فهرست مطالب

  • Volume:9 Issue: 1, Winter 2022
  • تاریخ انتشار: 1400/11/17
  • تعداد عناوین: 16
  • Eman Hamdy, Ismail Ramadan, Jaidaa Mekky, Dina Gaber, Aya Abdel Galeel Page 1

    Cerebellum has long been known to modulate not only motor coordination but also affective and cognitive functions. Thisstudy aimed to assess the impact of middle cerebellar peduncle (MCP) lesions on affective and cognitive function in patients with multiple sclerosis (MS).


    This was a cross-sectional study conducted on patients with relapsing-remitting MS (RRMS). All patients were subjected to 3-Tesla magnetic resonance imaging (3T MRI), brief international cognitive assessment for MS (BICAMS), and Depression, Anxiety, and Stress Score-21 (DASS-21) upon recruitment.


    Of the 30 patients recruited, 33.3% and 36.7% had right and left MCP lesions, respectively. Patients with right MCP lesions had significantly worse symbol digit modality test (SDMT) scores (P = 0.036), worse California verbal learning test (CVLT) immediate recall scores (P = 0.011), and worse CVLT delayed free recall scores (P = 0.049), whereas patients with left MCP lesions had lower DASS-21 scores (P < 0.005). On multivariate regression analysis,the presence of left MCP lesion was associated with an 8.9-point reduction in DASS-21 scores (CI: -16.985- -0.805, P = 0.033), whereas right MCP lesions did not have an independent effect on BICAMS scores after adjustment for age and educational level.


    Left MCP lesions were associated with significantly lower DASS-21 scores, whereas none of the MCP lesions had an independent impact on cognition

    Keywords: BICAMS, Cerebellum, Cognitive dysfunction, DASS-21, Depression, Middle cerebellar peduncle
  • Marjan Asadollahi, Elham Rahimian, AliAkbar Asadi Pooya, Majid Tahsini, Hans Jürgen Huppertz, Nayyereh Akbari, Leila Simani Page 2

    We assessed the presence of brain volume loss in the extratemporal structures in patients with temporal lobe epilepsy (TLE). The associations between brain volume loss in these structures and epilepsy duration, magnetic resonance imaging (MRI) findings, and occurrence of focal to bilateral tonic-clonic seizures (TCS) were assessed.


    In this cross-sectional study, all adult patients with drug-resistant TLE, who were admitted to the epilepsy monitoring unit at Loghman-Hakim Hospital, Tehran, Iran, during 2016-2020, were included. For all the participants, brain MRI was performed and patients with TLE were divided into two subgroups of those with hippocampal sclerosis (TLE-HS) and patients with normal-appearing brain MRI findings (TLE-no). Independent sample t test was applied to compare quantitative variables in the study groups. Pearson correlation test examined the correlation between the clinical and volumetric features.


    203 participants (81 patients with TLE and 122 healthy controls) were studied. Compared with healthy controls, patients with TLE showed a decrease in their midbrain (P = 0.02) and thalamus (P = 0.01) volume. The degree of thalamic atrophy was more significant in TLE-HS (P = 0.03). Moreover, the degree of midbrain volume loss was more significant (P = 0.07) in patients who had TCS in the past two years (N = 31) compared with those who did not (N = 50). The volume of the thalamus (r: -0.252, P = 0.02) and pallidum (r: -0.255, P = 0.02) had inverse correlations with the epilepsy duration.


    Patients with TLE have lower midbrain and thalamus volume compared with the healthy controls, which may be attributed to the seizure-induced injury. Midbrain atrophy may theoretically increase the risk of sudden unexpected death in epilepsy (SUDEP) because of the enhanced autonomic dysfunction.

    Keywords: Midbrain, Thalamus, Seizure, Temporal lobe epilepsy, Atrophy
  • HamidReza Kobravi, Rashin Abdolhossein Harisi Page 3

    In this study, three detecting approaches have been proposed and evaluated for online detection of balance situations during quiet standing. The applied methods were based on electromyography of the gastrocnemius muscles adopting the hidden Markov models.


