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2024

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Full-Text Articles in Neurology

Frozen By Worry And Fatigue? A Mixed Methods Approach To Understanding The Lived Experiences Of Freezing Of Gait, Sarah M. Ghose Jan 2024

Frozen By Worry And Fatigue? A Mixed Methods Approach To Understanding The Lived Experiences Of Freezing Of Gait, Sarah M. Ghose

Theses and Dissertations

This study utilized a mixed methods emergent, phenomenological approach to (1) understanding the lived experience of freezing of gait for individuals diagnosed with Parkinson’s Disease and (2) determining the role of anxiety and sleep in freezing of gait outcomes. Participants included 13 adults diagnosed with Parkinson’s Disease (N=14 for qualitative data, N=13 for quantitative data; 23.1% female-identifying, 76.9% male-identifying) who were predominantly white (92.3%) with an average age of 69 years (SD = 6.73 years). Data collection consisted of semi-structured interviews, self-report measures, actigraphic sleep data, and salivary alpha amylase biomarker collection. Results are organized into …


Dna Methylation In Aging And Alzheimer's Disease, Raymond Cheng, Jingmin Shu, Hai Chen, Ming Li, Xiaodong Cheng, Li Liu Jan 2024

Dna Methylation In Aging And Alzheimer's Disease, Raymond Cheng, Jingmin Shu, Hai Chen, Ming Li, Xiaodong Cheng, Li Liu

The Brown Foundation: Institute of Molecular Medicine

DNA methylation undergoes significant changes with age. These alterations play a pivotal role in the development of age-related diseases, including Alzheimer's disease (AD). Recent advancements in DNA methylome profiling have revealed global hypomethylation patterns, particularly within repetitive elements, as well as gene-specific changes that are associated with neurodegeneration. Age-related alterations in DNA methylation have been implicated in the disruption of key cellular processes, such as inflammation and proteostasis, both central to AD pathology. However, several challenges persist in this field. One major issue is the inconsistency of findings across different brain regions and tissue types, which complicates result interpretation. Furthermore, …


Utilizing Ai Integrated Neuroimaging Technology To Expand Upon Machine Learning In Positron Emission Tomography Technology With The Aim Of Detecting Amyloid Beta Biomarkers Early In The Onset Of Alzheimer's., Ethan S. Terman Jan 2024

Utilizing Ai Integrated Neuroimaging Technology To Expand Upon Machine Learning In Positron Emission Tomography Technology With The Aim Of Detecting Amyloid Beta Biomarkers Early In The Onset Of Alzheimer's., Ethan S. Terman

UROP Posters

Early intervention in Alzheimer's is vital for treatment. The earlier a professional can detect symptoms and make a diagnosis the earlier a prognosis can be implemented. With the prevalence of data in our day-to-day world combined with Artificial intelligence (AI), utilizing both for machine learning can pave the way for more accurate and efficient detection of Alzheimer's and other neurodegenerative diseases. AI combined with Machine learning (ML) increases diagnostic efficiency and reduces human errors, making it a valuable resource for physicians and clinicians alike. With the increasing amount of data processing and image interpretation required, the ability to use AI …


An Objective Assessment Of Neuromotor Control Using A Smartphone App After Repeated Subconcussive Blast Exposure, Charlend K. Howard, Masahiro Yamada, Marcia Dovel, Rie Leverett, Alexander Hill, Kenneth A. Manlapaz, David O. Keyser, Rene S. Hernandez, Sheilah S. Rowe, Walter S. Carr, Michael S. Roy, Christopher K. Rhea Jan 2024

An Objective Assessment Of Neuromotor Control Using A Smartphone App After Repeated Subconcussive Blast Exposure, Charlend K. Howard, Masahiro Yamada, Marcia Dovel, Rie Leverett, Alexander Hill, Kenneth A. Manlapaz, David O. Keyser, Rene S. Hernandez, Sheilah S. Rowe, Walter S. Carr, Michael S. Roy, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

Subconcussive blast exposure has been shown to alter neurological functioning. However, the extent to which neurological dysfunction persists after blast exposure is unknown. This longitudinal study examined the potential short- and long-term effects of repeated subconcussive blast exposure on neuromotor performance from heavy weapons training in military personnel. A total of 214 participants were assessed; 137 were exposed to repeated subconcussive blasts and 77 were not exposed to blasts (controls). Participants completed a short stepping-in-place task while an Android smartphone app placed on their thigh recorded movement kinematics. We showed acute suppression of neuromotor variability 6 h after subconcussive blast …


Prevalence And Patterns Of Cardiovascular Risk Factors In Young Hypertensive Patients, *Raghu V S R Tanuku Dr., Major Venkata Shree Krishna Dr., Sreedhar Tanuku Dr Jan 2024

Prevalence And Patterns Of Cardiovascular Risk Factors In Young Hypertensive Patients, *Raghu V S R Tanuku Dr., Major Venkata Shree Krishna Dr., Sreedhar Tanuku Dr

