Showing papers in "The Egyptian Journal of Neurology, Psychiatry and Neurosurgery in 2015"

Quantitative EEG in autistic children

Abstract: Background Autism spectrum disorder is a neurodevelopmental disorder that is characterized mainly by difficulties in social interaction and communication. Studies have suggested abnormal neural connectivity patterns in the brains of patients with autism. Objective The current work aimed to study the quantitative electroencephalography (EEG) findings in autistic children and compare it with those of normal controls. Methods The EEG recordings of 21 autistic children between 4 and 12 years of age were compared with those of 21 age-matched and sex-matched controls under an eyes-opened condition. Differences in cerebral functioning were examined using measurements of absolute and relative power and intrahemispheric and interhemispheric coherence. Results There were statistically significant differences in EEG power between the autistic and control groups, with greater absolute of delta and theta power especially at the frontal region in autistic children. There was also global reduction in relative alpha and beta power especially in the frontal, central, and posterior regions in autistic children. In addition, there was a pattern of underconnectivity and overconnectivity when measuring the intrahemispheric and interhemispheric coherence in the autistic compared with the control group. Conclusion These results suggested regional dysfunction of the brain in autistic children, along with a pattern of abnormal neural connectivity, which could explain the autistic symptomatology.

Assessment of precipitating factors of breakthrough seizures in epileptic patients

Abstract: Background The prevalence of breakthrough seizures is estimated to occur in 39-75.3% of epileptic patients in developing countries. Patients and physicians should be aware of the possible precipitating factors of breakthrough seizures to prevent their occurrence. Objective The aim of this study was to determine the precipitating factors for breakthrough seizures in patients attending Cairo University Hospital. Methods This cross-sectional study included 90 epileptic patients with idiopathic epilepsy receiving antiepileptic drugs (AEDs). They were divided into two groups. Group I included 55 epileptic patients with a history of recent breakthrough seizures. Group II included 35 epileptic patients who had not experienced any recent breakthrough seizures. Patients with breakthrough seizures were subjected to a thorough questionnaire addressing precipitating factors. All participants were subjected to an electroencephalogram (EEG) and the Morisky Medication Adherence Scale. Results Missed doses (56.4%) represented the most frequent reported precipitating factor, followed by sleep deprivation (36.4%) and psychological stress (34.5%). The patients in group I were found to have lower durations of seizure control, adherence to AEDs, and were more frequently on AED polytherapy than the participants in group II. In terms of the EEG, group I showed a higher percentage of abnormal EEGs and more frequent focal epileptiform discharges. No significant difference was found in age or sex, age at onset of epilepsy, duration of disease, and type of seizures between both groups. Conclusion Patients and their caregivers should be educated about these possible precipitating factors to achieve better control of epilepsy.

The influence of physical therapy on oropharyngeal dysphagia in acute stroke patients

Abstract: Background Dysphagia occurs in 65% of acute stroke patients, resulting in airway obstruction, malnutrition, and chest infection. Objective The aim of this study was to evaluate the effect of a designed physical therapy program that consists of therapeutic physical exercises in addition to neuromuscular electrical stimulation on severe swallowing disorders (oropharyngeal dysphagia) in acute ischemic cerebrovascular stroke patients. Methods Thirty stroke patients suffering from severe dysphagia were assigned randomly to two equal groups: the study group (G1) and the control group (G2). The patients in the study group (G1) received medical treatment in addition to a designed physical therapy program mainly directed at strengthening and stimulating the elevator muscles of the larynx above and below the hyoid bone, whereas the patients in the control group (G2) were under medical treatment only. Digital fluoroscopy was used to assess the following variables: oral transit time, laryngeal elevation, hyoid elevation, esophageal sphincter opening, and aspiration or penetration. Assessment was carried out before and at the end of treatment after 6 weeks. Results Before treatment, there were no significant differences in different variables between G1 and G2. After treatment there was significant improvement in all variables in G1 compared with G2, as measured by digital fluoroscopy. Conclusion The suggested physical therapy program could be an effective and safe method for improving and restoring the normal swallowing mechanism in ischemic stroke patients suffering from severe dysphagia.

