Effectiveness of Cognitive-Behavioral-Based Stress Management Training on Anxiety in Female MS Patients

Objectives: This present study aims to examine the effectiveness of cognitive-behavioral-based stress management training on anxiety in female MS patients.

Methods: This study employed a semi-experimental research method with pre-test post-test, control group and random assignment. The statistical population fully consisted of female MS patients referred to the Iran MS association in 2014, from which 24 individuals were selected by accessible sampling, who were randomly divided into intervention and control groups. For measuring the independent variable, Beck's Anxiety inventories were used.

Results: The results of ANCOVA showed that cognitive-behavioral-based stress management training was effective in reducing the anxiety of female MS patients [p= 0.05].

Discussion: According to the results obtained, we believe that the cognitive-behavioral-based stress management training program has been effective on anxiety reduction in female MS patients. Thus, this training method can be used for target groups and the general population as an interventional program.

Effectiveness of Cognitive Existential Approach on Decreasing Demoralization in Women with Multiple Sclerosis

Objectives: Multiple Sclerosis [MS] is the most prevalent central nervous system diseases that due to chronicity, frequent recurrence, uncertainty about progression, and disability, can lead to various distresses as well as demoralization. Rehabilitation method based on Cognitive-Existential therapy is an integrated approach to decreasing demoralization syndrome in these patients. This study aimed to exploring effectiveness of rehabilitation method based on Cognitive-Existential approach on decreasing demoralization syndrome in patients with Multiple Sclerosis.

Methods: Single subject design was used in this study. Among women who had referred to Tehran MS Association, 3 women [aged between 20-40] were selected through purposeful sampling and separately participated in 10 sessions [90 minutes]. Participants were assessed during 7 phases of intervention [2 baselines, 3 measurements during intervention, 2 follow-up] through Demoralization Syndrome Scale and Cognitive Distortion scale. Data were analyzed by calculating process variation index and visual analysis.

Results: Comparing patients with MS scores on the diagram during 7 time measurement and calculating recovery percentage, represent decreasing in demoralization syndrome score scale.

Discussion: Findings showed that rehabilitation method based on Cognitive Existential approach can decrease demoralization syndrome in patients with MS.

Effect of rTMS with Rehabilitation on Hand Function and Corticomotor Excitability in Sub-Acute Stroke

Objectives: Stroke is the leading cause of long-term disability. Hand motor impairment resulting from chronic stroke may have extensive physical, psychological, economical, and social implications despite available rehabilitative treatments. The best time to start treatment for stroke is in sub-acute period. Repetitive Transcranial Magnetic Stimulation [rTMS] is a method of stimulating and augmenting the neurophysiology of the motor cortex in order to promote the neuroplastic changes that are associated with motor recovery. The purpose of this study was to compare the effects of repetitive transcranial magnetic stimulation protocols plus routine rehabilitation on hand motor functions and hand corticomotor excitability in stroke patients with hemiplegia with pure routine rehabilitation programs.

Methods: This study was a randomized clinical trial which was performed on 24 patients with hemiplegia who were randomly divided in to three groups: received high frequency rTMS, received rehabilitation program with low frequency rTMSl, who were given only routine rehabilitation programs. The treatment was performed for 10 sessions, three times pre-post test and follow-up about neurophysiological contralesional hemisphere evaluations using record of MEP wave indices by single pulse TMS, and assessing functional wolf test and hand grip power of disabled hand by dynamometer.

Results: The results demonstrated that the rest MEP threshold reduction in experimental group which received high frequency magnetic stimulation was not statistically significant [P=0.387]. There was significant reduction for active MEP threshold in the within group [P=0.031]. Also there were statistically significant between obtained results from WOLF test and grip test.

Discussion: According to the results, it seems that Hf rTMS combined with routine physiotherapy can significantly improve hand functions and brain neurophysiology via specifically increase of contralesional corticomotor excitability in sever stroke patients. It indicated the role of neuroplasticity in nonlesioned hemisphere; but the hypothesis of movement improvement related cognitive balance can't be eliminated by exploring powerful approved effect of Hf rTMS on mood regulation.

Lexical access in Persian normal speakers: picture naming, verbal fluency and spontaneous speech

Lexical access is the process by which the basic conceptual, syntactical and morpho-phonological information of words are activated. Most studies of lexical access have focused on picture naming. There is hardly any previous research on other parameters of lexical access such as verbal fluency and analysis of connected speech in Persian normal participants. This study investigates the lexical access performance in normal speakers in different issues such as age, sex and education. The performance of 120 adult Persian speakers in three tasks including picture naming, verbal fluency and connected speech, was examined using "Persian Lexical Access Assessment Package". The performance of participants between two gender groups [male / female], three education groups [below 5 years / above 12 years / between 5 and 12 years] and three age groups [18 - 35 years / 36 - 55 years / 56 - 75 years] were compared. According to findings, picture naming increased with increasing education and decreased with increasing age. The performance of participants in phonological and semantic verbal fluency showed improvement with age and education. No significant difference was seen between males and females in verbal fluency task. In the analysis of connected speech there were no significant differences between different age and education groups and just mean length of utterance in males was significantly higher than females. The findings could be a primitive scale for comparison between normal subjects and patients in lexical access tasks, furthermore it could be a horizon for planning of treatment goals in patients with word finding problem according to age, gender and education

