Noropsikiyatri Arsivi-Archives of Neuropsychiatry最新文献

Introduction: We aimed to determine the effect of regular exercise on aerobic capacity, strength values, and plasma levels of Nerve Growth Factor (NGF) and Neurotrophin-3 (NT-3) in patients with multiple sclerosis (MS) and investigate its effects on MS symptoms including cognitive impairment, fatigue, balance disorders, and quality of life (QOL).

Methods: Forty-three relapsing-remitting MS patients with an Expanded Disability Status Scale (EDSS) score of 4 or less participated in the study. Participants were divided into three groups: aerobic group, strength group, and control group. The patients in the exercise groups had exercise programs three days a week for three months. Aerobic capacity (maximum VO₂ value), strength measurements, and balance tests were done, and NGF and NT-3 plasma levels were analyzed in all participants at the beginning and end of the study. Multiple Sclerosis Quality of Life-54 (MSQoL-54), fatigue impact scale, Pittsburgh Sleep Quality Index (PSQI) and, to evaluate cognitive functions, BICAMS scale were applied.

Results: Aerobic exercise and strength exercise groups had significant increases in VO₂ max, back and leg strength values, and NGF and NT-3 plasma levels (p<0.01). Cognitive functions, fatigue, sleep quality, and QOL significantly improved in the exercise groups (p<0.01). The balance values were also significantly improved in the aerobic group (p<0.01), and althoughimprovement although improvement was observed in the strength group, it was not statistically significant (p>0.05).

Conclusions: Our study provides evidence that regular exercise improves quality of life, cognitive functions, fatigue, and sleep quality in MS patients. The levels of NGF and NT-3, which are important factors in neural regeneration and remyelination, were increased post exercise. It can be suggested that exercise may have a potential effect on MS and slow down the disease process with these results.

Introduction: We aimed to evaluate and compare the clinical and electrophysiological features of post-COVID-19 Guillain-Barré syndrome (GBS) and non-COVID-19 GBS patients over the last five years.

Methods: We retrospectively analyzed patients diagnosed with GBS between October 2016 and September 2021. They were divided into five groups according to the flu season and the COVID-19 pandemic. Groups 1-4 were identified as non-COVID-19 groups, whereas Group 5 constituted the post-COVID-19 group. At the sixth month the Hughes functional grading scale score (HFGSS) was noted. Clinical and electrophysiological findings were compared between the groups.

Results: Fifty-nine GBS patients were enrolled in this study. Post-COVID-19 GBS patients had more facial diplegia than non-COVID-19 GBS patients. Except for facial diplegia, post-COVID-19 GBS patients did not differ from non-COVID-19 GBS patients regarding the need for mechanical ventilation, loss of ambulation, type of GBS, response to treatment, and patient outcomes. In 67% of post-COVID-19 GBS patients, HFGSS was ≤2. Acute inflammatory demyelinating polyneuropathy (AIDP) was the most common subtype in post-COVID-19 GBS patients. The 2018-2019 flu season saw more ambulation loss than other flu seasons. The 2017-2018 influenza season had the highest number of patients (39%).

Conclusion: The clinical and electrophysiological features of GBS may differ according to year, infectious etiology, and severity of seasonal viral infections. Post-COVID-19 GBS patients mostly had the AIDP subtype with frequent facial diplegia. The prognosis of post-COVID-19 GBS patients was good. The patients responded well to treatment with intravenous immunoglobulin and plasma exchange.

Introduction: This study aimed to analyze and report findings from the sessions conducted with healthcare workers during the early phase of COVID-19 pandemic.

Method: The study sample consisted of 130 healthcare workers who have consecutively reached out to nationwide psychosocial support line within the first ten days of COVID-19 pandemic and had a 30-minute video session and received psychological first aid and were evaluated using a socio-demographic data form. Mental state severity and progress were assessed using CGI (clinical global impressions) at the first and follow-up interviews.

Results: 90.4% of the applicants were female, 50.4% were nurses, 34.4% were doctors, 68.8% were frontline workers, whereas second-line healthcare workers had significantly higher rates of psychiatric illness history. Contracting the virus (n=83, 66.4%), infecting others (n=72, 57.6%) were the situations that caused the highest level of anxiety. Most common psychiatric complaints were anxiety (n=107, 85.6%), restlessness (n=80, 64%), fear (n=72, 64.0%) and insomnia (n=68, 57.6%). A second session was conducted with 36.8% (n=46) of the callers, and it was detected that 93.48% (n=43) of them were able to manage their stress and 33 of them reported that the severity of their complaints decreased.