Efficacy of transcutaneous electrical nerve stimulation versus biofeedback training on bladder and erectile dysfunction in patients with spinal cord injury

Abstract: Background Spinal cord injury is associated with urinary and erectile dysfunction. Objective This study compared the efficacy of transcutaneous electrical nerve stimulation (TENS) with pelvic floor biofeedback (PFBFB) training in the treatment of bladder and erectile dysfunction for male patients with traumatic partial spinal cord injury. Methods The study included 30 male patients with bladder and erectile dysfunction (precipitancy overactive bladder) after traumatic partial spinal cord injury above the level of T12 within 6-18 months after injury. Patients were randomly divided into two equal groups: the study group was subjected to TENS and pelvic floor exercises and the control group was subjected to PFBFB training in addition the exercises. Patients were assessed before and after treatment by means of cystometric measurements, electromyography activity of pelvic-floor muscles, and International Index of Erectile Function (IIEF-5) Questionnaire. Results Before treatment, there was no significant difference in cystometric measurements, pelvic-floor muscle strength, and IIEF-5 score. In the TENS group, the treatment produced significant improvement in bladder volume at first desire to void (P = 0.001), maximum bladder capacity (P = 0.001) and maximum flow rate (P = 0.001), detrusor pressure at maximum flow (P = 0.002), strength of pelvic floor muscles (P = 0.001), and IIEF-5 score (P = 0.001). PFBFB training resulted in significant improvement only in the maximum flow rate (P = 0.042). Conclusion TENS of pelvic floor muscles is a promising, safe, effective, and inexpensive physical therapy technique to improve urinary and erectile dysfunction in patients with partial suprasacral spinal cord injuries.

Serum matrix metalloproteinase-9 in acute ischemic stroke and its relation to stroke severity

Abstract: Background Thrombolytic therapy is currently the only FDA-approved treatment for acute ischemic stroke. Hence, early diagnosis and risk stratification is of great importance in management. Objective The aim of this work was to study serum level of matrix metalloproteinase-9 (MMP-9) within 24 h of acute ischemic stroke onset and its relation with clinical severity. Patients and methods Thirty patients with acute ischemic stroke were subjected to measurement of serum MMP-9 within 24 h of stroke onset and clinical assessment of stroke severity. Thirty healthy volunteers of matched age and sex were included as controls. Results Fifteen male and 15 female patients with a mean age of 61 ± 7.11 years were studied. The mean National Institutes of Health Stroke Scale (NIHSS) score on admission was 11.17 ± 4.76. The mean serum level of MMP-9 in patients was 998.8 ± 154.72 ng/ml, which was significantly higher compared with the serum level of MMP-9 in controls ( P = 0.003). The mean NIHSS of patients with normal serum level of MMP-9 was less than the mean NIHSS in patients with high MMP-9 serum levels ( P = 0.003). There was a significant positive correlation between serum level of MMP-9 and NIHSS score ( r = 0.5; P = 0.005) even after adjustment of other variables )age, sex, diabetes, hypertension, fasting blood sugar, uric acid, serum triglycerides, serum cholesterol, and right and left carotid intima media thickness( ( r = 0.48; P = 0.032). Conclusion Serum MMP-9 level was found to be high in acute ischemic stroke patients and correlated with clinical stroke severity.

Polysomnography and antidiuretic hormone secretion pattern in children with primary nocturnal enuresis

Abstract: Background Nocturnal enuresis (NE) is one of the most common pediatric sleep-related problems. Data on sleep patterns in children with NE are conflicting. Objective We aimed at studying the sleep architecture, associated breathing problems, and its relation to antidiuretic hormone (ADH) in children with primary NE. Patients and methods This study included 31 children aged 6-18 years with primary monosymptomatic NE and 16 healthy matched controls. They were subjected to a single overnight polysomnography and assessment of ADH levels at 9-11 a.m. and 9-11 p.m. Results Enuretic children had significantly prolonged sleep latency and higher stage N1 percentage, less total sleep time, lower sleep efficiency, and lower rapid eye movement sleep percentage compared with the control group. Ten (32.2%) NE children had nocturnal arrhythmia, whereas six (19.35%) had a respiratory distress index more than 5. Reversed ADH secretion pattern was present in 82% of the NE children. Children with reversed ADH secretion had lower stage N1 and respiratory distress index, and higher sleep efficiency, compared with NE children with normal ADH rhythm. Conclusion Primary NE is associated with disturbed sleep architecture. NE could be a presenting symptom for hidden sleep disordered breathing. The association of NE with cardiac arrhythmia is an interesting finding that requires further research. Most NE children have a reversed pattern of ADH secretion.

