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Fulltext Big Brain Data Initiative in Universiti Sains Malaysia: Challenges in Brain Mapping for Malaysia

Shekh Ibrahim SA, Hamzah N, Abdul Wahab AR, Abdullah JM, Nurul Hashimah Ahamed Hassain Malim, Sumari P, et al.

Malays J Med Sci, 2020 Jul;27(4):1-8.
PMID: 32863741 DOI: 10.21315/mjms2020.27.4.1

Universiti Sains Malaysia has started the Big Brain Data Initiative project since the last two years as brain mapping techniques have proven to be important in understanding the molecular, cellular and functional mechanisms of the brain. This Big Brain Data Initiative can be a platform for neurophysicians and neurosurgeons, psychiatrists, psychologists, cognitive neuroscientists, neurotechnologists and other researchers to improve brain mapping techniques. Data collection from a cohort of multiracial population in Malaysia is important for present and future research and finding cure for neurological and mental illness. Malaysia is one of the participant of the Global Brain Consortium (GBC) supported by the World Health Organization. This project is a part of its contribution via the third GBC goal which is influencing the policy process within and between high-income countries and low- and middle-income countries, such as pathways for fair data-sharing of multi-modal imaging data, starting with electroencephalographic data.
Fulltext Examination Approaches to Brachial Plexus Injury for Neurosurgical Residents

Saleh U, Tan GY, Fuad M, Abdullah JM, Idris Z, Ghani ARI, et al.

Malays J Med Sci, 2023 Dec;30(6):61-69.
PMID: 38239251 DOI: 10.21315/mjms2023.30.6.7

BACKGROUND: Brachial plexus injury is a severe peripheral nerve injury that affects the upper extremities and causes functional damage and disability. A detailed and accurate clinical examination is required to accurately localise the site of injury. This video manuscript aims to provide guidelines for the structured assessment of a patient with brachial plexus injury, specifically tailored to Malaysian medical students and trainees.
METHODS: A video demonstrating the examination of the brachial plexus was made. This video, created at the School of Medical Sciences at Universiti Sains Malaysia (USM), demonstrates the proper examination technique for brachial plexus.
CONCLUSION: We hope that this video will help students and young doctors evaluate patients with brachial plexus injury and reach accurate localisation of the injury.
What are Your Eyes Revealing? The Contemporary Bedside Neuro-Ophthalmological Examination

Ng PM, Abdullah JM, Idris Z, Ghani ARI, Abdul Halim S

Malays J Med Sci, 2021 Oct;28(5):142-148.
PMID: 35115897 DOI: 10.21315/mjms2021.28.5.15

The neuro-ophthalmological evaluation is done to assess the integrity of cranial nerves II, III, IV, VI. This work does not intend to substitute the examination in a fully equipped ophthalmology suite. The aim of this manuscript is to describe bedside examination of the eye by using simple apparatus that are easily available. This work incorporates the usage of smartphone application, as smartphone is deemed an accessory in almost every resident's pocket during review of patients as a consult in the emergency department. However, the essence of traditional physical examination remains the fundamental. Understanding of neuroanatomy and neurophysiology of the eye and the central nervous system can enhance the clinician's performance at the bedside.
Decoding of visual information from human brain activity: A review of fMRI and EEG studies

Zafar R, Malik AS, Kamel N, Dass SC, Abdullah JM, Reza F, et al.

J Integr Neurosci, 2015 Jun;14(2):155-68.
PMID: 25939499 DOI: 10.1142/S0219635215500089

Brain is the command center for the body and contains a lot of information which can be extracted by using different non-invasive techniques. Electroencephalography (EEG), Magnetoencephalography (MEG) and functional magnetic resonance imaging (fMRI) are the most common neuroimaging techniques to elicit brain behavior. By using these techniques different activity patterns can be measured within the brain to decode the content of mental processes especially the visual and auditory content. This paper discusses the models and imaging techniques used in visual decoding to investigate the different conditions of brain along with recent advancements in brain decoding. This paper concludes that it's not possible to extract all the information from the brain, however careful experimentation, interpretation and powerful statistical tools can be used with the neuroimaging techniques for better results.
Endoscopic fenestration at the splenial-habenular junctional area for symptomatic cavum and tumor at the foramen of Monro: case reports and anatomical review

