2^nd International Conference on Neurological Disorders and Stroke April 28-30, 2016 The Oberoi Dubai, Dubai, UAE

Biography:

Abstract:

Introduction: Intracranial angioplasty and stenting has been used for the treatment of symptomatic intracranial stenosis. However, a recent negative major randomized trial has dampened the enthusiasm for this procedure. We present our local experience with this procedure to assess its safety, efficacy, and outcome. Patients and Methods: This is a retrospective review of all the patients with symptomatic intracranial atherosclerotic disease who underwent endovascular treatment in our tertiary center over the past ten years. Clinical, procedural, and outcome variables were gathered. Results: We identified 22 patients who were referred for stenting of symptomatic intracranial atherosclerotic stenosis. In all but three, the stents were deployed successfully (86% procedural success rate). The procedure was done under conscious sedation in 32%. Excellent flow was restored immediately in all successfully-stented cases. Post procedural strokes occurred in four patients (17.4%). One non-neurological death was identified in a patient who suffered a major post procedural stroke (4.3%). Conclusion: Intracranial atherosclerotic disease is not uncommon in our population. Angioplasty and stenting might be a valid option for the treatment of patients with recurrent symptoms despite optimal medical treatment.

Biography:

Abstract:

Background: In developed countries stroke (Stk) is a major cause of morbidity and mortality, being responsible, in Portugal, for 11.5% of all deaths. HIV infection is regarded as an independent risk factor for ischemic Stk. Methodology: We retrospectively analyzed electronic files from all patients (pts) admitted to the Hospital de Santa Maria with an ischemic Stk diagnosis, from 1993 to 2013. Data was collected using the WHO 9th Revision International Classification of Diseases (ICD-9). A subset of HIV-infected pts (G2 - ICD-9 V08, 042) was extracted from the whole Stk group (G1 - ICD-9 433, 4340), to analyze patient’s characteristics and vascular risk factors encoded in the files (hypertension - HBP, diabetes - DM, dyslipidemia - Dsl). Smoking was excluded because of unreliable information. Additionally, we analyzed data from a cohort of 1,469 sequential HIV-infected patients followed-up at the Hospital HIV Clinic. We evaluated differences between HIV-infected and non-HIV-infected patients. The mean age, the prevalence of HBP, DM and Dsl for Stk pts with and without HIV were compared using t-tests for unpaired samples. Among the HIV-infected clinic cohort we compared the same means and proportions for patients with and without Stk. These results were also confirmed using multivariate logistic regression with age, HBP, DM and Dsl as covariates, controlling the results by gender. Results: From a total of 24,399 Stk pts admitted during the study period, 115 (0.47%) were HIV-infected (G2). A difference of 20 years was found between mean ages of G1 (77.63) and G2 (57.53) pts (p<0.01%). All studied risk factors were consistently inferior in G2. G1/G2: HBP – 0.5/0.28 (p<0.01%); DM – 0.19/0.08 (p<0.01%); Dsl – 0.21/0.11 (p<0.1%). HIV-infected patients from the HIV cohort were divided into "no Stk" (G3=1350 pts) and "with Stk" (G4=119 pts - 8.1%). The prevalence of DM and Dsl was not different between G3 and G4: DM 0.05/0.08 (p=0.25%); Dsl: 0.09/0.13 (p=0.31%). But in G4 mean age (42.4/55.32 - p<0.01%) and the prevalence of HBP (0.09/0.28 - p<0.01%) were significantly higher than in G3. Conclusions: A lower prevalence of hypertension, diabetes and dyslipidemia in the HIV-infected subgroup, along with an inferior mean age, supports the assumption that HIV infection can act as an independent risk factor for stroke. This conclusion appears to be supported as well by data from the HIV clinic cohort as although hypertension and age remain relevant risk factors for stroke in HIV-infected patients, diabetes and dyslipidemia lose strength as risk factors, offering additional support for this hypothesis.

