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Thiamine Pyrophosphokinase Deficiency Causes A Leigh Disease Like Phenotype In A Sibling Pair: Identification Through Whole Exome Sequencing And Management Strategies, Jamie L. Fraser, Adeline Vanderver, Sandra Yang, Taeun Chang, Laura Cramp, Gilbert Vezina, Uta Lichter-Konecki, Kristina Cusmano-Ozog, Patroula Smpokou, Kimberly A. Chapman, Dina Zand 2014 Children's National Medical Center

Thiamine Pyrophosphokinase Deficiency Causes A Leigh Disease Like Phenotype In A Sibling Pair: Identification Through Whole Exome Sequencing And Management Strategies, Jamie L. Fraser, Adeline Vanderver, Sandra Yang, Taeun Chang, Laura Cramp, Gilbert Vezina, Uta Lichter-Konecki, Kristina Cusmano-Ozog, Patroula Smpokou, Kimberly A. Chapman, Dina Zand

Neurology Faculty Publications

We present a sibling pair with Leigh-like disease, progressive hypotonia, regression, and chronic encephalopathy. Whole exome sequencing in the younger sibling demonstrated a homozygous thiamine pyrophosphokinase (TPK) mutation. Initiation of high dose thiamine, niacin, biotin, α-lipoic acid and ketogenic diet in this child demonstrated improvement in neurologic function and re-attainment of previously lost milestones. The diagnosis of TPK deficiency was difficult due to inconsistent biochemical and diagnostic parameters, rapidity of clinical demise and would not have been made in a timely manner without the use of whole exome sequencing. Molecular diagnosis allowed for attempt at dietary modification with cofactor supplementation …


Corticocortical Evoked Potentials Reveal Projectors And Integrators In Human Brain Networks, C. J. Keller, C. J. Honey, L. Entz, S. Bickel, D. M. Groppe, E. Toth, I. Ulbert, F. A. Lado, A. D. Mehta 2014 Northwell Health

Corticocortical Evoked Potentials Reveal Projectors And Integrators In Human Brain Networks, C. J. Keller, C. J. Honey, L. Entz, S. Bickel, D. M. Groppe, E. Toth, I. Ulbert, F. A. Lado, A. D. Mehta

Journal Articles

The cerebral cortex is composed of subregions whose functional specialization is largely determined by their incoming and outgoing connections with each other. In the present study, we asked which cortical regions can exert the greatest influence over other regions and the cortical network as a whole. Previous research on this question has relied on coarse anatomy (mapping large fiber pathways) or functional connectivity (mapping inter-regional statistical dependencies in ongoing activity). Here we combined direct electrical stimulation with recordings from the cortical surface to provide a novel insight into directed, inter-regional influence within the cerebral cortex of awake humans. These networks …


Evoked Effective Connectivity Of The Human Neocortex, L. Entz, E. Toth, C. J. Keller, S. Bickel, D. M. Groppe, D. Fabo, L. R. Kozak, L. Eross, I. Ulbert, A. D. Mehta 2014 Northwell Health

Evoked Effective Connectivity Of The Human Neocortex, L. Entz, E. Toth, C. J. Keller, S. Bickel, D. M. Groppe, D. Fabo, L. R. Kozak, L. Eross, I. Ulbert, A. D. Mehta

Journal Articles

The role of cortical connectivity in brain function and pathology is increasingly being recognized. While in vivo magnetic resonance imaging studies have provided important insights into anatomical and functional connectivity, these methodologies are limited in their ability to detect electrophysiological activity and the causal relationships that underlie effective connectivity. Here, we describe results of cortico-cortical evoked potential (CCEP) mapping using single pulse electrical stimulation in 25 patients undergoing seizure monitoring with subdural electrode arrays. Mapping was performed by stimulating adjacent electrode pairs and recording CCEPs from the remainder of the electrode array. CCEPs reliably revealed functional networks and showed an …


