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Introduction: Free radical-mediated peroxidation of biological molecules, such as lipids, is implicated in the pathogenesis of multiple sclerosis and it's animal model experimental allergic encephalomyelitis(EAE). Low concentration of antioxidant vitamin E has been observed in serum of multiple sclerosis. However, it is not known whether vitamin E has protective effect in EAE. Vitamin E may inhibit EAE by effect on the level of uric acid and Nitric Oxide (NO) production. Materials and Methods: In this experimental study some male C57BL/6 mice were placed in two therapeutic groups (n=8 per group) with age and weight-matched as follow: 1)Vitamin E-treated EAE mice (10mg/kg/every two days of vitamin E given i.p from day-3 until day+19 after disease induction, 2) Non-treated EAE mice (EAE control) received vehicle alone with same schedule. In addition, 5 age and weight-matched male C57BL/6 mice served as normal (non-EAE) controls. Clinical score of disease, uric acid and NO levels of the groups were analysed. Results: Results showed that vitamin E-treated mice had significantly less clinical score of EAE (4±0.8) than non-treated EAE induced mice (5.3±0.44), (p<0.01). Also, there was difference at the onset day of the disease between vitamin E-treated and non-treated EAE-induced mice (day 13±1 and day 11±1, respectively), although was not significant. Concentration of uric acid in vitamin E treated mice were significantly lower than EAE control (p<0.001). There was no difference at the level of NO between the groups. Conclusion: Vitamin E had no effect on NO level, but decreased serum uric acid level. It suggests that vitamin E can reduce or delay the onset of EAE by increasing uric acid consumption.

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 Introduction: Experimental autoimmune encephalomyelitis (EAE) is an animal model of multiple sclerosis distinguished by infiltration of leukocytes into the central nervous system. Changes in composition and levels of unsaturated fatty acids, affect the integrity of blood-brain barrier. In this study, we evaluated the effect of Sesame oil on the leukocyte infiltration into the brain of MOG35-55 induced EAE male C57BL/6 mice. Materials and Methods: In this experimental study, male C57BL/6 mice were placed in two therapeutic groups (n=10 per group) with age and weight-matched as follow: 1.Sesame oil-treated EAE mice received 4ml/kg/day of Sesame oil given i.p. from day -3 until day +19 after disease induction, 2.Non-treated EAE mice (EAE control) received Phosphate buffer alone with same schedule. EAE was induced by immunization of mice with MOG35-55 peptide and complete Freund's adjuvant. Leukocytes infiltration into the brain was investigated 20 days after immunization. Data was analyzed using Mann-Whitney U test. Results: The results show that Sesame oil-treated mice had significantly less clinical score of EAE (2.6±0.4) than non-treated EAE induced mice (4.2±0.6), (p<0.001). Also, there was a significant difference at number of the infiltrating cells in brain between Sesame oiltreated (80±20) and non treated EAE-induced mice (150±30), (p<0.01). Conclusion: These results indicate that Sesame oil reduces infiltration of leukocytes into the brain of EAE mice, therefore lessening the histological changes and clinical signs and thus ameliorating the disease.

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Introduction: Relationship between Multiple Sclerosis (MS) and primary headaches is not well recognized yet and the studies that have been done had different results. The aim of this study was to investigate the relation between primary headaches and multiple sclerosis. Materials and Methods: In this historical cohort study, 117 patients with actual MS were selected by convenience sampling as case group and 351 healthy subjects as control group. The incidence of primary headaches was assessed by a physician using a questannaire. Variables under investigation were age, sex, type of MS, Expanded Disability Status Score (EDSS), and characteristics of headache based on International Headache Society (IHS) classification. Data analysis was done using Chi-square, t-test, Fisher exact test, and logistic regression. Results: 53.8% of MS group and 27.4% of control group had chronic headaches (p=0.0001). Frequency of Migraine and tension type headaches among patients with headache in MS group were 73.1% and 26.98%, and in control group were 40.6% and 58.7% respectively. There was a statistically significant relation between Relapsing-Remitting MS and migraine headache (p<0.001).There was not any correlations between headache and using Interferone, MS duration, and EDSS. Conclusion: The results of this study indicate that primay headaches, especialy migraine without aura, are common in MS patients comparing to general population.

