فصلنامه علوم اعصاب شفای خاتم
سال نهم شماره 1 (پیاپی 46، زمستان 1399)

 Alzheimer disease (AD) is the most common type of dementia in the elderly. Memory impairment usually occurs gradually and progressively. AD has not only been associated with decreased cerebral acetylcholine concentration, oxidative stress, and beta-amyloid protein deposition, but more recent studies have shown that neurodegeneration induced by disturbance of the intracellular calcium homeostasis is also involved in the pathophysiology of the disease. It has been reported that calcium channel blockers (CCBs) have beneficial effects in different models of memory impairment. Here, we review and discuss the effects of CCBs, especially N-types, as novel agents that have effects on memory deficits in animal models of AD. on contrary to the L-type calcium channels, which are presented in the other organs in addition to nerve cells, N-type calcium channels are commonly located on the neurons. The main advantage of N-type CCBs is their lower side effects than other CCBs.

Targeting the N-type CCBs may contribute to the new strategies for the treatment of AD.

Thromboischemic events contribute substantially to morbidity and mortality of intracerebral hemorrhage and subarachnoid hemorrhage. Therefore, we aimed to evaluate the incidence of neurologic and systemic thromboischemic events in patients with acute non-traumatic intracerebral hemorrhage and subarachnoid hemorrhage during the first 6 months after hemorrhage.

In this randomized-cohort study, we enrolled 203 patients with acute non-traumatic intracerebral hemorrhage or subarachnoid hemorrhage admitted in the neurology ward of Zanjan Vali-e-Asr Hospital between January 2016 and September 2016. We recorded the risk factors (hypertension, diabetes mellitus, atrial fibrillation, Smoking), initial neurological indices (Glasgow coma scale, ICH score, Hunt and Hess grading), and bleeding size in these patients. Patients were then evaluated 1 week, 1 month, 3 months, and 6 months after intracerebral hemorrhage and subarachnoid hemorrhage for the incidence of deep vein thrombosis, pulmonary embolism, ischemic heart disease, and ischemic stroke.

165 patients had intracerebral hemorrhage and 38 patients had subarachnoid hemorrhage. The cumulative incidence of thromboischemic events in an unselected intracerebral hemorrhage and subarachnoid hemorrhage population was 31%. The overall incidence rates of deep vein thrombosis, pulmonary embolism, ischemic heart disease, and ischemic stroke after 6 months of intracerebral hemorrhage and subarachnoid hemorrhage onset were 10.9%, 5%, 10%, and 7.4%, respectively. The mean time to the events was 145.5 ± 5.5 days.

Age, smoking, hypertension, diabetes mellitus, and atrial fibrillation were the significant independent risk factors for thromboischemic events. Age, higher ICH score, Hunt & Hess grade, and hemorrhage size >30cc have shown significant correlations with the development of deep vein thrombosis.

Bipolar mood disorder is one of the most prevalent psychiatric disorders in which the emotional processing deficit is a common feature of the disorder. Due to the role of cortical functions in emotional processing, the purpose of the study was to evaluate the correlations between cortical coherence patterns with positive and negative emotional stimulus processing in patients with bipolar mood disorders.

To address the goal of the study, EEG cortical coherences were assessed in 40 bipolar patients. The cortical coherences within main frequency bands of brain function were calculated through 19 channels of EEG and neuroguide software across three brain regions (anterior, central, and posterior). Emotional processing was assessed by the emotional differentiation task.

Data showed that there are significant correlations between cortical frequency bands, especially alpha and beta bands, with positive and negative emotion processing. Furthermore, multivariate regression analysis revealed that alpha, theta, and beta bands in different regions could predict 94 and 35 percent of variations in positive and negative emotions, respectively.

Due to the role of coherence of different regions of the cortex in predicting of emotional processing of patients with bipolar disorder, part of the emotional problems of patients can be modified by presenting appropriate therapeutic strategies, such as psychotherapeutic and pharmacotherapeutic approaches.

Attention is a multi-dimensional cognitive process. Transcranial direct current stimulation (tDCS) is an effective approach for the improvement of attention. Using Event-related potentials (ERP) frequency components, the main goal of this study was to develop an attention index to assess improvement of attention in healthy people by applying tDCS.

