Neurology Research International The latest articles from Hindawi Publishing Corporation © 2016 , Hindawi Publishing Corporation . All rights reserved. Peripheral Nerve Ultrasonography in Chronic Inflammatory Demyelinating Polyradiculoneuropathy and Multifocal Motor Neuropathy: Correlations with Clinical and Neurophysiological Data Sun, 29 May 2016 14:13:13 +0000 Objective. This cross-sectional study analyzes the pattern of ultrasound peripheral nerve alterations in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy (MMN) at different stages of functional disability. Material and Methods. 22 CIDP and 10 MMN patients and a group of 70 healthy controls were evaluated with an ultrasound scan of the median, ulnar, peroneal, tibial, and sural nerves. Results were correlated with clinical disability scales and nerve conduction studies. Results. Patients with intermediate functional impairment showed relatively larger cross-sectional areas than subjects with either a milder () or more severe impairment (), both in CIDP and in MMN. In addition, MMN was associated with greater side-to-side intranerve variability (), while higher cross-sectional areas were observed in CIDP () and in nerve segments with predominantly demyelinating features (). Higher CSA values were observed in nerves with demyelinating features versus axonal damage ( for CIDP; for MMN). Discussion and Conclusions. Greater extent of quantitative and qualitative US alterations was observed in patients at intermediate versus higher functional disability and in nerves with demyelinating versus axonal damage. CIDP and MMN showed differential US aspects, with greater side-to-side intranerve variability in MMN and higher cross-sectional areas in CIDP. Aristide Merola, Michela Rosso, Alberto Romagnolo, Erdita Peci, and Dario Cocito Copyright © 2016 Aristide Merola et al. All rights reserved. The Potential of Curcumin in Treatment of Spinal Cord Injury Thu, 19 May 2016 07:52:23 +0000 Current treatment for spinal cord injury (SCI) is supportive at best; despite great efforts, the lack of better treatment solutions looms large on neurological science and medicine. Curcumin, the active ingredient in turmeric, a spice known for its medicinal and anti-inflammatory properties, has been validated to harbor immense effects for a multitude of inflammatory-based diseases. However, to date there has not been a review on curcumin’s effects on SCI. Herein, we systematically review all known data on this topic and juxtapose results of curcumin with standard therapies such as corticosteroids. Because all studies that compare the two show superior results for curcumin over corticosteroids, it could be true that curcumin better acts at the inflammatory source of SCI-mediated neurological injury, although this question remains unanswered in patients. Because curcumin has shown improvements from current standards of care in other diseases with few true treatment options (e.g., osteoarthritis), there is immense potential for this compound in treating SCI. We critically and systematically summarize available data, discuss clinical implications, and propose further testing of this well-tolerated compound in both the preclinical and the clinical realms. Analyzing preclinical data from a clinical perspective, we hope to create awareness of the incredible potential that curcumin shows for SCI in a patient population that direly needs improvements on current therapy. Raghavendra Sanivarapu, Vijayalakshmi Vallabhaneni, and Vivek Verma Copyright © 2016 Raghavendra Sanivarapu et al. All rights reserved. Utility of Plasmapheresis in Autoimmune-Mediated Encephalopathy in Children: Potentials and Challenges Thu, 28 Apr 2016 17:14:55 +0000 Autoimmune-mediated encephalopathy in children continues to constitute a diagnostic and therapeutic challenge in pediatric population. Utility and usefulness in this clinical setting of plasmapheresis have seldom been evaluated in current pediatric literature. Children with immune-mediated encephalopathies represent a uniquely different group among patients presenting to intensive care units or neurological services worldwide. Arriving at a final diagnosis is not an easy task for treating physicians. It is very crucial to consider early use of first-line immunotherapy modalities, save those children’s lives and improve outcomes. Plasmapheresis is an emerging, potentially beneficial first-line therapy in such patients. However, indications, value, logistics, and procedural difficulties are often faced. This study is mainly meant to review the current knowledge in regard to the clinical value of plasmapheresis in children with immune-mediated encephalopathy. Abdulhafeez M. Khair Copyright © 2016 Abdulhafeez M. Khair. All rights reserved. BMI, HOMA-IR, and Fasting Blood Glucose Are Significant Predictors of Peripheral Nerve Dysfunction in Adult Overweight and Obese Nondiabetic Nepalese Individuals: A Study from Central Nepal Wed, 20 Apr 2016 11:47:04 +0000 Objective. Nondiabetic obese individuals have subclinical involvement of peripheral nerves. We report the factors predicting peripheral nerve function in overweight and obese nondiabetic Nepalese individuals. Methodology. In this cross-sectional study, we included 50 adult overweight and obese nondiabetic volunteers without features of peripheral neuropathy and 50 healthy volunteers to determine the normative nerve conduction data. In cases of abnormal function, the study population was classified on the basis of the number of nerves involved, namely, “<2” or “≥2.” Multivariable logistic regression analysis was carried out to predict outcomes. Results. Fasting blood glucose (FBG) was the significant predictor of motor nerve dysfunction (, 95% confidence interval (CI) = 1.003–1.127). Homeostatic model assessment of insulin resistance (HOMA-IR) was the significant predictor (, 96% CI = 1.420–49.322) of sensory nerve dysfunction. Body mass index (BMI) was the significant predictor (, 95% CI = 1.018–1.577) in case of ≥2 mixed nerves’ involvement. Conclusion. FBG, HOMA-IR, and BMI were significant predictors of peripheral nerve dysfunction in overweight and obese Nepalese individuals. Lekhjung Thapa and P. V. S. Rana Copyright © 2016 Lekhjung Thapa and P. V. S. Rana. All rights reserved. Febrile Seizures and Febrile Seizure Syndromes: An Updated Overview of Old and Current Knowledge Mon, 30 Nov 2015 17:09:17 +0000 Febrile seizures are the most common paroxysmal episode during childhood, affecting up to one in 10 children. They are a major cause of emergency facility visits and a source of family distress and anxiety. Their etiology and pathophysiological pathways are being understood better over time; however, there is still more to learn. Genetic predisposition is thought to be a major contributor. Febrile seizures have been historically classified as benign; however, many emerging febrile seizure syndromes behave differently. The way in which human knowledge has evolved over the years in regard to febrile seizures has not been dealt with in depth in the current literature, up to our current knowledge. This review serves as a documentary of how scientists have explored febrile seizures, elaborating on the journey of knowledge as far as etiology, clinical features, approach, and treatment strategies are concerned. Although this review cannot cover all clinical aspects related to febrile seizures at the textbook level, we believe it can function as a quick summary of the past and current sources of knowledge for all varieties of febrile seizure types and syndromes. Abdulhafeez M. Khair and Dalal Elmagrabi Copyright © 2015 Abdulhafeez M. Khair and Dalal Elmagrabi. All rights reserved. The Role of the Craniocervical Junction in Craniospinal Hydrodynamics and Neurodegenerative Conditions Mon, 30 Nov 2015 14:30:22 +0000 The craniocervical junction (CCJ) is a potential choke point for craniospinal hydrodynamics and may play a causative or contributory role in the pathogenesis and progression of neurodegenerative diseases such as Alzheimer’s disease, Parkinson’s disease, MS, and ALS, as well as many other neurological conditions including hydrocephalus, idiopathic intracranial hypertension, migraines, seizures, silent-strokes, affective disorders, schizophrenia, and psychosis. The purpose of this paper is to provide an overview of the critical role of the CCJ in craniospinal hydrodynamics and to stimulate further research that may lead to new approaches for the prevention and treatment of the above neurodegenerative and neurological conditions. Michael F. Flanagan Copyright © 2015 Michael F. Flanagan. All rights reserved. Recurrence Quantification Analysis of F-Waves and the Evaluation of Neuropathies Tue, 24 Nov 2015 09:25:30 +0000 Electrodiagnostic (EDX) patterns of neuropathic dysfunction have been based on axonal/demyelinating criteria requiring prior assumptions. This has not produced classifications of desired sensitivity or specificity. Furthermore, standard nerve conduction studies have limited reproducibility. New methodologies in EDX seem important. Recurrent Quantification Analysis (RQA) is a nonlinear method for examining patterns of recurrence. RQA might provide a unique method for the EDX evaluation of neuropathies. RQA was used to analyze F-wave recordings from the abductor hallucis muscle in 61 patients with neuropathies. Twenty-nine of these patients had diabetes as the sole cause of their neuropathies. In the other 32 patients, the etiologies of the neuropathies were diverse. Commonly used EDX variables were also recorded. RQA data could separate the 29 patients with diabetic neuropathies from the other 32 patients (). Statistically significant differences in two EDX variables were also present: compound muscle action potential amplitudes () and F-wave persistence (). RQA analysis of F-waves seemed able to distinguish diabetic neuropathies from the other neuropathies studied, and this separation was associated with specific physiological abnormalities. This study would therefore support the idea that RQA of F-waves can distinguish between types of neuropathic dysfunction based on EDX data alone without prior assumptions. Morris A. Fisher, Vijaya K. Patil, and Charles L. Webber Jr. Copyright © 2015 Morris A. Fisher et al. All rights reserved. Prevalence of Provocative Seizures in Persons with Epilepsy: A Longitudinal Study at Khon Kaen University Hospital, Thailand Thu, 12 Nov 2015 13:24:42 +0000 Background and Objective. Provocative factors are one causative factor of seizure attacks in persons with epilepsy (PWE). There are limited data of prevalence and major provocative factors in Asian populations. Methods. This study was performed at the Epilepsy Clinic, Khon Kaen University Hospital. The patients who aged 15 years or over, who had been treated at least 3 months with at least one antiepileptic drug, and who were followed up for at least one year were included. Data of seizure control and triggers were collected retrospectively from medical records. Data analysis was performed to identify independent provocative factors. Results. A total of 382 PWE met the study criteria. The mean age was years. Approximately 44% of the patients had at least one provocative factor. By multivariate analysis, the independent provocative factors with the first