Neurology Commons^™

Understanding The Contributions Of Alzheimer’S Disease & Cardiovascular Risks To Cerebral Small Vessel Disease Manifest As White Matter Hyperintensities On Magnetic Resonance Imaging (Mri), Omar M. Al-Janabi

Theses and Dissertations--Clinical and Translational Science

Introduction: Alzheimer’s Diseases (AD) & cerebral small vessel disease associated with cardiovascular risk factors (cSVD) frequently coexist, differentially affecting both imaging and clinical features associated with aging and dementia. We hypothesized that Magnetic Resonance Imaging (MRI) can be used in novel ways to identify relative contributions of AD & cardiovascular risks to cSVD and brain atrophy, generating new biomarkers & insights into mixed disease states associated with cognitive decline and dementia.

Methods: Three experiments were conducted to address the overarching hypothesis. First, we visually rated the clinical MRI of 325 participants from a community-based cross-sectional sample to elucidate the relative …

Analysis Of Gene Transcription Changes Following Chlamydia Pneumoniae Infection Of Thpl Monocytes May Have Relevance To Alzheimer's Disease, Desiré Guthier

PCOM Biomedical Studies Student Scholarship

There is increasing evidence that neuroinflammation caused by infectious agents is an important etiologic factor in neurodegenerative diseases including Alzheimer's disease (AD). One infectious agent that has been associated with AD is Chlamydia pneumoniae (Cpn). Cpn DNA can be detected within peripherally circulating mononuclear cells and there is evidence that infected mononuclear cells could be involved in chronic infection and contribute to inflammation at numerous anatomical sites, including the brain. Understanding Cpn genetic changes progressing from an acute to a chronic infection within monocytes may help to further elucidate. the role of Cpn infected monocytes with regard to …

The Role Of Neck Musculature In Traumatic Brain Injuries In Older Adults: Implications From Sports Medicine, Tyler A. Wood, Steven Morrison, Jacob J. Sosnoff

Rehabilitation Sciences Faculty Publications

Traumatic brain injuries (TBIs) are common and serious injuries to older adults. The majority of TBIs in older adults are sustained when the head impacts the ground or other surface during a fall. While several non-modifiable risk factors have been identified for fall-related TBIs in older adults, there still remains a dearth of knowledge surrounding modifiable risk factors. Thus, this significant knowledge gap warrants an investigation into research across disciplines. The sports medicine literature has examined several modifiable risk factors to prevent a mild form of TBI known as concussion. While this research has identified several risk factors, one particular …

Epigenetic Classifiers For Precision Diagnosis Of Brain Tumors., Javier I Orozco, Ayla O Manughian-Peter, Matthew P Salomon, Diego M Marzese

Articles, Abstracts, and Reports

DNA methylation profiling has proven to be a powerful analytical tool, which can accurately identify the tissue of origin of a wide range of benign and malignant neoplasms. Using microarray-based profiling and supervised machine learning algorithms, we and other groups have recently unraveled DNA methylation signatures capable of aiding the histomolecular diagnosis of different tumor types. We have explored the methylomes of metastatic brain tumors from patients with lung cancer, breast cancer, and cutaneous melanoma and primary brain neoplasms to build epigenetic classifiers. Our brain metastasis methylation (BrainMETH) classifier has the ability to determine the type of brain tumor, the …

Does Sertraline Decrease Depression In Patients Who Suffered A Traumatic Brain Injury (Tbi)?, Christina Costantino

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Does sertraline decrease depression in patients who suffered a traumatic brain injury (TBI)?”

STUDY DESIGN: Review of three randomized controlled trials (RCTs) published in English between 2009-2016.

DATA SOURCES: One RCT and two double-blind, placebo-controlled, RCTs found via PubMed evaluated the benefit of the antidepressant drug, sertraline (Zoloft), in decreasing depression in patients who suffered a TBI.

OUTCOMES MEASURED: Main outcomes were measured using the DSM-IV, Hamilton Rating Score for Depression (HAM-D)6 , Beck Anxiety Inventory (BAI)6 , and the Life-3 quality of life (QOL)6 , …

Does Transcutaneous Vagal Nerve Stimulation (T-Vns) Reduce Seizure Frequency In Adult Patients With Pharmacoresistent Epilepsy?, Scott Poirier

PCOM Physician Assistant Studies Student Scholarship

Objective The objective of this selective EBM review is to determine whether or not transcutaneous vagal nerve stimulation is an effective measure in reducing seizure frequency in adult patients with pharmacoresistant epilepsy.

