Aim: This study aims to investigate whether asymptomatic median neuropathy (AMN) in patients with diabetic peripheral polyneuropathy (DPNP) is a result of polyneuropathic involvement of median nerve (MN) or its true entrapment. Subjects and Methods: We determined the grades of the Michigan severity scale and the rates of peripheral nerve conduction abnormalities in study subgroups, including patients with carpal tunnel syndrome (CTS), AMN, and normal MN conductions to highlight if the severity of polyneuropathic involvement was different between them. In addition, the results of conventional and comparative nerve conduction studies (NCSs) were compared between these study subgroups. Results: Distributions of Michigan grades and rates of abnormalities in peroneal and sural NCSs were similar between the subgroups (P > 0.05 for all analyses). Abnormality rates of ulnar NCSs were higher in the AMN group than in the other groups, whereas those of comparative transcarpal NCSs were higher in the CTS group. The mean distal sensory latency (DSL) and motor latency (DML) of MN were longer, sensory conduction velocity (SCV) was slower in the CTS group than AMN group, whereas MN motor conduction velocity (MCV) was slower, UN DSL was longer, SCV was slower, SNAP amplitude was smaller, DML was longer, and MCV were slower in the AMN group (P < 0.05 for all analyses). Discussion: Our findings reveal that grade of polyneuropathic involvement is more prominent in AMN, whereas transcarpal MN conduction delay is greater in CTS. The results of the study suggest that the prominence of polyneuropathic impairment in addition to a lesser degree of MN sheet compression obscures the clinical signs in patients with diabetes with AMN.
{"title":"Asymptomatic median neuropathy in patients with diabetic polyneuropathy","authors":"M. Alemdar","doi":"10.4103/nsn.nsn_54_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_54_21","url":null,"abstract":"Aim: This study aims to investigate whether asymptomatic median neuropathy (AMN) in patients with diabetic peripheral polyneuropathy (DPNP) is a result of polyneuropathic involvement of median nerve (MN) or its true entrapment. Subjects and Methods: We determined the grades of the Michigan severity scale and the rates of peripheral nerve conduction abnormalities in study subgroups, including patients with carpal tunnel syndrome (CTS), AMN, and normal MN conductions to highlight if the severity of polyneuropathic involvement was different between them. In addition, the results of conventional and comparative nerve conduction studies (NCSs) were compared between these study subgroups. Results: Distributions of Michigan grades and rates of abnormalities in peroneal and sural NCSs were similar between the subgroups (P > 0.05 for all analyses). Abnormality rates of ulnar NCSs were higher in the AMN group than in the other groups, whereas those of comparative transcarpal NCSs were higher in the CTS group. The mean distal sensory latency (DSL) and motor latency (DML) of MN were longer, sensory conduction velocity (SCV) was slower in the CTS group than AMN group, whereas MN motor conduction velocity (MCV) was slower, UN DSL was longer, SCV was slower, SNAP amplitude was smaller, DML was longer, and MCV were slower in the AMN group (P < 0.05 for all analyses). Discussion: Our findings reveal that grade of polyneuropathic involvement is more prominent in AMN, whereas transcarpal MN conduction delay is greater in CTS. The results of the study suggest that the prominence of polyneuropathic impairment in addition to a lesser degree of MN sheet compression obscures the clinical signs in patients with diabetes with AMN.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"234 - 244"},"PeriodicalIF":0.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42825803","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}
Introduction: Idiopathic generalized epilepsies (IGEs) include four different epilepsy syndromes and IGE have mostly a good response to antiepileptic drugs (AEDs). The most common IGE subgroup is juvenile myoclonic epilepsy (JME). It generally responds well to low doses of AEDs; however, some patients need higher doses of medication. In this study was hypothesized that patient and epilepsy characteristics of seizure-free patients with high drug load might differ from those with low drug load. For this purpose, it was aimed to compare patients with JME and patients with other generalized epilepsies (non-JME IGE) regarding these factors concerning drug load. Patients and Methods: The records of the epilepsy outpatient clinic from 2010 to 2020 were retrospectively evaluated for patients with IGEs. Patients