Neurology Commons^™

Comparison Of Best Versus Worst Clinical Outcomes For Adult Cervical Deformity Surgery., Justin S Smith, Christopher I Shaffrey, Han Jo Kim, Peter Passias, Themistocles Protopsaltis, Renaud Lafage, Gregory M Mundis, Eric Klineberg, Virginie Lafage, Frank J Schwab, Justin K Scheer, Michael Kelly, D Kojo Hamilton, Munish Gupta, Vedat Deviren, Richard Hostin, Todd Albert, K Daniel Riew, Robert A Hart, Doug Burton, Shay Bess, Christopher P Ames

Articles, Abstracts, and Reports

Study Design: Retrospective cohort study.

Objective: Factors that predict outcomes for adult cervical spine deformity (ACSD) have not been well defined. To compare ACSD patients with best versus worst outcomes.

Methods: This study was based on a prospective, multicenter observational ACSD cohort. Best versus worst outcomes were compared based on Neck Disability Index (NDI), Neck Pain Numeric Rating Scale (NP-NRS), and modified Japanese Orthopaedic Association (mJOA) scores.

Results: Of 111 patients, 80 (72%) had minimum 1-year follow-up. For NDI, compared with best outcome patients (n = 28), worst outcome patients (n = 32) were more likely to have had a …

Decreased Odds For Vasospasm Treatment In Patients With Aneurysmal Subarachnoid Hemorrhage After Transitioning From Neurosurgery Led Care To A Neurology Led Multidisciplinary Approach., Russell Bartt, Stephanie Jarvis, Lauren Cittadino, Benjamin Atchie, Kathryn Mccarthy, Rebecca Van Vliet, Alicia Bennett, Jeffrey Wagner, Alessandro Orlando, David Bar-Or

Articles, Abstracts, and Reports

Introduction: The limited research on the management of aneurysmal subarachnoid hemorrhages (aSAHs) has not assessed the efficacy of neurology-led care. Our objective was to describe aSAH patients' outcomes after transitioning from a neurosurgery-led intensive care unit (ICU) to a neurology-led multidisciplinary care neurocritical care unit (NCCU). The study hypothesis was that the neurology-led multidisciplinary care would improve patient outcomes.

Methods: This was a retrospective cohort study. We included patients (≥ 18) with aSAHs from 1/16 to 8/16 (pregroup) and from 3/17 to 11/17 (postgroup). The pregroup care was led by a neurosurgeon. The postgroup care included a neurologist, a pulmonary …

Dementia In Pakistan; An Unprecedented Challenge And Local Cultural Beliefs, Problems And Actions Required., Qamar Zaman, Maimoona Siddiqui, Zaha Iqbal Malik

Pakistan Journal of Neurological Sciences (PJNS)

Changing cultural and social dynamics has brought a major shift in lifestyles and associated risk factors for various disorders that were previously uncommon in Pakistan. Dementia is among the one of these emerging problems that is going to affect the elderly population worldwide but more so in the developing world. To adequately deal with the problems faced by patients with dementia and their caregivers, several important measures are needed that can help to reduce the morbidity and burden on the families and overall society. Increasing the awareness regarding the risk factors may help to reduce the dementia burden similarly knowledge …

Use Of Novel Oral Anticoagulants For Treatment Of Cerebral Venous Sinus Thrombosis: A Case Series And Follow Up, Rizwana Shahid, Noman Ishaque, Aishah Albakr, Nourah Abdulaziz Alkhaldi, Feras Abdulsalam, Abdullah Alsulaiman

Pakistan Journal of Neurological Sciences (PJNS)

Thrombosis of cerebral venous sinuses and/or cortical veins (CVST) is an infrequent type of stroke for which anticoagulation is considered standard of treatment. However, 40% of CVST patients have evidence of parenchymal changes like edema or haemorrhage on neuroimaging which complicates use of anticoagulation in such cases. Therefore, Novel Oral Anticoagulants (NOACs) are recently being used for treatment of CVST as they are associated with half the risk of intracerebral haemorrhage as caused by vitamin K antagonist. Case reports and case series have reported use of NOACs in CVST with good outcomes both clinically and radiologically. We report use of …

