Seyma Eroglu Durmaz, Oguzhan Kursun, Nese Oztekin, Yesim Sucullu Karadag
ABSTRACT Background: Transcranial sonography (TCS) is a noninvasive imaging method that practices ultrasound waves to examine the brain structure changes in many neurological pathologies, including Parkinson’s disease (PD) and parkinsonism. It allows for the visualization of the substantia nigra (SN), which is affected in these conditions and other brain parts. This technique has shown promise in aiding the diagnosis, follow-up, and progress of PD, in addition to differentiating it from other movement disorders. Our research explores the reliability of TCS in the diagnosis of PD and its impact on the differential diagnosis of atypical parkinsonism syndromes. Subjects and Methods: This study involved 52 PD patients, nine with other parkinsonism, and 54 healthy people. The same neurosonologist, blind to the patient’s diagnosis, assessed each individual’s SN, and the hyperechogenic area measurement was obtained. These measurements were compared between PD patients, with other forms of PD, and healthy people. In addition, hyperechogenic regions were compared based on the PD subtypes, dominant disease side, severity, and duration of the disease. Results: PD patients were presented with the highest value of SN hyperechogenic regions. TCS had an 87.5% specificity and a 73.3% sensitivity rate for the diagnosis of PD. The akinetic-rigid subtype of PD showed higher hyperechogenicity. In PD patients, there was no correlation between the disease side, length of the disease, Hoehn and Yahr stage, and SN hyperechogenicity. Conclusion: The results of this research demonstrate that the visualizing of SN hyperechogenicity with TCS in PD has diagnostic significance and may be valuable in the differential diagnosis of atypical parkinsonism disorders. However, the evaluation of only the SN may not be sufficient to advantage from TCS in the diagnosis of other parkinsonisms, and it may be essential to investigate the mesencephalon, other basal ganglia, and the third ventricle.
{"title":"Transcranial Sonography in Parkinson’s Disease and Parkinsonism","authors":"Seyma Eroglu Durmaz, Oguzhan Kursun, Nese Oztekin, Yesim Sucullu Karadag","doi":"10.4103/nsn.nsn_108_23","DOIUrl":"https://doi.org/10.4103/nsn.nsn_108_23","url":null,"abstract":"ABSTRACT Background: Transcranial sonography (TCS) is a noninvasive imaging method that practices ultrasound waves to examine the brain structure changes in many neurological pathologies, including Parkinson’s disease (PD) and parkinsonism. It allows for the visualization of the substantia nigra (SN), which is affected in these conditions and other brain parts. This technique has shown promise in aiding the diagnosis, follow-up, and progress of PD, in addition to differentiating it from other movement disorders. Our research explores the reliability of TCS in the diagnosis of PD and its impact on the differential diagnosis of atypical parkinsonism syndromes. Subjects and Methods: This study involved 52 PD patients, nine with other parkinsonism, and 54 healthy people. The same neurosonologist, blind to the patient’s diagnosis, assessed each individual’s SN, and the hyperechogenic area measurement was obtained. These measurements were compared between PD patients, with other forms of PD, and healthy people. In addition, hyperechogenic regions were compared based on the PD subtypes, dominant disease side, severity, and duration of the disease. Results: PD patients were presented with the highest value of SN hyperechogenic regions. TCS had an 87.5% specificity and a 73.3% sensitivity rate for the diagnosis of PD. The akinetic-rigid subtype of PD showed higher hyperechogenicity. In PD patients, there was no correlation between the disease side, length of the disease, Hoehn and Yahr stage, and SN hyperechogenicity. Conclusion: The results of this research demonstrate that the visualizing of SN hyperechogenicity with TCS in PD has diagnostic significance and may be valuable in the differential diagnosis of atypical parkinsonism disorders. However, the evaluation of only the SN may not be sufficient to advantage from TCS in the diagnosis of other parkinsonisms, and it may be essential to investigate the mesencephalon, other basal ganglia, and the third ventricle.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135302985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A severe course of COVID-19 infection in a patient with autoimmune encephalitis treated with rituximab","authors":"Ozdemir Cetin, I. Dogan, D. Tezer, S. Demir","doi":"10.4103/nsn.nsn_226_22","DOIUrl":"https://doi.org/10.4103/nsn.nsn_226_22","url":null,"abstract":"","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"40 1","pages":"109 - 111"},"PeriodicalIF":0.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46045966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yasemin Karakaptan, O. Bulut, D. Dibek, I. Öztura, B. Baklan
