Hussein Ziab, Rami Mazbouh, Soha Saleh, S. Talebian, A. Rifai Sarraj, M. Hadian
Context: Cerebral palsy (CP) results from damage to the central nervous system, leading to disturbances of motor and sensory functions, especially the balance. Virtual reality exercise intervention (VRI) is a promising technique to improve motor function in children with CP by engaging such individuals in real-like world events through simulations. This review study examines the effects of VRI on static and functional balances and summarizes the effective protocols of virtual reality-based rehabilitation interventions for the CP patients. Methods: A comprehensive search was performed using the following databases: Medline/PubMed, Scopus, Cochrane Library, PEDro, EBSCOhost, and the Online Library of the University of London. The PEDro scale was used to assess the methodological quality. The data extracted from the reviewed studies were coded according to Cooper and Hedges’ guidelines considering the following criteria: (I) Patients' characteristics, (II) intervention protocols, (III) outcomes, and (IV) results. To this end, twelve RCTs with 248 patients aged 4 - 20 years old were analyzed and assessed as "fair" to "good" methodological quality according to Pedro’s scale (4 to 8). VRI alone or in combination with a standard physiotherapy program or with other tools such as tDCS was applied. Results: Twelve RCTs met the inclusion criteria. The meta-analysis showed the good effect of VRI on the static and functional balances of patients with CP (Cohen’s d = 0.66). The funnel plot revealed no significant asymmetry or heterogeneity among the studies (P = 0.271, I2 = 19.71%), reflecting the absence of publication biases. Conclusions: This review reports four major perspectives of the VRI applications: (1) VRI settings, (2) selection of exercises, (3) outcome measures, and (4) long-term effects. Moreover, this review summarizes the specific effects of VRI on balance improvement in patients with CP from different perspectives. However, considering the limited number of well-conducted RCTs in this field, a large homogeneous samples size is still needed for future RCTs.
{"title":"Efficacy of Virtual Reality-Based Rehabilitation Interventions to Improve Balance Function in Patients with Cerebral Palsy: A Systematic Review and Meta-analysis of RCTs","authors":"Hussein Ziab, Rami Mazbouh, Soha Saleh, S. Talebian, A. Rifai Sarraj, M. Hadian","doi":"10.5812/ans-122865","DOIUrl":"https://doi.org/10.5812/ans-122865","url":null,"abstract":"Context: Cerebral palsy (CP) results from damage to the central nervous system, leading to disturbances of motor and sensory functions, especially the balance. Virtual reality exercise intervention (VRI) is a promising technique to improve motor function in children with CP by engaging such individuals in real-like world events through simulations. This review study examines the effects of VRI on static and functional balances and summarizes the effective protocols of virtual reality-based rehabilitation interventions for the CP patients. Methods: A comprehensive search was performed using the following databases: Medline/PubMed, Scopus, Cochrane Library, PEDro, EBSCOhost, and the Online Library of the University of London. The PEDro scale was used to assess the methodological quality. The data extracted from the reviewed studies were coded according to Cooper and Hedges’ guidelines considering the following criteria: (I) Patients' characteristics, (II) intervention protocols, (III) outcomes, and (IV) results. To this end, twelve RCTs with 248 patients aged 4 - 20 years old were analyzed and assessed as \"fair\" to \"good\" methodological quality according to Pedro’s scale (4 to 8). VRI alone or in combination with a standard physiotherapy program or with other tools such as tDCS was applied. Results: Twelve RCTs met the inclusion criteria. The meta-analysis showed the good effect of VRI on the static and functional balances of patients with CP (Cohen’s d = 0.66). The funnel plot revealed no significant asymmetry or heterogeneity among the studies (P = 0.271, I2 = 19.71%), reflecting the absence of publication biases. Conclusions: This review reports four major perspectives of the VRI applications: (1) VRI settings, (2) selection of exercises, (3) outcome measures, and (4) long-term effects. Moreover, this review summarizes the specific effects of VRI on balance improvement in patients with CP from different perspectives. However, considering the limited number of well-conducted RCTs in this field, a large homogeneous samples size is still needed for future RCTs.","PeriodicalId":43970,"journal":{"name":"Archives of Neuroscience","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46621686","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}
: Finding neural correlates underlying deception may have implementations in judicial, security, and financial settings. Telling a successful lie may activate different brain regions associated with risk evaluation, subsequent reward/punishment possibility, decision-making, and theory of mind (ToM). Many other protocols have been developed to study individuals who proceed with deception under instructed laboratory conditions. However, no protocol has practiced lying in a real-life environment. We performed a functional MRI using a 3Tesla machine on 31 healthy individuals to detect the participants who successfully lie in a previously-designed game to earn or lose the monetary reward. The results revealed that lying results in an augmented activity in the right dorsolateral and right dorsomedial prefrontal cortices, the right inferior parietal lobule, bilateral inferior frontal gyri, and right anterior cingulate cortex. The findings would contribute to forensic practices regarding the detection of a deliberate lie. They may also have implications for guilt detection, social cognition, and the societal notions of responsibility.
