Day 3 :
- Neurodegenerative and Neuromuscular Disorders
Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, UK
Time : 9:30-10:00
Khin Bo is a Lecturer (Hon.) in Hull York Medical School. He is a Specialist in Spasticity Management and Functional Electrical Stimulation. He has been involved in the management of long term neurological patients in MDM setting for over 10 years.
Statement of the Problem: 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.
Methodology: Seventy multiple sclerosis patients from outpatient clinics and home visits were tested for bimanual hand function. 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 has been done. Patients have to do as fast as they could. Noticeable slowing of clapping was taken as a sign of slowing down of conduction through CC. 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.
Findings: 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.
Conclusion & Significance: It is possible to detect CC involvement by doing bedside test. Positive patients will have difficulties in doing bimanual activities like mobility using two sticks, typing using keyboard, pushing wheel chair bimanually, etc. The magnitude of slowing down can be used as an indicator of the reference day (a good or a bad day). Clapping can also be used as an exercise for CC. It is difficult to test CC conduction speed electro physiologically. The sample size taken is not large enough and larger studies need to be performed to validate the findings.
Ramon Llull University, Spain
Time : 10:00-10:30
Judit Subirana-Mirete completed her PhD in 2016 at Ramon Llull University in the field of the assessment of cognitive impairment focusing on the importance of cognitive processing speed. She has focused her formation in Neuropsychology and Neurosciences accomplishing her specialization in Neuropsychology in 2010 at Universitat Autonoma de Barcelona. Her research spans different areas including the early detection and evaluation of cognitive impairments and dementia. She has published, in this field, many articles as well as four book chapters. She received a grant from the Catalan Government to span her knowledge abroad, and to take up a position in the Oliver Zangwill Center (UK). She is currently on daily private practice as well as at the Ramon Llull University where she complements her clinical profile with national and international research projects in the field of Neuropsychology
The aim of this communication is to introduce the importance of the inclusion of Cognitive Processing Speed (CPS) in neuropsychological assessments for MCI & AD as the slowdown of the CPS is present in multiple diseases of the CNS among which we can include cognitive impairments of diverse aetheologies. Relation between CPS not only with white matter but also with grey matter gives us some clues about its importance in cognitive neurodegenerative processes. The separation between CPS and other cognitive processes is important to be considered and, although it has been shown possible, its everyday clinical assessment still presents many knots which are not easy to cope with. When assessing other cognitive domains, we usually use time-controlled neuropsychological tasks. These timings are often considered for the final conclusions of the overall cognitive status of the patients. However, we do not take into consideration that maybe only the CPS is slowed and there's no affect in the other cognitive domains but only slowed capacity of the system. For enhancing the assessment of CPS, some tests are being developed and adapted in order to be able to differentiate among the cognitive difficulties presented over evaluation on everyday clinical practice. We will be presenting new outcomes on CPS construct and its assessment as well as several studies that have been conducted in order to quantitatively evaluate the slowing of CPS in different stages of aging and cognitive impairment, including MCI and early stages of AD.
Ivane Javakhisvili Tbilisi State University, Georgia
Maia Machavariani-Tsereteli completed her MSc in Clinical Neuropsychology from Ivane Javakhishvili Tbilisi State University. Currently, she is pursuing PhD in the same university. She is also working as Neuropsychologist (National programs on prevention and early diagnosis of epilepsy in children and adults) at the Institute of Neurology and Neuropsychology and delivers lectures and seminars as Assistant Professor at Ivane Javakhishvili Tbilisi State University. She conducted researches on naming development neuropsychological and neurolinguistic analysis, the research of creativity in Georgian population-Torrans Creativity Test adaptation, neuropsychological analysis of human executive and other cognitive functions during natural aging, stigma and self-stigma in adolescents with epilepsy.
Background: Psychological, social and emotional outcomes of epilepsy are not always obvious. Very often epilepsy-related psychological and emotional problems remain undetected and therefore ignored. As being one of the most stigmatized diseases, epilepsy causes many hidden and apparent problems like stigma and depression seem to be the most prevalent of them.
Aim: Aim of the study was to reveal stigma-related attitudes and relation between stigma and depression level in adolescents with epilepsy.
Methods & Materials: 48 patients and 48 controls aged 13-18 years participated in the research. Card sorting task was used to reveal stigma-related attitudes: Participants were given a stack of cards and were asked to group them together as it makes sense to them (no right or wrong answers). The results of categorization were fixed in protocol. To assess the level of depression we used Beck Depression Inventory (BDI).
