jamshid lotfi
Queen Mary, University of London, Neurology, Department Member
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The nervous system is particularly susceptible to the harmful effects of alcohol. These include Wernicke-Korsakoff syndrome, which is related to thiamine deficiency secondary to chronic alcohol abuse. Other neurotoxic effects of alcohol... more
The nervous system is particularly susceptible to the harmful effects of alcohol. These include Wernicke-Korsakoff syndrome, which is related to thiamine deficiency secondary to chronic alcohol abuse. Other neurotoxic effects of alcohol with cognitive impairments include delirium tremens, alcoholic seizures or "rum fits," and alcoholic neuropathies. It has become recognized in recent years that alcohol and its metabolites directly damage the nervous system even in the absence of nutritional deficiencies. Cerebral blood flow (CBF) measurements provide a noninvasive indirect monitor of cerebral metabolic activity. It has been shown conclusively that CBF measured by the 133Xe inhalation method is decreased in chronic alcoholism, correlating well with the amount of alcohol consumed. With abstinence, CBF returns toward normal levels provided the neurotoxic effects of chronic alcoholism are of recent onset. Clinical and pathological studies show significant loss of brain volume with ventricular dilatation after alcohol abuse even among young "social" drinkers. This toxic effect of alcohol is accompanied by varying degrees of cognitive impairments ranging from slight memory loss to frank dementia. Both the decrease in brain volume and the cognitive impairments, which occur with or without nutritional deficiency, are to a large extent reversible with abstinence and nutritional supplementation. Alcohol appears to accelerate age-related declines in CBF while nutritional deficiencies enhance the neurotoxic effects of alcohol. Measurements of local CBF (LCBF) and partition coefficients (L lambda) in deep cerebral structures, including the hypothalamus, thalamus, forebrain nuclei, and limbic system, can be achieved utilizing three-dimensional methods after inhalation of stable xenon as a contrast medium combined with serial computed tomographic imaging of the brain. Among chronic alcoholics, there are significant and diffuse reductions in cortical and subcortical gray matter CBF that are especially remarkable in hypothalamus and substantia innominata, which includes the nucleus basalis of Meynert, a major source of cholinergic input to neocortex and hippocampus. Reductions in LCBF are measurable in cognitively impaired patients with and without Wernicke-Korsakoff syndrome. Reductions of CBF include white matter and are more severe in patients with Wernicke-Korsakoff syndrome. Both types of encephalopathy improve with treatment, but recovery is usually more rapid and complete if nutritional deficiency is absent. Alcohol also appears to be a risk factor for stroke, possibly by depleting neuronal reserves and unfavorably influencing cardiovascular risks.
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Background: Iran was formerly considered to be located in a low prevalence zone for multiple sclerosis (MS). During the last decade the number of patients has increased. This study was conducted to estimate the prevalence of MS in the... more
Background: Iran was formerly considered to be located in a low prevalence zone for multiple sclerosis (MS). During the last decade the number of patients has increased. This study was conducted to estimate the prevalence of MS in the capital city of the country. Methods: We re-evaluated the files of all patients who had registered at the Iranian Multiple Sclerosis Society during a 10-year period. Results: 8,146 patients (72.3% female, 27.7% male) with a female-to-male ratio of 2.60 had registered. Mean age of disease onset was 27.24 (SD: 8.32). A relapsing-remitting pattern was recognized in 84.9% of the patients. The number of new registrations tripled from 2002 to 2008 and the female-to-male ratio increased from 2 to 3.12. The prevalence of MS in Tehran is estimated to be at least 51.9 per 100,000. Visual impairment was the main presenting symptom. Conclusions: It seems that the prevalence of MS has increased to a medium-to-high risk level in Iran. The mean age of onset was similar to other studies but the calculated prevalence of early onset MS was increased. The cumulative data indicates that the female-to-male ratio is increasing annually.
