2^nd International Conference on Central Nervous System Disorders and Therapeutics December 05-07, 2016 Dubai, UAE

Biography:

man Tourbah, MD, PhD, is a Neurologist and Neuroscientist (Paris VI). A Professor of Neurology, he is responsible for the MS Center at the University Hospital of Rheims, France. His main areas of research are MS, neuro-ophthalmology, neuro-metabolic diseases and MRI. He published more than 100 original articles and participates in many phase II and III clinical and MRI studies in MS, and recently coordinated two phase III trials studying the effect of high doses of biotin in patients with MS. He is a Member of the MS Experts’ Panel of the EAN, and the Coordinator of the LSN MS guidelines.

Abstract:

Progressive multiple sclerosis (MS) is characterized by the accumulation of disability over time that may follow a period of clinical relapses (secondary progressive MS) or appear since onset (primary progressive MS). Current therapeutical strategies are based on immunotherapies that may delay disability progression. No approved treatment has clearly demonstrated efficacy on the neurodegenerative component of the disease. Future strategies are studying the possibility of enhancing endogenous or exogenous remyelination, and presumed neuroprotective properties of anti-epileptic, anti-arrhythmic and anti-glutamatergic drugs, among others. We recently demonstrated that MD1003 (high doses of biotin, MedDay Pharmaceuticals, Paris, France) was able to reverse disease progression in patients with progressive not active MS, with a maintained efficacy over 2 years, and a good tolerance of the treatment. MD1003 may act as a neuroprotective agent, increasing energy supply and thus reversing virtual hypoxia that is present in progressive MS. It may also promote remyelination by activating intra-oligodendroglial lipid synthesis. Thus, targeting neuronal and oligodendroglial metabolism represents a promising perspective in treating patients with progressive MS.

Biography:

Gunel Zeynalova-Latifofa, has graduated at the age of 22years from Azerbaijan Medical University. She has practiced as an assistant of the Professor of Child Neurology Z.Aliev during 5years. Then she has worked as an child Neurology doctor in Child Neurology Center in Baku. In 2014 she has taken EEQ course in Neurophysiology University in Moscow, in Pediatrics University in Moscow, in Neurology University in Moscow during 2month. She has some certificates’ from World Neurology Congresses. She is working as a chief doctor in private hospital named by Medicus Klinika.

Abstract:

Nonepileptic paroxysmal disorders in children and adolescents is a large group of diseases and syndromes, which are characterized by relatively sporadic loss of consciousness and/or diverse motor, emotional, psychological vegetative problems. In broad sense of the concept N.E.P.R. includes any suddenly appeared symptoms for which the term "epilepsy" is not suitable.

1. Syncopal states - syncope, fainting, collapse.

2. Non epileptic sleep disorders.

3. Disorders related to impairment in emotional spheres (panic attacks, bouts of hysteria)

4. Other childhood paroxysmal disorders (affective-respiratory paroxysms, fading (starring), grimace, trembling attacks, masturbation in young children, muscle spasms while chewing).

5. Extrapyramidal symptoms

6. Migraine.

7. Somatogen paroxysmal disorders.

8. Paroxysmal disorders with acute cerebral blood circulation with traumatic brain injury etc.

The ILAE 2001 8th section includes seizures, for which the definition of "epilepsy" is not always suitable. This group can also contain the following disorders:Benign neonatal seizure, Febrile seizures, Reflex seizures, Seizures associated with alcohol withdrawal, Seizures associated with taking different medicines etc.

Affective-respiratory paroxysms occur in young children in response to exogenous adverse impacts. The frequency of the disease in the pediatric population comprises 4-17% .Given that affective-respiratory paroxysms are accompanied by apnea and/or asystole and many authors consider them to be life endangered state. According to some data, affective-respiratory paroxysms amount for about 8% of such states.

The causes and mechanisms of the emergence of the disease.

Affective-respiratory paroxysms are initiating paroxysms. For the activation of the disease there must be the impact of some factors causing dissatisfaction, anger, fear or pain. Each child can have a special practical factor. As a result, there is a strong cry, where hyperventilation of lungs, hypocapnic ischemia of the brain and low blood pressure problems take place.

Weeping causes the spasm of the respiratory tract and as a result the mechanism Valsalva Weber is triggered, when due to the rise in thoracic pressure, venous return to the heart and cardiac output as well as minute volume of blood stream decrease, which leads to hypoperfusion of cerebral arteries and simultaneously to venous stasis. In combination with hypoxemia it results to the loss of consciousness and/or convulsions. This gives diffuse cyanosis of the skin, i.e. cyanotic affective-respiratory paroxysms.

Sometimes “pale” affective-respiratory paroxysms can take place, where the initiating agent is either pain or fear. It is short-term state, where asystole takes 10 seconds, sometimes 20 seconds. Thus, the main pathogenetic link in the affective-respiratory paroxysms is apnea or apnea + asystole.

It is clear that apnea does not have central origin, as respiratory efforts and the motion of respiratory muscles are observed in the absence of air stream in the upper respiratory tract. If a child has epi center or epi activity it can lead to the epi seizures.

Anemia may contribute to an increase in the degree of hypoxia.

Usually children with affective-respiratory paroxysms grow up either in socially unfavorable families or in "overprotection" conditions. But typically if it does not result in the epi, the intellectual and mental development is normal. The affective-respiratory paroxysms can last till 6 years old and it reaches its peak at the age of 6-18 months old. The frequency of several attacks per hour may account for 1 attack per month, but during intercurrent diseases it quickens. 

Biography:

M B Evgenev has completed his PhD from Institute of Developmental Biology, Moscow, Russia. He was Professor of Biology in 1990. He spent ten years in USA as Visiting Professor (U of John Hopkins, Baltimore, U of Arizona and Chicago University within 1990-2000 time period). He is Head of Laboratory of Molecular Basis of Biological Adaptation in Engelhardt Institute of Molecular Biology. He has published more than 140 papers in reputed journals and has been serving as an Editorial Board Member of repute in several journals.

