Review Article

Diagnostic Value of Serum Neuron-Specific Enolase Level in Patients With Acute Ischemic Stroke; A Systematic Review and Meta-Analysis

Elham Najmi, Eshak I. Bahbah, Ahmed Negida, Ahmed M. Afifi, Alireza Baratloo

International Clinical Neuroscience Journal, Vol. 6 No. 2 (2019), 29 June 2019, Page 36-41

Background: We aim to assess the predictive value of serum neuron-specific enolase (NSE) level in patients with acute ischemic stroke referring to the emergency department.
Methods: This systematic review and meta-analysis performed, considering the PRISMA and MOOSE statement guidelines. A computerized literature search of the known medical database conducted by using the relevant keywords. We included studies published before November 2016 in which stroke patients compared with non-stroke controls and also studies evaluating the serum levels of NSE in the study groups. Statistical analysis was pooled in a random effect model analysis using the Comprehensive Meta-Analysis software.
Results: We included 12 articles in the qualitative and quantitative analysis, that their quality acceptable based on the Newcastle Ottawa Scale (NOS scale). The pooled effect estimates showed that NSE is significantly higher in ischemic stroke patients in comparison with their controls with a high effect estimate [OR 9.68, 95% CI (3.06 to 30.6)]. The effect estimate remained statistically significant under the fixed and random effects model.
Conclusion: Our results show higher levels of NSE in patients with stroke than in the control group, indicating that NSE plays a role in the diagnosis of stroke. In terms of prognosis, there is evidence regarding the direct and indirect relationship; and it founded that serum levels of NSE is higher in larger stroke volume, which needs further research.

Neonatal Seizure and Afterward, Epilepsy: A Systematic Review

Ali Zafari, Fatemeh Pajouhandeh, Mehran Arab Ahmadi

International Clinical Neuroscience Journal, Vol. 6 No. 2 (2019), 29 June 2019, Page 42-45

Background: The purpose of the current study is to estimate the incidence of epilepsy after neonatal seizure (NS) by reviewing of the latest studies on the relationship between NSs and epilepsy in newborns and also discuss risk factors may contribute to this relationship.
Methods: A literature review was performed using the search terms “neonatal seizure AND epilepsy,” “newborns AND epilepsy,” “postneonatal epilepsy.” After exclusion of several studies, which did not meet inclusion criteria, the epilepsy incidence rate was measured by dividing the number of all cases of epilepsy who had a history of NS in selected studies considered with the number of all newborns enrolled to the studies minus the number of cases who lost the follow-ups.
Results: By reviewing the literature, 13 studies were found, which completely meet the inclusion criteria and published between 2009 and 2019, of which three were population-based while the remaining studies performed hospital-based. Overall, the population evaluated in these series has been estimated to be 2438 newborns of which 454 died, and 300 missed the follow-ups. The incidence rate for afterward epilepsy in all 1684 subjects with NS was 20%, literally 343 of the NS subjects.
Conclusion: The presented review enrolled the most recent studies encompassing enough and extended the time as well as adequate sample size. Epilepsy is considered a common outcome of NS, particularly in those with other neurodevelopmental comorbidities, even if there were always several limits associated with various study designs and condition.

Original / Research Article

The Effectiveness of Acceptance and Commitment Therapy on Anxiety, Depression, and Stress in Patients with Spinal Cord Injuries

Saharalsadat Torabian, Vahid Hemmati Sabet, Farahnaz Meschi

International Clinical Neuroscience Journal, Vol. 6 No. 2 (2019), 29 June 2019, Page 46-52

Background: Since the number of patients with spinal cord injuries is increasing, paying attention to these patients’ psychological problems is a priority. This study aimed to evaluate the effect of acceptance and commitment therapy on anxiety, depression, and stress in patients with spinal cord injuries.
Methods: The present study had utilized a single-subject approach in the form of multiple baseline design. The samples were selected using purposive sampling based on convenience sampling method. The statistical population included all patients in Hamadan city with spinal cord injuries who referred to the Shahid Beheshti hospital in this city. The total numbers of them were 181 people in 2016. The researchers informed the patients about the research and presented them with informed consent forms. Among 50 screened patients, five patients (4 males and one female) selected and entered the treatment process: anxiety, depression, and stress measured by Depression Anxiety Stress Scales (DASS-21). Acceptance and commitment therapy conducted in 8 treatment sessions on anxiety, depression, and stress in patients with spinal cord injuries.
Results: The results of the graphic and chart analysis, reliable change index (RCI) and the percentage of recovery showed that acceptance and commitment therapy affected anxiety, depression, and stress in the patients with spinal cord injuries.
Conclusion: Findings indicated that acceptance and commitment therapy improved people’s mental health by working on acceptance and mindfulness processes and behavior change processes. This therapy decreased anxiety, depression, and stress in patients with spinal cord lesion.

