Ghorban Taghizadeh

Upper extremity function is crucial for daily living activities. This study aimed to validate the Persian version of the 10-item Arm Function in Multiple Sclerosis Questionnaire-Short Form (AMSQ-SF) in individuals with multiple sclerosis (MS). In this cross-sectional study involving 201 individuals with MS, the AMSQ-SF was evaluated for reliability (test-retest in 50 participants) and construct validity against a battery of established performance-based and patient-reported outcome measures. Spasticity and disability levels were employed to evaluate the questionnaire's ability to differentiate between various subgroups. The Persian AMSQ-SF demonstrated excellent reliability (ICC_(2,1) = 0.94) and internal consistency (α = 0.95). Its strong construct validity was evidenced by correlations in the hypothesized directions with measures of grip strength, quality of life, self-reported function, dexterity, and fatigue. It differentiated patients with and without spasticity and various disability levels (p < 0.001). Clinically useful cutoff scores were established to classify impairment severity (mild ≥16, moderate ≥20, severe ≥26) with high sensitivity (70-81%) and specificity (85-95%). The AMSQ-SF demonstrates strong validity and reliability as a questionnaire for individuals with MS, suitable for use in both research and rehabilitation settings.

Background A recent body of evidence has suggested regular exercise as a promising complementary therapeutic strategy in the management of epilepsy and its related cognitive impairments. Objectives To put it to the test, our study aimed to comparatively examine the effects of physical exercise, low and high doses of levetiracetam, or the combination of both on amygdala electrical kindling-induced epilepsy in rats, as well as the consequent learning and memory impairments. Methods Male Wistar rats were randomly divided into ten groups (n = 7 per group) as the following: (I) Control (without kindling and exercise), (II) Lev (rats were received 54 mg/kg of levetiracetam without kindling and exercise), (III) Ex (rats were subjected to exercise without kindling), (IV) Ex-K (rats were subjected to preventive exercise before kindling), (V) K (rats were subjected to kindling without any intervention), (VI) K-Ex (rats were subjected to exercise after kindling), (VII) K-L lev (rats were received 27 mg/kg levetiracetam after kindling), (VIII) K-H lev (rats were received 54 mg/kg levetiracetam after kindling), (IX) K-Ex-L lev (subjected to exercise and receiving a low dose of levetiracetam after kindling), and (X) K-Ex-H lev (rats were subjected to exercise and receiving a high dose of levetiracetam after kindling). After the kindling procedure and interventions, the seizure parameters, including dADD, S₁L, S₂L, S₃L, S₄L, S₅L, Max S5D, and Max ADD, were recorded, and seizure-related behavioral changes were evaluated using the MWM test. Results Our findings showed that in all therapeutic interventional groups, including Ex, L lev, H lev, and their combination (Ex-L lev and Ex-H lev), there was a substantial reduction in parameters, including seizure stages, seizure duration, and dADD. In contrast, there was a significant increase in the mean delay time or latency from electrical stimulation to the onset of stages 1, 2, and 3 of seizure (S₁L, S₂L, and S₃L), and all groups were significantly different from the kindling group. Moreover, the kindling-induced spatial memory and learning deficit was remarkably ameliorated by preventive exercise, Ex, L lev, H lev, and their combination. Conclusion Our study reveals that, in conjunction with levetiracetam, regular exercise can ameliorate the intensity and frequency of amygdala electrical kindling-induced epileptic seizures, as well as the consequent spatial memory and learning impairments. Graphical Abstract

Loneliness is highly prevalent among patients with Parkinson’s disease (PwPD) and, through complex body-brain interactions, increases their vulnerabi

This study aimed to (1) examine the impact of post-stroke fatigue (PSF) on saccadic control, (2) assess the effect of PSF on saccade adaptation, and (3) explore the correlation between serum levels of interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) with saccade control and adaptation in chronic stroke survivors. Fatigue was assessed in stroke survivors with high fatigue (HF-stroke, n = 13) and low fatigue (LF-stroke, n = 13) using the Fatigue Severity Scale and Fatigue Assessment Scale, alongside age-matched healthy controls (n = 13). The stroke groups were compared based on lesion volume and location. Eye-tracking recorded pro-saccade, anti-saccade, and saccade adaptation parameters. Serum levels of IL-6 and hsCRP were measured. HF-stroke survivors demonstrated significantly higher saccade latency, duration, and positional error, along with lower velocity, amplitude, and gain in pro- and anti-saccade tasks compared to the LF-stroke group (p < 0.05). HF-stroke survivors showed a lower adaptation rate (F_(2,36) = 144.38, p < 0.001, η² = 0.89) and adaptation after-effect (F_(2,36) = 98.93, p < 0.001, η² = 0.85) compared to other groups. The result revealed a significant main effect for group (F_{(2, 36)} = 1108.30, p < .001, η² = 0.98), BIN (F_{(9, 324)} = 318.05, p < .001, η² = 0.90), and group × BIN interaction (F_{(2, 324)} = 2.72, p = 0.01, η² = 0.13). Negative correlations were observed between serum levels of IL-6 and hsCRP and fatigue, saccadic velocity, adaptation rate and adaptation aftereffect in stroke survivors (p < 0.05). Both stroke groups showed significantly reduced gain in pro- and anti-saccade tasks compared to healthy controls, yet gain was not significantly correlated with IL-6 or hsCRP levels. The study demonstrated that fatigue significantly affects saccade control and adaptation in stroke survivors, with inflammation having a negative impact on these processes. Pro- and anti-saccadic gain was reduced in stroke participants but unrelated to inflammation, while adaptive gain during saccade adaptation correlated with inflammatory markers, suggesting a link between PSF, adaptation, and inflammation. These findings underscore the importance of careful assessment and management of fatigue in stroke survivors.

