Day 1 :
Keynote Forum
Dr. Sandro Iannaccone
San Raffaele hospital, Milan Italy
Keynote: New Technologies: A new era for Neurorehabilitation
Time : 10:00 AM - 10:40AM
Biography:
Dr. Sandro Iannaccone is a neurologist who received his medical training at the University of Milan (Italy) and completed his residency in Neurology in July 1986 and further specialized in Neuropathology in 1992. Since 1989, Dr. Iannaccone has been working as a contract Professor of Neurology at the Medical and Psychological Faculties of the University Vita-Salute San Raffaele of Milan. Dr. Iannaccone became Responsible of the Neurologic Unit of the San Raffaele Turro Hospital in 1999. In 2013, he became Director of the Neurorehabilitation Unit of the San Raffaele Hospital. Since 2014, Dr. Iannaccone is also the President of the Scientific Society entitled Association of Medical Rehabilitation Specialists of Private Hospitals (Associazione Medici Riabilitatori Specialisti dell’Ospedalità Privata). In a research point of view, Dr. Iannaccone is leading research and development of innovative rehabilitative strategies using new technologies based on virtual reality. He is also leading trials on new – pharmacological and non-pharmacological - therapies for Alzheimer’s disease. Dr. Iannaccone has also been involved in investigations in early detection of neurological degenerative disease biomarkers through neuropathological, proteomics and PET studies.
Abstract:
Over the last years, there has been increasing developments of new technologies to provide solutions to the limitations of standard rehabilitation (drop-outs, limited evaluation scores, or physical limitations of therapists) to enhance learning following neurological insults. To this aim, virtual reality (VR) settings provide an enriched environment able to generate augmented multisensory feedbacks (auditory, visual and proprioceptive). These settings, involving the mirror neurons system, help patients to develop a real-time "knowledge of results” and "knowledge of performance”, favoring the physiological mechanism of reinforcement learning. Such innovative strategies can be applied directly in the rehabilitation of motor, cognitive and speech functions, as well as in chronic pain treatment. Moreover, standard or virtual reality-based neurorehabilitation can be potentiated through the concomitant application of non-invasive brain stimulation, such as repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS). Indeed, the NeuroAD system offers the possibility of applying cortical stimulation during cognitive training. TDCS can also be applied on-line, during motor or cognitive rehabilitation. Moreover, as a portable device, it also brings the opportunity to the patient to be applied at home. Thus, the development of new technologies in NeuroRehabilitation is converging towards multimodal treatments offering the possibility of home-based monitoring.
Keynote Forum
Joshua K. Underwood
Vermont Academy, USA
Keynote: Effect of Positional Release Therapy in Reducing Somatic Symptoms at Secondary School Setting
Biography:
Joshua K. Underwood, ABD is the Head Athletic Trainer at Vermont Academy in Saxtons River, Vermont USA and is currently pursuing his doctorate of athletic training at the University of Idaho. He has worked in in a variety of clinical settings over the last 12 years including semi-professional football, summer collegiate baseball, adventure camps, secondary schools, and orthopedic clinics. He specializes in treating regional interdependent dysfunctions, concussions, orthopedic injuries, and fascia with a variety of treatments including Positional Release Therapy, Primal Reflex Release Technique, and Mulligan Concept. Mr. Underwood’s primary areas of research have focused on the treatment of concussions with manual therapy and the treatment of regional independent causation of pain or dysfunction.