without any epileptic seizures in the last year were accepted as seizure-free. Drug load is calculated by dividing the prescribed daily dose by defined daily dose (PDD/DDD). A total drug load (TDL) equal to one and greater was considered as a high TDL (≥1, high-TDL group), where a drug load of below one was considered as a low TDL (<1, low-TDL group). The high-TDL and low-TDL groups in patients with JME and non-JME IGE were compared in terms of sociodemographic characteristics, personal and family histories, duration of epilepsy, seizure characteristics, epilepsy syndromes, electroencephalography findings, and AEDs and doses. Results: In this study, 119 patients (69 females, 50 males) with a mean age of 30.11 (range, 18–65) years were included. The mean age of onset and duration of the disease was 16.21 (range, 3–47) years and 13.6 (1–45) years, respectively. Sixty-three of the patients were diagnosed as having JME, and 56 patients were diagnosed as having non-JME IGE (39 with generalized tonic-clonic seizures alone, 17 juvenile absence epilepsy). According to the TDL, 35 patients were classified in the low-TDL group and 84 patients in the high-TDL group. The age of disease onset was higher in the non-JME IGE group (P = 0.027). Triple-type seizures were significantly more common in the JME group (P < 0.001). No statistically significant differences were found between the low- and high-TDL groups regarding patient and epilepsy characteristics in the JME and non-JME IGE groups. Conclusion: Most seizure-free patients had low-TDL in the JME and non-JME IGE groups. No association was observed in the JME and non-JME IGE groups regarding the total AED load.
{"title":"Effects of patient and seizure-related factors on drug load in seizure-free patients with idiopathic generalized epilepsy","authors":"Fulya Eren, Günay Gül","doi":"10.4103/nsn.nsn_104_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_104_21","url":null,"abstract":"Introduction: Idiopathic generalized epilepsies (IGEs) include four different epilepsy syndromes and IGE have mostly a good response to antiepileptic drugs (AEDs). The most common IGE subgroup is juvenile myoclonic epilepsy (JME). It generally responds well to low doses of AEDs; however, some patients need higher doses of medication. In this study was hypothesized that patient and epilepsy characteristics of seizure-free patients with high drug load might differ from those with low drug load. For this purpose, it was aimed to compare patients with JME and patients with other generalized epilepsies (non-JME IGE) regarding these factors concerning drug load. Patients and Methods: The records of the epilepsy outpatient clinic from 2010 to 2020 were retrospectively evaluated for patients with IGEs. Patients without any epileptic seizures in the last year were accepted as seizure-free. Drug load is calculated by dividing the prescribed daily dose by defined daily dose (PDD/DDD). A total drug load (TDL) equal to one and greater was considered as a high TDL (≥1, high-TDL group), where a drug load of below one was considered as a low TDL (<1, low-TDL group). The high-TDL and low-TDL groups in patients with JME and non-JME IGE were compared in terms of sociodemographic characteristics, personal and family histories, duration of epilepsy, seizure characteristics, epilepsy syndromes, electroencephalography findings, and AEDs and doses. Results: In this study, 119 patients (69 females, 50 males) with a mean age of 30.11 (range, 18–65) years were included. The mean age of onset and duration of the disease was 16.21 (range, 3–47) years and 13.6 (1–45) years, respectively. Sixty-three of the patients were diagnosed as having JME, and 56 patients were diagnosed as having non-JME IGE (39 with generalized tonic-clonic seizures alone, 17 juvenile absence epilepsy). According to the TDL, 35 patients were classified in the low-TDL group and 84 patients in the high-TDL group. The age of disease onset was higher in the non-JME IGE group (P = 0.027). Triple-type seizures were significantly more common in the JME group (P < 0.001). No statistically significant differences were found between the low- and high-TDL groups regarding patient and epilepsy characteristics in the JME and non-JME IGE groups. Conclusion: Most seizure-free patients had low-TDL in the JME and non-JME IGE groups. No association was observed in the JME and non-JME IGE groups regarding the total AED load.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"219 - 225"},"PeriodicalIF":0.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46457211","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}
F. Ozden, Mehmet Özkeskin, Z. Sari, Ö. Ekmekçi, N. Yüceyar
