Introduction: Epileptic seizures occur in approximately 35%–40% of patients with cerebral venous thrombosis (CVT). The relationship between parenchymal lesions and epileptic seizures in CVT has been investigated, but the most associated types of parenchymal lesions have not been determined. This study, therefore, aimed to identify high-risk groups. Methods: A total of 159 patients were diagnosed as having CVT between 2015 and 2021 at our tertiary center. The risk factors for epileptic seizures after CVT were determined. Results: A total of 159 patients who were diagnosed with having CVT, 109 (68.5%) females and 50 (31.5%) males, were included in this study. The mean ages of the women and men were 41.20 ± 14.15 years and 43.60 ± 16.30 years, respectively. We found that superior sagittal sinus involvement (P = 0.019), sigmoid sinus involvement (P = 0.010), cortical vein involvement (P < 0.001), parenchymal lesion (P < 0.001), and the postpartum period (P = 0.003) increased the risk of epileptic seizures. When the significant variables associated with epileptic seizures in the patients were analyzed using binary logistic regression, the most significant variable was found to be the presence of parenchymal lesions. Conclusion: We found that the most significant variable for epileptic seizures after CVT was parenchymal lesions. Juxtacortical hemorrhages and nonhemorrhagic venous infarcts were the most common causes of epileptic seizures. CVT is a heterogeneous group of diseases caused by multiple aetiologies and may show ethnic and racial differences. For this reason, more precise information can be obtained with multi-center prospective studies in our population.
{"title":"Evaluation of the relationship between epileptic seizures and type of parenchymal lesion in patients with cerebral venous thrombosis","authors":"Yasemin Dinç, A. Demir, M. Bakar, İ. Bora","doi":"10.4103/nsn.nsn_139_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_139_21","url":null,"abstract":"Introduction: Epileptic seizures occur in approximately 35%–40% of patients with cerebral venous thrombosis (CVT). The relationship between parenchymal lesions and epileptic seizures in CVT has been investigated, but the most associated types of parenchymal lesions have not been determined. This study, therefore, aimed to identify high-risk groups. Methods: A total of 159 patients were diagnosed as having CVT between 2015 and 2021 at our tertiary center. The risk factors for epileptic seizures after CVT were determined. Results: A total of 159 patients who were diagnosed with having CVT, 109 (68.5%) females and 50 (31.5%) males, were included in this study. The mean ages of the women and men were 41.20 ± 14.15 years and 43.60 ± 16.30 years, respectively. We found that superior sagittal sinus involvement (P = 0.019), sigmoid sinus involvement (P = 0.010), cortical vein involvement (P < 0.001), parenchymal lesion (P < 0.001), and the postpartum period (P = 0.003) increased the risk of epileptic seizures. When the significant variables associated with epileptic seizures in the patients were analyzed using binary logistic regression, the most significant variable was found to be the presence of parenchymal lesions. Conclusion: We found that the most significant variable for epileptic seizures after CVT was parenchymal lesions. Juxtacortical hemorrhages and nonhemorrhagic venous infarcts were the most common causes of epileptic seizures. CVT is a heterogeneous group of diseases caused by multiple aetiologies and may show ethnic and racial differences. For this reason, more precise information can be obtained with multi-center prospective studies in our population.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"39 1","pages":"28 - 34"},"PeriodicalIF":0.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47999152","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. Ucar, E. Arhan, K. Aydin, T. Hirfanoğlu, A. Serdaroğlu
Purpose: Electrical status epilepticus during slow sleep (ESES) is an electroclinical syndrome with a specific electroencephalogram (EEG) pattern characterized by epileptic seizures, cognitive decline, and behavioral problems. The EEG pattern is defined by the percentage of the spike-wave index (SWI) in nonrapid eye movement (NREM) sleep without a clear cut-off value. The purpose of this study is to determine the significance of SWI calculation in the first 180 s of the NREM sleep stage. Methods: Patients with tonic seizures and those with SWI levels of <50% were excluded from the study. One hundred patients were enrolled in the study (typical ESES: 85; atypical ESES: 15). EEG findings were evaluated according to the following points: 1-ESES type: atypical ESES for SWI between 50% and 85% or typical ESES for ≥85%; 2-SWI calculation methods: Short method and long conventional method; 3-SWI percentage and spike frequency (SF). Results: A moderate correlation was determined between spike-wave percentage (SWP) and SF (r = 0.628; P < 0.001). A strong positive correlation was determined between the short method and long conventional method (r = 0.888; P < 0.001). In multivariate logistic regression with the SWI short method and the number of spikes in the first 180 s of NREM, only the SWI short method was found to predict typical ESES regardless of other factors (odds ratio: 1.18; P = 0.001). The optimal predictive value of the SWI short method for predicting typical ESES was >85, with sensitivity of 81.2%, and specificity of 73.3% (+PV: 94.5%, −PV: 40.7%; AUC ± SE = 0.850 ± 0.05; P < 0.001). Conclusion: Evaluating EEG epileptiform activities with objective and reproducible well-defined measurements such as SWP and SF allows for the comparison of different patient groups. We think that a shorter method for diagnosing ESES would potentially provide increased cost savings and patient comfort.
