Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 21st World Congress on Neurology and Therapeutics London, UK.

Day 1 :

Conference Series Neurology 2018 International Conference Keynote Speaker Harish C Pant photo
Biography:

Harish C Pant received his MA and PhD degrees in Physics from Agra University, Agra, India. His Postdoctoral studies were conducted on the mechanisms of electron and ion transport in model membrane systems at the Department of Biophysics at Michigan State University. He joined the Laboratory of Neurobiology in the NIMH as a Senior Staff Fellow in 1974 with Dr. Ichiji Tasaki where he studied the function of the axonal cytoskeleton in the squid giant axon. In 1979 he moved to the NIAAA extending his studies on the neuronal cytoskeleton and the effects of alcohol on its regulation. He moved to the NINDS, Laboratory of Neurochemistry in 1987 where he is presently Chief of the section on Cytoskeleton Regulation. 

 

Abstract:

Cdk5 is a proline directed serine/threonine kinase that is increasingly implicated in various nervous system functions, during nervous system development and survival. However, upon deregulation produces many neurodegenerative diseases including PD. Cdk5 is a member of cyclin-dependent kinases. Cdk5 is unique among its family; it is not activated by cyclins but is regulated exclusively by the brain-specific activator p35/p39. Cdk5 is a multifunctional kinase. Emerging evidence suggests that abnormal and hyper Cdk5 activity is implicated in the accumulation of neurofibrillary tangles in AD, synuclein in Lewy bodies in PD, and in inclusions of aberrant phosphorylation of tau and neurofilament proteins the hallmarks of ALS patients. Our recent studies have shown that a modified truncated 24-aa peptide (TFP5/TP5), derived from the Cdk5 activator p35, penetrates the blood-brain barrier after i.p. injections, inhibits abnormal Cdk5 hyperactivity, and significantly rescues AD pathology (up to 70–80%) in 5XFAD and P25Tg AD model mice. In this study, the mutant mice were injected with TFP5 and exhibited behavioral rescue, no toxic side effects, decreased inflammation, amyloid plaques, NFTs, cell death, and extended life by two months has been demonstrated. Neuroprotective and restorative role of TP5/TFP5 has also been demonstrated in other PD model cellular and animal system; human neuroblastoma (SHSY5Y) cell death, c-elegance and amphetamine induced rotational behavior in 5-OHDA rats. These results point out that TFP5/TP5 as a potential therapeutic, toxicity-free neuroprotective drug candidate. These and other studies presented demonstrate TP5/TFP5 exhibit a critical role in mitochondrial function, autophagy induction and neuronal loss in MPTP and other neurotoxic reagents-mediated neuronal toxicity, mitochondrial dysfunction well characterized animal models of PD

Keynote Forum

Vahe Poghosyan

King Fahad Medical City, Saudi Arabia

Keynote: Magnetoencephalography (MEG): A noninvasive alternative to invasive procedures

Time : 09:40-10:20

Conference Series Neurology 2018 International Conference Keynote Speaker Vahe Poghosyan photo
Biography:

Vahe Poghosyan received his MSc in Mathematics (1997) from Yerevan State University and PhD in Neurophysiology (2000) from National Academy of Sciences of Armenia. He held positions of Research Scientist in RIKEN Brain Science Institute in Japan (2000-2007), and Senior Scientist (2007-2016) and Director of Research Training Program (2011-2016) at AAI Scientific Cultural Services Ltd. in Cyprus. Currently, Dr. Poghosyan is the Head of MEG Laboratory and Consultant of Neuronavigation at King Fahad Medical City in Riyadh, KSA. He has published more than 20 research papers in the high-impact journals in the field of Neuroscience

Abstract:

Invasive electrophysiological recordings and other invasive diagnostic procedures are routinely used in patients undergoing neurosurgeries, both intra- and extra-operatively. Invariably, these invasive approaches are associated with higher morbidity and their use should be minimized. While in certain cases invasive procedures are indispensable, the evidence suggests that in other cases, they may be substituted by non-invasive recordings. In this work, I will demonstrate that magnetoencephalography (MEG) can be used as a viable alternative and significant addition to a number of widely used invasive procedures. More specifically, it can be used to accurately localize the epileptic foci, potentially replacing intracranial electroencephalography (iEEG) in certain well-defined cases and significantly enhancing the clinic yield of iEEG in nearly all cases. MEG can be used to determine the hemispheric dominance for language, fully replacing the widely popular, but invasive Wada procedure. It can be used to effectively map the eloquent cortex of receptive and expressive language functions, visual, auditory and somatosensory functions, motor functions and central sulcus, potentially avoiding the need for invasive mapping of these brain areas.