Introduction: Obstructive Sleep Apnea Syndrome (OSAS) is associated with clinical pictures ranging from morning headache to vascular diseases and sudden death. It negatively affects the quality of life by causing deterioration in sleep quality, a decrease in work and academic performance caused by excessive daytime sleepiness (EDS), social restriction, and an increase in work/traffic accidents and depression. OSAS may cause comorbidities and conditions by desaturation. We aimed to investigate the effect of desaturation and cellular level hypoxia in patients with OSAS on comorbid diseases and conditions and emphasize their importance. Subjects and Methods: The study design was cross-sectional. A total of 100 patients (73 males and 27 females) aged 18–70 years were included in the study. Demographic data, presence of comorbidities (diabetes mellitus [DM], hypertension [HT], coronary artery disease), and symptoms related to OSAS (nocturia, enuresis, and morning headache) were questioned. In addition, the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and Beck Depression Scale were administered, the results of polysomnographic data were evaluated, and lactic acid levels were measured as an indicator of hypoxia at the cell level. Results: The minimum oxyhemoglobin saturation level was found to be associated with body mass index (BMI) (P = 0.004), HT (P = 0.005), ESS scores (P = 0.022), sleep apnea severity, depression scale (P = 0.012), position-related sleep apnea (P = 0.005), and lactic acid levels (P = 0.002). No correlation was found between sex, DM, CAD, morning headache, nocturia and enuresis, PSQI, and repaid eye movement -related sleep apnea. Conclusion: Although hypoxemia was shown to be associated with BMI, HT, EDS, depression, sleep apnea severity, positional apnea, and lactic acid in our study, sufficient evidence could not be obtained to consider the minimum oxyhemoglobin saturation level in the OSAS treatment plan. In the clinical evaluation of OSAS, apnea-hypopnea index and these parameters should be taken into account by physicians in the prediction of comorbidities and risks.
{"title":"The relationship of desaturation, oxidative stress, comorbid diseases, and conditions in obstructive sleep apnea syndrome","authors":"Yasemin Karakaptan, O. Bulut, D. Dibek, I. Öztura, B. Baklan","doi":"10.4103/nsn.nsn_72_23","DOIUrl":"https://doi.org/10.4103/nsn.nsn_72_23","url":null,"abstract":"Introduction: Obstructive Sleep Apnea Syndrome (OSAS) is associated with clinical pictures ranging from morning headache to vascular diseases and sudden death. It negatively affects the quality of life by causing deterioration in sleep quality, a decrease in work and academic performance caused by excessive daytime sleepiness (EDS), social restriction, and an increase in work/traffic accidents and depression. OSAS may cause comorbidities and conditions by desaturation. We aimed to investigate the effect of desaturation and cellular level hypoxia in patients with OSAS on comorbid diseases and conditions and emphasize their importance. Subjects and Methods: The study design was cross-sectional. A total of 100 patients (73 males and 27 females) aged 18–70 years were included in the study. Demographic data, presence of comorbidities (diabetes mellitus [DM], hypertension [HT], coronary artery disease), and symptoms related to OSAS (nocturia, enuresis, and morning headache) were questioned. In addition, the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and Beck Depression Scale were administered, the results of polysomnographic data were evaluated, and lactic acid levels were measured as an indicator of hypoxia at the cell level. Results: The minimum oxyhemoglobin saturation level was found to be associated with body mass index (BMI) (P = 0.004), HT (P = 0.005), ESS scores (P = 0.022), sleep apnea severity, depression scale (P = 0.012), position-related sleep apnea (P = 0.005), and lactic acid levels (P = 0.002). No correlation was found between sex, DM, CAD, morning headache, nocturia and enuresis, PSQI, and repaid eye movement -related sleep apnea. Conclusion: Although hypoxemia was shown to be associated with BMI, HT, EDS, depression, sleep apnea severity, positional apnea, and lactic acid in our study, sufficient evidence could not be obtained to consider the minimum oxyhemoglobin saturation level in the OSAS treatment plan. In the clinical evaluation of OSAS, apnea-hypopnea index and these parameters should be taken into account by physicians in the prediction of comorbidities and risks.