Neurosciences Commons^™

The Neurobiology Of Interruptions In Emergency Medicine: The Case For Informed Interruption Management In Support Of Cognitive Stability In High-Reliability Clinical Environments, James Espinosa, Henry Schuitema, Alan Lucerna

Rowan-Virtua Research Day

Background: Interruptions are ubiquitous in Emergency Departments (EDs) and have been associated with task delay, multitasking, and increased error risk. While operational and human-factors impacts are well described, the underlying neurocognitive mechanisms remain underexplored. Not all interruptions are avoidable.  However,  interruptions in emergency medicine represent neurocognitive destabilization events that can degrade task representation and increase vulnerability to error during task resumption. Recognizing the neural mechanisms underlying interruptions reframes their management as a systems-level patient safety priority. The aim is not elimination of clinically necessary communication, but thoughtful reduction, prioritization, and design that protects cognitive stability.

Objective: To synthesize cognitive neuroscience …

Procedural Narration As An Important Cognitive Adjunct To Analgesia: Naming And Neurobiologically Grounding An Established Emergency Medicine Practice, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background: Experienced emergency physicians routinely provide real-time verbal guidance during procedures. Although widespread and intuitive, this practice has not been commonly conceptualized within pain neuroscience.

Objective: To name and mechanistically ground procedural narration as a form of cognitive analgesia, and to promote its intentional use and teaching in Emergency Medicine.

Methods: Narrative review integrating predictive coding theory, placebo/nocebo research, affective neuroscience, descending inhibitory pathway literature, and attentional modulation studies.

Results: Procedural narration reduces uncertainty, aligns expectation with sensation, modulates limbic threat processing, engages prefrontal cortical regulation, and supports descending inhibitory control of nociception.

Conclusion: Procedural narration is not a novel …

Sleep Architecture And Delirium In Patients With Intracerebral Hemorrhage: A Preliminary Observational Study, Lily Roessler, Kevin Eaise, Jamie Feinour Msn, Crnp, Jennifer Jond Ms, Pa-C, Vanessa Salasky Md, Mikel Shea Ehntholt Md, Bethany C. Young

Rowan-Virtua Research Day

Background: Delirium is common among ICU stroke patients and could possibly be associated with disrupted sleep. However, the relationship between specific sleep characteristics and delirium remains unclear.

Objective: To evaluate the association between sleep architecture and delirium in intracerebral hemorrhage (ICH) patients in the ICU.

Methods: We performed a primary analysis of 14 ICU ICH patients who underwent polysomnography. Sleep variables included total sleep time, sleep efficiency, sleep stages (N1, N2, N3, REM), arousal index, and sleep latency. Delirium was assessed using the Confusion Assessment Method for the ICU (CAM-ICU). Patients were categorized by presence or absence of delirium. Continuous …

In School Age Children With Autism Spectrum Disorder, Does Academic Achievement And Social Development Improve In Inclusive Classroom Environments?, Ashley A. Macquaid

Rowan-Virtua Research Day

Autism Spectrum Disorder (ASD) is a developmental disorder characterized by difficulties in social skills, communication, and sensory processing 1. ASD affects approximately 1 in 100 children internationally 2. With the growing prevalence, classroom inclusivity of individuals with autism has emerged as a priority in education. However, current literature presents a range of positive and negative factors without clear indication of effective classroom placement for students' specific needs. This research aims to determine if inclusive classroom environments improve academic achievement and social development for school-age children with ASD. A systematic search on PubMed, Embase, and Cochrane databases yielded studies published between …

Adolescent Opioid Use And Prefrontal Cortex Development - A Systematic Review, Jonathan Perumpail, Liam Kerrick, Shreya Kadi

Rowan-Virtua Research Day

Adolescence represents a critical period of neurodevelopment characterized by ongoing maturation of the prefrontal cortex (PFC), a brain region essential for executive function, impulse control, and behavioral regulation. Exposure to opioids during this vulnerable window may disrupt neural development and lead to long-term consequences. This review synthesizes current preclinical and human evidence examining the effects of adolescent opioid exposure on PFC development. Across rodent models, opioid exposure is associated with impaired synaptogenesis, altered dopaminergic signaling, and dysregulation of the prefrontal-mesolimbic circuits involved in decision making. Human studies showed reduced functional connectivity and white matter changes in those with opioid use …