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Research Interests: Cardiology, Cognition, Comparative Study, Brain, Humans, and 15 moreHyperlipidemia, Hemodynamics, Chronic Disease, Female, Male, Exploration, Brain Ischemia, Clinical Sciences, Aged, Analysis of Variance, Carotid Endarterectomy, Cerebral Ischemia, Cerebral Blood Flow, Carotid Arteries, and cerebral arteries
Background: Mesenchymal stem cells (MSCs) with their potential to differentiate into mesodermal and non-mesodermal lineages have several immunomodulatory characteristics. These properties make them promising tools in cell and gene... more
Background: Mesenchymal stem cells (MSCs) with their potential to differentiate into mesodermal and non-mesodermal lineages have several immunomodulatory characteristics. These properties make them promising tools in cell and gene therapy. Objective: To evaluate the potential therapeutic applications of autologous MSC in improving clinical manifestations of MS patients. Methods: Ten patients were included in this pilot study. All had progressive disease that had not responded to disease modifying agents including Mitoxantrone. Their Expanded Disability Status Scale (EDSS) score ranged from 3.5 to 6. Patients were injected intrathecally with culture expanded MSCs. They were followed with monthly neurological assessment and a MRI scan at the end of the first year. Results: During 13 to 26 months of follow up (mean: 19 months), the EDSS of one patient improved from 5 to 2.5 score. Four patients showed no change in EDSS. Five patients’ EDSS increased from 0.5 to 2.5. In the functional system assessment, six patients showed some degree of improvement in their sensory, pyramidal, and cerebellar functions. One showed no difference in clinical assessment and three deteriorated. The result of MRI assessment after 12 months was as following: seven patients with no difference, two showed an extra plaque, and one patient showed decrease in the number of plaques. Conclusion: This preliminary report emphasizes on the feasibility of autologous MSC for treatment of MS patients. However, in order to draw a definitive conclusion a larger sample size is required.
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Subacute sclerosing panencephalitis (SSPE) is a rare chronic, progressive encephalitis affecting primarily children and young adults, caused by a persistent infection of immune resistant measles virus. The aim of the present study is to... more
Subacute sclerosing panencephalitis (SSPE) is a rare chronic, progressive encephalitis affecting primarily children and young adults, caused by a persistent infection of immune resistant measles virus. The aim of the present study is to describe the clinical profile and natural history of patients with SSPE. We collected data of patients with SSPE during 2004-2010 who fulfilled Dyken's criteria. We analyzed demographical, clinical, electrophysiological, and imaging features. Study included 34 patients, 26 (76.5%) males with age of onset from 3 to 31 years. Twenty one patients were below 15 years of age formed childhood SSPE and 13 above 15 years of age constituted adult onset group. 85.3% had low-socioeconomic status. Eleven received measles vaccination and seven were unvaccinated. 59.9% patients had measles history. Most common presenting symptom was scholastic backwardness (52.5%) followed by seizures (23.5%). Three patients each had cortical blindness, macular degeneration, decreased visual acuity, and optic atrophy. Electroencephalographic (EEG) showed long interval periodic complexes and cerebrospinal fluid anti-measles antibody was positive in all. Magnetic resonance imaging was done in 70.5% with was abnormal in 52.5%. Mean incubation period of SSPE after measles was 9.6 years. The follow-up duration was 1-10 years, (average of 2 years). Only one patient died from available data of follow-up, 9 were stable and 10 deteriorated in the form of progression of staging. SSPE is common in low-socioeconomic status. The profile of adult onset did not differ from childhood onset SSPE, except for a longer interval between measles infection and presence of the ophthalmic symptom as presenting feature in adult onset group.
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Background: Multiple Sclerosis as the most common cause of demyelization disorders has a basis of autoimmunity. Objective: To describe a procedure to determine total and aromatic UNCR and their ratio as a marker of cell mediated immunity... more
Background: Multiple Sclerosis as the most common cause of demyelization disorders has a basis of autoimmunity. Objective: To describe a procedure to determine total and aromatic UNCR and their ratio as a marker of cell mediated immunity in MS patients and controlled ...