Conclusion: Our findings have shown that healthcare workers were significantly affected in the early stage of COVID-19 pandemic with a significant level of anxiety and insomnia symptoms. Healthcare workers with a history of psychiatric illness should be considered as a vulnerable group regardless of their position.

Ocular flutter (OF) is a rare oculomotor syndrome. The most common etiologies are paraneoplastic, postinfectious and toxic-metabolic. However post-vaccinal etiology was rarely reported in OF. Here, we reported a post-vaccinal clinical syndrome characterized by OF-myoclonus and ataxia associated with oligoclonal bands (OCBs). A 60-year-old male who presented with dizziness, unsteady gait, involuntary movements, involuntary conjugate eye oscillations and extremity jerks that started 3 days after the second dose of mRNA BNT162b2 Covid-19 vaccine. Routine biochemical and serological analysis were within normal limits. No pathological finding was detected in brain MRI. Paraneoplastic and autoimmune encephalitis tests were unremarkable in cerebrospinal fluid (CSF). Oligoclonal bands were positive in CSF. This is the first description of the relationship between vaccines against SARS-CoV-2 and the clinical syndrome of OF, Myoclonus and Ataxia (OFMAS). Humoral immune mechanisms seem to play an important role in OFMAS. Presence of OCBs in CSF may also be associated with this condition.

Introduction: The complex interaction of violent behavior, childhood trauma and bipolar disorder (BD) is unclear. Therefore, we aimed to investigate the risk factors of violence in BD and studied the relationship between different types of childhood trauma and violence.

Methods: We assessed 105 remitted patients diagnosed with BD I (n=91) or BD II (n=14). All patients were evaluated with the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HDRS), Childhood Trauma Questionnaire (CTQ), Buss-Perry Aggression Questionnaire (BPAQ) and Violence Tendency Scale (VTS). Uni- and Multivariable Linear Regression Analyses were conducted to predict violent behavior.

Results: All patients scored high points on CTQ and violence scales. In the univariate regression analysis, CTQ total and subscale scores (except physical neglect), age and presence of lifetime suicide attempts were correlated with both VTS and BPAQ. Emotional and sexual abuse subtypes had a significant correlation with violence. In the multivariate analysis, only CTQ total score and age were significantly correlated with violence. There was a negative relationship between age and violence.

Conclusion: All types of childhood traumas seem to be correlated with violent behavior in patients with BD. Childhood trauma and younger age are significant determinants of violence in BD. The VTS, which emerged in Turkey, may assist clinicians to detect potentially aggressive behavior before it becomes obvious.

Introduction: The aim of this study was to examine Theory of Mind (ToM) abilities in patients with Social Anxiety Disorder (SAD) with and without Avoidant Personality Disorder (AvPD) comorbidity.

Methods: A total of 55 patients with SAD, 25 patients with AvPD and SAD, who presented to the Diskapi Teaching and Research Hospital Psychiatry Outpatient Unit and were diagnosed with SAD according to the Structured Clinical Interview Diagnostic Criteria for DSM-5 and 30 healthy controls were included in the study. Sociodemographic data form for SAD, Autism Spectrum Quotient (ASQ), Liebowitz Social Anxiety Scale (LSAS), Reading the Mind in the Eyes Test (RMET), and Dokuz Eylül Theory of Mind Index (DEToMI) were used.

Results: The ToM positive-emotion scores measured by the RMET were higher in the control group than in the SAD and SAD+AvPD groups. The ToM negative-emotion scores were lower in the SAD+AvPD group than in the SAD and control groups. The ToM neutral-emotion scores were similar in all three groups. There were statistically significant differences in favor of the control group in the total score of DEToMI and its subtests among the three groups. There was no difference among the three groups in the faux pas comprehension test.

Conclusion: Our findings suggest that AvPD comorbidity is associated with a decrease in many ToM skills, both in decoding and reasoning, and that this decrease is mainly related to the perception of mental states with an emotional load. More specific methods are needed for ToM problems observed in patients with SAD and AvPD.

Introduction: It is aimed to investigate the relationship between the asymptomatic individiuals with elevated HbA1c and occurrence of polyneuropathy by way of comparison to normoglycemic condition.

