Any injury that results in trauma to the skull or brain can be classified as a head injury. The terms traumatic brain injury and head injury are often used interchangeably in the medical literature. This broad classification includes neuronal injuries, hemorrhages, vascular injuries, cranial nerve injuries, and subdural hygromas, among many others. These classifications can be further categorized as open (penetrating) or closed head injuries. This depends on if the skull was broken or not. Our Objective in this study was to compare the level of knowledge and awareness od a sector of Saudi population to other nations and cultures. We also aim to provide a reference or standpoint for future comparisons. Another issue that we aim to study is the defect in the knowledge of different age groups and genders to help in finding the right approach in to fixing the knowledge flaw. The study will be carried out using a 30 questions questionnaire that will be distributed to people focusing on 2 age groups (18-30 and 31-60).

Fawaz Fahad Alotaibi is a medical intern who has experience in medical research, has done four cross- sectional study & one case control study so, he is expertise in research field. He is professional in his work and caring of his patients. He is working hard to be a neurologist, doing three researches in this field.

Background: Multiple sclerosis (MS) is a chronic, inflammatory and immune-mediated demyelinating disease that originates from the central nervous system. It is characterized by infiltration of immune cells, abnormal formation of myelin sheath and the formation of multifocal plaques in the brain and spinal cord. Those diagnosed with MS are usually found to be in their most productive years of life. The disease usually starts between 20 and 40 years of age, and affects women more than men. According to the Atlas of MS database, worldwide about 2.5 million people are found to be diagnosed with multiple sclerosis1. Purpose: The study is designed to evaluate the knowledge & attitude of multiple sclerosis among women in Majmaah City. Methods: The study design was cross-sectional to study the knowledge and attitude of women in Majmaah, Saudi Arabia about multiple sclerosis & was conducted in Majmaah city at public places. Study population was women aged 18 years and more and whoreside in Majmaah city was included in the study. Sampling technique was consecutive sampling & the data was collected by a pre tested questionnaire. Results: The findings showed that (48.67%) of the respondents have very weak knowledge about multiple sclerosis, while (38.49%) of respondents’ knowledge is weak and (12.39%) of the respondents have an average knowledge of multiple sclerosis; while (0.29%) have a good knowledge about multiple sclerosis. The respondents who have a positive attitude about multiple sclerosis are more than the respondents who have a negative attitude about multiple sclerosis. Conclusion: The study revealed that the majority of the study participants had limited knowledge and severe weakness in the awareness level toward the multiple sclerosis disease which requires increasing the awareness level.

Jae Young Park completed his Graduation from Chonnam National Medical School and Residency in Department of Neurosurgery of Chonnam National University Hospital. He is Clinical Fellow in Department of Neurosurgery, Chonnam National University.

Acute calcific tendinitis of the longus colli muscle is a rare clinical entity that causes severe neck pain. This entity is not well recognized due to its non-specific presentation such as acute neck pain, neck stiffness, odynophagia or dysphagia. Acute calcific tendinitis of the longus colli muscle is an inflammatory condition caused by deposition of calcium hydroxyapatite in the superior oblique tendon fibers of the longus colli muscle. It can be misdiagnosed as other life-threatening conditions including retropharyngeal abscess, resulting in unnecessary medical or surgical interventions. We retrospectively reviewed eight patients who were diagnosed with acute calcific tendinitis of the longus colli between April 2008 and March 2015. There were eight patients (five men, three women) and mean age was 44.5 year-old (from 41 to 49). The associated symptoms included neck pain, stiffness, odynophagia and headache. The duration of symptoms varied from two days to one week. All patients showed calcific deposition inferior to the anterior arch of the atlas, and prevertebral effusion extending from C1 to C4. All patients were treated with NSAIDs and immobilization with a cervical brace and they showed complete resolution of symptoms within one week. We report eight cases of acute calcific tendinitis of the longus colli, and describe the symptoms and radiological findings in detail. Awareness of this rare, benign and self-limiting disease entity with characteristic radiologic findings is essential for early diagnosis and to avoid unnecessary medical and surgical interventions.

