Neurology Commons^™

Baseline Cognition And Demographic, Lifestyle, And Cardiovascular Risk Factors In Us Pointer, Kathryn V Papp, Sarah Tomaszewski Farias, Marjorie Howard, Amber Thro, Tiia Ngandu, Brad Caudle, Bonnie C Sachs, Michelle Chan, Kristin R Krueger, Elizabeth R T Hartman, Athene Lee, Michele K York, Marie T Austin, Kathryn E Demos, Thomas M Holland, Xiaoyan Leng, Rema Raman, Heather M Snyder, Maria C Carrillo, Rachel A Whitmer, Mark A Espeland, Laura D Baker

Faculty, Staff and Students Publications

Introduction: Validation of the primary cognitive composite and baseline cognitive characteristics are presented for the US-Study-to-Protect-Brain-Health-Through-Lifestyle-Intervention-to-Reduce-Risk (US POINTER).

Methods: US POINTER is a multicenter, randomized clinical trial of two lifestyle interventions testing cognitive benefit in older adults without significant cognitive impairment but at-risk for decline due to well-established factors. Cognition is measured using a global cognitive composite (US POINTER modified Neuropsychological Test Battery-PmNTB).

Results: The PmNTB is a valid cognitive composite, exhibiting good psychometric properties and tracking with other established outcomes. Among the 2111 enrolled participants (mean age = 68.2 years, 69% women, 31% from race and ethnic minoritized groups), …

Diagnostic Accuracy Of Screening Tools For Depression And Anxiety In Cervical Dystonia, Davide Martino, Mehrafarin Ramezani, Steven Bellows, Brian D Berman, Florence Ching-Fen Chang, Jeanne Feuerstein, Victor Fung, Gamze Kilic Berkmen, Irene A Malaty, Claire Maciver, Scott A Norris, Kathryn J Peall, Joel S Perlmutter, Sarah Pirio Richardson, Laura J Wright, Zahra Goodarzi, Hyder A Jinnah

Faculty, Staff and Students Publications

Introduction: Despite their high prevalence and impact, depression and anxiety are not routinely screened for, and accuracy of screening procedures is unknown in adult-onset dystonia. We evaluated accuracy parameters of selected self-rated scales for depression and anxiety in patients with idiopathic cervical dystonia (CD).

Methods: Two-hundred-and-ten patients with idiopathic CD were recruited from 10 movement disorders centers from the US, Canada, Australia, and UK. At the end of each botulinum toxin cycle, participants were administered the Adult Standard Mini-International Neuropsychiatric Interview (MINI) as reference standard for depression and anxiety. Participants completed 8 self-administered index instruments (2 for depression, 2 for …

Formation Of An Expanding Memory Representation In The Hippocampus, Sachin P Vaidya, Guanchun Li, Raymond A Chitwood, Yiding Li, Jeffrey C Magee

Faculty, Staff and Students Publications

How brain networks connected by labile synapses store new information without catastrophically overwriting previous memories remains poorly understood. To examine this, we tracked the same population of hippocampal CA1 place cells (PCs) as mice learned a task for 7 days. We found evidence of memory formation as both the number of PCs maintaining a stable place field and the stability of individual PCs progressively increased across the week until most of the representation was composed of long-term stable PCs. The stable PCs disproportionately represented task-related learned information, were retrieved earlier within a behavioral session and showed a strong correlation with …

Intracranial Injury Following Nasogastric Tube Placement After Skull Base Surgery: A Case Report And Systematic Review, Gabrielle Wolter, Zain U Naqvi, Ali Jalali, Tran Locke, K Kelly Gallagher, Meha G Fox

Faculty, Staff and Students Publications

Inadvertent intracranial nasogastric tube placement is a recognized risk following skull base fracture, but prior skull base surgery also poses a significant and underrecognized risk for this potentially fatal complication. We report the case of a 75-year-old female admitted with Clostridioides difficile colitis, six months after endoscopic endonasal resection of a pituitary macroadenoma. A systematic review identified 10 prior cases of intracranial tube placement following skull base or sinonasal surgery, including nasotracheal and feeding tube insertions. Literature suggests that using small-bore flexible tubes and preserving anatomical barriers, such as the position of the middle turbinate and intact bony structures like …

