Archives of Neuroscience
Volume:6 Issue: 1, Jan 2019

 Visual disturbances are frequent in Alzheimer’s disease (AD) and sometimes AD begins with visual disturbances, therefore many researchers have examined the eyes in order to confirm the diagnosis, to monitor the development of the disease or the response to drugs.  Medline literature until March 2018. Several indications suggest an early involvement of the visual system in AD, yet this evidence remains inconclusive. The reason for this uncertainty is two folds: The poor quality of the studies and the fact that some alterations are not unique to the AD, since they also occur in others degenerative CNS diseases. The eye can be a perfect place for early diagnosis of AD and to evaluate the effectiveness of therapies more studies are needed.

There is limited therapy for management of Bell’ palsy. However, none of the treatment modalities are effective, thus, the aim of this study was to evaluate the effect of repetitive transcranial stimulation (rTMS), as an adjuvant therapy, for management of Bell’s palsy. In this randomized controlled trial, 46 patients with unilateral Bell’s palsy were enrolled and were divided to two parallel groups an intervention and control groups. The intervention group was under treatment with oral prednisolone 1 mg/kg/day for two weeks and, continued with physical therapy/daily and rTMS/five sessions a week (1000 stimuli, 120% motor threshold) for two weeks and the control group was under treatment with oral prednisolone 1 mg/kg/day for two weeks and continued with physical therapy/daily for two weeks. The outcome was measured with the facial disability index (FDI), House-Brackmann (H-B) scale and World Health Organization quality of life (WHOQOL)-BREF questionnaire at baseline, and two and four weeks after therapy. The physical and social functions of FDI and WHOQOL-BREF questionnaire in the intervention group were significantly higher than the control group after four weeks. Also, H-B grading in the intervention group was better than the control group after four weeks. The rTMS as adjuvant therapy may be an active, non-invasive, and safe method for management of Bell’s palsy.

Long-term treatment with sodium valproate affects the lipid profile and serum homocysteine level. Studies have revealed different results in epileptic patients and there is very little data available regarding the effects of sodium valproate in serum homocysteine level and lipid profile in migraine patients. The present study investigated the serum homocysteine level and lipid profile of migraine patients before and after sodium valproate prophylactic therapy. This study included 52 adult patients with migraines who were candidates for prophylactic migraine treatment by sodium valproate. None of the patients were affected by hyperlipidemia syndromes, cardiovascular disease, stroke, diabetes, gout, carotid stenosis, hypertension, and thyroid, metabolic, or hepatic disorders. The initial peripheral venous blood sample was collected before receiving sodium valproate. Patients received sodium valproate 500 mg daily. The second venous blood sample was taken 3 months later, during the treatment period. Serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL), triglyceride (TG), high-density lipoprotein cholesterol (HDL), and homocysteine were measured by standard methods. The mean serum levels of TC, HDL, TG, and homocysteine increased significantly three months after treatment with sodium valproate. The mean serum level of LDL increased after treatment, however, the difference was not significant. Sodium valproate increases the level of serum lipids in patients with migraines; therefore, the risk of cardiovascular diseases may increase by the long-term use of this drug as a prophylactic treatment in migraine patients. Consequently, in patients with other risk factors of cardiovascular disease, sodium valproate should be prescribed with caution.

Today, due to recent developments in technology, children devote plenty of time to screen viewing. However, its harmful effects are not yet clear. The purpose of the present study was to examine the associations between screen viewing, sleep duration, and body mass index (BMI) in under-five-year-old children. This cross-sectional study was conducted on 322 under-five healthy children that were selected using a multistage stratified cluster sampling method in 2017. The data gathered by the time-use diary method were analyzed using the Kolmogorov-Smirnov test, Spearman Correlation test, Multiple Linear Regression Analysis, one-way ANCOVA, and two-way ANCOVA. There was a negative correlation between screen time and sleep duration (P < 0.001), a positive correlation between screen time and BMI (P < 0.001), and a negative correlation between sleep duration and BMI (P < 0.001). Screen viewing was a predictive factor for both sleep duration (P < 0.001) and BMI (P < 0.001). Screen viewing had a significant impact on sleep duration (P = 0.001) and BMI (P = 0.298). The results of this study indicate that screen viewing is related to sleep duration and BMI in under-five-year-old children. Furthermore, screen time has an impact on sleep duration and BMI of children.