Quantifying Expression Of Interneuron Subtype Markers For Dlx-2 Transfected Ng2 Cells, Timothy Nolan

Honors Scholar Theses

Neurons are a post-mitotic cell population, and therefore, they are not able to regenerate in vivo after a traumatic injury. Because inhibitory GABAergic interneurons and oligodendrocyte precursor cells (OPCs) are derived from the same precursor, recent studies have focused on transforming these OPCs into GABAergic neurons. However, there are different types of GABAergic interneurons that have different electrophysiological responses, which can lead to functional differences. The Nishiyama laboratory had already used a key gene in GABAergic interneuron and OPC differentiation, Distal-less homeobox 2 (Dlx-2), to transfect OPCs; early electrophysiology tests showed most of these transfected cells behaved like immature neurons, …

Cervical Posterior Longitudinal Ligament Ossification : Microscopy-Assisted Anterior Corpectomy And Fusion., Wanyi Wang, Tao Ding, James Harrop, Huilin Yang, Xiaofeng Gu, Dehong Feng, Yafeng Zhang, Hao Liu, Fenglin Tang, Yuntao Xue, Miao Lu, Chao Wu

Department of Neurosurgery Faculty Papers

OBJECTIVE: To explore the clinical efficacy and safety of microscopy-assisted anterior corpectomy and fusion for cervical ossification of the posterior longitudinal ligament (OPLL).

METHODS: A retrospective review of 32 cervical OPLL patients who underwent microscopy-assisted anterior corpectomy and fusion from June 2012 to March 2017 was carried out. Patients were evaluated with outcome metrics: Japanese Orthopaedic Association (JOA) scores (17 points method), visual analog scale (VAS), and radiographic parameters of the lordotic angle. The complications during treatment and follow-up were recorded.

RESULTS: This study included 32 patients (15 males and 17 females) with a mean age of 58.3 ± 2.9 …

Evaluating The Efficacy And Safety Of Transitioning Patients From Natalizumab To Ocrelizumab (Octave), Kyle E Smoot, Kiren Kresa-Reahl, Pavle Repovic, Jessica Craddock, Chiayi Chen, Lindsay Lucas, Tiffany Gervasi-Follmar, Stanley Cohan

Books, Presentations, Posters, Etc.

No abstract provided.

New Oral Anticoagulants Versus Warfarin For Cerebral Venous Thrombosis: A Multi-Center, Observational Study, Mohammad Wasay, Maria Khan, Haris Majid Rajput, Salman Farooq, Mohammed Ibrahim Memon, Suhail Abdulla Alrukn, Abdul Malik, Foad Abd-Allah, Raja Farhat Shoaib, Rizwana Shahid, Sadia Nishat, Safia Awan

Section of Neurology

No abstract provided.

A New Health Care Model For Pakistan, Mohammad Wasay, Ashar Malik

Section of Neurology

No abstract provided.

Re-Code Dcm (Research Objectives And Common Data Elements For Degenerative Cervical Myelopathy): A Consensus Process To Improve Research Efficiency In Dcm, Through Establishment Of A Standardized Dataset For Clinical Research And The Definition Of The Research Priorities, Benjamin M. Davies, Danyal Z. Khan, Oliver D. Mowforth, Angus G.K. Mcnair, Toto Gronlund, Angelos G. Kolias, Lindsay Tetreault, Michelle L. Starkey, Iwan Sadler, Ellen Sarewitz, Delphine Houlton, Julia Carter, Sukhvinder Kalsi-Ryan, Bizhan Aarabi, Brian K. Kwon, Shekar N. Kurpad, James Harrop, Jefferson R. Wilson, Robert Grossman, Armin Curt, Michael G. Fehlings, Mark R.N. Kotter

Department of Neurosurgery Faculty Papers

Study Design: Mixed-method consensus process.

