Day :
- Neurology | Neuronal functions and disorders | Neurorehabilitation | Neuropharmacology
Location: Olimpica 2
Chair
Aurelian Anghelescu
Carol Davila University of Medicine and Pharmacy, Romania
Co-Chair
Roberto Cartolari
Radiology Service S. Giovanni Hospital , Switzerland
Session Introduction
Jose Luis Carrillo Gamboa
Center for Medicine Regenerativa Queretaro, Mexico
Title: Cognitive impairment and its association to musculoskeletal chronic degenerative disorders
Time : 12:30-13:00
Biography:
José Luis Carrillo Gamboa has completed his PhD from National Autonomous University of México in the School of Medicine. He is the Director and Founder of Mexico. He is an Academic Coordinator in Orthopedics at Hospital H+ Querétaro and; advisory member of University of Valley of México. He has published results in osteoarthritis with stem cells.
Abstract:
As people get older, the incidence of musculoskeletal pathologies such as osteoporosis and osteoarthritis increases dramatically, especially by the age of 65 and the association of these pathologies to cognitive decline difficult diagnosis results in poor prognosis. Aging is a physiological process and is related to cognitive decline and when accompanied by degenerative disorders, requires specialized medical attention and treatment costs rise significantly. Pathologies at an old age include musculoskeletal disorders, which cause pain, limit the patient’s mobility, ability to dress up, cause social isolation and also put the patient on risk of fractures. Therefore, it is very important to identify changes related to aging such as articular inflammation, metabolic diseases, hypertension, immune deficiency and bone demineralization. Para clinic and imaging tests would be required to evaluate articular tissue, cartilage, ligaments, tendons, subchondral bone, meniscus and muscle. In menopausal patients bone mineral density, body mass and muscle mass indexes would be very useful. Cognitive decline associated with musculoskeletal deterioration and aging should be better prevented in order to avoid ineffective approaches when all these clinical entities are associated when patient vulnerability is present. We show clinical evidence of the association of cognitive decline and musculoskeletal deterioration.
Min-Cheol Lee
Chonnam National University, South Korea
Title: Mapping somatotopic of motor fibers and modeling internal capsular stroke
Time : 13:00-13:30
Biography:
Min-Cheol Lee has completed his MD and PhD from Chonnam National University Medical School (CNUMS), South Korea. He is the Professor in Department of Pathology/Neuropathology, CNUMS and Affiliated Professor at Gwangju Institute of Science and Technology. He has published more than 100 papers in reputed journals.
Abstract:
Recently, several capsular stroke models have been reported with different targets of destruction. This study was performed to establish an accurate internal capsule (IC) target for capsular stroke modeling in rats. We injected adeno-associated virus serotype 5 (AAV)-CaMKII-EYFP into forelimb motor cortex and AAV-CaMKII-mCherry into hindlimb motor cortex (n=9) to anterogradely trace the pyramidal fibers and map their somatotopic distribution in the IC. On the basis of the neural tracing results, we created photothrombotic infarct lesions in rat forelimb and hindlimb motor fiber (FMF and HMF) areas of the IC (n=29) and assessed motor behavior using a forelimb-use asymmetry test, a foot-fault test, and a single-pellet reaching test. We found that the FMFs and HMFs were primarily distributed in the inferior portion of the posterior limb of the IC, with the FMFs located largely ventral to the HMFs but with an area of partial overlap. Photothrombotic lesions in the FMF area resulted in persistent motor deficits. In contrast, lesions in the HMF area did not result in persistent motor deficits. These results indicate that identification of the somatotopic distribution of pyramidal fibers is critical for accurate targeting in animal capsular stroke models: only infarcts in the FMF area resulted in long-lasting motor deficits.
Guofeng Wu
Guizhou Medical University, China
Title: CT blend sign is closely associated with the post-operative re-haemorrhage in patients with hypertensive ICH
Time : 14:15-14:45
Biography:
Guofeng Wu completed his PhD from Fudan University. He is the Director of Emergency Department, Affiliated Hospital of Guizhou Medical University. He is serving as an Associate Editor of Neuropsychiatry. He has published more than 100 papers relating to epilepsy and intra-cerebral hemorrhage. He has undertaken several projects regarding intractable epilepsy and minimally invasive surgery for intra-cerebral hemorrhage evacuation. He is now the Chairman of the Professional Committee of Neuro-emergency of Emergency Medicine Branch, Chinese Medical Doctor Association. He is also the Standing Committee Member of Emergency Medicine Branch, Chinese Stroke Society as well as the Chairman of the Professional Committee for Epilepsy of Guizhou Preventive Medicine Association. He won the Guizhou Provincial Science and Technology Progress Award in 2015, and the Science and Technology Progress Award of Chinese Ministry of Education in 2014.
Abstract:
Intracranial post-operative re-haemorrhage is an important complication in patients with hypertensive intra-cerebral haemorrhage (ICH). The purpose of the present study was to determine the value of the computed tomography (CT) blend sign in predicting post-operative re-haemorrhage in patients with ICH. In this study, a total of 126 patients with ICH were included in the present study. All the patients underwent standard stereotactic minimally invasive surgery (MIS) to remove the ICH within 24 hours following admission. There were 41 patients with a blend sign on initial CT and 85 patients without a blend sign on the initial CT. Multivariable logistic regression analyses were performed to assess the relationship between the presence of the blend sign on the non-enhanced admission CT scan and post-operative re-haemorrhage. Post-operative re-haemorrhage occurred in 24 of the 41 patients with the blend sign, and in 9 of the 85 patients without the blend sign. The incidence of re-haemorrhage was significantly different between the groups. The multivariate logistic regression analysis demonstrated that the initial Glasgow coma scale score (p=0.002) and blend sign (P<0.00) on the initial CT scan are independent predictors of post-operative re-haemorrhage. The sensitivity, specificity, and positive and negative predictive values of the blend sign for predicting post-operative re-haemorrhage were 72.7%, 81.7%, 58.5% and 89.4%, respectively. The presence of the blend sign on the initial CT scan is closely associated with post-operative re-haemorrhage in patients with ICH who undergo stereotactic MIS.
Ying Li
City University of Hong Kong, China
Title: Vagus nerve stimulation alters phase synchrony of the anterior cingulate cortex and facilitates decision making in rats
Time : 14:45-15:15
Biography:
Ying Li has completed his MD from Beijing Medical University (1962–1968). He was a General Surgeon, and Oral-Maxillofacial Surgeon at Nanjing Medical School. He completed Post-doctoral fellowship in Department of Internal Medicine University of Michigan, where he was appointed as Research Scientist in 1997, and Research Professor in 2002.
