Neurology Commons^™

9th Annual Neurology Research Day 2015 Abstracts Shifa International Hospital, Islamabad

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Relationship Between Fear, Fall & Balance In Cummunity Dwelling Older Adults, Ayesha Afridi, Sadia Maqbool, Arshad Nawaz Malik

Pakistan Journal of Neurological Sciences (PJNS)

Background:
In older population the risk of fall is always at high risk and there are many contributing factor which increase the prevalence of fall. The impaired balance leads to limited daily activities and confidence level.

Purpose of the study:
The main purpose of this study was to determine the relationship between fall, fear and balance in older population.

Method & methodology:
The descriptive cross sectional study design was used and a sample of 271 older adult were recruited through purpose sampling technique. The detail demographic was noted, history of fall and other related co-morbidities were mention in performa. The …

A Rare Case Of Simple Hereditary Recessive Optic Atrophy, Fazal M. Arain, Prem Chand, Tanveer A. Choudary

Pakistan Journal of Neurological Sciences (PJNS)

Simple Autosomal Recessive Optic Atrophy (AROA) is a rare hereditary disorder that belongs to a group of disorders called Hereditary Optic Atrophy. Patients diagnosed with simple AROA have complete blindness since birth or from first few months of life. This blindness does not improve with age. However, no other organ or system is affected in this disorder. There is no known cause or gene mutation associated with it. Here we report a case of a two year old child diagnosed with simple AROA. Family history of the patient revealed that an older deceased relative also suffered from similar symptoms. Identification …

Challenges In Certification And Credentialing Of Pakistani Physicians In Middle East, Abdul Malik

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

The Need And Roadmap For Stroke Rehabilitation Guidelines In Pakistan, Farooq Azam Rathore

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Frequency Of Cerebrovascular Accidents And Brain Abscess In Childrens With Tetralogy Of Fallot Dr., Sommayya Aftab, Amir Usman, Tipu Sultan

Pakistan Journal of Neurological Sciences (PJNS)

OBJECTIVE:
To determine the frequency of cerebrovascular accidents and brain abscess in children of Tetralogy of Fallot presented with neurological manifestations.

PATIENTS AND METHODS:
It was a cross-sectional descriptive observational study done at the Pediatric Cardiology and Pediatric Neurology departments of The Children’s Hospital & Institute of Child Health, Lahore from Dec 2009 to Nov 2010. A total 75 patients of Tetralogy of Fallot (TOF) up to the age of 15 years with neurological manifestation meeting the inclusion criteria were enrolled in this study. CT brain with contrast was conducted in all patients to look for evidence of cerebrovascular accident …

Association Of Vitamin D With Statin Induced Myalgia, Ayla K. Zubair, Imran N Ahmad, Arsalan Ahmad Md

Pakistan Journal of Neurological Sciences (PJNS)

Objective:
To determine the association of serum 25-hydroxy vitamin D (25(OH) Vitamin D) deficiency with the occurrence of myalgia in patients on statin therapy.

Methods:
The pathology laboratory database was reviewed to identify patients tested for serum 25(OH) Vitamin D and creatine kinase. A retrospective chart review was then conducted to ascertain statin use and reporting of myalgia for patients tested concurrently for serum 25(OH) vitamin D and creatinekinase levels between January 1, 2013 and December 31, 2013.

Results:
Of the 825 patients tested for creatine kinase and 25 (OH) Vitamin D in 2013, 49 met the study criteria.The …

Validation Study Of The Mini-Mental State Examination In Urdu Language For Pakistani Population, Safia Awan, Naila Shahbaz,, Syed Wasim Akhtar, Arsalan Ahmad, Sadaf Iqba, Sellal Ahmed, Haider Naqvi, Mohammad Wasay

Section of Neurology

Validation study of the Mini-Mental State Examination in Urdu language for Pakistani population. Objective: This study was conducted primarily to validate and determine the optimal cutoff score in the diagnosis of dementia among Pakistani’s and study the effects of gender and education on the MMSE performance in our population. Methods: Four hundred participants took part in the study. Patient with dementia recruited from five major hospitals from Pakistan. The MMSE was translated into Urdu. Results: There were 61 men and 39 women in dementia group and 225 men and 75 women in the control group. The mean score of Urdu …