Feasibility Of 90-Day Follow Up For Patients With Intracerebral Hemorrhage: Early Data From A Neuro Icu Sleep Quality And Delirium Study, Sierra Triolo, Bethany C. Young, Mikel Shea Ehntholt, Anuoluwapo Fadare, Jamie R. Feinour, Jennifer A. Jond, Jonathan Perumpail, Kevin Eaise, Lily Roessler, Shay Lynn Greco, Vanessa Salasky

Rowan-Virtua Research Day

Background. Neuro intensive care unit (ICU) patients often experience sleep deprivation due to serial neurologic assessments, among other factors. Subjective sleep disturbance has been associated with increased delirium risk in patients with intracerebral hemorrhage (ICH).¹ However, relationships between specific sleep features, delirium and subsequent outcomes in neurocritically ill patients have not been studied.¹ Additionally, ICH-related clinical research has not historically been conducted at Virtua Our Lady of Lourdes (VOLOL) Hospital. This study aimed to assess feasibility of obtaining quantitative sleep data, delirium assessments, and 90-day functional outcomes in neurocritical care patients with ICH.

Hypothesis. We hypothesized that 90-day …

Parenting Style And Academic Success: How Can You Help Your Child Succeed?, Elizabeth A. Weicker

Caravel Undergraduate Research Journal

The goal of this study was to investigate the relationship between the parenting style a college student experienced during childhood and the student’s most recent college GPA. Using survey data collected from undergraduate students throughout the United States, a between-subjects ANOVA was conducted to comparing different parenting styles and mean GPA for those styles. The parenting styles analyzed were authoritative, authoritarian, and permissive. Results indicated significant differences in GPA between parenting styles, with the authoritative parenting style producing the highest college GPA. In addition, an independent samples t-test was conducted to analyze the relationship between student satisfaction with the parenting …

Predicting Narcissism Through Social Media, Cameryn Freglette, Melanie Palomares

Caravel Undergraduate Research Journal

The objective of this study was to assess if narcissism can be predicted through social media behaviors such as frequency of posts, posting selfies, and social media presence on a variety of platforms. This study was conducted through a questionnaire related to social media use and a brief assessment from the Narcissistic Personality Inventory (NPI- 16). Results indicated that social media use per day was significantly different between people who post selfies and those who do not. Participants that scored higher for narcissism used social media less but posted significantly more selfies. Results were not significant in predicting narcissism through …

Heads Up! Designing A Nursing Assessment Tool For Early Recognition Of Intracranial Hypertension Post Head Injury, Sergio A. Dondiego

Honors Capstones

This meta-analysis identifies noninvasive clinical predictors of intracranial hypertension (IH) post head trauma to develop a multi-criteria IH screening tool designed for nurses to wear on their badge reels. High-sensitivity predictors were prioritized to assist in early IH suspicion. Findings suggest that radiographic-measured abnormalities including an optic nerve sheath diameter (ONSD) 5.6 mm and signs of significant head trauma via computed tomography (CT) were highly effective for predicting IH and were therefore defined as major criteria for the assessment tool. Other significant examination findings include a Glasgow Coma Scale (GCS) score 8 and atypical pupillary reactivity. While age showed conflicting …

Stereotactic Radiosurgery For Unruptured Arteriovenous Malformation Of The Left Medial Temporal Lobe In A Young Female, Muhammed Suhail S, Gajalakshmi M Bpa, Danish Ansari Brt

Journal Of Indian Physician Associates

Background

Arteriovenous malformations (AVMs) are congenital vascular anomalies that can be present with seizures or hemorrhage. Management strategies vary based on Spetzler-Martin (SM) grading.

Case Presentation

I report a case of a 22-year-old female presenting with recurrent seizures due to an unruptured AVM (SM Grade 3) located in the left medial temporal lobe. Diagnosis was established using MRI and Digital Subtraction Angiography (DSA).

Intervention

The patient underwent single-fraction stereotactic radio-surgery (SRS) with curative intent using a TrueBeam linear accelerator.

