Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 13th International Conference on Neurology and Neurosurgery Paris, France.

Day 1 :

Keynote Forum

Roberto Cartolari

S. Giovanni Hospital, Switzerland

Keynote: The diagnostic evaluation of the operated lumbar spine

Time : 9:30-10:10

Conference Series Neurosurgery 2017 International Conference Keynote Speaker Roberto Cartolari photo
Biography:

Born in Urbino (PU), Italy, in 1955, is married with Maria Chiara and , has one daughter, Ginevra. Degree in Medicine and Surgery, University of Modena, 1980, board  on Radiology, University of  Modena in 1984,  board on Neurology, University of Siena in 1994. He Patented the device, "Axial Loader” and development of neuroradiological imaging  techniques known as" Axial Loaded - Computed Tomography -  AL-CT " and " Axial  Loaded Magnetic Resonance - AL-MR "for the in vivo biomechanical study of the spine  in 1992. At present  is  Senior Assistant Radiologist at the  Radiology Service, Ospedale S. Giovanni – EOC Bellinzona, Switzerland. He has published as  Author and co-author many   scientific publications, abstracts and reports in    national and international journals. He also collaborated on several chapters on   international treaties of Neuroradiology. Main interests are Diagnostic and Spinal non-vascular Interventional Neuroradiology, with   special  reference to CT and MRI, Biomedical applications of Virtual Reality,”   Biomechanics of the spine and  joints. He is a Member of the Italian Association of Neuroradiology – AINR,- Full Member of the European Society of Neuroradiology - ESNR.

Abstract:

The so-called failed back surgery syndrome (FBSS) is a common problem that often remains without a clear diagnosis. The diagnostic workout is complex and usually based on conventional X-ray films, MRI, CT and sometimes myelography and myelo-CT, especially if some mechanical device has been implanted. In the most part of the cases, an exact cause for low back pain and/or sciatic pain is hard to define and this can influence a correct therapy. The most important consideration is the difficulty to have a functional approach to the operated spine since the most part of the diagnostic procedures are made with the patient in rest position (supine). On the other hand metallic implants can interfere with MR and CT acquisitions. The only dynamic diagnostic procedure (orthostatic functional X-ray plain film) has known lack of precision. In last years, the possibility of functional studies in real or simulated orthostatism (orthostatic MR and axial loaded CT and MR) has led to a deeper comprehension of the mechanics of the operated spine, especially of the instrumented spine. In this lecture, the results of more than 20 years of experience with axial loaded CT and MRI will be presented. The axial loaded CT imaging could be the gold standard in the evaluation of the post-op lumbar spine, in particular when a mechanical device has been implanted.

Keynote Forum

Xiaoping Ren

Harbin Medical University, China

Keynote: Spinal Cord Fusion in Acute Spinal Cord Injury of Dog

Time : 10:10-10:50

Conference Series Neurosurgery 2017 International Conference Keynote Speaker Xiaoping Ren photo
Biography:

Xiaoping Ren received his M.D in Harbin Medical University in 1984. He performed his Clinical and Research Hand Fellowship training in University of Louisville in Kentucky (1996-2000). Currently, he has professor position in Harbin Medical University in China and adjunct faculty in Loyola University Chicago in US. Dr. Ren has had over 60 publications in peer-reviewed journals and he is holding active Memberships of the American Association for Hand Surgery, Orthopedics and Neurological of American Academy and the American Heart Association. He also service as peer-reviewer of several journals. As well as practice as a Hand and Microsurgeon in clinic, his research interest is on protective strategies against ischemia/reperfusion of CNS and SCI functional recovery.

Abstract:

Employing an acute dog model of spinal cord injury (SCI) using a diamond knife to generate a clean cut with little crush injury, we show that application of PEG preparations on the severed ends effects considerable neuroprotection and repair. Our results show that electrical continuity starts to be detected one hour after injury, and that BBB scores reach approximately 50% of the sham levels after three to four weeks. This level of restoration of function continues out to 6 month, which is the longest we assessed the dog. Neurophysiological and DTI MR data confirm electrophysiological and anatomical continuity. This study suggests that a form of spinal cord injury can effectively be treated and points out a way to treat spinal cord injury patients by removing the injured segment and, along with vertebral shortening, reapproximating and fusing the two stumps.