{"title":"The Electroencephalographic Evolution of Electrical Status: Is it Possible to Diagnosis ESES from 180 Seconds of Sleep?","authors":"H. Ucar, E. Arhan, K. Aydin, T. Hirfanoğlu, A. Serdaroğlu","doi":"10.4103/nsn.nsn_136_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_136_21","url":null,"abstract":"Purpose: Electrical status epilepticus during slow sleep (ESES) is an electroclinical syndrome with a specific electroencephalogram (EEG) pattern characterized by epileptic seizures, cognitive decline, and behavioral problems. The EEG pattern is defined by the percentage of the spike-wave index (SWI) in nonrapid eye movement (NREM) sleep without a clear cut-off value. The purpose of this study is to determine the significance of SWI calculation in the first 180 s of the NREM sleep stage. Methods: Patients with tonic seizures and those with SWI levels of <50% were excluded from the study. One hundred patients were enrolled in the study (typical ESES: 85; atypical ESES: 15). EEG findings were evaluated according to the following points: 1-ESES type: atypical ESES for SWI between 50% and 85% or typical ESES for ≥85%; 2-SWI calculation methods: Short method and long conventional method; 3-SWI percentage and spike frequency (SF). Results: A moderate correlation was determined between spike-wave percentage (SWP) and SF (r = 0.628; P < 0.001). A strong positive correlation was determined between the short method and long conventional method (r = 0.888; P < 0.001). In multivariate logistic regression with the SWI short method and the number of spikes in the first 180 s of NREM, only the SWI short method was found to predict typical ESES regardless of other factors (odds ratio: 1.18; P = 0.001). The optimal predictive value of the SWI short method for predicting typical ESES was >85, with sensitivity of 81.2%, and specificity of 73.3% (+PV: 94.5%, −PV: 40.7%; AUC ± SE = 0.850 ± 0.05; P < 0.001). Conclusion: Evaluating EEG epileptiform activities with objective and reproducible well-defined measurements such as SWP and SF allows for the comparison of different patient groups. We think that a shorter method for diagnosing ESES would potentially provide increased cost savings and patient comfort.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"39 1","pages":"21 - 27"},"PeriodicalIF":0.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44810634","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}
Z. Yapıcı, P. Topaloğlu, C. Turkmen, M. Eraksoy, S. Zuberi
Glucose transporter type 1 deficiency syndrome (GLUT-1 DS) is an inborn error of metabolism that results in defective glucose transport and consequently a reduced supply of glucose to the brain. Here, we describe a patient with a molecularly proven GLUT-1 mutation who presented with severe paroxysmal choreoathetosis. Different regional changes involving bilateral mesial temporal lobes were revealed using positron-emission tomography (PET). Several cases of GLUT-1 DS have been studied from the point of view of hyperkinetic movement disorders rather than epilepsy and ataxia. It is usual for these patients to first present with dystonia, choreoathetosis, parkinsonism, and paroxysmal exercise-induced dyskinesia, including dystonic, choreoathetotic, and ballistic movements. F18-fluorodeoxyglucose PET revealed hypometabolism in bilateral mesial temporal lobes along with the cerebellar cortex, confirming an impaired glucose metabolism effect on the area responsible for the extrapyramidal movement disorders.