The Investigation of Alpha-Tubulin Differential Expression in Oligodendroglioma Brain Tumor Aiming MALDI-TOF-TOF

Mehdi Pooladi, Mehrdad Hashemi, Saeed Hesami Tackallou, Soheila Karani

International Clinical Neuroscience Journal, Vol. 6 No. 2 (2019), 29 June 2019, Page 53-58

Background: Tubulin is known as a heterodimer protein, which includes alpha and beta tubulin subunits. This structural protein plays important roles in pathogenesis and healing different diseases. Biomarkers help in fast and accurate detection of cancer. Proteomic studies can be useful both in biological and clinical research, also help obtain protein expression profiles by using two-dimensional electrophoresis, mass spectrometry, and bioinformatics tools. Finding candidate proteins as cancer biomarkers is an interesting area in proteomic investigations.
Methods: In the present study, the total protein content of healthy cells of the brain and brain tumor cells were extracted, purified and quantified by Bradford assay. Two-dimensional electrophoresis used for protein separation followed by statistical analysis. Primary protein detection was performed based on the differences in isoelectric pH, the molecular weight of proteins and protein data banks, which was further confirmed by Matrix Assisted Laser Desorption Ionisation-Time-of-Flight (MALDI-TOF-TOF).
Results: In this study, an alpha-tubulin expression found changed (overexpression) in Oligodendroglioma tumors comparing control identified by proteomics analysis. Also, alpha-tubulin position showed in the oligodendroglioma tumors cluster diagram.
Conclusion: Proteome analysis approach has allowed biology and medical studies. Alpha-tubulin introduced as a candidate biomarker for the diagnosis and prediction of oligodendroglioma tumors.

Dyslipidemia Prevalence among Tinnitus Patients of a Referral ENT Clinic in Tehran, Iran, 2018

Kourosh Etemadi, Ali Goljanian Tabrizi, Mahdieh Fahimi

International Clinical Neuroscience Journal, Vol. 6 No. 2 (2019), 29 June 2019, Page 59-63

Background: Tinnitus is a common neurosensory disorder that can bring many problems such as stress and sleep disorders to the patients and affect their quality of life. Unfortunately, its pathophysiology has not been exactly discovered yet, but there have been some studies executed about the possibility of dyslipidemia causing tinnitus. Studying more on this subject and especially on the Iranian population in order to provide us with evidence-based information, can help us find the optimal method to control and treat this disorder.

Methods: In this study, 76 patients that have had complaints of tinnitus in the ENT (ears, nose, and throat) clinic of Taleghani hospital, Shahid Beheshti University of Medical Sciences, in the year 2018, were selected. Also, after taking a history about the severity and the onset of their problem, they were examined and also blood samples were taken to check their lipid profiles. Finally, the results of the lab tests, the severity and the onset of their disorder and also their age and sex were statistically analyzed.
Results: The study showed that the prevalence of dyslipidemia in patients with tinnitus is not significantly greater than its prevalence in the general population. Furthermore despite the relationship between dyslipidemia and the onset and severity of the tinnitus is not significant, the effect of dyslipidemia on tinnitus shows itself after about one year and a half (P=0.000), it means dyslipidemia does not cause the tinnitus but affects in its duration. It also indicated the most common type of dyslipidemia among the patients that we studied, was Hypercholesterolemia with the prevalence of 23.68%.
Conclusion: The Study suggests that despite the Hypercholesterolemia prevalence of 23.68% among these patients, dyslipidemia does not have a significant relationship with the severity of the neuro-sensory disorder “tinnitus’ overall, but dyslipidemia affects tinnitus after suffering for about one year and a half. Therefore there will not be a need to use blood tests in order to measure the lipid profile factors at the beginning and the first months of the patients’ tinnitus.


