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Considering the wide range of outcomes following sport-related concussions, biomarkers are needed to detect underlying pathological changes. The objective was to analyze the use of plasma phosphorylated tau 181 (pTau181) as a non-invasive measure of underlying brain changes in a cohort of retired contact sports athletes at risk of neurodegeneration.Fifty-four retired contact sport athletes and 27 healthy controls whose blood plasma was analyzed for pTau181 were included. A portion (N = 21) of retired athletes had a 2-years follow-up visit. All participants had completed a neuropsychological battery and MRI imaging.Plasma pTau181 was significantly higher in retired athletes compared to healthy controls (8.94 ± 5.08 pg/mL vs. 6.00 ± 2.53 pg/mL, respectively; 95% BCa CI 1.38-4.62; p = 0.02); and was significantly associated with fornix fractional anisotropy values only in the athletes group (β = - 0.002; 95% BCa CI - 0.003 to - 0.001; p = 0.002). When the retired athletes cohort was divided into high vs. normal pTau181 groups, the corpus callosum (CC) volume and white-matter integrity was significantly lower in high pTau181 compared to older healthy controls (CC volume: 1.57 ± 0.19 vs. 2.02 ± 0.32, p = 0.002; CC medial diffusivity: 0.96 ± 0.04 × 10Although high plasma pTau181 levels were associated with abnormalities in CC and fornix, baseline pTau181 did not predict longitudinal changes in regional brain volumes or white-matter integrity in the athletes. pTau181 may be useful for identifying those with brain abnormalities related to repeated concussion but not for predicting progression.

This study quantified the occurrence of an underlying synucleinopathy in 50 patients with idiopathic normal pressure hydrocephalus by means of real-time quaking-induced conversion, a highly sensitive and specific technique capable of detecting and amplifying misfolded aggregated forms of α-synuclein in the cerebrospinal fluid. Seven patients were positive and they did not differ from negative cases, except for a more frequent L-dopa responsiveness and gait characterized by a wider base. The two groups did not differ in terms of response rate to tap test or shunt surgery, although step length and gait velocity improved by a lesser extent in positive cases. ANN NEUROL 2022;92:985-991.

The study of structure-function relationships in the brain has been an active area of research in neuroscience. The availability of brain imaging data that captures the structural connectivity and functional co-activation of the brain regions has led to the study of multimodal technical frameworks that can help disentangle the mechanisms linking cognitive abilities and brain structural alterations. This paper analyzes the diffusion and resting state functional magnetic resonance imaging (dMRI and rs-fMRI) data collected from a population consisting of former athletes with a history of multiple concussions and healthy controls with no reported history of concussion. For each subject, the structural connectome is represented by a graph with its nodes associated with cortical brain regions and the adjacency matrix derived from dMRI. Each cortical brain region is associated with a blood oxygen level dependent (BOLD) signal derived from fMRI. This paper uses the tools from graph signal processing (GSP) to select the brain regions of interest (ROIs) that have significant statistical differences in the extracted high and low graph frequency components of the region specific BOLD signal across former athletes and healthy controls, where the graph frequencies represent the extent of spatial variations of the BOLD signal across the brain. The selected ROIs have also been previously identified to be affected in the existing clinical studies on traumatic brain injuries (TBI). Furthermore, the dynamic functional connectivity profiles of the selected ROIs are determined by leveraging the high and low graph frequency components of the BOLD signal and a sliding window based approach. Interestingly, the graph frequency functional connectivity profiles reveal unique characteristics that are not apparent in the unimodal dynamic functional connectivity profiles based on fMRI. Our analysis reveals statistically significant differences in the dwell times in multiple dynamic graph frequency functional connectivity states for the two groups of subjects. Therefore, the results presented in this paper underline the significance of graph signal processing tools for multimodal analysis of brain imaging data and also provide promising direction for applications in clinical research and medical diagnosis.

