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Dual-Hemisphere Repetitive Transcranial
Magnetic Stimulation for Rehabilitation of
Poststroke Aphasia: A Randomized, Double-
Blind Clinical Trial

Research Abstract
Background. Recent neuroimaging studies on poststroke aphasia revealed maladaptive cortical changes in both hemispheres, yet their functional contribution in language recovery remains elusive. The aim of this study was to evaluate the long-term efficacy of dual-hemisphere repetitive transcranial magnetic stimulation (rTMS) on poststroke aphasia. Methods. Thirty patients with subacute poststroke nonfluent aphasia were randomly allocated to receive real or sham rTMS. Each patient received 1000 rTMS pulses (1 Hz at 110% of resting motor threshold [rMT] over the right unaffected Broca’s area and 1000 pulses (20 Hz at 80% rMT) over the left affected Broca’s area for 10 consecutive days followed by speech/language training. The language section of the Hemispheric Stroke Scale (HSS), the Stroke Aphasic Depression Questionnaire–Hospital Version (SADQ-H), and the National Institutes of Health Stroke Scale (NIHSS) were measured before, immediately after the 10 sessions, and 1 and 2 months after the last session. Results. At baseline, there were no significant differences between groups in demographic and clinical rating scales. However, there was a significantly greater improvement in the HSS language score as well as in the SADQ-H after real rTMS compared with sham rTMS, which remained significant 2 months after the end of the treatment sessions. Conclusion. This is the first clinical study of dual-hemisphere rTMS in poststroke aphasia. Combining dual-hemisphere rTMS with language training might be a feasible treatment for nonfluent aphasia; further multicenter studies are needed to confirm this result.
Research Authors
Eman M. Khedr, MD1, Noha Abo El-Fetoh, MD1, Anwer M. Ali, MD1,
Dina H. El-Hammady, MD2, Hosam Khalifa, MD1, Haisam Atta, MD3,
and Ahmed A. Karim, PhD4,5
Research Journal
Neurorehabilitation and Neural Repair
Research Pages
NULL
Research Publisher
NULL
Research Rank
1
Research Vol
NULL
Research Website
NULL
Research Year
2014

Dual-Hemisphere Repetitive Transcranial
Magnetic Stimulation for Rehabilitation of
Poststroke Aphasia: A Randomized, Double-
Blind Clinical Trial

Research Abstract
Background. Recent neuroimaging studies on poststroke aphasia revealed maladaptive cortical changes in both hemispheres, yet their functional contribution in language recovery remains elusive. The aim of this study was to evaluate the long-term efficacy of dual-hemisphere repetitive transcranial magnetic stimulation (rTMS) on poststroke aphasia. Methods. Thirty patients with subacute poststroke nonfluent aphasia were randomly allocated to receive real or sham rTMS. Each patient received 1000 rTMS pulses (1 Hz at 110% of resting motor threshold [rMT] over the right unaffected Broca’s area and 1000 pulses (20 Hz at 80% rMT) over the left affected Broca’s area for 10 consecutive days followed by speech/language training. The language section of the Hemispheric Stroke Scale (HSS), the Stroke Aphasic Depression Questionnaire–Hospital Version (SADQ-H), and the National Institutes of Health Stroke Scale (NIHSS) were measured before, immediately after the 10 sessions, and 1 and 2 months after the last session. Results. At baseline, there were no significant differences between groups in demographic and clinical rating scales. However, there was a significantly greater improvement in the HSS language score as well as in the SADQ-H after real rTMS compared with sham rTMS, which remained significant 2 months after the end of the treatment sessions. Conclusion. This is the first clinical study of dual-hemisphere rTMS in poststroke aphasia. Combining dual-hemisphere rTMS with language training might be a feasible treatment for nonfluent aphasia; further multicenter studies are needed to confirm this result.
Research Authors
Eman M. Khedr, MD1, Noha Abo El-Fetoh, MD1, Anwer M. Ali, MD1,
Dina H. El-Hammady, MD2, Hosam Khalifa, MD1, Haisam Atta, MD3,
and Ahmed A. Karim, PhD4,5
Research Journal
Neurorehabilitation and Neural Repair
Research Member
Research Pages
NULL
Research Publisher
NULL
Research Rank
1
Research Vol
NULL
Research Website
NULL
Research Year
2014

Epidemiological Study and Clinical Profile of Parkinson’s Disease in the Assiut Governorate, Egypt: A Community-Based Study