Abstract:

Alzheimer’s disease (AD) is the most prevalent neurodegenerative pathology in the growing population of elderly humans and leads eventually to dementia and death. Despite tremendous efforts, no effective treatment for AD is currently available. Molecular chaperone Hsp70 plays protective role in various neurodegenerative disorders. Various data suggest that Hsp70 and other molecular chaperones function as a complex neuroprotective system, which fails in the brains of aged people and AD patients. In special experiments, we demonstrated that eHsp70 effectively crosses the blood-brain barrier when administered intranasally. Here we have shown that chronic administration of exogenous Hsp70 (eHsp70) decreased beta-amyloid level and preserved neuron density in two mouse models of Alzheimer disease. In both cases eHsp70 restored behavior and memory disturbed by Alzheimer disease and aging.  We also explored the effect of eHsp70 on neurons morphology and survival in the cortex and the hippocampus of transgenic animals. The proportion of pathologic neurons decreased drastically in Hsp70-treated animals. Therefore, Hsp70 treatment of model mice protects neurons from deterioration and death in brain areas most affected in AD patients. In conclusion, we can summarize that the intranasal administration of recombinant human Hsp70 drastically alleviates all symptoms, including memory loss, neuronal death, cellular aberrations and accumulation of the Aβ-peptide in both AD-models explored. Deep sequencing studies enabled to reveal candidate genes and signal pathways underlying beneficial effects of eHsp70 treatment. In our experiments we also demonstrated that intranasal administration of exogenous recombinant human Hsp70 can promote longevity in male but not female mice. The Hsp70 treatment also normalized the synthesis of synaptophysin in aged mice and decreased accumulation of lipofuscin which represents the marker of aging and neurodegeneration processes. Taken together, our findings establish exogenous human Hsp70 as a practical pharmacological agent for the treatment of various neurodegenerative diseases and aging.

Biography:

Sevinj Hamidova Abisalam graduated with MD from Azerbaijan Medical University in 2009. She then completed Internship in City Clinical Hospital in Baku and has now worked for over 6 years as a Neurologist at several hospital settings. During this period, she has participated in many conferences and has taken several continuing education neurology courses in Turkey, Germany, Spain and Denmark. She is well skilled and has managed headache, stroke, epilepsy/EEG and prolotherapy protocols. She organized and now directs a small Headache Center in Baku. At present, she is tasked to organize a Stroke Center–a first in Azerbaijan, and has been offered a new job in one of the big private clinics in Baku as a Director of Stroke and Headache Center.

Abstract:

Chronic migraine (CM) is a major global health problem in need of an effective prophylactic treatment with minimal side effects. And the purpose of this study was to compare the efficacy and safety of onabotulinumtoxin A with topiramate (Topamax), amitriptyline, and candesartan (Onsart) prophylactic treatments in CM. A total of 170 subjects with CM- comprising of four groups–received: Group 1) onabotulinumtoxin A, max 200 units (U) at baseline and month 3; group 2) topiramate (Topamax), 4 weeks titration 100 mg/day; group 3) amitriptyline, 3 months titration, 25 mg/day; and group 4) candesartan (Onsart), 16 mg/day. In all the treatment groups, control groups received oral placebo or placebo saline injections. Treatment responder rates were assessed using Physical Global Assessment 9-point scale, including the change from baseline in the number of headache (HA/migraine/day per month); disability was measured using Headache Impact Test (HIT-6), and Migraine Disability Assessments. The overall study duration was about 9 months. Of the 170 patients (mean age, 34.4 +/-10.6 years; 95% female), 117 completed the study at the end of the 7 months of active treatment: Onabotulinumtoxin A, n=24, topiramate (Topamax), n=37; amitriptyline, n=30; and candesartan (Onsart), n=17. Almost all patients in all treatment groups reported moderate to marked improvements at all points. But 26% in topiramate group, 28% in amitriptyline group and 23% in candesartan group reported adverse effects that required discontinuation of treatment compared to only 3.1% of patients in the onabotulinumtoxin A group. Onabotulinumtoxin A is as effective for treatment in CM as the other migraine prophylactic drugs with much less side effects.

Biography:

Swarupa Mitra has served as a Consultant, Faculty, and as Research Guide to post graduate students since 2000. She has many publications in international journals and has several research projects to her credit, including the prestigious one with the National Cancer Registry Program where she is the Principal Investigator. She has authored books and has been a Reviewer in some international journals. She is the Nominated Member of the Project Advisory Board by Department of Science and technology, Government of India.

Abstract:

Brain metastases constitute approximately 15%-30% of all intracranial tumors. As much as 30% of patients will develop brain metastases as a part of their primary cancer. Whole brain radiotherapy (WBRT), with or without SRS boost is the mainstay in the treatment of brain metastases. While, there has been an improvement in the median survival, with a significant decline in the risk of recurrence and in the risk of neurological death, a paradoxical reduction in neurocognitive functions (NCF) appears as a sequel and which cannot be neglected. This impairment starts within 1-4 months of the WBRT. The sub-granular zone of the hippocampus that contains proliferating neuronal progenitor cells is an integral component of memory formation and learning. Following WBRT, the decline in the neurocognitive functions may be due to radiation induced impairment in hippocampal neurogenesis. Mean doses of 45 Gy or higher to the left temporal lobes are associated with significant decline in the IQ. Biologically equivalent dose greater than 7.3 Gy applied to 40% of hippocampal volume may cause long-term impairment in neurocognitive functions. With improvements in imaging and its incorporation in conformal radiotherapy planning, it is now possible to selectively spare the hippocampus from radiation and improve the quality of life and NCF of patients. Neurocognitive sparing radiotherapy promises to prove as a novel mode for ensuring the efficacy of WBRT while minimizing its associated neurocognitive dysfunctions.

Biography:

Baris Cankaya graduated from Ankara University Medical Faculty in 2000. He has been working as Anesthesiology specialist at Marmara University Training Hospital. He has attended academic meetings nationally and internationally. His academic interest includes microcirculation, fluid therapy, resuscitation, patient safety and peri-operative analgesia.

Abstract:

Interventional neuroendovascular procedures have a larger percentage day by day. Comparing with surgery it has advantages for blood loss, length of stay in hospital and shorter time. But it has well-known complications such as ischemis, hemorrhage and bradycardia. The procedure is performed outside operating room in radiology unit, mainly. Additional to peripheral pulse oxymeter, the operating team will have additional parameter by monitoring cerebral oxygenation as regional monitoring for detecting early complications. Neurologic complications of cerebral angiography are reported to occur in 1% to 14% of cases. Common complications are permanent or transient neurologic deficits related to thrombus, embolism, vasospasm, air embolism, arterial occlusion and contrast induced nephropathy, lactic acidosis, contrast allergy and vessel rupture. Cerebral optical spectroscopy is a non-invasive technique and provides real-time results. This technique uses near-infrared light to supply physiologic information about the brain tissue and performs thorough preoperative evaluation and planning. We have to minimize the risk of the complications by focusing on patients with a high atherosclerotic disease, diabetes, chronic renal insufficiency. One-sided alterations on cerebral oxymeter give us early information about post-procedural neurologic outcome. The interventionist may change the decision for stent or coil placement according to these alterations. In case of balloon inflating, bradycardia may develop and the decision for atropine is made hardly if the beat-perm in is between 45 and 55. We can also get help from cerebral oxymeter if desaturation occurs or not for bradycardia.