Objective: The aim of the study was to translate and cross-culturally adapt the Telehealth Usability Questionnaire (TUQ) and the Telemedicine Satisfaction Questionnaire (TSQ) into Turkish and also to analyze the reliability and validity of both questionnaires. Materials and Methods: A total of 107 multiple sclerosis (MS) patients were recruited. The department clinician monitored all participants with telemedicine for 4 years. Internal consistency was evaluated with Cronbach's alpha coefficient. The test–retest reliability was calculated with intraclass correlation coefficient by analyzing the scores of retested 52 patients 1 week later. The construct validity was examined by Pearson's correlation coefficient (r). Besides, the internal consistency for the subscores of the TUQ and exploratory factor analysis of the TSQ was analyzed. Results: The mean age was 40.5 ± 11.0 years. Internal consistency of all items and the total score of the TUQ were excellent (>0.80; ranged: 0.976–0.979). On the other hand, the internal consistency of all items and total score of the TSQ was excellent, either (>0.80; ranged: 0.969–0.973). The reproducibility of the total score for the TUQ was excellent (>0.80). The test–retest reliability of all items and the total score of the TSQ were within limits ranging from acceptable to excellent (0.617–0.860). The reliability of the total score for the TSQ was excellent (>0.80). The internal consistency of all subscales of the TUQ was excellent (>0.80). The correlation between TUQ and TSQ was strong (r = 0.882, P < 0.001). The factor loading scores of the TSQ were high (0.814–0.919). Conclusions: The Turkish version of the TUQ and the TSQ are valid and reliable in MS patients.
{"title":"The reliability and validity of the Turkish version of the telehealth usability questionnaire and the telemedicine satisfaction questionnaire in patients with multiple sclerosis","authors":"F. Ozden, Mehmet Özkeskin, Z. Sari, Ö. Ekmekçi, N. Yüceyar","doi":"10.4103/nsn.nsn_41_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_41_21","url":null,"abstract":"Objective: The aim of the study was to translate and cross-culturally adapt the Telehealth Usability Questionnaire (TUQ) and the Telemedicine Satisfaction Questionnaire (TSQ) into Turkish and also to analyze the reliability and validity of both questionnaires. Materials and Methods: A total of 107 multiple sclerosis (MS) patients were recruited. The department clinician monitored all participants with telemedicine for 4 years. Internal consistency was evaluated with Cronbach's alpha coefficient. The test–retest reliability was calculated with intraclass correlation coefficient by analyzing the scores of retested 52 patients 1 week later. The construct validity was examined by Pearson's correlation coefficient (r). Besides, the internal consistency for the subscores of the TUQ and exploratory factor analysis of the TSQ was analyzed. Results: The mean age was 40.5 ± 11.0 years. Internal consistency of all items and the total score of the TUQ were excellent (>0.80; ranged: 0.976–0.979). On the other hand, the internal consistency of all items and total score of the TSQ was excellent, either (>0.80; ranged: 0.969–0.973). The reproducibility of the total score for the TUQ was excellent (>0.80). The test–retest reliability of all items and the total score of the TSQ were within limits ranging from acceptable to excellent (0.617–0.860). The reliability of the total score for the TSQ was excellent (>0.80). The internal consistency of all subscales of the TUQ was excellent (>0.80). The correlation between TUQ and TSQ was strong (r = 0.882, P < 0.001). The factor loading scores of the TSQ were high (0.814–0.919). Conclusions: The Turkish version of the TUQ and the TSQ are valid and reliable in MS patients.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"173 - 179"},"PeriodicalIF":0.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45701665","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":"Ribot's law and leo tolstoy","authors":"C. Erteki̇n","doi":"10.4103/nsn.nsn_53_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_53_21","url":null,"abstract":"","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"199 - 199"},"PeriodicalIF":0.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41693381","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}
Ebru Boluk, C. Uzunoğlu, Y. Seçil, Y. Çetinoğlu, Ş. Arıcı, M. Gelal, Tülay Kurt-İncesu
