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Showing 23 results for Multiple Sclerosis
Khatoonabadi Sar, Hadian Mr, Ghaffarpour M, Kahlaoui K, Hasanzadeh A,
Volume 66, Issue 10 (1-2009)
Volume 66, Issue 10 (1-2009)
Abstract
Background: Many studies have shown that about 45-65% of multiple sclerosis (M.S) patients suffer from cognitive impairments. Semantic memory as one of the subcategories of cognition is quite important for effective communication. In the present study, category-semantic memory was studied in order to evaluate the semantic memory organization in normal individuals and MS patients.
Methods: Ninety voluntaries participated in this study. Participants comprise of 45 MS patients and 45 normal individuals. All participants were matched in terms of age, sex and education. Variables such as the reaction time and the number of correct responses for retrieval (recognition) of natural (animal and fruit) and artifact (object) words were measured in both groups by presentation software. Data analyzed by t-paired and One-Way ANOVA tests. Ethical committee of Tehran University of Medical sciences approved the study.
Results: The results of current study showed significant differences in reaction time and correct responses of artifact and natural categories between the MS and normal individuals (p<0.05). Furthermore, there was significant difference between reaction time and number of correct responses to natural and artifact categories in each group (p<0.05).
Conclusions: This study showed that the organization of semantic categorization as natural and artifact categories is still preserved in multiple sclerosis patients. However, the processing of semantic categorization was different in term of reaction time and number of correct responses between MS patients and normal subjects and the processing of semantic-memory is slower than normal individuals.
Harirchian Mh, Karimi N, Abdollahi Y, Hashemi Chalavi L,
Volume 67, Issue 1 (4-2009)
Volume 67, Issue 1 (4-2009)
Abstract
Background: Visual, brain stem auditory and somatosensory evoked potentials (EPs) have been traditional paraclinical tests to evaluate the competency of sensory tracts in multiple sclerosis (MS) patients. It seems that only one of these EPs could be sufficient, at least as a screening test. The objective of this paper is to evaluate the frequency of these three evoked potentials in definite MS patients.
Methods: This descriptive cross-sectional study involved was 25 definite relapsing remitting MS patients who referred to our university hospital. Twenty five individuals from normal population without any neurologic, visual, auditory or sensory disorders have been evaluated as well to determine the standard values in our electrophysiology lab. Values more than mean+2.5SD for latencies and less than mean-2.5SD for amplitudes were considered as abnormal.
Results: Fifteen (60%), 13 (52%), and 13 (52%) had abnormal visual, auditory and somatosensory EPs respectively. The latency of P100 in visual EP (VEP) had the most sensitivity among all of the parameters. It was determined that the possibility of abnormality in each of auditory and somatosensory EPs in the presence of normal VEP could be 30.8%. In other words 30.8% of patients with negative VEP could have a positive auditory brain stem or somatosensory EPs.
Conclusion: In our study, a VEP abnormality was more frequent than auditory brain stem and somatosensory EPs. Thus it is not logical to perform triple EP tests in all suspected MS patients, but auditory and somatosensory EPs could be considered in patients with normal VEP.
Masood Etemadifar, Mehrdokht Mazdeh, Hamid Reza Torabi, Majid Ghaffarpour, Mojtaba Azimian, Shiva Salami, Sayyed Mohammad Amir Shahkarami,
Volume 68, Issue 1 (4-2010)
Volume 68, Issue 1 (4-2010)
Abstract
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Background: Recent studies present a
high prevalence of multiple sclerosis (MS) in Iran. Treatment with interferon is now the first choice in management
of MS. CinnoVexTM (an interferon beta 1-a) is available in
Iran, with achievement of the technology of producing beta interferon. The aim of
the present study is to evaluate the efficacy and safety of CinnoVexTM in a national study named CINA study.
Methods: This study was conducted from 2007 to 2008 in cities of Tehran, Isfahan, Mashhad,
Tabriz, and Shiraz. Patients with relapsing/remitting MS with 16-50 years of age and EDSS of <4 received CinnoVexTM (30µg/week, IM) after diagnosis by a neurologist. EDSS, drug side effects, and frequency of relapse were evaluated for one year
in four 3-month visits.
Results: A total of 1050 patients entered the study. Complete data
were collected from 627 (60%) patients. Mean age was 30.7±8.6 year and 514 (82%) were female. The most common onset presentations
were sensory symptoms (44%). Changes of EDSS through the study showed a significant decrease in the last 3-month of evaluation (p<0.05). Drug side effects
were observed in 47%, 50%, 61%, and 61.4% (p>0.05) and relapse was occurred in 13.4%, 15.7%, 16.9%, and 2.4% of the patients in the first, second, third,
and forth evaluation visits (p=0.001), respectively.
Conclusion: CinnoVexTM prevents progression and improves clinical course of MS. The conventional side
effects of beta interferon therapy, however, are observed with CinnoVexTM.
