Noropsikiyatri Arsivi-Archives of Neuropsychiatry最新文献

Introduction: Suicide is a serious public health problem worldwide, with most suicides occurring in low- and middle-income countries. This nationwide ecological study aimed to explore the relationship between crude suicide rates of the sexes and gender inequality.

Method: The data on age and gender-stratified crude suicide rates in all 81 provinces of Türkiye were retracted from the Turkish Statistical Institute database. Gender inequality was measured using Türkiye's provincial-level Gender Equality Index (GEI). Additionally, the following variables were considered gender inequality indicators: early marriages, fertility rate, and marriage/divorce rates; data were obtained from the Turkish Statistical Institute database. Data from 2019 were used to avoid the confounding effect of the COVID-19 pandemic.

Results: The associations between gender inequality and crude suicide rate differed between women and men. There was a positive correlation between crude suicide rate and GEI in men aged 45-64 (r=0.294 p<0.01), but no correlations were found in other groups of age and gender. Early marriage rates (r=0.341 p<0.01) and fertility rate (r=0.333 p<0.01) were positively associated with crude suicide rates in women aged 15-44, while divorce/marriage rate (r=-0.256 p<0.05) was negatively related to these rates. Divorce/marriage rate was associated with an increase in men's suicides in both the 45-64 (r=0.452 p<0.01) and 65 and over (r=0.290 p<0.01) age groups.

Conclusion: Gender inequality indicators were related to suicide. That relationship may vary across different age and gender groups. The findings may be limited to low- and middle-income countries. Suicide prevention interventions should be designed to account for age group, gender, and cultural characteristics of the place of residence concerning gender.

Introduction: Late-onset depression (LOD) has been implicated in irreversible cognitive decline, potentially mirroring early Alzheimer's Disease (AD) pathology. This study aimed to investigate brain activity differences during an episodic memory (EM) task in LOD patients compared to healthy controls (HC).

Methods: We recruited 15 LOD patients and 13 HC matched for age and gender. Participants completed a face-name association task during functional magnetic resonance imaging (fMRI) focusing on both the encoding and retrieval phases of EM.

Results: The statistical contrast between the groups revealed that the HC group showed increased activity in the left visual association cortex (VAC) and left caudate compared to the LOD group during the encoding task. During the face recognition task, the HC group showed increased activity in the right caudate, and during the name recognition task, they showed increased activity in the right frontal eye field (FEF) compared to the LOD group.

Conclusion: The differences observed between the HC and LOD groups in the VAC, caudate, and FEF suggest early changes in maintaining attention, goal-directed learning, EM formation, and coordination of information from storage to retrieval before apparent impairment develops in LOD. Although we did not find statistically significant activations in areas linked to increased vulnerability to AD, our findings of hypoactivation in regions responsible for visual processing and attentional orienting in LOD patients are consistent with hypoactivation patterns observed in AD patients in previous research. These results enhance our understanding of the neural mechanisms underlying memory impairments in LOD and their potential overlap with AD pathology.

Introduction: Alterations in cerebral blood flow (CBF) in subjects with psychosis spectrum disorders (PSD) and clinical high-risk (CHR) states may provide insights into the pathophysiology of these disorders. Arterial spin labeling (ASL) facilitated a more comprehensive examination of CBF in these subjects. This meta-analysis synthesizes findings on CBF in PSDs and CHR states, addressing literature gaps.

Methods: A systematic literature search of the PubMed database was performed using a protocol based on the PRISMA statement and the recommendations of the MOOSE group. Studies eligible for inclusion in the review involved: I) individuals with PSD, first-episode psychosis or CHR state, II) had healthy controls for comparison, III) neuroimaging should be performed with MRI using the pseudo-continuous ASL method, IV) resting cerebral blood flow (rCBF) should be recorded. Information related to participants, CBF analyses, and results were systematically extracted.

Results: The PubMed search for the meta-analysis identified 69 publications, including 24 articles that met the inclusion criteria for the meta-analysis, representing 491 SSD patients, 185 CHR states, and 554 controls. Studies included rCBFs for the whole brain, gray matter, and striatum. The meta-analysis results indicated that patients with PSD had decreased gray matter rCBF compared to controls (Hedge's g=0.33, 95% CI [0.08, 0.57]), but no difference in the whole brain (Hedge's g=0.09, 95% CI [-0.70, 0.88] and striatum rCBF (Hedge's g=0.38, 95% CI [-0.23, 1.00]). Additionally, subjects with CHR state showed no differences in the striatum rCBF compared to the controls (Hedge's g=-0.15, 95% CI [-0.80, 0.51]).

