Noropsikiyatri Arsivi-Archives of Neuropsychiatry最新文献

Introduction: Headache is a common symptom in patients with Coronavirus-19 infection (COVID-19). In this research, we aim to assess the frequency, characteristics, and response to treatment of headache in patients with COVID-19 and its correlation with psychosocial features in Turkey.

Methods: To describe the clinical features of headache in COVID-19 positive individuals. Patients were evaluated and followed up with face-to-face visits in a tertiary hospital during the pandemic period.

Results: One hundred and seventeen of 150 patients (78%) had a headache diagnosed before and during the pandemic, 62 of 150 (41.3%) had a new type of headache. No significant differences were observed in terms of demographics, Beck Depression Score, Beck Anxiety Score, and quality of life scales (QOLS) between patients with and without headache (p>0.05). The most common triggering factor for headache was stress and fatigue in 59% (n=69), while the second most common (32.4%, n=38) was COVID-19 infection. 46.5% of the patients reported that the severity and frequency of their current headaches increased after the COVID-19 infection. Among new-onset headaches, the social functionality and pain score subgroups of the QOLS form were significantly lower in housewives and unemployed patients compared to the working group (p=0.018; p=0.039 respectively). Twelve of 117 patients had a mild to moderate, throbbing headache in the temporoparietal region, which did not fulfill the International Classification of Headache Disorders diagnosis criteria, but showed as a common feature among COVID-19 patients. Nineteen of 62 patients (30.9%) had a newly diagnosed migraine syndrome.

Conclusion: The diagnosis incidence of migraine in patients with COVID-19 disease being more than other headaches types may suggest the existence of a common pathway in possible immune mechanisms.

Manganese regulates many enzymes in the human body and is essential for normal development and bodily function. Chronic manganese poisoning has an insidious and progressive course and usually begins with nonspecific complaints such as headache, fatigue, sleep disturbances, irritability and emotional instability. In the following process, neurological symptoms like parkinsonism are added. A severe clinical condition that is irreversible may occur. In this case report, a female patient who applied to the psychiatry outpatient clinic with depressive symptoms and was diagnosed with manganese intoxication in the following period will be presented.

Introduction: To investigate the differences in biochemical characteristics between Coronavirus Disease 2019 (COVID-19) patients with and without delirium in non-intensive care (IC) COVID-19 units was aimed.

Methods: This study was designed as an observational, single-centered, and case-control study consisting of 43 delirious patients and matched 45 non-delirious patients admitted to non-IC COVID-19 units. Delirium was diagnosed by a consultant psychiatrist according to the DSM-5 delirium diagnostic criteria. Independent variables such as laboratory tests at the time of admission, clinical features, and patient characteristics were obtained from electronic medical records by researchers. In the primary analyses, binomial logistic regression models were used to investigate the factors associated with delirium, which was identified as the outcome variable. Multivariate logistic models were then adjusted for potential confounding factors, including age, gender, history of neurocognitive disorders and Charlson Comorbidity Index (CCI).

Results: We observed higher levels of urea, d-dimer, troponin-T, proB-type natriuretic peptide, and CCI in patients with delirium compared to patients without delirium. We also observed lower levels of estimated glomerular filtration rate (eGFR), serum albumin, and O₂ saturation and a decrease in the length of stay at the hospital. After adjusting for confounding factors such as gender, age, and comorbidity, we found that urea (adjusted estimate=0.015; 95% Confidence Interval [CI]=0.058-0.032, P=0.039), urea/creatinine ratio (adjusted estimate=0.008; 95% CI=0.002-0.013, P=0.011), and troponin-T (adjusted estimate=0.066; 95% CI=0.014-0.118, P=0.014) were independent biomarkers associated with delirium.

Conclusion: Delirium is associated with higher urea levels and urea/creatinine ratios in COVID-19 patients. In addition, the relationship between troponin-T and delirium may help understand the potential link between the brain and the heart in COVID-19. Additional multi-centred studies with larger sample sizes are needed to generalise these results.

Introduction: Increasing migration, due to wars, is one of the environmental factors in the etiology of multiple sclerosis. This study aims to compare demographic and clinical features of immigrant and local MS patients, as well as relapses during pregnancy and postpartum in female patients.

Method: Immigrant (Group 1) and local (Group 2) MS patients were evaluated between January 2019 - September 2020 retrospectively. Below-mentioned data of two groups were recorded and compared: i) demographic data, ii) cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI) findings, iii) MS subtypes, iv) expanded disability status scores (EDSS), v) the time between first two relapses, vi) comorbidities, vii) treatment, viii) age of migration and country of origin, ix) pregnancy, x) relapse during pregnancy, xi) birth number, xii) breastfeeding, xiii) postpartum relapses.

Results: Both of the groups were composed of 34 MS patients (in total n=68). Gender distribution, mean age, MS subtypes, the time between first two relapses, disease duration, EDSS, CSF findings and comorbidities were similar between groups. Symptom of onset was predominantly sensory in both groups. Local patients had more cervical lesions and higher lesion load (p=0.003, p=0.006). 20.6% of migrant MS patients were untreated, all local patients were on treatment. Rates of injection and infusion therapies were similar, the rate of receiving oral therapy was higher in the second group. Clinical features and fertility status of female patients were similar.

Conclusion: According to the study no differences were preseentpresent between immigrant and local MS patients except for MRI lesion load and treatment parameters. The language barrier and irregular follow-ups were the major problems in treatment management.

