Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 18 3 2019 06 16 93 98 EN Sharareh Eskandarieh Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Abdorreza Naser Moghadasi Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Mohammad Ali Sahraian Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Amir Reza Azimi Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Negar Molazadeh Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran 2019 02 24 2019 06 12 Background: Neuromyelitis optica spectrum disorder (NMOSD) is a neuroinflammatory demyelinating disease caused by the presence of a highly specific serum autoantibody marker, NMO-immunoglobulin G (NMO-IgG), that reacts against the water channel aquaporin-4 (AQP4). The present study examined the association between NMO-IgG sero-positivity and environmental factors such as cigarette smoking. Methods: A cross-sectional study was conducted in Sina Hospital, a tertiary referral center in Tehran, Iran. All the patients with a definite diagnosis of NMOSD were involved in this study. The enzyme-linked immunosorbent assay (ELISA) was used to examine the AQP4-IgG status. To assess the association between NMO-IgG sero-positivity and cigarette smoking, a researcher-made questionnaire covering patients’ lifestyle information on smoking habits was designed and administered using the structured face-to-face interviews with the patients. Results: The positive and negative NMO-IgG results were found in 44 (46.8%) and 50 (53.2%) patients, respectively. The increased NMO-IgG sero-positivity odds were observed among the lifetime smokers [odds ratio (OR) = 3.24, 95% confidence interval (CI): 1.16-9.08], current smokers (OR = 6.08, 95% CI: 1.26-29.39), and passive smokers (OR = 2.22, 95% CI: 1.10-4.50). Conclusion: Lifetime and current smoking as well as passive smoking can be regarded as risk factors for NMO-IgG sero-positivity. Smoking with its immunological effects can lead to the production of autoantibodies such as NMO-IgG. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1757

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 18 3 2019 07 04 99 107 Hossein Salehi Department of Plastic and Reconstructive Surgery, School of Medicine, Rafsanjan University of Medical Sciences, Iran Clinical Research Development Center, Ali Ibn Abi Talib Hospital, Rafsanjan University of Medical Sciences, Iran Moein Moussaei School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Zahra Kamiab Department of Social Medicine, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Clinical Research Development Unit, Ali Ibn Abi Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Alireza Vakilian Department of Neurology, School of Medicine, University of Medical Sciences, Rafsanjan, Iran Non-Communicable Diseases Research Center, Ali Ibn Abi Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran 2019 04 17 2019 07 04 Background: Neuropathic pain is one of the most common problems in patients with diabetes mellitus (DM). In this study, the effect of botulinum toxin type A (BTX-A) on neuropathic pain, quality of sleep, and quality of life of diabetic patients with sensorimotor polyneuropathy was studied. Methods: This randomized placebo-controlled trial study was carried out in a double-blind (patient-researcher) method. The study was performed on 32 patients with type 2 DM. Neuropathy was confirmed by Douleur Neuropathique 4 (DN4) Questionnaire and nerve conduction study (NCS). The patients were randomly assigned to two intervention and control groups based on the random numbers table. After selecting the subjects, we used 36-Item Short Form Health Survey (SF-36), Neuropathic Pain Scale (NPS), Visual Analogue Scale (VAS), and Pittsburgh Sleep Quality Index (PSQI) questionnaires before and after 3 months of 100 units BTX-A injection (as intervention group) or same amount of chloride sodium (as control group) to the subjects' feet. The data were analyzed by SPSS software using independent two-sample t-test, chi-square test, and one-way repeated measures analysis of variance (ANOVA). Results: 12 male and 20 female patients participated in this study. There was a significant difference in the mean VAS, PSQI, physical dimension of the SF-36, and some NPS indices over time (12 weeks) (P < 0.001). Conclusion: The results of this study showed that BTX-A reduced neuropathic pain and improved the quality of life and sleep in people with diabetic neuropathy. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1789