Exemplar Selectivity Reflects Perceptual Similarities In The Human Fusiform Cortex, I. Davidesco, E. Zion-Golumbic, S. Bickel, M. Harel, D. M. Groppe, C. J. Keller, C. A. Schevon, G. M. McKhann, R. R. Goodman, G. Goelman, C. E. Schroeder, A. D. Mehta, R. Malach 2014 Northwell Health

Exemplar Selectivity Reflects Perceptual Similarities In The Human Fusiform Cortex, I. Davidesco, E. Zion-Golumbic, S. Bickel, M. Harel, D. M. Groppe, C. J. Keller, C. A. Schevon, G. M. Mckhann, R. R. Goodman, G. Goelman, C. E. Schroeder, A. D. Mehta, R. Malach

Journal Articles

While brain imaging studies emphasized the category selectivity of face-related areas, the underlying mechanisms of our remarkable ability to discriminate between different faces are less understood. Here, we recorded intracranial local field potentials from face-related areas in patients presented with images of faces and objects. A highly significant exemplar tuning within the category of faces was observed in high-Gamma (80-150 Hz) responses. The robustness of this effect was supported by single-trial decoding of face exemplars using a minimal (n = 5) training set. Importantly, exemplar tuning reflected the psychophysical distance between faces but not their low-level features. Our results reveal …


Guanine Nucleotide Exchange Factor Dock7 Mediates Hgf- Induced Glioblastoma Cell Invasion Via Rac Activation, D. W. Murray, S. Didier, A. Chan, V. Paulino, L. Van Aelst, R. Ruggieri, N. L. Tran, A. T. Byrne, M. Symons 2014 Northwell Health

Guanine Nucleotide Exchange Factor Dock7 Mediates Hgf- Induced Glioblastoma Cell Invasion Via Rac Activation, D. W. Murray, S. Didier, A. Chan, V. Paulino, L. Van Aelst, R. Ruggieri, N. L. Tran, A. T. Byrne, M. Symons

Journal Articles

Background: Glioblastoma multiforme (GBM), a highly invasive primary brain tumour, remains an incurable disease. Rho GTPases and their activators, guanine nucleotide exchange factors (GEFs), have central roles in GBM invasion. Anti-angiogenic therapies may stimulate GBM invasion via HGF/c-Met signalling. We aim to identify mediators of HGF-induced GBM invasion that may represent targets in a combination anti-angiogenic/anti-invasion therapeutic paradigm. Methods: Guanine nucleotide exchange factor expression was measured by microarray analysis and western blotting. Specific depletion of proteins was accomplished using siRNA. Cell invasion was determined using matrigel and brain slice assays. Cell proliferation and survival were monitored using sulforhodamine B and …


Head Model And Electrical Source Imaging: A Study Of 38 Epileptic Patients, G. Birot, L. Spinelli, S. Vulliemoz, P. Megevand, D. Brunet, M. Seeck, C. M. Michel 2014 Northwell Health

Head Model And Electrical Source Imaging: A Study Of 38 Epileptic Patients, G. Birot, L. Spinelli, S. Vulliemoz, P. Megevand, D. Brunet, M. Seeck, C. M. Michel

Journal Articles

Electrical source imaging (ESI) aims at reconstructing the electrical brain activity from scalp EEG. When applied to interictal epileptiform discharges (IEDs), this technique is of great use for identifying the irritative zone in focal epilepsies. Inaccuracies in the modeling of electro-magnetic field propagation in the head (forward model) may strongly influence ESI and lead to mislocalization of IED generators. However, a systematic study on the influence of the selected head model on the localization precision of IED in a large number of patients with known focus localization has not yet been performed. We here present such a performance evaluation of …


Hmgb1 Enhances Immune Suppression By Facilitating The Differentiation And Suppressive Activity Of Myeloid-Derived Suppressor Cells, K. H. Parker, P. Sinha, L. A. Horn, V. K. Clements, H. Yang, J. H. Li, K. J. Tracey, S. Ostrand-Rosenberg 2014 Northwell Health

