Day 2 :
Medical University of Innsbruck, Austria
Time : 10:00-10:40
Wilhelm Eisner studied Chemistry and Medicine at the University of Cologne, Mainz and Munich. Until 1999, Medical University Munich and since 1999 Medical University Innsbruck. At the LMU Munich he got his general neurosurgical training. In Bern, Munich, Pittsburgh, Cologne he got special training in Electrophysiology, Functional Neurosurgery, Stereotaxy and Radiosurgery. He was a founding member of the team (H J Reulen) who introduced awake craniotomy in Oncologic Neurosurgery in Europe in 1988 in Bern; Swiss and 1991 in Munich, Germany. He has a main concern of functional integrity of neurosurgical patients therefore he built up a reputation in intraoperative electrophysiology internationally in the beginning of the 1990’s. His second and predominant subject is deep brain stimulation in movement disorders and pharmaco resistant pain syndromes, beside psychiatric disorders and radiosurgery. He is the Founder and Head of the Austrian Society of Stereotactic and Functional Neurosurgery, Radiosurgery, Intraoperative Electrophysiology, Intraoperative Imaging beside member of the board of the Austrian Pain Society, Vice President of the German Society of Neuromodulation. He is Lecturer at the Medical University Innsbruck, Mozarteum Salzburg/Innsbruck, Danube University Krems beside many other academic functions. He published more than 100 articles and gained 3788 citations, RG score 35.29, CI 332.
Introduction: In the last 30 years neuromodulation by deep brain stimulation gained widely acceptance starting in the field of movement disorders. In pain syndromes deep brain stimulation is far less effective. The results in nociceptive pain syndromes are around 50% and in neuropathic pain syndromes less than 50%. For the last 25 years the author has focused on neurosurgical pain therapy by neuromodulation.
Material & Methods: We will provide a historical overview on neurosurgical pain therapy of the head and on the pain matrix evolved by imaging studies. Further we will demonstrate our development of deep brain stimulation consisting of two electrodes per cerebral hemisphere and our achievement of pain free patient including normalization of sensory function. Out of 46 treated patients with neuropathic pain syndromes we had a group of 12 patients with neuropathic pain of the face. 50% showed a severe sensory deficit for touch-, pain-, warmth- and cold sensation. All patients had pre- and postoperative neurophysiological-, neuropsychological examination beside of pain questionnaires. Further quantitative sensory testing (QST) in neuropathic areas and normal area in the contralateral face side were performed before and after surgery. We examined six women from 29 to 65 years of age with pure trigeminal neuropathia. All patients were treated with two electrodes in the same side of the pain. One electrode was reaching from a precoronal approach the ventral posteromedial nucleus (VPM) thalamic area and one electrode was inserted from a parietal approach into the posterior limp of the capsula interna by stereotaxy. 3T MRT and stereotactic computed tomography angiography were fused to gain maximum information and safety. Operation was performed under intubation anesthesia. Tractography was showing motor and sensory fiber tracts. All patients got neuropsychological testing of memory and cognition pre- and one year postoperatively to detect stimulation induced changes.
Results: All six patients lost allodynia, hyperpathia and dysesthesia. Pain did not exist anymore. Touch and repeated touch was not provoking pain anymore. All patients gained a relief of the permanent burning pain followed by normalization of sensory function in the face as it has been before the neural trauma. Neuropsychological testing showed no change in memory and cognition before and one year after surgery. We will give examples of the treatment on peripheral neuropathic pain syndromes and central neuropathic pain syndromes such as thalamic pain syndromes.
Conclusion: Our method against neuropathic facial pain is high effective and safe as it is in other neuropathic pain syndromes. More than five years of stable and successful treatment urge to perform prospective randomized and blinded trails.