Ahmadi Shadmehri A, Nicknam Mh, Shokrgozar Ma, Mahmoudi M, Sarial Sh, Ahmadi Shadmehri A, Moradi B, Farhadi E, Amirzargar Aa,
Volume 68, Issue 2 (5-2010)
Volume 68, Issue 2 (5-2010)
Abstract
Background: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system with presumed autoimmune origin. T cells are considered to play a pivotal role in orchestrating the self-reactive immune responses in multiple sclerosis (MS). This study was performed to investigate the role of polymorphisms of the programmed cell death 1 (PD-1) gene on susceptibility to ankylosing spondylitis.This gene codes an immunoreceptor named PD-1, which has a cytoplasmic domain containing two tyrosine residues located within immunoreceptor tyrosine-based inhibitory and switch motifs (ITIM and ITSM), suggesting that PD-1 is predominantly inhibitory which responsible for the negative regulation in T cell activation and peripheral tolerance. We investigated whether PD-1 gene polymorphism is a genetic modifier for risk and progression of MS.Methods: Blood samples from 150 Iranian Relapsing-Remitting MS patients (mean age, 34.98 years) and 202 healthy controls (mean age, 30 years) were enrolled in this study.The PD-1.3 (7146 G/A Intron 4) and PD-1.9 (7625 C/T Exon 5) polymorphisms were detected by Polymerase Chain Reaction and Restriction Enzyme digestion or Restriction Fragment Length Polymorphism (PCR-RFLP). Results: No significant association of the mutated alleles with the disease were detected. Because of the ethnic group genetic variation, our data is not like some of Asian population such as Korea and China.Conclusions: Our data suggest that PD-1 polymorphisms are not act as genetic modifiers of the progression of MS, possibly these polymorphisms don't induce a partial defect in PD-1 mediated inhibition of T-cell activation.
Najafi Mr, Sonbolestan F, Aghaghazvini Mr, Sonbolestan Sa,
Volume 68, Issue 12 (3-2011)
Volume 68, Issue 12 (3-2011)
Abstract
Background: Diagnosis of multiple sclerosis (MS), as a major cause of neurological disability in young adults, is difficult to establish, especially at the onset of the disease process, due to lack of reliable molecular markers.The goal of the present study was to evaluate serum and urinary concentrations of cystatin C and to find their relationship with patients' expanded disability status scale (EDSS).
Methods: Based on McDonald's criteria, 54 adult patients with M.S.(11 males and 43 females, with a mean age of 32.18±8.37 years) were enrolled as the case group and 24 age and sex-matched healthy, non-M.S. individuals (7 males and 17 females, with a mean age of 34.31±10.07 years) were recruited as the controls. Serum and urinary concentrations of cystatin C were measured in all the participants.
Results: The means of serum cystatin C concentrations (mg/Lit) in the case and control groups respectively were 0.90±0.01 and 0.89±0.02, (p=0.84) and the means for its urinary concentrations were 25.37±1.91 and 21.11±2.54 (p=0.18).The means of serum and urinary cystatin C concentrations were 0.90±0.01 and 25.11±2.33 in patients whose EDSS was ≤2.5 and 0.90±0.03 and 26.30±2.84 in patients whose EDSS was ≥2.5,respectively, although, the differences between the two groups of patients were not statistically significant (p=0.80 and 0.74,respectively for serum and urinary concentrations of cystatin C).
Conclusions: This study showed that serum and urinary cystatin C concentrations cannot be used for multiple sclerosis diagnosis or even as a marker in its treatment follow ups or for the determination of disease severity.
Abtahi Froushani Sm, Delirezh N, Hobbenaghi R, Mosayebi Gh,
Volume 69, Issue 11 (2-2012)
Volume 69, Issue 11 (2-2012)
Abstract
Background: Recent studies have demonstrated an essential role for IL-17 in the pathogenesis of experimental autoimmune encephalomyelitis (EAE). Furthermore, it has been shown that FoxP3+Treg cells play an important role in the suppression of autoinflammatory reactions. Although, previous studies have determined the immunomodulatory potentials of all-trans-retinoic acid (ATRA), but these immunomodulations have been mostly justified by alteration in Th1/Th2 cytokines. The present study was carried out to investigate the therapeutic effects of ATRA on EAE and its effects on T-helper cells responses.
Methods: EAE was induced by MOG35-55 peptide and complete Freund's adjuvant in female C57BL/6 mice. The mice were allocated to two therapeutic groups (n=7 per group). Treatment with ATRA (500 μg/mouse every other day) was initiated in treatment group on day 12 when they developed a disability score. EAE controls received vehicle alone with the same schedule. Signs of disease were recorded daily until day 33 when the mice were sacrificed. Splenocytes were tested for proliferation by MTT test, cytokine production by ELISA and FoxP3+Treg cell frequency by flowcytometry.
Results: ATRA significantly reduced the clinical signs of established EAE. Aside from decreasing lymphocytic proliferation (P<0.05), ATRA significantly inhibited the production of pro-inflammatory IL-17 (P<0.005) as well as IFN-γ (P<0.0005) upon antigen-specific restimulation of splenocytes. FoxP3+Treg cell frequency and IL-10 levels were not altered significantly. However, IFN-γ to IL-10 and IL-17 to IL-10 ratios decreased significantly (P<0.0005).
Conclusion: Parallel to reducing autoreactive lymphocyte proliferation and cytokine production in favor of pro-inflammatory cytokines, all-trans-retinoic acid ameliorated established experimental autoimmune encephalomyelitis.