    The levels of postural stability during quiet standing were regarded as the hidden states of the Markov models while the zones in which the center of pressure lies within determines the level of stability. The Markov models were trained by using the well-known Baum-Welch algorithm. The performance of a single hidden Markov model, the multiple hidden Markov model, and the multiple hidden Markov model alongside an adaptive neuro-fuzzy inference system (ANFIS), were compared as three different detecting methods.


    The obtained results show the better and more promising performance of the method designed based on a combination of the hidden Markov models and optimized neuro-fuzzy system.


    According to the results, using the combined detecting method yielded promising results.

    Keywords: Quiet Standing, Hidden Markov Model, Electromyography, Dynamic Balance
  • Fahr Syndrome and Syncope: Case Report and Clinical Radiological Characteristics
    Luis Avellaneda, Marco Rojas, Karen Torres, Luis Cetina, Ledmar Vargas Page 4

    Fahr´s syndrome is a rare neurodegenerative entity, which consists of calcifications of the basal ganglia and cerebrospinal nuclei, which can be associated with neurological and neuropsychiatric symptoms. However, the difference between syndrome and Fahr’s disease is highlighted.

    Case Report:

     a 55-year-old man with underlying thyroid disease undergoing treatment, debuted with syncope with posterior cranial trauma, which was admitted to the emergency service, performing imaging studies with findings compatible with Fahr´s syndrome.


    syncope as a cardiac symptom in a patient with Fahr syndrome, metabolic and structural abnormalities ruled out must be.

    Keywords: Calcinosis, Syncope, Syndrome, Tomography, Fahr’s syndrome
  • Sayedali Ahmadi, Jaber Hatam, Mahisa Mokhtari, Meysam Abolmaali, Eshagh Bahrami, Marjan Mirsalehi, Saleh Mohebbi Page 5

    Vestibular schwannoma is a benign and common slow-growing tumor that develops on the vestibular divisions of cranial nerve VIII. Some risk factors may enhance intratumoral hemorrhage risk which leads to tumor management to early surgical procedures. Hence, we describe a 57-year-old man presented with hearing loss and a 5*8 mm vestibular schwannoma. Eight months later, the patient was referred with headache, nausea and vomiting, right hemifacial paresis, and hemiparesis. Magnetic resonance imaging (MRI) revealed a 45*35 mm hemorrhagic vestibular schwannoma. Surgical pathology reported hemorrhagic vestibular schwannoma. This was a rare case of hemorrhagic vestibular schwannoma with none of the established risk factors for the intratumoral hemorrhage and presented with Wallenberg-like syndrome. Many risk factors can cause hemorrhagic vestibular schwannoma. We present one case of small vestibular schwannoma without any predisposing of hemorrhage and acute onset of same side hemifacial paresis and hemiparesis

    Keywords: Vestibular schwannoma, Acoustic neuroma, Intracranial hemorrhage, Hemorrhagic schwannoma
  • Saeideh Salehizadeh, Negar Bizhani, Zahra Arab Mazar, Sara Rahmati Roodsari Page 6
  • Nandana Welage, Michelle Bisssett, Kenneth N.K. Fong, Paul Fahey, Kristy Coxon, Karen P.Y. Liu Page 7

    The effectiveness of action observation (AO) and motor imagery (MI) in high-quality studies with less risk of bias is rarely reported together. This systematic review evaluates the effectiveness of AO and MI on improving upper extremity function among people after stroke by combining evidence of studies with high methodological quality. Randomised controlled trials, with a score of 6 or above in the PEDro Scale, that examined the effects of AO or MI for people with stroke were selected. A narrative analysis and meta-analysis were conducted using the PRISMA guidelines. Ten randomised controlled trials from 11 articles met the inclusion criteria. The results of meta-analysis showed that AO had a small to moderate statistically significant effect on improving upper extremity motor function (standardized mean difference, SMD = 0.34; confidence interval, CI = 0.08, 0.59; P = 0.35; I2 = 0.00%) and no significant effect on MI (SMD = 0.08; CI = -0.26, 0.42; P = 0.65; I2 = 0.00%) when compared with the control intervention. Evidence was found in support of AO and it is recommended for people with acute or sub-acute stroke.

