Faculty Bibliography
Searched for:
school:SOM
Department/Unit:Neurology
Total Results:
23438
Journal Club: Diffusion-weighted MRI in Transient Global Amnesia and its Diagnostic Implications [Editorial]
PMID: 33310875
ISSN: 1526-632x
CID: 4712542
Seeing the Finish Line: Can Baseline OCT Values Predict Long-Term Disability and Therapeutic Management in Multiple Sclerosis? [Editorial]
PMID: 33653903
ISSN: 1526-632x
CID: 4801412
Movement perception of the tonic vibration reflex is abnormal in functional limb weakness
INTRODUCTION/BACKGROUND:We tested the hypothesis that functional limb weakness is associated with possible dysfunction of the central processing of proprioceptive information, by evaluating the amount of tonic vibration reflex (TVR) and the perception of the TVR movement. METHODS:The study sample was 20 patients with functional weakness of the lower and/or the upper limbs and 25 healthy controls; delivery of 92-Hz transcutaneous vibration of the biceps brachii tendon of the unrestrained arm stimulated predominantly the muscle spindle afferent and elicited elbow flexion (tonic vibration reflex, TVR). Blindfolded participants had to match the final position of the vibrated arm with their contralateral tracking arm. The TVR and perception of the TVR movement were measured as angle movements of the vibrated arm and the tracking arm, respectively. RESULTS:The magnitude of the TVR of the vibrated arm and movement perception of the TVR of the tracking arm were significantly reduced in the patients compared to the controls. No correlation was found between magnitude of the TVR and perception of the TVR movement, suggesting that the abnormalities were independent of each other. Moreover, the abnormalities did not differ between the patients with/without bilateral upper limb involvement or between the affected and the unaffected side in patients with unilateral impairment, suggesting that the observed deficits are independent of motor impairment. CONCLUSIONS:Proprioceptive dysfunction may underlie alterations in body movement and in sense of agency in such patients and may play a role in the pathophysiology of functional limb weakness.
PMID: 33895678
ISSN: 1873-5126
CID: 4852862
3D super-resolution deep-tissue imaging in living mice
Stimulated emission depletion (STED) microscopy enables the three-dimensional (3D) visualization of dynamic nanoscale structures in living cells, offering unique insights into their organization. However, 3D-STED imaging deep inside biological tissue is obstructed by optical aberrations and light scattering. We present a STED system that overcomes these challenges. Through the combination of two-photon excitation, adaptive optics, red-emitting organic dyes, and a long-working-distance water-immersion objective lens, our system achieves aberration-corrected 3D super-resolution imaging, which we demonstrate 164 µm deep in fixed mouse brain tissue and 76 µm deep in the brain of a living mouse.
PMCID:8243577
PMID: 34239948
ISSN: 2334-2536
CID: 4933572
Acute Coronary Syndrome and Ischemic Stroke Discharges in the United States During the COVID-19 Pandemic [Letter]
PMID: 33874741
ISSN: 1524-4628
CID: 4846872
Migraine: epidemiology and systems of care
Migraine is a neurovascular disorder that affects over 1 billion people worldwide. Its widespread prevalence, and associated disability, have a range of negative and substantial effects not only on those immediately affected but also on their families, colleagues, employers, and society. To reduce this global burden, concerted efforts are needed to implement and improve migraine care that is supported by informed health-care policies. In this Series paper, we summarise the data on migraine epidemiology, including estimates of its very considerable burden on the global economy. First, we present the challenges that continue to obstruct provision of adequate care worldwide. Second, we outline the advantages of integrated and coordinated systems of care, in which primary and specialist care complement and support each other; the use of comprehensive referral and linkage protocols should enable continuity of care between these systems levels. Finally, we describe challenges in low and middle-income countries, including countries with poor public health education, inadequate access to medication, and insufficient formal education and training of health-care professionals resulting in misdiagnosis, mismanagement, and wastage of resources.
PMID: 33773613
ISSN: 1474-547x
CID: 4830352
Measurement of the Fluctuations in the Number of Muons in Extensive Air Showers with the Pierre Auger Observatory
We present the first measurement of the fluctuations in the number of muons in extensive air showers produced by ultrahigh energy cosmic rays. We find that the measured fluctuations are in good agreement with predictions from air shower simulations. This observation provides new insights into the origin of the previously reported deficit of muons in air shower simulations and constrains models of hadronic interactions at ultrahigh energies. Our measurement is compatible with the muon deficit originating from small deviations in the predictions from hadronic interaction models of particle production that accumulate as the showers develop.
