Letter to Editor

Review Article

New Advances in Acute Ischemic Stroke Management: Review Article

Hossein Aghamiri, Sepideh Paybast, Behnam Safarpour Lima, Behnam Mansoori

International Clinical Neuroscience Journal, Vol. 7 No. 2 (2020), , Page 55-60

Cerebrovascular disease is the second cause of death and the sixth cause of morbidity worldwide, which will rise to fourth place by 2020. The treatment strategies for acute ischemic stroke (AIS) divided into two groups, including intravenous or intra-arterial thrombolysis and mechanical thrombectomy. Regarding growing development in the realm of diagnosis and treatment of stroke through state-of-the-art approaches, including emergent thrombectomy, there are new opportunities for investigation in this area. This is while a rough rate of 85% for strokes is occupied by, and the remained is hemorrhagic. Hence, the present study aimed to review recent advances in AIS with a focus on emergent thrombectomy. Here, we first provided the relevant history, and then the recent advances were discussed. The library data collection method was employed so that such databases as Web of Science, PubMed, and Science Direct used for data extraction. The evidence confirms the importance of emergent thrombectomy as all believe the famous statement “time is the brain.” However, further investigations are required to find more strong evidence accordingly.

Original/Research Article

Evaluation of the Differences between Normal and Cancerous Prostate Tissue Response to Simple and Vibro-Neural Stimulation

Samir Zein, Farhad Tabatabai Ghomsheh, Hasan Jamshidian

International Clinical Neuroscience Journal, Vol. 7 No. 2 (2020), , Page 61-65

Background: Early detection of prostate cancer has significant benefits for its treatment and can increase the survival chance in patients. In recent years, new methods such as shear wave elastography and vibro-elastography, as well as artificial tactile sensing, have been used to detect a mass in the prostate tissue in-vivo and ex-vivo. This paper aims to investigate the difference between normal and malignant prostate tissue reaction to simple and vibro-neural stimulation for prostate tissue mass detection in order to determine neural stimulation intensity, velocity, and frequency to obtain the best result in detecting the type and location of the tumor.
Methods: This study has utilized neural stimulation devices in normal and cancerous tissues. The stimulation velocity, probe location, and the frequency of neural stimulation considered as the independent variables.
Results: The results show that for superficial masses, although dependent on the probe, the accuracy of detection at the low speed of 5mm/s is 50% higher than other conditions. On the other hand, in deep masses, with increasing mass depth, the accuracy of detection at the medium speed of 8mm/s is 30% higher than the low speed. Finally, the results showed that with increased stimulation frequency, the possibility of tumor detection, and its accuracy increases by 35%.
Conclusion: By improving the accuracy of the neural stimulation device, it can apply to detect hard materials such as tumors and malignant tissues.

Evaluation of Long-term Outcomes and Prediction of Failure Rate of Endoscopic Third Ventriculostomy in Less Than 2 Years Children

Hasanreza Mohammadi, Masoud Sadat, Hamidreza Khayat Kashani

International Clinical Neuroscience Journal, Vol. 7 No. 2 (2020), , Page 66-70

Background: The study was carried out to assess long term outcomes of ETV on less than 2 years hydrocephalous children and to determine prognostic factors of ETV success in this population.

Methods: our study was a retrospective cohort study which was carried out on 40 hydrocephalus children who were underwent ETV surgery. Clinical data were retrieved from patient’s medical records and we did active follow-up.  We used Kaplan-Meier and life-Table approaches to assess 6 months success rate of ETV. We also used multiple cox regression to determine prognostic factors associated to success. Moreover, ROC curve analysis was used to assess how ETVSS can predict possibility of ETV failure.

Results: Mean age of patients at surgery time was 7.8 (±7.8) months and 60% were male. Mean of failure time of ETV was 4.5 months and the most prevalent etiology was aqueduct (27.0%). According to our finding age at surgery time (HR=2.2, 95% CI= 1.1, 3.4) and birth age (HR=4.4, 95% CI 1.1, 17.2) were the main factors associated to ETV failure. We also observed, statistically lower hazard ratio for patients with aqueduct etiology (HR= 0.1, 95% CI= 0.01, 0.9). Moreover, area under ROC curve was estimated 76.1 illustrating partial validity to predict ETV failure in the study population.