Outcome

Post-treatment course was uneventful, and the patient was discharged in stable condition with excellent seizure control and progressive nidus reduction …

Stromal Interaction Molecule (Stim) Proteins In Microglia And The Impact On Store-Operated Calcium Entry (Soce) And Spinal Cord Injury Recovery, Norah G. Hill

College of Arts & Sciences Senior Theses

In spinal cord injury (SCI), worsening functional outcomes are largely because of secondary injury processes and prolonged chronic inflammation. A major contributor of secondary injury is overload of intracellular calcium, causing neuronal overexcitation and persistent inflammatory responses. One of the primary mediators of calcium entry into the cell is store-operated calcium entry (SOCE). In SOCE, sensors detecting calcium depletion from the endoplasmic reticulum stores are called STIM proteins (1-2). When calcium is low in the cell, STIM proteins will activate Orai channels to open, allowing for the influx of calcium into the cell. The purpose of this study was to …

The Power Of Belief: Investigating The Intersection Of Religious Observance, Social Support, And Psychological Distress, Victoria R. Atwater

Undergraduate Honors Thesis Collection

Religion can act as a protective factor against stress and depression (Koenig et al., 2009; Krok, 2008) and can be examined through an individual’s relationship with religion or the efficacy of religious practices on mental health. In this study, 206 participants completed an online questionnaire that measured stress, depression, religious coping, religiosity (intrinsic religiosity, organized religious activities and non-organized religious activities), and social support using validated scales. The results indicate a positive correlation between stress, depression, and negative religious coping as predicted. While intrinsic religiosity and positive religious coping did not significantly influence stress or depression, organized religious activities were …

Targeting The Dorsolateral Prefrontal Cortex With Transcranial Direct Current Stimulation To Improve Depression And Anxiety In Parkinson's Disease, Brock Renicks

Honors Theses

The aim of this study is to observe the outcomes of transcranial direct current stimulation (tDCS) as a treatment for Parkinson’s Disease (PD). This study will primarily look at changes in depression and anxiety, as these symptoms are often comorbid with Parkinson’s Disease. Transcranial direct current stimulation is a non-invasive, very low-intensity form of electrical stimulation of the brain. It is being increasingly used as a form of treatment for Parkinson’s Disease and depression and anxiety, however the literature is ambiguous, showing mixed results throughout various studies, with no standardization of tDCS administration. To determine the effect of tDCS on …

Evaluating Spect Neuroimaging In Psychiatric Diagnosis: A Critical Review And Proposed Randomized Controlled Study, Kiley Carter

Senior Honors Theses

Mental illness affects a substantial proportion of adults in the United States, yet psychiatric diagnosis remains subject to diagnostic variability. Single-photon emission computed tomography (SPECT) is a neuroimaging technique that measures cerebral blood flow and has been proposed as an adjunctive tool for psychiatric evaluation. Existing literature reports group-level perfusion patterns associated with certain psychiatric conditions, suggesting potential utility in diagnosing complex or treatment-resistant cases. However, critics of SPECT emphasize the absence of randomized controlled data demonstrating improved patient outcomes. To address this gap, a prospective randomized controlled trial comparing standard psychiatric care with SPECT-guided evaluation is proposed. The proposed …

Targeting The Dorsolateral Prefrontal Cortex With Transcranial Direct Current Stimulation To Improve Depression And Anxiety In Parkinson’S Disease, Brock Renicks

Poster Presentations

Around 40% of people with Parkinson’s Disease experience depression and anxiety (Zhao et al, 2025). Depression and Anxiety have been said to be localized to the dorsolateral prefrontal cortex (Brunoni et al, 2016). Transcranial Direct current stimulation (tDCS) has been shown to modulate depression and anxiety by targeting the dorsolateral prefrontal cortex (Sreeraj et al, 2023). It is beneficial due to its cost, portability, and simplicity of use. Thus we will be assessing the efficacy of tDCS in reducing depression and anxiety in individuals with Parkinson’s Disease.

