فهرست مطالب

Current Journal of Neurology
Volume:18 Issue: 2, Spring 2019

  • تاریخ انتشار: 1398/02/02
  • تعداد عناوین: 10
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  • Firoozeh Javan, Morteza Faghih, Jouibari, Mehdi Khaleghi, Parvin Mehdipour * Pages 43-49
    Background
    Vascular endothelial growth factor (VEGF) and epidermal growth factor (EGF) are involved in tumor development and progression. But, the classified-based data of protein expression (PE) in meningiomas is unavailable. Therefore, we aimed to explore the PE of VEGF and EGF in meningiomas by considering evolutionary strategy and the regional tumor-based assay.
    Methods
    PE was assayed using immunofluorescence (IF) within the peripheral, central, and basal sections of four meningioma tumors, and a lung metastatic brain tumor as a positive control.
    Results
    Diverse characteristics and harmonic cross-talk in the individual sections and between different tumor sections were traced. The mode of PE was puzzling and personalized issue. Co-expression had a key impact on tumor evolution and diverse PE profiles led to draw the heterogenic classification, as the personalized/complementary insight in the functional behavior of VEGF and EGF. D1853N polymorphism of ATM gene was mosaics in two patients with meningiomas.
    Conclusion
    The classified heterogeneity, harmonic co-expression, and diverse functional information in different regions of tumors may lead to predict the aggressiveness mode of tumors as a translational insight to the clinical managements including therapy in brain tumors.
    Keywords: Carotid Thrombosis, Carotid Artery, Common, Doppler Ultrasound, Anemia, Thrombocytosis, Carotid Endarterectomy
  • Munir Abdullahi Nasidi, Mukadas Akindele, Aisha Ahmad, Aliyu Musa, Aminu Ibrahim * Pages 50-56
    Background
    Spinal cord injury (SCI) is impairment of the spinal cord resulting in numerous health problems that considerably affect the quality of life (QOL) of the patients. Moreover, a number of sociodemographic and clinical characteristics may influence the persons’ health-related quality of life (HRQOL). However, there is limited information on the HRQOL and related characteristics among affected persons living in Nigeria. This study explores the HRQOL and related characteristics of persons with SCI in Kano, Northwestern Nigeria.
    Methods
    A prospective cross-sectional survey of 41 subjects with SCI and 40 age and gender matched healthy subjects was conducted from January to December 2016. Subjects' sociodemographic and clinical characteristics and HRQOL (using the SF-36 questionnaire) were collected and analyzed.
    Results
    The majority of the subjects were men in both the SCI (85.4%) and healthy (82.5%) groups. The mean injury duration was 28.4 ± 20.2 months. Road traffic accident (46.3%) was the leading cause of injury with paraplegia (70.7%) being the most frequent level of injury. A greater number of the subjects (43.9%) had a complete impairment. Subjects with SCI had significantly lower HRQOL in the domains of general health, physical functioning, bodily pain, social functioning, role-emotional, and mental health compared to healthy controls. Gender, level of injury, and severity of injury were commonly found to be related to lower HRQOL scores.
    Conclusion
    Persons with SCI from Kano, Northwestern Nigeria have lower HRQOL across various domains compared to healthy controls. Common factors related to lower HRQOL scores were gender, level of injury, and severity of injury. There is a need for optimal rehabilitation for persons with SCI in Kano, Northwestern Nigeria.
    Keywords: Health-Related Quality of Life, Nigeria, Spinal Cord Injury
  • Zahra Karimi, Siamak Abdi, Hajir Sikaroodi, Shahram Oveisgharan * Pages 57-63
    Background
    Transcranial direct current stimulation (tDCS) of the primary motor cortex of the lower limb has been exploited in the treatment of patients with stroke and spastic lower limb paresis. We examined this stimulation efficacy in the treatment of multiple sclerosis (MS)-related walking disability.