Study Design This systematic review comprises a randomized controlled trial and an observational pilot study, both published in 2014, as well as a double-blind randomized control trial published in 2016.

Data Sources All articles were published and displayed in English. The articles were obtained via the PubMed database.

Outcomes Measured Reductions in average seizure frequency were analyzed based on data from patient seizure diaries. Secondary outcomes, including quality …

Is Treadmill Training Effective In Improving Postural Instability, Balance, And Gait In Patients With Parkinson Disease?, Katelyn A. Matekovic

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not treadmill training is effective in improving postural instability, balance, and gait in patients with Parkinson disease.

STUDY DESIGN: A systematic review of three peer-reviewed primary studies published between the years of 2013 and 2017.

DATA SOURCES: Three randomized controlled trials comparing the efficacy of treadmill training for improving postural instability, balance, and gait for patients with Parkinson Disease. Sources were selected from PubMed based off of the relevance to the clinical question and if they include patient oriented outcome measures.

OUTCOMES MEASURED: The outcomes measured in …

Does Yoga Improve Symptoms In Patients With Parkinson’S Disease?, Victoria L. Starner

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not yoga improved symptoms in patients with Parkinson’s disease.

STUDY DESIGN: A systematic review of three peer-reviewed primary studies published between 2014 and 2018.

DATA SOURCES: Two randomized control trials and one before and after case study evaluating if yoga can improve symptoms for patients who are diagnosed with Parkinson’s disease.

OUTCOMES MEASURES: The outcomes that were measured were balance and movement speed. Balance was measured using single leg balance test, single leg stance, and Berg Balance Scale. Movement speed, bradykinesia, was measured using the Unified Parkinson’s …

Is Methylphenidate Effective In Reducing Apathy Among Alzheimer’S Disease Patients?, Jeremy Rinaldi

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE The objective of this selective EBM review is to determine whether or not “Is methylphenidate effective in reducing apathy among Alzheimer’s disease patients?”

STUDY DESIGN Systematic review of two randomized controlled trials published in 2008 and 2013 and one open label study published in 2010.

DATA SOURCES Two randomized controlled trials and one open label study were obtained using PubMed and Medline.

OUTCOMES MEASURED The focus of this review is to determine the efficacy of methylphenidate in decreasing symptoms of apathy in Alzheimer’s disease patients. The efficacy of methylphenidate was assessed in all three studies by using the Apathy …

Is The Use Of Methylcobalamin Alone Or In Combination With Lidocaine Clinically More Effective Than Lidocaine Alone In Relieving Herpes Zoster Related Neuropathic Pain With Subcutaneous Injections?, Rachel N. Todd

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Methylcobalamin alone or in combination with Lidocaine is clinically more effective than Lidocaine alone in relieving Herpes Zoster related neuropathic pain with subcutaneous injections.

STUDY DESIGN: This is a systematic review of three peer-reviewed primary studies. All were randomized, controlled trials published between the years of 2014 and 2016.

DATA SOURCES: Data sources obtained for this review were published in peer reviewed journals and selected from PubMed Database.

OUTCOME MEASURED: The outcomes measured reflected the effectiveness of incorporating subcutaneous Methylcobalamin in the treatment regimen for neuropathic …

Is Cannabis Effective In Reducing Muscle Spasticity And Body Pain Amongst Patients With Multiple Sclerosis?, William E. Johnson

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not cannabis is effective in reducing muscle spasticity and body pain amongst patients with Multiple Sclerosis (MS).

STUDY DESIGN: A systematic review of three peer-reviewed studies published between the years of 2003 and 2012.

DATA SOURCES: Three randomized control trials (RCTs) evaluating if cannabis can reduce muscle spasticity and body pain for patients diagnosed with Multiple Sclerosis. All three sources were selected from PubMed and examined for outcomes that were patient oriented.

OUTCOMES MEASURED: The two primary outcomes measured include: muscle spasticity measured by the Ashworth scale, …

Search Strategies For "The Interactions Between Anticonvulsants And Novel Oral Anticoagulants: A Systematic Review", Mohamed Taha, Wenyang Li, Cynthia M. Schmidt, Marco Gonzalez-Castellon, Olga Taraschenko

Search Strategies: Leon S. McGoogan Health Sciences Library

No abstract provided.

