Neurology Commons^™

Commentary: Use Of Bactrac Proteomic Database-Uromodulin Protein Expression During Ischemic Stroke, Gabriella-Salome K. Armstrong, Jacqueline A. Frank, Christopher J. Mclouth, Ann M. Stowe, Jill M. Roberts, Amanda L. Trout, Justin F. Fraser, Keith R. Pennypacker

Neurology Faculty Publications

Introduction: Uromodulin (UMOD) is a glycoprotein expressed by the epithelial cells of the thick ascending limb of Henle's loop in the kidney. Research has shown that increased uromodulin expression may be associated with lower risk of cardiovascular disease in adults. Utilizing the Blood and Clot Thrombectomy Registry and Collaboration (BACTRAC) (clinicaltrials.gov NCT03153683), a continuously enrolling tissue bank, we aimed to examine the associations between serum uromodulin, age, and high BMI (BMI> 25) and its relationship to stroke in patients.

Methods: Arterial blood distal and proximal to the thrombus was collected during a thrombectomy procedure using the BACTRAC protocol and sent …

Morbidity And Mortality Meetings; A New Digital Portal To Enhance Learning And Objectivity, Saqib Kamran Bakhshi, Kiran Ehsan, Gulzar S. Lakhani, Ather Enam

Section of Neurosurgery

Morbidity and mortality meetings have long been part of surgical education and practice. They have undergone several modifications over time to include improvement in patient safety and outcomes as an essential utility of conducting morbidity and mortality meetings. Time and again, it has been proposed in literature that standardisation of case discussion results in the efficiency of these meetings. Learning opportunities can be compiled for system improvement. The current review article was planned to present a newly implemented digital morbidity and mortality portal at the Aga Khan University Hospital (AKUH), Karachi, aiming at homogenising the discussion and to add objectivity …

Pregnancy Outcomes In Women With Epilepsy And Mthfr Mutations Supplemented With Methylated Folate And Methylcobalamin (Methylated B12)., Emma M Lascar, Nicole M Warner, Michael J Doherty

Articles, Abstracts, and Reports

Antiseizure medications (ASM) may contribute to adverse fetal outcomes in pregnant women with epilepsy (WWE). Folate processing (Methylenetetrahydrofolate reductase, MTHFR) gene abnormalities are common in women with epilepsy and depression. L-methylfolate supplements may bypass MTHFR deficiencies, yet their use in WWE during gestation or on fetal development is not well studied. We examine pregnancy histories of three WWE who supplemented with either folate or L-methylfolate and methylcobalamin (methylated B12) during pregnancies. Their pregnancy outcomes improved with L-methylfolate and methylcobalamin supplementation. L-methylfolate and methylcobalamin supplementation merits further study in WWE who have MTHFR mutations, fertility, recurrent miscarriage and or depression histories.

Cerebellar Coordination Of Neuronal Communication In Cerebral Cortex, Samuel S Mcafee, Yu Liu, Roy V Sillitoe, Detlef H Heck

Duncan NRI Faculty and Staff Publications

Cognitive processes involve precisely coordinated neuronal communications between multiple cerebral cortical structures in a task specific manner. Rich new evidence now implicates the cerebellum in cognitive functions. There is general agreement that cerebellar cognitive function involves interactions between the cerebellum and cerebral cortical association areas. Traditional views assume reciprocal interactions between one cerebellar and one cerebral cortical site, via closed-loop connections. We offer evidence supporting a new perspective that assigns the cerebellum the role of a coordinator of communication. We propose that the cerebellum participates in cognitive function by modulating the coherence of neuronal oscillations to optimize communications between multiple …

A Systematic Review Of Center Of Mass As A Measure Of Dynamic Postural Control Following Concussion, Sarah Patejak, Joshua Forrest, Emily Harting, Mable Sisk, Eric Schussler

Rehabilitation Sciences Faculty Publications

BACKGROUND: The incidence of sports-related concussion in the US is between 1.6-3.8 million annually. Identification of ongoing impairment post-concussion continues to be challenging, as research indicates many patients are cleared for return to activity while still suffering subclinical impairment of function. Purpose: To identify and review the current literature on the use of center of mass (COM) during gait as a potential indicator variable after concussive injury. Study Design: Systematic Review.

