Nervous System Diseases Commons^™

Objectivity, Practicality, And Significance Of Practice Guidelines For The Practicing Neurologists: What We Learnt From Consensus Criteria In Cidp, Myasthenia Gravis And Inflammatory Myopathies, Marinos C. Dalakas

Department of Neurology Faculty Papers

The value of practice guidelines in the three most common autoimmune neuromuscular disorders, namely Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), Myasthenia Gravis (MG) and Autoimmune Inflammatory Myopathies (AIM), has been extensively debated regarding their usefulness in clinical practice, objectivity and universal value considering that guidelines are also established regionally in certain countries. This commentary highlights common concerns on how guidelines are presently generated, pointing out: (a) non-sufficient diversity among Task-Force members to identify and address not only routine clinical and electrophysiology issues but also immunology, imaging, pathology, biomarkers, epidemiology or treatment economics; (b) Task-Force being often comprised by the same or …

Social Distancing And Extremely Preterm Births In The Initial Covid-19 Pandemic Period, Christopher M Orlando, Carlos A Pérez, Paunel Agyei, Marwah Elsehety, Sonia Kaur Singh, Joseph Thomas, Omar Alaina, John A Lincoln

Faculty, Staff and Student Publications

Background:

Black and Hispanic patients with multiple sclerosis (MS) have been shown to accumulate greater multiple sclerosis–associated disability (MSAD) than White patients. Disparities in social determinants of health (SDOH) among these groups have also been reported.

Objective:

To determine the extent to which associations of race and ethnicity with MSAD may be attributable to differences in SDOH.

Methods:

Retrospective chart analysis of patients at an academic MS center grouped by self-identified Black (n = 95), Hispanic (n = 93), and White (n = 98) race/ethnicity. Individual patient addresses were geocoded and matched with neighborhood-level area deprivation index …

Pimavanserin Treatment Increases Plasma Brain-Derived Neurotrophic Factor Levels In Rats, Ashutosh Tripathi, Henry A Nasrallah, Anilkumar Pillai

Faculty, Staff and Student Publications

BACKGROUND: Pimavanserin, a serotonin 5HT-2A receptor inverse agonist is the first-line, FDA-approved treatment of hallucinations and delusions associated with Parkinson's Disease psychosis (PDP), which occurs in up to 50% of PD patients. The neurobiological mechanism underlying the therapeutic effectiveness of Pimavanserin in PDP remains unknown. Several earlier studies have shown that treatment with 5HT-2A antagonists and other drugs acting on the serotonergic system such as SSRIs increase Brain derived neurotrophic factor (BDNF) levels in rodents. BDNF is synthesized as the precursor proBDNF, that undergoes cleavage intra or extracellularly to produce a mature BDNF (mBDNF) protein. mBDNF is believed to play …

Stiff Person Syndrome: A Rare Presentation Of A Rare Disorder, Muhammad Hammad Sharif, Basil George Verghese

Advances in Clinical Medical Research and Healthcare Delivery

Stiff Person Syndrome (SPS) is a rare autoimmune disease that is caused by the lack of inhibition to excitatory neurotransmitters in the central nervous system (CNS) which then leads to inappropriate and excessive motor unit firing causing stiffness, a characteristic feature of the disease. SPS has an incidence of one case in a million and occurs in the middle-aged population with a female predominance. SPS mostly occurs in the background of autoimmune disorders like type 1 diabetes, thyroid disorders, pernicious anemia, and less often, vitiligo. The pathophysiology is not completely understood; however, there is a strong correlation between high …

Referral Patterns For Pediatric Sports-Related Concussion In One New England Health Care System, Joseph Benert, Amy Haskins Phd, Christina T. Holt, Krystian Bigosinski

Journal of Maine Medical Center

Introduction: Patients with concussion may benefit from care provided by professionals from multiple disciplines based on the constellation of symptoms being reported. This study analyzed referral patterns from primary care and sports medicine clinicians for pediatric patients with sports-related concussion in one health care system.