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"40 1","pages":"95 - 100"},"PeriodicalIF":0.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46430430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim: Adverse effects should be questioned in outpatient clinics during routine visits. However, physicians have not yet had a questionnaire in Turkish for patients who take antiseizure medications (ASMs). The Liverpool Adverse Drug Events Profile “LAEP” was created to follow up on possible adverse effects of ASMs in different languages. This study aimed to assess the reliability and validity of LAEP for the Turkish-speaking population. Method: First, permission was requested from the authors of the original questionnaire. After that, English-Turkish and re-translations were made by two independent people, respectively. Finally, the questionnaire was administered to 10 people as a pilot study, and the final version was decided. Patients who were followed up at the epilepsy outpatient clinic of xxx Hospital and who had not changed antiseizure medications dosage for at least 3 months were included in the study. Cronbach's α and intraclass correlation coefficient (ICC) coefficients were calculated for internal consistency. A consistency study was performed by applying the scale to the same patient group with an interval of 2 weeks. Confirmatory factor analysis was performed for validity analyses using the questionnaire, which was divided into three subdimensions, neurologic, psychiatric, and other system adverse effects. Results: Thirty-seven [male: 16 (43.2%) and female: 21 (56.8%)] patients were included for test-retest analysis. Consistency measurements (ICCs) were performed, and high correlations of ICC >0.70 were obtained for all items. The questionnaire was administered to 168 [male: 64 (38.1%) and female: 104 (61.9%)] patients for validity by factor analysis and reliability by Cronbach's α correlation. Three dimensions were obtained in factor analysis, classified as nervous system-related, psychiatric-related, and other system-related. The Cronbach α values were found as 0.804, 0.828, and 0.484, respectively. Conclusion: The LAEP-TR scale can be used in outpatient clinics on patients who use ASMs.
{"title":"The liverpool adverse drug events profile (LAEP): Validity and reliability of Turkish version (LAEP-TR)","authors":"D. Dibek, Bülent Kılıç, Ibrahim Oztura, B. Baklan","doi":"10.4103/nsn.nsn_83_23","DOIUrl":"https://doi.org/10.4103/nsn.nsn_83_23","url":null,"abstract":"Aim: Adverse effects should be questioned in outpatient clinics during routine visits. However, physicians have not yet had a questionnaire in Turkish for patients who take antiseizure medications (ASMs). The Liverpool Adverse Drug Events Profile “LAEP” was created to follow up on possible adverse effects of ASMs in different languages. This study aimed to assess the reliability and validity of LAEP for the Turkish-speaking population. Method: First, permission was requested from the authors of the original questionnaire. After that, English-Turkish and re-translations were made by two independent people, respectively. Finally, the questionnaire was administered to 10 people as a pilot study, and the final version was decided. Patients who were followed up at the epilepsy outpatient clinic of xxx Hospital and who had not changed antiseizure medications dosage for at least 3 months were included in the study. Cronbach's α and intraclass correlation coefficient (ICC) coefficients were calculated for internal consistency. A consistency study was performed by applying the scale to the same patient group with an interval of 2 weeks. Confirmatory factor analysis was performed for validity analyses using the questionnaire, which was divided into three subdimensions, neurologic, psychiatric, and other system adverse effects. Results: Thirty-seven [male: 16 (43.2%) and female: 21 (56.8%)] patients were included for test-retest analysis. Consistency measurements (ICCs) were performed, and high correlations of ICC >0.70 were obtained for all items. The questionnaire was administered to 168 [male: 64 (38.1%) and female: 104 (61.9%)] patients for validity by factor analysis and reliability by Cronbach's α correlation. Three dimensions were obtained in factor analysis, classified as nervous system-related, psychiatric-related, and other system-related. The Cronbach α values were found as 0.804, 0.828, and 0.484, respectively. Conclusion: The LAEP-TR scale can be used in outpatient clinics on patients who use ASMs.