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Neopterin, a pyrazinopyrimidine compound, is produced by macrophages after induction by interferon gamma (IFN-g) and serves as a marker of cellular immune system activation followed by oxidative stress. The aim of this study was to... more
Neopterin, a pyrazinopyrimidine compound, is produced by macrophages after induction by interferon gamma (IFN-g) and serves as a marker of cellular immune system activation followed by oxidative stress. The aim of this study was to determine urinary neopterin to creatinine ratio (UNCR) as a surrogate marker of cell-mediated immune activation in multiple sclerosis (MS). Three weekly early morning urine samples were collected from 27 patients with MS and 31 age- and sex-matched apparently healthy subjects. Urinary neopterin and creatinine were determined using reversed phase high-performance liquid chromatography and Jaffe reaction, respectively. UNCR was significantly higher in patients than in healthy controls indicating IFN-g-induced cellular immunity activation and oxidative stress in multiple sclerosis. As a non-invasive method, UNCR determination may be helpful in monitoring disease progression and the effects of therapies, as well.
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SummaryClinical and pathological findings in two cases of degenerative progressive myoclonic epilepsy (PME) are described. The clinically difficult task of differentiating a “cerebellar” tremor from an action myoclonus is emphasized.... more
SummaryClinical and pathological findings in two cases of degenerative progressive myoclonic epilepsy (PME) are described. The clinically difficult task of differentiating a “cerebellar” tremor from an action myoclonus is emphasized. Simultaneous elect roencephalography and electrokymography was done, using capacity to ground transients for recording hand movements. This method was found useful in corroborating the cerebellar nature of the remaining disorder, after successful treatment of the myoclonic element with anticonvulsants.
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Despite updating knowledge and a growing number of medications for multiple sclerosis (MS), no definite treatment is available yet for patients suffering from progressive forms of the disease. Autologous bone marrow derived mesenchymal... more
Despite updating knowledge and a growing number of medications for multiple sclerosis (MS), no definite treatment is available yet for patients suffering from progressive forms of the disease. Autologous bone marrow derived mesenchymal stem cell (BM-MSC) transplantation is a promising method proposed as a therapy for MS. Although the safety of these cells has been confirmed in hematological, cardiac and inflammatory diseases, its efficacy in MS treatment is still under study. Patients with progressive MS (expanded disability status scale score: 4.0 -6.50) unresponsive to conventional treatments were recruited for this study. Twenty-five patients [f/m: 19/6, mean age: 34.7±7] received a single intrathecal injection of ex-vivo expanded MSCs (mean dose: 29.5×10(6) cells). We observed their therapeutic response for 12 months. Associated short-term adverse events of injection consisted of transient low-grade fever, nausea /vomiting, weakness in the lower limbs and headache. No major dela...
Research Interests: Magnetic Resonance Imaging, Treatment Outcome, Medicine, Humans, Female, and 12 moreDrug Resistance, Male, Follow-up studies, Adult, Gadolinium, Fever, Disease Progression, Biochemistry and cell biology, Autoantigens, postoperative nausea and vomiting, Disease Free Survival, and Medical biochemistry and metabolomics
Altitude illness results from hypobaric hypoxia at altitudes higher than 2500 meters above sea level. To determine whether vital signs can be used as predictors for severe acute mountain sickness, we carried out a prospective... more
Altitude illness results from hypobaric hypoxia at altitudes higher than 2500 meters above sea level. To determine whether vital signs can be used as predictors for severe acute mountain sickness, we carried out a prospective observational study. A cohort of 90 individuals (male/female ratio: 2; age: 13 - 65 years) in a mountain hotel's clinic at 3450 meters in Iran were studied from September through October 2006. Demographics and vital signs were measured during the first hour of ascent. The individuals were followed for acute mountain sickness symptoms including headache, dizziness, nausea or vomiting, insomnia, and fatigue. Lake Louise criteria were used to diagnose acute mountain sickness. Severe acute mountain sickness was considered if a score of equal or more than 5 was present. Significance was assigned to values of P<0.05. Acute mountain sickness was diagnosed in 34 (37.8%) participants after 24 hours of ascent. Severe acute mountain sickness was detected in 14 (15....
