Neurology Commons^™

The Rna-Binding Protein Hur Contributes To Neuroinflammation By Promoting C-C Chemokine Receptor 6 (Ccr6) Expression On Th17 Cells., Jing Chen, Jennifer L. Martindale, Carole Cramer, Myriam Gorospe, Ulus Atasoy, Paul D. Drew, Shiguang Yu

Department of Neurology Faculty Papers

In both multiple sclerosis and experimental autoimmune encephalomyelitis (EAE), the C-C chemokine receptor 6 (CCR6) is critical for pathogenic T helper 17 (Th17) cell migration to the central nervous system (CNS). Whereas many cytokines and their receptors are potently regulated via post-transcriptional mechanisms in response to various stimuli, how CCR6 expression is post-transcriptionally regulated in Th17 cells is unknown. Here, using RNA-binding protein HuR conditional knock-out (KO) and wild-type (WT) mice, we present evidence that HuR post-transcriptionally regulates CCR6 expression by binding to and stabilizing Ccr6 mRNA and by promoting CCR6 translation. We also found that HuR down-regulates several microRNA …

Efficacy, Safety, And Timing Of Anticoagulant Thromboprophylaxis For The Prevention Of Venous Thromboembolism In Patients With Acute Spinal Cord Injury: A Systematic Review, Paul M. Arnold, James S. Harrop, Geno J. Merli, Lindsay G. Tetreault, Brain K. Kwon, Steve Casha, Katherine Palmieri, Jefferson R. Wilson, Michael G. Fehlings, Haley K. Holmer, Daniel C. Norvell

Department of Neurosurgery Faculty Papers

Study Design: Systematic review. Objectives: The objective of this study was to answer 5 key questions: What is the comparative effectiveness and safety of (1a) anticoagulant thromboprophylaxis compared to no prophylaxis, placebo, or another anticoagulant strategy for preventing deep vein thrombosis (DVT) and pulmonary embolism (PE) after acute spinal cord injury (SCI)? (1b) Mechanical prophylaxis strategies alone or in combination with other strategies for preventing DVT and PE after acute SCI? (1c) Prophylactic inferior vena cava filter insertion alone or in combination with other strategies for preventing DVT and PE after acute SCI? (2) What is the optimal timing to …

Impulsivity In Patients With Attempted Suicide Presenting At A Tertiary Care Hospital In Karachi, Ayesha Abdul Hameed, Haresh Kumar, Sarika Bai, Azra Shaheen, Ravi Athwani, Mohammad Munir Hamirani

Pakistan Journal of Neurological Sciences (PJNS)

OBJECTIVE: To determine the prevalence of impulsivity in patients who attempted suicide presenting at a tertiary care hospital, Karachi. STUDY DESIGN: Cross sectional study. STUDY SETTING: Study was led in the Psychiatry Department, Abbasi Shaheed Hospital, Karachi. DURATION OF STUDY:Six month after approval of synopsis. SUBJECTS AND METHODS: Data was prospectively collected from patients after taking verbal consent. Permission was taken from ethical review committee. 95 patients presenting to the Psychiatry Department who met the inclusion criteria were included. A brief history about suicide attempt and demographic data was taken from the patient and confirmed by an attendee. The researcher …

Kernohan–Woltman Notch Phenomenon:Case Report And Review Of Literature, Fareed Ahmed, Muhammad Shahzad Shamim, Sidra Asad Ali

Pakistan Journal of Neurological Sciences (PJNS)

Subdural hematoma (SDH) is usually secondary to mechanical trauma. Spontaneous subdural hematoma is still rare with unclear pathophysiology. The classic findings of subdural hematoma is sudden drop in mental status, an ipsilateralmydriasis with contralateral hemiparesis. However SDH can sometimes compress the contralaterl corticospinal tract resulting in ipsilateral motor weakness, this phenomenon is known as Kernohan-Woltman Notch Phenomenon.

A Prevalent Disease Missed Under Cover Of An Uncommon Disorder- A Learning Experience In Clinical Practice, Sarah Razaq, Saeed Bin Ayaz, Aleem Arshad, Hussain Rashid Ihsan

Pakistan Journal of Neurological Sciences (PJNS)

Musculoskeletal pains are secondary complication of a my apathic disorder but other causes must be ruled out through meticulous evaluation. We report a case of distal my apathy who developed back pain due to tuberculous spondylitis but was overlooked and his complaint of backache was considered outcome of mechanical deterioration of vertebral column resulting from weakness of para spinal muscles due to my apathy. After detailed evaluation, his unnoticed ailment was identified and he was started off with the right management.

