Day 3 :
Nippon Medical School, Japan
Michihiko Koeda is a senior assistant professor of the psychiatry department at Nippon Medical School, Tokyo, Japan. He completed his PhD at the Medical
Research Institute of Tokyo Medical and Dental University. He was a visiting researcher at the University of Glasgow. He is continuing to investigate auditory brain
function by the use of functional MRI to clarify the pathophysiology of psychiatric symptoms, and pharmacological and/or genetic effects.
Evaluation of brain function by resting state fMRI is expected to be one of the convenient applications to help diagnosis of
mental disorders, such as depression and Alzheimer disease (AD). Especially, it is considered that functional connectivity
of the default mode network (DMN) would refl ect brain function of self-recognition as a biomarker at a preclinical stage of AD.
Further, the cerebral function of language is an important aspect for the evaluation of brain dysfunction in mental disorders, eg.,
epilepsy. To develop useful clinical applications, examining the infl uence of handedness shows promise, but to our knowledge,
there have been few studies on whether these networks infl uence the diff erence in handedness. We aimed to investigate the
functional connectivity of DMN and language-related area (LRA) by resting state fMRI. Further, we evaluated whether these
DMN-language networks infl uenced handedness. In the functional connectivity analysis of the 101 subjects, the main eff ect of
handedness was signifi cantly observed at the posterior cingulate from bilateral supplemental motor cortices, and the anterior
cingulate from the posterior cingulate. Further, the main eff ect of non-right-handed family history was signifi cantly observed
at the right inferior parietal cortices projected from bilateral supplemental motor areas (p<0.05, uncorrected; FDR p<0.05). As
for LRA, in right-handed subjects, a region of strong positive correlation with the right amygdala was observed at the thalamus,
middle frontal gyrus/anterior cingulate, cerebellum, and globus pallidus. On the other hand, in non-right-handed subjects,
the region of strong negative correlation with the right amygdala was observed at the bilateral inferiolateral occipital cortex,
posterior cingulate, medial frontal gyrus/anterior cingulate, superior frontal gyrus, and supplemental motor cortex (p<0.05,
uncorrected; FDR p<0.25). We could fi nd diff erent functional connectivities by diff erences of handedness or diff erences of
non-right-handed family history. Th ese results may suggest the infl uence of handedness or non-right-handed family history
when evaluating functional connectivity on mental disorders.
- Session on: Psychiatric Brain | Pediatric Neurology
Gemma Casadesus Smith
Kent State University, USA
Virginia Commonwealth University, USA
Time : 11:00-11:25
Dong Sun received a degree of Bachelor of Medicine from Chongqing Medical University, Chongqing, China, in 1986 and a M.Sc. in Radiology from West China Medical University, Chengdu, China in 1989. Following a residency training in Radiology, Dr. Sun became an attending Radiologist for a number of years in China before pursuing Ph.D. training in Experimental Neuropathology at School of Medicine, Southampton University, United Kingdom in 1995. After completing Ph.D. in 1999, Dr. Sun did postdoctoral trainings, first in the Department of Pharmacology at Uniformed Services University of Health Sciences, Maryland, and then in the Department of Neurosurgery at Medical College of Virginia, Virginia Commonwealth University (MCV/VCU), Virginia, before becoming an Assistant Professor in 2004 and then Associate Professor in 2010 in MCV/VCU. Dr. Sun’s research interest is to investigate strategies that can facilitate brain repair and regeneration following traumatic brain injury (TBI) and aging. Using varying type of rodent TBI models as well as Alzheimer’s transgenic model, her studies examine the association of TBI, aging, neuroinflammation with neurogenesis and cognitive function. Her search is well supported by NIH and other foundation grants.
Traumatic brain injury (TBI) is a major health problem worldwide. Despite improving survival rate after TBI, currently, there is no effective treatment to improve neural structural repair and functional recovery of TBI survivors. It is now well established that in the mature mammalian brain, new neurons are generated throughout life in the neurogenic regions of the subventricular zone (SVZ) and the dentate gyrus (DG) of the hippocampus. The extent and the function of adult neurogenesis under neuropathological conditions have been explored in varying types of disease models in animals. Increasing evidence has indicated that this endogenous neurogenesis may play regenerative and reparative roles in response to CNS injuries or diseases. In the field of brain trauma, neural regeneration either through stimulating endogenous neural stem cells or through stem cell transplantation has gained increasing attention. This presentation will discuss recent development of strategies we and others have explored to facilitate the repair and regeneration of the injured brain following TBI through manipulating endogenous neurogenesis and through optimizing neural transplantation.