Conclusion: According to our findings ETV could be suggested to treat Hydrocephaly in young kids with particular attention on over 6 month patients and those ones who were mature at birth. However, more studies are required to confirm our findings.   

Evaluation of Useful Biomechanical Parameters On Scoliosis Using Finite Element Method

Midiya Khademi, Ali Nikoo

International Clinical Neuroscience Journal, Vol. 7 No. 2 (2020), , Page 71-78

Background: Scoliosis is a deformity of the vertebral column, and shape-changing and deformation of the spine are some critical factors that can cause this abnormality. This condition causes some problems like deflection of the spine in the coronal plane toward medial or lateral. Cobb angle is a measurement for the investigation of the severity of this condition. There are several effective therapies suggested for the reduction of the Cobb angle for patients who has this abnormality. It has suggested that before applying external forces to correct this condition, biomechanical evaluation of this deformity, can be useful during diagnosis.

Methods: The purpose of this study is the evaluation of Cobb angle correction using external forces. For this aim first, the dimensional data of the patient’s vertebrae are extracted from CT-scan images using Mimics software, and the vertebral column modeled in Catia software for finite element analysis (FEA). Afterward, the model was imported into Abaqus software to evaluate the effect of forces on the spine model. The study was done by assuming two cases for the spine, one-piece (without a nucleus) and two-piece (with a nucleus) intervertebral disc.

Results: After studying the results of this simulation, it concluded that after applying gravity force to these two cases, the percentage of Cobb angle’s reduction was about 0.05 for a two-piece disc and about -0.18 for the one-piece disc. Therefore, the two-piece disc assumption was better for analyzing this parameter. The results of maximum displacement and von misses stress show that the two-piece disc is accurate.

Conclusion: In order to investigate which analysis is appropriate to be selected, choosing a twopiece intervertebral disc model is superlative. Whether our goal is only to examine the stress which is present in the patient model, choosing a one-piece disc is a more optimal duo to take much less time.

The Effectiveness of CBTAC Protocol on Burdens of Alzheimer’s Disease on Caregivers and their Sense of Coherence

Reza Shabahang, Seyed Javad Emadi, Farzin Bagheri Sheykhangafshe, Abbas Ali Hossien Khanzadeh, Seyedeh Maryam Mousavi

International Clinical Neuroscience Journal, Vol. 7 No. 2 (2020), , Page 79-87

Background: Alzheimer's disease is predicted to increase dramatically in the near future. Alzheimer caregiving brings about serious problems for caregivers. Considering corrosive consequences of Alzheimer’s disease on Alzheimer caregivers, finding an effective intervention is necessary. Thus, the present research was conducted by the aim of investigating the effectiveness of CBTAC protocol on burdens of Alzheimer’s disease on caregivers and their sense of coherence.

Methods: This study was a quasi-experimental research with pretest-posttest control group design. The target population included all mild Alzheimer’s disease patients and their caregivers referred to neurology ward of the hospitals in Rasht during summer 2018. According to the medical records and results of screening, 40 mild Alzheimer’s disease patients and their caregivers were recruited by convenience sampling method. After sampling, research participants were randomly assigned into two experimental (n= 20) and wait list control (n= 20) groups. The Impact of Alzheimer’s Disease on Caregiver Questionnaire and Sense of Coherence Scale were used to measure burdens of Alzheimer’s disease on caregivers and caregivers’ sense of coherence. The CBTAC provided for the experimental group participants in 25 sessions of 90-minutes. In the end, the data analyze have done by multivariate analysis of covariance (MANCOVA) and using SPSS24 software.

Results: The findings indicated that the CBTAC had significant effect on burdens and sense of coherence of Alzheimer caregivers in experimental group (p <0.01). In other words, the CBTAC decrease burdens and increase sense of coherence of Alzheimer caregivers significantly (p <0.01).

Conclusion: Based on research results, the CBTAC is an effective intervention in decreasing caregiving burden and increasing sense of coherence of Alzheimer caregivers. Therefore, the CBTAC is a multicomponent intervention that can be used to improve competency and mental health of Alzheimer’s caregivers.