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"40 1","pages":"101 - 105"},"PeriodicalIF":0.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41995407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: There is no consensus about the optimum treatment or treatment algorithm for carpal tunnel syndrome (CTS). In previous randomized studies that compared open carpal tunnel release and local steroid injections (LSIs), the two most used nonconservative treatments, conflicting results were found. Objective: The objective of the study was to compare the efficacies of surgery and LSI in the treatment of CTS. Subjects and Methods: A randomized, controlled clinical trial was conducted with 80 patients who were clinically diagnosed as having idiopathic CTS. The requirements for enrollment were awakening from sleep due to nocturnal paresthesia and a diagnosis to be confirmed through electrodiagnostic tests. Patients were randomly assigned to the surgery and the steroid groups. Assessments were performed at baseline and 1, 3, 6, and 12 months after initial treatment. The primary outcome measure was the improvement of awakening from sleep. Results: A total of 80 patients were enrolled in the study. Thirty-six patients were assigned to the surgery group and 44 to the steroid group. None of our patients were lost to follow-up. Fourteen out of the 44 patients in the steroid group and all 36 patients in the surgery group had a successful outcome at the 12-month assessment. Success rates in the steroid group at 1, 3, 6, and 12 months were 77.3%, 61.4%, 45.5%, and 31.8%, respectively. When the injection group was evaluated separately, LSI was found more successful in mild cases and unilateral cases. Conclusion: Surgery should be chosen for the treatment of moderate-to-severe idiopathic CTS, but LSI may be used for mild cases. The historical-objective scale may predict which patient will benefit from which treatment.
{"title":"Comparison of surgery and local steroid injections for the treatment of carpal tunnel syndrome: A randomized controlled trial","authors":"Mustafa Minoğlu, H. Sucu, T. Özdemirkıran","doi":"10.4103/nsn.nsn_170_22","DOIUrl":"https://doi.org/10.4103/nsn.nsn_170_22","url":null,"abstract":"Background: There is no consensus about the optimum treatment or treatment algorithm for carpal tunnel syndrome (CTS). In previous randomized studies that compared open carpal tunnel release and local steroid injections (LSIs), the two most used nonconservative treatments, conflicting results were found. Objective: The objective of the study was to compare the efficacies of surgery and LSI in the treatment of CTS. Subjects and Methods: A randomized, controlled clinical trial was conducted with 80 patients who were clinically diagnosed as having idiopathic CTS. The requirements for enrollment were awakening from sleep due to nocturnal paresthesia and a diagnosis to be confirmed through electrodiagnostic tests. Patients were randomly assigned to the surgery and the steroid groups. Assessments were performed at baseline and 1, 3, 6, and 12 months after initial treatment. The primary outcome measure was the improvement of awakening from sleep. Results: A total of 80 patients were enrolled in the study. Thirty-six patients were assigned to the surgery group and 44 to the steroid group. None of our patients were lost to follow-up. Fourteen out of the 44 patients in the steroid group and all 36 patients in the surgery group had a successful outcome at the 12-month assessment. Success rates in the steroid group at 1, 3, 6, and 12 months were 77.3%, 61.4%, 45.5%, and 31.8%, respectively. When the injection group was evaluated separately, LSI was found more successful in mild cases and unilateral cases. Conclusion: Surgery should be chosen for the treatment of moderate-to-severe idiopathic CTS, but LSI may be used for mild cases. The historical-objective scale may predict which patient will benefit from which treatment.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"40 1","pages":"64 - 69"},"PeriodicalIF":0.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44422068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jovann Figuera Rabor, Maria A. Cañete, Jhaphet Agunias
