Day 3 :
Keynote Forum
Wai K Wong Tang
Chinese University of Hong Kong, China
Keynote: Structural and functional MRI correlates of post-stroke depression
Time : 10:00-10:45
Biography:
Abstract:
- Brain Disorders | Development Disorders | Dementia | Central Nervous System Disorders | Peripheral Neuropathy
Location: Meeting Place 3
Chair
Thomas F Fiener
Institute for EEG-Neurofeedback, Germany
Co-Chair
Steven Benvenisti
Davis, Saperstein & Salomon, USA
Session Introduction
Albert Karimov
Samara State Medical University, Russia
Title: Locating zones of motor points (MPs) using needle invasive stimulation method (NISM)
Time : 11:20-11:50
Biography:
Albert Karimov has completed his PhD from State Medical University of Samara Department and Post-doctoral studies at State Medical University of Samara Department. He is the Head and Director of Medical Rehabilitation in the company Infomed-Neuro. He has published more than 10 papers in reputed journals and is a Doctor who is involved in clinical research.
Abstract:
The MP is a junction of an efferent nerve and a muscle. 3 sequential steps in our experiment with a purpose of most precise MP localization were made: 1) Localization of the MP on a cadaver model; 2) Intraoperative localization of human neuromuscular apparatus section during surgical efferent nerve grafting, and electric stimulation of the efferent nerve and the muscle and; 3) MP searching using NISM based on ultrasonography data and minimum current intensity (MCI), sufficient for muscular contraction. The results were then integrated. Cadaver model of 10 bodies was analysed. For experiment we chose musculus flexor digitorum superficialis (MDS) and musculus flexor digitorum profundus (MFDP). We measured distances from bone markers to MPs. Statistical average data was calculated. We localized efferent nerves and muscles on 3 patients during surgeries. We directly stimulated the nerve and the muscle at the point they are jointed (Z1), and area of that muscle 4 cm away from the nerve (Z2). Values of MCI, which caused visible muscle contraction, were protocoled. For stimulation of Z1 sufficient MCI value was 1 mA, Z2 – 6-10 mA. Also we measured distances from nerve-muscle connections to bone markers. We examined 37 healthy patients and two methods were used such as: NISM and ultrasonography (for muscles visualization). Muscle examination includes MDS and MFDP. Z1 and Z2 were stimulated with a monopolar needle electrode. MP zone was mapped using data gained during our experiments, information from anatomical charts of MPs and ultrasonography. To start visible muscle contraction of Z1 sufficient MCI value was 1-3 mA, Z2 – 8-15 mA. Data of anatomical model, functional open stimulation and NISM of the selected muscles are congruent. This method is very promising. Data accumulation process is still on going.
Waleed E Jarjoura
The Arab-American University- Palestine, Israel
Title: Possible implications of a shunt surgery on a blind child’s academic and spatial orientations skills - a case report
Time : 11:50-12:20
Biography:
Waleed E Jarjoura studied Occupational Therapy at Tel-Aviv University (BSc), and later in The Hebrew University (MSc), while the Doctoral studies in University of Haifa (PhD). He worked in various rehabilitation institutes and hospitals such as HADASA-Jerusalem and Alyn Pediatric Hospital for Rehabilitation, Jerusalem. In parallel, he also worked at the School for the Blind in Nazareth, Israel, since 1998. Since 2013, he was assigned as The Head of Occupational-Therapy Department at the Arab-American University in Palestine. His specialization is in the rehabilitation of the blind, in general, and interested in the process of acquisition of Braille code for tactile reading in young, totally-blind poor-Braille readers.