Biography:

Ahmed Al Jishi graduated from Arabian Gulf Neurosurgery, Bahrain and completed his Neurosurgery Training at McGill University, Montreal in 2012. On completion of training, he further completed Fellowships in Pediatric Neurosurgery and Spine Neurosurgery. He is recognized by the Royal College of Physicians and Surgeon in Canada. He is currently a practicing Neurosurgeon with Hamilton Heath Sciences where he also carries the Lead on the Neuromodulation Program for pain and spasticity. He published many papers in professional journals and has been an active participant in international conferences. His particular interests are in neuro-oncology, functional neurosurgery and spine research.

Abstract:

Introduction: Placement of an EVD is one of the most common ICU procedures that the neurosurgery residents practice at early stage of training. The safe use of such tool demands adherence to specific anatomical landmarks and procedure-related guidelines so as to avoid the certain pitfalls. It is valuable therefore that training programs periodically revisit their training in relation to outcomes in order to minimize problems and maximize training and clinical safety.

Methodology: The data were retrieved for patients admitted with an aneurysmal SAH to the Montreal Neurological Hospital and Institute between July 2006 and May 2009. We included all EVDs that were planned for frontal horn. The adequacy of EVD insertion, encountering vital anatomical structures, complications and resident’s level of training were analyzed based on the grading scheme.

Results: Around 160 EVDs were inserted in the ICU after intracranial bleeding. Of those 15.7% landed in optimum intraventricular zone “foramen of Monro” (grade I) and 47.6% landed in the third or lateral ventricles (grade II) while 36.7% had a remote landing in parenchyma or CSF space (grade III). The latter was associated with a higher risk for complications.

Conclusion: The practice of EVD insertion, based on external surface landmarks, is associated with a high risk of missing the intended intraventricular target and potential serious complications. The proposed grading system for EVD insertion can be a useful assessment tool to evaluate out practice but further testing is required prior to validation.

Biography:

Aguinaldo Pereira Catanoce is Graduate and Post-graduate in Medicine and Neurosurgery from the Catholic University of Campinas in Brazil. He is Member of the Brazilian Society of Neurosurgery since, 2009. He has 8 years of neurosurgery experience in video endoscopes for brain tumors at the base of skull and intraventricular area in addition to the improvement of microsurgical treatment of vascular lesions. He is Neurosurgeon Professor in the discipline of Neurosurgery at the University of Campinas, Brazil, since 2011 and Manager Medical and Technical Director of University Hospital, São Paulo, Brazil, with experience in hospital management of 7 years.

Abstract:

Held important development with the description and improvement of surgical treatment of pituitary tumor through video-endoscopic technique. The technique describes the endoscopic fully endonasal transsphenoidal surgery for pituitary tumors. A series (over 120 cases) of procedures, over last 7 years, in a University of Campinas and University Hospitals in Brazil was done. It described statistics biochemical, clinical and radiologic results with a specific radiologic pre- and post-operative image. An angiotopographic bone study for sphenoid sinus details and magnetic brain image is used. In the fully endonasal endoscopic technique, we encountered less morbidity/mortality statistics and more patient satisfaction. The advancements of fully endoscopic endonasal surgery of pituitary adenomas led to a better endocrinologic clinical and radiologic control, and less morbidity.

Biography:

Aguinaldo Pereira Catanoce is Graduate and Post-graduate in Medicine and Neurosurgery from the Catholic University of Campinas in Brazil. He is Member of the Brazilian Society of Neurosurgery since, 2009. He has 8 years of neurosurgery experience in video endoscopes for brain tumors at the base of skull and intraventricular area in addition to the improvement of microsurgical treatment of vascular lesions. He is Neurosurgeon Professor in the discipline of Neurosurgery at the University of Campinas, Brazil, since 2011 and Manager Medical and Technical Director of University Hospital, São Paulo, Brazil, with experience in hospital management of 7 years.

Abstract:

Development and improvement of multidisciplinary work in the treatment of major vascular lesions of the nervous system. Implemented a corporative hospital management system and clinical care aimed at the fast and efficient service in cases of hemorrhagic stroke, especially of the cerebral aneurysm. Feasibility of endovascular or surgical tratament. Described and documented the efficiency and the good results through the organization of medical and multidisciplinary team associated with the corporate organization focused on innovation in the management model.

Biography:

Suad Alanzi has completed her PhD in 2011 from Curtin University and Post-doctoral studies from different institutes. She is the founder of Developmental Coordination Disorder Clinic in Kuwait, a co-coordinator of CP clinic in Sabah hospital and a head of Risk analysis Committee and active member of risk management committee. She has presented more than 15 papers in international conferences and has been serving as a reviewer member of Journals and conferences. Furthermore, she conducted several postgraduate workshops in the field of pediatric, evidence-based practice and ICF model nationally and internationally.        

Abstract:

According to DSM-V, children with developmental coordination disorder (DCD) have motor coordination impairments and their motor abilities are substantially below their age and intelligence levels. The motor impairments are not due to medical or neurological disorder. Their motor difficulties negatively influence their life and cause medical and psychosocial problems. Identifying DCD and measuring its prevalence in society requires applying the inclusion and exclusion criteria. Therefore, ignoring one or more of these criteria would bias the results. There are many factors impact on the accuracy of diagnosing DCD like using valid assessment tools, reliable neurological examination, and co-morbidity with other disorders. Applying criteria A and B of the DSM-V requires valid standard assessment tools. A consultation held by the WHO reviewed several assessments of child development and found that not all the assessments were suitable for use in different cultures or in similar cultures with different societies. It was suggested that when using child development assessment or screening tools each country should have its own normative data. The DSM-V exclusion criterion is to exclude neurological disorders. However, not all children with minimal brain dysfunction due to low birth weight (LBW) and/or small for gestational age (SGA) show clear neurological problems that require examination or have been given a neurological disorder diagnosis. Therefore, children with mild Cerebral Palsy (CP) might be misdiagnosed with DCD. Furthermore, DCD overlaps with other developmental disorders like ADHD, LD, Autism, and SLD because of sharing etiology and/or symptoms. Their relations could be co-morbidity, co-occurrence or continuum. 

Biography:

Nadežda Lukáčová, DSc, is Head of Laboratory of Neurochemistry and Neurophysiology at the Institute of Neurobiology, Slovak Academy of Sciences. Her research focuses on the role of signaling molecules in the brain and spinal cord circuitry under physiological and pathological conditions. She has published more than 80 papers in peer-reviewed journals. Currently, she is a Garant of ongoing accredited program of doctoral studies in the field of Animal Physiology. She is experienced in the project management within both, national and international grant schemes.

