Noropsikiyatri Arsivi-Archives of Neuropsychiatry最新文献

Introduction: Metabolic dysfunctions are critical in the pathology of Alzheimer's disease. Impaired zinc homeostasis, in particular, is a significant issue in this disease that has yet to be explained. Gene expression of ZIP14 in brain tissue has been previously reported. But to date, only one study has reported reduced ZIP14 levels in aged brain tissue. We investigated how dietary zinc deprivation and supplementation impact ZIP14 levels in the cerebral cortex in rats with sporadic Alzheimer's disease (sAH) produced by intracerebroventricular streptozotocin (icv-STZ). Impaired zinc homeostasis, in particular, is a significant issue with this condition that has yet to be elucidated.

Methods: Animals were divided into 5 groups in equal numbers (n=8): Sham 1 group: icv received artificial cerebrospinal fluid (aCSF); Sham 2 group: retrieved icv aCSF and intraperitoneal (ip) saline, STZ group: received 3 mg/kg icv-STZ; STZ-Zn-Deficient group: received 3 mg/kg icv-STZ and fed a zinc-deprived diet; STZ-Zn-Supplemented: It received 3 mg/kg icv-STZ and ip zinc sulfate (5 mg/kg/day ZIP 14 levels (ng/L) in cortex tissue samples taken from animals sacrificed under general anesthesia were determined by ELISA at the final stage of the experimental applications.

Results: Decreased ZIP14 levels in the sporadic Alzheimer's group were severely by zinc deficiency. Zinc supplementation treated the reduction in ZIP14 levels.

Conclusion: The results of the current study show that ZIP14 levels in cerebral cortex tissue, which are suppressed in the experimental rat Alzheimer model and are even more critically reduced in zinc deficiency, can be restored by zinc supplementation.

Introduction: Although the contribution of enhanced glial activity in seizure induction is increasingly recognized, the role of glia-induced neuroinflammation in the physiopathology of epileptic encephalopathy (EE) has been scarcely investigated.

Methods: To delineate the contribution of glial activity in EE, we measured levels of glia-derived mediators with previously described biomarker value, including glial fibrillary acidic protein (GFAP), high mobility group box 1 (HMGB1), chitinase-3-like protein 1 (CHI3L1), soluble CD163 (sCD163) and triggering receptor expressed on myeloid cells 2 (TREM2) by ELISA in sera of patients with idiopathic West syndrome (WS, n=18), idiopathic Lennox-Gastaut syndrome (LGS, n=13) and healthy controls (n=31).

Results: Patients with EE showed significantly higher CHI3L1 levels compared to healthy controls. Levels of HMGB1, CHI3L1, sCD163 and TREM2 were higher in LGS patients than WS patients and/or healthy controls. One or more of the investigated mediators were associated with treatment responsiveness, disease severity and presence of pathological features on electroencephalography (EEG).

Conclusions: To our knowledge, our findings provide the initial patient-based evidence that astrocyte- and microglia-mediated neuroinflammation might be involved in the pathogenesis of LGS and WS. Moreover, glial mediators may serve as prognostic biomarkers in patients with idiopathic EE.

Introduction: This study aimed to investigate the effects of chronic swimming exercise and vitamin E administration on elemental levels in the bone tissue of epileptic rats.

Methods: Forty-eight rats were divided into six groups: Control, Swimming, Swimming + vitamin E, Swimming + Epilepsy, Swimming + Epilepsy + vitamin E, and Epilepsy. Vitamin E was administered to the animals chronically by gavage at a dose of 500 mg/kg every other day for 3 months. Epileptiform activity was induced with penicillin in animals 24 hours after the last vitamin E intake. The exercise program consisted of daily 30-minute swimming sessions. At the end of the treatment period, the levels of calcium, chromium, copper, iron, magnesium, manganese, lead, and zinc (µg/gram tissue) in bone tissue samples were measured using an atomic emission device.