three highest adjusted odds ratios were sleep deprivation (adjusted , 95% CI 3.73–19.99), alcohol consumption (adjusted , 95% CI 1.44–31.78), and feeling stressful (adjusted , 95% CI 1.29–6.86). Conclusion. Almost half of seizure attacks may be caused by provocative factors in Thai PWEs and some factors may be preventable. Avoidance of these factors should be emphasized to epilepsy patients for improving clinical outcomes and quality of life. Nutthaya Vongkasamchai, Sunee Lertsinudom, Acharawan Topark-Ngarm, Udomlack Peansukwech, Kittisak Sawanyawisuth, Somsak Tiamkao, and Integrated Epilepsy Research Group Copyright © 2015 Nutthaya Vongkasamchai et al. All rights reserved. Differential Expression of Tyrosine Hydroxylase Protein and Apoptosis-Related Genes in Differentiated and Undifferentiated SH-SY5Y Neuroblastoma Cells Treated with MPP+ Sun, 08 Nov 2015 11:56:42 +0000 The human neuroblastoma SH-SY5Y cell line has been used as a dopaminergic cell model for Parkinson’s disease research. Whether undifferentiated or differentiated SH-SY5Y cells are more suitable remains controversial. This study aims to evaluate the expression of apoptosis-related mRNAs activated by MPP+ and evaluate the differential expression of tyrosine hydroxylase (TH) in undifferentiated and retinoic acid- (RA-) induced differentiated cells. The western blot results showed a gradual decrease in TH in undifferentiated cells and a gradual increase in TH in differentiated cells from days 4 to 10 after cell plating. Immunostaining revealed a gradual increase in TH along with neuritic outgrowth in differentiated cells on days 4 and 7 of RA treatment. For the study on cell susceptibility to MPP+ and the expression of apoptosis-related genes, MTT assay showed a decrease in cell viability to approximately 50% requiring 500 and 1000 μM of MPP+ for undifferentiated and RA-differentiated cells, respectively. Using real-time RT-PCR, treatment with 500 μM MPP+ led to significant increases in the Bax/Bcl-2 ratio, p53, and caspase-3 in undifferentiated cells but was without significance in differentiated cells. In conclusion, differentiated cells may be more suitable, and the shorter duration of RA differentiation may make the SH-SY5Y cell model more accessible. Kawinthra Khwanraj, Chareerut Phruksaniyom, Suriyat Madlah, and Permphan Dharmasaroja Copyright © 2015 Kawinthra Khwanraj et al. All rights reserved. Visual Interhemispheric and Striate-Extrastriate Cortical Connections in the Rabbit: A Multiple Tracer Study Tue, 08 Sep 2015 06:38:51 +0000 Previous studies in rabbits identified an array of extrastriate cortical areas anatomically connected with V1 but did not describe their internal topography. To address this issue, we injected multiple anatomical tracers into different regions in V1 of the same animal and analyzed the topography of resulting extrastriate labeled fields with reference to the patterns of callosal connections and myeloarchitecture revealed in tangential sections of the flattened cortex. Our results extend previous studies and provide further evidence that rabbit extrastriate areas resemble the visual areas in rats and mice not only in their general location with respect to V1 but also in their internal topography. Moreover, extrastriate areas in the rabbit maintain a constant relationship with myeloarchitectonic borders and features of the callosal pattern. These findings highlight the rabbit as an alternative model to rats and mice for advancing our understanding of cortical visual processing in mammals, especially for projects benefiting from a larger brain. Adrian K. Andelin, David J. Bruning, Daniel J. Felleman, and Jaime F. Olavarria Copyright © 2015 Adrian K. Andelin et al. All rights reserved. Prevalence and Correlates of HIV-Associated Neurocognitive Disorders (HAND) in Northwestern Nigeria Sun, 09 Aug 2015 14:26:08 +0000 HIV-associated Neurocognitive Disorders (HAND) are common among HIV-positive individuals. This study explored the prevalence and correlates of HAND in Nigeria. 80 HIV-positive and 40 HIV-negative adults selected from Aminu Kano Teaching Hospital (AKTH) received comprehensive evaluations. A multidomain neuropsychological test (MDNPT) battery assessing 7 domains was administered to the participants and their performance was combined with measures of functional status to classify impairments into various grades of HAND. Univariate and multivariate analyses were performed to identify correlates of symptomatic HAND. Among the HIV-positive individuals, 50% were highly active antiretroviral therapy-experienced (HAART+) and 50% were highly active antiretroviral therapy naive (HAART−). Symptomatic HAND was found among 40% of the HAART− individuals and 30% of the HAART+ individuals. Respective prevalence of HIV-associated dementia (HAD) was 23% and 5%, respectively (). In a binary logistic regression model, only fewer years of education independently predicted symptomatic HAND [Odds Ratio (OR) = 1.2, 95% confidence interval (CI) = 1.04–1.44, ]. The prevalence of HAND in Nigeria is high with HAD being commoner among HAART− patients. Provision of HAART and strict monitoring of patients at risk of HAND are needed to scale down the burden of the disease. Ahmad M. Yakasai, Mustafa I. Gudaji, Hamza Muhammad, Aliyu Ibrahim, Lukman F. Owolabi, Daiyabu A. Ibrahim, Musa Babashani, Muhammad S. Mijinyawa, Musa M. Borodo, Abayomi S. Ogun, and Abdulrazaq G. Habib Copyright © 2015 Ahmad M. Yakasai et al. All rights reserved. Evaluation of the Effects of Charged Amino Acids on Uncontrolled Seizures Thu, 09 Jul 2015 11:27:25 +0000 Introduction. Epilepsy is one of the most common diseases of the