Soodeh Razeghi-Jahromi; Rozita Doosti; Zeinab Ghorbani; Roghayyeh Saeedi; Maryam Abolhasani; Naeemeh Akbari; Fatemeh Cheraghi-Serkani; Abdorreza Naser Moghadasi; Amirreza Azimi; Mansoureh Togha; Mohammad Ali Sahraian
Abstract
Background: Among multiple sclerosis (MS) related symptoms and complications, fatigue might impact roughly 90% of patients. Decline in cognitive function is one of the other complications that occur in the first years after disease onset. The Mediterranean diet is one of the well-known anti-inflammatory ...
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Background: Among multiple sclerosis (MS) related symptoms and complications, fatigue might impact roughly 90% of patients. Decline in cognitive function is one of the other complications that occur in the first years after disease onset. The Mediterranean diet is one of the well-known anti-inflammatory dietary approaches. Therefore, this study aimed to explore the effects of a modified Mediterranean-like diet on cognitive changes and fatigue levels in comparison with a conventional standard diet over a 1-year follow-up. Methods: In the current single-blind randomized controlled trial, 34 MS patients in the Mediterranean- like diet group and 38 patients in the standard healthy diet group were studied for 1 year. The dietary interventions were modified each month by an expert nutritionist. MS-associated fatigue level was evaluated using the Modified Fatigue Impact Scale (MFIS). Cognitive assessment was also performed using Minimal Assessment of Cognitive Function in MS (MACFIMS). Results: Intergroup comparisons demonstrated that after considering confounding variables in ANCOVA, fatigue scores appeared significantly lower in patients who were treated with the Mediterranean-like diet than those in the standard healthy diet group [Mean 95% confidence interval (CI)}: 33.93 (32.97-34.89) and 37.98 (36.99-38.97), respectively; P < 0.001]. However, the intergroup analysis of cognitive status only showed a difference in the mean score of Brief Visuospatial Memory Test-Revised (BVMT-R) subtest of the MACFIMS. The BVMT-R was higher among standard healthy diet patients compared to the Mediterranean-like diet group after the intervention following adjustment for covariates [Mean (95% CI): 23.73 (21.88-25.57) and 20.56 (18.60-22.51), respectively; P = 0.020]. Conclusion: In conclusion, the results of this study highlighted the higher protective effects of the Mediterranean-like diet against MS-related fatigue than the standard healthy diet. However, no significant improvement was observed in the cognitive status of MS patients after a 1-year treatment with the Mediterranean-like diet. More randomized clinical trials with larger sample sizes are needed to elucidate the effects of dietary modifications on MS-associated symptoms and complications.
Faezeh Khorsha; Atieh Mirzababaei; Nasim Ghodoosi; Mansoureh Togha; Mir Saeed Yekaninejad; Moein Askarpour; Khadijeh Mirzaei
Abstract
Background: Migraine is a neurologic disorder. Although, based on previous evidence, migraine is related with inflammation and oxidative stress, its relationship with the inflammatory potential of the diet is still unknown. Thus, the aim of this study was to show the correlation between Dietary Inflammatory ...
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Background: Migraine is a neurologic disorder. Although, based on previous evidence, migraine is related with inflammation and oxidative stress, its relationship with the inflammatory potential of the diet is still unknown. Thus, the aim of this study was to show the correlation between Dietary Inflammatory Index (DII) and severity and duration of migraine headache. Methods: In this cross-sectional study, 266 women who suffered from migraine, were included. Demographic and anthropometric data were collected form all participants. 147-item semiquantitative food frequency questionnaire (FFQ) was collected to assess dietary intake and consequently, DII scores were calculated. Migraine Disability Assessment (MIDAS) questionnaire, Visual Analog Scale (VAS), and a 30-day headache diary were also completed by each participant. Results: The DII score ranged between -4.22 and 5.19 and its median [interquartile range (IQR)] was 0.003 (-1.48-1.55). There was no meaningful association between age, occupation, physical activity (PA), weight, height, Body Mass Index (BMI), waist circumference (WC), hip circumference, waist-to-hip ratio (WHR) and DII score classifications (P > 0.050). Subjects with more than 20 days of headache had higher DII score compared to those with less than 10 days per month [odds ratio (OR) = 1.60, 95% confidence interval (CI) = 1.12-2.08, P = 0.001]. There was no association between DII and migraine severity (VAS and MIDAS) in the crude and adjusted model of logistic regression. Although there was a significant association between headache duration and DII (P = 0.020), this relationship was not meaningful after adjusting for age, PA, BMI, and job status (OR = 0.53, 95% CI = 0.28-1.00, P = 0.052). Conclusion: The present study showed a direct association between headache frequency and DII. Nevertheless, any relationship was not found between headache duration or migraine severity and DII score. Future large and prospective studies are needed to explore the effect of inflammatory potential of diet in migraine characteristics.
