Neurology Commons^™

Work Difficulties, Work Restrictions, And Disability Benefits In People With Functional Seizures: A Survey Study, Jared Woodward, A A Asadi-Pooya, Bridget Mildon, Benjamin Tolchin

Department of Neurology Faculty Papers

Purpose: Functional seizures (FS) cause significant long-term disability and clinicians offer differing views on proper work restrictions and qualifications for disability benefits in this population. We assess the views and perspectives of experienced disability and work limitations in people living with functional seizures. Methods: Between (4/29/2020–1/13/2021) an open-access 21-item internet survey was conducted via FNDHope.org; allowing for people living with self-reported functional seizures to remark on topics of work difficulties, work restrictions, qualifications for disability benefits, and driving. Demographic information was collected, and univariate and multivariate logistic regressions were used to evaluate potential predictors of current employment status. Results: One …

Associations Of Snfl With Clinico-Radiological Measures In A Large Ms Population., Elias S Sotirchos, Kathryn C Fitzgerald, Carol M Singh, Matthew D Smith, Maria Reyes-Mantilla, Carrie M Hersh, Megan H Hyland, Ryan Canissario, Sarah B Simmons, Georgina Arrambide, Xavier Montalban, Manuel Comabella, Robert T Naismith, Min Qiao, Lauren B Krupp, Jacqueline A Nicholas, Katja Akgün, Tjalf Ziemssen, Richard Rudick, Elizabeth Fisher, Robert A Bermel, Ellen M Mowry, Peter A Calabresi

Neuroscience Articles

OBJECTIVE: Evaluation of serum neurofilament light chain (sNfL), measured using high-throughput assays on widely accessible platforms in large, real-world MS populations, is a critical step for sNfL to be utilized in clinical practice.

METHODS: Multiple Sclerosis Partners Advancing Technology and Health Solutions (MS PATHS) is a network of healthcare institutions in the United States and Europe collecting standardized clinical/imaging data and biospecimens during routine clinic visits. sNfL was measured in 6974 MS and 201 healthy control (HC) participants, using a high-throughput, scalable immunoassay.

RESULTS: Elevated sNfL levels for age (sNfL-E) were found in 1238 MS participants (17.8%). Factors associated with …

Organization Of Sensorimotor Activity In Anterior Cruciate Ligament Reconstructed Individuals: An Fmri Conjunction Analysis., Amber J Schnittjer, Howon Kim, Adam S Lepley, James A Onate, Cody R Criss, Janet E Simon, Dustin R Grooms

Neuroscience Articles

INTRODUCTION: Anterior cruciate ligament reconstruction (ACLR) is characterized by persistent involved limb functional deficits that persist for years despite rehabilitation. Previous research provides evidence of both peripheral and central nervous system adaptations following ACLR. However, no study has compared functional organization of the brain for involved limb motor control relative to the uninvolved limb and healthy controls. The purpose of this study was to examine sensorimotor cortex and cerebellar functional activity overlap and non-overlap during a knee motor control task between groups (ACLR and control), and to determine cortical organization of involved and uninvolved limb movement between groups.

METHODS: Eighteen …

A Novel Pulsed Stimulation Pattern In Spinal Cord Stimulation: Clinical Results And Postulated Mechanisms Of Action In The Treatment Of Chronic Low Back And Leg Pain., Mehul J Desai, John Salmon, Paul Verrills, Bruce Mitchell, Neels Du Toit, Dan Bates, Girish Vajramani, Adam Williams, Sarah Love-Jones, Nikunj Patel, Serge Nikolic, Vivek Mehta, Alia Ahmad, James Yu, Nick Christellis, Sam Harkin, Ganesan Baranidharan, Robert Levy, Peter Staats, Mark N Malinowski, James Makous, Nicholas Sullivan, Shilpa Kottalgi, Melissa Hartley, Lakshmi Narayan Mishra

Neuroscience Articles

OBJECTIVES: The aim of this article is to discuss the possible mechanisms of action (MOAs) and results of a pilot study of a novel, anatomically placed, and paresthesia-independent, neurostimulation waveform for the management of chronic intractable pain.

MATERIALS AND METHODS: A novel, multilayered pulsed stimulation pattern (PSP) that comprises three temporal layers, a Pulse Pattern layer, Train layer, and Dosage layer, was developed for the treatment of chronic intractable pain. During preliminary development, the utility was evaluated of anatomical PSP (aPSP) in human subjects with chronic intractable pain of the leg(s) and/or low back, compared with that of traditional spinal …

Updated Parkinson’S Disease Motor Subtypes Classification And Correlation To Cerebrospinal Homovanillic Acid And 5-Hydroxyindoleacetic Acid Levels, Christopher Adams, Jessika Suescun, Anam Haque, Kelly Block, Shivika Chandra, Timothy M Ellmore, Mya C Schiess

Faculty, Staff and Student Publications

INTRODUCTION: Motor classifications of Parkinson's Disease (PD) have been widely used. This paper aims to update a subtype classification using the MDS-UPDRS-III and determine if cerebrospinal neurotransmitter profiles (HVA and 5-HIAA) differ between these subtypes in a cohort from the Parkinson's Progression Marker Initiative (PPMI).

