Letter to Editor

Review Article

Novel Treatments for Alzheimer’s Disease

Mansoureh Hashemi, Alireza Zali

International Clinical Neuroscience Journal, Vol. 4 No. 2 (2017), 12 June 2017, Page 39-45

Alzheimer’s disease (AD) is a multifarious neurodegenerative disorder that leads to cognitive impairment and dementia in late adult life. Pathology hallmarks of Alzheimer’s disease were observed intracellular neurofibrillary tangles and extracellular amyloidal protein. According to pathology of this disease, abundant studies were performed with focused on pharmacological therapeutics over the last two decades. Current treatments for AD are acetylcholinesterase inhibitors (rivastigmine, galantamine, donepezil) and N-methyl D-aspartate receptor antagonist (memantine) that can decrease the progression of the disease. In this review, authors will discuss the various aspects of pathophysiological mechanisms and therapeutic strategies of Alzheimer’s disease.

Original / Research Article

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

Farzad Ashrafi, Abdolnasser Rostami, Mehran Arab Ahmadi, Behdad Behnam

International Clinical Neuroscience Journal, Vol. 4 No. 2 (2017), 12 June 2017, Page 46-50

Background and Purpose: Cognitive impairment (CI) is one of the most notable disabilities of Parkinson’s disease that is associated with lower quality of life. Early detection of CI is therefore very important for these patients. The purpose of this study was to examine the relationship between cognitive function and the metabolic data from magnetic resonance spectroscopy (MRS) of the patient suffering with Parkinson’s disease.

Methods: Totally, 45 patients with Parkinson’s disease were used in this study. Subjects were divided into three groups based on scales for outcome from Parkinson cognition (SCOPA-COG) test. Patients were classified as non-cognitive impairment (NCI; n=15), mild cognitive impairment (MCI; n=15) and dementia (PDD; n=15). All subjects underwent MRI and 1H-MRS techniques and metabolic changes such as NAA/Cr and NAA/Cho ratios, which were measured in the left hippocampal area of the brain.

Results: The mean and standard deviation of the NAA/Cr ratio in the three cognitive groups (NCI, MCI, PDD) were (2.51±0.037), (2.50±0.033) and (2.47±0.025), respectively. ANOVA test showed a significant difference in the three groups. Furthermore, the Scheffé test showed a significant difference between patients in the MCI and PDD groups (p=0.01). There was no significant difference between the non-cognitive impairment and mild cognitive impairment groups (p=0.54). No significant difference was found in NAA/Cho ratio (p=091). 

Conclusion: A decreasing NAA/Cr ratio has influence on cognitive function and the development of severe cognitive dysfunction in Parkinson suffering patients. Furthermore, 1H-MRS determinant can be useful to evaluate cognition in Parkinson patients.

Semantic Encoding in Mild Cognitive Impairment: A Preliminary ERP Study

Michael Kuo

International Clinical Neuroscience Journal, Vol. 4 No. 2 (2017), 12 June 2017, Page 51-56

Background: This study examines semantic encoding in mild cognitive impairment (MCI) using the event-related potential (ERP) technique. Subsequent memory effect (SME) is used as an index of successful memory encoding. Typically, SMEs are positive at P550 and late positive component (LPC) time windows.

Methods: Ten MCI participants were recruited to complete the ERP experiment. A study and recognition paradigm was employed. Participants determined whether the item referred to by the Chinese character was able to produce sound at study phase and whether the Chinese character was studied at recognition phase while having their electroencephalograms recorded.

Results: Behaviourally, correct percentage at study was 81% and reaction time was 998.5±325.5. Correct percentage at recognition was 61% (d prime=0.87±0.7). Significant SMEs were not identified in P550 and LPC windows.

Conclusion: The behavioural and ERP results showed extensive cerebral deficits in MCI when performing semantic encoding. These deficits may be associated with assessing semantic memory and binding new information with long-term memory store.

Evaluation of Surgical Treatment and the Relationship between Thoracolumbar Injury Severity and Classification Score and Preoperative Cross-Sectional Area in Patients with Thoracolumbar and Lumbar Burst Fractures

Parisa Azimi, Shirzad Azhari, Edward C. Benzel, Sohrab Sadeghi, Hossein Nayeb Aghaei, Hassan Reza Mohammadi, Hamid Reza Khayat Kashani, Shervin Matin-rohani

International Clinical Neuroscience Journal, Vol. 4 No. 2 (2017), 12 June 2017, Page 57-62

Background: The aim of the study was to establish a correlation between (1) the Thoracolumbar Injury Severity and Classification score (TLICS) and sensory scores and motors scores of the American Spinal Injury Association (ASIA) Scale (surgical outcome); correlation between preoperative cross-sectional area (CSA) and the ASIA; (2) to establish a correlation between the TLICS and the CSA in thoracolumbar and lumbar burst fracture (TLBF) patients and (3) the evaluation of surgical outcome based on the ASIA scale and its relationship to TLICS.