Idris Z, Johnson JR, Abdullah JM

J. Neurosurg., 2015 Mar;122(3):504-10.
PMID: 25343181 DOI: 10.3171/2014.9.JNS132683

The splenial-habenular junctional area is an alternative site for neuroendoscopic fenestration to divert CSF flow into the quadrigeminal cistern in cases in which endoscopic third ventriculostomy is not amenable. In some patients with obstructive hydrocephalus, the splenium of the corpus callosum can be elevated from the habenular complex. This exposes the membranous connection between the splenium and habenula, which can be fenestrated to divert the CSF flow into the quadrigeminal cistern. This technique can be performed in patients in whom the foramen of Monro or the third ventricle is blocked by a lesion. Here, the authors present 3 complex cases that were managed by neuronavigation-guided transventricular transcavum endoscopic fenestration of the splenial-habenular junctional area. These cases may increase the knowledge and understanding of the anatomy of this region.
Addition of zygomatic arch resection in decompressive craniectomy

Martin AG, Abdullah JY, Jaafar A, Ghani AR, Rajion ZA, Abdullah JM

J Clin Neurosci, 2015 Apr;22(4):735-9.
PMID: 25564264 DOI: 10.1016/j.jocn.2014.09.021

Decompressive craniectomy (DC) is a surgical option in managing uncontrolled raised intracranial pressure refractory to medical therapy. The authors evaluate the addition of zygomatic arch (ZA) resection with standard DC and analyze the resulting increase in brain volume using three-dimensional volumetric CT scans. Measurements of brain expansion dimension morphometrics from CT images were also analyzed. Eighteen patients were selected and underwent DC with ZA resection. The pre- and post-operative CT images were analyzed for volume and dimensional changes. CT images of 29 patients previously operated on at the same center were retrieved from the picture archiving and communication system (PACS) and were similarly studied. The findings obtained from the two groups were compared and analyzed. Analysis from three-dimensional CT volumetric techniques revealed an significant increase of 27.97ml (95% confidence interval [CI]: 39.98-180.36; p=0.048) when compared with standard DC. Brain expansion analysis of maximum hemicraniectomy diameter revealed a mean difference of 0.82cm (95% CI: 0.25-1.38; p=0.006). Analysis of the ratio of maximum hemicraniectomy diameter to maximum anteroposterior diameter gave a mean difference of 0.04 (95% CI: 0.05-0.07; p=0.026). The addition of ZA resection to standard DC may prove valuable in terms of absolute brain volume gain. This technique is comparable to other maneuvers used to provide maximum brain expansion in the immediate post-operative period.
Fulltext Bilateral subtentorial empyema complicated with nosocomial acinectobacter ventriculitis: a case report

Sim SK, Ch'ng CH, Tan YC, Kandasamy R, Abdullah JM

Med J Malaysia, 2014 Apr;69(2):86-8.
PMID: 25241818 MyJurnal

Subtentorial subdural empyema is a rare and life threatening intracranial suppuration. It is usually an intracranial complication of otogenic infections. Early diagnosis and surgical drainage are the most important factors determining prognosis. The high mortality reported in the literature reflects the severity of subtentorial subdural empyema if proper management is delayed. Intracranial infections usually require between 4 to 6 weeks of intravenous antibiotics therapy. However, the prolonged duration of hospitalization as well as requirement for neurosurgically inserted indwelling devices may predispose these patients to new nosocomial infections.
Fulltext Pleomorphic xanthoastrocytoma in a case of tuberous sclerosis

Martin AG, Singh MS, Idris B, Abdullah JM

J Neurosci Rural Pract, 2014 Jul;5(3):258-60.
PMID: 25002765 DOI: 10.4103/0976-3147.133580

Tuberous sclerosis is a known phakomatosis and the associated finding of a subependymal giant cell astrocytoma is common with this disorder. A case of tuberous sclerosis with a finding not previously reported, i.e. that of a pleomorphic xanthoastrocytoma, is presented here.
Influence of education level on design-induced N170 and P300 components of event related potentials in the human brain

Begum T, Reza F, Ahmed I, Abdullah JM

J Integr Neurosci, 2014 Mar;13(1):71-88.
PMID: 24738540 DOI: 10.1142/S0219635214500058