central nervous system. The prevalence of epilepsy throughout the world is 0.5 to 1%, and the same rate is 7.8 per 1000 in Kerman. Almost 20 to 30% of epileptic patients do not respond properly to common medications. The present study investigated patients who did not respond to common and, even in some cases, adjuvant therapies, with two seizures or more per week, regardless of the type of the inflicted epilepsy. Methodology. The participants of the present double-blind study were randomly selected into three 10-member groups of uncontrolled epileptic patients (arginine, glutamic acid, and lysine). The patients used amino acid powder dissolved in water (three times the daily need) every day for two weeks before breakfast. The number of seizures was recorded one week prior to commencing amino acid use, as well as the first and the second weeks subsequent to use. Results. A total of 32 patients were studied in three groups. The decline rates of seizures were 53%, 41%, and 13%, and the P value was 0.013, 0.027, and 0.720, respectively. Conclusion. Administration of the charged amino acids, arginine, and glutamic acid can decrease the seizures of patients suffering from uncontrolled epilepsy. Hossein Ali Ebrahimi and Saeed Ebrahimi Copyright © 2015 Hossein Ali Ebrahimi and Saeed Ebrahimi. All rights reserved. Hypobaric Hypoxia Imbalances Mitochondrial Dynamics in Rat Brain Hippocampus Sun, 05 Jul 2015 08:55:55 +0000 Brain is predominantly susceptible to oxidative stress and mitochondrial dysfunction during hypobaric hypoxia, and therefore undergoes neurodegeneration due to energy crisis. Evidences illustrate a high degree of association for mitochondrial fusion/fission imbalance and mitochondrial dysfunction. Mitochondrial fusion/fission is a recently reported dynamic mechanism which frequently occurs among cellular mitochondrial network. Hence, the study investigated the temporal alteration and involvement of abnormal mitochondrial dynamics (fusion/fission) along with disturbed mitochondrial functionality during chronic exposure to hypobaric hypoxia (HH). The Sprague-Dawley rats were exposed to simulated high altitude equivalent to 25000 ft for 3, 7, 14, 21, and 28 days. Mitochondrial morphology, distribution within neurons, enzyme activity of respiratory complexes, , ADP: ATP, and expression of fission/fusion key proteins were determined. Results demonstrated HH induced alteration in mitochondrial morphology by damaged, small mitochondria observed in neurons with disturbance of mitochondrial functionality and reduced mitochondrial density in neuronal processes manifested by excessive mitochondrial fragmentation (fission) and decreased mitochondrial fusion as compared to unexposed rat brain hippocampus. The study suggested that imbalance in mitochondrial dynamics is one of the noteworthy mechanisms occurring in hippocampal neurons during HH insult. Khushbu Jain, Dipti Prasad, Shashi Bala Singh, and Ekta Kohli Copyright © 2015 Khushbu Jain et al. All rights reserved. Inventory of a Neurological Intensive Care Unit: Who Is Treated and How Long? Wed, 24 Jun 2015 08:10:19 +0000 Purpose. To characterize indications, treatment, and length of stay in a stand-alone neurological intensive care unit with focus on comparison between ventilated and nonventilated patient. Methods. We performed a single-center retrospective cohort study of all treated patients in our neurological intensive care unit between October 2006 and December 2008. Results. Overall, 512 patients were treated in the surveyed period, of which 493 could be included in the analysis. Of these, 40.8% had invasive mechanical ventilation and 59.2% had not. Indications in both groups were predominantly cerebrovascular diseases. Length of stay was 16.5 days in mean for ventilated and 3.6 days for nonventilated patient. Conclusion. Most patients, ventilated or not, suffer from vascular diseases with further impairment of other organ systems or systemic complications. Data reflects close relationship and overlap of treatment on nICU with a standardized stroke unit treatment and suggests, regarding increasing therapeutic options, the high impact of acute high-level treatment to reduce consequential complications. Roland Backhaus, Franz Aigner, Felix Schlachetzki, Dagmar Steffling, Wolfgang Jakob, Andreas Steinbrecher, Bernhard Kaiser, Peter Hau, Sandra Boy, Kornelius Fuchs, Ulrich Bogdahn, and Markus Ritzka Copyright © 2015 Roland Backhaus et al. All rights reserved. Children with Autism Spectrum Disorder and Patterns of Participation in Daily Physical and Play Activities Mon, 15 Jun 2015 12:06:51 +0000 Autism spectrum disorder (ASD) indicates several neurodevelopmental impairments which may end in impairments in motor or physical activities. Daily physical activity involvement was investigated in a total of 83 children (52 boys and 31 girls) with ASD aged 6–15 years. Results indicated that only 10 (12%) of children with ASD were physically active. Children were predominantly engaged in solitary play rather than social play activities. Gender, family income, and household structure were found to be associated with activity scores. Financial burden and lack of opportunities were noted as the leading barriers to physical activities. In conclusion, findings indicated a low rate of physical activity participation in children with ASD that is closely associated with sociodemographic variables. Amir Hossein Memari, Nekoo Panahi, Elaheh Ranjbar, Pouria Moshayedi, Masih Shafiei, Ramin Kordi, and Vahid Ziaee Copyright © 2015 Amir Hossein Memari et al. All rights reserved. Pioglitazone Ameliorates Neuron Loss in the Cortex after Aluminum-Treatment