Hmgb1 Enhances Immune Suppression By Facilitating The Differentiation And Suppressive Activity Of Myeloid-Derived Suppressor Cells, K. H. Parker, P. Sinha, L. A. Horn, V. K. Clements, H. Yang, J. H. Li, K. J. Tracey, S. Ostrand-Rosenberg

Journal Articles

Chronic inflammation often precedes malignant transformation and later drives tumor progression. Likewise, subversion of the immune system plays a role in tumor progression, with tumoral immune escape now well recognized as a crucial hallmark of cancer. Myeloid-derived suppressor cells (MDSC) are elevated in most individuals with cancer, where their accumulation and suppressive activity are driven by inflammation. Thus, MDSCs may define an element of the pathogenic inflammatory processes that drives immune escape. The secreted alarmin HMGB1 is a proinflammatory partner, inducer, and chaperone for many proinflammatory molecules that MDSCs develop. Therefore, in this study, we examined HMGB1 as a potential …


Inflammation Induces Irreversible Biophysical Changes In Isolated Nucleus Pulposus Cells, R. Maidhof, T. Jacobsen, A. Papatheodorou, N. O. Chahine 2014 Northwell Health

Inflammation Induces Irreversible Biophysical Changes In Isolated Nucleus Pulposus Cells, R. Maidhof, T. Jacobsen, A. Papatheodorou, N. O. Chahine

Journal Articles

Intervertebral disc degeneration is accompanied by elevated levels of inflammatory cytokines that have been implicated in disease etiology and matrix degradation. While the effects of inflammatory stimulation on disc cell metabolism have been well-studied, their effects on cell biophysical properties have not been investigated. The hypothesis of this study is that inflammatory stimulation alters the biomechanical properties of isolated disc cells and volume responses to step osmotic loading. Cells from the nucleus pulposus (NP) of bovine discs were isolated and treated with either lipopolysaccharide (LPS), an inflammatory ligand, or with the recombinant cytokine TNF-alpha for 24 hours. We measured cellular …


Jak/Stat1 Signaling Promotes Hmgb1 Hyperacetylation And Nuclear Translocation, B. Lu, K. Kwan, M. Robinson, M. A. D. Van Zoelen, H. Yang, J. Li, S. S. Chavan, H. Wang, U. Andersson, K. J. Tracey, +5 additional authors 2014 Northwell Health

Jak/Stat1 Signaling Promotes Hmgb1 Hyperacetylation And Nuclear Translocation, B. Lu, K. Kwan, M. Robinson, M. A. D. Van Zoelen, H. Yang, J. Li, S. S. Chavan, H. Wang, U. Andersson, K. J. Tracey, +5 Additional Authors

Journal Articles

Extracellular high-mobility group box (HMGB)1 mediates inflammation during sterile and infectious injury and contributes importantly to disease pathogenesis. The first critical step in the release of HMGB1 from activated immune cells is mobilization from the nucleus to the cytoplasm, a process dependent upon hyperacetylation within two HMGB1 nuclear localization sequence (NLS) sites. The inflammasomes mediate the release of cytoplasmic HMGB1 in activated immune cells, but the mechanism of HMGB1 translocation from nucleus to cytoplasm was previously unknown. Here, we show that pharmacological inhibition of JAK/STAT1 inhibits LPS-induced HMGB1 nuclear translocation. Conversely, activation of JAK/STAT1 by type 1 interferon (IFN) stimulation …


Mapping Epileptic Activity: Sources Or Networks For The Clinicians?, F. Pittau, P. Megevand, L. Sheybani, E. Abela, F. Grouiller, L. Spinelli, C. M. Michel, M. Seeck, S. Vulliemoz 2014 Northwell Health

Mapping Epileptic Activity: Sources Or Networks For The Clinicians?, F. Pittau, P. Megevand, L. Sheybani, E. Abela, F. Grouiller, L. Spinelli, C. M. Michel, M. Seeck, S. Vulliemoz