Biography:

Abstract:

Introduction: This study was conducted to review and compare the endovascular therapies for tandem occlusions of anterior cerebral circulation. Methods: Literature review was performed using PubMed. We reviewed studies that described endovascular management for patients with tandem occlusions/stenoses of extracranial and intracranial arteries in the anterior cerebral circulation. Results: 99 patients were included. The median NIHSS (for 97 patients) at the time of admission was 16 (SD ± 5.5). The mean times and ranges from onset of symptoms to recanalization (for 46 patients) and from groin to recanalization (for 54 patients) were 412 minutes (Range: 120-1574) and 83 minutes (Range: 14-180), respectively. The mean outcome mRS (for 97 patients) was 2.39 (SD ± 2.2), and 61.9% of patients had mRS of ≤2 at 90 days. 81.25% of patients who had mRS of ≤2 had groin to recanalization time of less than 90 minutes (p-value: 0.018). Despite that only 7% of patients underwent retrograde approach, 85.7% of them had outcome mRS of ≤2 compared to 60% of patients with anterograde approach (p-value: 0.016). TICI scale was described for 72 patients, 77.8% of them had scale of ≥2b. 95.8% (23 patients) who received intravenous t-PA had TICI scale of ≥2b while 75.7% (25 patients) who did not receive IV t-PA had same TICI scale (p-value: 0.041). 13.9% of patients experienced cerebral hemorrhage. Conclusion: Groin to recanalization time of less than 90 minutes and the retrograde approach were found to be favorable prognostic factors based on mRS. The use of IV t-PA was with higher TICI scales.

Biography:

WK Tang was appointed to professor in the Department of Psychiatry, the Chinese University of Hong Kong in 2011. Professor Tang completed his medical training at the Chinese University of Hong Kong. He joined the Chinese University of Hong Kong as an academic staff since 1999. His main research area is Neuropsychiatry in Stroke. Professor Tang has published over 100 papers in renowned journals, and has also contributed to the peer review of 40 journals. He has secured over 20 major competitive research grants. He has served the editorial boards of five scientific journals. He was also a recipient of the Young Researcher Award in 2007, awarded by the Chinese University of Hong Kong.

Abstract:

Stroke represents a major public health problem in the China and worldwide, but relatively little work has been directed toward identifying and treating the common neuropsychiatric disorders occurring after stroke. I will review the epidemiology, clinical and pathological correlates and treatment of depression after stroke. These disorders have been shown to inhibit physical recovery from stroke and reduced the quality of life. There are very few controlled trials examining the effectiveness of treatments for these disorders after stroke. Both pharmacological and psychological treatments, however, can alleviate symptoms of this disorder.

Biography:

Hari Priya Bandi has completed her MBBS at the age of 24 years from Adelaide University, Australia. She is currently an advanced Neurosurgical trainee of the Royal Australasian College of Surgeons. She is also currently a Master of surgery candidate at Macquarie University.

Abstract:

Aim: Arteriovenous malformations (AVMs) of the brain are a major cause of stroke in children and young adults and there are currently limited treatment modalities. Vascular targeting methods, where the AVM nidus is ‘primed’ to molecularly distinguish it from normal and in particular en passant vessels, that could then be targeted with a thrombotic agent, would be very attractive in the treatment of AVMs. Priming with radiosurgery is useful as irradiated endothelial cells over-express phosphatidylserine (PS). This can then be targeted with an antibody for PS, Annexin, which conjugated with thrombin, could effect occlusion of the AVM nidus. Methods: 30 animals were used, with 3 groups; GKS and conjugate (Annexin and thrombin); conjugate with sham GKS; and finally GKS with placebo. The model AVM was created by anastomosing the left external jugular vein to the common carotid artery in male Sprague-Dawley rats. Radiosurgery was delivered with the GammaKnife at Macquarie University Hospital (‘GammaKnife Surgery’, or ‘GKS’) with a marginal dose of 20 Gy. Results: Thrombosis rates of the AVM vessels assessed histologically were 47% in the GKS and conjugate group, 44% in the group with conjugate alone, and 63% in the GKS alone group. Conclusion: The results show that while the ligand-directed conjugate is selective, there was an unexpected decrease in thrombosis. This project is an important first step in vivo testing of vascular targeting methods for the treatment of AVMs.