Conclusions: This suggests that although perfusion changes in gray matter are present in PSD, they may not extend to wider brain regions or specific structures such as the striatum. Furthermore, the results imply that rCBF may be differentially regulated in subjects with PSD and CHR. Updated findings highlight hemodynamic correlations in PSD pathophysiology.

Introduction: Intellectual development disorder (IDD) is a heterogeneous condition, and genetic studies are essential to unravel the underlying cellular pathway for brain development and functioning in its etiology. This study aimed to investigate the possible genetic alterations contributing to IDD by performing next generation sequencing (NGS) in affected individuals and their parents, with a particular focus on the discovery of novel disease-associated genes.

Methods: Cases diagnosed with IDD according to DSM-5 criteria, who had normal results in conventional cytogenetic analyses, array comparative genomic hybridization and Fragile X (FMR1) testing, were analyzed by using Trio-Whole Exome Sequencing (Trio-WES). Genomic DNA was extracted, amplicon libraries were generated, and sequencing was conducted on a NGS platform.

Results: We detected pathogenic and/or likely pathogenic variations in MANBA, TLK2, NAA15, CSF1R, DRD4, TRIO genes in 5 of 7 cases included in the study. Protein stability prediction analysis were performed for the p.(Arg339Gln) variant in TLK2 and p.(Asn1406Ser) variant in TRIO gene. Both variants were predicted to reduce protein stability and classified as "destabilizing."

Conclusion: Trio-WES provided a substantial contribution to the molecular diagnosis of IDD. These findings highlight the utility of whole exome sequencing as a powerful tool for uncovering novel disease-associated genes.

Introduction: Only limited information is still available concerning cognitive dysfunctions and cortical thickness in individuals who recovered from mild COVID-19 infections and did not require hospitalization. Our aim was to evaluate if the highly adaptive potential of cortical thickness might play a critical role in COVID-19-related cognitive disorder in a compensatory manner.

Methods: Fifteen individuals with no history of medical, neurological, or psychiatric disease and with positive COVID-19 test results, and sixteen healthy age and education-matched healthy controls identified from the official hospital health system were evaluated in terms of cognitive scores using Alzheimer Disease's Assessment Scale-cognitive subscale (ADAS-Cog) and brain MRI cortical thickness measurements using FreeSurfer, Version 7.4.0.

Results: An increased cortical thickness in the right entorhinal cortex (EC) and impaired cognition (increased ADAS score) were observed in the post-COVID 19 group as compared to the controls confirmed by the student's t test (respectively, p=0.006, p<0.001).The apparent correlation observed between cognitive impairment and increased entorhinal cortical thickness in our COVID-19 patients might suggest a continuum pathophysiology between healthy and COVID-19 affected brains that was not evident in previous COVID-19 cases with cognitive impairment.

Conclusion: Our findings of increased entorhinal cortical thickness, together with impaired cognitive scores, may indicate a flexible role of EC thickness in compensatory mechanisms of cognition.

Introduction: Electroconvulsive therapy (ECT) is an important treatment modality in psychiatry. Despite the efficacy of ECT, its use worldwide is less than expected. Although limited access and stigma are the main factors contributing to this controversy, cognitive side effects are an important issue for clinicians who administer ECT. The present study aims to provide an assessment of the frequency of neuropsychiatric adverse effects associated with ECT.

Methods: A retrospective evaluation of 2935 files of patients who underwent ECT between January 1, 2013 and December 31, 2017 was performed. Specific data obtained from patient records, such as sociodemographic characteristics, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnoses, scale scores, medical evaluations, length of hospital stay, previous ECT history and indications for ECT administration, stimulus parameters, seizure duration, and neuropsychiatric adverse effects were evaluated.

Results: A significant proportion of patients experienced no neuropsychiatric adverse effects across multiple sessions, with the proportion increasing steadily from 70.7% after one session to 97.3% after ten sessions. Additionally, the group that showed neuropsychiatric adverse effects underwent a significantly higher number of previous ECT sessions (p<0.001), longer duration of hospitalization after the last ECT session (p<0.001), and overall duration of hospitalization (p<0.001).

Conclusion: The fact that the majority of patients in this study did not experience any neuropsychiatric adverse effects during more than one ECT session and that the frequency of adverse effects decreased as ECT sessions progressed may contribute clinicians to approach ECT application more confidently.