Results: The results showed that all epileptic groups had significantly lower bone chromium levels compared to the control groups (p<0.05). The epileptic, and epileptic swimming groups had the lowest levels of bone calcium, magnesium, and zinc (p<0.05). Vitamin E administration resulted in a significant increase in bone calcium, magnesium, and zinc levels in the epileptic swimming group with vitamin E compared to the epileptic and epileptic swimming groups. (p<0.05).

Conclusion: The findings of the study show that the administration of vitamin E improves calcium, magnesium, and zinc metabolism in the deteriorated bone tissue of the epileptic rat model.

Schizophrenia has a multifactorial etiology with a significant genetic component. Genome-wide association studies have identified common variants in candidate genes. However, the common variant can only account for a portion of the genetic variation underlying the disorder. Therefore, researchers suggest that rare variants may be one source of missing heritability in schizophrenia. We report the case of a 20-year-old male patient diagnosed with early-onset and ultra-treatment-resistant schizophrenia and mild intellectual disability and discuss certain rare genetic variants that may be involved in the etiology. He was hospitalized for the initiation of clozapine treatment and was referred to the department of genetics because he had macrocephaly, high arched palate, a prominent forehead, hearing impairment, and hyperpigmented skin lesions. The whole exome sequencing analysis revealed a heterozygous 4168G>A(p.Ala1390Thr) variant in exon 15 of KMT2D (Lysine N-Methyltransferase 2D) (NM_003482.4) gene, which is associated with Kabuki Syndrome. The variants in KMT2D have been reported to be associated with brain development and may play a role in schizophrenia. We discussed the relationship between schizophrenia and genetic variants detected in this case in light of the literature.

Introduction: The aim of this study is to demonstrate the conduction disturbance at the neuromuscular junction in a cranial muscle by measuring jitter with a concentric needle (CN) electrode in the diagnosis of Amyotrophic Lateral Sclerosis (ALS) and to investigate the utility of evaluating the peak number as an ongoing reinnervation marker.

Method: Twelve patients diagnosed with ALS were included in this study. Single fiber electromyography (SFEMG) was performed using a CN electrode during the voluntary contraction of the right extensor digitorum communis (EDC) and left frontalis muscles.

Results: In SFEMG from the right EDC muscle, the mean jitter value was high in all of them. The average jitter calculated in EDC muscles was 57.76±24.17 μs. The mean jitter value in the frontal muscles was 28.91±10.21 μs. In all patients, the number of CN electrode peaks was more than 4 in the EDC muscle and above 4 in 91.67% of the frontal muscle.

Conclusion: Detection of high jitter in SFEMG examination indicates that the examined muscle undergoes a denervation-reinnervation process in the case of increased peak number values. When such a determination is made in the extremity muscles, it becomes important for the diagnosis of ALS.

Introduction: Current studies indicate a strong relationship between sexual dysfunctions and eating disorders. The aims of this study were to investigate the frequency of disordered eating behaviors (DE) in patients with genito-pelvic pain and penetration disorder (GPPPD); and to determine the clinical features associated with DE.

Methods: Outpatients with GPPPD (n=105) were evaluated with sociodemographic data form, structured clinical interview for DSM-IV (SCID), Golombok-Rust inventory of sexual satisfaction female form (GRISS), Hamilton anxiety rating scale (HAM-A), Hamilton depression rating scale (HAM-D), eating disorder examination questionnaire (EDEQ), and eating attitudes test (EAT-40).

Results: The frequency of DE in patients included in the study was 85.7%. The presence of sexual trauma history, eating concern, binge eating scores were significantly higher in patients with DE than without that (p<0.05). A statistically significant positive correlation was observed among the restriction, sensuality and orgasm scores in GPPPD patients with sexual trauma (p<0.05).

Conclusions: Our results might be important in terms of showing that DE is frequently seen in patients with GPPPD and that the presence of a history of sexual trauma might be important in accompanying these two disorders.

Introduction: The current study evaluates the effects of COVID-19 infection and the safety of vaccines in patients with epilepsy (PWEs).