Delta-Aminolevulinic Acid-Mediated Photodiagnoses In Surgical Oncology: A Historical Review Of Clinical Trials., Joseph F Georges, Amber Valeri, Huan Wang, Aaron Brooking, Michael Kakareka, Steve S Cho, Zein Al-Atrache, Michael Bamimore, Hany Osman, Joseph Ifrach, Si Yu, Carrie Li, Denah Appelt, John Y K Lee, Peter Nakaji, Kristin Brill, Steven S. Yocom

PCOM Scholarly Works

Fluorescence imaging is an emerging clinical technique for real-time intraoperative visualization of tumors and their boundaries. Though multiple fluorescent contrast agents are available in the basic sciences, few fluorescence agents are available for clinical use. Of the clinical fluorophores, delta aminolevulinic acid (5ALA) is unique for generating visible wavelength tumor-specific fluorescence. In 2017, 5ALA was FDA-approved for glioma surgery in the United States. Additionally, clinical studies suggest this agent may have utility in surgical subspecialties outside of neurosurgery. Data from dermatology, OB/GYN, urology, cardiothoracic surgery, and gastrointestinal surgery show 5ALA is helpful for intraoperative visualization of malignant tissues in multiple …

Reducing Return Of Disease Activity In Patients With Relapsing Multiple Sclerosis Transitioned From Natalizumab To Teriflunomide: 12-Month Interim Results Of Teriflunomide Therapy., Stanley Cohan, Keith Edwards, Lindsay Lucas, Tiffany Gervasi-Follmar, Judy O'Connor, Jessica Siuta, Vineetha Kamath, Lore Garten, Chiayi Chen, James Thomas, Kyle E Smoot, Kiren Kresa-Reahl, Kateri Spinelli

Articles, Abstracts, and Reports

Background: Natalizumab is an effective treatment for relapsing multiple sclerosis. Return of disease activity upon natalizumab discontinuance creates the need for follow-up therapeutic strategies.

Objective: To assess the efficacy of teriflunomide following natalizumab discontinuance in relapsing multiple sclerosis patients.

Methods: Clinically stable relapsing multiple sclerosis patients completing 12 or more consecutive months of natalizumab, testing positive for anti-John Cunningham virus antibody, started teriflunomide 14 mg/day, 28 ± 7 days after their final natalizumab infusion. Physical examination, Expanded Disability Status Scale, laboratory assessments, and brain magnetic resonance imaging were performed at screening and multiple follow-up visits.

Results: Fifty-five patients were enrolled …

Addressing Stroke Patient And Family Reasons For Not Calling 911, Maygret Ramirez, Rodney Bedgio, Virginia Ramos, Ivis Gonzalez, Yaima Miro Gonzalez, Amy Starosciak, Daniel D'Amour, Jayme Strauss, Felipe De Los Rios La Rosa

All Publications

No abstract provided.

Depression Among Epileptic Patients And Its Association With Drug Therapy In Sub-Saharan Africa: A Systematic Review And Meta-Analysis., Getenet Dessie, Henok Mulugeta, Cheru Tesema Leshargie, Fasil Wagnew, Sahai Burrowes

BACKGROUND: Despite the high prevalence of epilepsy in sub-Saharan Africa and the established relationship between depression and epilepsy, the extent of comorbid epilepsy and depression in the region is still poorly understood. The objective of this systematic review and meta-analysis is to address this gap in the literature by determining the pooled prevalence of depression among epileptic patients in sub-Saharan Africa.

METHODS: A systematic desk review and electronic web-based search of PubMed, Google Scholar, EMBASE, PsycINFO and the World Health Organization's Hinari portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases) conducted from December 2, 2017 …

Altering Brain Dynamics With Transcranial Random Noise Stimulation, Onno Van Der Groen, Jason B. Mattingley, Nicole Wenderoth

Research outputs 2014 to 2021

Random noise can enhance the detectability of weak signals in nonlinear systems, a phenomenon known as stochastic resonance (SR). This concept is not only applicable to single threshold systems but can also be applied to dynamical systems with multiple attractor states, such as observed during the phenomenon of binocular rivalry. Binocular rivalry can be characterized by marginally stable attractor states between which the brain switches in a spontaneous, stochastic manner. Here we used a computational model to predict the effect of noise on perceptual dominance durations. Subsequently we compared the model prediction to a series of experiments where we measured …

Implementation Of Stroke Pathways To Reduce Length Of Stay, Cost, Readmissions, And Mortality, Jayme Strauss, Daniel Hartnett, Jenny Ductant, Peter De Armas, Albert Fernandez, Andrew Waisbrot, Amy Starosciak, Felipe De Los Rios La Rosa

All Publications

No abstract provided.