Sallahadin Feizollah , Shiva Khezri ,
Volume 73, Issue 8 (11-2015)
Volume 73, Issue 8 (11-2015)
Abstract
Background: Multiple Sclerosis (MS) is a neurodegenerative disease of the central nervous system (CNS). The hippocampus is a vital center for learning and memory it is extremely vulnerable to neurodegenerative diseases. The male hormones could be neuroprotective for the CNS. The current study is an attempt to investigate the effect of testosterone on learning and spatial memory following the demyelination of CA1 area by the injection of ethidium bromide in the rats' hippocampus. Methods: This experimental study has been conducted on healthy rats in the faculty of science of the Urmia University from September 2013 to February 2015. For demyelination in all previously gonadectomized healthy rats, 3µl ethidium bromide was injected into the CA1 area of rats by stereotaxic surgery. In addition, the treatment groups received 1µl testosterone (6µg/µl) during a 20-day timeframe on a daily basis after demyelination by the ethidium bromide. The control groups had no drug injection. The process of the learning and spatial memory of the rats were closely monitored by the radial Maze. The demyelination and remyelination in the hippocampus were checked by the myelin-specific coloring (Luxol fast blue and Cresyl violet). Results: The histological results suggest that the testosterone is capable of minimizing the destructive impacts of ethidium bromide in the treatment group as well as enhancing the remyelination process. In the group treated by testosterone, the percentage of the pyknotic cells 20 days after demyelination induction, represented a significant reduction compared to that of ethidium bromide group (P=0.008). The behavioral studies analyses show that the amount of the food finding time in those groups received ethidium bromide was significantly longer than those of the control groups (P=0.001). Furthermore, the application of the testosterone in the treatment groups reduced the extent of demyelination while the memory impairment induced by the ethidium bromide was significantly improved (P=0.001). Conclusion: Testosterone can act as a neuroprotective factor that reduces the extent of demyelination and the number of pyknotic cells. It also may improve the learning and memory impairment induced by ethidium bromide.
Roya Mahdavi, Mitra Jamali, Mehdi Rostami, Amin Safa, Abdollah Jafarzadeh, Mohsen Naseri,
Volume 74, Issue 6 (9-2016)
Volume 74, Issue 6 (9-2016)
Abstract
Background: Multiple sclerosis (MS) is a chronic inflammatory disorder of the CNS characterized by destruction of the myelin sheath, gliosis and progressive neurological dysfunction. The regulatory T (Treg) cells play a major role in the control of the autoimmunity and inflammation. The forkhead box p3 (FOXP3) is a central molecule in the function of Treg cells that play an important role in the immunoregulation. The aim of this study was to investigation single nucleotide polymorphism (SNP), rs2232365, in FOXP3 gene in patients with multiple sclerosis.
Methods: In a case-control study, peripheral blood samples were collected from 90 patients with MS (46 men and 94 women with different patterns of disease) from January 2014 to April 2015 in the Afzalipoor Hospital, Kerman (a city located in the southeast of Iran). In a total, 90 healthy subjects were also enrolled into the investigation as a control group. The healthy subjects were recruited among blood donations of the Kerman Transfusion Organization and interviewed regarding CNS disease, and none of them had any history of CNS diseases or other relevant disorders. The SNP rs2232365 in FOXP3 gene was assessed by single specific primer-polymerase chain reaction (SSP-PCR) method. Finally, statistical analysis was performed using SPSS version 22 (Chicago, IL, USA).
Results: In both patients and healthy control groups, there was significant difference among subjects with GG, AG, and AA genotypes at rs2232365 in FOXP3 gene. The frequencies of AA and AG genotypes at rs2232365 in the FOXP3 gene were significantly higher in MS group as compared with healthy subjects (P<0.002). Moreover, the frequency of GG genotype was significantly lower in the MS group in comparison with healthy control subjects (P<0.002). The frequency of A allele was significantly higher whereas the frequency of G allele was significantly lower in MS patients as compared with healthy subjects (P<0.001).
Conclusion: The results of the present study suggest that SNP rs2232365 may influence the susceptibility to multiple sclerosis. Therefore, SNP rs3761548 may directly or indirectly alter the level of the FOXP3 protein expression in Treg cells.
Ghasem Salehpoor, Abdulaziz Aflakseir,
Volume 74, Issue 11 (2-2017)
Volume 74, Issue 11 (2-2017)
Abstract
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Background: Body pain in multiple sclerosis (MS) is a common phenomenon that can create or exacerbate by different parameters of clinical, psychological and demographic. The aim of this study was to investigate the relationship between parameters of clinical (fatigue, clinical course, body mass index and duration), psychological (depression, anxiety and stress) and demographic (age, gender, marital status and education) characters with multiple sclerosis patient’s body pain. Methods: This cross-sectional study has been performed in the Multiple Sclerosis Society of Guilan Province and Imam Reza Specialized and Sub-specialized Clinic, Rasht City, Iran during June to February 2010. In this study 162 patients with MS were selected by consecutive sampling. We used the clinical and demographic variables inventory, body pain subscale of the health survey questionnaire, depression, anxiety and stress scale and fatigue severity scale along with identical analog-spring balance. The data were analyzed by Pearson correlation coefficient and point bi-serial, one-way analysis of variance, Gabriel test and stepwise multiple regression. Results: The findings showed that patients who scored 3 or higher in relapses experienced significantly more body pain than patients who scored 1-2 times of relapses (P= 0.031). In the meantime, significant differences were not found between the two groups of patients with a score of 3 or higher in relapses and non-relapse and between non-relapse patients and with a score 1-2 times of relapses in terms of body pain. Also, significant differences were not found in different groups of hospitalization in terms of body pain. However, anxiety and fatigue together could explain significantly 25% of the shared variance of body pain (F= 26.29, P≤ 0.0009). Conclusion: This study showed the effect of psychological and clinical factors on body pain exacerbation in MS patients. Therefore, it is necessary for clinicians to consider identifying these factors and the relationships of the factors with increasing pain in patients with MS. |
Zahra Raeisi , Pantea Ramezannezad , Marzieh Ahmadzade , Shahram Tarahomi ,
Volume 75, Issue 1 (4-2017)
