Day 1 :
Keynote Forum
Wai Kwong Tang
The Chinese University of Hong Kong, Hong Kong
Keynote: Structural and functional MRI correlates of poststroke depression
Time : 10:00-10:45
Biography:
Wai Kwong Tang was appointed as a Professor in the Department of Psychiatry, The Chinese University of Hong Kong in 2011. His main research areas are 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. He has served the 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:
Depression is common following an acute stroke. Poststroke Depression (PSD) has notable impacts on the function recovery and quality of life of stroke survivors. Incidence decreased across time after stroke but prevalence of PSD tends to be stable. Many studies have explored the association between lesion location and the incidence of PSD. For example, lesions in frontal lobe, basal ganglia and deep white matter have been related with PSD. Furthermore, cerebral microbleeds and functional changes in brain networks have also been implicated in the development of PSD. In this study, evidences of such association between the above structural and functional brain changes and PSD will be reviewed. Specifically, PSD is related to fronto-subcortial circuit infarcts, vascular markers of large and small vessael diseases as well as abnormal white matter integrity and functioning connectivity in various brain regions.
Keynote Forum
Priya Monrad
Pediatric Epileptologist, USA
Keynote: Whole genome/exome sequencing in pediatric epilepsy: Are there real clinical benefits?
Time : 11:05-11:50
Biography:
Priya Monrad is a practicing Pediatric Epileptologist and the program director for the Child and Adolescent Neurology program in Milwaukee, Wisconsin, USA. Her child neurology training was completed at Mayo Clinic, Rochester, MN and her clinical interests are prenatal/neonatal neurology and genetic/metabolic disorders.
Abstract:
Whole Exome Sequencing (WES) is becoming increasingly recognized as a valuable diagnostic tool in pediatric neurological disorders and pediatric epilepsy, but insurance or access to specialist testing remain major barriers in its widespread implementation. Currently it is primarily performed after standard workups have failed to provide a unifying diagnosis. Studies have demonstrated the cost-effectiveness and sensitivity of WES as a diagnostic modality, but a major remaining question for clinicians is whether WES results affect daily clinical decision-making about patient care in pediatric epilepsy. We will review the existing evidence for the use of WES in pediatric epilepsy, discuss case studies where WES is used in pediatric epilepsy patients in our personal practice and will discuss whether WES could become a useful clinical tool for changing management of pediatric epilepsy patients.
Keynote Forum
James Stoxen
Team Doctors Treatment Center, USA
Keynote: The integrated spring-mass model approach to treating thoracic outlet syndrome
Time : 14:50- 15:50
Biography:
Dr. James Stoxen has his honors in FSSEMM and FWSSEM. He is the President of Masters Academy Publishing Chicago Inc since 2015. He has finished his Bachelors in Human Biologic Sciences from National College of Chiropractic. He has been appointed to be part of the Global Advisory Board, The International Sports Hall of Fame. Dr Stoxen has been invited to speak at over 65 medical conferences for over 50,000 doctors and scientists in China, Japan, UK, Germany, Monaco, Malaysia, Indonesia, Russia, Australia, Thailand, Mexico, Columbia, South Africa, Scotland, India, Ireland, UAE, Portugal, Brazil, Italy and throughout the United States. Masters Academy Publishing will publish its first book entitled, Neck Pain, Upper Back Pain and Shoulder Pain, Could it be Thoracic Outlet Syndrome? By Dr James Stoxen DC, It is a 700 page fully referenced self-help book on the earliest detection, intervention and prevention of thoracic outlet syndrome based on the integrated spring-mass model and human spring approach to care.
