Current Journal of Neurology
Volume:19 Issue: 1, Winter 2020

Poor motor recovery of hip muscles affect the walking post-stroke. The study objective was to examine how lower extremity motor function and hip muscle weakness are related to weight-bearing asymmetry (WBA), excessive pelvic tilt, and gait speed in stroke survivors.

Eighty patients with chronic stroke, a mean and standard deviation (SD) of post-stroke duration of 350 ± 664 days, age of 30-70 years, independent standing, and 10-meter walking capacity participated in the study. Hip muscular strength was measured using a handheld dynamometer (HHD) and motor function was assessed by Fugl-Meyer Assessment of lower extremity (FMA-LE). The WBA was recorded using two weighing scales; whereas the pelvic tilt and gait speed were evaluated using palpation meter (PALM) and 10-meter walk test, respectively.

The muscles strength of hip flexors, extensors, abductors, and adductors of the paretic side ranged between 22.0 and 24.4 pounds. The mean score of FMA-LE was 22 points. Following Pearson product-moment correlation with statistically significant P < 0.05, the relationship of hip muscles strength and FMA with WBA, lateral pelvic tilt (LPT) and anterior pelvic tilt (APT), and speed are as follows: flexors (r = 0.47, r = 0.31, r = 0.44, r = 0.44), extensors (r = 0.45, r = 0.38, r = 0.37, r = 0.35), abductors (r = 0.49, r = 0.32, r = 0.38, r= 0.40), adductors (r = 0.45, r = 0.31, r = 0.23, r = 0.34), and motor function (r = 0.62, r = 0.33, r = 0.38, r = 0.62).

Motor performance of the paretic lower limb was highly correlated with WBA and gait speed in stroke survivors. Overall hip muscle strength of paretic side had a moderate correlation with WBA, excessive pelvic tilt, and gait speed.

Therapeutic plasma exchange (TPE) is the treatment of choice for many neurologic disorders. The safety of this procedure is a major concern for physicians. The aim of this study was to determine the complications of TPE in patients with neurologic disorders at a tertiary referral hospital.
This retrospective cross-sectional study evaluated patients with various neurologic disorders receiving TPE in neurology department of Shariati Hospital, Tehran, Iran. Major and minor complications related to TPE were recorded.
Clinical information records of 417 TPE sessions (88 patients) were available. Mean age of patients was 40.0 ± 15.8 years. Underlying diseases included central demyelinating disorders, myasthenia gravis (MG), chronic neuropathy, Guillain-Barre syndrome (GBS), and autoimmune encephalopathy in 34.1%, 33.0%, 17.0%, 14.8%, and 1.1% of patients, respectively. Major complications occurred in 15.9% of patients and 37.5% of patients accounted for minor complications. Among major adverse effects, thrombosis, infection, and life-threatening complications were seen more commonly in patients with central vascular access (P = 0.005, P = 0.003, and P = 0.010, respectively).
TPE complications were seen more commonly in patients with central vascular access. Therefore, use of peripheral vascular access and vigilant patient monitoring by trained health providers can reduce its complications.

Neuromuscular disorders affect physical and mental aspects of a patient and in other words alter the patients’ quality of life (QOL). In the present study, we investigated the validity and reliability of the Persian version of Individualized Neuromuscular QOL (INQOL) to provide a better insight into patients’ QOL.

Original version of the INQOL was translated backward and then forward. The resultant Persian version and a standard questionnaire, 36-Item Short Form Health Survey (SF-36), were then given to 83 participants with neuromuscular disorders. Internal consistency, known-group validity, concurrent validity, and test-retest reliability were assessed.

The scores of matched sections for QOL in the two questionnaires were favorably correlated (P < 0.05). Correlation between test and retest scores was also significant (P < 0.05). Moreover, the Cronbach’s alpha of 0.82 was representative of robust internal consistency between INQOL covering sections.

The Persian version of the INQOL can be used in clinical and research practice to detect changes in QOL which are related to neuromuscular disorders, due to its favorably reliable and valid characteristics.

Epilepsy is the most common pediatric neurologic disease accompanying with psychosocial delays causing a child’s isolation from the society. Developmental language delays are among the most common complaints of children with epilepsy. In the current study, verbal skills and expressive and receptive language development have been assessed in patients with epilepsy and compared with age-matched normal group.