Abstract:

Acute traumatic spinal cord injury (SCI) causes significant neuropathological deficits with limited regeneration, depending on the degree of neuronal tissue destruction. Our study was aimed to i) characterize a preclinical model of SCI (8N, 15N and 18N force) at L3 level in minipig using computer-controlled compression apparatus, ii) optimize conditions of local cooling of the spinal cord at the site of injury, and iii) to find out whether hypothermia applied at defined temperature (for 5 h) will have beneficial effect on the gray and white matter sparing, the number of neurofilaments and neurological outcome. Hypothermia was performed locally through perfusion chamber with 4°C saline solution perfusion, oxygenated culture medium or enriched medium. The animals were behaviorally assessed during 9 weeks of survival. We have found that saline hypothermia leads to a gray and white matter sparing, and to substantial sparing of neurofilaments in segments away (rostrally +3, +2, +1 and caudally -1, -2, -3) from the lesion site, i.e. in spinal cord sections that are likely to be affected by secondary injury. In particular, we have shown that saline hypothermia after 8N SCI, causing the sparing of axons in lateral funiculi at +1 and -1 (improvement by 25% and 19%), showed favorable neurological outcomes. Such improvements were not observed in the group subjected to more severe SCI. The application of local hypothermia in computer-controlled minipig compression model provides data analogous to impact of such treatments in patients. 

Biography:

Ajay Bajaj has done his MCh neurosurgery degree from Postgraduate institute of medical education and research, Chandigarh , India. He had 5 publications in various national and international journals. He also participated in CRASH trial conducted by MRC London. He is an active international member of CNS and executive council member of Neurological surgeon society of India. He had worked as assistant professor of neurosurgery in various medical institutes of India. Presently he is working as consultant Neurosurgeon at Wockhardt hospitals Ltd. Mumbai, India.

Abstract:

Spina bifida is a common congenital anomaly encompassing a wide spectrum of neural tube defects. It is broadly classified as spina bifida aperta and occulta. With the prenatal screening, the incidence of aperta is gradually declining, whereas the detection of occulta has increased with the advent of magnetic resonance imaging.

The estimated incidence of spinal dysraphism is about 1–3/1000 live births. The prevalence of spinal dysraphism has been in decline the world over in the last few decades due to the better nutrition for women, folic acid supplementation, improved antenatal care and high-resolution ultrasound for prenatal screening and biochemical markers.

Open dysraphism presents with a swelling over the back which is noticed at birth. Symptoms are primarily referable to CSF leak or the exposed spinal cord.

Tethered cord syndrome has been defined as progressive neurological deficits from the restraint of the spinal cord movement and traction due to either anatomical or physiological reasons. It may lead to progressive neurological, urological and orthopedic dysfunctions. Tethered cord can be seen in both varieties (Aperta and Occulta) of spinal dysraphism. Approximately 30% of patients present with retethering due to previous myelomeningocoel surgery .

Patients usually presents with neuro-urological symptoms with progressive foot deformity. In our experience, the common clinical presentations include the presence of cutaneous stigmata associated with occult spinal dysraphism (70%), neurogenic bladder with the development of primary or secondary incontinence or urinary tract infection (60%), leg or foot weakness, numbness and/or spasticity (60%%), leg or foot length discrepancy (10%)and foot deformity (for example, pes cavus, claw toes). One of our patients presents as auto amputations of toes of both feet. The neurological dysfunction in tethered cord syndrome is unusual, frequently having elements of both upper and lower motor dysfunction. Motor weakness is more prevalent than sensory deficits. Such motor dysfunction is usually asymmetrical.

The fundamental goals of surgical intervention in spinal dysraphism with tethered cord syndrome are as follows: 1) to improve or stabilize deficits in the symptomatic patient and 2) to prevent future deficits in the asymptomatic patient. These two goals are predicated on the fact that sectioning of the terminal filum can be conducted safely with minimal risk and a very low rate of morbidity. The incidence of neurological injury due to sectioning is less than 1%.

Detethering of the cord is an important part of surgical treatment as the major cause of neurological deterioration in these patients is due to abnormal fixation and traction on the conus and distal cord.

In conclusion, technically, detethering of the cord is not challenging but identification of the patients who will be benefitted with the procedure is really challenging. Therefore, there is a need to continue critically looking at this disease process to obtain better data through randomized prospective studies.

Biography:

Yafa Alshamlan is currently working in the department of neuro-ophthalmic at a tertiary referral hospital, Abdulaziz University Hospital (KAUH) in Riyadh, Saudi Arabia. Yafa Alshamlan has published several original research papers and also participated into the several meetings.

Abstract:

Purpose: To assess the pattern and epidemiological characteristics of neuro-ophthalmic cases presented to ophthalmic Emergency Department (E/D) at a tertiary referral hospital, King Abdulaziz University Hospital (KAUH) in Riyadh, Saudi Arabia from May 2013 to April 2015.

Method: A retrospective study that implied all patients who presented to the ophthalmology E/D from May 2013 to April 2015 at KAUH. Data were collected from ophthalmic emergency registry book for all patients fulfilling the inclusion criteria and were analyzed according to demographics, date of visit, diagnosis and management.

Results: Among the emergency cases that presented to KAUH for two consecutive years, 414 cases were diagnosed as neuro-ophthalmic patients. Mean (SD) age was 38.1(19.0) (ranging from 2 months-88 years). Of them, 93.5% were above 15 years of age, gender was almost equally distributed, with the majority being Saudi citizens. Most of cases (78.3%) had unilateral ocular involvement, while (21.7%) were bilateral. Optic neuritis was the most prevalent diagnosis comprising (22.5%) of neuro-ophthalmic emergencies, leaving (15%) for 6th nerve palsy, (10.9%) 3rd nerve palsy, (8.7%) bilateral optic disc swelling, and (7%) 7th nerve palsy in addition to other causes. Half of the cases were managed via home and appointment advice, home and rest covered (33.3%), (4.1%) had home rest and medical treatment regimen, while few cases equally required admission and referral either for further investigations or advised interventions.

Conclusion: The majority of cases were adults with equal gender distribution, mainly presenting with unilateral ocular involvement. Optic neuritis was the most prevalent diagnosis while the most common management was home and appointment advice. Early detection and referral of neuro-ophthalmic cases would enable delivering the optimal healthcare to such cases.

Biography:

Adriana Gini is working as a Staff Neuroradiologist in the Neuroscience Department of the San Camillo Forlanini Medical Center in Rome, Italy for last 24 years. She is also the Member of the Nominating Committee at International Neuroethics Society, US. She completed her Master’s degree in Science and Faith from Pontifical Athenaeum Regina Apostolorum (Ateneo Pontificio Regina Apostolorum), Rome, Italy. She has published several original research papers in reputed journals and participated in several meetings.

Abstract:

It is a fairly common opinion, in the public at large, but also among a majority of experts in some of the more technological fields of medicine that, like me, work in the government health system-especially those whose primary occupation consists in making a diagnosis through the use, visualization and elaboration, of acquired radiological images-that the development and application of new techniques of medical imaging, characterized by noninvasiveness, rapidity and sophistication, must always be favorably welcomed. In reality-and this is my personal, experience-based opinion-things are not as smooth and straightforward as they appear at first or are as they are presented in the press. In this abstract, I will try to make the point that, the application of technological tools to medical diagnosis, requires a coordinated and thoughtful evaluation of the same to avoid the perilous supremacy of high-tech, that is expensive, subject to overuse and unable, for most part, to meet the real patient’s needs and expectations; to prevent medical professionals and medical personnel from becoming less humane; and to reduce unnecessary economic burden to governments and insurance companies.