MEG is the newest and most advanced method of functional neuroimaging and neurophysiology, which provides both high spatial (of the order of few millimeters) and excellent temporal (sub-milliseconds) resolution. MEG is non-invasive, painless and safe for all ages, with no injections, radioactivity or strong magnetic fields.

Keynote Forum

Wai Kwong Tang

The Chinese University of Hong Kong, Hong Kong

Keynote: Structural and functional MRI correlates of poststroke depression

Time : 10:20-11:00

Conference Series Neurology 2018 International Conference Keynote Speaker Wai Kwong Tang photo
Biography:

Wai Kwong Tang was appointed as Professor in the Department of Psychiatry, Chinese University of Hong Kong in 2011. His main research area includes Addictions and Neuropsychiatry in Stroke. He 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, including Health and Medical Research Fund, reference number: 02130726. Health and Medical Research Fund, reference number: 01120376 and National Natural Science Foundation of China, reference number: 81371460. General Research Fund, reference number: 474513. General Research Fund, reference number: 473712. He has served in 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:

Many stroke survivors suffer from depression. Poststroke depression (PSD) adversely effect on the recovery and rehabilitation of stroke survivors. The frequency of PSD remained high in both acute and chronic stroke patients. Possible structural correlates of PSD include cerebral microbleeds, lacunar infarcts, and white matter changes. Functional changes in several brain networks, such as the default mode network and the affective network have been reported in PSD. Latest findings on the link between structural and functional brain changes and PSD will be discussed. 

Break: Networking and Refreshments Break 11:00-11:[email protected] Breakout Area
  • Neurological Disorders, Neuroimaging and Radiology, Neurotherapeutics, Diagnostics and Case Studies
Location: Armstrong
Speaker

Chair

Hardeep Sahota

Chelsea and Westminster NHS Foundation Trust, UK

Speaker

Co-Chair

Peggy Fooks

Chelsea and Westminster NHS Foundation Trust, UK

Speaker
Biography:

Hardeep Sahota is a NHS Doctor in the UK currently working at Chelsea and Westminster NHS Foundation Trust. His long-term ambition is to follow a path in neurosurgery. He is also a fully qualified Pharmacist in Great Britain. He completed his medical degree at Bristol Medical School.

Peggy Fooks is a NHS Doctor in the UK currently working at Chelsea and Westminster NHS Foundation Trust. She graduated from Oxford Medical School. She has passion for singing and has travelled the world with her choral music. She also enjoys long distance running.

 

Abstract:

A 19-year-old year university student was brought to the Emergency Department by his mother. He had been non-specifically unwell for about nine days, but his peers had called his parents when he began to become confused, disoriented and drowsy. On admission, he was complaining of headache and photophobia; his family had noticed right eyelid drooping. He had Glasgow Coma Scale/Score (GCS) 13 to 14 and generally weak, but no focal neurology on examination. He was febrile-spiking 38.8℃. An urgent CT head scan was performed, followed up with an MRI, which together showed marked oedema in the right temporal lobe and, to a lesser degree, in the medial right frontal lobe. Significantly, 7 mm of midline shift and effacement of the ventricles was noted. He was commenced immediately on IV aciclovir treating for likely HSV encephalitis with empirical ceftriaxone cover. Although the diagnosis was uncertain, a lumbar puncture was not performed as his imaging showed raised intracranial pressure. His case was discussed with Neurosurgical Registrar at our tertiary referral center, and the local Neurology Consultant. Neither of them felt that an immediate transfer to a neurosurgical unit was necessary given his GCS was relatively stable and he had been commenced on treatment for the most likely diagnosis. He was reviewed by ITU on site who did not find an indication to admit him to HDU while he remained stable. After 48 hours of antimicrobials and supportive therapy, his GCS deteriorated fluctuating between 8 and 13. There was still no focal neurology observed. A repeat CT showed new hypodense regions in the left hemisphere and increased midline shift at 12 mm. the condition was discussed with neurosurgeon who recommended urgent decompression surgery. They asked that the patient be intubated immediately and transferred as urgently as possible to the theatre for decompressive craniotomy. Audiences will gain knowledge on the following topics after the presentation: herpes simplex encephalitis is associated with 70% mortality if untreated; delay in treatment leads to higher morbidity and mortality; clinicians should aim for MRI to correlate images with the clinical presentation; aciclovir must be started immediately and only stopped once lumbar puncture definitely rules out diagnosis which can take up to ten days from having the initial investigation; and a combination gold standard for diagnosis are MRI, CSF, PCR for viral DNA.

