Abdorreza Naser Moghadasi; Omid Sanaei
Volume 12, Issue 1 , March 2013, , Pages 30-31
Abstract
#No Abstract#
Read More
#No Abstract#
Mohammad Hossein Harirchian; Somayeh Nasergivechi; Marzieh Maddah; Alipasha Meysamie; Homayoun Amini; Ehsan Esmaelii Shandiz; Abbas Tafakhori
Volume 12, Issue 1 , March 2013, , Pages 32-34
Abstract
Background: Fatigue, a major cause of disability in individuals with multiple sclerosis (MS), is associated with reduced quality of life. The aim of this study was to evaluate the reliability and reproducibility of the Persian version of Modified Fatigue Impact Scale (MFIS) in Iranian patients with MS.Methods: ...
Read More
Background: Fatigue, a major cause of disability in individuals with multiple sclerosis (MS), is associated with reduced quality of life. The aim of this study was to evaluate the reliability and reproducibility of the Persian version of Modified Fatigue Impact Scale (MFIS) in Iranian patients with MS.Methods: This study included 15 subjects with clinically definite MS, 15 hospitalized patients with MS, and 15 hospitalized patients with other chronic illnesses (as controls). They filled in the Persian version of the MFIS twice with a three-day interval. MFIS items were analyzed and the correlation coefficient was calculated.Results: There was a good correlation between the scores of the two measurements (correlation coe9cient: 0.984, P < 0.001) especially in physical and cognitive subgroups. The reproducibility of psychosocial subscale was lower than physical and cognitive subscales.Conclusion:According to our findings, the Persian version of the MFIS has a good reliability and reproducibility for assessment of fatigue in patients with MS.
Soha Mir-Reza; Maryam Tabatabaeiyan; Rozita Doosti; Mahsa Owji; Abdorreza Naser Moghadasi
Volume 12, Issue 1 , March 2013, , Pages 35-36
Mahmood Motamedi; Abdorreza Naser Moghadasi; Sanaz Ahmadi Karvigh
Volume 12, Issue 1 , March 2013, , Pages 37-38
Abstract
#No Abstract#
Read More
#No Abstract#
Masoud Mehrpour
Volume 12, Issue 1 , March 2013, , Pages 39-40
Abstract
#No Abstract#
Read More
#No Abstract#
Akram Hashemi; Mohammad Torabi Nami; Mohammad Ali Oghabian; Habib Ganjgahi; Zahra Vahabi; Hajir Sikaroodi
Volume 11, Issue 4 , December 2012, , Pages 127-134
Abstract
Background: Chronic daily headache (CDH) has gained little attention in functional neuro-imaging. When no structural abnormality is found in CDH, defining functional correlates between activated brain regions during headache bouts may provide unique insights towards understanding the pathophysiology ...
Read More
Background: Chronic daily headache (CDH) has gained little attention in functional neuro-imaging. When no structural abnormality is found in CDH, defining functional correlates between activated brain regions during headache bouts may provide unique insights towards understanding the pathophysiology of this type of headache.Methods: We recruited four CDH cases for comprehensive assessments, including history taking, physical examinations and neuropsychological evaluations (The Addenbrooke's Cognitive Evaluation, Beck's Anxiety and Depression Inventories, Pittsburg Sleep Quality Index and Epworth Sleepiness Scale). Visual analogue scale (VAS) was used to self-rate the intensity of headache. Patients then underwent electroencephalography (EEG), transcranial Doppler (TCD) and functional magnetic resonance imaging (fMRI) evaluations during maximal (VAS = 8-10/10) and off-headache (VAS = 0-3/10) conditions. Data were used to compare in both conditions. We also used BOLD (blood oxygen level dependent) -group level activation map fMRI to possibly locate headache-related activated brain regions.Results: General and neurological examinations as well as conventional MRIs were unremarkable. Neuropsychological assessments showed moderate anxiety and depression in one patient and minimal in others. Unlike three patients, maximal and off-headache TCD evaluation in one revealed increased middle cerebral artery blood flow velocity, at the maximal pain area. Although with no seizure history, the same patient's EEG showed paroxysmal epileptic discharges during maximal headache intensity, respectively. Group level activation map fMRI showed activated classical pain matrix regions upon headache bouts (periaqueductal grey, substantia nigra and raphe nucleus), and markedly bilateral occipital lobes activation.Conclusion: The EEG changes were of note. Furthermore, the increased BOLD signals in areas outside the classical pain matrix (i.e. occipital lobes) during maximal headaches may suggest that activation of these areas can be linked to the increased neural activity or visual cortex hyperexcitability in response to visual stimuli. These findings can introduce new perspective towards more in-depth functional imaging studies in headaches of poorly understood pathophysiology.