Stephanie Nadine Reichel studied Molecular Medicine at the Eberhard-Karls University in Tübingen. Since January 2014, she is doing her PhD at the Institute of Physiological Chemistry of the University of Ulm. Besides, she is a Student Representative in the International Graduate School in Molecular Medicine Ulm and a Member of the Biotechnological Student Initiative (bts e.V.), Ulm.

The transcription factor NF-κB is a central regulator of various cellular processes, including cell survival and inflammation. Inflammation in the CNS is mediated by both astroglia and microglia, which become activated and crosstalk upon CNS damage, such as traumatic brain injury (TBI). There is increasing evidence that IKK/NF-κB activation in astrocytes and microglia is part of the secondary pathophysiology in TBI. However, neither the cell-type-specific activation kinetics after TBI nor the exact associated cellular functions induced by NF-κB in this context is properly understood so far. We used the closed head injury model in transgenic NF-κB reporter gene mice, which allowed monitoring of NF-κB activation by GFP expression. Interestingly, we found increasing NF-κB activation in both astrocytes and microglia on the ipsilateral site after TBI, however with different kinetics. Notably, also on the contralateral site microglia showed NF-κB activation, suggesting that the TBI triggered inflammatory response can indeed spread from local site of damage to the uninjured hemisphere. Using conditional mouse models allowing conditional astrocyte-specific activation or inhibition of NF-κB, we found first evidence that NF-κB activation in astrocytes prior to TBI promotes development of neurological deficits post TBI. In contrast, animals with astrocyte-specific NF-κB inhibition show less neurological impairments suggesting beneficial effects of NF-κB suppression in astrocytes. Currently, we focus on the molecular mechanisms underlying this differential TBI outcome using immunohistochemical, biochemical and gene expression analyses as well as investigation of the blood-brain-barrier integrity and edema formation. This research is supported by a grant of the Deutsche Forschungsgemeinschaft (DFG SFB 1194).

Shiela M Ramos is currently working in the Department of the Internal Medicine at Ospital ng Makati, Philippines. Ramos has published several original research papers in the reputed journals and has also participated in the several scientific meetings.

Introduction: Spine is the third most common site for metastatic cancer. In fact, only one to three percent of tumors found in the spinal cord are metastatic. Spinal cord metastasis is very rare as initial manifestation of Cancer. Few patients with no known comorbids presents initially as neurologic manifestation and deficits. Rarely, patients demonstrate features of paraparesis. Radiotherapy is the gold-standard of therapy for spinal cord metastasis. The overall prognosis is poor and the mortality rate is very high. We present what is, to the best of our knowledge, the first case of spinal cord metastasis of rectal adenocarcinoma presenting with paraparesis at Ospital ng Makati, Philippines. Case Description: A 64 year old male presented with an isolated spinal cord metastasis which presents as first manifestation of malignancy without central nervous system involvement. Patient underwent laboratory and diagnostic work-up. After radiological work up, MRI revealed an enhancing epidural soft tissue at level of T3 causing severe cord compression, with narrowing of the spinal canal. Proctosigmoidoscopy with biopsy revealed rectal adenocarcinoma. Patient is still alive after 3 months of diagnosis. Conclusion: The patient had spinal cord metastasis secondary to rectal adenocarcinoma. The disease first manifest as neurologic symptom as paraparesis, which is very uncommon condition in an asymptomatic patient. This unique case has particular interest in medicine, especially for the specialties of medical, surgical and radiation oncology. Whole-body investigation might help for diagnosis of primary focus and approach to treatment.

Melanie Tepper has completed her Bachelor studies in Molecular Biotechnology at the University of Heidelberg, Germany. Afterwards, she had the chance to study one year at the San Francisco State University, CA, USA as a Fulbright student in Cell and Molecular Biology and finished her Master’s studies in Molecular Medicine at Ulm University, Germany. She is currently in her 3rd year as a PhD student from the International Graduate School Ulm in the group of Prof. Dr. Thomas Wirth and Dr. Bernd Baumann.