Simple geometric and organic shapes and their arrangement are being used in different neuropsychology tests for the assessment of cognitive function, special memory and also for the therapy purpose in different patient groups. Until now there is no electrophysiological evidence of cognitive function determination for simple geometric, organic shapes and their arrangement. Then the main objective of this study is to know the cortical processing and amplitude, latency of visual induced N170 and P300 event related potential components on different geometric, organic shapes and their arrangement and different educational influence on it, which is worthwhile to know for the early and better treatment for those patient groups. While education influenced on cognitive function by using auditory oddball task, little is known about the influence of education on cognitive function induced by visual attention task in case of the choice of geometric, organic shapes and their arrangements. Using a 128-electrode sensor net, we studied the responses of the choice of the different geometric and organic shapes randomly in experiment 1 and their arrangements in experiment 2 in the high, medium and low education groups. In both experiments, subjects push the button "1" or "2" if like or dislike, respectively. Total 45 healthy subjects (15 in each group) were recruited. ERPs were measured from 11 electrode sites and analyzed to see the evoked N170/N240 and P300 ERP components. There were no differences between like and dislike in amplitudes even in latencies in every stimulus in both experiments. We fixed geometric shapes and organic shapes stimuli only, not like and dislike. Upon the stimulus types, N170 ERP component was found instead of N240, in occipito-temporal (T5, T6, O1 and O2) locations where the amplitude is the highest at O2 location and P300 was distributed in the central (Cz and Pz) locations in both experiments in all groups. In experiment 1, significant low amplitude and non-significant larger latency of the N170 component are found out at O1 location for both stimuli in low education group comparing medium education groups, but in experiment 2, there is no significant difference between stimuli among groups in amplitude and latency. In both experiments, P300 component was found in Cz and Pz locations though the amplitudes are higher at Cz than Pz areas. In experiment 1, medium education group evoked significantly (geometric shape stimuli, P = 0.05; organic shape stimuli, P = 0.02) higher amplitude of P300 component comparing low education group at Cz location. Whereas, there is no significant difference of amplitudes among groups across stimuli in Cz and Pz locations in experiment 2. Latencies have no significant differences in both experiments among groups also, but longer latency are found in low education group at Cz location comparing medium education group, though not significant. We conclude that simple geometric shapes, organic shapes and their arrangements evoked visual N170 component at temporo-occipital areas with right lateralization and P300 ERP component at centro-parietal areas. Significant low amplitude of N170 and P300 ERP components and longer latencies during different shape stimuli in low education group prove that, low education significantly influence on visual cognitive functions in low education group.
Normabaric Hyperoxia Treatment Improved Locomotor Activity of C57BL/6J Mice through Enhancing Dopamine Genes Following Fluid-Percussion Injury in Striatum

Muthuraju S, Taha S, Pati S, Rafique M, Jaafar H, Abdullah JM

Int J Biomed Sci, 2013 Dec;9(4):194-204.
PMID: 24711754

Closed traumatic brain injury (CTBI) leads to increase mortality rates in developing countries. However, a sustainable therapeutic approach has not been established yet. Therefore, the present study was designed to evaluate the impact of normabaric hyperoxia treatment (NBOT) on striatum associated Locomotor Activity (LA) in IntelliCage after Fluid-Percussion Injury (FPI). Animals were divided in four groups: Group I control (n=24), Group II sham (n=24), Group III FPI (n=24) and Group IV FPI with NBOT (n=24). Animals were habituated in IntelliCage for 4 days following transponder implanted in mice neck region on day 5. Then the LA of all groups was assessed 6hr daily for 5 days before inducing FPI. On day 6, cannula was implanted on the striatum, on day 7 FPI was performed in Group III (kept in normal environment) and IV (immediately exposed to NBOT for 3 hr). LA (in terms of number of visits in all four corners) was assessed 6 hr at days 1, 7, 14, 21 and 28 following FPI. After the animals were sacrificed to study the neuronal damage, dopamine receptors and transporters expression in striatum. The results suggested that the LA of FPI impaired mice as compared to the control and sham showed less number of visits in all four corners in IntelliCage. Morphological results revealed that FPI induced neuronal damage as compared to sham and control. Dopamine receptors and transporters were down regulated in the FPI group as compared to the control. Immediate exposure to NBOT improved LA in terms of increased number of visits in all four corners, reduced number of cell death and improved receptor expression as compared to FPI. In conclusion, NBOT exposure could improve the LA of mice following FPI through prevention of neuronal damage, improved dopamine receptors and transporters.
A preliminary study of using active vision guided robotic arm for bone drilling in a developing country

