Neurology Commons^™

Mentoring Ethics In Postgraduate Surgical Training: A Developing Country Perspective From Pakistan, Mohsin Azam, Saleha Anwar, Muhammad Shahzad Shamim, Muhammad Waqas

Section of Neurosurgery

No abstract provided.

Postgraduate Training In Neurosciences - Role Of The Specialty Societies, Junaid Ashraf

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Frequency Of Raised Plasma Homocysteine Levels In Patients Of Ischemic Stroke, Mohsin Zaheer, Muhammad Naeem

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

The Effectiveness Of Botlinum Toxin In The Management Of Benign Essential Blepharospasm And Hemifacial Spasm, Amanullah Khan Sarangzal, Noor Ahmed Khosa, Wazir Akbar

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Acute Disseminated Encephalomyelitis (Adem) Presenting As A Multiphasic Encephalopathy: A Case Report, Tehreem Zahra, Zarmast Khan, Ejaz Ahmed Khan, Arsalan Ahmad

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

13th Annual International Neurology Update Meeting & 6th Biennial Stroke Conference, 13th Annual International Neurology Update Meeting & 6th Biennial Stroke Conference

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Clinical Research Challenges: Insight From A Pilot Study At An Academic Healthcare Center, Gretchen E. Maurer

PCOM Biomedical Studies Student Scholarship

An investigational clinical research study was conducted at an academic healthcare center evaluating memantine as an adjunct to opioid therapy for treatment of chronic low back pain. The N-Methyl-D-Aspartate (NMDA) receptor is located in pain signaling neuronal synapses of the central nervous system. The receptor binds the excitatory neurotransmitter glutamate in addition to NMDA, to increase the magnitude of the perception of pain. Memantine (Namenda©) is a highly tolerated NMDA receptor antagonist which is currently prescribed in the treatment of Alzheimer’s disease. The purpose of the non-randomized pilot study without placebo was to evaluate the use of adding memantine as …

Sociocultural Influences On Diabetes Self-Management Behaviors In Older African Americans, Barry W. Rovner, Robin J. Casten, Lynn Fields Harris

Department of Psychiatry and Human Behavior Faculty Papers

Objective. The purpose of this observational study was to describe the associations between cultural beliefs that are prevalent in older African Americans and adherence to diabetes self-management (DSM) behaviors.

Methods. In a community population of 110 older African Americans with type 2 diabetes, the investigators administered surveys that assess present time orientation (PTO), future time orientation (FTO), and religiosity, as well as exercising habits, reading food labels, and checking blood glucose.

Results. Participants who reported regularly exercising had significantly lower PTO scores and higher FTO and religiosity scores than participants who did not regularly exercise. Similarly, participants who reported reading …

Challenges Posed By Mental Disorders, Substance Abuse And Neurological Disorders: Need For A Joint Action By Psychiatrists And Neurologists, Mowadat H Rana, Haider A Naqvi

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Chronic Relapsing Inflammatory Optic Neuropathy (Crion), Muhammad Athar Athar Javed, Adnan Hameed Gill Dr, Ahmad Furqan Dr

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Frequency Of Dementia In Parkinson’S Disease, Noor Ahmed Khosa, Ammanullah Kakar, Wazir Akbar

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Tuberculosis Affecting The Nervous System: Can We Trace The Source Of Infection?, Naila Shahbaz, Saima Kashif, Hina Mushtaq

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Distinct Phenotypes In Zebrafish Models Of Human Startle Disease, Lisa R. Ganser, Qing Yan, Victoria M. James, Robert Kozol, Maya Topf, Robert J. Harvey, Julia E. Dallman

