Neurology Commons^™

Neuroprotective Effect Of Arctigenin Via Upregulation Of P-Creb In Mouse Primary Neurons And Human Sh-Sy5y Neuroblastoma Cells., Nan Zhang, Qingping Wen, Lu Ren, Wenbo Liang, Yang Xia, Xiaodan Zhang, Dan Zhao, Dong Sun, Yv Hu, Haiguang Hao, Yaping Yan, Guangxian Zhang, Jingxian Yang, Tingguo Kang

Department of Neurology Faculty Papers

Arctigenin (Arc) has been shown to act on scopolamine-induced memory deficit mice and to provide a neuroprotective effect on cultured cortical neurons from glutamate-induced neurodegeneration through mechanisms not completely defined. Here, we investigated the neuroprotective effect of Arc on H89-induced cell damage and its potential mechanisms in mouse cortical neurons and human SH-SY5Y neuroblastoma cells. We found that Arc prevented cell viability loss induced by H89 in human SH-SY5Y cells. Moreover, Arc reduced intracellular beta amyloid (Aβ) production induced by H89 in neurons and human SH-SY5Y cells, and Arc also inhibited the presenilin 1(PS1) protein level in neurons. In addition, …

Vitamin B12 Supplementation In Trea Ting Major Depressive Disorder: A Randomized Controlled Trial, Ehsan Ullah Syed, Mohammad Wasay, Safia Awan

Department of Medicine

Recent literature has identified links between vitamin B12 deficiency and depression. We compared the clinical response of SSRI-monotherapy with that of B12-augmentation in a sample of depressed patients with low normal B12 levels who responded inadequately to the first trial with the SSRIs. Methods: Patients with depression and low normal B12 levels were randomized to a control arm (antidepressant only) or treatment arm (antidepressants and injectable vitamin B12 supplementation). Results: A total of 199 depressed patients were screened. Out of 73 patients with low normal B12 levels 34 (47%) were randomized to the treatment group while 39 (53%) …

My Patient Has Carotid Stenosis. Should He Get Stenting Or Endarterectomy?, Quratulain Shaikh,, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

Immunopathology Of Cd4+ T Cell-Mediated Autoimmune Responses To Central Nervous System Antigens: Role Of Il-16, Harley Y. Tse, Dusanka S. Skundric, William W. Cruikshank, Paul C. Montgomery, Robert P. Lisak

Neurology Faculty Publications

Multiple sclerosis (MS) is a chronic, inflammatory, demyelinating and degenerative disease of the central nervous system (CNS). While etiology of the disease remains unknown, genetic susceptibility and autoimmune mechanisms in the initiation and progression of the disease have been strongly suggested. Experimental autoimmune encephalomyelitis (EAE) is commonly used to study immune regulation of MS. Infiltration by CD4⁺ T cells, through blood-brain barrier (BBB), precedes the onset and relapses of MS. CNS migration and homing patterns of T cells are tightly synchronized by astrocyte and microglia derived cytokines and chemokines. Autoimmune, CNS antigenreactive, infiltrating T cells produce and locally release …

Analysis Of Lmnb1 Duplications In Autosomal Dominant Leukodystrophy Provides Insights Into Duplication Mechanisms And Allele-Specific Expression, Elisa Giorgio, Harshvardhan Rolyan, Laura Kropp, Anish Baswanth Chakka, Svetlana Yatsenko, Adeline Vanderver, +31 Additional Authors

Neurology Faculty Publications

Autosomal dominant leukodystrophy (ADLD) is an adult onset demyelinating disorder that is caused by duplications of the lamin B1 (LMNB1) gene. However, as only a few cases have been analyzed in detail, the mechanisms underlying LMNB1 duplications are unclear. We report the detailed molecular analysis of the largest collection of ADLD families studied, to date. We have identified the minimal duplicated region necessary for the disease, defined all the duplication junctions at the nucleotide level and identified the first inverted LMNB1 duplication. We have demonstrated that the duplications are not recurrent; patients with identical duplications …

Safety Of Untreated Autologous Cranioplasty After Extracorporeal Storage At -26 Degrees Celsius, Muhammad Zubair Tahir, Muhammad Shahzad Shamim, Zain-Ul-Abdeen Sobani, Syed Nabeel Zafar, Mohsin Qadeer, Muhammad Ehsan Bari