METHODS: UPDRS and MDS-UPDRS scores were collected for 20 PD patients. Akinetic-rigid (AR), Tremor-dominant (TD), and Mixed (MX) subtypes were calculated using a formula derived from UPDRS, and a new ratio was developed for subtyping patients with the MDS-UPDRS. This new formula was subsequently applied to 95 PD patients from the PPMI dataset, and subtyping …

Clinical Manifestations And Outcome Of Patients With Primary Amoebic Meningoencephalitis In Pakistan A Single-Center Experience, Shakeel Ur Rehman, Salman Farooq, Muhammad Bilal Tariq, Nosheen Nasir, Mohammad Wasay, Sobia Masood, Musa Karim

Faculty, Staff and Student Publications

Primary amoebic meningoencephalitis (PAM) is a rapidly progressing central nervous system (CNS) infection caused by Naegleria fowleri, a free-living amoeba found in warm freshwater. The disease progression is very rapid, and the outcome is nearly always fatal. We aim to describe the disease course in patients admitted with PAM in a tertiary care center in Karachi, Pakistan between the periods of 2010 to 2021. A total of 39 patients were included in the study, 33 males (84.6%). The median age of the patients was 34 years. The most frequent presenting complaint was fever, which was found in 37 patients (94.9%) …

Case Report: Navigating The Challenges: Successful Mechanical Thrombectomy In A Case Of Persistent Primitive Hypoglossal Artery, Kamran Ahmed Khan, Irfan Amjad Lutfi, Jehangir Ali Shah, Salman Farooq, Shahnoor Ahmed, Bashir Ahmed Solangi, Ayan Ahmed Khan, Fazal Zaidi, Ali Ammar, Nadeem Qamar

Faculty, Staff and Student Publications

Persistent primitive hypoglossal artery (PPHA) is a highly uncommon abnormal connection between the internal carotid artery (ICA) and vertebral artery (VA), with reported incidences ranging from 0.027 to 0.26%. Attempting endovascular intervention in such cases presents a considerable challenge as it carries a higher risk of embolization and other procedure-related complications that may affect a wide area of the brain. We present a case study involving the utilization of mechanical thrombectomy (MT) to treat an ischemic stroke in the M1 segment of the middle cerebral artery (MCA) despite the presence of PPHA. Performing mechanical thrombectomy in an anomalous vascular connection …

Epilepsy Center Characteristics And Geographic Region Influence Presurgical Testing In The United States, Stephanie M Ahrens, Kristen H Arredondo, Anto I Bagić, Shasha Bai, Kevin E Chapman, Michael A Ciliberto, Dave F Clarke, Mariah Eisner, Nathan B Fountain, Jay R Gavvala, M Scott Perry, Kyle C Rossi, Lily C Wong-Kisiel, Susan T Herman, Adam P Ostendorf, Naec Center Director Study Group

Faculty, Staff and Student Publications

bjective

Persons with drug‐resistant epilepsy may benefit from epilepsy surgery and should undergo presurgical testing to determine potential candidacy and appropriate intervention. Institutional expertise can influence use and availability of evaluations and epilepsy surgery candidacy. This census survey study aims to examine the influence of geographic region and other center characteristics on presurgical testing for medically intractable epilepsy.

Methods

We analyzed annual report and supplemental survey data reported in 2020 from 206 adult epilepsy center directors and 136 pediatric epilepsy center directors in the United States. Test utilization data were compiled with annual center volumes, available resources, and US Census …

Attitudes, Perceptions, And Preferences Towards Sars Cov-2 Testing And Vaccination Among African American And Hispanic Public Housing Residents, New York City: 2020-2021, Chigozirim Izeogu, Emily Gill, Kaitlyn Van Allen, Natasha Williams, Lorna E Thorpe, Donna Shelley

Faculty, Staff and Student Publications

Background

African American and Hispanic populations have been affected disproportionately by COVID-19. Reasons are multifactorial and include social and structural determinants of health. During the onset and height of the pandemic, evidence suggested decreased access to SARS CoV-2 testing. In 2020, the National Institutes of Health launched the Rapid Acceleration of Diagnostics (RADx)- Underserved Populations initiative to improve SARS CoV-2 testing in underserved communities. In this study, we explored attitudes, experiences, and barriers to SARS CoV-2 testing and vaccination among New York City public housing residents.