13 subjects (6 males and 7 females, with mean age 24.53±4.5 years) participated in this study. First, participants were asked to fill out the Adult ADHD self-report scale, Beckchr('39')s depression, and Spielberger anxiety questionnaires. Simultaneous to recording their brain signals (19 channels), subjects were asked to participate in the Integrated visual and auditory (IVA) test. This test entails 500 stimulations, which include 125 auditory targets, 125 visual targets, 125 auditory non-target, and 125 visual non-target stimulations lasting for 13 minutes, after recording the electroencephalogram (EEG), the Dorsolateral Prefrontal Cortex (DLPFC) in subjectschr('39') left hemisphere is stimulated using tDCS, with 1mA current for 20 minutes. The stimulation period was 5 consecutive days. To analyze the data, after removing noise and artifacts, ERP components were extracted using synchronous averaging. Then frequency domains feature in every stimulation type were extracted from ERP components. Correlation between percentage changes and the subjectchr('39')s IVA test results were calculated before and after applying tDCS.

The result showed that Beta energy significantly increased after applying tDCS. Furthermore, a significant correlation was observed between beta energy and auditory omission error in FP1 channel.

  tDCS decreases omission error and increases beta energy in auditory stimulation, which then leads to the improvement of focus attention. Further studies are needed to assess the effect of tDCS on the improvement of attention in auditory attention deficit.

Cognitive limitations in Down syndrome affect learning. Furthermore, improper performance of movement and low muscle tone are among the crucial causes of postural control impairment and gait instability in Down syndrome. This study was aimed to investigate the role of secondary cognitive tasks on time of the stance phase of subjects with Down Syndrome.

20 males with Down syndrome with a mean age of 11.50 ± 2.28 years were selected from the patients registered by the Down Syndrome Association in Rasht, Anzali, and Lahijan, Gilan Province, Iran. Participants performed two different cognitive tasks while walking on the Foot Medisense machine and the timing of the stance-phase was measured.

The results showed no significant difference between the intra-group factors in the right and left heel strike phase. However, the foot flat phase, mid-stance phase, heel-off, and toe-off phase in the right and left heel strike phase have shown significant differences. Furthermore, a significant difference between intra-group factors for the left and right leg was observed.

Our data indicate that the evaluation of the stance-phase could be used for the assessment of motor function in children with Down syndrome.

Failure in response inhibition has been the underlying impairment is attention deficit/ hyperactivity disorder and constitute the core of the disruption of processing processes in the executive functions of this disorder. The purpose of this study was to determine the effectiveness of mindfulness intervention on response inhibition in children with attention deficit/hyperactivity disorders.

The present study is a semi-experimental study with pretest-posttest and control group design. The statistical population of the study included all male students studying in the secondary schools of Maku city in the academic year 2018-2019. From this population, a sample of 24 people was selected by purposeful sampling method using Conner’s parent rating scale (CPRS-48) and were randomly divided into two experimental and control groups. The GO/NO-GO tests was performed on the participants in two stages pre-test and post-test. Data analysis was performed using covariance analysis.

Data analysis showed that mindfulness intervention led to a significant difference between groups in response inhibition of 64% and its components including omission error 39%, commision error 44% and reaction time 46%.

Mindfulness intervention is a suitable strategy to improve response inhibition in children with attention deficit/ hyperactivity disorder and can be used as an effective intervention.

Rehabilitation interventions contribute to the recovery of impaired postural control. A promising strategy to improve the efficacy of rehabilitation is transcranial direct current stimulation. We investigated whether stimulating the primary motor cortex using transcranial direct current stimulation could affect postural control in schizophrenia patients with depression.

21 men with schizophrenia and depression (mean age: 48±11/9) were selected based on inclusion and exclusion criteria and were homogeneously assigned to the stimulation and control groups. The transcranial direct current stimulation group received 2 mA stimulation for 15 min during 12 weeks over the right and left primary motor cortices. Data of the pre-and post-test studies of standing on the dominant leg with opened and closed eyes were collected.

Significant differences in static balance with opened and closed eyes and dynamic balance were observed between the experimental and control groups.

The results provide preliminary evidence indicating that transcranial direct current stimulation of the primary cortex is a safe non-invasive tool to improve static balance in schizophrenia patients with depression.

The interval between voluntary actions and their outcomes are perceived as shorter than the interval between similar involuntary actions and the outcomes. This bias in time perception may be related to the sense of agency which has been referred to as intentional binding (IB). In this study, we investigated the effect of IB on voluntary action and its visual outcome (ie. color changing to red, green, blue, and yellow). Besides, we compared the IB effects among these different colors.