Background: Previous literature revealed the possible benefit of high-dose steroids in myasthenic crises. Steroids are more economical than standard therapy, especially in resource-poor settings. More data are therefore needed about the utility of steroids for the myasthenic crisis. Objective: The outcomes were compared between standard therapy (intravenous immunoglobulin [IVIg] or plasmapheresis [PLEX]) and high-dose steroid (intravenous methylprednisolone) for the myasthenic crisis. The primary outcome was the length of hospital stay. The secondary outcomes were the length of intubation, intensive care unit stay, readmission rate due to crisis, posttreatment muscle score, and mortality. Methodology: This study was a single-center, longitudinal, 12-year retrospective study. Sixty-five patients were analyzed. A comparison of means was made between the outcomes of the two groups. Regression analysis was done for hospital stay and intubation outcomes. Side effects of treatment were determined. Results: Shorter hospital stay (P = 0.001), shorter intubation length (P = 0.000), and shorter intensive care (P = 0.000) were observed in the steroid group. Mortality (P = 0.187) and muscle score (P = 0.281) were comparable between the two groups. There was a trend toward lesser readmission (P = 0.097) and longer time to readmission (P = 0.069) in the standard therapy group. The IVIg group had arrhythmias, hypotension, headache, renal impairment, and hypomagnesemia. The PLEX group had hypotension and lower limb pain. The steroid group had hyperglycemia, insomnia, infection, stomach upset, facial flushing, myopathy, and sudden death. No acute worsening of the myasthenia crisis was seen in all patients in the steroid arm. Conclusion: Data on hospital stay, intensive care days, and intubation length were better with high-dose steroids. Mortality and motor outcomes were comparable between the two groups. Readmission rates due to crisis were lower in the standard therapy group.
{"title":"High-dose steroids versus standard treatment for myasthenic crisis: A single-center, longitudinal, 12-year retrospective study","authors":"Jovann Figuera Rabor, Maria A. Cañete, Jhaphet Agunias","doi":"10.4103/nsn.nsn_175_22","DOIUrl":"https://doi.org/10.4103/nsn.nsn_175_22","url":null,"abstract":"Background: Previous literature revealed the possible benefit of high-dose steroids in myasthenic crises. Steroids are more economical than standard therapy, especially in resource-poor settings. More data are therefore needed about the utility of steroids for the myasthenic crisis. Objective: The outcomes were compared between standard therapy (intravenous immunoglobulin [IVIg] or plasmapheresis [PLEX]) and high-dose steroid (intravenous methylprednisolone) for the myasthenic crisis. The primary outcome was the length of hospital stay. The secondary outcomes were the length of intubation, intensive care unit stay, readmission rate due to crisis, posttreatment muscle score, and mortality. Methodology: This study was a single-center, longitudinal, 12-year retrospective study. Sixty-five patients were analyzed. A comparison of means was made between the outcomes of the two groups. Regression analysis was done for hospital stay and intubation outcomes. Side effects of treatment were determined. Results: Shorter hospital stay (P = 0.001), shorter intubation length (P = 0.000), and shorter intensive care (P = 0.000) were observed in the steroid group. Mortality (P = 0.187) and muscle score (P = 0.281) were comparable between the two groups. There was a trend toward lesser readmission (P = 0.097) and longer time to readmission (P = 0.069) in the standard therapy group. The IVIg group had arrhythmias, hypotension, headache, renal impairment, and hypomagnesemia. The PLEX group had hypotension and lower limb pain. The steroid group had hyperglycemia, insomnia, infection, stomach upset, facial flushing, myopathy, and sudden death. No acute worsening of the myasthenia crisis was seen in all patients in the steroid arm. Conclusion: Data on hospital stay, intensive care days, and intubation length were better with high-dose steroids. Mortality and motor outcomes were comparable between the two groups. Readmission rates due to crisis were lower in the standard therapy group.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"40 1","pages":"70 - 80"},"PeriodicalIF":0.