Comparison some of the syntactic skills in Relapsing Remitting Multiple sclerosis and normal adults resident in Esfahan Province

Introduction: Multiple sclerosis is a progressive disease of the central nervous system that deteriorates myelin sheath and produce plaques in white matters of the brain and spinal cord. Studies indicated that Language skills of these patients are affected .Speech and Language Pathologists take a little attention to the language skills of these patients. The purpose of this study was to comparison some of the syntactic skills in Relapsing Remitting Multiple sclerosis and normal adults’ resident in Esfahan Province. Materials and Methods: In this cross-sectional descriptive- analytical study was investigated 17 adult with Relapsing Remitting Multiple Sclerosis from Esfahan MS centre and 34 normal adults that matched in age, sex and education with patient group. When persons had entry criterion then was took speech sample about their biography. This sample was recorded and wrote. Then was gathered and compared data. Results: This study found significant difference between normal and patient groups in mean max leanghtsntence(Pvalue = 0/043) and number total sentence (Pvalue =0/001). There was no significant difference between two groups in mean leanght sentence and simple sentence ratio and compound sentence ratio. Conclusion: however patients in this study suffered to mild degree Multiple sclerosis (EDSS mean = 1/35) but they had differences in some of syntactic skills. Conclusion:This findings conform need to assessment language skills of this patients and intervention this problems

Effects of Adjunct Low-Dose Vitamin D on Relapsing-Remitting Multiple Sclerosis Progression: Preliminary Findings of a Randomized Placebo-Controlled Trial

The aim of this preliminary study was to evaluate the effect of low-dose oral vitamin D in combination with current disease-modifying therapy on the prevention of progression of relapsing-remitting multiple sclerosis (RRMS). A phase II double-blind placebo-controlled randomized clinical trial conducted between October 2007 and October 2008 included 50 patients with confirmed RRMS aged 25 to 57 years and normal serum 25-hydroxyvitamin D. They were randomly allocated to receive 12 months of treatment with either escalating calcitriol doses up to 0.5 μg/day or placebo combined with disease-modifying therapy. Response to treatment was assessed at eight-week intervals. In both groups, the mean relapse rate decreased significantly (P < 0.001). In the 25 patients treated with placebo, the mean (SD) Expanded Disability Status Scale (EDSS) increased from 1.70 (1.21) at baseline to 1.94 (1.41) at the end of study period (P < 0.01). Average EDSS and relapse rate at the end of trial did not differ between groups. Adding low-dose vitamin D to routine disease-modifying therapy had no significant effect on the EDSS score or relapse rate. A larger phase III multicenter study of vitamin D in RRMS is warranted to more assess the efficacy of this intervention

Obecność przeciwciał przeciw Chlamydia pneumoniae wśród irańskich chorych na stwardnienie rozsiane: badanie pilotażowe