Astrocyte Morphology, Heterogeneity, And Density In The Developing African Giant Rat (Cricetomys Gambianus), Matthew A. Olude, Oluwaseun A. Mustapha, Oluwatunde A. Aderounmu, James O. Olopade, Amadi O. Ihunwo

Brain and Mind Institute

Astrocyte morphologies and heterogeneity were described in male African giant rats (AGR; Cricetomys gambianus, Waterhouse) across three age groups (five neonates, five juveniles, and five adults) using Silver impregnation method and immunohistochemistry against glial fibrillary acidic protein. Immunopositive cell signaling, cell size and population were least in neonates, followed by adults and juveniles, respectively. In neonates, astrocyte processes were mostly detected within the glia limitans of the mid and hind brain; their cell bodies measuring 32 ± 4.8 μm in diameter against 91 ± 5.4 μm and 75 ± 1.9 μm in juveniles and adults, respectively. Astrocyte heterogeneity in …

Amyotrophic Lateral Sclerosis, The Primary Motor Neuron Disease, Jacob P. Naumann

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

Amyotrophic lateral sclerosis is a degenerative neurological disease that damages nerve cells in the brain, in particular the neurons that are involved in voluntary muscle movements. Internationally the disorder is also known as Charcot’s disease and motor neuron disease. In the United States, amyotrophic lateral sclerosis is often referred to as Lou Gehrig’s disease, motor neuron disease, and more colloquially ALS. Amyotrophic Lateral Sclerosis is the most prominent of the five motor neuron diseases, distinguishing itself from the others through degeneration of both upper motor neurons (UMN) and lower motor neurons (LMN) respectively. The “Father of neurology” Jean-Marie Charcot founded …

Novel Advances In Alzheimer's Disease, Jacob P. Naumann

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

Alzheimer’s disease, the most common form of dementia in adults, is a progressive degenerative neurological disease that affects memory, cognition, and behavior. Dr. Alois Alzheimer discovered and diagnosed the irreversible disease in 1906 after documenting the famous case of Auguste Deter.¹ Since the discovery of the disease, numerous advances have made it possible to not only better understand the causal factors, but also to improve the medical diagnosis and preventative measures that healthcare providers can implement. For the first time since 1984, the National Institute on Aging (NIAA) and the Alzheimer’s Association (AA) proposed and published new diagnostic guideline …

Dementia In The Context Of Disability, Rosanne Dizazzo-Miller, Fredrick D. Pociask

Department of Health Care Sciences

Patients and caregivers often associate dementia with devastation and a loss of productive contribution to society. People with dementia are often depicted as confused individuals struggling through embarrassing episodes, followed by a loss of independence. The burden and devastation of the diagnosis on the families of people with dementia is exacerbated by their assumption of the role of caregiver with inadequate preparation or training. Disability scholars, in contrast, offer physical and occupational therapists a nontragic view of disability that recognizes the importance of countering the stigma and discrimination that too often accompany dementia. This case example of a woman diagnosed …

Ferritin Levels In The Cerebrospinal Fluid Predict Alzheimer's Disease Outcomes And Are Regulated By Apoe, Scott Ayton, Noel G. Faux, Ashley I. Bush, Charles D. Smith, Greg A. Jicha, Peter A. Hardy, Partha Sinha, Elizabeth Oates, Gary Conrad, Alzheimer's Disease Neuroimaging Initiative

Neurology Faculty Publications

Brain iron elevation is implicated in Alzheimer's disease (AD) pathogenesis, but the impact of iron on disease outcomes has not been previously explored in a longitudinal study. Ferritin is the major iron storage protein of the body; by using cerebrospinal fluid (CSF) levels of ferritin as an index, we explored whether brain iron status impacts longitudinal outcomes in the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort. We show that baseline CSF ferritin levels were negatively associated with cognitive performance over 7 years in 91 cognitively normal, 144 mild cognitive impairment (MCI) and 67 AD subjects, and predicted MCI conversion to AD. …

Gap In Patient Expectations Of Deep Brain Stimulation For The Treatment Of Parkinson's Disease, Colleen D. Knoop Dnp-C

Graduate Theses, Dissertations, and Capstones

Abstract

Purpose: This project studied a specific group of patients with Parkinson’s disease to: determine if they were asked to verbalize expectations of DBS pre-operatively; determine if patient expectations were met post-operatively; gain information that could aid in improved pre-operative patient education for deep brain stimulation (DBS), address unrealistic expectations before surgery, and meet patient expectations post-operatively.