Abdullah MZ, Awang MS, Tan YC, Abdullah JM

J Neurol Surg A Cent Eur Neurosurg, 2014 Mar;75(2):155-7.
PMID: 23636911 DOI: 10.1055/s-0032-1330954

The study assesses the capability and accuracy of a robotic arm to perform burr holes.
Fulltext Viability reduction and Rac1 gene downregulation of heterogeneous ex-vivo glioma acute slice infected by the oncolytic Newcastle disease virus strain V4UPM

Mustafa Z, Shamsuddin HS, Ideris A, Ibrahim R, Jaafar H, Ali AM, et al.

Biomed Res Int, 2013;2013:248507.
PMID: 23586025 DOI: 10.1155/2013/248507

Oncolytic viruses have been extensively evaluated for anticancer therapy because this virus preferentially infects cancer cells without interfering with normal cells. Newcastle Disease Virus (NDV) is an avian virus and one of the intensively studied oncolytic viruses affecting many types of cancer including glioma. Nevertheless, the capability of NDV infection on heterogeneous glioma tissue in a cerebrospinal fluid atmosphere has never been reported. Recently, Rac1 is reported to be required for efficient NDV replication in human cancer cells and established a link between tumourigenesis and sensitivity to NDV. Rac1 is a member of the Rho GTPases involved in the regulation of the cell migration and cell-cycle progression. Rac1 knockdown leads to significant inhibition of viral replication. In this work, we demonstrated that NDV treatment led to significant reduction of tumour tissue viability of freshly isolated heterogeneous human brain tumour slice, known as an ex vivo glioma acute slice (EGAS). Analysis of gene expression indicated that reduced tissue viability was associated with downregulation of Rac1. However, the viability reduction was not persistent. We conclude that NDV treatment induced EGAS viability suppression, but subsequent downregulation of Rac1 gene may reduce the NDV replication and lead to regrowth of EGAS tissue.
Fulltext Platelet alloantigen polymorphism and migraine headaches

Bhaskar S, Abdullah JM

Neurosciences (Riyadh), 2013 Apr;18(2):185-6.
PMID: 23545624
Fulltext The role of repeat head computed tomography in the management of mild traumatic brain injury patients with a positive initial head CT

Sharifuddin A, Adnan J, Ghani AR, Abdullah JM

Med J Malaysia, 2012 Jun;67(3):305-8.
PMID: 23082423 MyJurnal

This was a prospective observational study done to evaluate the role of a repeat head CT in patients with mild traumatic brain injury. The aim was to evaluate wether the repeat head CT were useful in providing information that leads to any neurosurgical intervention. 279 adult patients with a mild head injury (GCS 13-15) were enrolled, and these comprised of patients with an initial traumatic intracranial haemorrhage not warranting any surgical intervention. All patients were subjected to a repeat head CT within 48 hours of admission and these showed no change or improvements of the brain lesion in 217 patients (79.2%) and worsening in 62 patients (20.8%). In thirty-one patients, surgical intervention was done following the repeat head CT. All of these patients had a clinical deterioration prior to the repeat head CT. Even if a repeat head CT had not been ordered on these patients, they would have had a repeat head CT due to deteriorating neurological status. When the 62 patients with a worsening repeat head CT were compared with the 217 patients with an improved or unchanged repeat head CT, they were found to have older age, lower GCS on admission, presenting symptoms of headache, higher incidence of multiple traumatic intracranial pathology and lower haemoglobin level on admission. On stepwise multiple logistic regression analysis, three factors were found to independently predict a worse repeat head CT (Table IV). This includes age of 65 years or older, GCS score of less than 15 and multiple traumatic intracranial lesion on initial head CT. As a conclusion, we recommend that, in patients with a MTBI and a normal neurological examination, a repeat cranial CT is not indicated, as it resulted in no change in management or neurosurgical intervention. Close monitoring is warranted in a subset of patients with risk factors for a worsening repeat head CT.
Keywords: Computed tomography, brain injury, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
Neuronavigation-guided endoscopic management of a pineal region tumour with obscured floor of the third ventricle: case report

Idris Z, Ghani AR, Idris B, Muzaimi M, Awang S, Pal HK, et al.