Results: For qualitative data, cluster analysis has been used. Results of the analysis revealed that social functioning and relationships appear to be the most important for adolescents suffering from epilepsy; positive emotional and social relationships are mediated by maintaining successive relationships with other members of the society; family seems to be considered by adolescents as a stable source of social respect. Safety and regime compliance are perceived as guaranteed success and luck. According to BDI completion results, 5.5% of patients have severe to extreme depression level, 18.2% have severe-moderate level, 27.3% have mild-moderate level, 49.1% had no depression. Gender differences: Girls with epilepsy, as well as healthy ones were more depressed than boys. Seizure control appeared to be a significant factor for depression level. In patients with well-controlled seizures, 60% reported no depression. Whilst in patients with uncontrolled seizures, only 37.9% reported no depression. Surprisingly, control group data have shown only slight difference: Only 54.2% of healthy adolescents’ data revealed no depression.
Conclusions: Social issues appear to be of biggest importance for adolescents with epilepsy. Evaluation of emotional state revealed that severe and extreme depression level is observed only in female adolescents with epilepsy. In both, control and patients groups, girls appeared to be more depressive than boys. As was expected, seizure control factor had significant influence on depression level. Surprisingly in control group healthy adolescents, mild-moderate depression rates appeared even higher than in patients with good seizure control. Generally speaking, depression rates in healthy merit attention, 48.8% of reported depression of different levels is too high a percentage for control group. For future, we are considering to conduct deeper and more complete research of depression level in healthy adolescents.
University of Minho, Portugal
Time : 11:20-11:50
Parreira M completed her Master’s Degree in Clinical Psychology at University of Minho (Braga, Portugal) in 2012 and later performed Postgraduate studies in Neuropsychology of Intervention. She has worked in hospitals as a Neuropsychologist, and actively collaborates with a Multiple Sclerosis Association and is currently conducting research in a clinical trial related to the Alzheimer’s disease and a study in Multiple Sclerosis at Alto Ave Hospital Centre, in association with University of Minho. She has published papers and presented oral and poster presentations, and she is an Editor of the International Journal of Psychology and Neuroscience.
In Multiple Sclerosis (MS), fatigue is a troublesome and common symptom that contributes to disability. Fatigue Management Intervention (FMI) is an approach that seeks to manage fatigue, based on energy conservation principles that work as guidelines for performing tasks conserving energy, following behavioural strategies. The main purpose of this research is to establish the efficacy of a FMI on physical and mental fatigue (Multidimensional Assessment of Fatigue Scale- MAF), quality of life (World Health Organization Quality of Life – Bref- WHOQoL-Bref), self-efficacy (Multiple Sclerosis Self-Efficacy- MSSE), MS impact (Modified Fatigue Impact Scale-MFIS) and social participation (Impact on Participation and Autonomy-IPA) in MS patients who are prescribed with injectable First-Generation Disease Modifying Therapies (FDMT). Fifty participants suffering from MS-related fatigue were recruited and twenty-five completed the FMI during 8 sessions, 1 hour/week, conducted by a psychologist in an individual-format protocol, a modified version of the Packer’s course (1995), the only standardized and published programme to date. 25 patients integrated the control group (allocated to current practice, also taking FDMT). Self-report measures and neuropsychological assessments were used to access fatigue before and after the experimental period and to compare with the control group. After the participation on MFI, participants reported a statistically significant decrease (MD=-3.1) in fatigue and MS impact, improved self-efficacy and quality of life. Moreover, they reported lower overall fatigue when compared to the control group. There was no improvement in social participation. All behavioural strategies were used by 55% of the participants and 72% were rated as effective. Despite the sample size, our findings highlight that this FMI can be a beneficial non-pharmacological intervention for MS participants and show that they implemented new energy conservation principles and also perceived them as effective.
Ann Marie Gillie works as an Education Assistant for Parkland County School Division in Alberta, Canada, where her role is working primarily with students who suffer from ADHD/ADD/ ODD and other behavioral disorders. She was asked in 2012 to be a Canadian Advocate for Epilepsy and with her passion and drive for motivating others; she has taken the role to speak internationally. She is also a Published Author (If Walls Could Talk and Let's Talk about Epilepsy) and has had several articles published in regards to her personal experience with Epilepsy and Surgery. Her topics of discussion at conferences and seminars are: Left Selective Amygdalhippocampectomy, Women and Epilepsy, Sex & Seizures. She is passionate about helping those that struggle with the disorder and her goal is to help others internationally, both professionals in the field and those living with the disorder.
