Day 1 :
Keynote Forum
Wai Kwong Tang
The Chinese University of Hong Kong, Hong Kong
Keynote: Evidence of brain damage in chronic ketamine users: A brain imaging study
Time : 09:30-10:10

Biography:
Wai Kwong Tang was appointed as a Professor in the Department of Psychiatry, the Chinese University of Hong Kong in 2011. His main research areas are Addictions and Neuropsychiatry in Stroke. He 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.
Abstract:
Background & Objectives: The objectives of this study were to ascertain the pattern of grey and white matter volume reduction and regional metabolic and activation abnormalities in chronic ketamine users, and to evaluate the correlations between these brain abnormalities and cognitive impairments in chronic ketamine users in Hong Kong.
Design, Setting & Participants: A cross-sectional observational study was conducted at the Counseling Centre for Psychotropic Substance Abusers in Hong Kong. One hundred and thirty-six participants were recruited from October 2011 to April 2014. The participants were divided into two groups: ketamine users (79) and healthy controls (57).
Main Outcome Measures: Psychiatric assessments included screening with self-rating questionnaires and face-to-face interviews. All of the participants completed a detailed cognitive battery that covered general intelligence, verbal and visual memory, executive functions, motor speed and language. All of the participants underwent magnetic resonance imaging of the brain.
Results: Many of the participants in the ketamine group also frequently used cocaine and cannabis. Among the ketamine users, 12.6% were diagnosed with a mood disorder and 8.9% with an anxiety disorder. The participants in the ketamine group had worse performance than the healthy controls in tests of general intelligence, verbal, visual and working memory and executive functioning. In terms of grey matter volumes, the right orbitofrontal cortex, right medial prefrontal cortex, left and right hippocampus and possibly the left orbitofrontal cortex were smaller in the ketamine group. In contrast, the volumes of the left basal ganglia, left putamen and possibly the left caudate were higher in the ketamine group. In terms of white matter volumes, the ketamine group had a lower periventricular white matter volume in the right hemisphere. The grey matter volumes of the left and right orbitofrontal cortex, right medial prefrontal cortex, left basal ganglia and left putamen, and right periventricular white matter volume were negatively correlated with the severity of ketamine dependence. The hippocampal volumes were correlated with performance on the arithmetic, information and digit span tests. The periventricular white matter volume was also correlated with the information score. A functional connectivity examination of the default mode network revealed significantly decreased connectivity in the medial part of the bilateral superior frontal gyrus, left middle frontal gyrus, bilateral gyrus rectus, left superior temporal pole, left inferior temporal gyrus, bilateral angular gyrus and bilateral cerebellum Crus II in the ketamine group. This group also displayed increased connectivity in the bilateral precuneus and right inferior occipital gyrus.
Conclusions: The results provide imaging evidence of brain damage in chronic ketamine users. Chronic ketamine use was associated with reduced grey and white matter volumes in certain regions of the brain. Chronic ketamine use was also associated with altered functional connectivity with the default mode network. Abnormal brain structures and altered functional organization of the brain network may underlie the hypersensitivity towards drug related cues but weakened cognitive control in those with ketamine addiction. Longitudinal or prospective studies would help to strengthen the evidence on the reversibility of the structural and functional brain damage caused by ketamine.
Keynote Forum
Wai Kwong Tang
The Chinese University of Hong Kong, Hong Kong
Keynote: Structural and functional MRI correlates of Poststroke Depression
Time : 10:10-10:50

Biography:
Wai Kwong Tang was appointed as a Professor in the Department of Psychiatry, the Chinese University of Hong Kong in 2011. His main research areas are Addictions and Neuropsychiatry in Stroke. He 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.
Abstract:
Depression is common, following an acute stroke. Poststroke Depression (PSD) has 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.
Keynote Forum
Giulio Maria Pasinetti
Icahn School of Medicine at Mount Sinai, USA
Keynote: TBA
Time : 11:10-11:50

Biography:
Giulio Maria Pasinetti, The Saunders Family Chair and Professor of Neurology, received an M.D. from the Milan University School of Medicine and a Ph.D. from the University of Milan. He is currently the Program Director of the NIH funded Mount Sinai Center for Molecular Integrative Neuroresilience and the Chief of the Brain Institute Center of Excellence for Novel Approaches to Neurodiagnostics and Neurotherapeutics. He is also a Professor of Psychiatry, of Neuroscience, and of Geriatrics and Adult Development. Dr. Pasinetti is the recipient of several academic awards including the prestigious Zenith and Temple awards from the Alzheimer's Association. Most recently, Dr. Pasinetti was awarded ''The Faculty Council Award'' for academic excellence at Mount Sinai School of Medicine and "The Charles Dana Alliance for Brain Research Award" from Dana Foundation, recognizing productivity and worldwide leadership in his field of expertise, which further emphasizes his standing as an academic role model
Abstract:
- CNS Function and Disorders | Signal Transduction | Cognitive Neurophysiology
Location: Forum 9

Chair
Giulio Maria Pasinetti
Icahn School of Medicine at Mount Sinai, USA
Session Introduction
Karolina Can
University in Göttingen, Germany
Title: Mitochondrial dysfunction and neuronal redox imbalance – The primary cause of Rett syndrome?
Time : 11:55-12:25