Introduction: Visual hallucinations are one of the common non-motor symptoms of Parkinson's disease. Although various theories have been proposed, the pathological mechanism is not fully understood. This study aimed to investigate spontaneous brain activity in hallucinated and non-hallucinated patients with Parkinson's disease (PD) by using EEG and also its relevance to the behavioral and neuropsychological status of patients.

Methods: A total of 30 people were included in the study: 10 hallucinated PD patients, 10 non-hallucinated PD patients, and 10 healthy controls. Spontaneous EEG data were recorded in eyes-open and eyes-closed conditions. A neuropsychological battery was used to evaluate visual and verbal memory, visuo-spatial abilities, executive functions, and behavioral/emotional status of participants.

Results: The hallucinated group did not show an increase in alpha power activity in response to eye closure, although healthy controls showed a significant increase in alpha power in eyes closed condition. Parkinson's disease patients with hallucinations showed significantly higher intra-hemispheric beta and gamma coherence and the non-hallucinated group demonstrated significantly lower inter-hemispheric alpha coherence. Additionally, Hallucinated PD patients showed higher NPI (Neuropsychiatric Inventory) scores and RBD-SQ (REM Behavior Disorder Screening Questionnaire) scores, lower motor scores (Unified Parkinson's Disease Rating Scale - UPDRS), and a higher number of Stroop Test errors compared to non-hallucinated PD patients.

Conclusion: Increased abnormal resting-state EEG activity and a tendency towards greater impairment of executive functions were seen in hallucinated PD patients. These results can be interpreted as an abnormal resting activity in cortical networks that may underlie their visual hallucinations symptoms.

Introduction: Sensory ganglionopathy (SG) is a rare and specific subgroup of the peripheral nervous system diseases. Electrophysiology shows a widespread amplitude decrease in sensory nerve action potential (SNAP) or absence of SNAPs in SG. SG diagnosis has a special importance in the context of etiology. We aimed to contribute to diagnosing SG as early as possible with the help of other supportive diagnostic work-up without the need for invasive methods by reviewing data of patients with electrophysiologically diagnosed SG.

Methods: The medical records of 56 patients with SG diagnosed by electrodiagnostic (EDx) tests were reviewed. EDx findings were compared with our laboratory normal values. Also EDx findings of patients with 23 pure SG patients and 9 SG with motor axonal involvement were analyzed.

Results: Etiology was determined in 35 (62.5%) of all patients besides a considerable idiopathic preponderance (n=14; 25%). Comparison of ulnar nerve DMLs of 23 pure SG patients and 9 SG with motor axonal involvement patients, was not statistically significant (p=0.064). Needle EMG findings of lower extremity were grade 1 in 52.9% and grade 3 in 5.8%. Of the patients who underwent upper extremity needle EMG, grade 1 was detected in 53.8% and grade 3 was detected in 7.6%.

Conclusion: In order to diagnose SG as early as possible without the need for invasive methods and to elucidate its etiology, a thorough electrophysiological screening should be performed with the help of other supportive diagnostic tools.

Introduction: Fatigue is a common symptom reported in epilepsy. The effect of fatigue on cognitive functions in patients with epilepsy (PWE) is unknown. The aim of this study is to examine the relationship between fatigue and cognitive functions in PWE.

Methods: Thirty-three PWE and twenty-two healthy controls participated in the study. Psychological examinations (Fatigue Impact Scale, Hospital Anxiety and Depression Scale, Epworth Sleepiness Scale, Quality of Life) and cognitive tests (Wisconsin Card Sorting Test, Serial Digit Learning Test, Stroop Test, Raven's Progressive Matrices Test) were administered to the participants.

Results: The results revealed that fatigue scores were significantly higher in PWE compared to the control group (p< .001). Fatigue was found to be associated with anxiety (p<.001), depression (p<.001) and quality of life (p<.05). The results demonstrated a significant difference between the groups in terms of Raven scores (p<.001), and a significant correlation between fatigue and Raven scores in the general epilepsy group (p<.001). Fatigue was found to be correlated with Stroop Test (p<.05) and Raven's Test in the focal epilepsy group (p<.001).

Conclusion: In conclusion, PWE experience higher levels of fatigue compared to healthy controls and this fatigue has a relationship with visuospatial perception. Fatigue is also associated with attention and visuospatial perception in patients with focal epilepsy. However, it remains unclear whether cognitive impairments are a direct consequence of fatigue or whether cognitive impairments contribute to fatigue.