Tehran University of Medical Sciences

School of Medicine

Department of Neurology

 

 

Introduction

 

Multiple Sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system that usually affects young and middle-aged adults and causes a considerable social and economic burden. During recent years MS has become one of the most common reasons for admissions to a neurological ward. Now MS is recognized throughout the world, with around 2.5 million affected individuals. Although the disease was recognized in the 19th century, there were limited data on the diagnosis, pathophysiology, and management of MS for the last 50 years. With every step of progress in immunology, imaging and biotechnology, there was indeed progress in our understanding of etiology and diagnosis of this potentially disabling disease. Even with such an amazing progress in technology, the exact etiology and absolute cure for MS is not known yet; thus, MS has been the focus of interest in clinical and basic science research in the past decades. Hundreds of MS research groups, centers and clinics are conducting research on this field ranging from animal studies to human clinical trials. Due to their interests and efforts, MS has become a partially treatable disease with the introduction of the drugs that are able to reduce annual relapse rates and delay disability.

 

MS management starts with diagnosis and continues with strategies to control relapses, increasing quality of life of the patients, symptomatic treatments and rehabilitation. With our progress in this field, management of different patients has become more complicated and in some cases needs special training. These facts led the pioneer MS research centers around the world to start special MS training programs for neurologists for better management and addressing of the ever-growing issues about understanding, diagnosis and treatment of Multiple Sclerosis.  The moderate to high prevalence of MS in Iran (20-50 in 100,000) has led the local neurologist to pay special attention to patient management and research. Tehran University of Medical Sciences, as the leading medical university in Iran provides 18 months of advanced training in diagnosis, treatment and clinical research in Multiple Sclerosis. This Fellowship program is conducted under the supervision of neurologists specialized in MS atTehran University of Medical Sciences and the invited authorities from other countries.

 

 

Sina MS Centre was founded in 2007 in Sina University Hospital, the oldest hospital in Tehran. It is located in downtown Tehran and provides care for more than 2,000 registered patients from all over the country, 1,100 of whom are visited regularly in the outpatient clinic. Under the direction of Dr. Mohammad Ali Sahraian, this centre provides comprehensive care including diagnostic and second opinion consultation for ambulatory patients, hospitalization for seriously ill patients, and rehabilitative care, apart from clinical and basic research and teaching. Currently, 15 research projects are ongoing to investigate the effect of some experimental treatments as well as the etiological and epidemiologic aspects of MS. The staff consists of two neurologists with interest and experience in MS, two research assistant physicians, three MS-trained nurses, one physiotherapist, and one psychiatrist. The Centre is also closely linked to the Radiology and Pathology departments. A lab with three different areas of staff is affiliated with the Centre, providing a gene bank for MS patients.  In addition, the Neurology Department which trains 12 neurology residents and medical students communicates frequently with the MS Centre.

 

 

Imam Khomeini Hospital is the biggest hospital affiliated with Tehran University of Medical Sciences and is located in the central part of Tehran. The Department of Neurology is one of the oldest departments having been involved in the training of neurology residents for more than 60 years. The Iranian Center for Neurological Research is located in this hospital and MS research group is headed by Prof. Mohammad Hossien Harirchian. More than 600 Patients are registered in Imam Khomeini MS center and receive ambulatory and inpatient care.

A molecular lab is affiliated to this center and is involved in research and molecular investigations on MS. MS clinics are active for 2 days per week.  A lab for performing evoked potentials is available in this department as well. An equipped imaging center in Imam Khomeini Hospital with 3 tesla MRI and facilities for fMRI and MRS are in close cooperation with the MS Center.  Several research projects on demyelinative disorders have been conducted in Imam Khomeini MS Center and currently 2 RCTs as well as 5 investigations about MRS in PPMS, and immunopathogenesis and genetic aspects of MS are ongoing in this center. There is also a cooperative genetic research program between Imam Khomeini MS center and St George’s University of London.