4-aminopyridine decreases MPTP-induced behavioral disturbances in animal model of Parkinson’s disease

Background and purpose: Progressive degeneration of dopaminergic neurons in the midbrain is the main mechanism of Parkinson’s disease (PD). Although potassium channels affect neural activity and death in this area, little research has investigated the effect of potassium channel blockers, such as 4-aminopyridine in the pretreatment of PD.Methods: Fifty-six healthy male Wistar rats were selected for this study. They were divided into seven groups according to receiving saline or 4-aminopyridine, receiving a low or high dose of 4-aminopyridine and receiving 4-aminopyridine for short or long periods. Apomorphine-induced rotational test, elevated body swing test and rotarod test were done to examine behavioral performances.Results: 4-aminopyridine could not completely block behavioral disturbances induced by MPTP, however, it decreased them in all behavioral tests. Long administration of 4-aminopyridine was more effective than short administration in lowering behavioral disturbances. Although high dose of 4-aminopyridine was more effective than low dose in initial trials of each behavioral test, there was no difference between them in the last trial.Conclusion: Long administration of low dose of 4-aminopyridine is the best way to lessen behavioral disturbances induce by MPTP and also avoiding side effects of high dose of 4-aminopyridine. 

Etiology of the Neonatal Seizures: An Epidemiological Study

Background: Neonatal seizure is a rare neurologic condition. The current study aimed at determining the etiology of neonatal seizure.Methods: The current study evaluated the data of 100 neonates who were hospitalized at neonatal intensive care unit (NICU) during 2015-2017. A pediatric neurologist made the final diagnosis of seizure. Patients’ medical records were used to review neonatal seizure variables. SPSS (version 16) was used to perform the statistical analyses.Results: The current study enrolled 100 newborns (41% female) admitted to the NICU following the first episode of seizure and the body temperature of 36.8-39.2°C (mean: 37.2°C). Of 100 participants, 94 (94%) had acute symptomatic seizure and 6 (6%) were compatible with neonatal epilepsy syndrome criteria. According to the results, the commonest etiologies were the neonatal encephalopathy and hypoxic-ischemic encephalopathy constituting 82% of participants.Conclusion: The consequences of acute symptomatic seizures in neonates are determined mainly by the etiology of the seizures. Seizure burden and use of anti-seizure drugs may also have some impact, but this has yet to be fully defined

Neonatal Seizure and Afterward, Epilepsy: A Systematic Review

Background: The purpose of the current study is to estimate the incidence of epilepsy after neonatal seizure (NS) by reviewing of the latest studies on the relationship between NSs and epilepsy in newborns and also discuss risk factors may contribute to this relationship.Methods: A literature review was performed using the search terms “neonatal seizure AND epilepsy,” “newborns AND epilepsy,” “postneonatal epilepsy.” After exclusion of several studies, which did not meet inclusion criteria, the epilepsy incidence rate was measured by dividing the number of all cases of epilepsy who had a history of NS in selected studies considered with the number of all newborns enrolled to the studies minus the number of cases who lost the follow-ups.Results: By reviewing the literature, 13 studies were found, which completely meet the inclusion criteria and published between 2009 and 2019, of which three were population-based while the remaining studies performed hospital-based. Overall, the population evaluated in these series has been estimated to be 2438 newborns of which 454 died, and 300 missed the follow-ups. The incidence rate for afterward epilepsy in all 1684 subjects with NS was 20%, literally 343 of the NS subjects.Conclusion: The presented review enrolled the most recent studies encompassing enough and extended the time as well as adequate sample size. Epilepsy is considered a common outcome of NS, particularly in those with other neurodevelopmental comorbidities, even if there were always several limits associated with various study designs and condition

Association between Body Mass Index and Cognitive Performance.