A Robust Nonlinear Control Strategy for Unsupported Paraplegic Standing Using Functional Electrical Stimulation: Controller Synthesis and Simulation

Seyedeh Sakineh Ruhbakhsh, Hamid Reza Kobravi

International Clinical Neuroscience Journal, Vol. 7 No. 2 (2020), , Page 88-102

Background: Functional electrical stimulation (FES) is known as a promising technique for movement generation in the paralyzed limbs through electrical stimulation of the muscle nerves. This paper focuses on the FES based control of upright standing in paraplegic patients. In this study a new approach for controlling the upright posture has been proposed. The posture control strategies proposed in the previous works were based on controlling the angular joint position, and none of them were focused on controlling the CoP dynamics directly. Since the CoP is representative of posture balance dynamics, in this study the adopted FES based control strategy was designed to control the CoP dynamics directly.

Method: In the proposed strategy, the controller has determined the stimulation intensity of ankle muscles in a manner to restrict the center of pressure (CoP) in a specific zone to guarantee the posture balance during unsupported standing. The proposed approach is based on a new cooperative based combination between two different controllers. Utilizing this strategy, until the CoP is confined within the stable zone, an adaptive controller is active and tries to preserve the posture stability. When the CoP goes out the stable zone, sliding mode control, as a nonlinear control technique presenting remarkable properties of robustness, is activated and tries to back the CoP within the preference zone. In this manner, not only the posture balance can be guaranteed but also the balance dynamics can be similar to the elicited dynamic postural behavior in the normal subjects.

Results: Extended evaluations carried out through the simulation studies on a musculoskeletal model. According to the achieved results, the proposed control strategy is not only robust against the external disturbances but also insensitive to the initial postural conditions.

Conclusion: The achieved results prove the acceptable performance of the proposed control strategy.

Postpartum Depression Among Women With Previous Infertility in Health Care Centers of Hamadan in 2018

Nasrin Matinnia, Saeid Yazdi-Ravandi

International Clinical Neuroscience Journal, Vol. 7 No. 2 (2020), , Page 103-108

Background: Childbirth is one of the important goals of family, so the infertility can cause many problems for the family. Therefore, the aims of the current study were the frequency of postpartum depression and evaluate the relationship between postpartum depression, socio demographic factors and quality of marital satisfaction in postpartum women with a history of infertility referring to health centers in Hamadan.

Methods: This study was a cross-sectional study. The study population consisted of all primiparous women with a history of infertility referring to Hamadan health care centres in 2018, of which 240 were randomly selected according to the inclusion criteria during one year. Subjects were assessed by demographic and clinical information checklist, Edinburgh Depression Inventory (EPDS) and marital relationship quality scale (Revised Dyadic Adjustment Scale; RDAS). All statistical calculations were performed by busing chi square with SPSS-17.

Results: Totally 152 out of 240 participants (63.3%), had a degree of depression, of which 57 (23.7%) had a mild depression, 63 (26.3%) had moderate depression and 32 (13.3%) had severe depression. According to result of the study, marital satisfaction in 23.3% (56), 37.1% (89) and 39.6% (95) were good, moderate and low respectively. The quality of marital relationship associated significantly with and postpartum depression (χ2=19.3,P<0.001). The results of the study showed that there was a significant relationship between age, occupation, educational level, duration of infertility and depression (P<0.05), but there was no significant relationship between ethnicity, insurance and depression (P<0.05).

Conclusion: Regarding the results obtained in this study and comparison with existing studies, the infertility problem can cause mental and psychological disorders in women. It seems that the marital satisfaction and its relationship with different factors and the proper interventions by health care providers are necessary to prevent postpartum depression in these women.

Case Report

Diffuse Multifocal Bilateral Dysembryoplastic Neuroepithelial Tumor: A Very Unusual Case Report

Hassan Reza Mohammadi, Ehsan Moradi, Elham Rahimian, Pascal Varlet, Yalda Nilipor

International Clinical Neuroscience Journal, Vol. 7 No. 2 (2020), , Page 109-112

Dysembryoplastic neuroepithelial tumor (DNT) considered as a benign cortical Glioneuronal neoplasm of children or young adults, typically present with drug-resistant focal epilepsy. DNTs are usually located in the temporal lobe but can found in any part of the supratentorial brain cortex. Multifocal DNTs have rarely reported. Here we present an eight years old boy with two years follow up, having a somewhat stable diffuse multinodular DNT of the most significant spatial extent that may have reported, involving cortical and subcortical left temporo-occipital lobe, bilateral basal ganglia and thalamus, presenting with headache, short stature, and behavioral disorder.