Objectives: Patients are frequently referred to electrophysiology laboratories by physicians from various specialties with a presumptive diagnosis of radiculopathy. Recent advances in spinal imaging techniques have led to an increase in magnetic resonance imaging (MRI) studies in the diagnosis of radiculopathy. This study aimed to compare these two techniques in the diagnosis of radiculopathy. Subjects and Methods: Data of 170 patients who were diagnosed as having radiculopathy using electrophysiologic studies in our laboratory by defining a myotome level and who had spinal MRI examinations in our hospital database were included in the study. Results: Among the 170 patients in our study, 40% (n = 68) had cervical radiculopathy and 60% (n = 102) had lumbar radiculopathy. In the electrophysiologic diagnosis of radiculopathy, the most sensitive root level of electromyography (EMG) was the C7 radix level in the cervical region and the L5 level in the lumbar region. Correlations between radiologic grading based on foraminal assessments for radicular involvement at the cervical region using MRI and EMG data showed fair agreement in C5, C7, and C8 radix levels (κ: 0.21–0.40), and the lumbar region showed fair agreement in L4 and L5 radix levels (κ: 0.21–0.40). Conclusion: Although EMG has indisputable importance in the diagnosis of radiculopathy, its use with MRI significantly increases the diagnostic power at most spinal levels.
{"title":"The role of electrophysiology in the diagnosis of radiculopathy and its comparison with magnetic resonance imaging","authors":"Ebru Boluk, C. Uzunoğlu, Y. Seçil, Y. Çetinoğlu, Ş. Arıcı, M. Gelal, Tülay Kurt-İncesu","doi":"10.4103/nsn.nsn_14_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_14_21","url":null,"abstract":"Objectives: Patients are frequently referred to electrophysiology laboratories by physicians from various specialties with a presumptive diagnosis of radiculopathy. Recent advances in spinal imaging techniques have led to an increase in magnetic resonance imaging (MRI) studies in the diagnosis of radiculopathy. This study aimed to compare these two techniques in the diagnosis of radiculopathy. Subjects and Methods: Data of 170 patients who were diagnosed as having radiculopathy using electrophysiologic studies in our laboratory by defining a myotome level and who had spinal MRI examinations in our hospital database were included in the study. Results: Among the 170 patients in our study, 40% (n = 68) had cervical radiculopathy and 60% (n = 102) had lumbar radiculopathy. In the electrophysiologic diagnosis of radiculopathy, the most sensitive root level of electromyography (EMG) was the C7 radix level in the cervical region and the L5 level in the lumbar region. Correlations between radiologic grading based on foraminal assessments for radicular involvement at the cervical region using MRI and EMG data showed fair agreement in C5, C7, and C8 radix levels (κ: 0.21–0.40), and the lumbar region showed fair agreement in L4 and L5 radix levels (κ: 0.21–0.40). Conclusion: Although EMG has indisputable importance in the diagnosis of radiculopathy, its use with MRI significantly increases the diagnostic power at most spinal levels.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"151 - 157"},"PeriodicalIF":0.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43330992","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}
K. Tufekci, J. Allmer, K. Carman, E. Bayram, Y. Topçu, S. Hiz, Ş. Genç, U. Yiş
Background: Subacute sclerosing panencephalitis (SSPE) is a chronic, progressive disease caused by a persistent infection of the measles virus. Despite extensive efforts, the exact neurodegeneration mechanism in SSPE remains unknown. MicroRNAs (miRNAs) have emerged as an essential part of cellular antiviral defense mechanisms and can be modulated by antiviral cytokines Such as interferon-beta (IFN-β). Aims and Objectives: In this study, we aimed to elucidate the role of antiviral miRNAs in the pathogenesis of SSPE and analyze the interaction between host antiviral miRNAs and virus genes. Materials and Methods: Thirty-seven patients who were followed with SSPE and age-matched healthy children were included in the study. Peripheral blood mononuclear cell levels of miR-196b, miR-296, miR-431, and miR-448 were analyzed using quantitative polymerase chain reaction. Target predictions and pathway constructions of deregulated miRNAs were assessed. Results: Here, we showed that IFN-β-modulated miR-196b, miR-296, and miR-431 were significantly upregulated in patients with SSPE compared with healthy controls. Besides, sequence complementarity analysis showed that miR-296 and miR-196b predicted binding regions in measles virus genomic RNA. Conclusion: Our findings suggest that antiviral miRNAs are upregulated in patients with SSPE, which could be a part of the host antiviral defense mechanism.