Volume 75, Issue 1 (4-2017)
Abstract
|
Background: One of the today most common and incurable diseases that is associated with central neural system is ‘MS’ disease. Multiple sclerosis (MS) is a demyelinating disease in which the insulating covers of nerve cells in the brain and spinal cord are damaged. In this disease become apparent a wide spectrum of symptoms such as lose muscles control and their coordination and vision derangement. The goal of this research is to consider to two problems: 1- Recognition of effective clinical symptoms on MS disease and 2- Considering levels of effectiveness of age, sex and education levels factors on MS disease and association between these factors according to verity of categories of this disease. Methods: Data mining science in medicine is worthy of attention with main application in diagnosis, therapy and prognosis, respectively high volume of collected datum. The data that were used in this article are about patients of Chaharmahal and Bakhtiari Province and collected by cure assistance. In this paper classification and association methods in software engineering field are used. Classification is a general process related to categorization, the process in which ideas and objects are recognized, differentiated, and understood. Association rules are created by analyzing data for frequent if/then patterns and using the criteria support and confidence to identify the most important relationships. Results: In consideration of first problem in this paper, concluded vision-clinical symptoms are the most effective symptoms and in consideration of second problem, concluded that from 584 records, women affected four times more than men. In other word 70% of MS patients with high graduate are in relapsing-remitting category and 62.5% of MS patients are 20-40 years old. Conclusion: Some of symptoms are quite temporary and transitory and are ignored by people. Awareness of clinical-symptoms prevalence manner can be warning for people before starting critical cycle of illness. This would cause early diagnosis, effective therapy and even prevention of disease progress, respectively to MS chronicity. |
Fatemeh Khayat Sarkar , Mahmoud Shirazi ,
Volume 75, Issue 8 (11-2017)
Volume 75, Issue 8 (11-2017)
Abstract
Background: Multiple sclerosis (MS) is one of the most common chronic diseases creating major psychological challenges. Hence, the purpose of this study was to investigate the effectiveness of cognitive-behavioral therapy (CBT) on mental toughness and life expectancy of MS patients.
Methods: The design of this quasi-experimental study has been with pre-test, post-test and follow-up with control group that was performed in Zahedan MS community, Iran, from September to November 2016. The sample of the study was selected voluntarily from 30 MS patients which were randomly divided into two experimental and control groups. Among 200 patients, 80 patients had the required qualifications to participate in the study and 38 patients volunteered to enter the study. At last, only 30 patients were selected and put randomly into two experimental and control group. The experimental group received treatment in 8 weekly sessions (90 to 120-minute-long sessions with the classroom task and homework and group discussion) but the control group did not go under such treatment. The research instrument being used in this study was Halajian life expectancy questionnaire and mental toughness questionnaire (MTQ-48).
Results: For the groups to be homogeneous in age and the level of education, T-test and chi-squared test were used respectively, which did not show a meaningful difference between experimental and control group. The analysis of covariance showed that cognitive-behavioral therapy (CBT) group has resulted in meaningful increase in mental toughness and life expectancy of patients. The results showed the average of mental toughness to be 1.05 in for the experimental group in the pre-test, 1.24 in the post-test, 1.21 in the follow-up and the average of life expectancy 4.56 before treatment, 7.20 after treatment and 7.01 in the follow-up (P<0.001).
Conclusion: Practicing group cognitive-behavioral therapy in the process of MS patients’ treatment led to the increase in their mental toughness and life expectancy.
Methods: The design of this quasi-experimental study has been with pre-test, post-test and follow-up with control group that was performed in Zahedan MS community, Iran, from September to November 2016. The sample of the study was selected voluntarily from 30 MS patients which were randomly divided into two experimental and control groups. Among 200 patients, 80 patients had the required qualifications to participate in the study and 38 patients volunteered to enter the study. At last, only 30 patients were selected and put randomly into two experimental and control group. The experimental group received treatment in 8 weekly sessions (90 to 120-minute-long sessions with the classroom task and homework and group discussion) but the control group did not go under such treatment. The research instrument being used in this study was Halajian life expectancy questionnaire and mental toughness questionnaire (MTQ-48).
Results: For the groups to be homogeneous in age and the level of education, T-test and chi-squared test were used respectively, which did not show a meaningful difference between experimental and control group. The analysis of covariance showed that cognitive-behavioral therapy (CBT) group has resulted in meaningful increase in mental toughness and life expectancy of patients. The results showed the average of mental toughness to be 1.05 in for the experimental group in the pre-test, 1.24 in the post-test, 1.21 in the follow-up and the average of life expectancy 4.56 before treatment, 7.20 after treatment and 7.01 in the follow-up (P<0.001).
Conclusion: Practicing group cognitive-behavioral therapy in the process of MS patients’ treatment led to the increase in their mental toughness and life expectancy.
Mitra Jamali , Mehdi Rostami Rad , Gholamreza Anani Sarab , Roya Mahdavi ,
Volume 76, Issue 7 (10-2018)
Volume 76, Issue 7 (10-2018)
Abstract
Background: Multiple sclerosis is the most common autoimmune demyelinating disease of the central nervous system (CNS). Interleukin-33 (IL-33) is a cytokine with both pro-inflammatory and anti-inflammatory activities that implicated in the pathogenesis of some autoimmune diseases. The aim of this study was to determine single nucleotide polymorphism (SNP) of IL-33, rs1929992, in patient’s gene with multiple sclerosis (MS) and investigation of this polymorphism with susceptibility to MS.
Methods: In this case-control study, peripheral blood samples were collected from 140 MS patients (patients in the Afzalipur Hospital in Kerman) and blood sample of 140 healthy subjects (people referred to the Blood Transfusion Organization) as a control group from March 2016 to January 2018. SNP at rs1929992 was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.
