Neurology Commons^™

Relative Contribution Of Arms And Legs Through Repetitive Assisted Sit-To-Stand Motion In Individuals With Incomplete Spinal Cord Injury, Abd Aziz Musfirah

Student Works (2020-2029)

Sit-To-Stand (SitTS) exercise is one of important prerequisites to achieve some functional independence goals in everyday life especially for individuals undergoing rehabilitation In general, the execution of SitTS in spinal cord injury (SCI) patients involves motor function in both upper and lower extremities. The use of arm support in particular is a very significant element while executing SitTS movement for SCI population. In addition, application of functional electrical stimulation (FES) onto the quadriceps muscles is one of the prescribed management for incomplete SCI to improve muscle action for simple lower limb movements. However, the relative contribution of upper and lower …

Acute Disseminated Encephalomyelitis, Ashan Hatharasinghe, Hossein Akhondi, Don Pepito

HCA Healthcare Journal of Medicine

Introduction: Acute Disseminated Encephalomyelitis (ADEM) is a rare autoimmune demyelinating disorder of the central nervous system. Clinical manifestations include encephalopathy, motor deficits, ataxia, and meningeal signs. In most cases, ADEM is preceded by either vaccination or viral illness. Here, we present a case with neither of the two predisposing elements.

Discussion: A 28-year-old Hispanic female presenting with substance use and suicidal ideation was placed on an involuntary psychiatric hold, started on olanzapine and scheduled for a psychiatric facility transfer. The following day, she was noted to have neurological deficits when ambulating. Computed tomography of the brain showed a right frontal …

Association Of Aβ With Ceramide-Enriched Astrosomes Mediates Aβ Neurotoxicity, Ahmed Elsherbini, Alexander S. Kirov, Michael B. Dinkins, Guanghu Wang, Haiyan Qin, Zhihui Zhu, Priyanka Tripathi, Simone M. Crivelli, Erhard Bieberich

Physiology Faculty Publications

Amyloid-β (Aβ) associates with extracellular vesicles termed exosomes. It is not clear whether and how exosomes modulate Aβ neurotoxicity in Alzheimer's disease (AD). We show here that brain tissue and serum from the transgenic mouse model of familial AD (5xFAD) and serum from AD patients contains ceramide-enriched and astrocyte-derived exosomes (termed astrosomes) that are associated with Aβ. In Neuro-2a cells, primary cultured neurons, and human induced pluripotent stem cell-derived neurons, Aβ-associated astrosomes from 5xFAD mice and AD patient serum were specifically transported to mitochondria, induced mitochondrial clustering, and upregulated the fission protein Drp-1 at a concentration corresponding to 5 femtomoles …

Iron Deficiency Anemia: An Unexpected Cause Of An Acute Occipital Lobe Stroke In An Otherwise Healthy Young Woman, Qian Zhang, Khine S. Shan, Conor O'Sullivan, Travis C. Nace

Abington Jefferson Health Papers

A 29-year-old caucasian woman who presented to the hospital with an acute onset of right eye visual disturbance and headache was found to have an acute left occipital lobe infarction. Past medical history was significant for iron deficiency anemia (IDA) secondary to menorrhagia. Her initial hemoglobin level was 7.8 G/DL, and her symptoms improved after iron and blood transfusions. Hypercoagulable studies were completed in the outpatient setting, and the results were unremarkable. Her acute stroke was most likely related to IDA as she had low cardiovascular risk factors along with a negative complete stroke workup.

Perceived Impact Of Non-Contact Boxing On Daily Life And Occupational Participation At Home Among Individuals With Parkinson's Disease, Kristen E. Bignal

Student Capstone Papers

The aim of this project was to determine whether individuals with Parkinson's disease perceive an impact on their daily life and occupational participation at home secondary to participation in non-contact boxing.

Semi-structured open-ended interview questions were conducted with 17 participants (3 female) who have been diagnosed with Parkinson's disease for(i.e., self-care, home and health maintenance, sleep, intimacy, social and leisure interests, etc.) in the home environment. Interviews were transcribed and analyzed utilizing thematic analysis.