Journal Articles

Epileptic seizures of focal origin are classically considered to arise from a focal epileptogenic zone and then spread to other brain regions. This is a key concept for semiological electro-clinical correlations, localization of relevant structural lesions, and selection of patients for epilepsy surgery. Recent development in neuro-imaging and electro-physiology and combinations, thereof, have been validated as contributory tools for focus localization. In parallel, these techniques have revealed that widespread networks of brain regions, rather than a single epileptogenic region, are implicated in focal epileptic activity. Sophisticated multimodal imaging and analysis strategies of brain connectivity patterns have been developed to characterize …


O-020 Modifying Flow In The Ica Bifurcation: Pipeline Deployment From The Supraclinoid Ica Extending Into The M1 Segment: Clinical And Anatomical Results, E. Nossek, D. J. Chalif, S. Chakraborty, A. Setton 2014 Hofstra Northwell School of Medicine

O-020 Modifying Flow In The Ica Bifurcation: Pipeline Deployment From The Supraclinoid Ica Extending Into The M1 Segment: Clinical And Anatomical Results, E. Nossek, D. J. Chalif, S. Chakraborty, A. Setton

Journal Articles

BACKGROUND: Utility of the pipeline embolization device (PED) extending to the M1 segment as well as its clinical and flow consequences at the ICA bifurcation, has not clearly described. We describe clinical and anatomical flow modifications results at the ICA bifurcation. METHODS: In this retrospective analysis of patients treated for distal supraclinoid carotid aneurysms, a single PED was deployed from the proximal M1 segment to the distal supraclinoid carotid. Flow assessment prior to the procedure, to predict the competence of the ACA/AcomA complex, was achieved by formal DSA angiography and occasional manual cross compression. In all cases a single PED …


The Regulation Of Rhoa At Focal Adhesions By Stard13 Is Important For Astrocytoma Cell Motility, B. D. Khalil, S. Hanna, B. A. Saykali, S. El-Sitt, A. Nasrallah, D. Marston, M. El-Sabban, K. M. Hahn, M. Symons, M. El-Sibai 2014 Northwell Health

The Regulation Of Rhoa At Focal Adhesions By Stard13 Is Important For Astrocytoma Cell Motility, B. D. Khalil, S. Hanna, B. A. Saykali, S. El-Sitt, A. Nasrallah, D. Marston, M. El-Sabban, K. M. Hahn, M. Symons, M. El-Sibai

Journal Articles

Malignant astrocytomas are highly invasive into adjacent and distant regions of the normal brain. Rho GTPases are small monomeric G proteins that play important roles in cytoskeleton rearrangement, cell motility and tumor invasion. In the present study, we show that the knock down of StarD13, a GTPase activating protein (GAP) for RhoA and Cdc42, inhibits astrocytoma cell migration through modulating focal adhesion dynamics and cell adhesion. This effect is mediated by the resulting constitutive activation of RhoA and the subsequent indirect inhibition of Rac. Using Total Internal Reflection Fluorescence (TIRF)-based Forster Resonance Energy Transfer (FRET), we show that RhoA activity …


Semapimod Sensitizes Glioblastoma Tumors To Ionizing Radiation By Targeting Microglia, I. S. Miller, S. Didier, D. W. Murray, T. H. Turner, M. Issaivanan, R. Ruggieri, Y. Al-Abed, M. Symons 2014 Northwell Health

Semapimod Sensitizes Glioblastoma Tumors To Ionizing Radiation By Targeting Microglia, I. S. Miller, S. Didier, D. W. Murray, T. H. Turner, M. Issaivanan, R. Ruggieri, Y. Al-Abed, M. Symons

Journal Articles

Glioblastoma is the most malignant and lethal form of astrocytoma, with patients having a median survival time of approximately 15 months with current therapeutic modalities. It is therefore important to identify novel therapeutics. There is mounting evidence that microglia (specialized brain-resident macrophages) play a significant role in the development and progression of glioblastoma tumors. In this paper we show that microglia, in addition to stimulating glioblastoma cell invasion, also promote glioblastoma cell proliferation and resistance to ionizing radiation in vitro. We found that semapimod, a drug that selectively interferes with the function of macrophages and microglia, potently inhibits microglia-stimulated GL261 …