Section of Neurosurgery

Background: Given the improved survival of patients requiring decompressive craniectomies, the frequency of subsequent cranioplasties are on the rise. The most feared complication of autologous cranioplasty is infection and one method for reducing the rate of infection, is to store the bone flaps at subnormal temperatures. However, to date there is no defined temperature for flap storage and temperature ranges from - 18 to - 83°C have been described in literature. Considering our limited resources it has been the practice at our center to store bone flaps at - 26°C. In this study, we have retrospectively reviewed our practice and …

Hippocampal Functional Connectivity Patterns During Spatial Working Memory Differ In Right Versus Left Temporal Lobe Epilepsy., Gaelle Eve Doucet, Karol Osipowicz, Ashwini Sharan Md, Michael R Sperling, Joseph I Tracy

Department of Neurology Faculty Papers

Temporal lobe epilepsy (TLE), affecting the medial temporal lobe, is a disorder that affects not just episodic memory but also working memory (WM). However, the exact nature of hippocampal-related network activity in visuospatial WM remains unclear. To clarify this, we utilized a functional connectivity (FC) methodology to investigate hippocampal network involvement during the encoding phase of a functional magnetic resonance imaging (fMRI) visuospatial WM task in right and left TLE patients. Specifically, we assessed the relation between FC within right and left hippocampus-seeded networks, and patient performance (rate of correct responses) during the encoding phase of a block span WM …

Surgical Management Of Traumatic Extra Dural Hematoma In Children: Experiences And Analysis From 24 Consecutively Treated Patients In A Developing Country, Muhammad Babar Khan, Muhammad Riaz, Gohar Javed, Fauzan Alam Hashmi, Maryam Sanaullah, Syed Ijlal Ahmed

Medical College Documents

Background: Children with epidural hematoma (EDH) present differently than adults. The outcome of treatment is also different. We aim to report our experiences with EDH in pediatric age group in terms of mode of injury, presenting features, management, and outcomes. We also aim to identify different prognostic indicators in pediatric patients with EDH.
Methods: We prospectively collected data from 24 consecutively surgically treated pediatric patients. The data collected included presenting features, radiological imaging, details of management, and outcomes. Descriptive analysis was performed and different variables were tested for any statistical significance with Glasgow Outcome Score (GOS).
Results: There were 19 …

Single-Trial Decoding Of Auditory Novelty Responses Facilitates The Detection Of Residual Consciousness, J. R. King, F. Faugeras, A. Gramfort, Aaron Schurger, I. El Karoui, J. D. Sitt, B. Rohaut, C. Wacongne, E. Labyt, T. Bekinschtein, L. Cohen, L. Naccache, S. Dehaene

Psychology Faculty Articles and Research

Detecting residual consciousness in unresponsive patients is a major clinical concern and a challenge for theoretical neuroscience. To tackle this issue, we recently designed a paradigm that dissociates two electro-encephalographic (EEG) responses to auditory novelty. Whereas a local change in pitch automatically elicits a mismatch negativity (MMN), a change in global sound sequence leads to a late P300b response. The latter component is thought to be present only when subjects consciously perceive the global novelty. Unfortunately, it can be difficult to detect because individual variability is high, especially in clinical recordings. Here, we show that multivariate pattern classifiers can extract …

Giant Cell Tumour Of The Sacrum: Function-Preserving Surgery With Extended Curettage And Ilio-Lumbar Fusion, Riaz Hussain Lakhdawala, Tashfeen Ahmad, Ather Enam

Section of Orthopaedic Surgery

Giant cell tumours of the sacrum pose a unique therapeutic challenge due to the inaccessibility of the tumour, significant intra-operative blood loss from extensive vascularity, high rate of local recurrence with conservative surgery, and loss of neurological function and mechanical instability with en-bloc excision. We present a case where successful outcome was achieved by tailoring treatment in consideration of the above issues. A 28 year old male diagnosed on biopsy to have giant cell tumour of the sacrum presented to us with low-back pain, left-sided S1 radiculopathy, ankle weakness and urinary incontinence. MRI showed a tumour involving the S1 and …