{"title":"A patient with glucose transporter type 1 deficiency syndrome: Paroxysmal choreoathetosis and cerebral positron-emission tomography findings","authors":"Z. Yapıcı, P. Topaloğlu, C. Turkmen, M. Eraksoy, S. Zuberi","doi":"10.4103/nsn.nsn_127_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_127_21","url":null,"abstract":"Glucose transporter type 1 deficiency syndrome (GLUT-1 DS) is an inborn error of metabolism that results in defective glucose transport and consequently a reduced supply of glucose to the brain. Here, we describe a patient with a molecularly proven GLUT-1 mutation who presented with severe paroxysmal choreoathetosis. Different regional changes involving bilateral mesial temporal lobes were revealed using positron-emission tomography (PET). Several cases of GLUT-1 DS have been studied from the point of view of hyperkinetic movement disorders rather than epilepsy and ataxia. It is usual for these patients to first present with dystonia, choreoathetosis, parkinsonism, and paroxysmal exercise-induced dyskinesia, including dystonic, choreoathetotic, and ballistic movements. F18-fluorodeoxyglucose PET revealed hypometabolism in bilateral mesial temporal lobes along with the cerebellar cortex, confirming an impaired glucose metabolism effect on the area responsible for the extrapyramidal movement disorders.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"39 1","pages":"53 - 55"},"PeriodicalIF":0.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42636715","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}
Objectives: The Boston Carpal Tunnel Questionnaire (BCTQ) is a patient-based outcome measure that has been developed for patients with Carpal tunnel syndrome (CTS). The purpose of this study was to investigate the association between BCTQ scores and electrophysiological findings in patients with CTS. Subjects and Methods: This study included 174 individuals (control group [n = 68] and patient group [n = 106]) admitted to Erciyes University Hospital Department of Neurology between August 2019 and November 2019 with complaints of pain, numbness, and paresthesia in the unilateral or bilateral median nerve trace and diagnosed with idiopathic CTS or normal after electrophysiological testing. The Turkish version of the BCTQ was applied to these patients. Results: The mean age of the participants was 46.6 (standard deviation ± 11.9). One hundred and fifty-seven (90.2%) of all the participants were female. Among patients, 29.9% (n = 52) had mild, 21.8% (n = 38) had moderate, and 9.2% (n = 16) had severe CTS. Both the Symptom Severity Scale (SSS) and functional status scale (FSS) scores were evaluated between the groups, and there was a significant difference between the groups (P < 0.001 and P = 0.001, respectively). Although there was a significant difference between the groups, the huge overlap in the distribution of the scores indicated that discrimination of an individual according to FSS/SSS scores is unrealistic in the clinical setting. Conclusion: The BCTQ will not be sufficient and objective in the diagnosis and management of CTS. Today, electrophysiological tests are still the gold standard for the diagnosis of CTS, and referring the patient to the electromyography EMG laboratory is necessary for early diagnosis and determining the effective treatment method.
{"title":"Value of boston questionnaire in carpal tunnel syndrome","authors":"A. Sarılar, Duygu Gök","doi":"10.4103/nsn.nsn_82_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_82_21","url":null,"abstract":"Objectives: The Boston Carpal Tunnel Questionnaire (BCTQ) is a patient-based outcome measure that has been developed for patients with Carpal tunnel syndrome (CTS). The purpose of this study was to investigate the association between BCTQ scores and electrophysiological findings in patients with CTS. Subjects and Methods: This study included 174 individuals (control group [n = 68] and patient group [n = 106]) admitted to Erciyes University Hospital Department of Neurology between August 2019 and November 2019 with complaints of pain, numbness, and paresthesia in the unilateral or bilateral median nerve trace and diagnosed with idiopathic CTS or normal after electrophysiological testing. The Turkish version of the BCTQ was applied to these patients. Results: The mean age of the participants was 46.6 (standard deviation ± 11.9). One hundred and fifty-seven (90.2%) of all the participants were female. Among patients, 29.9% (n = 52) had mild, 21.8% (n = 38) had moderate, and 9.2% (n = 16) had severe CTS. Both the Symptom Severity Scale (SSS) and functional status scale (FSS) scores were evaluated between the groups, and there was a significant difference between the groups (P < 0.001 and P = 0.001, respectively). Although there was a significant difference between the groups, the huge overlap in the distribution of the scores indicated that discrimination of an individual according to FSS/SSS scores is unrealistic in the clinical setting. Conclusion: The BCTQ will not be sufficient and objective in the diagnosis and management of CTS. Today, electrophysiological tests are still the gold standard for the diagnosis of CTS, and referring the patient to the electromyography EMG laboratory is necessary for early diagnosis and determining the effective treatment method.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"8 3","pages":"245 - 249"},"PeriodicalIF":0.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41265721","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}