{"title":"Brain Regions Activity During a Deceitful Monetary Game: An fMRI Study","authors":"Haady Ahmadzade, S. A. Batouli, M. Oghabian","doi":"10.5812/ans-122202","DOIUrl":"https://doi.org/10.5812/ans-122202","url":null,"abstract":": Finding neural correlates underlying deception may have implementations in judicial, security, and financial settings. Telling a successful lie may activate different brain regions associated with risk evaluation, subsequent reward/punishment possibility, decision-making, and theory of mind (ToM). Many other protocols have been developed to study individuals who proceed with deception under instructed laboratory conditions. However, no protocol has practiced lying in a real-life environment. We performed a functional MRI using a 3Tesla machine on 31 healthy individuals to detect the participants who successfully lie in a previously-designed game to earn or lose the monetary reward. The results revealed that lying results in an augmented activity in the right dorsolateral and right dorsomedial prefrontal cortices, the right inferior parietal lobule, bilateral inferior frontal gyri, and right anterior cingulate cortex. The findings would contribute to forensic practices regarding the detection of a deliberate lie. They may also have implications for guilt detection, social cognition, and the societal notions of responsibility.","PeriodicalId":43970,"journal":{"name":"Archives of Neuroscience","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46745694","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}
Parinaz Dadlani, P. Payandemehr, A. Abdollahi, F. Farham
Background: Patients with multiple sclerosis (MS) visit Emergency Departments (ED) due to both neurological and non-neurological symptoms. Objectives: Our main aim was to study some epidemiologic features of the ED visits of MS cases in a referral hospital. Methods: This cross-sectional study was conducted during 22 September 2018 - 21 September 2019 in Sina Hospital, Tehran, Iran. Admission causes were divided into two categories: patients admitted because of neurological complaints (MS true attacks and pseudo attacks) and patients admitted due to non-neurological reasons that may or may not be related to the disease. To compare the differences between the two categories, t and χ2 tests were used. Results: A total of 375 visits by 346 MS patients were reviewed. We observed that 239 (63.7%) visits were due to neurologic complaints, of which 213 (89.1%) were diagnosed with true MS relapses. Moreover, 136 visits were because of non-neurologic complaints, with urinary tract infection (UTI) being the most common complaint. The patients with MS visiting the ED were mostly female, though there was no significant difference between men and women diagnosed with true relapses (P = 0.154). Patients with neurologic symptoms were significantly younger than those with non-neurologic symptoms (P = 0.007). Our findings showed that 90% of patients with neurological symptoms underwent magnetic resonance imaging (MRI), and the yield of MRI was about 50%. Furthermore, the duration of admission was significantly higher in patients with neurological symptoms (P < 0.001) Conclusions: MS relapse was the most frequent cause of ED visits by individuals with MS. There were also many ED visits by MS patients due to non-neurological causes, and the UTI was the most prevalent chief complaint.