Shahrzad Mohebbi; Mojdeh Ghabaee; Majid Ghaffarpour; Ali Pasha Meisami; Reza Shah Siah; Mohammad Reza Mousavi Mirkala; Maryam Pour Ashraf; Mahbubeh Yaghubi
Volume 11, Issue 4 , December 2012, , Pages 135-139
Abstract
Background: High sensitive C-reactive protein (hs-CRP) is a systemic inflammatory marker that is produced in a large amount by hepatocytes in response to interleukin-1 (IL-1), IL-6 and tumor necrosis factor after ischemic stroke.Methods: Measurement of hs-CRP in the first 24 hours of onset in 162 patients ...
Read More
Background: High sensitive C-reactive protein (hs-CRP) is a systemic inflammatory marker that is produced in a large amount by hepatocytes in response to interleukin-1 (IL-1), IL-6 and tumor necrosis factor after ischemic stroke.Methods: Measurement of hs-CRP in the first 24 hours of onset in 162 patients suffering from ischemic stroke was done. Relation of CRP with the risk of early mortality, National Institutes of Health Stroke Scale (NIHSS), stroke subtypes and other factors was determined.Results:Regarding to ROC curve analysis, appropriate cut-off point for predicting patients' short time mortality was equal to 2.15 mg/dl in this study. Significantly increased rate of mortality by 13.3 times was seen in patients with simultaneous CRP > 2.15 mg/dl and NIHSS > 10.Conclusion:The Result of this study showed that there is a direct association between hs-CRP and mortality within the first week after stroke. Measuring hs-CRP within the first hours after stroke increases the predicting rate of early mortality risk with cut-off point of 2.15.
Mahnaz Taherianfard; Maryam Sharifi; Mina Tadjali; Mahboubeh Kohkiloezadeh
Volume 11, Issue 4 , December 2012, , Pages 140-145
Abstract
Background: Learning and memory are the most intensively studied subjects in neuroscience. Two sites of mammalian brain which are important in learning and memory are CA1 region of hippocampus and Purkinje cell layer of cerebellum. So, the aim of present investigation was to study of the effect of ovariectomy ...
Read More
Background: Learning and memory are the most intensively studied subjects in neuroscience. Two sites of mammalian brain which are important in learning and memory are CA1 region of hippocampus and Purkinje cell layer of cerebellum. So, the aim of present investigation was to study of the effect of ovariectomy and passive avoidance learning on NR1 subunit of N-methyl-D-aspartate (NMDA) receptor distribution in CA1 region of hippocampus and Purkinje cell layer of cerebellum.Methods:Twenty four Sprague-Dawley rats were used in 4 groups: control-1 (intact without learning), control-2 (intact with learning), ovariectomy without learning, and ovariectomy with learning. Immunohistochemical procedure was used for determination of NR1 subunit of NMDA receptor. A shuttle box apparatus used for passive avoidance learning procedure. The determination of color intensity was cone by Photoshop software.Results:Immunohistological findings indicated that ovariectomy has a negative effect on density of NR1 subunit of NMDA receptors in two brain regions. Passive avoidance learning significantly increased density of NR1 subunit of NMDA receptors in two brain regions.Conclusion:The results indicated that the sex hormone can modulate function and expression of the NR1 subunit of NMDA receptor in CA1 region of hippocampus and Purkinje cell layer of cerebellum.