İrem Yıldırım, A. Gurses, E. Ataoglu, G. Kurt, U. Akdemir, A. Oner, T. Hirfanoğlu, L. Atay, A. Serdaroğlu, E. Bilir
Background: Surgical treatment of epilepsy is a favored modality in the management of refractory temporal lobe epilepsy (TLE) and known to be quite effective. The aim of this study was to evaluate the long-term outcomes in surgical treatment of TLE and to identify prognostic factors influencing postoperative seizure remission. Materials and Methods: The patients who underwent anterior temporal lobectomy (ATL) with the diagnosis of refractory TLE in our center between the years of 2006 and 2020 were included. Preoperative workup process was carried out by a multidisciplinary team and consisted of neuropsychological examination, long-term electroencephalography, brain magnetic resonance imaging (MRI), and fluorodeoxyglucose positron emission tomography (FDG-PET) for each patient. Postoperative assessment of seizure control was repeated every year following surgery and categorized according to Engel's outcome classification. The predictive value of baseline demographic, clinical, laboratory, imaging, and histopathological parameters on postoperative seizure control was also evaluated. Results: One hundred and forty-three patients who underwent ATL with the diagnosis of TLE were included. According to Engel's classification, the seizure freedom rate was found to be 83.2% at the 2nd year, 81.3% at the 4th year, and 79.2% at the 10th year after surgery. In the univariate analysis, febrile seizure (FS) history, unilateral interictal epileptiform discharges (IEDs), hippocampal sclerosis (HS) on MRI, unilateral temporal hypometabolism (HM) on FDG-PET, and HS in histopathology were predictors of seizure control at the postoperative 2nd and 10th years. FS history, unilateral localization of IEDs, and unilateral FDG-PET findings of temporal HM were found to be the independent predictors of postoperative seizure control on multivariate analysis. Conclusions: In the current study, we revealed that epilepsy surgery provides effective seizure control and represents a beneficial therapeutic option in refractory TLE. Our results also suggested that FS history, unilateral IEDs, and unilateral FDG-PET findings of temporal HM were independent predictors of seizure remission in these patients.
{"title":"Long-term surgical outcomes and predictors of surgical treatment in temporal lobe epilepsy","authors":"İrem Yıldırım, A. Gurses, E. Ataoglu, G. Kurt, U. Akdemir, A. Oner, T. Hirfanoğlu, L. Atay, A. Serdaroğlu, E. Bilir","doi":"10.4103/nsn.nsn_200_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_200_21","url":null,"abstract":"Background: Surgical treatment of epilepsy is a favored modality in the management of refractory temporal lobe epilepsy (TLE) and known to be quite effective. The aim of this study was to evaluate the long-term outcomes in surgical treatment of TLE and to identify prognostic factors influencing postoperative seizure remission. Materials and Methods: The patients who underwent anterior temporal lobectomy (ATL) with the diagnosis of refractory TLE in our center between the years of 2006 and 2020 were included. Preoperative workup process was carried out by a multidisciplinary team and consisted of neuropsychological examination, long-term electroencephalography, brain magnetic resonance imaging (MRI), and fluorodeoxyglucose positron emission tomography (FDG-PET) for each patient. Postoperative assessment of seizure control was repeated every year following surgery and categorized according to Engel's outcome classification. The predictive value of baseline demographic, clinical, laboratory, imaging, and histopathological parameters on postoperative seizure control was also evaluated. Results: One hundred and forty-three patients who underwent ATL with the diagnosis of TLE were included. According to Engel's classification, the seizure freedom rate was found to be 83.2% at the 2nd year, 81.3% at the 4th year, and 79.2% at the 10th year after surgery. In the univariate analysis, febrile seizure (FS) history, unilateral interictal epileptiform discharges (IEDs), hippocampal sclerosis (HS) on MRI, unilateral temporal hypometabolism (HM) on FDG-PET, and HS in histopathology were predictors of seizure control at the postoperative 2nd and 10th years. FS history, unilateral localization of IEDs, and unilateral FDG-PET findings of temporal HM were found to be the independent predictors of postoperative seizure control on multivariate analysis. Conclusions: In the current study, we revealed that epilepsy surgery provides effective seizure control and represents a beneficial therapeutic option in refractory TLE. Our results also suggested that FS history, unilateral IEDs, and unilateral FDG-PET findings of temporal HM were independent predictors of seizure remission in these patients.