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Background: Multiple sclerosis (MS) is a auto-immune disease of central nervous system. The etiology of MS is unknown, but environmental factors such as viruses are involved in the development of MS. In this study, MS patients were assessed for antibodie titers against Human Herpes virus-6 (HHV-6) in Markazi Province. Methods and Materials: In this case-control study, 31 new cases of MS patients and 60 healthy subjects were selected with similar demographic criteria such as sex, age and location. Antibodies titer (IgM and IgG) against HHV-6 were examined by ELISA and Immunofluorescence methods. Data were analyzed using Logistic regression and Odds ratio. Results: Data indicates that 74.2% of case group and 34.2% of control group were identified as positive for IgM against HHV-6. The difference between the two groups in terms of IgM against HHV-6 was statistically significant (p=0.001). Incidence of IgM positivity against HHV-6 was increased more than five times in MS patients compared to control group. Also there was a statistically significant difference between case and control groups in IgG titer (p=0.019). Conclusion: Acute infection of HHV-6 is a risk factor for MS.

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Abstract Background: Aloe Vera species have diverse immunomodulatory and antitumor activities. The present study was set out to define the immunomodulatory activity of Aloe Vera extract on tumor necrosis factor-alpha (TNF-α) and development of experimental autoimmune encephalomyelitis (EAE) as an animal model of multiple sclerosis (MS). Materials and Methods: In this experimental interventional study, EAE was induced by MOG35-55 peptide and complete Freund's adjuvant in C57BL/6 mice. Mice were placed in two therapeutic groups (n=8 per group) with the same age and weight. Therapy with Aloe Vera extract (120mg/kg/every day given oral) was started on day 5 before the immunization until 25 day after that. EAE control received phosphate buffer alone with same schedule. Signs of disease were recorded daily until the day 25 when mice were bled and sacrificed. Produced TNF-α by cultured spleen mononuclear cells was detected by ELISA. Results: The Aloe Vera treatment significantly reduced the clinical signs of EAE and delayed onset of disease. Mononuclear cells isolated from spleen of treated-mice with Aloe Vera showed a significant decrease in TNF-α in compared with control mice (p=0.012). Conclusion: Aloe Vera ameliorated the EAE and reduced TNF-α level in MS animal model.

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Background: Multiple sclerosis (MS) is a chronic, autoimmune disease of the central nervous system (CNS) of unknown etiology. Vitamin D3 (1,25(OH)2D3) has strong immune modulating potential. Nitric Oxide (NO) has been identified as one of the most destructive products of the immune system and is an important factor in demyelination. The effect of short-term vitamin D3 supplementation on NO level was assessed in MS patients. Materials and Methods: The study included 60 MS patients (male and female). Patients were randomized independently, in a double blind design, into one of two treatment groups. Controls (n=30) received current treatment. Vitamin D treated (n=30) individuals received current treatment plus 300000 IU vitamin D3. Vitamin D3 injection was repeated monthly for 6 months. Nitric oxide (NO) production was estimated by Griess reaction. Results: NO levels decreased following vitamin D3 treatment but the differences did not reach significance (12.411.1 μmol/L to 9.88.9 μmol/L). Control group was also associated with an increase in NO levels but not statistically significant (18.417.07 μmol/L to 22.0716.8 μmol/L). Conclusion: Vitamin D3 has not significant effect on the level of nitric oxide. However, further studies should be done to evaluate the potential of vitamin D as an immune modulator in management of MS.

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Background: Multiple sclerosis (MS) is a demyelinating disease of central nervous system which has different clinical manifestations. Noticing the role of vitamin B12 in synthesis of myelin tissue and the existence of different views about its pathogenesis and causes, we decided to evaluate B12 serum levels in MS patients. Materials and Methods: In a case-control study, 40 patients with definite clinical diagnosis of MS and 80 traumatic patients hospitalized in the emergency ward of Vali-asr Hospital of Arak (the control group) were chosen. The level of blood vitamin B12 was measured for all the subjects through the same type of kit and clinical checklist. Data were analyzed through t-test. Results: The mean vitamin B12 serum level in case and control groups were, respectively, 295±133.3 pg/dl and 257.73±91.3 pg/dl which did not indicate a significant difference(p> 0.05). However, in terms of the type of clinical manifestations, the mean vitamin B12 serum level in MS patients showed at least one sensory, motor, or sphinctery symptom lower than the control group. This difference turned out to be significant(p< 0.05). In terms of MRI findings, patients with brainstem and vertebra plucks respectively had the maximum and minimum vitamin B12 serum levels. Conclusion: Although a significant difference was not observed between the mean vitamin B12 serum levels, based on the significant decreases in the serum levels of this vitamin in some of the patients with subtypes of MS, further studies with larger sample sizes and over longer periods of time are suggested.

