Neurology Commons^™

A Fatal Case Of Primary Amoebic Meningoencephalitis From Recreational Waters., Edward Hamaty, Saif Faiek, Minesh Nandi, David Stidd, Manish Trivedi, Hari Kandukuri

Department of Neurosurgery Faculty Papers

Background: Naegleria Fowleri is a single-cell, thermophilic amphizoid amoeba, and a rare known causative agent for primary amoebic meningoencephalitis with >97% mortality rate. The amoeba resides in freshwater lakes and ponds but can also survive in inadequately chlorinated pools and recreational waters. The mode of infection includes activities such as diving or jumping into freshwater or submerging the head under the water. Although most commonly seen in the southern United States, it is essential to keep this clinical suspicion in mind regardless of geography, as presenting symptoms can be very similar to classic bacterial meningitis.

Conclusion: As per the CDC, …

Anti-Aggregation Effects Of Phenolic Compounds On Α-Synuclein, Kenjiro Ono, Mayumi Tsuji, Tritia R. Yamasaki, Giulio M. Pasinetti

Neurology Faculty Publications

The aggregation and deposition of α-synuclein (αS) are major pathologic features of Parkinson's disease, dementia with Lewy bodies, and other α-synucleinopathies. The propagation of αS pathology in the brain plays a key role in the onset and progression of clinical phenotypes. Thus, there is increasing interest in developing strategies that attenuate αS aggregation and propagation. Based on cumulative evidence that αS oligomers are neurotoxic and critical species in the pathogenesis of α-synucleinopathies, we and other groups reported that phenolic compounds inhibit αS aggregation including oligomerization, thereby ameliorating αS oligomer-induced cellular and synaptic toxicities. Heterogeneity in gut microbiota may influence the …

Brain Structure Changes Over Time In Normal And Mildly Impaired Aged Persons, Charles D. Smith, Linda J. Van Eldik, Gregory A. Jicha, Frederick A. Schmitt, Peter T. Nelson, Erin L. Abner, Richard J. Kryscio, Richard R. Murphy, Anders H. Andersen

Neurology Faculty Publications

Structural brain changes in aging are known to occur even in the absence of dementia, but the magnitudes and regions involved vary between studies. To further characterize these changes, we analyzed paired MRI images acquired with identical protocols and scanner over a median 5.8-year interval. The normal study group comprised 78 elders (25M 53F, baseline age range 70-78 years) who underwent an annual standardized expert assessment of cognition and health and who maintained normal cognition for the duration of the study. We found a longitudinal grey matter (GM) loss rate of 2.56 ± 0.07 ml/year (0.20 ± 0.04%/year) and a …

Zinc Finger Rna-Binding Protein Zn72d Regulates Adar-Mediated Rna Editing In Neurons., Anne L Sapiro, Emily C Freund, Lucas Restrepo, Huan-Huan Qiao, Amruta Bhate, Qin Li, Jian-Quan Ni, Timothy J Mosca, Jin Billy Li

Department of Neurology Faculty Papers

Adenosine-to-inosine RNA editing, catalyzed by adenosine deaminase acting on RNA (ADAR) enzymes, alters RNA sequences from those encoded by DNA. These editing events are dynamically regulated, but few trans regulators of ADARs are known in vivo. Here, we screen RNA-binding proteins for roles in editing regulation with knockdown experiments in the Drosophila brain. We identify zinc-finger protein at 72D (Zn72D) as a regulator of editing levels at a majority of editing sites in the brain. Zn72D both regulates ADAR protein levels and interacts with ADAR in an RNA-dependent fashion, and similar to ADAR, Zn72D is necessary to maintain proper neuromuscular …

Correlations Of Calf Muscle Macrophage Content With Muscle Properties And Walking Performance In Peripheral Artery Disease, Kate Kosmac, Marta Gonzalez-Freire, Mary M. Mcdermott, Sarah H. White, R. Grace Walton, Robert L. Sufit, Lu Tian, Lingyu Li, Melina R. Kibbe, Michael H Criqui, Jack M. Guralnik, Tamar S. Polonsky, Christiaan Leeuwenburgh, Luigi Ferrucci, Charlotte A. Peterson

Physical Therapy Faculty Publications

Background

Peripheral artery disease (PAD) is a manifestation of atherosclerosis characterized by reduced blood flow to the lower extremities and mobility loss. Preliminary evidence suggests PAD damages skeletal muscle, resulting in muscle impairments that contribute to functional decline. We sought to determine whether PAD is associated with an altered macrophage profile in gastrocnemius muscles and whether muscle macrophage populations are associated with impaired muscle phenotype and walking performance in patients with PAD.

