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Najjar, souhel

Kevin Duh, Michael G Funaro, William DeGouveia, Sonia Bahlani, Dominic Pappas, Souhel Najjar, Inna Tabansky, Robert Moldwin, Joel N H Stern
Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a condition causing intense pelvic pain and urinary symptoms. While it is thought to affect millions of people and significantly impair quality of life, difficulty with diagnosis and a lack of reliably effective treatment options leave much progress to be made in managing this condition. We describe what is currently known about the immunological and neurological basis of this disease, focusing on the interactions between the immune and nervous system...
May 2018: Discovery Medicine
Souhel Najjar, Johann Steiner, Amanda Najjar, Karl Bechter
Growing data point to the overlap between psychosis and pathological processes associated with immunological dysregulation as well as inflammation. Notably, the recent discovery of antibodies against synaptic and neuronal cell membrane proteins such as anti-N-methyl-D-aspartate receptor provides more direct evidence of the etiological connection between autoimmunity and subsequent hazard of psychosis. Here, we advocate the use of term "autoimmune psychosis," as this term suggests that autoimmune disorders can masquerade as drug-resistant primary psychosis, and this subtype of psychosis has anatomical and immunological footprints in the brain, despite the frequent absence of structural abnormalities on conventional brain MRI...
February 13, 2018: Journal of Neuroinflammation
Souhel Najjar, Silky Pahlajani, Virginia De Sanctis, Joel N H Stern, Amanda Najjar, Derek Chong
Schizophrenia is a psychotic disorder characterized by delusions, hallucinations, negative symptoms, as well as behavioral and cognitive dysfunction. It is a pathoetiologically heterogeneous disorder involving complex interrelated mechanisms that include oxidative stress and neuroinflammation. Neurovascular endothelial dysfunction and blood-brain barrier (BBB) hyperpermeability are established mechanisms in neurological disorders with comorbid psychiatric symptoms such as epilepsy, traumatic brain injury, and Alzheimer's disease...
2017: Frontiers in Psychiatry
Michael Funaro, Mark Messina, Maya Shabbir, Paul Wright, Souhel Najjar, Inna Tabansky, Joel N H Stern
Multiple sclerosis (MS) is a multicomponent disease that is marked by continual inflammation, demyelination and irreparable damage to the central nervous system. While it was long thought to be mediated by T cells, B cells are now understood to be a central component of MS pathology. Dysfunction and aberrant activity of antigen presenting cells, T cells and B cells are all part of the pathophysiology of the disease. B cells and plasma cells contribute to disease progression through multiple mechanisms, including cytokine secretion, antibody production and antigen presentation...
November 2016: Discovery Medicine
Inna Tabansky, Mark D Messina, Catherine Bangeranye, Jeffrey Goldstein, Karen M Blitz-Shabbir, Suly Machado, Venkatesh Jeganathan, Paul Wright, Souhel Najjar, Yonghao Cao, Warren Sands, Derin B Keskin, Joel N H Stern
No abstract text is available yet for this article.
April 2016: Immunologic Research
Inna Tabansky, Mark D Messina, Catherine Bangeranye, Jeffrey Goldstein, Karen M Blitz-Shabbir, Suly Machado, Venkatesh Jeganathan, Paul Wright, Souhel Najjar, Yonghao Cao, Warren Sands, Derin B Keskin, Joel N H Stern
Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system. It is characterized by demyelination of neurons and loss of neuronal axons and oligodendrocytes. In MS, auto-reactive T cells and B cells cross the blood-brain barrier (BBB), causing perivenous demyelinating lesions that form multiple discrete inflammatory demyelinated plaques located primarily in the white matter. In chronic MS, cortical demyelination and progressive axonal transections develop. Treatment for MS can be stratified into disease-modifying therapies (DMTs) and symptomatic therapy...
December 2015: Immunologic Research
Daniel M Pearlman, Souhel Najjar
No abstract text is available yet for this article.
