Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 12 4 2013 12 15 125 128 Behnaz Sedighi Associate Professor, Department of Neurology AND Kerman Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran. Hossein Ali Ebrahimi Professor, Department of Neurology, Kerman University of Medical Sciences, Kerman, Iran Ali Akbar Haghdoost Professor, Department of Epidemiology, Kerman University of Medical Sciences, Kerman, Iran Marzie Abotorabi Resident, Department of Neurology, Kerman University of Medical Sciences, Kerman, Iran 2015 10 14 Background: There have  been  several studies  done  on the role of metals in the occurrence  of multiple sclerosis (MS) disease, but their roles have not been confirmed yet. Because of the lack of information on this issue, this study compared  the  serum  level  of  copper and zinc in MS patients with their levels in a control group. Methods: This  was  an  analytical,  cross-sectional  study conducted in  Kerman (a  medium   size  city),  Iran.  We assessed  the  serum  level of copper  and  zinc in 58 MS patients  and  39 healthy individuals, who were selected from the relatives of cases and matched  for age and sex. Results: The average  serum level of Copper in cases and controls   were 93.7 and 88.9 ml/dl, respectively. The corresponding numbers for Zinc were 36.7 and 40.9 ml/dl, respectively.There was no significant difference between the two groups (copper: P = 0.459; zinc: P = 0.249). Conclusion: The groups  were matched  for age, sex, and family. However, we did not find a considerable difference between the  level of these  metals  in MS patients  and controls. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/643 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/643/159

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 12 4 2013 12 15 129 135 Masoud Fereidoni Associate Professor, Department of Biology, Faculty of Sciences, Ferdowsi University of Mashhad, Mashhad, Iran. Farzaneh Sabouni Assistant Professor, National Institute of Genetic Engineering and Biotechnology (NIGEB), Tehran, Iran Ali Moghimi Professor, Department of Biology, Faculty of Sciences, Ferdowsi University of Mashhad, Mashhad, Iran Shirin Hosseini Department of Biology, Faculty of Sciences, Ferdowsi University of Mashhad, Mashhad, Iran 2015 10 14 Background:  Astrocytes are cells within the central nervous system which are activated  in a wide spectrum of infections,  and  autoimmune and  neurodegenerative diseases.In pathologic states, they produce  inflammatory cytokines, chemokines,  and  nitric oxide (NO), and sometimes  they induce apoptosis.Their protease-activated receptors (PARs) can be activated by proteases, e.g.thrombin and trypsin,which are important in brain inflammation.The current  study  aimed  to investigate the effects of different concentrations of trypsin (1 to 100U/ml) on cultured astrocytes. Methods: In the present  study, two-day rat infants’ brains were  isolated and homogenized after meninges removal, then  cultivated in DMEM+10% FBS medium. 10 days later, astrocytes were harvested  and recultivated for more purification (up to 95%), using Immunocytochemistry method, in order to be employed   for  tests. They were affected by different concentrations of trypsin (1, 5, 10, 15, 0, 40, 60, 80, and  100 U/ml). To reveal the inflammation progress, NO concentrations (the Griess test) were assessed after 24 and 48 hours. Results:The results showed  that  trypsin concentration up to 20 U/ml caused  a significant increase in NO, in a dose- dependent  manner, on cultured   astrocytes   (P <  0.001). Trypsin  20  U/ml  increased  NO production  fivefold  the control group (P < 0.001). At higher  concentrations than 20 U/ml, NO production diminished  (P < 0.001). At 100 U/ml, NO production was less than the  control  group (P < 0.001). Conclusion: Inflammatory effects of trypsin  5-20 U/ml are probably due to the stimulation of astrocytes’ PAR-2 receptors and the increasing of the activation of NF-κB, PKC, MAPKs. Stimulation  of astrocytes’ PAR-2 receptors causes an increase in iNOS activation which in turn leads to NO production. However, higher  trypsin concentration possibly made astrocyte apoptosis; therefore, NO production diminished. These assumptions need t  be further investigated. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/642 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/642/160

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 12 4 2013 12 15 136 143 Saeed Rezaali Researcher, MS Research Center, Neuroscience institute, Sina Hospital, Tehran University of Medical Sciences AND Tehran Medical Branch, Islamic Azad University, Tehran, Iran. Ahad Khalilnezhad Department of Immunology, School of Medical, Shahid Beheshti University of Medical Sciences, Tehran, Iran Abdorreza Naser Moghadasi Neurologist, Researcher, Department of Neurology AND MS Research Center, Neuroscience institute, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Samira Chaibakhsh Department of Biostatistics, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammad Ali Sahraian Associate Professor, Department of Neurology AND MS Research Center, Neuroscience institute, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran 2015 10 14 Background: Recent studies have demonstrated controversial results and somewhat increased frequency of multiple  sclerosis  (MS). We reevaluated  the  files of  MS patients  from Qom Province of Iran in order to investigate the epidemiology of the disease. Methods:  Demographic   and  clinical records  of  592  MS patients  were reviewed, which included; age, sex, date  of birth, marital and occupation status, presenting symptoms, time of onset, type and family history of MS, and history of autoimmune or other diseases. Results: At the  time  of our study, 11 patients  had  died, and 581 were alive with a total female-to-male  ratio of 3.4. The mean age of onset of the disease was 34.25 ± 9.01 for all the  patients.  11.2% of  patients   had  positive  family history  of MS. The majority  of patients  (80.1%) showed relapsing-remitting  (RR)  pattern.  The  prevalence   of  MS was calculated as 50.4/100000 for Qom. Conclusion: Qom is located within a high risk zone of MS. Although we found evidences about the role of environmental factors, geographical distribution, and etcetera, many more studies need  to be performed  in this respect. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/641 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/641/161

