Effect of Motor Imagery on the F-Wave Parameters in Hemiparetic Stroke Survivors

Mahshid Naseri,Peyman Petramfar,Alireza Ashraf 대한재활의학회 2015 Annals of Rehabilitation Medicine Vol.39 No.3

Objective To assess the effect of motor imagery, as a rehabilitation method in stroke, on F-wave parameters that undergo changes during upper motor neuron involvement. Methods Twenty-one fully conscious hemiparetic stroke survivors with a completely plegic hand (power 0/5) and a minimum interval of 72 hours since stroke were recruited into this study. The mean F-wave latency, amplitude, and persistence in the median and ulnar nerves were measured in both the affected and non-affected sides at rest and in the paretic hand during a mental task. Comparison was made between data from the affected hand and the non-affected hand as well as between data from the affected hand at baseline and during motor imagery. Results Patients had significantly different F-wave persistence between the affected and non-affected sides (paired t-test, p<0.001). Motor imagery could improve F-wave persistence in both the investigated nerves (paired t-test, p=0.01 for ulnar nerve and p<0.001 for median nerve) and F-response amplitude in the median nerve (paired t-test, p=0.01) of the affected limb. Conclusion The amplitude and persistence of F-wave were improved during motor imagery, representing F-wave facilitation. This result suggests that motor imagery can restore motor neuron excitability, which is depressed after stroke.

Correlation between Female Sex Hormones and Electrodiagnostic Parameters and Clinical Function in Post-menopausal Women with Idiopathic Carpal Tunnel Syndrome

( Azam Mohammadi ),( Mahshid Naseri ),( Hamid Namazi ),( Mohammad Javad Ashraf ),( Alireza Ashraf ) 대한폐경학회 2016 대한폐경학회지 Vol.22 No.2

Objectives: To investigate the role of sex-hormonal changes in idiopathic carpal tunnel syndrome (CTS) among post-menopausal women through measuring estrogen receptor (ER) expression in their transverse carpal ligament (TCL) and serum estrogen level, as well as determine the correlation between these factors and electrodiagnostic parameters and Boston score. Methods: Biopsy samples of TCL were collected from 12 postmenopausal women who had undergone surgery for severe idiopathic CTS; control specimens were collected from 10 postmenopausal women without CTS who had undergone surgery for the other hand pathologies. To determine the distributions of ER in TCL, histological and immunohistochemical examinations were performed. Serum estrogen level was also measured. Electrodiagnosis and Boston questionnaire were used for CTS severity and determination of the patients’ function. Results: ER expression in TCL and serum estrogen level were not significantly different in the case group compared to the control group (P = 0.79 and P = 0.88, respectively). Also, there was no correlation between ER expression or serum estrogen level and electrodiagnostic parameters or Boston score. Conclusions: Sex hormones cannot still be considered as the etiology of idiopathic CTS in postmenopausal women. The role of other factors such as wrist ratio and narrower outlet in females compared to the males should be considered along with hormonal changes. (J Menopausal Med 2016;22:80-86)

The Efficacy of Intramuscular Calcitonin Injection in the Management of Lumbar Spinal Stenosis

Alireza Ashraf,Mehdi Khodadadi,Amin Sadraei,Mahshid Naseri,Ali Nasseri 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.1

Study Design: A prospective, cross-sectional, non-randomized study. Purpose: To assess the effectiveness of intramuscular calcitonin injection in the treatment of lumbar spinal stenosis (LSS). Overview of Literature: LSS, manifesting as chronic low back pain and neurogenic claudication, is a chronic condition with an increasing incidence in the elderly population having inadequate effective conservative treatment options. Methods: In this study, 36 patients with LSS who were diagnosed based on the clinical findings and magnetic resonance imaging were included. Patients received 100 IU of calcitonin per week for one month and were evaluated before and after treatment using the Oswestry disability index (ODI) questionnaire and visual analogue scale (VAS). Before treatment, the patients were divided into two subgroups based on their ODI results: patients with mild to moderate low back pain (disability, 0%–40%) and patients with severe or very severe low back pain (disability, 40%–100%). Results: In patients with mild to moderate low back pain, there were no significant changes in the ODI and VAS after calcitonin injection. But in patients with severe or very severe low back pain, pain severity, personal functions, ability to lift and carry objects, time interval between standing and initiation of pain, social life, disability percentage, and VAS were significantly improved after treatment with calcitonin. Conclusions: It seems that an intramuscular injection of low dose of calcitonin may have some beneficial effects on the pain due to LSS, especially in patients who suffer from severe or very severe low back pain.