October 2014: American Journal of Psychiatry
Daniel M Pearlman, Haily S Vora, Brian G Marquis, Souhel Najjar, Lauren A Dudley
BACKGROUND: Autoimmune-mediated basal ganglia dysfunction is implicated in the pathophysiology of neuropsychiatric disorders commonly manifesting with obsessive-compulsive features (e.g. Sydenham chorea). The relationship between autoimmunity and primary obsessive-compulsive disorder (OCD), however, is less clear. AIMS: To pool data on serum and cerebrospinal fluid (CSF) anti-basal ganglia antibody (ABGA) positivity in primary OCD (without neurological or autoimmune comorbidity) relative to controls or neuropsychiatric disorders previously associated with increased odds of ABGA positivity...
July 2014: British Journal of Psychiatry: the Journal of Mental Science
Souhel Najjar, Daniel M Pearlman
BACKGROUND: Neuroinflammation and white matter pathology have each been independently associated with schizophrenia, and experimental studies have revealed mechanisms by which the two can interact in vitro, but whether these abnormalities simultaneously co-occur in people with schizophrenia remains unclear. METHOD: We searched MEDLINE, EMBASE, PsycINFO and Web of Science from inception through 12 January 2014 for studies reporting human data on the relationship between microglial or astroglial activation, or cytokines and white matter pathology in schizophrenia...
January 2015: Schizophrenia Research
Souhel Najjar, Daniel M Pearlman, Orrin Devinsky, Amanda Najjar, David Zagzag
About one-third of people with major depressive disorder (MDD) fail at least two antidepressant drug trials at 1 year. Together with clinical and experimental evidence indicating that the pathophysiology of MDD is multifactorial, this observation underscores the importance of elucidating mechanisms beyond monoaminergic dysregulation that can contribute to the genesis and persistence of MDD. Oxidative stress and neuroinflammation are mechanistically linked to the presence of neurovascular dysfunction with blood-brain barrier (BBB) hyperpermeability in selected neurological disorders, such as stroke, epilepsy, multiple sclerosis, traumatic brain injury, and Alzheimer's disease...
2013: Journal of Neuroinflammation
Orrin Devinsky, Adam Schein, Souhel Najjar
Systemic autoimmune disorders affect multiple organ systems. Brain involvement commonly causes seizures, which may be the presenting symptom. Systemic lupus erythematosus, Sjorgren's syndrome, Wegener's granulomatosis, sarcoidsosis, celiac disease, Crohn's disease, Behcet's, and Hashimoto's encephalopathy are reviewed. Mechanisms underlying CNS pathology in systemic autoimmune disorders-and specifically factors predisposing these patients-are discussed, including vascular disease (e.g., prothrombotic state, anticardiolipin antibody, emboli, vasculitis), antineuronal antibodies, immune complexes, cytokines, metabolic disorders, infection, and therapy...
March 2013: Epilepsy Currents
Souhel Najjar, Daniel M Pearlman, Kenneth Alper, Amanda Najjar, Orrin Devinsky
Multiple lines of evidence support the pathogenic role of neuroinflammation in psychiatric illness. While systemic autoimmune diseases are well-documented causes of neuropsychiatric disorders, synaptic autoimmune encephalitides with psychotic symptoms often go under-recognized. Parallel to the link between psychiatric symptoms and autoimmunity in autoimmune diseases, neuroimmunological abnormalities occur in classical psychiatric disorders (for example, major depressive, bipolar, schizophrenia, and obsessive-compulsive disorders)...
April 1, 2013: Journal of Neuroinflammation
Souhel Najjar, Daniel Pearlman, Orrin Devinsky, Amanda Najjar, Siddhartha Nadkarni, Tracy Butler, David Zagzag
We report a patient with a seronegative autoimmune panencephalitis, adding a subtype to the emerging spectrum of seronegative autoimmune encephalitis, and we review the sparse literature on isolated psychiatric presentations of autoimmune encephalitis. (A PubMed search for "seronegative autoimmune encephalitis," "nonvasculitic autoimmune inflammatory meningoencephalitis," and related terms revealed <25 cases.) A 15-year-old girl developed an acute-onset isolated psychosis with prominent negative symptoms and intermittent encephalopathy...
March 2013: Cognitive and Behavioral Neurology: Official Journal of the Society for Behavioral and Cognitive Neurology
Orrin Devinsky, Annamaria Vezzani, Souhel Najjar, Nihal C De Lanerolle, Michael A Rogawski
Epilepsy is characterized by recurrent spontaneous seizures due to hyperexcitability and hypersynchrony of brain neurons. Current theories of pathophysiology stress neuronal dysfunction and damage, and aberrant connections as relevant factors. Most antiepileptic drugs target neuronal mechanisms. However, nearly one-third of patients have seizures that are refractory to available medications; a deeper understanding of mechanisms may be required to conceive more effective therapies. Recent studies point to a significant contribution by non-neuronal cells, the glia--especially astrocytes and microglia--in the pathophysiology of epilepsy...
