Pub Date : 2023-10-09DOI: 10.18502/cjn.v22i3.13799
Amirhossein Azari Jafari, Seyyedmohammadsadeq Mirmoeeni, William Chase Johnson, Muffaqam Shah, Maryam Sadat Hassani, Shahrzad Nazari, Tristan Fielder, Ali Seifi
Aneurysmal subarachnoid hemorrhage (aSAH) accounts for 2-5% of all strokes, and 10%‐15% of aSAH patients will not survive until hospital admission. Induced hypertension (IH) is an emerging therapeutic option being used for the treatment of vasospasm in aSAH. For patients with cerebral vasospasm (CVS) consequent to SAH, IH is implemented to increase systolic blood pressure (SBP) in order to optimize cerebral blood flow (CBF) and prevent delayed cerebral ischemia (DCI). Prophylactic use of IH has been associated with the development of vasospasm and cerebral ischemia in SAH patients. Various trials have defined several different parameters to help clinicians decide when to initiate IH in a SAH patient. However, there is insufficient evidence to recommend therapeutic IH in aSAH due to the possible serious complications like myocardial ischemia, development of posterior reversible encephalopathy syndrome (PRES), pulmonary edema, and even rupture of another unsecured aneurysm. This narrative review showed the favorable impact of IH therapy on aSAH patients; however, it is crucial to conduct further clinical and molecular experiments to shed more light on the effects of IH in aSAH.
{"title":"The effect of induced hypertension in aneurysmal subarachnoid hemorrhage: A narrative review","authors":"Amirhossein Azari Jafari, Seyyedmohammadsadeq Mirmoeeni, William Chase Johnson, Muffaqam Shah, Maryam Sadat Hassani, Shahrzad Nazari, Tristan Fielder, Ali Seifi","doi":"10.18502/cjn.v22i3.13799","DOIUrl":"https://doi.org/10.18502/cjn.v22i3.13799","url":null,"abstract":"Aneurysmal subarachnoid hemorrhage (aSAH) accounts for 2-5% of all strokes, and 10%‐15% of aSAH patients will not survive until hospital admission. Induced hypertension (IH) is an emerging therapeutic option being used for the treatment of vasospasm in aSAH. For patients with cerebral vasospasm (CVS) consequent to SAH, IH is implemented to increase systolic blood pressure (SBP) in order to optimize cerebral blood flow (CBF) and prevent delayed cerebral ischemia (DCI). Prophylactic use of IH has been associated with the development of vasospasm and cerebral ischemia in SAH patients. Various trials have defined several different parameters to help clinicians decide when to initiate IH in a SAH patient. However, there is insufficient evidence to recommend therapeutic IH in aSAH due to the possible serious complications like myocardial ischemia, development of posterior reversible encephalopathy syndrome (PRES), pulmonary edema, and even rupture of another unsecured aneurysm. This narrative review showed the favorable impact of IH therapy on aSAH patients; however, it is crucial to conduct further clinical and molecular experiments to shed more light on the effects of IH in aSAH.
","PeriodicalId":40077,"journal":{"name":"Current Journal of Neurology","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Dysphagia can be a life-threatening issue for post-stroke patients, with aspiration pneumonia (AP) being a common risk. However, there is hope through the potential combination of transcranial direct current stimulation (tDCS) and classical behavior therapy. Our study aims to investigate the effectiveness of this combination in diminishing the risk of AP in patients with dysphagia who suffered from stroke.
Methods: In this randomized, parallel-group, blinded clinical trial, 48 patients were allocated into the sham group (speech therapy + 30 seconds of tDCS) and the real group (speech therapy + 20 minutes of tDCS). We used the Mann Assessment of Swallowing Ability (MASA) as an assessment tool. We assessed patients at baseline, one day after treatment, and at a one-month follow-up.
Results: Groups showed no significant difference at baseline. After treatment, the real group showed a significant difference in the severity risk of AP (P = 0.02); the same was for the follow-up (P = 0.04). The number of patients showing severe risk of AP was higher in the sham group after treatment (n = 13, 54.20%) and at follow-up (n = 4, 18.20%) than the real group (n = 4, 16.70%; n = 1, 4.50%, respectively). None of the patients reported the history of AP at any stage of assessment.