Methods and Results

Macrophages, satellite cells, and extracellular matrix in gastrocnemius muscles from 25 patients with PAD and 7 patients without PAD were quantified using immunohistochemistry. Among patients …

Functionally Distinct High And Low Theta Oscillations In The Human Hippocampus., Abhinav Goyal, Jonathan Miller, Salman E Qasim, Andrew J Watrous, Honghui Zhang, Joel M Stein, Cory S Inman, Robert E Gross, Jon T Willie, Bradley Lega, Jui-Jui Lin, Ashwini Sharan, Chengyuan Wu, Michael R Sperling, Sameer A Sheth, Guy M Mckhann, Elliot H Smith, Catherine Schevon, Joshua Jacobs

Department of Neurosurgery Faculty Papers

Based on rodent models, researchers have theorized that the hippocampus supports episodic memory and navigation via the theta oscillation, a ~4-10 Hz rhythm that coordinates brain-wide neural activity. However, recordings from humans have indicated that hippocampal theta oscillations are lower in frequency and less prevalent than in rodents, suggesting interspecies differences in theta's function. To characterize human hippocampal theta, we examine the properties of theta oscillations throughout the anterior-posterior length of the hippocampus as neurosurgical subjects performed a virtual spatial navigation task. During virtual movement, we observe hippocampal oscillations at multiple frequencies from 2 to 14 Hz. The posterior hippocampus …

Childhood Absence With Polyspike Ictal-Onset, Sherouk A. Abdelmoity

Research Days

No abstract provided.

Effects Of Acute Intracranial Pressure Changes On Optic Nerve Head Morphology In Humnans And Pig Model, Sachin Kedar

Theses & Dissertations

The optic nerve head (ONH) is located at the interface of intracranial and intraocular compartments. It is comprised of lamina cribrosa (LC), a fenestrated connective tissue tethered to the posterior sclera across the scleral canal. Since LC is exposed to intraocular pressure (IOP) anteriorly and intracranial pressure (ICP) posteriorly, it is an ideal site for noninvasively detecting intracranial pressure (ICP) fluctuation. We hypothesized that the pressure differential between IOP and ICP across LC, will determine LC position and meridional diameter of scleral canal (also called Bruch’s membrane opening- BMOD). We tested our hypothesis in 19 human subjects undergoing medically necessary …

The Neurology Of Covid-19 Revisited: A Proposal From The Environmental Neurology Specialty Group Of The World Federation Of Neurology To Implement International Neurological Registries, Gustavo C. Román, Peter S. Spencer, Jacques Reis, Alain Buguet, Mostafa El Alaoui Faris, Sarosh M. Katrak, Miguel Láinez, Marco Tulio Medina, Chandrashekhar Meshram, Mohammad Wasay

Section of Neurology

A comprehensive review of the neurological disorders reported during the current COVID-19 pandemic demonstrates that infection with SARS-CoV-2 affects the central nervous system (CNS), the peripheral nervous system (PNS) and the muscle. CNS manifestations include: headache and decreased responsiveness considered initial indicators of potential neurological involvement; anosmia, hyposmia, hypogeusia, and dysgeusia are frequent early symptoms of coronavirus infection. Respiratory failure, the lethal manifestation of COVID-19, responsible for 264,679 deaths worldwide, is probably neurogenic in origin and may result from the viral invasion of cranial nerve I, progressing into rhinencephalon and brainstem respiratory centers. Cerebrovascular disease, in particular large-vessel ischemic strokes, …

The Current Neuroscientific Understanding Of Alzheimer's Disease, Rachel A. Brandes

Pursuit - The Journal of Undergraduate Research at The University of Tennessee

Alzheimer’s disease is a degenerative neurological illness characterized by the deterioration of brain regions implicated in memory and cognitive function. While researchers have yet to find a cure or effective treatment, they have gained a better understanding of its pathology and development. Through years of neuroscience research, scientists have discovered much of what happens in the brain during Alzheimer’s disease onset and how this causes its symptoms; many hypotheses regarding this aspect of the illness involve temporal lobe atrophy, neurofibrillary tangles, and amyloid plaques. Although Alzheimer’s disease affects millions of people every day, it seems that most are unaware of …