Digital Journal of Clinical Medicine

Hypertension ranks among the top ten causes of mortality, with around 4% attributed to hypertensive complications. High salt intake, Type 2 diabetes, smoking, elevated serum lipids, a sedentary lifestyle, a diet heavy in saturated fat, genetic predisposition, as well as stress are among the factors that contribute to hypertension. Hypertension affects about 1 billion people worldwide, with considerable differences between populations and ethnic groups [2]. The Framingham Heart Study indicates that a person's lifetime risk of developing hypertension is 90% if they are normotensive at age 55. According to the NHANES IV (4th National Health and Nutrition Examination Survey), the …


Rapid Detection Of Mutations In Csf-Cftna With The Genexus Integrated Sequencer, Srividya Arjuna, Mauli Shah, Antonio Dono, Luis Nunez-Rubiano, Pavel S Pichardo-Rojas, Jay-Jiguang Zhu, Roy F Riascos, Rajyalakshmi Luthra, Sinchita Roy-Chowdhuri, Dzifa Duose, Daniel H Wang, Frederick F Lang, Yoshua Esquenazi, Leomar Y Ballester Jan 2024

Rapid Detection Of Mutations In Csf-Cftna With The Genexus Integrated Sequencer, Srividya Arjuna, Mauli Shah, Antonio Dono, Luis Nunez-Rubiano, Pavel S Pichardo-Rojas, Jay-Jiguang Zhu, Roy F Riascos, Rajyalakshmi Luthra, Sinchita Roy-Chowdhuri, Dzifa Duose, Daniel H Wang, Frederick F Lang, Yoshua Esquenazi, Leomar Y Ballester

Faculty, Staff and Student Publications

PURPOSE: Genomic alterations are fundamental for molecular-guided therapy in patients with breast and lung cancer. However, the turn-around time of standard next-generation sequencing assays is a limiting factor in the timely delivery of genomic information for clinical decision-making.

METHODS: In this study, we evaluated genomic alterations in 54 cerebrospinal fluid samples from 33 patients with metastatic lung cancer and metastatic breast cancer to the brain using the Oncomine Precision Assay on the Genexus sequencer. There were nine patients with samples collected at multiple time points.

RESULTS: Cell-free total nucleic acids (cfTNA) were extracted from CSF (0.1-11.2 ng/μl). Median base coverage …


Trajectory Clustering Of Immune Cells And Its Association With Clinical Outcomes After Aneurysmal Subarachnoid Hemorrhage, So Young Won, Museong Kim, Han-Gil Jeong, Bosco Seong Kyu Yang, Huimahn Alex Choi, Dong-Wan Kang, Yong Soo Kim, Young Deok Kim, Si Un Lee, Seung Pil Ban, Jae Seung Bang, Moon-Ku Han, O-Ki Kwon, Chang Wan Oh Jan 2024

Trajectory Clustering Of Immune Cells And Its Association With Clinical Outcomes After Aneurysmal Subarachnoid Hemorrhage, So Young Won, Museong Kim, Han-Gil Jeong, Bosco Seong Kyu Yang, Huimahn Alex Choi, Dong-Wan Kang, Yong Soo Kim, Young Deok Kim, Si Un Lee, Seung Pil Ban, Jae Seung Bang, Moon-Ku Han, O-Ki Kwon, Chang Wan Oh

Faculty, Staff and Student Publications

Background and purpose: The immune response following aneurysmal subarachnoid hemorrhage (aSAH) can exacerbate secondary brain injury and impact clinical outcomes. As the immune response after aSAH is a dynamic process, we aim to track and characterize immune cell trajectories over time to identify patterns associated with various clinical outcomes.

Methods: In this retrospective single-center study of patients with aSAH, we analyzed immune cell count trajectories, including neutrophil, monocyte, and lymphocyte counts, collected from day 1 to day 14. These trajectories were classified into four distinct clusters utilizing the k-means longitudinal clustering method. A comprehensive multivariable analysis was performed to explore …


Personalization Of Sudep Risk: A Survey Of Transient Subclinical Comorbid Changes, Kristina A Simeone, Dawn M Martenz, Shruthi H Iyer, Cameron P Booth, Shelby E Herr, Stephanie A Matthews, Samantha B Draves, Laura L Heinemann, Pierce L Greenberg, Samden D Lhatoo, Elizabeth Donner, Timothy A Simeone Jan 2024

Personalization Of Sudep Risk: A Survey Of Transient Subclinical Comorbid Changes, Kristina A Simeone, Dawn M Martenz, Shruthi H Iyer, Cameron P Booth, Shelby E Herr, Stephanie A Matthews, Samantha B Draves, Laura L Heinemann, Pierce L Greenberg, Samden D Lhatoo, Elizabeth Donner, Timothy A Simeone

Faculty, Staff and Student Publications

Objective: Preclinical data report within subject modifiable ailments emerge weeks prior to SUDEP, including sleep disorders and cardiorespiratory changes; findings which support anecdotal clinical data. Here, we bridge preclinical findings with future clinical/preclinical studies, and survey whether caretakers or family members of victims noticed transient changes prior to SUDEP. The aim of this pilot study is to identify potential modifiable changes that may synergistically increase SUDEP risk for future research.