Results: There was significant difference between healthy control group and patient with multiple sclerosis in the frequency of genotypes. The frequency of AA genotype at rs1929992 was significantly higher in the MS group in comparison with healthy control subjects (P= 0.0001), whereas frequency of AG genotype was significantly higher in the control group as compared with MS group (P= 0.02). There was no significant difference between the MS patients and healthy control group in GG genotype. Moreover, the frequencies of AA genotype at SNP rs1929992 were significantly higher in patients with secondary progressive MS (SP-MS) and primary progressive MS (PP-MS) as compared with control group (P= 0.03). However, the frequencies of AG genotype was significantly lower in patients with relapsing-remitting MS (RRMS) in comparison to the healthy group (P= 0.01). In patients with RR-MS, PP-MS and SP-MS patterns, the frequencies of A allele was significantly higher than that in control group (P= 0.03, P= 0.01, P= 0.001). In patients with RR-MS, PP-MS and SP-MS pattern, the frequency of G allele was significantly lower than control group (P= 0.03, P= 0.01, P= 0.001).
Conclusion: The results of this study suggest that the SNP rs1929992 in IL-33 gene, may be associated with different pattern of MS susceptibility.
Methods: In this case-control study, peripheral blood samples were collected from 140 MS patients (patients in the Afzalipur Hospital in Kerman) and blood sample of 140 healthy subjects (people referred to the Blood Transfusion Organization) as a control group from March 2016 to January 2018. SNP at rs1929992 was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.
Results: There was significant difference between healthy control group and patient with multiple sclerosis in the frequency of genotypes. The frequency of AA genotype at rs1929992 was significantly higher in the MS group in comparison with healthy control subjects (P= 0.0001), whereas frequency of AG genotype was significantly higher in the control group as compared with MS group (P= 0.02). There was no significant difference between the MS patients and healthy control group in GG genotype. Moreover, the frequencies of AA genotype at SNP rs1929992 were significantly higher in patients with secondary progressive MS (SP-MS) and primary progressive MS (PP-MS) as compared with control group (P= 0.03). However, the frequencies of AG genotype was significantly lower in patients with relapsing-remitting MS (RRMS) in comparison to the healthy group (P= 0.01). In patients with RR-MS, PP-MS and SP-MS patterns, the frequencies of A allele was significantly higher than that in control group (P= 0.03, P= 0.01, P= 0.001). In patients with RR-MS, PP-MS and SP-MS pattern, the frequency of G allele was significantly lower than control group (P= 0.03, P= 0.01, P= 0.001).
Conclusion: The results of this study suggest that the SNP rs1929992 in IL-33 gene, may be associated with different pattern of MS susceptibility.
Amir Hossein Hashemian , Sara Manochehri , Daryoush Afshari , Zohreh Manochehri , Nader Salari , Soodeh Shahsavari,
Volume 77, Issue 1 (4-2019)
Volume 77, Issue 1 (4-2019)
Abstract
Background: Multiple sclerosis (MS) is a degenerative inflammatory disease which is most commonly diagnosed by magnetic resonance imaging (MRI). But, since the MRI device uses of a magnetic field, if there are metal objects in the patient's body, it can disrupt the health of the patient, the functioning of the MRI, and distortion in the images. Due to limitations of using MRI device, screening seems necessary for those patients who have metal objects in their bodies. Therefore, this study is carried out to compare two models: support vector machine and random forest.
Methods: This analytical-modelling research was implemented on MS data collection, the specifications of which are recorded in health registry system in School of Public Health, Kermanshah University of Medical Sciences, Iran, from May 2017 to August 2018. For the purpose of this study, a total of 317 subjects were selected as a sample; 188 subjects were diagnosed with MS and 128 subjects showed no symptoms of MS. In order to fit the support vector machine (SVM) model, radial basis kernel function was used. The parameters of this machine were optimized with genetic algorithm. After this step, the support vector machine and random forest (RF) were compared with respect to three factors: accuracy, sensitivity, and specificity.
Results: Based upon the obtained results of study, accuracy, sensitivity, and specificity of SVM were 0.79, 0.80, and 0.78, respectively. In comparison, accuracy, sensitivity, and specificity of RF were found to be 0.76, 0.81, and 0.70, respectively.
Conclusion: In general, both models which were compared in current study showed desirable performance; however, in term of accuracy, as an important criteria for performance comparison in this area of research, it can be argued that support vector machine can do better than random forest in diagnosing multiple sclerosis.
Methods: This analytical-modelling research was implemented on MS data collection, the specifications of which are recorded in health registry system in School of Public Health, Kermanshah University of Medical Sciences, Iran, from May 2017 to August 2018. For the purpose of this study, a total of 317 subjects were selected as a sample; 188 subjects were diagnosed with MS and 128 subjects showed no symptoms of MS. In order to fit the support vector machine (SVM) model, radial basis kernel function was used. The parameters of this machine were optimized with genetic algorithm. After this step, the support vector machine and random forest (RF) were compared with respect to three factors: accuracy, sensitivity, and specificity.
Results: Based upon the obtained results of study, accuracy, sensitivity, and specificity of SVM were 0.79, 0.80, and 0.78, respectively. In comparison, accuracy, sensitivity, and specificity of RF were found to be 0.76, 0.81, and 0.70, respectively.
Conclusion: In general, both models which were compared in current study showed desirable performance; however, in term of accuracy, as an important criteria for performance comparison in this area of research, it can be argued that support vector machine can do better than random forest in diagnosing multiple sclerosis.