Method: The study was conducted with PWEs who were vaccinated against COVID-19. The sample was separated into two groups as those with drug-resistant epilepsy (DRE) and those with non-resistant epilepsy, and their seizure frequencies, seizure types, development of status epilepticus, changes in doses and/or types of drugs, electroencephalographs (EEGs) before and after COVID-19 infection, and vaccination with mRNA or inactivated vaccines were monitored and compared. Changes in seizure patterns were also inquired about following the administration of vaccines other than COVID-19.

Results: Included in the study were 307 PWEs with a mean age of 42.62±14.74, among whom COVID-19 PCR positivity was detected in 97(31.6%). Those who experienced no increase in seizure frequency while infected with COVID-19 were significantly under monotherapy (p=0.031). The mean seizure frequency was 2.70±5.19 per year before vaccination, but increased to 3.20±5.82 after. A significant relationship was identified between abnormal EEG and increased seizure frequency across the entire sample and the mRNA group (p=0.011, p=0.004). The frequency of seizures increased significantly in the DRE patients after receiving the mRNA vaccine (p=0.023). Overall, increased seizure frequencies were observed in 29.9% of the sample during COVID-19 infection, with increases of 16.4% in those who received the mRNA vaccine, 8.6% after inactivated vaccines and 25% after non-COVID-19 vaccines.

Conclusion: COVID-19 infection was found to be associated with a higher increased seizure frequency risk than being vaccinated, and COVID-19 vaccines do not differ from other vaccines in terms of the risk to PWEs.

Startle reaction is a physiological muscle reaction that occurs to protect against an unexpected, sudden stimulus. In this case, we wanted to discuss the response after the rTMS protocol, which we applied to our patient who had startle reactions that severely impair functionality and who did not meet the post traumatic stress disorders (PTSD) criteria or have a major brain lesion after a traffic accident. A 30-year-old single female patient who works as a stewardess in an airline company with no known history of physical or psychological illness but lost consciousness for about three hours after an in-vehicle traffic accident a week ago was admitted to our clinic. The patient had a history of having difficulty in doing her daily work due to the splashing movements that started in her body. No major brain lesion was detected in imaging studies. She did not meet the criteria for PTSD and her EEG results were normal. Medication did not help with the symptoms, so, rTMS was planned. After 6 sessions of rTMS, her movements had stopped completely. Our patient, who did not fully meet the criteria for PTSD and whose imaging and EEG results did not reveal any pathological findings had developed severe onset startle reactions after an in-vehicle traffic accident, fully responded to rTMS treatment and improved her functionality quickly and effectively. Thus, we think that rTMS should be investigated as an effective treatment method in such patients.

Introduction: The psychosocial effect of the pandemic on people with a disease such as multiple sclerosis (MS) that can cause disability and which medications that affect the immune system are used in treatment should be evaluated by physicians. We aimed to determine the psychosocial effects of the pandemic on MS patients and to evaluate the working and treatment continuation status, compliance with pandemic rules, and their perceptions regarding coronavirus disease 2019 (COVID-19).

Methods: This study was designed as a cross-sectional and descriptive survey study. A total of 315 MS patients' demographic data, comorbidities, and degrees of disability, Beck Depression Inventory (BDI), Coronavirus Anxiety Scale (CAS), and compliance scores with pandemic restrictions were evaluated.

Results: In the first period of the pandemic, approximately one-third of the patients were found to have major depression, and approximately 10% to have COVID anxiety. Both COVID anxiety and BDI scores were significantly higher in patients with symptoms suggestive of an attack during the pandemic process (p:0.0001 and p:0.002). CAS was higher in those who had a COVID-19 contact (p:0.045). BDI scores were significantly higher (respectively p:0.034, p:0.006, p:0.0001) in married/cohabiting patients, in patients who went on unpaid leave or lost their job, and in patients who described worsening of their previous MS-related complaints.

Conclusion: Although the pandemic negatively affects the psychosocial status of MS patients, this effect can be reduced by identifying the groups that may be affected via telemedicine and taking necessary interventions.