Noropsikiyatri Arsivi-Archives of Neuropsychiatry最新文献

Oromandibular dystonia and laryngospasm are defined as paraneoplastic syndromes of anti-Ri antibody. Herein, we report a 50-year-old woman admitted to the outpatient clinic with cervical contraction, speech and gait disturbance, and mental deterioration persisting for one year. She was diagnosed with undifferentiated nasopharyngeal carcinoma during further examination for two years of tinnitus and underwent radiotherapy. Her neurological symptoms started six months after radiotherapy. During this period, she underwent a tracheostomy due to a sudden laryngospasm. Anti-Ri antibody was positive in the paraneoplastic antibody screening. Her cervical dystonia and mental deterioration partially improved with intravenous pulse steroid and immunoglobulin therapies. However, the patient deceased due to aspiration pneumonia after six months. This rare clinical presentation, characterized by cervical dystonia, laryngospasm, spastic quadriparesis, and mental deterioration, should be considered anti-Ri antibody-associated paraneoplastic syndrome for patients with nasopharyngeal carcinoma.

Introduction: In metacognitive theory, thought fusion beliefs, beliefs about rituals, and beliefs about stop signals predict obsessive-compulsive symptoms. The number of controlled studies using specific scales to assess these three belief domains in different cultures is limited.

Methods: The comparison sample consisted of patients with obsessive-compulsive disorder (n: 106) and control (n: 200) group. Participants filled out the Obsessive-Compulsive Inventory-Revised form, Penn State Worry Scale, Obsessive Beliefs Scale-44, Thought Fusion Inventory, Beliefs about Rituals Inventory and Stop Signs Questionnaire. Correlation analysis of worry and OCD symptom severity levels, cognitions and metacognitions in OCD were performed between groups. Worry, cognition and metacognitive predictors of obsessive-compulsive symptoms were analyzed with a hierarchical linear regression model.

Results: The metacognitive scale scores were significantly higher in the OCD group than in the control group except for hoarding (p<0.001). Obsessive-compulsive symptoms were statistically positively correlated (r: 0.17-0.53) with all three metacognitive functions in the OCD and control groups (except ordering in the control group). In addition to the three metacognitive domains, worry, perfectionism and intolerance of uncertainty predicted obsessive-compulsive symptoms (p<0.05). All three metacognitive domains contributed to the variance in the hierarchical regression model in addition to worry and cognitions (p<0.05).

Conclusion: All the three metacognitive domains were correlated with OCD symptom severity. Metacognitions explained additional variance above and beyond cognitions. Metacognitive assessment domains of OCD predicted OCD symptom severity when included in the hierarchical regression model.

Introduction: The aim of the study was to investigate whether there is any effect of smoking status or passive exposure on different subtypes of multiple sclerosis (MS) and their association with the IL17 & IL23 levels.

Methods: Blood samples were obtained from patients diagnosed with clinically isolated syndrome (CIS), relapsing remitting MS (RRMS), primary progressive MS (PPMS), secondary progressive MS (SPMS) and healthy controls. Smoking habits and passive exposure were questioned via a specifically created questionnaire. Patients and controls were grouped into three subgroups according to smoking status as active smokers, former smokers and never smokers.

Results: There were 60 patients and 20 age and sex-matched healthy controls. Active smoking was associated with a higher relapse rate per year. Smoking was inversely proportional to IL23 levels. Passive smoking was associated with atrophy in the follow-up cranial MRI. In utero exposure was associated with a polysymptomatic disease onset. The onset symptoms differed between patients whose mothers smoked during their childhood.

Conclusıon: This study shows the effects of smoking and passive smoking on the presenting symptoms and course of MS. The relationship between these adverse effects and the Th17 pathway is not clear. It is evident that MS patients should be advised against smoking and should be directed to programs for quitting smoking.