PMID: 33929235
ISSN: 1079-7114
CID: 5911002
Superficial Temporal Artery to Middle Cerebral Artery Cranial Bypass for Nonmoyamoya Steno-Occlusive Disease in Patients Who Failed Optimal Medical Treatment: A Case Series
BACKGROUND:In the post-Carotid Occlusion Surgery Study (COSS) era, multiple reviews suggested subset groups of patients as potential candidates for superficial temporal artery to middle cerebral artery (STA-MCA) bypass. Among them are patients with recurrent strokes despite optimal medical therapy. There is a paucity of data on the outcome of bypass in these specific patients. OBJECTIVE:To examine the safety and efficacy of direct STA-MCA bypass in patients with nonmoyamoya, symptomatic steno-occlusive disease with impaired distal perfusion, who failed optimal medical management or endovascular treatment. METHODS:A retrospective review was performed to identify patients with cerebrovascular steno-occlusive disease who underwent bypass after symptomatic recurrent or rapidly progressive strokes, despite optimal conservative or endovascular treatment. RESULTS:A total of 8 patients (mean age 60 ± 6 yr) underwent direct or combined direct/indirect STA-MCA bypass between 2016 and 2019. All anastomoses were patent. One bypass carried slow flow. There were no procedure-related permanent deficits. One patient developed seizures which were controlled by medications. A total of 7 out of 8 patients were stable or improved clinically at last follow-up (mean 27.3 ± 13.8 mo) without recurrent strokes. One patient did not recover from their presenting stroke, experienced severe bilateral strokes 4 mo postoperatively, and subsequently expired. Modified Rankin Scale (mRS) improved in 6 patients (75%), remained stable in 1 patient (12.5%), and deteriorated in 1 (12.5%). Good long-term functional outcome was achieved in 5 patients (63%, mRS ≤ 2). CONCLUSION/CONCLUSIONS:Patients with symptomatic, hypoperfused steno-occlusive disease who fail optimal medical or endovascular treatment may benefit from cerebral revascularization. Direct or combined STA-MCA bypass was safe and provided favorable outcomes in this small series.
PMID: 33475724
ISSN: 2332-4260
CID: 4760762
Acute Transverse Myelitis as a Parainfectious Manifestation of SARS-CoV-2 Infection (4933)
We present a case of acute transverse myelitis associated with presumed Covid-19 infection.Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a single-stranded RNA virus that causes coronavirus disease 2019 (COVID-19). The full spectrum of neurological involvement of Covid-19 has not been characterized.Design/Methods: Case report and review of literature.Results: A 52-year-old man from New York City with hypertension, diabetes, and diabetic peripheral neuropathy presented after two days of progressive bilateral leg weakness and urinary retention. He reported fever, cough, and low back pain that started three weeks prior to this presentation. On arrival, he was febrile and hypoxic on room air (SpO2 88%). Neurological examination showed bilateral hip flexion weakness (Medical Research Council grade 3/5), stable length-dependent sensory loss in the lower extremities, and generalized hyporeflexia. Laboratory studies were notable for leukocytosis (15.9 103/uL), lymphopenia (13%), hyponatremia (126 mmol/L), and elevated inflammatory markers: Lactate dehydrogenase (390 IU/L), erythrocyte sedimentation rate (120 mm/hr), C-reactive protein (195 mg/L), and interleukin-2 receptor (1383 pg/mL). Chest radiography revealed interstitial opacities in both lungs. Magnetic resonance imaging of the total spine revealed increased T2 signal in the spinal cord at the level of the T3 vertebra (Figure 1B–D). Cerebrospinal fluid (CSF) analysis revealed normal cell count (1 cell/mL) with elevated protein (91 mg/dL) and negative RT-PCR for SARS-COV-2. Early mobility was encouraged and antipyretics successfully controlled the patient’s fever. Spontaneous voiding returned on day three of hospitalization. His respiratory status also improved, and he was discharged home.Conclusions: Neuroinvasion has been demonstrated to be a common feature of many coronaviruses. This case provides insight into the potential mechanisms by which SARS-CoV-2 can affect the central nervous system, highlights acute transverse myelitis as a neurological manifestation of Covid-19, and demonstrates an example of an affected individual with good potential for neurologic recovery.Disclosure: Dr. Valdes has nothing to disclose. Dr. Zakin has nothing to disclose.
ORIGINAL:0015373
ISSN: 1526-632x
CID: 5053492
Assessing the integrity of auditory processing and sensory memory in adults with cystinosis (CTNS gene mutations)
BACKGROUND:Cystinosis, a rare lysosomal storage disease, is characterized by cystine crystallization and accumulation within tissues and organs, including the kidneys and brain. Its impact on neural function appears mild relative to its effects on other organs, but therapeutic advances have led to substantially increased life expectancy, necessitating deeper understanding of its impact on neurocognitive function in adulthood. We previously demonstrated intact auditory sensory processing, accompanied by mild sensory memory difficulties, in children and adolescents with cystinosis. METHODS:We investigated whether further progressive decrements in these processes would be observed in adults with cystinosis, comparing high-density auditory-evoked potential (AEP) recordings from adults with cystinosis (N = 15; ages: 19-38 years) to those of age-matched controls (N = 17). We employed a duration oddball paradigm with different stimulation rates, in which participants passively listened to regularly occurring standard tones interspersed with infrequently occurring deviant tones. Analyses focused on AEP components reflecting auditory sensory-perceptual processing (N1 and P2), sensory memory (mismatch negativity, MMN), and attentional orienting (P3a). RESULTS:Overall, adults with cystinosis produced highly similar sensory-perceptual AEP responses to those observed in controls suggesting intact early auditory cortical processing. However, significantly increased P2 and P3a amplitudes and reduced MMN at slower stimulation rates were observed, suggesting mild-to-moderate changes in auditory sensory memory and attentional processing. While cognitive testing revealed lower scores on verbal IQ and perceptual reasoning in cystinosis, these did not correlate with the AEP measures. CONCLUSIONS:These neurophysiological data point to the emergence of subtle auditory processing deficits in early adulthood in cystinosis, warranting further investigation of memory and attentional processes in this population, and of their consequences for perceptual and cognitive function.
PMCID:8045394
PMID: 33849633
ISSN: 1750-1172
CID: 4845952