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BACKGROUND Mesenchymal stem cells (MSCs) with their potential to differentiate into mesodermal and non-mesodermal lineages have several immunomodulatory characteristics. These properties make them promising tools in cell and gene therapy.... more
BACKGROUND Mesenchymal stem cells (MSCs) with their potential to differentiate into mesodermal and non-mesodermal lineages have several immunomodulatory characteristics. These properties make them promising tools in cell and gene therapy. OBJECTIVE To evaluate the potential therapeutic applications of autologous MSC in improving clinical manifestations of MS patients. METHODS Ten patients were included in this pilot study. All had progressive disease that had not responded to disease modifying agents including Mitoxantrone. Their Expanded Disability Status Scale (EDSS) score ranged from 3.5 to 6. Patients were injected intrathecally with culture expanded MSCs. They were followed with monthly neurological assessment and a MRI scan at the end of the first year. RESULTS During 13 to 26 months of follow up (mean: 19 months), the EDSS of one patient improved from 5 to 2.5 score. Four patients showed no change in EDSS. Five patients' EDSS increased from 0.5 to 2.5. In the functional s...
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Interferon- gamma (IFN- gamma) is an important immune regulator and inflammatory cytokine which is implicated in the pathogenesis of multiple sclerosis (MS). A single nucleotide polymorphism, T to A, at position +874 in the first intron... more
Interferon- gamma (IFN- gamma) is an important immune regulator and inflammatory cytokine which is implicated in the pathogenesis of multiple sclerosis (MS). A single nucleotide polymorphism, T to A, at position +874 in the first intron has previously been shown. This polymorphism is associated with IFN- gamma production level. To study the effect of this polymorphism on susceptibility to multiple sclerosis, we screened genomic DNA samples from clinically definite MS patients and their unaffected first-degree relatives as controls, using sequence-specific primers (PCR-SSP). The results indicated that MS patients showed a lower TT (21.2% vs. 30.3%) and higher AA (21.2% vs. 12.1%) genotypes compared to controls, although there were statistically no differences in the IFN- gamma genotype distribution between these two groups. Thus, our data indicate that there is no association between IFN- gamma +874 polymorphism and MS susceptibility or severity of the disease.
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Different research groups have extensively studied the associations of cytokine gene polymorphisms in different diseases. The role of cytokines gene polymorphisms in multiple sclerosis (MS), as a chronic Immune-mediated neurodegenerative... more
Different research groups have extensively studied the associations of cytokine gene polymorphisms in different diseases. The role of cytokines gene polymorphisms in multiple sclerosis (MS), as a chronic Immune-mediated neurodegenerative disease, has been previously reported in the various populations. For determining pro-inflammatory cytokine gene polymorphisms, 100 relapsing remitting multiple sclerosis (RRMS) Iranian patients and 140 normal individuals as control enrolled in this study. DNA of each sample was extracted by a modified salting out method. Cytokine single gene nucleotide polymorphisms including IL-1alpha -889, IL-1beta (-511 and +3962), IL-1R pst1 1970, IL-1RA mspal 11100, and TNF-alpha (-308 and -238) were determined by using the PCR-SSP method. The results of our data indicate the decrease in frequency of IL-1alpha TC-889 genotype (p=0.002), IL-1beta TC +3962 genotype (p=0.004), IL-1R T pst1 1970 allele (p= 0.0001), IL-1 RA TC Mspa1 11100 genotype (p=0.009), TNF-al...
