2024-03-28T21:24:29+03:30 http://cjns.gums.ac.ir/browse.php?mag_id=13&slc_lang=en&sid=1
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Caspian Journal of Neurological Sciences Caspian J Neurol Sci 2383-4307 2423-4818 10.32596 2018 4 1 Tapering Oral Steroid Treatment After IV Methylprednisolone Pulse Therapy in Demyelinating Optic Neuritis Seyed-Ehsan Mohammadianinejad Nastaran Majidinasab Adel Nejati nejatiadel@gmail.com Hamidreza Hatamian Asieh Mehramiri Seyed-Aidin Sajedi Saeed Hesam Background: Optic neuritis is an inflammation of the optic nerve. Because of importance of vision for human, management of optic neuritis is an important issue in neurology. Objectives: This study aimed at assessing the effect of oral steroid treatment after intravenous (IV) methylprednisolone therapy on demyelinating optic neuritis. Materials & Methods: 60 Patients with first episode of acute demyelinating optic neuritis who referred to a neurology clinic in an academic hospital in south-west of Iran in 2015-2016 included in this randomized double-blind clinical trial study (No: IRCT2015102724735N1). They were divided into two groups with (A) and without (B) tapering oral steroid treatment after IV methylprednisolone. Visual acuity and color vision were measured before treatment, before oral tapering, 1 and 3 months after treatment. Independent t-test in SPSS software version 20 was used to analyze the data. P<0.05 was considered as the level of significance. Results: Visual acuity in two groups did not have any significant difference in any time point of assessment (P>0.05).Frequency of color vision abnormality in groups A and B were at baseline (53.3% vs. 56.6%) (P=0.796), before oral tapering (43.3% vs. 30%, P=0.284), 1 month after treatment (23.3% vs. 30%, P=0.559), 3 months after treatment (0% vs. 23%, P=0.011).  Conclusion: Oral steroid treatment after IV methylprednisolone pulse therapy improves color vision after 3 months in patients with demyelinating optic neuritis but has no effect on visual acuity. neuritis Methylprednisolone Therapy 2018 1 01 1 5 http://cjns.gums.ac.ir/article-1-212-en.pdf 10.29252/nirp.cjns.4.12.1
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Caspian Journal of Neurological Sciences Caspian J Neurol Sci 2383-4307 2423-4818 10.32596 2018 4 1 The Impact of Word Regularity on the Reading of Normal and Aphasic Gilak-Persian Adults Maedeh Zebardast maedehzebardast@yahoo.com Maryam Danaye Tous Background: Various factors influence the natural processing of words. The present study sought to investigate the effect of the regularity variable on the reading of words. Objectives: The participants in the study were 50 normal and 5 aphasic people (of Broca, transcortical motor and conduction aphasia types) who were selected through convenience sampling method. Materials & Methods: It was a quantitative study with quasi-experimental design. In this research, reading aloud subtest of the test 53 of the Psycholinguistic Assessment of Language Processing in Aphasia (PALPA) battery of tests was nativized and used. First, the mean and standard deviation was computed for the test scores of the two groups of participants (i.e. normal and aphasics). Regarding the aphasics’ data, after verifying their normality of distribution by Kolmogorov-Smirnov Test, paired samples t-test was used to compare the mean scores on the results of the test on regular and exception words. Results: Since normal subjects scored a perfect grade (SD=0), it was found that the regularity variable had no effect on the reading process in these individuals. Based on the results of paired samples t-test in the aphasic subjects (P=0.25), it was found that the regularity variable in these individuals has no effect on their reading process, too. Conclusion: The evidence from the present study shows that the word regularity has no impact on the reading of words in both normal and aphasic adults. The theoretical and clinical implications of the findings would be discussed. Aphasia Reading Language 2018 1 01 6 12 http://cjns.gums.ac.ir/article-1-213-en.pdf 10.29252/nirp.cjns.4.12.6