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Background: Multiple sclerosis (MS) is an autoimmune disease which demyelinates the central nervous system. Vitamin D, is a potential environmental factor which influences this disease. The majority of the biological activities of the polymorphism forms of vitamin D are done through its receptor gene (VDRG). The aim of this study was to examine the relationship between BsmI polymorphisms in VDRG and the incidence of MS. Materials and Methods: In this case-control study, the BsmI polymorphism in the VDRG was studied in 80 Iranian MS patients and 50 healthy controls of the same genetic background and age through polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method Results: There was a significant difference in the frequency of BsmI VDRG polymorphism genotypes between MS patients and controls (P=0.023). Conclusion: This study indicated that the VDRG BsmI polymorphism is associated with MS in this population.

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Background: Multiple sclerosis, an immune-mediated demyelinating disorder, is one of the most common diseases of the central nervous system. Two-thirds of patients with multiple sclerosis are women in their child bearing age, 20s and 30s. Multiple sclerosis is followed by neurological disability in young people. The purpose of this study was to determine pregnancy outcomes in patients with multiple sclerosis and compare them with healthy pregnant women. Materials and Methods: In this cohort study,37 pregnant women with multiple sclerosis and 73 healthy pregnant women were compared in terms of pregnancy, child birth, and infant variables. Patient information was collected through questionnaires and evaluated using independent t-test, Chi-square, and Mann-Whitney test. Results: The results showed that pregnancy complications like preeclampsia and gestational symptoms in women with multiple sclerosis were higher than the control group (p=0.001). Instrumental delivery was more in women with multiple sclerosis (p=0.05) and there was not a significant difference between the two groups in terms of neonatal outcomes. Conclusion: The resultsof this study show that some of the complications of pregnancy are higher in women with multiple sclerosis. Also, normal delivery and instrumental vaginal delivery were more in women with multiple sclerosis that couldbe due to fatigue in this population. Hence, these findings should be taken into consideration in planning andmanaging pregnant patients.

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Background: Multiple sclerosis is a chronic and degenerative disease of the central nervous systemthat due to such reasons as its chronic nature, no prognosis, and absence of a definitive treatment causes stress in patients. Thus, this study was designed to examine the impact of peer educational program on stress in patients with multiple sclerosis in 2011. Materials and Methods: In this clinical trial, 110 patients with multiple sclerosis were randomly allocated to test and control groups (each group including 55 patients). After preparing 5 multiple sclerosis patients as the peer group, six training sessions forthe test group were held by the peer group over two months. Data collection tool was DASS 21 questionnaire that assessed patients’ stress before and after 4 months which was completed by both groups. In order to analyze the results, SPSS software 16 was used. Results: The results showed that before intervention, there was not astatistically significant difference between the two groups in stress score(p=0.24) while a statistically significant difference was seen between the two groups after intervention (p=0.001). Also, stress score in test group was statistically significant (p=0.001) but there was not a statistically significant difference between the stress scores of the patients in the control groups (p=0.39). Conclusion: Peer group educational program caused stress reduction in patients with multiple sclerosis. Hence, it is recommended that peer groups be used for education of multiple sclerosis.

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Background: Multiple sclerosis is a chronic disease of the central nervous system which leads to myelin destruction. The aim of this study was to examine the effect of aerobic training on functional capacity and percent body fat in women with moderate multiple sclerosis.

Materials and Methods: In this clinical trial, 15 women with multiple sclerosis (aged 33.68±8.22 years) with EDSS<4 were randomly divided into experimental (n=8) and control (n=7) groups. An aerobic program prolonged for 8 weeks, 3 days/week, 20-40 minutes/day, with 60-80% of HRmax was run in the experimental group. Some functional capacities, such as speed running, walking endurance, balance, and VO2 Max, as well as BF% were measured before and after the training program in both groups.

Results: The results showed that aerobic training led to significant increases in walking endurance, walking speed, balance, and VO2max (p<0.001). These indices, however, decreased significantly in the control group (p<0.05). Additionally, after the training program, percent body fat decreased significantly in the experimental group (p=0.005), but it increased significantly in control group (p=0.002).

Conclusion: Considering the findings of this study, it can be stated that aerobic training can improve functional capacity and decrease percent body fat in multiple sclerosis patients

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Background: Several clinical studies suggest that melatonin is a neuroprotective molecule in neurodegenerative disorders and it showed to be reduced in Multiple Sclerosis (MS) patients. MS also results in blurred vision, papillitis and diplopia. The main objective of the study was to asses the influence of Melatonin supplimentation on visual characteristics in patients with MS.

