Annual Congress on
Advancements in Neurology and Neuroscience

Bence Andras Lazar is working as a Ph.D. candidate in the Department of Physiology, University of Szeged and as a clinical doctor in the Department of Psychiatry, University of Szeged. His current research fields include: neuromorphology and addictology. Now he is working with a fellowship of the UNKP-17-3 New National Excellence Program of the Ministry if Human Capacities.

In recent years, several studies indicated functional interactions between the insulin receptor (InsR) and the transient receptor potential vanilloid type 1 receptor (TRPV1) co-expressed in a subset of primary sensory neurons (PSNs) of unidentified target innervation. The aim of the present study was to reveal the target-specific expression of the InsR and its co-localization with TRPV1 in adult rats. Adult male Wistar rats (n=12) weighing 300-350 g were used. To identify somatic and visceral PSNs biotin-conjugated wheat germ agglutinin (bWGA) was injected into the hind paw skin, the lateral gastrocnemius muscle, the pancreas and the urinary bladder. Three days later representative serial sections were cut from Th10-13 and L3-S1 dorsal root ganglia. Immunohistochemistry and quantitative morphometry were used to analyze the expression of InsR and TRPV1 in bWGA-labelled somatic and visceral PSNs. The largest proportions of retrogradely labelled InsR-positive neurons were identified among PSNs serving the pancreas (~54%) and the urinary bladder. InsR-positive neurons innervating the hind paw skin and the gastrocnemius muscle amounted to ~22% and ~21% of labelled neurons. The majority (~64%) of the labelled PSNs exhibited TRPV1 immunoreactivity. Co-localization of the TRPV1 and the InsR was observed in ~16%, ~15%, ~29% and ~30% of labelled cutaneous, muscular, pancreatic and urinary bladder PSNs. Our quantitative morphological data provide evidence for the co-localization of InsR and TRPV1 in PSNs innervating somatic and visceral organs and demonstrate a preponderance of InsR-immunoreactivity among PSNs which innervate visceral targets. These findings suggest that visceral spinal PSNs might be more sensitive to the modulatory influence of insulin than PSNs innervating somatic organs. Keywords: insulin receptor; transient receptor potential vanilloid type 1 receptor; primary sensory neurons; retrograde labelling; somatic and visceral organs Funding: This work is supported by the GINOP-2.3.2-15-2016-00034 projects of the Hungarian National Research, Development and Innovation Office. B. A. Lázár is supported by the UNKP-17-3 New National Excellence Program of the Ministry if Human Capacities and TÁMOP 4.2.2.A-11/1/KONV-2012-0052.

Pediatric Neurologist at Children Welfare Teaching Hospital, Baghdad, Iraq.

Background: The annual incidence of stroke in children after the newborn period is approximately 2.3 per 100000. Half are ischemic, and half are non traumatic intracerebral and subarchnoidal hemorrhages. Objectives: To study the etiologic factors, clinical presentation and outcome of stroke among children admitted to children welfare teaching hospital/Baghdad. Patient and methods: A prospective study was carried out in Children Welfare Teaching Hospital; Children age ranged between 1 month -13 years and was admitted to pediatric neurology ward between 1st of November 2013 and 1st of November 2014. After carful clinical history, physical and neurological examinations, the diagnosis of brain stroke was confirmed in all patients by computerized tomography (CT) and/or magnetic resonance imaging (MRI). Patients included in this study were those diagnosed as having ischemic stroke, hemorrhagic stroke. Results: The total number of cases were 61, 36 were male (59%). The age at onset ranged from 1-156 months. Ischemic stroke constituted 39 patients (63.9%). The most common etiologic factors for the ischemic stroke were protein C deficiency (9, 23.1%). The most common etiologic factor for hemorrhage was bleeding disorders in about 50% of patients. The most common presenting features were hemiplegia, seizure, alteration of consciousness; Cranial nerves palsy is mostly present in the ischemic stroke (14, 35.9%) and only in one patient (4.5%) of hemorrhagic stroke. Conclusions: Ischemic stroke is more common than hemorrhagic stroke in pediatric age group. The significant risk factors for ischemic stroke are protein C deficiency, Congenital heart disease (CHD) and positive family history, while vitamin K deficiency, prolong Partial thromboplastin time (PTT) and trauma are significant for hemorrhagic stroke. The most common clinical features of both types of stroke are hemiparesis, siezure and alteration of consciousness. Keywords:Ischemic stroke, Hemorrhagic stroke, Children Welfare Teaching Hospital.

