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Eissazade N, Alavi A, Lang AE, Rohani M, Emamikhah M, Khoeini T. A new genetic variant, presenting as young onset rapidly progressive dementia and parkinsonism. Parkinsonism Relat Disord 2023:105849. [PMID: 37726184 DOI: 10.1016/j.parkreldis.2023.105849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 08/25/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023]
Abstract
There are various neurodegenerative or hereditary causes of Parkinsonism. Therefore, clinicians should consider an increasing range of differential diagnoses when facing a patient with Parkinsonism, especially when associated with additional clinical features. Young-onset Parkinsonism, especially when accompanied by features uncommon in idiopathic Parkinson's disease raises the possibility of genetic etiology. Herein, we present a case of a 40-year-old man with genetic Parkinson's disease, presenting with rapidly progressive dementia. This round will describe our approach to this clinical presentation and the unveiling of a rare genetic condition.
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Affiliation(s)
- Negin Eissazade
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Afagh Alavi
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Anthony E Lang
- Edmond J Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Mohammad Rohani
- Department of Neurology, School of Medicine, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran; Skull Base Research Center, Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Maziar Emamikhah
- Department of Neurology, School of Medicine, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Tara Khoeini
- Department of Neurology, School of Medicine, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
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Heyrani R, Sarabi-Jamab A, Grafman J, Asadi N, Soltani S, Mirfazeli FS, Almasi-Dooghaei M, Shariat SV, Jahanbakhshi A, Khoeini T, Joghataei MT. Limits on using the clock drawing test as a measure to evaluate patients with neurological disorders. BMC Neurol 2022; 22:509. [PMID: 36585622 PMCID: PMC9805016 DOI: 10.1186/s12883-022-03035-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/19/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The Clock Drawing Test (CDT) is used as a quick-to-conduct test for the diagnosis of dementia and a screening tool for cognitive impairments in neurological disorders. However, the association between the pattern of CDT impairments and the location of brain lesions has been controversial. We examined whether there is an association between the CDT scores and the location of brain lesions using the two available scoring systems. METHOD One hundred five patients with brain lesions identified by CT scanning were recruited for this study. The Montreal Cognitive Assessment (MoCA) battery including the CDT were administered to all partcipants. To score the CDT, we used a qualitative scoring system devised by Rouleau et al. (1992). For the quantitative scoring system, we adapted the algorithm method used by Mendes-Santos et al. (2015) based on an earlier study by Sunderland et al. (1989). For analyses, a machine learning algorithm was used. RESULTS Remarkably, 30% of the patients were not detected by the CDT. Quantitative and qualitative errors were categorized into different clusters. The classification algorithm did not differentiate the patients with traumatic brain injury 'TBI' from non-TBI, or the laterality of the lesion. In addition, the classification accuracy for identifying patients with specific lobe lesions was low, except for the parietal lobe with an accuracy of 63%. CONCLUSION The CDT is not an accurate tool for detecting focal brain lesions. While the CDT still is beneficial for use with patients suspected of having a neurodegenerative disorder, it should be cautiously used with patients with focal neurological disorders.