Kent State University, USA
Gemma Casadesus Smith has authored over 100 peer-reviewed manuscripts, chapters, and commentaries, has edited several books and special topics for various journals, and serves as editor in chief of Frontiers of Aging Neuroscience. Casadesus is a member of several editorial boards including Journal of Alzheimer’s disease, Neuropharmacology and Neurobiology of Aging, amongst others, serves in advisory and review panels for federal and private foundations such as the Alzheimer’s Association, NIH and the VA and is a member of various scientifi c societies including Society for Neurosciences, the International Behavioral Neurosciences Society and the International Society for Neurochemistry
The goal of my laboratory is to determine the chronology of appearance and interplay between pathological CNS events that underlie the loss of learning and memory function and neuronal plasticity during aging. Th e focus on my work is on Alzheimer’s Disease prevention/delay strategies, however, the basic understanding of mechanisms studied in my laboratory can be broadly translated to brain health strategies beyond AD such neuroprotection and repair. Particular focus is placed on understanding the basic mechanisms of peptide hormones such as leptin, amylin, estrogen and gonadotropins and how age-related changes in these metabolic and reproductive peptide and steroid hormones infl uence hippocampal function and plasticity and brain health. We use animal and cellular models and a broad variety of techniques including behavioral testing, histology, in vivo and in vitro viral and pharmacological delivery, imaging, and transgenic approaches to address these aims.
Université de Nice Sophia Antipolis, France
Time : 11:50-12:15
Marc Borsotto has obtained his PhD in the University of Nice Côte d’Azur. He is a Researcher Director (CNRS) at the Institut de Pharmacologie Moléculaire et Cellulaire (Valbonne, France), he is the PI of the project "Spadin and Depression". His laboratory is member of the ICST Excellence Network, a connection between ionic channels research teams. He is internationally recognized in the field of potassium channels (ATP-sensitive K+ channels, KCNQ2/3 K+ channels and Two-pore domain K+ channels). He published more than 50 articles cited more than 2600 fold, h-index = 25, i10 = 34 (Google scholar). He is coauthor of 4 patents.
From the posttranslational maturation process of sortilin, we identified a 17 aminoacid peptide, called spadin as a new antidepressant drug concept. Spadin exerts its antidepressant actions on the TREK-1 potassium channel, a novel antidepressant (AD) target. We showed that spadin acts more rapidly in comparison to other ADs. We have pointed out that spadin induced neurogenesis after only 4-day treatments. We demonstrated that spadin did not display side effects at the cardiac level and on TREK-1 controlled functions such as stroke, epilepsy or pain. With the final goal to make spadin a drug for human clinic, we sought analogs of spadin demonstrating a better affinity or a better in vivo stability or both. By electrophysiology on HEK293 cells stably transfected with TREK-1 channels, several analogs were tested for their ability to block the TREK-1 channel activity. AD effects were measured by using the forced swim and novelty suppressed feeding tests. Synaptogenesis was investigated by measuring the expression level of the synaptic protein PSD-95 in in vitro cultured neurons. Our data allow us to identify a shortened spadin, called mini-spadin, that displayed the same AD properties as spadin and a 400 fold increase in the TREK-1 affinity. Mini-spadin increased the synaptogenesis marker PSD95 levels after only 24 hours of treatment, suggesting that like spadin, mini-spadin was able to induce neurogenesis and synaptogenesis. Even if further experiments are required, the mini-spadin appears to be more efficient than spadin offering a very promising alternate to spadin as human drug.
Background: Body Dysmorphic Disorder (BDD) is a relatively common psychiatric disorder characterized by preoccupations with perceived defects in physical appearance. Objectives: This review aimed to explore epidemiology, clinical features, co morbidities and treatment options for BDD in different clinical settings. We reviewed the literature written between 1985 and 2012 using the key words body dysmorphic disorder, dysmorphophobia, Psychodermatology. Results: BDD occurs in 0.7%–2.4% of community samples and 13% of psychiatric inpatients. Etiology is multi-factorial with recent findings indicating deficits in visual information processing. There is considerable overlap between BDD and Obsessive Compulsive Disorder (OCD) in symptoms etiology and response to treatment which led to suggestions that BDD can be classified with anxiety disorders and OCD. A recent finding indicated genetic overlap between BDD and OCD. Over 60 % of BDD patients had a lifetime anxiety disorder, 38% had social phobia which tends to predate the onset of BDD. Studies reported a high level of co-morbidity with depression and social phobia occurring in >70% of BDD patients. BDD individuals present frequently to dermatologists (about 9%–14% of dermatologic patients have BDD). BDD co-occurs with pathological skin picking in 26-44.9% of cases. BDD has currently two variants: delusional and non-delusional and both variants respond similarly to Serotonin Reuptake Inhibitors (SRIs) which may have effect on obsessive thoughts and rituals. Cognitive behavioral therapy (CBT) has the best established treatment results. Conclusion: A considerable overlap exists between BDD and other psychiatric disorders such as obsessive compulsive disorder (OCD), anxiety and delusional disorder and this comorbidity should be considered in evaluation, management and long term follow up of the disorder. Individuals with BDD usually consult dermatologists and cosmetic surgeons rather than psychiatrist. Collaboration between different specialties (such as primary care, dermatology, cosmetic surgery and psychiatry) is required for better treatment outcome.
