Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 15 3 2016 08 15 111 120 EN Bahram Sangelaji Department of Physiotherapy, School of Physiotherapy, Otago University, Dunedin, New Zealand AND ‎Iranian Multiple Sclerosis Society Rehabilitation Centre, Tehran, Iran Mohammadreza Kordi Department of Exercise Physiology, School of Physical ‎Education and Sport Sciences, University of Tehran, Tehran, Iran Farzaneh Banihashemi Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran Seyed Massood Nabavi Department of Neurology, School of Medicine, Mostafa Khomeini Hospital, Shahed Universityof Medical Sciences, Tehran, Iran Sara Khodadadeh Department of Exercise Physiology, School of Physical ‎Education and Sport Sciences, University of Tehran, Tehran, Iran Maryam Dastoorpoor Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical ‎Sciences, Kerman, Iran 2015 10 19 2016 05 22 Background: Multiple sclerosis (MS) is a neurological disease with a variety of signs and symptoms. Exercise therapy has been shown to improve physical functions in MS. However, questions about an optimal exercise therapy remain. In this regard, we suggest a combined exercise therapy including aerobic and resistance exercises for MS patients. The study is designed to observe, test and compare the effects of proposed combined exercises on strength, balance, agility, fatigue, speed, and walking distance in people with mild to moderate MS [0 < expanded disability status scale (EDSS) < 5]. Methods: A total of 40 people with relapse-remitting MS (16 male, 0 < EDSS < 5) were randomized into one of the four groups (3 intervention and one control). The intervention consisted of various combinations of aerobic and resistance exercises with different repetition rates. Pre- and post-intervention scores of fatigue severity scale (FSS), timed up and go (TUG) test, 6-minute walk test (6MWT), 10- and 20-MWT, Berg balance scale (BBS), and one repetition maximum (1RM) test were recorded and analyzed. Results: For most tests, post-intervention values of the group 1, with 3-aerobic and 1-resistance exercises, were significantly higher compared to control group (P < 0.050). However, no significant progression was observed in the other two intervention groups. Conclusion: A combination of three aerobic exercises with one resistance exercise may result in improved balance, locomotion, and endurance in MS patients. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/862 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/862/285

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 15 3 2016 08 15 173 174 EN Mostafa Almasi-Doghaee Department of Neurology, School of of Medicine, Iran University of Medical Sciences, Tehran, Iran Reza Boostani Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Morteza Saeedi Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Saeed Ebrahimzadeh Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran Amir Moghadam-Ahmadi Department of Neurology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Mohammad Javad Saeedi-Borujeni Department of Anatomical Sciences, School of Medicine, Neurosciences Research Center, Alzahra Hospital, Isfahan University of Medical ‎Sciences, Isfahan, Iran 2016 05 01 2016 05 03 https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1047 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1047/289

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 15 3 2016 08 15 153 163 EN René Andrade Machado Department of Epilepsy, National Institute of Neurology, CES University, Medellín, ‎Colombia Vanessa Benjumea-Cuartas National Institute of Neurology, CES University, Medellín, Colombia 2015 10 12 2016 05 01 Background: Mesial temporal lobe epilepsy (TLE) is a remediable epileptic syndrome. About 40% of patients continue to have seizures after standard temporal lobectomy. It has been suggested that some of these patients could actually suffer from a more complex epileptogenic network. Because a few papers have been dedicated to this topic, we decided to write an article updating this theme. Methods: We performed a literature search using the following terminology: “temporal plus epilepsy and networks,” “temporal plus epilepsy,” “orbito-temporal epilepsy,” “temporo-insular epilepsy,” “temporo-parieto-occipital (TPO) epilepsy,” “parieto-temporal epilepsy,” “intracortical evoked potential and temporal plus epilepsy,” “temporal lobe connectivity and epilepsy,” “intracortical evoked potential and epilepsy surgery,” “role of extratemporal structures in TLE,” “surgical failure after temporal lobectomy,” “Diffusion tensor imaging (DTI) and temporal epilepsy,” and “positron emission tomography (PET) in temporal plus lobe epilepsy” in the existing PubMed databases. We searched only English and Spanish literature. Only papers that fit with the above-mentioned descriptors were included as part of the evidence. Other articles were used to reference some aspects of the temporal plus epilepsy. Results: A total of 48 papers from 2334 were revised. The most frequently reported auras in these groups of patients are gustatory hallucinations, vestibular illusions, laryngeal and throat constriction, atypical distribution of somatosensory symptoms (perioral and hands, bilaterally hands paresthesias, trunk and other). The most common signs are tonic posturing, hemifacial twist, and frequent bilateral clonic movements. Interictal electroencephalographic (EEG) patterns exhibit regional and frequently bilateral spikes and/or slow waves. The first ictal electrographic change is mostly regional. It is important to note that the evidence is supported by case series or case reports. Thus, most of the data presented could represent the features on these cases and not actually the totality of the iceberg. Conclusion: Temporal plus epilepsy is a diagnosis that can be done only after the invasive recordings have been analyzed but an adequate suspicion may arise based on clinical, EEG and imaging data. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/547 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/547/293

