Neurology Commons^™

Hippocampal Volume And The Detection Of Mild Cognitive Impairment In An Older Adult Population: Assessing Performance On Cognitive Screeners Administered In-Person And Electronically, Kristen Fabrizi

Dissertations

The present study investigated how performance on in-person and electronic neuropsychological assessment measures predicted subcortical hippocampal volume and cognitive decline consistent with mild cognitive impairment. It was hypothesized that the Montreal Cognitive Assessment would display better predictive strength than the Cogstate Brief Battery when evaluating subcortical hippocampal volume measured via structural magnetic resonance imaging. It was further hypothesized that the Montreal Cognitive Assessment would be more sensitive to predicting group membership to the diagnostic classification of mild cognitive impairment compared to the Cogstate Brief Battery. The sample included 445 older adult participants selected from the Alzheimer’s Disease Neuroimaging Initiative 3. …

Treatment Of Cervical Dystonia With Botox (Onabotulinumtoxina): Development, Insights, And Impact, Joseph Jankovic, Joseph Tsui, Mitchell F Brin

Faculty, Staff and Students Publications

Cervical dystonia (CD), the most common focal dystonia encountered in neurologic practice, is a chronic disorder in which the muscles of the neck involuntarily contract and cause abnormal postures and movements of the head, neck, and shoulders. Treatment of CD prior to botulinum toxin was unsatisfactory, as existing therapies often did not improve symptoms. The use of botulinum toxin for CD grew out of its success in treating blepharospasm, another type of focal dystonia. On the basis of results from a double-blind, placebo-controlled trial, onabotulinumtoxinA was approved in 2000 in the US for the treatment of CD in adults in …

Epileptic Spasms In Cdkl5 Deficiency Disorder: Delayed Treatment And Poor Response To First-Line Therapies, Heather E Olson, Scott Demarest, Elia Pestana-Knight, Ahsan N Moosa, Xiaoming Zhang, José R Pérez-Pérez, Judy Weisenberg, Erin O'Connor Prange, Eric D Marsh, Rajsekar R Rajaraman, Bernhard Suter, Akshat Katyayan, Isabel Haviland, Carolyn Daniels, Bo Zhang, Caitlin Greene, Michelle Deleo, Lindsay Swanson, Jamie Love-Nichols, Timothy Benke, Chellamani Harini, Annapurna Poduri

Faculty, Staff and Students Publications

OBJECTIVE: We aimed to assess the treatment response of infantile-onset epileptic spasms (ES) in CDKL5 deficiency disorder (CDD) vs other etiologies.

METHODS: We evaluated patients with ES from the CDKL5 Centers of Excellence and the National Infantile Spasms Consortium (NISC), with onset from 2 months to 2 years, treated with adrenocorticotropic hormone (ACTH), oral corticosteroids, vigabatrin, and/or the ketogenic diet. We excluded children with tuberous sclerosis complex, trisomy 21, or unknown etiology with normal development because of known differential treatment responses. We compared the two cohorts for time to treatment and ES remission at 14 days and 3 months.

RESULTS: …

Arterial Spin Labeling Changes Parallel Asymmetric Perisylvian And Perirolandic Symptoms In 3 Pediatric Cases Of Anti-Nmdar Encephalitis, Alexander J Sandweiss, Varun Kannan, Nilesh K Desai, Stephen F Kralik, Eyal Muscal, Kristen S Fisher

Faculty, Staff and Students Publications

BACKGROUND AND OBJECTIVES: Anti-NMDA receptor autoimmune encephalitis (NMDAR AE) is an autoantibody-mediated disorder characterized by seizures, neuropsychiatric symptoms, movement disorder, and focal neurologic deficits. Conventionally defined broadly as an inflammatory brain disease, the heterotopic localization is rarely discussed in children. Imaging findings are often nonspecific, and there are no early biomarkers of disease other than the presence of anti-NMDAR antibodies.