Methods: A mobile electronic survey was posted on SUDEP community websites. The survey queried whether changes in seizures, sleep, physical well-being, emotional well-being, cognition, breathing, or heart rate were noticed …


The Contribution Of Amyloid Deposition In The Aortic Valve To Calcification And Aortic Stenosis, Romeesa Khan, Claudia M Di Gesù, Juneyoung Lee, Louise D Mccullough Jan 2024

The Contribution Of Amyloid Deposition In The Aortic Valve To Calcification And Aortic Stenosis, Romeesa Khan, Claudia M Di Gesù, Juneyoung Lee, Louise D Mccullough

Faculty, Staff and Student Publications

Trillions of microbes live symbiotically in the host, specifically in mucosal tissues such as the gut. Recent advances in metagenomics and metabolomics have revealed that the gut microbiota plays a critical role in the regulation of host immunity and metabolism, communicating through bidirectional interactions in the microbiota-gut-brain axis (MGBA). The gut microbiota regulates both gut and systemic immunity and contributes to the neurodevelopment and behaviors of the host. With aging, the composition of the microbiota changes, and emerging studies have linked these shifts in microbial populations to age-related neurological diseases (NDs). Preclinical studies have demonstrated that gut microbiota-targeted therapies can …


The Emerging Role Of Notch3 Receptor Signalling In Human Lung Diseases, Grant W Goodman, Patrick Devlin, Bryce E West, Rodney M Ritzel Jan 2024

The Emerging Role Of Notch3 Receptor Signalling In Human Lung Diseases, Grant W Goodman, Patrick Devlin, Bryce E West, Rodney M Ritzel

Faculty, Staff and Student Publications

The recent identification of skull bone marrow as a reactive hematopoietic niche that can contribute to and direct leukocyte trafficking into the meninges and brain has transformed our view of this bone structure from a solid, protective casing to a living, dynamic tissue poised to modulate brain homeostasis and neuroinflammation. This emerging concept may be highly relevant to injuries that directly impact the skull such as in traumatic brain injury (TBI). From mild concussion to severe contusion with skull fracturing, the bone marrow response of this local myeloid cell reservoir has the potential to impact not just the acute inflammatory …


Corrigendum: High-Definition Transcranial Direct Current Stimulation For Upper Extremity Rehabilitation In Moderate-To-Severe Ischemic Stroke: A Pilot Study, Jordan N Williamson, Shirley A James, Dorothy He, Sheng Li, Evgeny V Sidorov, Yuan Yang Jan 2024

Corrigendum: High-Definition Transcranial Direct Current Stimulation For Upper Extremity Rehabilitation In Moderate-To-Severe Ischemic Stroke: A Pilot Study, Jordan N Williamson, Shirley A James, Dorothy He, Sheng Li, Evgeny V Sidorov, Yuan Yang

Faculty, Staff and Student Publications

No abstract provided.


Responsive Neurostimulation For People With Drug-Resistant Epilepsy And Autism Spectrum Disorder, Madeline C Fields, Christina Marsh, Onome Eka, Emily A Johnson, Lara V Marcuse, Churl-Su Kwon, James J Young, Maite Lavega-Talbott, Mohankumar Kurukumbi, Gretchen Von Allmen, John Zempel, Daniel Friedman, Nathalie Jette, Anuradha Singh, Ji Yeoun Yoo, Leah Blank, Fedor Panov, Saadi Ghatan Jan 2024

Responsive Neurostimulation For People With Drug-Resistant Epilepsy And Autism Spectrum Disorder, Madeline C Fields, Christina Marsh, Onome Eka, Emily A Johnson, Lara V Marcuse, Churl-Su Kwon, James J Young, Maite Lavega-Talbott, Mohankumar Kurukumbi, Gretchen Von Allmen, John Zempel, Daniel Friedman, Nathalie Jette, Anuradha Singh, Ji Yeoun Yoo, Leah Blank, Fedor Panov, Saadi Ghatan

Faculty, Staff and Student Publications

PURPOSE: Individuals with autism spectrum disorder (ASD) have comorbid epilepsy at much higher rates than the general population, and about 30% will be refractory to medication. Patients with drug-resistant epilepsy (DRE) should be referred for surgical evaluation, yet many with ASD and DRE are not resective surgical candidates. The aim of this study was to examine the response of this population to the responsive neurostimulator (RNS) System.