Conclusion: Although the results were more promising in the real group than the sham group in reducing the risk of AP, both techniques can prevent AP. Therefore, we recommend early dysphagia management to prevent AP regardless of the treatment protocol.
{"title":"The role of transcranial direct current stimulation in diminishing the risk of pneumonia in patients with dysphagia: A double-blinded randomized clinical trial","authors":"Sima Farpour, Majid Asadi-Shekaari, Afshin Borhani-Haghighi, Hamid Reza Farpour, Mahtab Rostamihosseinkhani","doi":"10.18502/cjn.v22i3.13793","DOIUrl":"https://doi.org/10.18502/cjn.v22i3.13793","url":null,"abstract":"Background: Dysphagia can be a life-threatening issue for post-stroke patients, with aspiration pneumonia (AP) being a common risk. However, there is hope through the potential combination of transcranial direct current stimulation (tDCS) and classical behavior therapy. Our study aims to investigate the effectiveness of this combination in diminishing the risk of AP in patients with dysphagia who suffered from stroke.
 Methods: In this randomized, parallel-group, blinded clinical trial, 48 patients were allocated into the sham group (speech therapy + 30 seconds of tDCS) and the real group (speech therapy + 20 minutes of tDCS). We used the Mann Assessment of Swallowing Ability (MASA) as an assessment tool. We assessed patients at baseline, one day after treatment, and at a one-month follow-up.
 Results: Groups showed no significant difference at baseline. After treatment, the real group showed a significant difference in the severity risk of AP (P = 0.02); the same was for the follow-up (P = 0.04). The number of patients showing severe risk of AP was higher in the sham group after treatment (n = 13, 54.20%) and at follow-up (n = 4, 18.20%) than the real group (n = 4, 16.70%; n = 1, 4.50%, respectively). None of the patients reported the history of AP at any stage of assessment.
 Conclusion: Although the results were more promising in the real group than the sham group in reducing the risk of AP, both techniques can prevent AP. Therefore, we recommend early dysphagia management to prevent AP regardless of the treatment protocol.","PeriodicalId":40077,"journal":{"name":"Current Journal of Neurology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.18502/cjn.v22i3.13797
Mohammad Amin Najafi, Alireza Zandifar, Mohsen Kheradmand, Luis Octavio Tierradentro-Garcia, Fariborz Khorvash, Arastoo Vossough, Mohammad Saadatnia
Background: Cerebrovascular diseases comprise a significant portion of neurological disorders related to coronavirus disease 2019 (COVID-19). We evaluated the clinical and imaging characteristics of a cohort of COVID-19 patients with stroke and also identified patients with watershed infarcts. Methods: In this cross-sectional study, seventy-three COVID-19 patients with ischemic stroke were included between October 2020 and January 2021. Patients were evaluated based on the following clinical and imaging features: severity of COVID-19 (critical/ non-critical), stroke type, presence/absence of clinical suspicion of stroke, medical risk factors, Fazekas scale, atherothrombosis, small vessel disease, cardiac pathology, other causes, and dissection (ASCOD) criteria classification, and presence or absence of watershed infarction. Clinical outcomes were assessed based on Modified Rankin Scale (MRS) and mortality. Results: Most cases of ischemic stroke were due to undetermined etiology (52.1%) and cardioembolism (32.9%). In terms of imaging pattern, 17 (23.0%) patients had watershed infarction. Watershed infarction was associated with the clinically non-suspicious category [odds ratio (OR) = 4.67, P = 0.007] and death after discharge (OR = 7.1, P = 0.003). Patients with watershed infarction had a higher odds of having high Fazekas score (OR = 5.17, P = 0.007) which was also shown by the logistic regression model (adjusted OR = 6.87, P = 0.030). Thirty-one (42%) patients were clinically non-suspected for ischemic stroke. Critical COVID-19 was more common among patients with watershed infarct and clinically non-suspicious patients (P = 0.020 and P = 0.005, respectively). Patients with chronic kidney disease (CKD) were more prone to having stroke with watershed pattern (P = 0.020). Conclusion: Watershed infarct is one of the most common patterns of ischemic stroke in patients with COVID-19, for which clinicians should maintain a high index of suspicion in patients with critical COVID-19 without obvious clinical symptoms of stroke.