{"title":"Antiviral microRNA expression signatures are altered in subacute sclerosing panencephalitis","authors":"K. Tufekci, J. Allmer, K. Carman, E. Bayram, Y. Topçu, S. Hiz, Ş. Genç, U. Yiş","doi":"10.4103/nsn.nsn_57_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_57_21","url":null,"abstract":"Background: Subacute sclerosing panencephalitis (SSPE) is a chronic, progressive disease caused by a persistent infection of the measles virus. Despite extensive efforts, the exact neurodegeneration mechanism in SSPE remains unknown. MicroRNAs (miRNAs) have emerged as an essential part of cellular antiviral defense mechanisms and can be modulated by antiviral cytokines Such as interferon-beta (IFN-β). Aims and Objectives: In this study, we aimed to elucidate the role of antiviral miRNAs in the pathogenesis of SSPE and analyze the interaction between host antiviral miRNAs and virus genes. Materials and Methods: Thirty-seven patients who were followed with SSPE and age-matched healthy children were included in the study. Peripheral blood mononuclear cell levels of miR-196b, miR-296, miR-431, and miR-448 were analyzed using quantitative polymerase chain reaction. Target predictions and pathway constructions of deregulated miRNAs were assessed. Results: Here, we showed that IFN-β-modulated miR-196b, miR-296, and miR-431 were significantly upregulated in patients with SSPE compared with healthy controls. Besides, sequence complementarity analysis showed that miR-296 and miR-196b predicted binding regions in measles virus genomic RNA. Conclusion: Our findings suggest that antiviral miRNAs are upregulated in patients with SSPE, which could be a part of the host antiviral defense mechanism.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"166 - 172"},"PeriodicalIF":0.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45425787","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 home-based interactive telerehabilitation program on balance performance in older people, and to compare the results with a nonsupervised home exercise (NHE) program. Subjects and Methods: A total of 50 participants (35 females), aged 65–90 years, were included in the study. The subjects were randomly assigned to one of three groups as the interactive telerehabilitation home exercise group (ITHE), NHE group or control group. The ITHE and NHE groups exercised three times per week for 8 weeks. The outcome measures were the Berg Functional Balance Scale (BBS), Timed Up and Go Test (TUG), Sway Balance Mobile Application, Trait Anxiety Inventory (TAI), and the World Health Organization Quality of Life Instrument-Older Adults Module (WHL). Results: In the control group, no difference was observed in the TUG and BBS scores, at the end of the 8 weeks compared with preexercise (pre-ex), whereas these scores increased significantly in the NHE (TUG: P < 0.001, BBS: P < 0.001) and ITHE groups (TUG: P < 0.001, BBS: P = 0.003). The WHL scores increased significantly in all three groups, and no difference was observed in the TAI scores. There was a significant difference in SWAY score only in the telerehabilitation group compared with pre-ex (P < 0.001). Conclusions: Although NHE and ITHE were effective on the improvement of balance, mobility and reduction of fall risk in older individuals, this effect was found to be greater in the ITHE group. Quality of life increased in all groups, but no change in anxiety level was observed.