Our study aimed to: 1)investigate the diagnostic utility of CSF Aβ42, t-tau, and p-tau to differentiate normal-pressure-hydrocephalus(NPH) from Alzheimer’s-disease(AD) and normal-controls; and 2)investigate if age and ventricular size affect the levels of CSF biomarkers in NPH patients. We recruited 131 participants: (a)Suspected-NPH: 72 with ventriculomegaly and clinical symptoms of NPH. These participants were then divided into two groups of 1)Probable-NPH (N = 38) and 2)Unlikely-NPH (N = 34) based on whether participants experienced gait improvement after removal of a large amount of CSF; (b)AD group: 30 participants with CSF biomarkers and cognitive symptoms consistent with AD; (c)Control-group: 29 participants who were cognitively and functionally normal. Lower levels of CSF Aβ42 and p-tau were observed in the probable-NPH compared to the normal controls(444.22 ± 163.3 vs. 1213.75 ± 556.5; and 26.05 ± 9.2 vs. 46.16 ± 13.3 pg/mL; respectively). Lower levels of CSF p-tau and t-tau were found in the probable-NPH compared to the AD(26.05 ± 9.2 vs. 114.95 ± 28.2; and 193.29 ± 92.3 vs. 822.65 ± 311.5 pg/mL; respectively) but the CSF-Aβ42 was low in both the probable-NPH and AD. CSF-Aβ42 correlated with age and Evans-index only in the probable-NPH(r = 0.460, p = 0.004; and r = −0.530, p = 0.001; respectively). Our study supports the hypothesis that age-related atrophy results in better Aβ42 clearance in the CSF because of the increase in the interstitial space.

Background/objective This study aimed to evaluate serum neurofilament light chain (NF-L) levels in former professional contact sports athletes with multiple concussions (ExPro) as a potential biomarker of neurodegeneration and predictor of white-matter (WM) abnormality progression. Methods Concentrations of NF-L in the serum of fifty-two cognitively normal ExPro and twenty-one healthy controls (HC) with no history of concussions were measured using single molecule array (Simoa) technology. Both groups underwent neuroimaging at the time of serum collection. Eighteen of the participants in the ExPro underwent follow-up imaging after 2 years. Results Levels of serum NF-L were not significantly different between the ExPro and HC. However, in the ExPro group, NF-L levels were positively correlated with the mean diffusivity (MD) of corpus callosum (CC) and fornix, and total ventricular volume. Moreover, NF-L levels in the ExPro group at the first visit were positively correlated with the amount of increase in CC MD at the 2-year follow-up. Conclusions NF-L levels reflect neuronal changes in the ExPro group and predict the extent of decrease in white matter integrity over time. Serum NF-L might be a biomarker of neurodegeneration and WM abnormality progression in ExPro.

Background Concussion and its associated sequel, postconcussion syndrome (PCS), have a debilitating impact on the lives of concussed patients. However, a diagnostic biomarker for this condition is lacking. Recently, there has been a surge of interest in using oculomotor function testing as an objective assessment of patients with PCS. Objectives To systematically synthesize, appraise, and summarize all published empirical studies that have assessed alteration of oculomotor functions in patients with PCS. Methods Medline, Embase, PsychINFO, and CINAHL databases searched up to July 2016 for studies that used oculomotor function assessment in patients with postconcussion symptoms. Results The search identified 1637 citations, and finally 8 case-control studies were included. Of these, 5 studies used a similar task with a target moving in a circular trajectory. Three other studies measured conventional oculomotor tasks such as saccade, vergence, and smooth pursuit eye movements. Conclusions Currently, there is limited support for the recommendation of oculomotor function assessments for diagnosis and identification of patients with PCS following head trauma. Therefore, more rigorous studies assessing oculomotor function changes in patients with PCS are warranted.