Gut Microbiome-Modified Polyphenolic Compounds Inhibit Α-Synuclein Seeding And Spreading In Α-Synucleinopathies, Tritia R. Yamasaki, Kenjiro Ono, Lap Ho, Giulio M. Pasinetti

Neurology Faculty Publications

Misfolding, aggregation and deposition of α-synuclein (α-syn) are major pathologic characteristics of Parkinson’s disease (PD) and the related synucleinopathy, multiple system atrophy (MSA). The spread of α-syn pathology across brain regions is thought to play a key role in the onset and progression of clinical phenotypes. Thus, there is increasing interest in developing strategies that target and attenuate α-syn aggregation and spread. Recent studies of brain-penetrating polyphenolic acids, namely, 3-hydroxybenzoic acid (3-HBA), 3,4-dihydroxybenzoic acid (3,4-diHBA), and 3-(3-hydroxyphenyl)propionic acid (3-HPPA) that are derived from gut microbiota metabolism of dietary polyphenols, show in vitro ability to effectively modulate α-syn misfolding, oligomerization, and …

Nk Cell-Derived Gm-Csf Potentiates Inflammatory Arthritis And Is Negatively Regulated By Cis, Cynthia Louis, Fernando Souza-Fonseca-Guimaraes, Yuyan Yang, Damian D'Silva, Tobias Kratina, Laura Dagley, Soroor Hediyeh-Zadeh, Jai Rautela, Seth Lucian Masters, Melissa J Davis, Jeffrey J Babon, Bogoljub Ciric, Eric Vivier, Warren S Alexander, Nicholas D Huntington, Ian P Wicks

Department of Neurology Faculty Papers

Despite increasing recognition of the importance of GM-CSF in autoimmune disease, it remains unclear how GM-CSF is regulated at sites of tissue inflammation. Using GM-CSF fate reporter mice, we show that synovial NK cells produce GM-CSF in autoantibody-mediated inflammatory arthritis. Synovial NK cells promote a neutrophilic inflammatory cell infiltrate, and persistent arthritis, via GM-CSF production, as deletion of NK cells, or specific ablation of GM-CSF production in NK cells, abrogated disease. Synovial NK cell production of GM-CSF is IL-18–dependent. Furthermore, we show that cytokine-inducible SH2-containing protein (CIS) is crucial in limiting GM-CSF signaling not only during inflammatory arthritis but also …

Steriotactic Radiosurgery For Vestibular Schwannomas, Ummey Hani, Dr Saqib Kamran Bakhshi, Muhammad Shahzad Shamim

Section of Neurosurgery

The approach to treating vestibular schwannomas ranges from wait-and-scan policies to micro-and radiosurgery. However, in the past few decades, Stereotac tic Radiosurgery (SRS) has emerged as an approved primary treatment option as well. In this review, we have assessed some of the existing literature on the role of SRS in the management of vestibular schwannomas, and to estimate its efficacy in tumour control and conservation of cranial nerve function.

Reflections On Texas Back Institute Internship, Shelby Jones

The Eleanor Mann School of Nursing Undergraduate Honors Theses

For my honors project, I chose to do the experimental option to gain more knowledge on topics that we do not spend much time covering in nursing school. I had the privilege to complete an internship with the Texas Back Institute, their main office is located in Plano, Texas. I worked closely the Scoliosis and Spine Tumor Center that is a branch of their team, and completed my internship from May to the first week of August 2019. I worked 20 hours a week during my internship between the clinic and the hospital. I was able to observe physicians in …

Stroke As The Initial Presentation Of Takayasu's Arteritis: A Case Report, Paran Davari, Paige Sutton, Kimberly S. Jones

Neurology Faculty Publications

In this study, we report the case of a pediatric neurology stroke patient who was ultimately diagnosed with Takayasu's Arteritis. Our case describes a 14-year-old Hispanic female with no significant past medical history who presented to an outside hospital for acute onset of confusion and right sided weakness. She was given tissue plasminogen activator (TPA) at the outside hospital and transferred as a stroke alert. Initial The NIH stroke scale (NIHSS) was 12 with primarily right sided symptoms. Physical exam was also significant for asymmetric pulses and blood pressures. Imaging was significant for multifocal stenosis. She was ultimately diagnosed with …