Neuroscientist, USA and Canadian University of Dubai, UAE
Keynote: Neurophysiological and psychometric data results from executive health coaching and biotechnology applications
Time : 11:00-11:40
Justin James Kennedy is a Brain Coach and a globally recognized Professor of Neuroscience, Executive Coach and Leadership Specialist. With over 20 years of C-Suite executive coaching experience globally in the USA, UK and South Africa, he translates his neuroscience research into practical business skills. His specialties include: coaching on performance leadership to deliver measurable business results; coaching on the business vision, brain management and corporate strategy; advising professionals on how to optimize systemic change and; improving executive brain functions to enhance mental focus, self and team performance. His first book "Brain Triggers" is co-authored by the world’s #1 coach, Dr. Marshall Goldsmith. He has also published innumerable corporate studies that demonstrate how to improve and sustain executive performance. In 2014, he delivered a TED talk on practical ways to control their brain to perform at peak and even increase IQ and memory.
Neurophysiological and cognitive/work performance data generated from a population of C-Suite executives participating in a health coaching program is analysed. The validity of direct current (DC) potential and heart rate variability (HRV) is assessed and compared to leadership and socio- psychometric data. Conclusions regarding resilient health performance and psychological toughness were compared between four groups. Application towards controlling symptoms of burn-out and stress related pathology is presented along with the impact the study had on improved working memory, leadership and socio-cognitive data. The assessment of neurophysiological resilience and psychological adaptation to occupational stress is suggested but would require further validation. Double blind studies are suggested in order to validate a proactive health-care tool for the health insurance industry.
Time : 11:40-12:20
Kim Baden Kristensen is the CEO and Co-founder of Brain+, which specializes in digital therapeutics for brain rehabilitation and remediation, specifically for the recovery of impaired cognitive functions due to injury or disease. It’s award winning Brain+ apps are being clinically tested in Parkinson’s disease, Major depressive disorder and Traumatic brain injury patients, and is being used by Danish national team athletes to enhance cognitive performance. Brain+ is also working on pre-symptomatic detection of Alzheimer’s disease in collaboration with leading European universities, providers, and patient organizations.
Combining the knowledge of neuroscience with computer game design, machine learning, and gaming psychology is set to be a major disruptor in the future of healthcare. Incorporating sensory, cognitive, emotional and behavioral technologies, creators of digital therapeutics are expected to be able to develop games that will improve both health and fundamental cognitive abilities. Neuro-games focused on attention, complex cognitive challenges and mindfulness are just the start as researchers look for solutions for patients suffering from cognitive impairments related to e.g. traumatic brain injury, stroke, depression, Parkinson’s disease, and Alzheimer’s disease. Real computer games + validated neuroscience = improved patient outcomes and quality of care.
- Brain and Neurological Disorders, Psychiatry and Addiction | Novel Therapeutic Strategies, Neurodegeneration and Aging Disorders
Location: Gate 2
Medical University of Innsbruck, Austria
INSERM, UMR 1000, Research unit “Neuroimaging and Psychiatry", France
Time : 12:20-12:50
Andre Galinowski completed his Medical School from Paris 12 Val de Marne University and studied Psychiatry in Paris and Ottawa (Canada). He graduated in Psychology from Paris V René Descartes University and in Neurobiology from Paris VI Pierre and Marie Curie University.
Introduction: The cortical-cerebellar circuit is vulnerable to heavy drinking (HD) in adults. We hypothesized HD adolescents would display early microstructural modifications of the pons/midbrain region, containing core structures of the reward system.
Methods: At age 14, 32 otherwise, symptom-free HD (HD14) and 24 sober adolescents becoming HD at age 16 (HD16), were identified in the community (IMAGEN cohort in 8 European cities) with the alcohol use disorders identification test (AUDIT) and compared with abstainers. The money incentive delay (MID) task assessed reward sensitive performance. Voxel-wise statistics of diffusion tensor imaging (DTI) values in the thalamo-ponto-mesencephalic region were obtained using tract-based spatial statistics. Projections between the ventral tegmental area (VTA) and the nucleus accumbens (NAcc) were identified by probabilistic tractography.