Abstract:
Statement of the Problem: Due to the comparable somatic presentation and biomechanical nature of concussions, cervicogenic headaches (CGH), tension-type headaches (TTH), cervicogenic vertigo (CGV), and whiplash, it is conceivable that cranial and/or cervical-based dysfunctions can occur secondarily to concussions and increase somatic symptom presentation. Fascial restrictions found within cervical and cranial structures have been found to increase biotensegrital tensions along cranial nerves and vestibular systems; however, fascial release techniques like Positional Release Therapy (PRT) have been found to be an effective treatment in reducing symptoms related to CGH, TTH, CGV, and whiplash. The purpose of this study is to examine the post intervention effect of PRT in resolving somatic symptoms (i.e- headaches, vertigo, hyperacusis, and photosensitivity) associated with concussions in a secondary school setting. Methodology & Theoretical Orientation: An action research study utilizing numerical rating scale (NRS) and post-concussion symptom score (PCSS) to measure changes to headaches, vertigo, nausea, hyperacusis, and/or photosensitivity pre/post PRT interventions. Findings: The participants in this study were of an active population within a secondary school setting. Statistically significant decreases in intensity of headaches, nausea, vertigo, hyperacusis, and photosensitivity were witnessed by outcome measures between pre/post PRT interventions. Conclusion & Significance: Patients suffering from symptoms associated with concussions may additionally be affected by cervicogenic and cranial-based fascial restrictions which exacerbates headaches, nausea, vertigo, hyperacucis, and/or photosensitivity. Findings suggest concussion patients may benefit from PRT in reducing somatic symptoms during their recovery.
Keynote Forum
Arshad Zaman
The Leeds Teaching Hospitals, Leeds, UK
Keynote: Clinical fMRI: From clinic to beyond
Biography:
Dr. Arshad Zaman is an experienced neuro specialist with over 15 years’ experience in developing and clinically applying functional Magnetic Resonance Imaging (fMRI) at international centers of excellence. Previous studies encompass a spectrum of clinical applications (epilepsy, oncology) to state-of-the-art applications (e.g. pain relief, mental health, brain training). Current commitments centre around further development and clinical utilisation of fMRI.
Abstract:
Functional magnetic resonance imaging or functional MRI (fMRI) is a state-of-the-art functional neuroimaging technique that measures brain activity by detecting associated changes in blood flow.
fMRI is increasingly playing a key role in providing a deeper insight into brain function and or functional brain networks. In fact, fMRI has matured over the last two decades from a research tool to a robust powerful clinical technique implemented in a wide spectrum of domains, from judicial, commercial to clinical. There are several new novel clinical applications of fMRI.
The session will cover an introduction to clinical fMRI, clinical and a wide spectrum of recent novel applications (in rehabilitation, neurobehavioural and cognitive disorders, neuropsychology, mental health and psychiatry). This session will spotlight what currently can and can't be done with fMRI.
- Neurological Disorders | Neuro Degeneration | Cerebrovascular disorders | Spine & Spinal Disorders | Stroke and its Management | Neuro Radiology & Imaging techniques | Multiple sclerosis | Neuropsychiatry and Mental health | Neuropsychology & Behavioural Sciences
Session Introduction
Turki Abualat
Imam Abdulrahman bin Faisal University, Dammam, SA
Title: Structural Neuroplastic Change nd Behavioral Motor Recovery after transcranial Direct Current Stimulation (tDCS) in Patient with Stroke: A Case Study
Biography:
Dr. Turki Abualait is a clinical researcher in neuroscience and neurorehabilitation interested in investigating the neurological disorders at Imam Abdulrahman bin Faisal University (university of Dammam formerly).
Abstract:
Fine motor and manual dexterity deficits are the main cause of functional disability that leave stroke survivors with significant impairment physically and psychosocially. transcranial direct current stimulation (tDCS) is one of the non-invasive brain stimulation (NIBS) novel techniques that can be used in modulating brain activity and improving functional and clinical outcomes. To investigate the therapeutic utility of applying tDCS in behavioral functions in patients with stroke, a 48-year- old, left-handed male who had a right-hemisphere-fronto- parietal ischemic stroke suffering from cortical sensation deficits; asterognosis and agraphesthesia was participated in 30 sessions of sham tDCS before crossover to 30 sessions of dual- hemispheric tDCS in a double-blind, sham-controlled single-case study. Six weeks of daily sessions (5 days per week) with (2 mA, 20 min). Direct current was delivered from a battery-driven, constant current stimulator (Magstim HDCStim stimulator, The Magstim Co., Whitland, UK) using saline-soaked surface sponge electrodes (5 × 5 cm) with anodal tDCS placed over ipsilesional primary motor area (M1), and cathodal over contralesional M1. Functional outcome measures were assessed with grooved pegboard, box and block test (BBT), action research arm test (ARAT), functional dexterity test (FDT) and nine-hole peg test (NHPT), in several times; prior stimulation (T0), immediately post (T1), as well as 1 month (T3) and 3 months after the end of procedure (T4). Structural and tensor diffusion imaging (DTI) data were also acquired prior (T0) and after stimulation (T1). Slight improvement in grooved pegboard, (BBT), (ARAT), (FDT) and (NHPT) in sham was noticed in (T1). However, with real dual-hemispheric stimulation all findings were clinically significant across all times (T1, T3 and T4). Higher fractional anisotropy (FA) and lower diffusivity of the corticospinal tract (CST) positively correlated with better recovery of fine motor and manual dexterity. tDCS intervention induces not only behavioral but also and structural changes in stroke.