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Caspian Journal of Neurological Sciences Caspian J Neurol Sci 2383-4307 2423-4818 10.32596 2018 4 1 Celecoxib or Prednisolone for Treatment of Medication Overuse Headache: A Randomized, Double-Blind Clinical Trial in Migrainous Patients Ahmad Chitsaz Mohammadreza Najafi Maryam Shirmardi drshirmardi_m@yahoo.com Roshanak Mehdipour Background:Treatment of Medication Overuse Headache (MOH) is yet under debate and Celecoxib as a Cyclooxygenase 2 (COX2) -inhibitor has not been tried widely as a pain relief drug for this type of headaches in migrainous patients.  Objectives: comparing the efficacy of celecoxib versus prednisolone for withdrawal period of MOH. Materials & Methods: A double-blind, randomized clinical trial was carried out, on 75 patients with MOH who visited the Isfahan Neurology Clinic in 2016. They were assigned into two groups of oral prednisolone and celecoxib prescribed for 15 days. Any changes in the duration (average hours of daily headache), frequency, and severity of headaches, and intake of rescue medication and their side effects were recorded after the 15-day intervention period. Data were analyzed by independent t, paired t, Mann-Whitney, Wilcoxon test, and chi-square tests in SPSS software version 20. Results: Average duration of headache in both groups significantly decreased after treatment (P<0.001). It decreased significantly in celecoxib group (P=0.04). Headache frequency decreased more but not significantly in the celecoxib group (P=0.08). Considering MIGSEV (Migraine Severity) and VAS (Visual Analogue Scale) scales, headache severity alleviated significantly after treatment in both groups (P<0.001). The decrease was more noticeable in the celecoxib group. Need for rescue medications (P=0.048), and side effect appearance (P=0.001) was also lower in patients who took celecoxib, compared to the other group. Conclusion: Celecoxib showed higher efficacy and fewer side effects, compared to prednisolone in treatment of medication overuse headache in migrainous patients. Headache Celecoxib Prednisolone 2018 1 01 13 17 http://cjns.gums.ac.ir/article-1-214-en.pdf 10.29252/nirp.cjns.4.12.13
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Caspian Journal of Neurological Sciences Caspian J Neurol Sci 2383-4307 2423-4818 10.32596 2018 4 1 Effectiveness of Mindfulness-Based Cognitive Therapy on Hope and Pain Beliefs of Patients With Chronic Low Back Pain Marie Abdolghaderi Seyed-Mousa Kafi Alia Saberi alia.saberi.1@gmail.com Saeed Ariaporan Background: Patients with Low Back Pain (LBP) suffer from physical and psychological disability. Mindfulness-Based Cognitive Therapy (MBCT) may be an effective treatment option for patients with chronic LBP, but its efficacy on hope and pain belief is uncertain. Objectives: To determine whether MBCT could increase hope and be effective in pain beliefs in patients with LBP. Materials & Methods: In this quasi-experimental study, 30 patients with chronic LBP were selected by convenient sampling method from Neurology and Neurosurgery Clinics affiliated to Guilan University of Medical Sciences, Gilan Province, Iran. Subjects were divided into experimental (MBCT) and control groups (n=15 each) by random sampling method. The experimental group as an intervention received 90-minute weekly MBCT sessions for eight weeks. Adult dispositional hope scale (Snyder hope scale) and pain beliefs and perceptions inventory were administrated to both groups as pretest-posttest. The data were analyzed using multivariate analysis of covariance using SPSS 20. Results: Mean age of the patients was 38.41 years. All of the subject were women with high school education. MBCT significantly increased the hope of patients with chronic LBP (P<0.001), however, it was ineffective in pain beliefs. Conclusion: The results of this study demonstrates that MBCT can be an effective treatment for increasing the hope of patients with chronic LBP. MBCT may be developed for alleviating LBP. Mindfulness Low back pain Hope Pain 2018 1 01 18 23 http://cjns.gums.ac.ir/article-1-215-en.pdf 10.29252/nirp.cjns.4.12.18
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Caspian Journal of Neurological Sciences Caspian J Neurol Sci 2383-4307 2423-4818 10.32596 2018 4 1 Expression of Matrix Metalloproteinase-2 and -9 in Meningioma Sohail Mashayekhi Alia Saberi Zivar Salehi salehiz@guilan.ac.ir Background: Meningioma is one of the most common tumors of the central nervous system. It was shown that meningioma had up-regulated expression of Matrix Metalloproteinases (MMPs) that involved in cell growth, angiogenesis and metastasis.  Objectives: The aim of the study was the assessment of serum MMP-2 and -9 levels in patients with different grades of meningioma.  