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45159694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The objective of the study was to determine the significance weights of the Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) item scores for better evaluation and classification of amyotrophic lateral sclerosis (ALS) status. Methods: We used an analytical hierarchy process (AHP) to determine the weights of the ALSFRS-R item scores based on the opinions of two neurologists. We analyzed data of 51 patients with ALS to group them into four ALS severity classes based on their (i) total ALSFRS-R score and (ii) total weighted ALSFRS-R scores using the proposed weight values. We analyzed the performance differences between the two classification approaches based on the outcomes of these 51 patients. We also used twenty additional patients' data to analyze the accuracies of the total and weighted ALSFRS-R score approaches compared with physicians' actual assessments. Results: The AHP analysis assigned the highest weights to the ALSFRS-R items for respiratory insufficiency, orthopnea, and bed rotation/covering. ALS status classification based on the total and weighted ALSFRS-R scores differed for about 27.5% (confidence interval [CI]: 15.2%–39.8%) of the 51 patients. The classification based on the total weighted ALSFRS-R complied with the actual assessments in 85% (CI: 69.4%–100%) of the patients in the comparison sample; the compliance rate was 60% (CI: 38.5%–81.5%) for the total ALSFRS-R-based classification. Conclusions: Assigning weights to the 12 ALSFRS-R criteria/questions may improve ALSFRS-R's ability to represent ALS severity. This finding requires further investigation.
{"title":"Determining the significance weights of ALSFRS-R items using analytic hierarchy process","authors":"G. Koc, Fatih Eranay, A. Kokangul, F. Koç","doi":"10.4103/nsn.nsn_4_23","DOIUrl":"https://doi.org/10.4103/nsn.nsn_4_23","url":null,"abstract":"Objective: The objective of the study was to determine the significance weights of the Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) item scores for better evaluation and classification of amyotrophic lateral sclerosis (ALS) status. Methods: We used an analytical hierarchy process (AHP) to determine the weights of the ALSFRS-R item scores based on the opinions of two neurologists. We analyzed data of 51 patients with ALS to group them into four ALS severity classes based on their (i) total ALSFRS-R score and (ii) total weighted ALSFRS-R scores using the proposed weight values. We analyzed the performance differences between the two classification approaches based on the outcomes of these 51 patients. We also used twenty additional patients' data to analyze the accuracies of the total and weighted ALSFRS-R score approaches compared with physicians' actual assessments. Results: The AHP analysis assigned the highest weights to the ALSFRS-R items for respiratory insufficiency, orthopnea, and bed rotation/covering. ALS status classification based on the total and weighted ALSFRS-R scores differed for about 27.5% (confidence interval [CI]: 15.2%–39.8%) of the 51 patients. The classification based on the total weighted ALSFRS-R complied with the actual assessments in 85% (CI: 69.4%–100%) of the patients in the comparison sample; the compliance rate was 60% (CI: 38.5%–81.5%) for the total ALSFRS-R-based classification. Conclusions: Assigning weights to the 12 ALSFRS-R criteria/questions may improve ALSFRS-R's ability to represent ALS severity. This finding requires further investigation.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"40 1","pages":"88 - 94"},"PeriodicalIF":0.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46741743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Unlu, Furkan Sarıdaş, O. Taskapilioglu, G. Cecener, U. Egeli, O. Turan, B. Tunca, M. Zarifoğlu
Introduction: Recent research into multiple sclerosis (MS) has focused on the role of microRNAs (miRNAs) in the development of the disease. This study was designed to analyze miR-146a expression in whole blood and fecal samples of patients with MS. The study aimed to analyze clinical data using the miR-146a expression values obtained. Subjects and Methods: This study included patients with relapsing–remitting MS (RRMS) (n = 53), clinically isolated syndrome (CIS) (n = 15), and healthy controls (n = 26). Total RNA was isolated from the participants' whole blood and fecal samples. RNA extraction was performed using QIAamp RNA Blood Mini Kits for blood samples and RNeasy PowerMicrobiome Kits for feces. miR-146a expressions were studied using real-time polymerase chain reaction. Finally, relative expression was correlated with clinicopathologic factors. Results: MiR-146a expression was significantly decreased in the whole blood (P < 0.001) and fecal