Methodology: This study was a retrospective, single academic center, two-part design that included a questionnaire and chart review of 29 patients. Those included were patients with Parkinson’s disease who had DBS programming at the academic center, between the years 2007 and 2014.

Results: …

Effects Of Training And Lung Volume Levels On Voice Onset Control And Cortical Activation In Singers, Nicholas A. Barone

Dissertations, 2014-2019

Singers need to counteract respiratory elastic recoil at high and low lung volume levels (LVLs) to maintain consistent airflow and pressure while singing. Professionally trained singers modify their vocal and respiratory systems creating a physiologically stable and perceptually pleasing voice quality at varying LVLs. In manuscript 1, we compared non-singers and singers on the initiation of a voiceless plosive followed by a vowel at low (30% vital capacity, VC), intermediate (50%VC), and high (80%VC) LVLs. In manuscript 2, we examined how vocal students (singers in manuscript 1) learn to control their voice onset at varying LVLs before and after a …

Reporting Practices, Knowledge And Opinion Of Policy Regarding Drivers With Dementia Among Arkansas Neurologists And Geriatricians, Erika Martin Gergerich

Graduate Theses and Dissertations

Background: States have various policies regarding a physician's ability or responsibility to report at-risk drivers with dementia to the Department of Motor Vehicles (DMV). Some states have mandatory reporting policies, others have optional reporting policies and some have no policy regarding this issue. Arkansas has no reporting policy regarding drivers with dementia to the DMV. Therefore, physicians in Arkansas face the risk of liability if they report a patient against their will to the DMV in good faith. Neurologists and geriatricians are often in a position to diagnose and treat individuals with dementia. Research Questions: The following three research questions …

Bridge/Adapt: A Systematic Cognitive Rehabilitation Curriculum, Julie S. Bergen, Natalie Repin, Amy Bennet, Abigail Lafrenz

Dissertations, Masters Theses, Capstones, and Culminating Projects

Cognitive impairment, including deficits in memory, attention, visual perception, executive functioning, and self-awareness, is a common consequence of acquired brain injury (ABI). Subsequently, these cognitive impairments result in functional impairments in daily life activities for clients with ABI. Rehabilitation efforts are categorized under two broad approaches: remediation and adaptation. Computer-assisted cognitive retraining (CACR) is a remediation approach using a computer platform to deliver cognitive exercises. CACR therapy can lead to improvements in memory and attention for adults with chronic ABI. However, memory and attention improvements from CACR may not carry over to functional improvements in occupational performance. Research suggested that …

Inflammatory Muscle Diseases., Marinos C Dalakas

Department of Neurology Faculty Papers

No abstract provided.

Clinical Outcome And Cost Effectiveness Of Early Tracheostomy In Isolated Severe Head Injury Patients, Usman Tariq Siddiqui, Muhammad Zubair Tahir, Muhammad Shahzad Shamim, S. Ather Enam

Section of Neurosurgery

Background: Early tracheostomy (ET) has been shown to be effective in reducing complications associated with prolong mechanical ventilation. The study was carried out to evaluate the role of ET in reducing the duration of mechanical ventilation, duration of intensive care unit (ICU) stay, ICU-related morbidities, and its overall effect on outcome, in patients with isolated severe traumatic brain injury (TBI).
Methods: This 7-year review included 100 ICU patients with isolated severe TBI requiring mechanical ventilation. ET was defined as tracheostomy within 7 days of TBI, and prolonged endotracheal intubation (EI) as EI exceeding 7 days of TBI. Of 100 patients, …

Role Of Il-16 In Cd4(+) T Cell-Mediated Regulation Of Relapsing Multiple Sclerosis, Dusanka S. Skundric, William W. Cruikshank, Jelena Drulovic