Faculty Articles

Startle disease is an inherited neurological disorder that causes affected individuals to suffer noise- or touch-induced non-epileptic seizures, excessive muscle stiffness and neonatal apnea episodes. Mutations known to cause startle disease have been identified in glycine receptor subunit (GLRA1 and GLRB) and glycine transporter (SLC6A5) genes, which serve essential functions at glycinergic synapses. Despite the significant successes in identifying startle disease mutations, many idiopathic cases remain unresolved. Exome sequencing in these individuals will identify new candidate genes. To validate these candidate disease genes, zebrafish is an ideal choice due to rapid knockdown strategies, accessible embryonic stages, and stereotyped behaviors. The …

Caveolins And Njks Influence Brain Endothelial Permeability After Juvenile Tbi, David Olufemi Ajao

Loma Linda University Electronic Theses, Dissertations & Projects

Disruption of blood-brain barrier (BBB) is a key secondary event that exacerbates brain damage following traumatic brain injury (TBI). BBB disruption is particularly damaging to the developing brain – which is highly vulnerable to various stress stimuli, resulting in increased brain swelling, disrupted cerebral blood flow (CBF) autoregulation, long-term disabilities and death following TBI in young demographic. Unsurprisingly, BBB disruption and the resultant cerebral edema have emerged as therapeutic targets in juvenile TBI. It is therefore important to understand the molecular players and mechanisms involved in TBI-induced BBB disruption in the juvenile brain. To this end, the endothelial caveolins and …

Granulocyte-Colony Stimulating Factor For Mobilizing Bone Marrow Stem Cells In The Sub Acute Stroke. How Safe Is The Use Of Granulocyte-Colony Stimulating Factor In Sub-Acute Stroke? Is This Stem Cell Trial Of Recovery Enhancement Beneficial?, Fauzia Nomani, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

Dopaminergic Modulation Of Memory And Affective Processing In Parkinson Depression, Lee X. Blonder, John T. Slevin, Richard J. Kryscio, Catherine A. Martin, Anders H. Andersen, Charles D Smith, Frederick A. Schmitt

Magnetic Resonance Imaging and Spectroscopy Center Faculty Publications

Depression is common in Parkinson's disease and is associated with cognitive impairment. Dopaminergic medications are effective in treating the motor symptoms of Parkinson's disease; however, little is known regarding the effects of dopaminergic pharmacotherapy on cognitive function in depressed Parkinson patients. This study examines the neuropsychological effects of dopaminergic pharmacotherapy in Parkinsonian depression. We compared cognitive function in depressed and non-depressed Parkinson patients at two time-points: following overnight withdrawal and after the usual morning regimen of dopaminergic medications. A total of 28 non-demented, right-handed patients with mild to moderate idiopathic Parkinson's disease participated. Ten of these patients were depressed according …

Short Duration Waveforms Recorded Extracellularly From Freely Moving Rats Are Representative Of Axonal Activity, Ashlee A. Robbins, Steven E. Fox, Gregory L. Holmes, Rod C. Scott, Jeremy M. Barry

Dartmouth Scholarship

While extracellular somatic action potentials from freely moving rats have been well characterized, axonal activity has not. We report direct extracellular tetrode recordings of putative axons whose principal feature is a short duration waveform (SDW) with an average peak-trough length less than 179 μs. While SDW recordings using tetrodes have previously been treated as questionable or classified as cells, we hypothesize that they are representative of axonal activity. These waveforms have significantly shorter duration than somatic action potentials, are triphasic and are therefore similar to classic descriptions of microelectrode recordings in white matter and of in vitro action potential propagation …

Acceptance Of Disability And Its Predictors Among Stroke Patients In Taiwan, Shan-Yun Chiu, Hanoch Livneh, Long-Lung Tsao, Tzung-Yi Tsai

Counselor Education Faculty Publications and Presentations

Background: Modern medicine has increased the survival rate for stroke patients; however, the patient’s psychosocial adaptation after stroke onset may be related to the clinical outcomes. This study aimed to investigate patients’ acceptance of disability (AOD) and its predictors in stroke patients. Methods: This cross-sectional study used a purposive sampling method to recruit 175 stroke patients from a hospital in southern Taiwan. A structured questionnaire gathered data on respondent demographics and disease characteristics, and included the Chinese version of the AOD Scale-Revised. Factors associated with AOD were examined by a multiple linear regression analysis. Results: The mean AOD score was …