Objectives: Degenerative cervical myelopathy (DCM) is a common and disabling condition that arises when mechanical stress damages the spinal cord as a result of degenerative changes in the surrounding spinal structures. RECODE-DCM (REsearch Objectives and Common Data Elements for Degenerative Cervical Myelopathy) aims to improve efficient use of health care resources within the field of DCM by using a multi-stakeholder partnership to define the DCM research priorities, to develop a minimum dataset for DCM clinical studies, and confirm a definition of DCM.

Methods: This requires a multi-stakeholder partnership and multiple parallel consensus development processes. It …

Angiogram Negative Subarachnoid Hemorrhage In The Setting Of Sexual Intercourse And Chronic Cannabis Use, Dakota T. May, Dominika Lozowska

Marshall Journal of Medicine

Etiology of unprovoked subarachnoid hemorrhage (SAH) is predominantly from cerebral aneurysm rupture and manifests classically as a thunderclap headache. Orgasmic cephalgia may herald SAH given that 4-12% of SAH sufferers were found to have engaged in prior sexual activity.(1) Precipitating causes of SAH leading to aneurysmal rupture may be the rise in blood pressure caused by physical activity. A conventional angiogram (CTA) is used to reveal a source of the bleed and but occasionally this is normal, and is labelled angiogram-negative SAH or non-aneurysmal SAH. In those cases digital subtraction imaging (DSA) is needed for verification. Herein we discuss an …

Effects Of Exercise On Eeg Activity And Standard Tools Used To Assess Concussion, David M Devilbiss, Jena L Etnoyer-Slaski, Emily Dunn, Christopher R Dussourd, Mayuresh V Kothare, Stephen J Martino, Adam J Simon

Rowan-Virtua School of Osteopathic Medicine Departmental Research

A variety of cognitive assessment tools are used to determine the functional status of the brain before and after injury in athletes. Questionnaires, neuropsychological tests, and electroencephalographic (EEG) measures have been recently used to directly assess brain function on and near the playing field. However, exercise can affect cognitive performance and EEG measures of cortical activity. To date, little empirical evidence exists on the effects of acute exercise on these measures of neurological function. We therefore quantified athlete performance on a standardized battery of concussion assessment tools and EEG measurements immediately before and after acute exercise to simulate conditions of …

Does It Matter Whether You Or Your Brain Did It? An Empirical Investigation Of The Influence Of The Double Subject Fallacy On Moral Responsibility Judgments, Uri Maoz, Kellienne R. Sita, Jeroen J. A. Van Boxtel, Liad Mudrik

Psychology Faculty Articles and Research

Despite progress in cognitive neuroscience, we are still far from understanding the relations between the brain and the conscious self. We previously suggested that some neuroscientific texts that attempt to clarify these relations may in fact make them more difficult to understand. Such texts—ranging from popular science to high-impact scientific publications—position the brain and the conscious self as two independent, interacting subjects, capable of possessing opposite psychological states. We termed such writing ‘Double Subject Fallacy’ (DSF). We further suggested that such DSF language, besides being conceptually confusing and reflecting dualistic intuitions, might affect people’s conceptions of moral responsibility, lessening the …

Brain Image Clustering By Wavelet Energy And Cbsso Optimization Algorithm, Hasan Hosseinzadeh, Mohammad Sedaghat

Journal of Mind and Medical Sciences

Previously, the diagnosis of brain abnormality was significantly important in the saving of social and hospital resources. Wavelet energy is known as an effective feature detection which has great efficiency in different utilities. This paper suggests a new method based on wavelet energy to automatically classify magnetic resonance imaging (MRI) brain images into two groups (normal and abnormal), utilizing support vector machine (SVM) classification based on chaotic binary shark smell optimization (CBSSO) to optimize the SVM weights.