Data analysis derived three overarching themes including psychological benefits, sense of community, and framework to develop routines. Subsequent research exploring how non-contact boxing directly impacts specific …

Animal-Assisted Therapy And Quality Of Life In Patients With Dementia, Karissa D. Thomson

Student Capstone Papers

The aim of this quantitative study was to examine the effects animal-assisted therapy (AAT) had on people diagnosed with dementia living in a nursing home. The study aimed to examine the effects AAT had on depression, blood pressure, social interaction, and how these factors impact quality of life (QOL). The study was conducted once a week for one hour on Thursdays for 6 weeks. 7 participants were included in the study and further broken down into two groups based upon their level of cognition as measured by the Mini-Mental Status Examination. Beck’s Depression Inventory (BDI) and the World Health Organization …

Animal-Assisted Therapy And Quality Of Life Of Patients With Dementia, Karissa D. Thomson, Kayla Collins, Mary P. Shotwell

Spring 2020 Virtual OTD Capstone Symposium

The aim of this quantitative study was to examine the effects animal-assisted therapy (AAT) had on people diagnosed with dementia living in a nursing home. The study examined the effects AAT had on depression, blood pressure, social interaction and how these factors impact quality of life (QOL). The study was conducted once a week for one hour on Thursdays for 6 weeks. 7 participants were included in the study and further broken down into two groups based upon their level of cognition as measured by the Mini Mental State Examination. The Beck’s depression inventory (BDI) and the World Health Organization …

Exploring The Occupation-Based Needs Of Older Adults With Alzheimer’S Disease At A Reminiscence Therapy Adult Day Center, Kendra C. Gillio, Susan Macdermott, Becki Cohill

Spring 2020 Virtual OTD Capstone Symposium

Alzheimer’s disease is the most common form of dementia, affecting approximately 60% to 70% of the older adult population aged 65 and older (Santos da Silva, de Oliveira Alves, Barros Leite Slagueiro & Bezerra Barbosa, 2018). Reminiscence therapy prompts an individual’s memory by stimulating their sense – sight, smell, hearing, taste, and touch, and provides an opportunity for them to revisit and relive their past through their surrounding environment (Swann, 2013). For individuals with Alzheimer’s disease, occupational therapy focuses on adapting the environment in order to promote their ability to engage in meaningful occupations, increase quality of life, and social …

The Effectiveness Of Lsvt-Big And Pwr! Programs On A Patient With Parkinson’S Disease: A Case Report, Naureen Imam, Jennifer Dannenbring

San Marcos, Spring 2020

Background: The prevalence of Parkinson’s Disease (PD) drives the search for effective interventions. While LSVT-BIG and high-intensity training improve gait speed and balance deficits, only limited research exists on the impact of the Parkinson's Wellness Recovery (PWR!) program on PD symptoms. Thus, LSVT-BIG and PWR! should be explored in tandem as standardized treatment for patients with PD.

Purpose: The primary purpose of this case report is to determine the effects of LSVT-BIG and PWR! programs on gait impairments, balance deficits, and participation restrictions in a patient with PD.

Case Description: A 74-year old male with PD attended PT …

Organized Caudal Photoreceptors In The Medicinal Leech, Baylee Bancroft

Honors Theses

Visual systems are essential to an organism’s survival. There are a wide range of photosensory organs across the animal kingdom, varying by means of structure, complexity, and the way in which they transduce information. Regardless of variation, visual systems provide the organism with information regarding external stimuli based on how light interacts with surrounding matter. The medicinal leech, Hirudo verbana, is one of the many important model organisms of neurobiology as this segmented annelid possesses a relatively simple nervous system and a rudimentary visual system. The leech also exhibits a restricted range of quantifiable overt behaviors and is capable of …

The Role Of Biotransformation Processes In Mediating Interactions Between Psychotropic Drugs And Natural Products, Nicolae Bacinschi, Ina Pogonea, Lilia Podgurschi, Maria Mihalachi-Anghel, Emil Ștefănescu, Bogdan Socea, Marin Chianu

Journal of Mind and Medical Sciences

Many patients are not aware that natural products such as fruit juices or plant infusions can cause significant interactions with several drugs, some of which can be dangerous, especially when the medical treatment is for neurological or psychiatric disorders. Among the most predisposed for interacting with drugs are citric juices, particularly grapefruit and plant infusions, especially St John`s wort (Hypericum perforatum). Understanding the mechanism and the frequency of this type of interaction helps to avoid it. The goal of this research was to identify and summarize the most relevant reports on interactions between psychotropic drugs and natural beverages, in order …

The Lysosomal Diseases Testing Laboratory: A Review Of The Past 47 Years., David A. Wenger, Paola Luzi

Department of Neurology Faculty Papers

Lysosomal disorders are diseases that involve mutations in genes responsible for the coding of lysosomal enzymes, transport proteins, activator proteins and protein processing enzymes. These defects lead to the storage of specific metabolites within lysosomes resulting in a great variety of clinical features depending on the tissues with the storage, the storage products and the extent of the storage. The methods for rapidly diagnosing patients started in the late 1960's when the enzyme defects were identified eliminating the need for tissue biopsies. The first requests for diagnostic help in this laboratory came in 1973. In that year, patients with Krabbe …

