Day 2 :
Keynote Forum
Debi Harmon Ference
Monroe Community College, USA
Keynote: My life with epilepsy
Time : 09:00-09:40
Biography:
Debi Harmon Ference has written a book Amazing Debi my secret before and after brain surgery for Epilepsy. It has gone global and is available in many Libraries and Colleges and Teaching Hospitals. I’ve been on Talk Shows, Radio Shows And also several Newspapers. Discussing my Brain Surgery And life before and after brain surgery. Debi Harmon Ference 734-807-0451 Discussing Neurology Oral Presentation Debi Harmon Ference LINKIN
Abstract:
I will be talking about my life with Epilepsy. How I started having seizures at 18 Months old, the different stages I went through. My trails the things I conquered refusing to ever give up! How my life has changed since my brain surgery on my left temporal lobe which was December 29-1995. Living Seizure Free how my life has changed. And my goals to in the future to help continue to spread Awareness and help find a cure for Epilepsy.
Keynote Forum
Yun Hee Kim
Samsung Medical Center, Republic of South Korea
Keynote: Noninvasive brain stimulation for modulating neural network plasticity in stroke rehabilitation
Time : 09:40-10:20
Biography:
Yun Hee Kim pursued her PhD in Neuroanatomy (1996); MD (College of Medicine- 1982) respectively from Yonsei University, Republic of South Korea. She is a Board Certified PM&R specialist (1986). Her clinical specialty is neurological rehabilitation and her main research interest is investigating human neural plasticity using functional neuroimaging and noninvasive brain stimulation. She has published more than 200 peer-reviewed articles in famous international and domestic academic journals such as Neurology (2006), NeurolImage (1999, 2008, 2015), NeurolImage Clinical (2017), Stroke (2006, 2011, 2017), Neurorehabilitation and Neural Repair (2009, 2012, 2015), and 10 chapters of books in the field of neurological rehabilitation.
Abstract:
After focal ischemic injury of brain such as stroke, activity of remaining neural network is changed to optimize neural resources for recovery of function. Modulation of neuroplastic activities of perilesional cortex or interconnected network regions may enhance the rehabilitative outcome and functional restoration after stroke, therefore, the methods of modulating neuroplasticity are crucial topics in neurorehabilitation research. Noninvasive brain stimulation (NBS) is a technique to modulate neural plasticity in a noninvasive manner and consequently to enhance neural recovery. The most popular noninvasive methods of neuromodulation include transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and transcranial alternating current stimulation (tACS). One of the considerations on the effect of NBS is individual variation of its responsiveness. Diverse factors such as individual skull and cortical morphology, lesion location and severity, genetic polymorphism, etc. are considered as the intrinsic factors affecting individual response variability. The patient-specific neural network modulation by customized brain stimulation methods may provide a novel neurorehabilitation strategy to enhance functional recovery after stroke. The modulating effect of NBS can expand to the interconnected subcortical network areas beyond the site of cortical stimulation. Use of multimodal functional neuroimaging methods such as functional MRI, PET, and functional near infrared spectroscopy can demonstrate the network spreading effect of NBS. Neural plasticity after stroke can be seen from microscopic to macroscopic levels. This process may be spontaneous or induced by training, although the former occurs only within a critical period after injury. Combination of neuromodulatory interventions such as NBS on top of various rehabilitation treatment may enhance successful reorganization of neural network which is utmost important for future researches.
- Dementia | Behavioural Neurology | Neuro Oncology
Location: Ovidio
Chair
Eduardo Flores Alvarez
National Autonomous University of Mexico, Mexico
Co-Chair
Christo Ranguelov
University Hospital Sofiamed, Bulgaria
Session Introduction
Philip Anthony McMillan
University of Stirling, United Kingdom
Title: Integrated biochemical theory of delirium and experience with pharmacological reversal
Time : 10:40-11:10
Biography:
Philip Anthony McMillan pursued his MBBS Degree from Royal College of Physicians, UK (1994). He is a Consultant Geriatrician at the National Health Service with an interest in dementia and stroke. He has over 23 years of clinical experience with a broad range of skills in medicine and business. He has collaborated (for his further publications) on the theory of dementia and the potential of reversal with a Professor in USA.
Abstract:
Delirium is a significant problem in older hospital admissions, with worse clinical outcomes, prolonged hospital stays and functional disability. This presentation will cover the clinical experience of managing these complex patients during their hospital stay. Looking at explaining an integrated theory of delirium, based on brain glutamate and ammonia management, the work aims to demonstrate the biochemical aspects of the condition. Anecdotal experience of reversing delirium using this biochemical framework and use of simple medication in hospital has been very successful with up to 70% of patients demonstrating clinical improvement. This theory has the potential to revolutionize our care of older patients and give insight into the links between delirium and dementia.