Abstract:
In various cases of visual impairments, the individuals are referred to expert Ophthalmologists in order to establish a correct diagnosis. Children with visual-impairments confront various challenging experiences in life since early childhood throughout lifespan. In some cases, blind infants, especially due to congenital hydrocephalus, suffer from high intra-cranial pressure and, consequently, go through a ventriculo-peritoneal shunt surgery in order to limit the neurological symptoms or decrease the cognitive impairments. In this article, a detailed description of numerous crucial implications of the V/P shunt surgery, through the right posterior-inferior parieto-temporal cortex, on the observed preliminary capabilities that are pre-requisites for the acquisition of literacy skills in Braille, basic Math competencies, Braille printing which suggest Gerstmann syndrome in the blind is given. In addition, significant difficulties orientation and mobility skills using the Cane, in general organizational skills and social interactions were observed. The primary conclusion of this report focuses on raising awareness among neuro-surgeons towards the need for alternative intracranial routes for V/P shunt implantation in blind infants that preserve the right posterior-inferior parieto-temporal cortex that is hypothesized to modulate the tactual-spatial cues in Braille discrimination. A second conclusion targets educators and therapists that address the acquired dysfunctions in blind individuals due to V/P shunt surgeries.
Khaled Al Hourani
Al Khalidi Hospital & Medical Center, Jordan
Title: Paraneoplastic neurological case report
Time : 12:20-12:50
Biography:
Khaled AlHourani is a Member of the Royal College of Physicians in UK. He received training in Neurology at the University of London. He is Ex-Head of the Neurology Department in King Hussein Medical Center in Amman-Jordan. He is an Associate Professor of Neurology in JUST (Jordan University of Science and Technology) and has published many papers.
Abstract:
This is the case of a 61 year old male patient with recent DM, who presented with picture of peripheral sensory neuropathy but clinical and neurophysiological findings were compatible with sensory ganglionopathy. Routine lab tests were normal, vasculitic screen and paraneopalstic markers were negative. Neck, chest, abdomen and pelvic CT scan were normal. One year later cervical lump proved to have a cystic mass lesion by CT; histopathology showed rare malignant process of branchial cystic carcinoma, no primary source clinically and radiologically is identified. Elective tonsillectomy was done and the primary source was found in the right tonsil, radio and chemotherapy were given, follow up of the case showed significant improvement in the clinical and electrophysiological findings.
Thomas F Feiner
Institute for EEG-Neurofeedback, Germany
Title: Clinical EEG-neuroimaging, EEG-biomarkers and neurofeedback
Time : 13:40-16:10
Biography:
Abstract:
Biography:
Anthony Lee has received his Bachelor of Science Degrees in Mechanical Engineering and in Biology with a minor on Music. He pursued his MD from The College of Physicians and Surgeons at Columbia University. He has completed his Internship at New York Hospital Queens and his residency training at NYU in Physical Medicine and Rehabilitation. He has obtained his Fellowship training at New England Baptist Hospital in Spine Medicine. He is a Faculty Physician at Harvard Medical School, directly responsible for training future pain physicians in one of the top pain fellowship programs in the United States. His expertise is in complex spinal disorders, headaches and general rehabilitation. He divides his clinical work between the Department of Anesthesia and the Department of Orthopedic Surgery at Beth Israel Deaconess Medical Center.
Abstract:
Biography:
Anthony Lee has received his Bachelor of Science Degrees in Mechanical Engineering and in Biology with a minor on Music. He pursued his MD from The College of Physicians and Surgeons at Columbia University. He has completed his Internship at New York Hospital Queens and his residency training at NYU in Physical Medicine and Rehabilitation. He has obtained his Fellowship training at New England Baptist Hospital in Spine Medicine. He is a Faculty Physician at Harvard Medical School, directly responsible for training future pain physicians in one of the top pain fellowship programs in the United States. His expertise is in complex spinal disorders, headaches and general rehabilitation. He divides his clinical work between the Department of Anesthesia and the Department of Orthopedic Surgery at Beth Israel Deaconess Medical Center.