METHODS: This multicenter study evaluated patients with ASD and DRE who underwent RNS System placement. Patients were included if they had the RNS System placed for 1 year or more. Seizure reduction and …


Proportional Sway-Based Electrotactile Feedback Improves Lateral Standing Balance, V S Raghav Hari Krishna, Jeonghee Kim, Shuo-Hsiu Chang, Yoonsuck Choe, Hangue Park Jan 2024

Proportional Sway-Based Electrotactile Feedback Improves Lateral Standing Balance, V S Raghav Hari Krishna, Jeonghee Kim, Shuo-Hsiu Chang, Yoonsuck Choe, Hangue Park

Faculty, Staff and Student Publications

INTRODUCTION: Plantar cutaneous augmentation is a promising approach in balance rehabilitation by enhancing motion-dependent sensory feedback. The effect of plantar cutaneous augmentation on balance has been mainly investigated in its passive form (e.g., textured insole) or on lower-limb amputees. In this study, we tested the effect of plantar cutaneous augmentation on balance in its active form (i.e., electrical stimulation) for individuals with intact limbs.

METHODS: Ten healthy subjects participated in the study and were instructed to maintain their balance as long as possible on the balance board, with or without electrotactile feedback evoked on the medial side of the heel, …


Precision Needle-Punch Tumor Enrichment From Paraffin Blocks Improves The Detection Of Clinically Actionable Genomic Alterations And Biomarkers, Douglas I Lin, Richard S P Huang, Ioannis Ladas, Rachel B Keller, Nimesh R Patel, Sotirios Lakis, Brennan Decker, Tyler Janovitz, Douglas A Mata, Jeffrey S Ross, Jo-Anne Vergilio, Julia A Elvin, Roy S Herbst, Philip C Mack, Jonathan K Killian Jan 2024

Precision Needle-Punch Tumor Enrichment From Paraffin Blocks Improves The Detection Of Clinically Actionable Genomic Alterations And Biomarkers, Douglas I Lin, Richard S P Huang, Ioannis Ladas, Rachel B Keller, Nimesh R Patel, Sotirios Lakis, Brennan Decker, Tyler Janovitz, Douglas A Mata, Jeffrey S Ross, Jo-Anne Vergilio, Julia A Elvin, Roy S Herbst, Philip C Mack, Jonathan K Killian

Faculty, Staff and Student Publications

BACKGROUND: While many molecular assays can detect mutations at low tumor purity and variant allele frequencies, complex biomarkers such as tumor mutational burden (TMB), microsatellite instability (MSI), and genomic loss of heterozygosity (gLOH) require higher tumor purity for accurate measurement. Scalable, quality-controlled, tissue-conserving methods to increase tumor nuclei percentage (TN%) from tumor specimens are needed for complex biomarkers and hence necessary to maximize patient matching to approved therapies or clinical trial enrollment. We evaluated the clinical utility and performance of precision needle-punch enrichment (NPE) compared with traditional razor blade macroenrichment of tumor specimens on molecular testing success.

METHODS: Pathologist-directed NPE …


Assessing Laryngectomy Patient Education On Youtube: Investigating Quality And Reliability, Matthew E Lin, Oluwatobiloba Ayo-Ajibola, Carlos X Castellanos, Jonathan West, Neil Luu, Ian Kim, Niels C Kokot Jan 2024

Assessing Laryngectomy Patient Education On Youtube: Investigating Quality And Reliability, Matthew E Lin, Oluwatobiloba Ayo-Ajibola, Carlos X Castellanos, Jonathan West, Neil Luu, Ian Kim, Niels C Kokot

Faculty, Staff and Student Publications

OBJECTIVE: This study aimed to characterize the quality of laryngectomy-related patient education on YouTube and understand factors impacting video content quality.

STUDY DESIGN: Cross-sectional cohort analysis.

SETTING: Laryngectomy-related videos on YouTube.

METHODS: YouTube was anonymously queried for various laryngectomy procedure search terms. Video quality was evaluated using the validated DISCERN instrument which assesses treatment-related information quality. Descriptive statistics were used to characterize our cohort. Univariate and multivariable linear regression were used to assess factors associated with increased DISCERN score. Significance was set at

RESULTS: Our 78-video cohort exhibited moderate levels of engagement, averaging 13,028.40 views (SD = 24,246.93), 69.79 likes …


High Doses Of Caffeine-Induced Cerebral Infarction Leading To Partial Locked-In Syndrome In A Young Adult: A Novel Association?, Vijay Sinha, Loc Lam, Michael V Nguyen Jan 2024

High Doses Of Caffeine-Induced Cerebral Infarction Leading To Partial Locked-In Syndrome In A Young Adult: A Novel Association?, Vijay Sinha, Loc Lam, Michael V Nguyen

Faculty, Staff and Student Publications

INTRODUCTION: This is a case of a 30-year-old male with no prior medical conditions presented to the emergency department for presumed seizures after ingesting 900 mg of caffeine via pre-workout drinks and pills.