Roya Amirinejad , Zeinab Shirvani Farsani , Bahar Naghavi Gargari ,
Volume 78, Issue 1 (4-2020)
Volume 78, Issue 1 (4-2020)
Abstract
Multiple Sclerosis (MS) is a chronic neurological and inflammatory disorder that affects the nervous system. The etiology of MS is unknown, but genetic and environmental factors are involved in its pathogenesis. There is increasing evidence suggesting the role of epigenetic mechanisms in the pathogenesis of multiple sclerosis. Lack of vitamin D, smoking, and Epstein barr virus can cause epigenetic changes. Several studies have found that Dysregulation in DNA methylation is related to abnormal immune responses and post-translation modifications of myelin proteins in the brain specimens of MS patients. Molecular mechanisms through environmental signals lead to gene expression changes include DNA methylation, post modification of nucleosomal histones and non-coding RNAs. Also, abnormal microRNA profiles have been reported in the brain tissues and peripheral immune blood cells of MS patients. Increased histone acetylation and citrullination of myelin basic protein are two epigenetic mechanisms that may intensify the disease course, in the progressive type. The activation of T cells by histone deacetylase (HDAC) may contribute to the pathogenesis of MS disease and increase the intensity of disease. Increased of HDAC transcripts can also be observed during immune cell activation. Th1 differentiation is produced by HDACs, and the inhibition of these enzymes reduces the production of IFN-γ. The expression of 364 miRNA in peripheral blood mononuclear cell (PBMC) has been reported in the patients with remitting and relapsing and increased miR-18b and miR-599 regulation in the relapsing course. Expression of miRNAs in astrocytes, microglia, and CD8+ T cells also increased. The role of epigenome in this disease can be deduced from epidemiological studies of the geographical location influence, a month of birth, nutritional status (food and vitamin D absorption), and smoking. Despite of the ever-increasing advances, the epigenetic mechanisms of MS are still unknown. Numerous studies are needed to treat and control the disease and discover new and effective drugs due to the complexity of multiple sclerosis and the importance of epigenetic changes in multiple signaling pathways and the molecular mechanisms of different types of MS.
Mansour Rezaei , Daryush Afshari, Negin Fakhri, Nazanin Razazian,
Volume 79, Issue 4 (7-2021)
Volume 79, Issue 4 (7-2021)
Abstract
Background: Multiple Sclerosis (MS) is one of the most debilitating disease among young adults. Understanding the disability score (Expanded Disability Status Scale (EDSS)) of these patients is helpful in choosing their treatment process. Calculating EDSS takes a lot of time for Neurologists, so having a way to estimate EDSS can be helpful. This study aimed to estimate the EDSS score of MS patients using statistical models including Artificial Neural Network (ANN) and Decision Tree (DT) models.
Methods: This cross-sectional study was performed on MS registry study data of Kermanshah province from April 2017 to November 2018. From the total data available in the registry system, The 12 variables including demographic information, information about MS disease and their EDSS score were extracted. EDSS scores were also estimated using ANN and DT models. The performance of the models was compared in terms of estimation error, correlation and mean of an estimated score. Data were analyzed using Weka software version 3.9.2 and SPSS software version 25 with a significance level of 0.05.
| Results: In this study, 353 people were studied. The mean age of the patients was 36.47±9.1 years, the mean age of onset was 9.2±30.34 years, the mean duration of the disease was 6.20±5.7 years and the mean EDSS score was 2.46±1.8. Estimation errors in the DT model were lower than in the ANN model. The real EDSS score was significantly correlated with scores estimated by DT (r=0.571) and ANN (r=0.623). The mean EDSS estimated by the DT model (2.46±1.1) was not significantly different from the real EDSS mean (P=0.621) but the mean EDSS estimated by the ANN model (2.87±1.3) was significantly higher than the real EDSS mean. (P<0.05). Conclusion: The DT model could better estimate the EDSS score of MS patients than the ANN model and made predictions that were closer to the actual EDSS scores. Therefore, the DT model can accurately estimate the EDSS score of MS patients. |
Hasan Asadi Gandomani , Abdorreza Naser Moghadasi , Mohammad Ali Sahraian , Sharareh Eskandarieh,
Volume 79, Issue 12 (3-2022)
Volume 79, Issue 12 (3-2022)
Abstract
Background: The onset of primary progressive multiple sclerosis (PPMS) can be triggered by sun exposure and physical activity. The present study aimed to determine the risk of sun exposure and physical activity in PPMS development.
Methods: The case-control study recruited PPMS cases and healthy controls from the general population from September 2019 to September 2020 in Tehran, Iran. The selection of sex-matched controls from the same source population of cases was performed. Sun exposure was assessed in terms of exposure time in two age groups of 13-19 years and over 20 years in winter and summer.
Methods: The case-control study recruited PPMS cases and healthy controls from the general population from September 2019 to September 2020 in Tehran, Iran. The selection of sex-matched controls from the same source population of cases was performed. Sun exposure was assessed in terms of exposure time in two age groups of 13-19 years and over 20 years in winter and summer.