The outcome of traumatic brain injury (TBI) greatly depends on the extent of secondary pathologies. This posttraumatic phase is characterized by diverse cellular events including neuroinflammation, apoptosis and necrosis as well as counteracting regeneration and remodeling processes. IKK/NF κB signaling is a key player in the regulation of inflammation, immune responses, cell survival and neuronal differentiation and is known to get activated in different cell types of the CNS upon TBI. However, the cell-type-specific functions of NF κB remain unclear. We therefore conducted a systematic approach to analyze whether IKK/NF κB signaling has either beneficial or detrimental effects on the outcome of TBI depending on the cell type. For this purpose, we used an experimental model of closed head injury in combination with either loss-of-function or gain-of-function mice allowing conditional inhibition or activation of NF κB in principal forebrain neurons. Outcome parameters consisted of in vivo neurological scoring as well as post mortem investigation of inflammatory, apoptotic and synaptic markers. We provide evidence that repression of IKK/NF κB signaling in neurons increases the acute posttraumatic mortality rate and worsens the neurological outcome of survivors at various time points post TBI. Interestingly, IKK2 DNCamk2a mice are more prone for hematoma formation and show increased neuroinflammation, reactive astrogliosis and alterations in gene expression. These findings suggest that neuronal NF κB inhibition plays a detrimental role for the outcome of TBI. Currently we investigate whether enhancing neuronal NF κB activation can reduce these harmful effects of secondary TBI pathogenesis. This study is supported by the German Research Foundation (SFB 1149/A03).

Hyung Min Kwon is currently working at the Department of the Neurology at SMG-SNU Boramae Medical Center at South Korea. Dr. Kwon has published several original research papers in the reputed journals and participated in the several meetings.

Transforaminal epidural steroid injection (TFESI) is a widely-used nonsurgical procedure in the treatment of patients with radicular pain syndrome. The procedure is efficacious in relieving the pain, but a number of minor and major complications have been reported in the medical literature. Increasing frequency of major complications, such as spinal cord infarction and cerebral infarction, has been more recently reported. We report a case of 49-year-old man with a history of chronic cervical radiculopathy, who experienced a devastating complication after TFESI. After 2 minutes of regular TFESI, the patient abruptly experienced muscle weakness in both upper extremities. Within 5 minutes after the start of the procedure, the patient became quadriplegic. Despite active rehabilitation, the patient remained bed-ridden 4 years after the catastrophic event. To our knowledge, this is the first reported case of spinal cord infarction occurring after TFESI in Korea. Considering the risk of dreadful complications, which appears in an unpredictable manner, the benefits of performing TFESI in radiculopathy patients need to be reappraised.

Basta Kaim Agnieszka has completed her PhD in 1998 in the Institute of Pharmacology Polish Academy of Sciences in Cracow, Poland. Since 2007, she is the Head of PhD program at the Institute of Pharmacology, PAS. Since 2014, she is a Professor of neuropsychopharmacology and an Expert of neuroimmunology. She has published more than 100 papers in reputed journals and has been serving as an Editorial Board Member of repute.

Current data reveal that early adverse life experiences may affect the developmental processes of the brain and can be involved in the pathogenesis of many psychiatric disorders including depression. It has been highlighted that stress during pregnancy activates the immune response in the offspring’s central nervous system. Results also show important role fractalkine (CX3CL1) in the neuron-microglia interactions and consequently in production of pro- and anti-inflammatory factors in the brain. Therefore, the aim of our study was to examine the impact of prenatal stress as well as the role of fractalkine (CX3CL1) on the behavioral and biochemical changes in adult rats. Adult 3-months old rats offspring (control and prenatally stressed), after behavioral verification, received icv injections with exogenous fractalkine. After the treatment, we evaluated time-dependent effects of fractalkine administration on the behavioral parameters. Moreover, we measured the changes in the production of pro-inflammatory cytokines in the two structures: Hippocampus and frontal cortex. The obtained data shows that 7 days after treatment with fractalkine, the behavioral disturbances evoked by prenatal stress procedure were normalized. Moreover, prenatal stress activates production of pro-inflammatory cytokines in the hippocampus and frontal cortex. Interestingly, treatment with fractalkine inhibited the expression of these factors mainly in the frontal cortex. Summing up, our study shows that the changes in fractalkine may play an important role in the pathogenesis of depression. Importantly, the action of the chemokine is connected with its effect on production of inflammatory factors in the brain.