Methods: This was a prospective study and 67 patients (mean age 30.3 ± 8.1 years; 18.2% were female) were assessed. The TLICS was determined and TLICS > 4 was hypothesized to be consistent with an indication for surgery. Nerve injury was assessed according to ASIA. The CSA and the ASIA were measured at two points in time: pre- and postoperative assessments. The surgical outcome and correlations were assessed.

Results: Patients were followed an average of 26.2 months. ASIA sensory scores and motor scores were improved significantly at last follow-up. No patient experienced neurological worsening during follow-up. No significant correlations were observed between the ASIA and the CSA at either the pre- or postoperative periods. However, there was a statistically significant correlation between TLICS and the ASIA motor and ASIA sensory (P < 0.01 and P < 0.02 respectively).

Conclusion: The findings confirm that a TLICS > 4 may be applied in the decision-making process for surgery for TLBF. However, the CSA is not useful for decision making for this pathology.

Background: This study investigates electroencephalogram (EEG) signals in positive, negative and neutral emotion states.

Method: It is assumed that the brain draws on several independent sources in any activity that are observable by independent component algorithm (ICA). To overcome the problem of ill-posedness of extracted components from ICA algorithm, first these sources are sorted out by Shannon entropy and then based on these sources, the features of trapping time and determinism of Recurrence Quantification Analysis (RQA) are extracted as representative of determination.

Result: The results show that the degree of determinism of sorted sources related by emotions is significantly different over time and in three positive, negative and neutral states. The degree of determinism increases in neutral, positive and negative emotional states respectively.

Life Skills Training Among 7-13 Years Old Afghan Refugee Children in Rafsanjan Camp, Kerman, Iran

Nasrin Emami Naeini, Said Nouroozi Javinani, Mehrdad Arabestani

International Clinical Neuroscience Journal, Vol. 4 No. 2 (2017), 12 June 2017, Page 72-76

Background and Purpose: Children as the most vulnerable refugees need a special care to improve their psychological-social capabilities and physical health. It seems that life skills education based on essential psychological and social skills is needed for a healthy life and is one of the most important teaching requirements for these children. The purpose of this study is to evaluate the effectiveness of three developed life skills education packages (for the grade one, four and five students) that carried out among Afghan children refugees in Rafsanjan camp in Iran.

Methods: All 7-13 years old children attended in a three-month life skill training course. During the course the occurrence frequency of ‘positive’ and ‘negative’ behaviors in four categories of hygiene, aggression, respectfulness and psychological difficulties were recorded by the coaches as well as the parents through a structured observation checklist. Semi-structured interviews with the parents and coaches also applied.

Results: Comparisons of teachers and coaches’ reports between first and third month in all categories using Chi-Square test were statistically significant in all grades (P-value <0.05) except aggression for grade 4 and 5. The training program have had a positive impact on the students’ personal hygiene and neat appearance, reduction of physical and verbal aggression, respect for the rights of others and class rules, reduction of psychological difficulties and improvement in cognitive-emotional abilities.

Conclusion: It seems that for making long lasting improvements, a long term continuous education is required to let the learned skills get stablished in the students through everyday real life situations.

Case Report

A Case of Guillain-Barre Syndrome with Significant Lymphocytic Pleocytosis

Sadegh Izadi, Mehdi Karimian

International Clinical Neuroscience Journal, Vol. 4 No. 2 (2017), 12 June 2017, Page 77-78

Guillain-Barre syndrome (GBS) is an immune-mediated polyneuropathy. In the cerebrospinal fluid (CSF) characteristic increased protein without pleocytosis i.e., albuminocytologic dissociation is seen. But cases of GBS with significant CSF lymphocytosis have rarely been reported. Here, we present a 38-year-old man with dysarthria, dysphagia, bilateral facial palsy, and limb weakness with the diagnosis of GBS. Nerve Conduction Study confirmed the diagnosis but interestingly in the CSF study increased protein and lymphocytic predominant pleocytosis were found. Other possible differential diagnoses were ruled out by appropriate paraclinical studies. The patient underwent treatment with intravenous immunoglobulin and showed favorable response.