Abstract:
Vagus nerve stimulation (VNS) can enhance memory and cognitive functions in both rats and humans. Studies have shown that VNS influenced decision-making in epileptic patients. However, the sites of action involved in the cognitive-enhancement are poorly understood. By employing a conscious rat model equipped with vagus nerve cuff electrode, we assess the role of chronic VNS on decision-making in rat gambling task (RGT). Simultaneous multichannel-recordings offer an ideal setup to test the hypothesis that VNS may induce alterations of in both spike-field-coherence and synchronization of theta oscillations across brain areas in the anterior cingulate cortex (ACC) and basolateral amygdala (BLA). Daily VNS, administered immediately following training sessions of RGT, caused an increase in ‘good decision-maker’ rats. Neural spikes in the ACC became synchronized with the ongoing theta oscillations of local field potential (LFP) in BLA following VNS. Moreover, cross-correlation analysis revealed synchronization between the ACC and BLA. Our results provide specific evidence that VNS facilitates decision-making and unveils several important roles for VNS in regulating LFP and spike phases, as well as enhancing spike-phase coherence between key brain areas involved in cognitive performance. These data may serve to provide fundamental notions regarding neurophysiological biomarkers for therapeutic VNS in cognitive impairment.
Muhammed Al-Jarrah
Jordan University of Science and Technology, Jordan
Title: Bilateral anodal transcranial direct current stimulation could attenuate the activity of oxidative stress serum biomarkers in patients with Parkinson’s disease
Time : 15:15-15:45
Biography:
Muhammed Al-Jarrah is an Associate Professor of Clinical Physiotherapy graduated from The University of Kansas Medical Center, USA in 2006 with PhD in Rehabilitation Sciences. Currently, Dr. Al-Jarrah is the Dean of the School of Applied Medical Science at Jordan University of Science and Technology. He has published more than 40 papers in well recognized journals in the last 10 years. His research interests focus on Neurorehabilitation mainly for Parkinson’s disease, stroke and cerebral palsy.
Abstract:
Objectives: Parkinson’s disease (PD) is progressive neurodegenerative disorder characterized by loss of dopaminergic neurons in the basal ganglia. Although the mechanisms underlying the loss of dopaminergic neurons in PD remain unclear, oxidative damage is one of these proposed mechanisms. The main goal of this study was to evaluate the activity of antioxidant enzymes in the blood of PD patients before and after bilateral anodal transcranial direct current stimulation (tDCS).
Methodology: 20 PD patients participated in this study. Internal Board Review (IRB) was obtained to conduct this study. 10 sessions of tDCS were given for each patient in the rate of five sessions per week for two weeks. The current intensity was low intensity direct electrical current (1 mA per each electrode) for 20 minutes per session. Activity of antioxidant enzymes; catalase (CAT, glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) have been quantified in plasma as measures of antioxidant capabilities before and after stimulation.
Results: Our study showed that treatment with tDCS increased SOD, CAT and GSH-Px activities P<0.05.
Conclusion: Oxidative stress refers to the cytological consequences of imbalance between the production of free radicals and the ability of the body to clear them. Increased production of free radicals or decreased capacity to clear them could lead to neurodegeneration in the PD. tDCS might be well considered to manage PD.
Barbara Barbini
Irccs San Raffaele Turro, Italy
Title: ECT: Clinical and anesthesiological aspects in treatment resistant depression
Time : 15:45-16:15
Biography:
B Barbini has completed her MD and Residency in Psychiatry from State University of Milan. She is medical official In-charge of the Psychiatric Department. She has published more than 25 papers in reputed journals.
Abstract:
Depression is associated with high morbidity and mortality. WHO has ranked depression as the leading cause of disability. Pharmacological treatment is the first choice. Despite appropriate treatment, 30-40% of patients with a depressive episode don’t achieve improvement. Of the patients that are resistant to conventional therapies, approximately 60% responded to ECT. In Italy, ECT is underused, with about 200-300 patients per year, treated for Treatment Resistant Depression (TRD) (Thase and Rush criteria). The American Psychiatric Association (APA) task force on severe affective illness considers ECT an effective treatment when pharmacological treatments failed. The close cooperation of the anesthesiologist and the psychiatrist is crucial to accomplish high quality and safe ECT. Indeed, the role of the anesthesiologist is not just to set the anesthesia plan but also to manage any clinical emergency. ECT requires general anesthesia with a combination of hypnotic and muscle relaxant drugs. Anesthesiological management of such patients is often complex because their comorbidities so the best anesthetic approach should be chosen to improve the outcome from treatment and to minimize associated adverse effects. The efficacy of ECT relies on duration and quality of seizure after shock. Given this requirements, we present data from a large sample of TRD inpatients of Mood Disorder Unit. We discuss about the procedure, the rate of response, and of side effects and outcome with follow-up data.
Mohamed A.Fahmy Zeid
Alexandria University, Egypt
Title: A Pre-Operative Stratigic Planning Of The Sellar & Para-Sellar Lesions By Neuro- Imaging Study
Time : 15:45-16:15
Biography:
Mohamed A.Fahmy Zeid completed MBBCH very good with honors on Nov 1982 and completed Master of General Surgery in 1987.He did fellowship in the department of Neurosurgery in 1994.He did doctorate degree in Neurological surgery in 1994.and member congress of American Neurological Surgeons on 2000 He is the House officerin Ministry of Health Hospitals and Alexandria university Hospitals for one year from 1983 to 1984.He worked as physician in the Ministry of Health Hospitals from 1984 to 1987.He is Registrar of Neurosurgery in private hospital from 1987 to 1988.He is Assistant lecturer of Neurosurgical department of Alexandria University Hospitals from 1988 to 1994.He is chief consultant of Neurosurgery in Saqr Hospitals, UAE from 2000 to 2003.He visit to Neurological surgery department, Royal College of Medicine,London in 2001. He is working as Professor of Neurosurgery department at Alexandria University from 2010 to till date.
Abstract:
Objective:
Surgical indication, More-over approaches and specific strategic planning to that pre-plexing anatomical as well as pathological origin of the sellar and jaxta-sellar lesions cause a changeable task for even an experienced neuro-surgeon. So our objective of this paper is to provide a better three dimensional approach/classification system.
Method:
We proposed a classification system which includes the pre-operative detailed Imaging "three dimensional studies by CT, MRI and dynamic contrast scanning”. The combination of tumor invasion (grading) with anatomical tumor extension "staging" that delineated precisely the anatomical spread and the possible pathological nature.
Results
- Eight different grades of spread in “height” of the lesion (cranio-caudal direction) could be delineated in the Sagittal imaging studies.
- The anterior to posterior extension of the same lesion and its angle at the “Tuberclem Sella” appearing also on the same Sagittal neuro-imaging studies.
- In Coronal neuro-imaging studies: A four different types of ( Midline ) lesions extension & expansion could be delineated.
- The height of the level of suprasellar pituitary tumor extension according to the mid sagittal cut on the MRI and high resolution CT & MRI scan with contrast.
- If the tumor is totally intra sellar with normal position and location of the diaphragma sella, A larger tumor elevating the diaphragma sella so (above the sella but infra-diaphragmatic).
- More Larger, the tumor spread above the diaphragm sella but below the level of the optic chiasma. (supra sellar and supra diaphragmatic but infra chiasmatic) means “extra-Sellar”
- The tumor spread above the chiasma but below the level of floor of the third ventricle, (super chiasmatic but infra ventricular) or in the level of optic chiasma cistern.
- The tumor invading the floor of the third ventricle (the hypothalamic level).
