[Show abstract][Hide abstract] ABSTRACT: To examine the relationship between different types of dementia and hippocampal volume.
Hippocampal volume was measured by magnetic resonance imaging in patients with Alzheimer's disease (n = 22), vascular dementia (n = 14), mild cognitive impairment (n = 12) or pseudodementia (n = 16), and in healthy control subjects (n = 11). The Mini Mental State Examination was used to stratify subjects according to cognitive function.
Hippocampal volume was reduced by 42% in Alzheimer's disease, 21% in vascular dementia, 15% in mild cognitive impairment and 13% in pseudodementia compared with controls. The severity of dementia increased in line with decreasing hippocampal volume.
Measurement of hippocampal volume may facilitate differentiation between dementia subtypes. There was a relationship between reduced hippocampal volume and the degree of cognitive impairment.
The Journal of international medical research 04/2012; 40(2):717-25. DOI:10.1177/147323001204000236 · 1.44 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Amyloid β42 (Aβ42) and proinflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) have been suggested to contribute to the pathogenesis of Alzheimer's disease (AD) and vascular dementia (VaD). Our aim was to examine whether the changes in these parameters would be able to discriminate the patients with AD from those with VaD and from healthy individuals. We have analyzed the levels of Aβ42, IL-6 and TNF-α in the serum of newly diagnosed 28 AD patients, 16 VaD patients and 26 healthy non-demented controls. We also investigated whether there is an association between Aβ42, IL-6 and TNF-α levels and mini-mental state examination (MMSE) scores and body mass indexes (BMI) of patients. Our data showed a significant decrease in serum Aβ-42 levels in AD patients compared to VaD patients and controls. Levels of IL-6 and TNF-α were not different between AD patients, VaD patients and controls. We observed a correlation between Aβ-42 levels and MMSE scores and BMI levels in both AD and VaD patients. However, Aβ-42 levels were not correlated with IL-6 and TNF-α levels. Significantly lower levels of Aβ42 found in the serum of AD patients than that of VaD patients and controls suggests that it can be a specific biochemical marker for AD.
Neurochemical Research 03/2012; 37(7):1554-9. DOI:10.1007/s11064-012-0750-0 · 2.59 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Alzheimer disease (AD) is a progressive, irreversible entity associated with behavioral changes, memory loss and disturbance of daily life activities. Current diagnostic tools can detect neuronal degeneration in AD only after irreversible damage that already existed. Vestibular evoked myogenic potentials (VEMP) test utilizes the sacculocolic reflex arc and has been used in neuro-otology practice for many years. In this study, we aim to determine if VEMP can be used for diagnostic purposes at the earliest stages of AD. Twenty patients with AD and ten patients with mild cognitive impairment were enrolled in this study. Control group was 30 healthy volunteers with no neurological or otological diseases. Abnormal VEMP responses were found in most of the patients at different stages of AD. VEMP test may be used for early diagnosis of AD. Also, it may provide a novel advancement in understanding of pathophysiology of this disease.
[Show abstract][Hide abstract] ABSTRACT: It is unclear whether hemostasis plays a role in the pathogenesis of ischemic stroke subtypes.
We aimed to investigate the possible relationship between different hemostatic markers and lacunar stroke.
The study consisted of 30 patients with symptomatic lacunar stroke and 30 healthy age-matched healthy individuals. We analyzed the values of "Mean Platelet Volume," D-dimer, "soluble p-selectin," "Plasminogen Activator Inhibitor Type-1" (PAI-1), "Thrombin-Activatable Fibrinolysis Inhibitor" (TAFI), and "Platelet Factor 4" (PF4) in patients with lacunar infarct and compared these values to those of control individuals. There were significant differences for D-dimer, mean platelet volume, thrombin-activatable fibrinolysis inhibitor, and platelet factor 4 values in symptomatic lacunar stroke group compared with the control group (P < 0.01).
Different hemostatic factors may play a role in the pathogenesis of lacunar stroke. Evaluating the role of hemostatic factors on different types of strokes may help us identify new therapeutic strategies and different prognostic stratifications for ischemic stroke.