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Background: Mesenchymal stem cells (MSCs) with their potential to differentiate into mesodermal and non-mesodermal lineages have several immunomodulatory characteristics. These properties make them promising tools in cell and gene... more
Background: Mesenchymal stem cells (MSCs) with their potential to differentiate into mesodermal and non-mesodermal lineages have several immunomodulatory characteristics. These properties make them promising tools in cell and gene therapy. Objective: To evaluate the potential therapeutic applications of autologous MSC in improving clinical manifestations of MS patients. Methods: Ten patients were included in this pilot study. All had progressive disease that had not responded to disease modifying agents including Mitoxantrone. Their Expanded Disability Status Scale (EDSS) score ranged from 3.5 to 6. Patients were injected intrathecally with culture expanded MSCs. They were followed with monthly neurological assessment and a MRI scan at the end of the first year. Results: During 13 to 26 months of follow up (mean: 19 months), the EDSS of one patient improved from 5 to 2.5 score. Four patients showed no change in EDSS. Five patients’ EDSS increased from 0.5 to 2.5. In the functional s...
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Multiple sclerosis (MS) is the most frequent demyelinating disease of the central nervous system that makes different symptoms; the most disabling symptom of which is speech impairment that has significant effect on patients' quality... more
Multiple sclerosis (MS) is the most frequent demyelinating disease of the central nervous system that makes different symptoms; the most disabling symptom of which is speech impairment that has significant effect on patients' quality of life. The aim of this study was to investigate the frequency of speech impairment and its influential factors among Iranian patients afflicted with MS. Methods and Materials: The records of 4553 patients registered in Iranian MS Society between 1998 and 2005 were studied and 3165 of them with complete profiles about speech impairments were included. Analyzing the data, SPSS software version 15 was used. Results: Speech impairment was seen in 37.4% of patients. The frequency of this impairment was higher among male (P<0.001), unemployed (P<0.05), and with lower educational level patients (P<0.001). Also patients with speech impairment had a higher mean age (P<0.001). The frequency of patients with speech impairment in relapsing remitti...
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Human mesenchymal stem cell (MSC) can be isolated from bone marrow (BM) and differentiated into multiple lineages. These properties make them promising tools in cell and gene therapy. Up to now, no definite therapeutic intervention for... more
Human mesenchymal stem cell (MSC) can be isolated from bone marrow (BM) and differentiated into multiple lineages. These properties make them promising tools in cell and gene therapy. Up to now, no definite therapeutic intervention for late stages of multiple sclerosis (MS) has been found. We decided to inject MS patients with autologous expanded MSC. Five patients participated in this ongoing study. Patients were injected intrathecally with the culture expanded BM MSCs. Patients were followed monthly for their clinical status and every 3 months re¬garding their magnetic resonance imaging. During 7 months follow up, one patient improved 1.5 EDSS, two patients improved by 1 and 2 scores, and two others remained unchanged till now. The first MRI findings of patients showed no change. We can claim that the injection of expanded MSC is a safe procedure. Three patients showed some de¬gree of improvement and the other two had no progression. Patients should be followed for at least one ye...
Background-Multiple sclerosis (MS) is a multi-factorial disease with different epidemiological patterns and clinical presentations in various populations. Study of these different patterns can help us find the possible etiologic factors... more
Background-Multiple sclerosis (MS) is a multi-factorial disease with different epidemiological patterns and clinical presentations in various populations. Study of these different patterns can help us find the possible etiologic factors of this disease. Methods-Following announcement in two national newspapers inviting MS patients to participate in this study, 411 individuals responded. By taking a complete medical history and reviewing medical record documents such as magnetic resonance imaging (MRI), 318 patients were diagnosed with MS and were included in this study. Data was collected by a self-administered questionnaire, which was mailed to the patients. Results-The mean age in this group was 35.4±9.6 years (mean±SD) and the female:male ratio was 1.5:1. The average age of onset for this disease was 26.6±8.1 years (mean±SD). Sensory and visual disturbance were the most common initial presentations with a prevalence of 30.5% and 24.6%, respectively. Conclusion-Data analysis showe...
