Neurology Commons^™

Care Gaps And Recommendations In Vestibular Migraine: An Expert Panel Summit, Monica P Mallampalli, Habib G Rizk, Amir Kheradmand, Shin C Beh, Mehdi Abouzari, Alaina M Bassett, James Buskirk, Claire E J Ceriani, Matthew G Crowson, Hamid Djalilian, Joel A Goebel, Jeffery J Kuhn, Anne E Luebke, Marco Mandalà, Magdalena Nowaczewska, Nicole Spare, Roberto Teggi, Maurizio Versino, Hsiangkuo Yuan, Ashley Zaleski-King, Michael Teixido, Frederick Godley

Department of Neurology Faculty Papers

Vestibular migraine (VM) is an increasingly recognized pathology yet remains as an underdiagnosed cause of vestibular disorders. While current diagnostic criteria are codified in the 2012 Barany Society document and included in the third edition of the international classification of headache disorders, the pathophysiology of this disorder is still elusive. The Association for Migraine Disorders hosted a multidisciplinary, international expert workshop in October 2020 and identified seven current care gaps that the scientific community needs to resolve, including a better understanding of the range of symptoms and phenotypes of VM, the lack of a diagnostic marker, a better understanding of …

Adult-Onset Alexander Disease Uncovered In A Previously Healthy Patient Presenting With Acute Stroke-Like Symptoms, Usaamah M. Khan, Matthew Barrett, Alex Dworetz Do

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Alexander Disease is a rare, often fatal, leukoencephalopathy of early childhood associated with a heterozygous mutation of the glial fibrillary acid protein (GFAP) gene. Adult-Onset Alexander Disease (AOAD) is an exceptionally rare leukoencephalopathy that often presents with slowly progressive brainstem and cervical cord dysfunction features. Acute onset of AOAD has only ever been reported three times in the literature. We report a case of acute onset AOAD in a patient that presented with bulbar symptoms and left hemiplegia initially concerning for acute stroke.

A Meta-Analysis: Significance Of Biofluid Biomarkers In Sports-Related Traumatic Brain Injury, Stephanie Oliveira

Honors Undergraduate Theses

Background: To reduce the reliance on clinical judgment for the regulation of sports-related traumatic brain injury, identifying and measuring objective to biofluid biomarkers can provide important insight into the diagnosis (Determining the type and origin of a disorder) and prognosis (Determining the chance of survival of a disorder) of SR-TBIs. A biomarker is a qualitative or quantitative measurement that provides a measure of a subject’s physiological or pathological condition at a specific time or during a disease state. Recent literature has suggested that biomarkers can help in the screening of patients exhibiting symptoms of mild traumatic brain injury (mTBI). Despite …

Repeated Exposure To Chlorpyrifos Is Associated With A Dose-Dependent Chronic Neurobehavioral Deficit In Adult Rats, Ana C. R. Ribeiro, Elisa Hawkins, Fay M. Jahr, Joseph L. Mcclay, Laxmikant Deshpande

Neurology Publications

Organophosphate (OP) chemicals include commonly used pesticides and chemical warfare agents, and mechanistically they are potent inhibitors of the cholinesterase (ChE) enzyme. Epidemiological studies report long-term neuropsychiatric issues, including depression and cognitive impairments in OP-exposed individuals. Chlorpyrifos (CPF) is one of the most widely used pesticides worldwide. Multiple laboratory studies have reported on either the long-term behavioral effect of an acute high-dose CPF (30-250 mg/kg) or studied sub-chronic behavioral effects, particularly the motor and cognitive effects of repeated low-dose CPF. However, studies are lacking on chronic mood and depression-related morbidities following repeated CPF doses that would mimic occupationally relevant OP …

Perceptions Of Parental Care And Overprotection In Childhood: Influences On The Neurobiological Adaptation To Motherhood, Leah Grande

Electronic Theses and Dissertations

Recalled memories of caregiving in childhood are especially salient during the postpartum period and inform mothers’ conceptualization of her new parenting role. Positive perceptions of care received from one’s parents are related to improved maternal-infant bonding and positive parenting behaviors, whereas negative perceptions of care convey risk for maladaptive parenting. Few studies have investigated neural and biological mechanisms contributing to observed associations between childhood care and the adaptation to motherhood. The following studies address this gap by examining how perceptions of childhood parental care and overprotection are related to maternal behavior, oxytocin levels, and neural response. Methods: Perceived childhood maternal …

The Intersection Of Traumatic Brain Injury And Homelessness, Stephanie A. Chassman

Electronic Theses and Dissertations

The rates of TBI are significantly higher among individuals experiencing homelessness compared to the general population. Up to half of individuals experiencing homelessness may have a TBI. Accurate prevalence rates of TBI among individuals experiencing homelessness are difficult to obtain due to different methods of sampling participants and differing definitions of TBI; therefore, estimates may be underrepresented. Despite past research that has examined the relationship between TBI and homelessness, there are specific gaps in knowledge such as correlates and risk factors of TBI among individuals experiencing homelessness. This three-manuscript dissertation attempts to address these gaps in knowledge.