Two-Category Place Representations Persist Over Body Rotations, Hyoun Kyoung Pyoun, Jesse Sargent, Stephen Dopkins, John W. Philbeck

Neurological Surgery Faculty Publications

We explored a system that constructs environment-centered frames of reference and coordinates memory for the azimuth of an object in an enclosed space. For one group, we provided two environmental cues (doors): one in the front, and one in the rear. For a second group, we provided two object cues: a front and a rear cue.For a third group, we provided no external cues; we assumed that for this group, their reference frames would be determined by the orthogonal geometry of the floor-and-wall junction that divides a space in half or into multiple territories along the horizontal …

Diagnosis, Treatment And Follow-Up In Four Children With Biotinidase Deficiency From Pakistan, Bushra Afroze, Mohammad Wasay

Department of Medicine

Biotinidase deficiency is an inherited disorder in which the vitamin biotin is not recycled. If untreated, affected individuals develop neurological and cutaneous symptoms. Untreated individuals with biotinidase deficiency either succumb to disease or are left with significant morbidity. We describe clinical course and follow-up of 4 children from Pakistan. All 4 presented with classical symptoms of biotinidase deficiency and responded dramatically to oral biotin within days to weeks. Biotinidase deficiency is reported in Pakistani children from different part of world, however; there is no such report from Pakistan. This highlights lack of awareness of biotinidase deficiency among physicians in Pakistan

Citicoline In The Treatment Of Acute Ischaemic Stroke: An International, Randomized, Multicentre, Placebo-Controlled Study (Ictus Trial) Is The Use Of Citicoline Is Beneficial For Acute Ischaemic Stroke?, Fauzia Nomani,, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

Primary Elective Spine Arthrodesis: Audit Of Institutional Cross Matched To Transfused (C/T) Ratio To Develop Blood Product Ordering Guidelines, Muhammad Mehboob Alam, Zain A. Sobani, Muhammad Shahzad Shamim, Khabir Ahmad, Fouzia Minai

Section of Neurosurgery

Background: Currently, there are no uniform guidelines regarding the appropriate amount of blood products ordered prior to spine surgery. Here, we audited our own institution's practices along with preoperative variables that contributed to perioperative transfusion requirements for elective spinal arthrodesis.
Methods: This study utilized a single institution retrospective chart review of patients undergoing elective spinal fusion over a 2 year period. The cross matched to transfused (C/T) ratio was utilized to compare different patient groups. Sub-group multivariate analysis enabled us to identify possible predictors of transfusion for this patient population.
Results: Eighty-five patients were included in the study. Of the …

Prolonged Febrile Seizures Cause Reversible Reductions In White Matter Integrity☆, M. Yoong, K. Seunarine, M. Martinos, R. F. Chin, C. A. Clark, R. C. Scott

Dartmouth Scholarship

Prolonged febrile seizures (PFS) are the commonest cause of childhood status epilepticus and are believed to carry a risk of neuronal damage, in particular to the mesial temporal lobe. This study was designed to determine: i) the effect of prolonged febrile seizures on white matter and ii) the temporal evolution of any changes seen.

