Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 3 2018 07 05 145 148 EN Fatemeh Omrani Department of Neurology, Hazrat-e-Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran Shahla Ansari-Damavandi Department of Pediatric Hematology, Ali Asghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran Babak Zamani Department of Neurology, Firouzgar Hospital, Iran University of Medical Sciences, Tehran, Iran Zahra Omrani Department of Neurology, Hazrat-e-Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran Nahid Mohammadzade Department of Neurology, Hazrat-e-Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran Sadra Rohani Department of Neurology, Hazrat-e-Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran Mohammad Rohani Department of Neurology, Hazrat-e-Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran 2017 07 14 2018 05 24 Background: 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. Methods: 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. Results: Mean aSNmax in GBA mutation carriers was significantly higher (0.31 ± 0.06 cm2) than controls (0.16 ± 0.04 cm2). Moreover, DTV was significantly higher in GBA mutation carriers group (3.98 ± 0.90 vs 3.29 ± 0.56 cm). Conclusion: 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. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1365

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 3 2018 10 27 99 104 EN Zahra Jafari Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran Mohammad Rahim Shahbodaghi Department of Speech Therapy, School of Rehabilitation, 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 Abdorreza Naser Moghadasi Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran 2017 11 05 2018 04 28 Background: About one third of patients with multiple sclerosis (MS) experience dysphagia. Dysphagia can cause complications such as malnutrition, lung infections, aspiration pneumonia and dehydration, thus it is very helpful to diagnose dysphagia as soon as possible. The aim in this study was to translate dysphagia in multiple sclerosis (DYMUS) questionnaire into Farsi and and validate it. Methods: Forward-backward method was used to translate original English version of DYMUS into farsi, and then the questionnaire (one for each patient) was filled in through asking questions from 200 patients with MS by a speech and language pathologist. Confirmatory factor analysis (CFA) was used to examine the construct validity. Internal consistency and test-retest reliability of the DYMUS were evaluated using Cronbach’s alpha and the intraclass correlation coefficient (ICC), respectively. Results: CFA showed that a two-factor model of DYMUS including “dysphagia for solid” and “dysphagia for liquid” fitted the data well [relative chi-square [χ2/degree of freedom (df) = 1.55, CFI = 0.967, Tucker-Lewis index (TLI) = 0.957, root mean square error of approximation (RMSEA) = 0.053, and weighted root mean square residual (WRMR) = 0.874]. The Cronbach’s alpha for total score and liquid and solid subscales were 0.776, 0.557, and 0.725, respectively. The DYMUS showed adequate test-retest reliability for the total and subscales (ICC: 0.880-0.956). Moreover, this study has shown a significant relationship between DYMUS score and Expanded Disability Status Scale (EDSS) score, disease duration, type of MS, and self-reported dysphagia. Conclusion: The Persian version of DYMUS is a reliable and valid tool to screen dysphagia among patients with MS. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1433

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 3 2018 07 05 129 136 EN Seyed Mohammad Baghbanian Bualicina Hospital, Mazandaran University of Medical sciences, Sari, Iran Mohammad Ali Sahraian Multiple Sclerosis Research Centre, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran 2017 05 31 2018 04 28 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. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1325

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 3 2018 08 11 152 153 EN Vida Mohammadzadeh Department of Neurology, Vali-e-Asr Hospital, Zanjan University of Medical Sciences, Zanjan, Iran Samira Akbarieh Department of Infectious Diseases, Vali-e-Asr Hospital, Zanjan University of Medical Sciences, Zanjan, Iran Seyed Abdolreza Ghoreishi Department of Neurology, Vali-e-Asr Hospital, Zanjan University of Medical Sciences, Zanjan, Iran Manizheh Jozpanahi Department of Infectious Diseases, Vali-e-Asr Hospital, Zanjan University of Medical Sciences, Zanjan, Iran 2018 04 22 2018 08 11 https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1551

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 3 2018 07 05 149 151 EN Morteza Faghih-Jouybari Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Soheil Naderi Department of Neurosurgery, School of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran Sara Mashayekhi Department of Neurosurgery, School of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran Tahereh Padeganeh Department of Maxillofacial Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Sina Abdollahzade Department of Neurosurgery, Rajaayi Hospital, Qazvin University of Medical Sciences, Qazvin, Iran 2017 11 30 2018 05 24 Background: 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. Methods: 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). Results: There were 33 men and 19 women. The average age was 52.4 ± 12.8 years. Among these, 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. Conclusion: Hypothyroidism is relatively prevalent in patients with treated GBM. Regular thyroid function test is advised to aid the introduction of appropriate hormone replacement therapy. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1454

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 3 2018 07 05 105 110 EN Shirin Farjadian Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Bahareh Fakhraei Department of Psychiatry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Zahra Niknam Iran Neurological Association, Tehran, Iran Mahboubeh Nasiri Allergy Research Center, Department of Immunology, Shiraz University of Medical Sciences, Shiraz, Iran Aslan Azad School of Pharmacy, International Branch, Shiraz University of Medical Sciences, Shiraz, Iran Mojtaba Farjam Noncommunicable Diseases Research Center, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran Alireza Nikseresht Department of Neurology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran 2017 10 19 2018 05 14 Background: 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. Methods: 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. Results: 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. Conclusion: 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. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1424