Distinguishing Pex2 And Pex16 Gene Variant Severity For Mild, Severe And Atypical Peroxisome Biogenesis Disorders, Vanessa A Gomez, Oguz Kanca, Sharayu V Jangam, Saurabh Srivastav, Jonathan C Andrews, Michael F Wangler

Duncan NRI Faculty and Staff Publications

Peroxisomal biogenesis disorders (PBD) are autosomal recessive diseases caused by mutations in specific PEX genes that impair peroxisome formation, leading to multi-systemic failure. Symptoms vary, even in patients with variants in the same PEX gene. Our goal is to select PEX mutations and use Drosophila to model a severity spectrum based on genotype-phenotype correlations. Utilizing KozakGAL4 (KZ) cassettes, we replaced the coding sequence of Pex with a GAL4 driver, ideal for making 'humanized' flies in which human PEX can replace the fly loss. We generated Pex2KZ and Pex16KZ lines and assessed them in various behavior assays, confirming their severe phenotypes. …

The Commonly Uncommon Presentation Of Cerebral Venous Thrombosis: A Case Report, Elizabeth Piwowarski, Kalyan Mantha, Martin Wegman

HCA Healthcare Journal of Medicine

Introduction

Cerebral venous thrombosis (CVT) is notoriously misdiagnosed as more benign etiologies during the initial examination owing to its relative rarity, its wide variety of presenting symptoms and onset and progression patterns, and its frequent requirement for less commonly utilized imaging techniques in its diagnosis. Accordingly, most cases are identified only after repeated evaluations for symptom persistence or progression, or in cases involving prothrombotic states linked to the disease, such as pregnancy, puerperium, genetic or acquired thrombophilia, and infection.

Case Presentation

We present the case of a 29-year-old woman with a history of obesity and oral contraceptive use who was …

Unraveling The Threads: A Case Report On Confusional Migraine And The Intricate Dance Between Psychiatry And Neurology, Mabit C. Gonzalez, Manjula Kottapalli

HCA Healthcare Journal of Medicine

Background

Migraine affects about 1 billion people worldwide and is associated with a significant negative impact on personal and occupational functioning. Migraine accompanied by aura is seen in about 15% of migraineurs. Visual aura is the most common type of aura. Much less common though are auras that involve higher mental function, such as confusional state. The confusional state may manifest with a wide variety of cortical dysfunction, such as speech impairment, increased alertness, agitation, and amnesia, often lasting longer than a typical migraine aura.

Case Presentation

The authors present the unique case of a 29-year-old patient with episodic and …

Unique Presentation Of Vertebral Artery Dissection: A Case Report, Rossen I. Kirkov, Daniel Fisher

HCA Healthcare Journal of Medicine

Background

Vertebral artery dissection (VAD) is a common cause of stroke within the younger patient population. It is usually associated with headache or neck pain, as well as signs and symptoms of a posterior circulation stroke, such as vertigo, dysarthria, and ataxia. However, there are very scarce reports of patients with this pathology presenting with focal neurologic deficits, which are more indicative of a cerebral stroke.

Case Presentation

This case involves a 46-year-old woman who presented to the emergency department (ED) with complaints of right-sided headache and neck pain, which had been ongoing for 1 week, with newly developed right …

The Benefits Of Infrared Therapy, Mirror Exercise, And Faradic Current In A Patient With Bell’S Palsy: Case Study, Dhyan Rachmawati, Sugiono -, Fendy Nugroho, Noerdjanah -

Jurnal Fisioterapi Terapan Indonesia

Background: Bell’s Palsy is defined as paralysis of one side of the facial nerve, with an unknown cause. Several other conditions can also cause facial paralysis, such as brain tumors, stroke, myasthenia gravis, and Lyme disease. However, if no specific cause can be identified, this condition is known as Bell’s Palsy, which is caused by swelling and pressure on the nerve at the stylomastoid foramen, leading to nerve compression or damage. Often, the affected side’s eye cannot be closed. Physiotherapy management plays a vital role in the rehabilitation process for Bell’s Palsy patients to reduce symptoms, accelerate recovery, and …

The Effectiveness Of The Addition Of Slow Deep Breathing To Brain Gym Exercise On Cognitive Impairment Of The Elderly, Dhia Maharani Ms, Mohammad Ali Mr, Zahra Sativani Mrs

