Original / Research Article

Cut-off Value for Stenosis Ratio and Zung Depression Scale in Successful Prediction of Posterior Spinal Fusion surgery

Mahsa Babaee, Alireza Zali, Mohammad Mehdi Sepehri, Zahra Razzaghi

International Clinical Neuroscience Journal, Vol. 5 No. 2 (2018), 19 June 2018, Page 46-50

Background: The aim of this study was to investigate effect of some clinical attributes in prediction of satisfaction with posterior spinal fusion (PSF) surgery in patients with lumbar disc herniation (LDH) and lumbar spinal canal stenosis (LSCS) and determine a cut-off point for these attributes.
Methods: The attributes such as stenosis ratio (SR) values (described by Lurencin), Japanese Orthopaedic Association (JOA), The Zung depression scale (ZDS), duration of symptoms (in months), were investigated for 329 patients with LSCS and 151 patients with LDH separately. Patient satisfaction was recorded based on the international standard questionnaire Swiss Spinal Stenosis Score (SSS). The sensitivity and specificity values and the optimal cut-off points were calculated for SR, JOA, ZDS and duration of symptoms using receiver operating characteristic (ROC) analysis.
Results: One hundred fifty-one patients with LDH (39 male, 112 female; mean age 50.24 ± 9.21 years) and 329 patients with LSCS (111 male, 218 female; mean age 53.28 ±7.81 years) were followed–up for 6 months. Post-surgical satisfaction was 73.86% in patients with LSCS and 85.43% in patients with LDH. The cut-off point of SR for prediction of besting surgical outcome was estimated more than 0.46 with asymptotic significance less than 0.05, 60% sensitivity and 75% specificity in LSCS patients (AUC-0.705, 95% CI, 0.644–0.766; P < 0.001).
Conclusion: The findings show that the SR with a cut off value of 0.46 cross sectional area, in patients with LSCS may be superior to JOA, duration of symptoms and ZDS for prediction of satisfaction with PSF surgery.

Relationship of Opening CSF Pressure and Visual Field Defect in Idiopathic Intracranial Hypertension

Sepideh Paybast, Farhad Assarzadegan, Behnam Safarpoor Lima, Mohsen Koosha

International Clinical Neuroscience Journal, Vol. 5 No. 2 (2018), 19 June 2018, Page 51-54

Background: Idiopathic intracranial hypertension (IIH) is an increased intracranial pressure with normal cerebrospinal fluid (CSF) characteristic in the absence of identifiable causes. The most important complication of this disorder is visual impairment. So far, no comprehensive study has been done on the relationship between the opening CSF pressure and visual field defect in IIH.
Methods: In this study, 35 patients with increased intracranial pressure who fulfilled modified Dandy’s criteria underwent ophthalmologic examination and lumbar puncture. The opening CSF pressure was categorized into mild (25-30), moderate (30-40) and severe (>40). The degree of visual field defect was reported both quantitatively and qualitatively. Eventually, the statistical relationship was established among these variables.
Results: The mean opening CSF pressure was 33.71 CmH2o. Twelve patients had minor CSF pressure, whereas in 14 and 9 patients the CSF pressure was respectively moderate and severe. There was not statistically significant relationship between the visual field defect and CSF pressure. The most common patterns of visual field involvement were enlarged blind spot and peripheral restriction.
Conclusion: The most important morbidity in IIH is visual impairment. According to the findings, the visual field impairment is not pertinent to CSF pressure. In other words, neither high CSF pressure predicts intense visual defect, nor low CSF pressure indicates minimal visual impairment.

Classification of Mental Stress Levels by Analyzing fNIRS Signal Using Linear and Non-linear Features

Reza Arefi Shirvan, Seyed Kamaledin Setaredan, Ali Motie Nasrabadi

International Clinical Neuroscience Journal, Vol. 5 No. 2 (2018), 19 June 2018, Page 55-61

Background: Mental stress is known as one of the main influential factors in development of different diseases including heart attack and stroke. Thus, quantification of stress level can be very important in preventing many diseases and in human health.
Methods: The prefrontal cortex is involved in body regulation in response to stress. In this research, functional near infrared spectroscopy (fNIRS) signals were recorded from FP2 position in the international electroencephalographic 10–20 system during a stressful mental arithmetic task to be calculated within a limited period of time. After extracting the brain’s hemodynamic response from fNIRS signal, different linear and nonlinear features were extracted from the signal which are then used for stress levels classification both individually and in combination.
Results: In this study, the maximum accuracy of 88.72% was achieved in classification between high and low stress levels, and 96.92% was obtained for the stress and rest states.
Conclusion: Our results showed that using the proposed linear and nonlinear features it is possible to effectively classify stress levels from fNIRS signals recorded from only one site in the prefrontal cortex. Comparing to other methods, it is shown that the proposed algorithm outperforms other previously reported methods using the nonlinear features extracted from the fNIRS signal. These results clearly show the potential of fNIRS signal as a useful tool for early diagnosis and quantify stress.