    Keywords: Motor imagery, Action observation, Stroke, Systematic review, Meta-analysis
  • Hedayat Sahraei *, Mohammad Sahraei Page 8

    Following the outbreak of COVID-19 disease, which is caused by the coronavirus, there were reports of neurological complications, indicating that virus infection may have risks involving the nervous system. Stroke, encephalopathy, moderate to severe headaches, anosmia and dysgeusia, hallucination, and depression were the most neurological complications reported. The most important neurological complication of COVID-19 is anosmia, which is caused by the infection of the olfactory support cells. Hallucination and depression have been observed in those admitted to the intensive care unit, which is primarily related to general inflammatory reactions. Although brain autopsies of people who have died because of COVID-19 have shown that the virus can be detected in brain tissue. Studies indicate that viral infection has only been detected in the vascular part of the blood-brain-barrier. Perhaps the most critical finding of coronavirus infection in the brain is the activation of astrocytes and microglia in patients with COVID-19, which dilates the cerebral arteries in the brainstem, allows killer T cells to enter brain tissue, and causes cytotoxic effects in this part of the brain. This review focused on the neurological complications associated with COVID-19 and the possible mechanisms underlying these complications.

    Keywords: Anosmia, COVID-19, Depression, Dysgeusia, Hallucination, Headache, Stroke
  • shahrzad valizadeh, Elham Saeedzadeh, Alireza Zali, Hasanali Nedaei, Saeed Zare Ganjaroodi Page 9

    Stereotactic brachytherapy (SBT) is an appropriate method that has been used for brain tumors and metastases treatment for more than 40 years for many patients in the world. Also, Iodine-125 brachytherapy has been utilized in brain tumors for interstitial brachytherapy treatment since 1979. Even though the physical and biological feathers make these implants particularly attractive for minimal invasive treatment.


    In this paper, monte carlo simulation have been applied by the Gate code with 20 (MBq) activity for an iodine seed design for the low-grade glioma tumors treatment. Dosimetry feathers of this source were defined by the updated TG-43U1 recommendations. The absorbed dose distribution around the seed was calculated using the Gate code in liquid water.


    Results show, the ideal condition for brachytherapy are for tumors smaller than 4 (cm). As the larger tumor size, the absorption dose at the border of tumor and healthy tissue will be decreased and the implantation time for seeds will increase.


    Placing an iodine-125 source inside the tumor is not sufficient due to the non-uniform dose distribution in the tumor and the length of treatment time. Using four iodine-125 sources eliminates the tumor, and also, a uniform dose distribution is created in the tumor and the implantation time will be reduced, respectively.

    Keywords: Brachytherapy, Tumor, Iodine-125, Gate
  • Mohammed Anwar, Ossama Yassin Mansour, Hany Eldeeb, Sameh M. Said Page 10

    Mechanical thrombectomy (MT) is becoming a growing trend in the management of large vessel occlusion (LVO) during the past few decades, although data on the predictors of outcome following MT are scarce. We aimed to study the predictors of 90-day outcome in a cohort of patients with ischemic stroke with large-vessel occlusion.


    This was a three-month prospective study of 40 patients with anterior circulation LVO who underwent MT and were followed up for three months with modified Rankin Score (mRS).


    Of the 40 patients recruited, 55% were men. M1 was the most common vessel occluded (32.5%) followed by internal carotid artery (ICA) and carotid trunk (20%). Tandem occlusion occurred in 25% of the cases. Among the demographic, clinical, radiological, and procedural variables studied, the factors that had a significant impact on the mRS at 3 months were age, diabetes mellitus (DM), hyperlipidemia, stroke mechanism, blood glucose level during procedure, post-procedural National Institutes of Health Stroke Scale (NIHSS), baseline Alberta stroke program early CT score (ASPECT) score, collaterals grade, and procedural thrombolysis in cerebral infarction (TICI) score (P < 0.05). On multivariate regression, patients’ age (B: 0.025, 95% CI: 0.001- 0.049, P = 0.038), post-procedural NIHSS (B: 0.192, 95% CI: 0.101–0.283, P < 0.001), and baseline ASPECT score (B: -0.442, 95% CI: -0.838- -0.046, P = 0.03) were the most independent factors to affect the mRS at 3 months.