Speaker
Biography:

Caroline Attwell graduated with a Master’s in Physiotherapy in 2004 from de University of Buenos Aires, Argentina. She started her career in a high-performance athletic training facility then left for the United States and Europe where she worked and did research for a polo organization. Since 2008, she has been in the acute neurorehabilitation team at the CHUV (University Hospital of Lausanne) as Physiotherapist and Researcher. She occasionally lectures for the HESAV (University of Applied Sciences and Arts, Western Switzerland). Her domains of preference are the new developments in neurorehabilitation, acute neurorehabilitation, new technologies and respiratory care for acute neurological patients

Abstract:

Introduction: The use of natural environments to promote health and prevent illness is widely recognized. However, in the case of individuals experiencing disorders of consciousness (DOC), little is understood about the use of contact with nature in treatment and rehabilitation. The aim of this study is to investigate the effects of outdoor therapy in relation to the awareness and wakefulness levels of this population.

Patients & Methods: This study is a non-randomized cross-over pilot trial. It is set within the Acute Neuro-Rehabilitation Unit (University Hospital, Lausanne). Twenty adults diagnosed with DOC were included in the study. They participated in an indoor-outdoor neurosensory interdisciplinary therapy program. As the primary outcome awareness and wakefulness were measured by an adapted behavioral grid. Functioning and disability were recorded as secondary outcomes.

Results: The difference in scores between indoor and outdoor therapy was computed. Preliminary results show a solid positive trend in favor of the outdoor therapy. We can clearly detect the improvement of several points such as, visual fixation, exploration, intentional movements and communication. It is noteworthy that these clinical items are involved in in the determination of DOC diagnosis.

Conclusion: Outdoor therapy may provide a beneficial complementary treatment option for DOC. The promising preliminary results of the study show the need to develop further interdisciplinary research in this field.

Speaker
Biography:

Tania Alexandra Couto is a Portuguese neuroscience researcher currently based in Macau, SAR, China. Her work is developed in the neuroimaging department in Faculty of Health Sciences at the University of Macau. The research aims are focused on neuroimaging fusion projects, integrating NIRS-ERP simultaneous measurements, applied to neuropsychiatric disorders. She has participated in different conferences, symposiums and Congress as speaker on a subject of Neurofeedback; haemodynamic approach with NIRS tool; NIRS-ERP studies: multimodal approach applied to neuropsychiatric disorders. She combines clinic experience in neurofeedback -EEG, cognitive rehabilitation and clinic psychology in several hospitals and Portuguese clinics between 2009-2016 and also, a valuable internship in Stroke Unit in King´s Hospital College (London), where she had the opportunity to develop her clinical practice with stroke acute patients, her major area of interest in cognitive rehabilitation. In parallel, the neurofeedback /EEG-Q clinic experience allowed to develop a deep interest in neuro creativity applied to the neuropsychiatric and healthy population.  As PhD student, she has been worked on the neurofeedback application in a multimodal approach (NIRS-ERP studies), focused on working memory and visual creativity.