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 15 3 2016 08 15 177 179 EN Masatoshi Yunoki Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan Kenta Suzuki Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan Atsuhito Uneda Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan Shuichi Okubo Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan Koji Hirashita Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan Kimihiro Yoshino Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan 2016 06 15 2016 06 24 https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1077 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1077/296

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 15 3 2016 08 15 891 891 EN Mohammad Rohani Department of Neurology, School of Medicine, Iran University of Medical Sciences, ‎Tehran, Iran Shahnaz Miri Department of Medicine, Medstar Union Memorial Hospital, Baltimore, Maryland, USA Alireza Rezai-Ashtiani Department of Neurology, School of Medicine, Arak University of Medical Sciences, Arak, ‎Iran 2015 11 12 2016 05 09     https://ijnl.tums.ac.ir/index.php/ijnl/article/view/891 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/891/295

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 15 3 2016 11 11 1174 1174 EN Iranian journal of neurology Iranian journal of neurology Official journal of Iranian Neurological Association 2016 11 11 Official journal of Iranian Neurological Association https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1174 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1174/298

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 15 3 2016 08 15 121 127 EN Hadis Sabour Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of ‎Medical Sciences, Tehran, Iran‎ Abbas Norouzi-Javidan Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of ‎Medical Sciences, Tehran, Iran‎ Zahra Soltani Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of ‎Medical Sciences, Tehran, Iran‎ Seyede Azemat Mousavifar Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of ‎Medical Sciences, Tehran, Iran‎ Sahar Latifi Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of ‎Medical Sciences, Tehran, Iran‎ Seyed Hassan Emami-Razavi Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of ‎Medical Sciences, Tehran, Iran‎ Seyed Mohammad Ghodsi Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of ‎Medical Sciences, Tehran, Iran‎ 2015 11 11 2016 05 13 Background: Studies have demonstrated the effect of different dietary fats on blood pressure (BP) in general population. However, these associations have not yet been described in people with spinal cord injury (SCI). Methods: Referred patients to Brain and SCI Research Center between 2011 and 2014 have been invited to participate. Only paraplegic individuals were recruited and patients with injury at cervical or higher thoracic sections were excluded to omit the bias effect of autonomic dysreflexia. Dietary intakes were assessed by recording consumed foods by 24-hour dietary recall interviews using Nutritionist IV 3.5.3 modified for Iranian foods. Systolic BP (SBP) and diastolic BP (DBP) were measured 3 times and the mean values entered analysis. Results: Higher intakes of cholesterol were related to higher BP (P = 0.010 and 0.011 for SBP and DBP, respectively). Similarly, intake of saturated fat was positively correlated to both SBP (P = 0.016, r = 0.21) and DBP (P = 0.011, r = 0.22). The effect of eicosapentaenoic acid (EPA) on BP was insignificant (P = 0.760 and 0.720 for SBP and DBP, respectively). However, intake of docosahexaenoic acid (DHA) was related to lower BP among people with SCI. Conclusion: This study has demonstrated that higher intakes of cholesterol and saturated fat are associated with increased BP, whereas DHA is an antihypertensive agent. Dietary modifications with reduction of cholesterol and saturated fat along with intake of additional DHA supplements may help to reduce BP in spinal cord injured-individuals with hypertension. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/890 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/890/284

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 15 3 2016 08 15 175 176 EN Abdorreza Naser Moghadasi Multiple Sclerosis Research Center, Neuroscience Institute, Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, ‎Tehran, Iran Soroor Advani ‎Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, ‎Iran Shiva Rahimi Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, ‎Iran 2015 12 28 2016 05 13 https://ijnl.tums.ac.ir/index.php/ijnl/article/view/938 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/938/290