    Methods
    In a single-center randomized double-blind clinical trial study, 13 patients with MS and walking disability and Expanded Disability Status Scale (EDSS) score of 3 to 6 were randomized to the real and sham stimulation groups. In the real tDCS stimulation, 7 patients received anodal 2.5 mA stimulation at 1 cm anterior to the Cz point for 30-minute daily sessions in 7 consecutive days. The other group received sham stimulation with the same protocol. The primary outcome of the trial was change in the Timed 25-Foot Walk (T25-FW) from before to after the stimulation. We also assessed the Multiple Sclerosis Walking Scale-12 (MSWS-12). We employed linear mixed effects model to examine the efficacy of tDCS stimulation on changing the outcomes.
    Results
    On average, patients who received real tDCS stimulation walked faster after 7 sessions of stimulation [Estimate = -2.7, standard error (SE) = 1.3, P = 0.049], while walking speed of sham stimulation recipients did not change. For every session of stimulation, recipients of real tDCS stimulation spent 2.7 seconds less for walking the 25 feet. Real tDCS stimulation was not effective in improving MSWS-12 scores.
    Conclusion
    tDCS stimulation of the lower limb motor cortex speeded up patients with MS in walking, but without improvement in patients’ mobility in daily activities.
    Keywords: Multiple Sclerosis, Transcranial Direct CurrentStimulation, Mobility Limitation
  • Reza Boostani, Morteza Saeidi, Mina Khodabandeh, Farveh Ramezanzadeh * Pages 64-69
    Background
    Guillain-Barre syndrome (GBS) is the major cause of acute flaccid paralysis (AFP). Comprehensive classification and predictive measures need to be created for GBS. This study was conducted to evaluate GBS patients’ prognosis and Brighton criteria validity in Iranian population.
    Methods
    This retrospective cohort study was conducted using medical records of patients with GBS admitted to Ghaem Hospital, Mashhad, Iran. After collecting data from cerebrospinal fluid (CSF) analysis, nerve conduction studies, and clinical examinations, Brighton criteria and GBS disability scores were calculated. Patients ultimately received follow-up telephone calls after 15 to 45 months of admission, checking on one’s clinical status and the ability to walk independently. Data were analyzed using SPSS software.
    Results
    Patients were mostly men (78.0%) with the mean age of 48.58 years. GBS onset was reported more frequently in spring. According to Brighton criteria, 41.4%, 51.6%, and 7.0% of the patients were classified as levels 1, 2, and 4, respectively. For GBS disability score, 54.7%, 16.4%, 9.4%, and 6.2% of the patients had grades of 4, 3, 2, and 1, respectively. 37 patients (39.4%) restored the ability to walk within the first month, while 3 patients (3.2%) were unable to walk by the end of the second year. Significant relationship was observed between the ability of walking independently and GBS disability score (P < 0.001).
    Conclusion
    In the Iranian GBS population, less than half of the patients met level 1 of Brighton criteria and more than half of them reached the GBS disability score of 4, and walking ability was correlated to GBS disability score.
    Keywords: Guillain-Barre Syndrome, Prognosis, Diagnosis, NerveConduction Study, Iran
  • Masoud Etemadifar, Elaheh Shams, Nasrin Yazdanpanahi * Pages 70-75
    Background
    Deoxyribonucleic acid (DNA) methyltransferase 3 beta (DNMT3B) gene encodes an MT enzyme involving in de novo methylation of DNA. The present investigation aimed to explore the association of DNMT3B-579G>T (rs1569686) polymorphism with multiple sclerosis (MS).
    Methods
    130 Iranian patients with MS and 130 controls were genotyped for the DNMT3B-579G>T using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.
    Results
    There was no statistically significant association between DNMT3B-579G>T and susceptibility to MS. The alleles and genotypes of DNMT3B-579G>T did not have different risks of MS development under various models [T vs. G (P = 0.86); GTvs. GG (P = 0.48); TT vs. GG (P > 0.99); GT+TT vs. GG (P = 0.60), and TT vs. GG+GT (P = 0.87)]. Also, there was no statistically significant association between genotypes and clinical and demographic characteristics of patients (P > 0.05).
