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35 MoCA performance as an indicator of NSAb positivity in focal epilepsy: A preliminary analysis
- Maria Pleshkevich, Emily St. John, Claude Steriade
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 34-35
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Objective:
Researchers are increasingly finding that the presence of neuronal surface antibodies (NSAb) may account for a larger percentage of outpatient epilepsy cases than previously thought (Elisak et al., 2018; Brenner et al., 2013). However, systematic NSAb screening is not included in standard epilepsy care (Kambadja et al., 2022). The Montreal Cognitive Assessment (MoCA; Nasreddine, 2005) is one of the most commonly used screening tools among physicians (Judge et al., 2019) across various neurological conditions, and has previously been validated in populations with autoimmune encephalitis (Hebert et al., 2018). Because patients with NSAb associated epilepsy often present with cognitive dysfunction (Greco et al., 2006), a MoCA is often administered as part of standard clinical care. The present analysis compared MoCA performance profiles in epilepsy patients with and without the presence of serum NSAbs. We explored what specific cognitive profile, as defined by the MoCA, may predict NSAb positivity.
Participants and Methods:Forty-eight epilepsy patients were enrolled through an outpatient epilepsy clinic or during non-intensive or elective hospital stays. Participants were eligible if they met one of three diagnostic categories: focal epilepsy of unknown cause (n = 33), lesional focal epilepsy (n = 5), or generalized epilepsy (n = 4). All participants signed consent, underwent a comprehensive interview, which included MoCA testing, and serum NSAb testing paralleling standard clinical practice. Mann-U Whitney tests were run to compare overall MoCA and subgroup domain performance between groups.
Results:Six patients (13%), all with focal epilepsy of unknown cause, had positive NSAb panels (LGI1: n = 3; GAD65: n = 2; CASPR2: n = 1). There was no significant difference in overall MoCA scores between participants with focal epilepsy of unknown cause who were antibody positive versus negative, and antibody positive versus antibody negative lesional or generalized epilepsy. However, when analyzing by MoCA subgroup, we found that antibody positive patients performed significantly worse on delayed recall than antibody negative patients with focal epilepsy of unknown cause (Mdn = 1.5 vs 3), U(Nantibodynegative=27, Nantibodypositive=6) = 69.00, p = .02. There was no significant difference in other MoCA cognitive domain tests, and delayed recall scores did not significantly differ between antibody positive patients and those with lesional focal and generalized epilepsy.
Conclusions:These preliminary findings suggest that episodic memory impairment, as measured by delayed recall on the MoCA, may predict NSAb antibody positivity among patients with focal epilepsy of unknown cause. This may relate to specific predilection of the hippocampal regions in antibody-mediated epileptogenesis and pathology.
Polymer-Single Wall Carbon Nanotube Composites for Potential Spacecraft Applications
- Cheol Park, Zoubeida Ounaies, Kent A. Watson, Kristin Pawlowski, Sharon E. Lowther, John W. Connell, Emilie J. Siochi, Joycelyn S. Harrison, Terry L. St. Clair
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- Journal:
- MRS Online Proceedings Library Archive / Volume 706 / 2001
- Published online by Cambridge University Press:
- 15 March 2011, Z3.30.1
- Print publication:
- 2001
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Polymer-single wall carbon nanotube (SWNT) composite films were prepared and characterized as part of an effort to develop polymeric materials with improved combinations of properties for potential use on future spacecraft. Next generation spacecraft will require ultra-lightweight materials that possess specific and unique combinations of properties such as radiation and atomic oxygen resistance, low solar absorptivity, high thermal emissitivity, electrical conductivity, tear resistance, ability to be folded and seamed, and good mechanical properties. The objective of this work is to incorporate sufficient electrical conductivity into space durable polyimides to mitigate static charge build-up. The challenge is to obtain this level of conductivity (10-8 S/cm) without degrading other properties of importance, particularly optical transparency. Several different approaches were attempted to fully disperse the SWNTs into the polymer matrix. These included high shear mixing, sonication, and synthesizing the polymers in the presence of pre-dispersed SWNTs. Acceptable levels of conductivity were obtained at loading levels less than one tenth weight percent SWNT without significantly sacrificing optical properties. Characterization of the nanocomposite films and the effect of SWNT concentration and dispersion on the conductivity, solar absorptivity, thermal emissivity, mechanical and thermal properties were discussed. Fibers and non-woven porous mats of SWNT reinforced polymer nanocomposite were produced using electrospinning.