Botulinum toxin type A on an intranasal sponge for chronic allergic rhinitis: randomized clinical trial

In this study, we examined the effect of botulinum toxin A [BTA] on chronic allergic rhinitis [CAR]. We tested the effects of BTA, applied to an intranasal sponge, on patients who had CAR for a minimum of three years and had been treated unsuccessfully with conventional medications. The study was an interventional case-control single-blind randomized clinical trial. Forty-four male and female CAR patients who were referred to Tehran's Saee and Pasargad Hospitals, and Saadat-Abaad, Sarv and Karimkhan Clinics in 2012; aged 20-40 years were selected on the basis of inclusion and exclusion criteria. The subjects were randomly assigned to the intervention [n=22] or control group [n=22]. The intervention group received BTA [100 IU/ml; Dysport], on a 5 cm nasal sponge retained in each nasal cavity for 30 minutes. The control group received normal saline. The groups were evaluated by the same examiner. Pre- and post-tests [1, 3, 6, and 12 weeks] were performed according to the authors' pre-designed checklist, the validity and reliability of which was previously established. The symptoms scored from none [0] to severe [10] at the test points. The statistical analysis was conducted with SPSS-19, with a significance level of 0.05. Based on ANOVA, there was a significant difference [P<0.05] in symptomatic relief between the intervention and control groups. No marked adverse effects were observed during the study. An intranasal 5 cm sponge impregnated with 100 IU/ml BTA, retained in each nasal cavity for 30 minutes, may alleviate CAR symptoms with no significant adverse effects

[Genotype-phenotype correlations in an iraninan myotonic dystrophy cohort]

Myotonic Dystrophy type I [DM1] the most common form of muscular dystrophy in adults affecting 1/800 individuals is a dominantly inherited disorder with a multi-systemic pattern affecting skeletal muscle, heart, eye, endocrine and central nervous system. DM1 is associated with the expansion and instability of a trinucleotide [CTG] repeat in the 3 untranslated region of the myotonic dystrophy protein kinase [DMPK] gene located on choromosome 19q13.3. The normal copy number is 5-37 CTG repeat whereas it is expanded in DM1 patients and the expansion size broadly correlates with the severity of the symptoms. The aim of this study was to determine the clinical and genetic characteristic of DM1 in Iranian patients for genotype-phenotype correlation methods. Clinical assessment was based on the muscular disability rating scale [MDRS] and a sum of symptoms score [SSS]. Molecular analysis [PCR and Southern blot] was used to clarify uncertain clinical diagnoses and confirm the clinical findings. Forty six patients from twenty five DM1 families were reviewed. In all the DM1 patients, the wide clinical symptoms confirmed the reported phenotypic vaiability of disorder. The range of CTG expansion of the mutated allele was 97-833 CTG repeats and an inverse correlation between age of onest and repeat length was observed. A clear relation between the size of the CTG repeat and the clinical disease score [MDRS] was found but not with SSS. No correlation was seen between the endocrine dysfunction and the expansion size in DM1 patients

glance on diagnosis and treatment of profound fatigue in multiple sclerosis

Multiple Sclerosis [M.S] is one of the prevalent diseases of the central nervous system which cause disability in young adults. This appears as neural signs in different parts and various times. The main defect is local deterioration or destruction of myelin tissue in the brain and spinal cord. Profound fatigue is one the most common symptoms of this disease. Because MS is prevalent in middle ages, so the presence of this symptom affects the life and activity of the patient; In these ages people have high amount of activities and this functional disorder creates many difficulties for daily works in patient. For this reason, fatigue problem in patients, always, have caught the attention of researchers. Despite numerous studies, still the exact reason for producing fatigue have not been mentioned; But several mechanisms have been discussed, such as: autoimmune mechanism of the disease, Involvement and disorder of endocrine system, involvement of central nervous system and de-synchronization of autonom system. Among these, autoimmune mechanism is considered as a main role in producing fatigue. Lack of proper knowledge regarding exact fatigue mechanism several problems in its treatment. Evaluation is the first step for controlling fatigue, which is done through various tests. Clear and proper evaluation can be obtained by these tests. After evaluation, non-drug and finally drug procedures are helpful. In non-drug treatment the focus is on: sport exercises, suitable diet program, identification and improvement of the patient psychotic disorders, energy conservation methods. Finally, the use of drugs such as Amantadine, Pemoline and Modafini is recommended for fatigue treatment