Mansoureh Togha; Maral Seyed-Ahadi; Elham Jafari; Zahra Vahabi; Fereshteh Naderi-Behdani; Somayeh Nasergivehchi; Samaneh Haghighi; Zeinab Ghorbani; Fatemeh Farham; Seyed Mohammad Hassan Paknejad; Pegah Rafiee
Abstract
Background: Headache is among the most common disabling neurologic disorders. We measured quality of life in chronic migraine (CM) and episodic migraine (EM), stratified by medication overuse headache (MOH) and presence of aura. Methods: In this observational study, conducted from January 2016 to December ...
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Background: Headache is among the most common disabling neurologic disorders. We measured quality of life in chronic migraine (CM) and episodic migraine (EM), stratified by medication overuse headache (MOH) and presence of aura. Methods: In this observational study, conducted from January 2016 to December 2018, adult patients referred to the tertiary headache clinic of Sina Hospital in Tehran, Iran, who met International Classification of Headache Disorders, 3rd Edition-beta (ICHD-3 β) criteria for migraine were classified to EM and CM subtyped based on presence of aura and MOH. Validated Farsi versions of Migraine Disability Assessment Scale (MIDAS) and 6-item Headache Impact Test (HIT-6) questionnaires were used. Results: A total of 2454 patients (1907 women) were enrolled from which 1261 (51.4%) patients had EM and 1193 (48.6%) had CM, while 908 subjects (37.0%) had MOH, of whom 890 (98.0%) had CM. Median scores of MIDAS and HIT-6 were significantly higher in patients with CM compared to EM sufferers. Chronic migraineurs with MOH had a significantly higher median score of MIDAS and HIT-6 compared to patients with non-MOH CM. Also, there was a moderate positive correlation between MIDAS (disability) and HIT-6 scores (impact on patients’ life) and a moderate correlation between HIT-6 and pain severity. Conclusion: The results of this study confirm that CM and MOH are associated with a higher headache-related disability and impact on life compared to EM. Therefore, treatment goals in prevention of MOH and migraine transformation warrant higher quality of life in patients with migraine.
Mansoureh Togha; Abdorreza Naser Moghadasi; Samaneh Haghighi; Mahmood Motamedi
Volume 18, Issue 3 , August 2019, , Pages 143-144
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Mansoureh Togha; Kamran Shirbache; Reza Rahmanzadeh; Zeinab Ghorbani; Zahra Yari; Farshid Refaeian; Shirin Behbahani; Parsa Panahi
Volume 17, Issue 4 , December 2018, , Pages 161-166
Abstract
Background: Idiopathic intracranial hypertension (IIH) encompasses patients with elevated intracranial pressure (ICP). Generally, it is difficult to make a differential diagnosis between IIH and co-existing migraine headaches. Thus, this article intends to estimate the prevalence of migraine in patients ...
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Background: Idiopathic intracranial hypertension (IIH) encompasses patients with elevated intracranial pressure (ICP). Generally, it is difficult to make a differential diagnosis between IIH and co-existing migraine headaches. Thus, this article intends to estimate the prevalence of migraine in patients with IIH and explain the occurrence of new-onset migraine after the diagnosis of IIH.
