Iranian Journal of Neurology http://ijnl.tums.ac.ir/index.php/ijnl <p align="center">&nbsp;</p> <p><strong>Indexed in</strong>, <strong>PubMed, PubMed Central</strong>, Academic Keys, Cite Factor (Directory Indexing of International Research Journals), Directory of Open Access Journals (DOAJ), Directory of Research Journal Indexing (DRJI), Ebsco, Electronic Journals Library, Google Scholar, InfoBase Index, Islamic World Science Citation Center (ISC), LocatorPlus, Scientific Information Database (SID), Ulrichsweb Global Serials Directory, Universal Impact Factor, WorldCat.</p> Tehran University of Medical Sciences en-US Iranian Journal of Neurology 2008-384X The validation of the Persian version of DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis http://ijnl.tums.ac.ir/index.php/ijnl/article/view/1433 - Zahra Jafari Mohammad Rahim Shahbodaghi Saman Maroufizadeh Abdorreza Naser Moghadasi ##submission.copyrightStatement## 2018-07-05 2018-07-05 Polymorphisms of serotonin transporter gene and psychological status in patients with multiple sclerosis http://ijnl.tums.ac.ir/index.php/ijnl/article/view/1424 <p><strong>Background:</strong> Multiple sclerosis (MS) is the most common neuroinflammatory disease in young adults. Anxiety and depression may predispose individuals to MS and flare-ups. Serotonin transmission is modified in some brain regions of patients with MS, and these changes may contribute to their psychiatric abnormalities. We studied the frequencies of common polymorphisms of the serotonin reuptake transporter (SERT) gene in patients with MS according to their psychological status.</p> <p><strong>Methods:</strong> The 5-HTTLPR, rs25531, and STin2VNTR polymorphisms of the SERT gene were genotyped by polymerase chain reaction (PCR)-based methods in 100 patients with MS and 100 healthy controls.</p> <p><strong>Results:</strong> There were no remarkable differences in SERT gene polymorphisms between patients with MS and healthy controls. Unlike the control group, 41% of the patients showed some degree of depression based on Beck Depression Inventory (BDI), but no association was observed between SERT gene polymorphisms after the patients were stratified by depression status.</p> <p><strong>Conclusion:</strong> In addition to SERT gene polymorphisms, modulation of serotonin at the synapses may also be regulated by genetic variations in tryptophan hydroxylase type 2 and serotonin receptors. Further studies with functional brain imaging of the serotonergic system in patients with MS can provide information on the role of serotonin in this disease.</p> Shirin Farjadian Bahareh Fakhraei Zahra Niknam Mahboubeh Nasiri Aslan Azad Mojtaba Farjam Alireza Nikseresht ##submission.copyrightStatement## 2018-07-05 2018-07-05 Association analysis of HLA-DRB1*1501-DRB5*01 haplotype in multiple sclerosis population of Khuzestan Province http://ijnl.tums.ac.ir/index.php/ijnl/article/view/1464 <p align="left"><strong>ABSTRACT</strong></p><p><strong>Background</strong>: Multiple sclerosis is an inflammatory, demyelinating disease of the central nervous system. Both genetic and environmental factors are involved in the MS pathogenesis. The human leukocyte antigen (HLA-II) alleles HLA-DRB1*1501, -DRB5*01, -DQA1*0102, -DQB1*0602 may have an important genetic effect. However, this is controversial in different population studies. Since, there are no data with respect to the association of HLA-DRB1*1501-DRB5*01 with MS in Khuzestan, the aim of this study was to investigate the correlation of this haplotype with MS in this population.</p><p><strong>Methods</strong>: The study focused on DRB5*01-DRB1*1501 haplotype association in 200 MS patients and 200 healthy individuals. HLA-typing was performed by polymerase chain reaction amplification with sequence-specific-primers (PCR-SSP) method. The statistical analyses were performed by SPSS software.