Terror Medicine As Part Of The Medical School Curriculum, L. A. Cole, K. Wagner, S. Scott, N. D. Connell, A. Cooper, C. A. Kennedy, B. Natal, S. Lamba 2014 Northwell Health

Terror Medicine As Part Of The Medical School Curriculum, L. A. Cole, K. Wagner, S. Scott, N. D. Connell, A. Cooper, C. A. Kennedy, B. Natal, S. Lamba

Journal Articles

Terror medicine, a field related to emergency and disaster medicine, focuses on medical issues ranging from preparedness to psychological manifestations specifically associated with terrorist attacks. Calls to teach aspects of the subject in American medical schools surged after the 2001 jetliner and anthrax attacks. Although the threat of terrorism persists, terror medicine is still addressed erratically if at all in most medical schools. This paper suggests a template for incorporating the subject throughout a 4-year medical curriculum. The instructional framework culminates in a short course for fourth year students, such as one recently introduced at Rutgers New Jersey Medical School, …


Carotid-Cavernous Fistula As A Mimicker Of Myasthenia Gravis, A. Eswar, H. D. Pomeranz, S. M. Vishnubhakat, M. Oller-Cramsie 2014 Northwell Health

Carotid-Cavernous Fistula As A Mimicker Of Myasthenia Gravis, A. Eswar, H. D. Pomeranz, S. M. Vishnubhakat, M. Oller-Cramsie

Journal Articles

BACKGROUND: A carotid-cavernous fistula (CCF) is an abnormal communication between the carotid arterial system and the cavernous sinus. Common symptoms of CCFs include proptosis and ophthalmoplegia, but fluctuating diplopia and presence of ptosis are not typical. CASE DESCRIPTION: We present an unusual case of CCF with fluctuating binocular diplopia and ptosis, mimicking myasthenia gravis. Electrodiagnostic testing, which included repetitive nerve stimulation and single-fiber electromyography, was normal. Magnetic resonance imaging of the brain and orbits was initially normal, but later magnetic resonance angiography revealed enlargement of the left superior ophthalmic vein along with a left CCF. Patient underwent a successful left …


The Utility Of Neuroimaging In The Differential Diagnosis Of Parkinsonian Syndromes, F. Holtbernd, D. Eidelberg 2014 Northwell Health

The Utility Of Neuroimaging In The Differential Diagnosis Of Parkinsonian Syndromes, F. Holtbernd, D. Eidelberg

Journal Articles

The differential diagnosis of parkinsonian syndromes can be challenging, particularly in early disease stages. However, prognosis and therapeutic regimes are not alike in Parkinson disease and atypical parkinsonism, and thus a correct diagnosis at the earliest possible stage is desirable. Over the past two decades, magnetic resonance imaging and radiotracer-based imaging techniques have proven to be helpful tools to enhance the accuracy of clinical diagnosis in these disorders. Here, we review recent advances in neuroimaging for the differential diagnosis of parkinsonian syndromes.


Abnormal Metabolic Network Activity In Rem Sleep Behavior Disorder, F. Holtbernd, J. F. Gagnon, R. B. Postuma, Y. Ma, C. C. Tang, A. Feigin, V. Dhawan, J. P. Soucy, D. Eidelberg, J. Montplaisir, +1 additional author 2014 Northwell Health

Abnormal Metabolic Network Activity In Rem Sleep Behavior Disorder, F. Holtbernd, J. F. Gagnon, R. B. Postuma, Y. Ma, C. C. Tang, A. Feigin, V. Dhawan, J. P. Soucy, D. Eidelberg, J. Montplaisir, +1 Additional Author