- Session on: Brain Nursing | Cerebro spinal Complications
Gemma Casadesus Smith
Kent State University, USA
Delia England Frederick is working in University of South Carolina Aiken, USA and his research interests are chronic conditions and health, education, and
socioeconomic disparities of people groups in the United States. In addition, an interest in describing care behaviors for nurses providing bedside care in the
medical-surgical and critical care units.
The brain is an organ in a jar, or better yet a pitcher with an amazing spout that fi lls all the glasses awaiting their stimulating neurological drink. Many nurses recognize the brain is enclosed in the skull, a feature that results in increased intracranial pressure or pressure on one part of the brain by excess fl uid or tissue in another place within the skull. Th e purpose of this presentation is to clarify the care needs of a person with a brain tumor. Personal hygiene, nutrition, hydration and mobility interventions are routinely needed. A head-to-toe assessment related to the neurological system will be described with a few methods of neurological monitoring explained. Psycho-social care needs for the person with a brain tumor will also be
University Of Cambridge, UK
Time : 14:00-14:25
Akter is a surgical resident and doctoral student at The Stem Cell Institute, University Of Cambridge. Akter’s current research interests include studying the pathophysiology and treatment of cervical myelopathy and spinal cord injury
Spinal cord injury (SCI) defects are complicated and there is currently no solution to completely repair spinal cord injuries. Neural tissue engineering offers hope to patients and is becoming a rapidly growing field, which aims to create engineered tissue that can replace and repair damaged tissue. Injury to the spinal cord can result in a permanent disability and is thus of significant psychological, social and economic morbidity to the patient and their relatives. As part of the endogenous repair process following acute injury, there is a migration of cells such as astrocytes, microglia and schwann cells. However, the spinal cord has limited endogenous regenerative capacity. Current treatment strategies including drug delivery and cell delivery have been investigated; however have been met with variable success. Tissue engineering is an emerging area in biomaterial research that possesses great therapeutic potential. We will be discussing the current use of scaffolds, cells and growth factors used in tissue engineering of the spinal cord.
Sonia Shahid is a final year M.B.B.S student of Karachi Medical and Dental College, Karachi Pakistan. She has been a part of several national and international researches and many are ongoing. She has attended several national and international seminars and conferences. Sonia is an inquisitive student with a passion for education as a power for change and improvement in the healthcare field of her country and is very ambitious in pursuing her career.
To determine the frequency of hydrocephalus, it’s causes and treatment outcomes in pediatric patients visiting Pediatric clinic in Tertiary Care Hospitals of Karachi, Pakistan
The aims of the study was to specify the common causes of hydrocephalus and the treatment outcomes in the pediatric population of Karachi and to determine the interventions required to decrease the incidence of hydrocephalus.
Hydrocephalus is a condition that occurs when fluid accumulates in the skull and causes the brain to swell. Brain damage can occur as a result of this. This can lead to developmental, physical, and intellectual impairments. Cerebrospinal fluid (CSF) flows through the brain and spinal cord in normal conditions. Under certain conditions, the amount of CSF in the brain increases, like obstruction in ventricles, increased CSF production or inadequate CSF drainage. In some cases, hydrocephalus starts before a baby is born, Congenital Hydrocephalus. This can result from a birth defect, in which the spinal column doesn’t close, genetic abnormality or certain infections mother affected during pregnancy, such as rubella. This condition can also occur in infants and toddlers, called Acquired Hydrocephalus, due to CNS infections such as meningitis; bleeding in the brain during or shortly after delivery, especially in babies born prematurely; injuries that occur before, during, or after delivery; injury or head trauma and CNS tumors. It requires treatment to prevent serious complications,whether shunt insertion or ventriculostomy.
This cross‐sectional study was conducted from February 2015 ‐ February 2016. Pediatric patients under 2 years of age were recruited in this study. A history and examination form designed from an application “Forms”,particularly for the study and was filled by concerned doctors. For data analysis SPSS 16.0 software was used.