目的:探讨以家庭为基础的交互式远程康复项目对老年人平衡能力的影响，并与无监督的家庭锻炼(NHE)项目进行比较。对象与方法:共纳入50例受试者，其中女性35例，年龄65 ~ 90岁。研究对象被随机分为交互式远程康复家庭运动组、NHE组和对照组。ITHE组和NHE组每周锻炼三次，持续8周。结果测量为Berg功能平衡量表(BBS)、计时起走测试(TUG)、摇摆平衡移动应用程序、特质焦虑量表(TAI)和世界卫生组织生活质量工具-老年人模块(WHL)。结果:在对照组中，8周结束时TUG和BBS评分与运动前(前ex)相比无差异，而NHE组(TUG: P < 0.001, BBS: P < 0.001)和ITHE组(TUG: P < 0.001, BBS: P = 0.003)这些评分显著增加。三组患者WHL评分均显著升高，TAI评分无显著差异。仅远程康复组SWAY评分与预康复组比较差异有统计学意义(P < 0.001)。结论:尽管NHE和ITHE对改善老年人的平衡、活动能力和降低跌倒风险有效，但ITHE组的效果更大。所有组的生活质量都有所提高，但焦虑水平没有变化。
{"title":"The effect of an interactive tele rehabilitation program on balance in older individuals","authors":"T. Yerlikaya, A. Öniz, Murat Özgùren","doi":"10.4103/nsn.nsn_91_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_91_21","url":null,"abstract":"Objective: To investigate the effect of a home-based interactive telerehabilitation program on balance performance in older people, and to compare the results with a nonsupervised home exercise (NHE) program. Subjects and Methods: A total of 50 participants (35 females), aged 65–90 years, were included in the study. The subjects were randomly assigned to one of three groups as the interactive telerehabilitation home exercise group (ITHE), NHE group or control group. The ITHE and NHE groups exercised three times per week for 8 weeks. The outcome measures were the Berg Functional Balance Scale (BBS), Timed Up and Go Test (TUG), Sway Balance Mobile Application, Trait Anxiety Inventory (TAI), and the World Health Organization Quality of Life Instrument-Older Adults Module (WHL). Results: In the control group, no difference was observed in the TUG and BBS scores, at the end of the 8 weeks compared with preexercise (pre-ex), whereas these scores increased significantly in the NHE (TUG: P < 0.001, BBS: P < 0.001) and ITHE groups (TUG: P < 0.001, BBS: P = 0.003). The WHL scores increased significantly in all three groups, and no difference was observed in the TAI scores. There was a significant difference in SWAY score only in the telerehabilitation group compared with pre-ex (P < 0.001). Conclusions: Although NHE and ITHE were effective on the improvement of balance, mobility and reduction of fall risk in older individuals, this effect was found to be greater in the ITHE group. Quality of life increased in all groups, but no change in anxiety level was observed.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"180 - 186"},"PeriodicalIF":0.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48730966","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: Sympathetic control of the circulation is considerably affected by female reproductive hormones. Sudomotor function can be easily evaluated with sympathetic skin response (SSR). Although studies reveal that SSR amplitude decreases with hormone replacement therapy, the effect of estrogen on SSR is unclear. Measuring axonal excitability provides information about the physiological and physical properties of axonal ion channels and nerves. Axonal excitability tests may also give valuable information about the pathophysiology underlying neuronal disorders. In this study, we investigate the influence of female hormones, especially estrogen, on neuronal excitability and the sympathetic nervous system. Methods: SSR and strength–duration time constant (SDTC) tests were conducted on healthy women with a mean age of 26 ± 4 years with regular menstrual cycles. The tests were performed during the first 3 days of the menstrual cycle when the level of estrogen is at its lowest and 2 days before ovulation when the estrogen is at its highest level. Results: SDTC, rheobase, and the latency of SSR were found to be relatively shorter at 2 days before ovulation when compared with the values of the first 3 days of the menstrual cycle. However, the difference was not statistically significant (P > 0.05). Discussion: The SDTC and SSR values in the 2 days before ovulation and the first 3 days of the menstrual cycle did not show any significant differences. We suggested that these parameters do not affect neuronal excitability associated with varied estrogen levels. Conclusion: Further research will be required to fully understand the influence of sex hormones on the nervous system in menstrual cycles, which can suggest underlying mechanisms of various diseases that are linked with autonomic and hormonal alterations.