A Systems Thinking Approach For Eliciting Mental Models From Visual Boundary Objects In Hydropolitical Contexts: A Case Study From The Pilcomayo River Basin, Riveraine S. Walters, Erin S. Kenzie, Alexander E. Metzger, William Jesse Baltutis, Kakali B. Chakrabarti, Shana Lee Hirsch, Bethany Laursen

Complex Systems Faculty Publications and Presentations

Transboundary collaborations related to international freshwater are critical for ensuring equitable, efficient, and sustainable shared access to our planet’s most fundamental resources. Visual artifacts, such as knowledge maps, functioning as boundary objects, are used in hydropolitical contexts to convey understandings and facilitate discussion across scales about challenges and opportunities from multiple perspectives. Such focal points for discussion are valuable in creating shared, socially negotiated priorities and integrating diverse and often disparate cultural perspectives that naturally exist in the context of international transboundary water resources. Visual boundary objects can also represent the collective mental models of the actor countries and transboundary …

Human Papillomavirus And Human Cytomegalovirus Infection And Association With Prognosis In Patients With Primary Glioblastoma In Pakistan, Syed Adnan Ali, Yumna Mirza, Zubair Ahmad, Nida Zahid, Ather Enam

Department of Surgery Docs

Objective: Glioblastoma multiforme (GBM) is the most common adult primary brain tumor. Human cytomegalovirus (HCMV) has been studied for the past decade, and conflicting results have been reported with no conclusive role established yet. Human papillomavirus (HPV) is involved in the pathogenesis of many cancers and has a high prevalence in patients with cervical and oral cancer in Pakistan. The objective of our study was to identify the prevalence of HCMV and HPV in Pakistani patients with primary GBM.
Methods: In total, 112 primary GBM biopsies were analyzed. HCMV and HPV infection was investigated using nested and conventional polymerase chain …

A Proof-Of-Mechanism Study To Test Effects Of The Nmda Receptor Antagonist Lanicemine On Behavioral Sensitization In Individuals With Symptoms Of Ptsd, Marijn Lijffijt, Charles E Green, Nicholas Balderston, Tabish Iqbal, Megan Atkinson, Brittany Vo-Le, Bylinda Vo-Le, Brittany O'Brien, Christian Grillon, Alan C Swann, Sanjay J Mathew

Faculty, Staff and Students Publications

Background: Individuals with post-traumatic stress disorder (PTSD) have a heightened sensitivity to subsequent stressors, addictive drugs, and symptom recurrence, a form of behavioral sensitization. N-methyl-D-aspartate receptors (NMDARs) are involved in the establishment and activation of sensitized behavior.

Objective: We describe a protocol of a randomized placebo-controlled Phase 1b proof-of-mechanism trial to examine target engagement, safety, tolerability, and possible efficacy of the NMDAR antagonist lanicemine in individuals with symptoms of PTSD (Clinician Administered PTSD Scale [CAPS-5] score ≥ 25) and evidence of behavioral sensitization measured as enhanced anxiety-potentiated startle (APS; T-score ≥ 2.8).

Methods: Subjects (n = 24; age range 21–65) …

Randomized Trial Of Polychromatic Blue-Enriched Light For Circadian Phase Shifting, Melatonin Suppression, And Alerting Responses., J. P. Hanifin, S. W. Lockley, K. Cecil, K. West, M. Jablonski, B. Warfield, M. James, M. Ayers, B. Byrne, E. Gerner, C. Pineda, M. Rollag, G. C. Brainard

Department of Neurology Faculty Papers

Wavelength comparisons have indicated that circadian phase-shifting and enhancement of subjective and EEG-correlates of alertness have a higher sensitivity to short wavelength visible light. The aim of the current study was to test whether polychromatic light enriched in the blue portion of the spectrum (17,000 K) has increased efficacy for melatonin suppression, circadian phase-shifting, and alertness as compared to an equal photon density exposure to a standard white polychromatic light (4000 K). Twenty healthy participants were studied in a time-free environment for 7 days. The protocol included two baseline days followed by a 26-h constant routine (CR1) to assess initial …