Journal Articles

OBJECTIVE: To determine whether the Parkinson disease-related covariance pattern (PDRP) expression is abnormally increased in idiopathic REM sleep behavior disorder (RBD) and whether increased baseline activity is associated with greater individual risk of subsequent phenoconversion. METHODS: For this cohort study, we recruited 2 groups of RBD and control subjects. Cohort 1 comprised 10 subjects with RBD (63.5 +/- 9.4 years old) and 10 healthy volunteers (62.7 +/- 8.6 years old) who underwent resting-state metabolic brain imaging with (18)F-fluorodeoxyglucose PET. Cohort 2 comprised 17 subjects with RBD (68.9 +/- 4.8 years old) and 17 healthy volunteers (66.6 +/- 6.0 years old) …


Network Modulation Following Sham Surgery In Parkinson's Disease, J. H. Ko, A. Feigin, P. Mattis, C. C. Tang, Y. L. Ma, V. Dhawan, M. J. During, M. G. Kaplitt, D. Eidelberg 2014 Northwell Health

Network Modulation Following Sham Surgery In Parkinson's Disease, J. H. Ko, A. Feigin, P. Mattis, C. C. Tang, Y. L. Ma, V. Dhawan, M. J. During, M. G. Kaplitt, D. Eidelberg

Journal Articles

Patient responses to placebo and sham effects are a major obstacle to the development of therapies for brain disorders, including Parkinson's disease (PD). Here, we used functional brain imaging and network analysis to study the circuitry underlying placebo effects in PD subjects randomized to sham surgery as part of a double-blind gene therapy trial. Metabolic imaging was performed prior to randomization, then again at 6 and 12 months after sham surgery. In this cohort, the sham response was associated with the expression of a distinct cerebello-limbic circuit. The expression of this network increased consistently in patients blinded to treatment and …


Quantifying Significance Of Topographical Similarities Of Disease-Related Brain Metabolic Patterns, J. H. Ko, P. Spetsieris, Y. L. Ma, V. Dhawan, D. Eidelberg 2014 Northwell Health

Quantifying Significance Of Topographical Similarities Of Disease-Related Brain Metabolic Patterns, J. H. Ko, P. Spetsieris, Y. L. Ma, V. Dhawan, D. Eidelberg

Journal Articles

Multivariate analytical routines have become increasingly popular in the study of cerebral function in health and in disease states. Spatial covariance analysis of functional neuroimaging data has been used to identify and validate characteristic topographies associated with specific brain disorders. Voxel-wise correlations can be used to assess similarities and differences that exist between covariance topographies. While the magnitude of the resulting topographical correlations is critical, statistical significance can be difficult to determine in the setting of large data vectors (comprised of over 100,000 voxel weights) and substantial autocorrelation effects. Here, we propose a novel method to determine the p-value of …


Characterization Of Disease-Related Covariance Topographies With Ssmpca Toolbox: Effects Of Spatial Normalization And Pet Scanners, S. C. Peng, Y. L. Ma, P. G. Spetsieris, P. Mattis, Andrew Feigin, V. Dhawan, D. Eidelberg 2014 Northwell Health

Characterization Of Disease-Related Covariance Topographies With Ssmpca Toolbox: Effects Of Spatial Normalization And Pet Scanners, S. C. Peng, Y. L. Ma, P. G. Spetsieris, P. Mattis, Andrew Feigin, V. Dhawan, D. Eidelberg

Journal Articles

To generate imaging biomarkers from disease-specific brain networks, we have implemented a general toolbox to rapidly perform scaled subprofile modeling (SSM) based on principal component analysis (PCA) on brain images of patients and normals. This SSMPCA toolbox can define spatial covariance patterns whose expression in individual subjects can discriminate patients from controls or predict behavioral measures. The technique may depend on differences in spatial normalization algorithms and brain imaging systems. We have evaluated the reproducibility of characteristic metabolic patterns generated by SSMPCA in patients with Parkinson's disease (PD). We used [F-18]fluorodeoxyglucose PET scans from patients with PD and normal controls. …


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