Neurology Faculty Publications

In an important article published in Nature Medicine, Liu and colleagues described a novel CD4⁺ FoxA1⁺ regulatory T (Treg) cell population as distinct regulators of relapsing-remitting multiple sclerosis (RRMS) and experimental autoimmune encephalomyelitis (EAE). CD4⁺ FoxA1⁺ Treg cells appear as key regulators of responsiveness to therapy with interferon beta (IFN-β) in RRMS patients. Data indicate that CD4⁺ FoxA1⁺ FOXP3⁻ Treg cells develop within the central nervous system (CNS), and a potential of cerebellar granule neurons (CGN) in generation of CD4⁺ FoxA1⁺ PD-L1^hiFOXP3⁻ Treg cells from encephalitogenic CD4^{+ …}

Diagnosis And Management Of Hyponatremia In Patients With Aneurysmal Subarachnoid Hemorrhage, Neena I. Marupudi, Sandeep Mittal

Neurosurgery Faculty Publications

Hyponatremia is the most common, clinically-significant electrolyte abnormality seen in patients with aneurysmal subarachnoid hemorrhage. Controversy continues to exist regarding both the cause and treatment of hyponatremia in this patient population. Lack of timely diagnosis and/or providing inadequate or inappropriate treatment can increase the risk of morbidity and mortality. We review recent literature on hyponatremia in subarachnoid hemorrhage and present currently recommended protocols for diagnosis and management.

Targeting Human Central Nervous System Protein Kinases: An Isoform Selective P38Αmapk Inhibitor That Attenuates Disease Progression In Alzheimer's Disease Mouse Models, Saktimayee M. Roy, Valerie L. Grum-Tokars, James P. Schavocky, Faisal Saeed, Agnieszka Staniszewski, Andrew F. Teich, Ottavio Arancio, Adam D. Bachstetter, Scott J. Webster, Linda J. Van Eldik, George Minasov, Wayne F. Anderson, Jeffrey C. Pelletier, D. Martin Watterson

Spinal Cord and Brain Injury Research Center Faculty Publications

The first kinase inhibitor drug approval in 2001 initiated a remarkable decade of tyrosine kinase inhibitor drugs for oncology indications, but a void exists for serine/threonine protein kinase inhibitor drugs and central nervous system indications. Stress kinases are of special interest in neurological and neuropsychiatric disorders due to their involvement in synaptic dysfunction and complex disease susceptibility. Clinical and preclinical evidence implicates the stress related kinase p38αMAPK as a potential neurotherapeutic target, but isoform selective p38αMAPK inhibitor candidates are lacking and the mixed kinase inhibitor drugs that are promising in peripheral tissue disease indications have limitations for neurologic indications. Therefore, …

Clinoidal Meningioma Associated With An Internal Carotid Artery Aneurysm, Muhammad Waqas, Yousuf Bashir Hadi, Badar Uddin Ujjan, Gohar Javed

Section of Neurosurgery

Coexistence of primary brain neoplasms with intracranial aneurysms is rare but presents a diagnostic and therapeutic challenge to healthcare providers. We describe the case of a 60-year-old woman who had a left internal carotid artery aneurysm with a small ipsilateral clinoidal meningioma. The meningioma was an unexpected finding encountered during the surgery for aneurysmal clipping. Both the lesions were dealt with simultaneously.

Molecular Pathways Of Chemokine Receptor Desensitization By Il-16 Pertinent To Multiple Sclerosis, Dusanka S. Skundric

Neurology Faculty Publications

No abstract provided.

A Very Rare Cause Of Pancytopenia., Talal Alzahrani, Dana Kay, Kelly Zhang, Linda Lesky

GW Research Days 2015

INTRODUCTION:

Levetiracetam (Keppra) is a pyrrolidone derivative and acts as an anti-epileptic medication by modulating neurotransmitter release. Pancytopenia is a very rare adverse effect caused by levetiracetam. There are fewer than four case reports in the medical literature discussing the association between levetiracetam and pancytopenia. The pathogenesis behind this relationship is unclear. Therefore, this case will serve to spread awareness of a rare cause of pancytopenia and to hypothesize how this medication causes pancytopenia.

