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4.MOTOR EVOKED POTENTIAL IN PATIENTS WITH PARKINSON’S DISEASE: A TRANSCRANIAL MAGNETIC STIMULATION STUDY

Authors: Ali F. Al-Hashimi علي فؤاد الهاشمي --- Haneen R. Ahmed حنين رباح احمد
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2018 Volume: 16 Issue: 1 Pages: 14-21
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Parkinson’s disease (PD) is a neurodegenerative condition of the central nervous system, which is accompanied by the impairment of the cortico-subcortical excitation and inhibition systems. It is characterized by motor and non-motor symptoms, having both hypokinetic and hyperkinetic features.Objective:To investigate the integrity of the central motor pathways by studying the motor evoked potential (MEP) latencies, amplitudes and central conduction time (CMCT) of the median nerve in patients with PD as compared to healthy controls.Methods:Twenty-five patients with documented PD were studied; with a mean age of (63.16±5.49 years) as compared to 25 age and sex matched apparently healthy controls. All subjects were instructed about the examination and informed consent was provided. Transcranial magnetic stimulation TMS-MEP study of the right median nerve was done. Cortical and cervical latencies and amplitudes of the MEP study were determined. The responses were recorded with both relaxed and slightly contracted target muscle. CMCT calculation was done by subtraction of the latency of peripheral segment of the motor pathway (spinal motor root to muscle) from that of the entire motor pathway (motor cortex to muscle) or by calculation of the CMCT with the F-wave method. Results:The means of the cortical latencies of PD patients during relaxation and facilitation states were lower than controls; and the differences were significant for both (P=0.03 and 0.02; respectively). In both relaxed and facilitation states, the means of CMCT in PD patients were lower than in control and the difference was significant during contraction (P=0.02), and near statistical significance during relaxation (P=0.08). CMCT calculations by the estimation of F wave and distal motor latency (DML) were equivocal between relaxation and facilitation states. Nevertheless, the differences were not statistically significant (P=0.45; P=0.62; respectively). The means of the MEP amplitude of PD patients were lower than controls (4.21±1.94 versus 4.28± 1.84 mV; respectively). Nevertheless, the differences were not significant (P=0.89).Conclusion:Single-pulse TMS is a valuable study to investigate central motor dysfunction in PD. CMCT measurement of the median nerve or any nerve in the upper limb is a potential marker for the evaluation of the severity of PD; especially in the facilitated state.Keywords:Parkinson’s disease, TMS, MEP, CL, CMCTCitation:Ahmed HR, Al-Hashimi AF. Motor evoked potential in patients with Parkinson’s Disease: a transcranial magnetic stimulation study. Iraqi JMS. 2018; Vol. 16(1): 14-21. doi: 10.22578/IJMS.16.1.4

Keywords

Parkinson’s disease --- TMS --- MEP --- CL --- CMCT


Article
The role of Herpes simplex virus type 1 and 2 in patients with neurodegenerative diseases

Authors: Mohamad I. Hassan --- Rana S. Aboud --- Saife D. Al-Ahmer
Journal: Iraqi Journal of Science المجلة العراقية للعلوم ISSN: 00672904/23121637 Year: 2018 Volume: 59 Issue: 4C Pages: 2179-2183
Publisher: Baghdad University جامعة بغداد

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Abstract

With the growing number of patient’s being diagnosed with Parkinson’s disease and Multiple Sclerosis each year it is becoming ever more important to find the cause for these neurological disorders. The present study attempts to shed light on one of the factors that may play a role as a causative agent in these neurological diseases by finding a correlation between the Herpes simplex virus type 1 and 2 in patients with Parkinson’s disease and multiple sclerosis by detecting the virus in these patients using immunological techniques. Sixty patients with neurological diseases (40 patients with Multiple sclerosis and 20 patients with Parkinson’s disease) who’s ages ranged from (17-76) years have been investigated. Samples were collected during the time period between November 2017 and April 2018 and compared to twenty five apparently healthy individuals as a control group. All the studied groups were measured for herpes simplex virus type-1 IgM and herpes simplex virus type-2 IgM by using the enzyme linked immuno sorbent assay. The results of the present study showed that there was a highly significant difference (p<0.01) in the concentration of IgM HSV-1 and HSV-2 in the sera of patients with MS and PD compared to the control group, While there was a none-significant difference (p>0.05) in the concentration of IgM HSV-1 and HSV-2 according to the gender. Thus, there is a likely possibility the HSV could be a contributing factor in the activation of some neurological diseases by the means of initiating an autoimmune reaction against the host’s nerve cells. The nerve cells have proteins that resemble portions of the virus from a structural and genetic stand point.

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