METHODS: We conducted a retrospective analysis of our pediatric NMDAR AE cases (as determined by either positive serum or CSF antibodies or both) at Texas Children's Hospital between 2020-2021 and extracted medical record data of those patients who had arterial …

Telehealth For Assessing And Managing Tardive Dyskinesia: Expert Insights From A Cross-Disciplinary Virtual Treatment Panel, Rif S El-Mallakh, Amy Belnap, Sanjay Iyer, Jeremy Schreiber, Desiree Matthews, Linda Lefler, Daniel Dees, Allen Bott, Nora Vanegas-Arroyave, Adam Wolff, Ulises Pesce, Khody Farahmand, Chirag Shah, Leslie Lundt

Faculty, Staff and Students Publications

Introduction: Publications on the integration of telehealth in the care of patients with movement disorders are increasing, but little has been presented regarding its use in tardive dyskinesia (TD), a drug-induced movement disorder associated with prolonged exposure to dopamine receptor blocking agents. This study was conducted to address that knowledge gap, based on insights from a panel of TD experts.

Methods: In 2020, six neurologists, three psychiatrists, and three psychiatric nurse practitioners participated in individual semistructured interviews about in-person and virtual TD assessment and management in their practices. Two virtual roundtables were then conducted to consolidate findings from these interviews. …

Reprogramming Tumour-Associated Macrophages To Outcompete Cancer Cells, Xian Zhang, Shun Li, Isha Malik, Mytrang H Do, Liangliang Ji, Chun Chou, Wei Shi, Kristelle J Capistrano, Jing Zhang, Ting-Wei Hsu, Briana G Nixon, Ke Xu, Xinxin Wang, Andrea Ballabio, Laura S Schmidt, W Marston Linehan, Ming O Li

Duncan NRI Faculty and Staff Publications

In metazoan organisms, cell competition acts as a quality control mechanism to eliminate unfit cells in favour of their more robust neighbours1,2. This mechanism has the potential to be maladapted, promoting the selection of aggressive cancer cells3-6. Tumours are metabolically active and are populated by stroma cells7,8, but how environmental factors affect cancer cell competition remains largely unknown. Here we show that tumour-associated macrophages (TAMs) can be dietarily or genetically reprogrammed to outcompete MYC-overexpressing cancer cells. In a mouse model of breast cancer, MYC overexpression resulted in an mTORC1-dependent 'winner' cancer cell state. A low-protein diet inhibited mTORC1 signalling in …

Predictors And Temporal Trends Of Withdrawal Of Life-Sustaining Therapy After Acute Stroke In The Florida Stroke Registry, Ayham Alkhachroum, Lili Zhou, Negar Asdaghi, Hannah Gardener, Hao Ying, Carolina M Gutierrez, Brian M Manolovitz, Daniel Samano, Danielle Bass, Dianne Foster, Nicole B Sur, David Z Rose, Angus Jameson, Nina Massad, Mohan Kottapally, Amedeo Merenda, Robert M Starke, Kristine O'Phelan, Jose G Romano, Jan Claassen, Ralph L Sacco, Tatjana Rundek

Faculty, Staff and Student Publications

Temporal trends and factors associated with the withdrawal of life-sustaining therapy (WLST) after acute stroke are not well determined.

DESIGN: Observational study (2008-2021).

SETTING: Florida Stroke Registry (152 hospitals).

PATIENTS: Acute ischemic stroke (AIS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) patients.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: Importance plots were performed to generate the most predictive factors of WLST. Area under the curve (AUC) for the receiver operating curve were generated for the performance of logistic regression (LR) and random forest (RF) models. Regression analysis was applied to evaluate temporal trends. Among 309,393 AIS patients, 47,485 ICH patients, and …

Steroids For The Treatment Of Viral Encephalitis: A Systematic Literature Review And Meta-Analysis, Emira Hodzic, Rodrigo Hasbun, Alejandro Granillo, Anna R Tröscher, Helga Wagner, Tim J Von Oertzen, Judith N Wagner

Faculty, Staff and Student Publications

Background: Specific antiviral treatment is only available for a small subset of viral encephalitis (VE). Adjunctive steroids are used, but there is scant evidence evaluating its utility. We present a systematic review and meta-analysis on the outcome of steroid use in VE.

