Fatemeh Hojjatipour

1. Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative illness that causes lower motor neurons in the brainstem and spinal cord and upper motor neurons in the motor cortex to los...

Introduction: In recent years, virtual reality (VR) training has gained momentum in stroke rehabilitation for reducing falls by enhancing balance and stability. Objectives: VR interventions offer superior immersion, interactivity and creative engagement compared with conventional therapies. However, the precise mechanisms by which VR influences dynamic stability remain unclear. Moreover, there is currently limited information regarding user experience (UX) in this context. Methods and analysis: This study protocol outlines a randomised controlled trial designed to evaluate the effects of an immersive VR intervention on the dynamic stability of gait parameters in stroke survivors, incorporating an assessment of UX. Two groups of subjects will be enrolled in this study, including patients with a stroke within the previous 6–12 months who will receive (1) 3 weeks of immersive VR training (intervention) or (2) conventional rehabilitation (control). The primary outcome of the study will be dynamic stability measures and the UX. The secondary outcomes include anxiety and depression, fatigue, functional mobility, functional walking ability, static balance, fear of falling and adverse effects. All participants will be assessed at baseline, after 3 weeks and after 2 months of the initiation of the study. Ethics and dissemination: The study ethics were approved by the ethical committee of Tehran University of Medical Sciences (registration No IR.TUMS.NI.REC.1401.091, registered on 8 January 2023). Written consent is going to be taken from all of the participants. The study adheres to the principles outlined in the Declaration of Helsinki. Dissemination of study findings will occur through peer-reviewed publications and knowledge translation activities targeting clinicians, researchers and rehabilitation professionals. Data generated from this study will be anonymised and curated in accordance with institutional and national data protection standards Trial registration number: IRCT20231031059916N1.

The use of paraquat as a pesticide exposes users to a high risk of death and morbidity in various organ systems. In Iran, poisoning from this deadly chemical occurs frequently as a result of suicide or accidental use. As such, knowledge about paraquat is essential for this region, and in this study, we conducted a systematic review of the available evidence on paraquat poisoning in Iran. We utilized databases including PubMed, Google Scholar, Web of Science, and ResearchGate to conduct a systematic literature review on paraquat poisoning in Iran up to June 2025. Studies involving human subjects who reported paraquat poisoning in any province of Iran were included in this systematic review. Two independent researchers searched and extracted the results using a predefined table in Microsoft Excel. After screening 14 studies including 752 cases in this review, we concluded that the mortality rate was about 40% and the first symptoms were typically nausea and vomiting. Also, the main side effects were renal and respiratory failure. All reported paraquat poisoning cases in the Iranian population were included in this systematic review, including an overview of the patient population, symptoms, comorbidities, hospital stays, and treatments. The data revealed a lack of an effective antidote and highlighted the urgent need for prevention strategies in Iran, offering actionable insights for health authorities. This review may also serve as a useful guide for clinicians in diagnosing, preventing, and treating paraquat poisoning.

Spinocerebellar ataxia (SCA) is a group of inherited disorders that encompasses different types and presentations. One of its types, SCA31, is a rare ataxia that has a wide spectrum of presentations. Therefore, it may be mistakenly diagnosed with another neurological disorder. Here we describe a 52-year-old woman with progressive imbalance and lower limb weakness who was initially diagnosed with multiple sclerosis (MS) based on periventricular MRI lesions and cerebrospinal fluid oligoclonal bands. She received interferon-beta for four years without improvement. After mistreatment for years, she was reassessed and, due to a strong family history of similar ataxic symptoms, was prompted to undergo genetic testing, which confirmed SCA31. This case highlights the diagnostic challenges associated with SCA31 that can mimic MS because of overlapping clinical and radiological features, potentially leading to misdiagnosis and inappropriate treatment. Therefore, clinicians should exercise caution and consider alternative diagnoses, particularly in the presence of poor response to immunotherapy, a progressive disease course, and a positive family history, all of which may indicate an inherited ataxia.

