Masoud Mehrpour

25-hydroxyvitamin D levels are associated with multiple sclerosis in Iran: A cross-sectional study.

Vitamin D is being increasingly studied in multiple sclerosis (MS). A number of studies have shown that MS patients have lower levels of 25-hydroxyvitamin D as compared to comparator populations, but previous studies in Iran have been conflicting, perhaps due to their small sample size. We performed the largest study to date investigating 25-hydroxyvitamin D levels in Iranian MS patients (n=700) and controls (n=1000). 25-hydroxyvitamin D was measured using a quantitative chemiluminescent immunometric assay. 25-hydroxyvitamin D levels were lower in patients with MS. Over 24% of controls were vitamin D sufficient as compared to 3.4% of patients. Logistic regression showed that for every 1 ng/mL increase in 25-hydroxyvitamin D, the odds for MS decreased (odds ratio=0.87; 95% confidence interval (CI) 0.85-0.88; p<0.001), after adjusting for age and sex. There was no association between 25-hydroxyvitamin D levels and disability scores in MS patients. Iranian Patients with MS have low levels of vitamin D and, where deemed necessary, appropriate supplementation should be given.

Optic nerve sonography in the diagnostic evaluation of pseudopapilledema and raised intracranial pressure: a cross-sectional study.

Introduction. Differentiating pseudopapilledema from papilledema which is optic disk edema and a result of increased ICP (intracranial pressure) is important and can be done with noninvasive methods like orbital ultrasound examination. Method. This was a cross-sectional study in which patients with optic nerve head swelling were referred for LP exam after optic nerve head swelling diagnosis confirmation and having normal brain imaging (CT scan). Before LP (lumbar puncture) exam the patients were referred for optic nerve ultrasound test of both eyes. Results. Considering 5.7 mm as the upper limit for normal ONSD (optic nerve sheath diameter), sensitivity and negative predictive value of optic sonography in diagnosis of pseudopapilledema are 100% for both eyes. Calculated accuracy validity of ONSD measurement in detecting pseudopapilledema is 90% for the right eye and 87% for the left eye. Conclusion. Our study demonstrated a close correlation between optic nerve sheath dilation on ocular ultrasound and evidence of elevated ICP with optic disk swelling. With the aid of noninvasive diagnostic tests we can avoid unnecessary concerns along with expensive and invasive neurological investigations while targeting the correct diagnosis in bilateral optic disk swelling. Our study showed optic nerve sonography as a reliable diagnostic method for further usage.

Oral consumption of α-linolenic acid increases serum BDNF levels in healthy adult humans.

Background aimsDietary omega-6 and omega-3 fatty acids have remarkable impacts on the levels of DHA in the brain and retina. Low levels of DHA in plasma and blood hamper visual and neural development in children and cause dementia and cognitive decline in adults. The level of brain-derived neurotrophic factors (BDNF) changes with dietary omega-3 fatty acid intake. BDNF is known for its effects on promoting neurogenesis and neuronal survival.MethodsIn this study, we examined the effect of the oral consumption of α-Linolenic acid (ALA) on blood levels of BDNF and Malondialdehyde (MDA) in healthy adult humans. 30 healthy volunteers, 15 men and 15 women, were selected randomly. Each individual served as his or her own control. Before consuming the Flaxseed oil capsules, 5cc blood from each individual was sampled in order to measure the plasma levels of BDNF and MDA as baseline controls. During the experiment, each individual was given 3 oral capsules of flaxseed oil, containing 500mg of alpha linolenic acid, daily for one week. Then, plasma levels of BDNF and MDA were tested.ResultsThe plasma levels of BDNF and MDA significantly (P < 0.05) increased in individuals who received the oral capsules of ALA. Plasma levels of BDNF increased more in the women in comparison with the men.ConclusionALA treatment could be a feasible approach to reduce size of infarcts in stroke patients. Thus, ALA could be used in adjunction with routine stroke therapies to minimize brain lesions caused by stroke.