Objective: To determine the relationship between alterations in resting state functional connectivity and social cognition dysfunction amongst patients with frontotemporal dementia (FTD), Alzheimer’s disease (AD), Parkinson’s disease (PD) and healthy controls (HC). Methods: Fifty-seven participants (FTD=10, AD=18, PD=19, and HC=10) underwent structural and functional imaging and completed the Awareness of Social Inference Test-Emotion Evaluation Test (TASIT-EET), Behavioral Inhibition System/Behavioral Activation System (BIS/BAS) scale, Revised Self-Monitoring Scale (RSMS), Interpersonal Reactivity Index (IRI), and Social Norms Questionnaire (SNQ). A multi-variate pattern analysis (MVPA) was carried out to determine activation differences between the groups. The clusters from the MVPA were used as seeds for the ROI-to-voxel analysis. Relationship between social cognition deficits and uncinate integrity was also investigated. Results: BOLD signal activation differed amongst the four groups of AD, PD, FTD and HC in the left inferior temporal gyrus-anterior division (L-ITG (ant)), right central opercular cortex (R-COp), right supramarginal gyrus, posterior division (R-SMG, post), right angular gyrus (R-AG), and R-ITG. The BOLD co-activation of the L-ITG (ant) with bilateral frontal pole (FP) and paracingulate gyrus was positively associated with IRI-perspective taking (PT) (r = .38, p = .007), SNQ total (r = .37, p = .009) and TASIT-EET (r = .47, p < .001). Conclusion: Patients with neurodegenerative diseases showed alterations in connectivity in brain regions important for social cognition compared with healthy controls. Functional connectivity correlated with performance on social cognition tasks and alterations could be responsible for some of the social cognition deficits observed in all neurodegenerative diseases.

Study of neurological disorders affecting the structure-function relationships in the brain has been an ongoing challenge in neuroscience. Joint analysis of structure and function of the brain may disentangle a number of mechanisms and operations that can help interpret the interdependence between white matter degeneration and degradation of cognitive abilities. In this scenario, graph signal processing analysis of different signals generated within the physical structure of the brain may provide new insights and corroborate existing clinical findings. This paper illustrates the utility of graph signal processing tools in the joint analysis of diffusion and functional magnetic resonance imaging (i.e. dMRI and fMRI) data collected from a population of former athletes with a history of multiple concussions, and healthy subjects. Specifically, the distributions of the energy of low-graph-frequency components of the functional networks (derived from fMRI) are observed to be significantly different for fronto-temporal regions of the brain in athletes and healthy subjects. Furthermore, for the two groups of subjects, we observe significantly different associations between the ages of subjects and the energies of high graph frequency components in lingual region. While the effect on fronto-temporal regions for former athletes is in line with the existing clinical studies on concussion, significantly different associations between age and features extracted using GSP for the two groups of subjects could inform future clinical applications and medical diagnosis.

ObjectiveTo identify CSF biomarkers that are related to decreased white matter (WM) integrity and poor cognitive performance in former professional athletes with a history of multiple concussions.MethodsConcentrations of phosphorylated tau181, total tau (t-tau), and β-amyloid in the CSF were measured in 3 groups: 22 former professional athletes with multiple concussions (mean ± SD age 55.9 ± 12.2 years), 5 healthy controls (age 57.4 ± 5.2 years), and 12 participants (age 60.0 ± 6.6 years) diagnosed with Alzheimer disease (AD). All participants in the former athletes group underwent diffusion tensor imaging to determine WM tract integrity and completed neuropsychological testing. We divided the former athletes group into those with normal (300 pg/mL) CSF t-tau.ResultsCSF t-tau in the former athletes group was significantly higher than in the healthy control group (349.3 ± 182.6 vs 188.8 ± 39.9 pg/mL, p = 0.003) and significantly lower than in the patients with AD (349.3 ± 182.6 vs 857.0 ± 449.3 pg/mL, p = 0.007). Fractional anisotropy values across all the tracts were significantly lower in the high CSF t-tau group compared to the normal CSF t-tau group (p = 0.036). Participants in the high CSF t-tau group scored significantly lower on the Trail Making Test (TMT) Part B compared to the normal CSF t-tau group (t scores 45.6 ± 18.8 vs 62.3 ± 10.1, p = 0.017).ConclusionOur findings indicate that former athletes with multiple concussions are at increased risk of elevated levels of CSF t-tau and that high CSF t-tau is associated with reduced WM integrity and worse scores on the TMT Part B.