Boshra Hatef; Saeed Talebian; Fahimeh Hashemirad; Majid Ghaffarpour
Volume 11, Issue 4 , December 2012, , Pages 146-150
Abstract
Background: The existence of a pathophysiological link between headaches and muscle activity pattern is still being debated. The purpose of this study was to investigate the effect of pain on the timing pattern of the masseter muscle in patients with tension-type headache (TTH) and migraine without aura ...
Read More
Background: The existence of a pathophysiological link between headaches and muscle activity pattern is still being debated. The purpose of this study was to investigate the effect of pain on the timing pattern of the masseter muscle in patients with tension-type headache (TTH) and migraine without aura (MOA).Methods: 57 women (22 controls, 19 MOA and 16 TTH) participated in the study. The electromyographic (EMG) activity of masseter during the open-close-clench cycle (OCC) was recorded in the interictal and ictal stages.Results: In the interictal stage, the results showed no significant difference in EMG activity between patients and control groups. However, masseter muscles in subjects with TTH (both sides) and in MOA patients (left side) activated significantly earlier than the control in the ictal stage. The duration of left masseter was also significantly greater in the TTH than in the control group (P < 0.05).Conclusion: The findings of this study showed that activity pattern of masticatory muscles in headaches patients were affected by existence of pain. Furthermore, this study confirmed that temporal variables of EMG such as onset and duration rather than amplitude could be more reliable to identify altered activity pattern of muscles.
Farzad Ashrafi; Alireza Zali; Hossein Pakdaman; Karim Johari
Volume 11, Issue 4 , December 2012, , Pages 151-154
Abstract
Background: Patients with Parkinson's disease (PD) have different cognitive impairments.The goal of this study is the analysis of these changes in the mentioned patients.A cross-sectional study was performed on 87 patients with PD. Patients were given a questionnaire to gather data about their medical ...
Read More
Background: Patients with Parkinson's disease (PD) have different cognitive impairments.The goal of this study is the analysis of these changes in the mentioned patients.A cross-sectional study was performed on 87 patients with PD. Patients were given a questionnaire to gather data about their medical and living statuses. To assess cognitive assessment, SCOPA-COG (Scales for Outcome in Parkinson Cognition) was used by an expert cognitive neuroscientist.Results:The age inversely correlated to memory and learning (P < 0.01). Education level correlated directly to attention, memory, learning, executive function and visuospatial function (for all items P < 0.001). Spouse relationship type showed inverse association with memory, learning, executive function and visuospatial function (P < 0.05).Conclusion:Cognitive domains in PD patients may be under the influence of different factors. Due to the lack of control group in this study, cautious interpretation of findings is needed.
Mitra Ansari Dezfouli; Elham Jaberi; Afagh Alavi; Mohammad Rezvani; Gholamali Shahidi; Elahe Elahi; Mohammad Rohani
Volume 11, Issue 4 , December 2012, , Pages 155-158
Abstract
Background: Pantothenate kinase associated neurodegeneration (PKAN) is the most prevalent type of neurodegeneration with brain iron accumulation (NBIA) disorders characterized by extrapyramidal signs, and 'eye-of-the-tiger' on T2 brain magnetic resonance imaging (MRI) characterized by hypointensity in ...
Read More
Background: Pantothenate kinase associated neurodegeneration (PKAN) is the most prevalent type of neurodegeneration with brain iron accumulation (NBIA) disorders characterized by extrapyramidal signs, and 'eye-of-the-tiger' on T2 brain magnetic resonance imaging (MRI) characterized by hypointensity in globus pallidus and a hyperintensity in its core. All PKAN patients have homozygous or compound heterozygous mutation in PANK2 gene.Methods:Three sibling patients were diagnosed based on clinical presentations especially extrapyramidal signs and brain MRI. The exons and flanking intronic sequences of PANK2 were sequenced from DNA of leukocytes of the affected individuals.Results:All patients were homozygous for c.C1069T, p.R357W in PANK2 gene. This mutation is well conserved in the homologous protein of distally related spices.Conclusion:In the current study we identified three siblings affected with PKAN, all of them have mutations in PANK2 gene. In MRI of all patients with PANK2 mutation eye-of-the-tiger sign was apparent.