Biography:
Karolina Can is a Post-Doctoral Researcher, whose expertise focuses on Rett syndrome and oxidative stress. She performed her PhD at the Georg-August University in Göttingen in Germany, where she now continues running various projects towards mitochondrial dysfunction and potential molecular targets involved in this neurodevelopmental disorder. She strictly extended her proficiency already during her Master’s studies (MSc performed at Jagiellonian University in Krakow in Poland), when she took advantage on annual internship in the Institute of Human Genetics in Göttingen in Germany, and switched her gears from genetics towards neurophysiology and live-cell imaging.
Abstract:
Statement of the Problem: Rett syndrome (RTT) is a neurodevelopmental disorder, which occurs almost exclusively in girls with a prevalence of 1:10.000-1:15.000 life births. The genetic causes of RTT are de novo mutations in the MECP2 gene. After a short normal development, developmental stagnation occurs with a neuronal and autonomic dysfunction, manifested as mental retardation, erratic breathing, epilepsy, loss of speech and stereotypical hand movements. Growing evidence indicates that RTT associates with mitochondrial dysfunction and oxidative stress. We previously showed that mitochondria of MeCP2-deficient (Mecp2-/y) mouse hippocampus are partly uncoupled and show a higher consumption of O2. To assess molecular events contributing to redox impairment, we intensified our analyses focusing specifically on neurons and their cytosolic and mitochondrial compartments.
Methodology & Theoretical Orientation: Quantitative real-time imaging of redox dynamics was performed with the genetically-encoded redox sensor roGFP1 in cytosol and mitochondrial matrix of dissociated neurons and organotypic hippocampal slices. Optimized expression was achieved by viral transduction.
Findings: Detailed excitation ratiometric fluorescence microscopy confirmed that in Mecp2-/y hippocampal neurons, the redox imbalance affects the cytosolic and mitochondrial compartments. These changes were especially obvious for more complex organotypic slices. Redox challenge by H2O2 and severe hypoxia elicited intensified oxidizing and reducing transients in Mecp2-/y neurons, respectively. Inhibition of superoxide dismutase elicited only a dampened oxidation in Mecp2-/y cytosol and mitochondria, suggesting a decreased efficiency of this scavenging enzyme in Rett mice. More importantly, stimulation by neurotransmitters consistently evoked intensified oxidizing shifts in the cytosol of Mecp2-/y neurons.
Conclusions & Significance: Redox imbalance associated with RTT clearly affects cytosol and mitochondria of central neurons. Even physiological events such as neurotransmitter stimulation are sufficient to provoke overshooting redox responses in Mecp2-/y neurons. As these changes are already evident in presymptomatic mice, they may promote the progression of RTT.
Xavier F Figueroa
Pontifical Catholic University of Chile, Chile
Title: Nitric oxide-dependent S-nitrosylation of Ca2+ homeostasis modulator 1 (CALHM1) channels coordinates neurovascular coupling through the control of astrocytic Ca2+ signaling
Time : 12:25-12:55

Biography:
Xavier F Figueroa has completed his PhD from Pontificial Catholic University of Chile and Postdoctoral Studies from University of Virginia, Cardiovascular Research Center. Currently, he is Associate Professor at Pontificial Catholic University of Chile and is the Director of the Laboratory of Vascular Biology at the Department of Physiology. He has published more than 30 papers in reputed peer-reviewed journals, several of which have been highly cited. His lab combines cellular approaches with studies in intact and in vivo preparations to study the mechanisms involved in the control of microvascular function in peripheral tissues and in the brain.
Abstract:
Neuronal activity depends on the fine and timely regulation of cerebral blood flow by a mechanism known as neurovascular coupling. Neurotransmitters released during an increase in synaptic activity (e.g. glutamate) activate receptors in astrocytes located between neurons and parenchymal arterioles, which initiates a Ca2+ signaling that is propagated to the astrocytic-endfeet and evokes the release of vasodilator factors, leading to an increase in local blood flow. This process is coordinated among neighboring astrocytes, mainly, through gap junctions and ATP release via hemichannels. It has been proposed that release of NO, a potent vasodilator, from neurons, during an increase in synaptic activity, may be involved in neurovascular coupling. However, astrocytes express the Ca2+-dependent NO-synthetizing enzymes eNOS and nNOS and NO may be involved in the control of Ca2+ signals by direct S-nitrosylation of Ca2+ permeable channels such as connexins-based gap junction channels and hemichannels or pannexin-formed channels. Then, the participation of NO in the neurovascular coupling initated by metabotropic glutamate receptor (mGluR) stimulation was assessed in primary cultures of astrocytes and rat brain slices. NO production, vasomotor response of brain cortex arterioles, changes in [Ca2+]i and ATP release were evaluated. In addition, the activity of connexin hemichannels, pannexin channels and Ca2+ homeostasis modulator 1 (CALHM1) channels was also analyzed. Interestingly, the results indicate that NO and CALHM1 channels play an essential role in the astrocyte signaling that mediates neurovascular coupling. Stimulation of astrocytes mGluRs leads to NO-mediated activation of CALHM1 channels by S-nitrosylation, which evokes ATP release. The subsequent ATP-dependent purinergic receptor stimulation induces the opening of Cx43 hemichannels and Panx-1 channels, which contributes to the astrocytic Ca2+ signaling. These findings may provide clues to the design of new therapeutic strategies for the treatment of neurodegenerative diseases.
Wang Liao
Sun Yat-Sen Memorial Hospital - SYSU, Chin
Title: Magnesium elevation affects fate determination of primary cultured adult mouse neural progenitor cells via ERK/CREB activation
Time : 12:55-13:25