Minim Invasive Neurosurg, 2011 Jun;54(3):125-7.
PMID: 21863520 DOI: 10.1055/s-0031-1277198

Shunt surgery is frequently chosen to manage periventricular metastasis of pineal region tumours which obscured the floor of the third ventricle. However, this procedure falls short due to distant metastasis. Neuronavigation-guided endoscopic surgery offers a viable alternative.
Fulltext Improving the management of brain injuries in Malaysian hospitals

Abdullah JM

Med J Malaysia, 2011 Jun;66(2):83.
PMID: 22106681
The role of a high augmentation index in spontaneous intracerebral hemorrhage to prognosticate mortality

Keong LH, Ghani AR, Awang MS, Sayuthi S, Idris B, Abdullah JM

Acta Neurochir. Suppl., 2011;111:375-9.
PMID: 21725785 DOI: 10.1007/978-3-7091-0693-8_63

The aim of the study was to determine the prognostic value of a high augmentation index, which was a surrogate marker of arterial stiffness in patients with spontaneous intracerebral hemorrhage. The outcome was divided into two groups in which the following data were collected in a computer running SphygmoCor CvMS software version 8.2. Logistic regression analysis was carried out among significant variables to identify an independent predictor of 6-month outcome and mortality. Sixty patients were recruited into the study. Admission Glasgow Coma Scale score (OR, 0.7; 95% CI, 0.450-0.971; P=0.035), total white cell count (OR, 1.2; 95% CI, 1.028-1.453; P=0.023) and hematoma volume (OR, 1.1; 95% CI, 1.024-1.204; P=0.011) were found to be statistically significant for identifying poor 6-month outcome in multivariate analysis. Factors independently associated with mortality were a high augmentation index (OR, 8.6; 95% CI, 1.794-40.940; P=0.007) and midline shift (OR, 7.5; 95% CI, 1.809-31.004; P=0.005). Admission Glasgow Coma Scale score, total white cell count and hematoma volume were significant predictors for poor 6-month outcome, and a high augmentation index and midline shift were predictors for 6-month mortality in this study.
Fulltext Role of high augmentation index in spontaneous intracerebral haemorrhage

Lee HK, Ghani AR, Awang MS, Sayuthi S, Idris B, Abdullah JM

Asian J Surg, 2010 Jan;33(1):42-50.
PMID: 20497882 DOI: 10.1016/S1015-9584(10)60008-5

Intracerebral haemorrhage (ICH) is the most disabling and least treatable form of stroke. Its risk factors include old age, hypertension, diabetes mellitus, hypercholesterolaemia, smoking and high alcohol intake, which are also associated with arterial stiffness. The aim of the present study was to determine the prognostic value of high augmentation index (AI), which is a surrogate marker of arterial stiffness, in patients with spontaneous ICH.
Outcome of 2 different types of operative techniques practiced for chronic subdural hematoma in Malaysia: an analysis

Zakaraia AM, Adnan JS, Haspani MS, Naing NN, Abdullah JM

Surg Neurol, 2008 Jun;69(6):608-15; discussion 616.
PMID: 18486703 DOI: 10.1016/j.surneu.2007.01.054

Traumatic chronic subdural hematomas in Malaysia are increasingly common in young patients after road traffic accidents as well as the elderly who fall at home. Most surgeons in this country manage these pathologies without irrigation, with only a drainage system. This has led to criticism that the recurrence rate might be higher when no irrigation is done and that rates are lower with irrigation and drainage. Thus, a study was done to look into the outcome of TCSH operated with and without irrigation, followed by drainage, to guide the surgeons in Malaysia as to what best could be done for these cases.
Newcastle diseases virus strain V4UPM displayed oncolytic ability against experimental human malignant glioma

Zulkifli MM, Ibrahim R, Ali AM, Aini I, Jaafar H, Hilda SS, et al.

Neurol Res, 2009 Feb;31(1):3-10.
PMID: 18937888 DOI: 10.1179/174313208X325218

Newcastle disease virus (NDV) is a virus of paramyxovirus family and lately has been studied for the treatment of cancer in human. In this study, we successfully determined the oncolysis potential of NDV vaccine, V4UPM tested on the human glioblastoma multiform cell line (DBTRG.05MG) and human glioblastoma astrocytoma cell line (U-87MG) in vitro and in vivo. The V4UPM strain is a modified V4 strain developed as thermostable feed pellet vaccine for poultry.

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