Oral abstracts最新文献

{"title":"030 Brain aging and cardiovascular risk factors in chronic HIV: A longitudinal MRI study","authors":"D. Jakabek, C. Rae, B. Brew, L. Cysique","doi":"10.1136/bmjno-2021-anzan.30","DOIUrl":"https://doi.org/10.1136/bmjno-2021-anzan.30","url":null,"abstract":"Objectives We aimed to examine the relative contributions of HIV infection, age, and cardiovascular risk factors to subcortical brain atrophy. Methods Virally suppressed HIV+ participants with low neuropsychological confounds (n = 75) and demographically matched HIV- controls (n = 31) completed baseline and 18-month follow-up MRI scans, neuropsychological evaluation, cardiovascular assessments, and laboratory tests. HIV+ participants were evaluated for HIV associated neurocognitive disorder (HAND). Subcortical volumes were extracted with Freesurfer. Volumetric and shape analyses were conducted using linear mixed-effect models incorporating interactions between age, time, and each of HIV status, HAND status, HIV disease factors, and cardiovascular markers. Results HIV+ participants had smaller volumes of most structures compared to HIV- participants. Premature aging was evident in the pallidum using volumetric (p = 0.032) and shape analyses. Accelerated aging was observed in the caudate volumes for the more severe HAND subgroup (p = 0.008) and was associated with longer HIV duration for putamen volumes (p = 0.04). Higher CD4 counts had a protective effect on hippocampal volumes in older participants (p = 0.04). Cardiovascular measures were associated with smaller volumes across time for most structures; only the putamen demonstrated accelerated atrophy over time in HIV+ participants with higher cardiovascular risk factors (p = 0.002). Conclusion The study demonstrates a three-hit model of subcortical injury in HIV+ individuals: HIV-driven atrophy in most subcortical structures; abnormal brain aging and HIV infection synergy in the caudate and pallidum; and cardiovascular-related injury linked to diffuse premature atrophy and emerging accelerated atrophy in the putamen.","PeriodicalId":19692,"journal":{"name":"Oral abstracts","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74882326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"028 Adjunctive intraarterial thrombolysis in endovascular clot retrieval: a systematic review and meta-analysis","authors":"William K. Diprose, M. Wang, Kaustubha Ghate, S. Brew, J. Caldwell, B. McGuinness, P. Barber","doi":"10.1136/bmjno-2021-anzan.28","DOIUrl":"https://doi.org/10.1136/bmjno-2021-anzan.28","url":null,"abstract":"Objective To evaluate the safety and efficacy of intra-arterial thrombolysis (IAT) as an adjunct to endovascular clot retrieval (ECR) in ischaemic stroke, we performed a systematic review and meta-analysis of the literature. Methods Searches were performed using Medline, Embase, and Cochrane databases for studies that compared ECR to ECR with adjunctive IAT (ECR+IAT). Safety outcomes included symptomatic intracerebral haemorrhage (sICH) and mortality at three months. Efficacy outcomes included successful reperfusion (Thrombolysis in Cerebral Infarction score of 2b to 3), and functional independence, defined as a modified Rankin Scale score of 0 to 2 at three months. Results Five studies were identified that compared combined ECR+IAT (IA alteplase or urokinase) to ECR-only, and were included in the random effects meta-analysis. There were 1693 ECR patients, including 269 patients treated with combined ECR+IAT and 1424 patients receiving ECR-only. Pooled analysis did not demonstrate any differences between ECR+IAT and ECR-only in rates of sICH (OR: 0.61, 95% CI: 0.20-1.85; P=0.78), mortality (OR: 0.77, 95% CI: 0.54-1.10; P=0.15), or successful reperfusion (OR: 1.05, 95% CI: 0.52-2.15; P=0.89). There was a higher rate of functional independence in patients treated with ECR+IAT, although this was not statistically significant (OR: 1.34, 95% CI: 1.00-1.80; P=0.053). Conclusions Adjunctive IAT appears to be safe. In specific situations, neurointerventionists may be justified in administering small doses of intraarterial alteplase or urokinase as rescue therapy during ECR.","PeriodicalId":19692,"journal":{"name":"Oral abstracts","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85466917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"022 Nitrous oxide induced myelo-neuropathy","authors":"G. Swart, Christopher Blair, Zhong X Lu, S. Yogendran, Joanna Offord, Emily Sutherland, Stephanie Barnes, N. Palavra, Phillip Cremer, S. Bolitho, G. Halmágyi","doi":"10.1136/bmjno-2021-anzan.22","DOIUrl":"https://doi.org/10.1136/bmjno-2021-anzan.22","url":null,"abstract":"","PeriodicalId":19692,"journal":{"name":"Oral abstracts","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90903873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"032 Cognitive deficits are associated with anosmia but not anxio-depressive symptoms in COVID-19","authors":"L. Cysique, Y. Allen-Davidian, David R Darley, A. Byrne, Kay Wilhelm, G. Dore, Gail V. Matthews, Bruce