Biography:
Wang Liao is a first-year PhD candidate majoring in Neurology at Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University. He mainly focused on regulation of adult neurogenesis, and development of new therapeutic targets for treatment of Alzheimer’s disease.
Abstract:
Adult neurogenesis, which is the generation of functional neurons from neural precursors, occurs throughout life in restricted anatomical regions among mammals. Numerous studies have demonstrated a correlation between the level of hippocampal neurogenesis and cognition, whereas dysfunction of neurogenesis contributes to some pathological processes including Alzheimer’s disease, Parkinson’s disease, and other degenerative diseases. Magnesium is the fourth most abundant ion in mammals, and its elevation in the brain has been shown to enhance memory and synaptic plasticity in vivo. The substantial synaptoprotective effects of magnesium elevation in the brain have also been demonstrated in a mouse model of Alzheimer’s disease. However, the effects of magnesium on fate determination of aNPCs, which are vital processes in neurogenesis, remain unknown. NPCs isolated from the dentate gyrus of adult C57/BL6 mice were induced to differentiate in a medium with varying magnesium concentrations (0.6, 0.8 and 1.0 mM) and extracellular signal-regulated kinase (ERK) inhibitor PD0325901. The proportion of cells that differentiated into neurons and glial cells was evaluated using immunofluorescence. Quantitative real-time polymerase chain reaction and Western blot methods were used to determine the expression of β-III tubulin (Tuj1) and glial fibrillary acidic protein (GFAP). The activation of ERK and cAMP response element-binding protein (CREB) was examined by Western blot to reveal the underlying mechanism. Magnesium elevation increased the proportion of Tju1-positive cells and decreased the proportion of GFAP-positive cells. Also, the expression of Tuj1 was upregulated, whereas the expression of GFAP was downregulated. Moreover, magnesium elevation enhanced the activation of both ERK and CREB. Treatment with PD0325901 reversed these effects in a dose-dependent manner. This study showed that magnesium elevation effected fate determination of adult neural progenitor cells (aNPCs) and the possibly via ERK-induced CREB activation.
Crissy Accordino
Specialty Care - IONM Division, USA
Title: Clinical Performance of IONM (Intraoperative Neuromonitoring) in the Operating Suite
Time : 14:25-14:55

Biography:
Christina Accordino has her expertise in operational accountability for the clinical and financial management of the utilization of intra-operative neuromonitoring (IONM) during surgical procedures that may put a surgical patient’s central nervous system at risk. Her passion is in providing superior patient care while meeting or exceeding clinical and quality metrics. Since 2007, she has held her Certification Examination in Neurophysiologic Intraoperative Monitoring (CNIM) through ABRET (American Board of Registration of Electroencephalographic and Evoked Potential Technologists). Her foundational skill-set includes SSEP, TceMEP, S/T-EMG, EEG, BAER, and direct cortical mapping. She feels that the use of these combined modalities supports spinal cord continuity during cranial, spine, vascular, ENT, and cardio-thoracic procedures. Her experience both in the operating room as a clinician and out, as Director of Operations for SpecialtyCare, has helped her excel in providing direction in managing complex customer, physician, employee and patient related tasks regarding the use of neurophysiological monitoring in the healthcare field.
Abstract:
Intraoperative neuromonitoring (IONM) can bring value to the operating suite. This presentation will review the expectations from adding this additional service to your practice. The talk will address the need for quality assurance processes and tell a story of the true purpose of IONM. A review of the benefit of utilizing a multi-modality approach, common signal changes, actions following changes, resolution of neuromonitoring changes, post-operative status, confound avoidance from a technical and anesthetic standpoint, and the necessity of performing safety checklists will be addressed during this demonstration. Learn how to walk through the processes of the use of IONM and look for opportunities of internal and external improvement to ultimately improve patient outcomes.
- Case Study on Neurophysiology | Experimental Neurophysiology | Neuro Therapeutics
Location: Forum 9

Chair
Xavier Figueroa
Pontifical Catholic University of Chile, Chile
Session Introduction
Getachew Desta Alemayehu
Bahir Dar University, Ethiopia
Title: Craniopagus parasiticus: Parasitic head protuberant from temporal area of cranium - A case report
Time : 15:05-15:35

Biography:
Getachew Desta Alemayehu is a 2011 graduate from Gondar University for the Doctor of Medicine and has one and half year working experience as a Lecturer at Bahirdar University. At present, he is a fourth year resident in Surgery at Bahir Dar University, Ethiopia.
Abstract:
Background: Craniopagus parasiticus is a rare medical case and it is unique unlike other cases reported from different literature. In this case, the head of parasitic twins is protruding from the temporal area of cranium. Parasitic head has two deformed lower limbs; one is too rudimentary attached to the mass; long bones of bilateral lower limbs and some pelvic bones. After dissection of the mass, the intestine was seen but no chest organs and other abdominal organs are seen. There is also rudimentary labium but no vaginal opening.
Case presentation: A 38-years-old multigravida (Gravida V para IV) women from Amhara ethnicity referred from rural health center to Referral Hospital due to prolonged second state of labor at 42+1 weeks. Upon arrival she had contraction, term sized gravid uterus, and fetal heart beat was 112. On digital pelvic examination the cervix was fully diluted, station of the head was high and the pulsating umbilical cord coming in front of the presenting part with ruptured membrane but yet in the vaginal canal. The team decided to emergency cesarean section and then a live female infant weighing 4200 g was delivered. The placenta was single and normal. The APGAR scores were 7 and 9 at 1 and 5 min, respectively. The infant appeared to be grossly normal except the parasitic co-twin attached at the cranium. The neonate was investigated with the available investigations (CBC, X-Ray, Doppler ultrasound) and pediatric side consultation was made. After a week of counseling and investigations, successful separation operation was done. During post-operative time the neonate was comfortably suckling on breasts with no neurological deficit. The details of the surgery, post-operative condition and subsequent follow up will be discussed during the conference.
Conclusion: The possible etiologies craniopagus parasiticus is still unknown due to a rarity of cases. Doctors, Genetic Scientists, Epidemiologists and Researchers continue to investigate this case as the reasons that could give clue to birth defect and to provide answer for better prognosis of cases and to improve the life chances of the twins. This case will have some input in the effort to know the etiology and pathogenesis of this new born
Saman Saghafi
Shahid Beheshti University, Iran
Title: History of Psychosomatic diseased and the Islamic medicine opinions about Brain and Mind
Time : 15:35-16:05