The Neurologist 05/2010; 16(3):188-91. DOI:10.1097/NRL.0b013e318198d8bc · 1.16 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study aimed to investigate the prevalence of various cognitive disorders in the older population (age 55 years and above) of Eskisehir, Turkey, by conducting a cluster sampled door-to-door survey. A total of 3100 inhabitants were screened with the Mini-Mental State Examination (MMSE) and a questionnaire concerning demographic, occupational and social data. Individuals (n=320) with MMSE scores of 25 were assessed according to the 10th Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) and were investigated in the more detailed phase 2 study. The overall prevalence of dementia was 8.4%, although it ranged from 2.2% among those aged 55-59 years to 5.3% among those aged 60-64 years, and to 30.4% among those aged 75 or above. Vascular dementia was the most common type (51.1%), followed by Alzheimer's dementia (48.8%). In a very small proportion of individuals (0.1%), dementia was due to other causes such as B12 deficiency, a tumour or hydrocephalus. Significant risk factors for dementia were female sex, low education, age, living in a rural area and a family history of dementia.
[Show abstract][Hide abstract] ABSTRACT: This study was carried out to determine if there is any association between plasminogen activator inhibitor type-1 (PAI-1) gene 4G/5G polymorphism and plasma PAI-1 enzyme activity in acute stroke patients.
In this study, 333 genomic DNAs (from 253 acute stroke patients and 80 healthy subjects) were analyzed. Genomic DNAs were prepared from peripheral blood using a saline method. These DNAs were amplified by PCR method using primers specific for 4G and 5G alleles. PCR products were separated by 2% agarose gel electrophoresis and visualized by a charge coupled device (CCD) camera. PAI-1 enzyme activities were measured by ELISA method. The results were evaluated statistically with Student's t-test, chi(2)-test, one-way analysis of variance, and stepwise regression analysis.
In this study, frequency of PAI-1 gene 4G5G genotype was found to be low both in patients and controls. PAI-1 enzyme activities were significantly increased in acute stroke patients compared to controls. Although PAI-1 gene 4G5G genotype frequencies were low, the patients carrying this allele had highest plasma PAI-1 enzyme activity; likewise, although PAI-1 gene 4G4G genotype frequencies were high, the patients carrying this allele had lowest plasma PAI-1 enzyme activities. Homocysteine levels had a positive effect of 65% on plasma PAI-1 enzyme activities.
Consequently, in this study, we may assert that PAI-1 gene, 4G4G and 5G5G genotypes, PAI-1 activity, and homocysteine level determination are significant criteria for identifying patients who are likely to develop stroke; on the other hand, a direct relation does not exist between gene polymorphism and enzyme activity.
[Show abstract][Hide abstract] ABSTRACT: Some methylenetetrahydrofolate reductase (MTHFR) gene mutations cause hyperhomocysteinemia and homocystinuria. These may be important risk factors for cardio and cerebrovascular diseases. We investigated whether the MTHFR C677T and A1298C polymorphisms contribute to hyperhomocysteinemia and increase the risk factor for stroke.
A total of 203 acute stroke patients and 55 controls were recruited. Polymorphisms were determined by using polymerase chain reaction-restriction fragment length polymorphism (RFLP) and plasma total homocysteine levels were measured by enzyme-linked immunosorbent assay (ELISA).
There were no significant differences between C677T and A1298C genotypes and allele frequencies in the stroke patients and controls. Total plasma homocysteine level was higher in the 677TT and 1298AA genotypes in stroke patients and especially small-vessel disease patient subgroup. Age, number of males, systolic-diastolic blood pressures, creatinine, vitamin B(12) and homocysteine levels were significantly high among stroke patients. Age, sex, systolic blood pressure and HDL-C were determined as risk factors for homocysteine levels. We also determined that the effect of A1298C polymorphism on homocysteine was not as high as that of C677T polymorphism in acute stroke patients. We conclude that the MTHFR genotype may be a modest risk factor for stroke in Turkish population.
[Show abstract][Hide abstract] ABSTRACT: We assessed the effect of intravenous high-dose methylprednisolone (IVMP) on cerebral reactivity in multiple sclerosis (MS) patients during exacerbations by means of functional transcranial Doppler imaging. Forty-eight clinically defined MS patients were evaluated with visual evoked potentials (VEP) and functional transcranial Doppler sonography (TCD) of both posterior cerebral arteries before and after 5 days of 1000 mg IVMP. After treatment, mean Expanded Disability Status Scale score, mean blood flow velocities and mean blood flow velocities at rest and at stimulation, significantly decreased (p < 0.0001, for each). The change in cerebral blood flow velocity ratio (CBFv) with visual stimulation after treatment increased slightly (p = 0.20). All TCD parameters were not significantly correlated with VEP changes. In conclusion, we observed significant changes in CBFv with a non-significant increase in vascular reactivity after treatment with IVMP in exacerbations of MS. Case-control studies are necessary to draw conclusions regarding the beneficial effects of IVMP treatment.