{"title":"Prevalence of Neurological and Non-neurological Complaints Among Patients Visiting the Emergency Department with Multiple Sclerosis: A Cross-sectional Study in Sina Hospital, Tehran, Iran","authors":"Parinaz Dadlani, P. Payandemehr, A. Abdollahi, F. Farham","doi":"10.5812/ans-122549","DOIUrl":"https://doi.org/10.5812/ans-122549","url":null,"abstract":"Background: Patients with multiple sclerosis (MS) visit Emergency Departments (ED) due to both neurological and non-neurological symptoms. Objectives: Our main aim was to study some epidemiologic features of the ED visits of MS cases in a referral hospital. Methods: This cross-sectional study was conducted during 22 September 2018 - 21 September 2019 in Sina Hospital, Tehran, Iran. Admission causes were divided into two categories: patients admitted because of neurological complaints (MS true attacks and pseudo attacks) and patients admitted due to non-neurological reasons that may or may not be related to the disease. To compare the differences between the two categories, t and χ2 tests were used. Results: A total of 375 visits by 346 MS patients were reviewed. We observed that 239 (63.7%) visits were due to neurologic complaints, of which 213 (89.1%) were diagnosed with true MS relapses. Moreover, 136 visits were because of non-neurologic complaints, with urinary tract infection (UTI) being the most common complaint. The patients with MS visiting the ED were mostly female, though there was no significant difference between men and women diagnosed with true relapses (P = 0.154). Patients with neurologic symptoms were significantly younger than those with non-neurologic symptoms (P = 0.007). Our findings showed that 90% of patients with neurological symptoms underwent magnetic resonance imaging (MRI), and the yield of MRI was about 50%. Furthermore, the duration of admission was significantly higher in patients with neurological symptoms (P < 0.001) Conclusions: MS relapse was the most frequent cause of ED visits by individuals with MS. There were also many ED visits by MS patients due to non-neurological causes, and the UTI was the most prevalent chief complaint.","PeriodicalId":43970,"journal":{"name":"Archives of Neuroscience","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46022593","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}
Context: Decompressive hemicraniectomy (DC) is the final surgical remedy for refractory raised intracranial pressure (ICP). Even with years of experience and profound refination of technique, the procedure has less rewarding results in traumatic brain injury (TBI). Besides, arrangements for bone flap preservation and the necessity of follow-up surgery in the form of cranioplasty bring in unavoidable monetary and logistic burdens to the patients. Step-ladder expansive cranioplasty was conceptualized as an alternative to achieve adequate intracranial volume expansion to help normalize ICP, with immediate reinstitution of the Monro-Kellie doctrine. It is also expected to prevent cerebral cortical pressure injury to the cortex underlying the craniectomy defect. The evolution of this concept, as worked out on different models, the surgical technique, and our experience with this technique are discussed in this article. Evidence Acquisition: Multiple research projects undertaken by our team to build up the concept and acquire data necessary to plan the surgical procedure have been published over last eight years. This review article attempts to evaluate the existing knowledge and our clinical experience so far. Results: Step-ladder expansive cranioplasty allows an assured centrifugal displacement of the inner table and underlying dural bag at craniotomy site by at least 9 mm, thereby achieving a minimum volume expansion of 120 cc. Both of these parameters can be increased as desired, if considered necessary by the surgeon. Conclusions: Step-ladder expansive cranioplasty offers an alternative that takes the centripetal pressure exerted by the combination of the tensile strength of the scalp and atmospheric pressure off the brain surface while achieving an assured augmentation of intracranial volume that can be optimized on a case-to-case basis, based on our future understanding of the subject. While it can be a single-stage surgery for those satisfied with the cosmesis, a revision cranioplasty (if required) will be easier, cheaper, and cosmetically superior to achieving cover over a craniotomy defect routinely done after DC.