Biography:

Ayodele J. Akinyemi has completed his PhD at the age of 31 years from Federal University of Technology, Akure and Lecturing in Afe Babalola University, Ado-Ekiti. He has published more than 25 papers in reputed and well indexed journals.

Abstract:

Ginger and turmeric rhizomes are used in folk medicine for the treatment of several cerebrovascular diseases with limited scientific basis for their action. Hence, in this study, we investigate the effects of two Zingiberaceae varieties (ginger and turmeric) on ectonu- cleotidases (NTPDase and 50-nucleotidase), adenosine deaminase (ADA) and acetylcholin- esterase (AChE) activities in synaptosomes of cerebral cortex from L-NAME induced hypertensive rats. The animals were divided into seven groups (n = 10): normotensive control rats; hypertensive rats; hypertensive rats treated with atenolol; normotensive and hypertensive rats treated with 4% supplementation of turmeric and ginger rhizomes, respectively. After 14 days of pre-treatment with both rhizomes the animals were induced with hypertension by oral administration of L-NAME. The results revealed an increase of ATP and AMP hydrolysis as well as ADA and AChE activities of cerebral cortex synaptosomes in induced rats when compared with the control. The supplementation of both rhizomes prevented these alterations by decreasing ATP and AMP hydrolysis and ADA and AChE activities in cerebral cortex. In conclusion, this study demonstrated that both rhizomes interfere with the purinergic and cholinergic neurotransmission in cerebral cortex of hypertensive rats. Therefore, we can suggest that both rhizomes exert neuroprotective potential under hypertensive state.

Biography:

Mansi has completed his Bachelor degrees in both Medical Technology and Medicine in Saudi Arabia at king Abdulaziz University and King Saud University for Health sciences respectively. And has done his postdoctoral studies from the University of Minnesota, department of Neurosurgery at the stem cell institution. He is a Neurosurgical Resident in Saudi Arabia, and is pursuing a career in Stereotactic and Functional Neurosurgery

Abstract:

Background data: The attempt of mouse, rat, and non-human primates transduction using retroviruses, lentiviruses and Adeno-Associated Viruses (AAV) has been utilized in the past with success seen using retrovirus and AAV in those animal species. In this study we compared AAV serotypes for expression levels of green fluorescent protein (GFP) in the cerebral cortex of adult rat, Canines, and Rhesus macaque by a developed new protocol to culture and harvest Astrocytes in vitro preceded by an in-vivo live injection into their stroke models. Followed by an in vitro experiment on human progenitor cells (HPCs) and mature human astrocytes (HA) using those same vectors. Objectives: To determine the specificity and safety profile of AAV serotypes transduction across those animal species specifically AAV serotypes AAV8, AAV9 and AAV10 on those species and human Astrocytes in vitro. Study design: this is an in-vitro and an in-vivo experimental study of direct reprograming of mature astrocytes to neurons using vector packaging specific transcription factors transduction injected into different experimental animal species. Methodology In-vitro a specific canine astrocyte culture protocol was developed using canine meningioma cells transduced with AVV free transcription factors first. After realizing that those viruses can infect canine cells. They were then used on mature canine astrocytes harvested from a live animal. Canine cortical astrocytes were cultured in an astrocyte medium on poly-l-lysine-coated flasks using an adjusted protocol. Astrocyte transductions were performed at 24 h post-plating on coated dishes. Transfected cells were cultured in human NSC medium supplemented with growth factors as per the Astro-Medium protocol. Cells were then picked for further culturing and some were fixed in 4% paraformaldehyde (PFA) for 10 min. Then they were permeabilized with 0.5% Tween-20 in PBS and then exposed to 0.1% Tween-20 with 10% horse serum. We incubated the cells with primary antibodies overnight and with secondary antibodies for 1 h when unconjugated primary antibodies were employed. Vectors were already designed and prepared in our labs and was frozen down and stored away. In-vivo a pterional craniotomy on the canine stroke model was performed. The internal carotid artery and the middle cerebral artery were then identified. Coagulation was done to the middle cerebral artery distal to the lenticulostriate vessels to preserve them. After developing a stroke in these animals a diagram model, infarct and a behavior protocol was done to determine if it’s a working model. Later, they were injected with the same vectors used in vitro. Observation is done to their neurological status and the progression in the resumption of the neurological functions lost. Euthanization is carried out later on those animals and sections of their brains were examined and fixed. Immunohistochemistry were done 3-4 weeks later after transduction. Three canine stroke models were successfully developed. The same methodology was carried out on rats/mice, and Rhesus Macaque with considerations to the distinct anatomical differences. Several rats and mice stroke models were developed with success to only one Rhesus Macaque stroke model. An in-virto experiment included the usage of AAV in transducing HPCs and HAs using three different AAVs (AAV8, AAV9 and AAV10) known from literature to be the most potent candidates for a successful robust transduction in gyrencephalic species Central Nervous Systems. Results: Cells were quantified and AAV8 were found to be a highly specific transducer in-vitro to HA (P<0.05) followed by AAV9 and AAV10 respectively, with AA10 being the least satisfactory to cause significant transduction among the AAVs on HA. AAV10 gave significant results with rats and mice in vitro (P<0.05) with mixed results in vivo (P>0.05). AAV9 gave impressive results in the Rhesus Macaque both in vivo and in vitro (P<0.05). Conclusion: AAV10 had robust results with rats and mice in vitro, with questionable results in vivo. On the contrary AAV10 were the least to react to HPCs and HA. AAV9 were abundant in the Rhesus Macaque in vitro and in vivo. AAV8 was found to be the best candidates for the transduction of canine and human astrocytes followed by AAV9. The other animal species gave mixed results when comparing in-vitro to in vivo results. Further experimentations needs to be done on those species using different transcription factors with considerable adjustment to their environmental conditions.

Biography:

Makarenko O.M. has taken PhD degree at the age of 30 at the Moscow medical stomatological institute, M.D. degree at the age of 40 at the Institute of higher nervous activity in Moscow. He carries out his post-dock researches at the Institute of higher nervous activity and T. G. Shevchenko national university of Kiev. He is a professor of the psychology department, the author of more than 100 articles in reputed journals and 5 monographs (Lambert Academic Publishing).

Abstract:

Investigation of pharmacological activity of brain Trophinotropic factors, that formed in brain cells is very actual. Receiving from female pigs after brain's hemorrhagic stroke recovery, medicine "Cerebral" is a peptide trophinotropines with brain protective, regulative, activative and modulative actions. Trophinotropine "Cerebral" was protected of the active zones of the axodendritic synapses. Destruction dendrites system of the microtubules in the pleximorph area of sensomotoric cerebrocortex are not so often registered in trophinotropine treated animals. It was shown, that "Cerebral" administrations (0,01 - 0,02 mg/kg bow., imp., twice with the interval of day) to cats with experimental model of hemorrhagic stroke was accompanied with 70% decrease of mortality, reduced symptoms of the disease: recovered of limbs movements decreases of coordination disturbances, and normalization of some reflexes. Under conditions of chronic emotional stress (15 days) "Cerebral" (0,1 mg/kg b.w., i.p., before and on the 9h day of stress exposure) prevented the decrease of rats body weight, reduced the concentration of initial and intermediate products of lipid peroxidation, normalized the activity of antioxidant enzymes (SOD and catalase) in hypothalamus and cerebrocortex zones. "Cerebral" normalized spleen cytological parameters and blood neitrophils cytochemical reactions. Trophinotropine accelerates progress of structural and functional restoration of alterative neurons (activities effect), have a cytoprotective and different pharmacological properties-trigger and contrapoptotic actions in early post stroke period. This medicine was suggested for treatment of sharp periods of stroke and decompensation phases of disease have had an original medicinal form (nasal drops), which essentially, will simplify treatment patients.