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 15 3 2016 08 15 164 172 EN Narjes Hazar Department of Community Medicine, School of Medicine, Tehran University of Medical ‎Sciences, Tehran, Iran Leila Seddigh Department of Community Medicine, School of Medicine, Tehran University of Medical ‎Sciences, Tehran, Iran Zahra Rampisheh Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran‎ Marzieh Nojomi Department of Community Medicine, School of Medicine, Preventive Medicine and Public Health Research Center, Iran University of ‎Medical Sciences, Tehran, Iran 2015 11 02 2016 05 18 Background: Alzheimer’s disease (AD) is the most common type of dementia. Demonstrating the modifiable risk factors of AD can help to plan for prevention of this disease. The aim of the current review was to characterize modifiable cardiovascular risk factors of AD using existing data and determine their contribution in AD development in Iran and the world. Methods: The systematic search was done in Medline, Scopus, and Cochrane databases from inception to May 2014 to find systematic reviews or meta-analyses about association between AD and cardiovascular modifiable risk factors included diabetes, hypertension (HTN), physical inactivity, smoking, hypercholesterolemia, and overweight and obesity. The population attributable fraction (PAF) was calculated for these risk factors in Iran and the world. Results: Of 2651 articles, 11 were eligible for data extraction after assessing relevancy and quality. Diabetes mellitus (DM) type 2, smoking, physical inactivity, overweight and obesity were significantly associated with increased risk of AD. Physical inactivity with 22.0% and smoking with 15.7% had the highest PAF for AD in Iran and the world, respectively. Conclusion: Our findings demonstrated that modifiable cardiovascular risk factors could increase the risk of AD. Moreover, about one-third of AD cases were attributed to five modifiable risk factors. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/875 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/875/294

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 15 3 2016 08 15 180 181 EN Seyed Mohammad Baghbanian Department of Neurology, School of Medicine, Booalisina Hospital, Mazandaran University of Medical Sciences, Sari, Iran 2015 12 24 2016 05 22 https://ijnl.tums.ac.ir/index.php/ijnl/article/view/936 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/936/291

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 15 3 2016 08 15 128 132 EN Ebrahim Barzegar-Bafrooei Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical ‎Sciences, Tehran, Iran Jalal Bakhtiary Department of Speech Therapy, School of Rehabilitation, Semnan University of Medical ‎Sciences, Semnan, Iran‎ Ahmad Reza Khatoonabadi Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical ‎Sciences, Tehran, Iran Farzad Fatehi Iranian Center of Neurological Research, Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Saman Maroufizadeh Department of Epidemiology and Reproductive Health, Reproductive Epidemiology ‎Research Center, Royan Institute for Reproductive Biomedicine, Academic Center for ‎Education, Culture and Research, Tehran, Iran Mojtaba Fathali Department of Ear, Nose and Throat, School of Rehabilitation, Tehran University of Medical ‎Sciences, Tehran, Iran 2016 06 01 2016 06 01 Background: Dysphagia as a common condition affecting many aspects of the patient’s life. The Dysphagia Handicap Index (DHI) is a reliable self-reported questionnaire developed specifically to measure the impact of dysphagia on the patient’s quality of life. The aim of this study was to translate the questionnaire to Persian and to measure its validity and reliability in patients with neurogenic oropharyngeal dysphagia. Methods: A formal forward-backward translation of DHI was performed based on the guidelines for the cross-cultural adaptation of self-report measures. A total of 57 patients with neurogenic dysphagia who were referred to the neurology clinics of Tehran University of Medical Sciences, Iran, participated in this study. Internal consistency reliability of the DHI was examined using Cronbach’s alpha, and test-retest reliability of the scale was evaluated using intraclass correlation coefficient (ICC). Results: The internal consistency of the Persian DHI (P-DHI) was considered to be good; Cronbach’s alpha coefficient for the total P-DHI was 0.88. The test-retest reliability for the total and three subscales of the P-DHI ranged from 0.95 to 0.98 using ICC. Conclusion: The P-DHI demonstrated a good reliability, and it can be a valid instrument for evaluating the dysphagia effects on quality of life among Persian language population. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1046 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1046/292

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 15 3 2016 08 15 133 139 EN Abdolhamid Shariat Shiraz Neuroscience Research Center AND Clinical Neurology Research Center AND Department of Neurology, Shiraz University of Medical Sciences, ‎Shiraz, Iran Leila Niknam Clinical Neurology Research Center AND Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran Sadegh Izadi Clinical Neurology Research Center AND Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran Alireza Salehi Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran 2016 05 02 2016 06 12 Background: The aim of this study is to determine the frequency of intracranial artery stenosis in patients with acute ischemic stroke in Iran. Methods: A total of 169 patients with acute ischemic stroke were eligible to participate and were enrolled in this study from January 2012 to February 2013. All the patients were admitted to the Nemazee ‎Hospital, affiliated to Shiraz University of Medical Sciences, Iran. They underwent transcranial Doppler (TCD) ultrasonography. Mean flow velocity (MFV) of basilar artery, vertebral artery, middle cerebral artery (MCA), anterior cerebral artery (ACA), and posterior cerebral artery (PCA) were evaluated. Results: A mean of patients’ age was 67.80 ± 8.14 years. There were 83 men (49.1%) and 86 women (50.9%). Overall, 43 patients (25.4%), with a mean age of 66.7 ± 6.2 years, had intracranial stenosis. The number of men and women with intracranial stenosis was comparable (52.4% men vs. 47.6% women). Hypertension (P < 0.001), hyperlipidemia (P < 0.001), and diabetes mellitus (DM) (P < 0.001) were major risk factors for intracranial stenosis. Conclusion: The prevalence of intracranial artery stenosis in patients with acute ischemic stroke is 25.4% which is comparable with previous reports from Iran and other Middle East countries. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1048 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1048/288