The results of the suggested CBSSO-based KSVM are compared favorably to several other methods in terms of better sensitivity and authenticity. The proposed …

The Risk Of Bleeding And Encephalopathy In Surgical Patients With Liver Cirrhosis, Petrișor Banu, Salvatore Settineri, Emanuele Maria Merlo, Maria Rosaria Anna Muscatello, Nicolae Bacalbașa, Carolina Negrei, Bianca Gălățeanu, Octav Ghinghină, Ioana Păunica, Cristian Bălălău

Journal of Mind and Medical Sciences

Liver cirrhosis is a disease with an increasing incidence. Surgical procedures in patients with cirrhosis are also increasing, due to a longer life expectancy in these patients and also to the improvement of therapeutic and diagnostic resources.

Digestive hemorrhage in the cirrhotic patient requires emergency medical intervention (intensive therapy, endoscopic or even surgical approaches), being at the same time a factor that precipitates episodes of encephalopathy, i.e. the conventional complication of cirrhosis. Hepatic encephalopathy represents one of the most severe clinical events of cirrhosis, being associated with high morbidity and mortality. The causes of hepatic encephalopathy are briefly presented in …

Total And Free Plasma Bilirubin And Clinical Outcomes In Severe Hyperbilirubinemia, Sean M. Riordan, Jean-Baptiste Lepichon, Steven Shapiro, Tina Slusher, Fatima Abdullahi, Hafsat M. Suleiman, Victor C. Pam, Mamu B. Samuel, Christopher S. Yilgwan, Christian Isichei, Idris Y. Mohammed

Posters

Acute bilirubin encephalopathy (ABE) and kernicterus spectrum disorder (KSD) have become relatively uncommon in high income countries but remain a major cause of morbidity and mortality in low- and middle-income countries. To better understand the relationship between free (Bf) and total (TB) bilirubin levels and the development of ABE and KSD we followed infants born in three large tertiary centers in northern and central Nigeria (Jos, Kano and Zaria).

Weighted Pathway Genetic Load Analysis Of Hyperbilirubinemic Infants Indicates A Potential Genetic Component For Susceptibility To Bilirubin Neurotoxicity, Sean M. Riordan, Jean-Baptiste Lepichon, Steven Shapiro, John Cowden, Monica Villagullen, Laurence Thielemans, Dina Villanueva Garcia, Jesus Aguirre-Hernandez

Posters

Severe kernicterus spectrum disorder (KSD) is described as motor and auditory deficits resulting from brain damage caused by hyperbilirubinemia. The severity of HB does not always predict the severity of injury. The lack of a strong monogenetic link to susceptibility suggests bilirubin-induced brain damage may be due to impaired bilirubin response pathways. This poster describes work to use a modified pathway genetic load (mPGL) score method to perform a targeted genetic analysis of whole exome data from patients with various degrees of neonatal HB, with an ultimate goal of developing a neonatal screen to susceptibiltiy to bilirubin neurotoxicity.

Developing Technologically Advanced Research In Low- And Middle-Income Countries, Isa Abdulkadir, Tina Slusher, Fidelia Bode-Thomas, Sean Riordan, Jean-Baptiste Lepichon, Laila Hassan, Shehu Abdullahi, Akinyemi Ofakunrin, Stephen Oguche, Steven Shapiro, William Ogala

Posters

This poster presents a collaboration between a group of scientists in Nigeria and the USA in developing a genomic research project and the solutions adopted in tackling the ethical implications and partnership equity and ownership of such a project.

The Correlation Between The Microbiome And Neurodegenerative Disorders Such As Alzheimer Disease, Aurora Mokris

Honors Theses

Recent studies suggest that there are 1.3 times as many microbial cells as human cells in the body (Abbot, 2016). Another study claims that the combined genomes of this microbiota is 150 times that of the human genome (Zhuang & Shen, 2018). If you have ever had the feeling that you are not alone in an empty room you are most certainly correct. Your body is teeming with millions of organisms living in mutualistic symbiosis with you and surrounding microbes, but at times, this seemingly harmonious relationship can be disturbed, resulting in serious physical and psychological changes to the human …

Body Mass Index In Multiple Sclerosis Modulates Ceramide-Induced Dna Methylation And Disease Course, Kamilah Castro, Achilles Ntranos, Mario Amatruda, Maria Petracca, Peter Kosa, Emily Y. Chen, Johannes Morstein, Dirk Trauner, Corey T. Watson, Michael A. Kiebish, Bibiana Bielekova, Matilde Inglese, Ilana Katz Sand, Patricia Casaccia

Advanced Science Research Center

Background: Multiple Sclerosis (MS) results from genetic predisposition and environmental variables, including elevated Body Mass Index (BMI) in early life. This study addresses the effect of BMI on the epigenome of monocytes and disease course in MS.