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"209 - 218"},"PeriodicalIF":0.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44887213","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: Effects of muscle cooling on the spinal stretch and monosynaptic reflexes have been studied to describe the properties of Group I and II afferents of muscle spindles. Masseter muscle differs from extremity muscles in structural and numerical features of the muscle spindles. The aim of this study was to examine the muscle spindle afferent features of masseter muscle by applying cold to understand the role of Group I and II afferents in reflexes of masseter. Patients and Methods: We included 12 healthy subjects (7 females and 5 males) in the study. Masseter inhibitory reflex (MIR), jaw tendon reflex (JTR), trigeminal motor evoked potential (MEP), and trigeminal somatosensory evoked potential (SEP) were studied before and after cold application. Left masseter muscle was cooled down to 18°C. We compared the data obtained before and after cold application. Results: After cold application, the mean total duration of MIR was shortened and it was absent in four subjects. The mean amplitude of JTR was higher after cold application (P = 0.018) without any significant change in latency. The mean latency of MEP was delayed without any change in amplitude (P = 0.003). There was no significant difference in SEPs. Conclusions: Changes observed in MIR, JTR, and MEP could not be ascribed to any specific type of muscle spindle afferents. Delayed mean reflex latencies were attributed to the effect of cold on nerve conduction. Summation of peripheral cold and pain receptor features, spindle afferents, and cortical mechanisms might have caused cold-associated changes.
{"title":"The effect of cold on the trigeminal reflexes","authors":"R. İnan, M. Erdemir-Kiziltan","doi":"10.4103/nsn.nsn_220_20","DOIUrl":"https://doi.org/10.4103/nsn.nsn_220_20","url":null,"abstract":"Objective: Effects of muscle cooling on the spinal stretch and monosynaptic reflexes have been studied to describe the properties of Group I and II afferents of muscle spindles. Masseter muscle differs from extremity muscles in structural and numerical features of the muscle spindles. The aim of this study was to examine the muscle spindle afferent features of masseter muscle by applying cold to understand the role of Group I and II afferents in reflexes of masseter. Patients and Methods: We included 12 healthy subjects (7 females and 5 males) in the study. Masseter inhibitory reflex (MIR), jaw tendon reflex (JTR), trigeminal motor evoked potential (MEP), and trigeminal somatosensory evoked potential (SEP) were studied before and after cold application. Left masseter muscle was cooled down to 18°C. We compared the data obtained before and after cold application. Results: After cold application, the mean total duration of MIR was shortened and it was absent in four subjects. The mean amplitude of JTR was higher after cold application (P = 0.018) without any significant change in latency. The mean latency of MEP was delayed without any change in amplitude (P = 0.003). There was no significant difference in SEPs. Conclusions: Changes observed in MIR, JTR, and MEP could not be ascribed to any specific type of muscle spindle afferents. Delayed mean reflex latencies were attributed to the effect of cold on nerve conduction. Summation of peripheral cold and pain receptor features, spindle afferents, and cortical mechanisms might have caused cold-associated changes.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"226 - 233"},"PeriodicalIF":0.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48825660","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}
M. Gencer, Gizem Koral, E. Şanlı, Selen Çirak, Ece Akbayır, Hande Yuceer, Tugce Kizilay, Ruziye Yildiz, S. Yentur, V. Yılmaz, E. Tuzun, R. Turkoglu
Introduction: Prevision of conversion from clinically isolated syndrome (CIS) to multiple sclerosis (MS) is required to avoid unnecessary use of immunomodulating agents and to recognize patients with high disease activity. Our aim was to evaluate the value of phosphorylated neurofilament heavy chain (pNFH, a marker for neuroaxonal degeneration) and Cyclic adenosine monophosphate response element-binding protein (cAMP response element-binding protein [CREB], a marker for neuroregeneration) levels in the prediction of conversion from CIS to MS. Methods: Twenty-three consecutively recruited treatment-naïve CIS patients were followed for 36 months. pNFH and CREB levels were measured in the first episode cerebrospinal fluid (CSF) and the serum of 12 converting (CIS-MS) and 11 nonconverting CIS patients (CIS-CIS) by enzyme-linked immunosorbent assay. Results: Baseline CSF but not serum samples of CIS-CIS patients displayed significantly lower pNFH