Abstract:

The present study investigated the neural correlates of prefrontal dysfunction in food addiction disorder activated by a n-back task in undergraduate and graduate students. We used a neuro-vascular coupling measure captured by near-infrared spectroscopy recordings with n-back paradigm in 2-back and 3-back conditions. We found that middle frontal gyrus (dorsolateral PFC – BA46) and frontopolar (orbitofrontal cortex BA 10) areas were activated, highlighting significant differences in three channels. Furthermore, to support the main hypothesis, in the behavioral performance students with low results in food addiction scale (less than three symptoms) were related with health conditions activated by n-back task, specifically the 2-back health condition. These results suggest that undergraduate and graduate students are sensitive to highly palatable food and the activation of BA 46 and BA 10 may correlate with unhealthy food pattern, which highlight the possibility of biomarker for food addiction disorder related to the dysfunction of working memory in PFC captured by nirs recordings. Even that the record of junk items has been presented higher activations during a 3-back task, junk conditions are not always related with inefficient emotional regulation underlying the binge eating events referred to in the YSAS and traditionally expected by the literature. This evidence could reflect that other patterns of eating behaviour and strategies of emotional regulation related should be more explored and redefined among students populations exposed to risky eating behaviors

Break: Lunch Break 12:50-13:50 @ RBG
  • Symposium
Location: Armstrong

Session Introduction

Amal Kalu

King Fahad Medical City, Saudi Arabia

Title: Electrodiagnosis of peripheral nerves
Speaker
Biography:

Abstract:

Electro diagnostic (EDX) studies play an essential role in the evaluation and disorders localization of the peripheral nervous system such as disorders of the primary motor neurons (anterior horn cells), primary sensory neurons (dorsal root ganglia), nerve roots, brachial and lumbosacral plexuses, peripheral nerves, neuromuscular junctions, and muscles. These studies include variety of tests such as nerve conduction studies (NCSs), repetitive nerve stimulation, late responses, blink reflexes, and needle electromyography (EMG). It is an extension of the clinical history and examination. Therefore, a directed history and examination prior to the study is important and it helps to formulate a study based on the differential diagnosis. Nerve conduction studies are tests of the peripheral sensory and motor nerves assess pre and post ganglionic lesions, identify lesions of the plexus or the relevant peripheral nerves. EMG helps further to localize the lesion by assessing the presence of active denervation in the muscles supplied by the affected nerve, the presence of re-enervating potentials, it also analyzes whether the underlying process is neuropathic or myopathic in origin as well as helps in predicting the prognosis. Patients with suspected neuromuscular junction disorders undergo repetitive nerve stimulation to assess for abnormalities in neuromuscular transmission and identify the presence of pre or post synaptic defect. A specific test for the single muscle fiber (single fiber EMG) assesses the presence of jitter. The use of the various EDX studies summarized

Sajjad Ali

King Fahad Medical City, Saudi Arabia

Title: EEG in pre-surgical evaluation of epilepsy surgery
Speaker
Biography:

Sajjad Ali completed his training in Clinical Neurophysiology from the West Midlands Denary, UK in 2009 and then worked as a Physician Consultant at the Queen Elizabeth Hospital Birmingham (QEHB), where he gained experience in the clinical and electrodiagnostic evaluation of peripheral nerve disorders and developed his special interest in single-fiber electromyography, under the mentorship of Prof. Erik Stalberg (Uppsala, Sweden). Currently, Dr. Ali works in one of the largest healthcare organization in KSA, at the National Neurosciences Institute, King Fahad Medical City, Riyadh. Other research and special interests include EMG-guided Botox injections for spasticity, neuro-intraoperative monitoring and sleep studies.

Abstract:

Scalp Electroencephalogram (EEG) recording is first step in the evaluation of patients being considered for Epilepsy Surgery. Most of these patients have undergone more than one EEG recording and due to intractable seizures are being considered for epilepsy surgery. The yield of a routine first EEG record is usually 40-50% which however, after the third to fourth EEG increases to up to 80%. Overall, standard EEG with 10–20 system provides limited coverage of the temporal regions detecting only about 58% of temporal spikes or interictal epileptiform discharges (IEDs) in temporal lobe epilepsy (TLE). Additional electrodes help in increasing this yield including zygomatic, mandibular notch, nasopharyngeal (NP), sphenoidal (SP), and foramen ovale (FO) electrodes also help similarly. Preoperative interictal EEG abnormalities commonly observed in TLE are focal arrhythmic slowing (either theta or delta) and focal IEDs that are often restricted to the anterior temporal areas. In majority, these abnormalities correlate well with seizure onset zone and the structural abnormalities seen on magnetic resonance imaging (MRI). In TLE, single or serial outpatient EEGs demonstrate strong correlation of interictal abnormalities with areas of surgical resection and postoperative seizure outcomes (90% for IEDs and 82% for focal slowing). Such strong correlations may obviate the need for mandatory ictal recordings during presurgical workup in patients with unilateral hippocampal atrophy (HA) and congruent clinical and neuropsychological data, However, ictal recording becomes essential to rule out the possibility of concurrent psychogenic nonepileptic seizures (PNESs). Moreover, bilateral TLE, coexisting extratemporal epilepsy, or generalized epilepsy. A number of illustrative cases will be reviewed.