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 12 4 2013 12 15 144 148 Navid Mohammadi Associate Professor, Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran. Shiva Kian Community and Preventive Medicine Specialist, Iran University of Medical Sciences, Tehran, Iran Farnoush Davoudi Assistant Professor, Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran Seyed Mohammad Ali Akbarian Nia Assistant Professor, Department of Neurology, Iran University of Medical Sciences, Tehran, Iran Marzieh Nojomi Professor, Department of Community Medicine, Iran University of Medical Sciences, Tehran, Iran 2015 10 14 Background: Health assessment in patients  with epilepsy (PWE) should  include  both  clinical outcomes and  health related quality of life (HRQOL) measures. The quality of life (QoL) in epilepsy-31 inventory  (QOLIE-31) is widely used for QOL studies  in epilepsy. This study  aims to evaluate psychometrics  of the Persian version of the inventory (QOLIE-31-P). Methods:  Following a  standard  forward-backward translation  and cultural adaptation, the construct  validity of the QOLIE-31-P  was  assessed  by  explanatory factor analysis, multi-trait  scaling  analysis, and  known group comparison. The criterion validity  was   assessed   by calculating   the   Pearson   correlation   to  SF-36 (36-item short-form health  survey). The reliability was assessed  by calculating Cronbach’s alpha and test-retest study. Results: The  factor analysis  extracted   from  8  factors explaining  70.35%  of  the  variations. Item-scale correlations  revealed  that  individual items  significantly had  the strongest  association  with  the  domain   they were  loaded on. The Pearson  coefficient  of correlation between QOLIE-31-P and the overall scores of SF-36 was 0.876  (P <  0.0001).  Patient  with  medically  controlled seizures  scored  higher than  those  who  experienced seizures   during the  previous year  to  study  date (P <  0.0001).  The Cronbach’s  α  of  overall  QOLIE-31-P inventory  was 0.9. The overall test-retest coefficient  of correlation was 0.68 (P = 0.003). Conclusion: QOLIE-31-P is a valid and reliable tool to be applied in health assessment of patients with epilepsy. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/640 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/640/162

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 12 4 2013 12 15 149 156 Maryam Kay MSc Student, Department of Biology, School of Sciences, University of Isfahan, Isfahan, Iran. Zohreh Hojati Assistant Professor, Department of Biology, School of Sciences, University of Isfahan, Isfahan, Iran Fariba Dehghanian MSc Student, Department of Biology, School of Sciences, University of Isfahan, Isfahan, Iran 2015 10 14 Multiple sclerosis (MS) is one of the most important autoimmune diseases recognized by demyelination and axonal lesion. It is the most common cause of disability in the young population. Various immunomodulatory and immunosuppressive therapies, including different formulations of interferon beta (IFNβ), glatiramer acetate (GA), mitoxantrone, and natalizumab are available for this disease. However, interferon has been the best prescribed. Although the precise mechanism of IFNβ is unclear, many studies indicate some potential mechanism including blocking T cells activation, controlling pro- and anti-inflammatory cytokine secretion, preventing activated immune cell migration through BBB, and inducing repair activity of damaged nerve cells by differentiating neural stem cells into oligodendrocytes. These molecular mechanisms have significant roles in IFNβ therapy. More researches are required in order for us to comprehend the mechanism of action of IFNβ, and improve and develop drugs for more efficient MS treatment. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/639 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/639/163

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 12 4 2013 12 15 157 165 Majid Ghaffarpour Professor, Department of Neurology, Imam Khomeini Hospital, Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran. Hossein Pakdaman Professor, Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammad Hossein Harirchian Professor, Department of Neurology, Imam Khomeini Hospital, Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran Hossein-Ali Ghelichnia Omrani Assistant Professor, Department of Neurology, Imam Khomeini Hospital, Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran Mojdeh Ghabaee Associate Professor, Department of Neurology, Imam Khomeini Hospital, Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran Babak Zamani Assistant Professor, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Parviz Bahrami Associate Professor, Department of Neurology, Lorestan University of Medical Sciences, Lorestan, Iran Bahaadin Siroos Resident, Department of Neurology, Imam Khomeini Hospital, Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran 2015 10 14 The new-AEDs, whose developments were motivated following the discovery of the valproate and its marketing in the U.S in 1978, have presented more therapeutic options. There are approximately twenty four FDA-approved antiepileptic drugs for use in patients with epilepsy, five of which were identified and have come on to the market between 2009 and 2012. The new-AEDs are of interest, not due to their efficacy, but rather owing to better tolerance, favorable pharmacokinetic profile, fewer interactions, and in some instances, lesser protein binding. No standard AED or those in developing have all properties of an ideal antiepileptic drug, thus to achieve desirable outcome, physicians should be aware of pharmacokinetics (PKs) and pharmacodynamics (PDs) of drugs. This review describes briefly the major features of the new AEDs. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/638 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/638/164

