Neurology Commons^™

Effect Of Dosage On Severity Of Dysphagia In A Toxicological Rat Model Of Parkinson's Disease, Shivam Patel, Taylor Good, Nicholas Zanghi, Francois Gould

Rowan-Virtua Research Day

Parkinson’s Disease (PD) is a prevalent and devastating neurodegenerative disorder that causes progressively worsening motor symptoms affecting locomotor and oropharyngeal function. There is limited research in animal models on swallowing dysfunction in PD. To examine how neurodegeneration in PD produces progressive impairment in the oropharyngeal and locomotor processes, rotenone, a type II mitochondrial inhibitor, was injected into Lewis rat models to reproduce a parkinsonian phenotype. We hypothesized that the animal models injected with the rotenone will exhibit both oropharyngeal dysfunction and locomotor deficiency with an increased deficit that correlates with prolonged treatment. We utilized 18 rats receiving either 2.75 mg/kg …

Moving On Up: A Case Study Of Hiv And Covid-Induced Guillain-Barre Syndrome, Victoria Wong Murray, Rebecca Chae, Isobel Moyer, Cindy Hou

Rowan-Virtua Research Day

COVID and HIV are both common diseases, with COVID affecting an estimated 775 million and HIV affecting 39 million people worldwide. Guillain-Barre is a rare but feared complication of immune stimulation in which the body generates autoantibodies against gangliosides, found in the nodes of Ranvier, in the myelin, and in the ganglia; causing ascending paralysis.

A mid-30s man with HIV maintained on Genvoya presented to the Jefferson Health New Jersey Early Intervention Program clinic with fatigue, fever, cough, and congestion and tested positive for SARS-CoV-2 on the following day. Two weeks later, he presented to the emergency department complaining of …

The Impact Of Vitamin Supplementation (D, B12, B9) On Behaviors Associated With Autism Spectrum Disorder, Rohan Mehra

Rowan-Virtua Research Day

Background: One in 36 children in the United States are diagnosed with Autism Spectrum Disorder (ASD). Although heritability of the condition ranges from 40 to 80%, other factors such as vitamin levels, may have a significant impact on the risk of development. These vitamins include D, B12, and B9.

Purpose: To assess the impact vitamin supplementation has on behaviors associated with ASD, and to determine which specific aspects of ASD may be improved with vitamin supplementation.

Methods: A literature review was performed. The search was utilized PubMed, JSTOR and Web of Science. Keyword strings included: “Vitamin D B12 B9 folate …

Utilizing Microwave Ablation In Combination With Vertebroplasty Is An Effective Method In Reducing Cancer Related Back Pain, Disability, And Opioid Use: A Systematic Review And Meta-Analysis, Jonathan Elias, Lothar Vidal, Richard Jermyn

Rowan-Virtua Research Day

Background: It is estimated that metastases from primary malignant neoplasms affect the spine around 30%-70% of the time. Many times, these osteolytic tumors will cause the degradation of the vertebrae, leaving patients in a tremendous amount of pain, disability, and dependence on opioids as analgesics. Microwave ablation (MWA) followed by vertebroplasties (VP) has been a developing treatment for such a condition; however, there are no systematic reviews or meta-analyses examining the method’s effectiveness thus far.

Purpose: This systematic review and meta-analysis analyzes the 4-week and 12-week outcomes of patients with metastatic spinal cancer treated with the combinatorial treatment …

Analyzing The Effectiveness Of Transcutaneous Auricular Vagus Nerve Stimulation On Parkinson’S Disease Related Gait Function: A Systematic Review And Meta-Analysis, Sami Dakhel, Jonathan Elias, Alexander King

Rowan-Virtua Research Day

Background: Those suffering from Parkinson’s Disease often experience a shuffling gait, alongside many other symptoms, due to the degradation of dopaminergic neurons in the substantia nigra. Transcutaneous auricular vagus nerve stimulation (taVNS) operates by non-invasively applying an electrical current to the cutaneous receptive field formed by the auricular branch of the vagus nerve in the outer ear. We sought to determine if taVNS would serve as a non-invasive alternative to addressing Parkinson’s related gait dysfunction.

Purpose: This systematic review and meta-analysis analyzes the effectiveness of taVNS on the reduction of gait dysfunction caused by Parkinson’s Disease.