METHODS: A Pubmed search was undertaken utilizing search terms involving gait performance and concussion. Study inclusion criteria included: (1) COM used as a variable in data analysis, (2) study …

The Influence Of Coronavirus Disease-2019 (Covid-19) On Parkinson’S Disease: An Updated Systematic Review, Vikash Jaiswal, Danah Alquraish, Zouina Sarfraz, Azza Sarfraz, Shavy Nagpal, Prakriti Singh Shrestha, Dattatreya Mukherjee, Prathima Guntipalli, Diana F. Sánchez Velazco, Arushee Bhatnagar

Department of Paediatrics and Child Health

Background: COVID-19 has affected global communities with multiple neurological complications in addition to other critical medical issues. COVID-19 binds to the host's angiotensin-converting enzyme 2 (ACE2) receptors, which are expressed in the neurons and glial cells, acting as an entry port to the central nervous system (CNS). ACE2 receptors are abundantly expressed on dopamine neurons, which may worsen the prognosis of motor symptoms in Parkinson's disease (PD). SARS-CoV-2 may lead to an indirect response via immune-mediated cytokine storms and propagate through the CNS leading to damage. In this systematic review, we aim to provide thorough analyses of associations between COVID-19 …

Picosecond Pulsed Electric Fields And Promise In Neurodegeneration Research, Martina Zamponi, Ross Petrella, Peter A. Mollica

School of Medical Diagnostics & Translational Sciences Publications

The delivery of pulsed electric fields to biological cells for regenerative research and therapeutic applications is a field that has been widely explored. Picosecond pulsed electric fields have been shown to induce intracellular effects and directly target cell membrane proteins as well as being able to induce cell permeabilization and death by apoptosis. Additionally, ultrashort pulses can be focused and delivered in a noncontact manner for possible targeting of deep and inaccessible tissues. The unique characteristics of picosecond pulses make them a possible approach for treatment of Huntington's and Alzheimer's diseases, both characterized by progressive neuronal degeneration and death, and …

Orthostatic Headaches Associated With Spontaneous Intracranial Hypotension And Autonomic Dysfunction-A Case Series In Young Patients, Ankita Ghosh, Yen X Tran, Leon Grant, Mohammed T Numan, Rajan Patel, Ian J Butler

Faculty, Staff and Student Publications

Background: Orthostatic headaches can be noted in spontaneous intracranial hypotension and orthostatic intolerance. We present a case series of young patients diagnosed with spontaneous intracranial hypotension and were treated for the same but subsequently developed orthostatic intolerance. Methods: We retrospectively reviewed charts for seven young patients with orthostatic headaches related to spontaneous intracranial hypotension and orthostatic intolerance. Results: Patients were diagnosed with spontaneous intracranial hypotension. Diagnosis was confirmed by identifying epidural contrast leakage and three of seven patients were noted to have early renal contrast excretion on computerized tomography myelography. Patients were treated with epidural blood patches. All patients showed …

Neuroimaging On Brain Aging And Neurodegeneration, Katelynn Nguyen

Scripps Senior Theses

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that usually affects but not limited to the elder population. We see that when an individual develops AD, the brain cells are degenerating and dying at rates that are uncontrollable. Worldwide AD has affected at least 50 million people and we will continue to see this number increase. Although the research done on AD has made great strides, much is still unknown and being studied. Previous studies have allowed us to understand that many of the impacts of AD are correlated to various regions of the brain experiencing atrophy. This causes an …

Concomitant Guillain-Barre Syndrome With Covid-19, Skylar A. Morongell

Honors Undergraduate Theses

The current Coronavirus disease 2019 (COVID-19) outbreak, caused by a virus called severe acute respiratory syndrome 2 (SARS-CoV-2), has become a global health emergency. Recent findings in case studies assert that the transmigration of SARS-CoV-2 to the nervous system implicates severe neurotropic pathologies, including the onset of the rare autoimmune disease called Guillain-Barré syndrome (GBS). GBS is recognized as several disorders characterized by immune-mediated polyradiculoneuropathy, which is typically preceded by an infection or other immune stimulation. The symptoms of GBS initially present as acute symmetrical ascending paresthesia, weakness, and paralysis.

