Objective: To assess the efficacy and safety of Melissa officinalis extract using a fixed dose (60 drops/day) in patients with mild to moderate Alzheimer's disease. Design: A four month, parallel group, placebo controlled trial undertaken in three centres in Tehran, Iran. Methods: Patients with mild to moderate Alzheimer's disease aged between 65 and 80 years (n = 42; 18 women, 24 men) with a score of > 12 on the cognitive subscale of Alzheimer's disease assessment scale (ADAS-cog) and < 2 on the clinical dementia rating (CDR) were randomised to placebo or fixed dose of Melissa officinalis extract. The main efficacy measures were the change in the ADAS-cog and CDR-SB scores compared with baseline. Side effects were systematically recorded. Results: At four months, Melissa officinalis extract produced a significantly better outcome on cognitive function than placebo (ADAS-cog: df = 1, F = 6.93, p = 0.01; CDR: df = 1, F = 16.87, p < 0.0001). There were no significant differences in the two groups in terms of observed side effects except agitation, which was more common in the placebo group (p = 0.03). Conclusions: Melissa officinalis extract is of value in the management of mild to moderate Alzheimer's disease and has a positive effect on agitation in such patients.

Summary Background:  Alzheimer's disease is characterized by a slow, progressive decline in cognitive function and behaviour. Acetylcholine esterase inhibitors are the only agents approved by the Food and Drug Administration for the treatment of Alzheimer's disease. All other agents prescribed for the treatment of Alzheimer's disease are used on an off‐label basis. Current research into new drugs is focused on agents that will prevent, slow down and/or halt the progress of the disease process. Savia officinalis has been used in herbal medicine for many centuries. It has been suggested, on the basis of traditional medicine, its in vitro cholinergic binding properties and modulation of mood and cognitive performance in humans, that Salvia officinalis might potentially provide a novel natural treatment for Alzheimer's disease. The objective of this study was to assess the efficacy and safety of Salvia officinalis extract using a fixed dose (60 drops/day), in patients with mild to moderate Alzheimer's disease, over a 4‐month period. Methods:  This was a 4‐month, parallel group, placebo‐controlled trial undertaken in three centres in Tehran, Iran. Patients with mild to moderate Alzheimer's disease aged between 65 and 80 years (n = 42, 18 women) with a score of ≥12 on the cognitive subscale of Alzheimer's Disease Assessment Scale (ADAS‐cog) and ≤2 on the Clinical Dementia Rating (CDR) were randomized to placebo or fixed dose of S. officinalis extract. Over the 16 weeks, the main efficacy measures were the change in the ADAS‐cog and CDR‐Sum of Boxes scores compared with baseline. In addition, side‐effects were systematically recorded throughout the study using a checklist. Results:  At 4 months, S. officinalis extract produced a significant better outcome on cognitive functions than placebo (ADAS‐cog: F = 4·77, d.f. = 1, P = 0·03) (CDR‐SB: F = 10·84, d.f. = 1, P < 0·003). There were no significant differences in the two groups in terms of observed side‐effects except agitation that appears to be more frequent in the placebo group (P = 0·09). Conclusions:  The results of this study indicate the efficacy of S. officinalis extract in the management of mild to moderate Alzheimer's disease. Moreover, S. officinalis may well reduce agitation of patients but this needs to be confirmed.

The results suggest that a substantial burden of psychiatric morbidity exists in the prison population of Iran, with treatment challenges that appear to be different from those observed in inmates in Western countries.

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Quantitative electroencephalography (qEEG) has been used as a tool for neurophysiologic diagnostic. We used spectrogram and coherence values for evaluating qEEG in 17 children (13 boys and 4 girls aged between 6 and 11) with autism disorders (ASD) and 11 control children (7 boys and 4 girls with the same age range). Evaluation of qEEG with statistical analysis demonstrated that alpha frequency band (8-13 Hz) had the best distinction level of 96.4% in relaxed eye-opened condition using spectrogram criteria. The ASD group had significant lower spectrogram criteria values in left brain hemisphere, (p < 0.01) at F3 and T3 electrodes and (p < 0.05) at FP1, F7, C3, Cz and T5 electrodes. Coherence values at 171 pairs of EEG electrodes indicated that there are more abnormalities with higher values in the connectivity of temporal lobes with other lobes in gamma frequency band (36-44 Hz).

Background: Postoperative cognitive decline is a common complication observed frequently after general anesthesia in the immediate postoperative phase. We studied the effects of dexmedetomidine versus midazolam during coronary artery bypass graft (CABG) surgery on cognitive and memory function.  Methods: In this clinical trial, 42 elective on-pump CABG candidates under general anesthesia, aged between 40 and 65 years, were enrolled randomly in 2 groups. Group A received 0.05–0.1 mg/kg of midazolam and Group B received 1 µg/kg of dexmedetomidine. One day before surgery, all the participants underwent the Persian version of the Mini-Mental State Examination (MMSE) and the Persian version of the Wechsler Memory Scale (WMS) test for a comparison of cognitive impairment and memory functions. Both groups were given fentanyl and propofol for the induction of anesthesia and muscle relaxants. The MMSE and WMS tests were repeated 5 and 30 days after surgery. Results: The mean±SD of age was 55.47±7.18 y in Group A and 55.39±6.08 y in Group B. Eighty percent of the participants were men in both groups. There were no significant differences between Group A and Group B in the MMSE and WMS before surgery (89.04±14.30 vs. 97.10±18.10, respectively;  P=0.059), but the WMS was significantly different 30 days after surgery (87.60±14.30 vs. 103.53±19.93, respectively; P=0.005). Group A showed high cognitive impairment and low WMS scores compared with Group B (P=0.005). Additionally, the MMSE results were not statistically different between the 2 groups postoperatively (24.80±3.18 vs. 23.55±4.18, respectively; P=0.394). Conclusion: Our results showed that dexmedetomidine might have a lower impact on cognitive function than might midazolam among patients undergoing CABG.   J Teh Univ Heart Ctr 2019;14(2):67-73   This paper should be cited as: Rajaei M, Tabari M, Soltani G, Alizadeh K, Nazari A, Noroozian M, Morovatdar N. Dexmedetomidine and Midazolam on Postoperative Cognitive Impairment after Coronary Artery Bypasses Graft Surgery: A Randomized Clinical Trial. J Teh Univ Heart Ctr 2019;14(2):67-73.

An important challenge in measuring whole brain activation is to develop a measure that could distinguish between normal and abnormal mood states. The application of chaos theory and non-linear dynamics to problems in biological sciences has resulted in a growing body of advancements and the notion of brain as a complex, non-linear system has attracted physicists, mathematicians, biologists and psychologists alike. To search for a correlation between alterations in chaotic brain states and mood disorders, we compared the fractal dimension of the electroencephalographic (EEG) signal in patients going through a manic episode of bipolar mood disorder (BMD) type I to a control group of healthy adults and showed that the EEG fractal dimension is significantly augmented in our patients. Thus, for the first time, we draw a clear objective distinction between normal and abnormal mood and associated brain states.

Caregiver burden was proposed as the strongest adjusted predictor for caregivers' poor QOL. Therefore, it seems that interventions to reduce caregiver burden can be effective in enhancing caregivers' QOL.