{"title":"Presenting Step-Ladder Expansive Cranioplasty as the Next Step After Decompressive Hemicraniectomy: It Is Different!","authors":"Sudip Kumar Sengupta","doi":"10.5812/ans.117417","DOIUrl":"https://doi.org/10.5812/ans.117417","url":null,"abstract":"Context: Decompressive hemicraniectomy (DC) is the final surgical remedy for refractory raised intracranial pressure (ICP). Even with years of experience and profound refination of technique, the procedure has less rewarding results in traumatic brain injury (TBI). Besides, arrangements for bone flap preservation and the necessity of follow-up surgery in the form of cranioplasty bring in unavoidable monetary and logistic burdens to the patients. Step-ladder expansive cranioplasty was conceptualized as an alternative to achieve adequate intracranial volume expansion to help normalize ICP, with immediate reinstitution of the Monro-Kellie doctrine. It is also expected to prevent cerebral cortical pressure injury to the cortex underlying the craniectomy defect. The evolution of this concept, as worked out on different models, the surgical technique, and our experience with this technique are discussed in this article. Evidence Acquisition: Multiple research projects undertaken by our team to build up the concept and acquire data necessary to plan the surgical procedure have been published over last eight years. This review article attempts to evaluate the existing knowledge and our clinical experience so far. Results: Step-ladder expansive cranioplasty allows an assured centrifugal displacement of the inner table and underlying dural bag at craniotomy site by at least 9 mm, thereby achieving a minimum volume expansion of 120 cc. Both of these parameters can be increased as desired, if considered necessary by the surgeon. Conclusions: Step-ladder expansive cranioplasty offers an alternative that takes the centripetal pressure exerted by the combination of the tensile strength of the scalp and atmospheric pressure off the brain surface while achieving an assured augmentation of intracranial volume that can be optimized on a case-to-case basis, based on our future understanding of the subject. While it can be a single-stage surgery for those satisfied with the cosmesis, a revision cranioplasty (if required) will be easier, cheaper, and cosmetically superior to achieving cover over a craniotomy defect routinely done after DC.","PeriodicalId":43970,"journal":{"name":"Archives of Neuroscience","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48179747","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}
D. Matías-Pérez, Emilio Hernández-Bautista, Ivan Antonio Garcia-Montalvo
{"title":"Oxidative Stress Derived from COVID-19 and Its Possible Association with the Development of Neurodegenerative Diseases","authors":"D. Matías-Pérez, Emilio Hernández-Bautista, Ivan Antonio Garcia-Montalvo","doi":"10.5812/ans.123302","DOIUrl":"https://doi.org/10.5812/ans.123302","url":null,"abstract":"<jats:p />","PeriodicalId":43970,"journal":{"name":"Archives of Neuroscience","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43233096","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}
M. Safari, M. Karimkhan-zand, N. Fakhraei, F. Mohammadi, F. Nili, Faranak Eivazi, Abbas Norouzi Javidan, Akbar Khodaei, A. Dehpour
Background: Exogenous electrical stimulation of the skin may mimic its endogenous bioelectric currents. In this study, a combination of direct current (DC) and magnetic field (MF) was investigated in the excision of the rat wound model. Methods: A circular wound was created on the posterior of the neck, and an electrode was fixed in the wound center. Rats were divided into sham, DC (600 µA), MF (~0.8 T), and magnet-direct current (MDC) groups. The study was conducted in 14 days with 20-min treatment daily. Results: The DC and MDC groups had higher healing percentages (P < 0.01) with mean differences of -13.42 and -15.63, respectively. Direct current on days 2, 5, and 6, and MDC on days 8, 9, 10, 11, 12, and 13 showed higher wound closing. In the DC-treated group, angiogenesis was improved on day 7. In MDC-treated rats, angiogenesis and fibroplasia were improved on day 13. The MF and MDC groups had lower granulation thicknesses on day 7. Granulation thickness increased on day 13 in the MF and MDC groups, while it decreased in the DC group. Direct current treatment improved healing in the first half of the study period, whereas MDC enhanced it in the second half, overtaking DC. From day 7, the magnet group started to overtake the control group slightly in the last four days. Conclusions: To accelerate wound healing, we suggest applying DC in the first days of wounding and MDC in the following days.
{"title":"Effect of Magnetohydrodynamic on Cutaneous Wound Healing in Rat Model","authors":"M. Safari, M. Karimkhan-zand, N. Fakhraei, F. Mohammadi, F. Nili, Faranak Eivazi, Abbas Norouzi Javidan, Akbar Khodaei, A. Dehpour","doi":"10.5812/ans.118387","DOIUrl":"https://doi.org/10.5812/ans.118387","url":null,"abstract":"Background: Exogenous electrical stimulation of the skin may mimic its endogenous bioelectric currents. In this study, a combination of direct current (DC) and magnetic field (MF) was investigated in the excision of the rat wound model. Methods: A circular wound was created on the posterior of the neck, and an electrode was fixed in the wound center. Rats were divided into sham, DC (600 µA), MF (~0.8 T), and magnet-direct current (MDC) groups. The study was conducted in 14 days with 20-min treatment daily. Results: The DC and MDC groups had higher healing percentages (P < 0.01) with mean differences of -13.42 and -15.63, respectively. Direct current on days 2, 5, and 6, and MDC on days 8, 9, 10, 11, 12, and 13 