samples (P = 0.036) of patients with RRMS. There was no significant difference in the miR-146a expression rate between patients with CIS and controls. Moreover, the miR-146a expression level in patients with RRMS was decreased compared with those with CIS (P < 0.001). A significant association was determined between miR-146a expression and sex in blood samples. When sex stratification was applied to expression values obtained from fecal samples, miR-146a expression was downregulated only in females (P = 0.008). Discussion: miRNAs play an essential role in maintaining the stable course of MS, and this process has some sex-specific differences. Expression of fecal miR-146a may be used as a biomarker to diagnose and predict prognosis in patients with RRMS.
{"title":"Investigation of miR-146a expression profiles in fecal samples of patients with multiple sclerosis for early diagnosis and treatment","authors":"H. Unlu, Furkan Sarıdaş, O. Taskapilioglu, G. Cecener, U. Egeli, O. Turan, B. Tunca, M. Zarifoğlu","doi":"10.4103/nsn.nsn_218_22","DOIUrl":"https://doi.org/10.4103/nsn.nsn_218_22","url":null,"abstract":"Introduction: Recent research into multiple sclerosis (MS) has focused on the role of microRNAs (miRNAs) in the development of the disease. This study was designed to analyze miR-146a expression in whole blood and fecal samples of patients with MS. The study aimed to analyze clinical data using the miR-146a expression values obtained. Subjects and Methods: This study included patients with relapsing–remitting MS (RRMS) (n = 53), clinically isolated syndrome (CIS) (n = 15), and healthy controls (n = 26). Total RNA was isolated from the participants' whole blood and fecal samples. RNA extraction was performed using QIAamp RNA Blood Mini Kits for blood samples and RNeasy PowerMicrobiome Kits for feces. miR-146a expressions were studied using real-time polymerase chain reaction. Finally, relative expression was correlated with clinicopathologic factors. Results: MiR-146a expression was significantly decreased in the whole blood (P < 0.001) and fecal samples (P = 0.036) of patients with RRMS. There was no significant difference in the miR-146a expression rate between patients with CIS and controls. Moreover, the miR-146a expression level in patients with RRMS was decreased compared with those with CIS (P < 0.001). A significant association was determined between miR-146a expression and sex in blood samples. When sex stratification was applied to expression values obtained from fecal samples, miR-146a expression was downregulated only in females (P = 0.008). Discussion: miRNAs play an essential role in maintaining the stable course of MS, and this process has some sex-specific differences. Expression of fecal miR-146a may be used as a biomarker to diagnose and predict prognosis in patients with RRMS.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"40 1","pages":"81 - 87"},"PeriodicalIF":0.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48934636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: This study aims to investigate the ulnar-median mixed nerve latency difference (U-MLD) recorded from the medial aspect of the arm both in patients with ulnar neuropathy at the elbow (UNE) and in healthy individuals and thus to assist in the diagnosis of UNE. Materials and Methods: Twenty-nine patients meeting electrophysiological criteria defined by the American Association of Neuromuscular and Electrodiagnostic Medicine for diagnosis of UNE, and 50 healthy individuals were included in the study retrospectively. All participants' data were evaluated, such as median/ulnar motor and sensory response, U-MLD and the percentage of ulnar mixed nerve response amplitude difference between sides. Results: The U-MLD was significantly higher in patients with UNE than in the control group (1.78 ± 0.64 ms vs. 0.6 ± 0.22 ms, P = 0.000). The percentage of the ulnar mixed nerve response amplitude loss was significantly higher in the patient group compared to the control group (43.9% ± 30.3% vs. 21.4% ± 12.2%, P = 0.018). The U-MLD was significantly higher in the patients with amplitude loss ≥50%, and the ulnar mixed nerve response amplitude loss was ≥50% in all five patients with the ulnar sensory nerve action potential pathology. Conclusions: U-MLD is higher in patients with UNE; it can provide additional data in mild cases regarding the diagnosis of UNE, especially. Furthermore, the criterion that the ulnar mixed nerve response amplitude difference between the sides ≥50% suggests that it can be used to evaluate the severity of UNE.