Diagnostic value of optical coherence tomography in patients with idiopathic intracranial hypertension

Abstract: Background Idiopathic intracranial hypertension (IIH) is characterized by raised intracranial pressure in the absence of space-occupying lesions or other known etiology. It mainly affects young obese women, and may cause visual loss due to secondary optic atrophy. Objective The aim of the study was to investigate optical coherence tomography (OCT) and perimetry changes in patients with IIH at admission and 6 months later and highlight the relationship between OCT changes and severity of visual dysfunction measured by automated perimetry. Patients and methods This study included 30 female patients with IIH. Cerebrospinal fluid opening pressure was recorded. Complete ophthalmic evaluation included assessment of best-corrected visual acuity, perimetry, and retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness within 3-4 days of performing the lumbar puncture. Thirty age-matched healthy women underwent a similar ophthalmological evaluation. Results In IIH patients the initial RNFL thickness was significantly higher, whereas GCC was significantly lower than that of controls (P = 0.045 and 0.004, respectively). The value of intracranial pressure measured was found to be positively correlated with the stage of papilledema (r = 0.494, P = 0.000). The final recordings showed significant decrease in GCC and RNFL values (P = 0.000 and 0.002, respectively) and improvement in mean deviation (P = 0.003). Conclusion GCC and RNFL thickness abnormalities in IIH patients were quantitatively correlated with visual field sensitivity losses. OCT is an effective tool for quantifying parameters of optic nerve damage.

Effect of glycemic control on the severity and outcome of stroke in Saudi Arabia

Abstract: Background Diabetes mellitus (DM) is a well-known risk factor of ischemic stroke. However, the effect of glycemic control regardless of the presence of DM on the clinical picture of stroke and its impact on the severity and outcome of stroke is not fully investigated. Objective The aim of this study was to assess the impact of prestroke glycemic control regardless of the presence of past history of DM on the size of infarction, stroke severity, and functional outcome in patients with acute ischemic stroke. Patients and methods We measured glycosylated hemoglobin (HbA1c) level as an indicator for glycemic control in the last 3 months before stroke in 56 patients with the diagnosis of the first attack of acute ischemic stroke. There were 26 female and 30 male patients between 45 and 94 years of age. After history taking and full clinical examination, the size of infarction was measured using computed tomography scan of the brain. Stroke severity within 72 h from onset of symptoms was assessed using the National Institute of Health Stroke Scale and outcome of stroke after 2 months was assessed using the modified Barthel Index, both of which were assessed for each stroke patient. Results There was a significant positive correlation between the value of HbA1c and both the size of infarction and National Institute of Health Stroke Scale score assessed within 72 h from symptom onset ( P P Conclusion Glycemic control has a significant effect on ischemic stroke severity and outcome.

Migraine comorbidity in patients with multiple sclerosis

Abstract: Background Migraine headache is a common feature in multiple sclerosis (MS) patients, with variable prevalence among studies. It can influence the diagnosis, radiological evaluation, treatment, and quality of life of these patients. Objective The aim of the study was to assess the frequency and severity of migraine in a sample of Egyptian patients with MS and to study the clinical and radiological characteristics in those patients. Patients and methods We studied 55 patients with MS. They were subjected to full clinical and neurological assessment, including the diagnosis of migraine. Migraine diagnosis was made using a questionnaire based on criteria proposed by the International Classification of Headache Disorders, 2nd ed. Neurological impairment was evaluated with the Multiple Sclerosis Severity Scale; migraine severity evaluation was made using the Migraine Disability Assessment Scale. MRI of the brain and spinal cord was also performed. Results Migraine headache was present in 19 (34.5%) patients. Our results indicate that the majority of patients with coexisting migraine and MS develop migraine years earlier. There was no statistically significant difference between patients with migraine and those without with respect to the age at onset of MS, duration of illness, annual relapse rate, Expanded Disability Status Scale, and Multiple Sclerosis Severity Scale. However, midbrain periaqueductal affection in MRI was more prevalent among MS patients with migraine. Conclusion Migraine is comorbid in patients with MS. The exact etiology and pathogenesis of these two seemingly disparate disorders has not been completely understood.