The study aimed to: (i) translate and culturally adapt the DAS into Persian; (ii) examine the psychometric properties of both the DAS-S and DAS-I; (iii) analyze the three components of both the DAS-S and DAS-I to assess apathy dimensionally; (iv) determine the optimal cut-off points using ROC analysis for the DAS-S, DAS-I, and their subscales; and (v) identify predictors of initiation, emotional, and executive apathy in stroke survivors. This study included 115 stroke survivors and 38 healthy controls. Both DAS versions were evaluated for acceptability, reliability, and validity. Exploratory factor analysis was conducted to assess construct validity. Receiver Operating Characteristic curve analysis was used to determine optimal cut-off points. Multiple regression analyses were performed to identify predictors of apathy. Cronbach’s alpha was 0.88 for DAS-S and 0.85 for DAS-I. ICC2,1 was > 0.93 for both versions. Total and subscale scores of both DAS versions showed weak to moderate correlations with the Neuropsychiatric Inventory-Apathy subscale (r = 0.39–0.69). Principal component analysis showed three components (executive, emotional, and initiation) for DAS-S and DAS-I, explaining 49.26% and 53.02% of the variance, respectively. The optimal cut-off was 31 for DAS-S (88.89% sensitivity, 86.36% specificity) and 29 for DAS-I (92.52% sensitivity, 86.36% specificity). Depression was the strongest predictor of executive subscale scores of both DAS versions, as well as the initiation subscale of the DAS-S, explaining 33.90–48.90% of the variance. However, for the emotional subscale of both DAS versions, the strongest predictor was the level of daily activity. The two versions of DAS effectively identify apathy subtypes and are reliable and valid for assessing apathy in stroke survivors. They effectively discriminate between apathetic and non-apathetic stroke survivors. Depression is the strongest predictor of executive and initiation apathy, whereas functional indicators—particularly independence in activities of daily living—predict emotional apathy.

Background The Minimal Clinically Important Difference (MCID) is a crucial measure in clinical research, reflecting the smallest change in symptoms that patients perceive as beneficial. While MCID values have been established for various symptoms in Parkinson’s disease (PD), they remain underexplored in the context of depression. Objective This study aims to determine MCID values for three commonly used depression scales in PD: The Beck Depression Inventory (BDI-II), the Hospital Anxiety and Depression Scale – Depression subscale (HADS-D), and the 15-item Geriatric Depression Scale (GDS-15). Methods A total of 112 individuals with PD and depression (mean age = 70.91 ± 3.12 years) participated in a 10-week cognitive behavioral therapy program. The MCID values were estimated using both distribution-based and anchor-based methods. The Global Rating of Change (GRoC) scale was used as an anchor to assess perceived changes in depressive symptoms. Results MCID values were refined using the mean difference approach, resulting in the following: -5.79 points for the BDI-II, -3.52 points for the HADS-D, and − 3.05 points for the GDS-15, all with statistical significance (p < 0.001). Using Youden’s index, the optimal MCID cut-off values were ≤ -3 points for BDI-II, ≤ -2 points for HADS-D, and ≤ -2 points for GDS-15, with high sensitivity and specificity for each. The MCID values derived from the distribution-based method for the BDI-II, HADS-D, and GDS-15 were 5.57–3.55, 1.11–3.07, and 0.96–2.66 points, respectively. Conclusions This study establishes MCID thresholds for commonly used depression scales in PD. These benchmarks are essential for improving clinical decision-making and evaluating the effectiveness of interventions in both clinical and research settings.