Methods: We conducted a systematic literature review and reported it according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Two observational studies from unpublished or partially published data were added. For the meta-analysis, we employed the metaphor package of the statistical software R-4.3.1.

Results: We screened 378 studies and included 50. 155 patients were …

Bystanders Or Not? Microglia And Lymphocytes In Aging And Stroke, Justin N Nguyen, Anjali Chauhan

Faculty, Staff and Student Publications

As the average age of the world population increases, more people will face debilitating aging-associated conditions, including dementia and stroke. Not only does the incidence of these conditions increase with age, but the recovery afterward is often worse in older patients. Researchers and health professionals must unveil and understand the factors behind age-associated diseases to develop a therapy for older patients. Aging causes profound changes in the immune system including the activation of microglia in the brain. Activated microglia promote T lymphocyte transmigration leading to an increase in neuroinflammation, white matter damage, and cognitive impairment in both older humans and …

Contrasting Features Between Tourette Syndrome And Secondary Tic Disorders, José Fidel Baizabal-Carvallo, Marlene Alonso-Juarez, Joseph Jankovic

Faculty, Staff and Students Publications

Tics are rapid, recurrent, non-rhythmic movements or emitted sounds. Tics are the hallmark of Tourette syndrome (TS); however, a number of other disorders may be associated with tics, so-called secondary tic disorders (STD). We assessed clinical history and performed blinded evaluations of video-recordings from patients with TS and STD in order to identify features that may differentiate tics associated with TS vs STD. There were 156 patients with TS and 38 with STD, 21 of whom had functional (psychogenic) tics. Patients with TS were more frequently male and had a younger age at onset. Tics in TS tend to involve …

Inhibition Of Autophagy In Microglia And Macrophages Exacerbates Innate Immune Responses And Worsens Brain Injury Outcomes, Nivedita Hegdekar, Chinmoy Sarkar, Sabrina Bustos, Rodney M Ritzel, Marie Hanscom, Prarthana Ravishankar, Deepika Philkana, Junfang Wu, David J Loane, Marta M Lipinski

Faculty, Staff and Student Publications

Excessive and prolonged neuroinflammation following traumatic brain injury (TBI) contributes to long-term tissue damage and poor functional outcomes. However, the mechanisms contributing to exacerbated inflammatory responses after brain injury remain poorly understood. Our previous work showed that macroautophagy/autophagy flux is inhibited in neurons following TBI in mice and contributes to neuronal cell death. In the present study, we demonstrate that autophagy is also inhibited in activated microglia and infiltrating macrophages, and that this potentiates injury-induced neuroinflammatory responses. Macrophage/microglia-specific knockout of the essential autophagy gene Becn1 led to overall increase in neuroinflammation after TBI. In particular, we observed excessive activation of …

Functional Assessment Of The Dural Lymphatic Vessels Using Dynamic Contrast Mri In Multiple Sclerosis, Refaat E Gabr, John A Lincoln, Khader M Hasan, Larry A Kramer

Faculty, Staff and Student Publications

BACKGROUND AND PURPOSE: The discovery of glymphatic function in the human brain has generated interest in waste clearance mechanisms in neurological disorders such as multiple sclerosis (MS). However, noninvasive in vivo functional assessment is currently lacking. This work studies the feasibility of a novel intravenous dynamic contrast MRI method to assess the dural lymphatics, a purported pathway contributing to glymphatic clearance.

