Pooja Kulkarni - Academia.edu (original) (raw)

Papers by Pooja Kulkarni

Journal of Neurorestoratology, Feb 1, 2017

Innovations in clinical neuroscience, 2020

Cerebral palsy (CP) is a chronic childhood disorder that is characterized by a group of motor and... more Cerebral palsy (CP) is a chronic childhood disorder that is characterized by a group of motor and cognitive impairments, resulting in abnormal movement patterns, loss of motor control, incoordination, and unbalanced posture. It can also have an impact on fine motor skills, gross motor skills, and oral motor functioning. Currently, the treatment of CP is palliative and does not cure the disease pathology. Hence, there is a need for an intervention that might be able to alter the core pathology. Autologous bone marrow mononuclear cells (BMMNC) transplantation is one of the novel treatment strategies in recent years. In this study, we presented the case of a 4-year-old male child with spastic diplegic CP who underwent two intrathecal transplantations at interval of seven months with autologous BMMNC along with neurorehabilitation program. During an overall 16-month follow-up, significant improvements were observed in motor control, coordination, balance, sitting tolerance, and memory. ...

International Journal Of Medical Science And Clinical Invention, 2019

Intellectual disabilities (ID) are neurodevelopmental disorders characterized by deficits in inte... more Intellectual disabilities (ID) are neurodevelopmental disorders characterized by deficits in intellectual functioning and adaptive behavior which includes conceptual, social and practical skills. 1 out of 4 individuals with ID have co-existing autism spectrum disorder (ASD). Recently, cell therapy has shown great potential in management of ID with ASD due to their ability to address the underlying pathophysiology via immunomodulation and synaptogenesis. We administered autologous bone marrow mononuclear cells intrathecally in a 20-year-old male patient diagnosed as ID with ASD. Over 3 years follow up, there were no adverse events and along with symptomatic improvements, IQ scores improved from 46 to 56 and scores on ISAA improved from 134 to 70. Comparative positron emission tomography– computed tomography brain showed improved metabolism in bilateral frontal, temporal cortices and cerebellum. Autologous bone marrow mononuclear cell therapy may be effective to improve quality of lif...

Autism is a very complex neurodevelopmental disorder. Different researchers have tried understand... more Autism is a very complex neurodevelopmental disorder. Different researchers have tried understanding the basic pathophysiology of autism. It is understood now, that the neural hypoperfusion and immune dysregulation are the two key pathologies associated with Autism. There is reduced blood flow to certain specific areas of the brain (mesial temporal and cerebellum), which in turn could be the cause of reduced functioning in these areas. This coupled with an overall imbalance in the activity of the brain, is possibly responsible for the manifestations associated with autism.

International Journal of Health Sciences, 2020

Objective: The objective of the study was to analyze the effect of intrathecal transplantation of... more Objective: The objective of the study was to analyze the effect of intrathecal transplantation of autologous bone marrow-derived mononuclear cells (BMMNCs) in functional recovery of spinal cord injury (SCI) patients along with neurorehabilitation and to evaluate various factors influencing the outcome of cellular therapy. Methods: We conducted an open-label study including 180 sub-acute and chronic SCI patients. All patients received intrathecal autologous BMMNCs along with neurorehabilitation. 80–100 mL of bone marrow was aspirated and BMMNCs were obtained using density gradient separation. An average of 1.06 × 108 cells with 97% viability was administered through lumbar puncture immediately. After transplantation, all patients underwent neurorehabilitation. Patients were followed up after an average of 9 ± 7 months. They were assessed for functional symptomatic changes and the outcome measures used were functional independence measure (FIM) and walking index for SCI (WISCI). Resul...

Cerebral palsy (CP) encompasses a group of nonprogressive disorders of movement and posture causi... more Cerebral palsy (CP) encompasses a group of nonprogressive disorders of movement and posture causing activity limitation or disability. Presently, the treatment options are limited with primary focus being on rehabilitation of the patients. Cellular therapy is being considered as an alternative therapeutic strategy. Our patient is11-year-old girl diagnosed as a case of mixed cerebral palsy with both spastic and dystonic components. She presented with complaints of poor sitting and walking balance, incoordination and faltering school grades. Autologous bone marrow derived mononuclear cells were administered intrathecally along with extensive neurorehabilitation. Shmar et al, World J. Biol. Med. Science Volume 4 (3) 70-74, 2017 71 On follow up at 1 week, 7 months and 12 months, patient showed significant signs of improvement in higher brain functions like attention, awareness and judgement. Muscle tone had shifted from hypertonic to normotonic. There was significant improvement in gait...