Methods: A retrospective chart review identified referrals placed to physical therapy, occupational therapy, speech pathology, optometry, psychology, neuropsychology, audiology, neurology, ophthalmology, otolaryngology, psychiatry, and sports medicine for pediatric patients with sports-related concussion. These patients were evaluated at MaineHealth family medicine, internal medicine/pediatrics, pediatrics, and sports medicine clinics in southern Maine between February 2019 and June …

Persistence To Anti-Cgrp Monoclonal Antibodies And Onabotulinumtoxina Among Patients With Migraine: A Retrospective Cohort Study, Larry Charleston, Brian Talon, Christine Sullivan, Carlton Anderson, Steven Kymes, Stephane A. Regnier, Seema Soni-Brahmbhatt, Stephanie J. Nahas

Department of Jefferson Headache Center Papers and Presentations

BACKGROUND: To date, real-world evidence on persistence to anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAbs) or onabotulinumtoxinA have excluded eptinezumab. This retrospective cohort study was performed to compare treatment persistency among patients with migraine on anti-CGRP mAbs (erenumab, fremanezumab, galcanezumab, or eptinezumab) or onabotulinumtoxinA.

METHODS: This retrospective study used IQVIA PharmMetrics data. Adult patients with migraine treated with an anti-CGRP mAb or onabotulinumtoxinA who had 12 months of continuous insurance enrollment before starting treatment were included. A "most recent treatment episode" analysis was used in which the most recent episode was defined as the latest treatment period with the same …

Causal Inference Methods For Estimation Of Survival And General Health Status Measures Of Alzheimer’S Disease Patients, Ehsan Yaghmaei

Computational and Data Sciences (PhD) Dissertations

Identifying optimal treatment options with respect to survival of Alzheimer's disease patients is crucially important and previously uninvestigated research question. Our objective was to estimate the causal effects of the most prevalent classes of Alzheimer’s disease drugs, Donepezil and Memantine, and their combined use on Survival and General Health Status Measures of Alzheimer's disease patients for the first five years after initial diagnosis. We carried out a thorough causal inference study using doubly robust estimators, nonparametric bootstrap confidence intervals, Bonferroni corrections for multiple comparisons and analyzing one of the largest high-quality medical databases containing millions of de-identified electronic health records …

Brominated Flame Retardants: A Literature Review Of The Toxicity Mechanisms, Clinical Manifestations, And Current Treatments, Yacobus Christian Prasetyo, Eti Nurwening Sholikhah

Occupational and Environmental Medicine Journal of Indonesia

Brominated flame retardants (BFRs) are organohalogen compounds that can inhibit fire formation and delay its spread in manufacturing materials. BFRs are known to be toxic for the environment and humans. BFRs could persist for years prolonging potential exposure and toxicity to living beings. Indonesia had begun to reduce the use, even though some of toxic BFRs are still illegally circulating. This review aims to describe some aspects of BFRs toxicity including the mechanism, its clinical manifestations, and the current possible treatments. Toxicity after BFRs exposure includes endocrine, neurodevelopmental, and genotoxicity. The toxicity is manifested into some clinical conditions such as …

Computational Modeling And Synthesis Of Pyridine Variants Of Benzoyl-Phenoxy-Acetamide With High Glioblastoma Cytotoxicity And Brain Tumor Penetration, Charles H. Ingraham, Joanna Stalinska, Sean C. Carson, Susan B. Colley, Monika Rak, Adam Lassak, Francesca Peruzzi, Krzysztof Reiss, Branko S. Jursic

School of Graduate Studies Faculty Publications

Glioblastomas are highly aggressive brain tumors for which therapeutic options are very limited. In a quest for new anti-glioblastoma drugs, we focused on specific structural modifications to the benzoyl-phenoxy-acetamide (BPA) structure present in a common lipid-lowering drug, fenofibrate, and in our first prototype glioblastoma drug, PP1. Here, we propose extensive computational analyses to improve the selection of the most effective glioblastoma drug candidates. Initially, over 100 structural BPA variations were analyzed and their physicochemical properties, such as water solubility (− logS), calculated partition coefficient (ClogP), probability for BBB crossing (BBB_SCORE), probability for CNS penetration (CNS-MPO) and calculated cardiotoxicity (hERG), were …

Genetics Of Functional Seizures; A Scoping Systematic Review, Ali A. Asadi-Pooya, Mark Hallett, Nafiseh Mirzaei Damabi, Khatereh Fazelian Dehkordi

Department of Neurology Faculty Papers

Background: Evidence on the genetics of functional seizures is scarce, and the purpose of the current scoping systematic review is to examine the existing evidence and propose how to advance the field.