Results: Significantly different DTI values were detected in a cluster of the upper dorsal pons of HD14 and HD16 adolescents compared with abstainers. When expecting reward: HD14 had higher MID task success scores than abstainers. MID task success scores were linked with the number of tracts in all adolescents.
Conclusion: In symptom-free community adolescents, a region of lower white matter (WM) integrity in the pons at age 14 was associated with current heavy drinking and predicted heavy drinking at 16. Heavy drinking was related to reward sensitivity.
Engjellushe Hasani is a Cardiologist near Polyclinic no.3 in Tirana, Albania for more than 20 years. She also works near private practices, and has also taught near many private universities in Tirana. She has completed her PhD near the University of Tirana, Faculty of Medicine after studying for many years’ hypertensive tendencies in the population of Albania. She has published numerous papers in Albania and is a member of Women in Science Society and sits on the board of two important foundations amongst which The Foundation of Children in Need.
Cardiovascular diseases represent a significant burden for patients with dementia. There is conflicting evidence as to which dementia disorder is accompanied by a larger number of comorbidities. We have included in this study 689 persons who were diagnosed with dementia in Neurology and Psychiatry Service, in UHC Mother Teresa, Tirana Albania and are residents in Tirana, Albania. 381 of them was diagnosed with Alzheimer`s disease, 177 with vascular dementia, 24 frontotemporal dementia, 57 Parkinson`s disease dementia and 50 other dementia types. Cardiovascular comorbidities of patients were defined from medical records from hospitalizations; the prescription of cardiovascular drugs was derived from the register of GP and outpatient service of cardiology in Polyclinic no. 3 in Tirana. Patients were diagnosed with Alzheimer´s disease (55.2%), vascular dementia (25.6%), frontotemporal dementia (3.4%), Parkinson´s disease dementia (8.2%), and other dementia types (7.2%). Multinomial logistic regression was applied to find differences in the occurrence of cardiovascular comorbidities and drug prescription among different dementia disorders. All cardiovascular comorbidities were found to be more common in vascular and mixed dementia when compared to Alzheimer´s disease (67% vs. 23%). Diabetes mellitus (DM) (42%) and myocardial infarction (MI) (31%) were significantly less likely to occur in patients suffering from vascular dementia when compared to Alzheimer´s disease patients (DM 16% and MI 6%). Diabetes mellitus was also less likely to be diagnosed in patients with Parkinson´s disease dementia than in Alzheimer´s disease. There were no significant differences in the frequency of cardiovascular comorbidities between frontotemporal dementia patients and Alzheimer´s disease patients.
Mashhad University of Medical Sciences, Iran
Title: Evaluating the neurotoxic effects of stanozolol on male rats' hippocampi: dose stanozolol cause apoptosis?
Time : 14:20-14:50
Faezeh Nemati Karimooy has been graduated as an MD from Mashhad Univeristy of Medical Sciences, Iran. After graduation she immediately started to work as a GP and the Head of a general health center in Taybad city. Along with her GP career, she was engaged in neuroscience researches. She has also written a book in Persian- translation and complition- named “Sleep and Its Disorders” which is going to be published soon. As an MD, she is also interested in emergencies and collaborated in writing a book in Persian on procedures in emergency medicine.