    Patients’ age, baseline ASPECT score and post-procedural NIHSS are significant predictors of 90-day outcome of large-vessel occlusion following MT.

    Keywords: Mechanical thrombectomy, Large vessel occlusion, Predictors
  • Malihe Sabeti, Ehsan Moradi, Mahsa Taghavi, Mokhtar Mohammadi, Reza Boostani Page 11

    Psychiatrists diagnose schizophrenia based on clinical symptoms such as disordered thinking, delusions, hallucinations, and severe distortion of daily functions. However, some of these symptoms are common with other mental illnesses such as bipolar mood disorder. Therefore, quantitative assessment of schizophrenia by analyzing a physiological-based data such as the electroencephalogram (EEG) signal is of interest. In this study, we analyze the spectrum and time-frequency distribution (TFD) of EEG signals to understand how schizophrenia affects these signals.


    In this regard, EEG signals of 20 patients with schizophrenia and 20 age-matched participants (control group) were investigated. Several features including spectral flux, spectral flatness, spectral entropy, time-frequency (TF)-flux, TF-flatness, and TF-entropy were extracted from the EEG signals.


    Spectral flux (1.5388 ± 0.0038 and 1.5497 ± 0.0058 for the control and case groups, respectively, P = 0.0000), spectral entropy (0.8526 ± 0.0386 and 0.9018 ± 0.0428 for the control and case groups, respectively, P = 0.0004), spectral roll-off (0.3896 ± 0.0434 and 0.4245 ± 0.0410 for the control and case groups, respectively, P = 0.0129), spectral flatness (0.1401 ± 0.0063 and 0.1467 ± 0.0077 for the control and case groups, respectively, P = 0.0055), TF-flux (1.2675 ± 0.1806 and 1.5284 ± 0.2057 for the control and case groups, respectively, P = 0.0001) and TF-flatness (0.9980 ± 0.0000 and 0.9981 ± 0.0000 for the control and case groups, respectively, P = 0.0000) values in patients with schizophrenia were significantly greater than the control group in most EEG channels. This prominent irregularity may be caused by decreasing the synchronization of neurons in the frontal lobe.


    Spectral and time frequency distribution analysis of EEG signals can be used as quantitative indexes for neurodynamic investigation in schizophrenia.

    Keywords: EEG signal classification, Spectral, Time-frequency distribution
  • Thi Phuong Hoai Dinh*, Ngoc Thanh Van Duong, Trong Hieu Le, Thi Mai Dieu Tran, Hai, Nguyen Vinh Lac Pham, Thanh Minh Nguyen Page 12

    Lumbar spondylolysis and multilevel lumbar spondylolysis account for 4.4-5.8% and 0.3% of the general population, and multilevel lumbar spondylolysis resulting in spondylolisthesis is even rarer. Herein, we report two cases of three-level lumbar spondylolisthesis because of spondylolysis: A 49-year-old woman was admitted to the hospital for dull lower back pain over the past 8 months, with exacerbating symptoms when standing and walking. Spasticity at lumbar region and radiculopathy at S1 nerve root was found on examination and a 63-year-old man was admitted to the hospital because of numbness and perianal sensory disturbances with difficulty urinating 2 weeks ago, the symptoms gradually increased to the time of examination. Both patients were diagnosed with multilevel lumbar spondylolisthesis because of spondylolysis and were indicated for posterior lumbar interbody fusion (PLIF). After surgery, both patients recovered well without any significant complications. The improved treatment results suggest the application of PLIF technique to treat spondylolysis-induced multilevel lumbar spondylolisthesis.Keywords: Multilevel lumbar spondylolisthesis; Low back pain; Nerve root pain; Spondylolysis; Posterior lumbar interbody fusion (PLIF).