METHODS: This prospective study included 20 patients with MS (17 women; age = 46.4 [27, 65] years; disease duration = 13.6 [2.1, 38.0] years, expanded disability status score (EDSS) = 2.0 [0, 6.5]). Patients were scanned on a 3.0T …

Pulvinar Neuromodulation For Seizure Monitoring And Network Modulation In Temporal Plus Epilepsy, Yash Shashank Vakilna, Ganne Chaitanya, Muhammad Ubaid Hafeez, Adeel Ilyas, Manojkumar Saranathan, Jay Gavvala, Nitin Tandon, Sandipan Pati

Faculty, Staff and Student Publications

Deep brain stimulation (DBS) is a promising treatment for drug-refractory epilepsies (DRE) when targeting the anterior nuclei of thalamus (ANT). However, targeting other thalamic nuclei, such as the pulvinar, shows therapeutic promise. Our pioneering case study presents the application of ambulatory seizure monitoring using spectral fingerprinting (12.15-17.15 Hz) recorded through Medtronic Percept DBS implanted bilaterally in the medial pulvinar thalami. This technology offers unprecedented opportunities for real-time monitoring of seizure burden and thalamocortical network modulation for effective seizure reduction in patients with bilateral mesial temporal and temporal plus epilepsies that are not suitable for resection.

A Retrospective Study Of Cerebrolysin In Patients With Moderate To Severe Traumatic Brain Injury: Cognitive And Functional Outcomes, Claudio Soto, Pablo Salinas, Daniel Muñoz, Sandra Olivares, Javiera González, Virginia Sáez, Violeta Romero

Faculty, Staff and Student Publications

In this retrospective study, we aimed to evaluate the effects of the neurotrophic compound Cerebrolysin on executive, cognitive, and functional performance in patients with traumatic brain injury (TBI) with a highly severe disability level. A total of 44 patients were included in the study, with 33 patients in the control group and 11 patients in the interventional group who received intravenous infusions of 30 mL Cerebrolysin. Both groups received standard rehabilitation therapy following the rehabilitation protocol for patients with TBI at Hospital Clínico Mutual de Seguridad. Functional and cognitive scales were evaluated at baseline, at four months, and at the …

Discriminating Mild Traumatic Brain Injury And Posttraumatic Stress Disorder Using Latent Neuroimaging And Neuropsychological Profiles In Active-Duty Military Service Members, Nicola L De Souza, Carrie Esopenko, Yuane Jia, J Scott Parrott, Tricia L Merkley, Emily L Dennis, Frank G Hillary, Carmen Velez, Douglas B Cooper, Jan E Kennedy, Jeffrey D Lewis, Gerald E York, Deleene S Menefee, Stephen R Mccauley, Amy O Bowles, Elisabeth A Wilde, David F Tate

Faculty, Staff and Students Publications

OBJECTIVE: Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) commonly occur among military Service Members and Veterans and have heterogenous, but also overlapping symptom presentations, which often complicate the diagnoses of underlying impairments and development of effective treatment plans. Thus, we sought to examine whether the combination of whole brain gray matter (GM) and white matter (WM) structural measures with neuropsychological performance can aid in the classification of military personnel with mTBI and PTSD.

METHODS: Active-Duty US Service Members ( n = 156; 87.8% male) with a history of mTBI, PTSD, combined mTBI+PTSD, or orthopedic injury completed a …

Targeting Aav Vectors To The Central Nervous System By Engineering Capsid-Receptor Interactions That Enable Crossing Of The Blood-Brain Barrier, Qin Huang, Albert T Chen, Ken Y Chan, Hikari Sorensen, Andrew J Barry, Bahar Azari, Qingxia Zheng, Thomas Beddow, Binhui Zhao, Isabelle G Tobey, Cynthia Moncada-Reid, Fatma-Elzahraa Eid, Christopher J Walkey, M Cecilia Ljungberg, William R Lagor, Jason D Heaney, Yujia A Chan, Benjamin E Deverman