Sympathetic Skin Response in Patients with Vascular Erectile Dysfunction

Mostafa Jazayeri,Behrooz Kazemi,Alireza Aminsharifi,Alireza Ashraf,Mahshid Naseri,Ali Nasseri,Amirhooshang Vahedi 대한남성과학회 2014 The World Journal of Men's Health Vol.32 No.1

Purpose: We aimed to investigate the utility of sympathetic skin response (SSR) test for evaluating vasculogenic erectile dysfunction (ED) which is the most common type of impotence. Materials and Methods: Men in the age group of 28 to 60 years and suffering from vasculogenic ED, as confirmed by a papaverin test and color Doppler sonography, at least for 6 months referred from our university urology department were included. We used the International Index of Erectile Function (IIEF-5) for grading severity of dysfunction and recorded the SSR of every patient from the median, tibial, and dorsal nerves of the penis. One-way analysis of variance (ANOVA), independent t-test and Pearson’s correlation coefficient were used for comparing quantitative variables, and Fisher's Exact test was used for comparing qualitative variables. The Mann-Whitney U Test and the Kruskal-Wallis test were performed for analysis of data that were not normally distributed. A p value of less than 0.05 was considered significant. Results: Forty-two patients were recruited for the study. We found a strong statistical relationship between the IIEF score and the pathologic SSR registered from every mentioned nerve. Patients with abnormal SSR had more severe ED according to IIEF score (p<0.001). In addition, the IIEF score had a significantcorrelation with diabetes mellitus and cardiovascular disease (t-test; p<0.05). Conclusions: Our results confirmed the presence of autonomic dysfunction in patients with vasculogenic impotence via an SSR test. We suggest evaluating the efficacy of the SSR test in patients with vascular impotence for treatment response monitoring in future studies.

Correlation between Radiologic Sign of Lumbar Lordosis and Functional Status in Patients with Chronic Mechanical Low Back Pain

Alireza Ashraf,Siamak Farahangiz,Bita Pakniat Jahromi,Nazanin Setayeshpour,Mahshid Naseri,Ali Nasseri 대한척추외과학회 2014 Asian Spine Journal Vol.8 No.5

Study Design: A cross-sectional study. Purpose: To describe the correlation between lumbar lordosis angle and functional status of patients with chronic mechanical low back pain (CMLBP). Overview of Literature: There are different and conflicting opinions regarding the relationship between the degree of lumbar lordosis and functional status of patients with low back pain. Nonetheless, the severity of lordosis is still one of the routine physical exams considered in rehabilitation clinics. Methods: The degree of lumbar lordosis of 150 patients with CMLBP was measured by means of Cobb’s method using sagittal standing spinal radiographs. Subjects with probable secondary causes of low back pain (trauma, congenital anomaly, spinal infection, rheumatologic problems and history of spinal surgery) were excluded. Besides recording demographic data, their score of functional disability was estimated using Oswestry Disability Questionnaire, one of the most useful and reliable questionnaires. Comparison between these data was made regarding different age and gender groups. Results: In this study, 119 subjects were female and 31 male, with an age range of 19–85 years. The average degree of lumbar lordosis was 44.69±11.43 and that of Oswestry disability index (ODI) 30.52%. Although we found a significant direct relationship between age and degree of lumbar lordosis (Pearson’s correlation coefficient, p =0.016, r =0.197), while insignificant correlation was seen between the degree of lumbar lordosis and ODI (p =0.129). Conclusions: There was no significant correlation between the degree of lumbar lordosis and the score of functional disability with regards to different age groups and gender.