Abstract:
- Brain Stroke| Spinal Cord Disorders | Psychiatric Disorders | Neuro inaging and Radiology| Brain Mapping
Location: Meeting Place 3
Chair
Trevor Archer
University of Gothenburg, Sweden
Co-Chair
Reza Amani
Isfahan University of Medical Sciences, Iran
Session Introduction
Lena Ehrhard
Institute for EEG-Neurofeedback Munich, Germany
Title: Q-EEG analysis as foundation for neurofeedback treatments on the neurologically disordered patients
Time : 10:30-11:00
Biography:
Lena Ehrhard successfully completed her apprenticeship as Occupational Therapist at the Rhön-Akademie in Schwarzerden/Germany in 2002. She also finished her professional training on Psychic Trauma Therapy in 2012. As a co-partner of the health care center in Rotenburg an der Fulda/Germany, she is currently working as a Neurofeedback Therapist, using a 19-channel-discovery-system, trained by IFEN, Munich/Germany.
Abstract:
New techniques make writing Q-EEG possible, especially ambulant treatment for severe affected patients in hospitals or at home. On this foundation is a grounded and progressive neurofeedback therapy in nearly everywhere possible. Patients who couldn't take part in treatments due to mobility reasons can now do so. Case by case examples (locked-in, stroke, pain disorders) will demonstrate appraisal, methods and the betterment of the patient during the ambulant neurofeedback therapy
Adrián Gaitán Fariñas
IFEN institute for EEG Neurofeedback, Germany
Title: sLORETA neurofeedback in the cognitive remediation of brain insults: Recovering from an alexia due to stroke
Time : 11:15-11:45
Biography:
Adrián Gaitán Fariñas is a PsyD professional who conducts the first clinic specialized in QEEG and Neurofeedback treatment in the area of Cadiz (South of the Spain). He is a QEEG and Neurofeedback Instructor at the IFEN Institute, and European Institution devoted to train professionals in Neurofeedback therapy. He is also a QEEG and Neurofeedback Treatment-Planning Consultant of several clinics in Spain.
Abstract:
Neurofeedback is a form of neuromodulation that uses brainwave conditioning to modify aberrant neural functioning and optimize brain functioning, leading to emotional and cognitive improvements. It has also been proposed to provide benefits in brain insults like traumatic brain injuries and stroke; through training the damaged networks and facilitating cognitive remediation. A recent evolution of Neurofeedback known as sLORETA neurofeedback uses an inverse problem algorithm solution to identify and train activity of specific Brodmann areas instead of EEG activity detected at the scalp, and it is believed to provide faster and better outcomes than classic neurofeedback due to the superior precision. We will review the case of a patient suffering from alexia following a left hemisphere stroke. QEEG and sLORETA brain imaging showed dysregulation in Brodmann areas linked to reading, and neuropsychological examination revealed profound impairment in reading function. After a relatively short, combined treatment with cognitive stimulation and sLORETA z-score neurofeedback of the damaged networks, patient experimented a significant improvement in reading and cognitive functioning. QEEG and sLORETA imaging demonstrated enhanced regulation of electrical activity in the areas trained, suggesting that sLORETA neurofeedback helped to recover the function impaired due to the brain damage. Implications of sLORETA neurofeedback in the cognitive remedation and brain insult treatment will be discussed
Hashim Hasan Balubaid
King Saud Bin Abdulazizz University for Health Sciences, KSA
Title: Quality of life post stroke
Time : 11:45- 12:15
Biography:
Hashim Hasan Balubald has been graduated from the Medical College at King Abdulaziz University-Jeddah in 1995 and completed his Internship at King Abdulaziz University- Hospital from 1995 to 1996 to 2001. He has joined the residency program in Internal Medicine at King Fahad National Guard hospital in Riyadh, Saudi Arabia.
Abstract:
Stroke is a chronic disease that affects the functional, cognitive and psychosocial status of the patient. Post stroke, the patient needs extensive medical, physical and psychosocial interventions. Rehabilitation to get the patient back into the community is essential. Things that need to be addressed and assessed post stroke include the following: social reintegration, depression, cognition, sexuality and care giver burden.
