فصلنامه علوم اعصاب شفای خاتم
سال سوم شماره 4 (پیاپی 17، پای ی ز 1394)

Because of the high similarity of symptoms and clinical characteristics between borderline personality and bipolar spectrum disorders particularly bipolar-II disorder, some investigators reclassified borderline personality disorder on bipolar spectrum and considered common etiology for two disorders. In the present study in order to evaluate this hypothesis, intimate relationship and anger experience in borderline personality and bipolar-II disorders were compared.
A sample consists of 27 borderline personality and 31 bipolar-II disorder outpatients, who were referred to the Psychiatric Ward of Kamkar-arabnia hospital in Qom, Iran were selected through convenience sampling method. They answered to "Quality of relationship inventory" (QRI) and "Multidimensional Anger Inventory" (MAI). The mean of variables in both groups were compared by Independent T-test.
The results of Independent T-test showed that there was no significant difference between two groups in quality of intimate relationship and anger experience. However, borderline and bipolar-II patients had a significant difference in conflict subscale of QRI and anger arousal subscale of MAI. Compared to the bipolar-II patients, borderline patients were obtained higher scores on both subscales.
No significant difference between quality of intimate relationship and anger experience in borderline and bipolar-II groups may suggest authenticity of the hypothesis that borderline disorder belongs to bipolar spectrum and both disorders might have common etiology.

Autism, a complex neurodevelopmental disorder, is characterized by social impairments, communication difficulties, as well as restricted, repetitive, and stereotyped patterns of behavior. Changes in serum level of brain-derived neurotrophic factor (BDNF) play a role in autism etiology. However, the serum levels and the mechanism of action of BDNF in autism are needed to be elucidated. Therefore, this study was aimed to determine the serum levels of BDNF and its relation with working memory in valproic acid animal model of autism.
Female Sprague Dawley rats were divided into two Phosphate-Buffered Saline receiver (PBS) and Valproic Acid receiver (VPA) groups. The pregnant rats were recieved VPA (500 mg/kg/ip) or PBS for 12.5 days after gestation. We evaluated the offspring in postnatal days 30 and 60. To measure changes in working memory and the periodic behaviors of the animals, Y maze test was used. In addition, the serum levels of BDNF were determined by ELISA method.
Increased alteration behavior was observed in Y-maze test among offspring received VPA group compared to control rats. The serum levels of BDNF in VPA rats were significantly higher than PBS group.
BDNF increases accompanied by enhancement of periodic behaviors in VPA rats suggested a crucial role of this protein in working memory of autistic individuals.

Epilepsy is one of the most common neurological disorders associated with uncontrolled electrical activities in the brain. Electrolyte homeostasis is important for brain normal function. Imbalance in electrolytes can cause a seizure. The aim of this study is to evaluate the changes in lipids and electrolytes in absence seizure.
In this study, 10 WAG/Rij and 10 Wistar rats (6-month old) were used. Blood samples were collected from heart under deep anesthesia. Biochemical parameters such as the amounts of cholesterol, triglycerides, high density lipoprotein (HDL), low density lipoprotein (LDL), sodium, potassium, calcium, and chloride were analyzed in the blood serum.
The amount of sodium, potassium, and chloride in WAG/Rij rat’s blood plasma were significantly higher compared to Wistar rats and the amount of calcium in WAG/Rij was significantly lower than Wistar rats. In addition, the values of blood plasma lipids, including cholesterol, triglycerides, HDL, and LDL in WAG/Rij was lower than Wistar rats.
The results showed the differences in electrolytes and lipids of plasma between WAG/Rij and Wistar rats. Further studies are needed if changes of electrolytes and lipids of plasma may be associated with seizure occurrence in this animal model of absence epilepsy.

Parkinson’s disease (PD) is associated with a wide range of cognitive, psychological, and behavioral impairments that significantly affect the life quality of patients and their relatives. Nowadays, it has been observed that prognosis and the stage of the PD could be identified by Frontal Assessment Battery (FAB) via measurement of the abnormality in executive function. FAB test is a brief and precise test. There is a correlation between this test and the other diagnostic tests for PD, such as Unified Parkinson’s Disease Rating Scale (UPDRS) that is time consuming. Therefore, the aim of this study was to measure FAB and UPDRS scores and to determine the possible correlation between these tests.
Forty-nine patients diagnosed with PD and 50 healthy controls were included in the study. We compared FAB scores in normal controls and in PD patients, which were matched for age, sex, UPDRS, education and Mini-Mental State Examination score.
The results indicated a correlation between FAB and UPDRS tests in early stage of PD in all patients while there was no correlation between these two tests in men and women groups separately.
FAB diagnostic test is not an appropriate alternative for UPDRS in Iranian Patients with early stage of PD. It is needed to provide a proper version of this test for the Iranian patients based on Persian language and culture.