Pediatric patients of age ≤ 2 years regardless of gender presenting to pediatric clinic of tertiary care hospitals of Karachi with principal complain of Hydrocephalus were included.
Patients who were having autoimmune disorders and also immunocompromised patients were excluded from the study.
Total 73 patients were inspected, out of which 32.88% were male and 67.12% were females. When inquired about the reason of hydrocephalus, 54.79% were due to obstruction of ventricles, 27.40% due to inadequate drainage of CSF and 17.81% due to increased CSF production.
Out of 73 patients, 73.97% were the cases of Congenital hydrocephalus and 26.03% were of Acquired hydrocephalus. Among these, 32 have birth defects, 13 have genetic abnormality, 10 infant’s mothers were infected with rubella, 9 have meningitis, 3 were prematurely delivered, 3 have injury to brain and 3 have CNS tumor.
93.15% were treated by shunt insertion and 6.85% by ventriculostomy. The outcomes of treatment by shunt insertion were not very good as there were 26 shunt failures.
Most of the cases were of Congenital hydrocephalus. The prognosis for infants and children with hydrocephalus depends on various factors, including the cause of the hydrocephalus. With early detection and treatment, the prognosis becomes better, though some children suffered from serious complications despite the adequate treatment was provided.
Adnan Menderes University Faculty of Nursing, Turkey
Emine Gerçek has completed her PhD at the age of 31 years from Ege University and postdoctoral studies from Adnan Menderes University Faculty of Nursing. She is the director of Adnan Menderes University Söke Health Services Vocational Schools, assistant professor in Adnan Menderes University Faculty of Nursing in Turkey. She has published more than 30 papers in national and international journals and has been serving as an editorial board member of repute
The nursing workforce in neurology clinics is closely associated with rehabilitation process of the patient. The inpatient neurology wards admit patients with a diagnosis of acute cerebral infarction, acute cerebral hemorrhage, or transient ischemic attack (TIA); other than the symptoms of the disease, most of these patients have additional symptoms and needs, such as high blood pressure, consciousness disorders, self-care deficiencies, movement deficiencies, feeding tubes, urinary catheters, and most require rehabilitation care. Some studies indicated that nurses are not satisfied with the pay, the job, or the nurse staffing level, job environment and that most nurses have high burnout, while working in a neurology clinic. The critical thinking and decision-making skills will provide to increase on skills such as take responsibility, empathy, questioning, using intuition of neuroscience intensive care unit (NICU) nurses. Many studies show that using critical thinking skills increased nurse satisfaction and motivation and decrease burnout level. With the instruction and help from experienced and having the critical thinking skills nurses, patients can gain the maximum level of wellness and achieve their optimal level of functioning. Therefore, improving nurse satisfaction and decreasing nurse burnout will be very important to keep the stability of the nursing workforce, increase the quality of care and promote patient outcomes. It is important to determine of NICU nurses' perceptions regarding their roles and responsibilities in the decision-making process during the change in intensity of care and end-of-life care for patients. More studies should be done concerning critical care nurses' levels of use critical thinking skills and experiences with end-of-life care.
Imagine that you come face to face with death in a moment while your health is very good. After undergoing any kind of major surgery, you thinks "What happened to me, what do I do next?" Then ıt may occur many side effects; depression or agitation.
Brain surgery - or even receiving a diagnosis of brain disease - can change someone's personality, pretty much like any psychological trauma.
Brain surgery that most often result in depressed patients who are with high levels of anxiety caused by the surgery. Symptoms may start within three months of the surgery and cause significant problems in social or work situations and in relationships.
This time is normal and part of the recovery period. Nurses are mostly concerned with just the patient’s physical recovery, rather than their mental status.
A major surgery and its treatments can cause changes in a personality and ability to think. Patients may experience challenges with their communication, concentration, memory and emotional abilities. Most brain tumor patients exhibit signs that are consistent with depression and agitation, especially post surgery. Patients may feel self worthlessness. Many lose interest in their usual activities and they become socially isolated. Sometimes it is due to the prescribed medications.
We will discuss what may cause this situations, some of the symptoms of it, and what can be done to minimize the effects and help get rid of it altogether.
Nurses should struggle to educate patients on what happened to them and what it could mean for their future
Shiraz University Of Medical Sciences, Iran
Ravanfar has completed MD at Shiraz University of Medical Sciences, Iran. Worked as researcher at clinical neurology research center Shiraz University of Medical Sciences. Now serving as research assistant and general practitioner at Neurology research center.