Biography:
Abstract:
Statement of the problem: Research results in Cognitive and Psychology sciences in field of relationships between mind and body led a new subject to appeared in modern age medicine calling “Psychosomatic”. Despite of the new concept of Psychosomatic but it has an old background particularly in Islamic Medicine.
The purpose of this study: This study has tried to shed light on Islamic physicians studies about Psychosomatic diseased till end of 10th century and categorized their methods in this field of study.
Methodology & theoretical Orientation: This research used historical method. This study has aimed several famous Islamic medicine books mostly between 6 BC till 10 BC. It consisted of Canon of Medicine from Avicenna, Al-Hawi from Rhazes, and Abu Zayd al-Balkhi notes.
Findings: This study has classified physiology-psychology impacts, diseased, Problems and methods of their treatment based on medieval Islamic Physicians opinions
Conclusion and Significance: For the first time the relationships between mind and body stated in Islamic medicine books theoretically. Islamic physicians used this method for curing not only mental disorders but also physical.
Keywords: Islamic Medicine, Psychosomatic, Mental Disorders, Physical Disorders
Robert L Tanguay
University of Calgary, Canada
Title: Cannabidiol’s (CBD) purported antipsychotic properties to cannabis induced psychotic disorder
Time : 16:25-17:25

Biography:
Robert L Tanguay completed his BSc from the University of Lethbridge, attended Medical School at University of Calgary and did his Residency in Psychiatry. He completed his Fellowship in Addiction Medicine under the guidance of Nady el-Guebaly. He is also a Pain Medicine Fellow in the Department of Anesthesia at University of Calgary. He is actively involved in education, teaching medical students and psychiatry residents at the University of Calgary.
Abstract:
We reviewed the literature that proposes the mechanisms of cannabis induced psychotic disorders and hence, increases the risk of early onset of schizophrenia. There have been recent studies showing psychosis as secondary to the THC levels in marijuana, and several studies were found showing CBD may be protective and actually have antipsychotic properties equal in efficacy to atypical antipsychotics such as amisulpride. The percentage of THC is much higher today than in the past and certain formulations have been able to even further concentrate THC such as shatter, wax, honey oil, etcetera. Complicating this is that CBD is almost nonexistent in illicit and legal marijuana around the world. Due to Mendelian genetics, as THC concentration is increased, CBD concentration seems to be inversely reduced. This eliminates the protective factors of CBD while increasing the risk of psychosis. THC and CBD seem to have opposite physiologic effects on endogenous anandamide levels and cannabinoid receptor binding, the mechanism likely leading to CBD’s antipsychotic effect.
- Drug Addiction | Science of Drug Abuse | Dual Diagnosis Rehabilitation and Recovery
Location: Forum 9

Chair
Charles Graham
Community College of Aurora, USA
Session Introduction
Kaufui Vincent Wong
University of Miami, USA
Title: Good Practices, Foods, and Nutrition for the Brain
Time : 11:45-12:15

Biography:
Kaufui Vincent Wong is a Professor of Mechanical and Aerospace Engineering at the University of Miami (UM), Florida, where he has taught and researched since 1979. His primary research areas are in energy and the environment, fluid mechanics, nanotechnology, nutrition and health. He has published over 200 refereed papers in journals and conferences. He authored 2 text-books on Thermodynamics, one on Intermediate Heat Transfer, one on Climate Change and one on Sustainable Engineering. He holds two patents. He has received awards for teaching and mentoring students. He has served on the UM Graduate Council for 3 terms, and elected Faculty Senator for one. He is active in the American Society for Mechanical Engineers (ASME), and have held many leadership positions, including Chair of the Advanced Energy Systems Division, and Deputy Group Leader of the Energy Group. He is the 2015 ASME Dixy Lee Ray Award recipient for the environment. He is a popular invited Keynote Speaker in international conferences and symposiums. He is serving as the Editor-in-Chief of the Journal of Renewable Bioresources, the Journal of Modern Mechanical Engineering and Technology, and the Journal Advanced Sustainable Engineering. He is on the Editorial Board of the Journal of Surface Modeling and Additive Manufacturing, the Journal of Ecology and Environment Sciences, the Journal of Epidemiology and Public Health Reviews
Abstract:
This work is a careful listing of the significant practices which are good for the body, practices which are especially good for the brain, as well as food and nutrition which are especially good for the brain. The objective of this study is to help researchers to promote brain health among the public. It is suspected that several of the practices may not be commonly known. The generation of discussion is healthy in the field of science, and this is a secondary function of this publication. Any omissions of significant actions which can be easily adopted by anyone are regretted. This mini review also produced a listing of commonly available brain- healthy foods. Regular, appropriate exercise that employs all the body’s muscles is advanced as one of the two significant pillars of physical health. In other words, everyone should move daily and try to avoid being too sedentary. The second pillar for one’s health is a balanced and nutritious diet, which would lead to an appropriate weight range and good mental health. Good practices for the brain are highlighted, hich makes use of the fact that the brain generates new cells periodically, but just as often dies, if not employed to form new neural networks when the person learns new activities. In other words, ‘use it or lose it’ applies to neurons as well as muscles
Gholamreza Heydari
Tobacco prevention and control research center, Iran
Title: Primery report of national study on merging smoking cessation with drug abuse treatment centers in Iran 2016
Time : 12:15-12:45