背景:脑血管疾病是2019冠状病毒病(COVID-19)相关神经系统疾病的重要组成部分。我们评估了一组COVID-19卒中患者的临床和影像学特征，并确定了分水岭梗死患者。
方法:在这项横断面研究中，纳入了2020年10月至2021年1月期间的73例COVID-19缺血性卒中患者。根据以下临床和影像学特征对患者进行评估:COVID-19严重程度(危重/非危重)、卒中类型、临床是否怀疑卒中、医疗危险因素、Fazekas评分、动脉粥样硬化血栓形成、小血管疾病、心脏病理、其他原因、夹层(ASCOD)标准分类、是否存在分水岭梗死。临床结果根据修正兰金量表(MRS)和死亡率进行评估。结果:缺血性脑卒中以病因不明(52.1%)和心脏栓塞(32.9%)为主。影像学表现为分水岭梗死17例(23.0%)。分水岭梗死与临床非可疑类别相关[比值比(OR) = 4.67, P = 0.007]和出院后死亡相关(OR = 7.1, P = 0.003)。分水岭梗死患者Fazekas评分高的几率更高(OR = 5.17, P = 0.007)， logistic回归模型也显示了这一点(调整后OR = 6.87, P = 0.030)。31例(42%)患者临床未怀疑为缺血性脑卒中。危重型COVID-19在分水岭梗死患者和临床无可疑患者中更为常见(P = 0.020和P = 0.005)。慢性肾脏疾病(CKD)患者更容易发生卒中，具有分水岭型(P = 0.020)。
结论:分水岭梗死是COVID-19患者缺血性脑卒中最常见的模式之一，对无明显脑卒中临床症状的危重型COVID-19患者应保持高度的怀疑指数。
{"title":"Watershed infarction in COVID-19: The necessity of neuroimaging in patients with subtle neurological symptoms","authors":"Mohammad Amin Najafi, Alireza Zandifar, Mohsen Kheradmand, Luis Octavio Tierradentro-Garcia, Fariborz Khorvash, Arastoo Vossough, Mohammad Saadatnia","doi":"10.18502/cjn.v22i3.13797","DOIUrl":"https://doi.org/10.18502/cjn.v22i3.13797","url":null,"abstract":"Background: Cerebrovascular diseases comprise a significant portion of neurological disorders related to coronavirus disease 2019 (COVID-19). We evaluated the clinical and imaging characteristics of a cohort of COVID-19 patients with stroke and also identified patients with watershed infarcts. Methods: In this cross-sectional study, seventy-three COVID-19 patients with ischemic stroke were included between October 2020 and January 2021. Patients were evaluated based on the following clinical and imaging features: severity of COVID-19 (critical/ non-critical), stroke type, presence/absence of clinical suspicion of stroke, medical risk factors, Fazekas scale, atherothrombosis, small vessel disease, cardiac pathology, other causes, and dissection (ASCOD) criteria classification, and presence or absence of watershed infarction. Clinical outcomes were assessed based on Modified Rankin Scale (MRS) and mortality. Results: Most cases of ischemic stroke were due to undetermined etiology (52.1%) and cardioembolism (32.9%). In terms of imaging pattern, 17 (23.0%) patients had watershed infarction. Watershed infarction was associated with the clinically non-suspicious category [odds ratio (OR) = 4.67, P = 0.007] and death after discharge (OR = 7.1, P = 0.003). Patients with watershed infarction had a higher odds of having high Fazekas score (OR = 5.17, P = 0.007) which was also shown by the logistic regression model (adjusted OR = 6.87, P = 0.030). Thirty-one (42%) patients were clinically non-suspected for ischemic stroke. Critical COVID-19 was more common among patients with watershed infarct and clinically non-suspicious patients (P = 0.020 and P = 0.005, respectively). Patients with chronic kidney disease (CKD) were more prone to having stroke with watershed pattern (P = 0.020). Conclusion: Watershed infarct is one of the most common patterns of ischemic stroke in patients with COVID-19, for which clinicians should maintain a high index of suspicion in patients with critical COVID-19 without obvious clinical symptoms of stroke.","PeriodicalId":40077,"journal":{"name":"Current Journal of Neurology","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135147044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.18502/cjn.v22i3.13796
Soroor Advani, Seyyed Mohammad Mahdi Hosseini, Rama Bozorgmehr, Arash Khameneh-Bagheri, Sevda Mohammadzadeh, Taha Hasanzadeh, Laya Jalilian, Mohammad Vahidi, Amir Hasan Nofeli, Zahra Hooshyari
