Current Journal of Neurology
Volume:8 Issue: 28, 2010

The γd motor axons that innervate the muscle spindle fibers could induce the excitation of spindle nerves.�The purpose of this study was comparing the quality effects of pinna reflex (PR) and dynamic stretch (DS) on the discharges and amplitudes of spike potentials (SPs) of spindle Ia, II, and γd axons in rat. Methods and Materials : The experimental study on the SPs discharges of 45 single caudate muscle spindle afferents and γd axons from the left side L5 roots were recorded at rest and during testing15 adult normal rats by PR and by DS. The comparison among the means SPs amplitudes of Ia, II, and γd axons in the resting discharge (RD) and after applying the PR and the DS were investigated by measuring their amplitudes. The SPs amplitudes of Ia (72±5.34μv), II (38±3.27μv), and γd (62±4.29 μv) were calculated in the RD. The obtained mean SPs amplitude difference was21% for Ia and7.7% for II in the DS more than in the PR. The SPs of Ia and II made some overlaps by using the two stimula. The γd SPs followed the SPs of Ia and II during the PR whereas this case didn’t occur for the spindle axons during the DS. The mean SPs amplitude difference of γd in the DS was 85% less than in the PR. The DS (independent to γd SPs) was as distinctive stimulus for exciting of single Ia and II fibers as the PR (dependent to γd SPs). The γd showed strong inactivity by the DS. These results would be playing role in controling the movement disorders.

HTLVI infection is an endemic disease of Khorasan state in Iran. Distribution of Multiple Sclerosis (MS) is different around the world. Methods and Materials: Data of MS patients were taken of MS registries for interferon prescription in Razavi, Northern and Southern Khorasan provinces. MS was diagnosed by neurologists based on McDonald criteria. Records from clinics and hospital based researches consitituted data of distribution of patients infected with HTLV1 with or without spastic paraparesis in Razavi and Southern Khorasan provinces. Serologic tests of blood and/or CSF for HTLV1 and neuroexam by neurologists formed the methodology of HTLV1 investigation. Statistical centers of health deputy of medical universities in the Khorasan provinces provided the population data. Total Prevalence of MS in Razavi, Northern and Southern Provinces of Khorasan is 12.9, 8.7 and 5.3 cases per 100000 population respectively. Prevalence of MS in female population of Razavi, Northern and Southern provinces of Khorasan is 19.9, 11.2 and 8.3 cases per 100000 women respectively. Prevalence of MS in male population of Razavi, Northern and Southern Provinces of Khorasan is 5.9, 6.2 and 2.5 cases per 100000 men respectively. Total prevalence of HTLV1 infection in Razavi and Southern provinces of Khorasan is 2.4 and 0.5 cases per 100000 population respectively. Prevalence of HTLV1 infection in female population of Razavi and Southern provinces of Khorasan is 2.9 and 0.3 cases per 100000 women respectively. Prevalence of HTLV1 infection in male population of Razavi and Southern provinces of Khorasan is 1.9 and 0.6 cases per 100000 men respectively. Spastic paraparesis was found in 46 % and 50% of cases infected with HTLV1 in Razavi and Southern provinces of Khorasan respectively. Frequency rate of MS is less than half in Southern province compared to Razavi province of Khorasan. HTLVI infection is 10 times more frequent in female population of Razavi compared to Southern province. There is considerable difference in geographical distribution of MS and HTLV1 cases in Khorasan territory.

This paper proposes a new emotional stress detection system using multi-modal bio-signals. Since EEG is the reflection of brain activity and is widely used in clinical diagnosis and biomedical researches, it is used as the main signal. Methods and Materials: We designed an efficient IAPS acquisition protocol to acquire the EEG and psychophysiological signals under picture induction environment (calm-neutral and negatively excited) for participants. Data such as skin conductance (SC), Blood Volume Pulse (BVP), respiratory rate (RR) and EEG were continuously recorded through bio-sensors placed on the participant. In order to choose the proper EEG channels we used the cognitive model of the brain under emotional stress. After pre-processing the bio-signals, linear features were employed to extract the psychophysiological signals and chaotic (or nonlinear) invariants like fractal dimension by Higuchi’s algorithm, correlation dimension and approximate entropy were used to extract the characteristics of the EEG signals. For emotional stress detection, Genetic Algorithm (GA) and Elman neural network are applied to design the emotional stress classifier are investigated. The results show that, classification accuracy with fusion link between EEG and psychophysiological signals was 82.6% using the Elman classifier in two classes from emotional stress space. Chaotic analysis can be representing good of human brain and behaviour in emotional stress states.�This is a good improvement in results compared to other similar published researches.