19 right-handed subjects (14 women and 5 men) have participated in baseline and experimental studies. Participants should press a key and after that, they would face color-change, then they reported the time perceptions, via referring to Libetchr('39')s clock. These data were compared to the baseline data (pressing key without color-change and color-change without pressing the key). We modified Libetchr('39')s clock in a new version to study the IB of visual effect.

The results show that the total IB (sum of action IB and color IB) in overall and distinct colors was significantly different. Action IB was not significantly different, however, the happening of the color IB in overall and distinct colors was significantly different. Furthermore, a significant difference between action IB - blue outcomes was observed compared to action IB – green and yellow outcomes. There were no significant differences among different color IB.

Using innovative Libetchr('39')s clock, we could investigate and compare IB of visual outcome in 4 different colors. Our results have been in line with previous studies and with the retrospective viewpoint of IB phenomena.

Stroke is one of the most prevalent causes of death worldwide. Strategies that increase the resistance of neural cells to ischemia-induced damages are crucial to prevent brain damage. This study aimed to investigate the effect of endurance training and adenosine injection on the expression of the A2B gene after ischemia-reperfusion in Wistar rats.

40 male Wistar rats (220±20g) were divided into four groups; endurance training +adenosine+ ischemia, ischemia+ adenosine, endurance training+ ischemia, and control. Ischemic induction was conducted through the common carotid artery ligation. After the ischemic insult, an endurance training protocol was performed. Eight weeks after ischemic induction and exercise protocol, blood samples were taken from rats, and expression of the A2B gene was measured.

There was a significant difference in the expression of the A2B gene between the ischemic control and endurance training +adenosine+ ischemia groups.

It seems endurance training protocol protected neurons from ischemic injury and improved rat brain function. The administration of adenosine has also played an important role in the regulatory mechanisms of ischemic-reperfusion.

Metacognition and self-concept are considered as one of the cognitive strategies in the mathematical competence of preschool children. The purpose of this study was to investigate the relationship between metacognitive beliefs, mathematical self-concept, and mathematical competence of preschool children.

This study was a descriptive correlational. The statistical population of this study was preschool children of Tehran, Iran in the academic year 2019-2020. 200 children were selected and randomly selected according to Morganchr('39')s table. Utrechtchr('39')s mathematical competence, Salonen et al.chr('39')s metacognitive beliefs and Marshchr('39')s mathematical self-concept were used to collect the data.

Our data have shown that metacognitive beliefs and mathematical self-concept have a positive and significant relationship with the mathematical competence of preschool children. Furthermore, mathematical self-concept can predict changes in the mathematical competence of preschool children.

Attention to metacognitive beliefs and self-concept play an important role in childrenchr('39')s mathematical competence.

In addition to coordination and motor difficulties, one of the main problems in children with developmental coordination disorder that prevents them from learning in early childhood education is a defect in executive functions. In recent years, the tendency to use novel therapeutic approaches for children with executive dysfunctions has increased. Cognitive rehabilitation or training in executive functions is an approach that has received much attention in recent years. The purpose of the present study was to investigate the effect of the Table Tennis Training Program on sustained attention and cognitive flexibility in children with developmental coordination disorder.

The research method was quasi-experimental with a pretest-posttest design. The statistical population of this study was all children aged 9-12 years with developmental coordination disorder in Kermanshah, Iran. Subjects in this study were 20 children with developmental coordination disorder who were selected by convenience sampling and were randomly assigned into two control and experimental groups. The tools of this study were Wilson Developmental Coordination Disorders Questionnaire, Movement Assessment Buttery for Children, Computerized Continuous Performance, and Wisconsin Card Sorting Test. Before and after the intervention program, sustained attention and cognitive flexibility of all subjects were measured. Table Tennis Training Program was held in the gym for 12 weeks and twice a week for 70 minutes.

The results showed a significant improvement in sustained attention and cognitive flexibility in children with developmental coordination disorder following 12 weeks of Table Tennis Training.

Table tennis training has improved sustained attention and cognitive flexibility in children with developmental coordination disorder. These data suggest the benefits of exercise programs based on Training of executive functions and high attentional load in children with coordination disorder.

Epilepsy is one of the most common brain disorders that greatly affect patients life. However, early detection of seizure attacks can significantly improve their quality of life. In this study, we evaluated a deep neural network to learn robust features from electroencephalography (EEG) signals to automatically detect and predict seizure attacks.