Abstract:
The utilization of Hand-Held Devices (HHD), for example, cell phones, tablets, convenient media players have expanded drastically in past decade. This drastic change has led to new batch of difficult to treat, musculoskeletal disorders of the upper extremities such as myofascial pain syndrome of neck and upper back and thoracic outlet syndrome. The thoracic outlet anatomy and how the bundle passes through the passageway is complex for even musculoskeletal experts. So, for doctors trained in other specialties there can be an inadequate understanding about nature and cause of thoracic outlet syndrome. A syndrome rather than a disease, the Mayo Clinic, Cleveland Clinic and the National Institute of Neurological Disorders and Stroke, plus top 10 ranked hospitals for neurology and neurosurgery agree persistent compression of nerves, arteries and veins traveling through the thoracic outlet is what leads to thoracic outlet syndrome. There are three models of human movement the inverted pendulum model, the spring-mass model and the Integrated Spring-Mass Model (ISMM). The (ISMM) which integrates the spring suspension systems of the foot and shoulder region as well as the torsion spring of the spine and the mass, the head. Clinical findings show compressive disorders like TOS and herniated discs are merely an over control of tension on the human spring mechanism leading to these syndromes. This study gives us a brief review of the symptoms and their patterns, the common orthopedic tests, and diagnostic tests, the 16 different common conservative therapies and the 10 reasons for when surgery is medically necessary. There has been an alternative treatment for this disorder based on the integrated spring mass model.
- Workshop
Session Introduction
Carol Ireland and Lisa Todd
CEO and Managing Director, Epilepsy Action Australia. Clinical Governance Manager, Epilepsy Action Australia
Title: Attitudes and experience of cannabinoid-based therapies for epilepsy in the Australian community.
Time : 11:50-12:50
Biography:
Carol Ireland:CEO and Managing Director of Epilepsy Action Australia (EAA), Carol has an extensive background spanning 35 years in the not-for-profit human services sector, holding a variety of executive positions. She has been at the forefront of the medical cannabis movement in Australia.
Lisa Todd:Lisa Todd is a Clinical Nurse Consultant in Epilepsy and Clinical Governance Manager for Epilepsy Action Australia. She is a Registered Nurse with a Post Graduate Certificate in Neuroscience Nursing and Masters of Education.
Abstract:
Epilepsy Action Australia (EAA) sought to understand the attitudes toward and lived experiences of adults and parents of children living with epilepsy of cannabinoid-based therapies in an ever-changing climate of public opinion, government legislation and clinical trials in Australia. Two studies were undertaken with the first informing the second study. A nationwide online survey was conducted assessing demographics, clinical factors, including diagnosis and seizure types, and experiences with and opinions towards cannabis use in epilepsy. The second study (PELICAN) focused on experiences of 61 families of children with epilepsy under the age of 16 years who desired, were currently or had previously administered cannabinoid-based therapies to their children to manage seizures. Semi-structured interviews were conducted; samples collected with subsequent laboratory analysis. 976 responses met the inclusion criteria of the initial survey. 15% of adults with epilepsy and 13% of parents/guardians of children with epilepsy were currently using, or had previously used, cannabinoid-based products to treat epilepsy. Of those with a history of cannabis product use, 90% of adults and 71% of parents reported success in reducing seizure frequency. Forty-one of the sixty-five families participating in the second study (PELICAN) were currently or had previously administered cannabinoid-based therapies to their children. Analysis of the products highlighted a wide variability of cannabinoid content and low concentration of Cannabidiol (CBD) while Δ9-tetrahydrocannabinol (THCΔ9) was present in nearly every sample.
- Epilepsy/Epilepsy in Children / Epilepsy in Women & Inborn/Cognitive Disorders of Epilepsy
Session Introduction
Cheryl Shoubridge
University of Adelaide
Title: Iqsec2 knockout mice recapitulate the intellectual disability and epilepsy phenotype of patients with loss-of-function mutations
Time : 14:50-15:20
Biography:
Cheryl Shoubridge is an Associate Professor of Human Genetics with a research focus on investigating the molecular pathogenesis underpinning genetic causes of intellectual disability and seizures. Her research utilizes numerous experimental models relevant to the associated clinical phenotypes, including rodent models, primary neurons in culture through to clinical specimens. Currently, A/Prof Shoubridge is working in the pre-clinical setting on identifying and validating treatments to improve disease outcomes. Her expertise in genetics, neuroscience and molecular biology underpin her more recent focus on investigating the pathogenic mechanisms contributing to disease outcomes of intellectual disability and seizures due to deficits in synaptic plasticity.
