Neurology Commons^™

Pocketnet: A Smaller Neural Network For Medical Image Analysis, Adrian Celaya, Jonas A Actor, Rajarajesawari Muthusivarajan, Evan Gates, Caroline Chung, Dawid Schellingerhout, Beatrice Riviere, David Fuentes

Faculty, Staff and Student Publications

Medical imaging deep learning models are often large and complex, requiring specialized hardware to train and evaluate these models. To address such issues, we propose the PocketNet paradigm to reduce the size of deep learning models by throttling the growth of the number of channels in convolutional neural networks. We demonstrate that, for a range of segmentation and classification tasks, PocketNet architectures produce results comparable to that of conventional neural networks while reducing the number of parameters by multiple orders of magnitude, using up to 90% less GPU memory, and speeding up training times by up to 40%, thereby allowing …

Drivers Of Cost In Primary Single-Level Lumbar Fusion Surgery, Raymond W Hwang, Samuel W Golenbock, David H Kim

Faculty, Staff and Student Publications

STUDY DESIGN: Retrospective cohort.

OBJECTIVES: Allocating cost is challenging with traditional hospital accounting. Time-driven activity-based costing (TDABC) is an efficient method to accurately assign cost. We sought to characterize the variation in direct total hospital cost (THC) among both lumbar fusion approaches and surgeons.

METHODS: Patients were treated with single-level anterior interbody (ALIF), lateral interbody (LLIF), transforaminal interbody (TLIF), instrumented posterolateral (PLF) or in-situ fusion (ISF) for degenerative disease. Process maps were developed for preoperative, intraoperative and postoperative care. THC was composed of implant, medication, other supply, and personnel costs. Linear regression and descriptive statistics were used to analyze THC …

Seed Amplification Assay For The Detection Of Pathologic Alpha-Synuclein Aggregates In Cerebrospinal Fluid, Luis Concha-Marambio, Sandra Pritzkow, Mohammad Shahnawaz, Carly M Farris, Claudio Soto

Faculty, Staff and Student Publications

Misfolded alpha-synuclein (αSyn) aggregates are a hallmark event in Parkinson’s disease (PD) and other synucleinopathies. Recently, αSyn seed amplification assays (αSyn-SAAs) have shown promise as a test for biochemical diagnosis of synucleinopathies. αSyn-SAAs use the intrinsic self-replicative nature of misfolded αSyn aggregates (seeds) to multiply them in vitro. In these assays, αSyn seeds circulating in biological fluids are amplified by a cyclical process that includes aggregate fragmentation into smaller self-propagating seeds, followed by elongation at the expense of recombinant αSyn (rec-αSyn). Amplification of the seeds allows detection by fluorescent dyes specific for amyloids, such as thioflavin T. Several αSyn-SAA reports …

Pmca For Ultrasensitive Detection Of Prions And To Study Disease Biology, Fei Wang, Sandra Pritzkow, Claudio Soto

Faculty, Staff and Student Publications

The emergence of a novel class of infectious agent composed exclusively of a misfolded protein (termed prions) has been a challenge in modern biomedicine. Despite similarities on the behavior of prions with respect to conventional pathogens, the many uncertainties regarding the biology and virulence of prions make them a worrisome paradigm. Since prions do not contain nucleic acids and rely on a very different way of replication and spreading, it was necessary to invent a novel technology to study them. In this article, we provide an overview of such a technology, termed protein misfolding cyclic amplification (PMCA), and summarize its …

Functional Phenotyping Of Microglia Highlights The Dark Relationship Between Chronic Traumatic Brain Injury And Normal Age-Related Pathology, Rodney M Ritzel, Junfang Wu

Faculty, Staff and Student Publications

No abstract provided.

Association Of Clinical Outcomes And Connectivity In Awake Versus Asleep Deep Brain Stimulation For Parkinson Disease, Ron Gadot, Nora Vanegas Arroyave, Huy Dang, Adrish Anand, Ricardo A Najera, Lisa Yutong Taneff, Steven Bellows, Arjun Tarakad, Joseph Jankovic, Andreas Horn, Ben Shofty, Ashwin Viswanathan, Sameer A Sheth

Faculty, Staff and Students Publications

OBJECTIVE: Deep brain stimulation (DBS) for Parkinson disease (PD) is traditionally performed with awake intraoperative testing and/or microelectrode recording. Recently, however, the procedure has been increasingly performed under general anesthesia with image-based verification. The authors sought to compare structural and functional networks engaged by awake and asleep PD-DBS of the subthalamic nucleus (STN) and correlate them with clinical outcomes.