Xia Gibbs Syndrome (XGS) is a rare disorder with different phenotypic and behavioral manifestations and clinical reflections known to develop as a result of de novo mutations in the AT-Hook DNA binding motif (AHDC1). Our patient was first evaluated in the pediatric psychiatry clinic at the age of 2 because of speech delay. The patient was followed up with a diagnosis of cognitive retardation and joint hypermobility was found as a result of pediatric neurology consultation due to his dysmorphic appearance. No pathology was found in detailed blood tests and imaging studies. During the follow-up period, it was determined that the cognitive skills gained between the ages of 4-4.5 started to regress, there was no joint attention, but there was stereotypic movements and limitation in eye contact. In the detailed genetic evaluation performed due to the deterioration in the clinical course and the addition of the diagnosis of Autism Spectrum Disorder, a mutation compatible with Xia Gibbs Syndrome was found in the whole exon sequencing test. Repeated psychiatric and medical evaluation as part of a multidisciplinary approach in rare genetic diseases such as Xia Gibbs Syndrome is important for educational planning and treatment of comorbidities. With this case, we wanted to emphasize the importance of psychiatric follow-up and further investigations especially in cases with loss of acquired skills after diagnosis.

Introduction: Misophonia is a neuropsychiatric disorder characterised by abnormally extreme reactions to certain sensory stimuli. In this paper, we aimed to investigate the effect of the individual producing the human-generated trigger sound on the level of discomfort reported to the trigger sound. Our hypothesis was that when the misophonic sound is presented with the information that it is produced by a relative, it will create more subjective discomfort than the sound presented with the information that is not produced by a relative.

Methods: This experimental study was conducted with 15 participants aged 18-65 years living in Antalya who volunteered to participate in the study.

Results: In the first comparison, participants reported more subjective discomfort when the voice from the sound bank was presented with the information that it was produced by the relative than when the relative's voice was presented with the information that it was not produced by the relative (p<0.001). In the second comparison, participants reported more subjective discomfort when the voice of the relative was presented with the information that it was produced by the relative than when the voice of the relative was presented with the information that it was not produced by the relative (p=0.001). In the final comparison, there was no significant difference in subjective discomfort between presenting the voice of the voice bank with the information that it was produced by the relative and presenting the voice of the relative with the information that it was produced by the relative (p=0.783).

Conclusion: In conclusion, it seems source of the trigger, especially for human-made sounds, is more important than the trigger sound itself.

Introduction: We aimed to examine the relationship between autistic traits, internet addiction and multidimensional perceived social support in individuals aged over 18 years in a non-clinical population sample.

Methods: Volunteers were invited to the study via social media and e-mail, and the data were collected using an online questionnaire form. The research sample consists of 355 participants. The socio-demographic and internet usage information of the participants were collected via the Personal Information Form. Autism-Spectrum Quotient (AQ), Young-Internet Addiction Test (Y-IAT), Multidimensional Scale of Perceived Social Support (MSPSS), and The Satisfaction with Life Scale (SWLS) which were administered to the participants.

Results: As the AQ scores increased, the scores of the Y-IAT also increased, and MSPSS and SWLS scores decreased. According to our results, autistic traits (ATs) were associated with internet addiction, perceived social support and life satisfaction. A positive and significant relationship was found between internet addiction and the sub-dimensions of the autism spectrum questionnaire, such as social skills, shifting attention, attention to detail and communication scores. We stated that 10% of the total variance regarding internet addiction, 8% of the total variance regarding social support and 2% of the total variance regarding life satisfaction are explained by autistic traits. Also, as the level of internet addiction increases, the perceived social support and life satisfaction levels decrease.

Conclusion: Individuals with more ATs are more prone to internet addiction. ATs negatively predicted the perceived social support and life satisfaction. Preventive and therapeutic algorithms need to be developed for individuals with autistic traits.

Introductıon: Long-reported dual comorbidity between migraine and sleep disorders suggests that some gene variations may play a role in this relationship. Our previous study found an association between poor sleep quality and the G allele of the hypocretin receptor 1 (HCRTR1) rs2271933 gene in patients with chronic migraine (CM). This study aimed to examine the relationship of this gene with some sleep parameters.

Methods: The present study was designed cross-sectional in the Mersin University Neurology Clinic between January 2000 and February 2018. Patients aged 18-75 years with CM according to the International Classification of Headache Disorders-3 (ICHD-3) criteria were included. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality of the patients. Patients were divided into two groups according to PSQI scores <6 or ≥6. Genotyping was performed for the HCRTR1 rs2271933 gene.