Multiple sclerosis (MS) is the most frequent demyelinating disease of the central nervous system that makes different symptoms the most disabling symptom of which is speech impairment that has significant effect on patients’ quality of life. The aim of this study was to investigate the frequency of speech impairment and its influential factors among Iranian patients afflicted with MS. Methods and Materials: The records of 4553 patients registered in Iranian MS Society between 1998 and 2005 were studied and 3165 of them with complete profiles about speech impairments were included. Analyzing the data, SPSS software version 15 was used. Speech impairment was seen in 37.4% of patients. The frequency of this impairment was higher among male (P<0.001), unemployed (P<0.05), and with lower educational level patients (P<0.001). Also patients with speech impairment had a higher mean age (P<0.001). The frequency of patients with speech impairment in relapsing remitting, secondary progressive, and primary progressive MS, in contrast with patients without this impairment was lower, higher, and higher respectively (P<0.001). The mean age of onset of patients with speech impairment was higher (P<0.05). Speech impairment was more frequent among patients with onset symptoms of motor or balance impairment (P<0.05) and less frequent in patients with onset symptoms of sensory impairment (P<0.001). The frequency of speech impairment was higher among Iranian patients compared with previous studies in western countries. The impairment was more frequent among male, unemployed, with lower educational level, and older patients and also among patents who were in progressive forms of MS, with higher mean age of onset and patients with onset symptoms of motor or balance impairment.

Current evidences has shown hypothalamic dysfunction in cluster headache (CH).CH is so explosive that finding any relationship between this type of headache and different hormones could help to its better prevention and treatment. Methods and Materials : This study was performed in Isfahan University of medical sciences from June 2006 to June 2007 among 131 CH patients. Data was obtained from 19 of these cases randomly. In our study we found statistically significant relation among cortisol, thyroid hormone (T3) and follicle stimulating hormone (FSH). Among 19 CH Patients, 11 cases had low FSH level (57.9%) and three cases (15.8%) had high values. One case (5.3%) had low serum T3 level. 52.6% (10cases) demonstrated low cortisol level. Other results for testosterone, T4, TSH and LH were not statistically significant. The altered hormone level (cortisol, FSH, T3) is a further indication of permanent hypothalamic disturbance in cluster headache and might be a clue to prevent, or treat this severe headache by hormonal modification. Abbreviations: CH cluster headache, FSH follicle stimulating hormone, LH luteinizing hormone, TSH thyroid stimulating hormone, T3 and T4 thyroid hormones.

Progressing stroke (PS) and Crescendo Transient Ischemic Attacks (CTIA) are generally accepted, though unproven, indications for urgent anticoagulation and there remains evidence-free practice of intravenous heparin therapy in these patients. Methods and Materials: Consecutive PS and CTIA patients admitted in Mashhad Ghaem hospital during 2007- 2008, enrolled in a prospective observational study. PS and CTIA patients underwent intravenous heparin therapy 1000 units per hour for 3 days without bolus dose. PS and CTIA patients who had a contraindication of intravenous heparin therapy received 80 mg Aspirin per day. Early clinical courses including improvement, stabilization, deterioration and development of residual stroke were evaluated in two therapeutic groups of PS and CTIA patients.. 170 PS patients (103 males, 67 females) with mean age 60.4±12.3 years and 88 CTIA patients (50 males, 38 females) with mean age 60.1± 6.8 years were investigated. 141 PS and 64 CTIA patients received a short period of intravenous heparinization. The distribution of subtypes of early clinical course into two therapeutic groups of PS and CTIA patients was significantly different X2=10.487, df=2, p=0.005 and X2=6.72, df=2, p=0.035 respectively. Distribution of residual stroke in two therapeutic groups of PS and CTIA patients was not significantly different X2=1.443, df=1, p=0.23, OR=0.557 (0.212-1.462) and X2=1.01, df=1, p=0.315, OR=0.617 (0.24-1.587) respectively. PS and CTIA patients who received a short period of intravenous heparin therapy have significantly more probability of improvement and less probability of deterioration in their early clinical course.

Homocysteimemia has been associated with increased risk for cerebralvasuclar disease and recurrent stroke. Homocysteinmia has primary atherogenic and prothrombotic properties. It can lead to both venous and arterial thrombosis by several mechanisms. We present a 45 years old female patient with hyperhomocysteinemia and past medical history of epilepsy, two strokes like attacks, livedo reticularis and a new ischemic stroke. Risk factors such as hypertension, diabetes, ischemic heart disease and hyperlipidemia were all absent. Hypercoagulation and vasculities tests were normal. Livedoretiularis was the clue in this patient that led us to consider homocysteinemia as the most probable diagnosis. This suggests that considering skin lesions in juvenile stroke may help to limit the differential diagnosis and treat the etiologic factor more rapidly.

Tuberculous meningitis is a medical emergency that low sensitivity of CSF smear staining and mycobacterial culture make its diagnosis difficult, so there is an urgent need for rapid, accurate and reliable laboratory test. The aim of this study was comparing the sensitivity and specificity of CSF adenosine deaminase (ADA) level with Polymerase Chain Reaction (PCR) test in the diagnosis of tuberculous meningitis (TBM). Methods and Materials: In the period between January 2007 and January 2008 we had 49 patients with primary diagnosis of TBM in Bou-Ali University hospital. After committing and using the definite and probable TB as a golden standard, the final diagnosis for 29 of them was TBM. Our study showed that the sensitivity and specificity of CSF-ADA level in comparison with PCR results in diagnosis of TBM with a 6.5 IU/L cut-off were 100% and 85% respectively. Our study showed that selecting a 6.5 IU/L cut-off with respect to the PCR results of the patients makes a reasonable sensitivity and specificity for CSF-ADA test in TBM diagnosis. Our study emphasized that CSF-ADA level measurement can be used as a good, rapid and reliable laboratory test for diagnosing tuberculous meningitis.