Mohamed Hamdy Ibrahim
GMU University, United Arab Emirates
Title: Could Ambulatory Blood Pressure Monitoring Be a Routine Investigation for Patients with Mild Cognitive Impairment?
Biography:
Abstract:
To study the ambulatory measured blood pressure (ABPM) profile in normotensive patients with mild cognitive impairment (MCI). Patients and Methods: The study was designed as a case control study including 50male patients with mild cognitive impairment in the age group of 30 - 50 years old. The control group included 30 volunteers with no cognitive impairment and in the same age group (30 - 50 years old) and same gender. Mini-mental estate examination, office and ABP monitoring (ABPM) and brain MRI scans were done for cases and controls. Results: Thirty patients (60%) with MCI revealed a non-dipper blood pressure pattern. Sleeping systolic blood pressure and sleeping systolic load were significantly higher in patients with MCI than in normal volunteers (p = 0.01). MRI brain showed more white matter lesions (WMLs) in patients with MCI than in normal volunteers; however, this didn’t reach significance level (p = 0.056). Conclusion: MCI in normotensive young adult patients could reflect an abnormal circadian blood pressure rhythm. Ambulatory blood pressure monitoring could be an essential investigation in young adult MCI patients.
Biography:
Abstract:
The natural history of depression in stroke patients is complex and the mechanism of change in symptoms over time is not fully understood. We hypothesise that there are different trajectories of symptoms after stroke.
Methods: The primary analysis comprised 761 patients who completed 5 years follow up, obtained from the prospective South London Stroke Register (1998–2013). The Hospital Anxiety and Depression scale(HADs) was used to screen patients for depression symptoms at 3 months after stroke, then annually. Trajectories of depression symptoms were detected using group based trajectory modelling (GBTM).
Results: Four patterns of symptoms were identified: 6.31% of patients had severe symptoms, improved slightly in early years then worsen (predicted mean HADs score, 15.74 (se¼1.06)); 28.65% had moderate symptoms, a tendency to get worse over time, predicted mean score 7.36 (se¼0.35); 49.54% had mild symptoms and a tendency of getting worse, predicted mean 3.89 (se¼0.30), and 15.51% of the cohort, had no symptoms and remained so over time. The lowest rate of Selective serotonin reuptake inhibitors (SSRI) use, over 5 years after stroke was 1.1% for group (I) and highest was 35% for group (IV). Sensitivity analyses were used to assess the robustness of the findings using several inclusion criteria and findings agreed with the primary results.
Conclusions: The study identified 4 trajectories of depression symptoms, providing further insight into the natural history of depression. These may be used to improve the long term management of stroke patients and to implement cost effective personalized interventions.
Muhamed Al-Jarrah
Department of Rehabilitation Sciences, Jordan University
Title: Parkinson disease-induced upregulation of apoptotic mediators could be attenuated in the skeletal muscle following chronic exercise training
Biography:
Abstract:
BACKGROUND: We have shown elevated levels of p53 and active caspase-3 in gastrocnemius skeletal muscle with Parkinson’s disease (PD). The main aim of this study is to examine the impact of endurance exercise training on the expression of p53 and active caspase-3 in the skeletal muscle of mouse with induced Parkinsonism.