Licorice root has been reported to contain several neuroprotective compounds. In the present study we investigated its benefit in the treatment of acute ischemic stroke for which, treatment modalities are limited. Randomized double-blind placebo controlled trial. Subjects: 75 patients admitted to the neurology emergency department of Namazi hospital affiliated to Shiraz University of Medical Sciences, Iran, diagnosed with acute ischemic stroke. Patients were randomly prescribed oral 450 mg or 900 mg licorice extract or placebo capsules three times daily for 7 days. National institute of Health stroke scale (NIHSS) and Modified Rankin Scale (MRS) scores were assessed before initiation of therapy and 3 months after treatment. Improvement of these scores were compared between study and control groups. Mean NIHSS scores in 450 mg and 900 mg groups decreased from an initial score of 10.68 and 10.44 to 6.4 and 5.48 after 3 months respectively; while in the control group changed from 8.36 to 5.64. The decline in NIHSS scores were significantly greater in licorice treated groups than the control group. Similarly the decrease in MRS was greater in the licorice treated groups (4.2–2.9 in 450 mg licorice group, and 4.4–2.8 in 900 mg licorice group) versus the control group (3.9–2.8). None of the participants developed adverse reactions attributed to licorice overdose. The results of this study support the beneficial effect of whole licorice extract in neurologic improvement of patients with acute ischemic stroke. Licorice may be useful as a medication for the treatment of the adverse effects caused by acute ischemic stroke.
- Virtual Presentations
WK Tang was appointed to professor in the Department of Psychiatry, the Chinese University of Hong Kong in 2011. His main research areas are Addictions and Neuropsychiatry in Stroke. Professor Tang has published over 100 papers in renowned journals, and has also contributed to the peer review of 40 journals. He has secured over 20 major competitive research grants. He has served the editorial boards of five scientific journals. He was also a recipient of the Young Researcher Award in 2007, awarded by the Chinese University of Hong Kong.
Depression is common following an acute stroke. Poststroke Depression (PSD) have notable impacts on the function recovery and quality of life of stroke survivors. Incidence decreased across time after stroke, but prevalence of PSD tend to be stable. Vascular factors such as diabetes, hypertension and smoking have been related to the development of PSD. Many studies have explored the association between lesion location and the incidence of PSD. For example, lesions in frontal lobe, basal ganglia and deep white matter have been related with PSD. Furthermore, cerebral microbleeds and functional changes in brain networks have also been implicated in the development of PSD. In this presentation, evidences of such association between the above structural and functional brain changes and PSD will be reviewed.
Taras Shevchenko National University of Kyiv, Ukraine
Makarenko O M has taken PhD degree from Moscow Medical Stomatological Institute, MD degree from the Institute of Higher Nervous Activity in Moscow. He carries out his post-doc researches at the Institute of higher nervous activity and Taras Shevchenko National University of Kyiv. He is a Professor of the psychology department, the author of more than 200 articles in reputed journals and 5 monographs (Lambert Academic Publishing).
In HS investigations researchers didn't pay much attention to disorders of the immune system, appearing under acute disorders of brain circulation. For evaluation of the immune disorders, under experimental hemorrhage stroke (HS) the experimental study was performed on 105 white mice and 24 white rats, in the conditions of HS modeling with different degrees of intensity. The first group was performed with the help of the part of a metal mandrin, the second group – by mandrin destroyed the central part of the brain and the third group – by addition injection of blood. An initial immune humoral response and cell immunity level, which were evaluated according to the reaction of hypersensitivity of slow type, were studied. The quantity increase of agglutinin-like antibodies is especially observed in the first group animals. HS was provoked according to the method, described above. The animals were decapitated on the 1st, 3rd and 10th day after the lethal dose of thiopental-sodium. The morphological study of the sub-neocortical injury was performed by thionine staining of the frontal brain slices. Ten rats from 14 under examination of brain showed clear inflammation changes of the brain tissue. The sings of productive ependimatitis and local vasculitis, consisted of microglia cells and lymphocytes, resembling inflammatory changes in the brain during viral infections (Herpes family). During the post-stroke condition development, we succeed in getting of the evidence of pathomorphological changes and activation of the latent infection in the form of encephalitis.
Osuna University, Spain
Francisco José Montero Bancalero, from Spain, studied psychology at Seville University and obtained his doctorate at Huelva University. He is currently a professor at Osuna University (Spain) www.euosuna.org . His professional career started in the field of addictions working as a therapist in an outpatient treatment center, and then he began to participate in different investigation projects. He reached the point of leading a pioneering tool in Aula de Alcoholismo (Alcoholism Classroom) www.auladealcoholismo.es . He has become a member of the National Hispanic Science Network on Drug Abuse and has presented his projects at different international conferences.