METHODS: Levodopa equivalent daily dose (LEDD), pre- and postoperative motor scores on the Movement Disorders Society-Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS III), and total electrical energy delivered (TEED) at 6 months were retroactively assessed in patients with PD who …

European Society Of Paediatric Radiology Artificial Intelligence Taskforce: A New Taskforce For The Digital Age, Lene Bjerke Laborie, Jaishree Naidoo, Erika Pace, Pierluigi Ciet, Christine Eade, Matthias W Wagner, Thierry A G M Huisman, Susan C Shelmerdine

Faculty, Staff and Students Publications

A new task force dedicated to artificial intelligence (AI) with respect to paediatric radiology was created in 2021 at the International Paediatric Radiology (IPR) meeting in Rome, Italy (a joint society meeting by the European Society of Pediatric Radiology [ESPR] and the Society for Pediatric Radiology [SPR]). The concept of a separate task force dedicated to AI was borne from an ESPR-led international survey of health care professionals' opinions, expectations and concerns regarding AI integration within children's imaging departments. In this survey, the majority (> 80%) of ESPR respondents supported the creation of a task force and helped define our …

Even Heterozygous Loss Of Cdkn2a/B Greatly Accelerates Recurrence In Aggressive Meningioma, A Basit Khan, Collin W English, William C Chen, Prazwal Athukuri, James C Bayley, Vicky L Brandt, Arya Shetty, Caroline C Hadley, Abrar Choudhury, Hsiang-Chih Lu, Arif O Harmanci, Akdes S Harmanci, Stephen T Magill, David R Raleigh, Tiemo J Klisch, Akash J Patel

Faculty, Staff and Students Publications

No abstract provided.

Correction To: Multiple Sclerosis And Neuromyelitis Optica Spectrum Disorder: Onset Following Acute Covid-19 Infection, A Case Series, Mirla Avila, Yuanyuan Tan, Roberto Hernandez, Hafsa Zuberi, Victor M Rivera

Faculty, Staff and Students Publications

Correction to: Neurol Ther (2023) 12:319–327 10.1007/s40120-022-00418-9

In this article, the author name Yuanyuan Tan was incorrectly written as YuanYan Tan.

The original article has been corrected.

Construction Of Semi-Supervised Spatial Projections To Identify The Source Of Beta- And High Frequency Oscillations In Parkinson’S Disease, Luciano R F Branco, Ashwin Viswanathan, Arjun Tarakad, Nuri F Ince

Faculty, Staff and Students Publications

Traditional deep brain stimulation (DBS) treatment for Parkinson's disease (PD) targets the placement of DBS leads into subthalamic nucleus (STN). Extraction of neurobiomarkers from STN local field potential activity can be used for the optimization of DBS. Beta (12-30 Hz) and high frequency oscillations (200-450 Hz, HFO) of STN and their phase-amplitude coupling have been previously correlated with symptom severity in PD. The typical approach is to take bipolar derivations of electrode contacts in order to enhance recordings of local brain activity and suppress noise levels. This approach can often cancel the signals in correlated neighboring contacts and create ambiguity …

Interactive Mobile Application For Parkinson’S Disease Deep Brain Stimulation (Map Dbs): An Open-Label, Multicenter, Randomized, Controlled Clinical Trial, Gordon Duffley, Aniko Szabo, Barbara J Lutz, Emily C Mahoney-Rafferty, Christopher W Hess, Adolfo Ramirez-Zamora, Pamela Zeilman, Kelly D Foote, Shannon Chiu, Michael H Pourfar, Clarisse Goas Cnp, Jennifer L Wood, Ihtsham U Haq, Mustafa S Siddiqui, Mitra Afshari, Melissa Heiry, Jennifer Choi, Monica Volz, Jill L Ostrem, Marta San Luciano, Nicki Niemann, Andrew Billnitzer, Daniel Savitt, Arjun Tarakad, Joohi Jimenez-Shahed, Camila C Aquino, Michael S Okun, Christopher R Butson

Faculty, Staff and Students Publications

INTRODUCTION: Deep brain stimulation (DBS) is an effective treatment for Parkinson's disease (PD), but its efficacy is tied to DBS programming, which is often time consuming and burdensome for patients, caregivers, and clinicians. Our aim is to test whether the Mobile Application for PD DBS (MAP DBS), a clinical decision support system, can improve programming.