  • Neurological Disorders| Pediatric Neurosurgery | Neuroaesthetics and Critical Care
Location: Sunset 1
Speaker

Chair

Roberto Cartolari

S. Giovanni Hospital, Switzerland

Biography:

Gabriel Fernando Todeschi Variane completed his graduation at Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo. She completed his/her Pediatric training and neonatal fellowship at Santa Casa de Sao Paulo, Brazil. He/she was Visiting Observer at McGill University, Canada (2014), University of Cambridge, UK (2015) and Stanford University, USA (2016). He is Coordinator of the Neuro-NICU of Santa Casa de Sao Paulo, a very large and one of the most important medical schools in Brazil. He is a Neonatologist responsible for Group’s Santa Joana Neuro-NICU.

Abstract:

Neonatology has experienced dramatically falls in mortality rates of critically ill neonates in the past few decades. However, many infants will develop severe neurological impairment. The big challenge consists in promoting survival with adequate quality of life. The implementation of a neurological neonatal ICU (Neuro-NICU) has been successfully described in several centers among the world. It consists in bringing to clinical practice new methodologies and a specific multidisciplinary approach in order to promote early diagnoses of brain injury and neuroprotection for infants at high risk. Four pillars are described: Neuro-monitoring (such as video aEEG/EEG and NIRS); neuroimaging (cranial ultrasound, tomography and MRI); neuro-assessment (close approach of neurology team and training neurological assessment tools for neonatologists and pediatricians in the NICU and after discharge and; neuroprotection (therapeutic hypothermia and strategies to minimize pain and stress for all infants). Newborns admitted to the Neuro-NICU include infants with hypoxic ischemic encephalopathy (HIE), seizures, extreme prematurity, large intra-ventricular hemorrhage, hydrocephalus, central nervous system infections and malformations (such as microcephaly), metabolic disease, and severe congenital heart diseases. Brain monitoring is specifically important in this population, since this is well described that 80 to 90 percent of seizures occurs with no clinical signs in the neonatal period. We have implemented and experienced the Neuro-NICU concept in five centers in Brazil, starting on 2015. Our Neuro-NICU has monitored over 300 infants. We found very high rates of seizures (47% of infants monitored, which 82% had subclinical seizures), and promoted cooling for over 80 infants with HIE.

Biography:

Sarah Adelaide Crawford completed her Doctoral degree at Columbia University College of Physicians and Surgeons, Department of Biochemistry and Biophysics. She completed her Master’s Degree in Biochemistry at Princeton University. Her Post-doctoral research was carried out at Memorial Sloan Kettering Cancer Center in New York. She is a Professor of Genetics at Southern Connecticut State University and Director of the Cancer Biology Research Laboratory. In 2013, she was awarded two patents [USA, Canada and Europe] for developing novel combined chemotherapy approaches using a new plant extract formulation for brain tumors and other malignancies. She has developed a new model to explain the causes of autism and its recent dramatic increase. Applications of this model can be used in preventive approaches to screen for autism risk factors to reduce the occurrence of this disorder.

Abstract:

Recent discoveries of the connections between the maternal immune system (IS) and prenatal brain development suggest that routine prenatal screening for chronic disorders associated with IS dysfunction may be useful in identifying women at heightened risk for giving birth to a child with autism. Epidemiological studies have shown that the incidence of IS disorders, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and chronic obesity in combination with insulin-resistant diabetes, has increased significantly over the past several decades and that pregnant women with these conditions are at increased risk for having a child with autism. For this reason, physiological parameters associated with these prenatal conditions that can be detected before onset or at early stages of disease may serve as biomarkers for increased autism risk. A physiological relationship between maternal IS dysfunction and impaired embryonic/fetal brain development may be defined by critical neurodevelopmental functions of brain microglia that are responsive to both neural and immunological stimuli. Impaired regulation of the developmentally versus immunologically defined functions of brain microglia may represent a primary cause of the neurological impairments characteristic of ASD. This critical cause/effect relationship provides the rationale for autism risk factor assessment using biomarkers associated with chronic immune conditions that impair the neurodevelopmental functions of microglia as a consequence of their inappropriate immunological activation. Moreover, the connection between abnormal IS function and impaired neural development suggests preventive approaches that can be used to decrease the overall risk for ASD in children born to mothers with these conditions. 

  • Special Session
Location: Sunset 1
Speaker

Chair

Radu Mutihac

University of Bucharest, Romania

Session Introduction

Radu Mutihac

University of Bucharest, Romania

Title: Brain connectivity dynamics in neurological dysfunctions
Speaker
Biography:

Radu Mutihac is a Head of Medical Physics Section, works in Neuroscience, Signal Processing, Microelectronics and Artificial Intelligence. As a Post-doc/Research Associate/Visiting Professor/Full Professor, he does his research at University of Bucharest, International Centre for Theoretical Physics (Italy), Ecole Polytechnique (France), Institute Henri Poincare (France) and KU Leuven (Belgium). His research in “Fused biomedical imaging modalities” was carried out at Johns Hopkins University, National Institutes of Health and Walter Reed Army Institute of Research, USA. He is a member of ISMRM, ESMRMB, OHBM, Romanian US Alumni Association, and Fellow of Signal Processing and Neural Networks Society IEEE. He has published over 100 scientific papers, 12 monographs and contributed with chapters in other 10 text books. He contributed to more than 150 scientific meetings with posters and oral presentations, seminars, invited and plenary lectures, as well as acting as Organizer, Chairman, and Keynote Speaker.