目的:本研究旨在探讨肘部尺神经病变(UNE)患者和健康人从手臂内侧记录的尺正中混合神经潜伏期差(U-MLD)，从而协助UNE的诊断。材料和方法:回顾性研究29例符合美国神经肌肉和电诊断医学协会诊断UNE的电生理标准的患者和50例健康个体。评估所有参与者的数据，如正中/尺侧运动和感觉反应，U-MLD和尺侧混合神经反应幅度差百分比。结果:UNE患者U-MLD明显高于对照组(1.78±0.64 ms vs. 0.6±0.22 ms, P = 0.000)。患者组尺混合神经反应幅度损失比例明显高于对照组(43.9%±30.3% vs. 21.4%±12.2%，P = 0.018)。幅度损失≥50%的患者U-MLD显著增高，5例尺侧感觉神经动作电位病变患者尺侧混合神经反应幅度损失均≥50%。结论:UNE患者U-MLD较高;它可以为诊断UNE的轻度病例提供额外的数据，特别是。此外，两侧尺侧混合神经反应幅度差≥50%的标准提示可用于评估UNE的严重程度。
{"title":"Mixed nerve conduction study in the diagnosis of ulnar neuropathy at the elbow","authors":"Selahattin Ayas, E. Issı","doi":"10.4103/nsn.nsn_151_22","DOIUrl":"https://doi.org/10.4103/nsn.nsn_151_22","url":null,"abstract":"Purpose: This study aims to investigate the ulnar-median mixed nerve latency difference (U-MLD) recorded from the medial aspect of the arm both in patients with ulnar neuropathy at the elbow (UNE) and in healthy individuals and thus to assist in the diagnosis of UNE. Materials and Methods: Twenty-nine patients meeting electrophysiological criteria defined by the American Association of Neuromuscular and Electrodiagnostic Medicine for diagnosis of UNE, and 50 healthy individuals were included in the study retrospectively. All participants' data were evaluated, such as median/ulnar motor and sensory response, U-MLD and the percentage of ulnar mixed nerve response amplitude difference between sides. Results: The U-MLD was significantly higher in patients with UNE than in the control group (1.78 ± 0.64 ms vs. 0.6 ± 0.22 ms, P = 0.000). The percentage of the ulnar mixed nerve response amplitude loss was significantly higher in the patient group compared to the control group (43.9% ± 30.3% vs. 21.4% ± 12.2%, P = 0.018). The U-MLD was significantly higher in the patients with amplitude loss ≥50%, and the ulnar mixed nerve response amplitude loss was ≥50% in all five patients with the ulnar sensory nerve action potential pathology. Conclusions: U-MLD is higher in patients with UNE; it can provide additional data in mild cases regarding the diagnosis of UNE, especially. Furthermore, the criterion that the ulnar mixed nerve response amplitude difference between the sides ≥50% suggests that it can be used to evaluate the severity of UNE.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"40 1","pages":"59 - 63"},"PeriodicalIF":0.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70838845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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