Raed Mohammad Odeh Aljubour,
King Hussien Medical Center, Jordan Lunch Break 12:4
Title: Management of severe head injury and rule of intracranial pressure monitoring to decrease the morbidity and mortality
Time : 12:15-12:45
Biography:
Raed M Aljubour, MD, FEBNS, is a Consultant Neurosurgeon at KHMC, Jordan. He has completed his Fellowship in Skull Base from INI Hannover, Germany. He is a Member in European Board of Neurological Surgery, Arab Board of Health Specializations. He pursued his Diploma in EuroSPIN.
Abstract:
Objective: Severe brain injury is defined as a brain injury resulting in a loss of consciousness of greater than 6 hours and a Glasgow Coma Scale of 3 to 8. Patients in this condition need endotracheal intubation and mechanical ventilation, the main cause of secondary brain injury is increase in intracranial pressure which is preventable when it is detected and can decrease mortality and morbidity rate.
Method: This study focused in management of severe head injury and of intracranial pressure monitoring to decrease the morbidity and mortality, multi-centric study compares the outcome between patients with same GCS in hospital with intracranial pressure monitor versus patients in hospital without intracranial pressure monitor.
Results: We took 2 groups with same GCS, first group patients in hospital with intracranial pressure monitor and second group patients in hospitals without intracranial pressure monitor. Compare the mortality rate in both groups, with same GCS which shows less mortality and morbidity rate is more significant in GCS 7 and 8.
Conclusion: Hospital with intracranial pressure monitor especially intra-ventricular had less mortality and morbidity rates in patients with severe head injury with GCS 7 and 8, no difference in GCS below 6.
Reza Amani
Isfahan University of Medical Sciences, Iran
Title: Vitamin D levels and body antioxidant status in ischemic stroke patients: A case-control study
Time : 13:35-14:05
Biography:
Reza Amani is the academic member at Isfahan University of Medical Sciences (IUMS), Isfahan, Iran. He received his PhD and MSc in Nutrition Science from Tabriz University of Medical Sciences, Tabriz, Iran. He has obtained his fellowship in Clinical Nutrition. He has also worked at the University of Sydney, Australia as Visiting Scholar. He has published more than 120 scientific papers in Persian and English academic journals and has supervised above 50 Post-graduate theses and research projects. Currently, he is working as the Head of Food Security Research Center at IUMS. He has been awarded as eminent Researcher at Ahvaz Jundishapur University of Medical Sciences for five years.
Abstract:
Background & Aim: Stroke is the second cause of death among elderly people and oxidative stress plays important role in brain damage after stroke. The aim of this study was to evaluate the status of Vitamin D, antioxidant enzymes, and the relation between the ischemic stroke patients.
Materials & Methods: This case–control study was carried out on 36 patients with ischemic stroke patients and 36 matched subjects as controls. Intake of fruits and vegetables, exposure of sunlight, serum lipid profile, concentrations of serum Vitamin D, activities of serum superoxide dismutase, and glutathione peroxidase enzymes were determined.
Results: Severe Vitamin D deficiency was seen in 30% of the patients versus 11% of the controls (P<0.05). Consumption of fruits and vegetables was lower in patients than that of controls (P<0.05). Activities of antioxidant enzymes and intake of fruits were positively correlated in stroke patients (P=0.02). The most potent predictors of stroke risk were hypertension, high levels of low-density lipoprotein cholesterol (LDL-C) and history of cardiovascular disease (CVD) (odds ratios: 3.33, 3.15, and 3.14, respectively, P<0.05 for all). There was no association between 25(OH) D levels with activities of serum antioxidant enzymes and lipid profile in the two groups.
Conclusion: Ischemic stroke patients have higher prevalence of severe Vitamin D deficiency and lower intakes of fruits and vegetables. Intake of fruits was positive correlated to higher antioxidant enzyme levels. High levels of blood pressure, history of CVD, and high LDL‑C levels are the strongest predictors of ischemic stroke.
Anatoly Uzdensky
Southern Federal University, Russia
Title: Biochemical processes in penumbra after photothrombotic stroke in the rat cerebral cortex
Time : 14:05-14:35
Biography:
Anatoly Uzdensky has completed his PhD in 1980 from Rostov State University (Russia). He is the Principal Investigator and Head of the Laboratory of Molecular Neurobiology in the Sothern Federal University (Rostov-on-Don, Russia). He has published more than 120 papers in reputed journals.