Spider Venom Administration Impairs Glioblastoma Growth And Modulates Immune Response In A Non-Clinical Model., Amanda Pires Bonfanti, Natália Barreto, Jaqueline Munhoz, Marcus Caballero, Gabriel Cordeiro, Thomaz Rocha-E-Silva, Rafael Sutti, Fernanda Moura, Sérgio Brunetto, Celso Dario Ramos, Rodolfo Thome, Liana Verinaud, Catarina Rapôso

Department of Neurology Faculty Papers

Molecules from animal venoms are promising candidates for the development of new drugs. Previous in vitro studies have shown that the venom of the spider Phoneutria nigriventer (PnV) is a potential source of antineoplastic components with activity in glioblastoma (GB) cell lines. In the present work, the effects of PnV on tumor development were established in vivo using a xenogeneic model. Human GB (NG97, the most responsive line in the previous study) cells were inoculated (s.c.) on the back of RAG-/- mice. PnV (100 µg/Kg) was administrated every 48 h (i.p.) for 14 days and several endpoints were evaluated: tumor …

De Novo Frameshift Variants In The Neuronal Splicing Factor Nova2 Result In A Common C-Terminal Extension And Cause A Severe Form Of Neurodevelopmental Disorder, Francesca Mattioli, Gaelle Hayot, Nathalie Drouot, Bertrand Isidor, Jérémie Courraud, Maria-Victoria Hinckelmann, Frederic Tran Mau-Them, Chantal Sellier, Alica Goldman, Aida Telegrafi, Alicia Boughton, Candace Gamble, Sebastien Moutton, Angélique Quartier, Nolwenn Jean, Paul Van Ness, Sarah Grotto, Sophie Nambot, Ganka Douglas, Yue Cindy Si, Jamel Chelly, Zohra Shad, Elisabeth Kaplan, Richard Dineen, Christelle Golzio, Nicolas Charlet-Berguerand, Jean-Louis Mandel, Amélie Piton

Faculty, Staff and Students Publications

The neuro-oncological ventral antigen 2 (NOVA2) protein is a major factor regulating neuron-specific alternative splicing (AS), previously associated with an acquired neurologic condition, the paraneoplastic opsoclonus-myoclonus ataxia (POMA). We report here six individuals with de novo frameshift variants in NOVA2 affected with a severe neurodevelopmental disorder characterized by intellectual disability (ID), motor and speech delay, autistic features, hypotonia, feeding difficulties, spasticity or ataxic gait, and abnormal brain MRI. The six variants lead to the same reading frame, adding a common proline rich C-terminal part instead of the last KH RNA binding domain. We detected 41 genes differentially spliced after NOVA2 …

Utility Of Tranexamic Acid To Minimize Blood Loss In Brain Tumour Surgery, Syed Sarmad Bukhari, Muhammad Shahzad Shamim

Section of Neurosurgery

Tranexamic acid is emerging as a useful option for a number of clinical indications, by virtue of its anti-fibrinolytic properties that allow better haemostasis and lesser blood loss. Herein, the authors have attempted to summarize the existing evidence on the possible role of tranexamic acid in brain tumour surgeries.

Transcutaneous Auricular Vagus Nerve Stimulation-Paired Rehabilitation For Oromotor Feeding Problems In Newborns: An Open-Label Pilot Study, Bashar W. Badran, Dorothea D. Jenkins, Daniel Cook, Sean Thompson, Morgan Darcy, William H. Devries, Georgia Mappin, Philipp Summers, Marom Bikson, Mark S. George

Publications and Research

Neonates born premature or who suffer brain injury at birth often have oral feeding dysfunction and do not meet oral intake requirements needed for discharge. Low oral intake volumes result in extended stays in the hospital (>2 months) and can lead to surgical implant and explant of a gastrostomy tube (G-tube). Prior work suggests pairing vagus nerve stimulation (VNS) with motor activity accelerates functional improvements after stroke, and transcutaneous auricular VNS (taVNS) has emerged as promising noninvasive form of VNS. Pairing taVNS with bottle-feeding rehabilitation may improve oromotor coordination and lead to improved oral intake volumes, ultimately avoiding the …

Management Of Childhood Migraine By Headache Specialist Versus Non-Headache Specialists, Kelly Valentini, Radhika Gutta, Gunjanpreet Kaur, Ahmad Farooqi, Lalitha Sivaswamy