METHODS: Sedentary control (SC), sedentary Parkinson diseased (SPD), and exercised Parkinson diseased (EPD) groups were formed; each consisting of 10 randomly selected normal albino mice. Chronic Parkinson disease was induced in the SPD and EPD animals using 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and probenecid (MPTP/p). The expression of p53 and active caspase-3 was investigated, using immunohistochemistry, in the gastrocnemius muscle in each animal group.
RESULTS: Both p53 and active caspase-3 expression was significantly (p value < 0.05) reduced in the PD gastrocnemius skeletal muscle following endurance exercise training.
CONCLUSION: Our present data suggest that chronic exercise training reduced Parkinson disease-induced upregulation of p53 and active caspase-3 in gastrocnemius skeletal muscle. Thus, our study suggests that inhibiting p53 and/or active caspase-3 may be considered as a therapeutic approach to ameliorate PD skeletal muscle abnormalities.
Arshad Zaman
The Leeds Teaching Hospitals, Leeds, UK
Title: Can we treat what we can't see? : Neuroimaging and mental health
Biography:
Dr. Arshad Zaman is an experienced neuro specialist with over 15 years’ experience in developing and clinically applying functional Magnetic Resonance Imaging (fMRI) at international centers of excellence. Previous studies encompass a spectrum of clinical applications (epilepsy, oncology) to state-of-the-art applications (e.g. pain relief, mental health, brain training). Current commitments centre around further development and clinical utilisation of fMRI.
Abstract:
Functional magnetic resonance imaging or functional MRI (fMRI) is a state-of-the-art functional neuroimaging technique (non-invasive) that measures brain activity by detecting associated changes in blood flow. fMRI is increasingly playing a key role in providing a deeper insight into brain function and or functional brain networks. There are several novel clinical applications of clinical fMRI. Indeed, fMRI brain functional imaging, can unlock the deepest secrets of the living brain, consequently plays a key role in modern mental health treatment and psychiatric methods (clinical and research). Recently, there has been considerable consensus that modern psychiatry practices do not take full advantage of new (yet matured) powerful science, e.g. neuroimaging techniques.
The session will cover an introduction to clinical fMRI, clinical and novel applications in mental health. This session will spotlight what can and can't be done with fMRI in the context of mental health and identification and or treatment of psychiatric disorders. The session will address the key question, whether it is the correct time to inject state-of-the-art science into psychiatric practice.
- Workshop on Autism
Session Introduction
Sharmila Alam
University of Calgary
Title: Autism Spectrum Disorder from Valproic Acid
Biography:
I was a neuroscience researcher from 2006 to 2010 in University of Calgary. Before that I obtained M.Sc in Biochemical Engineering from the same university. I am a mother of two kids and now residing in saudi arabia with my family. During my research days I worked with animal models (rat and mice) of Neuorlogical diseases to look for potential treatments. I have several publications in different journals. My inquisitiveness to find out the hidden mechanism, hope to find a cause and cure that can improve the quality of life of millions of people and my passion for science keeps me going.
Abstract:
Autism spectrum disorder (ASD) is a behaviorally defined brain disorder affecting approximately 1 in 150 children [1]. Autistic children exhibit impoverished verbal and non-verbal communication skills and reduced social interactions [2]. Several studies have shown that in utero VPA (valproic acid ) exposure may link to an increased risk of ASD, where, for example, it has been reported that the rate of ASD in the children of VPA-treated mothers may be roughly eight times may be larger than that of the general population [3,4]. The purpose of the study is to observe whether VPA can influence the speed of postnatal maturation in vivo and whether this can be associated with structural and behavioral characteristics related to autism. Methodology: Although the effects of VPA have been tested in rodents for many years [5], only relatively recently it has been used to model ASD in rodents for studying ASD-like behavioural features such as social play behaviors. Findings: We found that VPA treated animals can exhibit gross cortical hypertrophy and a reduced predisposition for social play behavior. Conclusion and Significance: Structural and behavioral findings from this research suggests that alteration of the developmental time course in certain high-order cortical networks may play an important role in the neurophysiological basis of autism.