Omid Hesami; Nahid Beladimoghaddam; Farhad Assarzadegan; Nasim Kazemi
Volume 11, Issue 4 , December 2012, , Pages 159-161
Abstract
#No Abstract#
Read More
#No Abstract#
Hossein Ali Ebrahimi; Faridadin Ebrahimi
Volume 11, Issue 4 , December 2012, , Pages 162-163
Abstract
#No Abstract#
Read More
#No Abstract#
Shahriar Nafissi; Shahram Niknam; Seyedeh Simindokht Hosseini
Volume 11, Issue 3 , September 2012, , Pages 83-86
Abstract
Background: Prevalence of electrophysiological abnormalities in patients with lumbosacral radiculopathy was evaluated.Methods:A cross-sectional study was performed on 97 consecutive patients with the clinical diagnosis of lumbosacral radiculopathy. Complete neurological examinations and standard electrophysiological ...
Read More
Background: Prevalence of electrophysiological abnormalities in patients with lumbosacral radiculopathy was evaluated.Methods:A cross-sectional study was performed on 97 consecutive patients with the clinical diagnosis of lumbosacral radiculopathy. Complete neurological examinations and standard electrophysiological evaluation was performed on the patients.Results:Patients under study had the mean age of 46.4 ± 13.1 years (mean ± standard deviation). There were positive MRI findings in 64% of the patients. In 43% L5 root and in 40% S1 root was involved. Abnormal electrophysiological findings were recorded in 82% of the patients. In patients with pretibial muscle weakness, there were significant abnormalities recorded in compound motor action potential (CMAP) amplitude of the common peroneal nerve. There was significantly increased frequency of electrophysiological abnormalities in the presence of chronic clinical symptoms (P = 0.001).Conclusion:The 82% positive findings in electrophysiological studies in the diagnosis of lumbosacral radiculopathy make it an efficacious tool in the evaluation of the patients suffering from lumbosacral radiculopathy.
Ali Imani; Mina Golestani
Volume 11, Issue 3 , September 2012, , Pages 87-90
Abstract
Background: Disease-modifying drugs (DMDs) are a significant expenditure for treating multiple sclerosis (MS). However, there is limited report on assessment of the cost-utility of DMDs compared with symptom management in the presence of long-term data. This study aimed to assess the lifetime cost-utility ...
Read More
Background: Disease-modifying drugs (DMDs) are a significant expenditure for treating multiple sclerosis (MS). However, there is limited report on assessment of the cost-utility of DMDs compared with symptom management in the presence of long-term data. This study aimed to assess the lifetime cost-utility from the Iranian healthcare perspectives of 4DMDs relative to symptom management alone in patients with relapsing-remitting multiple sclerosis using evidence from long-term published studies.Methods: A Markov model was developed with patients transitioning through health states based on Kurtzke's expanded disability status scale.Patient costs included drug costs, other medical and lost worker productivity costs. Patient quality of life was considered in the form of utilities. Costs were valued in 2011 USD, and were discounted at 7.2% per annum. Various parameters and assumptions were tested in sensitivity analyses.Results:Total costs per patient over the time horizon of a patient's lifetime were estimated at 20285, 144194, 299279, 251255 and 69796 USD for symptom management, Avonex, Betaferon, Rebif and CinnoVex, respectively. As a result, the incremental cost per quality adjusted life years (QALY) for patients receiving Avonex, Betaferon, Rebif and CinnoVex was 607397, 1374355, 1166515 and 1010429 USD, respectively, when compared with symptom management. The results were sensitive to changes in time horizon, disease progression and drug costs.Conclusion: DMDs in relapsing-remitting MS patients was associated with increased benefits compared with symptom management, albeit at higher costs. Because patients receiving Avonex incurred slightly higher QALYs than patients receiving other DMDs, treatment with Avonex dominates other DMDs in Iran.