Millions of people worldwide suffer from Parkinson’s disease (PD), which has a varying distribution and features in each country. Since there is a shortage of data regarding PD patients in Iran, we present a registry-based study to deepen our understanding of Iranian PD patients’ characteristics, distribution, and clinical differences between genders and different ages of onset. In six years, 4048 patients were interviewed, who had a mean age of 67.66 years, and consisted of 1474 (36.4%) females and 2571 (63.5%) males. Men suffered more from apathy, speech, handwriting, and salivation, while women experienced more anxiety, depression, pain, and psychosis, after multivariable regression. Early-onset Parkinson’s disease (EOPD) and late-onset Parkinson’s disease (LOPD) were divided based on the 50-year-old cut-off age. They were represented by 989 (24.6%) and 2834 (70%) of the total, respectively, and EOPD patients had a higher duration of the disease and a higher positive family history.

Background: Given the scarcity of comprehensive data on Huntington's disease in many Asian and African countries, it is more effective to focus on specific regions where there is a significant concentration of available data. Objective: This study decided to evaluate the epidemiology and features of Huntington's disease in countries of the Middle East, North Africa, and South Asia (MENASA) regions. Methods: In this meta-analysis, the limited maximum likelihood (REML) approach was applied to the estimated point prevalence mentioned in original studies of each MENASA country. Additionally, research on Huntington's disease characteristics in each nation was utilized to give a general picture of the disease's status in those nations. Results: The pooled point prevalence estimation of the prevalence studies was 8.64 per 100,000 (95% CI, −0.04–17.33; I ² = 100%). Among 14 cohort and cross-sectional studies on individuals with Huntington's disease in the MENASA region, 5.61% of the patients had juvenile-onset Huntington's disease, and 2.3% had late-onset Huntington's disease. In addition, 68.58%, 17.82%, and 45.17% of the individuals were reported with motor symptoms at the onset, abnormal cognitive assessment scores, and degrees of psychological disturbance, respectively. The mean age at onset was 44.85 years, and the mean number of pathologic CAG repeats was 45.46. Conclusions: Notable differences in the frequency of symptoms of onset and pooled prevalence of HD in the MENASA region probably address a serious lack of sufficient information. The results would help clinicians and governments develop public health strategies, and further research could be conducted on these results.

Background and aim: Lewy body diseases (LBD) include neurodegenerative diseases such as Parkinson's disease (PD), dementia with Lewy bodies (DLB), and Parkinson's disease dementia (PDD). Because DLB and Alzheimer's disease (AD) share similar neurological symptoms, DLB is frequently underdiagnosed. White Matter Hyperintensities (WMH) are associated with dementia risk and changes in both DLB and AD. In order to examine WMH discrepancies in DLB and AD patients and gain insight into their diagnostic utility and pathophysiological significance, this systematic review and meta-analysis is conducted.Material and methods: Databases such as PubMed, Scopus, Google Scholar, and Web of Science were searched for studies reporting WMH in DLB and AD patients based on Preferred Reporting Items for Systematic Review (PRISMA) guideline. Stata version 15 US is used to analyze the extracted data.Results: Twelve studies with 906 AD and 499 DLB patients were considered in this analysis. Although not statistically significant, the WMH was 0.03 ml larger in AD patients than in DLB patients. The prevalence of hypertension varied, ranging from 21% to 56% in DLB patients and from 30% to 52% in AD patients. Different findings were found on the prevalence of diabetes; some research suggested that DLB patients had greater rates (18.7%–37%) than AD patients (9%–17.5%). The imaging modalities FLAIR, T2-weighted, and T1-weighted sequences were employed. Compared to DLB patients, AD patients had higher cortical and infratentorial infarcts.Conclusion: Those with AD have greater WMH volumes than cases with DLB, suggesting that WMH can be a biomarker to help better differentiation between these neurodegenerative diseases; however, this difference is not significant. To better understand the therapeutic implications and options for reducing WMH-related cognitive loss in various patient populations, more research is necessary.