Abstract:

Studies on brain connectivity by means of functional neuroimaging data have increased the understanding of the organization of large-scale structural and functional brain networks. It has been argued that nonlinear analyses employing concepts like entropy, fractality and predictability provide significant diagnostic and prognostic information in a number of pathologies. The brain is like a mosaic of different and highly interconnected regions, so that knowledge of functional connectivity between brain regions is crucial to understanding perception, cognition, behavior, and differentiating healthy from sick subjects. Investigating functional connectivity constitute potential means to explore the causal relationship between the brain lesions and neuropsychological syndromes and, eventually, may suggest improved rehabilitation strategies for patients with brain injury through personalized treatment and recovery protocols. Spontaneous low-frequency (<0.1 Hz) fluctuations in BOLD resting-state fMRI signals are temporally coherent among brain areas that may be not structurally connected but functionally related. Neurological diseases stand for a range of conditions which primarily affect the neurons in the brain and are incurable and progressively result in degeneration and/or death of nerve cells. They are related with at least two brain functions: Memory loss and impaired judgment or language, and the inability to perform some common activities. Investigating the relationship between brain structure and function is a central issue in neuroscience research. The present work summarizes the specific changes in the resting-state networks univocally related to certain forms of neurological disorders and/or dementia phases, particularly among syndromes with relatively similar behavioral effects, on the basis of alterations in brain connectivity explored by the real-time fMRI during rest.

  • Neurology | Novel Therapeutics| Advance Techniques on Neurosurgery
Location: Sunset 1
Speaker

Chair

Radu Mutihac

University of Bucharest, Romania

Session Introduction

Marc Teichmann

Pitié-Salpêtrière Hospital, France

Title: Can non-invasive neurostimulation enhance language abilities in aphasic patients?
Biography:

Abstract:

Non-invasive brain stimulation including TMS and tDCS has been used as a potential therapy tool in various pathological conditions including aphasia. Despite a large number of studies on post-stroke aphasia and on degenerative language diseases such as primary progressive aphasia (PPA) stimulation results remain inconclusive because of methodological limitations. Here, I will discuss why post-stroke aphasia is a fragile lesion model for exploring potential therapeutic efficiency of non-invasive stimulation and how research in this filed could be improved by using PPA applying a rigorous methodological approach. More specifically, I will present recent data from a pre-therapeutic double-blind sham-controlled tDCS study in a relatively large and homogenous cohort of semantic variant PPA patients. The findings of this study demonstrate that a methodologically stringent application of non-invasive neurostimulation leads to efficient modulation of the targeted language system generating highly specific intra-semantic effects. These results provide ‘proof of concept’ for future applications of tDCS in therapeutic multi-day regimes, potentially driving sustained improvement of language processing, promoted by mechanisms of neuroplasticity. In addition, such rigorously controlled studies also provide insight in the functional and anatomical organization of the language/semantic system. 

Biography:

Thangarajan Sumathi completed her PhD in 2002 at University of Madras. Currently, she is working as an Assistant Professor in Department of Medical Biochemistry, University of Madras. She is guiding eight PhD students and four research scholars have been awarded PhD degree. She has 20 years of teaching and research experience. Her area of specialization is Neurodegenerative Diseases (Alzheimer’s disease, Parkinson’s disease and Huntington’s disease). She has more than 40 publications in reputed journals and sponsored research projects. She is a life member of ISAR, IAES, IABS, NJLS, ZSI, etc. She is a Reviewer of many international journals like Neurochemistry International, Experimental Biology and Medicine, etc. She is an Editorial Board Member of Current Updates in Gerontology and International Journal of Brain Disorder Therapy.