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 15 3 2016 08 15 140 145 EN Leila Ghelichi Department of Speech and Language Pathology, School of Rehabilitation ‎Sciences, Iran University of Medical Sciences, Tehran, Iran Mohammad Taghi Joghataei Cellular and Molecular Research Center, Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Shohreh Jalaie Department of Physiotherapy, School of Rehabilitation, Tehran University of ‎Medical Sciences, Tehran, Iran Noureddin Nakhostin-Ansari Department of Physiotherapy, School of Rehabilitation, Tehran University of ‎Medical Sciences, Tehran, Iran Bijan Forogh ‎Department of Physical Medicine and Rehabilitation, School of Medicine, Iran ‎University of Medical Sciences, Tehran, Iran Masoud Mehrpour ‎Department of Neurology, Firouzgar Hospital, Iran University of Medical ‎Sciences, Tehran, Iran 2016 04 27 2016 06 12 Background: Post-stroke dysphagia is common and is associated with the development of pneumonia. To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) combined with traditional dysphagia therapy (TDT) on swallowing function in patients with post-stroke dysphagia. Methods: In this single-subject study, four patients with dysphagia post-stroke included. The patients received the rTMS applied to the intact cerebral hemisphere at 1 Hz with train of 1200 for 5 consecutive days combined with TDT 3 days per week for 6 weeks. The main outcome measure was the Mann Assessment of Swallowing Ability (MASA). Measurements were taken before, after the end of 5th, 10th, 15th treatment sessions, and after the end of the treatment (18th session). Results: The MASA scores improved in all patients following treatment. The maximum and minimum change in level between the baseline phase and treatment phase was +84 and +36. The greatest percentage improvement was observed after 5th treatment sessions ranging between 11 and 35%. The treatment trend was upward shown by the directions of the slopes indicated by positive values (+9.1-+20.7). The dysphagia was resolved after 10th treatment session in all participants. The aspiration resolved in two participants after the 5th treatment session and resolved in another 2 participants after the 10th treatment session. Conclusion: The combination therapy of rTMS plus TDT improved swallowing function in patients with post-stroke dysphagia. Further research with a larger sample size is recommended. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1041 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1041/287

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 15 3 2016 08 15 146 152 EN Aparna Pandey ‎Department of Biochemistry, Narsinhbhai Patel Dental College and Hospital, Visnagar, India Amit Shrivastava Department of Biochemistry, Medanta-The Medicity, Gurgaon, ‎India‎ Ashok Solanki Department of Physiology, AMC MET Medical College, L.G. Hospital, Maninagar, Ahmedabad, ‎India 2016 04 26 2016 06 12 Background: Stroke is one of the most frequent causes of death and disability worldwide and has significant clinical and socioeconomic impact. Hyperlipidemia and inflammation play major roles in atherothrombosis and in stroke. This study is conducted to compare the high sensitive C-reactive protein (hs-CRP) levels and the lipid profile parameters between stroke patients and control group and demonstrate correlation between markers, neurological deficit, and short-term outcome. Methods: We have studied a total 162 patients according to inclusion criteria. Serum level of hs-CRP and lipid profile estimated and correlated with neurological deficit and short-term outcome. Results: We found stroke patients had significantly higher levels of hs-CRP, total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), and low level of high-density lipoprotein (HDL) than control. When we compared ischemic and hemorrhagic stroke (HS), data show increased level of triglyceride, LDL and HDL, and decreased the level of hs-CRP in ischemic stroke group than HS group. However, the National Institutes of Health Stroke Scale (NIHSS) score significantly higher in HS as compared to ischemic stroke at the time of admission and on the 7th day. Conclusion: Thus, continuous clinical observation is necessary for clear differentiation of those changes. Furthermore, the determination of some reliable soluble markers of neuronal damage in blood and cerebrospinal fluid in the early infarction period would be much easier and more useful for tracking the course and prognosis of the disease and for any appropriate therapeutic approach. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1037 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1037/286