Vahe Poghosyan

King Fahad Medical City, Saudi Arabia

Title: Magnetoencephalography (MEG) in epilepsy surgery
Speaker
Biography:

Vahe Poghosyan received his MSc in Mathematics (1997) from Yerevan State University and PhD in Neurophysiology (2000) from National Academy of Sciences of Armenia. He held positions of Research Scientist in RIKEN Brain Science Institute in Japan (2000-2007), and Senior Scientist (2007-2016) and Director of Research Training Program (2011-2016) at AAI Scientific Cultural Services Ltd. in Cyprus. Currently, he is the Head of MEG Laboratory and Consultant of Neuronavigation at King Fahad Medical City in Riyadh, KSA. He has published more than 20 research papers in the high-impact journals in the field of Neuroscience

Abstract:

Magnetoencephalography (MEG) is a state-of-the-art functional neuroimaging and neurophysiology technique, whose primary clinical application is in the diagnostic evaluation of patients with epilepsy. MEG’s value in epilepsy and in functional neuroimaging in general, stems from its high spatiotemporal accuracy and resolution: MEG is the only currently available non-invasive technique to offer both, high spatial (of the order of few millimeters) and excellent temporal (sub-milliseconds) resolution. Numerous studies have shown the clinical usefulness and added value of MEG in epilepsy. In a prospective blinded study (considered class 1 evidence by American Academy of Neurology), MEG yielded non-redundant information in 33% of patients, where it suggested to cover additional areas in 13% of patients and modifications of the surgical decision in 20% of patients. This information would not have been available from other techniques, although patients underwent video/EEG, imaging, and PET and SPECT when indicated. In general, recent incorporation of MEG in the clinical practice has been a valuable advancement in the field. MEG’s role in the pre-surgical evaluation of patients with epilepsy is threefold. First, it is used to localize the epileptic foci, estimating the epileptogenic zone. Second, MEG is used to determine the language-dominant hemisphere. Third, it is used to map the eloquent cortex of language, motor and sensory (visual, auditory and somatosensory) functions

Speaker
Biography:

Elamir H Elsherif is a Neurophysiologist Physician. He has completed his Medical degree in 2002 at Ain Shams University in Cairo. He had his training in Neurophysiology in Kings County and Downstate Hospitals in Brooklyn New York. In 2008, he completed the American Board of Neurophysiologic Monitoring in Chicago. Currently, he is working as a Consultant of Intra-operative Neuromonitoring and the Director of Neurosonology Lab at King Fahd Medical City. He is interested in Cortical Mapping, Neuromodulation and Brain Computer Interfaces.

Abstract:

Electrocorticography (ECoG) is the direct recording of electrical potentials associated with brain activity from the cerebral cortex, ECoG is comprehensive to reading electrical activity whether its spontaneous similar to Electroencephalogram (EEG) or evoked as in case of central sulcus mapping technique. The grid electrodes used for recording can be used as stimulators as well; this invasive stimulation and recording from the human brain can provide unique opportunities to study fundamental processes at fine temporal and spatial resolution. ECoG vs. EEG; while ECoG is useful in temporal and spatial localization, EEG is useful to look for diffusion of the seizure, either in the same or the contralateral hemisphere. The circumstances during which ECoG is employed vary among hospitals, at some institutions, recordings are made during all epilepsy surgeries, and the intraoperative findings are used to tailor the surgical resection to each patient. At other centers, ECoG is used selectively (e.g. only in extratemporal procedures). On the other hand, it may be performed universally for research purposes but the findings then are not used in determining the volume of brain tissue to be resected. EEG and ECoG recordings are important during the entire duration of the procedure because they allow monitoring for the occurrence of after-discharges, electrical seizures, and even clinical seizures. The occurrence of after-discharges is quite common during these procedures, and the main objective of monitoring is to recognize those that occur in response to stimulation. Technical limitations of recording and keeping the electrode in place during the surgery should be considered. Controversy also exists concerning the use of ECoG to guide the extent of resection of adjacent or distant seizure foci associated with brain tumors.