Abstract:
In focal ischemic stroke, vessel occlusion rapidly induces local infarct of the brain tissue. During next hours, injurious factors (glutamate, Ca2+ and others) propagate to surrounding tissue and form the transition zone, penumbra, where both, neurodegeneration and neuroprotection processes are developed. Cell protection in penumbra is the aim of neurologists, but effective neuroprotectors are not found yet. So, deeper studies of biochemical processes in penumbra are needed. Neuronal and signaling antibody microarrays (Panorama, Sigma-Aldrich) were used to study changes in expression of >400 signaling and neuronal proteins in penumbra surrounding photothrombotic infarct core in rat cerebral cortex 1, 4 or 24h after impact comparing with untreated contralateral cortex. The greatest changes were observed at 4h after photothrombosis. They included simultaneous upregulation of proteins involved in diverse subcellular systems: proapoptotic (caspases 3, 6 and 7, Bcl-10, AIF, SMAC/DIABLO, p53, E2F1, p38, JNK, NMDAR2a, c-myc, Par4, p75, GADD153, GAD65/67, PSR) and anti-apoptotic (Bcl-x, p63, p21WAF-1, MDM2, ERK5, MKP-1, NEDD8, estrogen receptor) proteins. Various signaling proteins (calmodulin, CaMKIIα, CaMKIV, ERK1/2, MAKAPK2, PKCα, PKCβ, PKCμ, RAF1, protein phosphatase 1α, ATF2, EGF receptor, DYRK1A) were upregulated, whereas others (phospholipase Cγ1, S-100, GSK-3, Axin1, NUMB, TDP-43, FRAT1) - downregulated. Proteins involved in mitochondria quality control (Pink1, parkin), proteolysis (ubiquilin-1, UCHL1), intercellular interactions (N-cadherin, PMP22), neurite integrity and guidance (Nav3, CRPM2, PKCβ2) were overexpressed. Proteins associated with actin cytoskeleton (cofilin, actopaxin, p120CTN, α-catenin, p35, myosin Va and pFAK) were upregulated, whereas other cytoskeleton components (ezrin, tropomyosin, spectrin (α+β), βIV-tubulin, polyglutamated β-tubulin, doublecortin, neurofilaments 68 and M, cytokeratins 7 and 19) - downregulated. Downregulation of syntaxin, synaptophysin, synaptotagmin, VILIP, ALS2, and adaptin β1/2 indicated impairment of vesicular transport and synaptic processes. Enzymes that mediate dopamine biosynthesis (tyrosine hydroxylase, DOPA decarboxylase, dopamine transporter) were downregulated, whereas proteins involved in biosynthesis of serotonin and GABA (tryptophan hydroxylase, MAO-B, glutamate decarboxylase) - upregulated. Down-regulation of CDK6, CDC7 kinase, TRF1, and topoisomerase-1 suppressed proliferation. Levels of mitochondrial antioxidant protein AOP-1, chaperons Hsp70 and Hsp90 were reduced. Amyloid precursor protein, nicastrin and β-amyloid were upregulated. These data provide the integral view on neurodegeneration or neuroprotection processes in penumbra after photothrombotic infarct. Some of these proteins can be considered as potential targets for anti-stroke therapy. Supported by Russian Science Foundation (14-15-00068) and Russian Ministry of Education and Science (6.4951.2017/6.7).
Biography:
Anthony Lee has received his Bachelor of Science Degrees in Mechanical Engineering and in Biology with a minor on Music. He pursued his MD from The College of Physicians and Surgeons at Columbia University. He has completed his Internship at New York Hospital Queens and his residency training at NYU in Physical Medicine and Rehabilitation. He has obtained his Fellowship training at New England Baptist Hospital in Spine Medicine. He is a Faculty Physician at Harvard Medical School, directly responsible for training future pain physicians in one of the top pain fellowship programs in the United States. His expertise is in complex spinal disorders, headaches and general rehabilitation. He divides his clinical work between the Department of Anesthesia and the Department of Orthopedic Surgery at Beth Israel Deaconess Medical Center.