levels compared to patients with CIS-MS. The analysis of receiver operating characteristic curve presented a high specificity for the prediction of MS conversion for the CSF pNFH cut-off level of 730.9 pg/ml. CSF pNFH levels significantly correlated with serum and CSF CREB levels. Higher baseline CSF pNFH and CREB levels were associated with more rapid progression to MS or increased disability scores. Conclusion: CSF pNFH measurement may potentially determine MS patients with unfavorable clinical progression after the first attack. pNFH and CREB appear to be increased in parallel in CSF of CIS patients with higher disease activity. These results suggest that neurofilaments are not only indicators of axonal degeneration but also partly a marker of neuronal differentiation and new axon regeneration mediated by CREB signaling pathway.
{"title":"Cerebrospinal fluid level of phosphorylated neurofilament heavy chain is higher in converting clinically isolated syndrome and correlates with CAMP response element-binding protein concentration","authors":"M. Gencer, Gizem Koral, E. Şanlı, Selen Çirak, Ece Akbayır, Hande Yuceer, Tugce Kizilay, Ruziye Yildiz, S. Yentur, V. Yılmaz, E. Tuzun, R. Turkoglu","doi":"10.4103/nsn.nsn_144_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_144_21","url":null,"abstract":"Introduction: Prevision of conversion from clinically isolated syndrome (CIS) to multiple sclerosis (MS) is required to avoid unnecessary use of immunomodulating agents and to recognize patients with high disease activity. Our aim was to evaluate the value of phosphorylated neurofilament heavy chain (pNFH, a marker for neuroaxonal degeneration) and Cyclic adenosine monophosphate response element-binding protein (cAMP response element-binding protein [CREB], a marker for neuroregeneration) levels in the prediction of conversion from CIS to MS. Methods: Twenty-three consecutively recruited treatment-naïve CIS patients were followed for 36 months. pNFH and CREB levels were measured in the first episode cerebrospinal fluid (CSF) and the serum of 12 converting (CIS-MS) and 11 nonconverting CIS patients (CIS-CIS) by enzyme-linked immunosorbent assay. Results: Baseline CSF but not serum samples of CIS-CIS patients displayed significantly lower pNFH levels compared to patients with CIS-MS. The analysis of receiver operating characteristic curve presented a high specificity for the prediction of MS conversion for the CSF pNFH cut-off level of 730.9 pg/ml. CSF pNFH levels significantly correlated with serum and CSF CREB levels. Higher baseline CSF pNFH and CREB levels were associated with more rapid progression to MS or increased disability scores. Conclusion: CSF pNFH measurement may potentially determine MS patients with unfavorable clinical progression after the first attack. pNFH and CREB appear to be increased in parallel in CSF of CIS patients with higher disease activity. These results suggest that neurofilaments are not only indicators of axonal degeneration but also partly a marker of neuronal differentiation and new axon regeneration mediated by CREB signaling pathway.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"256 - 261"},"PeriodicalIF":0.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49466165","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}
Coronavirus disease 2019 (COVID-19)-related headache is the fifth most frequent symptom and the most common neurologic manifestation of the disease with a prevalence of 6.5%–27.9%. Headache related to COVID-19 shows diverse features and can clinically manifest with different phenotypes. The most common clinical presentation is bilateral (mostly frontal or frontotemporal location), long-lasting, pressing/pulsating quality, and partially or completely resistant to analgesic treatment. The activation of the trigeminovascular system by either direct invasion of the virus or indirect mechanisms induced by cytokine storm, excess neuroinflammation, vasculopathy, and ischemia are the possible underlying pathophysiologic mechanisms. Patients with preexisting primary headaches is another important issue that needs to be enlightened to determine whether these patients are more susceptible to COVID-19-related headache. Headache is also an important symptom in patients with long COVID syndrome, which has a serious negative impact on the individuals' quality of life in the long term. Populations such as children, pregnant women, and the elderly are more vulnerable to COVID-19, and it is obvious that COVID-19 affects these populations differently. The headache characteristics and course of headache in these special populations is an important research topic that needs more focused studies. In this review, we attempted to update physicians with the new developments about COVID-19-related headaches and discuss the subject with different aspects in light of the recent “COVID-19-associated headache webinar” organized by the Global Migraine and Pain society (GMPS) in collaboration with the global COVID-19 Neuro Research Coalition and the European Academy of Neurology (EAN).