Methods: The systematic review …

Case Report: What’S That Smell? Olfactory Seizures, Devin Hoover, Neelesh Parikh, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 64-year-old male who presented with transient episodes of near syncope followed by a noxious odor and was diagnosed with olfactory seizures. The differential diagnosis for near syncope is broad. This case demonstrates that unusual olfactory symptoms can lead to a diagnosis of seizure disorder in the emergency department.

Spontaneous Intracranial Hemorrhage In A 29-Year-Old Male: A Case Report, Md Fateha, Caroline Nguyen, Michael A. Morris

Rowan-Virtua Research Day

Spontaneous intracranial hemorrhage is rare, especially in a young patient population. Signs and symptoms of intracranial hemorrhage include facial droop, vision loss, motor deficits with extraocular movements, deficits with tongue movement, weakness in the arms or legs, sensation loss, and mental status change. This is a case report of a 29-year-old male with no past medical history who presented for a spontaneous intracranial hemorrhage. This patient's only neurologic deficit was the loss of visual field on the left inferior quadrant of his field of vision. The patient obtained a CT head non-contrast which showed 21 mm acute right occipital hemorrhage …

Case Report: Varicella Zoster Virus Encephalitis Presenting With Monochorea, Chetna Thawani, Frank Wheeler

Rowan-Virtua Research Day

Meningoencephalitis is a broad range of symptoms as a sequela of inflammation of the CNS system. It is a diagnosis that is often missed, especially in atypical presentations. We describe a case of HSV encephalitis that presented to the ER afebrile with atypical arm movements, most similar to a monochorea, and discuss other cases in the literature of atypical presentations of this disease.

Examining The Differences In Functional Outcomes For Patients With Traumatic Brain Injury After Acute Rehabilitation And Subacute Rehabilitation: A Review Of The Literature, Michael Rangel, Ashley Kakkanatt

Rowan-Virtua Research Day

BACKGROUND/PURPOSE

Traumatic brain injury (TBI) is one of the major causes of morbidity in the US [1-4]. Studies suggest TBI patients’ enrollment in a rehabilitation program strongly predicts social reintegration. The structure and outcomes of inpatient rehabilitation programs, including acute and subacute rehabilitation, are not well-delineated [5-7].

DESIGN

A structured review of current literature was conducted. Articles were screened using the search string: (post-traumatic brain injury OR post-TBI OR traumatic brain injury OR TBI) AND (acute rehabilitation OR subacute rehabilitation) AND (outcomes OR functional outcomes) NOT (outpatient OR outpatient populations) NOT (pediatric OR pediatric populations). Articles were limited to 1990 …

Transcranial Electrical Stimulation As A Treatment For Aging-Related Cognitive Disorders: Review Of Published Evidence, Srujan Dadi, Kyle Jackson, Don Shamilov

Rowan-Virtua Research Day

Alzheimer's disease (AD) and MCI are a major concern in modern neuropsychiatric care, chiefly for their difficult management. This strategic literature review categorizes MCI via the Jak-Bondi criteria and relates it to tES treatment paradigms. Commonly used outcome measures and regional brain mapping data synergizes associations between MCI pathology and potential tES treatment targets. Effect sizes were calculated and attributed to outcome measures based on primary articles evaluating the efficacy of tES. These were then corresponded to a desired Jack-Bondi classification. A better understanding of the efficacy of tES on specific brain regions in synergy with diagnostic criteria will allow …

Blood Brain Barrier Disruption And Glutamatergic Excitotoxicity In Post-Acute Sequelae Of Sars Cov-2 Infection Cognitive Impairment: Potential Biomarkers And A Window Into Pathogenesis, Joga Chaganti, Govinda Poudel, Lucette Adeline Cysique, Gregory J Dore, Anthony Kelleher, Gael Matthews, David Darley, Anthony Byrne, David Jakabek, Xin Zhang, Marrissa Lewis, Nikhil Jha, Bruce James Brew

Department of Medicine Faculty Papers

Objective: To investigate the association between blood–brain barrier permeability, brain metabolites, microstructural integrity of the white matter, and cognitive impairment (CI) in post-acute sequelae of SARS-COV-2 infection (PASC).

