Efficacy of tDCS in chronic migraine: A multiprotocol randomized controlled trial.

OBJECTIVE: Given the prevalence and complicated pathophysiology of migraine, unknown or varied mechanisms of action of available monotherapies or add-on therapies, and their broad range of adverse effects, it is imperative to manage migraine symptoms using a non-invasive, multifunctional, and alternate monotherapy with no negative impacts. METHODS: We used a single-blind, randomized, sham-controlled design with baseline, post-test, and 24-weeks follow-up measurements to assess the efficacy of transcranial Direct Current Stimulation (tDCS) in chronic migraine. A total of 150 participants were randomly assigned to the five groups (i.e., allocation ratio of 1:1:1:1:1). Each group received tDCS-intervention for 11 consecutive-weeks (25 sessions; each session = two consecutive montages; each montage = a 20 min duration, 2000 µA intensity). RESULTS: The multivariate analysis of variance showed significant (p <.05) reductions in chronic migraine symptoms in the four intervention groups. Compared with the sham (η2 < 0.18) and other protocols (two = Î·2 > 0.42; three = Î·2 > 0.40; four = Î·2 > 0.51), protocol one [l. anode at the right ventrolateral prefrontal cortices, cathode at the left dorsomedial and superior frontal gyrus-first montage; anode at the right primary motor area, cathode at the medial crosstalk of hemispheres-second montage] showed a larger effect size (η2 > 0.59) in the present trial. CONCLUSIONS: With the applied protocols of the present trial, tDCS can be used as an effective intervention for the prophylactic and therapeutic treatment of chronic migraine. However, while the second protocol was the least effective, the first was the most effective at reducing migraine symptoms. SIGNIFICANCE: To our knowledge, the present trial is the first study to cover the gaps of the earlier ones, including the parameters like the site of stimulation, electrode range distribution and field intensity, number of sessions, session design, and sample size.

Post-saccadic Eye Movement Indices Under Cognitive Load: A Path Analysis to Determine Visual Performance.

Purpose: The evidence on the linear relationship between cognitive load, saccade, fixation, and task performance was uncertain. We tested pathway models for degraded task performance resulting from changes in saccadic and post-saccadic fixation under cognitive load. Methods: Participants' (n = 38) eye movements were recorded using a post-saccadic discrimination task with and without arithmetic operations to impose cognitive load, validated through recording heart rate variability and subjective measurement. Results: Results showed that cognitive load led to longer latencies of saccade and fixation; more inaccurate responses and fewer secondary saccades (P < 0.001). Longer saccade latencies influenced task performance indirectly via increases in fixation latency, therefore, longer reaction times and higher response errors were observed due to limited fixation duration on desired target. Conclusion: We suggest that latency and duration of fixation indicate efficiency of information processing and can predict the speed and accuracy of task performance under cognitive load.

Dietary patterns and health-related quality of life among Iranian adolescents.

PURPOSE: Examining the associations of a-posteriori-defined dietary patterns and health-related quality of life (HRQOL) among Iranian adolescents. METHODS: This cross-sectional study was conducted among 900 apparently healthy students (mean age 15.33 years; 53.0% female) during 2020-21. The validated Persian version of self-report Pediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales (PedsQL) for healthy adolescents was used in an online survey to assess HRQOL. Total, physical health, psychosocial health, emotional functioning, social functioning, and school functioning PedsQL scores were calculated, and impaired HRQOL was defined as > 1 standard deviation below the total population sample mean PedsQL scores. A validated food frequency questionnaire was used to assess dietary intakes during telephone interviews. Daily intakes of 20 predefined food groups were calculated and submitted to the principal component factor analysis to identify a-posteriori-defined dietary patterns. RESULTS: Three major dietary patterns labeled as Mediterranean, mixed, and unhealthy were identified, of which only the Mediterranean pattern characterized by high intakes of vegetables, fruits, olives, potatoes, eggs, nuts and legumes, pickles, low-fat dairy, fish, poultry, and vegetable oils was consistently associated with HRQOL. Controlling for covariates in the multivariable-adjusted binary logistic regression analysis, participants in the top tertile of Mediterranean pattern score were less likely to have impaired HRQOL than those in the bottom tertile (total: OR 0.25; physical health: OR 0.35; psychosocial health: OR 0.15; emotional functioning: OR 0.17; social functioning: OR 0.15; and school functioning: OR 0.18; all P < 0.010). CONCLUSION: Current findings indicate that an a-posteriori-defined Mediterranean-style dietary pattern is associated with better HRQOL among healthy Iranian adolescents.

Willingness to Receive Treatment for Hepatitis C among Injecting Drug Users on Methadone Program: Implications for Education and Treatment.