Background and purpose Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system. Genetic and environmental factors could not completely explain the pathogenesis of the disease. Among environmental factors, infectious agents are of more interest than other candidates, so Chlamydia pneumoniae (C. pneumoniae) may have a role in MS development or progression. This study aimed to evaluate C. pneumoniae seropositivity in MS patients. Material and methods Serum samples obtained from a cohort of 85 patients with MS and from 50 age- and sex-matched controls were assessed for the presence of antibodies. IgM and IgG concentration for C. pneumoniae were determined with enzyme-linked immunosorbent assay (ELISA). Results The mean age was 33.8 (9.96) years in the MS group and 33.9 (10.7) years in controls. Female/male ratio was 3.5 : 1 in the MS group; 69 patients (81%) had relapsing-remitting course (RRMS) and 16 patients (19%) had secondary progressive course (SPMS). The median concentration of C. pneumoniae IgM in the MS group was 0.5 RU/mL (0.25–1) versus 0.5 RU/mL (0.3–0.8) in the control group (p = 0.66); likewise, the median concentration of C. pneumoniae IgG in MS patients was 57.3 RU/mL (17.05–95.1) compared with 56.15 RU/mL (6.85–102.5) in the control group (p = 0.85). Regarding the clinical course, C. pneumoniae IgG was 55.1 RU/mL (20.7–88.6) in RRMS and 59.1 RU/mL (5.35–112) in SPMS (p = 0.8). Conclusion No association was observed between MS and C. pneumoniae in Iranian MS patients.Wstęp i cel pracy Stwardnienie rozsiane (SR) jest przewlekłą zapalną chorobą autoimmunologiczną ośrodkowego układu nerwowego. Czynniki genetyczne i środowiskowe nie tłumaczą w pełni patogenezy choroby. Wśród czynników środowiskowych szczególne zainteresowanie budzą drobnoustroje powodujące zakażenia. Chlamydia pneumoniae (C. pneumoniae) mogłaby odgrywać rolę w powstawaniu lub postępie SR. Celem badania była ocena obecności przeciwciał przeciwko C. pneumoniae w surowicy chorych na SR. Materiał i metody Od 85 chorych na SR i od 50 osób z grupy kontrolnej, dobranych pod względem wieku i płci, pobrano krew i za pomocą testów immunoenzymatycznych (ELISA) zbadano stężenia IgM i IgG przeciwko C. pneumoniae w surowicy. Wyniki Średnia wieku wyniosła 33,8 (9,96) roku w grupie chorych na SR i 33,9 (10,7) roku w grupie kontrolnej. W grupie chorych na SR proporcja kobiet do mężczyzn wyniosła 3,5 : 1. U 69 pacjentów (81%) choroba miała przebieg nawracająco-zwalniający, a u 16 pacjentów (19%) – wtórnie postępujący. Mediana stężenia IgM przeciwko C. pneumoniae wyniosła 0,5 RU/ml (0,25–1) w grupie chorych na SR w porównaniu z 0,5 RU/ml (0,3–0,8) w grupie kontrolnej (p = 0,66). Mediana stężenia IgG przeciwko C. pneumoniae wyniosła 57,3 RU/ml (17,05–95,1) w grupie chorych na SR w porównaniu z 56,15 RU/ml (6,85–102,5) w grupie kontrolnej (p = 0,85). Mediana stężenia IgG przeciwko C. pneumoniae wśród chorych na nawracająco-zwalniające SR wyniosła 55,1 RU/ml (20,7–88,6), a w grupie chorych z postacią wtórnie postępującą choroby − 59,1 RU/ml (5,35–112) (p = 0,8). Wnioski Wśród irańskich chorych na SR nie stwierdzono związku między SR a występowaniem przeciwciał przeciwko C. pneumoniae

A Case of Wolfram Syndrome

Purpose: To report a case of Wolfram syndrome characterized by early onset diabetes mellitus and progressive optic atrophy. Case Report: A 20-year-old male patient with diabetes mellitus type I presented with best corrected visual acuity of 1/10 in both eyes with correction of -0.25+1.50@55 and -0.25+1.50@131 in his right and left eyes, respectively. Bilateral optic atrophy was evident on fundus examination. The patient also had diabetes insipidus, neurosensory deafness, neurogenic bladder, polyuria and extra-residual voiding indicating atony of the urinary tract, combined with delayed sexual maturity. Conclusion: One should consider Wolfram syndrome in patients with juvenile onset diabetes mellitus and hearing loss. Ophthalmological examination may disclose optic atrophy; urologic examinations are vital in such patients

Quantifying environmental risk factors for multiple sclerosis in discordant monozygotic twins: a case report

Relative contribution of genetic and environmental risk factors in complex disorders is widely explored through discordant identical twins. Multiple sclerosis is a demyelinating disease of the central nervous system in which the interplay of genetic and environmental risk factors define the disease pathogenicity. Robust epidemiological studies in different populations suggested that active levels of serum vitamin D and viral load implicate in MS pathogenicity and severity. In order to refine non-shared components of susceptibility factors in MS, we investigated the role of serum 25-hydroxyvitamin D and viral infection in a pair of identical twins remained discordant for MS during the course of 5 years follow up. Here we report serological finding regarding the viral load and serum 25-hydroxyvitamin D level in a pair of discordant monozygotic twins. Based on our observation, lower levels of serum 25-hydroxyvitamin D and higher anti-viral IgG titre was consistent with the disease statues in the affected sib