Determining the Effectiveness of Cognitive Behavioral Training on the Rate of C-Reactive Protein and Depression in Patients Afflicted With Rheumatoid Arthritis

Zeinab Edalatjoo, Mohammadreza Zarbakhsh, Ahmad Shamsaldini

International Clinical Neuroscience Journal, Vol. 6 No. 2 (2019), 29 June 2019, Page 64-68

Background: Rheumatoid arthritis is a progressive autoimmune disease with variable clinical symptoms. This study aimed to investigate the effectiveness of cognitive behavioral training on C-reactive protein (CRP) and depression in patients with rheumatoid arthritis.
Methods: This research was a semi-experimental study with a pretest-posttest design and a control group. The statistical population of this study involved all women suffering from rheumatoid arthritis who went to Iran Rheumatology Center. From among them, 60 individuals were randomly selected and consigned to the control and experimental groups. The control group received only medication, and an educational package about rheumatoid arthritis provided for them. Beck’s depression and biochemical evaluations questionnaires were used to measure dependent variables. To analyze the data, multivariate analysis of covariance and SPSS. 22 software were used.
Results: The mean (SD) of depression in the experimental group in the pretest was 25.5 (3.8), which decreased to 18.9 (4.2) in the post-test (P < 0.01), but the mean (SD) of the control group was not statistically significant. Also, the mean (SD) of the CRP in the experimental group was 27.3 (6.9) in the pretest, which increased to 22.8 (4.6) in the post-test (P < 0.01), but the mean (SD) of the control group was not statistically significant.
Conclusion: This research revealed that cognitive behavioral training led to a reduction of CRP and depression in patients with rheumatoid arthritis.

The Effectiveness of Training Based on Rational-Emotional-Behavioral Therapy on Career Decision-Making Self-Efficacy

Gholamreza khalili, Kianoush Zahrakar, Abdulrrahim Kasaee

International Clinical Neuroscience Journal, Vol. 6 No. 2 (2019), 29 June 2019, Page 69-75

Background: Career decision-making is a complex process and one of the most critical decisions of an individual which has long-lasting consequences on life in areas of psychological wellbeing, physical health, and financial status. The present research was designed and conducted by the aim of investigating the effectiveness of training based on rational-cognitive-behavioral therapy (REBT-based training) on career decision-making self-efficacy among personnel of Petroleum Company.
Methods: The present research was conducted by the quasi-experimental method and used a pretest-posttest-follow up with control group design. The statistical population of the current research was included all the organizational personnel of Pipelines and Telecommunication Company, north region, in the second half of 2017. The sample of the present research included 30 individuals from this population who, after their obtained scores in the questionnaire and on inclusion/exclusion criteria of the study, were selected by available sampling method and they were assigned into experiment and control groups (15 individuals per group) by random assignment method. The research tool was the Career Decision-Making Self-Efficacy Scale of Betz, Klein, and Taylor, which was completed by all participants in pretest, posttest, and one-month follow up stages. REBT-based training was provided for the experiment group subjects in eight 90-minute sessions, while the participants of the control group received no intervention until the end of the follow-up stage. The research data were analyzed by covariance analysis with repeated measurements and Bonferroni post hoc test through SPSS version 20.
Results: Findings indicated that REBT-based training had a positive and significant effect on career decision-making self-efficacy and all its components (self-appraisal, career information, goal selection, planning, and problem-solving) in posttest and follow up stages (P<0.001).
Conclusion: According to the study results, it recommended that an REBT-based training package would provide for the personnel of organizations and institutions to improve their career decision-making self-efficacy.

Case Report

Anesthetic Considerations in a Case With Massive Recurrent Clivus Chordoma

Pardis Soltanpour, Faranak Behnaz, Hamidreza Azizi Faresani, Afsoun Seddighi, Maede Karimian

International Clinical Neuroscience Journal, Vol. 6 No. 2 (2019), 29 June 2019, Page 76-78

Chordomas rare low grade slow-growing malignant tumors with an incidence rate of 1 in 100 000 individuals.32% of chordomas occur in the clivus. Diagnosing Clival chordomas could be challenging due to their rare prevalence, insidious onset, and tendency to involve anywhere throughout the craniospinal column. Treating these tumors can also present as a challenge due to their proximity to vital structures and high recurrence rate. We present a case of massive recurrent Clival chordoma in a 27-year-old patient and discuss the anesthetic considerations in such cases.