BACKGROUND: Hepatitis C virus (HCV) is common among people who inject drugs (PWID) on methadoneprogram in Iran (Persia). However, a few PWID on methadone program report willingness to receive HCVtreatment. This study aimed to assess the factors which were associated with willingness to receive HCVtreatment in a group of PWID on methadone program in Iran. METHODS: We surveyed 187 PWID at seven drops in centers in Tehran, Iran. Details of demographiccharacteristics, drug use, injection, HCV, and drug treatment history were collected using a 25-itemquestionnaire. Participants were serologically tested for the current status of HCV. FINDINGS: The study found that 28.3% of the participants were HCV seropositive. In total, 49.1% of theparticipants reported unwillingness to receive HCV treatment. Awareness of current HCV status [odds ratio(OR) = 3.43; 95% confidence interval (CI): 1.33-7.26; P < 0.050]; adequate knowledge of HCV treatmentcenters in the community (OR = 3.9; 95% CI: 1.24-5.38; P < 0.050); participation in an educational programon HCV (OR = 2.9; 95% CI: 2.33-8.56; P < 0.001) and recent participation in the meetings of self-helpgroups (OR = 4.6; 95% CI: 3.43-9.33; P < 0.001) were significantly associated with current willingness toreceive HCV treatment. CONCLUSION: The study results indicate that awareness of HCV status and the provision of adequate HCVeducation via different information centers can be associated with an increased willingness for HCVtreatment among PWID on methadone program. Conducting more research is suggested to assess theefficacy of educational programs and self-help groups in facilitating HCV treatment among PWID onmethadone program.

The Prevalence of ADHD and Comorbid Disorders in Iranian Adult Male Prison Inmates.

OBJECTIVE: The aim of the present study was to explore the prevalence of ADHD and comorbid disorders in a community sample of adult male prisoners in Iran. METHOD: Through stratified sampling method, 908 adult male prison inmates in Gorgan Prison were recruited on a voluntary basis. Diagnostic assessments were based on the Adult ADHD Self-Report Scale Screener and a clinical interview based on Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria and psychiatric interview. Comorbid disorders were assessed with the Beck Anxiety Inventory, Beck Depression Inventory-Second Edition, and Millon Clinical Multiaxial Inventory-III. RESULTS: ADHD was present in 147 participants (16.2%). Eighty-five percent of participants with ADHD reported lifetime substance abuse. They had higher rates of mood (40.8%) and anxiety (55.1%) disorders. Antisocial and borderline personality disorders were also more prevalent among offenders with ADHD. CONCLUSION: ADHD is prevalent in offenders and it is associated with comorbid disorders. The results emphasize the necessity of treatment programs for offenders with ADHD.

Methamphetamine use among Iranian heroin kerack-dependent women: implications for treatment.

BACKGROUND: Co-use of heroin kerack with methamphetamine (MA) is a new epidemic health concern among Iranian female drug users. Yet, little is known about this issue because of stigma. OBJECTIVES: The current study aimed to investigate the reasons associated with initial and continued co-use of heroin kerack with MA among two groups of regular and recreational female co-users, their motivations associated with treatment entry and to compare their general characteristics at a drop in center (DIC) in Tehran. MATERIALS AND METHODS: 82 clients were randomly recruited. A researcher-designed questionnaire was used to collect data. Data was analyzed by performing descriptive statistics, the Chi-square test and t-test. RESULTS: The mean age of the participants were 31 (SD = 8) years. Reducing negative affect (55%), addicted family and social networks (50%), curiosity (48%), and the lack of knowledge on addictive effects of co-use of heroin kerack with MA (32%) were the most frequently reported reasons at initiation. Drug dependence (71%) and drug availability (56%) were reasons of continued co-use. Restoring health (61%), fear from becoming MA abuser only (33%), and fear from making a transition from heroin kerack and MA smoking to injection (15%) were important motivations for treatment entry. Regular co-users were more likely to be single (41.7% vs. 14.7%, P < 0.001), jobless (45.8% vs. 38.2, P < 0.05), homemaker (50% vs. 35.3%, P < 0.01), recently incarcerated (16.7% vs. 11.7%, P < 0.01), and were less likely to be enrolled in opioid replacement programs (33.5% vs. 41%, P < 0.01). Regular co-users were younger (30.6 vs. 32.1 years, P < 0.05), less educated (9.6 vs. 10.8 years, P < 0.05) and had a longer duration of drug dependence (9.6 vs. 8 years, P < 0.05). CONCLUSIONS: Reasons associated with initial and continued co-use of heroin kerack with MA, factors associated with treatment entry and the differences between regular and recreational co-users should be specifically considered in designing and tailoring drug use treatment programs for this group.