    Keywords: Multilevel lumbar spondylolisthesis, Low back pain, Nerve root pain, Spondylolysis, Posterior lumbar interbody fusion (PLIF)
  • Poorya Davoodi*, Atousa Hashemi, Negin Ahmadfakhredin, Melika Jourablou, Meisam Akhlaghdoust, Hasan Mosazadeh Page 13
  • Dinh Thi Phuong Hoai*, Duong Ngoc Thanh Van, Phan Quoc Tho, Nguyen Ngoc Anh Thu, Le Trong Phuoc, Le Trong Hieu, Nguyen Vinh Lac, Vo Ba Tuong, Nguyen Thanh Minh Page 14

    Meningioma is the most common, extra-axial, non-glial intracranial tumor with an incidence of 2.3-5.5/100 000, accounting for 20%-30% of all primary brain tumor diagnoses in adults. Meningiomas associated with intratumoral hemorrhage are very rare occurring in 0.5%-2.4%. of individuals. Herein, we report a rare case of hemorrhagic meningioma with the symptom of convulsion. The case was a 68-year-old woman admitted to the hospital with severe headache and convulsions. Computed tomography revealed an increase in heterogeneous lesion measuring 4 × 3 × 2.5 cm at the right parietal lobe. Brain magnetic resonance imaging (MRI) showed a grossly stable homogeneously enhancing extra-axial mass measuring 43 × 33 × 28 mm, small calcified peripheral, intratumoral hemorrhage. Histopathology showed a multi-celled meningioma with bleeding areas (WHO grade I).

    Keywords: Hemorrhagic meningioma, Intracranial hemorrhage, Meningioma, Bleeding, Convulsion
  • Mojtaba Rahnama Zadeh, Hassan Ashayerih*, Tahere Ranjbaripour, Alireza Kakavand, Farahnaz Mesch Page 15

    According to recent studies, cardiovascular diseases have been the most prevalent cause of death and disability worldwide, one of the most hidden types of which is coronary heart disease. Coronary heart disease is mainly psychosomatic in nature and the role of psychological (especially personality) and social factors in its occurrence is very important. We aimed to evaluate the effectiveness of acceptance and commitment therapy (ACT) on depression, alexithymia,and hypertension in patients with cardiovascular diseases.


    The was a quasi-experimental study with a pretest-posttest design, with a control group and baseline assessment after intervention and three-month follow-up. The statistical population included all patients with cardiovascular diseases referred to Imam Reza hospital in Amol city from Julyto December 2020. 24 patients were selected as the sample using purposeful sampling and assigned to equal experimental and control groups randomly. The study tools were a researcher-made demographic questionnaire (2019), Toronto Alexithymia Scale (1994), Beck Depression Inventory (1990), and acceptance and commitment treatment protocol (Hayes, 2012). Data were analyzed by repeated measures analysis of variance.


    We found that ACT had a significant effect on reducing depression, alexithymia, and hypertension.


    Patients who participated in ACT sessions had lower rates of depression, alexithymia, and hypertension

    Keywords: Acceptance, Commitment Therapy, Alexithymia, Depression, Hypertension, Cardiovascular Diseases
  • Shiva Rahimzadegan, Sajjad Basharpour*, Niloofar Mikaeili, Mohammad Nariman Page 16

    Cancer diagnosis causes emotional problems and profound psychological helplessness in patients. We aimed to investigate the relationship between post-traumatic growth and disease perception and emotion regulation in patients with cancer.


    The statistical population of this correlation study was all patients aged 18-65 years with breast, leukemia, and gastrointestinal cancer going to the oncology ward of Omid and Imam Khomeini hospitals in Urmia in the first half of 2021. 250 people (121 women and 129 men) were selected by the purposeful sampling method. Data collection tools included a post-traumatic growth questionnaire, a modified illness perception questionnaire, and the emotion regulation process strategies questionnaire. Pearson’s correlation test and multiple regression analysis were used for data analysis.


    The results showed that negative illness perception had a significant and negative relationship, and optimistic illness perception had a positive, meaningful relationship with post-traumatic growth (P < 0.05). Emotion regulation had a significant and positive association with post-traumatic growth (P < 0.05).


    How to perceive the disease and emotion regulation strategies in patients with cancer have an influential role in promoting post-traumatic growth.

    Keywords: Post-traumatic growth, Illness perception, Emotion regulation