J. Brew","doi":"10.1136/bmjno-2021-anzan.32","DOIUrl":"https://doi.org/10.1136/bmjno-2021-anzan.32","url":null,"abstract":"Objectives To characterise cognitive performance and olfaction in recovered COVID-19 patients. Methods Patients underwent cognitive, olfaction and mental health assessments 2 months after initial SARS-CoV-2 infection as part of the Sydney St. Vincent’s Hospital ADAPT study, a prospective cohort study. Cognition was assessed with the Cogstate computerised battery and expressed as a demographically-corrected composite z-score and clinically classified as impaired/borderline/unimpaired. Anxio-depressive symptoms were assessed with the Depression in the Medical ill scale-10 (DMI-10), the Somatic and Psychological HEalth Report-34 (SPHERE) Psych sub-scale, and the Impact of Events Scale-Revised (IESR) and reduced into single Principal Component explaining 80% of the variance. Olfaction was assessed with the NIH Toolbox Odor Identification test and expressed as demographically-corrected T-scores, and impaired/unimpaired. Disease severity was classified as mild (40%), moderate (50%) or hospitalised (10%). Results 132 patients (mean age=46±15; 40% women, median education=16 years, 10% Non-English-Speaking Background-NESB) were included. 17% had impaired cognition, 10% had borderline deficits, 25% has impaired olfaction. 25% had clinically elevated symptoms on the DMI-10, 13% on the IESR, and 35% on the SPHERE. Regression analyses showed that anxio-depression was not associated with cognitive performance (unadjusted p=.43; adjusted for sex & NESB p=.98) nor impaired/unimpaired status (unadjusted p=.50; adjusted for sex & NESB p=.78). Cognitively impaired patients were more likely to have impaired olfaction (p Conclusions Cognitive impairment is common and not related to psychological factors, may occur independent of disease severity and is associated with anosmia. These point to direct brain effects of COVID-19.","PeriodicalId":19692,"journal":{"name":"Oral abstracts","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91175317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"012 Volumetric and connectivity profile of regional thalamic abnormality in amyotrophic lateral sclerosis","authors":"S. Tu, Marion Sourty, F. Calamante, M. Saranathan, R. Menke, K. Talbot, M. Kiernan, M. Turner","doi":"10.1136/bmjno-2021-anzan.12","DOIUrl":"https://doi.org/10.1136/bmjno-2021-anzan.12","url":null,"abstract":"Objectives Neurodegeneration in ALS follows a diffuse pattern of cortical involvement.1 We have previously highlighted that thalamic abnormality is a robust disease signature in ALS,2 but the integrity of thalamic nuclei and their clinical association remains unclear. We employed a novel segmentation technique for thalamic nuclei and track-weighted functional connectivity (TW-sFC) to characterize volumetric and connectivity profiles of regional thalamic abnormality. Methods Forty ALS patients and 27 age-and-education matched controls were recruited. All patients underwent comprehensive clinical examination and 3T MRI scan (T1; DWI; rs-fMRI). Thalamic nuclei were robustly segmented from T1 images using the THOMAS pipeline.3 Whole-brain white matter fibre tracking was performed using MRtrix and combined with resting-state fMRI to generate combined structural and functional connectivity maps (TW-sFC).4 Results Reduced thalamus volume was observed bilaterally in ALS compared to control (p values Conclusions Regional thalamic abnormalities are present in ALS and hold a significant association with clinical features. Variability in thalamic connectivity demonstrated significant clinical associations with disease duration, progression rate, and upper motor dysfunction. The findings reinforce that diffusion and functional MR imaging modalities are promising markers of disease burden in ALS. References Brettschneider J, Del Tredici K, Toledo J, et al. Stages of pTDP-43 pathology in amyotrophic lateral sclerosis. Ann Neurol 2013;74:20–38. Tu S, Menke R, Talbot K, Kiernan M, Turner M. Regional thalamic MRI as a marker of widespread cortical pathology and progressive frontotemporal involvement in amyotrophic lateral sclerosis. JNNP 2018;89:1250–1258. Su J, Thomas F, Kaso W, et al. Thalamus optimized multi atlas segmentation (THOMAS): fast, fully automated segmentation of thalamic nuclei from structural MRI. Neuroimage 2019;194:272–282. Calamante F, Smith R, Liang X, Zalesky A, Connelly A. Track-weighted dynamic functional connectivity (TW-dFC): a new method to study time-resolved functional connectivity. Brain Struct Funct 2017;222:3761–3774.","PeriodicalId":19692,"journal":{"name":"Oral abstracts","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80638746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"023 Development of a bedside motion capture system: a pilot study","authors":"Paul Kopanidis, J. Lynch, Asikuzzaman, M. Pickering, D. Perriman, W. Spratford, C. Lueck","doi":"10.1136/bmjno-2021-anzan.23","DOIUrl":"https://doi.org/10.1136/bmjno-2021-anzan.23","url":null,"abstract":"Objectives