{"title":"COVID 19-Associated headache: Critical review after a scientific webinar","authors":"A. Atalar, Bengi Alpaslan Türk, A. Özge","doi":"10.4103/nsn.nsn_148_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_148_21","url":null,"abstract":"Coronavirus disease 2019 (COVID-19)-related headache is the fifth most frequent symptom and the most common neurologic manifestation of the disease with a prevalence of 6.5%–27.9%. Headache related to COVID-19 shows diverse features and can clinically manifest with different phenotypes. The most common clinical presentation is bilateral (mostly frontal or frontotemporal location), long-lasting, pressing/pulsating quality, and partially or completely resistant to analgesic treatment. The activation of the trigeminovascular system by either direct invasion of the virus or indirect mechanisms induced by cytokine storm, excess neuroinflammation, vasculopathy, and ischemia are the possible underlying pathophysiologic mechanisms. Patients with preexisting primary headaches is another important issue that needs to be enlightened to determine whether these patients are more susceptible to COVID-19-related headache. Headache is also an important symptom in patients with long COVID syndrome, which has a serious negative impact on the individuals' quality of life in the long term. Populations such as children, pregnant women, and the elderly are more vulnerable to COVID-19, and it is obvious that COVID-19 affects these populations differently. The headache characteristics and course of headache in these special populations is an important research topic that needs more focused studies. In this review, we attempted to update physicians with the new developments about COVID-19-related headaches and discuss the subject with different aspects in light of the recent “COVID-19-associated headache webinar” organized by the Global Migraine and Pain society (GMPS) in collaboration with the global COVID-19 Neuro Research Coalition and the European Academy of Neurology (EAN).","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"201 - 208"},"PeriodicalIF":0.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42595540","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: To investigate the effect of a structured home-based interactive telerehabilitation program on physical activity (PA) level, sleep, and quality of life (QoL) in older individuals who were in home confinement during the pandemic. Materials and Methods: A total of 23 participants in the age range of 65–90 (mean: 72.47 ± 5.58) years (15 females) were included in the study. A telerehabilitation exercise program was administered three times per week for 8 weeks. PA levels and sleep parameters were evaluated (using the Sensewear Armband) at baseline and at the end of the 8th week. In addition, the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale were used for self-reported evaluation of sleep, and the World Health Organization QoL Instrument-Older Adults Module was administered to evaluate the QoL. Results: Comparing pre- and postexercise evaluation results demonstrated a significant increase in PA levels and significant improvements in sleep duration, sleep latency, and daytime sleepiness. In addition, a significant increase was observed in the total QoL scores. Conclusion: The telerehabilitation exercise program seems to be an effective method to increase PA levels, improve sleep-related parameters, and enhance QoL in older adults affected by home confinement during the pandemic.