Comparison of Effectiveness of the Mindfulness-Based Cognitive Therapy and the Metacognition Treatment on Anxiety, Depression and Stress Among Breast Cancer Patients

Tahereh Haji Seyed Javadi, Fakhri Tajikzadeh, Hossein Bayat, Nasim Eshraghi, Zahra Roshandel, Soheila Rahmani

International Clinical Neuroscience Journal, Vol. 5 No. 2 (2018), 19 June 2018, Page 62-66

Background: The present study aimed to compare the effectiveness the metacognition treatment (MCT) and mindfulness-based cognitive therapy (MBCT) on anxiety, depression, and stress in the females with breast cancer.
Methods: The planning of this study is through a quasi-experimental method of pretest and posttest type with control group. The target society of the research included every cancer patient who admitted to Tehran hospitals for breast cancer. Through assigned randomly, 12 patients were selected for the MCT group and 12 patients for the MBCT group, and the other were assigned control group. The data collection tools included depression, anxiety and stress scale - 21 items (DASS-21) questionnaire. For statistical analysis, descriptive tests and repeated measures analysis of variance were performed.
Results: Data analysis with repeated multivariate measurements illustrated that there is a significant difference in the rate of depression, anxiety and stress, in three groups.
Conclusion: According to our results, MBCT was more effective compared to metacognitive therapy.

Comparison of the Effectiveness of Creativity Therapy Training and Group Counseling Based on Choice Theory on Students’ Motivation Improving

Fahime Yousefi Jooybari, Ramazan Hassanzadeh, Mohammad Kazem Fakhri

International Clinical Neuroscience Journal, Vol. 5 No. 2 (2018), 19 June 2018, Page 67-71

Background: According to findings educational psychologist's motivation has important effect upon student's achievement and performance. Therapists and psychologists have tried to study the methods of motivation improving in students.

Objective: The present study compares the effectiveness of creativity therapy training and group counseling based on the choice theory on motivation improving in students.

Methods: The participants of this study included all students referring to the counseling center of Payam Noor University, Sari center, in the academic year of 2016-2017. The convenience sampling method was used for the selection of all the subjects. The sample consisted of 45 individuals who were randomly divided in to three experimental and control groups (15 individuals per group). In pre-test, the motivation improving questionnaire was administered for all groups. The experimental groups received the training of creativity therapy and group counseling based on the theory of choice in 8 (90 minutes) sessions for 2 months. The control group did not receive training during this period. After completing the training, post-test was obtained in three groups. Data were analyzed using covariance analysis by the spss-16.

Results: The results showed that there is a significant difference between the effectiveness of creativity therapy training and group counseling based on choice theory in promoting students motivation (p˂0.05). Also, group counseling based on choice theory had more effect upon students motivation improving than creativity therapy (p=0.001).

Conclusion: creativity therapy training and group counseling based on choice theory may be effective in improving motivation in students.


Beta Actin Expression Profile in Malignant Human Glioma Tumors

Mohsen Ghezelbash, Nahid Masoudian, Mehdi Pooladi

International Clinical Neuroscience Journal, Vol. 5 No. 2 (2018), 19 June 2018, Page 72-77

Background: Proteomics is considered a new era in neurophysiological/ neuropathological research including brain tumors. Gliomas which are derived from glial cells are the most common type of brain tumor in humans.
Methods: In the present study the total protein content of healthy cells of the brain and brain tumor cells was extracted, purified and quantified by Bradford assay. Two-dimensional electrophoresis were used for protein separation followed by statistical analysis. Primary protein detection was performed based on the differences in isoelectric pH, molecular weight of proteins and protein data banks, which was further confirmed by MALDI-TOF/TOF mass spectrometry (MS).
Results: Our results showed elevated levels of beta-actin protein expression in glioma brain tumor cells. It is important to know when a cell is transformed and when it becomes malignant. Here we evaluated the beta-actin expression in malignant cells.
Conclusion: Since structural changes are highly involved in tumor cell malignancy, beta-actin elevations can contribute in glioma tumor cell invasiveness.

Case Report

Bilateral Third Nerve Paralysis as a Manifestation of Guillain–Barré Syndrome

Sepideh Paybast, Omid Hesami, Mohsen Koosha

International Clinical Neuroscience Journal, Vol. 5 No. 2 (2018), 19 June 2018, Page 78-80

Gullian–Barré syndrome (GBS) is an acute autoimmune polyradiculoneuropathy with many variants and distinct presentations. Although cranial neuropathy is a common feature in GBS, third nerve palsy is a rare presentation. Herein, we describe a case of GBS patient who has presented by acute flaccid quadriparesis coexisting bilateral third nerve palsy. We tried to highlight the importance of other cranial nerve involvement in the natural history of GBS.