Methods: The study includes 30 female patients diagnosed with subclinical elevation of HbA1c and 30 normoglycemic healthy female patients who applied to our hospital polyclinics with symptoms other than neuropathy between January-March 2017. Nerve conduction examination is done in these patients, parameters of both groups are compared.

Results: In regard to amplitude distribution; when compared to control group, tibial motor and ulnar sensory nerve amplitude is lower than the control group (p<0.05). In peroneal, median and ulnar motor nerves, distal latency values are extended compared to control group (p<0.05). Sural, median and ulnar sensory nerve latency is extended compared to control group. In terms of transmission rate distribution; in sural, median and ulnar sensory nerve, transmission speed is lower compared to the control group (p<0.05).

Conclusions: In asymptomatic cases with subclinical elevation of HbA1c, peripheral nervous system involvement is monitored, and early glycemic control should be provided in order to prevent development of neuropathy in patients.

Introduction: Cannabis is the most widely used illegal psychoactive substance worldwide. Although there are clinical studies examining the differences between psychotic symptoms emerging after cannabis use and non-cannabis-related psychotic symptoms, data are limited in the scientific literature. We aimed to investigate the effects of cannabis use on psychotic symptoms and compare the cognitive function differences between the cannabis-user and non-user groups.

Methods: First-episode psychotic patients were included in the study and divided into two groups based on cannabis use. Participants with cannabis use and without cannabis use were compared in terms of socio-demographic factors, psychotic symptoms, cognitive functions, and childhood trauma. All patients were assessed twice, during recruitment and after treatment for psychotic symptoms.

Results: A total of 38 patients comprising of 18 patients with a history of cannabis use and 20 patients without a history of cannabis use were included. There were significant correlations between cannabis use, and living apart from family and family history of substance abuse. Negative psychotic symptoms were higher in the non-user group. The negative psychotic symptoms improved more significantly after treatment in the non-user group. There was a significant correlation between cannabis use and Stroop Color-Word Test scores.

Conclusion: Our results give us a chance to argue that psychosis has different features in people with and without a history of cannabis use. These two phenomena could differ in many ways, so different prevention strategies and treatment options should be considered.

Introduction: Modulation of visual cortical structures by repetitive transcranial magnetic stimulation is rarely observed in literature. In this study; the researchers aimed to investigate the neurophysiological alterations by using continuous theta burst stimulation (cTBS) protocol over the occipital cortex in healthy subjects.

Methods: Twenty-five (15 female, 10 male) (mean age 29.84±4.7 years) healthy individuals were included in sham and real cTBS occipital stimulation sessions. Before and after each session, neurophysiological studies including phosphene threshold and visual evoked potential (VEP) responses were recorded. The P100 latency values and maximum amplitude values between N75-P100 peaks of 100 responses of 1000 uninterrupted continuous visual stimuli were measured. The VEP habituation and phosphene thresholds were compared in sham and real cTBS sessions.

Results: The phosphene threshold values increased to statistically significant levels after the real cTBS session. Visual evoked potential habituation was observed in both sham and real cTBS sessions in individuals without significant differences. Also, no difference between the P100 latencies and N75-P100 amplitude values in the sham and real cTBS sessions was observed.

Conclusion: Phosphene threshold measurements demonstrated the modulation of the occipital cortex excitability via cTBS in healthy subjects.

Introduction: The aim of this study was to investigate the relationships between functional performance, physical activity level, and depression level with postural control in older adults.

Methods: Data were collected from 48 community-dwelling subjects aged ≥65 years. As measurement parameters, Sway mobile balance application for postural control, Sit - Stand Test for lower extremity muscle strength, SenseWear armband for physical activity level, Mini-Mental Test for mental status and Beck Depression Inventory (BDI) for depression level were used.

Results: Sway score was positively correlated with total energy expenditure (TEE) (r=0.28, p=0.04) and number of steps (r=0.30, p=0.03) and negatively correlated with BDI (r=-0.33, p=0.03). The BDI score was negatively correlated with all physical activity parameters. While lower extremity strength, which indicates functional performance, showed moderate-good correlation with physical activity parameters, it showed moderate negative correlation with BDI (r=-0.63, p<0.001). Body mass index value positively correlated with TEE (r=0.34, p=0.01).

Conclusions: The results of this study showed a significant correlation between postural control, physical activity, and depression level. A sufficient level of physical activity is important for the maintenance and improvement of depression level and postural control system. The relationship between physical activity, depression level and postural control should not be ignored in healthy aging.