Methods

Between December 2020 and March 2021, we conducted 9 virtual focus groups among …

Population-Based Mini-Mental State Examination Norms In Adults Of Mexican Heritage In The Cameron County Hispanic Cohort, Avram S Bukhbinder, Miriam Hinojosa, Kristofer Harris, Xiaojin Li, Christine M Farrell, Madison Shyer, Nathan Goodwin, Sahar Anjum, Omar Hasan, Susan Cooper, Lois Sciba, Amanda Falk Vargas, David H Hunter, Guadalupe J Ortiz, Karen Chung, Licong Cui, Guo-Qiang Zhang, Susan P Fisher-Hoch, Joseph B Mccormick, Paul E Schulz

Faculty, Staff and Student Publications

Background:

Accurately identifying cognitive changes in Mexican American (MA) adults using the Mini-Mental State Examination (MMSE) requires knowledge of population-based norms for the MMSE, a scale which has widespread use in research settings.

Objective:

To describe the distribution of MMSE scores in a large cohort of MA adults, assess the impact of MMSE requirements on their clinical trial eligibility, and explore which factors are most strongly associated with their MMSE scores.

Methods:

Visits between 2004–2021 in the Cameron County Hispanic Cohort were analyzed. Eligible participants were ≥18 years old and of Mexican descent. MMSE distributions before and after stratification by …

Hermann ("Hugh") Blaschko (1900-1993): Father Of Catecholamine Metabolism, Heinrich Taegtmeyer, Jiries Ganim, Anne B Leuppi-Taegtmeyer

Faculty, Staff and Student Publications

No abstract provided.

Artificial Intelligence-Driven Meta-Analysis Of Brain Gene Expression Identifies Novel Gene Candidates And A Role For Mitochondria In Alzheimer’S Disease, Caitlin A Finney, Fabien Delerue, Wendy A Gold, David A Brown, Artur Shvetcov

Faculty, Staff and Student Publications

Alzheimer's disease (AD) is the most common form of dementia. There is no treatment and AD models have focused on a small subset of genes identified in familial AD. Microarray studies have identified thousands of dysregulated genes in the brains of patients with AD yet identifying the best gene candidates to both model and treat AD remains a challenge. We performed a meta-analysis of microarray data from the frontal cortex (n = 697) and cerebellum (n = 230) of AD patients and healthy controls. A two-stage artificial intelligence approach, with both unsupervised and supervised machine learning, combined with a functional …

Editorial: Big Data Analytics To Advance Stroke And Cerebrovascular Disease: A Tool To Bridge Translational And Clinical Research, Alexis Nétis Simpkins, Hari Kishan Reddy Indupuru, Sean Isaac Savitz

Faculty, Staff and Student Publications

No abstract provided.

Precision Medicine Approach To Alzheimer’S Disease: Rationale And Implications, Dale E. Bredesen, Kat Toups, Ann Hathaway, Deborha Gordon, Henrianna Chung, Cyrus Raji, Alan Boyd, Benjamin D. Hill, Sharon Hausman-Cohen, Mouna Attarha, Won Jong Chwa, Alexei Kurakin, Michael Jarrett

University Faculty and Staff Publications

The neurodegenerative disease field has enjoyed extremely limited success in the development of effective therapeutics. One potential reason is the lack of disease models that yield accurate predictions and optimal therapeutic targets. Standard clinical trials have pre-determined a single treatment modality, which may be unrelated to the primary drivers of neurodegeneration. Recent proof-of-concept clinical trials using a precision medicine approach suggest a new model of Alzheimer’s disease (AD) as a chronic innate encephalitis that creates a network insufficiency. Identifying and addressing the multiple potential contributors to cognitive decline for each patient may represent a more effective strategy. Here we review …

Interactive Association Of Posttraumatic Stress Disorder, Apolipoprotein Ε4 Genotype, And Age On Cognitive Functioning, Karen A. Lawrence, Colton Rippey, Bianca Welikson, Robert H. Pietrzak, Thomas G. Adams Jr.

Psychology Faculty Publications

Background: The ε4 allele of the apolipoprotein (APOE) gene and posttraumatic stress disorder (PTSD) are associated with cognitive deficits. Both associations may vary depending on age. No previous study has examined a possible three‐way interaction between APOE ε4, PTSD, and age on cognitive functioning.

Methods: Data were analyzed from 1244 European‐American U.S. military veterans who participated in the 2011 National Health and Resilience in Veterans Study (NHRVS). Analyses of covariance were used to examine the main effects and in- teractions of APOE ε4, PTSD, and age on learning/working memory (LWM) and attention/psychomotor (APM) performance.