Introduction: Alzheimer's disease (AD) is a neurodegenerative disease caused by the accumulation of amyloid plaques in the cerebral cortex and hippocampus. In this study, the effects of local anesthetic lidocaine on neurodegeneration markers and memory were investigated for the first time in streptozotocin-induced rat AD model.

Methods: Streptozotocin (STZ) was administered intracerebroventricularly (ICV) into Wistar rats to develop AD model. For lidocaine group (n=14), lidocaine (5 mg/kg) was administered intraperitoneally (IP) in addition to STZ injection. Control group animals (n=9) were treated with saline for 21 days. Morris Water Maze (MWM) test was performed to evaluate memory after the injections were completed. Also, the serum levels of TAR DNA-binding protein-43 (TDP-43), amyloid precursor protein (APP), β-secretase 1, nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), response element binding protein (CREB), c-FOS were measured using ELISA test and compared between groups.

Results: Lidocaine group animals showed lower escape latency and time in quadrant scores in MWM inferring better memory performance. Furthermore, lidocaine administration caused a significant decline in TDP-43 levels. However, the expression of APP and β-secretase were significantly higher in AD and lidocaine groups compared to control group. Moreover, lidocaine group markedly had higher serum NGF, BDNF, CREB, and c-FOS levels compared to those in the AD group.

Conclusion: In addition to neuroprotective effects in STZ-induced AD model, Lidocaine also appears to improve memory. This effect might be associated with increased levels of several growth factors and associated intracellular molecules. The therapeutic role of lidocaine in the pathophysiology of AD should be studied in the future.

The Westphal variant of Huntington's disease (HD) is a progressive neurodegenerative disease characterized by a rigid-hypokinetic syndrome rather than choreiform movements. This variant is a distinct clinical entity of HD and is often associated with a juvenile onset of the disease. We present the case of a 13-year-old patient diagnosed with the Westphal variant with an onset at approximately 7 years of age and primarily exhibited developmental delay and psychiatric symptoms. In the light of findings from both physical and clinical examinations, possible difficulties in the diagnosis and treatment of juvenile HD are discussed in here.

[This corrects the article on p. 23 in vol. 60, PMID: 36911568.].

Introduction: While data on oxidative stress in psychiatric disorders are increasing, studies on obsessive-compulsive disorder (OCD) are limited. Although many studies report neurocognitive deficits in OCD, to our knowledge, no study exists examining the relationship between neurocognitive functions and oxidative stress in OCD. This study investigated the neurocognitive functions in OCD and its relationship with OCD severity and oxidative metabolism.

Methods: In our study, 50 OCD patients and 50 healthy controls were included. The groups were well-matched for age, gender, education years, and other socio-demographic characteristics. Comorbid psychiatric diagnoses were excluded. To assess cognitive functions, a battery of neurocognitive tests was used. Oxidative metabolism parameters such as oxidants homocysteine, malondialdehyde, nitric oxide and antioxidants; sialic acid and glutathione peroxidase were measured. Obsessive-compulsive disorder severity was assessed with Yale-Brown-Obsession-Compulsion-Scale (YBOCS). Patients with OCD and control groups were compared in terms of neurocognitive functions, oxidative stress and OCD severity.

Results: OCD group performed significantly worse in various aspects of attention, memory, executive functions (p<0.05). Homocysteine, nitric oxide, malondialdehyde, sialic acid levels were significantly (p<0.05) higher, glutathione peroxidase was significantly (p<0.05) lower in patients versus controls. Yale-Brown-Obsession-Compulsion-Scale scores correlated negatively with most of neurocognitive functions. The relationship between oxidative parameters and cognitive tests was contradictory as some results were opposite to what was expected.

Conclusions: Cognition is affected by OCD and worsens with disorder severity. Considering oxidative parameters were meaningful in patients, oxidative metabolism may be a risk factor for OCD. However, more studies are needed to evaluate the effect of oxidative metabolism on cognitive functions.

Introduction: Clozapine may affect the outcome of severe COVID-19 infection due to its anti-inflammatory and immunosuppressant effects. This study aimed to investigate whether the risk of COVID-19 changed in schizophrenic patients using clozapine and to compare patients using clozapine with other antipsychotics in terms of COVID-19 severity.

Methods: A total of 732 patients who were registered and followed up with a diagnosis of schizophrenia were included in the study. These patients' sociodemographic data, smoking status, medications, comorbidities, COVID-19 PCR results, and COVID-19 outcomes (inpatient care admission, intensive care unit admission, death) were retrospectively analyzed.

Results: Of the 732 patients included in our study, 177 were using clozapine. Ninety-six of 732 patients were diagnosed with COVID-19, and 34 of these were being treated with clozapine. We found that clozapine use was an independent risk factor for COVID-19 positivity (OR=1.81 95% CI=1.13-2.90), inpatient care admission (OR=3.01, 95% CI=1.12-8.06).

Conclusion: In our study, clozapine use was associated with an increased risk of COVID-19 positivity and inpatient care admission; however, it was not associated with ICU admission or death. Due to the frequent follow-up of patients using clozapine and the effects of clozapine on immunity, the frequency and/or identification of COVID-19 may be increased in these patients. Clozapine toxicity, granulocytopenia or agranulocytosis during the COVID-19 infection may have increased these patients' hospitalisation frequency.