showed higher wound closing. In the DC-treated group, angiogenesis was improved on day 7. In MDC-treated rats, angiogenesis and fibroplasia were improved on day 13. The MF and MDC groups had lower granulation thicknesses on day 7. Granulation thickness increased on day 13 in the MF and MDC groups, while it decreased in the DC group. Direct current treatment improved healing in the first half of the study period, whereas MDC enhanced it in the second half, overtaking DC. From day 7, the magnet group started to overtake the control group slightly in the last four days. Conclusions: To accelerate wound healing, we suggest applying DC in the first days of wounding and MDC in the following days.","PeriodicalId":43970,"journal":{"name":"Archives of Neuroscience","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47680399","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}
Tayebeh Zarei, Arzoo Ahmadi, A. Najafi, M. Mojtahedzadeh, K. Basiri, Somayeh Mehrpour, Khalil Komlakh, Kaveh Hedayati Emami
Background: Several studies have examined the possible role of beta-blockers, including esmolol, in controlling intracranial pressure (ICP). This study aimed to evaluate the effect of esmolol on ICP in patients with severe traumatic brain injury. Methods: In this case-control study, all TBI patients with ICP > 20 cmH2O, who were admitted to ICU during the study period, were included. Some patients received standard treatment plus esmolol (500 μg/kg and then 50 mg/kg/min for 24 hours), and some others just received standard treatment with no esmolol. The patients were monitored, and the ICP measurement was performed via inserted intra-ventricular catheter. The ICP and vital signs were measured and recorded before, 8, 16, and 24 hours after starting the treatment in the two groups, and the findings were then compared. Results: Twenty-two patients (13 males and 9 females) were included in this study, of whom 12 patients received esmolol, and 10 patients were in the control group. The mean age of those who received esmolol was smaller than those who did not receive it (46.6 ± 18.5 vs. 62.3 ± 19.1 years; P = 0.08). Moreover, the mean length of the ICU stay was smaller in the esmolol receivers than the control group (5.6 ± 1.1 vs. 17.3 ± 7.7 days; P = 0.04 (there was no significant difference between the two groups in terms of mortality rates (P = 0.30). The variations of the vital signs over time was not significantly different between the two groups (P > 0.05); however, the mean of ICP was lower in those who received esmolol compared to the control group at all checkpoints (P < 0.05). Conclusions: Those patients with TBI who received esmolol as part of their ICP control management in ICU had lower ICP than those who received no esmolol.
{"title":"Intravenous Esmolol for Intracranial Pressure Reduction After Traumatic Brain Injury","authors":"Tayebeh Zarei, Arzoo Ahmadi, A. Najafi, M. Mojtahedzadeh, K. Basiri, Somayeh Mehrpour, Khalil Komlakh, Kaveh Hedayati Emami","doi":"10.5812/ans.121425","DOIUrl":"https://doi.org/10.5812/ans.121425","url":null,"abstract":"Background: Several studies have examined the possible role of beta-blockers, including esmolol, in controlling intracranial pressure (ICP). This study aimed to evaluate the effect of esmolol on ICP in patients with severe traumatic brain injury. Methods: In this case-control study, all TBI patients with ICP > 20 cmH2O, who were admitted to ICU during the study period, were included. Some patients received standard treatment plus esmolol (500 μg/kg and then 50 mg/kg/min for 24 hours), and some others just received standard treatment with no esmolol. The patients were monitored, and the ICP measurement was performed via inserted intra-ventricular catheter. The ICP and vital signs were measured and recorded before, 8, 16, and 24 hours after starting the treatment in the two groups, and the findings were then compared. Results: Twenty-two patients (13 males and 9 females) were included in this study, of whom 12 patients received esmolol, and 10 patients were in the control group. The mean age of those who received esmolol was smaller than those who did not receive it (46.6 ± 18.5 vs. 62.3 ± 19.1 years; P = 0.08). Moreover, the mean length of the ICU stay was smaller in the esmolol receivers than the control group (5.6 ± 1.1 vs. 17.3 ± 7.7 days; P = 0.04 (there was no significant difference between the two groups in terms of mortality rates (P = 0.30). The variations of the vital signs over time was not significantly different between the two groups (P > 0.05); however, the mean of ICP was lower in those who received esmolol compared to the control group at all checkpoints (P < 0.05). Conclusions: Those patients with TBI who received esmolol as part of their ICP control management in ICU had lower ICP than those who received no esmolol.","PeriodicalId":43970,"journal":{"name":"Archives of Neuroscience","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47675757","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}
F. Mohammadian, Fattaneh Abdi-Masouleh, Zahra Hooshyari, Zahra Mirsepassi