33 children were recruited 1 month following PFS and underwent diffusion tensor imaging (DTI) with repeat imaging at 6 and 12 months after the original episode of PFS. 18 age-matched healthy control subjects underwent similar investigations at a single time point. Tract-based spatial statistics (TBSS) was …

Residual Fmri Sensitivity For Identity Changes In Acquired Prosopagnosia, Christopher J. Fox, Giuseppe Iaria, Bradley C. Duchaine, Jason J. S. Barton

Dartmouth Scholarship

While a network of cortical regions contribute to face processing, the lesions in acquired prosopagnosia are highly variable, and likely result in different combinations of spared and affected regions of this network. To assess the residual functional sensitivities of spared regions in prosopagnosia, we designed a rapid event-related functional magnetic resonance imaging (fMRI) experiment that included pairs of faces with same or different identities and same or different expressions. By measuring the release from adaptation to these facial changes we determined the residual sensitivity of face-selective regions-of-interest. We tested three patients with acquired prosopagnosia, and all three of these patients …

Reducing Multi-Sensor Data To A Single Time Course That Reveals Experimental Effects, Aaron Schurger, Sebastien Marti, Stanislas Dehaene

Psychology Faculty Articles and Research

Background: Multi-sensor technologies such as EEG, MEG, and ECoG result in high-dimensional data sets. Given the high temporal resolution of such techniques, scientific questions very often focus on the time-course of an experimental effect. In many studies, researchers focus on a single sensor or the average over a subset of sensors covering a “region of interest” (ROI). However, single-sensor or ROI analyses ignore the fact that the spatial focus of activity is constantly changing, and fail to make full use of the information distributed over the sensor array.

Methods: We describe a technique that exploits the optimality and …

Why We Must Provide Better Support For Pakistan's Female Frontline Health Workers, Svea Closser, Rashid Jooma

Section of Neurosurgery

Svea Closser and Rashid Jooma argue that achieving polio eradication and strengthening Pakistan's health system must focus not just on international engagement but also on local partnerships with Lady Health Workers and other ground-level staff. Please see later in the article for the Editors' Summary.

Load: A Pilot Study Of The Safety Of Loading Of Aspirin & Clopidogrel In Acute Ischaemic Stroke And Transient Ischaemic Attack. Is The Loading Dose Of Aspirin And Clopidogrel A Good Alternative For Patients With Acute Ischaemic Stroke And Tia? How This Will Impact Our Clinical Practice?, Fauzia Nomani,, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

Left Atrial Volumes And Associated Stroke Subtypes., Quratulain Shaikh,, Bilal Ahmed, Maryam Ahmed,, Jamal Hussain Mahar,, Masood Ahmad,, Ayesha Ahmed,, Farzin Majeed, Fariha Sadiq Ali,, Maria Khan, Ayeesha Kamran Kamal

Department of Medicine

Background: Cardio embolism and cerebrovascular atherosclerosis are two major mechanisms of stroke. Studies investigating associations between advanced echocardiographic parameters and stroke mechanisms are limited.

Methods: This study is a standardized review of 633 patients admitted to the stroke service of a tertiary care hospital following a standardized stroke investigation and management pathway. Stroke subtypes were characterized using the Causative Classification System, using the hospitals online radiologic archival system with CCS certified stroke investigators. Patients with two mechanisms were excluded.

Results: Patients with cardioembolic stroke had a higher proportion of atrial fibrillation (p < 0.001), acute myocardial infarction (p < 0.001) and ischemic heart disease (p < 0.001). On electrocardiogram (ECG) and transthoracic Echo (TTE), patients with cardioembolic stroke had a greater atrial fibrillation (p < .00), left ventricular thrombus (p < .00), left ventricular ejection fraction <30% (p >< .00) and global hypokinesia (p < .00) Patients with cardioembolic stroke had higher mean left atrial volume indices (LAVi) (p < 0.001), mean left ventricular mass indices (LVMi) (p < 0.05) and mean left atrial diameters (LAD) (p < 0.05). At LAVi of 29–33 ml/m2 , the risk of atherothrombotic stroke increased. The risk of cardioembolic stroke increased with LAVi of 34 ml/m2 and above.