Plant extracts contain useful components that could be considered in pharmacotherapy. Due to containing anticancer components such as phenol, cyclotide, and anthocyanins, Viola odorata (sweet violet) is one of the most important components used in cancer therapy. The current study aimed at examining antitumor activity and related mechanisms to V. odorata on primary culture of human glioblastoma multiforme (GBM). It was observed that survival rate of the obtained astrocytes from human GBM tumor decreased with V. odorata hydroalcoholic extract (10 - 500 µg/mL) in a dose- and time-dependent manner and DNA fragmentation happened in concentrations above 100 µg/mL of this extract. Further observations revealed that induced apoptosis activates mitochondrial death pathway, release cytochorome C, and activates caspase-3. The current study findings revealed the effect mechanism of V. odorata extract and suggested its potential application in cancer therapy.

Patients with migraine always experience from pain. For this reason, the present study aimed at investigating the effect of adaptive stability model, as an indigenous model developed in Iran, on the headache of patients with migraine. This was a semi-experimental study with post- and pre-intervention groups. The sample size composed of patients with migraine in the city of Ilam, who were assigned randomly to the experimental group (31 patients) and control group (33 patients). The tools used in this study included demographic features questionnaire, a checklist showing the duration and frequency of pain, and a pain evaluation tool. For the test group, the interventions were performed according to the adaptive stability care model, which was developed in Iran. The SPSS V. 16 software, descriptive statistical tests (mean and standard deviation) and inferential tests (T-test and ANOVA) were used to analyze the data. Before the intervention, there was no significant difference between the mean severity, hours, and frequency of headache in the experimental and control groups (P > 0.05). However, after the intervention, the severity, headache, and headache hours of the patients in the experimental group was reduced compared to the control group and the reduction was statistically significant (P < 0.001). Given the fact that the implementation of the adaptive stability model, as a non-pharmacological and less expensive approach has proved to be significant, it is highly recommended for reducing pain in patients with migraine.

Several clinical conditions and factors have been proposed as the outcome predictors in patients with subarachnoid hemorrhage (SAH) following ruptured intracranial aneurysms. The impact of the intraventricular hemorrhage (IVH), which is commonly observed in the anterior communicating artery (ACoA) aneurysm, has not been discussed in detail. The purpose of the study was to compare the outcome of early and delayed aneurysm surgery in patients with SAH regarding the presence of IVH. The study included consecutive ACoA aneurysm patients presenting with subarachnoid hemorrhage, who received microsurgical aneurysm clipping. The medical records of the patients were reviewed retrospectively. As the outcome, the Glasgow outcome score was compared between the two groups of the patients, regarding the presence or absence of the IVH. 101 patients (55 males, 46 females) were enrolled in the study. The initial CT scan revealed the presence of IVH in 49 patients (mean age 52 ± 11.1 years). 52 patients (mean age 49 ± 10.7 years) had no sign of IVH. Regarding the time of surgery, 25, 44, and 32 patients underwent early (0 - 3 days), intermediate (4 - 14 days), and delayed (> 14 days) surgery from the ictus of SAH, respectively. The follow-up period was 27 months (range 0.5 - 76 months). The survival rate was 73.5% in the presence of IVH and 94.2% in patients without signs of IVH, which represented a significant difference in the outcome between the two groups (P < 0.05). In patients with SAH having aneurysms located in the ACoA associated with the third ventricular hemorrhage, delayed surgery might be considered in achieving a better outcome.

While a great deal of attention has been paid to the study of the control of hormone secretion from Pituitary Adenomas (PAs), less attention has been paid to the study of molecular events that underlie the development of these tumors. The goal of the present study was to analyze the expression of p53 tumor suppressor gene to allow for its comparison with that of oncoprotein bcl-2 in a series of PA patients followed for a minimum of nine years. This retrospective study included 51 patients diagnosed with a PA (33 nonfunctioning, 13 acromegaly, 4 Cushing’s disease, and one prolactinoma), who underwent trans-sphenoidal surgery at a single center between 2006 and 2008. P53 and bcl-2 expression were immunohistochemically evaluated and correlated with clinico-radiological and histopathological tumor parameters, as well as post-operative progression/recurrence. Out of 51 tumors, 40 were categorized as typical and 11 as “atypical” PAs. From typical PAs, 28 showed positivity for p53 (cellular mean: 0.99%) and 20 for bcl-2 (cellular mean: 0.58%); from “atypical”, seven had p53 positive cells and six bcl-2 (mean: 2.02% and 0.73%, respectively). Nineteen (37.25%) were positive for the two markers. There were no differences in the expression of p53 and bcl-2 with regards to age or gender of the patient, size, invasiveness or post-operative tumor recurrence. In the study group, p53 and bcl-2 were abnormally expressed in 68.63% and 50.98% of pituitary tumors, respectively. One-third of PAs were co-expressed across both immunomarkers. The simultaneous genetic complementation of deregulated p53 and bcl-2 is implicated through the apoptosis regulation pathway in the pathogenesis of these tumors.