Biography:

Hiroyuki Nakase has completed his MD and PhD in 1989 from Graduate course of Medicine, Nara Medical University. He is the Professor and Chairman at the Department of Neurosurgery, Nara Medical University. He has published more than 100 papers in journals and has been serving as an Editorial Board Member. He will be a President of The 29^th annual meeting of the Japan Geriatric Neurosurgery Society in 2016, the 40^th annual meeting of Epilepsy Surgery of Japan in 2017, the 27^th annual conference on Neurosurgical Techniques and Tools and the 33^rd annual meeting of the Japanese Society of Spinal Surgery in 2018.

Abstract:

Surgical management of cranio-vertebral junction (CVJ) tumors continues to present as a challenge to neurosurgeons especially in cases at the anterior aspect or involving neighboring neurovascular structures. We here describe our surgical strategy and results of CVJ tumors in our institute. Of the 146 patients with CVJ lesions surgically treated since 2000 in our institute, tumors included 36. The series consist of 17 males and 19 females; their ages ranged from 6 to 76 years old. Tumor types were neurinoma in 14; meningioma in 10; hemangioblastoma in 5; ependymoma in 4; astrocytoma and chordoma, and medulloblastoma in one patient each. Surgical approach were posterior in 26 and extreme lateral approach in 10 cases. The operations were done under intraoperative neurophysiological monitoring in all cases; somatosensory evoked potentials (SEP) and motor evoked potentials (MEP). Temporary pacemaker was inserted in 4 cases in the tumor located in or around the medulla oblongata. No operations required fusion. Total removal of the tumors could be accomplished in 30 and subtotal in 6 cases. No deaths occurred in the perioperative period, but complications include postoperative hemorrhage in 2, cerebellar infarct in 2, swallowing disturbance in 2, sore throat in 3, CSF leakage in 6 and infection in 2. In conclusions, we concluded, from our experiences, that we have to make surgical strategy for CVJ tumors in consideration of the anatomical complexity and postoperative instability as well. Also, neuromonitorings were effective to decrease the morbidity.

Biography:

Ahmed Al Jishi graduated from Arabian Gulf Neurosurgery-Bahrain and completed his Neurosurgery training at McGill University-Montreal in 2012. On completion of training, Dr. Al Jishi further completed Fellowships in Pediatric Neurosurgery and Spine Neurosurgery. He is recognized by the Royal College of Physicians and Surgeon in Canada. Dr. Al Jishi is currently a practicing neurosurgeon with Hamilton Heath Sciences where he also carries the lead on the Neuromodulation Program for pain and spasticity. He published many papers in professional journals and has been an active participant in international conferences. Dr. Al Jishi’s particular interests are in neuro-oncology, functional neurosurgery and spine research.

Abstract:

Background    

Bilateral jumped facets (BJF) are serious cervical spine injuries that require reduction and surgical stabilization. Closed reduction often performed, however, the argument of having disc herniation suggested deferred treatment until MRI is done. The later has been criticised for delaying the treatment.

Methodology

We conducted a systematic review focusing on BJF in order to assess the validity of performing an MRI prior to closed reduction. The immediate neurological state after reduction and long term outcome were the primary goals.

Results

A total of 49 articles were found (1973-2014). Only 20 of them fit our criteria. A total of 203 BJF were evaluated with C6/7 and C5/6 being the most common level of injury. Closed reduction was performed in 194 patients with no MRI in 118 patients. Clinical changes had occurred in 7 patients (3 improved, 2 worsened, 2 transient worsening). The long term outcome showed no significant difference between the two groups who had closed reduction before or after the MRI (p>0.05)

Conclusion

The risk of neurological worsening with closed reduction prior to MRI is low and insignificant. The MRI will be helpful post reduction to assess the status of the cord and adequacy of closed reduction, especially in comatose patients. 

Biography:

Hossein Pakdaman graduated in Neurology from the Pennsylvania and Henry Ford University in 1976. He is Professor of Neurology affiliated to Shahid Beheshti University School of Medicine, since 1990, President of Iranian Neurological Association, since 1991, and Director of Iranian Neurological Board Examination, since 1978. Also, he has published more than 40 papers in international journals and is Chairman of Iranian Journal of Neurology, since 1998. 

Abstract:

Background & Aim: Minimal cognition impairment (MCI) is characterized by declined cognitive function greater than that of expected for person’s life. The clinical significance of this condition is its possible progression to dementia. Currently there is no approved therapy for MCI. ML601 (NeuroAid) is natural neuroprotective medication that has shown promising effects in different diseases including Alzheimer’s disease. Accordingly, we conducted this randomized, double-blind, and placebo controlled study to evaluate the efficacy and safety of ML601 (NeuroAid) in patients with MCI.

Methods: Seventy-two (72) patients with MCI diagnosis according to Peterson et al. were recruited. Eligible participants were randomly assigned to each group to receive MLC601 capsule or placebo three times daily and they were prospectively followed for 6 months. Global cognitive function evaluation was performed at baseline, 3-month and 6-month follow-up visits. Global cognitive function was assessed with MMSE and ADAS-cog score.

Results: Seventy (70) patients completed the study. There were finally 34 patients in MLC601 group and 36 patients in placebo group. The mean (SD) age of MLC601 group and placebo group were 70.8 (±3.69) and 70.2 (±3.3), respectively. The mean changes (±SD) in cognition scores over 6 months in the MLC601 group were-2.26 (±3.42) for MMSE and 3.82 (±6.16) for ADAS-cog score and in placebo group were -2.66 (±3.43) for MMSE and 4.41 (±6.66) for ADAS-cog score. The cognition changes based on both MMSE and ADAS-cog score were statistically significant between placebo and ML601 groups (p value<0.001). Only 5 (14.7%) patients reported side effects and the most commonly reported side effects were gastrointestinal.

Conclusion: In our study, ML601 has shown promising efficacy and acceptable side effects for MCI patients but the result of this study needs to be replicated in other studies.

Biography:

Hussein Algahtani is the Associate Dean of Clinical Affairs and the Head of the simulation Center in the College of Medicine at King Saud bin Abdulaziz University for Health Sciences in Jeddah, Saudi Arabia. He is also an Assistant Professor in Neurology and the neurosciences block coordinator. In addition, he is the Neurology section Head and the Head of Neurophysiology laboratory at King Abdulaziz medical city in Jeddah, Saudi Arabia. He is a well-known researcher with more than 50 publications in the literature.