Abstract:
The IQ motif and SEC7 domain-containing protein 2 (IQSEC2) is an X-chromosome gene mutated in both males and females leading to intellectual disability (ID) and severe early-onset seizures. The pathogenesis underpinning these mutations remains unknown. Utilising CRISPR/Cas9 targeted editing (Prof PQ Thomas, SA Genome Editing Facility, University of Adelaide) we have generated an Iqsec2 KO mouse model to investigate the molecular and cellular deficits in this gene resulting in disease outcomes; a fundamental step towards the design and implementation of potential treatment options. We confirmed the loss of Iqsec2 mRNA expression and the lack of Iqsec2 protein detected within the brain of founder and progeny mice. Recapitulating the human setting, both male (48%) and female (45%) Iqsec2 KO mice present with frequent and recurrent seizures. There was an increased occurrence of seizures, reabsorption and unsuccessful nurturing of live young in breeding females. Developmentally, the KO mice exhibit significantly increased hyperactivity, altered anxiety and fear responses, decreased social interactions, delayed learning capacity and decreased memory retention/novel recognition; recapitulating the psychiatric issues, autistic-like features and cognitive deficits present in patients with loss-of-function IQSEC2 mutations. Interestingly, the loss of Iqsec2 function not only causes severe ID and seizures in KO male mice, but in agreement with the patient setting, similar severity is also noted in females despite being in a heterozygous state for this X-chromosome gene. We contend this newly generated mouse model provides a highly relevant biological tool required to interrogate IQSEC2/Iqsec2 function in the brain.
Yung-Feng Liao
Institute of Cellular and Organismic Biology-Academia Sinica, Taiwan
Title: The development of ErbB2-targeted therapy for Alzheimer’s disease
Biography:
Yung-Feng Liao has completed his PhD in Biochemistry and Molecular Biology from University of Georgia and Postdoctoral studies from Harvard Medical School/Massachusetts General Hospital/Brigham and Women’s Hospital. He is the Principal Investigator of the Laboratory of Molecular Neurobiology in the Institute of Cellular and Organismic Biology, Academia Sinica, Taiwan. He has published more than 50 papers in reputed journals and has been serving as an Editorial Board Member and as a Peer Reviewer of prestigious journals.
Abstract:
γË—Secretase catalyzed production of Amyloid-β (Aβ) underlies the pathogenesis of Alzheimer’s Disease (AD). The aim is to identify genetic modifiers that can selectively affect γ-secretase cleavage of Alzheimer's disease amyloid protein precursor i while sparing Notch cleavage, we generated cell-based assays employing Bioluminescence Resonance Energy Transfer (BRET) technology to monitor the protein-protein interactions between PS1 and two γ-secretase substrates, Alzheimer's disease amyloid protein precursor i C-terminal fragment (C99) and extracellular domain truncated Notch (N∆E). An RNAi screen identified 14 candidate genes whose downregulation resulted in a selective decrease in the interaction between PS1 and C99. Among those 14 candidate genes, an ErbB2-centered interaction network was found to preferentially govern the proteostasis of APP-C99. We further demonstrated that overexpression of ErbB2 upregulates the levels of C99 and AICD effectively. The knockdown of ErbB2 selectively decreased the protein levels of C99, AICD, and secreted Aβ40 but not those of N∆E and NICD. Selective suppression of ErbB2 expression by CL-387,785, an ErbB1/2-selective irreversible tyrosine kinase inhibitor can preferentially attenuate the levels of C99 and AICD, resulting in a significant reduction in Aβ production. Down-regulation of ErbB2 by CL-387,785 also resulted in a significant decrease in the levels of C99 and secreted Aβ in both zebrafish and mouse models of AD, through the activation of autophagy. Oral administration of CL-387,785 for 3 weeks significantly improves the cognitive functions of APP/presenilin-1 (PS1) transgenic mice. These findings unveil a noncanonical function of ErbB2 in modulating autophagy and established ErbB2 as a novel therapeutic target for AD.