Use Of Smokeless Tobacco Among Young Patients With Acute Ischemic Stroke, Saba Zaidi

Pakistan Journal of Neurological Sciences (PJNS)

This cross sectional study was conducted from April to September 2015at emergency department of Aga khan university.A total of 135 patients presented with signs and symptoms of acute ischemic stroke were included in this research. Participants were selected throughNon probability consecutive samplingtechnique. SPSS 20 was used for data analysis.A predesigned proforma was filled. It has three parts including SocioDemographics, Factors for stroke like hypertension, diabetes Mellitus, dyslipidemia, cigarrete smoking and History of smokeless tobacco use.Young stroke was defined as patients between 20-49 years of age having symptoms of acute ischemic stroke. Smokeless Tobacco users: An individual taking greater than and …

Factors Affecting Compliances With Physiotherapy Among Stroke Patients: Physiotherapist's Perspective: A Study From Peshawar Pakistan., Rabia Basri, Maryam Naseen, Aatika Naz

Pakistan Journal of Neurological Sciences (PJNS)

Non-compliances to physiotherapy are common. Outside the Western nations, little is known to the factors responsible for non-compliances with physiotherapy. This study aimed to evaluate the factors affecting non-compliances with physiotherapy among stroke patients, in Peshawar, Pakistan. METHOD: Seven in practice physiotherapists from Peshawar, Pakistan, were invited to focus group discussion to discuss their opinions about factors affecting stroke patient's non-compliances and the strategies to manage with these factors. The dialogues were transcribed and analyzed. Significant words and statements describing noncompliances were identified. The cluster of meanings developed and used to write a combined description presenting the real meaning of …

Ibrutinib Unmasks Critical Role Of Bruton Tyrosine Kinase In Primary Cns Lymphoma., Christian Grommes, Alessandro Pastore, Nicolaos Palaskas, Sarah S. Tang, Carl Campos, Derrek Schartz, Paolo Codega, Donna Nichol, Owen Clark, Wan-Ying Hsieh, Dan Rohle, Marc Rosenblum, Agnes Viale, Viviane S. Tabar, Cameron W. Brennan, Igor T. Gavrilovic, Thomas J. Kaley, Craig P. Nolan, Antonio Omuro, Elena Pentsova, Alissa A. Thomas, Elina Tsyvkin, Ariela Noy, M. Lia Palomba, Paul Hamlin, Craig S. Sauter, Craig H. Moskowitz, Julia Wolfe, Ahmet Dogan, Minhee Won, Jon Glass, Scott Peak, Enrico C. Lallana, Vaios Hatzoglou, Anne S. Reiner, Philip H. Gutin, Jason T. Huse, Katherine S. Panageas, Thomas G. Graeber, Nikolaus Schultz, Lisa M. Deangelis, Ingo K. Mellinghoff

Department of Neurology Faculty Papers

Bruton tyrosine kinase (BTK) links the B-cell antigen receptor (BCR) and Toll-like receptors with NF-κB. The role of BTK in primary central nervous system (CNS) lymphoma (PCNSL) is unknown. We performed a phase I clinical trial with ibrutinib, the first-in-class BTK inhibitor, for patients with relapsed or refractory CNS lymphoma. Clinical responses to ibrutinib occurred in 10 of 13 (77%) patients with PCNSL, including five complete responses. The only PCNSL with complete ibrutinib resistance harbored a mutation within the coiled-coil domain of CARD11, a known ibrutinib resistance mechanism. Incomplete tumor responses were associated with mutations in the B-cell antigen receptor-associated …

Efficacy And Safety Of Methylprednisolone Sodium Succinate In Acute Spinal Cord Injury: A Systematic Review, Michael G. Fehlings, Jefferson R. Wilson, James S. Harrop, Brian Kwon, Lindsay A. Tetreault, Paul M. Arnold, Jeffrey M. Singh, Gregory W.J. Hawryluk, Joseph R. Dettori

Department of Neurosurgery Faculty Papers

Study Design: Systematic review and meta-analysis. Objective: The objective of this study was to conduct a systematic review to assess the comparative effectiveness and safety of high-dose methylprednisolone sodium succinate (MPSS) versus no pharmacological treatment in patients with traumatic spinal cord injury (SCI). Methods: A systematic search was performed in PubMed and the Cochrane Collaboration Library for literature published between January 1956 and June 17, 2015. Included studies were critically appraised, and Grades of Recommendation Assessment, Development and Evaluation methods were used to determine the overall quality of evidence for primary outcomes. Previous systematic reviews on this topic were collated …

Intracranial Eeg Fluctuates Over Months After Implanting Electrodes In Human Brain., Hoameng Ung, Steven N. Baldassano, Hank Bink, Abba M. Krieger, Shawniqua Williams, Flavia Vitale, Chengyuan Wu, Dean Freestone, Ewan Nurse, Kent Leyde, Kathryn A. Davis, Mark Cook, Brian Litt

Department of Neurosurgery Faculty Papers

OBJECTIVE: Implanting subdural and penetrating electrodes in the brain causes acute trauma and inflammation that affect intracranial electroencephalographic (iEEG) recordings. This behavior and its potential impact on clinical decision-making and algorithms for implanted devices have not been assessed in detail. In this study we aim to characterize the temporal and spatial variability of continuous, prolonged human iEEG recordings.