- The tumor extends to the cavity of the third ventricle (the tumor located intra ventricular).
- The tumor expands up to the level of the roof of the third ventricle.
- If the tumor reaching above the third ventricle up to “corpus callosm”.
- The degree of expansion & extension of the pituitary tumor also on Sagittal cuts imaging “ in Anterior to Posterior” direction could be centered on (A Line Horizontally With Sella Floor) here the location could be localizing by the same numerical clockwise direction, if the anterior part would be located in the left side of the plate imaging, (9 clock on the left side, 3 clock on the right side etc.).
- The degree of invasions of the pituitary tumor could be evaluated by coronal cuts of the “ MRI with contrast and multislice CT angiography “ α) if the pituitary tumor invading the sellar floor (reaching to the sphenoid air sinuses), β) if the pituitary tumor invading the full thickness of the lateral wall of the sella reaching to the cavernus sinuses cavity, γ) if the pituitary tumor invading more to the lateral direction up to the lateral wall of the cavernus sinuses reaching to the medial aspect of the temporal fossa region, δ) If the pituitary tumor reaching to the floor sphenoid air sinus.
- Coronal T1W with contrast showing focal lesion at the right side of the pituitary representing a micro-adenoma without extension into the cavernous sinus Coronal T1WI with contrast showing large macro adenoma with apoplexy (bright T1 areas).
- Coronal FLAIR showing a mass Lesion with left para-sellar extension implicating the left cavernous sinus.
Conclusions:
The use of bony anatomical landmarks of the skull base in addition to the anatomical location of the third ventricle with cavernous sinus shapes also, the sizes and morphology of the carotid arteries could help us for pre-operative planning. Also, comparative studies of the operative results between different approaches, techniques and tumors sizes with different neuro-surgical centers worldwide “having” various post-operative outcome including varieties of follow up duration in different protocols of management could be verified and compared.
- Young Research Forum
Session Introduction
Prisca-Rolande Bassole
Cheikh Anta Diop University, Senegal
Title: Early epileptic encephalopathies with suppression burst
Time : 15:45-16:05
Biography:
Prisca-Rolande Bassole is a Physician. She has completed her Doctorate from Faculty of Medicine of Ouagadougou University of Burkina Faso and Post-doctoral studies in Neurology and Epileptology from Cheikh Anta Diop University, Senegal. She is currently a trainee in a clinical neurophysiology laboratory of Fann Teaching Hospital of Dakar, Senegal.
Abstract:
Early epileptic encephalopathies (EE) with suppression burst (SB) are serious because of their drug resistance and the impact on psychomotor development of children involved. Our objective is to identify the determinants of this pathology in Dakar. This is a retrospective and prospective study from medical records from January 2013 to January 2015, performed on children who followed at Neurological Clinic of Fann Teaching Hospital of Dakar. Interested patients with early epilepsy, delayed psychomotor development and EEG pattern of SB. Anamnestic, clinical, electroencephalographic and progressive aspects with treatment were evaluated. We report four cases of children with two family epilepsy notion, undocumented, who presented early encephalopathy with polymorphic seizures dominated by tonic seizures which began the first day of life for two, 30 days of life and the beginning of the third month for the other two. The first sleep EEG performed showed a pattern of suppression burst. The electro-clinical evolution is good for three patients with the treatment, based mainly on sodium valproate at a dose of 20 mg/Kg/day in average. It is marked by the disappearance of seizures or decreased in frequency and by improving the sleep EEG monitoring with disappearance of SB. For the 4th patient, the change made to another type of EE which is the West syndrome. Psychomotor retardation remained evident for all patients. The early EE with SB represent a vast and serious disease. The ictal expression, mixing myoclonus and tonic seizures underlie the same pathophysiology. Even in the absence of crisis, the interictal activity seems worsen treatment response with bad psychomotor prognosis. The precise description of these syndromes remains useful for achieving optimal diagnosis and treatment of these EE age-dependent. The results of this work open up the prospect for further studies including longitudinal that would better individualize these serious early diseases especially because there are treatable causes and identify a better prognosis factors.
Mostafa Azimi
Sports Medicine Research Center, Iran
Title: Effects of eight-week home-based yoga and resistance training on muscle strength, functional capacity and balance in patients with multiple sclerosis
Time : 16:05-16:25
Biography:
Mostafa Azimi has completed his MD from Tehran University of Medical Sciences and studying Sports Medicine as 3rd year Clinical Resident. He is the Scientific Director of Sportmedicine.ir website in Farsi. He is affiliated with Sports Medicine Research Center, Neuroscience Institute in Spine Group.
Abstract:
Background & Aim: Muscle weakness, fatigue and balance disturbances contribute to the reduction of daily activity in multiple sclerosis (MS) patients. Therapeutic strategies to promote improvements in muscle strength, functional capacity and balance are limited in individuals with MS. Yoga training (YT) is a most popular mind-body interventions and has been known to positively affect physical, mental and other symptoms of multiple sclerosis patients with moderate disability and other cases.
Materials & Method: This study was designed to determine effect of 8-week home-based yoga (YT) and resistance training (RT) on muscle strength, functional capacity and balance in 26 patients with multiple sclerosis (MS) with mild to moderate disability. 26 male and female patients (Age:31.3±9.0749) with mild to moderate disability, were recruited and randomized into three groups randomly: Yoga training (n=9) with three-times weekly home based Hatha Yoga training for eight weeks, resistance training (n=9) with three-times weekly home based resistance training program for eight weeks and control groups (n=8).
Results: The data analyzed using one way ANOVA showed; however, that Yoga Training (YT) had no significant effect on leg muscle strength, but home resistance training (RT) increased it. Also, functional capacity was not affected by any YT and RT, but the balance changed.
Conclusion: It seems that prescribing regular training programs with controlled intensity and time, particularly resistance training (RT) and yoga training (YT) can have a positive impact on the performance and improvement of MS patients’ quality of life.
Oritoke Aluko
Federal University of Technology, Akure, Nigeria
Title: Protective effects of methyl jasmonate on chronic stress-activated behavioral alterations and markers of oxidative stress
Time : 16:40-17:00
Biography:
Oritoke Aluko is a Doctoral student in Department of Pharmacology and Therapeutics, University of Ibadan, Nigeria. Her research is basically in the area of Behavioural Neuroscience and Psychopharmacology, which has brought her in contact with International Brain Research Organization (IBRO). She is an Assistant Lecturer in Department of Physiological Sciences, School of Health and Health Technology, Federal University of Technology, Akure, Nigeria. She is involved in teaching some topics in Physiology and Pharmacology to undergraduate students. She has some publications in reputable journals with large proportions of them in behavioral neuroscience.