Archana A
University of Madras, India
Title: A study to assess the noise stress-induced changes on cognition in Wistar albino rats
Biography:
Archana A is currently pursuing her PhD in Stress Physiology in Department of Physiology, University of Madras, Tamil Nadu. She has published two papers in sleep deprivation and unpredictable acute and chronic stress. She is currently researching noise stress on hippocampus and Alzheimer’s disease.
Abstract:
Background: In our modern lifestyle exposure to noise stress/pollution not only affects the auditory system but rather extend to the central nervous system.
Objective: The aim of the study is to investigate the effect of acute noise stress on cognitive functions in male Wistar albino rats.
Methods: Adult albino rats were randomly divided into two groups. Each group contains six animals. Rats exposed to acute noise stress (100 dB/4 hour) were compared with control animal and assessed for cognition by using T-maze, hole board test, open field test, marble burying test, and social interaction behavior.
Results: The rats exposed to acute noise stress shown the significance (p<0.05) of behavioral alterations such as impaired learning and memory, memory retention, increased fear and anxiety, obsessive-compulsive behavior, social avoidance and decreased social interaction.
Conclusion: The results report that acute noise stress affects the cognition and it became chronic may confer the increased risk of neurodegenerative disorders.
Irma Khachidze
Caucasus University, Tbilisi, Georgia
Title: EEG biomarkers in epileptic children during the treatment
Biography:
Abstract:
Antiepileptic drug (AED) therapy in epileptic children can be optimized via an anticipation of AED efficacy during early stages of therapy. We hypothesize that the comprehensive EEG evaluation can determine AED efficacy in epileptic children. Thus, this study aimed to investigate the alteration of characteristics of interictal EEG during AED therapy. Forty-three children aged 3-9 were investigated. EEGs were recorded three times: prior to Valproic Acid-Depakin (Dep) monotherapy and twice under Dep therapy (at three and six/eight months). Baseline EEG was analyzed for quantitative characteristics of interictal EEG such as absolute values of the power (AVP) spectra and EEG topography/Brain Mapping. The study involved epileptiform EEG and clinical condition assessments. Dep decreased AVP spectra in a low-frequency range, suppressed spontaneous epileptic discharge, and spike-wave complex 3/s. Dep partially decreased spikes-polyspikes, sharp waves, and generalized paroxysmal bursts during functional trials. Dep did not diminish rhythmic monomorphic theta-waves (RMT) of tempo-parietal localization observed by Brain Mapping. The presence of RMT correlated with the reocurrence of seizures if Dep was withdrawn.
Nadia Ben Ali
Charles Nicolle hospital
Title: Vagus nerve stimulation: Tunisian clinical experience in drug-resistant epilepsy
Biography:
Nadia ben Ali has her expertise in neurology especially on epileptology and passion in improving the health and wellbeing. Her open and contextual evaluation model based on novel therapy and creates new pathways for improving healthcare. She has built this model after 10 years of clinical research both in hospital and education institutions.
Abstract:
Vagus nerve stimulation (VNS) is a new therapeutic approach of drug-resistant epilepsy, when surgery is not indicated. Though effective, few data from developing countries exist. The aim of this work is to draw out the Tunisian experience in VNS, concerning its efficacy in patients with different intractable epileptic syndromes. We retrospectively reviewed 6 patients with different epileptic syndromes who underwent VNS therapy. All patients have a neurological exam, EEG recording, MRI and neuropsychological tests. The mean duration of the follow-up was 48 60 months. Demographic data, epileptic syndrome, the different stimulation parameters, seizure frequency as well as clinical response after implantation and side effects were described. The mean age was 19.6 year. Output current, pulse duration, frequency, and off time changed significantly between the 3- and 48 month long-term follow-ups. The global mean decrease in seizure frequency at last follow-up was over than 50 %. Some seizure types responded better than others did: complex partial seizures with secondary generalization and atonic seizures. Improvements in memory, mood, alertness and postictal recovery period were observed in all patients.