How Effective Is The Local Anesthetic Infiltration Of Pin Sites Prior To Application Of Head Clamps: A Prospective Observational Cohort Study Of Hemodynamic Response In Patients Undergoing Elective Craniotomy, Ayesha Arshad, Muhammad Shahzad Shamim, Muhammad Waqas, Hina Enam, Syed Ather Enam

Section of Neurosurgery

Background: Use of Mayfield clamps is associated with potentially hazardous hemodynamic effects. Use of local anesthetic infiltration has yielded varying results in blunting of this response. The authors' objective was to study the effect of lidocaine with adrenaline infiltration at Mayfield pin sites on hemodynamic response in comparison with no intervention.
Methods: This was a prospective cohort study conducted at a tertiary care center from January 2012 to July 2012. Patents undergoing elective craniotomies over the study period were included and divided in two groups, Group A received lidocaine infiltration of the pin sites prior to insertion, while Group B …

Role Of Anterior Decompression With Internal Fixation In Dorsal Spine Tuberculosis, Zahid Khan, Khalid Khanzada, Mumtaz Ali,, Shahid Ayub

Pakistan Journal of Neurological Sciences (PJNS)

This observational study was conducted in the Department of Neurosurgery Lady Reading HospitalPeshawar from July 2010 to June 2012 (2 years).There were 38 patients with dorsal spine tuberculosis who underwent anterior decompression and fusion using anterior spinal instrumentation and allograft replacement. We included those patients in our study, who undergone anterior decompression with internal fixation for dorsal spine tuberculosis, of both genders irrespective of their age. We excluded those patients who were unfit for surgery, treated conservatively, involved spine other than dorsal spine or undergone procedure other than anterior approach for Carrie’s spine.Clinical outcome of the patients was assessed using …

Neurological Care In Afghanistan, Esmatullah Hamed

Pakistan Journal of Neurological Sciences (PJNS)

Afghanistan is struggling to recover from more than 3 decades of conflict, displacement, and destruction of its infrastructure. The population of Afghanistan is around 31,108,077 (July 2013 est.), which includes the 2.7 million Afghan refugees the population of Afghanistan is increasing rapidly. Afghanistan has a predominantly young population, where almost 50 percent is less than 17.9 years of age, the proportion of population under 17.9 is among the highest in the world and significantly higher than that of neighboring countries.

Recumbent Syncope Mimicking Nocturnal Seizures, Maria Siddiqi, S. Nizam Ahmed

Pakistan Journal of Neurological Sciences (PJNS)

A fifty seven year old man presented to the emergency at the University hospital with a 3 month history of episodes of arousals from sleep with groaning and deviation of head to his right side. These were followed by a period of “confusion” that lasted for a “couple of minutes”. He had a witnessed “convulsion” in the hospital during this last visit and was loaded with one gram of phenytoin. A computed tomography (CT) scan of the head three months ago was reported as normal. Neurology was consulted for further investigations and long-term management

An Unusual Presentation Of Neurononopathic Gauchers Disease., Prem Chand, Shahnaz Ibrahim, Bushra Habib, Farida Jan

Pakistan Journal of Neurological Sciences (PJNS)

A six years old male child presented with tremor, ataxia, speech apraxia, supranuclear gaze palsy and hepatosplenomegaly. There was no history of seizures and psycho-cognitive abnormalities. The clinical and bone marrow findings were consistent with Gaucher's disease type 3.

KEY WORDS: Gauchers disease, Enzyme replacement therapy, Gene therapy, Bone marrow transplant.

Dementia In Pakistan: National Guidelines For Clinicians, Arsalan Ahmad, Khurram Owais, Maimoona Siddiqui, Kayser Mamun, Faiza Rao, Abdul Wahab Yousufzai

Pakistan Journal of Neurological Sciences (PJNS)

Dementia refers to a range of disorders characterized by declining memory, multiple cognitive deficits and eventual mortality due to progressive and irreversible brain damage¹. Disease entities comprising dementia characteristically affect mainly the geriatric population. Together, they constitute a major component of global disease burden in general and geriatric disease burden in particular². In 2005, it was estimated that 24.3 million people in the world were living with dementia; 4.6 million cases have been added each year ever since³. Overall, dementia contributes 11.3% of years of life lived with disability, making it a major contributor …

Dementia – The Next Impending Epidemic Knocking On Our Door – Are We Ready?, Ismail A. Khatri, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

Late-onset dementias are life-shortening diseases of largely unknown cause. Predictions of the number of persons living with dementia by 2050 have spawned alarming headlines forecasting a “tsunami” of dementia cases that will overwhelm families and health care systems and impose unbearable economic burdens [Whalley].