{"title":"Reversing the deconditioning effects of the pandemic in the elderly via telerehabilitation","authors":"Melis Bağkur, T. Yerlikaya, Gonca Inanc, A. Oniz","doi":"10.4103/nsn.nsn_107_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_107_21","url":null,"abstract":"Objective: To investigate the effect of a structured home-based interactive telerehabilitation program on physical activity (PA) level, sleep, and quality of life (QoL) in older individuals who were in home confinement during the pandemic. Materials and Methods: A total of 23 participants in the age range of 65–90 (mean: 72.47 ± 5.58) years (15 females) were included in the study. A telerehabilitation exercise program was administered three times per week for 8 weeks. PA levels and sleep parameters were evaluated (using the Sensewear Armband) at baseline and at the end of the 8th week. In addition, the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale were used for self-reported evaluation of sleep, and the World Health Organization QoL Instrument-Older Adults Module was administered to evaluate the QoL. Results: Comparing pre- and postexercise evaluation results demonstrated a significant increase in PA levels and significant improvements in sleep duration, sleep latency, and daytime sleepiness. In addition, a significant increase was observed in the total QoL scores. Conclusion: The telerehabilitation exercise program seems to be an effective method to increase PA levels, improve sleep-related parameters, and enhance QoL in older adults affected by home confinement during the pandemic.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"250 - 255"},"PeriodicalIF":0.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43448232","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: Paclitaxel (Ptx), used to treat cancer, still causes neuropathic pain and peripheral neuropathy today. This study was conducted to evaluate the effects of progesterone (Pg) and oxytocin (Oxy) on peripheral neuropathy rat model induced by Ptx. Materials and Methods: A total of 38 male Sprague–Dawley rats were randomly divided into five groups, e.g., control (n = 6), Ptx (n = 8), Ptx + Oxy (n = 8), Ptx + Pg (n = 8), and Ptx + Oxy + Pg (n = 8). The rats were monitored daily for body weight change throughout the experiment. To evaluate peripheral neuropathy, electroneuromyography measurements (latency, amplitude, and motor nerve conduction velocity (MNCV)) were recorded from the sciatic nerve innervating the gastrocnemius muscle. Sciatic nerve tissue samples were collected for histopathological evaluation. Results: Ptx led to significant reductions in body weight from day 6 (P < 0.05). There was no difference between groups in the distal latency and amplitudes (P > 0.05). Proximal latency was prolonged in Ptx group rats than in other groups (P < 0.05). Importantly, it was found that MNCV was higher in the Ptx + Pg group than Ptx, Ptx + Oxy, and Ptx + Oxy + Pg groups (P < 0.05). Furthermore, Pg-administered rats had the lowest nerve degeneration compared to rats administered Oxy and Oxy + Pg (P < 0.05). Conclusions: The present findings suggest that Pg has a protective effect on peripheral neuropathy induced by Ptx in rat.
{"title":"Protective effects of oxytocin and progesterone on paclitaxel-induced neuropathy in rats","authors":"M. Ekici, Muharrem Balkaya1","doi":"10.4103/nsn.nsn_113_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_113_21","url":null,"abstract":"Objective: Paclitaxel (Ptx), used to treat cancer, still causes neuropathic pain and peripheral neuropathy today. This study was conducted to evaluate the effects of progesterone (Pg) and oxytocin (Oxy) on peripheral neuropathy rat model induced by Ptx. Materials and Methods: A total of 38 male Sprague–Dawley rats were randomly divided into five groups, e.g., control (n = 6), Ptx (n = 8), Ptx + Oxy (n = 8), Ptx + Pg (n = 8), and Ptx + Oxy + Pg (n = 8). The rats were monitored daily for body weight change throughout the experiment. To evaluate peripheral neuropathy, electroneuromyography measurements (latency, amplitude, and motor nerve conduction velocity (MNCV)) were recorded from the sciatic nerve innervating the gastrocnemius muscle. Sciatic nerve tissue samples were collected for histopathological evaluation. Results: Ptx led to significant reductions in body weight from day 6 (P < 0.05). There was no difference between groups in the distal latency and amplitudes (P > 0.05). Proximal latency was prolonged in Ptx group rats than in other groups (P < 0.05). Importantly, it was found that MNCV was higher in the Ptx + Pg group than Ptx, Ptx + Oxy, and Ptx + Oxy + Pg groups (P < 0.05). Furthermore, Pg-administered rats had the lowest nerve degeneration compared to rats administered Oxy and Oxy + Pg (P < 0.05). Conclusions: The present findings suggest that Pg has a protective effect on peripheral neuropathy induced by Ptx in rat.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"262 - 270"},"PeriodicalIF":0.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43542462","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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