Biography:
Gholamreza Heydari completed his MD in 1996, and has done MPH and PhD degrees on Epidemiology from Shahid Beheshti University of Medical Sciences. He is currently the Director of Tobacco Prevention and Control Research Center and WHO Collaborating Center on Tobacco Control in Eastern Mediterranean region and also the Chairman and Editor-in- Chief of many tobacco control journals of Iran. He is conducting several studies on tobacco control and smoking cessation in Iran. He has more than 40 papers on this topic internationally. He has attended many training courses such as Classical Method in Data Analysis, Erasmus Medical University, Netherlands, December 2001; Tobacco Free Initiative for Clinicians, St George’s Hospital, London, England, July 2002 and Smoking Cessation, European Respiratory Society School, Bucharest, Romania, December 2004.
Abstract:
Many of opium abusers are tobacco smokers, though they would like to quit smoking but unfortunately only a small number of them can benefit from assistance in this respect. Thus, authorities in different countries are responsible for providing low-cost and cost-effective interventions and quit programs to help smokers stop smoking. Nicotine addiction is rarely regarded with the same urgency as drug narcotics abuse in the scope of public health. The aim of this study was to evaluate effect of merging smoking cessation with drug abuse treatment nationally. This was a cross sectional study of educating 3 sessions quit smoking intervention with clinical behavioral therapy CBT and medication in 24 drug abuse treatment center in 6 districts of Iran in 2016. More than 2000 clients were involved with mean age of 41 and 89% male. 78% of them were satisfied with this new treatment and after 6 months, 23% had quit smoking, smoking less than half amount at first was seen in 46% and 31% were yet a smoker. In conclusion, smoking cessation intervention with CBT and medication can have a significant impact on the general health of drug abusers.
Esmeralda Thoma
University of Medicine of Tirana, Albania
Title: Co-morbidity of alcohol abuse in Albania
Time : 12:45-13:15

Biography:
Esmeralda Thoma is a Clinical Toxicologist and Addictologist. He has completed his Doctoral studies in 2015 and Specialization in 2010 from University of Medicine of Tirana. He is a Professor at the Faculty of Technical Medical Studies/University of Medicine in Tirana since 2005 and has published several articles in journals and has participated in several conferences.
Abstract:
Introduction: Alcohol abuse used to be a common phenomenon mainly among male in Albania. Women usually can be classified as social drinkers.
Aim: The aim of this study is to highlight common co-morbidity of alcohol abuse in Albania.
Materials & Methods: This is a retrospective study that was conducted at the Clinic of Toxicology and Addictology at Mother Teresa University Hospital during January 2012-june 2013. In this study, 330 patients were included. The diagnosis of alcoholism was based on lab exams and anamnesis.
Results: Out of 330 patients 98% were male. 174 of these patients had at least one other diagnosis except alcoholism, from which 107 had dual diagnosis. We have observed statistically significant positive correlation between the time and the amount of alcohol abuse and the number of comorbid diagnosis, respectively (rho=0.2 95% CI 0.05-0.26 p<0.01 and rho=0.2 95% CI 0.079-0.382 p<0.01). In 58.2% of patients with comorbidity, alcohol abuse was considered the main factor responsible for the comorbid diagnosis i.e., alcoholic hepatitis, alcoholic pancreatitis, alcoholic liver cirrhosis, psychiatric diseases, except schizophrenia and post traumatic disorder. Sixty-six patients had a dual diagnosis, alcohol abuse and psychiatric disorder. From these, the most prevalent was anxiety disorder in 45.5% of patients. Forty-five patients had alcoholic hepatitis, 40.4% of patients had Wernicke-Korsakoff syndrome and equally 40.4% had polyneuropathy.
Conclusions: As it is known that long term alcohol abuse virtually causes different organ injury, it is important that all alcohol abuse patients must be carefully evaluated for co-morbidity.
- Addictive Disorder | Clinical Intervention and Case Report
Location: Forum 9

Chair
Kaufui Vincent Wong
University of Miami, USA
Session Introduction
Muhammad Akbar Malik
The Brain Associates Institute, Pakistan
Title: Emergent electroencephalogram patterns in encephalopathy among systemic cancer patients admitted in neurointensive care units
Time : 14:25-14:55

Biography:
Muhammad Akbar Malik was trained in General Pediatrics in Pakistan and then was trained in Frenchay Hospital Bristal, UK. He established Pediatric Neurology department and worked for five years in Lahore Children Hospital.
Abstract:
Background & Purpose: Evaluating medical coma in systemic cancer patients is inherently complex, neurologic consultation supported with the standard emergent bed-side electroencephalogram (EEG) can be useful. Recommendations for EEG monitoring in the Neurointensive Care Units (NCUs) are lacking. We sought to determine, usefulness of emergent standard bedside EEG features among cancer patients with unexplained coma (GCS≤8).
Materials & Methods: We conducted a prospective EEG assessment of 200 systemic cancer patients consecutively diagnosed and admitted in neurointensive care units (NCUs) of the tertiary care cancer hospitals with unexplained acute impaired consciousness (GCS≤08). Bed-side EEG recordings were done according to the clinical scenario and the requirements of the treating neurologist/intensivist. Patients with brain tumor, brain metastasis, seizures or those with known cause of coma were excluded. Data surrounding clinical, electrographic and treatment factors were collected via a prospective systematic review of medical records and electronic EEGs for correlation with diagnosis, change in the diagnosis and management.
Results: Over a period of two years (from January 2014 to December 2016), a total of 200 systemic cancer patients with an average age of 36 years with acute deterioration of conscious level (GCS≤08) were identified. Of the total, males were 120 (60%), and overall 40 (20%) of these patients were of ≤16 years. At least one bed-side EEG of ≥30 minutes was monitored on each of these patients, which was abnormal in 100% of the records. The main reasons for EEG requests were: 1) Unexplained impaired consciousness/not gaining consciousness 130 (65%) and, 2) One plus convulsions 70 (35%). The EEG records were abnormal in 100% of these comatose patients. The EEG findings in clinical category 1 were: i) Encephalopathy 90 (69.2%), among these 90 patients 26 (23%) patients had encephalopathy with epileptiform discharges, ii) Continuous spike-wave discharges (NCSE) 14 (10.8%), iii) Burst-suppression pattern 12 (9.3%), iv) Electrocerebral inactivity pattern 8 (6.2%), v) Theta coma 4 (3%) vii) alpha coma 2 (1.5). The EEG findings in clinical category 2 were: i) Encephalopathy 54 (77%), among these 54 patients 17 (24%) patients had encephalopathy with epileptiform discharges, ii) Continuous spike-wave discharges (NCSE) 6 (8.6%), iii) Burst-suppression pattern 6 (8.6%), iv) No electrocerebral inactivity pattern, v) Theta coma 2 (2.9%) and vi) Alpha coma 2 (2.9%).
Conclusion: Bed-side EEG record of ≥30 minutes is useful in general cancer patients admitted in NCU with acutely impaired consciousness with or without abnormal body movements. Neurology consultation and EEG studies in these comatose patients provide useful diagnostic and therapeutic information.
Etdal Eltoum
University of Khartoum, Sudan
Title: Schizophrenic patient and nicotine addiction clinical observation in mental health psychiatry outpatient clinics
Time : 14:55-15:25

