Ideggyogyaszati Szemle-Clinical Neuroscience最新文献

Background and purpose:

Although ru­mination and schizotypal traits can be considered transdiagnostic phenomena and can occur within non-clinical population as well, a relatively small number of research has been carried out on the topic involving both patient and non clinical participants. The aim of this study is to examine the rela­tionship between schizotypal traits and rumination using a transdiagnostic approach, involving participants living with psychotic disorders and sine morbo individuals.

Methods:

We recruited participants living with psychotic disorders (paranoid schizophrenia, hebephrenia, schizoaffective disorder, etc.) (n = 30) and controls who had not been diagnosed with any mental illnesses (n = 67). The connection between rumination and schizotypal traits was examined by self-report questionnaire method in a cross-sectional arrangement. The Oxford-Liverpool Inventory was used to measure schizotypal traits, and the Ruminative Thought Style Questionnaire was used to determine the level of rumination. 

Results:

Schizotypal symptoms (β = 0.575; p < 0.001), especially cognitive disorganization (β = 0.459; p < 0.001) and unusual experiences (β = 0.221; p = 0.029) significantly explained the degree of rumination. 

Conclusion:

Our results support the hypothesis that the association between rumination and schizotypic traits is due to decreased cognitive inhibitory functions.

Background and purpose:

Long noncoding RNAs (lncRNAs) are highly expressed in the brain and alterations in their levels have been shown in many neurodegenerative disorders. Evidence has shown that lncRNAs play role in the onset and progression of Parkinson’s disease (PD) and it can be used as a potential therapeutic target. Our purpose was to detect whether the serum levels of four candidate lncRNAs H19, GAS5, HAR1B and LINC01783 are related with the clinical findings and treatment of PD or not. 

Methods:

83 patients and 50 healthy controls were included in this study. We assessed how severe the disease is, by using Hoehn Yahr (HY) staging and Unified PD rating scale (UPDRS). Venous blood samples were taken from the participants. Serum samples were centrifuged and stored at -80°C until analysis. Expression levels of these lncRNAs were analyzed by a real-time PCR instrument after RNA isolation and complementary DNA synthesis in the laboratory.

Results:

There was no significant difference between PD patients and healthy controls in these lncRNAs’ serum levels. Just as sociodemographic characteristics, also onset type and right or left predominance of the disease, its duration and treatment did not differ in lncRNA levels. Solely, there was a significant negative correlation between GAS5 and HY and UPDRS scores. Patients with family history of PD had significantly higher levels of LINC01783.

Conclusion:

Serum lncRNA GAS5 level may be a possible biomarker for disease severity in PD patients. 

Background and purpose:

The decline of episodic memory is one of the earliest cognitive markers of mild cognitive impairment and various types of dementia. Until today, however, there is no standardized Hun­garian episodic memory test that takes into account the characteristics of the Hungarian language. The study presents the structure and standardized use of a new memory test (Verbal Episodic Memory Test, VEMT) as well as normative data in Hungary. 

Methods:

The VEMT is suitable for the comprehensive examination of verbal learning abilities in a broader sense, and more specifically, for the neuropsychological measurement of verbal list learning abilities. In the present study, we constructed a normative database consisting of data from 385 participants.

Results:

We showed that the VEMT is sensitive to demographic factors (e.g., age) which are linked to differences in episodic memory performance. Open access to the test is provided, and the normative scores are presented as well. 

Conclusion:

The indicators of the test are suitable for drawing a learning curve, for showing the interaction of new and previously learned information (interference effects), and for measuring differences between free recall and cued recall. Furthermore, the test scores are appropriate for distinguishing the effects of different types of memory encoding forms (phonological, semantic, and episodic), for measuring the ability to reconstruct the presentation of a sequence (memory order information), for detecting the rate of forgetting, for measuring recognition abilities, and for detecting hippocampus-related mnemonic pattern separation and completion functions. 

Background and purpose:

Using patient registries is essential both in clinical research and in medical practice. Headaches, more specifically migraines are one of the most common complaints that can detract the quality of a patient’s life and these complaints also have a significant socio-econo­mic effect. Our goal is to create a national Headache Registry and to also provide the pre-analysis of the registry’s database.

Methods:

Our research is based on the national Multiple Sclerosis Registry, which we modified using the latest version of diagnostic criteria published by the International Headache Society. This clinical study contains data collected from patients suffering from migraines and currently receiving care at the Headache Outpatient Department at the Neurologic Clinic of the University of Szeged.

Results:

The data of 412 patients (363 wo­men and 49 men) suffering from migraine (migraine without aura: n = 313 and migraine with aura: n = 99) were added to the Headache Registry. The average age of participants was 44.1 ± 12.5 SD years. Regarding the attributes of migraine headaches we examined the following characteristics: localization, quality and intensity (based on the Visual Analogue Scale) of the pain, frequency (the number of headache days per month), medications (acute or prophylactic), comorbidities (depression, anxiety, hypertension, asthma, epilepsy and others), family history and the occurrence of stroke among patients.