Jurnal Fisioterapi Terapan Indonesia

Background: According to WHO, 65.5 million elderly people worldwide have impaired cognitive function. Cognitive impairment can be caused by impaired oxygen supply to the brain, stress, and lack of physical activity. Physiotherapy has a role in elderly cognition through interventions to improve cognition, namely in the form of Brain Gym Exercise with the addition of Slow Deep Breathing. Objective: Knowing the effectiveness of the addition of Slow Deep Breathing to Brain Gym Exercise on cognitive impairment of the elderly at Panti Sosial Tresna Werdha Budi Mulia 4. Methods: This study used quasi experimental with two group pre-post …

Efektivitas Massage Endorphin Untuk Mengurangi Kecemasan Pada Ibu Hamil Menjelang Persalinan, Widiya Saryani, Dini Nur Alpiah

Jurnal Fisioterapi Terapan Indonesia

Pregnancy is a biological process involving complex physiological and psychological transitions that demand high adaptability from women, especially approaching childbirth. Anxiety during the third trimester is frequently reported and is associated with increased cortisol secretion, which may negatively impact labor effectiveness. This literature review aimed to synthesize scientific evidence regarding the effectiveness of endorphin massage in reducing anxiety among pregnant women in the third trimester. The review used a systematic approach based on the PICO framework, covering studies published between 2021 and 2025. Databases such as PubMed, Google Scholar, and SINTA were used to identify quasi-experimental studies comparing endorphin massage …

Peningkatan Keterampilan Makan Pada Anak Down Syndrome Melalui Terapi Okupasi Berbasis Sensory Integration: Studi Kasus, Reza Nur Arsyi, Tambunan Seselia Thresagloria, Muhammad Luthfi, Ayleen Alicia K, Hermito Gideon

Jurnal Fisioterapi Terapan Indonesia

Children with Down Syndrome (DS) frequently experience feeding difficulties due to hypotonia, sensory processing disorder, and oromotor impairments. This case study aimed to describe the clinical reasoning and effectiveness of a sensory integration (SI)-based occupational therapy intervention in improving feeding skills in a 10-year-old child with DS. The intervention consisted of 12 structured sessions focusing on postural stability, proprioceptive awareness, fine motor control, and oromotor coordination. Evaluation tools included Sensory Profile 2 and the Functional Independence Measure (FIM). Post-intervention outcomes indicated significant improvement in spoon use, posture during mealtime, texture tolerance, and self-feeding independence. FIM scores improved from total assistance …

Efektivitas Latihan Aerobik Dalam Mengurangi Gejala Depresi: Literature Review, Putra Adytio Giriyoga, Dini Nur Alpiah

Jurnal Fisioterapi Terapan Indonesia

Depression is one of the most common mental health disorders worldwide and can significantly affect an individual's quality of life. Various treatment approaches have been implemented, with one of the most noteworthy being non-pharmacological interventions in the form of aerobic exercise. This study aims to review the effectiveness of aerobic exercise in reducing depressive symptoms. This research is a narrative literature review, in which 3,610 articles were initially identified and then filtered based on inclusion-exclusion criteria, resulting in 8 articles. After eliminating duplicates, further screening was conducted through critical appraisal. The final selection of 8 articles was reviewed. The findings …

Spinoplastic Surgery: A Review Of Techniques, Indications, And Optimal Patient Selection, Daniel Vernik, Camryn Payne, Krishna Sinha, Casey Martinez, Walter Nicholas Jungbauer, Jonathan L Jeger, Michael Bohl, Alexander E Ropper, Sebastian Winocour, Edward Reece

Faculty, Staff and Students Publications

Background/Objectives: Spinoplastic surgery is an emerging multidisciplinary field developed to address and reduce the complication of pseudoarthrosis following complex spinal reconstructions. While the number of spinal fusion procedures continues to rise every year, fusion failure rates remain as high as 40%. Although pseudoarthrosis may not always manifest clinically, it remains a leading cause of persistent pain and need for subsequent revision surgeries. The multidisciplinary collaboration between spine and plastic surgeons in spinoplastic surgery has therefore emerged as a proactive strategy aimed at preventing complications, particularly in patients identified as high-risk for pseudoarthrosis. As the patient population expands and spinoplastic surgery …