Delinquency is one of the social problems which is usually erupted during adolescence and caused serious problems for them, their families, and the society. There are various factors lead to delinquency, like early maladaptive schemas, anxiety, and cognitive regulation of emotion. This study was aimed to compare the early maladaptive schemas, hidden anxiety, and cognitive regulation of emotion in normal and delinquent juveniles in Mashhad, Iran.
In this causal-comparative study, there were two groups consisted of 60 male students (aged 12-17 years), divided in normal and delinquent groups. The group of normal juveniles (from high school) was selected by multistage cluster sample and the group of juvenile delinquents (from offenders group in juvenile institution) was selected by simple random sample. The questionnaires were concluded the Young early maladaptive schemas questionnaire, the Spielberger State-Trait Anxiety questionnaire, and the Cognitive Emotion Regulation questionnaire by Garnefski & Kraaij.
Data indicated that the mean scores of early maladaptive schemas in the juvenile delinquents were higher than in normal juveniles. In contrary, the mean scores of hidden anxiety and positive cognitive regulation of emotion were significantly higher in normal group. Regarding the negative cognitive regulation of emotion, there was no difference between two groups.
According to significant difference of early maladaptive schemas, hidden anxiety, and positive cognitive regulation of emotion between the delinquent and the normal groups, individual adjustment as well as psychological and social growth can be advantageous and helpful.

Both at the 11th edition of the international classification of diseases (ICD-11) and in the Fifth edition of the diagnostic and statistical manual of mental disorders (Fifth edition-DSM-5), It has been noted that the attitudes (toward self, others, world and future) and quality of sleep can be seriously impaired by post-traumatic stress disorder (PTSD). The present study was conducted to compare hostility and sleep disorders among nursing students with and without PTSD.
This descriptive-comparative causal study was performed on 190 (140 females & 50 males) nursing students from Islamic Azad University, Toyserkan, Iran. Participants were chosen by stratified sampling. Three questionnaires were used in this study, including the Post-Traumatic Stress Disorder Checklist-Civilian version (PCL-C), hostility subscale from Buss & Perry aggression questionnaire, and sleep disorder subscale from Mississippi scale for combat-related PTSD.
Fifty-six out of the 190 students were identified with PTSD symptoms. This group of students had significantly higher scores on hostility and sleep disorders. Regression analysis indicated that sleep disorders and hostility were strong positive predictors for PTSD.
Due to considerable prevalence and impact of PTSD on sleep quality and hostility in patients who suffering from PTSD, intervention to promote appropriate diagnosis and treatment seems to be crucial.

Fibromyalgia is a chronic and widespread pain syndrome, which is often accompanied by emotional disturbances. In this study, a hypothetical model of the effect of alexithymia, anxiety, and depression on pain severity in female patients with fibromyalgia in Tehran was tested.
In this cross sectional study, we selected 150 women with Fibromyalgia via convenience sampling. The patients were completed alexithymia (TAS-20), depression and anxiety (HADS), and pain intensity (SF-MPQ) scales.
The results indicated that the structural model of the variables was fitting well. Pain variable was found to be correlated with Alexithymia, depression, and anxiety. In this model, Alexithymia, depression, and anxiety have significant effects on pain severity.
This study demonstrated that anxiety and depression, which may be avoided and not expressed by individual, can affect pain in women with fibromyalgia. The findings suggest that interventions based on emotion regulation can effect on decreasing pain intensity in women suffering from fibromyalgia.

Due to the possible impact of posttraumatic stress disorder (PTSD) on biological markers of cardiovascular responses, it has become an essential part and hallmark of the diagnostic and statistical manual of mental disorders in the Fifth edition-DSM-5. This study aimed to investigate the biomarkers of cardiovascular responses in war veterans with PTSD.
34 male war veterans, among veterans with posttraumatic stress disorder in Kermanshah, participated in this cross sectional study on 2014. They were approved by medical committee as patients who suffer from PTSD. The data were collected by PTSD Checklist-Military version (PCL-M).
Data indicate that the mean age, the percentage of injury, and the duration that each individual spent in the war were 53.73, 45.72, and 4.07, respectively. The mean scores of systolic blood pressure, diastolic blood pressure, heart rate, and body temperature were 123.72 mm Hg, 82.94 mm Hg, 89, and 36.51°C, respectively. In addition, the Pearson correlation coefficient among the biomarkers of cardiovascular and the total score obtained in the posttraumatic stress disorder checklist was positive and significant.
The results indicate the biological markers of cardiovascular responses as a risk factor for cardiovascular diseases in the war veterans with PTSD.