Pronator drift is one of many clinical signs that would benefit from detailed study, but this requires accurate measurement of movement in three dimensions. The Vicon system is currently considered to be the gold standard for measurement of limb kinetics in a movement analysis lab but it cannot be used at the bedside for many reasons. This study aimed to investigate a portable camera-based motion capture system (MCS) as a clinically-useful alternative. Methods The MCS used two commercially-available cameras arranged so as to permit stereoscopic calculation of depth (i.e. distance from the cameras), and therefore a 3-D representation of movement at the shoulder, elbow and wrist. Data were obtained simultaneously from both movement capture and Vicon systems while three normal subjects simulated four scenarios of the pronator drift test in each limb. Outputs from Vicon and MCS were analysed using Matlab to determine root mean square error (RMSE) in XYZ coordinates. A priori, an acceptable difference was considered to be an average RMSE of Results Collectively, the studies generated 53,424 sets of data. The average RMSE in the XYZ axis was 14.9 mm (range 5.0-20.3 mm). Inaccuracy was greatest at the wrist during trials involving larger degrees of pronation. Conclusion The motion capture system was able to generate a 3-D trajectory of limb motion but further refinement is needed before it can be used for the purposes of clinical measurement.","PeriodicalId":19692,"journal":{"name":"Oral abstracts","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89506318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"039 Prevalence of MRI signs of intracranial hypertension and their association with papilledema: a prospective study using ocular fundus photography","authors":"Benson S. Chen, B. I. Meyer, A. Saindane, B. Bruce, N. Newman, V. Biousse","doi":"10.1136/bmjno-2021-anzan.39","DOIUrl":"https://doi.org/10.1136/bmjno-2021-anzan.39","url":null,"abstract":"Objectives MRI signs of intracranial hypertension (MRI-IH) are classically associated with idiopathic intracranial hypertension (IIH), but also detected in asymptomatic individuals without papilledema. The objective of this study was to determine the prevalence of MRI-IH in consecutive outpatients undergoing brain MRI for any clinical indication, and explore their association with papilledema. Methods Prospective cross-sectional observational study of outpatients undergoing brain MRI, with ocular fundus photographs taken concurrently. Radiologic studies were analyzed for MRI-IH. Univariate analysis with Fisher’s exact test or t-test was performed. Results Of 296 patients included, the most common indication for MRI was surveillance of a brain neoplasm (27.7%). Investigation of headaches (8.8%) or disorders of raised ICP (1.4%) were uncommon. At least one MRI-IH was present in 49% of patients [empty sella (33.1%), enlarged Meckel’s cave (15.9%), increased peri-optic CSF (10.8%), optic nerve tortuosity (7.8%), scleral flattening (0.7%), cephaloceles (1.4%)]. Bilateral transverse venous sinus stenosis (TVSS) was present in 3.0% of 198 patients. Five patients (1.7%) had papilledema. Compared to patients without papilledema, those with papilledema had significantly higher BMI and prior history of IIH, and increased prevalence of empty sella, optic nerve tortuosity, and TVSS on MRI. The prevalence of papilledema increased from 2.8% among patients with at least one MRI-IH to 40% among patients with four or more MRI-IH. Conclusion MRI-IH are common in patients undergoing brain MRI, but rarely associated with papilledema. The management of patients with incidentally detected MRI-IH likely does not require systematic lumbar puncture unless concerning symptoms or papilledema are present.","PeriodicalId":19692,"journal":{"name":"Oral abstracts","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73749176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"037 The gut microbiome in Parkinson’s disease: longitudinal insights into disease progression and the use of device-assisted therapies","authors":"M. Lubomski, Xiangnan Xu, A. Holmes, Samuel Mueller, J. Yang, C. Sue, R. Davis","doi":"10.1136/bmjno-2021-anzan.37","DOIUrl":"https://doi.org/10.1136/bmjno-2021-anzan.37","url":null,"abstract":"Objectives Previous studies have reported altered gut microbiome (GM) composition in association with motor and non-motor symptoms in Parkinson’s disease (PD). Only a few prior studies considered the influences of PD medications, namely oral therapies, on the GM. We investigated the temporal stability of GM profiles from PD patients initiating device-assisted therapies (DAT) and in a separate cohort characterise GM influences on PD progression. Methods Clinical data from validated questionnaires and stool samples from 74 PD patients and 74 healthy controls (HCs) were longitudinally evaluated, at t=0, 6 and 12 months. PD patients were sub-stratified as faster or slower progressors, inferred from levodopa equivalence dose and motor severity