in Rats Mon, 08 Jun 2015 14:00:03 +0000 The objective was evaluation of the effects of pioglitazone on medial prefrontal cortex (mPFC) of the rats exposed to aluminum (Al). Al induces structural changes in several brain regions, including mPFC. Pioglitazone is an agonist of peroxisomal proliferator activated receptor gamma. Male rats were randomly assigned to control, Al-treated (10 mg/kg/day), and Al + PIO-treated groups (Al+ 40 mg/kg/day). After 56 days, the right mPFCs were removed. Then, the volume of mPFC and its subdivisions, volume of vessels, and total number of neurons and glia were estimated using stereological methods. The results showed 13–38% decrease in the volume of the mPFC and its subdivisions, mainly in the infralimbic region (). Besides, the volume of the vessels reduced by 47% after Al-treatment (). The total number of the neurons and glial cells was also reduced (40% and 25%, resp.) in the Al-exposed rats in comparison to the control ones (). Treatment of the animals with Al + PIO ameliorated the neuron loss and no improvement was seen in other parameters (). It can be concluded that treatment of the rats with PIO could ameliorate the neuron loss in the mPFC of the Al-treated animals. Ali Rafati, Hajar Yazdani, and Ali Noorafshan Copyright © 2015 Ali Rafati et al. All rights reserved. Atrial Fibrillation in the Young: A Neurologist’s Nightmare Thu, 02 Apr 2015 18:17:24 +0000 Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia seen in clinical practice with prevalence in excess of 33 million worldwide. Although often asymptomatic and until recently considered a “benign” arrhythmia, it is now appreciated that thromboembolism resulting from AF results in significant morbidity and mortality predominantly due to stroke. Although an arrhythmia more commonly affecting the elderly, AF can also occur in the young. This review focuses on the impact of AF in the younger population and discusses the dilemmas of managing younger patients with AF. Nikhil Aggarwal, Subothini Selvendran, Claire E. Raphael, and Vassilios Vassiliou Copyright © 2015 Nikhil Aggarwal et al. All rights reserved. Clinical Manifestations of Herpes Zoster, Its Comorbidities, and Its Complications in North of Iran from 2007 to 2013 Sun, 29 Mar 2015 13:20:44 +0000 Background. Herpes zoster infection is a painful worldwide disease. Inappropriate and delayed treatment causes prolongation of the disease with debilitating symptoms and postherpetic neuralgia. Method. A cross-sectional study evaluated shingles cases admitted in a teaching hospital with one-year followup in north of Iran from 2007 to 2013. Results. From 132 patients, 60.4% were male. Head and neck involvement occurred in 78 people (59.1%), thoracoabdominal region in 37 cases (28%), and extremities in 16 cases (12.1%), and one case (0.8%) got multisites involvement. 54 cases (40.9%) had predisposing factors including diabetes mellitus in 26 cases (19.7%), malignancy in 15 (11.4%), immunosuppressive medication in 7 (5.03%), HIV infection in 3 (2.3%), radiotherapy in 2 (1.5%), and tuberculosis in one patient (0.8%). The most common symptoms were pain (95.5%), weakness (56%), fever (31.1%), headache (30.3%), ocular complaints (27.3%), itching (24.2%), and dizziness (5.3%). 21 cases (15.9%) had bacterial superinfection on blistering areas and overall 18 cases (13.6%) had opium addiction. 4 cases (3.03%) died during admission because of comorbidities. Postherpetic neuralgia was reported in 56 patients (42.5%) after three months and seven cases (5%) in one-year followup. Conclusion. Shortening interval between skin lesion manifestation and starting medication can accelerate lesion improvement and decrease disease course, extension, and complication. Farhang Babamahmoodi, Ahmad Alikhani, Fatemeh Ahangarkani, Leila Delavarian, Hamidreza Barani, and Abdolreza Babamahmoodi Copyright © 2015 Farhang Babamahmoodi et al. All rights reserved. Optic Nerve Sonography in the Diagnostic Evaluation of Pseudopapilledema and Raised Intracranial Pressure: A Cross-Sectional Study Sun, 22 Mar 2015 11:43:26 +0000 Introduction. Differentiating pseudopapilledema from papilledema which is optic disk edema and a result of increased ICP (intracranial pressure) is important and can be done with noninvasive methods like orbital ultrasound examination. Method. This was a cross-sectional study in which patients with optic nerve head swelling were referred for LP exam after optic nerve head swelling diagnosis confirmation and having normal brain imaging (CT scan). Before LP (lumbar puncture) exam the patients were referred for optic nerve ultrasound test of both eyes. Results. Considering 5.7 mm as the upper limit for normal ONSD (optic nerve sheath diameter), sensitivity and negative predictive value of optic sonography in diagnosis of pseudopapilledema are 100% for both eyes. Calculated accuracy validity of ONSD measurement in detecting pseudopapilledema is 90% for the right eye and 87% for the left eye. Conclusion. Our study demonstrated a close correlation between optic nerve sheath dilation on ocular ultrasound and evidence of elevated ICP with optic disk swelling. With the aid of noninvasive diagnostic tests we can avoid unnecessary concerns along with expensive and invasive neurological investigations while targeting the correct diagnosis in bilateral optic disk swelling. Our study showed optic nerve sonography as a reliable diagnostic method for further usage. Masoud Mehrpour, Fatemeh Oliaee Torshizi, Shooka Esmaeeli, Salameh Taghipour, and Sahar Abdollahi Copyright © 2015 Masoud Mehrpour et al. All rights reserved. Biological Motion Perception Is Affected by Age