Epilepsy­ causes significant effects on child's physical and mental functions and is associated with different psychiatric disorders. The aim of this study was to compare the frequency of attention deficit hyperactivity disorder (ADHD) and quality of life (QOL) in children with epilepsy.
This study was conducted on 90 children that divided to 3 groups: chronic epilepsy, recent epilepsy (with diagnosis of less than a month), and control groups. In the first stage, all patients were screened with a questionnaire containing demographic data, ADHD Rating Scale (ADHD-RS), Child-self report and Parent-proxy report as well as Pediatric Quality of Life Inventory TM (Peds QL™) forms. Then, the children were evaluated for definite diagnosis of ADHD according to DSM-IV criteria.
ADHD was diagnosed in 43.3%, 36.7% and 6.7% of chronic epilepsy, recent epilepsy, and control groups, respectively. There was a significant correlation between Parent-proxy report QOL score and the type of epilepsy. In analysis of QOL subgroups, the score of physical function and school performance were different in three groups. Children with ADHD had significantly lower total QOL score than non-ADHD children.
The physical function, school performance, and total QOL score of chronic epileptic children are lower than recent epileptic and non-epileptic children. The ADHD is more common in epileptic children than normal children. Screening and early treatment of ADHD in epileptic children may improve their QOL.

According to the nature of heart diseases and the use of cardiopulmonary bypass, transient or permanent neurologic complications may arise during or after pediatric cardiac surgery. The aim of this study was to evaluate the incidence of acute neurologic complications in postoperative cardiac surgery period in children with congenital heart diseases (CHD) undergoing cardiac surgery.
In this study, all patients with cardiovascular disease (including CHD and other cardiovascular diseases) had been operated (open or closed) in the Children’s Medical Center, Tehran, Iran, were evaluated for a year between July 2014 and July 2015. Those who had died during hospital stay or surgery, patients with incomplete information in their medical records, and children who had not been operated because of CHD were excluded. Of the 435 patients surveyed, 364 patients were enrolled in this study. Acute neurologic complications and related findings in brain CT scan were investigated.
The age range for patients was between 5 days to 15 years old, of whom 64 (17.6%) patients were under 2 months, 131 (36%) patients were between 2 months to 1 year, and 169 (46.6%) patients were over one year. Thirty-three patients (9.06%) were identified with acute neurological complications after heart surgery, including seizures, movement disorders, loss of consciousness, visual disturbances, headache, and hydrocephalus.
Improving the implementation of the cardiopulmonary bypass protocols and using neural monitoring for ischemia and bleeding as well as arterial filter during surgery can reduce the incidence of neurological complications after pediatric cardiac surgery.

Alzheimer's disease (AD) is the most common neurodegenerative disorder with the prevalence of one eighth or about 10% of people older than 65 years old. Aiming to induce progressive dementia and neurodegeneration, intracerebroventricularly (ICV) injection of streptozocin (STZ), a diabetogenic factor, was performed. Since this model leads to behavioral disorders, impaired energy, and glucose utilization, it is an appropriate model for AD. Reduction of the potency of stem cells in the subventricular zone (SVZ), one of the brain neurogenic regions, in AD has been reported. In this study, we examined the effect of ICV administration of STZ on stem cell proliferation in SVZ.
Thirty male Wistar rats were classified into three groups, including control, sham, and STZ. Drug injection (3 mg/kg- ICV) was performed in lateral ventricles in days 1 and 3 after recovery of operation. Finally, after SVZ cell culture, cell proliferation was measured by evaluation of morphology, number, and diameter indexes of neurospheres.
Our study revealed that proliferation indexes, such as diameter and the number of neurosphere, were significantly decreased in the treatment group compared to control and sham groups.
Our data has shown that application of STZ decreases proliferation of stem cells in SVZ of the brain.

Stem cells are characterized by two fundamental properties; self-renewal and differentiation. Self-renewal is an integration of proliferation control with the maintenance of an undifferentiated state. Self-renewal trait is regulated by a dynamic process between transcription factors, epigenetic control, microRNA regulators, and cell-extrinsic signals from the niche of stem cells. The other feature of stem cells is the capability of differentiation to various cell types. Neural stem cells are able to differentiate to neuron, glial cell, and oligodendrocyte. The process of oligodendrocyte differentiation also is regulated by an interaction between the genetic and epigenetic programs. Recent studies reveal the key role of histone modifications in epigenetic regulation of gene expression during oligodendrocyte development. Moreover, retinoic acid pathway has been shown in stem cell differentiation toward neurons.
Detection of signaling cascades and regulatory networks of self-renewal and differentiation of neural stem cells improve new therapeutic methods for neural diseases, such as brain injuries and brain tumors as well as neurodegenerative diseases, like Huntington, Alzheimer, Parkinson, and demyelination diseases, such as multiple sclerosis. Moreover, understanding of these pathways leads to specific and stable differentiation of neural stem cells toward functional oligodendrocyte for alternative therapy.