Methods: The case group included 108 patients with IIH referred to the neurology wards of three university hospitals. A random sample of controls (n = 103) were recruited from patients hospitalized in the surgery and orthopedics ward. A checklist for migraine diagnosis was filled out. Cerebrospinal fluid (CSF) pressure and presence or absence of papilloedema (PE) in the patients and any necessary data were also recorded from the inpatient medical documents. All statistical analyses were done by SPSS software.
Results: There were 70 (64.80%) and 22 (21.40%) migraineurs in the case and control groups, respectively, and the difference was found to be significant (P < 0.001). In 26 (37.14%) migraine cases in the IIH group, the disorder was diagnosed after developing IIH. Also, there was a past medical history of having migraine in 44 (62.85%) migraineurs. In the fully adjusted regression models, the odds of being affected by migraine in patients with IIH was 6.17 times greater than the controls [odds ratio (OR) = 7.15, 95% confidence interval (CI) = 3.56-14.36, P < 0.010]. The patients’ mean CSF opening pressure was 32.10 ± 1.03 cmH2O and 93 (81.60%) subjects were found to have PE.
Conclusion: It was demonstrated that subjects with IIH might have about a 6-time higher likelihood of developing migraine headache than the general population. These considerations can help prevent misdiagnosis of migraine headache as the recurrence of IIH or uncontrolled IIH and subsequent inappropriate management.
Rozita Doosti; Mansoureh Togha; Abdorreza Naser Moghadasi; Aida Aghsaei; Amir Reza Azimi; Saeideh Khorramnia; Zahra Moinfar; Fereshteh Ensani; Mohammad Hossein Harirchian; Alireza Minagar; Mohammad Ali Sahraian
Volume 17, Issue 2 , April 2018, , Pages 64-70
Abstract
Background: Since most patients with relapsing-remitting multiple sclerosis (RRMS) are women, the present study aimed to determine whether treatment of patients with MS by cytotoxic agents is associated with an increased risk of cervical dysplasia. Cancer screening is often neglected in the chronic diseases ...
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Background: Since most patients with relapsing-remitting multiple sclerosis (RRMS) are women, the present study aimed to determine whether treatment of patients with MS by cytotoxic agents is associated with an increased risk of cervical dysplasia. Cancer screening is often neglected in the chronic diseases such as MS, so more attention in this field was needed. Decreasing morbidity and mortality due to cervical cancer is the most important goal of screening in female MS patients especially in child bearing age. Thus, it can be said that this is the first study which investigated this important issue.
Methods: A total of 129 individuals participated in this cohort study. They were assigned into 3 groups including 43 patients with MS who were treated with cytotoxic drugs, 43 patients with MS on immunomodulators, and 43 normal healthy controls. Pap smears were performed following standard methods and the results obtained from the three groups were compared by statistical analysis. Demographic data, Expanded Disability Status Scale (EDSS), and Pap smear changes were analyzed by SPSS software.
Results: The most commonly detected abnormality in all examined patients and healthy controls was inflammation. Five patients with MS who were treated with cytotoxic agents revealed benign cellular changes (BCC) in their Pap smear that were statistically significant in comparison with other groups (P = 0.03). Patients who took Mitoxantrone presented BCC more than other groups [Odds ratio (OR) = 9.44, 95% confidence interval (CI): 1.46-60.70]. There was no significant difference between mean duration of MS diagnosis (P = 0.12), mean duration of previous MS treatments (P = 0.25), and mean duration of current MS treatments (P = 0.21) in patients with BCC compared to normal healthy controls or inflammatory change.
Conclusion: According to the results of present study, BCC is more frequently observed in patients with MS who were treated with cytotoxic agents with immunosuppressive effect. Since BCC is a ‘premalignant condition’, the authors suggest that mandatory annual Pap smear should be performed for patients with MS who are treated with cytotoxic agents irrespective of their age in order to detect early signs of malignancy.