Abdolreza Esnaashari became a Specialist in Nuclear Medicine in Norway at Akershus University Hospital, Ullevaal University Hospital and Rikshospitalet. He has co-authored several research papers in neurology.

Objective: Knowledge of the cognitive performance associated with REM sleep behavior disorder (RBD) in newly diagnosed Parkinson disease (PD) patients is limited. We thus wanted to explore 1) the frequency of RBD in patients with PD at a relatively early stage and 2) cognitive performance associated with RBD in PD. We hypothesized that RBD would be associated with cognitive impairment in PD. Methods: 29 non-demented patients recently diagnosed with PD (disease duration<5 years, Hoehn and Yahr stage <2.5 and no dementia) were recruited. The diagnosis of PD was supported by dopamine transporter SPECT. RBD was diagnosed based on standardized clinical interview and confirmed by polysomnography. Overall cognition was assessed by screening tests including the Mini-Mental State Examination (MMSE), and neuropsychological tests of memory, language, executive, attentional and visuospatial functions tests were performed. Results: 13 patients (45%) had probable RBD. There were no significant differences between PD with and without RBD in any of the neuropsychological tests, but a numerically lower performance was observed in the PD RBD group on memory tests Conclusions: RBD is common even in early PD without dementia, but was not found to be associated significantly with cognition.

Slavikova Barbora has received her Master’s degree in 1983 from the Institute of Chemical Technology in Prague. She has been working at the Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech Republic in Prague for almost 25 years with specialization in steroidal synthesis. During this period, she has synthesized thousands of compounds and is the author and co-author in 18 original papers and 4 patents.

Our main avenue of investigation is design and synthesis of steroidal inhibitors of N-methyl-D-aspartate receptors (NMDAR) that could serve as drug-like candidates for CNS disorders as these receptors are essential for synaptic plasticity, learning and memory. However, under pathological conditions, the over-excitation of the NMDAR can induce cell death. Our ongoing structure-activity relationship studies (SAR) are focused on structural modifications of steroidal skeleton that would afford potent inhibitors of NMDAR. In general, the inhibitory effect of neurosteroids on NMDAR is dependent upon the 5β-pregnane skeleton. To elucidate the SAR of the pregnane acetyl moiety, we have prepared a series of compounds with lipophilic D-ring modifications and showed that these analogues are more potent modulators of NMDA-induced currents (IC50 values varying from 90 nM to 5.4 μM) than the known endogenous neurosteroid- pregnanolone sulfate (IC50=24.6 μM). The obtained results emerged us to assess the structural motif of the steroidal D-ring. As such, a series of compounds with partially of fully degraded D-ring was synthesized (IC50 values varying from 15 μM to 224 μM). Finally, using the total synthesis of steroidal A, B and C-ring, we have prepared a series of compounds with non-steroidal structural characteristics of various types that allowed us to define new structural motifs for inhibitors of NMDA receptors.

Any injury that results in trauma to the skull or brain can be classified as a head injury. The terms traumatic brain injury and head injury are often used interchangeably in the medical literature. This broad classification includes neuronal injuries, hemorrhages, vascular injuries, cranial nerve injuries, and subdural hygromas, among many others. These classifications can be further categorized as open (penetrating) or closed head injuries. This depends on if the skull was broken or not. Our Objective in this study was to compare the level of knowledge and awareness od a sector of Saudi population to other nations and cultures. We also aim to provide a reference or standpoint for future comparisons. Another issue that we aim to study is the defect in the knowledge of different age groups and genders to help in finding the right approach in to fixing the knowledge flaw. The study will be carried out using a 30 questions questionnaire that will be distributed to people focusing on 2 age groups (18-30 and 31-60).

