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The Parkinson's Story of a Neurologist with 32 Years of Experience on Parkinson's Disease. 一位拥有 32 年帕金森病治疗经验的神经科医生的帕金森病故事。
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-05-27 eCollection Date: 2024-01-01 DOI: 10.29399/npa.28634
Sibel Özekmekçi

As a neurologist who has followed up countless Parkinson's patients over the last 32 years of my fifty-year career; I denied diagnosing myself with Parkinson's disease (PD), although the seldom mild involuntary "twitches" that occurred in the thumb of my right hand over a two-year period, resembled Parkinson's disease tremor. However, when these involuntary contractions became persistent; considering its similarity to characteristic resting tremor in typical PD, the positive effect of dopaminergic medications, the development of levodopa-induced dyskinesias and other non-motor symptoms, it was clear that the PD diagnosis was accurate. This situation naturally caused me anxiety, and for a year and a half, I kept my diagnosis hidden from everyone except a few close relatives. However, with the encouragement of a psychiatrist friend, when I was able to share my condition with my loved ones, I felt a relative reduction in the burden I was carrying and consequently experienced emotional relief. I am still able to carry out my daily activities independently with a rather low dose of medication, and my PD symptoms do not attract noticeable attention.

在我五十年的职业生涯中,作为一名神经科医生,我在过去 32 年里随访了无数帕金森病患者;虽然在两年时间里,我右手拇指出现了很少的轻微不自主 "抽搐",与帕金森病震颤相似,但我否认自己患有帕金森病(PD)。然而,当这些不自主收缩变得持续时;考虑到它与典型帕金森病的静止性震颤特征相似、多巴胺能药物的积极作用、左旋多巴诱发的运动障碍和其他非运动症状的发展,帕金森病的诊断显然是准确的。这种情况自然引起了我的焦虑,在长达一年半的时间里,除了几位近亲之外,我对所有人都隐瞒了我的诊断结果。然而,在一位精神科医生朋友的鼓励下,当我能够与亲人分享我的病情时,我感到身上的负担相对减轻了,情绪也随之舒缓了。现在,我仍然能够独立进行日常活动,只需服用较少剂量的药物,而我的帕金森病症状也不会引起人们的注意。
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引用次数: 0
A Potentially Treatable Genetic Disorder Which Presented with Neuropsychiatric Involvement and Drug-Resistant Focal Epilepsy: Niemann-Pick Disease Type C. 一种可能治疗的遗传性疾病,表现为神经精神受累和耐药性局灶性癫痫:尼曼-皮克病 C 型。
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-05-25 eCollection Date: 2024-01-01 DOI: 10.29399/npa.28717
Ebru Altındağ, Yasemin Alanay, Betul Baykan, Aysin Dervent
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引用次数: 0
Correction: Psychometric Properties of Questionnaire of Cognitive and Affective Empathy (QCAE): Reliability and Factor Analysis Study in Turkish Sample. 更正:认知与情感移情问卷(QCAE)的心理测量特性:土耳其样本的可靠性和因子分析研究。
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-03-02 eCollection Date: 2024-01-01 DOI: 10.29399/npa.28743
Şakir Gica, Ahsen Büyükavşar, M Sinan Iyisoy, Hüseyin Güleç

[This corrects the article on p. 228 in vol. 58, PMID: 34526847.].