Abstract:

Objectives: Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome characterized by headache, altered mental status, seizures, or loss of vision. In this study, we report the largest series of PRES coming from Saudi Arabia and explore the etiology, clinical presentation, and outcome. We also report new imaging findings associated with this condition.

Methods: We performed a retrospective study of all cases of PRES admitted to King Abdulaziz Medical City, Jeddah, Saudi Arabia, between the years 2005 and 2015. A neurologist reviewed all charts and analyzed the clinical presentations, etiological factors, and outcomes, and a neuroradiologist reviewed the imaging studies. Only patients with clinical and imaging features consistent with PRES were included in the study.

Results: We collected 31 patients who had clinical and radiological features consistent with PRES. Females were more affected than males (18 females and 13 males), and patients’ age ranged from 6 to 95 years, with a mean of 38.3 years. Patients were treated by removing the precipitating causes and treating the underlying conditions. Resolution of neurologic signs occurred within 2 to 3 weeks in all patients.

Conclusion: In our opinion, PRES itself is usually a benign condition with complete recovery if the condition is recognized early and managed appropriately. Although clinical signs are nonspecific, the constellation of symptoms including headache, visual problems, seizures, and altered level of consciousness should suggest the possibility of PRES, especially in high-risk group. Abnormalities on magnetic resonance imaging are often characteristic and may be the first clue to the diagnosis.

Biography:

Ahad Abdullah is a medical intern currently training at King Abdulaziz Medical City National Guard in Jeddah, Saudi Arabia. She obtained her MBBS degree in year 2016 from Battarjee Medical College in Jeddah, Saudi Arabia. She attended several seminars, courses and workshops related to research methodology. She is determined to pursue her career as a physician, surgeon and researcher.

Abstract:

Background: Teratoma is a common form of germ cell tumors composed of multiple tissues foreign to the site in which arise with histological representation of all three germ cell layers (ectoderm, mesoderm, and endoderm). It was derived from the Greek word teraton meaning a “monster”. It commonly presents during infancy and childhood and accounts for 2% of intracranial tumors in patients under the age of 15 years. Intracranial teratomas are very rare.

Methodology: This is a retrospective study done in king Abdulaziz Medical city- Jeddah, and it was approved by the Institutional review board (IRB) of King Abdullah international Medial Research Centre (KAIMRC). All 69 cases with the diagnosis of teratoma during the period of January 2005 to June 2016 were reviewed. Clinical, demographic, radiological and treatment details of the patines were retrieved from the medical records (both hard and electronic). A sub-group analysis was also made for all 3 cases diagnosed as intracranial teratoma.

Results: A total number of 69 patients were reviewed, 11 (15.9%) male and 58 (84.1 %) female. The age range is 1 day to 76 years. The sites of pathology of these teratomas were as follows: ovarian: 50 (72.5%), central nervous system (CNS) 3 (4.3%), kidney 1(1.4%), lumbosacral 1(1.4%), neck 2 (2.9 %), retro-peritoneum 3 (4.3%), testis 2 (2.9%) sacrococcygeal 4 (5.8%) and mediastinal 3 (4.3%). The three patines with CNS teratomas had different sites as-well, 1 cerebral hemisphere, 1 posterior fossa and 1 pineal gland. There was 1 (33.3 %) mature and 2 immature (66.6 %) , 1 (33.3%) cystic and 2 (50%) solid.

Conclusion: Intracranial teratomas 4% of all types of teratomas. The prognosis is dependents on location, size and surgical experience, short coming of this study are small number of patients, lack of statistics regarding other forms of brain tumors and being a single study.

Biography:

Abdulrahman Bazaid is a medical intern at King Abdulaziz Medical City in Jeddah, Saudi Arabia. He obtained his MBBS degree from Battarjee Medical College in Jeddah, Saudi Arabia. He attended several seminars, courses and workshops in research methodology. He is determined to pursue his career as a physician, academician and researcher.

Abstract:

Background: Biotin-Responsive Basal Ganglia Disease (BBGD) is an autosomal recessive neurometabolic disorder caused by mutations in the SLC19A3 gene. The disease is characterized by subacute encephalopathy with confusion, dysphagia, dysarthria and seizures.

Methods: We diagnosed a family affected by BBGD and studied them including prognosis of cases when diagnosed and treated early in the disease process. We also review the literature comprehensively and summarize all published data about this disorder.

Results: Since its first description, a total of 89 cases (46 females and 43 males) have been published in the literature. We studied six patients in this article in which three died before a diagnosis was established, one was diagnosed lately and is currently severely affected, and two were diagnosed early and are currently stable on treatment. The clinical phenotype of each family member was studied in details and a genetic testing using whole exome sequencing and Sanger sequencing of the family members was done to confirm the diagnosis. The whole exome sequencing revealed a homozygous mutation in the exon 5 of the SLC19A3 gene c.1264A˃G (p.Thr422Ala) which is diagnostic of biotin-responsive basal ganglia disease.

Conclusion: BBGD is a treatable condition if recognized early and managed appropriately. Children presenting with unexplained encephalopathy and MRI abnormalities including bilateral signal alteration of caudate nucleus and putamen should raise the suspicion for BBGD and be started immediately on biotin and thiamine regimen since the prognosis of the disease is affected by the timing of treatment initiation.

Biography:

Tabinda Salman has good background knowledge of neuroscience and hand-on experience of working with all type of behavioral models, neurochemical analyses, molecular tools to check gene expression and other related experimental protocols. She is currently working as a PhD Fellow at National Center for Proteomics, University of Karachi, Pakistan. She has done her MPhil in Molecular Medicine (Neuropharmacology). The study which is designed to monitor receptor regulation together with associated changes in serotonin and dopamine metabolism is expected to help identify novel therapeutic targets for improving cognition and to treat addiction in future studies.​

Abstract:

Methylphenidate (MPD) is the most regularly prescribed psychostimulant for patients with attention-deficit hyperactivity disorder (ADHD). It has also been used by general population, especially college students, without ADHD to improve academic and work related performances which later produce addiction. Although dopamine is the main neurotransmitter involved in the pathophysiology of drug abuse, serotonin (5-hydroxytryptamine; 5-HT) can modulate addictive effects of drugs of abuse. The present study was designed to check MPD-induced behavioral sensitization and cognition along with the 5HT-1A receptor expression in the nucleus accumbens and prefrontal cortex of repeated MPD treated rats. Twenty four (24) male albino Wistar rats (180-220 gm) were used to determine dose related effects of MPD (0.5, 2.5 and 5 mg/kg) on cognition in water maze test. Acquisition of memory was assessed after two hours of the three successive training sessions. After 20 hours of drug administration, retention of memory was assessed. In another experiment, 12 male albino Wistar rats were randomly assigned to two equal groups. Water and methylphenidate (2.5 mg/kg) were administered orally to the respective groups. Animals were exposed to 12 (one daily) place conditioning sessions of 30 min each. Motor behavior during this session was also recorded. Reinforcing effects of methylphenidate were monitored during the test session on day 13. On day 14, drug/water was administered and learning acquisition was done after training sessions. Retention of memory was assessed after 24 hours of the drug administration. Decapitation was done on the next day and brains were micro-dissected to collect the nucleus accumbens and prefrontal cortex. 2.5 mg/kg MPD found to enhance cognitive effects in Morris water-maze test. Conditioned place preference test on day 13 revealed that repeated administration of MPD (2.5 mg/Kg) produced reinforcement as well as the behavioral sensitization. While repeated administration of MPD moderately enhanced acquisition of memory while significantly increased memory retention. We also report that 5HT-1A receptor expression was also down regulated in methylphenidate treated rats both in the nucleus accumbens and prefrontal cortex. These findings may help to improve pharmaco-therapeutics in treating ADHD.