Methods: Fifty-four therapy-naive Relapsing Remitting (RR) MS patients with high and normal BMI received clinical and MRI evaluation. Blood samples were immunophenotyped, and processed for unbiased plasma lipidomic profiling and genome-wide DNA methylation analysis of circulating monocytes. The main findings at baseline were validated in an independent cohort of 91 therapy-naïve RRMS patients. Disease course was evaluated by a two-year longitudinal follow up …

Diffuse Low-Grade Glioma - Changing Concepts In Diagnosis And Management: A Review, Rashid Jooma, Muhammad Waqas, Inamullah Khan

Section of Neurosurgery

Though diffuse low-grade gliomas (dLGGs) represent only 15% of gliomas, they have been receiving increasing attention in the past decade. Significant advances in knowledge of the natural history and clinical diversity have been documented, and an improved pathological classification of gliomas that integrates histological features with molecular markers has been issued by the WHO. Advances in the radiological assessment of dLGG, particularly new magnetic resonance imaging scanning sequences, allow improved diagnostic and prognostic information. The management paradigms are evolving from "wait and watch" of the past to more active interventional therapy to obviate the risk of malignant transformation. New surgical …

Role Of Surgery In Spinal Metastases, Altaf Ali Laghari, Humza Faisal Siddiqui, Muhammad Shahzad Shamim

Section of Cardiology

Spinal metastases constitute two-third of all cases of bone metastases. Surgical intervention in these tumours has been recommended in highly selective cases, for confirming diagnosis, stabilizing the spine, and decompressing nerves or spinal cord for alleviation of pain and preservation of function.In this article,the authors have reviewed available evidence on role of surgery in spinal metastases and have presented results of selected papers on this vast topic.

Rationale And Methods For A Multicenter Clinical Trial Assessing Exercise And Intensive Vascular Risk Reduction In Preventing Dementia (Rrad Study), Amanda N. Szabo-Reed, Eric Vidoni, Ellen F. Binder, Jeffrey Burns, C. Munro Cullum, William P. Gahan, Aditi Gupta, Linda S. Hynan, Diana R. Kerwin, Heidi Rossetti, Ann M. Stowe, Wanpen Vongpatanasin, David C. Zhu, Rong Zhang, Jeffrey N. Keller

Neurology Faculty Publications

Alzheimer's Disease (AD) is an age-related disease with modifiable risk factors such as hypertension, hypercholesterolemia, obesity, and physical inactivity influencing the onset and progression. There is however, no direct evidence that reducing these risk factors prevents or slows AD. The Risk Reduction for Alzheimer's Disease (rrAD) trial is designed to study the independent and combined effects of intensive pharmacological control of blood pressure and cholesterol and exercise training on neurocognitive function. Six hundred and forty cognitively normal older adults age 60 to 85 years with hypertension and increased risk for dementia will be enrolled. Participants are randomized into one of …

Evidence-Based Intervention To Improve Assessment Of Headache Pain And Its Functional Capacity, Mavjuda Saydazamova

Doctoral Projects

Introduction: Headache is a chronic pain that is challenging to properly assess in clinical practice, as it is based almost entirely on the ability of the clinician and patient to communicate. This communication is based on pain scale tools. To assess patients’ disability and pain intensity, the selected organization uses the Migraine Disability Assessment (MIDAS) screening tool. Pain intensity is measured with a Numeric Pain Scale within the MIDAS. Measuring chronic headache pain accurately, while using a very subjective and inadequate pain scale to measure chronic pain was an issue. The literature review supported replacing the Numeric Pain Scale with …