Abstract:
Methyl jasmonate is a naturally-occurring anti-stress plant hormone and has been shown to ameliorate the effects of acute and chronic stress in mice. The present study aimed to study the behavioral and biochemical mechanisms underlying the adaptogenic-like properties of methyl jasmonate. Male Wistar albino rats were subjected to stressors of the unpredictable chronic mild stress (UCMS) paradigm for 28 days and treated with methyl jasmonate at 10, 25 and 50 mg/kg. Body and organ weights, behavioral and hematological parameters, as well as levels of biomarkers of oxidative stress were determined. UCMS resulted in a progressive weight loss, hypertrophy of liver and adrenal gland, and atrophy of spleen and testes. An aberrant behavioral pattern as evident by swim endurance and post summing motor function tests was also observed in UCMS-subjected rats. Likewise, UCMS induced a deviant in hematological parameters. UCMS also significantly increased the levels of serum glucose, corticosterone, monoamine oxidase, lactate dehydrogenase, cholesterol, triglyceride, creatine kinase and blood urea nitrogen. There was also an alteration of oxidative stress markers viz malondialdehyde, superoxide dismutase, catalase, reduced glutathione, and nitric oxide arginase, ATPase, adenosine deaminase induced by UCMS. Methyl jasmonate (10, 25 and 50 mg/kg) significantly ameliorated the UCMS-induced alterations in the body and organ weights. There was a significant amelioration of the UCMS-induced behavioral alterations by methyl jasmonate. Methyl jasmonate reversed the UCMS-induced suppression of erythrocytes, leukocytes, and hemoglobin content, packed cell volume and lymphocyte count. Methyl jasmonate significantly reversed the alteration of oxidative stress markers induced by UCMS. Also, pretreatment with methyl jasmonate significantly attenuated UCMS-associated biochemical alterations, pathological outcomes and oxidative stress. The present findings showed the adaptogenic potential of methyl jasmonate in relation to the antioxidant systems implicating their therapeutic importance in stress-related disorders. Further investigations on the neurochemical and morphological mechanisms are being studied.
Xue Deng
The University of Hong Kong, China
Title: Exploration of Use of Ultrasound to differentiate Carpal Tunnel Syndrome Associated with Axonal Degeneration
Time : 17:00-17:20
Biography:
Mr. Xue Deng is a Hong Kong and U.S-registered Occupational Therapist. He has completed his Master of Occupational Therapy from Tufts University and bachelor’s degree in Occupational Therapy from the Hong Kong Polytechinic University. He is now a PhD Candidate in the department of Orthopaedics & Traumatology from the University of Hong Kong. He has published several papers relevant to Occupational Therapy and has been serving as a reviwer for American Journal of Physical Medicine & Rehabilitation.
Abstract:
Nerve conduction studies (NCS) is clinically used to confirm the diagnosis and grade the severity of carpal tunnel syndrome (CTS), a median nerve entrapment due to chronic compression at wrist. However, the NCS cannot differentiate the CTS with demyelination alone from the disease with secondary axonal degeneration. As a cross-validated and sensitive diagnostic tool with NCS, it is unknown if ultrasound (US) can compensate the deficit. This study aimed at exploring US to differentiate demyelinated CTS from that in association with axonal degeneration. We studied 75 demyelinated CTS hands and 93 demyelinated CTS hands with axonal degeneration by comparing cross-sectional area (CSA-W) and perimeter (P-W) of median nerve at wrist, ratio of CSA and P of wrist over mid-forearm (R-CSA, R-P) measured by US. Results revealed significant differences in CSA-W (p<.0001), P-W (p<.0001), R-CSA (p=.007, p<.05) and R-P (p<.0001). ROC curves indicated poor-to-fair accuracy of CSA-W (Area=.626, p<.0001); P-W (Area=.695, p<0.0001), RCSA (Area=.601, p=.025, p<.05) and R-P (Area=.662, p<.0001). Our findings were consistent with previous relevant studies. We conclude that US may be potentially used to differentiate demyelinated CTS from that with axonal degeneration in clinical practice.
- Workshop
Session Introduction
Kamlesh Jha
All India Institute of Medical Sciences, Patna, India
Title: Hands-on autonomic function test and its interpretation
Time : 11:45-12:30
Biography:
Kamlesh Jha is an Associate Professor of Physiology at All India Institute of Medical Sciences, Patna, India. He has more than 10 years of teaching experience in the field of Physiology. His interest of field is Neurophysiology especially Autonomic Physiology and Electro-diagnostics. Till date, he has published more than 10 research articles in national and international journals, published three book chapters and presented his works in many national/international conferences. At Present, he is working upon the EEG signal processing in cognitive physiology.
Abstract:
Autonomic nervous system has very important role in the regulation of the overall homeostatic mechanism of our body. It could be tested in a non-invasive way with good reproducibility and accuracy. It is a promising tool of investigation for many sub clinical conditions and prognostication of many chronic disorders too. The tests are mainly based upon the heart rate and blood pressure recordings and the effect of sympathovagal influence upon its regulation. The test is done following certain pre-requisites to avoid any interference with the result due to any external reason. To start with, Heart Rate Variability (HRV) is tested using sophisticated computer based system followed by Deep Breathing Test (DBT), Valsalva Manoeuvre (VR), Isometric Hand grip Test (IHT) and Orthostatic Test (OT) in the same sequence. The DBT and VR is mainly a pulse rate based test and it usually quantifies the parasympathetic function whereas OT and IHT is mainly blood pressure based test and used for quantifying sympathetic function. HRV is very specific test of ANS utilized for the assessment of cardio vagal function in objective manner. The principle components of HRV includes Standard Deviations of RR intervals (SDNN), Root Mean Square Deviations of RR intervals (RMSSD), total power, Low Frequency variations (LF), Very Low Frequency Variations (VLF) and High Frequency variations (HF) in the heart rate besides other parameters. HF represents mainly Parasympathetic functions whereas LF and VLF mainly represents sympathovagal balance and sympathetic functions respectively.
Tribhuwan Kumar
All India Institute of Medical Sciences, Patna, India
Title: Role of heart rate variability in autonomic function testing
Time : 12:30-13:15
Biography:
Tribhuwan Kumar is a Faculty of Physiology at All India Institute of Medical Sciences, Patna, India. He has an inherent interest in the field of Cardiovascular Physiology and its relation with autonomic functions. Besides, he has a keen interest in the field of Medical Education. Besides having more than 10 years of teaching experience as Faculty of Physiology, he has good research experience with many research publications in national and international journals. He is also member of Association of Physiologists and Pharmacologists of India and South Association of Physiologists.
Abstract:
Like all internal organs heart is innervated by autonomic nervous system (ANS). The constant fluctuation in blood pressure and heart rate is mainly due to interactions between the mutually opposing actions of sympathetic and parasympathetic subdivisions of the ANS. The vagal activity dominates at rest and is mainly responsible for heart rate variability (HRV).The HRV analysis can be used to find out early signs of development of pathological process, presence of functional disorder, assess stress coping ability, evaluate treatment effectiveness and prognosis to name a few. The response of parasympathetic system to stimulation is quick and transient whereas the response to sympathetic stimulation is slower but of higher amplitude. This fluctuation can be analyzed and quantified by time domain and frequency domain analysis methods that provide insight of cardiac autonomic regulation in health and disease. Out of the time domain parameters rMSSD (square root of the mean squared differences of successive NN intervals) and pNN50 (proportion of differences in consecutive NN intervals that are longer than 50 ms) describes short term variations, SDANN describes slow changes in the HRV whereas SDNN (standard deviation of NN) describes both short term and long term variability. The frequency domain or power spectral density (PSD) analysis describes heart rate as function of frequency and reveals the cyclical pattern in the series of changing RR intervals. It provides means to quantify autonomic balance at any given time. Some frequency domain parameters are Total Power (TP), Very Low Frequency (VLF), Low Frequency (LF), High Frequency (HF) and LF/HF ratio. Higher LF/HF ratio reflects sympathetic dominance whereas lower value means parasympathetic dominance.
