Stem cell therapy in stroke: a review literature

Stroke is an important cause of death in the world and disability world-wide especially in developed countries. Following acute phase of stroke, some procedures and medical treatment such as thrombolytic agents has been recommended; nevertheless many patients have enduring deficits. Thus, there is a realistic need to develop treatment strategies for reducing neurological deficits. However, the stem cell [SC] therapy could arrange an alternative intervention for disease modifying therapy. In this article, we present a brief review of different methods of SC therapy in stroke patients and discuss the results with different cell types and routes of administration

literature review on the efficacy and safety of botulinum toxin: an injection in post-stroke spasticity

A variety of techniques for the management of spasticity have been suggested, including positioning, cryotherapy, splinting and casting, biofeedback, electrical stimulation, and medical management by pharmacological agents, Botulinum toxin A [BTA] is now the pharmacological treatment of choice in focal spasticity. BTA by blocking acetylcholine release at neuromuscular junctions accounts for its therapeutic action to relieve spasticity. A computerized search of Pub Med was carried out to find the latest result about efficacy of BTA in management of post stroke spasticity. Among 84 articles were found, frothy of them included in this review and divided to lower and upper extremity. BTA is a treatment choice in reducing tone and managing post stroke spasticity

Restless legs syndrome in Iranian multiple sclerosis patients: a case-control study

Restless legs syndrome [RLS] is a common movement disorder. The occurrence of this syndrome is due to genetic factors and lifestyle. This study performed to determine restless legs syndrome [RLS] prevalence in Iranian multiple sclerosis [MS] patients and the possible risk factors. This cross-sectional study was conducted with MS patients, and the age- and sex-matched control group comprised healthy persons. Then, all subjects were asked about RLS symptoms. After the diagnosis of RLS, the patients were divided into two groups: With and without RLS. In both groups, the following variables were evaluated: Age, sex, other underlying disease, duration of MS, MS course, family history of RLS, history of anemia, and drug intakes. The severity of the disease in subjects diagnosed with RLS was also evaluated. A total of 126 patients in the MS group and 126 healthy controls were included in the study, with no statistically significant differences between them in terms of age and gender. In MS group, 82 [65.1%] and, in control group, 16 [12.7%] had RLS. The frequency of RLS in the MS patients was significantly higher than that in the control group. Among MS patients, 60 male [73.2%] and 22 female [26.8%] had RLS. Mean age of MS patients with RLS was significantly higher than that in MS patients without RLS. MS patients and higher EDSS score had more RLS symptoms. We suggest that RLS always be considered during neurological examinations of MS patients

Is anti-cyclic citrullinated peptide antibody a good value biomarker for Alzheimer disease?

Alzheimer's disease [AD] is one of the most important neurodegenerative disorder. Anti-cyclic citrullinated peptide [anti-CCP] may all be involved in the development of vascular disease such as AD. The aim of this study is detection of seropositivity for anti-CCP antibody in AD patients. In our study, 30 patients with AD and 29 healthy controls [age and-sex matched] were recruited. Homocysteine and anti-CCP was measured by spectrophotometrically and immunoassay. Mean +/- SE anti-CCP was higher significantly between AD [13.6 +/- 3] and healthy subjects [4.8 +/- 0.2] [P = 0.006]. In the patients, anti CCP serum level was in high range [32.1%] of abnormal levels, but there was no significant difference in serum homocysteine in AD patients compared with controls. There is no correlation between anti-CCP and homocysteine levels in AD patients [P = 0.75], but between age and anti-CCP level observed a significantly correlation [P = 0.04]. It needs more studies to clarify confirmation the role of anti-CCP antibody production in AD patients

Olanzapine versus haloperidol: which can control stuttering better?