Eduardo Flores Alvarez
National Autonomous University of Mexico, Mexico
Title: Advantage of endoscopic surgical technique for resection of pituitary adenoma with suprasellar extension: first series of the General Hospital of Mexico
Time : 11:10-11:40
Biography:
Eduardo Flores Alvarez pursued his Master´s Degree from National Autonomous University of Mexico (UNAM) School of Medicine, Mexico with focus on the application of advanced magnetic resonance in glioblastomas. He completed his neurosurgical training program from General Hospital of Mexico of the UNAM and is the Head of Endoscopic Neuro Surgery Department. His area of research include: the advanced analysis of magnetic resonance.
Abstract:
Background: Pituitary adenoma is the most common tumor in the sella turcica and constitutes 10-15% of the intracranial neoplasms, making them the third most common primary brain tumor in adults after meningiomas and gliomas. It is estimated that between 20 and 25% of the general population could have small hypophyseal tumors without symptoms. Aim: Our retrospective study carried out in the General Hospital of Mexico, Mexico city aimed to determine the advantage of endoscopic endonasal approach for surgical treatment of pituitary adenomas with suprasellar extension. Methodology: A series of 48 patients from December 2014 to December 2017 including patients from 18-75 years old were operated using an endoscopic endonasal approach, measurement of size, extension and invasion was performed based on the Knops and Wilson Hardy classification in the pre-operative and in the post-operative period using magnetic resonance imaging, endocrinological evaluations were performed in addition to the visual function evaluations, post-surgical complications were also documented. Evaluation of the volume of resection is done by comparing the pre-operative and post-operative magnetic resonance studies. Results: Of the total 48 patients less than 30% have non-functioning pituitary adenomas, study groups were comprising patients with surgical resection greater than 80%, resection between 50-80% and patients with resection less than 50% resulting respectively 73%, 22% and 5%. Only one deaths occurred and no group differences were noted in the post-operative complications (p=0.021). The endoscopic endonasal approach is safe, improving vision, illumination and degree of resection in the case of adenomas with supraselar extension.
Yun Hee Kim
Samsung Medical Center, Republic of South Korea
Title: Wearable hip-assist robot modulated cortical activation during gait in stroke patients
Time : 11:40-12:10
Biography:
Yun Hee Kim pursued her PhD in Neuroanatomy (1996); MD (College of Medicine- 1982) respectively from Yonsei University, Republic of South Korea. She is a Board Certified PM&R specialist (1986). Her clinical specialty is neurological rehabilitation and her main research interest is investigating human neural plasticity using functional neuroimaging and noninvasive brain stimulation. She has published more than 200 peer-reviewed articles in famous international and domestic academic journals such as Neurology (2006), NeurolImage (1999, 2008, 2015), NeurolImage Clinical (2017), Stroke (2006, 2011, 2017), Neurorehabilitation and Neural Repair (2009, 2012, 2015), and 10 chapters of books in the field of neurological rehabilitation.
Abstract:
The purpose of this study is to investigate the modulating effect of hip-assist robot on cortical activation during gait in stroke patients. Twenty stroke patients participated in this study. A wearable type hip-assist robot, gait enhancing mechatronic system (GEMS, Samsung Electronics Co., Ltd., Korea) was used. Each patient randomly performed assigned two sets of treadmill walking sessions at self-selected speed with assistance of GEMS and without assistance of GEMS. An experimental session began with a fixed standing condition (60s), followed by one of the two walking conditions (60s) and then a resting condition (60s) for five repetitions. Cerebral oxygenation was measured by oxyhemoglobin (OxyHb) concentration using the 49 channels of functional near infrared spectroscopy (fNIRS) imaging system (NIRScout, Germany) covering bilateral prefrontal cortices (PFC), premotor cortices (PMC), supplemental motor areas (SMA) and lower limb sensorimotor cortices (SMC). In GEMS condition, stroke patients demonstrated improved spatio-temporal gait parameters, such as speed and symmetricity. We also observed less OxyHb concentration over the lower limb SMC, SMA and PMC regions in the late phase of gait between 31 and 60 seconds after initiating walking task with GEMS than No GEMS conditions. Less activation in the lower limb SMC, PMC and SMA in the late phase of walking with GEMS may indicate that GEMS helps producing rhythmic and symmetric hip flexion and extension movement and allows more coordinated gait pattern.
Christo Ranguelov
University Hospital Sofiamed, Bulgaria
Title: NS management of ischemic and hemorrhagic stroke- SAH and aneurysm
Time : 12:10-12:40
Biography:
Christo Ranguelov is currently Consultant neurosurgeon at University Hospital Sofiamed, Sofia, Bulgaria. He is experienced Assistant Professor with a demonstrated history of working in the hospital & health care industry. Skilled in Emergency Medicine, Public Speaking, Neurosurgery, Healthcare Information Technology (HIT), and Grant Writing. Strong education professional graduated from Medical University/Medical Academy, Sofia. He did his MD from Medical Academy, Sofia from 1968-1975.
