Background: Neuro-Behcet’s disease (NBD) is similar to multiple sclerosis (MS) in multiple aspects. This study was conducted to investigate the sensitivity, specificity, accuracy, positive and negative predictive values for the 2005 revised McDonald MRI criteria for the diagnosis of MS and NBD. Methods: This study enrolled 28 consecutive patients with a diagnosis of NBD and 48 patients with a diagnosis of clinically definite MS, who were referred to the Nemazee Hospital, Shiraz University of Medical Sciences, between March 2009 and March 2010. Brain and spinal cord magnetic resonance imaging (MRI) were obtained. Two Radiologists, blinded to clinical diagnosis, reviewed the MRI. We investigated the sensitivity, specificity, accuracy, and positive and negative predictive values of the 2005 revision of the McDonald criteria for dissemination in space for the diagnosis of MS and NBD. Results: There were a total of 10 men and 38 women with a mean age of 32.76±7.5 years, with a diagnosis of MS, and 18 men and 10 women with a mean age of 26.8±5.9 years with a diagnosis of parenchymal NBD. The interobserver agreement for the diagnosis of MS using the 2005 revision of the McDonald criteria for dissemination in space with the use of the Cohen kappa scores was 0.82. The sensitivity, specificity, accuracy, and positive and negative predictive values were 80%, 61%, 71.5%, 77% and 64%, respectively. Conclusion: The accuracy and specificity of the McDonald criteria for dissemination in space for the differentiation of MS and NBD are not optimal.

OBJECTIVE: Deficits in olfactory function are common features in neurodegenerative and neuropsychiatric disorders. Olfactory processing is related to dopamine metabolism and orbitofrontal cortex functioning, both known to be involved in the neurobiology of ADHD. Some investigations suggested alterations in olfactory processing (identification and detection threshold) in patients with ADHD. Despite increasing knowledge, controversy about this topic still exists regarding children with ADHD. This study was conducted to help elucidate some of this controversy. METHODS: 50 participants (8-15 years, mean=10.70+/-1.77) with ADHD were compared to 50 controls. The two groups were well matched for age, gender and Mean School Scores (MSS). We assessed odor identification and threshold through a smell test composed of two tests of identification and detection threshold. Odor detection threshold was assessed with the odorant phenyl ethyl alcohol solved in propylene glycol using a single staircase method. Odor identification was assessed with chemical essences of five common odorants. RESULTS: The mean Sensory Identification Score for children with ADHD and the control groups were 3.76 (1.06) and 4.46 (0.76), respectively (p<0.001). The mean for Sensory Threshold Score for ADHD and control group was 6.4 (3.35) and 9.75 (2.16), respectively (p<0.001). CONCLUSION: This study replicated altered olfactory performance in ADHD. Substantial olfactory deficits across the two domains of identification and detection threshold are observed in children with ADHD. These deficits do not seem to be a result of olfactory task difficulty and are not influenced by age, gender and MSS. Further studies are required to investigate whether olfactory function can be used as a biological marker for early diagnosis, treatment and prognosis of ADHD.
Alkenes ; Attention Deficit Disorder with Hyperactivity ; Biomarkers ; Child ; Dopamine ; Early Diagnosis ; Ethanol ; Humans ; Neurobiology ; Odors ; Prognosis ; Propylene Glycol ; Sensory Thresholds ; Smell