Mri Guided Functional Neurosurgery At L.G.H: The Beginning Of A New Era, Khalid Mahmood

Pakistan Journal of Neurological Sciences (PJNS)

Lahore General Hospital has the credit of being pioneer of “Functional Neurosurgery in Pakistan” when Prof. Bashir Ahmad started the Department of Neurosurgery at LGH in 1966. Prof. BashirAhmad, Prof. Nazir Ahmad and Late Prof. Javed MajidMian had done lot of work and performedThalamotomiesfor Parkinsoniantremors

Clear: The Intraventricular Haemorrhage Thrombolysis Trial., Anjum Akhtar, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

Astrocyte-Specific Overexpression Of Insulin-Like Growth Factor-1 Protects Hippocampal Neurons And Reduces Behavioral Deficits Following Traumatic Brain Injury In Mice, Sindhu K. Madathil, Shaun W. Carlson, Jennifer M. Brelsfoard, Ping Ye, A Joseph D'Ercole, Kathryn E. Saatman

Spinal Cord and Brain Injury Research Center Faculty Publications

Traumatic brain injury (TBI) survivors often suffer from long-lasting cognitive impairment that stems from hippocampal injury. Systemic administration of insulin-like growth factor-1 (IGF-1), a polypeptide growth factor known to play vital roles in neuronal survival, has been shown to attenuate posttraumatic cognitive and motor dysfunction. However, its neuroprotective effects in TBI have not been examined. To this end, moderate or severe contusion brain injury was induced in mice with conditional (postnatal) overexpression of IGF-1 using the controlled cortical impact (CCI) injury model. CCI brain injury produces robust reactive astrocytosis in regions of neuronal damage such as the hippocampus. We exploited …

Botulism In Children: A Diagnostic Dilemma In Developing Countries, Muhammad Rehan Khan, Prem Kumar, Shahnaz Shahid, Anwarul Haque

Department of Paediatrics and Child Health

Botulism is a well-known disease of the neuromuscular junction. It is a rare but curable cause of paralysis in paediatric population. In addition to classical clinical signs and symptoms, the diagnosis of botulism requires laboratory confirmation of intoxication by various biological tests. These include demonstration of botulinum toxin in serum or isolation of the Clostridium botulinum from stool/gastric aspirates. However, it is not always possible to confirm intoxication due to unavailability of technical facilities, especially in resource limited countries like Pakistan. Under these circumstances, electrophysiological studies serve as an excellent diagnostic tool. These studies can provide quick diagnosis of botulism …

A Descriptive Study To Find Possible Correlation Between Mri Findings Of Pituitary Gland And Serum Prolactin Level, Muhammad Azeemuddin, Rohana Naqi, Mohammad Wasay

Department of Medicine

Objective: To explore equation, if any, between findings of magnetic resonance imaging of pituitary gland and serum prolactin level.

Methods: The retrospective, descriptive study was conducted at the Department of Radiology, Aga Khan University Hospital, Karachi, and related to patients\' records from April 19, 2006 to April 23, 2009. Seventy patients underwent magnetic resonance imaging of brain for pituitary gland. Inclusion criteria were all patients referred with relevant clinical symptoms or deranged serum prolactin level. Patients who were claustrophobic or had a pacemaker, aneurysm clip, metallic foreign body in the orbit or with no laboratory investigation were excluded from the …

Benefit Of Neuroprotection In Acute Ischaemic Stroke, Shall We Dare To Hope?, Anjum Akhtar, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

My Patient Has Intracranial Stenosis, Does He Need An Intracerebral Stent? Results Of The Sammpris Study., Muhammad Faisal Wadiwala,, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

Hyper-Arousal Decreases Human Visual Thresholds, Adam J. Woods, John W. Philbeck, Philip Wirtz

