Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 32nd European Neurology Congress London, UK.

Day 2 :

Keynote Forum

Inderjit Singh

Medical University of South Carolina, USA

Keynote: Targeting stroke by S-nitrosylation mechanisms: Preclinical studies

Time : 09:40-10:20

Conference Series Neurology Congress 2019 International Conference Keynote Speaker Inderjit Singh photo

Inderjit Singh is a University Professor at the Medical University of South Carolina, USA. He is investigating the mechanisms of stroke and other neuroinflammatory diseases including vascular dementia associated with Alzheimer’s disease. Over the years, he has authored more than 300 high quality peer reviewed original articles and book chapters. He is continuously funded by the NIH for his studies on the disease mechanisms of neurodegeneration. Based on his credentials in neurodegenerative studies; he was awarded Jacob Javits Award for meritorious research in neurological sciences by NINDS/NIH (2002-2009). One of the goals is to evaluate a stroke drug therapy using clinically relevant stroke mouse models of cerebral ischemia and reperfusion (IR) and permanent ischemia (IS). The focus of the present study is on functional recovery and the mechanisms regulated by S-nitrosylation of HIF-1α using an effi cient S-nitrosylating agent S-nitrosglutathione (GSNO). GSNO is a natural component of the human body and its exogenous administration in human studies is not associated with adverse effects. In neuroinflammatory diseases, the levels of S-nitrosylation are decreased due to increased formation of peroxynitrite from NO and superoxide thus S-nitrosylation-mediated cellular functions are dysregulated. Presently, we are investigating neuroprotection/neuro-recovery therapy using GSNO in stroke, TBI and SCI.


Stroke is the leading cause of disability worldwide. It immediately sets into motion various neurodegenerative mechanisms including excitotoxicity and calcium dysregulation leading to infl ammatory/nitoxidative-mediated injury mechanisms. Our studies with a rat model of ischemia and reperfusion (1/R) show that an exogenous treatment with S-nitrosoglutathione (GSNO), a multi-targeting naturally-occurring compound provides neuroprotection as well as stimulates neurorepair and aids functional recovery. Stroke was induced by middle cerebral artery occlusion for 60 min followed by reperfusion followed by drug (GSNO) treatment at various time points after reperfusion. The studies show that GSNO-mediated targeting of neuronal nitric oxide synthase/peroxynitrite/calpains and inflammatory NF-KB mechanisms provides protection against neurodegeneration during acute stroke injury. Furthermore, GSNO-mediated mechanisms also stimulated neurorepair process via targeting HIF-la/VEGF/PECAM-1 as well as BDNF/CNTF signaling pathways to promote recovery of motor and neurological functions during the chronic disease of stroke. These studies document that targeting of S-nitrosylating mechanisms is potentially attractive therapy for stroke patients. In clinical settings, GSNO is of even greater relevance to stroke therapy because it additionally shows antiplatelet, anti-embolization and vasodilatory properties in humans. Based on the efficacy of GSNO in our preclinical studies using animal models of stroke and absence of toxicity in human uses, we submit that GSNO is a promising drug candidate to be evaluated for human stroke therapy and other neurodegenerative diseases treatment.

Conference Series Neurology Congress 2019 International Conference Keynote Speaker Annie Weir photo

Annie Weir is the Director of Impact Research NZ and an Honorary Academic with the School of Critical Studies in Education, Faculty of Education, University of Auckland. Dr. Weir has worked in research and evaluation in New Zealand and the UK for over 20 years and her interests include: healthcare management, quality assurance in higher education, third sector social services provision and building organisational capacity.


Background: Two case studies were undertaken to determine the eff ectiveness of a) home support and b) day programmes that were designed to support older people living with dementia to remain at home in their community. Home support programmes provide services for both the person living with dementia and their main caregivers. These services are aimed at optimising client functioning and independence as well as promoting healthy daily routines, exercise, social interaction and support for clients to undertake their own daily needs. Typically day programmes provide a range of psychosocial and physical activities aimed at maximising client independence and importantly provide respite for caregivers.
Methods: A mixed method approach was used to determine the eff ectiveness of home support programmes. The first phase included an international literature review that identified a range of positive outcomes for clients receiving restorative home support such as improved functioning and better quality of life. The second phase included 1:1 interviews, focus groups and surveys with key stakeholders to elicit their views on the elements that make up eff ective home support. For the day programme research a mixed methods approach was also employed including an international literature review, document analysis, interviews, focus group, online survey, site observations and a photovoice exercise. Participants included multiple stakeholders including service funders, those delivering the service, clients and their caregivers. Quantitative survey data from both studies was reported using descriptive statistics and inductive thematic pattern analysis was performed on the qualitative data.
Results: Ten key factors of effective home support services were identified under three broad categories: 1) Client and Caregivers 2) Community and 3) Organisational. The research revealed that eff ective day programmes comprised five core elements, including activities aimed at improved client functioning; caregiver benefits; workforce capability; cultural responsiveness; and service processes. Reporting and auditing processes as well as surveys are reportedly used as methods to measure the quality of outcomes of day programmes.
Conclusions: The findings from both studies raise issues firstly around what constitutes effective restorative home support and secondly around the effectiveness of day programmes and may inform international debate and lead to better outcomes for people living with dementia.

