alzheimer’s disease resulting in neuroinflammation. Therefore, we investigated the GABA-mediated suppression of the synergistic release of interleukin-6 (IL-6) induced by interleukin 1- (IL-1) and …

Pms And Eosinophilia-Myalgia Syndrome, Mary Guinan

School of Public Health Faculty Research

No abstract provided.