Ideggyogyaszati Szemle-Clinical Neuroscience最新文献

Background and purpose: Back and neck pain are among the most prevalent musculoskeletal complaints, imposing a substantial individual and societal burden on healthcare systems. Effective management requires adequate education, strong clinical decision-making skills, and accurate interpretation of red flags. This narrative literature review explores the educational, diagnostic, and decision-making aspects of back and neck pain among laypeople, healthcare students, and professionals. It aims to synthesize findings from studies assessing disease-specific knowledge to emphasize how targeted educational programs can enhance students' understanding and, consequently, improve their future clinical practice.

Methods: A thematic analysis of relevant international literature published between 2000 and 2025 was conducted. The review focused on studies examining disease-specific knowledge, differential diagnostic skills, psychosocial factors, and the interpretation of red flags. Findings were organized by target group and summarized narratively.

Results: Across all target groups, substantial gaps were identified in disease-specific knowledge, differential diagnostic competencies, and clinical decision-making skills. While educational interventions demonstra-ted po-sitive effects on knowledge levels and at- titudes, their implementation remains incon- sistent.

Conclusion: Structured, targeted educational programs introduced early in healthcare training can significantly enhance students' disease-specific knowledge. Strengthening differential diagnostic skills, improving red flag interpretation, and integrating evidence-based guidelines are essential for promoting safe, effective, and standardized clinical practice.

Background and purpose: Parkinson's disease is a combined motor and nonmotor disorder, including reduced vocal loudness, monotone, slurred speech. The only standardized, evidence-based speech therapy that currently available for people with Parkinson's disease is Lee Silverman Voice Treatment (LSVT).We aimed to present the first results of using LSVT in our country through six case studies.

Methods: Six patients with Parkinson's disease were treated at the Neurorehabilitation Department of Department of Neurology, University of Szeged. The average age of patients was 68 years. The patients' antiparkinsonian medication was not changed during the treatment. Patients received speech therapy 16 times, four times a week for 60 minutes for 4 weeks. Data were collected before and after therapy, following the LSVT Loud examining protocol that involved dictaphone recordings about sustained vowel phonation, pitch changes, reading and conversation. The voice recordings were analysed using Praat software, we annotated the sustained vowel phonations, and the pause-to pause speech segments in the reading and conversation tasks.

Results: Our results show that the quality of speech and the sound pressure level improved in all patients with the LSVT Loud technique.

Conclusion: The prevalence of Parkinson's disease and the changes in speech and voice quality demonstrate the need for expanding the therapeutic options available to manage Parkinson's speech symptoms. In addition to conventional dysarthria therapy, it is recommended to introduce Lee Silverman Voice Treatment (LSVT) into clinical practice, which can significantly improve patients' communication abilities and quality of life. Based on the results, we can say that LSVT can be successfully applied in our country.

Background and purpose: Previous suicidal intent and attempt(s) are strong risk factors for current suicidal behaviour. In psy- chiatric practice, however, there are few self-report-based suicide risk assessment measures that can cover the past suicidal spectrum from multiple aspects and identify a cut-off point for suicidal risk. Our aim was therefore to introduce the Suicide Behaviors Questionnaire Revised (SBQ-R) into the Hungarian test battery.

Methods: In our cross-sectional questionnaire study, 229 hospitalized adult psychiatric patients (mean age = 41.64 ys; SD = 14.41; 56.3% female) participated. Beside the SBQ-R, the Rihmer's Brief Suicide Questionnaire, 6-item version, the Beck Hopelessness Scale and the Minnesota Multiphasic Persona-lity Inventory-2 (MMPI-2) clinical personality questionnaire were completed.

Results: We confirmed the single-factor structure of the SBQ-R with excellent model fit indices in a Hungarian sample. The reliability of the questionnaire is adequate and its construct validity is optimal: it shows moderate to strong correlations with other measures of the suicide spectrum, with hopelessness and with the clinical scales of the MMPI-2. The cut-off point for suicidal risk was set at 7 points, broadly in line with international studies; patients at or above this value are 9 times more likely to have an expressed suicide risk. Hopelesness increases by 13.5% the possibility of the high-risk group membership based on the SBQ-R, while previous suicidal act(s) increase this odds five times higher.

Conclusion: The self-report-based SBQ-R is a reliable, valid, multi-faceted assessment of suicidal behaviour and an effective tool for screening suicidal risk.