    Conclusion
    The current findings suggest that DNMT3B-579G>T is probably not a crucial potential risk marker in molecular diagnostics of MS among Iranian. However, to the best of our knowledge, this is the first genetic association study about the DNMT3B polymorphisms and MS. Therefore, further surveys should be included to estimate the exact relevance of DNMT3B gene to the development of autoimmune disorders like MS.
    Keywords: Multiple Sclerosis, Genes, DNA Methyltransferase, Polymorphism, Genetic, Iran
  • Yaser Moadabi, Alia Saberi, Sajjad Hoseini, Ashkan Karimi, Chabok, Shahrokh Yousefzadeh * Pages 76-81
    Background
    Ischemic stroke as the major cause of mortality and morbidity worldwide has different risk factors. One of its modifiable risk factors is opium addiction whose role is not clear yet. This study aimed at assessing the hemodynamic parameters in ischemic stroke patients addicted to opium using transcranial Doppler (TCD) ultrasonography and comparing them with non-addicted patients.
    Methods
    This comparative cross-sectional study was conducted in an academic hospital in the north of Iran in 2016. All the patients diagnosed as ischemic stroke underwent cerebrovascular ultrasound in the first 4 days of symptoms onset. Frequency of hemodynamic abnormalities confirmed by pulsatility index (PI) and mean flow velocity (MFV) were determined and compared between the two groups. The data were analyzed by chi-square test, t-test, and multiple logistic regression models using SPSS software.
    Results
    A total of 353 patients with ischemic stroke (92 addicted and 261 non-addicted patients) were enrolled in the study. Univariate analysis indicated that the PI and MFV differences were statistically significant between two groups of addicted and non-addicted patients (P = 0.0001). By multivariate logistic regression model, the age [odds ratio (OR) = 1.143], diabetes mellitus (DM) (OR = 3.875), hypertension (HTN) (OR = 2.557), and opium usage (OR = 9.615) had influence on PI and only opium usage (OR = 3.246) had influence on MFV.
    Conclusion
    Opium usage affects the cerebral hemodynamic parameters and increases the chance of having abnormal PI as ten-fold and abnormal MFV as three-fold.
    Keywords: Opium, Doppler Transcranial Ultrasonography, Stroke, Blood Flow Velocity
  • Masoud Ghiasian, Maryam Mansour, Nasrin Moradian Pages 82-84
    Background
    There have been studies that showed a higher incidence of cerebral venous thrombosis (CVT) in Ramadan, a month in which people fast in Muslim countries, which was associated with increasing use of oral contraceptives (OCPs) in women. We aimed to evaluate the effect and prognosis of fasting in patients with CVT using OCPs.
    Methods
    Consecutive patients with diagnosis of CVT in Sina hospital, Hamadan, West of Iran, from May of 2009 to June of 2016 were evaluated, and women using OCPs were included. Other risk factors except fasting were excluded. Clinical presentation and outcomes of CVT was assessed. Patients were followed up for 12 months.
    Results
    58 patients were included in this study. 31 of these patients had fasting simultaneously. Fasting in patients using OCPs caused significantly higher focal neurological deficit (64.5%, P = 0.018), and higher hemorrhage (66.7%, P = 0.042). At discharge, 51.6% and after three months, 25.8% of patients with fasting had disability [6 > modified Rankin Scale (mRS) >1]. In patients who used OCPs as sole risk factor, 25.9% at discharge and 11.1% after three months had disability.
    Conclusion
    Fasting in patients with CVT using OCPs causes significant increase in focal neurological deficit and hemorrhage, which also increases the hospital stay and lengthens recovery. However, long-term prognosis and mortality of CVT is similar between the two groups.
    Keywords: Cranial Sinus Thrombosis, Venous Thrombosis, OralContraceptives, Fasting
  • Payam Sarraf, Dina Motamedi, Arman Habibi, Sama Bitarafan * Pages 85-86
  • Maziar Emamikhah, Narges Yazdi, Monireh Eslami, Mehdi Moghaddasi, Nafiseh Mohebi * Pages 87-89
  • Payam Sariaslani, Dalir Parsa, Hiwa Mohammadi * Pages 90-92