Background: Because of well-established role of obesity in brain lesions, progressing cognitive deficits in obese patients has been recently suggested. In current study and for the first time, we aimed to assess cognition status in Iranian obese people and to compare it with non-obese individuals.Methods: One hundred and eighteen consecutive patients with the different cardiovascular and metabolic primary complaints were assigned to obese group (n = 25, 21.2%) and non-obese group (n = 93, 78.8%). Cognitive status was assessed at initial visiting using the Montreal Cognitive Assessment (MoCA) questionnaire.Results: Mean total cognitive score in obese patients was 20.04 ± 4.57 and in non-obese ones was 20.19 ± 5.32 with no difference (p = 0.886). In total, 8.0% of obese patients and 20.4% of non-obese patients had normal cognitive function (p = 0.149). No significant difference was also found in different subdomains of cognitive ability between obese and non-obese groups. None of the cognitive domains had significant association with BMI as the considered indicator for defining obesity. Based on multivariate linear regression modeling, obesity could not predict cognitive deficit (beta = 0.034, SE = 0.1.015, p = 0.973).Conclusion: Our survey could not demonstrate an association obesity and cognitive impairment in a sample of Iranian patients

MRI Findings in Children with the First Unprovoked Seizure Presenting to the Emergency Department; Does Developmental Delay Suggest the Importance of Brain MRI Evaluation?

Introduction: The first unprovoked seizure (FUS) in children is a convulsive seizure with an unknown cause, which may be due to an underlying neurological disease or a manifestation of epilepsy. Objective: The aim of this study was to evaluate the findings of brain magnetic resonance imaging (MRI) in pediatric patients with FUS, presenting to the emergency department (ED). Methods: In this cross-sectional study, all children with FUS (age: >1month and<14 years), who were referred to the ED of Qaem Hospital, Mashhad, Iran from 2016 to 2019, were investigated. Medical records, brain MRI findings, electroencephalography (EEG) results, and developmental status of children were reviewed retrospectively. Results: The brain MRI findings of 56 children with FUS were reviewed. The mean age of children was 3.92±6.05 years, and the sex distribution was equal. Seventeen (30.4%) patients had abnormal EEG findings, while 13 (23.2%) patients’ had non-specific EEG findings. Neurological examination of 4 (7.1%) children was abnormal. Overall, 6 (10.7%) patients had non-specific abnormal brain MRI findings for seizure, while 3 (5.4%) patients had specific abnormal findings. A significant relationship was observed between the developmental status of children and abnormal MRI findings (P=0.04). However, MRI findings had no significant relationship with EEG or neurological findings (P>0.05). Conclusion: It may be useful to perform brain MRI for children with FUS presenting to ED, especially those who are suspected of developmental disorders

MRI Findings in Children with the First Unprovoked Seizure Presenting to the Emergency Department; Does Developmental Delay Suggest the Importance of Brain MRI Evaluation?

Introduction: The first unprovoked seizure (FUS) in children is a convulsive seizure with an unknown cause, which may be due to an underlying neurological disease or a manifestation of epilepsy. Objective: The aim of this study was to evaluate the findings of brain magnetic resonance imaging (MRI) in pediatric patients with FUS, presenting to the emergency department (ED). Methods: In this cross-sectional study, all children with FUS (age: >1month and<14 years), who were referred to the ED of Qaem Hospital, Mashhad, Iran from 2016 to 2019, were investigated. Medical records, brain MRI findings, electroencephalography (EEG) results, and developmental status of children were reviewed retrospectively. Results: The brain MRI findings of 56 children with FUS were reviewed. The mean age of children was 3.92±6.05 years, and the sex distribution was equal. Seventeen (30.4%) patients had abnormal EEG findings, while 13 (23.2%) patients’ had non-specific EEG findings. Neurological examination of 4 (7.1%) children was abnormal. Overall, 6 (10.7%) patients had non-specific abnormal brain MRI findings for seizure, while 3 (5.4%) patients had specific abnormal findings. A significant relationship was observed between the developmental status of children and abnormal MRI findings (P=0.04). However, MRI findings had no significant relationship with EEG or neurological findings (P>0.05). Conclusion: It may be useful to perform brain MRI for children with FUS presenting to ED, especially those who are suspected of developmental disorders

Magnetic Resonance Spectroscopy Findings and Cognitive Function in Patients with Parkinson’s disease