Methods: Web of science and MEDLINE were searched, from their initiation until May 2023. The following key words were used: functional neurological disorder(s), psychogenic neurological disorder(s), functional movement disorder(s), psychogenic movement disorder(s), functional seizures(s), psychogenic seizure(s), nonepileptic seizure(s), dissociative seizure(s), or psychogenic nonepileptic seizure(s), AND, gene, genetic(s), polymorphism, genome, epigenetics, copy number variant, copy number variation(s), whole exome sequencing, or next-generation sequencing.

Results: We identified three original studies. …

Building A Community-Academic Partnership To Improve Underrepresented Group Awareness Of Parkinson’S Disease And Research, Danielle N. Larson, Jennifer Adrissi, Madison Lyleroehr, Emily Zivin, Karen Williams, Tanya Simuni

Journal of Health Disparities Research and Practice

BACKGROUND: Members of underrepresented groups (URGs) are more likely to have delays in PD diagnosis and less likely to receive specialized care when compared to non-Hispanic Caucasians. URGs are not proportionately represented in PD clinical research. Barriers to optimal diagnosis and treatment and research participation are multifaceted but include insufficient community knowledge of PD and research.

OBJECTIVES: To establish a community-academic partnership (CAP) for increasing knowledge of Parkinson’s Disease (PD) and research opportunities in underrepresented Chicago communities. Here, we describe the development, structure, and outcomes of this pilot program.

METHODS: The Chicago Movement Coalition (CMC) was established with academic leaders …

Targeted Muscle Reinnervation To Reduce Postoperative Pain In Patients Undergoing Hindquarter Resections, Mikaela H. Sullivan, Gavin L. Mills, Hiba Saifuddin, Elyse J. Brinkman, Brian T. Carlsen, Steven L. Moran, Matthew T. Houdek

School of Medicine Faculty Publications

Background/Aim: Pre-emptive targeted muscle reinnervation (TMR) at the time of amputation results in less phantom limb pain (PLP) compared with untreated amputee controls. There is limited literature describing the technique in patients undergoing hindquarter amputation despite up to 90% of these patients reporting PLP and 50% presenting with painful neuroma. The purpose of the current study was to describe the motor nerves accessible through a primary hind-quarter amputation to be used for TMR and review pain outcomes in clinical case correlates of patients with TMR. Patients and Methods: Six limbs were obtained from three fresh adult cadavers and proximal sensory …

Incorporating Poi As A Therapeutic Modality For Preschool Aged Children In The Care Clinic, Danielle Zirkle

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Amyloid-Beta Protein Concentration Dependence Of Reversible Aggregation Using Gold Colloid Particles, Renee Spencer, Lila Kocieniewski, Bryan Martinez, Kazushige Yokoyama

McNair Scholars Program

Although Alzheimer’s and COVID-19 are different diseases, the commonality between them is during the process of them developing in a person by fibrillogenesis. The product of fibrillogenesis results in the development of these diseases. We study the first stage of fibrillogenesis where the amyloid-beta peptide monomers are assembled into an oligomer. We want to isolate this oligomer using gold colloids because this step can be reversed. Utilizing gold colloids allows us to freeze fibrillogenesis in the first step by folding and unfolding the protein repeatedly through a series of pH changes from 4 or below to 10 or higher. At …

Stellate Ganglion Block For Refractory Raynaud’S Phenomenon- A Case Report, William J. Naber Ii, Derik J. Scribner, Gabriel Howard

Graduate Medical Education Research Journal

Introduction: Raynaud’s phenomenon (RP) is predominately a sympathetically mediated ischemic vasospastic disease involving the distal limbs and is associated with sharp pains, numbness, and dermatological color changes. The symptoms are commonly induced by cold weather, stress, and trauma and it is known to affect 4.85% of the population. There are few well-defined treatments for patients with RP that are refractory to 1st-line therapies. We present a case of intractable RP with corresponding response to stellate ganglion block (SGB) which demonstrates the efficacy profile and safety of SNS blocks in treatment of resistant RP.