Biography:
Eltoum Etdal has completed her RN, BSN, MSN at the age of 40 years from University of Khartoum Faculty of Medicine School of Nursing and she joined Kingdom of Saudi Arabia-Riyadh King Faisal Specialist Hospital & Research Center since 1992 up to date as register nurse RN. She is the Psychiatry Nurse Coordinator of Mental Health Department. She has published continuum of care of clonazepam misuse prescription mental health psychiatry out patient at King Faisal Hospital & Research Centre.
Abstract:
Background: Mild schizophrenia patient with nicotine addiction may have benefit from alternative therapy such as cognitive behavioral therapy added to nicotine replacement therapy compared to other substance abuse, but patient with severe schizophrenia a token economic therapy is best chose. Smoking cessation in Schizophrenia population, its harmful effects on health, finances, role of mental health care providers and better available options for treatment as are in general population.
Objective: To decrease risk of cardiovascular and pulmonary compaction and early death bu using the method of Clinical observation with the schizophrenic patients and nicotine addiction.
Result: Patients referred to psychotherapy in addition to nicotine replacement for the better outcome. In agreement with literature mild schizophrenia get benefit from cognitive behavioral therapy than sever schizophrenic patients.
Vahid Farnia
Kermanshah University of Medical Sciences, Iran
Title: Methamphetamine- Induced Psychiatric Disorders
Time : 15:25-15:55

Biography:
Vahid Farnia is the Head of Substance Abuse Prevention Research Centre at Kermanshah University of Medical Sciences, Kermanshah, Iran. He has studied Medicine from the Isfahan University of Medical Sciences, and obtained his Medical degree in 2000. He studied Psychiatry at the Tehran University of Medical Sciences, and obtained his National Psychiatry Board Certification in 2008. He has undertaken more than 20 projects concerning drug abuse and drug induced psychiatric disorders. He is the author of several published papers in accredited journals, and the author of the chapter entitled: Amphetamine psychosis in "Neuropathology of Drug Addictions and Substance Misuse" published by Elsevier.
Abstract:
Amphetamine and methamphetamine are the principal members of amphetamine-type stimulants. Amphetamine usually prescribed for treatment of several mental disorders including attention deficit hyperactive disorder and narcolepsy. Illegal use of methamphetamine is a global and growing phenomenon and in recent years, there has been a significant increase in the production and use of methamphetamine worldwide. According to the World Drug Report, the amount of methamphetamine seized was increased from 34 tons in 2009 to 88 tons in 2013. In addition to the growing market for methamphetamine in Asia, there are also reports which show increasing use in some parts of the North America and Europe. Amphetamine-related psychiatric disorders are a group including several mental disorders which are induced by amphetamine use. Although the relationship between amphetamines use and development of psychiatric disorders are well established from several years ago, the data related to the prevalence, clinical features and treatment of these disorders are very limited. Considering the highly addictive nature, and its ability to produce psychiatric disorders, methamphetamine abuse is a major public health concern in the current century. While the number of the patients with methamphetamine induced mental disorders as well as the patients with abuse and chronic dependence on methamphetamine is growing, more comprehensive understanding of clinical course and treatment of these disorders seems necessary for mental practitioners. In this presentation, the author will talk about their studies regarding several amphetamine-induced psychiatric disorders including methamphetamine induced psychosis, obsessive compulsive disorder, and sexual disorders.
- Neurophysiology and Critical Care Monitoring | Neuropharmaceutics
Location: Forum 9

Chair
Felix-Martin Werner
Euro Academy Pößneck, Germany
Session Introduction
Ettore Di Scipio
Ospedale San Filippo Neri, Italy
Title: Intra-operative monitoring of auditory pathways: A new faster BAEP's technique
Time : 11:45-12:15

Biography:
Ettore Di Scipio is an MD and Clinical Neurophysiologist at San Filippo Neri Hospital in Rome. He is shifting his focus from neurological investigation to nervous system protection. He treats both inpatients and outpatients, and has expertise in electromyography, intraoperative neurophysiological monitoring, electroencephalography and polysomnography. Currently, he is studying new applications of "CE-Chirp® BAEP's stimulus" in Neurology.
Abstract:
CE Chirp© LS is a new acoustic stimulus designed to provide faster detection of larger amplitude BAEP's waves. CE Chirp LS BAEP's are performed in the same way as click BAEP's. Surface electrodes are placed at the vertex (Cz) and on each earlobe (A1 and A2). Filters bandwidth are 150-1500 Hz. Two channels are used: A1-Cz and A2-Cz. Stimuli are presented by inserting earphones with alternate polarity at 41.1 Hz, but can also be presented at higher frequencies. Sound pressure range is 80 to 100 dB nHL, choosing the sound pressure level giving the clearest waves. Controlateral ears are masked by white noise at 50 dB nHL. CE Chirp© LS stimulus has the same spectrum and the same calibration as a usual square wave click stimulus. Acoustic energy from low, mid and high frequency components of CE Chirp© LS stimulus reaches all the regions of the cochlea at the same time. This allows neurons in the cochlea to fire synchronously. This change in stimulus presentation results in a CE Chirp© LS BAEP's wave V of double amplitude than click BAEP's wave V. Double amplitude of wave V translates in a reduction of test time. SNR improvement is equal to the square root of the number of trials averaged. If we want to achieve the same Signal/Noise Ratio (SNR) of click ABR, if the response is 2 times bigger, then we need 1/(2)2 of sweeps, that means only 25%. So, instead of 2000 sweeps we need only 500. This is a quarter of test time. Combined with high frequency of stimulation, e.g. 63 Hz, we can have a very clear BAEP's in 5-15 seconds. In our experience, CE Chirp© LS BAEP's monitoring can be performed up to four times faster than click BAEP's. Neurophysiologists can be able to inform neurosurgical equipe in few seconds about variations of wave V parameters.
Sadaf Mohtashami
McGill University, Canada
Title: Expression and proteomic analyses of kif1a/25b in hereditary sensory and autonomic neuropathies type II
Time : 12:15-12:45