The first manuscript …

Aneurysmal Subarachnoid Hemorrhage And Acute Subdural Hematoma, Neurosurgical And Endovascular Rescue. Case Report., José Omar Santellan Resident, José Ramón Aguilar Dr., Abraham Ibarra Dr., Ulises García Dr.

Archives of Neurosurgery

Introduction: Acute subdural hemorrhage (aSDH) in association with aneurismal subarachnoid hemorrhage (SAH) is a severe disease with an incidence of 0.5% to 7.9% of all SAH. Due to the rarity of aneurysmal aSDH, it remains difficult to define a comprehensive management protocol. In this case review, following the CARE guidelines, we show the hybrid management of this pathology to know the importance of using different types of neurosurgical treatments in case of two severe diseases in critical patients.

We present two patients who developed sudden onset cephalea and neurological impairment secondary to aneurysmal subarachnoid hemorrhage associated with acute subdural hematoma. …

Antioxidant Biomarkers And Nutraceutical Therapeutics In Neurodegeneration And Neurotrauma, Lilia A. Koza

Electronic Theses and Dissertations

Mild traumatic brain injury (mTBI), yielding a Glascow Coma Scale of 13-15, is the most commonly occurring severity of TBI. Pathology from mTBI consists of blood brain barrier disruption, neuroinflammation, oxidative stress, excitotoxicity, mitochondrial dysfunction, protein aggregation, axonal degeneration, and resulting neuronal death. These processes deplete the body’s endogenous antioxidant system. We report a retrospective analysis of antioxidant blood biomarkers in patients with a history of mTBI from a local sports medicine clinic, Resilience Code. We found persistent sex-specific antioxidant depletions in mTBI patients associated with worsened symptomology.

Certain populations, such as athletes, are at high risk for repetitive mTBI …

Organellar Zn2+ Homeostasis And The Role Of Trpml Channels In Neuronal Lysosome Physiology And Axonal Transport, Taylor Franklin Minckley

Electronic Theses and Dissertations

Zinc (Zn²⁺) is crucial for proper cellular function, and as such it is important to measure and track Zn²⁺ dynamics in living cells. Fluorescent sensors have been used to estimate Zn²⁺ content of subcellular compartments, but little is known about endolysosomal Zn2+ homeostasis. Similarly, although numerous sensors have been reported, it is unclear whether and how Zn²⁺ can be released from intracellular compartments into the cytosol due to a lack of probes that can detect physiological dynamics of cytosolic Zn²⁺. My dissertation started with comparing and characterizing different Zn²⁺ sensors including the …

Pediatric Stroke Outcome Measures: A Systematic Review, Janice Brown, Jordan Ng, Reilly Todd, Alyssa Vo

Occupational Therapy | Graduate Student Research Posters

In collaboration with SFSU/UCSF Physical Therapy and Dominican University of California Occupational Therapy, this systematic review took a critical look at the pediatric stroke outcome measures in the current literature. By ascertaining what is currently in place,

occupational therapists as members of the interprofessional team, can better advocate for occupation centered outcome measures in research and clinical care for children and families who have experienced pediatric stroke.

Effective Pharmacological And Non-Pharmacological Treatments For Sleep Disturbances And Fatigue In Patients Who Have Experienced A Mild To Severe Traumatic Brain Injury, Mika Muras

Theses and Graduate Projects

Background: In the United States alone, an estimated 1.5 million people sustain a head injury every year.1 With improved recognition of traumatic brain injuries by healthcare providers, the number of patients diagnosed with a traumatic brain injury (TBI) is only increasing. Unfortunately, many patients who sustain a TBI, regardless of the severity, experience sleep disturbances, insomnia, fatigue, and daytime sleepiness.

Purpose: For the purposes of this systematic review, the focus will be primarily on the comparison of nonpharmacological treatments of sleep disturbances or fatigue secondary to a TBI. In addition, the focus will include recent studies on pharmacological …

Stereotactic Radiosurgery For Pituitary Adenomas: A Review Of Literature, Kaynat Siddiqui, Saqib Kamran Bakhshi, Muhammad Shahzad Shamim

Section of Neurosurgery

Stereotactic radiosurgery (SRS) is a choice of treatment for pituitary adenomas (PA), particularly for residual or recurrent disease, apart from surgery. It has a progression free survival and endocrine remission rate comparable to surgery, with fewer side effects, making it an ideal tool for dealing with PA. In this review, we have discussed the role of SRS for primary as well as post-operative residual/ recurrent PA, and have assessed its safety and outcomes.