Abstract:
Stroke is still one of the leading healthcare problems worldwide. We present you some important points from our 5 years’ experience. In this retrospective review we analyze a series of about 500 pts with ischemic stroke (IS) treated last 2y at stroke centers in Sofia, so as another 500 pts with hemorrhagic stroke treated at NS Clinic, Sv. Ivan Rilsky Hospital, and Department of Neurosurgery at Sofiamed hospital, Sofia. Bulgaria is a small country and the capital Sofia has about 2 million inhabitants. In NS Clinics there is a tradition with neurosurgical treatment of hemorrhagic stroke and aneurysms, but since year 2011 progressively growing number of endovascular procedures for hemorrhagic stroke and aneurysms: more than 500 pts, incl. 411 aneurysms, 79 brain AVM, 10 spinal AVM. Since year 2015/16 started acute treatment of ischemic stroke at 2 stroke centers, so as endovascular treatment of ischemia. From more than 50000 pts with IS annually 330 are treated with tPA during first 3 h. Recently there are 250 pts with tPa, and 60 with additionally endovascular thrombectomy following initial venous thrombolysis. Inspite of huge number of patients only 1.6% of them can be treated with tPa, and lately with endovascular. Mortality rate among surgical and endovascular treatment of hemorrhagic stroke patients is about 5%, morbidity – 10% Mortality rate in ischemic. We discuss the cause of delay and how to increase further this type of treatment, and how to improve the outcome.
Lystratenko Oleksandr Ivanovich
Donetsk National University, Ukraine
Title: Military neurosurgical traumas with their complications
Time : 12:40-13:10
Biography:
Lystratenko Oleksandr Ivanovich has completed his study at the age of 25 years from Donetsk National University and internship from Donetsk National University – postgraduate department as neurosurgeon. He is the Deputy Chief Neurosurgical Clinic by DOKTMO. He has published more than 22 papers in reputed journals and has been serving as an editorial board member of repute.
Abstract:
This work contains information about military neurosurgical traumas with their complications. Here will be spoken about neurosurgical medical treatment in the present military actions (local military conflict in Donbass from 2014 till nowadays). You can realize what kind of neurosurgical treatment could be used in megapolis which appears under fire. Content of the work: soft tissue- damages, open not penetrating wounds, open penetrating wounds with- and without- brain perforation. In addition will be noticed the difference between projectile (shrapnel) wounds and bullet wounds with their following treatment based on numerous cases of such kind of injuries. This work has a lot of pictures in order to show pre- and post- operative patient’s condition.
- Young Researchers Forum
Location: Ovidio
Session Introduction
Mariel Pietri
University of Nice Sophia Antipolis, France
Title: Spadin and its analogs improve recovery after stroke by preventing post-stroke depression
Time : 13:50-14:10
Biography:
Mariel Pietri is currently a PhD student at the University of Nice Sophia Antipolis, France, under the guidance of the Drs Catherine Heurteaux and Marc Borsotto. Her work mainly focuses is the development of new treatment for stroke and depression, targeting the TREK-1 channel. She works on the development of spadin and its analogs as a new medicine and her thesis project focuses more specifically on the protection against stroke. She has her expertise in surgery of small animal, behavioural mouse models, immunochemistry and biochemical analyses.
Abstract:
Stroke is a major disease associated with high mortality and serious long-term disability. Unfortunately, usual treatments fail to improve long-term recovery and thrombolysis, which is the unique short-term treatment, is efficient only on 10% of patients. Consequently, developing new treatments is necessary. The TREK-1 channel represents an interesting target since its activity has recently been shown to be protective against stroke. We have identified a short molecule (spadin or PE 12-28) derived from a larger endogenous peptide, which is a potent antidepressant and is able to specifically inhibit TREK-1, as a potential new treatment. Using the in vivo model of MCAO in mice, we demonstrated that chronic treatment with spadin or a shorter analog (PE 22-28) improved the post stoke recovery from days to months after the ischemia. The protocol we used was designed thanks to electrophysiology studies and consisted in a two phase treatment, a low dose for one week followed by a high dose treatment for several weeks. Treated mice showed a significant reduction of the immobility time in the Forced Swimming Test. The eat latency in the Novelty Suppressed Feeding test was significantly reduced. The learning capacity was increased in the Morris Water Maze and the motor coordination was improved in both rotarod and pole test. The increase in neurogenesis, measured by BrdU incorporation was still present even at 10 weeks post trauma. Taken together our results suggest that spadin or its analog are very potent candidates for the development of new treatments improving stroke recovery
Yoon Kyum Shin
Yonsei University College of Medicine, Republic of Korea
Title: Therapeutic effects of the collagen-binding motif as a novel osteoporosis medication in cerebral palsy with bone loss
Time : 14:10-14:30
Biography:
Yoon Kyum Shin completed her PT, MSc from Yonsei University College of Medicine, Republic of Korea and is pursuing Doctoral course from Brain Korea 21 PLUS Project for Medical Science at Yonsei University College of Medicine. She is interested especially in the therapeutic strategies for patients with cerebral palsy and neurologic disorders. She has contributed in 14 papers and published 8 papers as the first-author in the field of neurorehabilitation medicine.
