Current Journal of Neurology
Year:2017 | Volume:16 | Issue:1|Papers Count:11

Background: This study was performed to compare the effects of low dose interferon beta-1 (IFN-β-1) (CinnoVex, 30 mcg) and high dose IFN-β-1 (REBIF, 44 mcg) on the reduction of the number and size of plaques in magnetic resonance imaging (MRI) in patients with multiple sclerosis (MS). Methods: This historical cohort study, which was performed in 2014 in Sanandaj (western part of Iran). 43 MS patients in two groups were investigated. The first group, which included 19 patients, was treated using high dose IFN (44 mcg) and the second group, which was consisted of 24 patients, was treated using low dose IFN (30 mcg). Patients’ data were collected and analyzed by the Stata version 11 software; the analyses were performed using statistical t-test, chi-square test, Fisher test, and logistic regression. Results: Both drugs were effective in controlling active demyelinating plaque and in preventing plaque activation (P = 0. 633). The impact of both drugs in the reduction of the number and size of plaques was evaluated. Based on the results of the MRI, high dose IFN therapy was more effective than the low dose IFN drugs and had a better performance in terms of reducing the number of plaques and in stop-and-recovery (P = 0. 039), as well as in reducing the plaque size (P = 0. 050). Conclusion: The high dose IFN therapy was more effective than the low dose IFN therapy in reducing the number and size of brain plaques in patients with relapsing-remitting MS (RRMS).

Background: Stroke is the leading cause of death and functional disability. While there have been major advances regarding the management of stroke, a significant proportion of people are still unaware of stroke-related symptoms and risk factors. This study was performed to assess the awareness of stroke’ s warning signs and risk factors among a sample of Iranian population. Methods: A total of 649 participants were randomly selected using systematic randomization from the list of telephone numbers obtained from the telephone directory. Demographic characteristics were recorded. Participants were asked to answer questions regarding the awareness about stroke, its warning signs and risk factors. Results: Patients’ mean age was 32. 0 ± 12. 2 years old, and 56. 4% were women. Hypertension and history of stroke were major risk factors, and loss of consciousness, vertigo and ataxia were major warning signs of stroke correctly identified by respondents. Multiple linear regressions showed that age (β = 0. 277, P < 0. 001), academic level of education (β = 6. 41, P = 0. 01), housewifery (β = 8. 9, P < 0. 001), jobs related to medical care (β = 13. 17, P = 0. 016) and previous information about stroke (β = 18. 71, P < 0. 001) were significant predictors of the overall awareness about stroke. Conclusion: The awareness of people about stroke, its risk factors and warning signs were good in this study. The awareness toward stroke can be associated with factors such as age, academic level of education, job and previous information about stroke. Further studies are recommended to program public multimedia and health education in academies and colleges.

Background: Interleukin (IL)-17/IL-23 axis performs a prominent role in the pathogenesis of several autoimmune disorders. This study aimed to investigate the concentrations of IL-17 in patients with multiple sclerosis (MS) and its relationship with gender, medication, disease forms and single nucleotide polymorphisms (SNP) in IL-23R gene, including rs11209026 and rs1004819. Methods: The blood specimens were obtained from 135 healthy individuals and 135 MS patients. The patients exhibited relapsing-remitting (RRMS; n = 65), primary progressive (PPMS; n = 19), secondary progressive (SPMS; n = 35) or progressive relapsing (PRMS; n = 14) MS. The DNA was analyzed for SNPs using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and IL-17 concentrations were measured by enzyme-linked immunosorbent assay (ELISA). Results: We have observed elevated serum IL-17 concentrations in MS patients compared with healthy individuals (P < 0. 001). The men with MS had higher IL-17 concentrations than women patients (P < 0. 050). Untreated patients had significantly higher IL-17 concentrations than healthy individuals and treated patients (P < 0. 001 and P < 0. 010, respectively). The IL-17 concentrations were significantly decreased in patients treated with interferon-β (IFN-β ), methylprednisolone or both drugs as compared with untreated MS patients (P < 0. 050, P < 0. 020 and P < 0. 050, respectively). The IL-17 concentrations were also significantly higher in patients with RRMS and PRMS compared with healthy individuals (P < 0. 005 and P < 0. 010, respectively). The genetic variations at SNPs rs11209026 and rs1004819 were not significantly different between healthy individuals and patients. The IL-17 concentrations were not influenced by genetic variations at investigated SNPs. Conclusion: These results indicated higher levels of IL-17 in MS patients that may be influenced by disease patterns, medication and gender. No association was observed between investigated SNPs and MS.