Diagnosis of multiple sclerosis by detecting asymmetry within the retina using a similarity-based neural network

Multiple sclerosis (MS) is a chronic neurological disorder that targets the central nervous system, causing demyelination and neural disruption, which can include retinal nerve damage leading to visual disturbances. The purpose of this study is to demonstrate the capability to automatically diagnose MS by detecting asymmetry within the retina, using a similarity-based neural network, trained on optical coherence tomography images. This work aims to investigate the feasibility of a learning-based system accurately detecting the presence of MS, based on information from pairs of left and right retina images. We also justify the effectiveness of a Siamese Neural Network for our task and present its strengths through experimental evaluation of the approach. We train a Siamese neural network to detect MS and assess its performance using a test dataset from the same distribution as well as an out-of-distribution dataset, which simulates an external dataset captured under different environmental conditions. Our experimental results demonstrate that a Siamese neural network can attain accuracy levels of up to 0.932 using both an in-distribution test dataset and a simulated external dataset. Our model can detect MS more accurately than standard neural network architectures, demonstrating its feasibility in medical applications for the early, cost-effective detection of MS

Discrimination of multiple sclerosis using scanning laser ophthalmoscopy images with autoencoder-based feature extraction

Optical coherence tomography (OCT) investigations have revealed that the thickness of inner retinal layers becomes decreased in multiple sclerosis (MS) patients, compared to healthy control (HC) individuals. To date, a number of studies have applied machine learning to OCT thickness measurements, aiming to enable accurate and automated diagnosis of the disease. However, there have much less emphasis on other less common retinal imaging modalities, like infrared scanning laser ophthalmoscopy (IR-SLO), for classifying MS. IR-SLO uses laser light to capture high-resolution fundus images, often performed in conjunction with OCT to lock B-scans at a fixed position. We incorporated two independent datasets of IR-SLO images from the Isfahan and Johns Hopkins centers, consisting of 164 MS and 150 HC images. A subject-wise data splitting approach was employed to ensure that there was no leakage between training and test datasets. Several state-of-the-art convolutional neural networks (CNNs), including VGG-16, VGG-19, ResNet-50, and InceptionV3, and a CNN with a custom architecture were employed. In the next step, we designed a convolutional autoencoder (CAE) to extract semantic features subsequently given as inputs to four conventional ML classifiers, including support vector machine (SVM), k-nearest neighbor (K-NN), random forest (RF), and multi-layer perceptron (MLP). The custom CNN (85 % accuracy, 85 % sensitivity, 87 % specificity, 93 % area under the receiver operating characteristics [AUROC], and 94 % area under the precision-recall curve [AUPRC]) outperformed state-of-the-art models (84 % accuracy, 83 % sensitivity, 87 % specificity, 92 % AUROC, and 94 % AUPRC); however, utilizing a combination of the CAE and MLP yields even superior results (88 % accuracy, 86 % sensitivity, 91 % specificity, 94 % AUROC, and 95 % AUPRC). We utilized IR-SLO images to differentiate between MS and HC eyes, with promising results achieved using a combination of CAE and MLP. Future multi-center studies involving more heterogenous data are necessary to assess the feasibility of integrating IR-SLO images into routine clinical practice. [Abstract copyright: Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.

Correlation of Midkine Serum Level with Pro- and Anti-Inflamatory Cytokines in Multiple Sclerosis

Background: Midkine (MK) is a heparin-binding growth factor with promoting effects in inflammatory responses through enhancing leukocytes migration. Objective: To study the correlation between MK serum levels and concentration of inflammatory cytokines in Multiple Sclerosis (MS) patients. Methods: We evaluated the MK level and its relationship with inflammatory cytokines (IL-17 and IL-23) and anti-inflammatory ones (IL-10 and TGF-beta) in multiple sclerosis (MS) patients. The serum concentrations of MK and cytokines were assessed by ELISA in 32 MS patients in comparison with 32 healthy subjects. Results: Our data showed that the MK concentration in MS patients is lower than healthy controls (341.15 +/- 40.71 Pg/ml vs. 620.15 +/- 98.61 Pg/ml, respectively, p= 0.015). We also observed a significant decrease in IL-10, IL-23, and TGF-beta cytokine levels in MS patients. There was a significant correlation between MK and IL-23 concentrations in our study (r = + 0.829, p <= 0.001). Conclusion: These results confirm a role for MK in inflammatory reactions in MS