Background and Purpose: Cognitive impairment (CI) is one of the most notable disabilities of Parkinson’s disease that is associated with lower quality of life. Early detection of CI is therefore very important for these patients. The purpose of this study was to examine the relationship between cognitive function and the metabolic data from magnetic resonance spectroscopy (MRS) of the patient suffering with Parkinson’s disease.Methods: Totally, 45 patients with Parkinson’s disease were used in this study. Subjects were divided into three groups based on scales for outcome from Parkinson cognition (SCOPA-COG) test. Patients were classified as non-cognitive impairment (NCI; n=15), mild cognitive impairment (MCI; n=15) and dementia (PDD; n=15). All subjects underwent MRI and 1H-MRS techniques and metabolic changes such as NAA/Cr and NAA/Cho ratios, which were measured in the left hippocampal area of the brain.Results: The mean and standard deviation of the NAA/Cr ratio in the three cognitive groups (NCI, MCI, PDD) were (2.51±0.037), (2.50±0.033) and (2.47±0.025), respectively. ANOVA test showed a significant difference in the three groups. Furthermore, the Scheffé test showed a significant difference between patients in the MCI and PDD groups (p=0.01). There was no significant difference between the non-cognitive impairment and mild cognitive impairment groups (p=0.54). No significant difference was found in NAA/Cho ratio (p=091). Conclusion: A decreasing NAA/Cr ratio has influence on cognitive function and the development of severe cognitive dysfunction in Parkinson suffering patients. Furthermore, 1H-MRS determinant can be useful to evaluate cognition in Parkinson patients

A Rare Case of Type II Odontoid Fracture With Bilateral Vertebral Arteries Occlusion Without Neurological Deficits

Cervical spine fractures are common fractures due to spine trauma. Odontoid fracture is responsible for 20% of cervical spine fractures. Vertebral artery injuries (VAIs) had widely focused in this setting due to its occurrence with upper cervical fractures. In our case of study, a 42-year-old female presented in the hospital’s emergency department with a history of cervical spine injury without neurological deficits. In further investigations, cervical spine X-ray, magnetic resonance imaging (MRI), and angiography were done to evaluate the possible injuries to the bone, spinal cord, and vascular structures surrounding the spine that eventuated in the accidental diagnosis of bilateral vertebral artery occlusion. This case of the study demonstrated the importance of diagnostic investigations that can evaluate in an emergency department and bilateral vertebral artery occlusion without neurological symptoms due to collateral arteries establishment

The Survey of Malnutrition Prevalence in Patients With Parkinson Disease In Tehran, Iran

Background: Parkinson disease (PD) introduced as the second most prevalent neurodegenerative disease following Alzheimer disease. A patient’s nutritional status may be compromising in PD. This study aimed to describe the outpatient nutritional status in patients with PD at a third-level hospital in Iran.Methods: The validated Persian version of the Mini-Nutritional Assessment (MNA) questionnaire was used to evaluate the nutritional status of 158 Iranian PD patients (age, 35-85 years). The exclusion criteria were as follows: chronic comorbidities affecting the nutritional status (e.g., diabetes and hypertension); adherence to special diets; and cognitive disorders. Based on the MNA questionnaire, a total score below 17 represented malnutrition, while scores 17-24 indicated a risk of malnutrition.Results: Based on the findings, 26% of the participants had low weight, 67% of whom were over 65 years. According to the MNA questionnaire, 14.3% of the participants showed malnutrition and 26.2% were at risk of malnutrition.Conclusion: Based on our findings, PD can contribute to reduced nutritional status. More than one-fourth of the PD population was at risk of malnutrition, which highlights the need for more attention towards nutritional assessment. Nutritional assessment is essential for the development of nutritional interventions and early detection of PD patients who are at risk of malnutrition

Depression and its Main Determinants Among Iranian Operating Room Personnel: A Systematic Review and Meta-Analysis

Background: Most nurses, especially operating room personnel, seems to be more likely to be affected by mood disorders than other social strata. The present study attempted to systematically review the prevalence of depression and its main determinants among operating room personnel in Iran.Methods: The method of this systematic review is documenting in a published protocol in the International Prospective Register of Systematic Reviews (PROSPERO) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. After this massive search, titles and abstracts of retrieved documents have screened and all irrelevant articles excluded. Two reviewers screened the documents and selected all relevant studies and assessed included articles separately.Results: Totally, 12 citations found in the initial literature search where four citations excluded, as they did not meet the inclusion criteria. The final number of studies available for analysis was 12 including a total of 373 operating room personnel (86 men and 287 women, mean the age of 27.71 years ranged from 20 to 36 years). The pooled prevalence of depression among operating room personnel was estimated to be 45.3%. In this regard, 27.0% of personnel suffered from severe depression. A significant heterogeneity found in the overall analysis of the overall prevalence of depression and its severe pattern.Conclusion: A notable number of operating room personnel in Iran suffer from depression even in its severe condition emphasizing the importance of the managerial approach to minimize its adverse effects on their performance as well as to improve their quality of life