Conclusion: Left atrial volume indices may be linked …

Stroke Radiology And Distinguishing Characteristics Of Intracranial Atherosclerotic Disease In Native South Asian Pakistanis., Maria Khan, Asif Rasheed, Saman Hashmi, Moazzam Zaidi, Saba Akhtar, Lajpat Bansari, Nabi Shah, Maria Samuel, Sadaf Raza, Umer Rais Khan, Bilal Ahmed, Bilawal Ahmed, Naveeduddin Ahmed, Jamal Ara, Tasnim Ahsan, S. M. Munir, Shoukat Ali, Khalid Mehmood, Karim Ullah Maki, Muhammad Masroor Ahmed, Niaz Sheikh, Abdul Rauf Memon,, Philippe M. Frossard, Ayeesha Kamran Kamal

Department of Medicine

Background: There are no descriptions of stroke mechanisms from intracranial atherosclerotic disease in native South Asian Pakistanis.

Methods: Men and women aged ≥ 18 years with acute stroke presenting to four tertiary care hospitals in Karachi, Pakistan were screened using magnetic resonance angiography/transcranial Doppler scans. Trial of ORG 10172 in Acute Stroke Treatment criteria were applied to identify strokes from intracranial atherosclerotic disease.

Results: We studied 245 patients with acute stroke due to intracranial atherosclerotic disease. Two hundred thirty scans were reviewed. Also, 206/230 (89.0%) showed acute ischaemia. The most frequent presentation was with cortically based strokes in 42.2% (87/206) …

Epilepsy, Hippocampal Sclerosis And Febrile Seizures Linked By Common Genetic Variation Around Scn1a., Dalia Kasperaviciute, Claudia B Catarino, Mar Matarin, Costin Leu, Jan Novy, Anna Tostevin, Bárbara Leal, Ellen V S Hessel, Kerstin Hallmann, Michael S Hildebrand, Hans-Henrik M Dahl, Mina Ryten, Daniah Trabzuni, Adaikalavan Ramasamy, Saud Alhusaini, Colin P Doherty, Thomas Dorn, Jörg Hansen, Günter Krämer, Bernhard J Steinhoff, Dominik Zumsteg, Susan Duncan, Reetta K Kälviäinen, Kai J Eriksson, Anne-Mari Kantanen, Massimo Pandolfo, Ursula Gruber-Sedlmayr, Kurt Schlachter, Eva M Reinthaler, Elisabeth Stogmann, Fritz Zimprich, Emilie Théâtre, Colin Smith, Terence J O'Brien, K Meng Tan, Slave Petrovski, Angela Robbiano, Roberta Paravidino, Federico Zara, Pasquale Striano, Michael R Sperling, Russell J Buono, Hakon Hakonarson, João Chaves, Paulo P Costa, Berta M Silva, António M Da Silva, Pierre N E De Graan, Bobby P C Koeleman, Albert Becker, Susanne Schoch, Marec Von Lehe, Philipp S Reif, Felix Rosenow, Felicitas Becker, Yvonne Weber, Holger Lerche, Karl Rössler, Michael Buchfelder, Hajo M Hamer, Katja Kobow, Roland Coras, Ingmar Blumcke, Ingrid E Scheffer, Samuel F Berkovic, Michael E. Weale, Uk Brain Expression Consortium, Norman Delanty, Chantal Depondt, Gianpiero L Cavalleri, Wolfram S Kunz, Sanjay M Sisodiya

Department of Neurology Faculty Papers

Epilepsy comprises several syndromes, amongst the most common being mesial temporal lobe epilepsy with hippocampal sclerosis. Seizures in mesial temporal lobe epilepsy with hippocampal sclerosis are typically drug-resistant, and mesial temporal lobe epilepsy with hippocampal sclerosis is frequently associated with important co-morbidities, mandating the search for better understanding and treatment. The cause of mesial temporal lobe epilepsy with hippocampal sclerosis is unknown, but there is an association with childhood febrile seizures. Several rarer epilepsies featuring febrile seizures are caused by mutations in SCN1A, which encodes a brain-expressed sodium channel subunit targeted by many anti-epileptic drugs. We undertook a genome-wide association …