{"title":"The effects of menstrual cycle on sympathetic skin response and strength–duration properties","authors":"A. Keskin, V. Yerdelen","doi":"10.4103/nsn.nsn_184_20","DOIUrl":"https://doi.org/10.4103/nsn.nsn_184_20","url":null,"abstract":"Background: Sympathetic control of the circulation is considerably affected by female reproductive hormones. Sudomotor function can be easily evaluated with sympathetic skin response (SSR). Although studies reveal that SSR amplitude decreases with hormone replacement therapy, the effect of estrogen on SSR is unclear. Measuring axonal excitability provides information about the physiological and physical properties of axonal ion channels and nerves. Axonal excitability tests may also give valuable information about the pathophysiology underlying neuronal disorders. In this study, we investigate the influence of female hormones, especially estrogen, on neuronal excitability and the sympathetic nervous system. Methods: SSR and strength–duration time constant (SDTC) tests were conducted on healthy women with a mean age of 26 ± 4 years with regular menstrual cycles. The tests were performed during the first 3 days of the menstrual cycle when the level of estrogen is at its lowest and 2 days before ovulation when the estrogen is at its highest level. Results: SDTC, rheobase, and the latency of SSR were found to be relatively shorter at 2 days before ovulation when compared with the values of the first 3 days of the menstrual cycle. However, the difference was not statistically significant (P > 0.05). Discussion: The SDTC and SSR values in the 2 days before ovulation and the first 3 days of the menstrual cycle did not show any significant differences. We suggested that these parameters do not affect neuronal excitability associated with varied estrogen levels. Conclusion: Further research will be required to fully understand the influence of sex hormones on the nervous system in menstrual cycles, which can suggest underlying mechanisms of various diseases that are linked with autonomic and hormonal alterations.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"147 - 150"},"PeriodicalIF":0.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45076492","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 and Purpose: Cerebral venous sinus thrombosis (CVST) is one of the rare causes of cerebrovascular disease and has an extremely heterogeneous prognosis. The aim of this study was to investigate the potential relationship between early neurological deterioration, poor clinical outcome in CVST and the venous collateral score. Materials and Methods: A total of 121 patients diagnosed with CVST between 2010 and 2020 were retrospectively included. The demographic, clinical, and radiological findings related to venous sinus thrombosis and early neurological deterioration were investigated in relation to the clinical outcome. Results: The factors associated with early neurological deterioration were superior sagittal sinus thrombosis (P < 0.001), sinus rectus thrombosis (P = 0.031), parenchymal lesions (P < 0.001), and venous collateral score (P < 0.001). The factors associated with poor clinical outcome were superior sagittal sinus thrombosis (P < 0.001), cortical vein thrombosis (P < 0.001), venous collateral score (P < 0.001), and initial clinical symptoms. Binary logistic regression analyses revealed poor clinical outcome as a significant variable, with a venous collateral scale of 0 or 1 as a risk factor for a poor outcome (significance of the model P < 0.001). Conclusion: Early neurologic deterioration and poor clinical outcome may occur due to poor collateralization in CVST. Identifying the subgroup of CVST patients at risk of clinical deterioration is therefore important. This study highlights the clinical importance of venous collaterals; however, larger prospective multicenter studies are required to confirm the relationship with venous collaterals in patients with CVST.