Background and purpose: Head trauma is one of the leading causes of morbidity and mortality in childhood and can lead to traumatic brain injury (TBI). In our study, we present a retrospective analysis of the clinical and radiological findings of patients presenting with head trauma in 0-5 age range, examining the relationship between pediatric skull and brain development and age-related changes in trauma mechanisms. The study aims to evaluate the clinical characteristics and injury mechanisms in young children with head trauma, providing insights for improved management strategies tailored to this vulnerable population.

Methods: The study assessed patients who presented to Şanliurfa Education and Research Hospital between January 1, 2016, and January 1, 2022. The clinical and radiological data of 1216 patients aged 5 years and younger who were admitted due to head trauma were analyzed. Symptoms, physical examination findings, trauma mechanisms, and CT findings were evaluated for each age group.

Results: Among the included 1216 patients 62.9% (n=765) were male and 37.1% (n=451) were female. The incidence of scalp hematoma showed a significant difference in the 0-1 and 1-2 age groups (p.

Conclusion: The findings of this study reveal distinct differences in head trauma presentations among the various age groups, indicating that younger children experience different trauma mechanisms and types of injuries compared to older children. Recognizing these differences is crucial for tailoring prevention strategies and therapeutic interventions, allowing for more effective management of head trauma in pediatric patients. This study emphasizes the significance of analyzing head trauma in rapidly developing age groups. The observed variations in trauma mechanisms and clinical findings necessitate age-specific approaches in patient management, which can ultimately enhance treatment outcomes for young patients suffering from head trauma.

Background and purpose: Misfolded protein stress has come to the fore among the molecular mechanisms that can cause degeneration. Whereas one of the most important protein of adaptive Endoplasmic Reticulum stress (ERS) is XBP1, CHOP and ASK proteins are associated with apoptosis and terminal ERS. To the best of our knowledge, methylation levels of adaptive and terminal ERS genes in Parkinson's Disease (PD) patients' blood are unknown. We aimed to evaluate if there is a difference in the DNA methylation levels of the ERS related protein-coding genes in peripheral blood of PD patients compared with healthy controls. The clinical significance of these gene methylation levels was evaluated as the second aim.

Methods: DNA was isolated from the blood of PD patients (n=23) and controls (n=19). We used a methylation-specific qPCR approach to assess the methylation status of the ERS genes. The correlation between clinical findings and the methylation levels in PD patients were evaluated with appropriate statistical methods.

Results: Terminal ERS related genes were statistically significantly hypomethylated in PD (ASK1 p=0.020, and CHOP p.

Conclusion: PD patients' peripheral blood methylation levels of adaptive and terminal ERS related genes are significantly different from healthy controls'. While XBP1 is known to be neuroprotective, CHOP and ASK are important proteins in apoptosis, and their methylation differences in peripheral blood provide a clue that they could be used as biomarkers in the future. Therefore, further biomarker and treatment studies should be conducted on these proteins and their pathways.

Neuromyelitis optica spectrum disorder is a rare neuroimmunological disease associated with unpredictable deterioration. Even the first signs of the disease can be severe enough to lead to permanent neurological impairment, such as loss of vision or paralysis. Early symptoms can often be mistaken for another disease, leaving patients bouncing between several specialists, leading to diagnostic delay. Early detection of the disease can save lives and quality of life, as appropriate therapy started early can prevent neurologically debilitating deterioration. In Hungary, the "off label" rituximab has so far been given a facilitated procedure for therapy, while evidence-based medicines are not yet available to us.

Background and purpose: Spinal muscular atrophy (SMA) is a rare autosomal recessive neuromuscular disorder, affecting approximately one out of 10,000 live births. Muscular atrophy is caused by the gradual loss of alpha motor neurons within the ventral spinal cord or motor nuclei in the lower brainstem. In this study, we aimed to evaluate the carrier frequency of SMN1 gene mutation causing SMA in the Turkish Cypriot population.

Methods: This is the first study to evaluate the SMN1 deletion mutations in this population. Exon 7 and 8 deletions of the SMN1 gene, and c.849C/T substitution within exon 7 were detected by Quantitative Real-Time PCR (RT-qPCR) method.