Binge drinking among young people in Spain is a result of the interaction between multiple factors: globalization of consumption patterns; weather conditions that favor consumption in the street, in squares, or in large groups; easy access to alcohol; and a favorable culture of consumption associated with fun, celebration. To achieve a better understanding of this phenomenon, the influence of brain development during adolescence and young adulthood, as well as the late acquisition of reflection skills and self-control, must be taken into account. The human brain continues to develop until the individual is around 25 years of age. Because the brain matures from back to front and the last region to mature is the frontal area, which is involved in making thoughtful and planned decisions, it is necessary that programs are developed with this in mind. It is important to consider the late development of self-control and planning skills when designing and implementing educational programs and strategies to combat heavy drinking in youth. These actions should involve political, social, and educational agents, in addition to the family: • Train teachers in the field of addiction prevention. • Establish appropriate channels of communication between schools and families to facilitate early detection of problems. • Implement education plans to help youth develop skills in critically analyzing the current alcohol consumption messages in advertising, films… in order to enable better decision-making and the ability to say "no". • Promote and publicize healthy leisure activities available at institutions as alternatives to binge drinking. • Promote education on emotional development.
McGill University, Canada
Belchior earned her bachelor’s degree in Occupational Therapy from Dom Bosco Catholic University in Brazil. She completed a Ph.D. in Rehabilitation Sciences at the University of Florida, Gainesville. Her postdoctoral work focused on cognitive aging and was also completed at the University of Florida, at the department of Clinical and Health Psychology. Dr. Belchior is currently an assistant professor at the School of Physical and Occupational Therapy at McGill University and she is affiliated with the Institut Universitaire de Gériatrie de Montréal. Her research program focuses on the promotion of functional autonomy in individuals at risk for dementia.
Dementia is becoming a global epidemic with no known cure or prevention strategy. The presymptomatic course of dementia can last over a decade [1,2], offering researchers and clinicians a crucial window of opportunity to provide pharmacological and non-pharmacological interventions with the potential to limit the catastrophic effects of this disease on the person’s overall functioning and quality of life. Despite growing evidence suggesting that individuals at risk for dementia already face subtle but important functional declines , it is still not clear how to capture these declines in the clinical setting. This presentation will focus on the lessons learned from a series of studies that we have conducted in this topic and propose a novel approach to help early identification of individuals at risk for dementia. Our first study investigated current occupational therapists’ practices regarding functional assessments in individuals with MCI . Subsequently, we have conducted a series of reviews in this topic to investigate which assessment tools have been validated with this population and what are the functional domains covered in each of these tools. In this presentation we will discuss the best available assessment tools to date and the strengths and weakness of these tools. [5-7]. Finally, we will present a novel investigative technique to help in the identification of the subtle functional declines in individuals at risk for dementia [
Alsadir medical city, Iraq
Abbas Alnaji A consultant neurosurgeon, had the degree of Iraqi board of Neurosurgery form university of Baghdad 1999 and worked as clinical neurosurgeon to the teaching hospital of Alkufa university.
Over more than fifteen years of my Career in Neurosurgery I focused my efforts on the causation of surgical pathologies ( biological bases). Idiopathic intracranial hypertension is embarrassing, that whatever the neurosurgeon do, still some end with big disability, the blindness . My vision is based on two, first, as the histopathology of brain parenchyma say presence of long standing water In extracellular spaces without trauma or toxins, the logic explanation for that is the chronic inflammatory process. The second base, I concentrated on the patient as a whole rather than on CNS only trying to discover the relation between this CNS inflammatory process and presence of any systemic disease which make this CNS impairment as a complication to it. By taking a strict history, systemic review and physical examination I concluded the presence of a chronic or sub-acute general disease which in my career it was chronic Brucellosis however ( pre PCR era in Iraq) serology is negative in most, for that anti Brucella trial treatment was adopted to result in a very high success rate in mild to moderate cases which are several tens in number ( apart from two severe cases) over the 15 years. Complete work up done to exclude other entities , fundus camera to register and follow optic disc edema or atrophy. The two sever cases underwent all modalities of treatment in other centers but end with blindness, one fifty five years old male no light perception and the second is twenty three old female end with shadow perception, on ensuing this anti Neurobrucellosis ( no steroids), the male after six months regained his full vision gradually , the female after three months also regained her full vision gradually for this female patient PCR of CSF was positive for Brucella.
Saga Woman Junior College, Japan
Tohru Hasegawa has has completed his PhD of Okayama University and worked at Saga Medical School as an associate professor and moved to Saga Woman University as Professor. He retired and got the professor emeritus. He found the Homocysteic acid as one of pathogens of AD.