Methods: Per Bon Secours Mercy Health …

Sirna Drug Delivery Across The Blood–Brain Barrier In Alzheimer's Disease, Muhammad Imran Sajid, Fahad Sultan Sheikh, Faiza Anis, Nourina Nasim, Rachita K. Sumbria, Surya M. Nauli, Rakesh K. Tiwari

Pharmacy Faculty Articles and Research

Alzheimer’s disease (AD) is a progressive neurodegenerative disease with a few FDA-approved drugs that provide modest symptomatic benefits and only two FDA-approved disease-modifying treatments for AD. The advancements in understanding the causative genes and non-coding sequences at the molecular level of the pathophysiology of AD have resulted in several exciting research papers that employed small interfering RNA (siRNA)-based therapy. Although siRNA is being sought by academia and biopharma industries, several challenges still need to be addressed. We comprehensively report the latest advances in AD pathophysiology, druggable targets, ongoing clinical trials, and the siRNA-based approaches across the blood–brain barrier for addressing …

Posttreatment Lyme Disease Syndrome And Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Systematic Review And Comparison Of Pathogenesis, Natalie Bai, Christie Richardson

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Lyme disease is the most common vector-borne illness in the United States and has been causing significant morbidity since its discovery in 1977. It is well-documented that about 10% of patients properly treated with antibiotics never fully recover, but instead go on to develop a chronic illness dubbed, posttreatment Lyme disease syndrome (PTLDS) characterized by severe fatigue, cognitive slowing, chronic pain, and sleep difficulties. This review includes 18 studies that detail the symptoms of patients with PTLDS and uses qualitative analysis to compare them to myalgic encephalitis/chronic fatigue syndrome (ME/CFS), a strikingly similar syndrome. In the majority of the PTLDS …

Complement System In Multiple Sclerosis: Its Role In Disease Course And Potential As A Therapeutic Target, Michael R. Linzey

Dartmouth College Ph.D Dissertations

Multiple sclerosis (MS) is a clinically heterogeneous neurological condition characterized by neuroinflammation and neurodegeneration. Relapsing-remitting MS, defined by inflammatory attacks, is the most common initial form of MS and there are currently 23 FDA-approved treatments for these patients. These therapies work primarily by reducing inflammation in the CNS; they do not work well in progressive disease. Therefore, an unmet medical need exists for effective therapeutic options to treat progressive MS (PMS).

In MS, intrathecal immunoglobulins synthesis (IIgS) correlates with disease progression. My goals for this dissertation were to establish the pathological role of IIgS and identify new potential therapeutic …

Age And Sex Effects On Superg Performance Are Consistent Across Internet Devices, Andrew Hooyman, Sidney Y. Schaefer

Physical Therapy Faculty Articles and Research

There have been recent advances in the application of online games that assess motor skill acquisition/learning and its relationship to age and biological sex, both of which are associated with dementia risk. While this online motor learning assessment (called Super G), along with other computer-based cognitive tests, was originally developed to be completed on a computer, many people (including older adults) have been shown to access the internet through a mobile device. Thus, to improve the generalizability of our online motor skill learning game, it must not only be compatible with mobile devices but also yield replicable effects of various …

Bridging Empathy, Qianwen Lu

Masters Theses

As a jeweler, ally, and sympathetic witness to the traumatic stories of survivors, my work aims to support the process of reconstruction and reintegration for victims and the greater community. To move beyond isolation, resentment, and debilitating helplessness requires care and support. I want my jewelry to act as catalysts in the healing process by straddling both sides of the trauma-induced situation, to create greater awareness and empathy. National Coalition Against Domestic Violence shows that women are more likely to become victims of domestic violence, sexual assault, or other forms of physical and psychological abuse in unhealthy emotional relationships. These …