The aim of this study was to examine the potential utility of a self-paced saccadic eye movement as a marker of post-concussion syndrome (PCS) and monitoring the recovery from PCS. Fifty-nine persistently symptomatic participants with at least two concussions performed the self-paced saccade (SPS) task. We evaluated the relationships between the number of SPSs and 1) number of self-reported concussion symptoms, and 2) integrity of major white matter (WM) tracts (as measured by fractional anisotropy [FA] and mean diffusivity) that are directly or indirectly involved in saccadic eye movements and often affected by concussion. These tracts included the uncinate fasciculus (UF), cingulum (Cg) and its three subcomponents (subgenual, retrosplenial, and parahippocampal), superior longitudinal fasciculus, and corpus callosum. Mediation analyses were carried out to examine whether specific WM tracts (left UF and left subgenual Cg) mediated the relationship between the number of SPSs and 1) interval from last concussion or 2) total number of self-reported symptoms. The number of SPSs was negatively correlated with the total number of self-reported symptoms (r = -0.419, p = 0.026). The number of SPSs were positively correlated with FA of left UF and left Cg (r = 0.421, p = 0.013 and r = 0.452, p = 0.008; respectively). FA of the subgenual subcomponent of the left Cg partially mediated the relationship between the total number of symptoms and the number of SPSs, while FA of the left UF mediated the relationship between interval from last concussion and the number of SPSs. In conclusion, SPS testing as a fast and objective assessment may reflect symptom burden in patients with PCS. In addition, since the number of SPSs is associated with the integrity of some WM tracts, it may be useful as a diagnostic biomarker in patients with PCS.

Clinical diagnosis of Alzheimer’s disease (AD) prior to the age of 65 years is classified as young-onset (YOAD), whereas diagnosis after the age of 65 years is considered late-onset (LOAD). Although rare autosomal mutations more commonly associate with YOAD, most YOAD and LOAD cases are sporadic. YOAD and LOAD share amyloid and tau pathology, but many YOAD patients show increased disease severity and rate of progression. The current study examined the microRNA (miRNA) expression profile from exosomes isolated from the cerebrospinal fluid (CSF) of YOAD patients with biomarker-confirmed AD. Results uncovered miR-16-5p, miR-125b-5p, miR-451a, and miR-605-5p as differentially expressed in the CSF-derived exosomes of YOAD patients when compared with healthy controls (HC). In a cohort of LOAD patients, miR-125b-5p, miR-451a, and miR-605-5p were similarly altered in expression, but miR-16-5p showed similar expression to control. Analysis of the mRNA targets of these miRNAs revealed transcripts enriched in biological processes relevant to the post-mortem posterior cingulate cortex transcriptome in YOAD from a previously published microarray study, including those related to neuron projections, synaptic signaling, metabolism, apoptosis, and the immune system. Hence, these miRNAs represent novel targets for uncovering disease mechanisms and for biomarker development in both YOAD and LOAD. Electronic supplementary material The online version of this article (10.1007/s12035-018-1032-x) contains supplementary material, which is available to authorized users.

Post-concussion syndrome (PCS) is associated with incomplete recovery following a mild traumatic brain injury (mTBI). Currently, there is no biomarker to diagnose post-concussion syndrome. Although microstructural damage to white matter tracts is postulated and reported in some studies, there is no diagnostic biomarker available. In this paper, we present preliminary results of a novel and simple-toadminister eye-tracking paradigm that relates visual scanning behaviour to microstructural integrity of the corpus callosum (CC). The novel paradigm is based on the Matching Familiar Figures Test (MFFT). In the MFFT test, a series of slides each containing a familiar standard figure and six variants are presented. Only one of the variants is identical to the standard figure and subjects are instructed to select the matched variant. The normalised number of transitions to the standard figure prior to the first selection (NNTP) is used as an indirect measure of the microstructural integrity of the CC. Microstructural integrity was evaluated by measuring the fractional anisotropy (FA) of the CC derived from tract based spatial statistics on diffusion tensor imaging (DTI). Fifty-five patients with PCS completed the visual scanning paradigm and magnetic resonance imaging. Significant inverse correlation was found between the NNTP and the FA of the CC (r= -0.463, p