BDNF is a critical regulator of the cognitive functions of the brain. According to the modulatory role of BDNF in the chronic pain state, this study focused on changes in BDNF expression in the hippocampus and anxiety-like behavior, following an injury to the sciatic nerve. 30 adult male Wistar rats were randomly divided into three subsets as neuropathic, sham, and control. The neuropathic pain was induced due to chronic constriction injury of the sciatic nerve. Anxiety-like behavior was observed using the open field and elevated plus-maze tests. The level of BDNF was determined by real-time polymerase chain reaction analysis. The results showed that the pain threshold decreased two weeks after CCI. Simultaneously, there was a decrease in the BDNF levels (P < 0.001, F = 15. 03). In addition, the anxiety-like behaviors increased in the open field (P < 0.01, F = 25.67; P < 0.05, F = 23.02) and elevated plus-maze (P < 0.05, F = 6.01; P < 0.001, F = 5.95) tests. In the third week after CCI, the increased pain threshold was accompanied by an increase in the level of BDNF, latency to leave the first quadrant, number of rearing behaviors (P < 0.05, F = 26.07, F = 24.04), and time spent in open arms (P < 0.05, F = 5.30) while time spent in closed arms decreased (P < 0.05, F = 4.70). Alteration in BDNF expression is involved in CCI-induced anxiety-like behavior.

Changing lifestyle can be effective in preventing pain and facilitates the process of chronic pain and its side effects. Pain acceptance is an important and valuable concept related to the manner of a person, reaction, and compatibility with chronic pain. The current study was conducted to determine lifestyle with chronic pain and pain acceptance in patients with stroke in Ilam city in 2018. This was a descriptive cross-sectional study conducted in 2018 on 200 patients, who were hospitalized at Shaheed Mostafa Hospital of Ilam city due to stroke. According to the goals of the study, demographic specifications, the questionnaire of lifestyle with chronic pain, and the questionnaire of chronic pain acceptance were used. The obtained data of this study were analyzed using descriptive statistics (mean, standard deviation, and the table of frequency distribution) and inferential statistical tests (independent t and analysis of variance (ANOVA)). According to the findings, the mean (SD) of pain acceptance was 16.22 (1.99) and that of lifestyle with chronic pain was 21.83 (3.91). Also, the maximum score in lifestyle with chronic pain and chronic pain acceptance was respectively 32 and 22. Also, there was no significant relationship between lifestyle and chronic pain and pain acceptance in elderly with stroke (P = 0.22). According to the findings, mean (SD) scores of lifestyle with chronic pain and the rate of pain acceptance were not desired, therefore, nurses need to make improvements through nursing interventions.

Meniere’s disease is one of the most common inner ear and vestibular disorders. Its conventional treatment gives unsatisfying results in some cases. This article introduces a patient with Meniere’s disease who has been treated with Persian medicine. The patient was a 40-year-old woman, a known case of Meniere’s disease, who was advised to consume cinnarizine and betahistine. Due to lack of satisfactory response to treatment, the patient referred to Persian medicine clinic. She followed the recommendations of Persian medicine and the disease was completely recovered. Treatment of Meniere's disease in this patient was based on lifestyle modification, warming up the body, strengthening the brain and the nervous system, enhancing the digestive system, modifying the condition of defecation, and removing waste materials and accumulated humors from the body, especially the head. It is believed that this case report will provide a basis for further studies on the impact of Persian medicine on the treatment of Meniere’s disease.

Multiple paraphilia is characterized as a disorder that includes three or more paraphilias; for instance pedophilia, exhibitionism, or rape together make up multiple paraphilia. It is hard to estimate prevalence rates of paraphilias due to changes in criterion with time and in divergent cultures. Our case is a young man whose marriage lead to exacerbation of his paraphilic behavior and more substance abuse. He represented with multiple type of paraphilia simultaneously, which can occur rarely. There’s a possibility of different paraphilia occurrence at the same time and to prevent further aversive consequences of the aggregation of paraphilia; devising a treatment plan for such patients would avoid devastating conditions.