Cell Journal (Yakhteh), 2015

Cerebral palsy (CP) is a non progressive, demyelinating disorder that affects a child’s developme... more Cerebral palsy (CP) is a non progressive, demyelinating disorder that affects a child’s development and posture and may be associated with sensation, cognition, communication and perception abnormalities. In CP, cerebral white matter is injured resulting in the loss of oligodendrocytes. This causes damage to the myelin and disruption of nerve conduction. Cell therapy is being explored as an alternate therapeutic strategy as there is no treatment currently available for CP. To study the benefits of this treatment we have administered autologous bone marrow mononuclear cells (BMMNCs) to a 12-year-old CP case. He was clinically re-evaluated after six months and found to demonstrate positive clinical and functional outcomes. His trunk strength, upper limb control, hand functions, walking stability, balance, posture and coordination improved. His ability to perform activities of daily living improved. On repeating the Functional Independence Measure (FIM), the score increased from 90 to ...

Spinal Cord Injury Therapy [Working Title], 2019

Journal of Neuropsychiatry, 2018

Stem cell research & therapy, Jan 31, 2018

The underlying pathophysiology in intellectual disability (ID) involves abnormalities in dendriti... more The underlying pathophysiology in intellectual disability (ID) involves abnormalities in dendritic branching and connectivity of the neuronal network. This limits the ability of the brain to process information. Conceptually, cellular therapy through its neurorestorative and neuroregenerative properties can counteract these pathogenetic mechanisms and improve neuronal connectivity. This improved networking should exhibit as clinical efficacy in patients with ID. To assess the safety and efficacy of cellular therapy in patients with ID, we conducted an open-label proof-of-concept study from October 2011 to December 2015. Patients were divided into two groups: intervention group (n = 29) and rehabilitation group (n = 29). The intervention group underwent cellular transplantation consisting of intrathecal administration of autologous bone marrow mononuclear cells and standard neurorehabilitation. The rehabilitation group underwent only standard neurorehabilitation. The results of the s...

Advanced biomedical research, 2018

Cellular therapy is being actively pursued as a therapeutic modality in many of the neurological ... more Cellular therapy is being actively pursued as a therapeutic modality in many of the neurological diseases. A variety of stem cells from diverse sources have been studied in detail and have been shown to exhibit angiogenetic and immunomodulatory properties in addition to other neuroprotective effects. Published clinical data have shown bone marrow mononuclear cell (BMMNC) injection in neurological disorders is safe and possesses regenerative potential. We illustrate a case of 27-year-old male with traumatic brachial plexus injury, administered with autologous BMMNCs intrathecally and intramuscularly, followed by multidisciplinary rehabilitation. At the follow-up assessment of 3 and 7 months after first cell transplantation, improvements were recorded in muscle strength and movements. Electromyography (EMG) performed after the intervention showed a response in biceps and deltoid muscles suggesting the process of reinnervation at the site of injury. In view of the improvements observed...

Journal of Clinical Case Reports, 2013

Journal of Clinical Case Reports, 2012

Transplantation Open, 2017

Journal of Neurorestoratology, 2017

European journal of translational myology, Jan 23, 2016

Becker muscular dystrophy (BMD) is an inherited disorder due to deletions of the dystrophin gene ... more Becker muscular dystrophy (BMD) is an inherited disorder due to deletions of the dystrophin gene that leads to muscle weakness. Effects of bone marrow mononuclear cell (BMMNC) transplantation in Muscular Dystrophy have shown to be safe and beneficial. We treated a 20-year-old male suffering from BMD with autologous BMMNC transplantation followed by multidisciplinary rehabilitation. He presented with muscle weakness and had difficulty in performing his activities. The BMMNCs were transplanted via intrathecal and intramuscular routes. The effects were measured on clinical and functional changes. Over 9 months, gradual improvement was noticed in muscle strength, respiratory functions and North Star Ambulatory Assessment Scale. Functional Independence Measure, Berg Balance Score, Brooke and Vignos Scale remained stable indicating halting of the progression. The case report suggests that cellular therapy combined with rehabilitation may have possibility of repairing and regenerating musc...