The Β3-Adrenergic Receptor Agonist Mirabegron Improves Glucose Homeostasis In Obese Humans, Brian S. Finlin, Hasiyet Memetimin, Beibei Zhu, Amy L. Confides, Hemendra J. Vekaria, Riham H. El Khouli, Zachary R. Johnson, Philip M. Westgate, Jianzhong Chen, Andrew J. Morris, Patrick G. Sullivan, Esther E. Dupont-Versteegden, Philip A. Kern

Internal Medicine Faculty Publications

BACKGROUND. Beige adipose tissue is associated with improved glucose homeostasis in mice. Adipose tissue contains β3-adrenergic receptors (β3-ARs), and this study was intended to determine whether the treatment of obese, insulin-resistant humans with the β3-AR agonist mirabegron, which stimulates beige adipose formation in subcutaneous white adipose tissue (SC WAT), would induce other beneficial changes in fat and muscle and improve metabolic homeostasis.

METHODS. Before and after β3-AR agonist treatment, oral glucose tolerance tests and euglycemic clamps were performed, and histochemical analysis and gene expression profiling were performed on fat and muscle biopsies. PET-CT scans quantified brown adipose tissue volume and …

A Protocol Driven Stroke Code's Impact On Door-To-Needle Times, Jesse Osborne

Electronic Theses and Dissertations

Tissue plasminogen activator (tPA) is most effective the faster it is able to be administered to a patient that has been affected by stroke. A Stroke Code is a strategy that acute care facilities implement to reduce the time from diagnosing a stroke to administering tPA. The purpose of this study was to determine if the initiation of a Stroke Code in an acute care hospital reduces the door-to-needle time for patients affected by a stroke. In particular, does a Stroke Code reduce door-to-needle times. The research was conducted using data from April 1, 2014 to December 31, 2014 (pre-Stroke …

Relative Contribution Of Arms And Legs Through Repetitive Assisted Sit-To-Stand Motion In Individuals With Incomplete Spinal Cord Injury, Abd Aziz Musfirah

Student Works (2020-2029)

Sit-To-Stand (SitTS) exercise is one of important prerequisites to achieve some functional independence goals in everyday life especially for individuals undergoing rehabilitation In general, the execution of SitTS in spinal cord injury (SCI) patients involves motor function in both upper and lower extremities. The use of arm support in particular is a very significant element while executing SitTS movement for SCI population. In addition, application of functional electrical stimulation (FES) onto the quadriceps muscles is one of the prescribed management for incomplete SCI to improve muscle action for simple lower limb movements. However, the relative contribution of upper and lower …

Baclofen-Induced Changes In The Resting Brain Modulate Smoking Cue Reactivity: A Double-Blind Placebo-Controlled Functional Magnetic Resonance Imaging Study In Cigarette Smokers, Ariel Ketcherside, Kanchana Jagannathan, Sudipto Dolui, Nathan Hager, Nathaniel Spilka, Chaela Nutor, Hengyi Rao, Teresa Franklin, Reagan Wetherill

Psychology Faculty Publications

Objective: Smoking cue-(SC) elicited craving can lead to relapse in SC-vulnerable individuals. Thus, identifying treatments that target SC-elicited craving is a top research priority. Reduced drug cue neural activity is associated with recovery and is marked by a profile of greater tonic (resting) activation in executive control regions, and increased connectivity between executive and salience regions. Evidence suggests the GABA-B agonist baclofen can reduce drug cue-elicited neural activity, potentially through its actions on the resting brain. Based on the literature, we hypothesize that baclofen’s effects in the resting brain can predict its effects during SC exposure.

Methods: In this longitudinal, …

Neurological Manifestations Of Covid-19, Dureshahwar Kanwar, Abdul Mannan Baig, Mohammad Wasay

Section of Neurology

Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) has turned out to be a formidable pandemic. Upcoming evidence from confirmed cases of COVID-19 suggests an anticipated incursion of patients with neurological manifestations in the weeks to come. An expression of the angiotensin-converting enzyme 2 (ACE 2), the cellular receptor for SARS-CoV-2 over the glial cells and neurons have made the brain a potential target. Neurotoxicity may occur as a result of direct, indirect and post-infectious complications. Attention to neurological deficits in COVID-19 is fundamental to ensure appropriate, timely, beneficial management of the affected patients. Most …