 

Break: Networking and Refreshments Break 15:50-16:10 @ Breakout Area
Speaker
Biography:

Lahbib Soualmi is an expert in Image Guided Neurosurgical Navigation. He has been, from 1998 until 2008, Director of Neuronavigation Unit, in Montreal Neurological Institute and Hospital, McGill University Health Center (MUHC) and Assistant Professor in the department of Neurology and Neurosurgery, McGill University, Montreal, Canada. He holds an MS and a PhD in Biomedical Engineering from Ecole Polytechnique of Montreal. In 2008, he relocated to the National Neuroscience Institute at King Fahad Medical City in Riyadh, Saudi Arabia, where he is currently, Consultant of Image Guided Neurosurgical Navigation and the Head of Neuronavigation Unit and Intraoperative Surgical Imaging. Furthermore, he has been a Consultant Faculty in the Biomedical Technology Department, King Saud University, Riyadh, Saudi Arabia from 2008 to 2013

Abstract:

Introduction: Recent decades have shown substantial progresses in the development of adjunctive tools in epilepsy surgery, specifically, image-based neuronavigation and electrophysiological neuromonitoring. For many patients, surgery for intractable epilepsy provides freedom or significant relief from seizures, offering functional improvement that ameliorates their quality of life. The aim of this paper is to show how neuronavigation helps to improve the precision and safety of epilepsy surgery.

Methods: Despite the availability of noninvasive structural and functional neuroimaging techniques, invasive monitoring with depth electrodes, strips and grids is still often indicated in the management of intractable epilepsy. Neuronavigation is used as a common platform to merge complementary information obtained from the correlation of anatomic and structural details with functional information. During surgery, neuronavigation is a valuable tool in planning the best trajectory for inserting recording electrodes in the brain. Also, it will enhance the precision and accuracy of the surgery during the removal of the epileptogenic area without damaging any vital structures. Precise identification of the epileptogenic area in medically refractory epilepsy is of vital importance. The main benefits of neuronavigation in epilepsy surgery is the effective precision of targeting even in small and deeply seated lesions, safe manipulation in critical brain areas, accurate placement of electrodes, and correlation of electro-clinical information modalities with underlying structures. Furthermore, navigation provides individual tailoring of the craniotomy and reaches the target in the planned trajectory. Additionally, minimally invasive procedures are performed rather than traditional surgeries, which require more invasive craniotomies. The whole procedure is achieved, through a small incision, to remove the seizure-producing regions deep within the brain.

Conclusion: The neuronavigation concept proved its value in epilepsy surgery by linking anatomic and functional data of a specific patient. Enhanced by the integration of multimodal information, neuronavigation significantly improved the available treatment options. Neuronavigational imaging data combined with functional investigations can greatly help discussion within the multidisciplinary epilepsy surgery team helping in the shared decision making process. Finally, during surgery, an intraoperative acquisition can be acquired to refresh the navigation data. These intraoperative acquisitions allow the assessment of surgical results within the operating room while the patient still on the surgical table and before closing the craniotomy.

Majed H Al-Hameed

King Fahad Medical City, Saudi Arabia

Title: Applied and integrated science of epilepsy
Speaker
Biography:

Abstract:

The neurodiagnostic tools employed in the epilepsy work-up, diagnosis and management have come a long way – from the basic scalp EEG to the multitude of advanced neurophysiology and neuroimaging techniques available today. In this presentation, I will describe the series of steps and tests that are used to evaluate the patients with epilepsy, and will link these to our advances in the understanding of epilepsy from basic research, and animal and human models. The presentation will cover neurodiagnostic tools of EEG, quantitative EEG, neurometabolic imaging techniques and their clinical utility in the modern medicine.