Conference Series Neurology Congress 2019 International Conference Keynote Speaker Ann Ali Abdelkader Hanafy photo

Ann Ali Abdelkader Hanafy has completed her MD at the age of 30 years from Cairo University and postdoctoral studies from Cairo University School of Medicine. She is a Professor of Clinical Neurophysiology and the President of Egyptian Clinical Neurophysiology Society. She has published more than 100 papers in local and international journals.


Repetitive transcranial magnetic stimulation is non-invasive brain stimulation to the motor cortex. It can alter excitability of the brain after stroke by modulating cortical activity. At low frequencies (1 HZ or less), it has an inhibitory effect, whereas at high frequencies (5-25 HZ), it is able to enhance cortical excitability. As it produces long-lasting effects which persist past the initial period of stimulation through long-term potentiating (LTP) and long-term depression (LTD) (Chen et al., 2008).
Following stroke, the brain undergoes various stages of recovery where the central nervous system can reorganize neural circuits (neuroplasticity) both spontaneously and with the aid of behavioral rehabilitation and non-invasive brain stimulation (Auriat, et al., 2015).
Motor deficits in patients after stroke are due to a reduced output from the affected hemisphere and excess transcallosal inhibition of the affected hemisphere from the unaffected hemisphere. Therefore, using rTMS, could improve motor deficits by increasing the excitability of the affected hemisphere or inhibition of the unaff ected hemisphere and so the interhemispheric inhibition, through increasing or decreasing the excitability of the neuronal circuits, which is called neuroplascity and so motor recovery after stroke (Murase et al.,2004).
Cortical plasticity can be manipulated to improve stroke outcome by numerous techniques such as task-oriented physiotherapy. Task oriented exercise is assumed to learn patients (depending on the idea that learning is the basis of neuroplasticity) by allowing them to try solving problems actively by providing them with a functional task, instead of having them repetitively practice the normal patterns of movements. It is an approach suggested to be an efficient treatment
method, it consists of tasks that encourage various functional activities and help enhance patient's ability to perform daily activities and thus helping motor recovery after stroke (Yoo and Park, 2015). For continuous motor improvement, it is important to impart additional motor training while repetitive trans cranial magnetic stimulation modulates the neural network between both hemispheres and remodels work in the affected hemisphere (Takeuchi and izumi., 2012).
Researchers have tested the efficacy of HF rTMS over the affected hemisphere and efficacy of LF-rTMS over the unaffected hemisphere for patients post stroke (Khedr et al., 2009; Emara et al., 2010; Chang et al., 2010). Takeuchi et al., (2009) and Sung et al., (2013) hypothesized the safety, feasibility and efficacy of applying bilateral rTMS; HF- and LFrTMS in patients with chronic stroke. In the present study we hypothesized that the combined application of HF-rTMS over the affected hemisphere and LF-rTMS over the unaff ected hemisphere as bilateral rTMS may facilitate motor functional recovery in patients with acute stroke. The present study was conducted on different types; ischemic, hemorrhagic and embolic stroke, different sites; supra and infratentorial stroke and associated co-morbidities; ischemic heart disease, vasculitis and atherosclerosis.
Fifty-five patients with subacute stroke (2 weeks to 6 months) were divided into four groups: bilateral, inhibitory, stimulatory and control groups. Bilateral group received five sessions of high-frequency 5Hz rTMS over the affected hemisphere alternating with low-frequency 1 Hz rTMS over the unaffected hemisphere. Inhibitory group received low frequency 1 Hz rTMS over the unaff ected hemisphere alternated by sham 5 Hz rTMS over the affected hemisphere. Stimulatory group received high frequency 5 Hz rTMS over the affected hemisphere alternated by sham 1 Hz rTMS over
the unaffected hemisphere. Control group received sham stimulatory rTMS over the affected hemisphere alternated by sham inhibitory rTMS over the unaffected. All sessions were associated with task-oriented physiotherapy from day one of treatment till one month. Assessment from before to after sessions then after one month was done by FMA and WMFT to assess the motor performance, modifi ed Ashworth scale for spasticity and MEP for cortical plasticity. All groups showed statistically significant improvement of the motor disability of the paretic upper limb post stroke assessed by FMA, WMFT and change in excitability assessed by MEP, from before to aft er sessions and after one month. When groups were compared with each other, bilateral group showed the best improvement of spasticity measured by the modified ashworth scale, while all other groups failed to change the Ashworth scale. Control group failed to show change in the MEP and stimulatory group failed to change the MEP of the healthy hemisphere and its eff ect was on the unhealthy
hemisphere only.
Conclusion: According to the finding yielded from this study, it can be concluded that five daily sessions of bilateral rTMS combined with one month of task-oriented physiotherapy, improves motor disability of the paretic upper limb after stroke. Inhibitory and stimulatory rTMS show nearly same efficacy as bilateral protocol, however bilateral stimulation is superior in spasticity. No correlation was found between improvement in motor power and stroke duration, site and extent of neurologic deficit. Presenting patients with different types, sites of stroke and associated comorbidities will help for future studying; it will open a new trend in rTMS research and help optimizing the best rTMS module for each patient according to type and site of stroke and associated comorbidities.