Ali Moghtaderi; Maryam Dahmardeh; Soroosh Dabiri
Volume 11, Issue 3 , September 2012, , Pages 91-95
Abstract
Background: Stroke is the first cause of morbidity all around the world. Entrapment neuropathies are a known complication of stroke. The objective of this study is to assess the frequency of subclinical carpal tunnel syndrome in the healthy and paretic hands of stroke patients.Methods:The authors performed ...
Read More
Background: Stroke is the first cause of morbidity all around the world. Entrapment neuropathies are a known complication of stroke. The objective of this study is to assess the frequency of subclinical carpal tunnel syndrome in the healthy and paretic hands of stroke patients.Methods:The authors performed nerve conduction study in the first three days after admission in 39 stroke patients without subclinical carpal tunnel syndrome and 30 days after admission. Electrophysiological studies were done in both paretic and non-paretic hands. Both ulnar and median nerves were studied.Results:After one month we found subclinical carpal tunnel syndrome in 16 paretic hands and 13 healthy hands. We did not find any difference in the frequency of carpal tunnel syndrome in two sides.Conclusion:The authors suggest that simultaneous different mechanisms may act in inducing carpal tunnel syndrome in both hands of hemiparetic patients.
Ghasem Salehpoor; Mozaffar Hosseininezhad; Sajjad Rezaei
Volume 11, Issue 3 , September 2012, , Pages 96-105
Abstract
Background: Multiple sclerosis (MS) is a neurological disease with fatigue as most prevalent symptom. Psychopathological symptoms, physical and mental dysfunctions and body mass abnormalities potentially could deteriorate fatigue. Thus, in this study, we aimed at evaluating the effect of these factors ...
Read More
Background: Multiple sclerosis (MS) is a neurological disease with fatigue as most prevalent symptom. Psychopathological symptoms, physical and mental dysfunctions and body mass abnormalities potentially could deteriorate fatigue. Thus, in this study, we aimed at evaluating the effect of these factors on fatigue severity of MS patients.Methods: In this cross-sectional study, 162 patients with mean age of 34.1 ± 9.4 (16-58 years) were recruited by consecutive sampling. All the patients, after completing demographic information were evaluated using Persian versions of Fatigue Severity Scale (FSS), depression, anxiety and stress scale (DASS-21), and short form Health Survey Questionnaire (SF-36).Results: Correlation analysis showed a significant relationship between fatigue severity and depression, anxiety, stress, physical component summary (PCS) and mental component summary (MCS) (P < 0.01). Findings of path analysis demonstrated that PCS is the only variable which has a direct effect on fatigue severity (β = -0.278, P < 0.05). Moreover, the strongest standard coefficient (β) belonged to cause and effect relationship between MCS and depression (β = -0.691, P < 0.0001).Conclusion:Present study made the role of psychopathological symptoms and physical and mental dysfunctions prominent in exacerbation of fatigue severity. Moreover, we can refer to more sensible effect of physical dysfunction related to life on fatigue.
Hooshang Gerami; Alia Saberi; Shadman Nemati; Ehsan Kazemnejad; Mohammad Aghajanpour
Volume 11, Issue 3 , September 2012, , Pages 106-110
Abstract
Background: It is still a challenge to find an effective treatment for tinnitus. The aim of this study was the evaluation of carbamazepine and oxcarbazepine effects on tinnitus.Methods:In a randomized double-blind clinical trial, 57 patients who were visited in a university hospital due to chronic non-pulsatile ...