Admission leukocytosis, C-reactive protein and erythrocyte sedimentation rate in acute noncardioembolic cerebral ischemia: influence on early outcome

Abstract: Background There is growing evidence regarding the role of inflammation in the pathogenesis of ischemic stroke, especially nonembolic types of ischemic stroke. Despite this, there is a need to investigate the direct impact of inflammatory markers on the early outcome in nonembolic ischemic stroke. Objective The aim of the present study was to determine whether positive inflammatory markers such as raised erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and leukocytosis could be used as biochemical predictors for poor early outcome in patients with acute noncardioembolic ischemic stroke. Patients and methods A total of 60 patients(40 men and 20 women; median age: 64.5 years) with first attack of noncardioembolic ischemic stroke were included in the study. Full clinical assessment and routine laboratory investigation were conducted for all patients. MRI of brain, ECG, and cardiac echo were carried out to confirm the diagnosis and exclude cases with embolic stroke. Blood samples for all patients within the first 24 h of onset of symptoms were taken for assessment of ESR, qualitative CRP, and leukocyte count on admission. National Institute of Health Stroke Scale was used for all patients after 7 days. On the basis of their scores patients were divided into two groups: 40 patients with favorable outcome were included in the first group and 20 patients with bad outcome in the second group. Results There was significant difference between the two groups regarding ESR value, and the leukocyte count was higher in the group with bad prognosis. In addition, positive CRP was associated more with the same group in statistically significant way. Conclusion Inflammatory markers play an important role in detecting the early outcome of noncardioembolic stroke.

Retinal nerve fiber layer thickness in multiple sclerosis subtypes

Abstract: Background Optical coherence tomography (OCT) is a promising tool for detecting subclinical changes in retinal nerve fiber layer (RNFL) and macular volume in multiple sclerosis (MS). Objectives The aim of the study was to assess the relationship of retinal changes in different MS subtypes with and without optic neuritis (ON) with clinical disability, duration of illness, and MRI results. Methods Twenty-four patients with relapsing-remitting subtype and 12 patients with secondary progressive subtype, of age range 16-55 years, with and without ON, and 16 age-matched and sex-matched healthy controls were enrolled in this study; in total, there were 15 male and 37 female participants. Patients were subjected to history, clinical evaluation, Extended Disability Status Score for disease severity, MRI brain with contrast, and OCT to assess the RNFL and macular volume of the optic nerve. The control group underwent OCT. Results RNFL thinning was highly correlated in both subtypes with and without ON in all field quadrants compared with the healthy controls. In addition, retinal and macular thickness inversely correlated with Extended Disability Status Score and disease duration in the progressive group than in the relapsing-remitting type. MRI with contrast inversely correlated with both macular and RNFL thickness in the progressive type. Conclusion Retinal axonal loss is more prominent in advanced stages of disease with proportionally greater thinning in eyes previously affected by clinically evident ON. In the absence of clinically evident ON, OCT is a promising potential biomarker of retinal pathology in MS subtypes.

Postoperative visual field outcome measured by perimetry in sellar and parasellar tumors

Abstract: Background Compressive optic neuropathy at chiasm may lead to different degrees of visual acuity affection, color vision loss, and visual field (VF) changes in both eyes. Objective This study evaluates the predictive value of VF outcome 3 months after treatment of chiasmal and parachiasmal tumor compressing the anterior visual pathways. Methods Fifteen patients (eight women and seven men) were included in this study; their ages ranged from 30 to 57 years. All patients were operated upon at the Kasr El-Aini Neurosurgical Department. All of them underwent an evaluation of their history, a clinical examination, standard automated perimetry, evaluation of their hormonal profile, and radiological investigations. Ten patients were operated upon by means of the microscopic-assisted endoscopic endonasal trans-sphenoidal approach, and the remaining five patients were operated upon transcranially. Results Best-corrected visual acuity showed significant improvement from 0.464 ± 0.367 to 0.16 ± 0.17 LogMAR ( P = 0.009) in all patients after surgery. Mean deviation showed improvement in all patients, which was not statistically significant, from −11.289 ± 9.952 dB before surgery to −8.578 ± 7.651 dB at 3 months after surgery ( P = 0.330). As regards temporal VF sensitivity, group 1 showed significant improvement in temporal field sensitivity, from 88.054 to 237.967 1/Lambert (l/L), whereas group 2 showed significant worsening in temporal sensitivity, from 198.272 to 100.764 (l/L), and group 3 showed improvement in temporal sensitivity from 702.97 to 820.568 (l/L). Conclusion In this series, temporal field sensitivity was the best prognostic factor for determining the VF outcome in decompression surgery for sellar and parasellar tumors.