Research Abstract
Background: Few comprehensive epidemiological studies of the prevalence of Parkinson’s disease (PD) have been undertaken in Arab countries, and none has been carried out in Egypt. A community-based survey was conducted in the Assiut Governorate to estimate the prevalence and clinical profile of PD. Methods: A community-based study was carried out, with random sampling of 7 districts, involving 6,498 inhabitants. Out of this sample, 578 subjects dropped out, leaving 3,066 males (51.8%) and 2,854 females (48.2%). There were 3,660 urban residents (61.8%) and 2,260 (38.2%) from the rural community. Patients were evaluated using a screening questionnaire, the Unified Parkinson Disease Rating Scale and the Non-Motor Symptoms Scale for PD. Results: Thirty-nine subjects were found to have parkinsonism, giving a crude prevalence rate of 659/100,000 inhabitants. Of these subjects, 33 were diagnosed with PD (21 males), with a mean age of 66.9 8 8.4 years, a crude prevalence rate of 557/100,000 and an age-specific prevalence rate ( 6 50 years old) of 2,748/100,000. There were more males than females (3,395 vs. 1,989/100,000), but the difference was not signifi-cant. The highest age-specific prevalence rate was recorded among subjects 70–79 years old (7,263/100,000). There was a significantly higher prevalence among rural than urban inhabitants (973 vs. 301/100,000) and among illiterate than literate persons (1,103 vs. 280/100,000). The clinical profile of our patients was similar to that of other populations but was characterized by a high prevalence of mood/cognition dysfunction and gastrointestinal symptoms; there were few reported perceptual problems. Conclusion: The overall prevalence of PD was high, especially in older adults.
Research Authors
Eman M. Khedr a Ghada S. Al Attar b Mahmoud R. Kandil a Nageh F. Kamel a
Noha Abo Elfetoh a Mohamed A. Ahmed a
Research Journal
Neuroepidemiology
Research Member
Research Pages
pp. 154–163
Research Publisher
NULL
Research Rank
1
Research Vol
Vol. 38
Research Website
NULL
Research Year
2012

Epidemiological Study and Clinical Profile of Parkinson’s Disease in the Assiut Governorate, Egypt: A Community-Based Study

Research Abstract
Background: Few comprehensive epidemiological studies of the prevalence of Parkinson’s disease (PD) have been undertaken in Arab countries, and none has been carried out in Egypt. A community-based survey was conducted in the Assiut Governorate to estimate the prevalence and clinical profile of PD. Methods: A community-based study was carried out, with random sampling of 7 districts, involving 6,498 inhabitants. Out of this sample, 578 subjects dropped out, leaving 3,066 males (51.8%) and 2,854 females (48.2%). There were 3,660 urban residents (61.8%) and 2,260 (38.2%) from the rural community. Patients were evaluated using a screening questionnaire, the Unified Parkinson Disease Rating Scale and the Non-Motor Symptoms Scale for PD. Results: Thirty-nine subjects were found to have parkinsonism, giving a crude prevalence rate of 659/100,000 inhabitants. Of these subjects, 33 were diagnosed with PD (21 males), with a mean age of 66.9 8 8.4 years, a crude prevalence rate of 557/100,000 and an age-specific prevalence rate ( 6 50 years old) of 2,748/100,000. There were more males than females (3,395 vs. 1,989/100,000), but the difference was not signifi-cant. The highest age-specific prevalence rate was recorded among subjects 70–79 years old (7,263/100,000). There was a significantly higher prevalence among rural than urban inhabitants (973 vs. 301/100,000) and among illiterate than literate persons (1,103 vs. 280/100,000). The clinical profile of our patients was similar to that of other populations but was characterized by a high prevalence of mood/cognition dysfunction and gastrointestinal symptoms; there were few reported perceptual problems. Conclusion: The overall prevalence of PD was high, especially in older adults.
Research Authors
Eman M. Khedr a Ghada S. Al Attar b Mahmoud R. Kandil a Nageh F. Kamel a
Noha Abo Elfetoh a Mohamed A. Ahmed a
Research Journal
Neuroepidemiology
Research Pages
pp. 154–163
Research Publisher
NULL
Research Rank
1
Research Vol
Vol. 38
Research Website
NULL
Research Year
2012

Epidemiological Study and Clinical Profile of Parkinson’s Disease in the Assiut Governorate, Egypt: A Community-Based Study