Background: Electroconvulsive therapy (ECT) is one of the most effective treatments for severe refractory mental diseases. Widespread cognitive complications have affected the acceptance of this treatment. Despite current evidence of short-term cognitive impairment, long-term cognition consequences are less determined. Objectives: This study aimed to evaluate the clinical approach of psychiatrists, psychiatry residents, and nurses in psychiatric hospitals to the necessity, method, and frequency of cognitive assessment in candidate patients for ECT. Methods: In this descriptive study, 89 professional members of Roozbeh and Razi hospitals, Tehran, Iran, including nurses, residents, and faculty members of psychiatry, were selected using the purposive sampling method. The research questionnaires were sent, and 58 fulfilled questionnaires were sent back. The data were analyzed using central indicators and statistical dispersion. The designed questionnaire included the items related to the specialists’ views on the necessity of post-ECT cognitive evaluations, best batteries, frequency of performing the tests, and other related domains. Results: After close follow-up, 58 out of 89 participants completed the questionnaires, including 17 psychiatrists (29.3%), 20 nurses (34.5%), and 21 psychiatry residents (36.2%). The results were analyzed and interpreted in detail. The average work experience of respondents in the psychiatry field was 6.89 years (range: 1 - 25 years). Additionally, 97% of the specialists did not have any project in the ECT field and cognitive disorders. More than 80% of the participants believed that cognition evaluation is necessary for ECT-candidate patients; however, only 15% of the specialists referred patients for the assessment. Moreover, 43% of the experts recommended the Wechsler Memory Scale-Revised; nevertheless, nearly 26% of the experts recommended the Delis-Kaplan Executive Function System for the cognitive assessment of these patients. The Rey Auditory Verbal Learning Test was recommended by 20% of the experts. Nearly two-thirds of the respondents believed that a proper assessment should be carried out in about 30 minutes. More than 60% of the experts believed that patients should be evaluated before receiving the first session of ECT, and nearly one-third of the experts recommended only a post-ECT evaluation. More than half of the experts believed that ECT should be discontinued in case of severe cognitive impairment after ECT. Alternatively, less than 30% of the experts believed that it is necessary to make changes in the treatment dose and the interval between sessions. Furthermore, 80% of the experts recommended cognitive rehabilitation for patients with significant cognitive impairment after ECT; nonetheless, less than 20% of the experts recommended treatment with a cholinesterase inhibitor. Conclusions: A large percentage of patients do not undergo a comprehensive cognitive assessment after ECT, which is an important
{"title":"Clinicians’ Approach to Cognitive Impairment After Electroconvulsive Therapy: Current Situations and Challenges","authors":"F. Mohammadian, Fattaneh Abdi-Masouleh, Zahra Hooshyari, Zahra Mirsepassi","doi":"10.5812/ans.120762","DOIUrl":"https://doi.org/10.5812/ans.120762","url":null,"abstract":"Background: Electroconvulsive therapy (ECT) is one of the most effective treatments for severe refractory mental diseases. Widespread cognitive complications have affected the acceptance of this treatment. Despite current evidence of short-term cognitive impairment, long-term cognition consequences are less determined. Objectives: This study aimed to evaluate the clinical approach of psychiatrists, psychiatry residents, and nurses in psychiatric hospitals to the necessity, method, and frequency of cognitive assessment in candidate patients for ECT. Methods: In this descriptive study, 89 professional members of Roozbeh and Razi hospitals, Tehran, Iran, including nurses, residents, and faculty members of psychiatry, were selected using the purposive sampling method. The research questionnaires were sent, and 58 fulfilled questionnaires were sent back. The data were analyzed using central indicators and statistical dispersion. The designed questionnaire included the items related to the specialists’ views on the necessity of post-ECT cognitive evaluations, best batteries, frequency of performing the tests, and other related domains. Results: After close follow-up, 58 out of 89 participants completed the questionnaires, including 17 psychiatrists (29.3%), 20 nurses (34.5%), and 21 psychiatry residents (36.2%). The results were analyzed and interpreted in detail. The average work experience of respondents in the psychiatry field was 6.89 years (range: 1 - 25 years). Additionally, 97% of the specialists did not have any project in the ECT field and cognitive disorders. More than 80% of the participants believed that cognition evaluation is necessary for ECT-candidate patients; however, only 15% of the specialists referred patients for the assessment. Moreover, 43% of the experts recommended the Wechsler Memory