Any injury that results in trauma to the skull or brain can be classified as a head injury. The terms traumatic brain injury and head injury are often used interchangeably in the medical literature. This broad classification includes neuronal injuries, hemorrhages, vascular injuries, cranial nerve injuries, and subdural hygromas, among many others. These classifications can be further categorized as open (penetrating) or closed head injuries. This depends on if the skull was broken or not. Our Objective in this study was to compare the level of knowledge and awareness od a sector of Saudi population to other nations and cultures. We also aim to provide a reference or standpoint for future comparisons. Another issue that we aim to study is the defect in the knowledge of different age groups and genders to help in finding the right approach in to fixing the knowledge flaw. The study will be carried out using a 30 questions questionnaire that will be distributed to people focusing on 2 age groups (18-30 and 31-60).

Any injury that results in trauma to the skull or brain can be classified as a head injury. The terms traumatic brain injury and head injury are often used interchangeably in the medical literature. This broad classification includes neuronal injuries, hemorrhages, vascular injuries, cranial nerve injuries, and subdural hygromas, among many others. These classifications can be further categorized as open (penetrating) or closed head injuries. This depends on if the skull was broken or not. Our Objective in this study was to compare the level of knowledge and awareness od a sector of Saudi population to other nations and cultures. We also aim to provide a reference or standpoint for future comparisons. Another issue that we aim to study is the defect in the knowledge of different age groups and genders to help in finding the right approach in to fixing the knowledge flaw. The study will be carried out using a 30 questions questionnaire that will be distributed to people focusing on 2 age groups (18-30 and 31-60).

Any injury that results in trauma to the skull or brain can be classified as a head injury. The terms traumatic brain injury and head injury are often used interchangeably in the medical literature. This broad classification includes neuronal injuries, hemorrhages, vascular injuries, cranial nerve injuries, and subdural hygromas, among many others. These classifications can be further categorized as open (penetrating) or closed head injuries. This depends on if the skull was broken or not. Our Objective in this study was to compare the level of knowledge and awareness od a sector of Saudi population to other nations and cultures. We also aim to provide a reference or standpoint for future comparisons. Another issue that we aim to study is the defect in the knowledge of different age groups and genders to help in finding the right approach in to fixing the knowledge flaw. The study will be carried out using a 30 questions questionnaire that will be distributed to people focusing on 2 age groups (18-30 and 31-60).

Budziszewska Bogusława has completed her PhD in 1981 at the Institute of Pharmacology, Polish Academy of Sciences in Cracow, Poland. Since 2004, she is Head of Immunoendocrinology Laboratory in the Institute of Pharmacology; since 2011, a Professor of Medical Sciences and from 2011 Head of Department of Biochemical Toxicology, Jagiellonian University, Medical College, Cracow, Poland. She has published more than 100 papers in reputed journals.

Current data reveals that early adverse life experiences may affect the developmental processes of the brain and can be involved in the pathogenesis of many psychiatric disorders including depression. It has been highlighted that stress during pregnancy activates the immune response in the offspring’s central nervous system. Results also show important role fractalkine (CX3CL1) in the neuron-microglia interactions and consequently in production of pro- and anti-inflammatory factors in the brain. Therefore, the aim of our study was to examine the impact of prenatal stress as well as the role of fractalkine (CX3CL1) on the behavioral and biochemical changes in adult rats. Adult 3-months old rats offspring (control and prenatally stressed), after behavioral verification, received icv injections with exogenous fractalkine. After the treatment, we evaluated time-dependent effects of fractalkine administration on the behavioral parameters. Moreover, we measured the changes in the production of pro-inflammatory cytokines in the two structures: Hippocampus and frontal cortex. The obtained data show that 7 days after treatment with fractalkine the behavioral disturbances evoked by prenatal stress procedure were normalized. Moreover, prenatal stress activates production of pro-inflammatory cytokines in the hippocampus and frontal cortex. Interestingly, treatment with fractalkine inhibited the expression of these factors mainly in the frontal cortex. Summing up, our study shows that the changes in fractalkine may play an important role in the pathogenesis of depression. Importantly, the action of the chemokine is connected with its effect on production of inflammatory factors in the brain.