Preoperative sleep quality and inhalation anesthetic requirements: a sleep electroencephalography study

Abstract: Background On the night before surgery, poor sleep quality due to anxiety is a frequently encountered problem. Objective This study aimed at determining the effect of preoperative sleep quality on intraoperative isoflurane requirements in patients undergoing elective surgeries and also offers an electroencephalography (EEG)-based classification of sleep quality. Patients and methods Twenty-seven adult male patients scheduled for elective open cholecystectomy with ages ranging from 20 to 40 years were included in this study. The night before the operation, the patients were subjected to an at least 8 h sleep EEG, which was scored for the following: total sleep time, percentage of slow wave sleep, and percentage of rapid eye movement sleep. Intraoperative isoflurane requirements were determined by recording the amount of inspired isoflurane concentration (every 2 min) needed to achieve an intraoperative bispectral index value between 40 and 60. Patients were classified according to sleep EEG into good sleepers and bad sleepers. Isoflurane requirements were first correlated with the EEG and then compared between the two groups. Results The inspired concentration of isoflurane in good sleepers was 1.15% (1.01-1.22%), whereas in bad sleepers it was significantly lower, at 0.99% (0.87-1.18%) ( P = 0.003). There was a positive correlation between isoflurane requirements and both slow wave sleep percentage ( r = 0.693; P = 0.003) and rapid eye movement sleep percentage ( r = 0.687; P = 0.005). Conclusion Patients suffering from poor sleep quality on the night before surgery need less intraoperatively inspired isoflurane concentration. This finding may have clinical importance in adjusting the isoflurane dose to meet patients' requirements, avoiding intraoperative complications. In addition, an EEG-based classification of sleep is offered.

Carpal tunnel syndrome among other referral diagnoses in the Egyptian Clinical Neurophysiology Unit

Abstract: Background Nerve conduction (NC) studies and electromyography (EMG) are invaluable tools in the diagnosis of neuromuscular disorders. Databases with plenty of observations are useful in better assessment and safe and effective decision making. Objective The aim of this study was to analyze data provided by the EMG and NC records and to correlate referral diagnoses, especially carpal tunnel syndrome, with the final electrodiagnostic ones. This will offer strategic clues to minimize time, cost, and human errors. Methods The study was carried out in the Clinical Neurophysiology Unit, Faculty of Medicine, Cairo University. Tabulation of EMG/NC details for the cases examined during the study period (first half of the year 2014), followed by extensive analysis of the data provided, was carried out. Results Most of the referral clinical diagnoses were of carpal tunnel syndrome (44%) and the least were of ulnar entrapment (1.3%). Concordance between referrals and final diagnoses was found only in 59.2% of patients. The most concordant referral was facial palsy and the most nonconcordant referral diagnosis was anal dysfunction. Conclusion Because of the occurrence of the referral diagnoses and the percentage of concordance between provisional and electrodiagnostic diagnoses, the unit is launching a local project for standardized guidelines for every provisional diagnosis.

Quantitative electroencephalographic changes in attention deficit hyperactivity disorder children

Abstract: Background The electroencephalogram (EEG) has long been used to pick up and analyze the electrical activity of the outermost layer of the brain. Attention deficit hyperactivity disorder (ADHD) patients revealed increased power in the lower frequency bands (δ and θ power) and a raised θ/β ratio. Objective The aim of this study was to detect the quantitative EEG changes in children with ADHD compared with normal children. Patients and methods The sampled group consisted of 45 children suffering from ADHD and represented the patient group, and 45 normal children represented the control group. EEG was recorded under resting conditions for all participants. Data from frontal areas were digitally processed and analyzed to calculate the four frequency bands' power (β, α, θ, and δ) and then θ/β ratio was computed. For the patient group, the Wechsler Intelligence Scale for Children was applied and parents of these patients filled out the Arabic version of Conners' Parent Rating Scale-revised-long version. Results The patient group showed significantly higher θ/β ratio in frontal areas compared with the control group ( P P P Conclusion Quantitative EEG markers - namely, the θ/β ratio - could play a role in the understanding and identification of ADHD.