Biography:
Sadaf Mohtashami is a Master’s student in the Division of Experimental Medicine in the Faculty of Medicine at McGill University. She is pursuing her research under the supervision of Dr. Guy Rouleau who has contributed to the identification of over 20 disease-causing genes and new mutational mechanisms. The laboratory team of Dr. Rouleau is focused on identifying genes involved in neurological and psychiatric diseases and on understanding the biological function of those genes.
Abstract:
Hereditary sensory and autonomic neuropathies form a group of genetic disorders characterized by variable sensory and autonomic dysfunctions. HSAN type II (HSANII) is a debilitating subtype manifesting in early childhood with distal numbness and loss of pain, temperature and touch. The first cluster of HSANII cases was reported in eastern Canada, with half the patients of French-Canadian descent. Our laboratory has reported truncating mutations in a nervous-tissue-specific exon (HSN2) of the WNK1 gene. The WNK1 isoform containing the alternatively spliced exon (HSN2) is referred to as the WNK1/HSN2 isoform. Interestingly the protein region encoded by the alternatively spliced exon was found to interact with a particular isoform of another HSANII causative gene, KIF1A. The HSANII-causing KIF1A isoform is referred to as KIF1A/25B since disease-causing mutations were exclusively found in the alternative exon “25B”. KIF1A belongs to a superfamily of microtubule-dependent proteins that mediate specific and diverse motile processes within the cell.
Materials & Methods: The expression profile of KIF1A/25B across the nervous system is determined by performing WB immunodetection using tissues from wild-type mice and a rabbit antiserum. The function of the protein encoded by exon 25B is assessed through a profiling of its interacting partners by performing co-immunoprecipitation for full-length KIF1A/25B protein, full-length KIF1A/25B minus exon 25B, the protein that correspond to exon 25B and EGFP protein as a negative control. Positive interactions are confirmed using liquid chromatography–mass spectrometry.
Results: KIF1A/25B is the transit system through which WNK1/HSN2 traffics within the cells and offers the two proteins an opportunity to interact with other cellular elements relevant to the sensory and nociceptive aspects of HSANII.
Conclusions: This study answers fundamental questions regarding the molecular pathophysiology of HSANII, though our findings have an impact on the understanding of other neuropathies and of normal neuronal processing.

Biography:
Abstract:
Introduction: Sleep as a widespread physiological phenomenon is seen in all vertebrates. In primates as human, the sleep consists of two components REM & non-REM. One of the major centers involved in the control of REM sleep is Locus Coeruleus. REM sleep deprivation causes neural death in the LC. In the present study, we administered melatonin as an antioxidant factor and neuroprotective agent to prevent neural death.
Material & methods: In this study, the Flowerpot approach has been used to induce RSD. Melatonin was administered for 7 days, the count & the volume of the LC neurons examined due to stereology methods. The enzymatic test for GSH & measurement of Caspase-3 & C-Fos was done to assess the antioxidant property and apoptosis process and neural activity respectively. Immunohistochemistry of Anti-TH factors was done to assess the noradrenergic neurons and the Iba-1 test was also done to show the microglial migration.
Results: According to the papers the RSD cause neural apoptosis in LC. Melatonin leads to a reduction in the level of apoptotic factor Caspase-3 expression followed by RSD. According to stereology analysis, the count of adrenergic neurons & the volume of the nucleus reduces after RSD & in the administered-melatonin group the apoptotic protein Caspase-3 reduces to prevent neural death. Microglial migration to the LC occurs after neural death and the melatonin increases GSH levels in RSD group finally.
Conclusion: Melatonin with neuroprotective property can be used to treatment of adrenergic-depended sleep disorders & prevention of neural apoptosis in LC
Keywords: Locus Ceoruleus, Melatonin, RSD, apoptosis, oxidative stress
Ayissi Mbomo
University of Yaoundé I, Cameroon
Title: Medicinal plants real or placebo properties? The case of Mimosa pudica empirically used in Cameroon to treat anxiety and depression
Time : 14:15-14:45