Methods: In this multimodal longitudinal MRI study 14 PASC participants with CI and 10 healthy controls were enrolled. All completed investigations at 3 months following acute infection (3 months ± 2 weeks SD), and 10 PASC participants completed at 12 months ± 2.22 SD weeks. The assessments included a standard neurological assessment, a cognitive screen using the brief CogState battery and multi-modal MRI derived metrics from Dynamic contrast enhanced (DCE) perfusion Imaging, …

Systemic Symptoms In Huntington's Disease: A Comprehensive Review, Raja Mehanna, Joseph Jankovic

Faculty, Staff and Student Publications

Background: Although Huntington's disease (HD) is usually thought of as a triad of motor, cognitive, and psychiatric symptoms, there is growing appreciation of HD as a systemic illness affecting the entire body.

Objectives: This review aims to draw attention to these systemic non-motor symptoms in HD.

Methods: We identified relevant studies published in English by searching MEDLINE (from 1966 to September 2023), using the following subject headings: Huntington disease, autonomic, systemic, cardiovascular, respiratory, gastrointestinal, urinary, sexual and cutaneous, and additional specific symptoms.

Results: Data from 123 articles were critically reviewed with focus on systemic features associated with HD, such as …

Targeted Accurate Rna Consensus Sequencing (Tarc-Seq) Reveals Mechanisms Of Replication Error Affecting Sars-Cov-2 Divergence, Catherine C Bradley, Chen Wang, Alasdair J E Gordon, Alice X Wen, Pamela N Luna, Matthew B Cooke, Brendan F Kohrn, Scott R Kennedy, Vasanthi Avadhanula, Pedro A Piedra, Olivier Lichtarge, Chad A Shaw, Shannon E Ronca, Christophe Herman

Duncan NRI Faculty and Staff Publications

RNA viruses, like SARS-CoV-2, depend on their RNA-dependent RNA polymerases (RdRp) for replication, which is error-prone. Monitoring replication errors is crucial for understanding the virus’s evolution. Current methods lack the precision to detect rare de novo RNA mutations, particularly in low-input samples such as those from patients. Here, we introduce a new targeted Accurate RNA Consensus sequencing method (tARC-seq) to accurately determine the mutation frequency and types in SARS-CoV-2, both in cell culture and clinical samples. Our findings show an average of 2.68×10−5 new errors per cycle with a C>T bias that cannot be solely attributed to APOBEC …

A Comparison Of Spinal Reflex Function And Morphological Adaptations Of The Achilles Tendon Between Individuals Chronically Post-Stroke And Healthy Controls, Migi Contreras, Mira Seekins, Johanna Mendez, Trevor Diez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: The hallmark gait deviation in individuals with post-stroke hemiparesis is slow walking speed. Reduction in gait speed after stroke is influenced by decreased propulsive forces, which may likely be related to impaired spinal circuit function and spasticity of the paretic plantarflexors. Chronic muscle tone maladaptations in paretic ankle plantarflexors can result in altered Achilles tendon (AT) morphology, therefore leading to altered mechanical properties, force transmission capabilities and subsequent insufficient propulsive forces during walking. The purpose of this study is to characterize the chronic maladaptations in both the spinal Ia afferent loop excitability and AT morphology after stroke lesions in …

Cerebral Venous Sinus Thrombosis (Cvst): A Retrospective Study, Nia Acharya

Theses/Capstones/Creative Projects

This retrospective study investigates the long-term management of Cerebral Venous Sinus Thrombosis (CVST) in 51 patients over a 3-month follow-up. The analysis covers demographics, risk factors, CVST presentation, associated diseases, thrombophilia, laboratory results, and antithrombotic treatments. CVST, a rare thrombosis of dural/cerebral sinuses, poses life-threatening risks with an annual incidence aligning with literature, notably affecting young individuals. Underlying causes range from rare disorders to common triggers, complicating diagnosis, especially during pregnancy. Imaging techniques aid diagnosis, with systemic anticoagulation preferred despite bleeding risks. Noteworthy findings include a higher incidence in women, predominantly presenting with headaches. Two cases of vaccine-induced immune thrombotic …

Plant Model Of Α-Synucleinopathy: Expression Of Α-Synuclein A53t Variant In Hairy Root Cultures Leads To Proteostatic Stress And Dysregulation Of Iron Metabolism, Jasmina Kurepa, Kristen A. Bruce, Greg A. Gerhardt, Jan A. Smalle