This meta-analysis serves to help understand the predisposing factors (such …

In Patients With Mild To Moderate Alzheimer’S, Does Music Therapy Help To Decrease Mood Disturbances When Compared To Those Not Participating In Music Therapy?, Lauren Bauer

Capstone Showcase

Abstract:

Introduction: Affecting both memory and cognitive abilities, Alzheimer’s disease is a growing problem as the baby boomer population ages. Clinical trials for new medications fail or are slow going, researchers have sought alternatives to alleviate symptoms for patients of this disease. This paper will address the effect of music therapy on mood disturbance in patients with Alzheimer’s disease.

Method: A literature search was completed in November of 2019 using PubMed, EBSCO Search, ScienceDirect, and Google Scholar. Six articles were chosen based on relevance to the research question, study design, outcome, and results.

Results: Based on review, music …

Heritability Of Ocular Traits In Hispanics, Aaron T. Gomez, Gladys E. Maestre, Jesus D. Melgarejo, Vincent P. Diego, Nicholas B. Blackburn, Juan B. Yepez, Michele Petitto, Felipe A. Murati, Rosa V. Pirela, Carlos A. Chavez, Winston Lee, Lama A. Al-Aswad, Matthew P. Johnson, Joseph H. Lee, John Blangero

MEDI 9331 Scholarly Activities Clinical Years

Purpose: The burden of glaucoma disease among Hispanics is significantly higher than in their white counterparts. It remains unclear to what extent these differences are determined by genetic factors in Hispanics. We therefore examined a highly inbred family population-based cohort in Venezuela to estimate the proportion of genetic contribution of ocular traits relevant to glaucoma disease.

Methods: A subset of 67 participants ≥40y from the Maracaibo Aging Study (MAS) with family pedigree were randomly included. The papillary retinal nerve fiber layer (RNFL) and macular thickness were measured with Spectralis Domain-OCT. Heritability analyses (h², expressed as %) …

Spinal Cord Mri Analysis Techniques In Post-Stroke Patients, Sarvani Uppati, Sravani Mannuru, Kelsey Baker

MEDI 9331 Scholarly Activities Clinical Years

Stroke, also termed cerebral infarction, results in neurodegeneration and neuroinflammation in the brain at area of the infarct and peri-infarct regions. Recent research has shown involvement of alternate motor pathways of the spinal cord in disease progression. Creating optimal techniques to study spinal cord MRI can give way to higher prognostic methods and enhanced treatment modalities in post-stroke patients. Here, we will review current research proposing various spinal cord MRI analysis techniques in different neurological conditions that can be applied to analyzing post-stroke spinal cord.

Potential Perioperative Complications Due To Difference In Timing Of Systemic Heparinization During Ruptured Aneurysm Coiling, Rouzbeh Kotaki, Ameer E. Hassan, Wondwossen G. Tekle

MEDI 9331 Scholarly Activities Clinical Years

Potential Perioperative Complications Due To Differences in Timing Of Systemic Heparin Distribution During Ruptured Aneurysm Coiling

Introduction:

In general, systematic heparin anticoagulation is standard in regards to neurovascular intervention. When coiling ruptured aneurysms, many neurointerventionalists have their own protocol as to timing of systemic heparinization. There is ample research and literature reviewing the frequency of perioperative events, predictors and outcomes, as well as the efficacy in the use of anticoagulants and/or antiplatelets before, during, and after neurovascular procedures to prevent adverse outcomes. However, there currently exists a dearth of research in regards to timing of distribution of heparin intraoperatively and …

Neurodegeneration Difference Between The Non-Lesioned And Lesioned Hemisphere In Stroke Patient, N. Cortez, Elle Wynn, Kelsey Baker

School of Medicine Publications

Stroke is the 4th leading cause of death in Hispanics. It has generally been suggested that neurodegeneration is isolated to the lesioned hemisphere. However, recent evidence has suggested that the non-lesioned side of the brain may also undergo neurodegeneration. Here, we sought to evaluate the amount of neurodegeneration in the lesioned and non-lesioned hemisphere in chronic stroke patients and identify the impact of stroke size and location

Risk Factors For Amyotrophic Lateral Sclerosis: A Regional United States Case-Control Study., Angeline S Andrew, Walter G Bradley, Daniel Peipert, Tanya Butt, Kwadwo Amoako, Erik P Pioro, Rup Tandan, John Novak, Adam Quick, K Doug Pugar, Komal Sawlani, Bashar Katirji, Todd A Hayes, Pamela Cazzolli, Jiang Gui, Paul Mehta, D Kevin Horton, Elijah W Stommel