CASE PRESENTATION: The patient was described as having nearly 15 min of generalized seizure activity observed by emergency medical service, requiring midazolam. A head computerized tomography (CT) demonstrated a possible thrombus, and further, CT angiography and CT perfusion confirmed a basilar artery occlusion. He was treated with tissue plasminogen activator and underwent thrombectomy achieving TICI grade 3 in the left posterior cerebral artery and TICI grade 2b …


Stimulating Superior Cluneal Nerves Via Peripheral Nerve Stimulation As A Treatment For Chronic Low Back Pain, Peter D Vu, Christopher L Robinson, Alan D Kaye, Jamal Hasoon Jan 2024

Stimulating Superior Cluneal Nerves Via Peripheral Nerve Stimulation As A Treatment For Chronic Low Back Pain, Peter D Vu, Christopher L Robinson, Alan D Kaye, Jamal Hasoon

Faculty, Staff and Student Publications

Low back pain (LBP) is a challenging clinical condition for both patients and physicians. It requires a comprehensive initial diagnosis to avoid missing potential causes. One less common cause is superior cluneal neuralgia (SCN), which can present with limited lumbar motion, LBP, buttock pain, or an antalgic gait. While conservative therapies are often first line for LBP, neuromodulation, such as peripheral nerve stimulation (PNS), can be considered for more refractory cases. This case report is unique in that SCN was treated with a temporary PNS system, which provided sustained analgesic benefits without the need for permanent implantation.


Re-Evaluating The Gender Gap: A Cross-Sectional Analysis Of Accepted American Academy Of Neurology Annual Meeting Abstracts In 2020 And 2021, Minseon Kim, Youngran Kim, Anjail Z Sharrief, Thy P Nguyen Jan 2024

Re-Evaluating The Gender Gap: A Cross-Sectional Analysis Of Accepted American Academy Of Neurology Annual Meeting Abstracts In 2020 And 2021, Minseon Kim, Youngran Kim, Anjail Z Sharrief, Thy P Nguyen

Faculty, Staff and Student Publications

BACKGROUND AND OBJECTIVE: Prior studies reveal that invited speaker panels, editorial boards, authors of practice guidelines, and senior authors of published articles are disproportionately male in the neurology field. We aimed to analyze a gender gap in authorship of accepted abstracts to the American Academy of Neurology annual meetings in 2020 and 2021.

DESIGN/METHODS: This is a cross-sectional study evaluating the proportions of female first and senior abstract authors in 2020 and 2021. Abstracts were reviewed manually (

RESULTS: Accepted abstracts with female first and senior authors comprised 46%, 34% in 2020, and the same in 2021, without change. Female …


Late-Onset Parry-Romberg Syndrome With Atypical Neurological Manifestations: A Case Report, Sema Akkus, Suban Amatya, Kriti Shrestha, Shitiz Sriwastava, Demetrios A Karides Jan 2024

Late-Onset Parry-Romberg Syndrome With Atypical Neurological Manifestations: A Case Report, Sema Akkus, Suban Amatya, Kriti Shrestha, Shitiz Sriwastava, Demetrios A Karides

Faculty, Staff and Student Publications

Parry-Romberg Syndrome (PRS) is a rare neurocutaneous disorder characterized by gradual facial hemiatrophy. We present a case study of a 64-year-old woman with late-onset PRS and linear scleroderma. The patient exhibited atypical PRS symptoms including leg numbness, hyper-reflexia, trigeminal neuralgia, and severe headaches. Diagnostic evaluations revealed chronic left-sided cerebral infarction, microhemorrhages, and nerve involvement. Treatment options for PRS are limited and aim to manage symptoms. This case highlights the diagnostic challenges of late-onset PRS, emphasizing interdisciplinary approach. Further research and improved therapies are essential for better patient outcomes.


Multimodal Therapy And Use Of Adjunctive Therapies To Bont-A In Spasticity Management: Defining Terminology To Help Enhance Spasticity Treatment, Rajiv Reebye, Luis Jorge Jacinto, Alexander Balbert, Bo Biering-Sørensen, Stefano Carda, Nathalie Draulans, Franco Molteni, Michael W O'Dell, Alessandro Picelli, Andrea Santamato, Monica Verduzco-Gutierrez, Heather Walker, Joerg Wissel, Gerard E Francisco Jan 2024

Multimodal Therapy And Use Of Adjunctive Therapies To Bont-A In Spasticity Management: Defining Terminology To Help Enhance Spasticity Treatment, Rajiv Reebye, Luis Jorge Jacinto, Alexander Balbert, Bo Biering-Sørensen, Stefano Carda, Nathalie Draulans, Franco Molteni, Michael W O'Dell, Alessandro Picelli, Andrea Santamato, Monica Verduzco-Gutierrez, Heather Walker, Joerg Wissel, Gerard E Francisco