Iranian Parents' Perceptions On Physical Activity For Their Children With Autism Spectrum Disorder During The Covid-19 Pandemic, Sarvin Salar, Justin A. Haegele, Hassan Daneshmandi

Human Movement Studies & Special Education Faculty Publications

Purpose: The COVID-19 pandemic is a remarkable health crisis that enforced most people to stay at home and quarantine for a period of time and seems to be having negative impacts on physical activity and mental health worldwide. Autism Spectrum Disorder (ASD), is a neurodevelopmental disorder with a deficit in social interaction characteristics, relationships, and stereotyped behaviors. This study examined Iranian parents’ perceptions of physical activity for their children with ASD during the COVID-19 pandemic.

Methods: In this study, an explanatory qualitative methodology was used and data were collected via semi-structured phone interviews. The samples included 40 Iranian parents (aged …

Mechanisms Of Memory Updating: State Dependency Vs. Reconsolidation, Christopher Kiley, Colleen M. Parks

Psychology Faculty Research

Reactivating a memory trace has been argued to put it in a fragile state where it must undergo a stabilization process known as reconsolidation. During this process, memories are thought to be susceptible to interference and can be updated with new information. In the spatial context paradigm, memory updating has been shown to occur when new information is presented in the same spatial context as old information, an effect attributed to a reconsolidation process. However, the integration concept holds that memory change can only occur when reactivation and test states are the same, similar to a state-dependent effect. Thus, in …

Effect Of Living Arrangements On Cognitive Function In Chinese Elders: A Longitudinal Observational Study, Yanwei Lin, Qi Zhang, Tingxian Wang, Zhirong Zeng

Community & Environmental Health Faculty Publications

Objective To examine how living arrangement as a social contextual factor can affect Chinese elders’ cognitive function.

Setting and participants Our sample consists of 2486 Chinese elders from two waves (2014 and 2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) that was administered in 22 of China’s 31 provinces using a multi-stage, disproportionate, purposive random sampling method. The CLHLS aims to better understand the determinants of healthy longevity in China and collects extensive data on a large population of fragile elders aged 80–112 in China.

Outcome measures Cognitive function was measured by the Mini-Mental State Examination (MMSE). Living arrangement …

Editorial: Infection, Inflammation, And Neurodegeneration: A Critical Path To Alzheimer's Disease, Volume Ii., Roberta Mancuso, Simone Agostini, Denah Appelt, Brian J. Balin

PCOM Scholarly Works

No abstract available

Role Of Micrornas In Non-Functioning Pituitary Adenoma, Mehak Ismail Rajani, Yumna Mirza, Rohan Advani, Syed Muhammad Adnan Ali, Ather Enam

Centre for Innovation in Medical Education

Non-functioning pituitary adenomas account for 30% of anterior pituitary tumours. Based on their inability to secrete hormones, these are often diagnosed incidentally or due to pressure symptoms. Understanding the pathogenesis of these adenomas can provide insight into factors leading to its progression and serving as biomarkers for early recognition. A literature search was performed in the current narrative review for articles published in PubMed for the last 10 years till January 2020 on micro-ribonucleic acid involved in the pathogenesis of non-functioning pituitary adenomas. Of the 478 articles found, 21(4.4%) were filtered. In total, 106 micro-ribonucleic acids were identified, 25(23.5%) of …

Thyroid Steal Syndrome Secondary To Active Hyperthyroid State, Harrison Humphries, Johnathon Chung, Reza Pirzadeh, Wesley Jones, Mohamad Ezzeldin

Gulf Coast Division GME Research Day 2022

No abstract provided.