Highlights • Cortical PET tau was compared between APOE4 carriers and non-carriers. • APOE4 carriers had higher cortical PET tau comparing to non-carriers. • APOE4 as a risk factor for tau accumulation in former contact sports athletes., Background Genetic polymorphisms like apolipoprotein E (APOE) and microtubule-associated protein tau (MAPT) genes increase the risk of neurodegeneration. Methods 38 former players (age 52.63±14.02) of contact sports underwent neuroimaging, biofluid collection, and comprehensive neuropsychological assessment. The [F-18]AV-1451 tracer signal was compared in the cortical grey matter between APOE4 allele carriers and non-carriers as well as carriers of MAPT H1H1 vs non-H1H1. Participants were then divided into the high (N = 13) and low (N = 13) groups based on cortical PET tau standard uptake value ratios (SUVRs) for comparison. Findings Cortical grey matter PET tau SUVR values were significantly higher in APOE4 carriers compared to non-carriers (p = 0.020). In contrast, there was no significant difference in SUVR between MAPT H1H1 vs non-H1H1 carrier genes (p = 1.00). There was a significantly higher APOE4 allele frequency in the high cortical grey matter PET tau group, comparing to low cortical grey matter PET tau group (p = 0.048). No significant difference in neuropsychological function was found between APOE4 allele carriers and non-carriers. Interpretation There is an association between higher cortical grey matter tau burden as seen with [F-18]AV-1451 PET tracer SUVR, and the APOE4 allele in former professional and semi-professional players at high risk of concussions. APOE4 allele may be a risk factor for tau accumulation in former contact sports athletes at high risk of neurodegeneration. Funding Toronto General and Western Hospital Foundations; Weston Brain Institute; Canadian Consortium on Neurodegeneration in ageing; Krembil Research Institute. There was no role of the funders in this study.

Background: Surgically induced weight loss is a treatment option for the management of obesity and the related common disorders. This study evaluated the beneficial effects of bariatric surgery on metabolic profile and the prevalence of metabolic syndrome (MetS) among Iranian patients.Materials and Methods: A prospective observational study was performed on 26 morbidly obese patients scheduled for bariatric surgery, using laparoscopic Roux-en-Y gastric bypass (LRYGB). The parameters of hypertension, type 2 diabetes mellitus (T2DM), hyperlipidemia, MetS prevalence, and anthropometric measurements of Iranian patients, were recorded, at the preoperative visit and in follow-ups. The follow-up was performed for a median of 12 months, and the change in MetS prevalence and its componnts were assesed.Results: LRYGB induced a mean weight loss of 69.0±21.2%, after 12 months. Preoperative MetS was diagnosed in 21 patients (84%) and decreased to 6 patients (24%) after LRYGB (P=0.001). Likewise, the prevalence of hypertension was significantly decreased from 76% (pre-LRYGB values) to 20% (post-LRYGB values) (P=0.001). The prevalence of T2DM was also decreased from 20% to 8% (P=0.5).Conclusion: According to our results, RYGB produced a rapid and significant weight loss and improvement in hypertension and MetS within one year but there was a controversy about the improvement of T2DM, in Iranian morbidly obese patients.

With improvement in the diagnosis and treatment of cystic fibrosis cases in recent years, the survival of these cases has been increased. On the other hand, an increasing number of cases are presented during adulthood. Here we report a 24-year-old man with a history of productive cough, bilateral paranasal sinusitis and polyps, and recurrent abdominal pain. Thoracic computed tomography revealed a bilateral scattered tree in bud pattern and some bronchiectatic changes. Semen analysis showed azoospermia. A sweat chloride test was >60 mEq/l in two occasions.