Being diagnosed with epilepsy at the age of two and half years definitely created several obstacles for myself and my family, but being stubborn as well as positive individual that I am, I was able to get through it. I actually beat Epilepsy. On December 03, 2002 my life was changed forever when I underwent neurosurgery at University of Alberta Hospital in Edmonton, Alberta, Canada. My surgery was called Left Selective Amygdalohippocampectomy and the procedure was a 100% success. I had six grand mal seizures two days before my surgery and never imagined that those would be my last. I have been off all medications now for over 11 years and that too is an amazing accomplishment and feeling. My history with Epilepsy was like a roller coaster, on meds, off meds, side effects, seizures, no seizures; it was a never ending series of hurtles, but I stayed focused and survived it. I was never in special need classes, I played sports and told that I have an infectious personality, so I am regularly told. Since my surgery in 2002, I have accomplished some amazing tasks and ones I thought would never have been possible. I have published two books have had several articles published in papers and magazines, as well as international medical sites like SNI (Surgical Neurology International) and CURE. My number one goal is to educate others around the world, but not from a professional side of things but from someone that has lived it and that understands the obstacles others go through that live with Epilepsy. From my understanding, there are not a lot of individuals that speak on the topic of Epilepsy, locally or internationally and I want to change that. I have been a people’s person for my whole life and I feel that there was a reason I am here today speaking about my story. Epilepsy needs to be talked about and I am the one to do that. I want to be that Voice for Epilepsy.
Time : 12:20-12:50
Selma Pelaez has completed her Msc in Neurorehabilitation from the University of Nottingham, UK. She is working in a unit where patients are mainly affected by dementia, Alzheimer and ictus. Additionally, she is one of the members of a project called “Theraschool” in which therapy for children is performed at the school. Her main aims are to explore the areas and environments, in which a neurophysiotherapist can work, and to nourish her knowledge in different settings and to be involved in research in Neurorehabilitation.
Parkinson is a disease characterized by four cardinal signs: Bradykinesia, rigidity, tremor and postural instability. The traditional treatment was based on gait re-education due to the slow movement pattern and short steps that increases the risk of falling and this fact leads to work the balance and compensatory strategies to prevent it. Commonly, referral to physiotherapy is done once the disease has progressed enough to lead the patient to fall. Nevertheless, innovations in physiotherapy are among others related to the new evidence-based PD warrior developed by Melissa MacConaghy for stages I/II in Parkinson’s disease (PD). The core principles of this recent physiotherapy treatment define how the exercises to-do have to be tailored; thus, the main characteristics are amplitude/ power, fun, specific, high effort, frequency and meaningfulness. Amplitude works as an effective element to reduce bradykinesia and also drives patients to perform activities symmetrically. Another intrinsic element of the different exercises is the required high effort throughout the session. The physiotherapist has the responsibility to encourage patients to get the maximum energy in each exercise because this fact alters cortical hyper-excitability what may help to push the disease back. The frequency of attending the sessions enhances the skill acquisition and improves the cognitive state of the patient as well as making the exercises fun, dynamic and attractive motivates the patients to perform and follow-up the treatment. Finally, meaningful activities empower the linkage of the patients to the treatment because they would see improvements in functional tasks of their daily life; thus, a relevant goal setting is crucial in the design of the session along with increasing the complexity of the tasks with the objective of driving neuroplasticity, assisting with retention, skill acquisition and other characteristics. Therefore, physiotherapy can contribute to diminish or hopefully, stop the progression of this disease by fighting against the symptoms of PD through an exercise program, education of the patients, behavior change towards the disease and peer support. Similarly, LSVT BIG and John Argue Method are recent techniques which can be taken into account because they may share common aims in PD’s therapy
- Young researcher forum
Padang State University, Indonesia
Title: Neuroprotective effect of catechins gambier on beta amyloid plasma and cognitive in Dawley-Sprague as model of Alzheimer
Time : 13:30-13:50
Objectives: Alzeimer’s disease (AD) is an important social and economic issue for our societies. Patient with AD progress from stage of mild memory impairment to complete dementia. The development of therapeutics against this severe dementia requires assessing the effects of new drugs in animal model. An increasing body of evidence implicates both brain inflammation and oxidative stress in pathogenesis of AD. A variety of studies have demonstrated that herbal extract and active compound of Uncaria are effective on the in vitro and in vivo neurodegenerative models. Cathecin from Uncaria gambier Indonesian traditional herbs have been found to possess anti inflamatory and antioxidative effect. There was no report about neuro protective effect of cathechins gambier in Dawley-Sprague as model of Alzheimer. In the present study, we investigated the neuroprotective effect of cathechin gambier on beta amyloid-42 plasma (Aβ-42) and cognitive function of the Dawley-Sprague as animal model for Alzheimer's.
Methods: Five groups of each 7 female, 12 weeks, Dawley Sprague, based on negative control, positive control, catechins dose 1, 2, 3. Four groups with ovarectomy and D-galactose 500 mg/weight for 4 weeks. Four animals of each group underwent necropsy to collect the blood for blood evaluation on the second weeks after treatment of cathechins. Terminal sacrified all groups in the 4th week after the treatment.