  • Pediatric Neurology | Central Nervous System | Neuro Cardiology & Strokes | Neuropathology Vascular Dementia and Stroke | Neuropathology | Neurogenetic and Neurometabolic Disorders | Dementia
Location: London, UK


Alper İbrahim Dai

Gaziantep University, Turkey


Kasid Ahmed Nouri

Mohammed Bin Rashid University of Medicine and Health Sciences, UAE


Alper İbrahim Dai, graduated from Istanbul University, School of Medicine. He completed his paediatric residency at Jackson Memorial Hospital, University of Miami / Florida and Children's hospital of West Virginia at Morgantown. As a fellowship he had 3 years of paediatric neurology at SUNY, Children's Hospital at Buffalo / New York. He had 1 year of EEG / Epilepsy fellowship at Vanderbilt University, Nashville / Tennessee. He has been working at Division of Pediatrics Neurology at Gaziantep University Hospital, Gaziantep / Turkey for 15 years. His major interests are, phase III clinical trial in anti-epileptic medications and phase I and II clinical trials in stem cell therapy in children with neurological problems.


Purpose: Duchenne muscular dystrophy (DMD) is an X-linked recessive paediatric disorder that ultimately leads to progressive muscle degeneration. It has been known that cell-based therapies were used to promote muscle regeneration. The main purpose of this study was to investigate the effects of allogeneic Wharton jelly-derived mesenchymal stem cells therapy in Duchene muscular dystrophy.
Patients & Methods: Four ambulatory and five non-ambulatory male patients were assessed as having acceptance criteria. Gene expression and immunohistochemical analysis were performed for dystrophin gene expression. The fluorescent in situ hybridization method was used for detection of chimerism and donor–recipient compatibility. Complement dependent lymphocytotoxic crossmatch test and detection of panel reactive antigen were performed. All patients were treated with 2 × 106 cells/kg dose of allogeneic Wharton jelly derived mesenchymal stem cells via intra-arterial and intramuscular administration. Stability was maintained in patient follow up tests, which are respiratory capacity tests, cardiac measurements and muscle strength tests.
Results: The vastus intermedius muscle was observed in one patient with MRI. Chimerism was detected by fluorescent in situ hybridization and mean gene expression was increased to 3.3-fold. An increase in muscle strength measurements and pulmonary function tests was detected. Additionally, we observed two of nine patients with positive panel reactive antigen result.
Conclusion: All our procedures are well tolerated and we have not seen any application related complications so far. Our main purpose of this study was to investigate the effects of allogeneic mesenchymal stem cell therapy and determine its suitability and safety as a form of treatment in this untreatable disorder.

Kasid Ahmed Nouri

Mohammed Bin Rashid University of Medicine and Health Sciences, UAE

Title: Varicella-zoster

Time : 12:30-13:00


Kasid Ahmed Nouri is an adjunct Clinical Assistant Professor of Neurology at Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU) College of Medicine, Dubai, UAE. He is also working as a consultant neurologist at Mediclinic City and Welcare Hospitals, Dubai, UAE.