Ambulatory and Primary Care Articles

Most amyotrophic lateral sclerosis (ALS) cases are considered sporadic, without a known genetic basis, and environmental exposures are thought to play a causal role. To learn more about sporadic ALS etiology, we recruited n = 188 ALS patients from northern New England and Ohio and matched controls 2:1 from the general population of the same regions. Questionnaires evaluated the association between a variety of lifestyle, behavioral (ie, hobbies and activities), and occupational factors and the risk of ALS, including the duration of time between exposure and ALS onset, and exposure frequency. Head trauma was associated with increased ALS risk (adjusted …

A Preliminary Dti Tractography Study Of Developmental Neuroplasticity 5–15 Years After Early Childhood Traumatic Brain Injury, Elisabeth A Wilde, Ilirjana Hyseni, Hannah M Lindsey, Jessica Faber, James M Mchenry, Erin D Bigler, Brian D Biekman, Laura L Hollowell, Stephen R Mccauley, Jill V Hunter, Linda Ewing-Cobbs, Mary E Aitken, Marianne Macleod, Zili D Chu, Linda J Noble-Haeusslein, Harvey S Levin

Faculty, Staff and Student Publications

Plasticity is often implicated as a reparative mechanism when addressing structural and functional brain development in young children following traumatic brain injury (TBI); however, conventional imaging methods may not capture the complexities of post-trauma development. The present study examined the cingulum bundles and perforant pathways using diffusion tensor imaging (DTI) in 21 children and adolescents (ages 10-18 years) 5-15 years after sustaining early childhood TBI in comparison with 19 demographically-matched typically-developing children. Verbal memory and executive functioning were also evaluated and analyzed in relation to DTI metrics. Beyond the expected direction of quantitative DTI metrics in the TBI group, we …

Conservation Of Epithelial-To-Mesenchymal Transition Process In Neural Crest Cells And Metastatic Cancer, April Zhang, Hira Aslam, Neha Sharma, Aryeh Warmflash, Walid D Fakhouri

Faculty, Staff and Student Publications

Epithelial to mesenchymal transition (EMT) is a highly conserved cellular process in several species, from worms to humans. EMT plays a fundamental role in early embryogenesis, wound healing, and cancer metastasis. For neural crest cell (NCC) development, EMT typically results in forming a migratory and potent cell population that generates a wide variety of cell and tissue, including cartilage, bone, connective tissue, endocrine cells, neurons, and glia amongst many others. The degree of conservation between the signaling pathways that regulate EMT during development and metastatic cancer (MC) has not been fully established, despite ample studies. This systematic review and meta-analysis …

Can Erythropoietin Reduce Hypoxemic Neurological Damages In Neonates With Congenital Heart Defects?, Sara Ottolenghi, Giuseppina Milano, Michele Dei Cas, Tina O Findley, Rita Paroni, Antonio F Corno

Faculty, Staff and Student Publications

Congenital heart defects (CHD), the most common cause of birth defects with increasing birth prevalence, affect nearly 1% of live births worldwide. Cyanotic CHD are characterized by hypoxemia, with subsequent reduced oxygen delivery to the brain, especially critical during brain development, beginning in the fetus and continuing through the neonatal period. Therefore, neonates with CHD carry a high risk for neurological comorbidities, even more frequently when there are associated underlying genetic disorders. We review the currently available knowledge on potential prevention strategies to reduce brain damage induced by hypoxemia during fetal development and immediately after birth, and the role of …

Recurrent Nontuberculous Mycobacterial Tenosynovitis, Melissa Kwan, Richard Tupler

Faculty, Staff and Student Publications

Background: Nontuberculous mycobacteria are an uncommon pathogen for musculoskeletal infection and are difficult to treat because of delays in diagnosis, prolonged treatment requiring both antimycobacterial therapy and surgical debridement, and high rates of resistance to antimycobacterial therapy.

Case Report: We report the case of an 88-year-old male with recurrent Mycobacterium avium complex tenosynovitis despite receiving multiple courses of pharmacologic therapy and surgical debridement.

Conclusion: Nontuberculous mycobacterial musculoskeletal infections can be difficult to diagnose and equally difficult to treat. A combination of antimycobacterial therapy and surgical debridement is often required; however, the rate of treatment failure remains high, particularly with rapidly …