APPROACH: Intracranial electroencephalography from 15 patients with drug-refractory epilepsy, each implanted with 16 subdural electrodes and continuously monitored for an average of 18 months, was included in this study. Time and spectral domain features were computed each day for each channel for …

Debate On Human Aging And Lifespan, Mohammad Rafi, Abass Alavi

Department of Neurology Faculty Papers

The issue of human lifespan has long been a matter of controversy among scientists. In spite of the recent claim by Dong et al that human lifespan is limited to 115 years, with the mounting improvements in biotechnology and scientific understanding of aging, we may be confident that aging will slow down over the course of the current century extending human longevity much longer than 115 years.

Clopidogrel Alone Is Safer Than Clopidogrel And Aspirin For Secondary Prevention Of Acute Ischemic Stroke., Bradford J. Woelke, Daniel Angell Do, Katherine Litow Md

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Diener HC, Bogousslavsky J, Brass LM, et al. Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebo-controlled trial. Lancet. 2004;364(9431):331-337. doi: 10.1016/s0140-6736(04)16721-4

Delirium Reduction Strategies For The Critically Ill, June Chaves, Sam Canonico, Will Cheney, Tammy Corey, Gil Fraser, Alex Kowalewski, Jen Low, Cardiac Intensive Care Unit, Haley Pelletier, Cathy Palleschi, Stephen Tyzik, Suneela Nayak, Ruth Hanselman

MaineHealth Maine Medical Center

Delirium, an acute and fluctuating disturbance of consciousness and cognition, is a common manifestation of acute brain dysfunction in critically ill patients. Patients with delirium have longer hospital stays and a lower 6-month survival rate than do patients without delirium. Preliminary research suggests that delirium may be associated with cognitive impairment that persists months to years after discharge.

In a large acute care hospital, the cardiac intensive care staff became interested in mitigating their unit’s high delirium rate of ventilated patients. At baseline, many members of the healthcare team did not believe that delirium could be prevented and the predominant …

The Effects Of Dance Therapy On Patients With Parkinson’S Disease: An Integrative Literature Review, Jennifer Pence

Grace Peterson Nursing Research Colloquium

Abstract

Parkinson’s disease (PD) is a chronic, progressive, degenerative disease of the nervous system that affects more than one million Americans. Individuals who have PD generally exhibit bradykinesia, postural instability, shuffling steps and freezing during gait. These impairments in motor function cannot be fully addressed with pharmacological treatment and can eventually become unresponsive to this form of treatment. Dance therapy, on the other hand, is one non-pharmacological method that may prove beneficial for PD. It utilizes motor planning skills, which can lead to an improvement in muscle flexibility and balance. The purpose of the systematic integrative literature review was to …

Pineal Gland Tumor But Not Pinealoma: A Case Report, Syeda Naqvi, Chintan Rupareliya, Abdullah Shams, Maria Hameed, Zabeen Mahuwala, Pirthvi Raj Giyanwani

Neurology Faculty Publications

The pineal gland is a small pinecone-shaped and functionally endocrine structure located in the epithalamus region. Developmentally, the pineal gland is considered as a part of the epithalamus. It plays a role in the entrainment of the circadian rhythms of an organism by producing melatonin, a functionally important hormone. Lesions of the pineal region are rare compared to other parts of the brain. A lesion may be tumorous or non-tumorous in nature. The most common lesions are tumors that are pineal parenchymal tumors (PPT) in origin. Gliomas are the second most common tumors in the pineal region. We report a …

Anterior Inferior Cerebellar Arteries Juxtaposed With The Internal Acoustic Meatus And Their Relationship To The Cranial Nerve Vii/Viii Complex., Fernando Alonso, Mohammad W Kassem, Joe Iwanaga, Rod J Oskouian, Marios Loukas, Amin Demerdash, R Shane Tubbs

Articles, Abstracts, and Reports

Vascular loops in the cerebellopontine angle (CPA) and their relationship to cranial nerves have been used to explain neurological symptoms. The anterior inferior cerebellar artery (AICA) has variable branches producing vascular loops that can compress the facial cranial nerve (CN) VII and vestibulocochlear (CN VIII) nerves. AICA compression of the facial-vestibulocochlear nerve complex can lead to various clinical presentations, including hemifacial spasm (HFS), tinnitus, and hemiataxia. The formation of arterial loops inside or outside of the internal auditory meatus (IAM) can cause abutment or compression of CN VII and CN VIII. Twenty-five (50 sides) fresh adult cadavers underwent dissection of …