Background: Evidence-based medicine (EBM) is a current practice in medicine to produce clinical practice guidelines from well-designed, randomized, controlled trials. We studied knowledge, attitude, and practice of EBM of neurologists who participated in the Iranian congress of neurology. Methods: A self-administered anonymous questionnaire was distributed and filled by neurologists. A total of 200 neurologists were randomly sampled and with response rate of 56%. 33. 9% of responder had previously participated in EBM courses. Results: The average total knowledge score was 4. 05 ± 0. 80 out of a maximum possible score of 5. 0. Textbooks were still the most favorite source of knowledge for our neurologists. A lack of time was the highest, and motivation the least mentioned barrier in using EBM. Conclusion: Overall, the Iranian neurologist had acceptable knowledge and attitude toward EBM and had same similar as found in other studies.

Background: Activated protein C (APC) inactivates factor V (FV) by cleavage of its heavy chain at Arg306, Arg506, Arg679, and Lys994. Mutational changes, which abolish APC cleavage sites, may predispose thrombosis by altering the inactivation process of FV. FV Leiden (FVL) (Arg506Glu) has been demonstrated as a strong risk factor for thrombosis. In the current study, we have studied whether mutations in the cleavage sites of FV for APC, not due to FVL, would have a role in presenting APC resistance (APCR) and initiation of a cerebral thrombotic event. Methods: A group of 22 patients with a history of cerebral venous thrombosis (CVT), who were not carriers of FVL enrolled in the study. The patients who had conditions associated with acquired APCR were excluded from the study. APCR test was performed on the remaining 16 patients, which showed APCR in 4 plasma samples. DNA sequencing was performed on four exons of FV of APCR patients, encoding Arg306, Arg506, Arg679, and Lys994. Results: Mutations were not found within nucleotides encoding the cleavage sites; neither was found within their close upstream and downstream sequences. Conclusion: Our results show that polymorphisms affecting cleavage sites of FV other than Arg506Glu it would be less likely to be the basis for APCR and its increased thrombosis susceptibility. In addition, it emphasizes on the importance of screening for APCR in the patients diagnosed with CVT.

There has been a global rising trend in recent years in the incidence of multiple sclerosis (MS). Despite being an MS low-risk region, this disease has also been recently on the rise in the Middle East. As part of the Middle East, Iran has not been spared either; however, the cause of this dramatic increase remains to be discovered. This study reviews possible reasons for this increase in Iran. Although many factors such as the increased rate of smoking, lifestyle changes, modernization, and contact with toxic solvents can be proposed as reasons for this sudden rise in the prevalence of MS in Iran, these factors cannot be taken as definite causes and further studies are required to prove their impact.

There are many studies have reported that nutritional deficiencies (macro and micronutrients) are involved in the etiology of multiple sclerosis (MS). . . .

Aphasia defined as an acquired communication disorder caused by brain damage and characterized by an impairment of language modalities including speaking, listening, reading, and writing. 1 There are many treatments to restore language functions. Intensive language therapy is one of the most effective treatment approaches. ...

Myoclonic epilepsy with ragged-red fibers (MERRF) syndrome was first described by Tsairis, et al. in 1973. 1 The phenotypic spectrum broadened with the description of > 320 MERRF-patients since then (Table 1). 2 Here, we report further phenotypic variability. . . .

Carotid occlusion is a common disease and its incidence is about 6 in 100000. Annual risk of stroke is between 3% and 10% in older than 60 years with carotid occlusion and recurrent ischemic event have been reported in 25% of symptomatic carotid occlusion. . . .

A 23-year-old man presented with progressive bulbar and oromandibular dystonia, in addition to distal limbs involvement. In neurological exam, the patient had diverse manifestations, most commonly movement disorder, cognitive impairment, ataxia and speech disorder. . . .