Ramji Singh
All India Institute of Medical Sciences, Patna, India
Title: Autonomic functions: the tests and their clinical applications
Time : 14:00-14:45
Biography:
Ramji Singh is working as a Professor and Head of the Department of Physiology at All India Institute of Medical Sciences, Patna. With more than 30 years of teaching experience, he has enormous experience in the field of Clinical and Experimental Neurophysiology. He has more than 50 research publications in national and international indexed journals. Presently, he is supervising many research projects in the department including neurocognitive and behavioural physiology. He is also a member of the elite club of FAIMER fellows and has been a well-recognized figure in the field of Indian medical education technology.
Abstract:
Autonomic nervous system plays an important role in the homeostasis of internal organ system and their integrated functions in the human body. The derangement of this function at any level may affect multiple system functions simultaneously. Disorders associated with autonomic functions are quite common, but only recently medical world has started quantifying the autonomic functions to make it a reasonably sensitive and specific diagnostic and prognostic tool. Testing and quantifying autonomic function is very complex because of the wider distribution and diverse functions it is associated with. One relatively simple battery of tests that is used commonly is Ewing battery which includes Valsalva maneuver, Deep Breathing Response (DBR), Orthostatic Testing (OT) and Isometric Handgrip Test (IHT). Besides Heart Rate Variability (HRV) is another important test of autonomic function that has high reproducibility and specificity. Most of these tests could be performed even in a resource limited settings with fair accuracy. Out of these tests deep breathing test, Valsalva manoeuvre and HRV are heart rate based tests and quantifies the cardiovagal function by assessing the heart rate changes during various manoeuvre whereas IHT is a BP based test meant for sympathetic system. Orthostatic test includes both HR and BP response to change in posture from supine to standing, hence quantifies both the vagal and sympathetic system functions. One another test which is also of significance is Quantitative Sudomotor Axon Reflex Test (QSART) which is based upon the quantitative estimation of sweat produced due to local acetylcholine stimulation. The test is useful in diagnosing distal small fibre autonomic neuropathy. Although autonomic function assessment is complex, it has got enormous value in clinical field. Standardization of the techniques and training of medical personals in the field may prove it an important tool in the clinical diagnostics.
Yogesh Kumar
All India Institute of Medical Sciences, Patna
Title: Clinical applications of autonomic function testing
Time : 14:45-15:30
Biography:
Yogesh Kumar is presently working as an Associate Professor of Physiology at All India Institute of Medical Sciences, Patna. He is a proficient Educationist with more than 10 years of teaching experience in the field of Physiology. He has good research experience with more than eight research papers to his name published in national and international journals. He is working mainly in the field of Neurophysiology with special interest in Electrophysiology of seizure disorders.
Abstract:
The autonomic nervous system play a very important role as it regulate many important functions such as heart rate, blood pressure (BP), respiration, temperature regulation, gastrointestinal, bladder, and sexual function. If autonomic nervous system is not working properly than an individual is bound to suffer from many diseases. A physician mainly concentrate on symptoms of dysautonomia, but it is then necessary to determine if these symptoms are really due to involvement of autonomic systems. Previously methods to evaluate autonomic function were either unavailable or too invasive. Nowadays we have tests which non-invasively evaluate the severity and distribution of autonomic failure. They have sufficient sensitivity to detect even subclinical dysautonomia. Standard laboratory testing evaluates cardiovagal, sudomotor and adrenergic autonomic functions. Cardiovagal function can be evaluated by a number of methods. In the time domain, the commonly used and most reliable approach is to quantify heart rate response to deep breathing and to the Valsalva manoeuvre. Cardiovagal function can also be quantified in the frequency domain. The highest frequency peak (>0.15 Hz) reflects oscillations of heart rate due to respiratory sinus arrhythmia and is considered to be a measure of cardiovagal function. Sudomotor function can be evaluated with the quantitative sudomotor axon reflex test and the thermoregulatory sweat test. Adrenergic function is evaluated by the blood pressure and heart rate responses to the Valsalva manoeuvre and to head-up tilt. Tests are useful in defining the presence of autonomic failure, their natural history, and response to treatment. They can also define patterns of dysautonomia that are useful in helping the clinician diagnose certain autonomic conditions. Some clinical uses of autonomic function testing are: 1) Distal small fibre neuropathy: Common causes are diabetic and inherited neuropathy, but the most common cause is idiopathic. QSART will show abnormalities at the feet and normal sweating more proximally in about three out of four patients tested; 2) Generalized autonomic failure: For a clinician symptoms of generalized failure include orthostatic light-headedness, syncope, erectile dysfunction, and symptoms suggestive of neurogenic bladder and bowel. Examples of generalized autonomic failure are the autonomic neuropathies and multiple system atrophy; 3) Selective autonomic failure: Autonomic tests can confirm that a specific autonomic function is affected and that other systems are intact; 4) Synucleinopathies: These are neuro-degenerative disorders characterized by fibrillary aggregates of alpha-synuclein protein in oligodendroglia and in selective population of neurons e.g., Parkinson’s disease and multiple system atrophy and; 5) Orthostatic intolerance: It refers to development of symptoms after assuming the standing posture that clears on sitting or lying down. Specific examples are orthostatic hypotension, postural tachycardia syndrome, and neurocardiogenic syncope. Clinical management of the dysautonomia depends on good clinical judgment. Autonomic testing increases sensitivity and specificity in the detection of autonomic failure. There are limitations of clinical autonomic testing. The non-invasive approach is appropriate but imperfect. Autonomic testing is a growing and evolving field so it is important that we should keep on updating guidelines.
- Video Presentation
Location: Olimpica 2
Session Introduction
James D Weinstein
Marshall University, USA
Title: A new direction for Alzheimer’s research
Time : 15:30-15:55
Biography:
James D Weinstein completed his MD in 1964 from University of Pennsylvania and his internship from New England Center Hospital in Boston 1965. He worked as a Neurosurgeon for more than 40 years in New Jersey and West Virginia. He has published more than 25 papers in reputed journals.
Abstract:
Although billions of dollars have been spent for research on Alzheimer’s disease (AD), little progress has been made in finding a therapy which stops the progressive dementia characteristic of the disease. Numerous drugs, having failed over years of research, suggest the need for a reevaluation of how the research is now being done. To that end, three changes in current AD research methodology are offered and these changes are absolutely necessary to provide the means to find an effective treatment for the disease. First, AD is a disease of four etiologies rather than from a single primary cause. These four should be treated simultaneously for an effective therapy. Second, AD drug testing is wasting much time effort and money by aiming for a statistical verification of the slowing of dementia. The end point should be the complete cessation of progressive dementia, and testing should begin with small cohorts. Third, combination therapies with drugs currently available, used off label, ought to be tried. One example of such a combination is reviewed.