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 18 3 2019 07 06 108 113 Anahid Safari Stem Cells Technology Research Center, Shiraz University of Medical Sciences Shiraz, Iran Hamzeh Badeli-Sarkala Histomorphometry and Stereology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Mohammad Reza Namavar Histomorphometry and Stereology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Elias Kargar-Abarghoue Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Neda Anssari Department of Neurology, University of Manitoba, Winnipeg, Manitoba, Canada Sadegh Izadi Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Afshin Borhani-Haghighi Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 2018 12 17 2019 06 16 Background: There is evidence that supports the neuroprotective effects of dimethyl fumarate (DMF) in stroke. Nuclear factor erythroid 2-related factor 2 (Nrf2) has both anti-oxidant and anti-inflammatory mechanisms. We investigated the neuroprotective effects of DMF via Nrf2 activation in the cortex, striatum, and diencephalon in a middle cerebral artery occlusion (MCAO) model of stroke. Methods: 22 Sprague-Dawley male rats were randomized into 3 groups. In DMF-treated group (n = 8), rats received 15 mg/kg oral DMF twice daily by gavage from day 0 to 14 after a 60-minute MCAO. The vehicle group (n = 7) underwent MCAO and were given methocel/H2O, using the same method and schedule. In the sham group (n = 7), neck was opened, but neither middle cerebral artery (MCA) was occluded nor any drug was administered. After 14 days, the animals were sacrificed. The infarct volume were assessed by stereology method. Nrf2 expression was evaluated in the cortex, striatum, and diencephalon by immunohistochemistry method. Results: Ratio of infarct to total brain volume was significantly lower in the DMF-treated group (5.76%) in comparison with the vehicle group (22.39%) (P < 0.0001). Nrf2 expression was higher in DMF-treated group in comparison with both the vehicle and sham groups in cortex, striatum, diencephalon, and total brain (P < 0.0001). In the DMF-treated group, significant negative correlation between Nrf2 expression and infarct volume was observed in cortex, striatum, diencephalon, and total brain. Conclusion: DMF induces Nrf2 expression and its neuroprotective effects in different brain anatomical regions. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1705

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 18 3 2019 06 16 114 118 EN Marjan Erfani Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Ariane Sadr-Nabavi Department of Medical Genetics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Reza Jafarzadeh-Esfehani Department of Medical Genetics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Mohammad Shariati Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Leila Ghanbari-Garekani Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Samaneh Vojdani-Chahchaheh Department of Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran Payam Sasannejad Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 2018 06 02 2019 06 16 Background: Stroke is a multifactorial disorder and a major cause of morbidity and mortality around the world. There are growing numbers of candidate gene pathways which are thought to be associated with stroke. Genes involved in lipid metabolism are important issues in stroke studies. Studying different polymorphisms in these genes are becoming an interest for researchers. 5-lipoxygenase activating protein (ALOX5AP) is one of these genes. Different studies have provided different relations between ALOX5AP promoter polymorphism (rs17222919) and stroke. In the present study, we have evaluated this gene polymorphism in a population in north east of Iran. Methods: This case-control study took place in Ghaem Hospital, Mashhad, Iran. Patients with computed tomography (CT) or magnetic resonance imaging (MRI) confirmation for ischemic stroke were enrolled in this study and considered as case group. Healthy persons without ischemic stroke were control group. During 1-year period of this study, ALOX5AP gene polymorphism in 200 healthy patients (control group) as well as 228 patients with stroke (case group) was evaluated by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results: All of 428 persons (228 cases and 200 healthy controls) enrolled in this study. The genotype and allele frequency was significantly different between both groups (P = 0.001 and P = 0.003, respectively). A total number of 54 patients had G allele in case group in contrast to 27 ones in control group. Also, 174 patients in case group had T allele and 173 persons had this allele in control group. In compression of TT genotype, the risk of developing stroke in GG and TG genotypes increased by 3.998 and 1.643, respectively. Also the risk of ischemic stroke with G allele would increase by 2.128. Conclusion: According to our results, ALOX5AP promoter polymorphism (rs17222919) is related to increased ischemic stroke in Iranian population. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1583

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 18 3 2019 06 13 119 126 EN Davood Fathi Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Brain and spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Shahriar Nafissi Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Shahram Attarian Reference Centre for Neuromuscular Disorders and ALS, CHU La Timone, Aix-Marseille University, Marseille, France Christoph Neuwirth Neuromuscular Disease Unit/ALS Clinic, Kantonspital St. Gallen, St. Gallen, Switzerland Farzad Fatehi Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran 2017 12 09 2019 06 13 Motor unit number index (MUNIX) is an electrophysiological technique to give an estimate of functioning motor neurons in a muscle. For any given neurophysiological technique for the use in clinical or research studies, reproducibility between different operators and in a single operator in different times is one of the most important qualities, which must be evaluated and approved by different examiners and centers. After its introduction, testing the reproducibility of MUNIX was the aim of many studies to show this quality of the technique. In this review, we aimed to summarize all the studies, which have been performed up to now to approve MUNIX reproducibility in amyotrophic lateral sclerosis comparing healthy individuals. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1463

