Current Journal of Neurology

Assessment of median nerve with magnetic resonance neurography in cases with carpal tunnel syndrome and controls

Ghasem Farahmand — 2024-10-26

Background: Carpal tunnel syndrome (CTS) is a common peripheral nerve entrapment disorder that is diagnosed using clinical signs and symptoms and confirmed via nerve conduction studies (NCSs). While NCS is a semi-invasive procedure, magnetic resonance imaging (MRI) is a non-invasive diagnostic tool that detects macroscopic nerve abnormalities and evaluates a patient's surgical or medication treatment options. This study assessed magnetic resonance neurography (MRN)’s diagnostic and grading value by comparing it to electrodiagnostic studies in patients with CTS and healthy individuals.

Methods: This was a cross-sectional study on 27 wrists with CTS and 27 healthy wrists. After history taking and physical examination, we employed an NCS to confirm and determine the severity of CTS, then MRN and diffusion tensor imaging (DTI) were used to calculate apparent diffusion coefficient (ADC), fractional anisotropy (FA), and cross-sectional area (CSA).

Results: 18 patients with CTS (27 median nerves) and 15 healthy controls (27 median nerves) were evaluated. The mean FA in the CTS group was significantly lower (0.38 ± 0.05 vs. 0.45 ± 0.06, P < 0.001).The mean CSA and ADC were higher in patients with CTS but not statistically significant. FA’s diagnostic cut-off was 0.42, with a sensitivity of 70.4% and a specificity of 63%.

Conclusion: MRN with DTI can be an effective and non-invasive diagnostic technique for the detection of CTS. The FA measure demonstrated adequate sensitivity and specificity for differentiating patients with CTS from healthy individuals.

The evaluation of complete blood count parameters in the patients with idiopathic versus secondary cerebral venous thrombosis

Mohammad Javad Gholamzadeh — 2024-10-26

Background: Several laboratory markers derived from a complete blood count (CBC) have been proposed as potential indicators for assessing the risk of cerebral venous thrombosis (CVT). However, limited and conflicting evidence exists regarding this association. This study aimed to evaluate the role of CBC parameters in CVT development and their link to disease characteristics.

Methods: This case-control study included patients diagnosed with CVT between March 2018 and and March 2021. All participants with CVT were registered in the organized registry system at the Neurology Research Center of Shiraz University of Medical Sciences, Shiraz, Iran (CVT registry code: 9001013381). The control group consisted of age- and sex-matched individuals without systemic diseases. CBC results from the control group and the first recorded hospital CBC of the patient group were collected.

Results: The study included 295 patients with CVT [49 with idiopathic CVT (iCVT) and 246 with secondary CVT (sCVT)] and 341 healthy individuals. Among the CVT group, 72.54% were women. Patients with CVT had higher red cell distribution width (RDW) and lower red blood cell (RBC) count, hemoglobin (Hb) levels, and hematocrit compared to the non-CVT group. In iCVT cases, male gender, RBC count, Hb levels, and hematocrit were notably higher compared to sCVT cases. Logistic regression analysis showed that female gender, smoking, and higher hematocrit values were associated with increased probability of iCVT.

Conclusion: The study suggests that certain CBC parameters may serve as potential markers for assessing CVT risk and differentiating between iCVT and sCVT cases. Validation and further research are needed to explore the underlying mechanisms.
March 2021.

Investigation of pregnancy tendency, reproductive characteristics, and disability in women with multiple sclerosis: A secondary data analysis of the national registry in Iran

Sajjad Ghane Ezabadi — 2024-10-26

Abstract

Background: Multiple sclerosis (MS) predominantly affects women of childbearing age, significantly impacting their quality of life (QOL).The diagnosis of MS can influence pregnancy intention, and the level of disability associated with MS may change before and after pregnancy. This study aims to analyze the reproductive characteristics of Iranian female patients with MS (PwMS) and their association with the Expanded Disability Status Scale (EDSS) and pregnancy tendency, providing valuable insights into disease progression and the development of tailored treatments.

Methods: A cross-sectional study was conducted using data from the nationwide MS registry of Iran (NMSRI) from 2018 to 2021. Patients without a documented history of pregnancy, MS type, or EDSS score were excluded from the study. Various statistical methods, including nonparametric tests, the generalized estimating equation (GEE) model, and multiple logistic regression, were employed to analyze the data.

Results: The study included 1120 PwMS with a median diagnostic age of 31 and a disease duration of 6 years. The majority had relapsing-remitting MS (RRMS) and the mean EDSS score at bassline was 1.5 ± 1.4. A history of pregnancy or abortion was associated with higher EDSS scores. Multiparity before MS diagnosis was linked to EDSS score ≥ 5, while this EDSS range was associated with decreased parity after MS diagnosis (all P-values < 0.05).