Biography:

Ibtisam Al-Thubaiti has finished his Saudi board in Neurology in 2008. He finished Neuroimmunology fellowship from University of British Colombia in 2011. He is currently a consultant neurologist in King Fahd Specialist Hospital in Saudi Arabia, practicing neurology and neuroimmunology.

Abstract:

Neuromyelitisoptica (NMO) is an inflammatory disease that traditionally described to affect the spinal cord and the eyes causing severe transverse myelitis and optic neuritis. The discovery of disease specific NMO- IgG antibodies in 2004 has revolutionized the understanding of the disease pathology, widened its clinical spectrum, aided in earlier diagnosis, targeted therapy and consequently in a better outcome. Despite that, NMO-IgG antibody sensitivity is high reaching 73% with cell-based assays, there are cases that are seronegative and will be challenging to diagnose. Recently, the discovery of myelin oligodendrocytes glycoprotein (MOG) antibodies in seronegative NMO patients has delineated another spectrum of inflammatory CNS diseases that mimic NMO clinically but not pathologically. This presentation will highlight the clinical picture of NMO spectrum disorder, the diagnostic challenges, 2015 diagnostic criteria, and the differences between anti-NMO and anti-MOG antibody positive disorders. 

Biography:

Ahmed Alhusban graduated from Jordan University of Science and Technology (JUST) in 2008 with a Doctor of Pharmacy (PharmD) degree. He had his PhD in Experimental Therapeutics from University of Georgia, USA. His PhD research was under the supervision of Dr. Susan C. Fagan to study the mechanisms of recovery after cerebral ischemia and how to manipulate them to improve stroke outcome. His PhD thesis focused on interventions to up-regulate brain derived neurotrophic factor (BDNF) mediated signaling after stroke. His research interests are focused on brain angiogenesis. Currently he is an Assistant Professor at the Faculty of Pharmacy, JUST.

Abstract:

Introduction: Angiotensin II type 2 receptor (AT2R) stimulation is neuroprotective after experimental stroke. However, the therapeutic utility of AT2R stimulation has been hampered by the lack of a specific agonist with favorable bioavailability. Compound 21 (C21) - the first non-peptide AT2R agonist - offers a potential option to enhance stroke recovery. This study aimed to investigate the effect of C21 administration on early and late stroke outcomes, and the molecular mediators involved.

Methods: Rats were subjected to 3 h or 90 min of middle cerebral artery occlusion (MCAO) and randomized to intraperitoneal C21 (0.03 mg/kg) or saline at reperfusion. Animals were sacrificed at 24 h or 7 days and brains were collected for molecular analysis and immunostaining, respectively. Functional outcome at days 1, 4 and 7 was assessed blindly. C21 angiogenic potential was assessed in vitro.

Results: After 3 h of MCAO, C21 treatment reduced infarct size and improved behavioral outcome at 24 h without affecting blood pressure. Co-administration of the AT2R antagonist (PD123319) blocked these effects. On the molecular level, C21 decreased brain hemoglobin content, down-regulated apoptotic and oxidative markers, and increased pro-survival molecules in the brain. After 90 min of MCAO, C21 treatment resulted in sustained functional improvement at 7 days, together with increased vascular density in the ischemic penumbra. In vitro, C21 showed a pro-angiogenic effect that was blocked with brain-derived neurotrophic factor neutralization.

Conclusion: These findings demonstrate that a single dose of C21 is neurovascular-protective and improves stroke outcome possibly through increasing neurotrophin activity, mitigating brain inflammation and promoting antioxidant and pro-angiogenic effects.

Biography:

M Sathya is currently working in the Department of Biochemistry at Bharathidasan University in Trichy, India. She has published several original research papers in the reputed journals and participated in the several scientific meetings.

Abstract:

Dysregulation of cholesterol homeostasis has been linked to Alzheimer’s disease (AD) pathology since several decades ago, while the fundamental molecular pathways led by cholesterol and its precursors are still unclear. Amyloid deposition is considered as the principal pathology of Alzheimer’s disease, and the mechanistic link between cholesterol and its intermediates (GGPP and FPP) in amyloid formation has emerged as an unrevealed mystery in the journey of targeting its pathology. Since amyloid precursor protein (APP) is the primary protein involved in the Ab formation, the present study tends to study the role of cholesterol and its intermediates geranyl geranyl pyrophosphate (GGPP) & farnesyl pyrophosphate (FPP) on APP cleavage and processing in CHO-APPswe cell lines. Inhibition of cholesterol biosynthesis not only inhibits the function of cholesterol, but also inhibits the process of prenylation that are the major functions of GGPP and FPP and further it may disturb the cellular homeostasis and are the consequential events that are reported with statin like drugs. Therefore, our study utilized resveratrol (RSV) as a natural polyphenolic compound that is found to exert several neuroprotective functions. Analysis on the therapeutic efficiency of resveratrol (RSV) attenuated cholesterol and isoprenoids mediated alteration in APP cleavage patterns through its ability to promote SIRT1 activity. Further, the APP cleaving enzymes were regulated decreasing total Aβ and Ab42 levels. Therefore, this study provides a therapeutic avenue for use of RSV as a potent drug in regulating vital. 

Biography:

M Sathya is currently working in the Department of Biochemistry at Bharathidasan University in Trichy, India. She has published several original research papers in the reputed journals and participated in the several scientific meetings.