Research Abstract
Background: Few comprehensive epidemiological studies of the prevalence of Parkinson’s disease (PD) have been undertaken in Arab countries, and none has been carried out in Egypt. A community-based survey was conducted in the Assiut Governorate to estimate the prevalence and clinical profile of PD. Methods: A community-based study was carried out, with random sampling of 7 districts, involving 6,498 inhabitants. Out of this sample, 578 subjects dropped out, leaving 3,066 males (51.8%) and 2,854 females (48.2%). There were 3,660 urban residents (61.8%) and 2,260 (38.2%) from the rural community. Patients were evaluated using a screening questionnaire, the Unified Parkinson Disease Rating Scale and the Non-Motor Symptoms Scale for PD. Results: Thirty-nine subjects were found to have parkinsonism, giving a crude prevalence rate of 659/100,000 inhabitants. Of these subjects, 33 were diagnosed with PD (21 males), with a mean age of 66.9 8 8.4 years, a crude prevalence rate of 557/100,000 and an age-specific prevalence rate ( 6 50 years old) of 2,748/100,000. There were more males than females (3,395 vs. 1,989/100,000), but the difference was not signifi-cant. The highest age-specific prevalence rate was recorded among subjects 70–79 years old (7,263/100,000). There was a significantly higher prevalence among rural than urban inhabitants (973 vs. 301/100,000) and among illiterate than literate persons (1,103 vs. 280/100,000). The clinical profile of our patients was similar to that of other populations but was characterized by a high prevalence of mood/cognition dysfunction and gastrointestinal symptoms; there were few reported perceptual problems. Conclusion: The overall prevalence of PD was high, especially in older adults.
Research Authors
Eman M. Khedr a Ghada S. Al Attar b Mahmoud R. Kandil a Nageh F. Kamel a
Noha Abo Elfetoh a Mohamed A. Ahmed a
Research Journal
Neuroepidemiology
Research Pages
pp. 154–163
Research Publisher
NULL
Research Rank
1
Research Vol
Vol. 38
Research Website
NULL
Research Year
2012

Epidemiological Study and Clinical Profile of Parkinson’s Disease in the Assiut Governorate, Egypt: A Community-Based Study

Research Abstract
Background: Few comprehensive epidemiological studies of the prevalence of Parkinson’s disease (PD) have been undertaken in Arab countries, and none has been carried out in Egypt. A community-based survey was conducted in the Assiut Governorate to estimate the prevalence and clinical profile of PD. Methods: A community-based study was carried out, with random sampling of 7 districts, involving 6,498 inhabitants. Out of this sample, 578 subjects dropped out, leaving 3,066 males (51.8%) and 2,854 females (48.2%). There were 3,660 urban residents (61.8%) and 2,260 (38.2%) from the rural community. Patients were evaluated using a screening questionnaire, the Unified Parkinson Disease Rating Scale and the Non-Motor Symptoms Scale for PD. Results: Thirty-nine subjects were found to have parkinsonism, giving a crude prevalence rate of 659/100,000 inhabitants. Of these subjects, 33 were diagnosed with PD (21 males), with a mean age of 66.9 8 8.4 years, a crude prevalence rate of 557/100,000 and an age-specific prevalence rate ( 6 50 years old) of 2,748/100,000. There were more males than females (3,395 vs. 1,989/100,000), but the difference was not signifi-cant. The highest age-specific prevalence rate was recorded among subjects 70–79 years old (7,263/100,000). There was a significantly higher prevalence among rural than urban inhabitants (973 vs. 301/100,000) and among illiterate than literate persons (1,103 vs. 280/100,000). The clinical profile of our patients was similar to that of other populations but was characterized by a high prevalence of mood/cognition dysfunction and gastrointestinal symptoms; there were few reported perceptual problems. Conclusion: The overall prevalence of PD was high, especially in older adults.
Research Authors
Eman M. Khedr a Ghada S. Al Attar b Mahmoud R. Kandil a Nageh F. Kamel a
Noha Abo Elfetoh a Mohamed A. Ahmed a
Research Journal
Neuroepidemiology
Research Member
Research Pages
pp. 154–163
Research Publisher
NULL
Research Rank
1
Research Vol
Vol. 38
Research Website
NULL
Research Year
2012

Prevalence of Diabetes and Diabetic Neuropathy in Qena Governorate: Population-Based Survey