Background: Coronavirus disease 2019 (COVID-19) is a multisystem disease, manifested by several symptoms of various degrees. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) can affect the central nervous system (CNS) through several mechanisms and brain imaging plays an essential role in the diagnosis and evaluation of the neurological involvement of COVID-19. Moreover, brain imaging of patients with COVID-19 would result in a better understanding of SARS-CoV-2 neuro-pathophysiology. In this study, we evaluated the brain imaging findings of patients with COVID-19 in Shohada-e Tajrish Hospital, Tehran, Iran.
Methods: This was a single-center, retrospective, and observational study. The hospital records and chest and brain computed tomography (CT) scans of patients with confirmed COVID-19 were reviewed.
Results: 161 patients were included in this study (39.1% women, mean age: 60.84). Thirteen patients (8%) had ischemic strokes identified by brain CT. Subdural hematoma, subdural effusion, and subarachnoid hemorrhage were confirmed in three patients. Furthermore, there were four cases of intracranial hemorrhage (ICH) and intraventricular hemorrhage (IVH). Patients with and without abnormal brain CTs had similar average ages. The rate of brain CT abnormalities in both genders did not differ significantly. Moreover, abnormal brain CT was not associated with increased death rate. There was no significant difference in lung involvement (according to lung CT scan) between the two groups.
Conclusion: Our experience revealed a wide range of imaging findings in patients with COVID-19 and these findings were not associated with a more severe lung involvement or increased rate of mortality.
{"title":"Abnormalities of brain imaging in COVID-19 patients with neurological symptoms","authors":"Soroor Advani, Seyyed Mohammad Mahdi Hosseini, Rama Bozorgmehr, Arash Khameneh-Bagheri, Sevda Mohammadzadeh, Taha Hasanzadeh, Laya Jalilian, Mohammad Vahidi, Amir Hasan Nofeli, Zahra Hooshyari","doi":"10.18502/cjn.v22i3.13796","DOIUrl":"https://doi.org/10.18502/cjn.v22i3.13796","url":null,"abstract":"Background: Coronavirus disease 2019 (COVID-19) is a multisystem disease, manifested by several symptoms of various degrees. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) can affect the central nervous system (CNS) through several mechanisms and brain imaging plays an essential role in the diagnosis and evaluation of the neurological involvement of COVID-19. Moreover, brain imaging of patients with COVID-19 would result in a better understanding of SARS-CoV-2 neuro-pathophysiology. In this study, we evaluated the brain imaging findings of patients with COVID-19 in Shohada-e Tajrish Hospital, Tehran, Iran.
 Methods: This was a single-center, retrospective, and observational study. The hospital records and chest and brain computed tomography (CT) scans of patients with confirmed COVID-19 were reviewed.
 Results: 161 patients were included in this study (39.1% women, mean age: 60.84). Thirteen patients (8%) had ischemic strokes identified by brain CT. Subdural hematoma, subdural effusion, and subarachnoid hemorrhage were confirmed in three patients. Furthermore, there were four cases of intracranial hemorrhage (ICH) and intraventricular hemorrhage (IVH). Patients with and without abnormal brain CTs had similar average ages. The rate of brain CT abnormalities in both genders did not differ significantly. Moreover, abnormal brain CT was not associated with increased death rate. There was no significant difference in lung involvement (according to lung CT scan) between the two groups.