[此处更正了第 58 卷第 228 页的文章,PMID:34526847]。
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引用次数: 0
Virtual Reality Supported Intervention Program for Trauma Symptoms of Individuals Who Experienced an Earthquake: An Effectiveness Study. 针对地震幸存者创伤症状的虚拟现实辅助干预计划:有效性研究
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-02-21 eCollection Date: 2024-01-01 DOI: 10.29399/npa.28568
Ali Yasin Kafes, Alpay Çiller, Mehmet Şakiroğlu
<p><strong>Introduction: </strong>This study aimed to develop an effective virtual reality (VR)-based intervention program to improve trauma symptoms of survivors of the 2023 Kahramanmaraş earthquake.</p><p><strong>Methods: </strong>In line with this aim, the sample of the study consisted of 34 earthquake survivors aged 15-72 years (mean: 38.09, standard deviation (SD): 15.09) who were directly affected by the Kahramanmaraş earthquake on February 6, 2023. A five-stage intervention program (normalization, reinterpretation, creating a safe place, developing problem-focused coping strategies, and social support) was applied to 17 participants (mean: 36.88, SD: 13.65), who constituted the intervention group, using VR technology. All participants assigned to the intervention group received the intervention, which included normalization, reinterpreting the earthquake, creating a safe place, problem-focused coping, and increasing social support, one time in a standardized manner. In the stages of reinterpretation, creating a safe place and problem-focused coping VR technology was used and, the stages of normalization and increasing social support were carried out with psychotherapeutic work involving one-to-one interaction between the researcher and the participant. The five-stage intervention program started to be implemented 51 days after the February 6 Kahramanmaraş earthquakes and all stages of the intervention were completed within seven days. Measurements were taken from the participants at two different times: pre-intervention pre-test and post-intervention post-test. The 17 participants in the control group (mean: 39.29, SD: 16.75) were placed on a waiting list. Data were collected using the "Sociodemographic Information Form", "Posttraumatic Growth Inventory", "Scale for Determining the Level of Post-Earthquake Trauma" and "Ways of Coping Scale".</p><p><strong>Results: </strong>Before the intervention, the groups were controlled in terms of posttraumatic growth, post-earthquake trauma level, fatalistic coping, social support-seeking coping, and helplessness style coping levels and no difference was observed between them (p>0.05). After the intervention, it was found that the posttraumatic growth and social support-seeking coping scores of the earthquake survivors who received VR-supported intervention were significantly higher than the scores of the control group, and the post-earthquake trauma level, fatalistic coping and helplessness style coping scores were significantly lower than the control group scores (p<0.05). As a result of the in-group analyses, it is seen that the post-traumatic growth, social support-seeking coping and problem-focused coping scores of the intervention group participants after the VR-supported intervention increased statistically significantly compared to the pre-intervention, while the post-earthquake trauma level, fatalistic coping and helplessness style coping scores decreased statistically significantly compared
简介:本研究旨在开发基于虚拟现实(VR)的有效干预方案,以改善 2023 年卡赫拉曼马拉什地震幸存者的创伤症状:本研究旨在开发一种基于虚拟现实(VR)的有效干预方案,以改善 2023 年卡赫拉曼马拉什地震幸存者的创伤症状:根据这一目标,研究样本包括 34 名年龄在 15-72 岁之间的地震幸存者(平均年龄为 38.09 岁,标准偏差(standard deviation)为 0.5%):38.09,标准差(SD):15.09),他们都直接受到了 2023 年 2 月 6 日卡赫拉曼马拉什地震的影响。17 名参与者(平均值:36.88,标准差:13.65)组成了干预组,他们使用 VR 技术接受了五阶段干预计划(正常化、重新诠释、创建安全场所、制定以问题为中心的应对策略和社会支持)。所有被分配到干预组的参与者都接受了一次标准化的干预,包括正常化、重新解读地震、创建安全场所、问题集中应对和增加社会支持。在重新解读、创建安全场所和问题集中应对阶段,使用了虚拟现实技术;在恢复正常和增加社会支持阶段,研究人员与受试者进行了一对一的心理治疗。五阶段干预计划在 2 月 6 日卡赫拉曼马拉什地震发生 51 天后开始实施,所有干预阶段均在七天内完成。在两个不同的时间段对参与者进行了测量:干预前的前测和干预后的后测。对照组的 17 名参与者(平均值:39.29,标准差:16.75)被列入候选名单。使用 "社会人口信息表"、"创伤后成长量表"、"震后创伤程度量表 "和 "应对方式量表 "收集数据:干预前,两组在创伤后成长、震后创伤水平、宿命应对、寻求社会支持应对和无助型应对水平方面进行对照,未发现差异(P>0.05)。干预后发现,接受虚拟现实支持干预的地震幸存者的创伤后成长和寻求社会支持应对得分明显高于对照组,震后创伤水平、宿命应对和无助式应对得分明显低于对照组(P0.05):分析结果表明,所开发的虚拟现实辅助干预方案能有效改善地震幸存者的创伤症状。所开发的干预措施能迅速降低地震幸存者的创伤程度,且在统计学上具有显著意义,这表明相关干预措施可应用于其他创伤领域,并建议开展进一步研究。
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引用次数: 0
The Present and Future of Artificial Intelligence Applications in Psychiatry. 人工智能在精神病学中应用的现状与未来。
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-02-19 eCollection Date: 2024-01-01 DOI: 10.29399/npa.28725
Cenan Hepdurgun
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引用次数: 0
The Association Between Serum Levels of Glial Biomarkers, Clinical Severity and Electro-encephalography Features in Idiopathic West and Lennox-Gastaut Syndromes. 128 特发性韦斯特综合征和伦诺克斯-加斯塔特综合征中神经胶质生物标志物血清水平、临床严重程度和脑电图特征之间的关联。
IF 1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-02-02 eCollection Date: 2024-01-01 DOI: 10.29399/npa.28669
Minara Cherkezzade, Selen Soylu, Erdem Tüzün, Vuslat Yılmaz, Mine Sezgin, Zuhal Yapıcı, Cem İsmail Küçükali, Pınar Topaloğlu