Research Abstract
Background: No previous study was done to estimate the prevalence of diabetic neuropathy (DN) in Arabic countries. The aim of this study was to estimate the prevalence of DN and its characteristics in Qena governorate. Material and Methods: This is a random sampling of 10 study areas, involving 9,303 inhabitants; 51.1% men and 48.9% women were recruited. There were 57.3% urban residents and 42.7% rural residents. Patients were diagnosed using a screening questionnaire for diabetes mellitus (DM) as well as for DN in addition to measuring blood sugar in suspected cases. All positive cases were referred to Qena University Hospital and were subjected to full clinical, electrophysiological and laboratory investigations. Results: Out of 9,303 people screened, 837 were diabetic giving prevalence 8.99% of the population. Eight hundred eleven had type II DM and 26 cases had type I giving prevalence of 8.7 and 0.3%, respectively. One hundred fifty-five out of 837 (18.5%) diabetic patients had evidence of DN with prevalence rate being 1.7% of the total
Research Authors
Eman M. Khedr a Gharib Fawi c Mohammed Abd Allah Abbas d
Research Journal
Neuroepidemiology
Research Member
Research Pages
NULL
Research Publisher
NULL
Research Rank
1
Research Vol
NULL
Research Website
NULL
Research Year
2015

Prevalence of Mild Cognitive Impairment and Dementia among the Elderly Population of Qena Governorate, Upper Egypt:
A Community-Based Study

Research Abstract
Background: There are only a few reports which provide prevalence rates of mild cognitive impairment (MCI) and dementia specifically in Arabic countries. Objective: This study is aimed at estimating the prevalence of MCI and dementia among subjects aged ≥60 years using door-to-door survey in Qena Governorate/Egypt. Methods: We conducted a door-to-door survey with multistage probability random sampling. Screening of all subjects aged ≥60 years (n = 691) employed a simple questionnaire including changes in memory, behavior, and daily activity, Memory and Executive Screening test (MES) as well as the Mini-Mental State Examination. Suspected cases were referred to the hospital for full clinical examination, DSM-IV diagnostic criteria, Hachinski Ischemic Score, neuroimaging, and laboratory investigations if indicated. Results: Of the 691 participants, 12 cases had MCI, giving a crude prevalence rate (CPR) of 1.74/100 and 35 were identified as positive for dementia with a CPR of 5.07/100. The highest age-specific prevalence rates were recorded among subjects ≥85 years old (100/100). The CPRs were significantly higher in urban than rural areas (7.1 versus 3.27/100, respectively; p = 0.03), in industrial areas than non-industrial areas (13.23 versus 1.99; p = 0.00001), and in illiterate than literate participants (10.12 versus 2.25/100; p = 0.00001). Conclusion: Overall, the prevalence rate of MCI and dementia were lower in Qena/Egypt than in other countries. Advanced age, illiteracy, and living in an industrial area were found to be associated with dementia.
Research Authors
Eman Khedra,∗, Gharib Fawib, Mohammed Abd Allah Abbasc, Talal A. Mohammedc, Noha Abo El-Fetoha, Ghada Al Attard, Mostafa Noamana and Ahmed F. Zakic
Research Journal
Journal of Alzheimer’s Disease
Research Member
Research Pages
pp. 117–126
Research Publisher
NULL
Research Rank
1
Research Vol
Vol. 45
Research Website
NULL
Research Year
2015

A double-blind randomized clinical trial on the efficacy of
cortical direct current stimulation for the treatment of
Alzheimer’s disease.

Research Abstract
NULL
Research Authors
Eman M. Khedr 1*, Nageh F. El Gamal1, Noha Abo El-Fetoh1, Hosam Khalifa1, Elham M. Ahmed1,
Anwer M. Ali 1, Mostafa Noaman1, Ahmed Abd El-Baki 1 and Ahmed A. Karim2,3
Research Journal
CLINICALTRIAL ARTICLE
Research Pages
NULL
Research Publisher
NULL
Research Rank
1
Research Vol
NULL
Research Website
NULL
Research Year
2015

A double-blind randomized clinical trial on the efficacy of
cortical direct current stimulation for the treatment of
Alzheimer’s disease.

Research Abstract
NULL
Research Authors
Eman M. Khedr 1*, Nageh F. El Gamal1, Noha Abo El-Fetoh1, Hosam Khalifa1, Elham M. Ahmed1,
Anwer M. Ali 1, Mostafa Noaman1, Ahmed Abd El-Baki 1 and Ahmed A. Karim2,3
Research Journal
CLINICALTRIAL ARTICLE
Research Pages
NULL
Research Publisher
NULL
Research Rank
1
Research Vol
NULL
Research Website
NULL
Research Year
2015
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