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Background Coronavirus infection is a novel respiratory disease affecting people across the world. Although the majority of patients present with fever, dyspnea, cough, or myalgia, various signs and symptoms have been reported for this disease. Recently, neurological symptoms have been noticed in patients with COVID-19 with unknown etiology. However, the occurrence of strokes in young and middle aged patients with COVID-19 is not fully explained. Methods In this series, six patients younger than 55 years of age with diagnosis of stroke and a confirmed diagnosis of COVID-19 were evaluated for symptoms, lab data, imaging findings, and outcomes from March 2020 to the end of April 2020 from all stroke cases in a tertiary academic hospital. Patients older than 55 and all others who had evidence of cardiac abnormalities (arrhythmia/valvular) were excluded. Results Fever, myalgia, cough, and dyspnea were the most common clinical symptoms noted in 66.66% (4/6), 66.66% (4/6), 50% (3/6), and 50% (3/6) of the patients, respectively. The mean ± standard deviation (SD) of National Institutes of Health Stroke Scale (NIHSS) for the patient was 10.16 ± 7.13 (ranged 5-24). The most involved area was middle cerebral artery (MCA) (five in MCA versus one in basal ganglia) and the majority of our patients had a low lung involvement score (mean ± SD: 13.16 ± 6.49 out of 24). Finally, one patient was deceased and rest discharged. Conclusion Stroke may be unrelated to age and the extent of lung involvement. However, different factors may play roles in cooccurrence of stroke and COVID-19 and its outcome. Future studies with long-term follow-up and more cases are needed to assess prognostic factors.

Aim of the study Parkinson's disease is associated with iron deposition in the brain. The QSM (quantitative susceptibility mapping) is more sensitive than T2-weighted imaging, T2* and R2. Few studies have been used QSM to evaluate the iron in the basal ganglia of patients with Parkinson's disease. Our aim was to evaluate the iron deposition in the basal ganglia using QSM and determination of diagnostic value of this method and evaluation of the association between disease stage with QSM and age with QSM in all nuclei, separately. Materials and methods Thirty patients were tested using Hoehn and Yahr test in three different stages. Fifteen healthy subjects were considered as control group. MRI sequences were performed using SIEMENS 3 T scanner.The Signal Processing in NMR software was used to process and analyze the images. The QSM in every of the basal ganglia was measured separately. Results There was a significant difference for QSM in the Subtania Nigera, Red Nucleus, Thalamic Nucleus and Globus Pallidus nucleus between two groups. The relationship between disease stage with QSM was significant in Subtania Nigera, Red Nucleus, and Globus Pallidus nucleus. The QSM values had a significant association with disease stage in all nuclei. The results showed that QSM has a higher accuracy in Subtania Nigera, Globus Pallidus, Red Nucleus and Thalamic Nucleus, respectively. Conclusions Using QSM in Red Nucleus, Subtania Nigera, and Globus Pallidus nuclei can help diagnosis and staging the patients with Parkinson's disease. In future, studies with emphasis on the disease stage can be helpful in evaluation the different parts of these three nuclei.

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Background: COVID-19 has been associated with several neurological complications. One of these complications is transverse myelitis. Several cases of acute transverse myelitis are reported in association with this disease among the world. As there is lack of knowledge about the association of COVID-19 and myelitis and the clinical features of this complication are still ambiguous, we report two patients with transverse myelitis following COVID-19 infection. Patients: This study was performed in a referral center of COVID-19 in Iran(Shohada Tajrish hospital) and two patients with paraparesis and diagnosis of transverse myelitis were enrolled. Both patients had longitudinally extensive transverse myelitis that resulted in paraparesis. One of the patients had favorable outcome after treatment with plasma exchange but the other had no improvement following treatment.Conclusion: Transverse myelitis could be a complication of COVID-19 and infarction and inflammation could be suggested as probable mechanisms for this condition.

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Background: MLC601 is a possible modulator of amyloid precursor protein processing, and in a clinical trial study MLC601 showed some effectiveness in cognitive function in Alzheimer's disease (AD) patients. We aimed to evaluate the effectiveness and safety of MLC601 in the treatment of mild to moderate AD as compared to 3 approved cholinesterase inhibitors (ChEIs) including donepezil, rivastigmine and galantamine. Methods: In a multicenter, nonblinded, randomized controlled trial, 264 volunteers with AD were randomly divided into 4 groups of 66; groups 1, 2, 3 and 4 received donepezil, rivastigmine, MLC601 and galantamine, respectively. Subjects underwent a clinical diagnostic interview and a cognitive/functional battery including the Mini-Mental State Examination (MMSE) and Alzheimer's Disease Assessment Scale - Cognitive subscale (ADAS-Cog). Patients were visited every 4 months, and the score of cognition was recorded by the neurologists. Results: There were no significant differences in age, sex, marital status and baseline score of cognition among the 4 groups. In total, 39 patients (14.7%) left the study. Trend of cognition changes based on the modifications over the time for MMSE and ADAS-cog scores did not differ significantly among groups (p = 0.92 for MMSE and p = 0.87 for ADAS-Cog). Conclusion: MLC601 showed a promising safety profile and also efficacy compared to 3 FDA-approved ChEIs.