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Affiliation(s)
- Raheleh Heyrani
- grid.411746.10000 0004 4911 7066Department of Psychiatry, School of Medicine, Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Atiye Sarabi-Jamab
- grid.418744.a0000 0000 8841 7951School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
| | - Jordan Grafman
- grid.477681.bShirly Ryan AbilityLab, Departments of Physical Medicine and Rehabilitation, Neurology, Cognitive Neurology, and Alzheimer’s Center, Chicago, IL USA ,grid.16753.360000 0001 2299 3507Department of Psychiatry, Feinberg School of Medicine and Department of Psychology, Weinberg College of Arts and Sciences, Northwestern University, Chicago, IL USA
| | - Nesa Asadi
- grid.411746.10000 0004 4911 7066Department of Psychiatry, School of Medicine, Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Sarvenaz Soltani
- grid.411746.10000 0004 4911 7066Department of Psychiatry, School of Medicine, Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sadat Mirfazeli
- grid.411746.10000 0004 4911 7066Department of Psychiatry, School of Medicine, Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran ,grid.490421.a0000 0004 0612 3773Faculty of Medicine, Rasool Akram Hospital, Iran Unversity of Medical Sciences, Tehran, Iran
| | - Mostafa Almasi-Dooghaei
- grid.411746.10000 0004 4911 7066Department of Neurology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Vahid Shariat
- grid.411746.10000 0004 4911 7066Department of Psychiatry, School of Medicine, Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Amin Jahanbakhshi
- grid.411746.10000 0004 4911 7066Department of Neurosurgery, Skull Base Research Center, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran ,grid.411746.10000 0004 4911 7066Stem Cell and Regenerative Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Tara Khoeini
- grid.411746.10000 0004 4911 7066Department of Neurology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Taghi Joghataei
- grid.411746.10000 0004 4911 7066Cellular and Molecular Research Center (CMRC), Iran University of Medical Sciences, Tehran, Iran
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Derakhshanian H, Rastad H, Ghosh S, Zeinali M, Ziaee M, Khoeini T, Farrokhpour M, Qorbani M, Ramezani Ghamsari M, Hasani H, Mirzaasgari Z. The predictive power of serum vitamin D for poor outcomes in COVID-19 patients. Food Sci Nutr 2021; 9:6307-6313. [PMID: 34760260 PMCID: PMC8565195 DOI: 10.1002/fsn3.2591] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 01/19/2023] Open
Abstract
Considering the high prevalence of vitamin D deficiency worldwide and its relationship with immune response to viral infections, this study attempted to identify the predictive power of serum vitamin D for poor outcomes among the COVID-19 patients. This retrospective cohort study included all patients with confirmed COVID-19 hospitalized between February 20, 2020, and April 20, 2020, at a designated COVID-19 hospital, located in Tehran province, Iran. General characteristics, medical history and clinical symptoms were recorded by trained physicians. Blood parameters including complete blood count, creatinine, lactate dehydrogenase, creatine phosphokinase, erythrocyte sedimentation rate, C-reactive protein and vitamin D were tested. This study included 290 hospitalized patients with COVID-19 (the mean age [SD]: 61.6 [16.9], 56.6% males), of whom 142 had vitamin D concentrations less than 20 ng/ml, defined as vitamin D deficiency. COVID-19 patients with vitamin D deficiency were more likely to die (Crude OR [95% CI]: 2.30 [1.25-4.26]), require ICU (2.06 [1.22-3.46]) and invasive mechanical ventilation (2.03 [1.04-3.93]) based on univariate logistic regression results. Although, after adjusting for potentials confounders such as gender and age, the association between vitamin D and need to invasive mechanical ventilation lost its significance, adjusted values for the risk of death and ICU requirement were still statistically significant. Vitamin D deficiency can be considered as a predictor of poor outcomes and mortality in COVID-19 patients. Therefore, checking serum 25 (OH) D on admission and taking vitamin D supplements according to the prophylactic or treatment protocols is recommended for all COVID-19 patients.
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Affiliation(s)
- Hoda Derakhshanian
- Department of Biochemistry Genetics and NutritionSchool of MedicineAlborz University of Medical SciencesKarajIran
- Dietary Supplements and Probiotic Research CenterAlborz University of Medical SciencesKarajIran
| | - Hadith Rastad
- Non‐communicable Diseases Research CenterAlborz University of Medical SciencesKarajIran
| | - Sanjoy Ghosh
- Department of Biology Okanagan CampusUniversity of British ColumbiaKelownaBCCanada
| | - Marjan Zeinali
- Department of NeurologyFiroozgar HospitalIran University of Medical SciencesTehranIran
| | - Mahsa Ziaee
- Department of NeurologyFiroozgar HospitalIran University of Medical SciencesTehranIran
| | - Tara Khoeini
- Department of NeurologyFiroozgar HospitalIran University of Medical SciencesTehranIran
| | - Mohsen Farrokhpour
- Department of Internal MedicineFiroozgar HospitalIran University of Medical SciencesTehranIran
| | - Mostafa Qorbani
- Non‐communicable Diseases Research CenterAlborz University of Medical SciencesKarajIran
| | - Mona Ramezani Ghamsari
- Clinical Research Development UnitShahid Rajaei Educational and Medical CenterAlborz University of Medical SciencesKarajIran
| | - Hossein Hasani
- Department of Community NutritionSchool of Nutritional Sciences and DieteticsTehran University of Medical SciencesTehranIran
| | - Zahra Mirzaasgari
- Department of NeurologyFiroozgar HospitalIran University of Medical SciencesTehranIran
- Shefa Neuroscience Research CenterTehranIran
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