The architecture consists of convolutional neural networks and long short-term memory networks. It is designed to simultaneously capture spectral, temporal, and spatial information. Moreover, the architecture does not rely on explicit channel selection algorithms. The method is applied to the Childrenchr('39')s Hospital of Boston-Massachusetts Institute of Technology dataset (CHB-MIT). To evaluate the method, the proposed model is trained in the patient-specific approach.

The proposed architecture achieves a sensitivity of 90.7 ± 7.9 percent, a false prediction rate of 0.12/h, and a mean prediction time of 36.8 minutes. Moreover, in the cases of focal seizures, the proposed model estimates the seizure focus.

The proposed model achieved a high capability in seizure prediction. Moreover, by using the automated feature selection of the deep learning algorithm, the patterns of the pre-ictal period in EEG signals were determined. Furthermore, by specifying the seizure focus, the model can help neurologists to take further curative actions.

Body dysmorphic disorder is one of the obsessive-compulsive disorders, which is characterized by rumination and obsessive worries about imaginary defects in appearance. Today, the significant referral of people with this disorder to dermatologists, cosmetologists, and plastic surgeons is a sign of difficulties in diagnosis and appropriate treatments for this disorder. this study aimed to compare the effectiveness of mental training and treatment based on acceptance and commitment on rumination and worry in people with body dysmorphic disorder in Ahvaz, Iran.

The research design was experimental with pre–test/post-test, control group, and follow-up. The statistical population included 280 individuals who had been referred to counseling centers in Ahvaz in 2019 due to body dysmorphic disorder. Based on the sample size of a similar research design, 100 subjects were selected voluntarily. Then 45 people who obtained the highest scores from the Body Deformity Questionnaire of Rabiee et al. (2011) were selected by purposive sampling method and randomly assigned to two experimental and one control groups. Data were collected via implementing Nolen Hocsma and Morrow (1991) Rumination Questionnaire and the Pennsylvania Concern Questionnaire (1990).

The results of multivariate analysis of covariance showed that in the post-test and follow-up stages, mental training and treatment based on acceptance and commitment were effective on rumination and worry. Furthermore, the efficacy of treatment based on acceptance and commitment was significantly greater than mental training. However, in the follow-up phase, no difference was observed between the effectiveness of the two interventions on rumination and worry.

Mental training and acceptance and commitment therapy can be used to reduce rumination and worry in body dysmorphic disorder.

Despite the importance of health literacy in chronic diseases and its impact on health behaviors, its importance in patients with spinal cord injuries has been neglected. This study aimed to determine health literacy in veterans with spinal cord injury referred to Khatam Alanbia Hospital, Tehran, Iran.

This study was a descriptive-analytical cross-sectional study. All veterans with paraplegia following spinal cord injury, who were referred to Khatam Alanbia Hospital in 2018 were our statistical research community. 200 veterans were selected and examined through the purposive sampling method based on inclusion criteria. Demographic characteristics of veterans and Iranian adult health literacy questionnaires were used to collect data.

The overall health literacy score was inadequate in 38% of the veterans. The mean score of health literacy was 51.4 ± 8.8. The aspect of access to health literacy promotion resources received the highest score and there was a significant relationship between health literacy, education, and occupation.

The data revealed that the level of health literacy of veterans with spinal cord injury is not desirable. Improving health literacy in these patients reduces the complications and promotes self-care behaviors.

Children and adolescents with autism spectrum disorder are an exceptional group who exhibit symptoms, such as defects in social interaction, poor interpersonal relationships, and complex verbal communication as well as stereotyped behaviors and movements. To partially improve these disorders, the use of palliative supportive interventions, such as art therapy and theater therapy, is common in Europe, the United States, and Canada. This study aimed to investigate the effectiveness of drama therapy techniques in improving symptoms in children and adolescents with an autism spectrum disorder.

This experimental study was performed using a pre-test-post-test group design, the study population consisted of all 8-18-year children and adolescents with an autism spectrum disorder referred to a rehabilitation education school in Sachr('39')adat Abad, Tehran, Iran. Of this group, a sample of 10 people was selected through convenience sampling. All of them were pre-tested and after applying the techniques, they underwent post-tests. The Gilliam Autism Rating Scale-First Edition (GARS-1) was used for the study. Furthermore, the paired-samples t-test, the independent t-test, and Pearson correlation coefficient test were used to examine the hypotheses.

