Day 2 :
Keynote Forum
Khin Bo Maung
Northern Lincolnshire and Goole NHS Foundation Trust, UK
Keynote: Metabolism of myelin in health and pathology
Time : 10:15-11:00
Biography:
Khin Bo Maung is involved in Neurorehabilitation over 20 years. He is also a Lecturer (Hon) in Hull and York Medical School teaching 4th Year Medical Students in CNS and Musculoskeletal Blocks. He is doing Botulinum Toxin injection in Spasticity, Dystonia and Involuntary Movement disorders over 15 years. He has given poster and oral presentations in international neurorehabilitation conferences. He is also involved in using Functional Electrical Stimulation (FES) over 10 years and presented regularly in International FES Conferences. He is working on developing Hypertonic Hand Monitoring Scale.
Abstract:
Demyelination affects highly myelinated structures like Corpus Callosum (CC). CC is unique in function that it connects right and left hemisphere. It synchronises bimanual or bipedal activities. Affecting CC can disturb synchrony between the two hemispheres and will affect bimanual and bipedal tasks. The aim is to see if speed of clapping (bimanual activity) can reflect the involvement of CC in multiple sclerosis. Consecutive 70 multiple sclerosis patients from outpatient clinics and home visits were tested for bimanual hand function (clapping). Exclusion criteria are upper limb power <3/5 MRC scale, pain, visual impairment, intentional tremors, stroke or cognitive impairment. Study period started from 01-09-2016. Comparison of speed between rapid supination/pronation of left and right hand separately and then clapping of both hands (supination/pronation of each hands alternatively). Patients had to do as fast as they could. Noticeable slowing of clapping compared to single hand supination/pronation was taken as a sign slowing down of conduction through CC. 31 patients were excluded, 34 patients showed no noticeable difference, 2 patients were difficult to make conclusions and 3 patients showed definite slowing down in clapping. Positive patients will have difficulties in doing bimanual activities like using two sticks for mobility, typing using keyboard, pushing wheel chair bimanually, etc. It is possible to detect CC involvement by doing above bedside test and can be used in rehabilitation setting. Sample size is not large enough and larger studies are needed to validate the finding.
Keynote Forum
Alessandro M Morelli
Northern Lincolnshire and Goole NHS Foundation Trust, UK
Keynote: Metabolism of myelin in health and pathology
Time : 11:20-12:05
Biography:
Alessandro M Morelli carried out research in varied fields of biology, focusing in those areas most directly linked to medicine. He investigated on the enzyme Glucose-6-P-dehydrogenase and on its molecular mechanism of senescence. He has been working in the phototransduction molecular events in photoreceptor cells of vertebrate retina. He has discovered the protein FX, a NADP dependent enzyme, catalyzing synthesis of GDP-L-fucose. He has been working on the effects of electromagnetic fields of extremely low frequency on the activity of enzymes involved in phototransduction in retinal cells of vertebrates. Moreover, he has put in evidence the reversible effects of electromagnetic fields on lipid-linked enzymes such as acetylcholinesterase of retinal synaptosomes. Recently, with Isabella Panfoli, Silvia Ravera, Daniela Calzia, he has discovered the brain myelin energetic function and the ATP extramitochondrial synthesis operating in it, involving new paradigms for neurobiology, with application in the study of multiple sclerosis and other neurodegenerative diseases.
Abstract:
Myelin is a site of active aerobic energy metabolism, producing ATP through the oxidative phosphorylation (OXPHOS) machinery, which contributes to the acceleration of nervous impulse. This innovative view simplifies current ideas about the physical chemical mechanisms that ensures the advancement of the action potential (CAP) as such basic mechanisms are unchanged in the passage of the CAP from the non-myelinated to myelinated axon. The ATP produced in myelin sheath is transferred to the axon through the Gap Junctions, which are abundant in myelin sheath. The OXPHOS proteins expresses in myelin is closely related to that of mitochondria and hence there must be some process still to be defined, which guarantees the transfer of OXPHOS machinery from mitochondria to myelin; overall the mitochondria-myelin link is known since many mitochondrial pathologies primarily affect myelin. For perfect functioning, OXPHOS requires an active synthesis of the heme group, considering that it is a fundamental component of several subunits of respiratory complexes, and interestingly, myelin sheath displays a higher heme group synthesis in comparison with other districts. In particular, proper functioning of myelin is closely linked to an efficient biosynthetic pathway of the heme and the crucial passage is catalyzed by the enzyme ALA dehydratase (EC 4.2.1.24) that requires zinc as cofactor. Lead poisoning (Saturnism) results in an imbalance of this enzyme and myelin degeneration. Moreover, analyzing the OXPHOS metabolism in myelin isolated from autopsy specimens of multiple sclerosis (MS) patients, we have observed a defective energy/respiratory capacity. With this knowledge, the hypothesis that MS is not an autoimmune disease, but a disease triggered by myelin degeneration following a malfunction of some process related to its energy function and heavy metal pollution seems confirmed, also considering the historical link between industrialization and the MS onset.