Results: In a total of 100 individuals, 3 patients turned out to be carriers of the pathogenic SMN1 gene variant in both exon 7 and 8 (carrier status type 1) and another patient (Carrier status type 2) showed a car- rier status of SMN1 gene only in exon 7. Our findings revealed that the carrier frequency of mutation in the SMN1 gene exon 7 is 4% (4:100 healthy individuals) while for exon 8 is 3% (3:100 healthy individuals). In conclusion, health precautions must be taken due to the high frequency of SMA linked to the deletion of the SMN1 gene.

Conclusion: Carrier testing as a technique for genetic counseling may be advantageous for individuals with a positive family history or can even be a useful test in a society with a high prevalence of this disease. For this population, we strongly recommend prenatal testing. The Ministry of Health has received our findings, and they will decide whether to include tests for the SMN1 gene variant in premarital examinations.

Background and purpose: Chronic migraine (CM) and medication overuse headache (MOH) present significant therapeutic challenges, often accompanied by mood disturbances and functional impairment. Although prophylactic drug therapies remain essential, adjunct interventions such as Greater Occipital Nerve (GON) and Supraorbital Nerve (SON) blocks may offer additional benefits. This study aimed to assess whether adding these nerve blocks to standard medication prophylaxis could improve mood and functionality in patients diagnosed with CM or MOH.

Methods: A retrospective analysis was conducted on 147 patients (131 females, 16 males) treated between December 2020 and March 2021. The patients were divided into three groups: prophylactic pharmacotreatment alone, prophylactic treatment with GON block, and prophylactic treatment with combined GON and SON blocks. Following this, pain and functionality metrics were assessed using Visual Analog Scale (VAS), Migraine Disability Assessment Scale (MIDAS) and Beck Depression Inventory (BDI) scores. Statistical analyses utilized the Statistical Package for the Social Sciences (SPSS) and R software for non-parametric longitudinal data evaluation.

Results: Among the 147 patients analysed for this study, GON + SON blocks significantly reduced VAS scores from week 2 onwards (Mann-Whitney U test p = 0.021), demonstrating faster improvement compared to other treatment groups. MIDAS scores significantly improved across all groups, with the combined GON + SON blocks show- ing the most pronounced reduction (Wald Time Statistic [WTS] = 1262.52, p < 0.01). BDI scores decreased significantly over time (WTS = 997.89, p < 0.01), though no treatment-specific superiority was observed. Minimal and manageable minor complications were reported, confirming procedural safety.

Conclusion: Adding GON and SON blocks to prophylactic drug treatment enhances pain reduction and functionality in CM and MOH patients. Combined blocks yield faster, significant benefits, with VAS improvements from the second week. BDI scores improved across all groups, though mood-related gains require further study. In the future multicenter randomized controlled trials are needed.

Background and purpose: Nowadays ever more studies are devoted to the causes and background of suicide attempts by psychiatric patients. The research results so far show that the motivations behind borderline suicidality are also closely related to attachment patterns. In addition, many investigations are also directed at the disturbance of interpersonal relationships in this context. Recently, the examination of the disturbance of interpersonal relations as a risk factor has received significant emphasis. The present research aims to explore the mediating effect of Leary's interpersonal relationships in relation to attachment styles and suicidality in borderline personality disorder.

Methods: Our compiled questionnaire package was administered in the form of a paper-and-pencil test at the Traumatology Center, Crisis Intervention and Psychiatry Department, Toxicology Department and Crisis Ambulance of Péterfy Sándor Hospital with a sample of borderline patients (N = 213; 155 female, 58 male; M age = 38.16, SD age = 13.40) who underwent suicide attempts. Attachment styles were defined by the Relationship Scales Questionnaire (RSQ) and the Adult Attachment Scale (AAS), while the interpersonal relationships were assessed using Leary's Interpersonal Checklist. We tested the direct and indirect effects between the variables using structural path analysis.

Results: All attachment forms had a significant direct effect on the Managerial-Autocratic (AP) category (secure: ß = 0.32; p < 0.5; preoccupied: ß = 0.53; p < 0.5; dismissing: ß = 0.34; p.

Conclusion: In the background of the development of borderline suicidality, the disturbance of interpersonal relationships, especially the Rebellious-Distrustful (FG) category, and the risk factors behind suicidal behavior have a stronger efficacy than the attachment styles themselves. Attachment forms can exert their influence on borderline suicidality through mediating effect of interpersonal relationships.