</p><p><strong>Results</strong>: We found no association between DRB5*01<sup>+</sup>-DRB1*1501<sup>+</sup> with MS (p=0.156). Distribution of DRB1*1501<sup>+</sup>-DRB5*01<sup>-</sup> (carrying DRB1*1501<sup>+</sup> but not DRB5*01<sup>-</sup>) and DRB1*1501<sup>-</sup>-DRB5*01<sup>-</sup> haplotypes were statistically different between <em>patients</em> and controls "(29.73% vs. 11.81%, <em>p=0.000</em>) and (42.16% vs. 68.50%, <em>p=0.000</em>)", respectively. However, DRB1*1501<sup>-</sup>-DRB5*01<sup>+</sup> showed no association with the disease (15.135% vs. 11.81%, <em>p=</em>0.403). HLA-DRB1*1501<sup>-</sup>-DRB5*01<sup>+</sup> was significantly more frequent among female MS patients (16.19% vs. 6.12%, p=0.019) and Fars group (17.11% vs. 5.79%, p=0.027).  HLA-DRB1*1501<sup>+</sup>-DRB5*01<sup>-</sup> haplotype was positively associated with EDSS steps 5 to 10 (62.5% vs. 25.76%, p=0.026). Furthermore, No meaningful correlation was observed among these haplotypes with sex, ethnicity, MS course and EDSS.</p><p><strong>Conclusions</strong>: Our results indicate that DRB1*1501<sup>+</sup>-DRB5*01<sup>-</sup> and DRB1*1501<sup>-</sup>-DRB5*01<sup>-</sup> haplotypes may have correlation with MS risk. Also, our findings suggest that HLA-DRB1*1501<sup>-</sup>-DRB5*01<sup>+</sup> is involved in MS susceptibility among females and Persians. DRB1*1501<sup>+</sup>-DRB5*01<sup>-</sup> genotype frequency may play a role in MS developing.</p> Hamid Galehdari ##submission.copyrightStatement## 2018-05-28 2018-05-28 Cognitive function, depression, and quality of life in patients with ruptured cerebral aneurysms http://ijnl.tums.ac.ir/index.php/ijnl/article/view/1368 <p><strong>Background:</strong> Neuropsychiatric dysfunction is one of the most common complications after aneurysmal subarachnoid hemorrhage (aSAH). The aim of this study was to evaluate cognitive function, depression, and quality of life (QOL) in patients with aSAH.</p> <p><strong>Methods:</strong> In this study, we prospectively enrolled patients with SAH due to rupture of anterior circulation aneurysms who referred to Ghaem hospital, Mashhad, Iran, and who had good function outcome [modified Rankin scale (mRS) &gt; 2]. They underwent microsurgery or endovascular treatment. Cognitive function, depression, and QOL were evaluated 6 months after surgery with standard psychiatric examinations, including Mini-Mental State Examination (MMSE) for cognitive function, Hospital Anxiety and Depression Scale (HADS) for depression, and 36-Item Short Form Health Survey (SF-36) for QOL. Risk factors for cognitive dysfunction were assessed.</p> <p><strong>Results:</strong> Fifty-three patients were entered the study. The mean of age was 50.9 ± 13.6 years. QOL and its components were affected in most patients. Fifty-five percent of patients suffered from depression. Cognitive impairment was found in 57% of patients. Older patients experienced more cognitive impairment (P &lt; 0.001).</p> <p><strong>Conclusion:</strong> Neuropsychological sequels are common in patients with aSAH, even if they classified as good functional outcome (mRS &gt; 2). These complications could be found with appropriate neuropsychological evaluation of these patients to be managed as soon as possible.</p> <p><strong>&nbsp;</strong></p> Samira Zabihyan Seyed Javad Mousavi-Bayegi Humain Baharvahdat Farhad Faridhosseini Payam Sasannejad Maryam Salehi Maryam Boroumand Zahra Hatefipour ##submission.copyrightStatement## 2018-07-12 2018-07-12 Pegylated versus non-pegylated interferon beta 1a in patients with relapsing-remitting multiple sclerosis: A cost-effectiveness analysis http://ijnl.tums.ac.ir/index.php/ijnl/article/view/1328 <p><strong>Background:</strong> Pegylated (PEG) interferon beta 1a has been approved by the United States Food and Drug Administration (USFDA) as an alternative to interferon beta 1a for multiple sclerosis (MS). Due to its higher price, this study aimed to evaluate the cost-effectiveness of PEG-interferon beta 1-a compared with interferon beta 1a from an Iranian payer perspective.