Chodounska Hana has completed her PhD in 1983 from Charles University in Prague. She has been working at the Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech Republic in Prague from 1986. During this period, she was the PI of steroidal research group for almost 10 years. She is author or co-author of 52 articles, 7 patents and has many contributions to scientific conferences. She has been Supervisor of undergraduate, graduate and doctoral students and the Lecturer of the course “Chemistry of Natural Products” at the Charles University and various scientific and popularizing lectures.

N-Methyl-D-aspartate (NMDA) receptors (NMDARs) are a major class of excitatory neurotransmitter receptors in the central nervous system. They form glutamate-gated ion channels that are highly permeable to calcium and mediate activity-dependent synaptic plasticity. NMDAR dysfunction is implicated in multiple brain disorders, including stroke, various forms of neurodegeneration, chronic pain and schizophrenia. NMDARs are activated by agonists-glutamate and glycine, and their activity is modulated by allosteric modulators including endogenous neurosteroids pregnenolone sulfate and 20-oxo- 5β-pregnan-3α-yl sulfate (PAS) and their synthetic analogues. Our recent research allowed us to identify the site of action of PAS- the extracellular vestibule of the activated/desensitized receptor’s ion channel pore. The structure of the open channel and recognition of molecular steps in the transition from closed to the open state provide a unique opportunity for the design of new therapeutic, neurosteroid-based ligands to treat diseases associated with dysfunction of glutamate system. As such, a series of pregnanolone analogues was prepared and these derivatives substituted with a carboxylic acid moiety at the end of an aliphatic chain of varying length at C-3, have the difference in potency between tonic and phasic inhibition increased with the length of the residue. Moreover, pregnanolone hemipimelate (PA-hPim), had no effect on phasically activated receptors while inhibiting tonically activated receptors. In behavioral tests, PA-hPim showed neuroprotective activity without psychotomimetic symptoms.

Elena Solntseva graduated from the Lomonosov Moscow State University (Moscow, Russia) with a degree "neuroscience". She then worked at the Center for Mental Health in Moscow, where she defended her PhD thesis and then a Doctoral thesis. She currently works at the Research Center of Neurology in Moscow. She is the author of dozens of scientific publications.

Lithium salts are successfully used to treat bipolar disorder. At the same time, according to recent data lithium may be considered as a candidate medication for the treatment of neurodegenerative disorders. The mechanisms of therapeutic action of lithium have not been fully elucidated. In particular, in the literature there are no data on the effect of lithium on the glycine receptors. In the present study we investigated the effect of Li+ on glycine-activated chloride current (IGly) in rat isolated pyramidal hippocampal neurons using patch-clamp technique. Short (600 ms) application of Li+ caused two effects: (1) an acceleration of desensitization (a decrease in the time of half-decay, or “τ”) of IGly and (2) a reduction of the peak amplitude of the IGly, Both effects were not voltage-dependent. Dose-response curves for both effects were N-shaped with two maximums at 100nM and 1mM of Li+ and a minimum at 1 μM of Li+. This complex form of dose-response may indicate that the process activated by high concentrations of lithium inhibits the process that is sensitive to low concentrations of lithium. Longer application (10 min) of Li+ caused similar effects, but in this case 1μM lithium was effective and the dose-effect curves were not N-shaped. The inhibitory effect of lithium ions on glycine-activated current suggests that lithium in low concentrations is able to modulate tonic inhibition in the hippocampus. This important property of lithium should be considered when using this drug as a therapeutic agent.