Progress In Protein Structure Prediction: An Xai Perspective, Yosef E. Granillo, Badri Adhikari

Undergraduate Research Symposium

The full extent of the impact of deep learning models on structural biology will depend on their ability to provide novel biological insights. The field of structure prediction, where deep learning has produced miraculously accurate results, is at a critical stage of benefiting from the methods in interpretable deep learning. The exact mechanisms by which advanced computational models learn to interpret protein shapes and functions during their training remain largely unclear. These questions underscore the need for further research, as understanding these mechanisms is crucial for researchers to trust the predictions of these models. However, interpretable machine learning is ripening …

Profiles And Correlates Of Language And Social Communication Differences Among Young Autistic Children, Rachel Reetzke, Vini Singh, Ji Su Hong, Calliope B. Holingue, Luther G. Kalb, Natasha N. Ludwig, Deepa Menon, Danika L. Pfeiffer, Rebecca J. Landa

Communication Disorders & Special Education Faculty Publications

Delays in early language development are characteristic of young autistic children, and one of the most recognizable first concerns that motivate parents to seek a diagnostic evaluation for their child. Although early language abilities are one of the strongest predictors of long-term outcomes, there is still much to be understood about the role of language impairment in the heterogeneous phenotypic presentation of autism. Using a personcentered, Latent Profile Analysis, we first aimed to identify distinct patterns of language and social communication ability in a clinic-based sample of 498 autistic children, ranging in age from 18 to 60 months (M = …

Analysis Of Race And Sex Bias In The Autism Diagnostic Observation Schedule (Ados-2), Luther G. Kalb, Vini Singh, Ji Su Hong, Calliope Holingue, Natasha N. Ludwig, Danika Pfeiffer, Rachel Reetzke, Alden L. Gross, Rebecca Landa

Communication Disorders & Special Education Faculty Publications

Importance: There are long-standing disparities in the prevalence of autism spectrum disorder (ASD) across race and sex. Surprisingly, few studies have examined whether these disparities arise partially out of systematic biases in the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), the reference standard measure of ASD.

Objective: To examine differential item functioning (DIF) of ADOS-2 items across sex and race.

Design, Setting, and Participants: This is a cross-sectional study of children who were evaluated for ASD between 2014 and 2020 at a specialty outpatient clinic located in the Mid-Atlantic region of the US. Data were analyzed from July 2021 to …

A Novel Framework To Estimate Cognitive Impairment Via Finger Interaction With Digital Devices, Ashley A Holmes, Shikha Tripathi, Emily Katz, Ijah Mondesire-Crump, Rahul Mahajan, Aaron Ritter, Teresa Arroyo-Gallego, Luca Giancardo

Faculty, Staff and Student Publications

Measuring cognitive function is essential for characterizing brain health and tracking cognitive decline in Alzheimer's Disease and other neurodegenerative conditions. Current tools to accurately evaluate cognitive impairment typically rely on a battery of questionnaires administered during clinical visits which is essential for the acquisition of repeated measurements in longitudinal studies. Previous studies have shown that the remote data collection of passively monitored daily interaction with personal digital devices can measure motor signs in the early stages of synucleinopathies, as well as facilitate longitudinal patient assessment in the real-world scenario with high patient compliance. This was achieved by the automatic discovery …

Brain Antigens Stimulate Proliferation Of T Lymphocytes With A Pathogenic Phenotype In Multiple Sclerosis Patients, Assaf Gottlieb, Hoai Phuong T Pham, John William Lindsey

Faculty, Staff and Student Publications

A method to stimulate T lymphocytes with a broad range of brain antigens would facilitate identification of the autoantigens for multiple sclerosis and enable definition of the pathogenic mechanisms important for multiple sclerosis. In a previous work, we found that the obvious approach of culturing leukocytes with homogenized brain tissue does not work because the brain homogenate suppresses antigen-specific lymphocyte proliferation. We now report a method that substantially reduces the suppressive activity. We used this non-suppressive brain homogenate to stimulate leukocytes from multiple sclerosis patients and controls. We also stimulated with common viruses for comparison. We measured proliferation, selected the …

A Multimodal Clinical Data Resource For Personalized Risk Assessment Of Sudden Unexpected Death In Epilepsy, Xiaojin Li, Shiqiang Tao, Samden D Lhatoo, Licong Cui, Yan Huang, Johnson P Hampson, Guo-Qiang Zhang

Faculty, Staff and Student Publications

Epilepsy affects ~2–3 million individuals in the United States, a third of whom have uncontrolled seizures. Sudden unexpected death in epilepsy (SUDEP) is a catastrophic and fatal complication of poorly controlled epilepsy and is the primary cause of mortality in such patients. Despite its huge public health impact, with a ~1/1,000 incidence rate in persons with epilepsy, it is an uncommon enough phenomenon to require multi-center efforts for well-powered studies. We developed the Multimodal SUDEP Data Resource (MSDR), a comprehensive system for sharing multimodal epilepsy data in the NIH funded Center for SUDEP Research. The MSDR aims at accelerating research …

Radiomic Texture Feature Descriptor To Distinguish Recurrent Brain Tumor From Radiation Necrosis Using Multimodal Mri, M. S. Sadique, A. Temtam, E. Lappinen, K. M. Iftekharuddin