Read More
Background: It is still a challenge to find an effective treatment for tinnitus. The aim of this study was the evaluation of carbamazepine and oxcarbazepine effects on tinnitus.Methods:In a randomized double-blind clinical trial, 57 patients who were visited in a university hospital due to chronic non-pulsatile tinnitus, were randomized in three groups and treated with carbamazepine (300-600 mg/day), oxcarbazepine (450-900 mg/day) and placebo for 12 weeks. Visual analogue scale (VAS) and tinnitus severity index (TSI) were measured in all subjects in the beginning and at the end of the 8(th) and 12(th) weeks of the trial. Data was analyzed by repeated measure analysis, paired and independent t-test.Results: Among 51 participants who completed the trial course (28 men, 23 women), carbamazepine, oxcarbazepine and placebo decreased tinnitus severity in 56.6%, 46.2% and 38.5% of patients according to VAS, and in 61.1%, 58.8% and 50% of patients according to TSI, respectively. The effects of carbamazepine and oxcarbazepine were better in the first 8 weeks of treatment. However, their effect on tinnitus did not show any statistical difference in comparison with placebo (P = 0.34, P = 0.28).Conclusion: Carbamazepine and oxcarbazepine are not more effective than placebo in decreasing tinnitus severity.
Kavian Ghandehari; Kosar Ghandehari
Volume 11, Issue 3 , September 2012, , Pages 111-114
Abstract
Background: Vertebrobasilar arterial territory nourishes one-quarter of human brain. It constitutes some vital and strategic parts of the central nervous system.Methods: A number of keywords (vertebral, basilar, artery, and territory) were searched in MEDLINE (Ovid and PubMed) as well as Google, ProQuest, ...
Read More
Background: Vertebrobasilar arterial territory nourishes one-quarter of human brain. It constitutes some vital and strategic parts of the central nervous system.Methods: A number of keywords (vertebral, basilar, artery, and territory) were searched in MEDLINE (Ovid and PubMed) as well as Google, ProQuest, Scopus, Cochrane Library, and Science Direct online databases. Only articles containing all keywords were included. We also reviewed archives of libraries in Mashhad University of Medical Sciences (Iran) for all anatomy, embryology, neurology, and neuroscience books and journals about vertebrobasilar arterial territories.Results:The vertebrobasilar arterial (VA) system has a high incidence of variations, anomalies, and persistent fetal vessels. Two important anatomic facts explain why VA origin lesions seldom cause chronic hemodynamically significant low flow to the vertebrobasilar system. First, the VAs are paired vessels that unite to form a single basilar artery. Second, the extracranial VA gives off numerous muscular and other branches as it ascends in the neck. Thus, in the VA system, there is much more potential for development of adequate collateral circulation. Even when there is bilateral occlusion of the VAs at their origins, patients do not often develop posterior circulation infarcts.Conclusion: VA origin disease is more benign than ICA origin disease from hemodynamic aspect. This important point could make influence in therapeutic interventional decisions in asymptomatic VA origin stenosis.
Abbas Tafakhori; Mohammad Salehi Sadaghiani; Mohammad Hossein Harirchian; Zeinab Taheri; Vajiheh Aghamollaii
Volume 11, Issue 3 , September 2012, , Pages 115-117
Abstract
Background: Paget's disease is a focal bone disorder manifested as bone overgrowth and disrupted bone integrity as a result of accelerated bone remodelling rate. Rarely, Paget's disease of the base of the skull results in hydrocephalic dementia, and the triad of normal pressure hydrocephalus syndrome ...
Read More
Background: Paget's disease is a focal bone disorder manifested as bone overgrowth and disrupted bone integrity as a result of accelerated bone remodelling rate. Rarely, Paget's disease of the base of the skull results in hydrocephalic dementia, and the triad of normal pressure hydrocephalus syndrome is a much more scarce entity.Case Report: Herein, we report an elderly woman who presented in Imam Khomeini Hospital, Tehran, Iran, with normal pressure hydrocephalus syndrome due to Paget's bone disease. Furthermore, we have reviewed relevant previous studies.Conclusion: Paget's disease can be presented as normal pressure hydrocephalus syndrome.
Kurosh Gharagozli; Leila Poorsaadat; Ali Amini Harandi; Hossein Pakdaman; Hossein Kalanie
Volume 11, Issue 3 , September 2012, , Pages 118-120
Abstract
Background: Initial symptoms of multiple sclerosis (MS) may be varied and nonspecific. We tried to find the frequency distribution of the first clinical symptoms in Iranian patients with MS.Methods: In a case series study, 1130 patients with definite diagnosis of MS who had been referred to three referral ...