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 3 2018 07 05 137 144 EN Zeba Khan Department of Biotechnology, Saifia Science College, Bhopal, India Sharique Athar Ali Department of Biotechnology, Saifia Science College, Bhopal, India 2018 03 31 2018 05 07 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 > 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 < 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 < 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. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1538

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 17 3 2018 08 04 111 116 EN Fatemeh Akbarian Department of Medical Genetics, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran Department of Biology, School of Basic Sciences, University of Guilan, Rasht, Iran Ahmad Aoude Department of Neurosurgery, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Soheil Naderi Department of Neurosurgery, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Zeynab Najafi Department of Pediatrics, School of Medicine AND Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Morteza Faghih-Jouibari Department of Neurosurgery, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 14 Background: Distinction between radiation necrosis and recurrence of intraparenchymal tumors is necessary to select the appropriate treatment, but it is often difficult based on imaging features alone. We developed an algorithm for analyzing magnetic resonance spectroscopy (MRS) findings and studied its accuracy in differentiation between radiation necrosis and tumor recurrence. Methods:   Thirty-three   patients   with   a   history   of intraparenchymal brain tumor resection and radiotherapy, which had developed new enhancing lesion were evaluated by MRS and subsequently underwent reoperation. Lesions with Choline (Cho)/N- acetyl aspartate (NAA) > 1.8 or Cho/Lipid > 1 were considered as tumor recurrence and the remaining as radiation necrosis. Finally, pre-perative MRS diagnoses were compared with histopathological report. Results: The histological diagnosis was recurrence in 25 patients and necrosis in 8 patients. Mean Cho/NAA in  recurrent  tumors  was  2.72,  but  it  was  1.46  in radiation necrosis (P < 0.01). Furthermore, Cho/Lipid was significantly higher in recurrent tumors (P < 0.01) with the mean of 2.78 in recurrent tumors and 0.6 in radiation     necrosis.    Sensitivity,    specificity,    and diagnostic accuracy of the algorithm for detecting tumor recurrence were 84%, 75% and 81%, respectively. Conclusion: MRS is a safe and informative tool for differentiating    between   tumor   recurrence   and radiation necrosis. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/576 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/576/226

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 14 1 2015 03 15 35 40 Siamak Abdi Department of Neurology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Shahram Oveis-Gharan Department of Neurology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Farnaz Sinaei Department of Neurology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Askar Ghorbani Department of Neurology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 14 Background: Serum troponin elevation, characteristic of ischemic myocardial injury, has been observed in some acute ischemic stroke (AIS) patients. Its cause and significance are still controversial. The purpose of this study is to find determinants of troponin elevation and its relationship with stroke severity and location. Methods:Between January 2013 and August 2013, 114 consecutive AIS patients confirmed by diffusion- weighted magnetic resonance imaging were recruited in this study. Serum troponin T level was measured as part of routine laboratory testing on admission. Ten lead     standard     electrocardiogram    (ECG)     was performed and stoke severity was assessed based on National Institutes of Health Stroke Scale (NIHSS). Results: Troponin T was elevated in 20 (17.6%) of 114 patients. Patients with elevated troponin were more   likely   to   have   higher   age,   higher   serum creatinine  and  ischemic  ECG  changes.  Troponin levels were higher in patients with more severe stroke measured  by  NIHSS  [7.96  (6.49-9.78)  vs.  13.59 (10.28-18.00)].  There  was  no  association  between troponin and locations of stroke and atrial fibrillation. There were 6 (5%) patients with elevated troponin in the presence of normal creatinine and ECG. Conclusion:  Stroke  severity,  not  its  location,  was associated   with   higher   troponin   levels.   Abnormal troponin levels are more likely, but not exclusively, to be due to cardiac and renal causes than cerebral ones. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/575 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/575/227

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 14 1 2015 03 15 41 46 Saeid Khosrawi Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Parisa Taheri Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Seyed Hasan Hashemi Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. 2015 10 14 Background: H-reflex is a valuable electrophysiological technique for assessing nerve conduction through entire length of afferent and efferent pathways, especially nerve roots and proximal segments of peripheral nerves. The aim of this study was to investigate the relation between normal values of flexor carpi radialis (FCR) H-reflex latency, upper limb length and age in normal subjects, and to determine whether there is any regression equation between them. Methods: By considering the criteria of inclusion and exclusion, 120 upper limbs of 69 normal volunteers (68 hands of 39 men and 52 hands of 30 women) with the mean age of 39.8 ± 11.2 years participated in this study. FCR H-reflex was obtained by standard electrodiagnostic  techniques,  and  its  onset  latency was recorded. Upper limb length and arm length weremeasured   in   defined   position. The   degree   of association between these variables was determined with  Pearson correlation and  linear  regression was used for obtaining the proposed relaions. Results: Mean FCR H-reflex latency was found to be 15.88 ± 1.27 ms. There was a direct linear correlation between FCR H-reflex latency and upper limb length (r = 0.647) and also arm length (r = 0.574), but there was no significant correlation between age and FCR H-reflex latency (P = 0.260). Finally, based on our findings, we tried to formulate these relations by statistical methods. Conclusion: We found that upper limb length and arm length are good predictive values for estimation of normal FCR H-reflex latency but age, in the range of 20-60 years old, has no correlation with its latency. This estimation could have practical indications in pathologic conditions. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/574 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/574/228

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 14 1 2015 03 15 47 49 Fahmi