This case-control study was conducted on 78 2-5-year-old children with epilepsy and 78 age-matched normal children referred to the outpatient clinic of Imam Reza affiliated to Shiraz University of Medical Sciences, Shiraz, Iran, in 2017-2018. Demographic information of cases (age, age of onset, type of seizure, and number of consumed remedies) and controls was gathered. In order to assess study population’s verbal, receptive, and expressive language development, Newsha growth measurement test, a validated Persian version of verbal language development questionnaire, was utilized.

Comparison of children with epilepsy with normal controls showed a significant difference in spoken, expressive, and receptive language development between children with epilepsy and normal peers (P < 0.05). Spoken and receptive language developments were significantly in association with earlier age of onset, higher number of remedies received for seizure control, generalized type of seizures, and lacking of seizure control (P < 0.05). Expressive language development showed no association with type and control of seizures (P > 0.05) but had significant association with age of onset of epilepsy and number of remedies (P < 0.05).

Assessment of verbal language development aspects among children with epilepsy showed a higher rate of delay among these children as compared with normal age-matched ones. Moreover, earlier age of onset, generalized type of seizures, higher number of consumed remedies, and poor seizure control were accompanied with higher and more severe speech and language delay.

Multiple sclerosis (MS) is a complex incurable neurodegenerative disease featuring demyelination of neurons, resulting in impairment of neuron impulses. Recently, an association of two single nucleotide polymorphisms (SNP) (rs2104286 and rs12722489) in interleukin 2 receptor subunit alpha (IL2RA) gene was found to be a risk factor of MS in white European population. Therefore, we performed a study to investigate the contribution of these two intronic variations in Iranian patients with MS.

We determined the genotypes of rs2104286 and rs12722489 in patients with MS (n = 100) and in the control group (n = 111). The SNPs were genotyped using tetra-primer amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR) for both of SNPs. Statistical analysis was performed by SPSS software. Also, odds ratios (ORs) and 95% confidence interval (CI) were calculated.

Logistic regression revealed that various genotypes of rs12722489, regarding sex-adjusted effect, yielded meaningful association with MS risk in Iranian patients (OR = 2.67, 95% CI: 1.03-6.90). However, no association was obtained for rs2104286 and rs12722489 with MS.

The results confirmed partially the reports in white European population performed recently. However, further investigation in larger scale is necessary to validate our study.

Facial emotion recognition (FER) is a complex process, involving many brain circuits, including the basal ganglia that its motor involvement causes Parkinson's disease (PD). The previous studies used different tools for assessment of FER in PD. There is a discrepancy between the results of these studies due to different tools. In this study, we used a modified version of the Multimodal Emotion Recognition Test (MERT) to compare patients with PD to healthy controls (HCs).

It was a cross-sectional study with primary objective of the mean percentage of the correct answers in MERT. Subjects had to name the emotions presented with different modalities.

30 subjects were recruited and assessed in each group. The mean total MERT score was significantly lower in subjects with PD compared to HCs (35.0% vs. 44.5%). FER was significantly better when emotions were presented by video and worse when presented by still pictures. Both subjects with PD and HCs had lower MERT scores in recognizing negative emotions. There was no significant correlation between the duration and severity of PD and MERT score.

Our study provided more pieces of evidence for impairment of FER in PD for recognizing emotions like sadness, disgust, and fear compared to happy expressions.

The literature speculates that there may be a relationship between cognitive capacities and levels of fatigue in people with multiple sclerosis (MS), which has been under reported. This study has investigated one aspect of cognition by evaluating the association between problem-solving ability and the severity of fatigue.

A cross-sectional, descriptive study was used to investigate the association between levels of problem-solving ability and degrees of fatigue severity. Eighty-five participants living in the city of Shiraz, Iran, completed Cassidy Problem-Solving Inventory (PSI) and the Fatigue Severity Scale (FSS). Pearson’s Product Moment Correlation Coefficient was used to analyze the data.

Problem-solving was inversely associated with fatigue (r = -0.381, P = 0.009), whereby higher levels of problem-solving ability were associated with lower degrees of fatigue.

The results of this study contributed to the ongoing debate about the linkage between cognition and fatigue in people with MS, suggesting an association between problem-solving ability and fatigue severity. A possible implication would be the importance of problem-solving training for people with MS.