Electrical & Computer Engineering Faculty Publications

Despite multimodal aggressive treatment with chemo-radiation-therapy, and surgical resection, Glioblastoma Multiforme (GBM) may recur which is known as recurrent brain tumor (rBT), There are several instances where benign and malignant pathologies might appear very similar on radiographic imaging. One such illustration is radiation necrosis (RN) (a moderately benign impact of radiation treatment) which are visually almost indistinguishable from rBT on structural magnetic resonance imaging (MRI). There is hence a need for identification of reliable non-invasive quantitative measurements on routinely acquired brain MRI scans: pre-contrast T1-weighted (T1), post-contrast T1-weighted (T1Gd), T2-weighted (T2), and T2 Fluid Attenuated Inversion Recovery (FLAIR) that can …

Uncertainty Estimation In Classification Of Mgnt Using Radiogenomics For Glioblastoma Patients, W. Farzana, Z. A. Shboul, A. Temtam, K. M. Iftekharuddin

Electrical & Computer Engineering Faculty Publications

Glioblastoma Multiforme (GBM) is one of the most malignant brain tumors among all high-grade brain cancers. Temozolomide (TMZ) is the first-line chemotherapeutic regimen for glioblastoma patients. The methylation status of the O6-methylguanine-DNA-methyltransferase (MGMT) gene is a prognostic biomarker for tumor sensitivity to TMZ chemotherapy. However, the standardized procedure for assessing the methylation status of MGMT is an invasive surgical biopsy, and accuracy is susceptible to resection sample and heterogeneity of the tumor. Recently, radio-genomics which associates radiological image phenotype with genetic or molecular mutations has shown promise in the non-invasive assessment of radiotherapeutic treatment. This study proposes a machine-learning framework …

Neuromotor Changes In Participants With A Concussion History Can Be Detected With A Custom Smartphone App, Christopher K. Rhea, Masahiro Yamada, Nikita A. Kuznetsov, Jason T. Jakiela, Chanel T. Lojacono, Scott E. Ross, F. J. Haran, Jason M. Bailie, W. Geoffrey Wright

Rehabilitation Sciences Faculty Publications

Neuromotor dysfunction after a concussion is common, but balance tests used to assess neuromotor dysfunction are typically subjective. Current objective balance tests are either cost- or space-prohibitive, or utilize a static balance protocol, which may mask neuromotor dysfunction due to the simplicity of the task. To address this gap, our team developed an Android-based smartphone app (portable and cost-effective) that uses the sensors in the device (objective) to record movement profiles during a stepping-in-place task (dynamic movement). The purpose of this study was to examine the extent to which our custom smartphone app and protocol could discriminate neuromotor behavior between …

Eagle Syndrome: Efficacies Of Medical And Surgical Treatments, Kirklin Mitchell

Capstone Showcase

Eagle Syndrome is a rare syndrome caused by elongation of the styloid process of the temporal bone or calcification of the stylohyoid ligament occurring in a very small percentage of the population that can cause a wide range of common symptoms, leading to it being often misdiagnosed. While there are no set standards for treating Eagle Syndrome, both pharmaceutical and surgical options exist. Pharmaceutical options are often ineffective in long term treatment so surgery is usually required for full symptom resolution. Transoral and Transcervical surgeries have similar efficacies but each come with important drawbacks when considering which type of surgery …

The Diverse Neurological Manifestations Of The Sars-Cov-2 Pandemic, Asmeda Spalding

Capstone Showcase

SARS-CoV-2 remains an international public health concern and can be encountered in all aspects of healthcare. Although most neurological manifestations are benign, clinicians must be aware and able to recognize more serious conditions that require urgent referral and intervention. Patients at risk for severe cases should be given extra attention given their propensity for neurological and clinical deterioration. This article highlights the most common and urgent neurological symptoms and diagnoses of the COVID-19 pandemic as well as clinical pearls for their identification.

Theta Burst Brain Stimulation In Painful Diabetic Neuropathy Patients: Investigating Neural Mechanisms, Bhushan Thakkar

Theses and Dissertations

Chronic pain (CP) is a significant contributor to disability and disease burden globally. In 2019, approximately 50.2 million adults (20.4% of the US population) experienced chronic pain, contributing to $560-635 billion in direct medical costs. In addition, the worldwide prevalence of diabetes mellitus has reached epidemic proportions and is set to increase to 629 million by 2045. Almost 50% of patients with diabetes present with diabetic neuropathy (DN), and one in five patients with diabetes presents with painful DN (pDN) which is the most common cause of neuropathic pain (NP) in the US. Symptomatic treatment is the mainstay of management …