Conclusion:

Based on international expe­rience, patient registries are the most optimal systems for structured patient mo­nitoring. For high level management and long-term follow up of the patients the application of registries is essential. The registries include the detailed medical history and the diagnostic and therapeutic data of the patients, and they trace the changes during the follow up medical visits. Registries are able to record the entire course of the disease in digital way. The numerous data can be set out any time from the digital database. Extensive spread of patients’ registries is fundamental not only in every day clinical practice, but also in clinical research.

Background and purpose:

 Thrombolysis and/or thrombectomy have been proven effective in the treatment of acute ischemic stroke. Due to the narrow time window, the number of patients suitable for these treatments is low. The main limitation is the pre-hospital stage, few people call an ambulance in time. The delay may be caused by the population’s insufficient health knowledge, but also by the loneliness and isolation of the population most prone to stroke. Among the latter, there are many grandparents who spend considerable time with their grandchildren. This gave rise to the idea of educating even younger children about the symptoms of a stroke, enabling them to call an ambulance if necessary. To this end, we adapted the Angels Initiative project previously tested in Greece. The Hungarian pilot study Budapest District XII. took place in district kindergartens. The Angels’ original role-playing program could not be implemented due to the COVID epidemic, so the necessity called for a new, Hungarian version: the online “Stroke Ovi” program. We introduced this in several stages, and in the third we also carried out an impact study.

Methods:

 We adapted the Angels Initiative’s international program and its Hungarian translation to our program. We prepared the original, live role-playing form, with a parent meeting in the selected “test kindergarten”. Due to the uncertainly lingering impact of the COVID epidemic, we reevaluated our plan, using the Hungarian storybook and take-home workbook created in the meantime, we developed our own online version in several kindergartens in Budapest. We held 10 and then 25 minute sessions a week for 5 weeks. In the third educational cycle, which always targets new groups, we already examined the impact of the program by taking pre- and post-tests, in which not only the children but also their parents participated. In addition to neurologists and kindergarten teachers, we also included psychologists and speech therapists in our work, because we believed that in a social environment that includes parents and children, results can only be achieved through multidisciplinary cooperation.

Results:

 In the third cycle of the program, tests were taken before (pre-test) and after (post-test) among children and their parents. We only took into account those answers where we received an evaluable answer in the survey before and after the program. Our most important results: 1. there was no negative change in any question, so it was not the case that the total score of any question in the pre-test was higher than in the post-test. 2. The children learned that not only adults can call the ambulance. 3. Before the program, all children were already aware that if “someone is very ill”, the ambulance should be called. 4. Among the questions about stroke symptoms, it is important

Background and purpose:

This study aims to investigate the validity and reliability of the Turkish Version of the 39-item Parkinson Disease Questionnaire.

Methods:

A total of 100 patients with Parkinson’s disease who were admitted to the outpatient neurology clinic in Koc University and Istanbul University were enrolled. 39-item Parkinson Disease Questionnaire, Parkinson Disease Quality of Life Questionnaire, Unified Parkinson’s Disease Rating Scale, Hoehn-Yahr Scale, and Short Form Health Survey-36 were administered to all participants. 39-item Parkinson Disease Questionnaire was repeated 2 weeks later.

Results:

The internal consistency coefficient of the 39-item Parkinson Disease Questionnaire was 0.957. Test-retest correlation ranged between r = 0.693-0.979. Reliability of Turkish version of the 39-item Parkinson Disease Questionnaire was found to be very high with the exclusion of one item (30th item). The scale was found to be consistent over time and correlated positively with Hoehn-Yahr Scale, and negatively with Unified Parkinson’s Disease Rating Scale, Parkinson Disease Quality of Life Questionnaire, and Short Form Health Survey-36.

Conclusion:

Turkish version of the 39-item Parkinson Disease Questionnaire, with the exclusion of the 30th item can be used reliably in assessing the quality of life of Parkinson’s patients.

Background and purpose:

In our study, we aimed to evaluate inflammation by measuring serum Adenosine deaminase and dipeptidyl peptidase IV levels of individuals diagnosed with autism spectrum disorder and to determine its relationship with the Childhood Autism Rating Scale.

Methods:

37 children aged 2-12 years with a diagnosis of autism spectrum disorder and 27 children aged 2-12 years without any psychiatric disease were included in the study. Psychiatric examination and clinical evaluation according to DSM-5 diagnostic criteria for the diagnosis of autism spectrum disorder were performed on the children included in the study. The Childhood Autism Rating Scale was filled in by the researcher by interviewing the parents of the children diagnosed with autism spectrum disorder. 5 ml of venous blood samples were taken from the children in both groups in the morning on a full stomach.

Results:

There was no statistically significant difference between the groups in terms of age, gender, and sociodemographic data. While serum adenosine deaminase levels were found to be statistically significantly higher in the group with autism spectrum disorder, serum dipeptidyl peptidase IV levels were found to be significantly lower. A positive correlation was found between dipeptidyl peptidase IV and Childhood Autism Rating Scale.