 Conclusion: Our experience revealed a wide range of imaging findings in patients with COVID-19 and these findings were not associated with a more severe lung involvement or increased rate of mortality.","PeriodicalId":40077,"journal":{"name":"Current Journal of Neurology","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.18502/cjn.v22i3.13801
Bardiya Ghaderi-Yazdi, Hajir Sikaroodi
The Article Abstract is not available.
文章摘要不可用。
{"title":"Characteristic brain computed tomography of infective endocarditis after thrombolysis for ischemic stroke: A clinical note","authors":"Bardiya Ghaderi-Yazdi, Hajir Sikaroodi","doi":"10.18502/cjn.v22i3.13801","DOIUrl":"https://doi.org/10.18502/cjn.v22i3.13801","url":null,"abstract":"The Article Abstract is not available.","PeriodicalId":40077,"journal":{"name":"Current Journal of Neurology","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.18502/cjn.v22i3.13802
Shyma Markose, Shriram Varadharajan, Haritha Vasudevan, Virna M. Shah
The Article Abstract is not available.
文章摘要不可用。
{"title":"Stealthily growing large sinonasal lymphoma with intracranial extension","authors":"Shyma Markose, Shriram Varadharajan, Haritha Vasudevan, Virna M. Shah","doi":"10.18502/cjn.v22i3.13802","DOIUrl":"https://doi.org/10.18502/cjn.v22i3.13802","url":null,"abstract":"The Article Abstract is not available.","PeriodicalId":40077,"journal":{"name":"Current Journal of Neurology","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135147041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.18502/cjn.v22i3.13798
Ayfer Ertekin
Background: The Martin-Gruber anastomosis (MGA) represents a nerve innervation anomaly in the upper extremity, potentially leading to misinterpretation during standard nerve conduction studies (NCSs). This study aims to characterize the electrophysiological attributes of MGA in both healthy subjects and individuals diagnosed with carpal tunnel syndrome (CTS).
Methods: This case-control study involved the electrophysiological assessment of 506 forearms, segregated into two distinct groups: a CTS positive (+) case group and a CTS negative (-) control group. The evaluations were conducted over an average period of 8 months in the neurophysiology laboratory. The study encompassed 294 forearms from 147 healthy individuals without CTS and 212 forearms from 106 patients diagnosed with CTS, both clinically and electrodiagnostically.
Results: The relationship between the presence of type I MGA and the CTS (+) group was statistically significant (P = 0.002). Similarly, the relationship between the presence of type II MGA and the CTS (+) group was statistically significant (P = 0.013). On the other hand, the relationship between the presence of type III MGA and the CTS (+) group was not statistically significant (P = 0.208). Likewise, the relationship between the presence of type IV MGA and the CTS (+) group was not statistically significant (P = 0.807). The correlation between the side of type I MGA and the groups did not reach statistical significance (P = 0.770).
The relationship between the side of type II MGA and the groups also did not attain statistical significance (P = 0.990). Similarly, the side of type III MGA and its association with the groups did not yield statistical significance (P = 0.402). Finally, the relationship between the side of type IV MGA and the groups was not statistically significant (P = 0.166).
Conclusion: The MGA represents a relatively frequent anatomical variation observed in the upper extremity. Notably, its presence demonstrated significance in the first dorsal interosseous (FDI) muscle (type II) and the abductor digiti minimi (ADM) muscle (type I) among patients with CTS. The present study emphasizes the importance of recognizing this variation during upper extremity NCSs for a correct diagnostic approach and treatment plan to avoid misdiagnosis of median-ulnar peripheral neuropathy.
{"title":"An assessment of Martin-Gruber anastomosis discrepancies between healthy individuals and patients with carpal tunnel syndrome in motor nerve conduction studies","authors":"Ayfer Ertekin","doi":"10.18502/cjn.v22i3.13798","DOIUrl":"https://doi.org/10.18502/cjn.v22i3.13798","url":null,"abstract":"Background: The Martin-Gruber anastomosis (MGA) represents a nerve innervation anomaly in the upper extremity, potentially leading to misinterpretation during standard nerve conduction studies (NCSs). This study aims to characterize the electrophysiological attributes of MGA in both healthy subjects and individuals diagnosed with carpal tunnel syndrome (CTS).