Materials & Methods: The study included the number of 66 normal control and 101 patients with different grades of meningioma (42 cases of grade I, 38 grade II and 21 grade III). The serum samples was recruited between March 2013 and August 2017 at the Departments of neurology and neurosurgery, in an academic hospital affiliated to Guilan University of Medical Sciences, in the north of Iran. MMP-2 and -9 levels determined by Enzyme Linked Immunosorbent Assay (ELISA). All data presented are expressed as mean±Standard Error of the Mean (SEM). Statistical analysis was done using one-way ANOVA by SPSS software, version: 24.0 and only values with P≤0.05 were considered as significant  Results: We showed that the level of MMP-2 and -9 in the serum samples of patients with meningioma was higher than in controls (P<0.01). We also showed that all serum samples from patients and controls, presented MMP-2 and -9 expression, whereas, starting from grades I to III meningioma, a significant increase of MMP-2 and -9 protein expression was observed (P<0.05).  Conclusion: It is concluded that MMP-2 and -9 are a constant composition of human serum. It is also concluded that MMP-2 and -9 might be involved in the pathophysiology of meningioma and their detection in serum may be useful in classifying meningioma. Matrix metalloproteinases Gene expression Meningioma 2018 1 01 24 29 http://cjns.gums.ac.ir/article-1-216-en.pdf 10.29252/nirp.cjns.4.12.24
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Caspian Journal of Neurological Sciences Caspian J Neurol Sci 2383-4307 2423-4818 10.32596 2018 4 1 Serum Bilirubin Level Changes in Multiple Sclerosis Patients Mahdi Barzegar Vahid Shaygannejad Omid Mirmosayyeb Samane Valipour Roya Akbari Sahar Vesal Fereshte Ashtar Leila Dehghani Abdolrasoul Mohammadi Nafiseh Esmaeil nafesm5@gmail.com Background: Multiple Sclerosis (MS) is a demyelinating disorder of the Central Nervous System (CNS). In addition to the role of immune mediated mechanisms, oxidative and nitrosative stress also play an important role in neuropathology of MS. Bilirubin as an endogenous antioxidant has neuroprotective effects; however few studies have assessed the association between serum bilirubin level and MS. Objectives: To evaluate serum level of bilirubin in MS patients. Materials and Methods: Serum samples were collected from participants who referred to Kashani MS clinic in Isfahan between July 2016 and July 2017. A total of 80 MS patients (67 females and 13 males) and 94 Healthy Control subjects (HCs) (62 female and 32 male) enrolled. Compression of bilirubin levels between MS patients and HCs was done with covariance analysis. Regression analysis was used to assess the relation between bilirubin concentration and EDSS. SPSS software version 17.0 for Windows (SPSS, Chicago, IL, USA) was used. Results: The level of Direct bilirubin (Dbil) was significantly lower in MS patients compared with HCs (P=0.02). Otherwise the serum concentration of Total bilirubin (Tbil) and in Direct bilirubin (Ibil) were higher in MS patients, but it was not statistically significant. There was a negative correlation between Extended Disability Status Scale (EDSS) and bilirubin levels (Tbil, Dbil and Ibil) but it was not significant.  Conclusion: Bilirubin level is lower in MS patients and deficit of its antioxidant level may play role in neuropathology of MS. Bilirubin Multiple sclerosis Antioxidants 2018 1 01 30 34 http://cjns.gums.ac.ir/article-1-217-en.pdf 10.29252/nirp.cjns.4.12.30
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Caspian Journal of Neurological Sciences Caspian J Neurol Sci 2383-4307 2423-4818 10.32596 2018 4 1 A Case Report of Congenital Myasthenia Gravis Presenting With Respiratory Distress Reza Shervin Badv Sara Memarian Masoud Ghahvechi Hossein Farshad Moghaddam Maryam Saidi Reihaneh Mohsenipour Parisa Rahmani Bahram Yarali Mojtaba Gorji Behdad Gharib behdad_gharib@yahoo.co.uk Congenital Myasthenic Syndromes (CMS) are rare inherited disorders characterized by dysfunction of neuromuscular transmission at the neuromuscular junction. Most patients with congenital myasthenic syndromes present in the infancy. Major symptoms of affected individuals include weakness and fatigue during the first years of life. Patients may show hypotonia, facial weakness, swallowing difficulties, respiratory dysfunction, ptosis and ophthalmoparesis. Here we report a 6 month old boy congenital myasthenia gravis due to homozygous mutation in COLQ gene. The patient presented with several episodes of apnea and didn’t have ptosis until 6 months of age, and even at this time it started as just left eye ptosis and after a few days became bilateral. He had been misdiagnosed with several other causes of episodic apnea. Later by using electrophysiology he was diagnosed as congenital myasthenia gravis and mutation analysis of the patient revealed the presence of mutation of COLQ gene and was treated successfully. Myasthenia gravis Congenital Apnea 2018 1 01 35 38 http://cjns.gums.ac.ir/article-1-218-en.pdf 10.29252/nirp.cjns.4.12.35