Abstract:

The amyloid-β (Aβ) is the major protein component of brain senile plaques in Alzheimer’s disease (AD) and is known to be directly responsible for the production of free radicals toxic to brain tissue. The present study was designed to elucidate the neuroprotective effect of Isorhamnetin (IRN), a flavone aglycones against the pathogenesis of AD. Experimental AD in rats was produced by intracerebroventricular administration of Aβ (25-35) peptide. Employing the following strategies of neurobehavioral, biochemical, immunohistochemistry, docking and molecular approach, we explored the attenuating effects of IRN against Aβ (25-35) peptide induced hippocampal neuronal loss and memory impairment. The present study has proven that IRN also reduced the expression of BACE-1 via inactivation of GSK3β and NFκB inhibition thereby inhibiting the accumulation of Aβ. Furthermore, IRN up regulated the phosphorylated GSK-3β and down regulated the expression of phosphorylated P-38 thereby inhibiting the Nrf-2 ubiquitination and improved the nuclear translocation of Nrf-2 which subsequently alleviated the expression of inflammatory cytokines which further reduced the ROS and RNS generation. Considering all the results, it can be suggested that IRN not only acts via antioxidant and anti-inflammatory activity but also by modulating the expression and function of AD related proteins. Hence, an amalgamation of in vivo, in vitro and in silico evidence might be supportive to delineate the neuroprotective potentials of IRN in the therapy of AD.

Simona Spînu

University of Bucharest, Romania

Title: Visual Memory in a Factorial Event-Related Paradigm
Biography:

Abstract:

Memory, especially visual memory is essential in the human social relation process and knowledge of brain correlates human body control is limited due to less accessibility in performing, using recently neuroimaging methods, controlled experimental paradigms. It is a fact that active repetition increases memory consolidation process and that all complex events are identified by making connections to prior knowledge.

Action understanding is a complex process depending on the type of action and, therefore, the brain hemodynamic activity in parietal cortex, which is quite often correlated with the processing of visual activities during functional magnetic resonance imaging (fMRI), analyzed in view of studying a factorial event-related face repetition/recognition (FR) task. The experimental paradigm has involved a healthy adult subject called to recognize the random repetition of one popular face among several unknown faces.

Inferential statistical analysis (CDA – Confirmatory Data Analysis) performed by the general linear model (GLM) in the framework of SPM (Statistical Parametric Mapping) has identified the areas of activation and the results have subsequently been confirmed by exploratory statistical analysis methods (EDA – Exploratory Data Analysis). Furthermore, in this work, we studied the transparency of statistical analysis methods creating a parallel between hypothesis-driven models and data-driven models. In the end, we found that inferential and exploratory analysis methods are efficient, associative and integrative for statistical analysis of an FR paradigm, being more complementary than competitive.

Biography:

Sniedze Murniece is working as a Neuroanesthesiologist at Riga East University Hospital, Latvia. Currently, she is pursuing her PhD in Medicine and doing her research in Spinal Neurosurgery and Cerebral Oxygen Saturation Monitoring.

Abstract:

Introduction: Cerebral hypoxia is a leading cause of adverse cerebral outcomes. Regional cerebral oxygenation intraoperative monitoring can prevent from complications like cognitive dysfunction, organ failure reducing hospitalization time.

Aim: The aim of the study was to determine whether prone position impacts cerebral oxygenation in spinal neurosurgical patients using near infrared spectroscopy device intraoperatively.

Materials & Methods: 25 patients (mean age 56 years) undergoing transpedicular fixation, microdiscectomy, removal of spinal tumors in prone position were included. Cerebral oxygen saturation (rScO2) was continuously monitored using INVOS 4100 NIRS device. We assessed cognitive dysfunction, blood loss, postoperative complications (stroke, organ dysfunction, days spent in ICU). Anesthesia induction: fentanyl 0.1-0.2 mg, propofol 1-2 mg/kg, cisatracurium 0.2 mg/kg; maintenance-fentanyl 0.03-0.06 μg/kg/min, cisatracurium 0.06-0.1 mg/kg/h, sevoflurane to MAC 0.7-1.0, FiO2 0.5.

Results: Mean rScO2 during induction was 72% for left side (L), 73% right side (R). In prone position L74%, R74%, was returning back to spinal position L74%, R73% during the whole surgery L73%, and R73%. Significant difference in calculated mean rScO2 values between supine and prone position was not observed. Despite the calculated mean rScO2 values 11/25 patients showed a slight up to significant decrease in rScO2 in prone position. The minimum rScO2 value observed was 55%. One patient with adipositas rScO2 values decreased for 26% from baseline values when turned to prone position (from 85% supine to 58% in prone position). No incidence of cognitive dysfunction, stroke, organ dysfunction was observed, no patients were admitted to ICU.

Conclusions: Although our first experience revealed that the mean intraoperative cerebral oxygen saturation changes during spinal neurosurgery in prone position from baseline values is not significant, almost half of the patients experienced mild to moderate decrease in cerebral oxygen saturation. Near infrared spectroscopy devices can be served as a supplementary tool in spinal neurosurgery to maintain adequate cerebral oxygen saturation.