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.

导言:尽管人们越来越认识到神经胶质活动的增强在癫痫诱发中的作用,但对神经胶质诱发的神经炎症在癫痫性脑病(EE)的生理病理中的作用却鲜有研究:为了明确神经胶质活动在 EE 中的作用,我们测量了具有生物标志物价值的神经胶质衍生介质水平,包括神经胶质纤维酸性蛋白 (GFAP)、高迁移率基团框 1 (HMGB1)、甲壳素酶-3 样蛋白 1 (CHI3L1)、通过酶联免疫吸附法检测特发性韦斯特综合征(WS,18 人)、特发性伦诺克斯-加斯豪特综合征(LGS,13 人)患者和健康对照组(31 人)血清中的可溶性 CD163(sCD163)和髓样细胞上表达的触发受体 2(TREM2)。结果显示与健康对照组相比,EE患者的CHI3L1水平明显较高。LGS患者的HMGB1、CHI3L1、sCD163和TREM2水平高于WS患者和/或健康对照组。所研究的一种或多种介质与治疗反应性、疾病严重程度和脑电图(EEG)上的病理特征有关:据我们所知,我们的研究结果提供了基于患者的初步证据,证明星形胶质细胞和小胶质细胞介导的神经炎症可能参与了 LGS 和 WS 的发病机制。此外,神经胶质介质可作为特发性 EE 患者的预后生物标志物。
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引用次数: 0
Relationship Between Collateral Status, Infarct Growth and Outcome in Patients with Middle Cerebral Artery Occlusion by CT Angiography and CT Perfusion Imaging.
IF 1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-01-04 eCollection Date: 2025-01-01 DOI: 10.29399/npa.28643
Serdar Baraklı, Mehmet İlker Yön, Karabekir Ercan

Introduction: Unveiling the dynamic penumbra region represents another crucial stage in treating individuals with ischemic strokes. Our objective was to explore how collateral blood flow assessments using multiphasic (triphasic) CT angiography (mpCTA) and CT perfusion (CTP) examinations correlate with the expansion of infarcted areas and disability levels in patients with middle cerebral artery (MCA) M1 and M2 occlusion.

Methods: The research was carried out as a prospective, descriptive, case series study. mpCTA and CTP were performed while patients were referred to the emergency department. Baseline National Institutes of Health Stroke Scale (NIHSS), Modified Rankin Scale (mRS) and the Barthel Index for Activities of Daily Living at 3 months were calculated. The connection between perfusion parameters that represent penumbral information derived from CTP and collateral flow information obtained from mpCTA with infarct expansion and outcome was investigated.