Scale-Revised; nevertheless, nearly 26% of the experts recommended the Delis-Kaplan Executive Function System for the cognitive assessment of these patients. The Rey Auditory Verbal Learning Test was recommended by 20% of the experts. Nearly two-thirds of the respondents believed that a proper assessment should be carried out in about 30 minutes. More than 60% of the experts believed that patients should be evaluated before receiving the first session of ECT, and nearly one-third of the experts recommended only a post-ECT evaluation. More than half of the experts believed that ECT should be discontinued in case of severe cognitive impairment after ECT. Alternatively, less than 30% of the experts believed that it is necessary to make changes in the treatment dose and the interval between sessions. Furthermore, 80% of the experts recommended cognitive rehabilitation for patients with significant cognitive impairment after ECT; nonetheless, less than 20% of the experts recommended treatment with a cholinesterase inhibitor. Conclusions: A large percentage of patients do not undergo a comprehensive cognitive assessment after ECT, which is an important","PeriodicalId":43970,"journal":{"name":"Archives of Neuroscience","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42725051","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: One of the chronic diseases with various challenges for patients and caregivers is spinal cord injury (SCI). The spread and prevalence of coronavirus disease 2019 (COVID-19) have been an influential risk factor for abuse. Objectives: The aim of this study was to assess the rate of abuse in patients with SCI during the COVID-19 pandemic. Methods: This cross-sectional descriptive study population was all SCI cases in Ilam, Iran. Researcher-made forms and questionnaires with confirmed validity and reliability, including the demographic characteristics, form and perceived abuse researcher-made questionnaire for people with SCI, were used. The perceived abuse questionnaire for patients with SCI was a researcher-made questionnaire designed based on library studies, interviews with patients, and determination of abuse instances. This instrument consists of 20 questions answered as yes (score 1) or no (score 0). After data collection, statistical analyzes were performed using the SPSS software version 16. Results: According to our results, the mean ± SD of the perceived abuse score by caregivers and patients was 8.48 ± 2.31 and 42.45% during the COVID-19 pandemic, respectively. Moreover, the mean ± SD of the age of patients was 62.86 ± 19.15 years, and the patient abuse increased with elevation in age (P = 0, F = 27.42). The possible abuse score was 0 - 20 divided into three categories of low (20, 20.4%), moderate (76, 76.5%), and high (2, 2%). The perceived abuse score was significantly higher among women and patients with a history of more than 10 years of SCI. Abuse prevalence did not have a significant relationship with income and marital status. Regarding age and abuse, our results showed a rise in perceived abuse scores with an increase in age. Conclusions: The present study showed that it is necessary to take measures to prevent abuse in patients with SCI. Moreover, the prevalence of abuse related to COVID-19 in patients with SCI was high. Therefore, preventive actions need to be proposed in this field.
背景:脊髓损伤(SCI)是对患者和护理人员提出各种挑战的慢性疾病之一。2019冠状病毒病(COVID-19)的传播和流行已成为虐待的一个重要风险因素。目的:本研究的目的是评估COVID-19大流行期间脊髓损伤患者的滥用率。方法:该横断面描述性研究人群为伊朗Ilam的所有SCI病例。采用研究者自编表格和经信度和效度确认的问卷，包括SCI患者的人口学特征、表格和感知虐待研究者自编问卷。SCI患者感知虐待问卷是研究者根据图书馆研究、患者访谈和虐待事例的确定设计的问卷。该仪器由20个问题组成，回答为“是”(1分)或“否”(0分)。数据收集后，使用SPSS软件版本16进行统计分析。结果:根据我们的研究结果，在COVID-19大流行期间，护理人员和患者感知虐待得分的平均值±SD分别为8.48±2.31和42.45%。患者年龄的平均值±SD为62.86±19.15岁，患者滥用行为随年龄的增加而增加(P = 0, F = 27.42)。可能的滥用得分为0 ~ 20分，分为低(20,20.4%)、中(76,76.5%)、高(2.2%)3个等级。感知虐待得分在女性和有10年以上脊髓损伤史的患者中明显更高。虐待发生率与收入和婚姻状况无显著关系。关于年龄和虐待，我们的结果显示，随着年龄的增长，感知虐待得分也在上升。结论:本研究表明，有必要采取措施防止脊髓损伤患者滥用。此外，SCI患者中与COVID-19相关的滥用发生率很高。因此，需要在这一领域提出预防行动。
{"title":"Abuse in Patients with Spinal Cord Injury During the COVID-19 Pandemic","authors":"Khalil Komlakh, M. Hatefi","doi":"10.5812/ans.121167","DOIUrl":"https://doi.org/10.5812/ans.121167","url":null,"abstract":"Background: One of the chronic diseases with various challenges for patients and caregivers is spinal cord injury (SCI). The spread and prevalence of coronavirus disease 2019 (COVID-19) have been an influential risk factor for abuse. Objectives: The aim of this study was to assess the rate of abuse in patients with SCI during the COVID-19 pandemic. Methods: This cross-sectional descriptive study population was all SCI cases in Ilam, Iran. Researcher-made forms and questionnaires with confirmed validity and reliability, including the demographic characteristics, form and perceived abuse researcher-made questionnaire for people with SCI, were used. The perceived abuse questionnaire for patients with SCI was a researcher-made questionnaire designed based on library studies, interviews with patients, and determination of abuse instances. This instrument consists of 20 questions answered as yes (score 1) or