Results: Rats treated Alzheimer showed shift to the light arms and spent long time compared with controls. It shows that the Alzheimer's rat did not fear or panic, which is one of the characteristics amygdala damage. Since the amygdala also affect hypocampus memory’s performance.They showed decreased the ability of spatial memory from the 2nd week of giving D-galactose and ovarectomy, but then they showed visible improvement of spatial memory in the 4th weeks. Trends of increasing in movement of group treated with high cathechins dose showed an improvement of locomotion. At the end of study, cathechins reduced the level of soluble beta amyloid 42 plasma. Low level of Aβ is required to set up and maintain the plasticity of sinaps and to improve cognitive function.
Conclusions: The result of the present study supports the concept of neuroprotective effect of cathechin gambier on beta amyloid plasma and cognitive function.
China Medical University, Taiwan
Time : 13:50-14:10
Vivian Hsu is currently obtaining her Master’s Degree at China Medical University. She opts to apply for Doctorate studies in the future. She is a student of Professor Chia-Hung Hsieh who has published more than 10 research papers in notable journals. He is currently researching on therapeutics for cocaine addictions with a plan to go into clinical trials.
The cystine-glutamate antiporter or system xc- is a membrane-bound Na+-independent amino acid transporter which exchanges intracellular glutamate for extracellular cysteine. Previous studies have shown that activation of system xc- by its activator N-acetylcysteine (NAC) inhibits reinstated cocaine or nicotine seeking behaviors. In addition, the expression of system xc- subunit xCT in brain was up-regulated in cocaine dependence mice, but down-regulated in cocaine withdrawal mice, suggesting a dynamic change in xCT expression and its activity during addiction. Unfortunately, system xc- is not the only target for NAC and all pharmacological inhibitors commonly used to study system xc- activity have off-target effects. These issues raise the uncertain role of system xc- in addiction. In this study, we tested xCT knockout (xCT-/-) mice for dependence-induced drinking using the chronic intermittent cocaine-two bottle choice drinking protocol. There was significant inhibition in daily cocaine consumption in xCT-/- mice during free-choice drinking as compared to wild type (WT) mice, indicating genetic deficiency of system xc- blocked cocaine dependence. Moreover, sulfasalazine (SAS), the US Food and Drug Administration (FDA) that ㄓblocks system xc-, significantly attenuated the daily cocaine consumption during free-choice drinking in cocaine-dependence mice as compared to control vehicle (DMSO). Taken together, these findings show blockage of system xc- improves cocaine addiction in cocaine dependence-mice. Inhibition of system xc- represents a new class of therapeutics against cocaine addiction.
University of Roehampton, UK
Title: Novel Psychoactive Substance (NPS): Effects of the 5-IT and D2PM on the Dopamine System and 5-HTA, 5-HTC receptors site
Time : 14:10-14:30
Zia Uddin Ahmed recently graduated from the University of Roehampton with a merit in MSc Clinical Neuroscience. Zia is working as a private tutor at a weekend education service since 2012, tutoring Key stages 3, 4, Btec and A-level pupils. He is currently looking for Research Assistant position. His ambition to become a neuroscientist as he believes neuroscientist is a noble profession, and not one to be taken lightly.
The use of Novel Psychoactive Substances (NPS) has grown rapidly in recent years. NPS, formerly known as “legal highs” are man-made substances which are used like the illegal drugs. 5-(2-Aminopropyl)indole is an indole and phenethylamine derivative with empathogenic effects. Diphenylprolinol (D2PM) is another novel stimulant psychoactive drug, which is an inhibitor of norepinephrine-dopamine reuptake. Their effects can be powerful and they have long lasting psychostimulant properties. The aim of study was to investigate the potential addictive and hallucinogenic properties of two novel psychoactive substances 5-IT and D2PM, through testing their effects at the dopamine transporter (DAT) and on serotine 5HTA and 5HTC receptors site in rat brain in vitro. Cocaine was used as reference substance in considering DAT effects. It was hypothesised that 5-IT, D2PM and cocaine would compete with [125I] RTI-121 at DAT in a concentrations-dependent manner and with [125I]-DOI at 5-HTA, C systems which may trigger its effect of putative stimulant and hallucinogenic. Quantitative Autoradiography was employed and results revealed that there are concentration-dependent effects of 5-IT, D2PM and Cocaine on the intensity of iodine-125 signal in brain tissue while competed with [125I] RTI121. Whereas both 5-IT and D2PM showed that no significant effects at 5-HTA and 5-HTC receptors while competed with [125I] DOI. The present study established that 5-IT and D2PM are both more effective and potent than cocaine in stimulating dopamine release. These data suggests that 5-IT and D2PM are dopaminergic rather than serotonergic. Therefore, 5-IT and D2PM may pose significant adverse effects in human users.