Varicella- zoster virus (VZV) is an exclusively human neurotropic, double-stranded DNA alpha herpesvirus, primary infection causes varicella (chickenpox), with a decline in VZV-specific cell-mediated immunity in elderly and immunocompromised individuals and VZV reactivates to cause herpes zoster (shingles) with its complications. Varicella-zoster virus infections can produce multiple disorders of the central and peripheral nervous system and often without rash. The most common complication of herpes zoster is post herpetic neuralgia, pain that persists months to years after rash resolved. Herpes zoster may cause serious chronic complications, including PHN, cerebral arteritis and herpes zoster ophthalmicus. The important of early diagnosis with a rapid virology verification and early prompt treatment with antiviral agents can lead to complete recovery; even in patients with protracted disease. Herpes zoster vaccination significantly reduces the incidence of both Herpes zoster, post herpetic neuralgia and other complications. Given the limitations of existing zoster therapies, the prevention of VZV infection has gained overriding importance. VZV vaccinations can reduce both the health and economic eff ects of Herpes zoster. Although relatively costly, vaccinations not only reduce the risk of infection but may also preserve healthrelated QOL in the geriatric population. With seven cases studies presentation there will be a high light on different Varicella- zoster clinical presentations.


Wael Osman M Amer has completed his MD Al- Azhar University and Postdoctoral studies in Neuro intervention from School of Medicine, REIMS University, France. He is the Director of the stroke unit at Al-Azhar University School of Medicine. He has published more than 15 papers in reputed journals.


Objective: To investigate the relationship between silent brain infarcts and metabolic syndrome in middle aged patients with ischemic stroke.
Methods: We studied fift y middle aged patients between 40-59 years, (mean, 52.26 ± 5.29 years) with ischemic stroke who admitted to Al-Azhar University Hospitals or followed up in outpatient clinic. Metabolic syndrome was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III definition. Silent brain infarct was diagnosed using magnetic resonance imaging of the brain and without a history of corresponding neurologic symptoms or signs.
Results: Silent brain infarcts was diagnosed in 24(48%) patients (18 men and 6 women) while metabolic syndrome was diagnosed in 31(62%) patients of the 50 patients including (22 men and 9 women). There was a strong association
between metabolic syndrome and silent brain infarction in middle aged subjects with ischemic stroke. Among metabolic syndrome components elevated blood pressure and impaired fasting glucose were strongly associated
with the presence of silent lacunar infarction while hyper triglyceridemia, low high density lipoprotein cholesterol and large waist circumference were not significantly associated with silent brain infarction. Although, only elevated
blood pressure and impaired fasting glucose were found to be significant components, subjects with a greater number of metabolic syndrome components showed more prevalent silent brain infarctions.
Conclusions: Metabolic syndrome was significantly associated with the prevalence of silent brain infarction in middle aged patients with ischemic stroke. Independent risk factors for silent brain infarctions include elevated blood pressure and impaired fasting glucose. The clustering of metabolic syndrome components tends to increase the prevalence of silent brain infarctions as there is a dose response relationship between the number of metabolic syndrome components and the risk of having silent brain infarction.

Break: Lunch Break 13:30-14:30 @ RBG

Chika Okwuolisa

Brain and Spine Foundation, Africa

Title: Giving a voice to neurological disorders in Sub-Saharan Africa

Time : 14:30-15:00


Chika Okwuolisa is the Founder and Executive Director of Brain and Spine Foundation, Africa. Brain & Spine Foundation (BSFA) is an operational registered non-Governmental Organisation (NGO). It was established it following a first-hand traumatic experience during a harrowing pathological Brain event that has changed their lives forever. BSFA is founded to create awareness on the burden of Brain and Spinal conditions and all the variants there are of these in Nigeria and Africa. We also focus on ways to prevent, manage and reduce the burden of these illnesses which thrive on the general ignorance of individuals.


It’s a common knowledge that Africa has the least neurological services and African neurologists and neurosurgeons cannot match the rapid progress in the developed world. And this I write with extreme sadness. As the founder of The Brain and Spine Foundation Africa, it is no gain saying the fact I am coming from a background of diametric ramifications of health emergencies- ours is a harrowing experience and indeed, a sordid reality that no one can be proud of. Prominent among the challenges in the Nigerian health sector for example, is the escalation of various degrees of neurological emergencies. The world, especially European and American institutions/organizations  must rise to this urgency, and bring their technological edges to bear on this very challenging bracket, vis-à-vis the deployment of alleviative fiscal policies. Brain and Spine Foundation, Africa is from the grassroots; we are close to these unfortunate ones who are going through agonies everyday, never as a result of any fault of theirs. We hear their cries everyday, we see their despairs, because the cost of treatment is usually beyond their reach or there is no Neurospecialist available to attend to them. We render our helps which are usually grossly inadequate. Most importantly, we stay by their sides intentionally to be available for them, and serve as psychological reinforcements for their survival instincts. We watch them die sometimes owing to the lack of adequate facility for treatment and precarious volume of resources available to us, which often empty into paucity sooner or later. Neurological disorders as we all know are associated with high mortality, prolonged hospital stay and socioeconomic burden for the families. Unfortunately, in Sub-Saharan African countries, there’s a huge disconnect between where disease is and where experts are. We need you, most especially those of African descents to come and help us make changes to our national policies that could help our people. We need your help in working to build up the resources and networks necessary to conduct clinical trials in Africa, and to create education and training programs for health care providers and researchers. We as a Charity Organization are creating awareness, educating the public, providing support and hope, but we also work with the health care structure to ensure there are providers and treatment.