METHODS: We conducted an open-label, 1:1 randomized, controlled, multicenter clinical trial comparing six months of SOC standard of care (SOC) to six months of MAP DBS-aided programming. We enrolled patients between 30 and 80 years old who received DBS to treat idiopathic PD at six …

Approaching Object Acceleration Differentially Affects The Predictions Of Neuronal Collision Avoidance Models, Fabrizio Gabbiani, Thomas Preuss, Richard B Dewell

Faculty, Staff and Students Publications

The processing of visual information for collision avoidance has been investigated at the biophysical level in several model systems. In grasshoppers, the (so-called) [Formula: see text] model captures reasonably well the visual processing performed by an identified neuron called the lobular giant movement detector as it tracks approaching objects. Similar phenomenological models have been used to describe either the firing rate or the membrane potential of neurons responsible for visually guided collision avoidance in other animals. Specifically, in goldfish, the [Formula: see text] model has been proposed to describe the Mauthner cell, an identified neuron involved in startle escape responses. …

Phage Peptide Technology To Characterize Extracellular Vesicles In The Brain Tumors, Jadelynn Rudolf

Undergraduate Research Conference

Extracellular vesicles (EV) are lipid-bound containers derived from the endosomal membrane network or from the extracellular membrane of cells. They can carry proteins, lipids, miRNAs, and other molecules, and may be involved in intercellular communication via membrane-associated proteins. Glioblastomas (GBM) are aggressive cancers of the brain and spinal cord derived from astrocytes. Extracellular vesicles derived from glioblastomas can make their way through the blood brain barrier and find their way to different bodily fluids, and so could serve as biomarkers for this cancer. We have isolated phage-display peptides from a commercial library of random phage-displayed peptides that will bind glioblastoma …

Central Pattern Generator And Control Of Breathing (Ośrodkowy Generator Wzorca I Kontrola Oddychania), Jaroslaw Richard Romaniuk

Faculty Scholarship

Fifty years ago, Clark and Euler published a model of the neural control of respiration that stimulated modern studies on the central generator of the rate and depth of breathing. These studies led to new discoveries concerning both anatomical localization and functional characteristics of respiratory central pattern generator (CPG), and as a result our knowledge has greatly changed. This article describes the history of respiratory CPG research and, more specifically, explains how studies concerning the regulation of breathing parameters affect the creation of new hypotheses and theoretical models of the neural control of respiration. Comparing studies on the generators of …

Genetic Correlations Between Alzheimer’S Disease And Gut Microbiome Genera, Davis Cammann, Yimei Lu, Melika J Cummings, Mark L Zhang, Joan Manuel Cue, Jenifer Do, Jeffrey Ebersole, Xiangning Chen, Edwin C Oh, Jeffrey L Cummings, Jingchun Chen

Faculty, Staff and Student Publications

A growing body of evidence suggests that dysbiosis of the human gut microbiota is associated with neurodegenerative diseases like Alzheimer's disease (AD) via neuroinflammatory processes across the microbiota-gut-brain axis. The gut microbiota affects brain health through the secretion of toxins and short-chain fatty acids, which modulates gut permeability and numerous immune functions. Observational studies indicate that AD patients have reduced microbiome diversity, which could contribute to the pathogenesis of the disease. Uncovering the genetic basis of microbial abundance and its effect on AD could suggest lifestyle changes that may reduce an individual's risk for the disease. Using the largest genome-wide …

Diagnostic Performance Of Afirma And Interpace Diagnostics Genetic Testing In Indeterminate Thyroid Nodules: A Single Center Study †, Emad Kandil, Tyler A. Metz, Peter P. Issa, Mohamed Aboueisha, Mahmoud Omar, Abdallah S. Attia, Bert Chabot, Mohammad Hussein, Krzysztof Moroz, Mohamed Shama, Eman Toraih