Natalia Ivanova
Polenov Neurosurgical Institute, Russia
Title: Neuro-Rehabilitation in neurosurgery. Opportunities and prospects
Time : 15:55-16:15
Biography:
Ivanova Natalia Evgenievna, doctor of medical Sciences, Professor, head of the scientific Department of the "Russian Polenov Neurosurgical Institute ", - branch of “National Medical Research Center after V. A. Almazov ", chief neurologist of the Institute, honored doctor of the Russian Federation, Deputy editor-in-chief Of the Russian neurosurgical journal. prof. A. L. Polenov, member of the Board of the Association of neurosurgeons of Russia. The main directions of scientific and practical activity are neurosurgical pathology of brain vessels, neurotrauma, neurorehabilitation and ultrasound diagnostics. Author of 450 scientific works, including 30 patents and three monographs, supervisor of 30 candidates and 4 doctors of Sciences in "nerve diseases" and "neurosurgery".
Abstract:
Introduction. The purpose of early rehabilitation (as a combination of neurological, rehabilitation and neurosurgical interferences in the form of interdisciplinary work) is promoting spontaneous recovery of patients and prevention of secondary complications.
Purpose: to assess the results of use early rehabilitation.
Methods: CT, MRT, EEG, ENM, rehabilitation scales.
Results: 1800 neurosurgical patients (neurotrauma, neurooncology, vascular neurosurgery, pediatric neurosurgery, vertebrologie, epilepsy, pain and spastic syndromes) received early rehabilitation. Etiology, pathogenesis, pathophysiological mechanisms, pathological conditions, the disease stage and duration of dysfunction before surgery have great importance for the restoration of the disturbed functions.
Neuroreanimation department: methods used in the acute period can produce paradoxical responses and lead to a breakdown of compensation: the need to find methods of stabilizing stem dysfunction as early as possible, stem dysfunction correction, body-oriented techniques, treatment of bulbar disorders, breathing exercises, passive gymnastics and position treatment with the gradual expansion of the motion mode, early verticalization prevention of bedsores, polymodal sensory stimulation.
Neurosurgical and rehabilitational departments: kinesitherapy with a maximum extension motor mode treatment for dysphagia, prevention and treatment of spasticity, treatment of flaccid paresis, correction of dysfunction of the pelvic organs, cognitive rehabilitation, speech therapy techniques, neuropsychological methods, prevention and treatment of pressure ulcers, simulation methods. Consequent cognitive impairment that worsen the prognosis of rehabilitation after neurosurgical pathology, a high degree of disability ( including those, due to the presence of intellectual and memory impairment), makes the problem of diagnosis and treatment of cognitive dysfunction socially significant.
Conclusion: Early rehabilitation improved the outcome and the long-term quality of life.
- Poster Presentations
Location: Foyer
Session Introduction
Panaree Busarakumtragul
Srinakharinwirot University, Thailand
Title: The study of association between serum brain derived neurotrophic factor protein and dyslipidemia on memory performance in Thai Alzheimer disease patients
Time : 16:30-18:00
Biography:
Panaree Busarakumtragul has completed her PhD from Mahidol University, Thailand and short course training from Innsbruck University, Innsbruck Medical School, Austria. At present, she is the Associate Dean of Administrative and Academic Affair. She has published a number of international papers in reputed journals and has been serving as an Editorial Board Member of repute.
Abstract:
Brain Derived Neurotrophic Factor (BDNF) protein has many important function in neuronal survival, synaptic plasticity, and neurogenesis in rat hippocampus including learning and memory. The lower BDNF protein level results in a decrease in synaptic transmission leading to neuronal damage in hippocampus and neurodegenerative diseases. Aim of this study is to investigate the association between serum BDNF protein and dyslipidemia on memory performance in Thai Alzheimer Disease (AD) patients. After this research project has been certified by human ethic committee of Srinakharinwirot University, we recruited male and female volunteer subjects with aged 45 or more. Before all subjects began to participate in this research, they had to perform Thai Mini Mental State Examination (TMMSE) which represented memory performance. Then 30 healthy subjects were enrolled as control group whereas 15 AD patients were participated as experimental group. 10 milliliters of venous blood samples were withdrawn from left antecubital vein and left at room temperature (25oC) until they become clotted. They were centrifuged to seperate supernatant for BDNF protein assay by Enzyme Linked Immunosorbent Assay (ELISA) (Milliplex assay kit, Merck Millipore, Germany). Additionally, supernatant was used to analyze lipid profiles including triglycerides, total cholesterol, low density lipoprotein and high density lipoprotein by colorimetric method. Serum BDNF protein in AD patients was lower and significantly different from that in control group at p<0.05. However, lipid profiles in AD had no significant difference from control group. Furthermore, TMMSE scores in AD was significantly lower than that in control group at p<0.001. However, memory performance in AD patients has changed significantly in the same manner of serum BDNF protein. It can be concluded that significant difference of lower level of serum BDNF protein in AD patients at p<0.05 may cause the lower scores of TMMSE leading to a decrease in memory performance in Thai AD patients.
Aurelian Anghelescu
Carol Davila University of Medicine and Pharmacy, Romania
Title: Clinical and pathophysiological considerations of gait limitations and high prevalence of falls, in elderly with most common, disabling neurological diseases – mini review
Time : 16:30-18:00
Biography:
Aurelian Anghelescu is a founding member (2007) and Prime Vice-President of the Romanian Society for Neurorehabilitation (RoSNeRa) - affiliated to WFNR; Romanian Spinal Cord Society (RoSCoS) - affiliated to ISCoS and ESCIF and; member of the International Spinal Cord Society (ISCoS, since 2000), World Federation for Neurorehabilitation (WFNR, since 2008). He is Coordinator of Romanian team in five international projects and participated in four national projects. He is co-author of two patent certificates (appointed by Romanian State Office for Inventions and Marks, OSIM), nine books, and over 70 published papers. He is actively implied in national educational prophylactic interventions, aimed to prevent severe central nervous lesions.
Abstract:
Age-related gait and balance disturbances represent one of the most common geronto neurological symptoms, with different etiology and clinical pathological features (antalgic gait, paretic, spastic, ataxic, sensory deficit, hypokinetic, dyskinetic, anxious, and psychogenic) and often lead to falls in seniors. The pathogenesis of gait disorders include sensory deficits (visual, vestibular, somatosensory), neurodegenerative processes (cortical, extrapyramidal, cerebellar), cognitive degradation, depression and anxiety (primary or concerning falls), orthostatic hypotension, cardiac arrhythmia or insufficiency, adverse effects of medication, toxic factors (alcohol). Physiopathological basis of gait and balance dysfunctions is better understood with modern neuroanatomical mapping technique (diffusion-tensor tractography, DTI). The authors make a review of the literature regarding age and gender-related effect on microstructural topographic degeneration of the white matter (WM), respectively the disproportionate myelin alterations (density and topography) in different pathological neurologic entities: stroke, Parkinson's disease, leuconevraxitis, cerebral small vessel disease, Alzheimer. For geronto neurological impaired people, falling represent an important cause of injury, disability, even death, and a major public health problem. Prevention is better than cure, and can considerably reduce the psychological and physical morbidity, and the dependence on family care, social support and healthcare services. A targeted and adequate prophylaxis with multilevel interventions at endogenous and/or exogenous pathological items, addressing general public and community-dwelling elderly in prevention programs focused to raise awareness, represent the real cure for injurious falling.