At present we have no hope to recover the Alzheimer cognitive impairment. Just only an intervention which combines an exercise with DHA supplement establishes to recover the cognition. It is interested in DHA supplement combination. Many hypothesises are considered why these interventions can recover the cognitive decline in AD. The exercise indeed stimulates the blood circulation which induces the urinary excretion of blood unknown pathogens for the cognitive impairment and consequently some recovery can be observed. We hypothesize that the homocysteic acid in blood is the one of pathogens which are excreted into urine. Why is DHA supplement needed for the recovery process induced by an exercise? DHA is known to decrease homocysteine level and exercise contributes DHA effect. In other words, the combination of exercise and DHA induces the strong decrease of homocysteine in blood, which supports our hypothesis, the targeting homocysteic acid in blood is a possible method which can recover an Alzheimer cognitive impairment. Our hypothesis was proved by the fact that the memorial problem of 3xTg- AD model mice which were developed by amyloid pathology and the model for the familial AD were recovered by anti-HA antibody and not by amyloid treatment. Why did 3xTg-AD mice which increased amyloid pathology increase HA level? APP and/or presenilin increased calcium inflax which could increase superoxide level and consequently increase HA level from homocysteine or methionine. Also our hypothesis is partially supported by the open clinical trial of some supplement which can decrease the homocysteic acid in blood for Alzheimer’s patients and the result is very impressive.
State University of Medicine and Pharmacy, Moldova
INTRODUCTION: Stroke is one of the leading causes of morbidity and mortality worldwide. The importance of the problem is determined by social and economic burden of stroke but a good management of risk factors can lead to dramatic changes in the incidence of stroke. METHODS: In november 2015 we have initiated an epidemiological study in a village located in the center of the country for estimation of stroke risk factors in the population of Republic of Moldova. The subjects were examined according to our Protocol of risk factors’estimation in the population of Republic of Moldova. This protocol includes: questionnaire, clinical examination, ECG and Doppler Duplex ultrasound of extracranial segment of carotid arteries RESULTS: In the study were included 337 subjects, 215 (64 %) were women and 122 (36 %) men. The mean age was 50.25 years. The most common risk factor was obesity, identified in 157 (46 %) subjects, while 110 (33 %) subjects were overwighted and 70 (21 %) were normal weighted. Second risc factor by frequency was hypertension, noticed in 149 (44 %) subjects. The third risk factor by frequency was migraine 43 (13%) subjects, where 36 subjects were women and seven were men. Thirty one (9%) of examined had atrial fibrillation and 30 (9%) had diabetes mellitus. Thirty one (9 %) subjects were smokers and aterosclerotic plaques was found in 60 (20%) subjects. Left myocardial hypertrophy on ECG was present in 182 (54%) subjects and also on ECG was detected old myocardial infarction at 9 (3%) and acute ischemic changes in 6 (2%) subjects. The most frequent association of risk factors was arterial hypertension and obesity 99 (29%) subjects. Results of laboratory tests showed that glycosylated hemoglobin rate was increased in 52 (18%) of subjects, predominantly in males (19% vs 16%) and was increased with age. Serum glucose was increased in 92 (30%) of studied persons, and again predominantly in males (36% vs 26%). And more then 50 % of subjects had dyslipidemia, so total cholesterol was increased in 175( 58%), LDL cholesterol was increased in 198 (66%) subjects. CONCLUSIONS: Stroke is a major health and social problem. Therefore it becomes obvious need to strengthen all efforts in stroke prevention to reduce its impact on society. The are many risk factors involved in appearance of stroke but the degree of their expression differs from one community to another. Study results will allow the identification of specific stroke risk factors and the elaboration of primary prevention strategies with the purpose to minimize burden of stroke in the population of Republic of Moldova.
The University of Tokyo, Japan
NGUYEN Tran Quynh Nhu graduated from University of Medicine and Pharmacy, Ho Chi Minh city, Vietnam in 2007. Since 2008, she has worked as cardiologist in Children’s Hospital 2, Ho Chi Minh city, Vietnam. She has completed master course from School of Medicine, The University of Tokyo, Japan in March 2015 and now continues Ph.D course at the same above university.
Ellis-van Creveld syndrome (EvC) is a ciliopathy with cardiac anomalies, disproportionate short stature, polydactyly, dystrophic nails and oral defects. Approximately 60% of EvC patients have severe congenital heart disorders (CHDs), of which more than half are atrio-ventricular septal defect (AVSD) and common atrium. Neuropsychological development of EvC is generally normal. However, CHD was confirmed as a high risk of developmental disabilities (DDs). Here we presented a typical EvC case with DDs. She is a 2.5-year-old female, the first child of consanguineous couple. Here height was 62.0 cm (under the 2nd percentile), post-axial polydactyly of hands, nail dystrophy, and AVSD with pulmonary stenosis. Her SPO2 was 70-80% from birth. We detected two novel compound heterozygous variants (p. E177X, p.R826X) in this patient. Her mental development was normal up to the age of 2 years old. From 2 to 2 ½ years-old, she reveals DDs, which was evaluate by ASQ-3 score. The head circumference is 47.0 cm. MRI showed no defects. We suggested that hypoxia caused DDs in this patient.