Faculty, Staff and Student Publications

Spasticity management should be provided within the context of a comprehensive person-centered rehabilitation program. Furthermore, active goal setting for specific spasticity interventions is also important, with a well-established "more is better" approach. It is critical to consider adjunctive therapy and multimodal approaches if patients are not attaining their treatment goals. Often used interchangeably, there may be confusion between the terms adjunctive and multimodal therapy. Yet it is imperative to understand the differences between these approaches to achieve treatment goals in spasticity management. Addition of a secondary pharmacologic or non-pharmacologic treatment to optimize the efficacy of the initial modality, such as …


Safety And Feasibility Of Paired Vagus Nerve Stimulation With Rehabilitation For Improving Upper Extremity Function In People With Cervical Spinal Cord Injury: Study Protocol For A Pilot Randomized Controlled Trial, Nuray Yozbatiran, Gerard E Francisco, Radha Korupolu Jan 2024

Safety And Feasibility Of Paired Vagus Nerve Stimulation With Rehabilitation For Improving Upper Extremity Function In People With Cervical Spinal Cord Injury: Study Protocol For A Pilot Randomized Controlled Trial, Nuray Yozbatiran, Gerard E Francisco, Radha Korupolu

Faculty, Staff and Student Publications

Introduction: Pairing vagus nerve stimulation with traditional rehabilitation therapies results in improved motor recovery in people with stroke. However, this approach has not yet been studied in people with spinal cord injury (SCI). Motor recovery continues to be challenging after SCI, and there is a need for innovative research strategies to enhance motor recovery after SCI. Hence, this pilot randomized controlled trial aims to evaluate the safety, feasibility, and potential efficacy of pairing vagus nerve stimulation (VNS) with rehabilitation therapy to restore the motor function of the paretic upper limbs in people with cervical SCI.

Methods and analysis: In this …


Prognostic Value Of The 5-Sense Score To Predict Focality Of The Seizure-Onset Zone As Assessed By Stereoelectroencephalography: A Prospective International Multicentre Validation Study, Alexandra Astner-Rohracher, Alyssa Ho, John Archer, Fabrice Bartolomei, Milan Brazdil, Melita Cacic Hribljan, James Castellano, Irena Dolezalova, Martin Ejler Fabricius, Mercedes Garcés-Sanchez, Kahina Hammam, Akio Ikeda, Kristin Ikeda, Philippe Kahane, Giridhar Kalamangalam, Gudrun Kalss, Mays Khweileh, Katsuya Kobayashi, Patrick Kwan, Joshua Andrew Laing, Markus Leitinger, Samden Lhatoo, Julia Makhalova, Aileen Mcgonigal, Iona Mindruta, Mary Margaret Mizera, Andrew Neal, Irina Oane, Prachi Parikh, Piero Perucca, Francesca Pizzo, Rodrigo Rocamora, Philippe Ryvlin, Victoria San Antonio Arce, Stephan Schuele, Andreas Schulze-Bonhage, Ana Suller Marti, Alexandra Urban, Vincente Villanueva, Laura Vilella Bertran, Benjamin Whatley, Sandor Beniczky, Eugen Trinka, Georg Zimmermann, Birgit Frauscher Jan 2024

Prognostic Value Of The 5-Sense Score To Predict Focality Of The Seizure-Onset Zone As Assessed By Stereoelectroencephalography: A Prospective International Multicentre Validation Study, Alexandra Astner-Rohracher, Alyssa Ho, John Archer, Fabrice Bartolomei, Milan Brazdil, Melita Cacic Hribljan, James Castellano, Irena Dolezalova, Martin Ejler Fabricius, Mercedes Garcés-Sanchez, Kahina Hammam, Akio Ikeda, Kristin Ikeda, Philippe Kahane, Giridhar Kalamangalam, Gudrun Kalss, Mays Khweileh, Katsuya Kobayashi, Patrick Kwan, Joshua Andrew Laing, Markus Leitinger, Samden Lhatoo, Julia Makhalova, Aileen Mcgonigal, Iona Mindruta, Mary Margaret Mizera, Andrew Neal, Irina Oane, Prachi Parikh, Piero Perucca, Francesca Pizzo, Rodrigo Rocamora, Philippe Ryvlin, Victoria San Antonio Arce, Stephan Schuele, Andreas Schulze-Bonhage, Ana Suller Marti, Alexandra Urban, Vincente Villanueva, Laura Vilella Bertran, Benjamin Whatley, Sandor Beniczky, Eugen Trinka, Georg Zimmermann, Birgit Frauscher

Faculty, Staff and Student Publications

Introduction: Epilepsy surgery is the only curative treatment for patients with drug-resistant focal epilepsy. Stereoelectroencephalography (SEEG) is the gold standard to delineate the seizure-onset zone (SOZ). However, up to 40% of patients are subsequently not operated as no focal non-eloquent SOZ can be identified. The 5-SENSE Score is a 5-point score to predict whether a focal SOZ is likely to be identified by SEEG. This study aims to validate the 5-SENSE Score, improve score performance by incorporating auxiliary diagnostic methods and evaluate its concordance with expert decisions.