 Methods: This case-control study involved the electrophysiological assessment of 506 forearms, segregated into two distinct groups: a CTS positive (+) case group and a CTS negative (-) control group. The evaluations were conducted over an average period of 8 months in the neurophysiology laboratory. The study encompassed 294 forearms from 147 healthy individuals without CTS and 212 forearms from 106 patients diagnosed with CTS, both clinically and electrodiagnostically.
 Results: The relationship between the presence of type I MGA and the CTS (+) group was statistically significant (P = 0.002). Similarly, the relationship between the presence of type II MGA and the CTS (+) group was statistically significant (P = 0.013). On the other hand, the relationship between the presence of type III MGA and the CTS (+) group was not statistically significant (P = 0.208). Likewise, the relationship between the presence of type IV MGA and the CTS (+) group was not statistically significant (P = 0.807). The correlation between the side of type I MGA and the groups did not reach statistical significance (P = 0.770).
 The relationship between the side of type II MGA and the groups also did not attain statistical significance (P = 0.990). Similarly, the side of type III MGA and its association with the groups did not yield statistical significance (P = 0.402). Finally, the relationship between the side of type IV MGA and the groups was not statistically significant (P = 0.166).
 Conclusion: The MGA represents a relatively frequent anatomical variation observed in the upper extremity. Notably, its presence demonstrated significance in the first dorsal interosseous (FDI) muscle (type II) and the abductor digiti minimi (ADM) muscle (type I) among patients with CTS. The present study emphasizes the importance of recognizing this variation during upper extremity NCSs for a correct diagnostic approach and treatment plan to avoid misdiagnosis of median-ulnar peripheral neuropathy.","PeriodicalId":40077,"journal":{"name":"Current Journal of Neurology","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135147193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Recent research shows that most of the patients with multiple sclerosis (MS) have cognitive-like disorders. Due to the beneficial effects of atomoxetine on improving cognition in limited animal and human surveys, the aim of the present study was to investigate the effect of the atomoxetine on improving cognitive disorders of MS.
Methods: This study was a parallel, randomized clinical trial, designed to investigate the effect of atomoxetine drug on the improvement of cognitive impairment (CI) in MS, from April 2021 to March 2022. According to the inclusion and exclusion criteria, a total of 52 participants were involved in the study and then randomly divided in two groups of 26. Experimental group was treated with atomoxetine and the control group was treated with placebo. The Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) test was performed for assessment at the beginning and after 3 months. The California Verbal Learning Test (CVLT), the CVLT-delay, the Brief Visuospatial Memory Test-Revised (BVMT-R), and the Symbol Digit Modalities Test (SDMT) were used to evaluate the CI and changes following medication. Finally, data were analyzed by SPSS software at significance level of 0.05.
Results: The mean age of patients in the experimental group was 37.7 ± 8.5 and in the placebo group was 37.8 ± 7.6 (P = 0.32). The results showed significant changes in cognitive levels before and after the use of atomoxetine and also in comparison to the placebo group (P < 0.05).
Conclusion: This study showed that atomoxetine improved the cognitive domains after administration compared to placebo.
{"title":"The effect of atomoxetine on cognitive function in patients with multiple sclerosis","authors":"Ehsan Mohammadian Nejad, Effat Amouzadeh, Davood Kashipazha, Gholamreza Shamsaei, Bahman Cheraghian","doi":"10.18502/cjn.v22i3.13792","DOIUrl":"https://doi.org/10.18502/cjn.v22i3.13792","url":null,"abstract":"Background: Recent research shows that most of the patients with multiple sclerosis (MS) have cognitive-like disorders. Due to the beneficial effects of atomoxetine on improving cognition in limited animal and human surveys, the aim of the present study was to investigate the effect of the atomoxetine on improving cognitive disorders of MS.