Not only in early human societies, even today, there are people who tried to interpret dream spiritually. According to different functions of sleep and dreaming in human daily life, dream and sleep are of interest in modern science. Evolution of scientific study of dreaming during the history of medicine as well as current theories of dream have discussed in this manuscript. On the other hand, due to connection of sleep and dreaming, sleep physiology and pathology have shortly described.
Despite of significant improvement in dream study and different theories to explain dream and sleep functions, further studies are needed to integrate all aspect of dream and sleep in human.

Long-term potentiation (LTP) is a generic term that applies to a form of activity-dependent plasticity that induced by high-frequency or theta burst stimulation and results in enhancement of synaptic transmission. LTP has a key role in learning and memory. Different types of LTP have been observed in distinctive areas of the central nervous system. Hippocampal CA1 area is vital for the formation of long-term memory.
Several studies have been shown the importance of signaling pathways in the development of memory and learning. In this review is intended to present an overview of the role of synaptic ion channels, ionotropic and metabotropic glutamate receptors as well as TrkB receptor in LTP formation of learning and memory.

The effects of exercise and physical activity on the function of various human organs, such as heart, lung, and skeletal muscle have long been known. In recent years, more attention has been focused on the effects of exercise on the nervous system and memory. Recently, it has been shown that the brain responds to the physical activities in the anatomical, cellular, and molecular levels. It is surprising that many of these changes occur in some brain structures that involve in the memory, learning, and cognitive functions. It has been shown that exercise can improve mental performance and enhances learning and memory.
Both structural and functional changes of the brain in response to exercise play a crucial role in improvement of the memory and learning. The present study was reviewed the mechanisms involved in the memory and learning improvement followed by exercise.

Several investigations revealed that the activation of the innate immune system plays a crucial role in the pathogenesis of numerous diseases. The innate immune system activation occurs in response to pathogens or tissue injury via pattern-recognition receptors that recognize pathogen-associated molecular patterns. The innate immune system triggered by these interactions besides the general responses causes a specific response to pathogen. In addition, this pathogen-specific innate response affects the specificity of the adaptive immune response through directing the differentiation of T-cells into functionally distinct subtypes. Although the mechanism(s) by which different Rabies viruses induce differential immune responses are unknown, recent studies indicate that the consequence of rabies virus infection is dependent upon the rapid stimulation of innate and adaptive immunity. The responses prevent viral entry into the central nervous system (CNS), where it can escape immunity. Laboratory strains that reach the CNS can be cleared and this has obviously happened in individuals with rabies. Thus, during rabies virus infection, pattern-recognition receptors of rabies can be recognized in the periphery and the CNS.
To study these possibilities, the consequence of rabies infection in mice lacking adaptor myeloid differentiation factor 88 (MyD88) was demonstrated. Toll-like receptors (TLRs) signals, except for TLR3, activate proinflammatory reaction via the adaptor protein MYD88. Only mice lacking TLR7 displayed a marked mortality compared with MyD88 negative and control mice with deficits in both the development of peripheral immunity and rabies virus clearance from the CNS. The review demonstrated that TLR7 plays a vital role in controlling and directing of immune response against the rabies virus.

Traumatic brain injury (TBI) is one of the leading causes of death of men under the age of 35 that mostly occurs during the road accidents. Current clinical treatments cannot prevent the secondary brain damage induced by cytotoxicity. Progesterone, as a primary sex hormone, is a neuroprotective compound in TBI and stroke. Indeed, progesterone increases anti-oxidant activities, decreases inflammatory factors, and reduces the expression of inflammatory cytokine, which can prevent secondary brain injury and edema.
This review focused on the preventive effect of progesterone on secondary brain injury and edema by modulation of inflammatory factors in TBI. Although, the exact mechanism of TBI has not been discovered, studies suggest that this hormone can be a safe treatment for TBI and other neurodegenerative diseases.

Depression is a chronic, multifactorial, and potentially life-threatening mental disorder that affects up to 20% of the worldwide population. Over several decades, numerous animal models have been established to study the underlying pathophysiology of depression and to test novel antidepressant treatment strategies. The criteria for identifying animal models of depression based on two principles: the side effects of antidepressants and responses to stress. Here, we summarized depression animal models, including learned helplessness, chronic mild stress, social defeat paradigms, and early life stress. Also, we reviewed the behavioral tests for screening antidepressants, such as forced swimming test, tail suspension test, sucrose preference test, open field test, elevated plus maze test, novelty-induced hypophagia, intracranial self-stimulation, and dark/light box test.
The complexity of the depression and its etiologic as well as pathophysiological similarities with anxiety disorders challenge the developing of a comprehensive animal model that accurately reflect different aspects of depression. However, these animal models could so far help in a better understanding of the pathophysiology of depression.