Anabolic-androgenic steroids make a cluster of hormones consisting natural male hormone, testosterone and its synthetic derivation. One of the most appealing drugs of this family is stanozolol which is abused by athletes in high doses for improving their energy, appearance and physical size. It is proved before not only dose stanozolol cause changes in behaviour; it also has various physical effects. Researches have been conducted on its neurotoxic impacts on CNS most of which are psychological-based. This study was performed to examine the apoptotic effect of stanozolol on different parts of rat hippocampus. For this experiment, 16 male Wistar rats were divided randomly and equally in two groups (control and experimental). The experimental group received subcutaneous injections of stanozolol (5 mg/Kg/day) for 28 days uninterruptedly. The control group was treated with normal saline in the same period. Then, animals were anesthetized and their brains were extracted. After routine procedures, the brain sections were stained with toluidine blue and TUNEL for dark neuron and apoptotic cell detection respectively. In order to compare the groups, the mean numbers of TUNEL-positive cells and dark neurons per unit area were calculated with stereological methods and analysed by SPSS software. Our histopathological examination revealed the number of dark neurons and apoptotic cells in the CA1, CA2, CA3 and dentate gyrus of hippocampus have significantly increased in stanozolol group compared to the control group. Therefore, abusing of stanozolol may induce dark neuron and apoptotic cell formation in different regions of hippocampus and cause memory disorders.
Redina Hasani is a sixth-year student in the Second Faculty of Medicine in Charles University in Prague. Her involvement in Pediatrics and in issues in her home country that can find improvement has found her as part of the medical community every summer. Amongst her projects are helping assess methods to aid children in need and families through the foundation “Femijet ne Nevoje”. She is also the Coordinator for Albania and Kosovo for the newest research project in cystic fibrosis by Vertex Pharmaceutical
Presently, there is limited information on stroke care in the very old (80 years and older). In part, this is due to a paucity of publications on stroke in the elderly and low participation of this group. Population aging is a summary term to describe shifts in the age distribution of a population toward older ages, most in highly developed countries. In 2050, these figures are projected to be 29% and 18% in developed and developing countries respectively. A stroke occur when the blood supply to part of the brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients. About 85 percent of strokes are ischemic strokes and main etiological factors include high blood pressure, cigarette smoking, diabetes, and obstructive sleep apnea. Stroke incidence rates increase steeply with age. Therefore, we would also expect a rise in the number of elderly patients with stroke in the future. We included in this study 504 patients with ischemic stroke admitted to neurovascular service, in University Hospital Centre “Mother Teresa”, Tirana Albania, between February 2011, and December 2014. Aging-related alterations in cerebral vessels might eventually reduce cerebrovascular reserves and increase the susceptibility of the brain to vascular insufficiency and ischemic injury. Such changes could underlie the increase in morbidity and mortality rates following ischemic stroke in older individuals and the high level of vascular cognitive impairment in this age group. Our results constitute a first step in the understanding of stoke outcomes in those over age 80 and the approaching burden and challenges faced by the healthcare system.
- Special Keynote Lecture
Location: Gate 2
Neural Signals Inc., USA
Philip Kennedy is the Chief Scientist at Neural Signals Inc. He received his MD from National University of Ireland in 1972 and his PhD from Northwestern University, Chicago in 1983. He has published over 50 refereed papers
There is a general emphasis and movement towards non-invasive techniques and away from invasive neurosurgical procedures in the development of neural prosthetics that would restore movement to paralyzed limbs, control robotic limbs, provide access to computers and restore speech. The main issues come down to signal resolution and task requirements. For example, low resolution signals are adequate for communication with a computer. These signals could be from electroencephalography (EEG) or even residual electromyography (EMG) from a locked-in patient’s face for example. Even some movements of a robotic limb or paralyzed limb can be controlled with external EEG signals. Invasive, internal signals such as brain surface electrocorticography (ECoG), for example, are also being used for those tasks. ECoG signals, however, do not have the resolution of single unit signals but have made remarkable progress in developing control paradigms. So why bother with neurosurgical invasion of the brain to obtain high resolution single unit signals? There are at least two tasks that require these invasive, high resolution signals: fine digit movements and conversational speech. However, an alternative approach to solving the control issues for these highly precise tasks is to use low resolution signals combined with high performing deep mind computers. In other words, low resolution signals such as EEG might be adequate if combined with powerful neural net based computers. In that situation, ECoG and single unit recordings will become a thing of the past. The pros and cons of these approaches will be presented in this keynote talk.