School of Medicine Faculty Publications

Indeterminate thyroid nodules (ITN) represent 20–30% of biopsied nodules, with a 10–60% risk of malignancy. Molecular testing can stratify the risk of malignancy among ITNs, and subsequently reduce the need for unnecessary diagnostic surgery. We aimed to assess the performance of these molecular tests at a single institution. Patients with Bethesda III, IV, and V nodules with Afirma and Interpace Diagnostics genetic testing data from November 2013 to November 2021 were included. Three cohorts were formed, including GSC + XA, ThyGeNEXT + ThyraMIR, and GSC + GEC. Statistical analysis determined the sensitivity, specificity, positive predictive value (PPV), negative predictive value …

A Learned Map For Places And Concepts In The Human Medial Temporal Lobe, Nora A. Herweg, Lukas Kunz, Daniel Schonhaut, Armin Brandt, Paul A. Wanda, Ashwini D. Sharan, Michael R. Sperling, Andreas Schulze-Bonhage, Michael J. Kahana

Department of Neurology Faculty Papers

Distinct lines of research in both humans and animals point to a specific role of the hippocampus in both spatial and episodic memory function. The discovery of concept cells in the hippocampus and surrounding medial temporal lobe (MTL) regions suggests that the MTL maps physical and semantic spaces with a similar neural architecture. Here, we studied the emergence of such maps using MTL microwire recordings from 20 patients (9 female, 11 male) navigating a virtual environment featuring salient landmarks with established semantic meaning. We present several key findings. The array of local field potentials in the MTL contains sufficient information …

Pre-Surgical Features Of Intrinsic Brain Networks Predict Single And Joint Epilepsy Surgery Outcomes, Walter Hinds, Shilpi Modi, Ankeeta Ankeeta, Michael R Sperling, Dorian Pustina, Joseph I Tracy

Department of Neurology Faculty Papers

Despite the effectiveness of surgical interventions for the treatment of intractable focal temporal lobe epilepsy (TLE), the substrates that support good outcomes are poorly understood. While algorithms have been developed for the prediction of either seizure or cognitive/psychiatric outcomes alone, no study has reported on the functional and structural architecture that supports joint outcomes. We measured key aspects of pre-surgical whole brain functional/structural network architecture and evaluated their ability to predict post-operative seizure control in combination with cognitive/psychiatric outcomes. Pre-surgically, we identified the intrinsic connectivity networks (ICNs) unique to each person through independent component analysis (ICA), and computed: (1) the …

Single-Cell Rna Sequencing Reveals Immunosuppressive Myeloid Cell Diversity During Malignant Progression In A Murine Model Of Glioma, Sakthi Rajendran, Yang Hu, Alessandro Canella, Clayton Peterson, Amy Gross, Maren Cam, Matthew Nazzaro, Abigail Haffey, Akdes Serin-Harmanci, Rosario Distefano, Giovanni Nigita, Wesley Wang, Daniel Kreatsoulas, Zihai Li, Jesse A Sepeda, Andrew Sas, Mark E Hester, Katherine E Miller, Olivier Elemento, Ryan D Roberts, Eric C Holland, Ganesh Rao, Elaine R Mardis, Prajwal Rajappa

Faculty, Staff and Students Publications

Recent studies have shown the importance of the dynamic tumor microenvironment (TME) in high-grade gliomas (HGGs). In particular, myeloid cells are known to mediate immunosuppression in glioma; however, it is still unclear if myeloid cells play a role in low-grade glioma (LGG) malignant progression. Here, we investigate the cellular heterogeneity of the TME using single-cell RNA sequencing in a murine glioma model that recapitulates the malignant progression of LGG to HGG. LGGs show increased infiltrating CD4+ and CD8+ T cells and natural killer (NK) cells in the TME, whereas HGGs abrogate this infiltration. Our study identifies distinct macrophage clusters in …

Botulinum Neurotoxin Injections In Children With Self-Injurious Behaviors, Mariam Hull, Mered Parnes, Joseph Jankovic

Faculty, Staff and Students Publications

Self-injurious behaviors are repetitive, persistent actions directed toward one's body that threaten or cause physical harm. These behaviors are seen within a broad spectrum of neurodevelopmental and neuropsychiatric conditions, often associated with intellectual disability. Injuries can be severe and distressing to patients and caregivers. Furthermore, injuries can be life-threatening. Often, these behaviors are challenging to treat and require a tiered, multimodal approach which may include mechanical/physical restraints, behavioral therapy, pharmacotherapy, or in some cases, surgical management, such as tooth extraction or deep brain stimulation. Here, we describe a series of 17 children who presented to our institution with self-injurious behaviors …