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 12 4 2013 12 15 166 168 Leila Aghaghazvini Assistant Professor, Department of Radiology, School of Medicine AND Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Anahita Sadeghi Assistant Professor, Department of Internal Medicine, School of Medicine AND Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Bahman Rasuli Resident, Department of Radiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Shirin Aghaghazvini General Physician, Advanced Diagnostic and Interventional Research Center, Tehran University of Medical Sciences, Tehran, Iran 2015 10 14 Balo's concentric multiple scleroses (MS) is a rare demyelinating disease and a variant of multiple sclerosis. We report a case with interesting misleading clinical history and typical RI findings of Balo disease. A 19-year-old girl presented with fever and left hemiparesis following dental procedure 15 days ago. On physical examination fever and left limbs forces loss were noted. On CT scan a hypodense mass like area, and in MRI a low T1 and high T2, and flair concentric onion-like partial enhancement of mass in parieto-frontal periventricular white matter was detected. Regarding the findings tumefactive MS, Low grade glioma, lymphoma, and abscess and regarding the history of abscess formation were in differential diagnosis. After therapy and no improvement in clinical condition and MRI findings during 2 months, the patient underwent stereotactic biopsy and tumefactive balo MS was revealed. After 4 months of intensive therapy, the patient was discharged with normal condition. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/637 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/637/165

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 12 4 2013 12 15 169 171 Shruti Thakur Resident, Department of Radiology, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India. Ram Gopal Sood Professor, Department of Radiology, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India Anupam Jhobta Associate Professor, Department of Radiology, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India Sushma Makhaik Assistant Professor, Department of Radiology, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India Charusmita Thakur Resident, Department of Radiology, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India 2015 10 14 Intracranial lipomas are congenital malformations. These uncommon lesions have an incidence of 0.1 to 1.7% of all intracranial tumors. Most cases are located at midline and 5% are along the sylvian fissures. If symptomatic, seizures are the most common symptom. These tumors are slow growing and have favorable outcome. We report a case of a 25-year-old man whose CT and MRI revealed a lesion in right sylvian fissure suggesting a lipoma with abnormal vasculature and overlying cortical dysplasia. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/636 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/636/166

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 12 4 2013 12 15 172 175 Masoud Etemadifar Professor, Isfahan Multiple Sclerosis and Neuroimmunology Research Center, Isfahan Eye Research Center, Ophthalmology Ward, Feiz Hospital, Isfahan University of Medical Sciences, Isfahan, Iran. Leila Dehghani PhD Student, Department of Medical Sciences, School of Medicine, Najafabad Branch, Islamic Azad University, Isfahan, Iran Soheil Tahani Department of Medical Sciences, School of Medicine, Najafabad Branch, Islamic Azad University, Isfahan, Iran Nafiseh Toghianifar Assistant Professor, Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Marzieh Rahaimi Assistant professor, Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Nahid Eskandari Assistant professor, Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 2015 10 14 Background: Anti-phospholipids syndrome (APS) is considered a non inflammatory auto-immune disease with a significant thrombophilic risk with varied clinical manifestations. The purpose of the current study was to investigate the frequency of thrombotic and non-thrombotic events in patients with APS. Methods: In this retrospective study, 102 definite APS subjects were recruited (2007-2011) at Alzahra Hospital, Isfahan, Iran. The patients were referred to Multiple Sclerosis Clinic with the diagnosis of definite APS according to 2006 Sydney's criteria. Disorders associated with APS such as pregnancy complication, vascular thrombosis and livedo reticularis (LR) were assessed. Neurological signs and symptoms such as cognitive dysfunction were recorded. Data analyses were performed using SPSS software and P < 0.05 were considered to be statistically significant. Results: Our findings showed that majority of female gender, higher rate of ischemic thrombotic stroke and high miscarriage lied in a large number of APS patients. Conclusion:Overall recurrent miscarriage is a common complication among (antiphospholidpid antibody) aPL patients. Furthermore, ischemic stroke is the second common neurological manifestations of APS patients. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/635 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/635/167

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 12 4 2013 12 15 176 179 Shirin Jamal Omidi Resident, Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 14 ####No abstract ## https://ijnl.tums.ac.ir/index.php/ijnl/article/view/634 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/634/168

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 12 4 2013 12 15 180 181 Siamak Abdi Resident, Department of Neurology, School of Medicine AND Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Askar Ghorbani Assistant Professor, Department of Neurology, School of Medicine AND Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 2015 10 14 #No Abstract# https://ijnl.tums.ac.ir/index.php/ijnl/article/view/633 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/633/169