Results: Among the 100 patients with CM, only the data of those (n=67) with poor sleep quality were included in this study. The mean age of patients was 40.9±11.8%, and the female rate was 89.6%. We detected that increasing the time to fall asleep (p=0.369) and the rate of poor sleep quality (p=0.461) and also shortening sleep duration (p=0.016) with the increase of G allele carrier of HCRTR1 rs2271933 gene.

Conclusıon: As the G allele carrier of the HCRTR1 rs2271933 gene increased, a shorter sleep duration was observed. This finding may contribute to studies on the physiological roles of orexins.

Introduction: Vertigo, characterized by a sensation of spinning or movement, presents as a common complaint in primary care, emergency departments, neurology, psychiatry, and otolaryngology clinics. Its diverse etiologies, including inner ear disorders and neurological conditions, pose diagnostic challenges. The diagnostic process typically involves a comprehensive neurological examination, but additional tests like vertebral artery Doppler examination may be necessary, particularly when vascular causes are suspected. However, the necessity of this examination remains unclear. In this retrospective study, we aimed to evaluate the necessity of vertebral artery Doppler/USG examination in patients presenting with vertigo.

Methods: A cohort of 1021 patients attending a neurology outpatient clinic with complaints of dizziness/vertigo underwent comprehensive evaluation, including vertebral artery ultrasound/Doppler examination.

Results: The study revealed that the majority of patients (about 90%) exhibited no evidence of significant vertebral artery atherosclerosis. However, hemodynamically significant vertebral artery pathology was observed in 5.1% of patients, predominantly among older male individuals with cardiovascular risk factors. Additionally, anatomical variations in vertebral artery anatomy were noted, highlighting the importance of considering vascular factors in vertigo evaluation.

Conclusion: These findings underscore the importance of tailored diagnostic approaches and comprehensive assessment in patients with vertigo, emphasizing the role of vertebral artery Doppler examination, particularly in specific patient subgroups. Over 60-year-old patients with vertigo are likely to have hemodynamically important vertebral artery atherosclerotic lesions and clinicians should keep this information in mind during daily practice. Understanding the necessity of this adjunctive diagnostic tool can aid in timely diagnosis and management, potentially reducing healthcare costs and optimizing patient outcomes. However, this examination may not be necessary in 90% of vertigo patients.

[This corrects the article on p. 248 in vol. 61.].

Introduction: The aim of the study is to determine the role of upper motor neuron (UMN) or lower motor neuron (LMN) dysfunction as the primary initiator of distal-proximal and lateral-medial gradients of muscle involvement in amyotrophic lateral sclerosis (ALS).

Methods: Concentric needle electromyography recordings were performed in deltoid, abductor digiti minimi, and first dorsal interosseous (FDI) muscles in patients with ALS and controls during slight voluntary contraction needed to activate two motor units (MU). Five motor unit potential (MUP) pairs were recorded from each muscle. Motor unit potential analyses were performed offline using Multi-MUP analysis program. Quantitative MUP parameters, MU firing rate (FR), FR variability (FRV), and mean consecutive difference (MCD) were calculated. Motor-evoked potentials and the triple stimulation technique (TST) were performed to evaluate UMN involvement.

Results: Twenty patients with ALS along with 20 age and sex-matched healthy volunteers were enrolled. Quantitative MUP parameters compatible with denervation and reinnervation were found in patients with ALS, who also showed higher FR, FRV, and MCD values, most prominently in FDI. First dorsal interosseous FRV was lower in patients with abnormal central motor conduction time (CMCT). Firing rate and FRV were negatively correlated with CMCT, but not with TST.

Conclusion: Distal limb muscles, particularly FDI, revealed more prominent FR abnormalities in patients with ALS in parallel with the distal-proximal and lateral-medial gradients of the selective muscle involvement pattern which seems predominantly to be correlated with LMN dysfunction. Reduced FRV may be associated with the presence of UMN dysfunction in ALS.