and Cognitive Style in Children Aged 8–15 Mon, 16 Mar 2015 08:22:50 +0000 The current paper aims to address the question of how biological motion perception in different social contexts is influenced by age or also affected by cognitive styles. We examined developmental changes of biological motion perception among 141 school children aged 8–15 using point-light displays in monadic and dyadic social contexts. Furthermore, the cognitive styles of participants were investigated using empathizing-systemizing questionnaires. Results showed that the age and empathizing ability strongly predicted improvement in action perception in both contexts. However the systemizing ability was an independent predictor of performance only in monadic contexts. Furthermore, accuracy of action perception increased significantly from 46.4% (SD = 16.1) in monadic to 62.5% (SD = 11.5) in dyadic social contexts. This study can help to identify the roles of social context in biological motion perception and shows that children with different cognitive styles may present different biological motion perception. Parisa Ghanouni, Amir Hossein Memari, Monir Shayestehfar, Pouria Moshayedi, Shahriar Gharibzadeh, and Vahid Ziaee Copyright © 2015 Parisa Ghanouni et al. All rights reserved. Comparison of Percutaneous Endoscopic Lumbar Discectomy and Open Lumbar Surgery for Adjacent Segment Degeneration and Recurrent Disc Herniation Tue, 10 Mar 2015 11:28:17 +0000 Objective. The goal of the present study was to examine the clinical results of percutaneous endoscopic lumbar discectomy (PELD) and open lumbar surgery for patients with adjacent segment degeneration (ASD) and recurrence of disc herniation. Methods. From December 2011 to November 2013, we collected forty-three patients who underwent repeated lumbar surgery. These patients, either received PELD (18 patients) or repeated open lumbar surgery (25 patients), due to ASD or recurrence of disc herniation at L3-4, L4-5, or L5-S1 level, were assigned to different groups according to the surgical approaches. Clinical data were assessed and compared. Results. Mean blood loss was significantly less in the PELD group as compared to the open lumbar surgery group . Hospital stay and mean operating time were shorter significantly in the PELD group as compared to the open lumbar surgery group . Immediate postoperative pain improvement in VAS was 3.5 in the PELD group and −0.56 in the open lumbar surgery group . Conclusion. For ASD and recurrent lumbar disc herniation, PELD had more advantages over open lumbar surgery in terms of reduced blood loss, shorter hospital stay, operating time, fewer complications, and less postoperative discomfort. Huan-Chieh Chen, Chih-Hsun Lee, Li Wei, Tai-Ngar Lui, and Tien-Jen Lin Copyright © 2015 Huan-Chieh Chen et al. All rights reserved. Methylphenidate Efficacy: Immediate versus Extended Release at Short Term in Mexican Children with ADHD Assessed by Conners Scale and EEG Sun, 08 Mar 2015 09:30:33 +0000 Attention deficit hyperactivity disorder (ADHD) affects 5-6% of school aged children worldwide. Pharmacological therapy is considered the first-line treatment and methylphenidate (MPH) is considered the first-choice medication. There are two formulations: immediate release (IR) MPH and long-acting (or extended release) formulation (MPH-ER). In this work, we measure the efficacy of treatment for both presentations in one month with Conners’ scales and electroencephalography (EEG). Results. for IR group, in parents and teachers Conners test, all items showed significant differences, towards improvement, except for teachers in perfectionism and emotional instability. For ER group in parent’s Conners test, the items in which there were no significant differences are psychosomatic and emotional instability. For teachers, there were no significant differences in: hyperactivity and perfectionism. Comparing the Conners questionnaires (parents versus teachers) we find significant differences before and after treatment in hyperactivity, perfectionism, psychosomatics, DSM-IV hyperactive-impulsive, and DSM-IV total. In the EEG the Wilcoxon test showed a significant difference . As we can see, both presentations are suitable for managing the ADHD and have the same effect on the symptomatology and in the EEG. Alfredo Durand-Rivera, Efren Alatorre-Miguel, Elizabeth Zambrano-Sánchez, and Celia Reyes-Legorreta Copyright © 2015 Alfredo Durand-Rivera et al. All rights reserved. Predictor’s of Mortality in Patients with Aneurysmal Subarachnoid Haemorrhage and Reebleding Thu, 05 Feb 2015 09:27:18 +0000 Methods. “Ameijeiras Brother’s” and “Cmdt. Manuel Fajardo” Hospitals enrolled 64 patients (multicentre retrospective cohort) with aneurysmal subarachnoid haemorrhage and rebleeding. The patients were admitted to the Stroke Unit (SU) between January 1, 2006, and December 1, 2013. Demographic, clinical, and radiological variables were examined in logistic regression to evaluate independent factors for increasing the risk of death. Results. Patients with systolic blood pressure >160 mmHg (), serum glucose >7 mmol/L (), aneurysm location in artery communicant anterior (), and black/mixed race () were significant related to death in univariate analysis. Risk factors (HTA, smoke, alcohol consumption, and DM), complication, multiplex rebleeding and stage of WFNS, and Fisher’s scale were not related to mortality. Patients with three or more complications had a higher mortality rate (). The results of the multivariate logistic regression analysis indicated that race (black/mixed, , OR 4.62, and 95% IC 1.40–16.26), systolic blood pressure (>160 mmHg, , OR 2.54, and 95% IC 