Clinical and Epidemiological Aspects of Multiple Sclerosis in Children

How to Cite This Article: Nasehi MM, Sahraian MA, Naser Moghaddasi A, Ghofrani M, Ashtari F, Taghdiri MM, Tonekaboni SH, Karimzadeh P, Afshari M, Moosazadeh M. Clinical and Epidemiological Aspects of Multiple Sclerosis in Children. Iran J Child Neurol. Spring 2017; 11(2):37-43.AbstractObjectiveOverall, 2%-5% of patients with multiple sclerosis (MS) experienced the first episode of disease before the age 18 years old. Since the age of onset among children is not similar to that in general population, clinicians often fail to early diagnose the disease. This study aimed to determine the epidemiological and clinical patterns of MS among Iranian children.Materials &amp; Methods In this cross-sectional study carried out in Iran in 2014-2015, information was collected using a checklist with approved reliability and validity. Method sampling was consensus. Data were analyzed using frequency, mean and standard deviation indices by means of SPSS ver. 20 software.Results Totally, 177 MS children were investigated. 75.7% of them were female. Mean (SD), minimum and maximum age of subjects were 15.9 (2), 7 and 18 yr, respectively. The most reported symptoms were sensory (28.2%), motor (29.4%), diplopia (20.3%) and visual (32.8%). Primary MRI results showed 91.5% and 53.1% periventricular and spinal cord lesions, respectively.Conclusion MS is significantly more common among women. The most common age of onset is during the second decades. Sensory and motor problems are the most symptoms, while, periventricular and spinal cord lesions are the most MRI results. References 1. Ascherio A, Munger K. Epidemiology of multiple sclerosis: from risk factors to prevention. Semin Neurol 2008; 28(1): 17-28.2. Abedidni M, Habibi Saravi R, Zarvani A, Farahmand M. Epidemiologic study of multiple sclerosis in Mazandaran,Iran, 2007. J Mazandaran Univ Med Sci 2008; 18(66): 82-6.3. Taghdiri MM, Gofrani M, Barzegar M, Moayyedi A, Tonekaboni H. The survey of 20 cases of multiple sclerosis in children in mofid hospital of Tehran. J Rehabil, 2001; 4(6-7):61-67.4. Benito-Leon J, Martinez P. Health-related quality of life in multiple sclerosis. Neurologia 2003; 18: 207-10.5. Nedjat S, Montazeri A, Mohammad K, Majdzadeh R, Nabavi N, Nedjat F, et al . Quality of Life in Multiple Sclerosis Compared to the Healthy Population in Tehran. Iran J Epidemiol 2006; 2 (3 and 4) :19-24.6. Marrie RA. Environmental risk factors in multiple sclerosis aetiology. Lancet Neurol 2004; 3(12):709-18.7. Milo R, Kahana E. Multiple sclerosis:geoepidemiology, genetics and the environment. Autoimmun Rev 2010; 9(5): A387-A394.8. Banwell B, Ghezzi A, Bar-Or A, Mikaeloff Y. Multiple sclerosis in children: clinical diagnosis, therapeutic strategies, and future directions. The Lancet Neurol, 2007;6(10):887-902.9. Ebers GC. Environmental factors and multiple sclerosis. The Lancet Neurol, 2008;7(3):268-277.10. Noseworthy JH, Lucchinetti C, Rodriguez M, Weinshenker BG. Multiple Sclerosis. N Engl J Med 2000; 343(13):938-52.11. Rudick RA, Cohen JA, Weinstock-Guttman B, Kinkel RP, Ransohoff RM. Management of multiple sclerosis. N Engl J Med 1997: 337(22): 1604-11.12. Greer JM, McCombe PA. Role of gender in multiple sclerosis: clinical effects and potential molecular mechanisms. J Neuroimmunol 2011;234(1-2): 7-18.13. Boiko A, Vorobeychik G, Paty D, Devonshire V, Sadovnick D. Early onset multiple sclerosis A longitudinal study. Neurology 2002; 59(7):1006-1010.14. . Ashtari F, Shaygannejad V, Heidari F, Akbari M. Prevalence of Familial Multiple Sclerosis in Isfahan, Iran. Journal of Isfahan Medical School, 2011;29(138.2):555- 561.15. Mazaheri S, Fazlian M, Hossein Zadeh A. Clinical and Epidemiological Features of Early and Adult Onset Multiple Sclerosis in Hamedan, Iran, 2004–2005. Yafteh 2008; 9 (4) :39-44.16. Saman-Nezhad B, Rezaee T, Bostani A, Najafi F, Aghaei A. Epidemiological Characteristics of Patients with Multiple Sclerosis in Kermanshah, Iran in 2012. J Mazand Univ Med Sci 2013; 23(104): 97-101 (In Persian).17. Renoux C, Vukusic S, Mikaeloff Y, Edan G. Natural history of multiple sclerosis with childhood onset. N Engl J Med 2007. 356(25): p. 2603-2613.18. Ness JM, Chabas D, Sadovnick AD, Pohl D, Banwell B, Weinstock-Guttman B. Clinical features of children and adolescents with multiple sclerosis. Neurology 2007; 68(16 suppl 2):S37-S45.19. Etemadifar M, Janghorbani M,Shaygannejad V, Ashtari F . Prevalence of multiple sclerosis in Isfahan. Iran. Neuroepidemiology 2006; 27(1):39-44 (In Persian).20. Saadatnia M, Etemadifar M, Maghzi AH. Multiple sclerosis in Isfahan, Iran. Int Rev Neurobiol 2007; 79: 357-75.21. Nabavi SM, Poorfarzam S, Ghassemi H. Clinical Course and prognosis of 203 patients with MS in shahid Mostafa Khomeini Hospital, Tehran 2002, Tehran University Medical Journal, 200l 64( 7)6: 90-97