March 2013: Trends in Neurosciences
Souhel Najjar, Daniel Pearlman, David Zagzag, John Golfinos, Orrin Devinsky
INTRODUCTION: Glutamic acid decarboxylase (GAD) is the rate-limiting enzyme converting glutamate into γ-aminobutyric acid. Impaired GAD function can alter motor, cognitive, and behavioral function. Anti-GAD antibodies (GADAbs) can cause several neurological disorders. However, the association between anti-GADAbs and pure psychosis, without seizures or focal neurological deficits, is not well defined. CASE REPORT: A 19-year-old woman with recent-onset psychotic disorder was diagnosed with schizophrenia...
March 2012: Neurologist
Orrin Devinsky, Souhel Najjar
"If I wished to show a student the difficulties of getting at truth from medical experience, I would give him the history of epilepsy to read." Oliver Wendell Holmes (1)If the medical experience of epilepsy is obscured by uncertainties, then its classification is mired in the mud of expert opinion. The newly revised terms and concepts for "organizing" (also known as "classifying") seizures and epilepsy provide a humble and modern perspective, with many superb suggestions (2). The central points are well articulated and valid: 1) divorcing classification from "expert opinion" and marrying it to science; 2) acknowledging what is unknown; and 3) simplifying and clarifying terminology...
September 2011: Epilepsy Currents
Souhel Najjar, Daniel Pearlman, Douglas C Miller, Orrin Devinsky
BACKGROUND: Experimental and clinical studies support a pathogenic role of microglial activation and proliferation (MAP) in epileptogenesis. METHODS: From a consecutive series of 319 surgically treated epilepsy cases, we retrospectively reviewed the histopathological sections of 92 cases to define the prevalence and severity of MAP after excluding the other 227 because of coexisting disorders that might contribute to MAP. Severity of MAP was compared with underlying abnormalities...
September 2011: Neurologist
Souhel Najjar, Daniel Pearlman, David Zagzag, Orrin Devinsky
OBJECTIVE: We describe a patient with seronegative autoimmune limbic encephalitis (SNALE) masquerading as glioma. Brain magnetic resonance imaging (MRI) abnormalities, distinctive pathological findings, and spontaneous remission are highlighted. BACKGROUND: There are 15 previously reported SNALE cases, 1 with pathology. MATERIALS AND METHODS: A 66-year-old man presented with prominent amnestic syndrome, progressive cognitive decline, and refractory complex partial seizures...
June 2011: Cognitive and Behavioral Neurology: Official Journal of the Society for Behavioral and Cognitive Neurology
Souhel Najjar, Daniel Pearlman, Amanda Najjar, Vahid Ghiasian, David Zagzag, Orrin Devinsky
Nonparaneoplastic glutamic acid decarboxylase antibody (GADAb)-related autoimmune encephalitis is a syndrome characterized by refractory seizures, progressive cognitive deficits, and psychiatric manifestations. The limbic subtype is well described, has characteristic affective and memory disturbances, and typical mesial temporal MRI abnormalities. We found only one single case report of the extralimbic subtype. We report clinical, radiological, and pathological findings of two additional cases with contrast-enhancing lesions...
July 2011: Epilepsy & Behavior: E&B
Souhel Najjar, Melissa Bernbaum, George Lai, Orrin Devinsky
Immune mechanisms play a critical role in systemic disorders (systemic lupus erythematosus, Sjögren's syndrome, Crohn's disease, and sarcoidosis) and in localized central nervous system (CNS) disorders (CNS vasculitis, multiple sclerosis, acute disseminated encephalomyelitis, and encephalitides). Both humoral and cell-mediated mechanisms are involved in the systemic and CNS-limited disorders. Immune mechanisms may also be a factor in a number of epilepsies such as Rasmussen's encephalitis, Lennox-Gastaut syndrome, Landau-Kleffner syndrome, and temporal lobe epilepsy...
2008: Reviews in Neurological Diseases
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