The Expanded Disability Status Scale Score and Demographic Indexes Are Correlated with the Severity of Cognitive Impairment in Multiple Sclerosis Patients

Background@#and Purpose Cognitive impairment (CI) is a common symptom of multiple sclerosis (MS). Although demographic and clinical factors contribute to MS-dependent CI, previous findings have been inconsistent. This study aimed to identify the cognitive domains that are impaired in MS patients, and to determine the impacts of the Expanded Disability Status Scale (EDSS) score and other clinical and demographic factors on them domains. @*Methods@#This study enrolled 115 MS patients. Cognitive performance was assessed using the Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) battery. CI severity was assessed based on the number of impaired tasks in the MACFIMS battery, with impairment in two or more tasks defined as CI cases. Correlation analysis was used to determine whether factors including current age, age at disease onset, EDSS score, disease duration, relapse rate, and education level affect the severity of CI. @*Results@#The scores on the Paced Auditory Serial Addition Test and Delis-Kaplan Executive Function System were the most and least affected, respectively. EDSS score (r=0.438, p<0.001), current age (r=0.393, p<0.001), and disease duration (r=0.486, p<0.001) were positively correlated with CI severity, whereas education level (r=-0.527, p<0.001) had a negative correlation with CI severity, and age at disease onset and relapse rate were not correlated with CI severity (r=0.150 and p=0.107, and r=0.052 and p=0.530, respectively). However, all variables (except EDSS score) significantly predicted CI severity in a multiple regression model (p<0.001, r=0.668). @*Conclusions@#Information processing speed and working memory were the most commonly affected cognitive domains in the present MS patients. CI severity had strong positive correlations with current age, EDSS score, and disease duration, and a negative correlation with education level. The relapse rate and age at disease onset were not correlated with CI severity.

Amyloid-beta: a crucial factor in Alzheimer's disease

Alzheimer's disease [AD] is the most prevalent form of dementia which affects people older than 60 years of age. In AD, the dysregulation of the amyloid-beta [Abeta] level leads to the appearance of senile plaques which contain Abeta depositions. Abeta is a complex biological molecule which interacts with many types of receptors and/or forms insoluble assemblies and, eventually, its nonphysiological depositions alternate with the normal neuronal conditions. In this situation, AD signs appear and the patients experience marked cognitional disabilities. In general, intellect, social skills, personality, and memory are influenced by this disease and, in the long run, it leads to a reduction in quality of life and life expectancy. Due to the pivotal role of Abeta in the pathobiology of AD, a great deal of effort has been made to reveal its exact role in neuronal dysfunctions and to finding efficacious therapeutic strategies against its adverse neuronal outcomes. Hence, the determination of its different molecular assemblies and the mechanisms underlying its pathological effects are of interest. In the present paper, some of the well-established structural forms of Abeta, its interactions with various receptors and possible molecular and cellular mechanisms underlying its neurotoxicity are discussed. In addition, several Abeta-based rodent models of AD are reviewed

Association between visual evoked potential and disease severity, disease duration and visual hallucination in patients with idiopathic Parkinsonism

Parkinson's disease [PD] is a neurodegenerative disorder impairing motor, verbal and other abilities. Visual evoked potential [VEP] assessment is a useful method for analysis of visual system and its function. The present study was designed in order to evaluate whether VEP changes are associated with PD. In the present study, 100 subjects encompassing 40 patients with Idiopathic Parkinson's Disease [Idiopathic PD] and 60 aged-matched controls were selected and assigned into case and control groups, respectively. VEP analysis was conducted in either group and the results were compared. In the present study, 16 patients [40%] showed prolonged P100 latency. P100 latency in the case group was significantly longer than in controls. P100 Amplitude was significantly higher in case group than control. There were no significant association between prolonged VEP and sex and diseases duration, in the participants. Also from our participants who suffer from visual hallucination, P100 latency was significantly longer than in the controls. There was a significant association between prolonged P100 latency and severity of disease in the case group. We suggest that prolonged VEP latencies and amplitude are associated with PD and might be associated with a predisposition for visual hallucinations