Sleep-related breathing disorders in stage II essential hypertension

Abstract: Background Sleep-related breathing disorders (SRBDs) are reported to be common among patients with hypertension (HTN). Objective Our aim was to use polysomnography (PSG) to objectively study the frequency and types of SRBDs in essential stage II HTN. Patients and methods We used an attended full PSG recording in a group of 20 patients suffering from stage II HTN and in a group of 20 age-matched and sex-matched controls. The Berlin Questionnaire was also administered to the patients. The patients were assessed for a history of smoking, fasting blood sugar, and BMI. Results We found that 70% of HTN patients had SRBDs: 15% had mild, 30% had moderate, and 25% had severe SRBDs. As for the controls, we found that 40% of controls had SRBDs: 20% had mild, 15% had moderate, and 5% had severe SRBDs. The overweight patients with HTN had a significantly higher hypopnea index compared with normal weight patients. The diabetic hypertensive group showed a lower sleep efficiency. In addition, all the high-risk patients identified by the Berlin Questionnaire showed evidence of SRBDs, but not all SRBD patients were identified as high-risk patients by the Berlin Questionnaire. Conclusion SRBD is very common in stage II HTN. Clinicians should be aware of this high prevalence and make use of the Berlin Questionnaire and PSG, as treatment for SRBDs can have a profound impact on these patients.

Value of seizure semiology and ictal source analysis in lateralizing and localizing the epileptic zone

Abstract: Background Sophisticated analysis of seizure semiology and electroencephalography (EEG) has a significant role in lateralizing and localizing the epileptogenic zone. Hence, understanding the pathophysiology of epileptogenic dysrhythmia requires thorough knowledge of how to put the very different pieces of the puzzle together. Objective The aim of the study was to investigate the concordance between seizure semiology, electrophysiological generator, anatomical lesions, and neuropsychological evaluation in patients with partial epilepsy, and to identify the importance of ictal EEG recording and the diagnostic yield of other electrophysiological techniques. Patients and methods Thirty patients with a diagnosis of intractable partial epilepsy and lesional MRI were prospectively included. All of them were clinically evaluated and identified according to semiological seizure classification. Long-term video digital EEG with ictal recording was done, along with a source analysis (SA) study. Results Clinical evaluation by seizure semiology lateralized 73% of the cases and localized 80%. Ictal EEG lateralized 80% of cases and localized 66.9%. SA revealed a much superior power to lateralize and localize (96.7%) the epileptogenic zone, but what is more important is the added value of SA, as it lateralized and localized 96-100% of the cases that failed on semiology. SA has the highest expected value for additional lateralizing and localizing information ( ±7.73 and ±7.30, respectively). Conclusion Seizure semiology and ictal EEG recording with SA are the most accurate ways to lateralize and localize the epileptogenic zone in intractable partial epileptic cases, giving the patient a respectable chance to avoid other invasive diagnostic techniques.

Neurophysiological and psychometric evaluation of cognition in the normal aging population

Abstract: Background Assessment of cognitive function in normal aging has been considered as an important issue nowadays. There is a generalized proportional decline in mental processing speed among elderly adults that affects all elements of mentation equally. Objective The aim of this study was to assess cognitive functions in normal elderly individuals using psychometric cognitive assessment scales and electrophysiological studies including late cortical responses, P300 and contingent negative variation (CNV). Methods Thirty-five healthy elderly individuals of both sexes were included. Their ages ranged from 60 to 75 years. The participants were subjected to thorough clinical assessment, cognitive evaluation using psychometric scales and neurophysiological tests in the form of P300 and CNV. Results The results of P300 showed a significant positive correlation between reaction time and age. A significant negative correlation was found between reaction time and performance on the Wechsler Intelligence Scale (WIS) ( P = 0.03). The mean amplitude of P300 wave recorded from the parietal region was significantly greater in male participants than in female participants. As regards the results of CNV, a significant negative correlation was noted between N2 latency and the verbal scale of WIS. Comparison of the mean CNV parameters between male and female participants showed that the mean latency of P2 wave was significantly higher in the male population compared with the female population. No significant correlation was revealed between P300 and CNV parameters and scores of Wechsler Memory Scale subtests and parameters of Wisconsin Card Sorting Test. Conclusion Results suggest that the psychiatric scales do not provide a substitute for electrophysiological tests in evaluating the cognitive changes that occur with normal aging. However, there was a limitation for the study in detecting changes because of the narrow age range of the cases.