Utilizing Brain Computer Interfaces That Interact With A Virtual Keyboard, Skye Lilienthal

Honors Theses

A brain-computer interface (BCI) can allow someone to utilize electrical signals in their brain to complete tasks using a computer. BCIs can help people take advantage of technology to type without the need for a traditional keyboard setup. This paper used the OpenBCI Mark IV to test the effectiveness of non-invasive BCIs with dry electrodes within the OpenViBE P300 Speller. This paper shows how to use the P300 speller through a setup pipeline. Results indicate that electrode placement affects P300 accuracy and that areas related to visual processing improve accuracy, suggesting that P300 signals can be detected within OpenBCI Mark …

Novel Biomarker Discovery In Multiple Sclerosis, Manisha Gangasani

Honors Theses

Multiple Sclerosis (MS) is a chronic neuroinflammatory disorder affecting the brain, spinal cord, and optic nerve. Patients experience cognitive, motor, autonomic, and emotional symptoms that often overlap with other neurological conditions, making early diagnosis challenging. Current diagnostic criteria require evidence of lesions with dissemination in time and space. Racial disparities in MS outcomes are well documented, with Black individuals often exhibiting greater disease severity, higher relapse rates, and increased disability compared to White individuals. These differences likely reflect a combination of genetic, biological, environmental, and healthcare access factors, underscoring the need to improve early diagnosis and reduce inequities in care. …

A High-Throughput Assay For Monitoring And Quantifying Amyloid-Β Accumulation And Clearance In Alzheimer's Disease Cell Models, Ajish Ariyath, Fraulein Denise Arigo, Anna Fyfe, W. M.A.D.Binosha Fernando, Ralph Martins, Prashant Bharadwaj

Research outputs 2022 to 2026

Amyloidogenic proteins, such as amyloid-β (Aβ), self-assemble into cross-β fibrils whose accumulation is central to Alzheimer's disease (AD). Measuring Aβ aggregation and clearance in living cells remains challenging using current cell-based assays, which are often low-throughput or not suited for real-time monitoring. This study aimed to (1) develop a robust, quantitative, and scalable fluorescence-based assay using Amytracker to monitor Aβ accumulation and clearance in an Aβ-producing neuronal cell model, and (2) validate its utility for mechanistic studies and therapeutic screening. We established a plate-based fluorescence assay using Amytracker in MC65 neuronal AD model expressing the Amyloid precursor protein C-terminal fragment …

Circulating Sphingomyelins Correlate With Plasma T-Tau In Cognitively Unimpaired Older Adults At Risk Of Developing Alzheimer's Disease, Tahmida Sharmin, James D. Doecke, Pratishtha Chatterjee, Steve Pedrini, Hamid R. Sohrabi, Nicholas J. Ashton, Henrik Zetterberg, Manohar L. Garg, Kaj Blennow, Ralph N. Martins

Research outputs 2022 to 2026

Alterations in plasma sphingomyelin (SM) levels have been reported in Alzheimer's disease (AD), pointing to disturbances in lipid metabolism that may contribute to disease pathogenesis. Neuronal damage in early AD triggers tau release into central and peripheral systems. Despite influence from peripheral contributions, alterations in plasma total-tau (T-tau) remain valuable in indicating AD-related neurodegeneration. Investigating relationships between SM metabolism and tau release during preclinical AD may uncover important biochemical processes and support advancing early non-invasive detection and treatment approaches. This cross-sectional study investigated cognitively unimpaired (CU) older adults from the KARVIAH cohort, grouped by cortical amyloid-β (Aβ) status through positron …

Maximal Motor Unit Firing Rates Decline With Amyotrophic Lateral Sclerosis Progression, Gabriel L. Fernandes, Lucas B.R. Orssatto, Matheus D. Pinto, Joao S. Henkin, Ehsan Shandiz, Pamela A. Mccombe, Robert D. Henderson, Gabriel S. Trajano

Research outputs 2022 to 2026

Objective: Amyotrophic lateral sclerosis (ALS) is characterised by progressive degeneration of upper and lower motor neurons and their motor units (MUs). MU loss is compensated by collateral sprouting and reinnervation of muscle fibres. There is limited information about the properties of these surviving MUs as these processes take place. High-density surface electromyography (HD-sEMG) decomposition enables non-invasive analysis of individual MU firing behaviour during maximal voluntary contractions and assess their changes with ALS progression. Methods: Thirty-nine individuals with ALS (24 men; mean age 63 ± 16 years) completed up to five visits (interval 20.0 ± 7.9 weeks). Tibialis anterior HD-sEMG recordings …