{"title":"The relationship between early neurological deterioration, poor clinical outcome, and venous collateral score in cerebral venous sinus thrombosis","authors":"Yasemin Dinç, Rıfat Özpar, B. Hakyemez, M. Bakar","doi":"10.4103/nsn.nsn_223_20","DOIUrl":"https://doi.org/10.4103/nsn.nsn_223_20","url":null,"abstract":"Background and Purpose: Cerebral venous sinus thrombosis (CVST) is one of the rare causes of cerebrovascular disease and has an extremely heterogeneous prognosis. The aim of this study was to investigate the potential relationship between early neurological deterioration, poor clinical outcome in CVST and the venous collateral score. Materials and Methods: A total of 121 patients diagnosed with CVST between 2010 and 2020 were retrospectively included. The demographic, clinical, and radiological findings related to venous sinus thrombosis and early neurological deterioration were investigated in relation to the clinical outcome. Results: The factors associated with early neurological deterioration were superior sagittal sinus thrombosis (P < 0.001), sinus rectus thrombosis (P = 0.031), parenchymal lesions (P < 0.001), and venous collateral score (P < 0.001). The factors associated with poor clinical outcome were superior sagittal sinus thrombosis (P < 0.001), cortical vein thrombosis (P < 0.001), venous collateral score (P < 0.001), and initial clinical symptoms. Binary logistic regression analyses revealed poor clinical outcome as a significant variable, with a venous collateral scale of 0 or 1 as a risk factor for a poor outcome (significance of the model P < 0.001). Conclusion: Early neurologic deterioration and poor clinical outcome may occur due to poor collateralization in CVST. Identifying the subgroup of CVST patients at risk of clinical deterioration is therefore important. This study highlights the clinical importance of venous collaterals; however, larger prospective multicenter studies are required to confirm the relationship with venous collaterals in patients with CVST.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"158 - 165"},"PeriodicalIF":0.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41952128","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}
Turner syndrome (TS) is one of the most common sex chromosome abnormalities in women, but there are only a few case reports of patients with TS who have epilepsy or seizures. Here, we report two additional cases with drug-resistant temporal lobe epilepsy (TLE) and TS mosaicism. Patient #1 is a 22-year-old female with drug-resistant TLE whose karyotype analysis showed that 84% of interphase cells had (45,X) genotype and brain magnetic resonance imaging (MRI) initially reported as normal showed developmental left temporal lobe encephalocele. She underwent left temporal lobectomy, and she is seizure free for 10-year postoperative follow-up period. Patient #2 is a 49-year-old female who has TLE with normal brain MRI. The karyotype analysis showed that 2/30 of metaphase cells had (45, X) genotype. In addition, 11 cases of epilepsy associated with TS were determined through PubMed. The clinical characteristics of all are reviewed.
{"title":"Refractory temporal lobe epilepsy in patients with mosaic turner syndrome: two case reports and literature review","authors":"Doruk Arslan, Eda Ütine, S. Saygi","doi":"10.4103/nsn.nsn_37_21","DOIUrl":"https://doi.org/10.4103/nsn.nsn_37_21","url":null,"abstract":"Turner syndrome (TS) is one of the most common sex chromosome abnormalities in women, but there are only a few case reports of patients with TS who have epilepsy or seizures. Here, we report two additional cases with drug-resistant temporal lobe epilepsy (TLE) and TS mosaicism. Patient #1 is a 22-year-old female with drug-resistant TLE whose karyotype analysis showed that 84% of interphase cells had (45,X) genotype and brain magnetic resonance imaging (MRI) initially reported as normal showed developmental left temporal lobe encephalocele. She underwent left temporal lobectomy, and she is seizure free for 10-year postoperative follow-up period. Patient #2 is a 49-year-old female who has TLE with normal brain MRI. The karyotype analysis showed that 2/30 of metaphase cells had (45, X) genotype. In addition, 11 cases of epilepsy associated with TS were determined through PubMed. The clinical characteristics of all are reviewed.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"194 - 198"},"PeriodicalIF":0.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44653644","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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