Materials and Methods: In a Quasi Experimental plan, approved by AUMS ethical Committee, 34 (9 males and 25 females) patients with stable MS were asked to voluntearly participate in the study. All subjects (Mean EDSS 3.14) were taking their routine medications. Visual funtions were evaluated by Visual Functioning Questionnaire (VFO-25) and standard Pattern Reversal Visual Evoked Potentials (PR-VEP) records. Serum Melatonin levels were also measured using an ELISA assay. Recordings were performed after a single dose and after taking 1 tablet every night for 14 days, at the day 16th.

Results: In all subjects, Serum Melatonin levels were significantly enhanced. VFQ scores also showed significat improvement. Except the change in N75 latencies of left eyes, VEP latencies of P100, N145 of both eyes and N75 of right eyes were significantly (p<0.05) reduced.

Conclusion: Our findings suggest significat improvements of visual symptoms of MS after daily intake of 3 mg Melatonin. The results calls for further studies and clinical trails before asking all MS patients to take Melatonin suppliment every night.

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Background: Sudden visual loss is one of the emergent problems that it may be a sign of a life-threatening disease. It should be quickly evaluated and identified the treatable causes.

Case report: A young man without any history of certain disease was referred to the emergency department with complaints of sudden blindness. He was presented with fever, coriza symptoms and progressive blurring of vision that ultimately led to his visual loss. After carefully evaluation, finally suspected diagnosis of acute fulminant multiple sclerosis was made.

Discussion: Multiple sclerosis is a chronic inflammatory disease that is associated with acute attacks of neurological dysfunction. Some of these attacks are an emergent situation and need to early detection and treatment. There is a variant of Multiple sclerosis that called Acute Fulminant Multiple sclerosis which can cause sudden visual loss.

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Background: Multiple sclerosis (MS) is an autoimmune disorder with unknown etiology. Genetic and environmental factors associated with MS susceptibility. Genetic studies show an important role for human leukocyte antigens (HLA) and susceptibility to autoimmune diseases such as MS. There is controversy between the association of HLA alleles with MS susceptibility in various studies. However, with consider the high incidence of MS in Iranian population and limit information about association of HLA and MS, we analyzed HLA alleles in MS patients.

Materials and Methods: In this case-control study, 60 MS patients and 40 normal individuals with the same ethic background and geographic area were analyzed for HLA-DRB and DQB alleles by single specific primer-polymerase chain reaction (SSP-PCR) method.

Results: HLA-DRB1*03 and DQB1*02 alleles frequencies in MS patients were greater than healthy controls. There was no significant difference in frequency of other HLA-DR alleles between the MS patients and normal individuals.

Conclusion: DRB1*03 and DQB1*02 alleles confer increased susceptibility to MS in this population. However, to determine the role of HLA in Iranian MS patients, more studies are needed.

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Background: Multiple sclerosis (MS) is a chronic progressive  disease  of the central nervous system with signs and symptoms such as fatigue and balance that are disable. The purpose of this study was to assess the effect of training which instructions focus of attention on postural sway of multiple sclerosis patients.

Materials and Methods: The present quasi-experimental study used a pretest-posttest design. The subjects with the age of 27-42, expanded disability status scale 1-4 and were purposefully and voluntarily selected and randomly allocated to the experimental and control groups. Training program for groups was carried out in 3 weeks, five sessions per week, and each session lasted about one hour. Berg Balance Scale was used to measure balance. The data was analyzed by using analysis of independent and dependent sample t-test at a significance level of p≤0.05.

Results: The results showed that significant improvements observed in balance (p≤0.05). Also significant differences observed between  post hoc scores in the experimental and control groups (p≥0.05).

Conclusion: According to research findings, the exercise walking program on textured surface resulted in considerable improvements in balance in multiple sclerosis. Also, the respective specialists can use these exercies as a complementary treatment along with the drug therapy for patiens with multiple sclerosis.

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Background: studies in adults have shown that external focus of attention is better than internal focus in motor learning. So, the aim of this study is to evaluate the effects of focus of attention- self talk on balance of women with multiple sclerosis.

Materials and Methods: In this semi- experimental study, statistical population included women with MS referred to MS Society of Arak. Whereas balance disorder in patients was diagnosed by neurologyist, they were invited to the study. Patients were accidentally divided into 3 groups each of 15 concluding control, self tak-external focus of attention and self talk- internal focus of attention groups and were evaluated by Berg balance scale. 42 samples completed executive steps of study. ANOVA and Tukey tests were used to compare balance score between groups with significant level of less than 0.05. All patients practiced balance tasks for 9 days and then they were undergone post test.