The Acute Effects Of Melatonin On Striatal Dopamine Release: Progressive Electrochemical Analysis In An Ex Vivo Mouse Model Utilizing Fast Scan Cyclic Voltammetry, Kevin D. Hughes

Masters Theses

The caudate putamen is a sub region of the basal ganglia, containing neural tracts important for cognition, reward learning, and voluntary motor function. Dopamine (DA) signaling received from the dopaminergic neurons of the substantia nigra pars compacta mediate locomotion, degradation of which is the characteristic neuropathology for Parkinson’s disease (PD). PD is an initially neurovegetative motor disorder but can progress to include cognitive impairments as well. Sundowner’s syndrome (SS) has been observed in patient populations with neurodegenerative diseases, characterized by the decline of cognition into evening hours. Due to the circadian influence which the hormone melatonin has on the sleep-wake …

Neuroprotective Activity Of Leukemia Inhibitory Factor Is Relayed Through Myeloid Zinc Finger-1 In A Rat Model Of Stroke, Stephanie M. Davis, Lisa A. Collier, Elspeth A. Foran, Christopher C. Leonardo, Craig T. Ajmo Jr., Keith R. Pennypacker

Neurology Faculty Publications

The aim of this study was to determine whether leukemia inhibitory factor (LIF) exerts its neuroprotective effects through signal transduction of the transcription factor myeloid zinc finger-1 (MZF-1). According to the hypothesis of this study, MZF-1 mediates LIF-induced neuroprotective signaling during ELVO through increased expression and transcriptional activity. To determine the in vivo role of MZF-1 in LIF-induced neuroprotection, we used Genomatix software was used to MZF-1 sites in the promoter region of the rat superoxide dismutase 3 (SOD3) gene. Stroke was induced via middle cerebral artery occlusion, and animals were administered PBS or 125 μg/kg LIF at …

Rare Variant Of Guillain-Barré Syndrome After Chikungunya Viral Fever, Sajid Hameed, Sara Khan

Section of Neurology

Chikungunya (CHIK) viral fever is a self-limiting illness that presents with severe debilitating arthralgia, myalgia, fever and rash. Neurological complications are rare. We present a case of a 36-year-old woman who presented with acute onset progressive difficulty swallowing and left arm weakness. She was diagnosed with CHIK viral fever 4 weeks prior to admission. After investigations, she was diagnosed with a pharyngeal-cervical-brachial variant of Guillain-Barré syndrome. In hospital, she required ventilator support. Her condition improved after five sessions of intravenous immunoglobulin with almost complete resolution within 6 months of symptom onset. With frequent CHIK outbreaks, the neurological complications are increasingly …

Predictors Of Good Functional Outcome At Discharge In Stroke Patients With Depression In The Fl-Pr Collaboration To Reduce Stroke Disparities, Amy Starosciak

All Publications

No abstract provided.

Maximum Iv Tpa Dose For Obese Patients Is Associated With Greater Likelihood Of Hemorrhagic Conversion And Worse Functional Outcome At Discharge, Amy Starosciak, Felipe De Los Rios La Rosa

All Publications

No abstract provided.

Tobacco Smoking And Dementia In A Kentucky Cohort: A Competing Risk Analysis, Erin L. Abner, Peter T. Nelson, Gregory A. Jicha, Gregory E. Cooper, David W. Fardo, Frederick A. Schmitt, Richard J. Kryscio

Epidemiology and Environmental Health Faculty Publications

Tobacco smoking was examined as a risk for dementia and neuropathological burden in 531 initially cognitively normal older adults followed longitudinally at the University of Kentucky’s Alzheimer’s Disease Center. The cohort was followed for an average of 11.5 years; 111 (20.9%) participants were diagnosed with dementia, while 242 (45.6%) died without dementia. At baseline, 49 (9.2%) participants reported current smoking (median pack-years = 47.3) and 231 (43.5%) former smoking (median pack-years = 24.5). The hazard ratio (HR) for dementia for former smokers versus never smokers based on the Cox model was 1.64 (95% CI: 1.09, 2.46), while the HR for …