Surendra Kumar Anand
Jawaharlal Nehru University, India
Title: Involvement of BDNF/TrkB signaling in regulating the injury induced regeneration response in adult zebrafish (Danio rerio) brain
Time : 16:30-18:00
Biography:
Surendra Kumar Anand completed his MSc from School of Life Sciences (SLS), Jawaharlal Nehru University (JNU), Delhi, India in 2016. Currently, he is pursuing his PhD from Laboratory of Cellular and Molecular Neurobiology (Lab 215), SLS, JNU under the supervision of Dr. Amal Chandra Mondal, Associate Professor, SLS, JNU. He is interested in studying the fundamental cellular and molecular mechanisms that orchestrate the brain regeneration process in the zebrafish model, especially the role of neurotrophins. He has published a review article and a research article in reputed international journals. Besides he has four poster presentations, one oral presentation and volunteering experience in national and international conferences and symposia.
Abstract:
Brain-derived neurotrophic factor (BDNF), acting via its receptor TrkB, is known to promote neuronal maturation, differentiation, maintenance and survival during embryonic development through its cognate receptor TrkB. The BDNF/TrkB system is highly conserved among vertebrates. Although the role of BDNF and TrkB during brain development is well established, their role in adult neurogenesis and brain regeneration awaits thorough investigation. In this study, we used the zebrafish stab wound injury model to determine whether the injury induced regeneration response in the telencephalon region is governed by BDNF/TrkB system or not. We induced stab wound injury in the mid-dorsal region of telencephalon of zebrafish brain without and with ANA-12 (selective TrkB antagonist) injection and examined the proliferation activity in selected brain regions using immunohistochemistry. We found that proliferation activity was significantly low in ANA-12 injected injured fish as compared to vehicle control injured fish. Other major findings of the study include the temporal pattern of proliferation activity after an injury and activation of adult neural stem cells (aNSCs) situated distantly apart from the injury site in the zebra fish brain.
E S Berdnikovich
Research Center of Neurology, Russia
Title: Differentiated approach to the restoration of speech in patients with aphasia in the acute and early periods of stroke
Time : 16:30-18:00
Biography:
Abstract:
Introduction: Stroke has high prevalence and severe consequences for public health. Annually there are 450000, strokes in Russia and post-stroke aphasia is seen in 35.9% of cases, so as dysarthria is seen in 13%. There is a need to develop a differentiated system of rehabilitation with justification of principles, areas and methods of correction and restorative influence.
Aim: To explore methods of logopedic influence with differentiated approach and personalized sensory stimulation based on the leading modality of perception of speech function disorders in acute and early recovery periods of stroke.
Patients & Methods: 138 patients were included. The experimental group: 108 acute stroke patients in early period of rehabilitation (up to three months). Also 30 patients received ambulatory basis treatment. All patients were right-handed with ischemic, hemorrhagic stroke in the left hemisphere verified by CT/MRI. We defined three groups by leading perception modality and observed patients through recovery dynamics. We provided logopedic and neuropsychological examination of patients, selected the method of synergistic approach and used neuropsychological, neurolinguistic and statistical methods in ascertaining and training experiments.
Results: We implemented the differentiated approach depending on the aphasia form and patients’ sensory profile by gradual complication of training tasks and training methods, considering the psycho-physiological state. Thus, application of differentiated sensory stimulation methods considering perceptual leading modality was effective for all patients, regardless to aphasia form.
Conclusion: The combination of different sensory stimulation with dominant representational system demonstrates efficiency of developed model of logopedic impact in the acute and early stroke recovery period.
Sara Karimi
Kashan University of Medical Sciences, Iran
Title: Orexin receptor 1 in the anterior cingulate cortex regulates effort-based decision making
Time : 16:30-18:00
Biography:
Sara Karimi is a working as a PhD student from Kashan University of medical sciences, Iran .She holds a Master Degree (MSc) in Animal physiology from Shahid Beheshti University, Iran. She is extending her valuable service as a Research Scholar in Dr. Haghparast lab for 2 years and has been a recipient of many award and grants. Her research experience includes various programs, contributions and participation in different countries for diverse fields of study. Her research interests as a Research Scholar reflect in her wide range of publications in various national and international journals.
Abstract:
Orexinergic neurons are discretely localized within the lateral hypothalamus. In addition, several lines of evidence specify that orexins may also participate in the regulation of a variety of affective and cognitive processes. Orexin-1 receptor (OX1r) is distributed extensively throughout the prefrontal cortex. Effort-based decision-making is mediated largely by the anterior cingulate cortex (ACC). Hence, in the present study, we conducted an experiment to clarify the role of OX1r in the ACC in effort-based decision making. 20 male Wistar rats were used in this study. The rats had been trained in an effort-based form of cost-benefit T-maze decision making task. The two goal arms were different in the amount of accessible reward. After the rats had learned unequal size of reward, they then underwent barrier training. Rats were given three training days with a 30 cm barrier. The animals could choose high reward arm (HRA) and pay cost to achieve large reward or obtain a low reward in the other arm (LRA) without any cost. Before surgery, all animals were selecting the HRA on almost every trial. During test days, the rats received local injections of either DMSO 20%/0.5 µl, as vehicle, or SB334867 (3, 30, 300 nM/0.5 µl), as selective OX1r antagonist, within the ACC. Our results demonstrate profound effects of ACC's OX1r on effort based decision making, SB334867 administration into the ACC, changed the animal's preference to a LRA. These results imply that OX1r has a crucial role for allowing the animal to try to acquire greater rewards.
Mathilde DeGraff and Holly Battsek
NYU Langone Health, USA
Title: Use of weighted exercise and gait training to improve function in the ataxic patient: a case study on a patient with acute motor-sensory axonal neuropathy
Time : 16:30-18:00
Biography:
Mathilde DeGraff completed her Undergraduate degree in Health Sciences and Doctorate of Physical Therapy at Boston University in 2013. In 2017, she became Neurologic Certified Specialist. She has over four years of experience working at Rusk Rehabilitation at NYU Langone Health located in New York City where she is now a permanent Senior Physical Therapist in the acute inpatient rehabilitation department. She has presented at multiple conferences across the USA to promote physical therapies impact in both acute care and inpatient rehabilitation, with a focus on neurological conditions including Parkinson's disease and she is an active member of the APTA.
Holly Battsek completed her Undergraduate degree in Health Sciences and Doctorate of Physical Therapy at Boston University in 2013. In 2017, she became a Neurologic Certified Specialist. She has over four years of experience working at Rusk Rehabilitation at NYU Langone Health located in New York City, with her most recent rotation being inpatient rehabilitation for the medically complex patient. She has presented at multiple conferences across the USA and has an abstract published in a Journal of Rehabilitation Medicine. Her presentations and research focus on promoting the benefits of physical therapy in the acute, inpatient and outpatient settings for the neurologically impaired population.