Results: Balance was improved in all groups. Although the external- self talk group was better than the two other groups, there was no significant difference between external and internal- self talk groups.

Conclusion: The findings of this study showed the effect of practice on improvement of balance skill and superiority of the experimental groups in comparison with control group. Probably, focus of attention with self talk has effect on balance of women with MS.

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Abstract

Background: Self-talk is a psychological intervention that can affect the performance of an individulal, so the aim of this study was to investigate the effect of balance-training with educational and motivational self-talk on balance in women with MS in the city of Arak.

Materials and Methods: This study was a semi-experimental research with pre-test and post-test. The statistical population included women with MS in the city of Arak. 42 patients with the age range of 20-50 years old were chosen as samples and randomly were divided in 3 groups of individuls as control, educational self-talk and motivation self-talk and were experimented by Berg balance test.The experimental groups practiced the balance excercises for a month , 3 times a week and 45 minutes in each session. Then, post-test was performed for them. For data collecting, the demographic questionnaire, Berg balance test, one leg balance test and star test were used. Data analysis was done by using ANOVA and Tokey post-test by SPSS23 software at a significant level less than 0.05.

Results: The results of this study showed that the mean score of balance in educational self- talk group than motivational self-talk group (p = 0.045) a control group (p = 0.008) was significantly higher. Thus, the mean score balance performance test, motivational self-talk and control groups showed no significant difference (p = 0.689)

Conclusion: According the findings of this study, balance training with educational self-talk affects on balance in women with MS. Thus, balance training with educational self-talk can be a good approach to improve the balance in the women with MS. oxidative stress and DNA damage considerably. Thus, it is advisable for operating room personnel to consume green tea as a natural antioxidant supplement.

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Abstract

Background: The multiple sclerosis is a chronic disease of the central nervous system. Since the level of sex hormone and multiple sclerosis (MS) disease affects one another, the aim of this study was to evaluate the impact of the hydroalcoholic extract of truffle on the hormone levels of estrogen and progesterone administered in experimental model of MS-induced rats.

Materials and Methods: In this experimental study, 42 Wistar female rats, weighing 180±10 grams selected into 6 groups each consisting of 7 rats. Normal control didn’t receive any treatment and experimental group was given Cuprizone toxin (as a MS model inducer) for 40 days. The experimental groups (2, 3, 4 and 5) in addition to Cuprizone received the normal saline, 110, 220 and 330 mg/kg/0.2ml (i.p.) of Hydroalcoholic extract of truffle for 12 days too. Blood samples were taken at the end of the twelfth day from all groups involved and levels of sex hormones were measured.

Results: Cuprizone decreases estrogen, progesterone levels and also causes weight loss, while injection of hydroalcoholic extract of truffle increased serum levels of estrogen (in experimental group 4) and progesterone (in experimental group 4 & 5) compared to MS-induced group.

            Conclusion: Results of the study revealed that the hydroalcoholic extract of truffle (at dosages of 220 and 330 mg/kg) could increase estrogen and progesterone levels in rats experienced experimental multiple sclerosis.

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Abstract

Background: Multiple sclerosis (MS) is a chronic inflammatory disorder described by central nervous system (CNS) demyelination and axonal damage. While the cause of MS is still unknown, it is extensively accepted that novel drug targets need to attention. Retromers are protein complex that have an essential role in endosomal trafficking, and retromer dysfunction has been associated to several neurological disorders. Therefore, this study aimed to compare the expression of SNX2 gene as a part of retromer complex in MS patients with health individuals.

Materials and Methods: In this case-control study, 50 samples of cases of multiple sclerosis (MS) and 50 healthy controls were enrolled. Followed verifying disease, 3cc peripheral blood was given from all subjects. Total RNA was extracted and complementary DNA (cDNA) was synthesized. The relative gene expression was determined using quantitative real-time RT PCR (qRT-PCR) and evaluated by  method.

Results: The expression of SNX2 gene was lower in MS patients compared with healthy controls and it was statistically significant (p< 0.05).

Conclusion: Our study showed that the expression of SNX2 is lower in multiple sclerosis disorder. Considering the functional role of SNX2 as a protein involved in trafficking process, SNX2 may affect receptor function or drug targeting. Therefore, supplementary studies should be done to elucidate the exact mechanism of action of the gene in cellular trafficking.

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