Conclusion: Pregnancy and parity can affect the disability in female PwMS irrespective of clinical symptoms, diagnosis age, and MS type. Moreover, the chance of parity may be affected by a higher disability score, which should be considered in the clinical setting.

Diagnostic potential of lncRNAs-ANRIL and MIAT in the blood of patients with cerebral venous thrombosis

Zoofa Zayani — 2024-10-26

Background: Long non-coding ribonucleic acids (lncRNAs) have been implicated as possible circulating stroke indicators. This study focused on the expression status of antisense non-coding ribonucleic acid in the INK4 locus (ANRIL) and myocardial infarction associated transcript (MIAT) in patients with cerebral venous thrombosis (CVT).

Methods: In this study, fifty patients with CVT and one hundred age/gender-matched individuals as controls were included. The circulating levels of ANRIL and MIAT in the first 24 hours after admission were evaluated using the quantitative real-time polymerase chain reaction (RT-PCR) method. We compared the expression levels of ANRIL and MIAT between patients and controls using the independent two-sample t-test. Subgroup analysis was used to investigate the association of lncRNAs with clinical characteristics in patients with CVT. Receiver operating characteristic (ROC) curve analyses were conducted to evaluate the diagnostic value of two lncRNAs in patient assessment.

Results: The relative expression of lncRNAs ANRIL and MIAT significantly decreased in patients compared to the control. ANRIL and MIAT were shown as potential markers for discriminating patients with CVT from the healthy controls with an area under the curve (AUC) of 0.98 and 0.99, respectively.

Conclusion: For the first time, we found down-regulation and diagnostic potential of lncRNAs-ANRIL and MIAT in the blood of patients with CVT.

The assessment of the perceived stress and the quality of life in the patients with myasthenia gravis: The mediating role of the psychological capital and social support

Hossein Pourshahriar — 2024-10-26

Background: Stress has been known as a risk factor for the onset and modification of autoimmune disorders such as myasthenia gravis (MG). However, the patients can control their stress and improve their quality of life (QOL) using some factors such as psychological and social support. Psychological capital and social support play a key role in decreasing stress and improving QOL in the patients with MG. Therefore, the present study aimed to assess the mediator role of the psychological capital and social support in perceived stress and QOL of the patients with MG.

Methods: In the present cross-sectional study, 203 patients with MG, including 138 women and 65 men, were selected from Iran Myasthenia Gravis Association and Shariati Hospital, Tehran City, Iran, using available sampling. The selected patients completed the Myasthenia Gravis Quality of Life questionnaire (MG-QOL), Luthans Psychological Capital Questionnaire (PCQ), Multidimensional Scale of Perceived Social Support (MSPSS), and Cohen Perceived Stress Scale (PSS-14). To assess the mediator role of the psychological capital and the perceived social support in the relationshipwith the perceived stress and QOL of the patients with MG, structural equation modeling (SEM) was used.

Results: There was a significant negative relationship between the perceived stress and the variables of psychological capital (including hope, resilience, optimism, and self-efficacy), perceived social support dimensions (including support from important people, support from family, and support from friends), and QOL dimensions (including social activity and mental health) (P < 0.01). The results also showed that the perceived social support dimensions (including support from important people, support from family, and support from friends) and the variables of psychological capital (including hope, resilience, optimism, and self-efficacy) had a significant positive relationship with the QOL in patients with MG
(P < 0.01). The indirect effect of perceived stress on the QOL through social support and psychological capital was 0.16 and 0.15, respectively, which was statistically significant (P < 0.05).

Conclusion: The present study results show that a part of the shared variance between the conceptual circles of the perceived stress and QOL in patients with MG results from variability in the psychological capital and social support.

Mass-like presentation of primary angiitis of the central nervous system: A clinical note

Faramarz Roohollahi — 2024-10-26

The Article Abstract is not available.

Acute subdural haemorrhage in a warfarin user following leech bite: Clinical note and review

Aviraj Satish Deshmukh — 2024-10-26

he Article Abstract is not available.

Transient global amnesia in a patient with painless spontaneous internal carotid artery dissection: An unusual but possible underlying cause

Francesco Natale — 2024-10-26

he Article Abstract is not available.

Meralgia paresthetica treated with temporary peripheral nerve stimulation

Jamal Hasoon — 2024-10-26

The Article Abstract is not available.

The first mention of the word “brain” in texts related to the Iranian continental plateau

Abdorreza Naser Moghadasi — 2024-10-26

The Article Abstract is not available