 Methods: This study was a parallel, randomized clinical trial, designed to investigate the effect of atomoxetine drug on the improvement of cognitive impairment (CI) in MS, from April 2021 to March 2022. According to the inclusion and exclusion criteria, a total of 52 participants were involved in the study and then randomly divided in two groups of 26. Experimental group was treated with atomoxetine and the control group was treated with placebo. The Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) test was performed for assessment at the beginning and after 3 months. The California Verbal Learning Test (CVLT), the CVLT-delay, the Brief Visuospatial Memory Test-Revised (BVMT-R), and the Symbol Digit Modalities Test (SDMT) were used to evaluate the CI and changes following medication. Finally, data were analyzed by SPSS software at significance level of 0.05.
 Results: The mean age of patients in the experimental group was 37.7 ± 8.5 and in the placebo group was 37.8 ± 7.6 (P = 0.32). The results showed significant changes in cognitive levels before and after the use of atomoxetine and also in comparison to the placebo group (P < 0.05).
 Conclusion: This study showed that atomoxetine improved the cognitive domains after administration compared to placebo.","PeriodicalId":40077,"journal":{"name":"Current Journal of Neurology","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135250876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-08DOI: 10.18502/cjn.v22i3.13791
Mai Elrayes, Abdullah AlSalti
Background: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an immune-mediated condition with variable clinical characteristics and different treatment modalities. We aim to present different clinical and demographic features of all patients with CIDP presented to the neuromuscular clinic within four years and their follow-up results.
Methods: A retrospective study from a hospital database of 23 patients met the European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) diagnostic criteria for CIPD. Complete demographic and clinical data were collected. Progress and outcome were assessed using two clinical score systems at regular intervals at 6, 12, and 18 months.
Results: Mean age of patients was 43.4 ± 20.9 years (male-to-female ratio was 1.6:1). Age of onset was 39.7 ± 18.0 years. At the presentation, the Medical Research Council sum score (MRCss) was 50 (39.7-51.3), and the modified Rankin Scale (mRS) was 3 (2.2-3.4). There was a significant improvement in MRCss during four periods (P < 0.001). Multiple comparisons revealed a significant difference in MRCss between the baseline and 12 and 18 months but no significant change between the baseline and 6 months. Likewise, mRS showed a significant improvement between the baseline and 18 months (no significant change between the baseline and 6 months or 12 months).
Conclusion: The clinical characteristics of CIDP in our cohort were similar to other reported studies, and most of the studied patients had good outcomes. Our results could be utilized as baseline data for a better understanding of the characteristics of CIDP in Oman and, consequently, for better management of the disease.
{"title":"Prognosis and outcome in patients with chronic inflammatory demyelinating polyradiculoneuropathy in a tertiary center in Oman","authors":"Mai Elrayes, Abdullah AlSalti","doi":"10.18502/cjn.v22i3.13791","DOIUrl":"https://doi.org/10.18502/cjn.v22i3.13791","url":null,"abstract":"Background: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an immune-mediated condition with variable clinical characteristics and different treatment modalities. We aim to present different clinical and demographic features of all patients with CIDP presented to the neuromuscular clinic within four years and their follow-up results.
 Methods: A retrospective study from a hospital database of 23 patients met the European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) diagnostic criteria for CIPD. Complete demographic and clinical data were collected. Progress and outcome were assessed using two clinical score systems at regular intervals at 6, 12, and 18 months.
 Results: Mean age of patients was 43.4 ± 20.9 years (male-to-female ratio was 1.6:1). Age of onset was 39.7 ± 18.0 years. At the presentation, the Medical Research Council sum score (MRCss) was 50 (39.7-51.3), and the modified Rankin Scale (mRS) was 3 (2.2-3.4). There was a significant improvement in MRCss during four periods (P < 0.001). Multiple comparisons revealed a significant difference in MRCss between the baseline and 12 and 18 months but no significant change between the baseline and 6 months. Likewise, mRS showed a significant improvement between the baseline and 18 months (no significant change between the baseline and 6 months or 12 months).
 Conclusion: The clinical characteristics of CIDP in our cohort were similar to other reported studies, and most of the studied patients had good outcomes. Our results could be utilized as baseline data for a better understanding of the characteristics of CIDP in Oman and, consequently, for better management of the disease.","PeriodicalId":40077,"journal":{"name":"Current Journal of Neurology","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135250870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：