Aquaporin-4 (AQP4), a modulator of motor symptoms and synaptic plasticity, may contribute to freezing of gait (FOG)—a significant gait disturbance in Parkinson’s disease with an unclear pathophysiology—and its associated impairments in balance learning. However, this potential relationship has not been investigated until now. This preliminary study explores the potential role of AQP4 in FOG and its associated balance learning deficits. The study involved fifteen patients with FOG, fifteen patients without FOG, and fifteen healthy controls. Serum AQP4 levels were measured using enzyme-linked immunosorbent assay, and balance learning was assessed using a voluntary dynamic balance task performed on a stabilometer. Notably, patients who were FOG-positive exhibited significantly higher serum AQP4 levels compared to the other two groups (p < 0.001). These elevated levels showed a positive correlation with FOG severity (ρ = 0.51, p = 0.004). Furthermore, the serum AQP4 levels were inversely correlated with both the slope (ρ = -0.65, p < 0.001) and rate (ρ = -0.46, p = 0.01) of balance learning in PwPD. FOG-positive individuals exhibited impaired voluntary balance learning compared to both FOG-negative and healthy participants. FOG-negative participants showed initial improvement, while healthy individuals demonstrated continuous enhancement across consecutive learning blocks (the first significant main effect of time on balance performance, comparing Blocks 1 and 2, was p = 0.02 for FOG-negative and p = 0.03 for healthy groups), with both groups maintaining their acquired skills over time. These findings suggest that AQP4 may play a significant role in FOG and its associated learning impairments, warranting further investigation for potential treatments. Additionally, alternative balance learning protocols may be necessary for FOG-positive patients.

Background: Opioid abuse is a global crisis, with diamorphine being one of the most dangerous substances of abuse. Diamorphine is a major contributor to addiction and social issues. Objectives: This study aimed to investigate the impact of different doses of diamorphine on spatial learning and memory by examining its effects on brain mitochondria function. Methods: Four groups of nine rats were selected to receive diamorphine at doses of 1, 5, and 10 mg/kg, while one group received diamorphine solvent at a dose of 1 mL/kg. All treatments were given twice a day at 12-hour intervals for 10 days. The animals' memory performance was assessed using the Morris Water Maze test. Additionally, tests were conducted to measure ADP/ATP levels, mitochondrial reactive oxygen species (ROS) levels, mitochondrial membrane potential (MMP), lipid peroxidation (LPO), and antioxidant function, including total thiol groups measurement (TTM), and ferric reducing antioxidant power (FRAP). Results: The results indicated that diamorphine at doses of 5 and 10 mg/kg significantly disrupted learning and spatial memory, as evidenced by changes in latency (P < 0.0001), distance (P < 0.0001), and time spent in the target quadrant (P < 0.0001). Diamorphine also negatively impacted mitochondrial function parameters, such as ROS levels (P < 0.0001), MMP (P < 0.0001), mitochondrial swelling (P < 0.0001), and ADP/ATP ratio (P < 0.0001). Furthermore, brain antioxidant capacity was compromised (P < 0.0001). Conclusions: This study on the mechanisms of brain damage induced by diamorphine showed that the harm arises from the impairment of mitochondrial function. This impairment leads to the generation of ROS, reduced antioxidant capacity, decreased MMP, and an elevated ADP/ATP ratio.

Commonly used clinical tools like the Mini-Balance Evaluation Systems Test (Mini-BESTest), Dynamic Gait Index (DGI), Berg Balance Scale (BBS), and Performance-Oriented Mobility Assessment (POMA) are essential for assessing balance impairments in people with Parkinson’s disease (PwPD), but their clinical relevance depends on understanding the Minimal Important Difference (MID) and Minimal Detectable Change (MDC). To assess the responsiveness of the Mini-BESTest, DGI, BBS, and POMA in PwPD. This prospective cohort study included 130 PwPD who were recruited. Participants underwent baseline and post-intervention assessments using the Mini-BESTest, DGI, BBS, and POMA. The intervention consisted of task-oriented exercises focused on motor re-learning to improve functional balance. Anchor and distribution methods were used to determine the MID (the receiver-operating characteristic(ROC)-based (MID_ROC), the predictive modeling method (MID_pred), and the MIDpred-based method adjusted by the rate of improvement (MID_adj)) and MDC. ROC-derived MID(MID_ROC) exceeded 1 point for all scales, but improvement-rate-adjusted MID (MID_adj) provided more conservative estimates: Mini-BESTest (2.96 points), DGI (2.29), BBS (1.97), and POMA (0.83). Predictive modeling (MID_pred) yielded higher thresholds (e.g., 4.0 for Mini-BESTest), likely reflecting baseline variability. The MDCs was 1.9, 2.0, 1.0, and 2.8 points for the Mini-BESTest, DGI, BBS, and POMA, respectively. The findings suggest that the Mini-BESTest, DGI, BBS, and POMA are responsive outcome measures for PD. This study’s results can provide valuable insights into interpreting changes in patient performance, thereby supporting clinical interventions and facilitating research planning.