Results: Thirty-six patients were included in the study. The mean age of the participants in the research was found 73.47±10.67. 52.8% of the individuals were male. 72.3% of the patients exhibited an unfavorable functional outcome according to mRS at 3 months. Based on the Menon collateral score from the mpCTA, the infarct expansion showed a statistically significant difference between the groups (p=0.037). The mRS scores at 3 months did not show a statistically significant difference between the groups according to the mpCTA Menon collateral score (p=0.073). Penumbra volume information obtained by using Tmax/CBV and CBF/CBV thresholds on CTP showed statistically significant differences among good and poor clinical outcome groups based on mRS at 3 months (respectively p=0.010, 0.029). The average MTT value within the penumbra obtained from the MTT/CBV map exhibited a statistically significant difference among the groups based on the mRS at 3 months (p=0.011). There was a weak but statistically significant relationship between the volume of the penumbra obtained from CTP maps created by selecting Tmax=6 sec and the infarct growth (p=0.028).

Conclusion: Final infarct volume and infarct growth can be predicted using collateral circulation data acquired through mpCTA. The patient's disability can be assessed by analyzing the penumbral MTT value and the penumbral volume data obtained from CTP maps generated using various threshold values. Moreover, penumbra volume obtained from CTP maps created by selecting Tmax as a threshold can give information about infarct growth.

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引用次数: 0
c.4168G>A(p.Ala 1390Thr) Variation in KMT2D Gene Detected in an Ultra-treatment-resistant Schizophrenia Patient: A Case Report and Literature Review. 在一名超耐药精神分裂症患者中发现的 KMT2D 基因 c.4168G>A(p.Ala 1390Thr)变异:病例报告和文献综述。
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-11-22 eCollection Date: 2023-01-01 DOI: 10.29399/npa.28417
Anıl Alp, Elçin Özçelik Eroğlu, M İrem Yıldız, Ahmet Cevdet Ceylan, Başaran Demir, Suzan Özer

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.

精神分裂症的病因是多因素的,其中有重要的遗传因素。全基因组关联研究发现了候选基因中的常见变异。然而,常见变异只能解释精神分裂症的部分遗传变异。因此,研究人员认为,罕见变异可能是精神分裂症遗传性缺失的来源之一。我们报告了一例被诊断为早发超耐药精神分裂症和轻度智力障碍的 20 岁男性患者的病例,并讨论了可能与病因有关的某些罕见遗传变异。该患者因开始接受氯氮平治疗而住院,并因巨脑症、高拱腭、前额突出、听力障碍和皮肤色素沉着病变而被转诊至遗传学部门。全外显子组测序分析显示,KMT2D(赖氨酸 N-甲基转移酶 2D)(NM_003482.4)基因第 15 外显子中存在一个 4168G>A(p.Ala1390Thr)杂合子变异,该变异与卡布奇综合征有关。据报道,KMT2D 的变异与大脑发育有关,并可能在精神分裂症中发挥作用。我们根据文献讨论了精神分裂症与本病例中检测到的基因变异之间的关系。
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引用次数: 0
Anaplastic Ependymoma and Atypical Refractory Longitudinal Expansive Transverse Myelitis Due to Immune Reaction After COVID-19 - A Case Discussion That Raises Many Unknown Questions About Covid-19. COVID-19后免疫反应致间变性室管膜瘤和非典型难治性纵向扩张性横贯脊髓炎——一例对COVID-19提出许多未知问题的讨论
IF 1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-11-21 eCollection Date: 2024-01-01 DOI: 10.29399/npa.28464
Yağmur İnalkaç Gemici, Fatih Çelik, Zeynep Zerrin Göz, Aydın İşisağ, Gülgün Yılmaz Ovalı, Mehmet Zileli, Mustafa Barutçuoğlu, Hatice Mavioğlu

Inflammatory neurologic manifestations, both infectious and non-infectious, have been reported secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19). However, the relationship of spinal tumor and COVID-19 longitudinally extensive transverse myelitis (LETM) coexistence has never been reported in our knowledge. The clinical presentation and response to treatment of a 24-year-old female patient diagnosed with COVID-19 LETM and anaplastic ependymoma are described in this case report. The Patient's cerebrospinal fluid COVID-19 antibody level was higher than serum and she was resistant to immunosuppressive treatment. The interaction between COVID-19 and spinal tumor was discussed in the light of the literature. It is thought that COVID-19 infection could trigger tumor growth in this patient. Also, this is the first case of anaplastic ependymoma and COVID-19 myelitis coexistence in the literature.