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Seventy multi-infarct dementia patients were randomized into an aspirin-treated group and an untreated control group for an exploratory investigation to determine any effects of 325 mg aspirin daily on cognitive performance. The control... more
Seventy multi-infarct dementia patients were randomized into an aspirin-treated group and an untreated control group for an exploratory investigation to determine any effects of 325 mg aspirin daily on cognitive performance. The control group did not receive placebo but evaluations were carried out in a blinded manner. The index group (N = 37, mean age 67.1 years) received 325 mg of aspirin by mouth once daily while the control group (N = 33, mean age 67.6 years) was followed and treated in a similar manner except that they received no aspirin. Both groups had comparable risk factors for stroke, which were treated similarly, as well as comparable initial cerebral blood flow values, as measured by the 133xenon inhalation method, and initial scores on Cognitive Capacity Screening Examination testing. Patients were evaluated at intervals of one year. Significant improvements were demonstrated for cerebral perfusion values (P less than .0001) and cognitive performance scores (P less tha...
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A number of pharmacological agents have recently become available that are capable of limiting or blocking calcium passage through cellular membrane channels. These drugs are termed calcium antagonists or calcium channel or calcium entry... more
A number of pharmacological agents have recently become available that are capable of limiting or blocking calcium passage through cellular membrane channels. These drugs are termed calcium antagonists or calcium channel or calcium entry blockers. Cell membranes of smooth muscle and nerve cells have several different calcium channels which may be selectively altered by calcium channel blockers [28, 29]. Since the cellular entry of calcium initiates contraction of vascular smooth muscle, calcium channel blockers exert both antispasmodic and slight vasodilator actions [6]. Calcium channels are susceptible to ischemia resulting in calcium entry with intracellular “overload”, which may be responsible for cell damage and eventually cell death [7, 26]. Calcium antagonists also exert protective actions against ischemic and anoxic damage to both nerve cells and smooth muscle.
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Despite updating knowledge and a growing number of medications for multiple sclerosis (MS), no definite treatment is available yet for patients suffering from progressive forms of the disease. Autologous bone marrow derived mesenchymal... more
Despite updating knowledge and a growing number of medications for multiple sclerosis (MS), no definite treatment is available yet for patients suffering from progressive forms of the disease. Autologous bone marrow derived mesenchymal stem cell (BM-MSC) transplantation is a promising method proposed as a therapy for MS. Although the safety of these cells has been confirmed in hematological, cardiac and inflammatory diseases, its efficacy in MS treatment is still under study. Patients with progressive MS (expanded disability status scale score: 4.0 –6.50) unresponsive to conventional treatments were recruited for this study. Twenty-five patients [f/m: 19/6, mean age: 34.7±7] received a single intrathecal injection of ex-vivo expanded MSCs (mean dose: 29.5×106 cells). We observed their therapeutic response for 12 months. Associated short-term adverse events of injection consisted of transient low-grade fever, nausea /vomiting, weakness in the lower limbs and headache. No major delaye...
Research Interests: Magnetic Resonance Imaging, Treatment Outcome, Medicine, Humans, Female, and 12 moreDrug Resistance, Male, Follow-up studies, Adult, Gadolinium, Fever, Disease Progression, Biochemistry and cell biology, Autoantigens, postoperative nausea and vomiting, Disease Free Survival, and Medical biochemistry and metabolomics
Background: Altitude illness results from hypobaric hypoxia at altitudes higher than 2500 meters above sea level. To determine whether vital signs can be used as predictors for severe acute mountain sickness, we carried out a prospective... more
Background: Altitude illness results from hypobaric hypoxia at altitudes higher than 2500 meters above sea level. To determine whether vital signs can be used as predictors for severe acute mountain sickness, we carried out a prospective observational study. ...