Abstract:
Acute motor-sensory axonal neuropathy (AMSAN) is a rare subtype of Guillian Barre Syndrome (GBS) accounting for 3-5% of cases. Symptoms include impaired joint proprioception and ataxia. Treatment includes medication and physical therapy (PT), with limited research on PT protocols. This case demonstrates the effectiveness of weighted exercise and gait training in an ataxic patient with AMSAN in an inpatient rehabilitation unit. Patient is a 40yo female with AMSAN initially treated with plasmapheresis and IVIG prior to admission to rehabilitation. Physical therapy presented with bilateral extremity ataxia, weakness and impaired proprioception and sensation in all extremities. Patient received daily 60-90 minute PT sessions for seven weeks. Patient initially required a 3-person assist for transfers and was unable to ambulate. Week one focused on frenkel exercises and beasy-board transfers. Weighted exercise started on week two with 3 lb ankle weights (AW) for proprioceptive feedback, starting with standing weight-shifting and seated multidirectional toe taps. This progressed to pre-gait exercises including standing marching and toe taps onto a step with body weight support (BWS). This advanced to gait training over-ground with BWS and RW. At week 6 AW were removed for all training. By discharge patient was independent with bed mobility, supervision with RW for transfers, and ambulating 160 ft. There is evidence on using weights to improve proprioception and ataxia in populations such as multiple sclerosis, and further research is needed in the GBS/AMSAN population. This case describes a PT protocol that can effectively improve functional independence in AMSAN patient with ataxia.
Shyan-Lung Lin
Feng Chia University, China
Title: Assessment of autonomic dysfunctions in patients with Parkinson’s disease by cerebrovascular regulation to CO2 reactivity
Time : 16:30-18:00
Biography:
Shyan-Lung Lin has completed his PhD from Northwestern University, USA. He joined Feng Chia University in 1992 and is currently a joint Professor in Department of Automatic Control Engineering and in the International School of Technology and Management. He has published more than 200 papers in reputed journals and international conferences, and has participated in over 40 grant-projects from National Science Council and Minister of Science and Technology, Taiwan, during the past 25 years.
Abstract:
The relationship between changes in cerebral blood flow and arterial carbon dioxide tension can be applied to assess cerebrovascular function with steady-state and transient hypercapnia, however, both responses were found to be similar. The purpose of this study is to evaluate the cerebrovascular response to carbon dioxide (CO2) in patients with Parkinson’s disease (PD) and explored the interaction between cerebral auto-regulation and ventilatory control by using nonlinear regression models. 18 PD patients underwent hyperventilation to stimulate cerebral auto-regulation based on CO2 reactivity during the experiment. The cerebral vasomotor reactivity (CVMR) measurements were compared by performing nonlinear regression of the cerebral blood flow velocity (CBFV) versus the end-tidal partial pressure of carbon dioxide (PETCO2). The cerebrovascular conductance index (CVCi) was also derived to minimize the effects of arterial blood pressure on CVMR estimation and to quantify the relationship between CVCi and PETCO2. Statistical analysis of significance values between PD patients and healthy groups was evaluated. The results showed that the PD patients demonstrated a significantly lower level of CBFVmax (%) (39.24±30.17%) than did the healthy elders (78.59±28.68%) with Claassens et al.’s model. With Battisti-Charbonney et al.’s model, significance was found in CBFVmax (%) (56.39±20.42%) of PD patients in comparison with healthy elders (97.95±29.41%), and in both CBFVmax(%) and PETCO2 (1.19±1.24 mmHg) range in comparison with healthy youths (86.39±29.80%; 2.89±2.14 mmHg).
Yong-Il Shin
Pusan National University, South Korea
Title: Low-level light emitting diode (LED) therapy suppresses inflammasome-mediated brain damage in experimental ischemic stroke
Time : 16:30-18:00
Biography:
Yong-Il Shin has completed his PhD from JeonBuk National University. He is the Professor of Yangsan Pusanl National University Hospital. He has published more than 99 papers in reputed journals and his research interests are the areas of neurorehabilitation based on neuroscience after CNS diseases.
Abstract:
Use of photostimulation including low-level light emitting diode (LED) therapy has broadened greatly in recent years because it is compact, portable, and easy to use. Here, the effects of photostimulation by LED (610 nm) therapy on ischemic brain damage was investigated in mice in which treatment started after a stroke in a clinically relevant setting. The mice underwent LED therapy (20 min) twice a day for three days, commencing at 4 hours post-ischemia. LED therapy group generated a significantly smaller infarct size and improvements in neurological function based on neurologic test score. LED therapy profoundly reduced neuroinflammatory responses including neutrophil infiltration and microglia activation in the ischemic cortex. LED therapy also decreased cell death and attenuated the NLRP3 inflammasome, in accordance with down-regulation of pro-inflammatory cytokines IL-1β and IL-18 in the ischemic brain. Moreover, the mice with post-ischemic LED therapy showed suppressed TLR-2 levels, MAPK signaling and NF-kB activation. These findings suggest that by suppressing the inflammasome, LED therapy can attenuate neuroinflammatory responses and tissue damage following ischemic stroke. Therapeutic interventions targeting the inflammasome via photostimulation with LED may be a novel approach to ameliorate brain injury following ischemic stroke.
Ji Hong Min
Pusan National University, South Korea
Title: New-LED-based light therapy improves cognitive function in mouse model of Alzheimer’s disease
Time : 16:30-18:00
Biography:
Ji Hong Min has completed his PhD from Pusan National University. He is the MD of Department of Rehabilitation Medicine at Pusan National University Hospital in Korea. His research interests include Neurorehabilitation and Neurology. He has published more than 10 papers in Korean journals.
Abstract:
We aimed to investigate the effects of LED-T on plaque formation, gliosis, and neuronal death to prevent cognitive impairment and dementia, and optimal timing of LED-T initiation for functional recovery. LED-T was applied by placing the skin-adhesive light-emitting probes onto the skin at two locations on the head. Experimental groups receiving treatment are divided into early-treat group and late-treat group according to the time of starting LED-T [two months (early group) or six month (late group)], and the mice of each group received LED-T three times a week for 14 weeks, 20 minutes per session. Morris water maze, passive avoidance test, and elevated plus maze were evaluated at 10 months of age. The brain sample for immunohistochemistry (IHC) was used by cryo-section. In the Morris water maze test, early-treat group of both groups showed improved learning and memory, and recovery of reduced anxiety compared to the light-untreated group was evaluated by the elevated plus maze. Aß1-42 and thioflavin-S, early stage LED-T may reduce plaque production in the cortex and amyloid precursor protein was staining with no difference between the groups. The western blot results showed an increase in NEP in the early group compared to the sham group. As a result, LED-T has a decomposition effect on the plaque. In addition, the activation of microglia decreased in the cortex area of the LED-T treatment group. LED-T reduced the amyloid plaque in the 5XFAD mouse and alleviated the behavioral characteristics of Alzheimer’s disease.