Abstract:

Dysregulation of cholesterol homeostasis has been linked to Alzheimer’s disease (AD) pathology since several decades ago, while the fundamental molecular pathways led by cholesterol and its precursors are still unclear. Amyloid deposition is considered as the principal pathology of Alzheimer’s disease, and the mechanistic link between cholesterol and its intermediates (GGPP and FPP) in amyloid formation has emerged as an unrevealed mystery in the journey of targeting its pathology. Since amyloid precursor protein (APP) is the primary protein involved in the Ab formation, the present study tends to study the role of cholesterol and its intermediates geranyl geranyl pyrophosphate (GGPP) & farnesyl pyrophosphate (FPP) on APP cleavage and processing in CHO-APPswe cell lines. Inhibition of cholesterol biosynthesis not only inhibits the function of cholesterol, but also inhibits the process of prenylation that are the major functions of GGPP and FPP and further it may disturb the cellular homeostasis and are the consequential events that are reported with statin like drugs. Therefore, our study utilized resveratrol (RSV) as a natural polyphenolic compound that is found to exert several neuroprotective functions. Analysis on the therapeutic efficiency of resveratrol (RSV) attenuated cholesterol and isoprenoids mediated alteration in APP cleavage patterns through its ability to promote SIRT1 activity. Further, the APP cleaving enzymes were regulated decreasing total Aβ and Ab42 levels. Therefore, this study provides a therapeutic avenue for use of RSV as a potent drug in regulating vital. 

Biography:

Dmitri A Rusakov is a Professor of Neuroscience and Wellcome Trust Principal Fellow at Institute of Neurology, University College London. His laboratory has been focusing on multi-faceted synaptic mechanisms of memory trace formation in the brain also involving astroglial signaling.

Abstract:

Targeted drug delivery is a high-priority issue in the emerging concept of precision medicine. We have been developing a breakthrough methodology involving nano-engineered biodegradable polymer microcapsules (0.5-2 µm in diameter) that carries medicinal cargo and are equipped with controllable biophysical and cargo-release properties. Our aim has been to implement this technique in the targeted treatment of nervous tissue and potentially other complex tissues. In our recent studies, we have established nano-engineering tools and protocols to encapsulate releasable drugs relevant to neuronal control, with a wide range of parameters that control capsule permeability. In the case study, we used patch-clamp electrophysiology to document physiological effects of encapsulated sodium channel blocker QX-314 on excitability of nerve cells in culture. In experiments on intact animals, we have established beneficial longer-term effects of encapsulated QX-314 injected in vivo, using a standard behavioral model of inflammation-induced peripheral hypersensitivity in the rat. Building upon these advances, we are currently advancing to optimize preparation, delivery and release of encapsulated anesthetics agents, attempting to establish the underlying physiological mechanisms, controlling factors, and a feasible application scope pertinent to this methodology. Our quest should pave the way for exploring future clinical trials involving microencapsulated drug delivery.

Biography:

Mohsin Raza completed his MD and PhD from Pakistan. He completed his post-doctorate from Virginia Commonwealth University in 2000. Dr Raza is basic and clinical neuroscience researcher especially on Epilepsy as well as Multiple Sclerosis and has published his research in famous journals including Brain Research, PNAS, Epilepsy Research, Science and Engineering Ethics and Epilepsy and Behavior. He also teaches Scientific Ethics and is the director of Faculty Development Program at the Faculty of Medicine in his institution and has developed several academic programs for the students and the faculty. 

Abstract:

Proper parental care is an important aspect of the lives of children with epilepsy. The impact of parental education on the Quality of Life (QOL) of these patients is an understudied topic, especially in developing countries. We investigated the QOL and general health (GH) of children with epilepsy presenting at the pediatric neurology clinic at Baqiyatallah Hospital and a private clinic. The QOL in Childhood Epilepsy (QOLCE) questionnaire, that covers physical activity, well-being, cognition, behavior, social activity, overall QOL, and GH, was used for interviewing parents. A total of 106 patients (m=61, 57.5% and f=45, 42.5%; 5–17 years, mean: 10.31±2.91) participated in the study. The maternal education level had a significant impact on the overall QOL (high school: 3.02 ± 0.85 vs. B.Sc.: 3.67 ± 0.61, p b 0.05) and GH (high school: 2.81 ± 0.79 vs. B.Sc.: 3.8 ± 0.94, p b 0.05) of male patients, while paternal education had no significant effect. Multiple linear regression showed that the maternal education level had an independently significant association with the physical activity of the patients (p = 0.02, CI: 1.4–6.25), while the paternal education level had with the well-being (p=0.02, CI: 0.43–5.36). Additionally, the maternal education level (high school vs. B.Sc.) had a significant effect on physical activity, well-being, cognition, and behavior for all of the patients (p<0.05), while the paternal education level had no significant impact. We conclude that maternal education, in particular, plays a significant role in GH and the overall QOL of male patients. 

Biography:

Claire Donnellan is a Registered Psychologist with the Psychological Society of Ireland, and Assistant Professor and Director of International Initiatives with Trinity College Dublin (TCD), Ireland. She graduated with an Honors BSc in Psychology from University of London in 2002 and a PhD in Medical Gerontology from the Department of Clinical Medicine, TCD in 2008. Her work experience in healthcare as a Researcher and Educator expands across the health sciences both here in Ireland and internationally in Australia, United Kingdom and the Middle East. Her research interests include examining the challenges to successful ageing in both healthy ageing and in age-related illness and disease populations; specifically stroke and neurological patient cohorts. She has published widely in neurology, gerontology and psychology journals and her memberships include the International Federation of Ageing, the World Federation for Neuro-Rehabilitation, and both the European and World Stroke Organizations. 

Abstract:

Introduction: The link between psychological comorbidity and biological factors has been well recognized for many conditions; however, less evidence is reported in the context of stroke. The aim of the study was to examine psychological comorbidity and biological correlates post- stroke in a Middle Eastern cohort.

Method: A prospective stroke sample of n=50 patients (case group) and n=50 healthy ageing individuals (control group) were recruited from the largest Medical Complex in Bahrain. A neuropsychological battery of assessments (including global, executive and meta- cognition and mood), were conducted on all participants. Blood samples were taken for ApoE and other biomarkers levels to determine clinical characteristics.

Results: Total metacognition scores were significantly associated with both anxiety (r=.47, p=.001) and depression (r=.54, p<.0001). Global cognition (r=.32, p<.01) but not executive function, was significantly associated with depression only. Metacognition remained a statistically significant correlate with depression (beta=.42, p<.0001) and anxiety (beta=.51, p<.0001) after adjusting for education and global cognition. The most frequent ApoE genotype was É›2/3 in both cases (44%) and control groups (63%). No statistical significant association was found by cognitive impairment stratification and ApoE genotype for either case or control groups. ApoE genotype É›2/4 had worse cognitive function (χ² (3)=8.29, p<.05) in the control group. A statistical significant difference was found between ApoE genotype and total anxiety scores in that ApoE genotype É›3/3 were highly anxious in the case group (χ² (2)=6.77, p<.05).

Discussion: Metacognition is a better determinant of mood symptoms after stroke, especially in regions where illiteracy levels are high in older populations. The presence of ApoE genotype ɛ4/3 and ɛ4/4 was low to non-existent in this sample explaining no significant associations with cognitive impairment. Further examination of mood dysregulation and ApoE genotype polymorphism may be warranted post-stroke.