1.01–3.13), and serum glucose (>7.0 mmol/L, , OR 1.82, and 95% IC 1.27–2.67) were independent risk factors for death. Conclusions. The black/mixed race, SBP, and serum glucose were independent predictors of mortality. Three or more complications were associated with increasing the probability to death. Further investigation is necessary to validate these findings. Dannys Rivero Rodríguez, Claudio Scherle Matamoros, Leda Fernández Cúe, Jose Luis Miranda Hernández, Yanelis Pernas Sánchez, and Jesús Pérez Nellar Copyright © 2015 Dannys Rivero Rodríguez et al. All rights reserved. Brain Activity during Lower-Limb Movement with Manual Facilitation: An fMRI Study Mon, 02 Feb 2015 06:26:18 +0000 Brain activity knowledge of healthy subjects is an important reference in the context of motor control and reeducation. While the normal brain behavior for upper-limb motor control has been widely explored, the same is not true for lower-limb control. Also the effects that different stimuli can evoke on movement and respective brain activity are important in the context of motor potentialization and reeducation. For a better understanding of these processes, a functional magnetic resonance imaging (fMRI) was used to collect data of 10 healthy subjects performing lower-limb multijoint functional movement under three stimuli: verbal stimulus, manual facilitation, and verbal + manual facilitation. Results showed that, with verbal stimulus, both lower limbs elicit bilateral cortical brain activation; with manual facilitation, only the left lower limb (LLL) elicits bilateral activation while the right lower limb (RLL) elicits contralateral activation; verbal + manual facilitation elicits bilateral activation for the LLL and contralateral activation for the RLL. Manual facilitation also elicits subcortical activation in white matter, the thalamus, pons, and cerebellum. Deactivations were also found for lower-limb movement. Manual facilitation is stimulus capable of generating brain activity in healthy subjects. Stimuli need to be specific for bilateral activation and regarding which brain areas we aim to activate. Patrícia Maria Duarte de Almeida, Ana Isabel Correia Matos de Ferreira Vieira, Nádia Isabel Silva Canário, Miguel Castelo-Branco, and Alexandre Lemos de Castro Caldas Copyright © 2015 Patrícia Maria Duarte de Almeida et al. All rights reserved. Deletion of Ovarian Hormones Induces a Sickness Behavior in Rats Comparable to the Effect of Lipopolysaccharide Thu, 29 Jan 2015 06:18:59 +0000 Neuroimmune factors have been proposed as the contributors to the pathogenesis of sickness behaviors. The effects of female gonadal hormones on both neuroinflammation and depression have also been well considered. In the present study, the capability of deletion of ovarian hormones to induce sickness-like behaviors in rats was compared with the effect lipopolysaccharide (LPS). The groups were including Sham, OVX, Sham-LPS, and OVX-LPS. The Sham-LPS and OVX-LPS groups were treated with LPS (250 μg/kg) two hours before conducting the behavioral tests. In the forced swimming (FST), the immobility times in both OVX and Sham-LPS groups were higher than that of Sham (). In open-field (OP) test, the central crossing number by OVX and Sham-LPS groups were lower than Sham () while there were no significant differences between OVX-LPS and OVX groups. In elevated plus maze (EPM), the percent of entries to the open arm by both OVX and Sham-LPS groups was lower than that of Sham group (). The results of present study showed that deletion of ovarian hormones induced sickness behaviors in rats which were comparable to the effects of LPS. Moreover, further investigations are required in order to better understand the mechanism(s) involved. Hamid Azizi-Malekabadi, Mahmoud Hosseini, Masoume Pourganji, Hoda Zabihi, Mohsen Saeedjalali, and Akbar Anaeigoudari Copyright © 2015 Hamid Azizi-Malekabadi et al. All rights reserved. Is Parkinson’s Disease Truly a Prion-Like Disorder? An Appraisal of Current Evidence Tue, 13 Jan 2015 11:42:29 +0000 Parkinson’s disease (PD) is the world’s second most common neurodegenerative disease and most common movement disorder. Characterised by a loss of dopaminergic neurons and the development of intraneuronal inclusions known as Lewy bodies, it has classically been thought of as a cell-autonomous disease. However, in 2008, two groups reported the startling observation of Lewy bodies within embryonic neuronal grafts transplanted into PD patients little more than a decade previously, suggesting that PD pathology can be propagated to neighbouring cells and calling basic assumptions of our understanding of the disease into question. Subsequent research has largely served to confirm this interpretation, pointing towards a prion-like intercellular transfer of misfolded α-synuclein, the main component of Lewy bodies, as central to PD. This shift in thinking offers a revolutionary approach to PD treatment, potentially enabling a transition from purely symptomatic therapy to direct targeting of the pathology that drives disease progression. In this short review, we appraise current experimental support for PD as a prion-like disease, whilst highlighting areas of controversy or inconsistency which must be resolved. We also offer a brief discussion of the therapeutic implications of these discoveries. Aneesha Chauhan and Alexander F. Jeans Copyright © 2015 Aneesha Chauhan and Alexander F. Jeans. All rights reserved. Sweet Taste Receptor Signaling Network: Possible Implication for Cognitive Functioning Sun, 11 Jan 2015 06:13:21 +0000 Sweet taste receptors are transmembrane protein network specialized in the