Loss-of-function GRN mutations lead to GRN haploinsufficiency and consequently neurodegeneration with significant heterogeneity in clinical presentation of various syndromes. The aim of this study was to investigate the genetics and clinical features of patients with GRN-related frontotemporal lobar degeneration (FTLD) syndromes. We performed mutation analysis of GRN in 45 unrelated Canadian patients with a broad spectrum of FTLD-like syndromes (mean age at onset of 64.0 ± 11.2 years). In our cohort, two patients were carriers of two novel heterozygous alterations in GRN: 2 bp insertion (c.769–770insCC:p.Q257fs) and 12 bp deletion (c.1009–1020del:p.337–340del). Both patients presented with corticobasal syndrome supported by clinical and radiological findings. The absence of the mutant allele in the RT–PCR product was only observed for the sample with 2 bp insertion in GRN. In contrast, the allele with 12 bp deletion in GRN was not down-regulated at the RNA level and did not segregate with FTLD in the family. Our report extends the evidence for genetic and phenotypic variability in FTLD disorders and detects a novel pathogenic GRN mutation, carriers of which could eventually help to evaluate the efficacy of different treatments at early stages of dementia.

Background: Obesity as a worldwide health problem is associated with nonalcoholic steatohepatitis (NASH). Since severe liver injury may be present in asymptomatic obese patients and a definite diagnosis of nonalcoholic steatohepatitis can only be made after an invasive procedure of liver biopsy, there is a need for noninvasive methods to predict the probability of NASH. Objectives: To investigate the role of vitamin D endocrine system in predicting the probability of presence of NASH in asymptomatic morbidly obese candidates of bariatric surgery. Patients and Methods: From December 09 to March 11, every patient undergoing bariatric surgery had a liver biopsy. Nonalcoholic steatohepatitis was diagnosed using the Lee’s criteria, the baseline labs obtained and the association between laboratory data and presence of NASH assessed. Results: Forty-six patients (34 women, aged 36.5 ± 10.6 years) were analyzed. The mean levels of liver enzymes were significantly higher in the group with NASH (P value < 0.01). In an unadjusted logistic model, PTH was the only variable in vitamin D endocrine system which was significantly associated with NASH (odds ratio (OR): 1.04, 95%CI: 1.01 - 1.07). After adjustment for possible confounding factors, age (OR: 1.22, 95%CI: 1.00 - 1.50) and PTH (OR: 1.08, 95%CI: 1.01 - 1.16) were predictive factors for NASH (P value < 0.05). Conclusions: Elevated serum PTH level was the predictive factor for NASH in morbidly obese patients. Also, we reported elevated serum liver enzymes, high serum PTH levels and older age as predictors of NASH in patients seeking obesity surgical treatments.

Background: Post concussion syndrome (PCS) can affect up to 30% of patients with concussion. Biomarkers of this condition would be beneficial for diagnosis and management. We hypothesized that eye tracking parameters would correlate with microstructural changes of white matter integrity, as measured by diffusion tensor imaging (DTI), in patients with PCS. Methods: Sixty patients with PCS and at least 2 concussions participated in our prospective study. Attention and executive function were tested using Visual Attention Scanning Technology (VAST). In a matching task, the normalized number of visits to master image before making the first selection is used as a surrogate of working memory. We related performance on VAST to white matter integrity using Tract-Based Spatial Statistics of diffusion tensor imaging data. Results: 60 participants (mean age 34.3 years, SD 13.8) had a mean of 4 concussions. There were negative correlations between fractional anisotropy (FA) of the genu, body, and splenium of the corpus callosum and normalized number of visits to master image before first selection (r=-0.432, p=0.001; r=-0.504, pConclusions: Impaired performance on eye tracking measures of attention and executive function may reflect alterations in white matter tracts.