Neda Soveyd; Mina Abdolahi; Sama Bitarafan; Abbas Tafakhori; Payam Sarraf; Mansoureh Togha; Ali Asghar Okhovat; Mahsa Hatami; Mohsen Sedighiyan; Mahmoud Djalali; Niyaz Mohammadzadeh-Honarvar
Volume 16, Issue 4 , October 2017, , Pages 210-217
Abstract
Migraine is a common chronic inflammatory neurological disease with the progressive and episodic course. Much evidence have shown a role of inflammation in the pathogenesis of migraine. Omega-3 fatty acids are an important components of cell membranes phospholipids. The intake of these fatty acids is ...
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Migraine is a common chronic inflammatory neurological disease with the progressive and episodic course. Much evidence have shown a role of inflammation in the pathogenesis of migraine. Omega-3 fatty acids are an important components of cell membranes phospholipids. The intake of these fatty acids is related to decrease concentration of C-reactive protein (CRP), proinflammatory eicosanoids, cytokines, chemokines and other inflammation biomarkers. Many of clinical trials have shown the beneficial effect of dietary supplementation with omega-3 fatty acids in inflammatory and autoimmune diseases in human, including Parkinson’s disease (PD), amyotrophic lateral sclerosis (ALS), Alzheimer’s disease (AD), multiple sclerosis (MS) and migraine headaches. Therefore, omega-3 fatty acids as an alternative therapy can be potentially important. This review focuses on the pathogenesis of a migraine, with an emphasis on the role of omega-3 fatty acid and its molecular mechanisms.
Mansoureh Togha; Nahid Abbasi Khoshsirat; Abdorreza Naser Moghadasi; Faezeh Mousavinia; Mohammad Mozafari; Mohamadreza Neishaboury; Seyed Mahmood Mousavi
Volume 15, Issue 1 , January 2016, , Pages 1-8
Abstract
Background: Headaches are one of the most frequent reasons for pain in multiple sclerosis (MS) individuals. Characterization of headaches and delineating possible relationships with MS-related determinants can ultimately circumvent headaches.Methods: In a prospective case-control study, 65 Iranian relapsing- ...
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Background: Headaches are one of the most frequent reasons for pain in multiple sclerosis (MS) individuals. Characterization of headaches and delineating possible relationships with MS-related determinants can ultimately circumvent headaches.Methods: In a prospective case-control study, 65 Iranian relapsing- remitting MS (RRMS) patients and 65 healthy controls were recruited during patients’ admission for attack-period treatment and asked about characteristics and co-symptoms of headaches they experienced in the preceding week and usage of disease modifying drugs (DMDs) and types of MS attacks were also inquired. The same questions were asked from the same patients 3 months later in a follow-up visit.Results: A total of 57 patients and 57 controls were included in the final analyses. In total, 26 (45.6%) patients in relapse, 18 (27.7%) controls, and 22 (38.6%) patients in remission reported headaches and only significant difference existed between relapse patients and controls (P = 0.036). In headache prevalence was higher in patients in relapse phase having MS < 3 years compared to relapse patients with more than 3 years of MS (68 vs. 28.1%; P = 0.004). Other variables of interest did not differ among the three groups.Conclusion: The RRMS patients in relapse phase suffer from headaches more than healthy people do.
Mansoureh Togha
Volume 15, Issue 1 , January 2016, , Pages 60-61
Sara Momtaz; Fahimeh Hajiabolhassan; Mansoureh Togha; Shohre Jalaie; Amir Almasi
Volume 13, Issue 4 , December 2014, , Pages 250-252
Abstract
Background: Neurotologic signs and symptoms, especially vestibular symptoms are common in migrainous patients. Involvement of the visual system in migrainures has received a great deal of attention in recent years, but the oculomotor part of the visual system has been largely ignored. The goal of this ...