Comparative Analysis of Apigenin-3 Acetate versus Apigenin and Methyl-Prednisolone in Inhibiting Proliferation and Gene Expression of Th1 Cells in Multiple Sclerosis

Objective: In spite of the advances in therapeutic modalities, morbidity, due to multiple sclerosis (MS), still remains high.Therefore, a large body of research is endeavouring to discover or develop novel therapies with improved efficacy fortreating MS patients. In the present study, we examined the immunomodulatory effects of apigenin (Api) on peripheralblood mononuclear cells (PBMCs) isolated from MS patients. We also developed an acetylated form of Api (apigenin-3-acetate) to improve In its blood-brain barrier (BBB) permeability. Additionally, we compared its anti-inflammatoryproperties to original Api and methyl-prednisolone-acetate (a standard therapy), as a potential option in treating MSpatients.Materials and Methods: The current study was an experimental-interventional research. The half maximal inhibitoryconcentration (IC50) values for apigenin-3-acetate, apigenin, and methyl-prednisolone-acetate were determined inhealthy volunteers’ PBMCs (n=3). Gene expressions of T-box transcription factor (TBX21 or T-bet) and IFN-γ, as wellas proliferation of T cells isolated from MS patients’ PBMCs (n=5), were examined in co-cultures of apigenin-3-acetate,Api and methyl-prednisolone-acetate after 48 hours of treatment, using quantitative reverse transcription polymerasechain reaction (qRT-PCR).Results: Our findings showed that apigenin-3-acetate, apigenin, and methyl-prednisolone-acetate at concentrations of80, 80, and 2.5 M could inhibit Th1 cell proliferation after 48 hours (P=0.001, P=0.036, and P=0.047, respectively); theyalso inhibited T-bet (P=0.015, P=0.019, and P=0.022) and interferon-γ (IFN-γ) gene expressions (P=0.0001).Conclusion: Our findings suggested that Api may have anti-inflammatory properties, possibly by inhibiting proliferationof IFN-producing Th1 cells. Moreover, comparative immunomodulatory effects were found for the acetylated version ofapigenin-3-acetate versus Api and methyl-prednisolone-acetate