Objective To assess eye movements in patients with post-concussion syndrome (PCS) and use diffusion tensor imaging (DTI) to determine relationship between eye movements and white matter integrity. Design cross-sectional study. Intervention Attention and executive function were tested using Visual Attention Scanning Technology (VAST) [EL-MAR Inc., Toronto, Ontario, Canada]. In a matching task, the normalised number of transitions (NNT) to a master image before making the first selection was used as a surrogate of working memory. During this task, subjects view a set of slides, each slide includes a master image and six variants, and they have to select a variant that is similar to the master (only one variant is an exact replica of the master). Outcome measures We related performance on VAST to white matter integrity using Tract-Based Spatial Statistics of DTI metrics such as fractional anisotropy (FA) for whole brain analyses as well as seed-based probabilistic tractography analysis of the superior longitudinal fasciculus (SLF), Cingulum tract, and Uncinate fasciculus (UF). Main results 60 participants (mean age 34.3 years, SD 13.8) had a mean of 4 concussions. There were negative correlations between whole brain FA and NNT (r=−0.501, p Conclusions Impaired performance on eye tracking measures of attention and executive function may reflect alterations in white matter tracts. Competing interests None. Moshe Eizenman is a director in EL-MAR Inc.

Objective To compare the efficacy of celecoxib for treatment of withdrawal headache vs prednisone in patients with medication overuse headache (MOH). Methods In this prospective, double-blind, parallel-group clinical trial, 97 consecutive subjects with MOH were randomized (simple randomization using computer-generated numbers) for treatment with either 400 mg/day celecoxib (for the first 5 days then decreased at a rate of 100 mg every 5 days) or prednisone 75 mg/day orally (for the first 5 days then tapered off every 5 days). Subjects who met the International Headache Society criteria for MOH were included in the trial. The change in headache days and intake of rescue medication were considered as primary outcomes while the change in headache severity defined as a secondary outcome. Results Patients treated with celecoxib experienced lower headache intensity during the first 3 weeks after withdrawal (after 3 weeks, the median of visual analog scale was 3 for patients in celecoxib group vs 4.5 for prednisone group [P

Objective To assess the efficacy and safety of cinnarizine for the prophylaxis of migraine associated vertigo in the vestibular migraine and migraine with brainstem aura. Background Vestibular migraine and migraine with brainstem aura are two principal clinical syndromes that frequently are associated with vertigo. Since cinnarizine is a well-tolerated calcium channel blocker which has acceptable effect on both vertigo and migraine headache, we carried out this study to evaluate the efficacy and safety of this medication in vestibular migraine and also migraine with brainstem aura associated with vertigo. Methods This was a retrospective, single-center, open-label, investigation of the effects of cinnarizine on vestibular migraine and migraine with associated with vertigo. We assessed the change in monthly frequency of vertigo and also frequency, duration and intensity of migraine attacks after one, two and three months of cinnarizine administration. Results The mean frequency of vertigo and also the mean frequency, duration and intensity of migraine headaches per month were reduced significantly after three months of cinnarizine therapy (all p Conclusion This study suggests that cinnarizine is safe and effective in reducing both headache and vertigo aspects of “migraine plus vertigo” among the patients who suffer from either vestibular migraine or migraine with brainstem aura associated with vertigo.

Introduction: Annually a considerable number of people die because of breast cancer, a common disease among women also in Iran. Identifying risk factors and susceptible people can lead to prevention or at least early diagnosis. Among susceptibility risks, 5-10% of patients have a family history predisposing factor which can influence the risk of incidence among the family. Having a registry program can be a more practical way to screen high risk families for preventive planning. Method: Based on inclusion criteria, a questionnaire was prepared and after a pilot study on a small number of patients, actual data were collected on 400 patients and processed in SPSS 16.0. Results: Totally, 28.2%of the patients were younger than 40 years old and 36.8% had the included criteria for familial breast cancer (FBC). 102 patient's samples could be compared for receptor presentation. Similar to other studies, the number of triple negative breast cancers increased as the age decreased. Conclusion: The high percentage of patients with FBC among 400 cases in this study demonstrates that in order to design an infrastructural diagnostic protocol and screening of patients with FBC, a precise survey related to frequency and founder mutations of FBC is needed nationwide.

Conclusions In this double-blind, randomized study extended-release venlafaxine 150 mg/day found to be effective in chronic migraine. Our study showed a clear effect that was in subgroup of subjects with medication overuse. In addition, in this study, the low number of adverse events showed venlafaxine to be well tolerated. Future controlled trials expended lon ger with larger sample size, should also support the effectiveness and safety of venlafaxine in patients suffering from chronic migraine. No conflict of interest.