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Background: Neurotologic signs and symptoms, especially vestibular symptoms are common in migrainous patients. Involvement of the visual system in migrainures has received a great deal of attention in recent years, but the oculomotor part of the visual system has been largely ignored. The goal of this study was to investigate some parts of the central vestibular system using the oculomotor part of videonystagmographic evaluation, including spontaneous nystagmus, gazeevoked nystagmus, smooth pursuit, saccade and optokinetic ystagmus interictally in migrainous patients.Methods: In this case–control study, 30 patients with migraine and 38 healthy volunteers within the age range of 18-48 years old were included spontaneous nystagmus; gaze-evoked nystagmus in right, left and up sides, smooth pursuit, optokinetic nystagmus using three different velocities and saccade test performed in both groups. The data were analyzed using SPSS for Windows 18.0.Results: Some parameters of gain and phase and also morphology of he smooth pursuit, velocity of the saccade and slow phase velocity of optokinetic were significantly different in migrainures, although the statistical differences of these parameters were not clinically important as they were in the normal range of a defined device.Conclusion: These results may suggest the presence of subtle otoneurologic abnormalities in migrainous patients that is probably due to the efficiency of oculomotor function with vestibulocerebellar origin.
Sama Bitarafan; Mohammad-Hossein Harirchian; Shahriar Nafissi; Mohammad-Ali Sahraian; Mansoureh Togha; Fereydoun Siassi; Ahmad Saedisomeolia; Elham Alipour; Nakisa Mohammadpour; Maryam Chamary; Niyaz Mohammadzadeh Honarvar; Ali-Akbar Saboor-Yaraghi
Volume 13, Issue 1 , March 2014, , Pages 28-32
Abstract
Background: The role of nutrition in the progression of multiple sclerosis (MS) and related complications such as fatigue has been reported by several studies. The aim of this study is the assessment of nutritional status and its relationship with fatigue in multiple ...
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Background: The role of nutrition in the progression of multiple sclerosis (MS) and related complications such as fatigue has been reported by several studies. The aim of this study is the assessment of nutritional status and its relationship with fatigue in multiple sclerosis patients.Methods: This is a cross-sectional study, in which 101 relapsing-remitting MS patients were enrolled.The fatigue status was determined using the validated Persian version of the Modified Fatigue Impact Scale (MFIS). Dietary intake was assessed using a 3-day food record questionnaire and compared to dietary reference intake (DRI) values. Association between variables was determined using Pearson Correlation Coefficient.Results: In the preset study, 25 men and 76 women (total = 101) were enrolled. Analysis of dietary intake showed that daily intake of vitamin D, folate, calcium, and magnesium were significantly lower than DRI in all of patients. In men, zinc intake was significantly lower than DRI; while, in women, iron was significantly below the DRI level. After adjusting for energy, MFIS and its physical subscale were highly correlated with intake of folate and magnesium.Conclusion: Our findings support that lower magnesium and folate diets are correlated with higher fatigue scores in MS patients.
Samaneh Aalami Harandi; Mansoureh Togha; Azadeh Sadatnaseri; S Hamed Hosseini; Soodeh Razeghi Jahromi
Volume 12, Issue 3 , September 2013, , Pages 98-101
Abstract
Background: Migraine with aura (MA) has been identified as a risk factor for cardiovascular disease. Previous observation has also found higher prevalence of cardiovascular risk factors in migraineurs without aura (MO), but the results have been conflicting. The present study was conducted to assess ...
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Background: Migraine with aura (MA) has been identified as a risk factor for cardiovascular disease. Previous observation has also found higher prevalence of cardiovascular risk factors in migraineurs without aura (MO), but the results have been conflicting. The present study was conducted to assess the association between cardiovascular risk factors and migraine without aura among Iranians.Methods: In our study the prevalence of cardiovascular risk factors, including hypertension, hyperglycemia, dyslipidemia, obesity, cigarette smoking, and family history of early coronary artery disease, were studied in 347 migraineurs without aura and 267 non-migraineurs. The odds ratio (ORs) with 95% confidence interval (95% CI) was used to assess the strength of the association.Results:Patients with migraine without aura were at an increased risk of developing hypertension (ORadj = 1.9; P = 0.029), but there was no difference in other cardiovascular risk profiles, including hyperglycemia, dyslipidemia, obesity, cigarette smoking, and family history of early coronary artery disease.Conclusion: Our study revealed that the prevalence of hypertension was higher in migraineurs without aura in comparison with non-migraineurs. Therefore, physicians are supposed to be more vigilant in examining these patients and take care not to prescribe medications that may provoke hypertension.