据报道,严重急性呼吸综合征冠状病毒2 (SARS-CoV-2/COVID-19)继发有感染性和非感染性神经系统炎症表现。然而,据我们所知,脊柱肿瘤与COVID-19纵向广泛横断面脊髓炎(LETM)共存的关系尚未报道。本文报告1例24岁女性COVID-19 lem合并间变性室管膜瘤的临床表现及治疗效果。患者脑脊液COVID-19抗体水平高于血清,对免疫抑制治疗有耐药性。结合文献探讨新冠病毒与脊柱肿瘤的相互作用。据认为,COVID-19感染可能会引发该患者的肿瘤生长。此外,这是文献中第一例间变性室管膜瘤和COVID-19脊髓炎共存的病例。
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引用次数: 0
Comparison of epidural analgesia combined to general anesthesia and general anesthesia for postoperative cognitive dysfunction in elderly patients 硬膜外联合全麻与全麻治疗老年患者术后认知功能障碍的比较
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2019-01-01 DOI: 10.29399/npa.24863
G. Orhun, Z. Sungur, K. Koltka, M. Karadeniz, A. Yavru, H. Gurvit, M. Senturk
BACKGROUND: Cognitive dysfunction in the early postoperative course is common for the elderly population. Anesthetic management may affect postoperative cognitive decline. Effective analgesia, early recovery and modulation of the stress response are advantages of neuraxial blocks. This study aims to compare the effects of general anesthesia and the combination of general anesthesia with epidural analgesia for postoperative cognitive dysfunction (POCD). We hypothesized that neuraxial block combined with general anesthesia (GA) would have a favorable influence on POCD prevention. METHODS: Patients above 60 years undergoing non-cardiac surgery were included in this randomized, prospective study and randomized into two groups. Patients in the first group (GI) were treated under GA, whereas in the second group (GII), epidural analgesia was combined with GA. Patients’ cognitive function was assessed before and one week after surgery using a neuropsychological test battery. POCD was defined as a drop of one standard deviation from baseline on two or more tests. RESULTS: A total of 116 patients were allocated for the final analysis. Demographic and operative data were similar between groups, except maximum pain scores, which were significantly higher in GI than GII (4.9±2.8 vs. 1.7±1.7; p<0.001, respectively). The incidence of POCD was comparable between groups (26% in GI and 24% in GII). Memory performance, visuospatial functions, and language skills tests were significantly higher in GII compared to GI. CONCLUSION: General anesthesia and epidural analgesia combined with general anesthesia resulted in similar POCD in elderly patients undergoing abdominal surgery. However, in combined anesthesia group memory, language skills and visuospatial functions appeared to be better preserved. Effective pain control might contribute to preventing cognitive decline in some domains.
背景:老年人群术后早期认知功能障碍很常见。麻醉处理可能影响术后认知能力下降。有效的镇痛,早期恢复和调节应激反应是神经轴传导阻滞的优点。本研究旨在比较全麻与全麻联合硬膜外镇痛治疗术后认知功能障碍(POCD)的效果。我们假设神经轴阻滞联合全身麻醉(GA)对POCD的预防有良好的影响。方法:60岁以上接受非心脏手术的患者纳入本随机前瞻性研究,随机分为两组。第一组(GI)患者在GA下治疗,而第二组(GII)患者在硬膜外镇痛与GA联合治疗。患者的认知功能在手术前和手术后一周通过神经心理学测试进行评估。POCD被定义为在两次或两次以上的测试中从基线下降一个标准差。结果:共有116例患者被纳入最终分析。组间人口统计学和手术数据相似,除了最大疼痛评分,GI明显高于GII(4.9±2.8比1.7±1.7;分别为p < 0.001)。POCD的发生率在两组间具有可比性(GI组26%,GII组24%)。记忆表现、视觉空间功能和语言技能测试在GII中明显高于GI。结论:全麻与硬膜外镇痛联合全麻对老年腹部手术患者POCD的影响相似。然而,联合麻醉组的记忆、语言技能和视觉空间功能似乎得到了更好的保存。有效的疼痛控制可能有助于防止某些领域的认知衰退。
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引用次数: 17
期刊
Noropsikiyatri Arsivi-Archives of Neuropsychiatry
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