Spinoplastic Surgery: A Review Of Techniques, Indications, And Optimal Patient Selection, Daniel Vernik, Camryn Payne, Krishna Sinha, Casey Martinez, Walter Nicholas Jungbauer, Jonathan L Jeger, Michael Bohl, Alexander E Ropper, Sebastian Winocour, Edward Reece

Faculty, Staff and Students Publications

Background/Objectives: Spinoplastic surgery is an emerging multidisciplinary field developed to address and reduce the complication of pseudoarthrosis following complex spinal reconstructions. While the number of spinal fusion procedures continues to rise every year, fusion failure rates remain as high as 40%. Although pseudoarthrosis may not always manifest clinically, it remains a leading cause of persistent pain and need for subsequent revision surgeries. The multidisciplinary collaboration between spine and plastic surgeons in spinoplastic surgery has therefore emerged as a proactive strategy aimed at preventing complications, particularly in patients identified as high-risk for pseudoarthrosis. As the patient population expands and spinoplastic surgery …

Idiopathic Transverse Myelitis: A Case Report, Danielle Whitacre

Lynchburg Journal of Medical Science

The objective of this paper is to review a case report for a patient with idiopathic transverse myelitis. This rare disease can easily be forgotten based on the vagueness of symptoms and as the presentation can vary drastically. In this case, a magnetic resonance imaging (MRI) test was ordered after a patient presented with a sensory deficit from the level of his chest to his toes that showed a 1.5 centimeter (cm) intramedullary spinal cord lesion at the level of T1. From the imaging, the differential diagnosis included transverse myelitis, a demyelinating lesion, and primary neoplasms such as ependymoma and …

Stress And Seizures: The October 7th Experience, Alon Doron, Firas Fahoum, Lilach Goldstein

Department of Neurology Faculty Papers

OBJECTIVE: Stress is a frequently self-reported seizure trigger in patients with epilepsy (PWE), with studies regarding this issue having conflicting results. On October 7th, 2023, a large-scale military invasion accompanied by massive rocket launches against Israel, including Tel Aviv, occurred, providing an opportunity to investigate the role of acute stress in provoking seizures.

METHODS: All adults who presented to the emergency department (ED) of Tel Aviv Sourasky Medical Center between January 1st, 2017, and February 29th, 2024, and were diagnosed with seizures were included. Data were collected using MDClone, a data acquisition tool. The overall seizure-related ED admissions were compared …

Pharmacogenetic-Guided Antiplatelet Therapy For Personalized Medicine In Patients With Stroke And Transient Ischemic Attack Without Cardioembolic Stroke: A Systematic Review Of Economic Evaluations, Nathapol Samprasit, Chamipa Phanudulkitti, Nattanichcha Kulthanachairojana, Jatapat Hemapanpairoa

The Thai Journal of Pharmaceutical Sciences

Background: Stroke is a major global public health burden. Ischemic stroke is the most common type of all stroke cases worldwide. Antiplatelet therapy is a key strategy for secondary prevention in patients with stroke and transient ischemic attacks (TIAs) without cardioembolic stroke. Dual antiplatelet therapy (DAPT) with clopidogrel is recommended in patients with early mild stroke or high-risk TIA, followed by long-term single antiplatelet therapy (SAPT). Clopidogrel is often used as an alternative for patients with aspirin resistance or intolerance. However, clopidogrel is a prodrug metabolized by the CYP2C19 enzyme, leading to variability in its effectiveness.

Objectives: This study aims …

Contrast Enhancement, G-Cimp Subtype, And Cdkn2a/B Homozygous Deletion In Idh-Mutant Astrocytoma, Mehak Majid Khan, Wenyin Shi, Iyad Alnahhas

Department of Neurology Faculty Papers

No abstract provided.

Author Correction: Beta Activity In Human Anterior Cingulate Cortex Mediates Reward Biases, Jiayang Xiao, Joshua A Adkinson, John Myers, Anusha B Allawala, Raissa K Mathura, Victoria Pirtle, Ricardo Najera, Nicole R Provenza, Eleonora Bartoli, Andrew J Watrous, Denise Oswalt, Ron Gadot, Adrish Anand, Ben Shofty, Sanjay J Mathew, Wayne K Goodman, Nader Pouratian, Xaq Pitkow, Kelly R Bijanki, Benjamin Hayden, Sameer A Sheth

Faculty, Staff and Students Publications

No abstract provided.