Abdorreza Naser Moghadasi; Razieh Aghakhani; Mahsa Owji; Mansoureh Togha
Volume 12, Issue 3 , September 2013, , Pages 117-118
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Soodeh Razeghi Jahromi; Maryam Abolhasani; Alipasha Meysamie; Mansoureh Togha
Volume 12, Issue 1 , March 2013, , Pages 23-27
Abstract
Background: Obesity seems to be associated to migraine headache. Increase in body fat, especially in gluteofemoral region, elevates adiponectin and leptin secretion which in turn impair inflammatory processes that could be contributing to migraine risk. This study was designed to assess the relationship ...
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Background: Obesity seems to be associated to migraine headache. Increase in body fat, especially in gluteofemoral region, elevates adiponectin and leptin secretion which in turn impair inflammatory processes that could be contributing to migraine risk. This study was designed to assess the relationship between body composition and risk of migraine for the first time.Methods:In this cross-sectional study, 1510 middle-aged women who were visited in a weight reduction clinic of university were recruited. Migraine was diagnosed with HIS criteria. Body composition parameters including total fat mass (FATM), total fat free mass (FFM), truncal fat mass (TFATM), and truncal fat free mass (TFFM) was assessed using bioelectric impedance. We further assessed cardiovascular risk factors and smoking as confounding factors. To determine the real association between different variables and risk of migraine, the associations were adjusted by multivariate logistic regression analysis.Results:Elevation in fasting blood sugar, total cholesterol, LDL cholesterol, FFM, TFFM, and waist-to-hip ratio increased the risk of migraine. When the associations were adjusted for other factors, only the association between migraine and FFM remained statistically significant.Conclusion:Lower FFM increased the risk of migraine in overweight and obese individuals. In the other words, higher fat free mass could be a protective factor for migraine.
Yaser Hamidian; Mansoureh Togha; Shahriar Nafisi; Shahab Dowlatshahi; Soodeh Razeghi Jahromi; Nahid Beladi Moghadam; Navid Namazi; Parvin Tajik; Masoud Majed; Mahdi Aloosh
Volume 11, Issue 1 , March 2012, , Pages 16-20
Abstract
Background: The most common neurologic manifestation of gluten sensitivity is ataxia, which accounts for up to 40% of idiopathic sporadic ataxia. Timing of diagnosis of gluten ataxia is vital as it is one of the very few treatable causes of sporadic ataxia and causes irreversible loss of Purkinje cells. ...
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Background: The most common neurologic manifestation of gluten sensitivity is ataxia, which accounts for up to 40% of idiopathic sporadic ataxia. Timing of diagnosis of gluten ataxia is vital as it is one of the very few treatable causes of sporadic ataxia and causes irreversible loss of Purkinje cells. Antigliadin antibody (AGA) of the IgG type is the best marker for neurological manifestations of gluten sensitivity. This study was conducted to measure the prevalence of gluten ataxia in a group of Iranian patients with idiopathic ataxia.Methods: For 30 patients with idiopathic cerebellar ataxia, a questionnaire about clinical and demographic data was completed. Serum AGA (IgA and IgG) and antiendomysial antibody (AEA) were assessed. Gluten ataxic patients underwent duodenal biopsy. Magnetic resonance imaging was done for all patients to see if cerebellar atrophy is present.Results: Only 2 patients had a positive IgG AGA (6.7%) who both had a positive AEA while none of them showed changes of celiac disease in their duodenal biopsies. Conclusion: Only presence of gastrointestinal symptoms and pursuit eye movement disorders were higher in patients with gluten ataxia.Prevalence of gluten ataxia in Iranian patients with idiopathic ataxia seems to be lower than most of other regions. This could be explained by small sample size, differences in genetics and nutritional habits and also effect of serologic tests in clinical versus research setting. Further researches with larger sample size are recommended.