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 18 3 2019 06 15 127 133 Reza Ahmadi-Beni Department of Medical Genetics, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran Ali Najafi Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Student Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran Seyed Mehrdad Savar School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Niayesh Mohebbi Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Alireza Khoshnevisan Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 2019 04 13 2019 06 15 Glioblastoma multiforme (GBM), the most frequent malignant and aggressive primary brain tumor, is characterized by genetically unstable heterogeneous cells, diffused growth pattern, microvascular proliferation, and resistance to chemotherapy. Extensive investigations are being carried out to identify the molecular origin of resistance to chemo- and radio-therapy in GBM and find novel targets for therapy to improve overall survival rate. Dimethyl fumarate (DMF) has been shown to be a safe drug with limited short and long-term side effects, and fumaric acid esters (FAEs), including DMF, present both anti-oxidative and anti-inflammatory activity in different cell types and tissues. DMF has also anti-tumoral and neuroprotective effects and so it could be repurposed in the treatment of this invasive tumor in the future. Here, we have reviewed DMF pharmacokinetics and different mechanisms by which DMF could have therapeutic effects on GBM. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1787

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 18 3 Askar Ghorbani Iranian Center of Neurological Research, Department of Neurology, Shariati Hospital, ‎Tehran University of Medical Sciences, Tehran, Iran 2016 01 28 2016 04 09 Background: The purpose of this study is to demonstrate the advantages of gradient echo (GRE) sequences in the detection and characterization of cerebral venous sinus thrombosis compared to conventional magnetic resonance sequences. Methods: A total of 17 patients with cerebral venous thrombosis (CVT) were evaluated using different magnetic resonance imaging (MRI) sequences. The MRI sequences included T1-weighted spin echo (SE) imaging, -weighted turbo SE (TSE), fluid attenuated inversion recovery (FLAIR), -weighted conventional GRE, and diffusion weighted imaging (DWI). MR venography (MRV) images were obtained as the golden standard. Results: Venous sinus thrombosis was best detectable in -weighted conventional GRE sequences in all patients except in one case. Venous thrombosis was undetectable in DWI. -weighted GRE sequences were superior to -weighted TSE, T1-weighted SE, and FLAIR. Enhanced MRV was successful in displaying the location of thrombosis. Conclusion: -weighted conventional GRE sequences are probably the best method for the assessment of cerebral venous sinus thrombosis. The mentioned method is non-invasive; therefore, it can be employed in the clinical evaluation of cerebral venous sinus thrombosis. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/974 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/974/276

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 15 2 2016 04 15 100 102 EN Ali Asadi-Pooya Neuroscience Research Center, School of Medicine, Shiraz University of Medical ‎Sciences, Shiraz, Iran AND Jefferson Comprehensive Epilepsy Center, Department of ‎Neurology, Thomas Jefferson University, Philadelphia, USA 2016 04 01 2016 04 15 Background: We investigated the perceptions of the neurologists practicing in Fars province in Southern Iran about psychogenic nonepileptic seizures (PNES); their diagnostic processes and management strategies. Methods: In this survey, all neurologists participating at the annual meeting of neurologists were asked to participate. These neurologists practice in Fars province. An anonymous questionnaire was specifically developed for this study. Results: About 18 neurologists (14 males and four females), out of 20 attendees, agreed to participate in the study. The mean age of the participants was 41.6 ± 7.5 years. They estimated that 10.8% of patients attending their clinic had seizures or blackouts, whereas 4.4% of patients attending their clinic had PNES. The experiences of the participants about the manifestations that potentially differentiate PNES from epileptic seizures; the tests they use to diagnose suspected patients and their treatment strategies showed significant variability. For example, the tests the neurologists always used for the diagnosis of PNES in suspected patients included routine electroencephalographs (EEGs) by 9 (50%), video-EEG monitoring by 4 (22%), and serum creatine phosphokinase (CPK) measurement by 2 (11%). Conclusion: There is much variability in the approaches to diagnosis and management of PNES in southern Iran. The participants in our study were aware of the many knowledge gaps in this area. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1020 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1020/279

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 15 2 2016 04 05 103 105 EN Salman Mansoor FCPS Trainee Neurology, Shifa International Hospital Islamabad, Department of Neurology, Islamabad, Pakistan Arsalan Ahmad Consultant Neurologist, Department of Neurology, Shifa International Hospital, Islamabad, Pakistan 2015 10 19 2016 03 07 -- https://ijnl.tums.ac.ir/index.php/ijnl/article/view/861 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/861/270

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 15 2 2016 04 05 106 108 EN Samaneh Haghighi ‎Department of Neurology, Sina Hospital, Tehran University of Medical ‎Sciences, Tehran, Iran Maral Seyed Ahadi ‎Department of Neurology, Sina Hospital, Tehran University of Medical ‎Sciences, Tehran, Iran Abdorreza Naser Moghadasi ‎Department of Neurology, Sina Hospital AND MS Research Center, ‎Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran‎ 2015 10 27 2016 04 03 -- https://ijnl.tums.ac.ir/index.php/ijnl/article/view/869 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/869/272

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 15 2 2016