The aim of this study was to compare the effects of olanzapine versus haloperidol to control the signs and symptoms of stuttering. Ninety-three patients were recruited in a 12-week single-blind randomized clinical trial, which was held between October 2009 and October 2010. Forty-three patients received olanzapine [5 mg/day] and 50 patients, haloperidol [2.5 mg/day]. Before and after the study, they were evaluated by a speech pathologist by Van Riper's questionnaire. The data were analyzed using the SPSS version 16. T-test was used to compare the data between the two groups. Mean of stuttering score [SD] before treatment was 4.67 [0.81] and 4.40 [1.14] in haloperidol and olanzapine groups, respectively [P > 0.05]. After treatment, the mean [SD] score was 2.87 [1.32] and 1.56 [0.71] in haloperidol and olanzapine groups, respectively [P = 0.000]. It seems that olanzapine does have better impact in controlling stuttering, and it may be recommended to prescribe olanzapine for stutters as the first choice to control the stuttering under a careful follow-up

Neuroprotective effects of erythropoietin in acute ischemic stroke

Ischemic brain strokes consist two-thirds of strokes and their complications bear a lot of disability for patient and society. In this study, we seek for effect of Erythropoietin on ischemic brain stroke's outcomes according to National Institutes of Health Stroke Scale [NIHSS] changes. This study is a RCT [randomized clinical trial]. All patients with focal neurologic deficit with primary suspicion of brain stroke undergone neuroimaging evaluations. After confirmation of new ischemic brain stroke, the patients with inclusion criteria's randomized into two groups of cases and controls. NIHSS was defined for each patient and all patients received a routine treatment protocol. Erythropoietin 16,000 IU as a bolus intravenous dose was given to case patients as soon as neuroimaging study confirmed new ischemic stroke and continued as 8000 IU each 12 h up to total dose of 56,000 IU during 3 days. Patients re-evaluated at days 14 and 28 and NIHSS was assessed by another neurologist blinded to patient's group. Finally, NIHSS changes of both groups compared with each other's. Evaluations revealed that in days14 and 28 during follow-up, Erythropoietin was effective in NIHSS [P= 0.0001]. This effect was of value in level of consciousness Commands [P= 0.024], facial palsy [P= 0.003], motor arm [P= 0.0001], motor leg [P= 0.0001], sensory [P= 0.009], and best language [P= 0.023]. Administration of high-dose erythropoietin in first 24 h can be effective on reduction of ischemic stroke complication. A larger scale clinical trial is warranted

Association between plasma homocysteine concentrations and extracranial carotid stenosis

Increasing epidemiologic data support a relationship between elevated plasma total homocysteine levels and an increased risk for vascular disease. Higher plasma total homocysteine [tHcy] levels have been associated with extra cranial carotid atherosclerosis and cerebral infarction in whites. However, data regarding such associations are limited for Asians. This study examined the association between tHcy level and carotid stenosis in Iranian subjects. In this retrospective study, the subjects were 158 patients with ischemic stroke, including 105 with a normal tHcy level and 53 with a high tHcy level. We investigated the extracranial carotid arteries by ultrasonography and measured serum tHcy by the ELISA method in these two groups. We found no meaningful association between a high tHcy level and carotid stenosis. The lack of any meaningful difference in carotid stenosis between patients with normal and elevated tHcy levels is probably due to the low frequency of extracranial disease in the Asian population and to the nature of homocysteine atherosclerosis

Extracranial cerebral arterial atherosclerosis in Iranian patients suffering ischemic strokes

To determine the distribution and severity of extracranial carotid arterial atherosclerosis in Iranian patients with ischemic stroke. 328 patients with ischemic stroke were included in this study. Doppler ultrasound was used for evaluation of atherosclerosis in extracranial carotid arteries. The NASCET criteria were used to measure carotid stenosis. Ninety of 328 patients [27.4%] were found to have atherosclerotic plaques; 40 of these patients were women and 50 were men. Sixty-eight patients [20.7%] had artery stenosis <50%, 13 patients [3.95%] had 50-70% artery stenosis and 6 [1.8%] had >70% artery stenosis. Extracranial atherosclerosis is not rare in Iranian patients with ischemic stroke, but most carotid artery lesions were plaques with <50% stenosis