Neurology Faculty Publications

Synucleinopathies, typified by Parkinson’s disease (PD), entail the accumulation of α- synuclein (αSyn) aggregates in nerve cells. Various αSyn mutants, including the αSyn A53T variant linked to early-onset PD, increase the propensity for αSyn aggregate formation. In addition to disrupting protein homeostasis and inducing proteostatic stress, the aggregation of αSyn in PD is associated with an imbalance in iron metabolism, which increases the generation of reactive oxygen species and causes oxidative stress. This study explored the impact of αSyn A53T expression in transgenic hairy roots of four medicinal plants (Lobelia cardinalis, Artemisia annua, Salvia miltiorrhiza, and Polygonum multiflorum). In all …

Abnormality Of Early White Matter Development In Tuberous Sclerosis Complex And Autism Spectrum Disorder: Longitudinal Analysis Of Diffusion Tensor Imaging Measures, Siddharth Srivastava, Fanghan Yang, Anna K Prohl, Peter E Davis, Jamie K Capal, Rajna Filip-Dhima, E Martina Bebin, Darcy A Krueger, Hope Northrup, Joyce Y Wu, Simon K Warfield, Mustafa Sahin, Bo Zhang, Tacern Study Group

Faculty, Staff and Student Publications

Background:

Abnormalities in white matter development may influence development of autism spectrum disorder in tuberous sclerosis complex (TSC). Our goals for this study were as follows: (1) use data from a longitudinal neuroimaging study of tuberous sclerosis complex (TACERN) to develop optimized linear mixed effects models for analyzing longitudinal, repeated diffusion tensor imaging metrics (fractional anisotropy, mean diffusivity) pertaining to select white matter tracts, in relation to positive Autism Diagnostic Observation Schedule–Second Edition classification at 36 months, and (2) perform an exploratory analysis using optimized models applied to all white matter tracts from these data.

Methods:

Eligible participants (3-12 months) …

Standing Posterior Trunk Rotation With Adaptive Proprioceptive Toss, Jennifer Elvir

Electronic Theses and Dissertations

Parkinson’s disease (PD) is a remarkably individualized disease. Nearly every person’s trajectory is unique. One person may experience tremor at an early stage of the disease, while another may experience tremor at a later stage or even not at all. For all PD patients, for certain can expect increasing difficulty as the disease progresses. Parkinson’s disease is responsible for the loss of dopamine which displays itself most notably through motor and cognitive symptom disruption. Although Parkinson’s is a chronic and progressive condition that is irremediable, significant strides have been facilitated to help control and manage the trajectory of the disease. …

Comparison Of Associated Autoimmune Disease Diagnoses In Myasthenia Gravis And Multiple Sclerosis Patients, Alecca Como, Jacob Keeley, Daniel Menkes

Posters

Autoimmune diseases often co-exist given the non-specific nature of the immune response. For example, myasthenia gravis [MG], a well-established autoimmune disease, has a 2.36-fold increased risk of developing thyroid diseases as compared to normal controls. 1,2 In contrast, multiple sclerosis [MS] is a disorder in which the immune system subserves an important pathogenic role, although there is insufficient evidence to definitively classify it as an autoimmune disease. 3,4 Since the etiology of MS has yet to be identified, and the specific autoimmune mechanism requires further elucidation, the comparison of its coassociated autoimmune diseases with that of a well-studied neuroautoimmune disease, …

Targeted-Sequencing Evaluation For Fzd4 Variants In Familial Exudative Vitreo-Retinopathy, Mary Drekh, Wendy Dailey, Vincent Le, Savyo Krikor, Kimberly A. Drenser, Kenneth P. Mitton

Posters

• The Familial hereditary vision loss disease may present with symptoms including retinal detachment, folding, neovascularization, or vitreous hemorrhage due to peripheral retina avascularity.
• The manifestation of FEVR genetically has been associated with a loss of function mutation of the Wnt/bcantenin-signaling pathway involving 7 genes (FZD4, NDP, CTNNB1, KIF11, LRP5, TSPAN12, and ZNF408). In our patient population of 72 individuals the distribution of FZD4 gene variants leading to FEVR has been recorded.
• The Frizzled4 gene (FZD4) codes for the G-coupled protein receptor and effects Wnt/b-cantenin-signaling pathway In endothelial cells.
• What frequency of FEVR from our patient pool will have FZD4 variants …