</p> <p><strong>Methods:</strong> A Markov model was designed according to health states based on Expanded Disability Status Scale (EDSS) and one-month cycles over a 10-year time horizon. Direct medical and non-medical costs were included from a payer perspective.</p> <p><strong>Results:</strong> The incremental cost-effectiveness ratio (ICER) was estimated around 11111 US dollars (USD) per quality-adjusted life-year (QALY) gained for the <br> PEG-interferon versus interferon regimen [with currency rate of 29,000 Iranian Rial (IRR) to 1 USD in 2016].</p> <p><strong>Conclusion: </strong>Considering the cost-effectiveness threshold in Iran [three times of gross domestic product (GDP) per capita or 15,945 USD], PEG-interferon beta 1-a could be considered as a cost effective treatment for Iranian patients with MS.<strong><br></strong></p> Amir Hashemi-Meshkini Hedieh Sadat Zekri Hasan Karimi-Yazdi Pardis Zaboli MohammadAli Sahraian Shekoufeh Nikfar ##submission.copyrightStatement## 2018-08-11 2018-08-11 Induction or aggravation of other immune-mediated disorders by disease-modifying therapy in treatment of multiple sclerosis http://ijnl.tums.ac.ir/index.php/ijnl/article/view/1325 <p>Interferon beta (IFN-β) and glatiramer acetate (GA) are the primary therapeutic immunomodulatory agents that interfere with relapsing-remitting multiple sclerosis (RRMS), and the most commonly-used drugs as well. Induction or aggravation of other immune-mediated diseases has been reported following INF-β administration. We have reviewed the reported cases to notify the treating physicians about these rare adverse events. Although co-morbid autoimmune disorders have been reported in patients with MS, the pro-inflammatory role of disease-modifying drugs, especially INF-β, could affect and enhance this co-occurrence. Clinical or laboratory autoimmunity histories suggest the use of GA over INF-β as the treatment of choice.</p> Seyed Mohammad Baghbanian Mohammad Ali Sahraian ##submission.copyrightStatement## 2018-07-05 2018-07-05 Oxidative stress-related biomarkers in Parkinson’s disease: A systematic review and meta-analysis http://ijnl.tums.ac.ir/index.php/ijnl/article/view/1538 <p>Parkinson’s disease (PD) is a neurodegenerative disease characterized with the loss of dopamine-producing neurons in a mid-brain. This loss is believed to be associated with number of environmental and genetic factors. Oxidative stress is found to be one of the factors responsible for the initiation and progression of PD. However, studies are still continued to confirm the connection and mechanism associated with oxidative stress and PD. This systematic review and meta-analysis aimed to assess the association between oxidative stress markers and PD, and explore factors that may elucidate the contradictions in these results. As per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline systematic literature search was carried out. Meta-analysis was carried out on pooled standardized mean differences with 95% confidence interval (CI) of patients with PD and controls using random effect model in comprehensive meta-analysis statistical software. Total 17 studies were included into which 25 oxidative stress markers were analyzed. The results revealed that oxidative stress markers [nitrate and nitric oxide (NO)] and antioxidant markers [total antioxidant status (TAS) and thiols] were not statistically different between the PD and control group (P &gt; 0.05). In case of oxidative stress markers, levels of malondialdehyde (MDA), 8-Oxo-2'-deoxyguanosine (8-oxo-dG), and lipid hydro-peroxide (LPO) were found to be high in patients with PD as compared to controls with P &lt; 0.05, whereas lower levels of antioxidant activity of superoxide dismutase (SOD), glucose 6 phosphate dehydrogenase (G6PD), catalase (CAT), and glutathione peroxidase (GPx) were noticed in the PD group as compared to controls (P &lt; 0.05 for all). From the results, it is concluded that patients with PD have high oxidative stress and lower antioxidant activity, and these studied biomarkers would be used as potential diagnostic tool to measure oxidative stress in patients with PD.</p> Zeba Khan Sharique Athar Ali ##submission.copyrightStatement## 2018-07-05 2018-07-05 Transcranial sonography in carriers of Gaucher disease http://ijnl.tums.ac.ir/index.php/ijnl/article/view/1365 <p><strong>Background:</strong> Glucocerebrosidase (GBA) mutation is the most common genetic risk factor in Parkinson’s disease (PD). Transcranial sonography (TCS) shows increased substantia nigra (SN) echogenicity in both idiopathic and genetic forms of PD. The goal of this study was to compare maximal area of SN hyperechogenicity (aSNmax) and diameter of third ventricle (DTV) between GBA mutation carriers and healthy controls.</p> <p><strong>Methods:</strong> Twenty-six carriers of GBA mutation and twenty-six healthy controls underwent TCS. The aSNmax and the DTV were measured. Mini-mental status examination (MMSE) and demographic data of the subjects were recorded, too.</p> <p><strong>Results: </strong>Mean aSNmax in GBA mutation carriers was significantly higher (0.31 ± 0.06 cm<sup>2</sup>) than controls (0.16 ± 0.04 cm<sup>2</sup>). Moreover, DTV was significantly higher in GBA mutation carriers group (3.98 ± 0.90 vs 3.29 ± 0.56 cm).</p> <p><strong>Conclusion:</strong> Increased SN echogenicity and increased third ventricle diameter in GBA mutation carriers may be caused by alterations in iron metabolism with reference to their genetic status.</p> Fatemeh Omrani Shahla Ansari-Damavandi Babak Zamani Zahra Omrani Nahid Mohammadzade Sadra Rohani Mohammad Rohani ##submission.copyrightStatement## 2018-07-05 2018-07-05 Hypothyroidism among patients with glioblastoma multiforme http://ijnl.tums.ac.ir/index.php/ijnl/article/view/1454 <p><strong>Background:</strong> Patients with glioblastoma multiforme (GBM) are prone to various metabolic changes such as hypothyroidism. The present study was planned to assess the frequency of hypothyroidism in these patients.</p> <p><strong>Methods:</strong> Fifty-two patients with GBM were included. All of them had been treated by tumor resection followed by cranial irradiation. Thyroid function was assessed by measurement of serum thyroid stimulating hormone (TSH), free thyroxin (FT4), and free triiodothyronine (FT3).</p> <p><strong>Results:</strong> There were 33 men and 19 women. The average age was 52.4 ± 12.8 years. Among these, <br> 32 (61%) had normal thyroid function test, whereas 4 (8%) had subclinical hypothyroidism, 5 (10%) had overt primary hypothyroidism, and 11 (21%) had secondary hypothyroidism. Sixteen patients (31%) needed thyroid hormone replacement therapy.</p> <p><strong>Conclusion:</strong> Hypothyroidism is relatively prevalent in patients with treated GBM. Regular thyroid function test is advised to aid the introduction of appropriate hormone replacement therapy.</p> Morteza Faghih-Jouybari Soheil Naderi Sara Mashayekhi Tahereh Padeganeh Sina Abdollahzade ##submission.copyrightStatement## 2018-07-05 2018-07-05 Neurobrucellosis with intramedullary spinal cord involvement: A case report http://ijnl.tums.ac.ir/index.php/ijnl/article/view/1551 <p>-</p> <p>&nbsp;</p> Vida Mohammadzadeh Samira Akbarieh Seyed Abdolreza Ghoreishi Manizheh Jozpanahi ##submission.copyrightStatement## 2018-08-11 2018-08-11