transmission of information from special “sweet” molecules into the intracellular domain. These receptors can sense the taste of a range of molecules and transmit the information downstream to several acceptors, modulate cell specific functions and metabolism, and mediate cell-to-cell coupling through paracrine mechanism. Recent reports indicate that sweet taste receptors are widely distributed in the body and serves specific function relative to their localization. Due to their pleiotropic signaling properties and multisubstrate ligand affinity, sweet taste receptors are able to cooperatively bind multiple substances and mediate signaling by other receptors. Based on increasing evidence about the role of these receptors in the initiation and control of absorption and metabolism, and the pivotal role of metabolic (glucose) regulation in the central nervous system functioning, we propose a possible implication of sweet taste receptor signaling in modulating cognitive functioning. Menizibeya O. Welcome, Nikos E. Mastorakis, and Vladimir A. Pereverzev Copyright © 2015 Menizibeya O. Welcome et al. All rights reserved. MS Prevalence and Patients’ Characteristics in the District of Braga, Portugal Thu, 08 Jan 2015 07:06:02 +0000 Multiple Sclerosis (MS) is a chronic autoimmune disease of the Central Nervous System causing inflammation and neurodegeneration. There are only 3 epidemiological studies in Portugal, 2 in the Centre and 1 in the North, and there is the need to further study MS epidemiology in this country. The objective of this work is to contribute to the MS epidemiological knowledge in Portugal, describing the patients’ epidemiological, demographic, and clinical characteristics in the Braga district of Portugal. This is a cross-sectional study of 345 patients followed in two hospitals of Braga district. These hospitals cover a resident population of 866,012 inhabitants. The data was collected from the clinical records, and 31/12/2009 was established as the prevalence day. For all MS patients, demographic characteristics and clinical outcomes are reported. We have found an incidence of 2.74/100,000 and a prevalence of 39.82/100,000 inhabitants. Most patients have an EDSS of 3 or lower and a mean age of 42 years. The diagnosis was done at mean age of 35, with RRMS being the disease type in more than 80% of patients. In this cohort, we found a female : male ratio of 1.79. More than 50% of patients are treated with Interferon β-1b IM or IFNβ-1a SC 22 μg. José Figueiredo, Ângela Silva, João J. Cerqueira, Joaquim Fonseca, and Paulo A. Pereira Copyright © 2015 José Figueiredo et al. All rights reserved. Desmopressin Acetate in Intracranial Haemorrhage Tue, 23 Dec 2014 13:18:02 +0000 Introduction. The secondary increase in the size of intracranial haematomas as a result of spontaneous haemorrhage or trauma is of particular relevance in the event of prior intake of platelet aggregation inhibitors. We describe the effect of desmopressin acetate as a means of temporarily stabilising the platelet function. Patients and Methods. The platelet function was analysed in 10 patients who had received single () or multiple () doses of acetylsalicylic acid and 3 patients (control group) who had not taken acetylsalicylic acid. All subjects had suffered intracranial haemorrhage. Analysis was performed before, half an hour and three hours after administration of desmopressin acetate. Statistical analysis was performed by applying a level of significance of . Results. (1) Platelet function returned to normal 30 minutes after administration of desmopressin acetate. (2) The platelet function worsened again after three hours. (3) There were no complications related to electrolytes or fluid balance. Conclusion. Desmopressin acetate can stabilise the platelet function in neurosurgical patients who have received acetylsalicylic acid prior to surgery without causing transfusion-related side effects or a loss of time. The effect is, however, limited and influenced by the frequency of drug intake. Further controls are needed in neurosurgical patients. Thomas Kapapa, Stefan Röhrer, Sabine Struve, Matthias Petscher, Ralph König, Christian Rainer Wirtz, and Dieter Woischneck Copyright © 2014 Thomas Kapapa et al. All rights reserved. A Comparative Study on Visual Choice Reaction Time for Different Colors in Females Tue, 16 Dec 2014 11:28:08 +0000 Reaction time is one of the important methods to study a person’s central information processing speed and coordinated peripheral movement response. Visual choice reaction time is a type of reaction time and is very important for drivers, pilots, security guards, and so forth. Previous studies were mainly on simple reaction time and there are very few studies on visual choice reaction time. The aim of our study was to compare the visual choice reaction time for red, green, and yellow colors of 60 healthy undergraduate female volunteers. After giving adequate practice, visual choice reaction time was recorded for red, green, and yellow colors using reaction time machine (RTM 608, Medicaid, Chandigarh). Repeated measures of ANOVA and Bonferroni multiple comparison were used for analysis and was considered statistically significant. The results showed that both red and green had significantly less choice visual choice reaction ( values and 0.0002) when compared with yellow. This could be because individual color mental processing time for yellow color is more than red and green. Grrishma Balakrishnan, Gurunandan Uppinakudru, Gaur Girwar Singh, Shobith Bangera, Aswini Dutt Raghavendra, and Dinesh Thangavel Copyright © 2014 Grrishma Balakrishnan et al. All rights reserved.