Methods and analysis: Non-interventional, observational, multicentre, prospective study including 200 patients with drug-resistant …


Optimizing Medication Querying Using Ontology-Driven Approach With Omop: With An Application To A Large-Scale Covid-19 Ehr Dataset, Xiaojin Li, Yan Huang, Licong Cui, Shiqiang Tao, Guo-Qiang Zhang Jan 2024

Optimizing Medication Querying Using Ontology-Driven Approach With Omop: With An Application To A Large-Scale Covid-19 Ehr Dataset, Xiaojin Li, Yan Huang, Licong Cui, Shiqiang Tao, Guo-Qiang Zhang

Faculty, Staff and Student Publications

Efficient querying for medication information in Electronic Health Record (EHR) datasets is crucial for effective patient care and clinical research. To address the complexity and data volume challenges involved in efficient medication information retrieval, we propose an ontology-driven medication query (ODMQ) optimization approach, leveraging the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM). Integrating semantic ontology structures from the OMOP CDM can help enhance query accuracy and efficiency by broadening the scope of relevant medication terms like drug names, National Drug Codes, and generics, resulting in more comprehensive query outcomes than traditional methods. ODMQ significantly reduces manual search time …


A Web-Based Interface For Visualizing And Documenting Seeg Strategic Planning (Wisp): Development And Qualitative Evaluation, Wei-Chun Chou, Johnson P Hampson, Antarr T Byrd, Samden D Lhatoo, Guo-Qiang Zhang, Shiqiang Tao Jan 2024

A Web-Based Interface For Visualizing And Documenting Seeg Strategic Planning (Wisp): Development And Qualitative Evaluation, Wei-Chun Chou, Johnson P Hampson, Antarr T Byrd, Samden D Lhatoo, Guo-Qiang Zhang, Shiqiang Tao

Faculty, Staff and Student Publications

WISP stands as an efficacious solution to the challenges associated with Stereoelectroencephalography (SEEG) strategic planning, offering lightweight and interactive web interfaces for rendering multiple brain views. These interfaces facilitate collaborative engagement among care team members across various disciplines during patient case conferences and SEEG strategic planning sessions. Moreover, WISP incorporates a collaborative electrode and electrode group library, serving as a standardized repository of knowledge. The application enables seamless conversion of case conference outcomes and SEEG plans into images and PDF files, with transmission to Electronic Health Record (EHR) systems through a customized HL7 engine. The initial assessment findings demonstrate WISP …


Characterizing Treatment Non-Responders And Responders In Completed Alzheimer's Disease Clinical Trials, Dulin Wang, Yaobin Ling, Kristofer Harris, Paul E Schulz, Xiaoqian Jiang, Yejin Kim Jan 2024

Characterizing Treatment Non-Responders And Responders In Completed Alzheimer's Disease Clinical Trials, Dulin Wang, Yaobin Ling, Kristofer Harris, Paul E Schulz, Xiaoqian Jiang, Yejin Kim

Faculty, Staff and Student Publications

Characterizing differential responses to Alzheimer's disease (AD) drugs will provide better insights into personalized treatment strategies. Our study aims to identify heterogeneous treatment effects and pre-treatment features that moderate the treatment effect of Galantamine, Bapineuzumab, and Semagacestat from completed trial data. The causal forest method can capture heterogeneity in treatment responses. We applied causal forest modeling to estimate the treatment effect and identify efficacy moderators in each trial. We found several patient's pretreatment conditions that determined treatment efficacy. For example, in Galantamine trials, whole brain volume (1092.54 vs. 1060.67 ml, P < .001) and right hippocampal volume (2.43e-3 vs. 2.79e-3, P < .001) are significantly different between responsive and non-responsive subgroups. Overall, our implementation of causal forests in AD clinical trials reveals the heterogeneous treatment effects and different moderators for AD drug responses, highlighting promising personalized treatment based on patient-specific characteristics in AD research and drug development.


Role Of Alpha-Synuclein Seed Amplification Assay In Parkinson’S Disease Clinical Trials: A Case Of Misdiagnosis, Emily Tharp, Juan D Martinez-Lemus, Mya C Schiess, Timothy M Ellmore, Jessika Suescun, Mohammad Shahnawaz Jan 2024

Role Of Alpha-Synuclein Seed Amplification Assay In Parkinson’S Disease Clinical Trials: A Case Of Misdiagnosis, Emily Tharp, Juan D Martinez-Lemus, Mya C Schiess, Timothy M Ellmore, Jessika Suescun, Mohammad Shahnawaz

Faculty, Staff and Student Publications

•Early differentiation between PD and atypical parkinsonism is challenging.•Variability in diagnosis can weaken statistical power in trials.•Precise diagnostic tools are needed for trial population homogeneity.•This patient initially diagnosed with PD, was diagnosed with MSA via CSF αSyn-SAA.•Adding αSyn-SAA to inclusion criteria could enhance subject selection in trials.