DDs in children with CHD are common and should be alert. The feeding difficulty, hypoxia, medical comorbidities, genetic abnormalities, and more complex treatment increased risk for DD. Thus, longitudinal follow-up throughout childhood and into adulthood is necessary for children with CHD because exposure to risk and prevalence of DD change over time. Primary and special care for children with CHD is critical to minimize DDs.
University of Sao Paulo , Brazil
Introduction: Diffuse axonal injury (DAI) is prevalent in traumatic brain injury (TBI), often associated with poor outcomes, including cognitive impairments and psychiatric disturbance. Cognitive impairments resulting from the DAI are related to disorders in the white matter pathway connections, especially between the cortex and deep structures. Also, over-activation of NMDA-mediated excitatory processes and excess of GABA-mediated inhibition are described after TBI on the acute and sub-acute phases. Nevertheless, there are few studies regarding this circuitry on the chronic phase. Our primary aim was to assess cognition in patients with DAI at 6 and 12 months after the trauma. The secondary aim was to evaluate neuropsychiatric symptoms and RMI in patients with DAI at 3, 6 and 12 months after the trauma; and assess the cortical excitability on chronic phase (more than 12 months after the trauma) Methods: This was a longitudinal, open label, one arm, no interventional study. Consecutive patients diagnosed with DAI aged 18 years or older were invited to participate. The study had four time-points: (1) between 1 to 3 months after the trauma – evaluation of neuropsychiatric symptoms and MRI; (2) 6 months after the trauma – evaluation of neuropsychiatric symptoms, MRI, and cognitive assessment; (3) 12 months after the trauma - evaluation of neuropsychiatric symptoms, MRI, and cognitive assessment; (4) more than 12 months after the trauma – evaluation of cortical excitability. Results: From Agost 2010 to July 2015, 187 patients were diagnosed with DAI. 63 patients agreed to participate on the trial. N=47 patients completed the neuropsychiatric evaluation at 3, 6 and 12 months after the trauma. Multivariate test of pooled data showed no significant difference in depression (p=0.067) and anxiety symptoms (p=0.43) among the three time-points. No significant interactions were found between the severity of the trauma and the depression (p=0.898) and anxiety symptoms (p=0.622). MRI results showed a correlation between the number of lesions (MARS) and cerebral atrophy (r=0.51, p=0.0096). Our analysis did not find correlation between number of lesions (MARS) and attentional processes by Trail Making Test (TMT) form A and B, neither in verbal episodic memory by HVLT. The results of cognitive assessment between 6 and 12 months after the trauma, showed an improvement on response time by TMT forms A and B, (p=0.001); improvement on selective attention by Stroop test, card A, (p=0.044), B (p=0.003), and C (or interference, p=0.001). For episodic memory, our analysis showed an improvement on visuospatial memory by Rey Complex Figure (RCF) recall over time (p=0.013), but not on the RCF copy (p=0.657) scores. We also found improvement on immediate verbal memory assessed by HVLT (p=0.001) but a trend on delay recall (p=0.056). We did not find differences on the other cognitive tests. For cortical excitability, no significant differences between left and right hemispheres were found. Values of RMT, MEPs and ICF from DAI patients were found within the normality. However, short interval intra-cortical inhibition (SIICI) values were higher on DAI patients (DAI SIICI 1.60±1.15 versus 0.56±0.63; DAI pp02-Rel 1.57±1.28 vs. 0.40±0.44; DAI pp04-Rel 1.64±1.47 vs. 0.61±0.84) showing a disarranged inhibitory system. Conclusion: No significative clinical or statistical changes were observed for depression or anxiety symptoms. We also did not observe any interaction between the severity of the trauma and the different time-points. We found a positive and significant correlation between the reduction of the white matter volume between three and 12 months after the trauma. Additionally we observed a time-dependent improvement on attentional processes, visuo-spatial and verbal episodic memory in patients with DAI. It seems that neuroplasticity play an important role in the first year of the trauma, leading to an open window to cognitive improvements. Also, as inhibition processes are GABA-mediated, it is likely to infer that DAI pathophysiology may deplete GABA leading to a disinhibition of the neural system.