no (score 0). After data collection, statistical analyzes were performed using the SPSS software version 16. Results: According to our results, the mean ± SD of the perceived abuse score by caregivers and patients was 8.48 ± 2.31 and 42.45% during the COVID-19 pandemic, respectively. Moreover, the mean ± SD of the age of patients was 62.86 ± 19.15 years, and the patient abuse increased with elevation in age (P = 0, F = 27.42). The possible abuse score was 0 - 20 divided into three categories of low (20, 20.4%), moderate (76, 76.5%), and high (2, 2%). The perceived abuse score was significantly higher among women and patients with a history of more than 10 years of SCI. Abuse prevalence did not have a significant relationship with income and marital status. Regarding age and abuse, our results showed a rise in perceived abuse scores with an increase in age. Conclusions: The present study showed that it is necessary to take measures to prevent abuse in patients with SCI. Moreover, the prevalence of abuse related to COVID-19 in patients with SCI was high. Therefore, preventive actions need to be proposed in this field.","PeriodicalId":43970,"journal":{"name":"Archives of Neuroscience","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48158891","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}
A. Shokoh, Seyed Mohammad Mousavi Mirzaei, Alireza Khalesi, M. Ganjifard
Objectives: This study aimed to evaluate the correlation of the Brain Function Index (BFI) with three criteria of consciousness (Glasgow, Richmond, and FOUR score) in the intensive care unit. Methods: We enrolled patients aged over 15 years who required no muscle relaxants and had no hearing and visual impairment, mental retardation, mental disorder, hemodynamic instability (MAP < 60 mmHg), and hypoxia (SpO2 < 90%), as well as patients with no brain electrical activity disorders such as epilepsy and focal brain disease, and those who had not undergone anesthesia and surgery for the past 24 hours. Results: All ICU patients were enrolled in the study in the autumn and winter based on inclusion and exclusion criteria (n = 85). During 24 hours, BFI and three clinical criteria of sedation and consciousness including RASS, GCS, and FOUR score were assessed three times with a minimum of four-hour intervals. Among the patients, 45 (52.9%) were males, and 40 (47.1%) were females; 24 (28.2%) patients were under 40 years of age, 13 (15.3%) patients were between 41 and 60 years old, and 48 (56.5%) patients were over 61 years old. There was a significant positive relationship between the BFI score of ICU patients and the score of patient consciousness based on RASS, FOUR score, and GCS. The correlation of BFI with the FOUR score was higher than those with the other two criteria. Conclusions: Objective criteria for assessing the consciousness level such as BFI are sufficiently accurate and can be used instead of clinical criteria to assess the level of consciousness in special wards.
{"title":"Assessment of Correlation Between Brain Function Index and Three Common Sedation Scales in Intensive Care Unit Patients","authors":"A. Shokoh, Seyed Mohammad Mousavi Mirzaei, Alireza Khalesi, M. Ganjifard","doi":"10.5812/ans.119726","DOIUrl":"https://doi.org/10.5812/ans.119726","url":null,"abstract":"Objectives: This study aimed to evaluate the correlation of the Brain Function Index (BFI) with three criteria of consciousness (Glasgow, Richmond, and FOUR score) in the intensive care unit. Methods: We enrolled patients aged over 15 years who required no muscle relaxants and had no hearing and visual impairment, mental retardation, mental disorder, hemodynamic instability (MAP < 60 mmHg), and hypoxia (SpO2 < 90%), as well as patients with no brain electrical activity disorders such as epilepsy and focal brain disease, and those who had not undergone anesthesia and surgery for the past 24 hours. Results: All ICU patients were enrolled in the study in the autumn and winter based on inclusion and exclusion criteria (n = 85). During 24 hours, BFI and three clinical criteria of sedation and consciousness including RASS, GCS, and FOUR score were assessed three times with a minimum of four-hour intervals. Among the patients, 45 (52.9%) were males, and 40 (47.1%) were females; 24 (28.2%) patients were under 40 years of age, 13 (15.3%) patients were between 41 and 60 years old, and 48 (56.5%) patients were over 61 years old. There was a significant positive relationship between the BFI score of ICU patients and the score of patient consciousness based on RASS, FOUR score, and GCS. The correlation of BFI with the FOUR score was higher than those with the other two criteria. Conclusions: Objective criteria for assessing the consciousness level such as BFI are sufficiently accurate and can be used instead of clinical criteria to assess the level of consciousness in special wards.","PeriodicalId":43970,"journal":{"name":"Archives of Neuroscience","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45917951","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}
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