Read More
Background: Initial symptoms of multiple sclerosis (MS) may be varied and nonspecific. We tried to find the frequency distribution of the first clinical symptoms in Iranian patients with MS.Methods: In a case series study, 1130 patients with definite diagnosis of MS who had been referred to three referral university hospitals of Tehran, Iran, were enrolled. The patients' medical records were reviewed for neurological history to find the first symptom at presentation.Results:884 (78.2%) patients were female and 246 (21.8%) were male. The mean ± SD age of patients was 31.4 ± 9.1 years. The most common initial symptoms were motor in 492 (43.5%), ocular in 366 (32.4%), cerebellar in 91 (8.1%), sensory in 76 (6.7%), cranial nerve involvement in 51 (4.5%), and fatigue in 23 (2%) patients. There was no difference between female and male patients in first clinical symptoms (P > 0.05).Conclusion: The motor symptoms were the most common finding at presentation in the Iranian population with MS. Complementary studies with larger sample sizes are needed to increase the external validity.
Vahid Reza Ostovan
Volume 11, Issue 3 , September 2012, , Pages 121-122
Abstract
#No Abstract#
Read More
#No Abstract#
Mohammad Ali Sahraian; Ali Amini Harandi; Hossein Kalanie
Volume 11, Issue 3 , September 2012, , Pages 123-124
Abstract
#No Abstract#
Read More
#No Abstract#
Jon Andoni Urtizberea
Volume 11, Issue 3 , September 2012, , Pages 125-126
Mohammad Reza Najafi; Behnaz Ansari; Mohammad Zare; Farzad Fatehi; Ali Sonbolestan
Volume 11, Issue 2 , June 2012, , Pages 37-41
Abstract
Background: Diminished libido and sexual dysfunction are unusually common among male epileptic patients. The most important etiologic factor may be antiepileptic drugs (AEDs)-induced androgen deficiency. We compared reproductive hormone levels among men with epilepsy taking various AEDs and normal controls.Methods: ...
Read More
Background: Diminished libido and sexual dysfunction are unusually common among male epileptic patients. The most important etiologic factor may be antiepileptic drugs (AEDs)-induced androgen deficiency. We compared reproductive hormone levels among men with epilepsy taking various AEDs and normal controls.Methods: Subjects were 59 male epileptic patients who aged 24 ± 5 years. They had been receiving lamotrigine (LTG) (n = 17), carbamazepine (CBZ) (n = 18), and sodium valproate (VPA) (n = 15) for at least 6 months. We also recruited 23 healthy controls. Testosterone, estradiol, dehydroepiandrosterone sulfate (DHEAS), sex hormone-binding globulin (SHBG), androstenedione (AND), luteinizing hormone (LH), and follicle stimulatin hormone (FSH) levels and gonadal efficiency (testosterone/LH) were compared between the four groups. The patients and the control group were examined and evaluated for male reproduction by urology and endocrinology services.Results: Subjects receiving CBZ, VPA, and LTG had significantly lower mean testosterone levels than the control group (P < 0.01). In addition, patients receiving LTG had significantly higher mean testosterone levels than CBZ and VPA groups (P < 0.01) and controls (P < 0.05). There were not any significant differences between the groups in mean estradiol levels. The mean AND level in VPA was higher than CBZ, LTG, and control groups (P < 0.01). Men receiving CBZ had significantly lower DHEAS levels than the other groups (P < 0.01). Testosterone/LH ratio in the control group was more than other groups (P < 0.01). On the other hand, this value in LTG group was higher than CBZ and VPA groups (P < 0.01). However, CBZ and VPA groups were not significantly different in terms of testosterone/LH ratio.Conclusion: Although the mean levels of reproductive hormones were lower in the LTG group compared to the controls, among traditional antiepileptic drugs, LTG had fewer side effects on reproductive hormones. Therefore, it is a good adjuvant and substitute drug for epilepsy control instead of CBZ and VPA.