Neurological Surgery Faculty Publications

Arousal has long been known to influence behavior and serves as an underlying component of cognition and consciousness. However, the consequences of hyper-arousal for visual perception remain unclear. The present study evaluates the impact of hyper-arousal on two aspects of visual sensitivity: visual stereoacuity and contrast thresholds. Sixty-eight participants participated in two experiments. Thirty-four participants were randomly divided into two groups in each experiment: Arousal Stimulation or Sham Control. The Arousal Stimulation group underwent a 50-second cold pressor stimulation (immersing the foot in 0–2° C water), a technique known to increase arousal. In contrast, the Sham Control group immersed their …

Converging Evidence For The Processing Costs Associated With Ambiguous Quantifier Comprehension., Corey T Mcmillan, Danielle Coleman, Robin Clark, Tsao-Wei Liang, Rachel G Gross, Murray Grossman

Department of Neurology Faculty Papers

Traditional neuroanatomic models of language comprehension have emphasized a core language network situated in peri-Sylvian cortex. More recent evidence appears to extend the neuroanatomic network beyond peri-Sylvian cortex to encompass other aspects of sentence processing. In this study, we evaluate the neuroanatomic basis for processing the ambiguity in doubly-quantified sentences. For example, a sentence like "All the dogs jumped in a lake" can be interpreted with a collective interpretation (e.g., several dogs jumping into a single lake) or a distributive interpretation (e.g., several dogs each jumping into a different lake). In Experiment 1, we used BOLD fMRI to investigate neuroanatomic …

Asymptomatic Unilateral Cerebellar Hypoplasia In An Adult Patient - A Unique Presentation., Pari Gul, Bushra Rehan, Saleha Anwar, Ambreen Majeed, Ayub Mansoor

Pakistan Journal of Neurological Sciences (PJNS)

Unilateral cerebellar hypoplasia is a relatively rare malformation. We report a case of 54 year old female patient who presented with single episode of sudden unconsciousness and slurring of speech. Imaging finding suggests the diagnosis of unilateral cerebellar hypoplasia. The patient recovered with conservative management probably because the symptoms were due to Transient ischemic attack not due to hypoplasia.

Tacrolimus Induced Reversible Encephalopathy, Nirmal Surya, Devshi Visana

Pakistan Journal of Neurological Sciences (PJNS)

Tacrolimus is a novel immunosuppressant used to prevent graft rejection after allogenic organ transplantation. Serious neurological complications of tacrolimus are rare. We present a lady who developed confusion, paresthesiae and visual hallucinations while on tacrolimus following a renal transplant.Her tacrolimus level was high and she improved on stopping the drug. This case highlights the reversible encephalopathy induced by tacrolimus.

Efficacy Of Interferon In Multiple Sclerosis, Evangelos A, , Nikolaos Ch. Syrmos, Anastasios Orologas

Pakistan Journal of Neurological Sciences (PJNS)

Introduction of interferon b-1b in the therapeutic strategy against Multiple Sclerosis has resulted in a great amelioration of treatment in various terms. Relapse rates, delaying progression of the activity, improvement of imaging outcomes as well as reduction of disease activity itself consist great achievements against a pathological condition that challenged medical effectiveness throughout decades. Two recombinant human IFN-1a and an IFN-1b preparations have been proved effected and well tolerated. We reviewed the most important literature concerning pharmacodynamics, medical efficacy, tolerability and adverse effects of interferon-b usage. In parallel, despite the wide range of trials referring to INF-b treatment, we tried …

Neuroinflammation And Psychiatric Illness, Souhel Najjar, Daniel M. Pearlman, Kenneth Alper, Amanda Najjar, Orrin Devinsky

Dartmouth Scholarship

Multiple lines of evidence support the pathogenic role of neuroinflammation in psychiatric illness. While systemic autoimmune diseases are well-documented causes of neuropsychiatric disorders, synaptic autoimmune encephalitides with psychotic symptoms often go under-recognized. Parallel to the link between psychiatric symptoms and autoimmunity in autoimmune diseases, neuroimmunological abnormalities occur in classical psychiatric disorders (for example, major depressive, bipolar, schizophrenia, and obsessive-compulsive disorders). Investigations into the pathophysiology of these conditions traditionally stressed dysregulation of the glutamatergic and monoaminergic systems, but the mechanisms causing these neurotransmitter abnormalities remained elusive. We review the link between autoimmunity and neuropsychiatric disorders, and the human and experimental evidence …