Biography:
Abstract:
In the columns of one paper of the World Health Organization published on 16th May, 2002, it appears that in the developing countries, over 80% of the population lives in rural areas. Generally, the content of the exchange of these populations is insufficient to help all the needs of daily life including access to modern medicines already very expensive in large cities. To solve the problems of health, these populations use medicinal plants. Often the therapeutic properties of these plants remain hypothetical or just placebos. Currently in Cameroon and elsewhere in Africa, Asia and South America, government efforts are growing in the direction of more rational and scientific use of medicinal plants. Mimosa pudica Linn. (M. pudica) is a plant empirically used in some countries to treat anxiety and depression. In the present study, two months old mice, Mus musculus Swiss were acutely treated by different doses of M. pudica (3, 10 and 30 mg/kg) and anxiety related responses evaluated by analyzing Stress-Induced Hyperthermia (SIH), Elevated Plus Maze (EPM), Elevated T Maze (ETM), open field and hole board parameters. The horizontal wire and rota-rod tests were then used to highlight possible myorelaxant properties of M. pudica. Finally, we investigated the effect of aqueous extract of M. pudica on regulation of Dorsal Raphe Nucleus (DRN) 5-Hydroxytryptamine (5-HT) neuronal activity using an in-vitro mouse brain slice preparation providing from adult male C57/BL6 mice. The decrease of SIH was observed with M. pudica (30 mg/kg) treatment. In the EPM, significant increase of open arms entries and percentage of time spent in the open arms with M. pudica (10 mg/kg) was observed. Neither diazepam (3 mg/kg) nor M. pudica (3 and 10 mg/kg) produced changes of motor activity. However the change of motor activity was observed with M. pudica (30 mg/kg). In the hole-board test, M. pudica (3 and 10 mg/kg) significantly increased the number and duration of the head-dips respectively. The anxiolytic properties of M. pudica as assessed using the EPM test were abolished by flumazenil (3 mg/kg), by bicuculline (5 mg/kg), and FG 7142 (10 mg/kg). Acute treatment with M. pudica extract also had an anxiolytic effect on behaviour in the ETM, specifically on inhibitory avoidance behaviour. In the horizontal wire test, both M. pudica (3 and 10 mg/kg) and distilled water allowed animals to grasp within 30 s. M. pudica (3 and 10 mg/kg) did not impair the duration of the time spent on the rota-rod. However at the dose of 30 mg/kg, up to 60 min, the M. pudica significantly reduced the time that animals remained on the rota-rod. Acute application of the extract alone had no effect on the activity of DRN 5-HT neurones. However, when co-applied with the GABAA receptor agonist THIP (4,5,6,7-tetrahydroisoxazolo[5,4-c] pyridin-3-ol), the extract enhanced the inhibitory effect of the THIP on DRN 5-HT neurones. This study indicates that M. pudica contains an effective psychotropic agent that acts via the benzodiazepine site of the GABAA receptor complex as an anxiolytic at low doses and as a muscle relaxant at higher doses. These results in part could justify and confirm the use of this plant extract as an anxiolytic agent.
Adam D Swanson
Suicide Prevention Resource Center in Washington, USA
Title: Listen Without Labels: An Effective Engagement Strategy to Address Health Disparities
Time : 14:45-15:15

Biography:
Adam D. Swanson is a nationally awarded public speaker dedicated to equity in public and health care systems. He assists state governments, universities and other organizations improve quality of care for people in crisis at the Suicide Prevention Resource Center in Washington, DC. He has served on national and international expert panels to advise organizations in addressing minority health disparities. He previously led LGBTQ initiatives and oversaw national efforts to implement innovative first-episode psychosis treatment services at the National Council for Behavioral Health. In the U.S. Senate, he helped advance anti-bullying legislation and Ryan White HIV/AIDS Care Act reforms. He is a former Mental Health America fellow.
Abstract:
For more than a decade, studies have shown that Americans of minority status face remarkable disparities when it comes to preventable illnesses, mental health and addicition conditions, and overall mortality. The statistics speak for themselves: Black babies are almost 5 times more likely to die before reaching their first birthday than white babies; suicide attempts for high school-aged Hispanic girls are 70 percent higher than for white girls in the same age group; lesbian, gay and bisexual (LGB) adults are about 5 times more likely than heterosexual men and women to have a mental illness in their lifetime such as those related to mood, anxiety or substance use; and nearly 40 percent of all transgender people report that they have faced harassment or discrimination when seeking routine health care. Explainations of this phenomna from researchers and policymakers varies across issues of access, poverty, and biology. But the less talked about root cause of health dispairities— discriminiation—is all too often glossed over. Adam D. Swanson, a nationally awarded public speaker and health equity advocate, will share his harrowing life story about crisis health care interactions to help demostrate the impact of discrimination as a major root cause of systemic health disparities within clinical care settings. His story and supporting data about the vulnerablities facing minority populations will help providers of all levels and researchers think more broadly about how to improve health outcomes, eliminate health disparities, and achieve health equity.
- Virtual Presentation
Location: Forum 9
Session Introduction
Abbas A Shakir Alnaji
Al-sadder General Teaching Hospital, Iraq
Title: Vomiting is beneficial following traumatic head injury
Time : 15:20-15:50

Biography:
Abbas A Shakir Alnaji has completed his degree in Neurosurgery from University of Baghdad in 1999. He is interested in research work and has 12 papers published in the field of Surgical Pathology Causations.
Abstract:
Head injury is often associated with vomiting, which varies in frequency and severity with the magnitude of the injury. In this article, we want to throw some light on the nature of this phenomenon from social and medical visions. It is really of benefit to the patient. It should not be inhibited, the expelled fluid not replaced but assure the patient, vomiting is a regulatory neurophysiologic event that occurs to assist the body to accommodate itself against the changes inside the brain after being injured; hence it is not considered as a harmful reaction. The vomitus mainly is water with some hydrogen ion as HCl from the gastric content, which is a natural regulatory step taken by the body to bring a relative dehydration, for which, some use diuretics. Secondly, this hydrogen ion, however little in percentage, brings about smooth metabolic alkalosis; the third benefit of vomiting is the accompanying valsalva maneuver which is associated with sympathetic activation (fear) which brings for spontaneous hyperventilation then respiratory relative alkalosis. So the metabolic alkalosis caused from losing hydrogen ion with vomited water, along with the sympathetic hyperventilation alkalosis, decreases the blood acidity similar to what is practiced by some neurosurgeons to subject head injured patients to mechanical hyperventilation in ICU to wash CO2 (decrease blood acidity), so that cerebral vasoconstriction is attained