CASE REPORT:

A brain MRI of a 79-year-old female with a medical history of hypertension, Type II diabetes, and CVA revealed a right temporoparietal mass. She …

The Therapeutic Role Of Turmeric In Treatment And Prevention Of Alzheimer’S Disease, Rylan M. Mcquade

Selected Honors Theses

As a devastating neurological condition that expends millions of lives each year, Alzheimer’s disease (AD) is a subject of intense investigation.¹ Although AD has been known for over a century, the precise mechanisms that underlie AD pathogenesis and development are still poorly understood. The Alzheimer phenotype is typified by extracellular amyloid-beta (Aβ) plaques and intracellular neurofibrillary tangles (NFTs), causing researchers to notice several key enzymes implicated in this process.¹ Most notable are β and γ secretases (which drive Aβ plaque production) and phospholipase

A₂ (which stimulates major cascade activation through the specific cleavage of fatty acyl esters). …

Ubiquitous L1 Mosaicism In Hippocampal Neurons., Kyle R. Upton, Daniel J. Gerhardt, J. Samuel Jesuadian, Sandra R. Richardson, Francisco J. Sánchez-Luque, Gabriela O. Bodea, Adam D. Ewing, Carmen Salvador-Palomeque, Marjo S. Van Der Knaap, Paul M. Brennan, Adeline Vanderver, Geoffrey J. Faulkner

Neurology Faculty Publications

Somatic LINE-1 (L1) retrotransposition during neurogenesis is a potential source of genotypic variation among neurons. As a neurogenic niche, the hippocampus supports pronounced L1 activity. However, the basal parameters and biological impact of L1-driven mosaicism remain unclear. Here, we performed single-cell retrotransposon capture sequencing (RC-seq) on individual human hippocampal neurons and glia, as well as cortical neurons. An estimated 13.7 somatic L1 insertions occurred per hippocampal neuron and carried the sequence hallmarks of target-primed reverse transcription. Notably, hippocampal neuron L1 insertions were specifically enriched in transcribed neuronal stem cell enhancers and hippocampus genes, increasing their probability of functional relevance. In …

Short-Wavelength Enrichment Of Polychromatic Light Enhances Human Melatonin Suppression Potency., George Brainard, John P. Hanifin, Benjamin Warfield, Marielle K. Stone, Mary E. James, Melissa Ayers, Alan Kubey, Brenda Byrne, Mark Rollag

Department of Neurology Faculty Papers

The basic goal of this research is to determine the best combination of light wavelengths for use as a lighting countermeasure for circadian and sleep disruption during space exploration, as well as for individuals living on Earth. Action spectra employing monochromatic light and selected monochromatic wavelength comparisons have shown that short-wavelength visible light in the blue-appearing portion of the spectrum is most potent for neuroendocrine, circadian, and neurobehavioral regulation. The studies presented here tested the hypothesis that broad spectrum, polychromatic fluorescent light enriched in the short-wavelength portion of the visible spectrum is more potent for pineal melatonin suppression in healthy …

The Effect Of Exercise Training On Skeletal Muscle Gdnf Content And Neuromuscular Physiology In A Mouse Model Of Amyotrophic Lateral Sclerosis., Nicole Carpp

Honors Theses

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease accompanied by the loss of motor neurons, leading to paralysis and death. Glial cell line-derived neurotrophic factor (GDNF) promotes neuron health and function and has been proposed as a therapeutic treatment for ALS. GDNF protein expression in skeletal muscle is regulated by physical activity. The aim of this study was to determine if low intensity exercise would increase GDNF expression in skeletal muscle and slow degeneration of motor neurons in a mouse model of ALS. Following the first sign of disease onset, transgenic ALS mice were randomly assigned to one of three …

The Cognitive Effects Of Chronic Malnutrition And Environment On Working Memory And Executive Function In Children, Kristiana E. Morgan

Independent Study Project (ISP) Collection

Chronic malnutrition, or stunting, occurs frequently in many developing countries such as Uganda. Stunting hinders physical growth and has been associated with delayed cognitive development, especially in young children. This study examined the effect of stunted growth on the function of cognitive processes involving the working memory and executive functions using neuropsychological assessments. Additionally, this study compared cognitive performances among rural and urban populations to analyze the environmental background differences which may affect cognition.

Population samples of fifteen five year old children classified as rural adequately nourished, rural stunted and urban adequately nourished were examined. Tests for working memory and …