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Results: This study examined 146 PPMS cases and 294 controls. The sun exposure in summer in the age group 13-19 was negatively associated with the incidence of the disease (OR=0.68 (CI=0.57-0.82)). This relationship was also observed in the groups of men (OR=0.55 (CI=0.40-0.74)) and women (OR=0.70 (CI=0.53-0.91)). Exposure to sunlight in winter in the age group 13-19 was negatively associated with the incidence of the disease (OR=0.28 (CI=0.19-0.42)). In the group over 20 years, sun exposure was negatively associated with disease incidence in summer (OR=0.49 (CI=0.36-0.66)). Exposure to sunlight on average in winter in the age group over 20 years was negatively associated with the incidence of the disease (OR=0.14 (CI=0.07-0.28)) which in the male group OR=0.12 (0.04-0.32)) and women (OR=0.06 (CI=0.02-0.21)) were seen. Regarding physical activity, only physical activity above 4000 MET per week in the group of women was negatively associated with the incidence of the disease (OR=5.30 (CI=1.05-26.59), but in other groups, this negative relationship was not observed.
Conclusion: Exposure to sunlight in winter and summer had a negative relationship with the incidence of the disease. Physical activity was only negatively associated with the incidence of the disease in very high doses and women. |
Arash Bostani, Hadi Gharabaghian Azar, Mehdi Jafari, Mastane Babaei Gramkhani,
Volume 80, Issue 1 (4-2022)
Volume 80, Issue 1 (4-2022)
Abstract
Background: Multiple sclerosis (MS), as an inflammatory autoimmune disease and chronic degenerative central nervous system degeneration, often occurs in early adulthood. One of the common and debilitating symptoms of this disease is fatigue, which can affect up to 80% of patients with MS. This study aimed to evaluate the effectiveness of magnetic field therapy on fatigue in patients with MS.
Methods: Present study is a single-blind randomized clinical trial (RCT) that Was conducted on patients with multiple sclerosis from March 2019 to September 2021. In this study, 46 patients who met our inclusion criteria were divided into two groups randomly: magnetotherapy intervention and control group. The intervention was performed in the form of a pulsed magnetic field with a frequency of 15 Hz and an intensity of 4.5 Millie Tesla. In order to blind patients, they were unaware of the intervention or control group, and the technician in charge of the treatment and the statistician knew about it. Data were then collected and recorded using the Fatigue Severity Scale, the Patient Health Questionnaire, and the Epworth Sleepiness Scale Questionnaire.
Results: Of the 46 patients studied, 22 (48%) were male and the rest of them were female [24 cases (52%)]. The mean age of men and women was 34.4±7.3 and 33.5±1.7 years, respectively. Among the intervention and control groups, 8 people took amantadine equally in each group. In the magneto-therapy intervention group, the mean severity of fatigue reduced from 4.91±0.86 to 4.27±1.10, which was significant (p=0.024). In our control group, the mean intensity of fatigue reduced from 4.83±0.83 to 4.37±0.81, which was significant statistically (p=0.028). Although, the difference between the response of the two groups to treatment was not significant (p=0.382).
Conclusion: Due to the lack of significant differences in the reduction of fatigue severity, this treatment is not recommended for the treatment and management of fatigue in patients with MS.
Methods: Present study is a single-blind randomized clinical trial (RCT) that Was conducted on patients with multiple sclerosis from March 2019 to September 2021. In this study, 46 patients who met our inclusion criteria were divided into two groups randomly: magnetotherapy intervention and control group. The intervention was performed in the form of a pulsed magnetic field with a frequency of 15 Hz and an intensity of 4.5 Millie Tesla. In order to blind patients, they were unaware of the intervention or control group, and the technician in charge of the treatment and the statistician knew about it. Data were then collected and recorded using the Fatigue Severity Scale, the Patient Health Questionnaire, and the Epworth Sleepiness Scale Questionnaire.
Results: Of the 46 patients studied, 22 (48%) were male and the rest of them were female [24 cases (52%)]. The mean age of men and women was 34.4±7.3 and 33.5±1.7 years, respectively. Among the intervention and control groups, 8 people took amantadine equally in each group. In the magneto-therapy intervention group, the mean severity of fatigue reduced from 4.91±0.86 to 4.27±1.10, which was significant (p=0.024). In our control group, the mean intensity of fatigue reduced from 4.83±0.83 to 4.37±0.81, which was significant statistically (p=0.028). Although, the difference between the response of the two groups to treatment was not significant (p=0.382).
Conclusion: Due to the lack of significant differences in the reduction of fatigue severity, this treatment is not recommended for the treatment and management of fatigue in patients with MS.
Milad Jalilian, Iraj Abedi, Mohammadreza Sharifi,
Volume 80, Issue 2 (5-2022)
Volume 80, Issue 2 (5-2022)
Abstract
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Background: Magnetic resonance imaging (MRI) is a non-invasive imaging technology that shows detailed anatomical and pathological images. It is often used for disease detection, diagnosis, and treatment monitoring, in particular with neurodegenerative diseases, such as Multiple sclerosis (MS), Alzheimer's and amyotrophic lateral sclerosis. However, conventional MRI provides only qualitative information and cannot distinguish between myelin and axon destruction. One of the new methods in early detection for axonal injury is the DTI sequence, which can be used to observe and quantify the various dimensions of these plaques, including the direction of diffusion and average diffusion. In other words, in DTI, quantitative data from the image helps to estimate the physiological and pathophysiological information of plaques in the brain. This study aimed to investigate the relationship between DTI parameters including FA, MD, RD, AD, axon injury and severity of clinical symptoms in patients with MS.
Conclusion: Indicators obtained from the DTI sequence can be used in the prognosis of the disease and the estimation of the severity of clinical symptoms during the patients' involvement. |
Nazanin Razazian, Mansour Rezaei, Poona Ahmadi, Negin Fakhri,
Volume 80, Issue 4 (7-2022)
Volume 80, Issue 4 (7-2022)
Abstract
Background: Multiple sclerosis (MS) is an inflammatory disease affecting the central nervous system. Rituximab (Zytux) is a type of monoclonal antibody against B cells with CD20 antigen that reduces B cells. The present study examined the one-year effectiveness and side effects of Rituximab.