Dr.Noor ul Huda Maria is one of a few female neurosurgeons in Pakistan .She is currently working at Pakistan's largest dedicated neurosurgery hospital ,Punjab institute of neurosciences (PINS).She has completed her fellowship training from the same institute as well.Graduate of Services Institute of Medical Sciences with top position ,distinctions and gold medals, she has always been passionate about neurosurgery.She has got special interest in research work and has various articles published in national and international journals.She has presented her abstracts and e posters at different international conferences.Currently working on a book.

Objective: To study the efficacy of post operative rise in serum sodium level as indicator of diabetes insipidus after pituitary adenoma surgery. Methodology: The study is randomized control trail. It was conducted in Departments of Neurosurgery and Biochemistry Punjab Institute of Neurosciences/Lahore General Hospital/Postgraduate Medical Institute/Ameeruddin Medical College from March 2016 to December 2017. Ethical approval was obtained from hospital Ethics Committee. Total no. of 169 patients was enrolled for transsphenoidal surgery of their pituitary adenoma. Sample size was calculated from the reference study conducted by Schreckinger M et al (10). Non probability consecutive sampling technique was used to collect the sample size. Data was calculated from all the patients regarding age, gender, duration of transsphenoidal surgery, postoperative evidence of diabetes insipidus by measuring rise in serum sodium level >145mEq. Mean and standard deviation was calculated for demographic variables like age and gender while frequency and percentage was calculated for outcome variables like type of diabetes insipidus and sensitivity and specificity of serum sodium >145mEq test. Chi square test was applied and analysis was done using computer software SPSS version 23. P value less than 0.05 was considered significant. Results: Overall, 100% (n=169) patients were enrolled in this study, both genders. Gender distribution showed there were 68% (n=115) males and 32% (n=54) females. The mean age of the patients was 40.88±4.95 years. Post-operative transient noted in 13.6% (n=23) patients. Serum sodium level (specific) observed in 92.9% (n=157) patients. While, > 145 mEq sensitive was observed in 88.2% (n=149) patients. (Table. 1). The main outcome variable of this study was diabetes insipidus permanent, in our study, it was noted in 9.5% (n=16) patients. (Table. 2). There was no association between diabetes insipidus permanent and effect modifiers. (Table. 3). Conclusion: From this study we conclude that level of sodium >145mEq is very sensitive and specific test which can be used to predict the outcome after pituitary adenoma surgery in the form of Diabetes Insipidus.

Rosamaria Bruni is a Pediatric Neurologist at Andorra General Hospital,Andorra

Sensory processing disorders (SPD) affect 5–16% of school-aged children and can cause long-term deficits in intellectual and social development. Current theories of SPD implicate primary sensory cortical areas and higher-order multisensory integration (MSI) cortical regions. We investigate the role of white matter microstructural abnormalities in SPD using diffusion tensor imaging (DTI). DTI was acquired in 16 boys, 8–11 years old, with SPD and 24 age-, gender-, handedness- and IQ-matched neurotypical controls. Behavior was characterized using a parent report sensory behavior measure, the Sensory Profile. Fractional anisotropy (FA), mean diffusivity (MD) and radial diffusivity (RD) were calculated. Tract-based spatial statistics were used to detect significant group differences in white matter integrity and to determine if microstructural parameters were significantly correlated with behavioral measures. Significant decreases in FA and increases in MD and RD were found in the SPD cohort compared to controls, primarily involving posterior white matter including the posterior corpus callosum, posterior corona radiata and posterior thalamic radiations. Strong positive correlations were observed between FA of these posterior tracts and auditory, multisensory, and inattention scores (r = 0.51–0.78; p b 0.001) with strong negative correlations between RD and multisensoryand inattention scores (r = − 0.61–0.71; p b 0.001). To our knowledge, this is the first study to demonstrate reduced white matter microstructural integrity in children with SPD. We find that the disrupted whitematter microstructure predominantly involves posterior cerebral tracts and correlates strongly with atypical unimodal and multisensory integration behavior. These findings suggest abnormal white matter as a biologic basis for SPD and may also distinguish SPD from overlapping clinical conditions such as autism and attentiondeficit hyperactivity disorder.