Angiogenic factors are associated with multiple sclerosis

A growing body of evidence suggests that angiogenesis plays a crucial role in the pathogenesis of multiple sclerosis (MS). Animal models of MS show a significant improvement when the process of angiogenesis is halted. In this study, we measured the serum levels of vascular-endothelial growth factor (VEGF), soluble Endoglin (sEng), angiopoietin 1(Ang-1), angiopoietin 2 (Ang-2), and uric acid (UA) as well as serum anti-Epstein-Barr virus (EBV) EBNA-1 IgG in 50 MS patients (including 20 newly diagnosed and 30 patients taking IFN-beta for >6months) and 40 healthy individuals. Enzyme-linked immunosorbent assays (ELISA) were used apart from UA where the uricase quantitative enzymatic assay was used. A significant increase of VEGF, Ang-1, Ang-2, and sEng in serum samples of MS patients with respect to healthy subjects was observed. VEGF was higher in newly diagnosed MS patients in comparison to patients taking interferon-beta and was associated with EDSS. The serum levels of UA were statistically lower in MS patients as compared to the healthy group. Higher levels of anti-EBV antibody titers were seen in MS patients than controls and anti-EBV titers correlated with angiogenic factors. It seems that in summary, angiogenesis may play an important role in MS and infection with EBV might be correlated with this phenomenon.

Increased Serum Brain-derived Neurotrophic Factor in Multiple Sclerosis Patients on Interferon-β and Its Impact on Functional Abilities.

Objectives:To investigate the potential role of disease-modifying therapies (DMTs) used to treat multiple sclerosis on inducing brain-derived neurotrophic factor (BDNF) production. Methods:A total of 82 patients entered the study. Sixty (73%) patients were on DMTs (15 on Avonex, 13 on Rebif, 27 on Betaferon, 3 on Mitoxantrone, and 2 on IVIg), whereas 22 received no DMTs. The degree of neurological impairment was recorded using the expanded disability status scale (EDSS). Serum BDNF levels were assessed using the Sandwich ELISA method. We compared mean serum BDNF levels among patient groups based on whether or not they were on DMTs, and the specific agent used. Then, the relationship between BDNF levels and EDSS scores was assessed. The receiver operating characteristic (ROC) curve was used to calculate a cutoff value by which serum BDNF could predict the degree of disability. Results:The study sample had a mean age of 34.6 years, mean EDSS score of 3.8, and mean BDNF level of 198.9 pg/mL. Patients on interferon-&bgr; 1b therapy had significantly higher levels of BDNF compared with patients on Mitoxantrone or patients not on DMTs (237.6, 68.6, and 155.9, respectively; P=0.003). The degree of neurological impairment correlated negatively with BDNF levels (P<0.001). A cutoff value of 190 pg/mL was calculated for BDNF (ROC analysis, area under the curve: 0.729, P=0.002). At BDNF levels >190, the sensitivity for a milder degree of neurological impairment (EDSS<3) was 80%. Conclusions:This study showed a significant effect of interferon-&bgr; 1b therapy on increasing BDNF production in multiple sclerosis.

Cytomegalovirus and varicella zoster virus seropositivity of Iranian patients with multiple sclerosis: A population-based study

Multiple Sclerosis is a demyelinating disease of the central nervous system (CNS) affecting young individuals with age range of 20-40years of age. The precise mechanism underlying the disease is still unclear. Some viruses have been proposed to play roles in disease causation. In this study, we recruited 800 MS patients along with 1000 healthy individuals to determine the seropositivity of anti-CMV and anti-VZV IgG titers using enzyme-linked immunosorbent assay (ELISA). Our results showed significant higher titers of anti-CMV and anti-VZV IgG titers in serum of MS patients with respect to healthy individuals (for both p<0.001). It seems that CMV and VZV play a key role in MS pathogenesis.

Sex steroid hormones and sex hormone binding globulin levels, CYP17 MSP AI (−34 T:C) and CYP19 codon 39 (Trp:Arg) variants in children with developmental stuttering

HighlightsThere was an association between stuttering and serum levels of testosterone, DHT and oestradiol.Stuttering was not associated with digit ratio (2D:4D), an estimation of foetal exposure to testosterone.The frequency of an allele of the CYP17 −34 T:C polymorphism was associated with susceptibility to stuttering. Abstract Developmental stuttering is known to be a sexually dimorphic and male‐biased speech motor control disorder. In the present case‐control study, we investigated the relationship between developmental stuttering and steroid hormones. Serum levels of testosterone, dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA), oestradiol, progesterone, cortisol, and sex hormone binding globulin (SHBG), as well as the 2nd/4th digit ratio (2D:4D), an indicator of prenatal testosterone level, were compared between children who stutter (CWS) and children who do not stutter (CWNS). Moreover, two SNPs (CYP17 −34 T:C (MSP AI) and CYP19 T:C (Trp:Arg)) of cytochrome P450, which is involved in steroid metabolism pathways, were analysed between the groups. Our results showed significantly higher levels of testosterone, DHT, and oestradiol in CWS in comparison with CWNS. The severity of stuttering was positively correlated with the serum levels of testosterone, DHEA, and cortisol, whereas no association was seen between the stuttering and digit ratio, progesterone, or SHBG. The CYP17CC genotype was significantly associated with the disorder.