measures. Additionally, 19 PD patients receiving Deep Brain Stimulation or levodopa-carbidopa intestinal gel were longitudinally evaluated at t=0, 6 and 12 months post-therapy initiation. Results Persistent underrepresentation of short-chain fatty-acid-producing bacteria, Clostridium_XVIII, Butyricicoccus and Fusicatenibacter was apparent in PD patients compared to HCs. No persisting GM profiles were recognised between faster and slower progressing patients, although predictive modelling supported the use of GM profiles to assist in defining PD progression. Our previous findings of acute GM changes in response to DAT initiation were not sustained at 6 and 12 months, although differing microbiota profiles persisted following DAT initiation. Conclusions We present the largest longitudinal GM study in PD patients showing persistently altered GM profiles indicative of underrepresentation of short-chain fatty-acid-producing bacteria. DAT’s were found to exert acute variable influence on the GM that didn’t persist over time.","PeriodicalId":19692,"journal":{"name":"Oral abstracts","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80005593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"026 Posturography as a biomarker of IVIG efficacy in CIDP patients","authors":"Matthew Silsby, C. Yiannikas, K. Ng, M. Kiernan, V. Fung, S. Vucic","doi":"10.1136/bmjno-2021-anzan.26","DOIUrl":"https://doi.org/10.1136/bmjno-2021-anzan.26","url":null,"abstract":"Introduction Poor balance is a common and debilitating feature in patients with Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP). Posturography is an objective method of assessing balance. Intravenous Immunoglobulin (IVIG) exerts clinical benefits in CIDP, including improving balance, although this is difficult to quantify. The present study used posturography as a biomarker for determining IVIG efficacy in CIDP. Methods Eighteen patients with CIDP established on IVIG were compared with healthy controls. Five conditions were used to assess balance: Feet 16cm apart with eyes open and closed, feet together with eyes open and closed (Romberg’s test), and tandem stance. Centre of pressure (COP) was sampled for 15 seconds at 100Hz using a Kistler force platform, and the total path travelled by the COP was calculated (sway path). Testing was performed on the day of IVIG, corresponding to a trough, and at the mid-point of treatment, corresponding to a peak. Results At baseline, there was a significant increase in the sway path in CIDP patients compared with healthy controls (average performance 1191 ± 104mm vs 724 ± 26mm, P Conclusion The present study shows that objective assessment of balance using posturography may serve as a biomarker of IVIG efficacy in patients with CIDP.","PeriodicalId":19692,"journal":{"name":"Oral abstracts","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83024083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"040 The quest to reduce stroke treatment delays at a melbourne metropolitan primary stroke centre over the last two decades","authors":"P. S. Park, T. Frost, P. Tan, J. Wong, A. Pope, H. Dewey, P. Choi","doi":"10.1136/bmjno-2021-anzan.40","DOIUrl":"https://doi.org/10.1136/bmjno-2021-anzan.40","url":null,"abstract":"Objectives To examine door-to-needle time (DNT) trends and the impact of continuous quality improvement initiatives since thrombolysis became standard of care in Australian metropolitan setting for eligible acute ischaemic stroke patients. Methods Single-centre retrospective cohort study of consecutive patients treated with thrombolysis at high volume primary stroke centre from January 2003 to December 2019. Primary outcomes are DNT, and annual number of ‘Code Stroke’ activations and stroke admissions. Regression modelling for potential factors associated with DNT. Results 1,250 patients were treated with thrombolysis over 17 years; 54% were male with a median age of 76 (interquartile ranges [IQR], 66–83). Median DNT fluctuated between 70 to 93 minutes (IQR, 55–95 to 82–120) from 2003 to 2012, reaching 60 minutes in 2013 and nadir of 47 minutes in 2014. Median DNT then decreased from 58 minutes in 2015 to 51 minutes in 2019 with progressive tightening of IQR (46–78 to 40–62). Number of patients treated within 60 minutes of hospital arrival was less than 30% between 2003-2012. This rose to an average of 63% during 2015–2018 and 71% in 2019. From 2015 to 2019, per annum number of ‘Code Stroke’ activations increased from 940 to 1300 while stroke admissions plateaued at 750. ‘Direct-to-CT’ protocol and acute stroke presence were two modifiable workflow factors independently associated with faster DNT (P Conclusion Targeted quality improvement initiatives are key to reducing treatment delays in the Australian metropolitan setting. Relative stagnation in DNT improvement is concerning and needs further investigation.","PeriodicalId":19692,"journal":{"name":"Oral abstracts","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73536191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}