- Neurobiology of CNS | Clinical Trails in CNS
Location: Vienna, Austria
Chair
Khin Bo Maung
Northern Lincolnshire and Goole NHS Foundation Trust, United Kingdom
Co-Chair
Hanan Sheikh Ibrahim
Cleveland Clinic Abu Dhabi, UAE
Session Introduction
Abdel Wahhab O Gh
V N Karazin Kharkiv National University, Ukraine
Title: Neuromyelitis optica: A case report
Biography:
DELICH Olena: Currently a student and head of scientific society of the medical faculty of V.N. Karazin Kharkiv National University, Ukraine.
ABDEL WAHHAB O GH: Currently he is a student of the medical faculty of V.N. Karazin Kharkiv National University, Ukraine.
Abstract:
A 54-year-old woman was treated initially with neuritis of right optic nerve in 2013 that resolved completely. Two years later, she presented with relapse and partial visual functions recovery of right optic nerve. Ophthalmoscopy analysis showed atrophic changes of the disc optic nerve. After undercooling in March 2016, a patient complained of interscapular pain, weakness of the right limbs and urinary retention. MRI of thoracic part of spinal cord showed high T2 signal spread at least more than three vertebral segments, osteochondrosis. CT-angiography of spinal cord showed an absence of vascular malformations. A patient was treated with dexamethasone, ceftriaxone, vascular and metabolic therapy and was discharged with partial recovery, but interscapular pain was still present, sensory impairments from Th6 level down, urinary retention and constipation were revealed. From June 2016, she developed the lower spastic paraplegia. MRI of the brain (2015) didn’t reveal any local change of the brain tissues, besides asymmetric hydrocephalus of the lateral ventricles. Biochemical analysis serum antibodies IgG, the specific markers of neuromyelitis optica (NMO), connected with aquaporin -4-(AQP4) usually led to increase of AQP4 concentration, which was 1:320 in our case. Course treatment included solumedrol, aciclovir, ceraxon, actovegin, and cytostatic drugs. The patient was discharged with certain improvements and diagnosed with NMO, partial atrophy of the disc right optic nerve, lower paraplegia, reduced sensitivity in trunk and right lower limb, pelvic sphincter disturbances. From September 2016, the patient started to use copaxone (40 mg/ml 3 times a week s.c. for 4 months). Pain in upper thoracic, cervical parts of vertebra with irradiation to the occipital region increased after respiratory infection in December 2016. The numbness spread to Th4-Th5 segments, appear the clinic of lower paraplegia. She got plasmapheresis as an out-patient one time. Every month from September 2016 to March 2017, infusion of methylprednisolone was performed (1000 mg), rituximab (375 mg/kg i.v. infusion every 10 days â„–4 from February to March). So, clinical diagnosis now is Neuromyelitis optica (Devic`s disease), remitting course, exacerbation, lower spastic paraplegia, pelvic sphincter disturbances by type of urinary retention and constipation, of the right disc optic nerve atrophy.
Seyed Behnamedin Jameie
Iran University of Medical Sciences, Iran
Title: Effects of 660 nm low-level laser therapy on P2X3 expression of lumbar DRG of adult male rats with neuropathic pain
Biography:
Seyed Behnamedin Jameie is currently working as a Professor in the Neuroscience Research Center (NRC) at Iran University of Medical Sciences, Tehran, Iran. He has published several original research papers in the reputed & peer-reviewed journals and also participated into several scientific meetings.
Abstract:
Background: Neuropathic Pain (NP) is a serious suffering medical condition that frequently leads to disability and life style changes. Although the exact mechanisms of NP are still unknown, recently the role of reactive oxygen species (ROS) reported as an important factor for NP. Apoptosis, increase of ATP production and reduction of antioxidants are also the other factors influencing NP. There are certain therapeutic procedures for NP, among them using laser therapy newly received more attention. In the present research, we studied the molecular effects of Low Level Laser Therapy (LLLT) on a rat model of NP.
Material & Methods: Thirty adult male Wistar rats (200-250 g) that are randomly divided into three groups including chronic constriction injury (CCI), CCI+LLLT and control were used in this study. CCI technique was used to induce NP. Laser therapy was done by using laser beam of 660 for 14 days following CCI. After that, expression of P2X3 of the DRG, Bax and Bcl2 in lumbar spinal segments measured by Western blotting. Level of glutathione (GSH) was also measured in lumbar spinal cord segments by Continuous Spectrophotometric Rate Determination method. For behavioral study, the mechanical and thermal hyperalgesia were evaluated in days 7 and 14 after CCI.
Results: LLLT for two weeks increased expression of Bcl2 and GSH, whereas decreased Bax and P2X3 expression significantly. Comparing the results of behavioral study showed significant differences in the mechanical and thermal threshold showed between CCI and CCI+ LLLT groups.
Conclusion: Based on our findings, the therapeutic effects of LLLT for NP act throughout cellular and molecular mechanisms which improve mitochondrial function that in turn improve cell function and prevent apoptosis.