Auditory Temporal Processing Deficits in Chronic Stroke: A Comparison of Brain Damage Lateralization Effect

BACKGROUND There have been a few reports about the effects of chronic stroke on auditory temporal processing abilities and no reports regarding the effects of brain damage lateralization on these abilities. Our study was performed on 2 groups of chronic stroke patients to compare the effects of hemispheric lateralization of brain damage and of age on auditory temporal processing. METHODS Seventy persons with normal hearing, including 25 normal controls, 25 stroke patients with damage to the right brain, and 20 stroke patients with damage to the left brain, without aphasia and with an age range of 31-71 years were studied. A gap-in-noise (GIN) test and a duration pattern test (DPT) were conducted for each participant. RESULTS Significant differences were found between the 3 groups for GIN threshold, overall GIN percent score, and DPT percent score in both ears (P ≤ .001). For all stroke patients, performance in both GIN and DPT was poorer in the ear contralateral to the damaged hemisphere, which was significant in DPT and in 2 measures of GIN (P ≤ .046). Advanced age had a negative relationship with temporal processing abilities for all 3 groups. CONCLUSIONS In cases of confirmed left- or right-side stroke involving auditory cerebrum damage, poorer auditory temporal processing is associated with the ear contralateral to the damaged cerebral hemisphere. Replication of our results and the use of GIN and DPT tests for the early diagnosis of auditory processing deficits and for monitoring the effects of aural rehabilitation interventions are recommended.

The role of expression and activity of 15-Lipoxygenase isoforms and related cytokines in patients with Multiple Sclerosis and healthy controls

BACKGROUND Multiple Sclerosis (MS) as an inflammatory multifactorial auto immune nervous system disease imposes devastating burden of morbidity worldwide. Among environmental and genetic factors, the relevance of inflammatory mediators in MS pathogenesis is well documented. 15-Lipoxygense enzyme and its derived products have received attention as possible mediators of inflammatory responses. The involvement of 15-Lipoxygense pathway in the pathogenesis of inflammatory diseases such as MS has yet to be illustrated which is perused in the current study. METHODS The expression level of 15-Lipoxygense isoforms was assessed via Real-Time PCR in the peripheral blood mononuclear cells separated from patients with MS and healthy subjects. The level of 15-Lipoxygense products (15(S) HETE, 13(S) HODE) and related cytokines (IL4 and IL13) were evaluated using enzyme immunoassay kits in serum samples. RESULTS Our results demonstrated that 15-Lipoxygense-1 and 15-Lipoxygense-2 expression levels were increased in patients suffering from MS comparing to healthy subjects which were more obvious in Relapsing-Remitting MS. The elevated levels of 15-Lipoxygense isoforms were accompanied with 15(S) HETE and 13(S) HODE enhancement in serum of patients and the IL 13 elevation but not IL4 was consistent with higher expression of 15-Lipoxygense. The diagnostic value of 15-Lipoxygense isoforms and products were considerable between patients and healthy groups. CONCLUSION The possible effect of 15-Lipoxygense pathway in the regulation of inflammatory events may light up new therapeutic possibilities regarding MS pathogenesis.

The paced auditory serial addition test for working memory assessment: Psychometric properties

Background: The paced auditory serial addition test (PASAT) was primarily developed to assess the effects of traumatic brain injury on cognitive functioning. Working memory (WM) is one of the most important aspects of cognitive function, and WM impairment is one of the clinically remarkable signs of aphasia. To develop the Persian version of PASAT, an initial version was used in individuals with aphasia (IWA). Methods: In this study, 25 individuals with aphasia (29-60 years) and 85 controls (18-60 years) were included. PASAT was presented in the form of recorded 61 single-digit numbers (1 to 9). The participants repeatedly added the 2 recent digits. The psychometric properties of PASAT including convergent validity (using the digit memory span tasks), divergent validity (using results in the control group and IWA group), and face validity were investigated. Test-retest reliability was considered as well. Results: The relationship between the PASAT and digit memory span tests was moderate to strong in the control group (forward digit memory span test: r= 0.52, p< 0.0001; backward digit memory span test: r = 0.48, p< 0.0001). A strong relationship was found in IWA (forward digit memory span test: r= 0.72, p< 0.0001; backward digit memory span test: r= 0.53, p= 0.006). Also, strong testretest reliability (intraclass correlation= 0.95, p< 0.0001) was observed. Conclusion: According to our results, the PASAT is a valid and reliable test to assess working memory, particularly in IWA. It could be used as a feasible tool for clinical and research applications.