Results: A significant three‐way interaction between …

Atlas-Based Shared-Boundary Deformable Multi-Surface Models Through Multi-Material And Two-Manifold Dual Contouring, Tanweer Rashid, Sharmin Sultana, Mallar Chakravarty, Michel Albert Audette

Electrical & Computer Engineering Faculty Publications

This paper presents a multi-material dual “contouring” method used to convert a digital 3D voxel-based atlas of basal ganglia to a deformable discrete multi-surface model that supports surgical navigation for an intraoperative MRI-compatible surgical robot, featuring fast intraoperative deformation computation. It is vital that the final surface model maintain shared boundaries where appropriate so that even as the deep-brain model deforms to reflect intraoperative changes encoded in ioMRI, the subthalamic nucleus stays in contact with the substantia nigra, for example, while still providing a significantly sparser representation than the original volumetric atlas consisting of hundreds of millions of voxels. The …

Prediction Of Rapid Early Progression And Survival Risk With Pre-Radiation Mri In Who Grade 4 Glioma Patients, Walia Farzana, Mustafa M. Basree, Norou Diawara, Zeina Shboul, Sagel Dubey, Marie M. Lockheart, Mohamed Hamza, Joshua D. Palmer, Khan Iftekharuddin

Electrical & Computer Engineering Faculty Publications

Rapid early progression (REP) has been defined as increased nodular enhancement at the border of the resection cavity, the appearance of new lesions outside the resection cavity, or increased enhancement of the residual disease after surgery and before radiation. Patients with REP have worse survival compared to patients without REP (non-REP). Therefore, a reliable method for differentiating REP from non-REP is hypothesized to assist in personlized treatment planning. A potential approach is to use the radiomics and fractal texture features extracted from brain tumors to characterize morphological and physiological properties. We propose a random sampling-based ensemble classification model. The proposed …

Comparison Of Machine Learning Methods For Classification Of Alexithymia In Individuals With And Without Autism From Eye-Tracking Data, Furkan Iigin, Megan A. Witherow, Khan M. Iftekharuddin

Electrical & Computer Engineering Faculty Publications

Alexithymia describes a psychological state where individuals struggle with feeling and expressing their emotions. Individuals with alexithymia may also have a more difficult time understanding the emotions of others and may express atypical attention to the eyes when recognizing emotions. This is known to affect individuals with Autism Spectrum Disorder (ASD) differently than neurotypical (NT) individuals. Using a public data set of eye-tracking data from seventy individuals with and without autism who have been assessed for alexithymia, we train multiple traditional machine learning models for alexithymia classification including support vector machines, logistic regression, decision trees, random forest, and multilayer perceptron. …

Safety And Tolerability Results Of Atogepant For The Preventive Treatment Of Episodic Migraine From A 40-Week, Open-Label Multicenter Extension Of The Phase 3 Advance Trial, Brad C Klein, Rosa Miceli, Lawrence Severt, Peter Mcallister, Laszlo Mechtler, Jennifer Mcvige, Merle Diamond, Michael J. Marmura, Hua Guo, Michelle Finnegan, Joel M Trugman

Department of Neurology Faculty Papers

Background: Atogepant is a United States Food and Drug Administration-approved oral calcitonin gene-related peptide receptor antagonist for the preventive treatment of episodic migraine. The study objective was to evaluate the long-term safety and tolerability of atogepant in participants who completed the phase 3 ADVANCE trial (NCT03777059).

Methods: This 40-week, open-label extension trial (NCT03939312) monitored safety in participants receiving oral atogepant 60 mg once daily, followed by a four-week safety follow-up period.

Results: Of the 685 participants taking at least one dose of atogepant, the treatment period was completed by 74.6% of participants with a mean (standard …

Segmentation Of Acute Stroke Infarct Core Using Image-Level Labels On Ct-Angiography, Luca Giancardo, Arash Niktabe, Laura Ocasio, Rania Abdelkhaleq, Sergio Salazar-Marioni, Sunil A Sheth

Faculty, Staff and Student Publications

Acute ischemic stroke is a leading cause of death and disability in the world. Treatment decisions, especially around emergent revascularization procedures, rely heavily on size and location of the infarct core. Currently, accurate assessment of this measure is challenging. While MRI-DWI is considered the gold standard, its availability is limited for most patients suffering from stroke. Another well-studied imaging modality is CT-Perfusion (CTP) which is much more common than MRI-DWI in acute stroke care, but not as precise as MRI-DWI, and it is still unavailable in many stroke hospitals. A method to determine infarct core using CT-Angiography (CTA), a much …