Abstract:
- Neurosurgery | Neuropharmacology |Neuropathology | Brain Injury | Neurotherapeutics
Location: Meeting Place 3
Chair
Anthony Lee
Harvard University, USA
Session Introduction
Hashim Hasan Balubaid
King Saud Bin Abdulazizz University for Health Sciences, KSA
Title: Control of agitation among demented patients
Time : 11:50-12:20
Biography:
Hashim Hasan Balubald has been graduated from the Medical College at King Abdulaziz University-Jeddah in 1995 and completed his Internship at King Abdulaziz University- Hospital from 1995 to 1996 to 2001. He has joined the residency program in Internal Medicine at King Fahad National Guard hospital in Riyadh, Saudi Arabia.
Abstract:
Delirium is a confused mental state that causes changes in awareness and behavior and may come and go during the day. A person with delirium may also have problems with attention, sleep, thinking and memory, hallucinations, judgment and agitation. Delirium has an enormous impact on the health of the elderly; it increases hospital mortality and prolonged hospital stay. An early diagnosis and treatment of delirium are essential.
Aurélien Ndoumbe
University of Douala, Cameroon
Title: Epidemiological analysis of severe traumatic brain injuries managed at a surgical intensive care unit
Time : 12:20-12:50
Biography:
Aurélien Ndoumbe has completed his MD from the Faculty of Medicine & Biomedical Sciences at the University of Yaoundé 1, and Post-doctoral neurosurgical studies from University René Descartes, Paris 5, and France. He is Associate Professor of Neurosurgery at the Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon where he teaches Neurosurgery and Neuroanatomy. He has published more than 21 papers in reputed journals.
Abstract:
This study was a retrospective analysis of the epidemiologic profile of severe traumatic brain injuries (STBI) managed at the surgical intensive care unit of the University Hospital Center of Yaoundé, Cameroon, between January 2011 and December 2015. All the patients admitted at the surgical intensive care unit for a traumatic brain injury with an initial Glasgow coma scale score ≤8 were included. One hundred and thirty-five cases were enrolled. One hundred and fourteen were males and 21 were females. Their mean age was 32.75 years. Forty-four patients were aged between 16 to 30 years. Road traffic accidents represented the first mode of injury with 101 cases and most of the patients were pedestrians hit by a car. Pupils and students were the most involved. Twenty-three patients had additional extracranial injury. On admission, 97 (71.85%) patients had GCS 7-8. A brain CT scan was done for 115 patients. Intracranial and intracerebral hemorrhages were the most frequent radiological findings with 57 cases. The overall mortality was 32.59% with 44 deaths. Thirty-two of the deaths occurred in patients with GCS 7-8 on admission. Ninety-one (67.40%) patients survived, 74 (54.81%) had persisting disabilities, while only 17 (12.59%) recovered fully. The following factors had an impact on the outcome: GCS at admission, pupillary anomalies, length of hospital stay, endotracheal intubation and surgery. Severe TBI remains a heavy socio-economic burden worldwide. In Cameroon where the health system is poorly organized, the outcome of individuals who sustained a severe TBI was dismal.
Biography:
Anthony Lee has received his Bachelor of Science Degrees in Mechanical Engineering and in Biology with a minor on Music. He pursued his MD from The College of Physicians and Surgeons at Columbia University. He has completed his Internship at New York Hospital Queens and his residency training at NYU in Physical Medicine and Rehabilitation. He has obtained his Fellowship training at New England Baptist Hospital in Spine Medicine. He is a Faculty Physician at Harvard Medical School, directly responsible for training future pain physicians in one of the top pain fellowship programs in the United States. His expertise is in complex spinal disorders, headaches and general rehabilitation. He divides his clinical work between the Department of Anesthesia and the Department of Orthopedic Surgery at Beth Israel Deaconess Medical Center.