Conclusion:

We think that inflammation may play a role in the etiology of autism spectrum disorder due to altered adenosine deaminase and dipeptidyl peptidase IV levels in children with autism spectrum disorder.

Background and purpose:

Background and purpose – To evaluate the efficacy of the combined therapy of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) and dopaminergic medication on balance and mobility in patients with Parkinson’s disease (PD).

Methods:

Eighteen PD patients under bilateral STN-DBS stimulation therapy, were enrolled in this study. Unified Parkinson’s Disease Rating Scale (UPDRS) was applied to assess the patients’ clinical characteristics. UPDRS part III postural instability/gait disorder (PIGD) scores (sum of items 3.9-3.13) and UPDRS part III postural stability item (item 3.12) were calculated separately. Patients were evaluated with Berg Balance Scale (BBS), Mini-Balance Evaluation Systems Test (Mini-BESTest), Timed Up and Go (TUG) test, dual-task TUG test, and Forward Functional Reach (FFR) Test in two conditions: Stimulation-ON (stim-ON)/Medication-ON (Med-ON) and Stimulation-OFF (Stim-OFF)/Med-ON.

Results:

The mean age of patients was 59.5±9.1 (R: 41-71) years. The UPDRS part III total score and PIGD subsection score significantly improved after stimulation (p=0.001), but the postural instability item of the UPDRS part III did not change significantly (p=0.1). There were no significant differences between the Stim-ON/Med-ON and Stim-OFF/Med-ON conditions, in terms of total Mini-BESTest total scores, total BBS score, FFR test score (p>0.05 for all of them). TUG test was significantly improved in the Stim-ON/Med-ON condition compared to Stim-OFF/Med-ON condition (p=0.03), but DT-TUG test did not change (p=0.1). 

Conclusion:

Combined bilateral STN-DBS and dopaminergic medication therapy had an additional improvement on motor symptoms and mobility performance, but not on balance and dual-task mobility. 

Background and purpose:

 To prevent ischemic strokes caused by carotid artery stenosis, carotid artery stenting (CAS) and carotid endarterectomy (CEA) have been utilized. However, complications could be linked to either or both procedures. The pur­pose of our study is to find the most efficient carotid ultrasound method to forecast peri­pro­cedural risk (embolization, new neu­ro­logical symptoms).  

Methods:

We used Pubmed, EMBASE, and the Cochrane Library to conduct a sys­te­ma­tic literature search for the years 2000 to 2022.

Results:

The grayscale medium (GSM) scale of plaque is the most promising criterion for evaluating periprocedural complications. According to the published observations (relatively small cohorts), peri-procedural problems would be significantly predicted by ≤ 20 of grayscale medium cut-off values. The diffusion-weighted MRI (DW-MRI) is the most sensitive method for assessing whether stenting or carotid endarterectomy resulted in peri-procedural ischemic lesions on diffusion-weighted MRI.  

Conclusion:

A future, large-scale, multi-center study should confirm which grayscale medium  value is optimal to forecast periprocedural ischemic complications.

Background and purpose:

Obstructive sleep apnea syndrome (OSAS) may cause daytime sleepiness, mood changes and dysfunction in various cognitive areas due to recurrent arousals and / or chronic intermittent hypoxia. Different possibilities have been proposed regarding the most affected cognitive areas and mechanisms of OSAS. However, it is difficult to compare findings of the different studies due to the fact that individuals with different disease severities were included in the study groups. In the current study, we aimed to determine the relationship between severity of OSAS and cognitive functions, to investigate the effect of continuous positive airway pressure (CPAP) titration treatment on cognitive functions and the relationship between these changes and electrophysiological potential. 

Methods:

The study included 4 groups of patients with simple snoring and mild, mo­de­rate and severe OSAS. In the pre-treatment evaluations, verbal fluency, visuospatial me­mory, attention, executive functions, lan­guage abilities and electrophysiological tests for event-related potential were performed. The same procedure was reapplied after 4 months of CPAP-therapy. 

Results:

Long-term recall scores and total word fluency scores were found to be low in the groups with moderate and severe disease compared to the patients with simple snoring (p: 0.04, p: 0.03, respectively). The information processing time was higher in patients with severe disease compared to patients with simple snoring (p: 0.02). The P200 and N100 latencies related to event related potentials (ERP) were significantly different between the groups (p: 0.004, p: 0.008, respectively). After CPAP treatment, significant differences were found in N100 amplitude and latencies and all cognitive areas except abstraction. In addition, N100 amplitude and latency change rate as well as change in attention and memory abilities were correlated (r: 0.72, p: 0.02; r: 0.57, p: 0.03, respectively). 

Conclusion:

In the current research, disease severity was found to negatively affect long-term logical memory, sustained attention and verbal fluency. Moreover, significant improvement was detected in all cognitive areas with CPAP treatment. The findings of our study support that changes in N100 potential have the potential to be used as a biomarker that can be used to monitor cognitive function recovery after treatment.