The mean of autism spectrum disorder and its components (stereotyped behaviors, verbal communication, social interactions) in the pre-test and post-test are significantly different. Among the components of variable autism spectrum disorder, stereotyped behaviors, and social interactions among boys and girls were significantly different. In stereotyped behaviors and social interactions, boys and girls had significantly more improvement in autism spectrum disorder symptoms, respectively. In the components of social interactions and verbal communication, girls and boys had the highest mean improvement, respectively. The value of the correlation coefficient of the variable autism spectrum disorder and its components with age was positive, indicating that theater therapy and its techniques at younger ages improve the symptoms of children and adolescents with an autism spectrum disorder.

Drama therapy techniques can be effective in improving the symptoms of autism spectrum disorder and enhancing social skills, verbal communication, and modifying stereotypical behaviors.

Alzheimerchr('39')s disease is a brain disorder that gradually destroys cognitive function and eventually the ability to carry out daily routine tasks. Early diagnosis of this disease has attracted the attention of many physicians and scholars, and several methods have been used to detect it in early phases. Evaluation of artificial neural networks is low-cost with no side effect method that is used for diagnosing and predicting Alzheimerchr('39')s disease in subjects with mild cognitive impairment based on electroencephalogram signals.

for this systematic review, keywords "Alzheimerchr('39')s", "Artificial Neural Network" and "EEG" were searched in IEEE, PubMed central, ScienceDirect, and Google Scholar databases between 2000 to 2019. Then, they were selected for critical evaluation based on the most relevance to the subject under study.

The search result in these databases was 100 articles. Excluding unrelated articles, only 30 articles were studied. In the present study, different types of artificial neural networks were described, Next, the accuracy of the classification obtained by these methods was investigated. The results have shown that some methods, despite being less used in research or have simple architecture, have the highest accuracy for classification. In many studies, artificial neural networks have also been considered in comparison with other classification methods and the results show the superiority of these methods.

Artificial neural networks can be used as a tool for early detection of Alzheimerchr('39')s disease. This approach can be evaluated for its classification accuracy, speed, architecture, and common use. Some networks are accurate at classifying and understanding data, but are slow or require specific hardware/software environments. Some other networks work better with simple architectures than complex networks. Furthermore, changing the architecture of conventional networks or combining them with other methods resulted in significantly different results. Increasing accuracy of classification of these networks in the diagnosis of mild cognitive impairment could help to predict Alzheimerchr('39')s disease appropriately.

Functional improvement is the major goal of therapeutic intervention in animal models of different diseases. To test therapeutic approaches of spinal cord injury (SCI), it is essential to produce an appropriate SCI animal model. In this model, the pathophysiological processes and histological alterations should be similar to humans. Most of the mechanisms for drug effect in SCI in human and animal spinal cord seems to be similar. The main types of experimental models of SCI with various applications have been reviewed. In the next step, behavioral tests to assess spinal cord injuries were mentioned.

Choosing an appropriate SCI model is crucial for the accuracy of investigations. The validity of any behavioral test depends on the reliability, authenticity, and universality. In this article, besides the illustration of different models and evaluating tests of spinal injury, selection criteria, as well as advantages and disadvantages, are discussed.

The prevalence of early symptoms of Parkinsonchr('39')s disease, even in middle age and adolescence, has caused widespread concern. Physical activity is known as one of the non-pharmacological methods to reduce behavioral, motor, biochemical, cardiovascular, and mitochondrial dysfunctions in Parkinsonchr('39')s disease. Although the basis of such biological and molecular benefits is unknown, the antioxidant and anti-inflammatory properties of physical activity may improve the symptoms of Parkinsonchr('39')s disease.

Although there is no definitive cure for Parkinsonchr('39')s disease, the use of medications along with adjunctive therapies, such as exercise, can be resulted in promising improvements. However, more research is required to achieve an exercise program that provides optimal benefits to patientschr('39') quality of life and reduces mortality.

Epilepsy has been considered a chronic brain disorder, which affects almost 1% of the world population. Among this population, about a third of epilepsy patients are considered as the drug-resistant group who are not responsive to anti-epileptic medicaments. The ketogenic diet has been defined as a diet containing high fat, low carbohydrate, and limited protein. The ketogenic diet has a substantial effect on body metabolism in a way that body and brain would utilize ketone bodies instead of glucose. Fundamentally, this diet helps some patients who are resistant to anticonvulsant drugs.

Maintaining this diet for a long time causes a positive effect and has a much more efficient impact on children rather than adults, but it could lead to some adverse effects, including renal stone, bone fracture, and hypercholesterolemia. In this study, we reviewed the relationship between ketogenic diet and epilepsy disorder and discussed the potential mechanisms of action.