Abstract:
Cerebral palsy (CP) is a static lesion occurring in the immature brain from multifactorial causes including hypoxicischemia, resulting a life long motor impairment. Of note, severe patients with CP suffer from bone loss due to prolonged conditions of limited weight bearing in adulthood. In the transcriptome analysis, osteopontin (SPP1) gene expression in the peripheral blood mononuclear cells was significantly down regulated in adults with CP (n=13) than healthy adults. (n=13; fold change=-70.10). The osteopontin has multifaceted function of biomineralization by involving bone resorption and formation. A novel collagen binding motif (CBM) of osteopontin, is recently identified to induce bone formation via facilitating osteogenesis and inhibiting adipogenesis. We aim to propose reasonable therapeutic evidences for patients with CP who have osteopenia or osteoporosis by applying a novel osteoporosis medication in an animal model of neonatal hypoxic-ischemic (HI) brain injury. 7-day-old CD-1 pup mice underwent ischemic brain injury induced by unilateral right common carotid artery ligation and induced hypoxic condition. Severe HI brain injured mice were included to CBM administration for eight weeks. In the bone geometrical analysis, bone surface density and trabecular number were significantly increased after long term administration of CBM, while trabecular separation was significantly reduced compared to saline control. Through enzyme linked immunosorbent assay, we identified bone turnover markers including C - terminal telopeptide and procollagen type I were highly regulated in CBM treatment group compared to saline control. In an animal model of neonatal hypoxic-ischemic (HI) brain injury, the CBM improved bone geometrical components and bone turn over activity. This clinically translational investigation using the CBM shed lights on therapeutic administration for bone loss in adults with CP.
Surbhi Chaturvedi
Mahatma Gandhi Medical College & Hospital, India
Title: Stroke in young: rare associations
Time : 14:30-14:50
Biography:
Surbhi Chaturvedi is pursuing her Doctorate (DM) in Neurology, and, is in her final year at the age of 30 years from Mahatma Gandhi Medical College & Hospital, Jaipur, India. She did her MBBS from Jiangsu Medical College, China and completed her MD in Medicine from Mahatma Gandhi Medical College & Hospital, India. Surbhi Chaturvedi did her thesis in Medicine assessing impact of iron and vitamin B12 deficieny anameia on glycosylated Hb level. While doing her MD, she explored other fields of Medicine apart from Neurology by completing a post-graduate program in Cardiology by John Hopkins University School of Medicine, ECG education programme, course on Diabetes certified by Public Health Foundation of India. She developed a strong interest in Neurology which led her to specialize in the field and publish several research articles relating to stroke, epilepsy and headache. Currently, she is working on clinical profiling of stroke patients to provide critical insights on the etiology, clinical presentation, radiological findings and the role of various drugs with a special interest in stroke in young patients. Additionally, she is involved in “Epilepsy in Pregnancy” registry which is the first of its kind in North India.
Abstract:
The issue of stroke in young in the world has long been of interest to the neurologists. Though the traditional risk factors of stroke play a significant role in young age group also, the presence of high number of cryptogenic strokes, cardio-embolic and venous strokes makes diagnostic evaluation in this age group more challenging. Here, we report 2 cases of young patients with stroke as a rare manifestation of vasculitis and emphasize the need for thourough evaluation of young patients with stroke to establish the underlying etiology. Our 1st patient was a young female of 35 years with recurrant stroke (2 episodes till now and this time 2nd episode), presented with few episodes of TIA followed by aphasia and right hemiparesis with skin lesions in form of livedo retucularis and digital infarction and 1 episode of left focal seizure. MRI was suggestive of infarcts in different stages both acute and chronic in different vascular distribution. Possibility of vasculitis and embolic event was there. Skin biopsy was suggestive of Sneedon syndrome that matched our clinical presentation as well. Our 2nd patient was a young female of 13 years with young onset acute right hemiplegia, global aphasia with absent left carotid, brachial and radial pulse. MRI brain was suggestive of acute infarct in left MCA territory. CT angiography showed significant stenosis(80-90%) at the origin of left CCA and subclavian artery. ESR, CRP, ANA and anticardiolipin antibody was positive. So she was diagnosed to have Takayasu arteritis with APLA syndrome. Total 9 cases of TA with APS have been reported as yet.