Medical Student Research Symposium

This study aims to compare the management practices of a headache specialist with non-headache specialists in the treatment of pediatric migraine. The use of appropriate rescue medications and prophylactic agents, application of neuro-imaging, and short-term outcomes are compared in children treated by the two groups of physicians. A retrospective cohort study was conducted utilizing the electronic medical records of children 3-18 years of age with migraine, who were evaluated at a tertiary care children’s hospital from 2016-2018. Of the 849 patients that met the study criteria, 469 were classified as having chronic migraine or high-frequency episodic migraine and were followed …

Novel Rvd6 Stereoisomer Induces Corneal Nerve Regeneration And Wound Healing Post-Injury By Modulating Trigeminal Transcriptomic Signature, Thang L. Pham, Azucena H. Kakazu, Jiucheng He, Bokkyoo Jun, Nicolas G. Bazan, Haydee E.P. Bazan

School of Medicine Faculty Publications

The high-density corneal innervation plays a pivotal role in sustaining the integrity of the ocular surface. We have previously demonstrated that pigment epithelium-derived factor (PEDF) plus docosahexaenoic acid (DHA) promotes corneal nerve regeneration; here, we report the mechanism involved and the discovery of a stereospecific Resolvin D6-isomer (RvD6si) that drives the process. RvD6si promotes corneal wound healing and functional recovery by restoring corneal innervation after injury. RvD6si applied to the eye surface elicits a specific transcriptome signature in the trigeminal ganglion (TG) that includes Rictor, the rapamycin-insensitive complex-2 of mTOR (mTORC2), and genes involved in axon growth, whereas genes related …

Musculoskeletal Pain Outcomes Pre- And Post Intrathecal Baclofen Pump Implant In Children With Cerebral Palsy: A Prospective Cohort Study., Chantel C. Barney, Alyssa M. Merbler, Jean Stansbury, Linda E. Krach, Michael D. Partington, Patrick Graupman, Peter D. Kim, Debbie Song, Frank J. Symons

Manuscripts, Articles, Book Chapters and Other Papers

Objective: To characterize musculoskeletal pain intensity, duration, frequency, and interference with activities of daily living in children with cerebral palsy (CP) before and after intrathecal baclofen pump placement.

Design: Prospective cohort study.

Setting: Children's tertiary hospital.

Participants: Participants were children with CP (N=32; 53% male; mean age, 9.9y; age range, 4-17y). The majority of participants had a CP diagnosis of quadriplegia (76%) and relied on wheeled mobility (91%).

Interventions: Assessments were completed pre- and post intrathecal baclofen pump implant.

Main outcome measures: Because of considerable patient heterogeneity, both pain measures (Brief Pain Inventory, Dalhousie Pain Interview) were completed by proxy …

Metastatic Spinal Cord Compression Mimicking Cauda Equina Syndrome Illustrating Importance Of Adequate Diagnostic Imaging, Jonathan L. Holt, Joseph Hill, Farzin Farhandnejad, Karyn Doddy, Se Won Lee

Physical Medicine & Rehabilitation

See additional files.

Rehabilitation Following Valproic Acid-Induced Hyperammonemic Encephalopathy (Vhe) In A Patient With Intractable Epilepsy, Dan Nguyen, Ann Ikonne, Sewon Lee, Mark Steinhauer

Physical Medicine & Rehabilitation

See additional documents.

Worsening Weakness After Posterior Cervical Decompression And Fusion; The Challenge In Diagnosis, Steven D. Kim, Joseph Hill, Farzin Farhandnejad, Karyn Doddy

Physical Medicine & Rehabilitation

See additional files.

Unmasking Severe Hypotension After Intermittent Catheter For Distended Bladder In A Patient With Cervical Spinal Cord Injury, Dennis Nguyen, Neal Ekpoudia, Ellsworth Remson, Farzin Farhandnejad, Se Won Lee

Physical Medicine & Rehabilitation

See additional files.

Cell Type Composition And Circuit Organization Of Clonally Related Excitatory Neurons In The Juvenile Mouse Neocortex, Cathryn R Cadwell, Federico Scala, Paul G Fahey, Dmitry Kobak, Shalaka Mulherkar, Fabian H Sinz, Stelios Papadopoulos, Zheng H Tan, Per Johnsson, Leonard Hartmanis, Shuang Li, Ronald J Cotton, Kimberley F Tolias, Rickard Sandberg, Philipp Berens, Xiaolong Jiang, Andreas Savas Tolias