Methods: This quasi-experimental clinical trial was conducted from September 2018 to September 2019 in Imam Reza Hospital in Kermanshah. 44 eligible patients were selected by the available sampling method and entered the study after evaluation in terms of inclusion and exclusion criteria. Patients were treated with rituximab for one year. At the beginning of the study and at the end of the year, the disability score based on the Expanded Disability Status Scale (EDSS) and active lesions based on MRI for patients were evaluated. Also, the patients were followed up in terms of relapse and medication side effects throughout the year. This study was performed with the support of Kermanshah University of Medical Sciences. Informed consent was obtained from all participants. The data were analyzed by SPSS-25 software.
Methods: This quasi-experimental clinical trial was conducted from September 2018 to September 2019 in Imam Reza Hospital in Kermanshah. 44 eligible patients were selected by the available sampling method and entered the study after evaluation in terms of inclusion and exclusion criteria. Patients were treated with rituximab for one year. At the beginning of the study and at the end of the year, the disability score based on the Expanded Disability Status Scale (EDSS) and active lesions based on MRI for patients were evaluated. Also, the patients were followed up in terms of relapse and medication side effects throughout the year. This study was performed with the support of Kermanshah University of Medical Sciences. Informed consent was obtained from all participants. The data were analyzed by SPSS-25 software.
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Results: 44 patients with MS including 29 (65.9%) female and 15 (34.1%) male were studied. 22 patients had RRMS and 22 patients had progressive-relapsing MS (PRMS). In patients with RRMS, the EDSS score at the end of the study was significantly reduced compared to the beginning of the study (P=0.010) but in PRMS patients EDSS was increased but this increase was not significant (P=0.148). In both RRMS and PRMS patients, the number of MRI lesions at the end of the study was lower than the beginning of the study and this decrease was not significant (P>0.05). More Immediate side effects occurred in RRMS patients (13.6% vs. 4.5%) and more delayed side effects were observed in PRMS patients (54.5% vs. 36.3%).
Conclusion: rituximab caused a greater reduction in EDSS in the treatment of RRMS than PRMS and its use had few side effects. |
Outcomes of AstraZeneca vaccine for relapse and Covid-19 infection in people with multiple sclerosis
Nazanin Razazian, Mohammad-Ali Sahraian, Sharareh Eskandarieh, Nooshin Jafari, Mansour Rezaei, Negin Fakhri,
Volume 80, Issue 6 (9-2022)
Volume 80, Issue 6 (9-2022)
Abstract
Background: People with chronic diseases of the immune system, such as multiple sclerosis (MS), are at risk for Covid-19 disease. However, more research is needed with long-term follow-up. The aim of the study was to follow up people with MS (PwMS) for up to three months after AstraZeneca vaccination for the recurrence of MS and Covid-19 infection.
Methods: This study was a case study (descriptive-analytical) of follow-up type. The study population was PwMS over 18 years of age in Kermanshah province who received both doses of the AstraZeneca vaccine. This study was conducted from August to November 2021. Sampling was done with existing methods based on the National MS Registry of Iran (NMSRI). Demographic information of patients was extracted from NMSRI. A researcher-made form was used to collect information by telephone three months after vaccination about clinical characteristics, Covid-19 infection, and recurrence of MS. Data were analyzed using SPSS-25 software.
Results: Study participants were 40 MS patients with a mean (SD) age of 39.27 (8.8) years, including 32 (80.0%) women. A mean of 9.39 (4.6) years had passed since The patients were diagnosed with MS, and 29 (76.4%) had RR type MS. Four patients (10%) relapsed between the second dose and three months later, of whom two (50%) had sensory symptoms, one (25%) had optic nerve involvement, and one (25%) had motor symptoms and pyramidal pathway involvement. The symptoms of Covid-19 were mild in three patients (10%), while severe symptoms developed in one patient (10%) who received rituximab. Among the patients, no cases of thrombosis were observed. Infusion therapy, a leg fracture, and kidney stones were the only hospitalized cases.
Methods: This study was a case study (descriptive-analytical) of follow-up type. The study population was PwMS over 18 years of age in Kermanshah province who received both doses of the AstraZeneca vaccine. This study was conducted from August to November 2021. Sampling was done with existing methods based on the National MS Registry of Iran (NMSRI). Demographic information of patients was extracted from NMSRI. A researcher-made form was used to collect information by telephone three months after vaccination about clinical characteristics, Covid-19 infection, and recurrence of MS. Data were analyzed using SPSS-25 software.
Results: Study participants were 40 MS patients with a mean (SD) age of 39.27 (8.8) years, including 32 (80.0%) women. A mean of 9.39 (4.6) years had passed since The patients were diagnosed with MS, and 29 (76.4%) had RR type MS. Four patients (10%) relapsed between the second dose and three months later, of whom two (50%) had sensory symptoms, one (25%) had optic nerve involvement, and one (25%) had motor symptoms and pyramidal pathway involvement. The symptoms of Covid-19 were mild in three patients (10%), while severe symptoms developed in one patient (10%) who received rituximab. Among the patients, no cases of thrombosis were observed. Infusion therapy, a leg fracture, and kidney stones were the only hospitalized cases.
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Conclusion: Covid-19 and MS relapse prevalence did not differ significantly in the three months before and after vaccination. There is a need for further studies with a longer follow-up period.
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