Coding Of Velocity Storage In The Vestibular Nuclei, Sergei B. Yakushin, Theodore Raphan, Bernard Cohen

Publications and Research

Semicircular canal afferents sense angular acceleration and output angular velocity with a short time constant of ≈4.5 s. This output is prolonged by a central integrative network, velocity storage that lengthens the time constants of eye velocity. This mechanism utilizes canal, otolith, and visual (optokinetic) information to align the axis of eye velocity toward the spatial vertical when head orientation is off-vertical axis. Previous studies indicated that vestibular-only (VO) and vestibular-pause-saccade (VPS) neurons located in the medial and superior vestibular nucleus could code all aspects of velocity storage. A recently developed technique enabled prolonged recording while animals were rotated and …

Tia1 Mutations In Amyotrophic Lateral Sclerosis And Frontotemporal Dementia Promote Phase Separation And Alter Stress Granule Dynamics., Ian R. Mackenzie, Alexandra M. Nicholson, Mohona Sarkar, James Messing, Maria D. Purice, Cyril Pottier, Kavya Annu, Matt Baker, Ralph B. Perkerson, Aishe Kurti, Billie J. Matchett, Tanja Mittag, Jamshid Temirov, Ging-Yuek R. Hsiung, Charles Krieger, Melissa E. Murray, Masato Kato, John D. Fryer, Leonard Petrucelli, Lorne Zinman, Sandra Weintraub, Marsel Mesulam, Julia Keith, Sasha A. Zivkovic, Veronica Hirsch-Reinshagen, Raymond P. Roos, Stephan Züchner, Neill R. Graff-Radford, Ronald C. Petersen, Richard J. Caselli, Zbigniew K. Wszolek, Elizabeth Finger, Carol Lippa, David Lacomis, Heather Stewart, Dennis W. Dickson, Hong Joo Kim, Ekaterina Rogaeva, Eileen Bigio, Kevin B. Boylan, J. Paul Taylor, Rosa Rademakers

Department of Neurology Faculty Papers

Amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) are age-related neurodegenerative disorders with shared genetic etiologies and overlapping clinical and pathological features. Here we studied a novel ALS/FTD family and identified the P362L mutation in the low-complexity domain (LCD) of T cell-restricted intracellular antigen-1 (TIA1). Subsequent genetic association analyses showed an increased burden of TIA1 LCD mutations in ALS patients compared to controls (p = 8.7 × 10

Chiari I Malformation And Spinal Cord Ischemia In A Cadaver., Faizullah Mashriqi, Marios Loukas, Rod J Oskouian, Anthony V D'Antoni, R Shane Tubbs

Articles, Abstracts, and Reports

With advanced imaging, the Chiari I malformation (CIM) is more frequently diagnosed than in the past when this entity was identified most commonly at autopsy. Herein, we report the rare case of an adult cadaver found not only to have CIM but also adjacent spinal cord ischemia. This case is discussed in the context of chronic compression of the spinal cord by a CIM and the need for close monitoring of these patients.

Cascaded Multi-View Canonical Correlation (Camcco) For Early Diagnosis Of Alzheimer's Disease Via Fusion Of Clinical, Imaging And Omic Features, Asha Singanamalli, Haibo Wang, Anant Madabhushi, Michael Weiner, Paul Aisen, Ronald Petersen, Clifford Jack, William Jagust, John Trojanowki, Arthur Toga, Laurel Beckett, Robert Green, Andrew Saykin, John Morris, Leslie Shaw, Jeffrey Kaye, Joseph Quinn, Lisa Silbert, Betty Lind, Raina Carter, Sara Dolen, Lon Schneider, Sonia Pawluczyk, Mauricio Beccera, Liberty Teodoro, Bryan Spann, James Brewer, Helen Vanderswag, Adam Fleisher, Judith Heidebrink, Charles Smith, Greg A. Jicha, Peter A. Hardy, Partha Sinha, Elizabeth Oates, Gary Conrad

Neurology Faculty Publications

The introduction of mild cognitive impairment (MCI) as a diagnostic category adds to the challenges of diagnosing Alzheimer's Disease (AD). No single marker has been proven to accurately categorize patients into their respective diagnostic groups. Thus, previous studies have attempted to develop fused predictors of AD and MCI. These studies have two main limitations. Most do not simultaneously consider all diagnostic categories and provide suboptimal fused representations using the same set of modalities for prediction of all classes. In this work, we present a combined framework, cascaded multiview canonical correlation (CaMCCo), for fusion and cascaded classification that incorporates all diagnostic …