Faculty, Staff and Students Publications

Viruses have evolved the ability to bind and enter cells through interactions with a wide variety of cell macromolecules. We engineered peptide-modified adeno-associated virus (AAV) capsids that transduce the brain through the introduction of de novo interactions with 2 proteins expressed on the mouse blood-brain barrier (BBB), LY6A or LY6C1. The in vivo tropisms of these capsids are predictable as they are dependent on the cell- and strain-specific expression of their target protein. This approach generated hundreds of capsids with dramatically enhanced central nervous system (CNS) tropisms within a single round of screening in vitro and secondary validation in vivo …

Efektivitas Manual Therapy Dan Ultrasound Terhadap Peningkatan Fungsi Gerak Bahu Pada Kasus Nyeri Bahu Et Causa Bursitis Subacromialis Dengan Parameter Spadi Di Rsud Muhammad Natsir, Fadhilah Az-Zahra, Ronal Lufitos, Faizah Abdullah Djawas

Jurnal Fisioterapi Terapan Indonesia

ABSTRACT: Adhesive Capsulitis is a disorder that occurs in the shoulder area in the form of inflammation of the joint capsule which causes a feeling of stiffness and pain. Glenohumeral joint mobilization with the Maitland mobilization technique is using passive mobilization with physiological oscillatory movements which can produce a stretching effect and release of adhesive on the ligament capsule in the shoulder so that the range of motion of the shoulder joint can be increased. Hold relax is an exercise therapy with the principle of reciprocal inhibition which aims to improve antagonistic pattern relaxation, and mobilization, and to reduce pain. …

Neurodynamic Technique Terhadap Penurunan Nyeri, Peningkatan Grip Strength, Dan Peningkatan Kemampuan Fungsional Pada Carpal Tunnel Syndrome, Safrin Arifin, Fathia Dheanisa

Jurnal Fisioterapi Terapan Indonesia

Carpal tunnel syndrome is a syndrome that occurs in 1-4% of the total population worldwide. This condition causes disruption of function and motion in the wrist that spreads to the fingers. Physiotherapy intervention is necessary to reduce the severity of symptoms in patients with CTS. Neurodynamic Techniques are nerve mobilization techniques that aim to restore homeostasis in the nerves so as to reduce pain and improve functional ability. Materials and methods. This research was conducted through searching several databases, found 31 articles which were then filtered and selected as many as 10 articles. However, of the 11 articles, further screening …

Aerobic Exercise Terhadap Peningkatan Endurance Pada Pasien Penyakit Jantung Koroner Dengan Pemeriksaan 6mwt : Studi Kasus, Dela Fariha Fuadi, Andrew Wijaya Saputra, Nabilla Nur Awaliah Dzatikhulwani

Jurnal Fisioterapi Terapan Indonesia

Background: Coronary heart disease (CHD) is a condition in which the heart's blood vessels (coronary arteries) are blocked by fat deposits. Based on data from Riskesdas (2018) it is revealed that cases of heart and blood vessel disease in Indonesia are increasing every year, increasing the mortality rate. This is due to the presence of risk factors that support the emergence of coronary heart disease. Objective: The aim of this paper is to evaluate the evaluation of aerobic exercise to increase endurance in patients with coronary heart disease by examining 6MWT. Method: This research is in the form of a …

Pengaruh Durasi Penggunaan Smartphone Di Kalangan Pelajar Terhadap Frekuensi Nyeri Leher, Irawan Wibisono, Didik Purnomo, Suci Amanati

Jurnal Fisioterapi Terapan Indonesia

Neck pain is a musculoskeletal problem that is often encountered in productive age, one of the triggers for neck pain is an unergonomic position for a long time. For example when using a smartphone, the position of the neck will tend towards the front. The use of smartphones in this technological era takes a long time. This is because smartphones have become part of student life. This study aims to determine the effect of the duration of smartphone use on the frequency of neck pain. This research method uses descriptive cross sectional with a total sample of 68 people, while …