Biography:

Margherita Di Paola is currently Lecturer at LUMSA University in Rome (Italy) and Researcher at IRCCS Santa Lucia Foundation in Rome (Italy). She is Principal Investigator for a Grant of the Italian Ministry of Health on “Degenerative Disease and NeuroImaging”. NeuroImaging is indeed her field of Research, with many International publications on impacted peer-journals. She has a background as Neuropsychologist. She graduated in Psychology at University of Palermo, (Italy). She specialized in “Neuropsychology” at University of Rome “La Sapienza” (Italy). She obtained her PhD at Policlinico Agostino Gemelli Rome (Italy).

Abstract:

White matter abnormalities have been shown in the large deep fibers of Alzheimer’s disease patients (Sachdev et al., 2013; Matsuda, 2013; Liu et al., 2011). However, the late myelinating superficial white matter comprised of intracortical myelin and short-range association fibers has not received much attention. In order to investigate this area, we extracted a surface corresponding to the superficial white matter beneath the cortex, and then applied a cortical pattern-matching approach which allowed us to register and subsequently sample diffusivity along thousands of points at the interface between the gray matter and white matter in 44 patients with Alzheimer’s disease (Age: 71.02+5.84, 16M/28F) and 47 healthy controls (Age 69.23+4.45, 19M/28F). In patients we found an overall increase in the axial and radial diffusivity across most of the superficial white matter (p < 0.001) with increases in diffusivity of more than 20% in the bilateral parahippocampal regions and the temporal and frontal lobes. Furthermore, diffusivity correlated with the cognitive deficits measured by the Mini-Mental State Examination scores (p < 0.001). The superficial white matter has a unique microstructure and is critical for the integration of multimodal information and during brain maturation and aging. Here we show that there are major abnormalities in patients and the deterioration of these fibers relates to clinical symptoms in Alzheimer’s disease.

Biography:

Sofya Markdorf studies medicine in the National Research University Novosibirsk State University. She makes her scientific work in the laboratory MRT Technologies of the Institute International Tomography Center of the Russian Academy of Sciences.

Abstract:

The aim of investigation is to value the effectiveness of surgical revascularization using the functional MRI. Two groups of patients in the recovery period (> 1 year) of the stroke were investigated. Patients in the first group were after cerebral bypass surgery (10 persons), the second group included patients after conservative therapy (7 persons). MRI study was made at 1.5T system (PHILIPS). The paradigm for the functional MRI included small ball squeeze in response to a visual cue. We examined patients from group №1 before surgery, in the early postoperative and recovery periods. We tested the neurological status before and after surgery (in the recovery period). The neuronal activity from the stroke region (precentral gyrus), supplementary motor cortex and contralesional hemisphere were compared. A significant increasing neuronal activity was found in the stroke region after conservative treatment (p < 0,05). The comparing of patients with extracranial-intracranial bypass in dynamics before surgery, after revascularization and in the recovery period didn’t show any significant increasing neuronal activity in the stroke region. In the surgical group a significant decreasing neuronal activity was observed in the contralesional hemisphere in the recovery period (p < 0,05). According to the data from neurological examination the motor function recovery of the damaged upper extremity took place in the 20% of patients after surgical revascularization. The investigation was made with financial supporting of FASO Russia in theme 0333-2014-0003 in the theoretical part and clinical analysis and the RSF grant (project №14-35-00020) in the MR-tomography.