Katherine Radcliffe conducted this original research whilst incalating and studying MRes Translational Medicine at the University of Manchester. She has just graduated from Manchester Medical School and is due to start as an FY1 doctor in August. This research earned her the best poster prize within her course and she has presented posters at multiple conferences including a European Congress whilst studying.


A hexanucleotide repeat expansion in the C9orf72 gene is the most common genetic cause of frontotemporal dementia and motor neuron disease. Carriers present with both conditions concurrently, so they are considered a continuum. Th e RNA from the hexanucleotide expansion is translated by repeat associated non-ATG (RAN) translation; producing five dipeptide repeat (DPR) proteins. These are the alanine rich polyAP and polyGA, the arginine-rich polyGR and polyPR, and polyGP. Previous in vitro studies show that the arginine-rich DPRs are toxic because they localise to the nucleolus, causing nucleolar stress. However, preliminary research showed sequestration of polyGR by polyGA when they were co-expressed in HeLa cells, Drosophila and human neurons. Our aim was to determine whether alanine-rich DPR proteins sequester arginine-rich DPR proteins when the two are co-expressed in vitro. This was investigated using alternative coding sequences for the DPR proteins, cloned into mCherrytagged plasmids. Next, two DPR proteins with different fl uorescent tags were co-transfected into HeLa cells and the subcellular locations of the DPR proteins were visualised using immunofluorescence. Our results showed cytoplasmic co-localisation of the arginine-rich DPRs with polyGA. This was replicated 3 times in HeLa cells and once in SH-SY5Y cells. Co-transfection, but no colocalisation, was seen when two alanine-rich or two argininerich DPR proteins were co-expressed. Overall, our findings suggest that the arginine-rich DPRs are sequestered by polyGA in the cytoplasm, meaning they are unlikely to cause nucleolar stress. This demonstrates that single transfections of DPR proteins may not be a good model to study DPR protein function or toxicity.

Güllü Tarhan

Gaziosmanpasa Taksim Training and Research Hospital, Turkey

Title: Two homozygous KIF1C mutations in a Turkish family with cerebellar dysfunction and spastic paraparesis

Time : 15:30-16:00


Güllü Tarhan is a 26 year old and working as a Neurology resident in the Gaziosmanpasa Taksim Training and Research Hospital. She has completed Istanbul Faculty of Medicine two years ago.


KIF1C mutation is genetic defect which is observed with hereditary spastic paraparesis and cerebellar dysfuntion. In this report, we analyzed the Turkish family who had spastic paraparesis and cerebellar dysfunction with KIFC mutation. There were paraparesis, ataxia, dysarthria, tremor in brothers whom parents were second degree relatives and asymptomatic. Father and mother's ages were 65 and 62 and brothers were 44, 42, 36. Their complaints appeared
with tremor in their hands in childhood. In the following terms, the other complaints began to reveal. There were no point in family history. Patients' neurologic examination: their speech were dysarthric, biletaral dysmetria and
dysdiadokokinezi in all. Intention tremor could be seen in all brothers' heads and extremities. The patient's, who were 44 years old, spastic paraparesis is more serious than the other two and he were walking by using one crutch. The other two brothers', who are 42 and 36 years old, spastic paraparesis were less serious and they could walk without using any crutch. General medical tests such as routine biochemistries, hemograms, hormones, B12, VDRL, HIV, vitamin A and E, thyroid hormones, plasma ceruloplasmin and copper were normal. In Cranial-Spinal MR, there were remarkable cortical and cerebellar atrophie. Electrocardiographies, electromyographies and odiographies were normal. They had adequate IQ scores, which were among 80-100 scores. In whole exome sequencing two variant mutation were identified in their KIF1C genes. The parents are heterozygote and brothers are homozygote. On the basis of clinical and genetical analyzies, autosomal recessive spastic paraparesis and ataxia were considered due to mutation in KIF1C.

Break: Networking & Refreshments 16:00- 16:20 @ Foyer