Faculty, Staff and Students Publications

Clones of excitatory neurons derived from a common progenitor have been proposed to serve as elementary information processing modules in the neocortex. To characterize the cell types and circuit diagram of clonally related excitatory neurons, we performed multi-cell patch clamp recordings and Patch-seq on neurons derived from Nestin-positive progenitors labeled by tamoxifen induction at embryonic day 10.5. The resulting clones are derived from two radial glia on average, span cortical layers 2–6, and are composed of a random sampling of transcriptomic cell types. We find an interaction between shared lineage and connection type: related neurons are more likely to …

Neurological Involvement In Covid-19 Infections; Pathophysiology, Presentation And Outcome., Dureshahwar Kanwar, Muhammad Imran, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

Severe acute respiratory syndrome corona virus 2 (SARS CoV 2) seems to display an increasing affinity for the nervous system. The ongoing pandemic has made evident that diverse neurological manifestations may occur with COVID 19. Headache and dizziness remain the most common symptoms however stroke, seizures, encephalopathy, neuropathy and skeletal muscle injury may be seen. An increasing number of patients report initial anosmia and ageusia. Tendency for serious illness is believed to be in the elderly or people with a history of diabetes, high blood pressure and heart disease. Many patients on immunosuppressive therapies such as multiple sclerosis, myasthenia gravis …

Primary Intracranial Malignant Melanoma, Ummey Hani, Dr Saqib Kamran Bakhshi, Muhammad Shahzad Shamim

Section of Neurosurgery

Primary intracranial malignant melanoma (PIMM) are rare brain tumours; more infrequent than melanomas metastasizing to the brain or those extending to the brain from adjacent structures such as the orbit. Complete surgical excision with adjuvant chemotherapy and radiation remains the mainstay of treatment. Herein, we have reviewed the literature to find the treatment modalities for PIMMs that can lead to longer overall survivals and better patient outcomes.

Narcolepsy :A Review Amongst Sleep Disorders., Muhammad Umer Ahmed, Manahil Jeoffrey, Omer Ahmed

Pakistan Journal of Neurological Sciences (PJNS)

Narcolepsy is a sleep disorder known and studied about from time to time is a sleep disorder characterized by a combination of myriad of symptoms including excessive day time sleepiness with recurrent irresistible sleep attacks , hypnogogic hallucinations ,hypnopompic hallucinations ,sleep paralysis and cataplexy (sudden and bilateral loss of muscle tone.1 Narcolepsy may present it self long with cataplexy or without cataplexy. The pathogenesis behind narcolepsy is found to be due to degeneration of hypocretin/orexin secreting neurones in the central nervous system due to disorder of human leukocyte antigen DQB1*0602.Narcolepsy is a deblitating disorder which causes intense functional impairment and …

Factors Predicting Need For Post-Operative Ventilation After Microsurgical Clipping Of Cerebral Aneurysms – A Multivariate Analysis, Usman Siddiqui, Muhammad Faheem Khan, Saad Bin Anis, Bushra Ahmad, Muhammad Shahzad Shamim, Rida Mitha, Fouzia Anis Khan, Erfan Hussain

Pakistan Journal of Neurological Sciences (PJNS)

Patients with aneurysmal Subarachnoid Hemorrhage (aSAH) frequently require Intensive Care Unit (ICU) beds, pre-operatively and more often, post-operatively due to the need for ventilatory support and specialized monitoring. We aimed to evaluate the frequency of post-operative ventilatory requirement in patients with aSAH and identify the possible predictive factors that might influence the need of post-operative ventilation in these patients. METHODS: We retrospectively identified a five-year data of all patients with aSAH who underwent surgical clipping using a structured proforma. Aneurysm was confirmed by Digital Subtraction Angiography (DSA) or Computerized Tomographic Angiography (CTA).

Amylin As A Potential Link Between Type 2 Diabetes And Alzheimer Disease, Florin Despa, Larry B. Goldstein, Geert Jan Biessels

Pharmacology and Nutritional Sciences Faculty Publications

No abstract provided.

Prediction Of Cognitive And Intellectual Competence In Kindergarten Schools Associated With General Measures Of Health: A Study On Children With Age Ranges Between 4 To 7 Years, Abeer Musaddiq, Yusra Saleem, Muhammad Bilal Siddiqui, Shamoon Noushad, Sadaf Ahmed

Pakistan Journal of Neurological Sciences (PJNS)

BACKGROUND Stunting refers to the low “height-for-age” measurement. Literature suggests that it is associated with delayed or diminished physical development, cognition and intellectual abilities. OBJECTIVES: This study aimed to estimate the physical growth measures among children under 4 to 7 years of age and to determine its relationship with cognitive deficits & intellectual performances.