Study on serum homocysteine level in Alzheimer's disease and its relationship with the stage of this disease

To investigate homocysteine levels in Alzheimer's disease and its relationship with the severity of disease. This investigation was performed as a case-control study on 40 Alzheimer patients and 40 non-Alzheimer patients in Tabriz, Iran from May 2006 to September 2007. Alzheimer patients were selected based on the criteria of the American Psychological Association. The severity of illness was determined based on Reisberg scale. Mental status of the patients was evaluated by Mini Mental State Examination [MMSE]. The serum levels of homocysteine were measured by enzyme-linked immunosorbent assay method. The average serum homocysteine level in the 40 patient group was 23.01 +/- 14.40mmol/L, and in the 40 patient control group was 15.40 +/- 6.23 [p=0.003]. The average serum homocysteine level in the first group of patients was 21.7 +/- 12.7mmol/L, in the second group 22.3 +/- 13.8, and in the third group 24.9 +/- 17.2. The relationship between MMSE score and serum homocysteine level of patients was not significant [p=0.4]. The average serum homocysteine level in Alzheimer patients was higher than in the control group, however, it did not show a significant relationship with the severity of illness

Study on brainstem auditory evoked potentials in diabetes mellitus

To determine the changes of brain stem auditory evoked potential [BAEP] in diabetes mellitus [DM]. In a case-control study, 50 diabetic subjects [54.2 +/- 9.9 years] and 69 healthy subjects [50.87 +/- 10.6 years] were selected in the Clinic of Neurology, Emam Reza Hospital, Tabriz, Iran, from April 2006 to July 2007. Diabetic subjects were classified according to type of diabetes [type I and II], fasting blood sugar [FBS] level [>130mg/dl] and glycosylated hemoglobin [HbA1C] [>7% and <7%]. In a comparison of 50 diabetic samples and 69 non-diabetic samples, there was no significant difference between BAEP findings with FBS level [p=0.683], HbA1C [p=0.151], and type of diabetes [p=0.496]. There was a meaningful association between latency of wave III [p=0.012], IV [p=0.023], V [p<0.0001], and interpeak latency of I-III [p=0.035] and III-V [p=0.003] in the diabetic and control group. Subjects with DM have abnormalities in BAEP, and for evaluation of defects of the brainstem in diabetic patients usage of BAEP is recommended

C-reactive protein, fibrinogen, lipoprotein [a], and lipid profile levels and platelet counts in ischemic stroke patients

To ascertain the most prevalent risk factor for stroke. We performed a descriptive and analytical prospective study on patients with stroke admitted to the neurology wards of Imam Hospital, Tabriz, Iran during 2004 and 2005. The study comprised 100 ischemic stroke [IS] patients consisting of 46 men and 54 women with a mean age of 67 +/- 15, and 100 age and gender matched apparently healthy subjects. Plasma levels of C-Reactive protein [CRP], fibrinogen, platelet counts, lipoprotein [a] [LP [a]], high-density lipoprotein cholesterol [HDL-c], low-density lipoprotein cholesterol [LDL-c], total cholesterol [TC], and triglycerides [TG] were measured in both patients and controls. Background disease was also investigated in the patients. Hemorrhagic and embolic stroke patients were excluded from the study. We found no significant difference in serum fibrinogen, HDL-c levels, and platelet counts between patients and control subjects, however, levels of LP [a], TG, LDH-c, and CRP were significantly higher in patients than controls. Among the predisposing background illnesses, the most common risk factors were hypertension and hyperlipidemia. The frequency of studied risk factors among patients was: no risk factors [20%], one risk factor [32%], 2 risk factors [36%], and 3 risk factors [12%].Hypertension was the most prevalent background disease in IS patients. We also found that although there is close relationship in the incidence of IS with levels of LP [a], TC, TG, LDL-c, and CRP, the cutoff point frequency of fibrinogen, CRP, LP [a], and platelet counts was variable from patient to patient