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Headache is the most prevalent symptom of acute mountain sickness. We conducted a pilot clinical trial at an altitude of 3500 m to evaluate the efficacy of gabapentin in treatment of high-altitude headache (HAH). Twenty-four adult HAH... more
Headache is the most prevalent symptom of acute mountain sickness. We conducted a pilot clinical trial at an altitude of 3500 m to evaluate the efficacy of gabapentin in treatment of high-altitude headache (HAH). Twenty-four adult HAH patients (10 female, 14 male; age 18–50 years) were randomly assigned to receive either 300 mg of gabapentin capsule or identical placebo. After 1 h the presence of HAH and need to receive supplementary analgesic were assessed. The duration of the HAH-free phase after taking additional analgesic was also registered. Four patients in the gabapentin group asked for additional analgesics, whereas nine placebo recipients did not find primary medication satisfactory after the first hour of treatment ( P = 0.04). The mean HAH-free period was 17.10 h in the gabapentin group, which was significantly higher than in the placebo group with a mean of 10.08 h ( P = 0.02). This preliminary observation indicates that gabapentin is effective in treatment and alleviati...
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The main purpose of this cross-sectional study was to compare the acceptance rate (AR) of left-handers (LHs) with that of right-handers (RHs) in the college entrance examination (CEE) for the national universities in Iran. During 5... more
The main purpose of this cross-sectional study was to compare the acceptance rate (AR) of left-handers (LHs) with that of right-handers (RHs) in the college entrance examination (CEE) for the national universities in Iran. During 5 successive years, fifty thousand ...
Research Interests: Cognitive Science, Intelligence, Handedness, Natural Science, Adolescent, and 15 moreIran, Humans, Female, Academic achievement, Male, Cortex, Aptitude, Guilt, Educational Status, Gifted Child, Cross sectional Study, Cross Sectional Studies, Neurosciences, Cerebral lateralization, and Functional Laterality
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... 2004;3:57. PERIPHERAL NEUROPATHY IN DIABETICS AND IT'S CONTRIBUTING FACTORS. Fargol BOYA 1 , Bagher LARIJANI 1 , Mohammad PAJOUHI 1 , Jamshid LOTFI 2 , Mohammad Mahdi NORAII 1 , Fatemeh BANDARIAN 1. ...
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High-altitude headache (HAH) is a hypobaric hypoxia-induced symptom that is commonly experienced by newcomers to high-altitude areas. To assess the efficacy of gabapentin in the prevention of HAH. A placebo-controlled randomised trial was... more
High-altitude headache (HAH) is a hypobaric hypoxia-induced symptom that is commonly experienced by newcomers to high-altitude areas. To assess the efficacy of gabapentin in the prevention of HAH. A placebo-controlled randomised trial was performed at an altitude of 3500 m. Two hundred and four unacclimatised 15-65-year-old (mean age (+/-SD), 31.5 (SD 11.7)) hotel guests were randomly assigned to a 600 mg single-dose of gabapentin capsule or identical placebo. HAH incidence and intensity were measured to assess gabapentin efficacy. Intention-to-treat analysis was performed. HAH incidence was not significantly different between subjects under gabapentin (44 (43.1%)) compared with placebo (56 (54.9%); p = 0.09). In contrast, moderate/severe HAH had a lower incidence in the gabapentin group (27 (26.5%)) versus the placebo group (42 (41.2%)), showing that gabapentin reduced HAH attack intensity (p = 0.03). Gabapentin was effective for the prevention of HAH and had satisfactory tolerability. ISRCTN26123577.
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1. Bladin PF: Dissecting aneurysm of carotid and vertebral arteries. Vasc Surg 8:203-223, 1974. 2. Ojemann RG, Fisher CM, Rich JC: Sponta-neous dissecting aneurysm of the internal carotid artery. Stroke 3:434-440, 1972. 3. Roome NS,... more
1. Bladin PF: Dissecting aneurysm of carotid and vertebral arteries. Vasc Surg 8:203-223, 1974. 2. Ojemann RG, Fisher CM, Rich JC: Sponta-neous dissecting aneurysm of the internal carotid artery. Stroke 3:434-440, 1972. 3. Roome NS, Aberfeld DC: Spontaneous ...