Saint Paul, The Apostle, And The Gastaut-Geschwind Syndrome, Leonardo Cruz De Souza, Guilherme Nogueira Mendes De Oliveira, Leandro Boson Gambogi, Ana Paula Gonçalves, Antônio Lúcio Teixeira Jan 2024

Saint Paul, The Apostle, And The Gastaut-Geschwind Syndrome, Leonardo Cruz De Souza, Guilherme Nogueira Mendes De Oliveira, Leandro Boson Gambogi, Ana Paula Gonçalves, Antônio Lúcio Teixeira

Faculty, Staff and Student Publications

The interface between epilepsy and religiosity has been a long-standing matter of debate. Epilepsy has affected several religious leaders throughout history. Hyperreligiosity may be observed in patients with temporal lobe epilepsy as a component of the so-called Gastaut-Geschwind syndrome which involves other behavioral and personality traits such as hyposexuality, viscosity, philosophical concerns, sense of personal destiny, hypergraphy, emotionality, and irritability. Saint Paul, the Apostle, probably had temporal lobe epilepsy. He was a genius man of intellectual excellence and refined culture, whose life and writings exerted a decisive influence on Western history. The current paper investigates the elements of Gastaut-Geschwind syndrome …


Clearance Of Neutrophils From Ich-Affected Brain By Macrophages Is Beneficial And Is Assisted By Lactoferrin And Cd91, Xiurong Zhao, Shun-Ming Ting, Guanghua Sun, Jesus Bautista Garrido, Lidiya Obertas, Jaroslaw Aronowski Jan 2024

Clearance Of Neutrophils From Ich-Affected Brain By Macrophages Is Beneficial And Is Assisted By Lactoferrin And Cd91, Xiurong Zhao, Shun-Ming Ting, Guanghua Sun, Jesus Bautista Garrido, Lidiya Obertas, Jaroslaw Aronowski

Faculty, Staff and Student Publications

Background: Within hours after intracerebral hemorrhage (ICH) onset, masses of polymorphonuclear neutrophils (PMNs) infiltrate the ICH-affected brain. After degranulation involving controlled release of many toxic antimicrobial molecules, the PMNs undergo rapid apoptosis and then are removed by phagocytic microglia/macrophages (MΦ) through a process called efferocytosis. Effective removal of PMNs may limit secondary brain damage and inflammation; however, the molecular mechanisms governing these cleanup activities are not well understood. We propose that scavenger receptor CD91 on myeloid phagocytes especially in presence of CD91 ligand, LTF (lactoferrin, protein abundant in PMNs), plays an important role in clearance of dead apoptotic PMNs (ANs). …


Mnemonic Utilization In Stroke Education: Fast And Befast Adoption By Certified Comprehensive Stroke Centers, Christopher Hogge, Larry B Goldstein, Sushanth R Aroor Jan 2024

Mnemonic Utilization In Stroke Education: Fast And Befast Adoption By Certified Comprehensive Stroke Centers, Christopher Hogge, Larry B Goldstein, Sushanth R Aroor

Faculty, Staff and Student Publications

Introduction

Symptom recognition and timely access to treatment are critical components of acute stroke care systems. Two mnemonics widely used in public educational campaigns for recognizing stroke symptoms include FAST (Face-Arm-Speech-Time) and BEFAST (Balance-Eyes-Face-Arm Speech-Time). The FAST mnemonic can miss up to 14% of strokes. BEFAST includes common posterior circulation stroke symptoms and has been implemented by several Comprehensive Stroke Centers (CSCs).

Methods

We sought to analyze the pattern of public educational materials available on the websites of US CSCs. The Joint Commission (JC) quality check website compiles a list containing the names and locations of the country’s 217 JC-certified …


An Ewas Of Dementia Biomarkers And Their Associations With Age, African Ancestry, And Ptsd, Mark W. Miller, Erika J. Wolf, Xiang Zhao, Mark W. Logue, Sage E. Hawn Jan 2024

An Ewas Of Dementia Biomarkers And Their Associations With Age, African Ancestry, And Ptsd, Mark W. Miller, Erika J. Wolf, Xiang Zhao, Mark W. Logue, Sage E. Hawn

Psychology Faculty Publications

Background

Large-scale cohort and epidemiological studies suggest that PTSD confers risk for dementia in later life but the biological mechanisms underlying this association remain unknown. This study examined this question by assessing the influences of PTSD, APOE ε4 genotypes, DNA methylation, and other variables on the age- and dementia-associated biomarkers Aβ40, Aβ42, GFAP, NfL, and pTau-181 measured in plasma. Our primary hypothesis was that PTSD would be associated with elevated levels of these markers.

Methods

Analyses were based on data from a PTSD-enriched cohort of 849 individuals. We began by performing factor analyses of the biomarkers, the results of which …