[Show abstract][Hide abstract]ABSTRACT: Objective:
This study will evaluate how decreasing depression severity via group psychotherapy affects the cognitive function of patients with multiple sclerosis (MS) who are also diagnosed with depression and cognitive dysfunction.
MS patients completed the Brief Repeatable Battery of Neuropsychological Tests and Beck Depression Inventory (BDI). The group members diagnosed with depression and cognitive dysfunction underwent group psychotherapy for 3 months. Upon completion of psychotherapy, both tests were readministered.
Depression and cognitive dysfunction were comorbid in 15 (13.9%) of patients. Although improvement was detected at the end of the 3-month group psychotherapy intervention, it was limited to the BDI and the Paced Auditory Test.
Group psychotherapy might decrease cognitive impairment in MS patients.
Full-text Article · Jan 2015 · Arquivos de Neuro-Psiquiatria
[Show abstract][Hide abstract]ABSTRACT: OBJECTIVE: Multiple Sclerosis (MS) is such a disease that not only leads to different levels of disabilities in mobility and functional activities, but also creates severe disability and impairs the quality of life via causing limitations in person’s social and occupational life. Most MS patients experience depression. Besides, cognitive dysfunction is present. In this study, it is aimed to detect the frequency of depression and cognitive dysfunction in MS patients.
METHODS: 108 patients diagnosed with MS are evaluated. Each one of the MS patients are administered the Brief Repeatable Battery of Neuropsychological Test (10/36 Spatial Recall Test, Symbol Digit Modalities Test, Paced Auditory Serial Test, Word List Generation Test), Beck Depression Inventory and Benedict Test.
RESULTS: Of the 108 MS cases participated in the study, 69.4 % (n=75) are female, while 30.6 % (n=33) are male patients. Depression is detected in 19.5 % (n=21) of the patients, while cognitive dysfunction is detected in 41.7 % (n=45). Depression and cognitive dysfunction are detected together in 13.9 % (n=15) of the patients.
CONCLUSION: Depression and cognitive dysfunction are not a rarity in patients with MS. A multidisciplinary approach is needed to treat the patients diagnosed with MS.
[Show abstract][Hide abstract]ABSTRACT: Benign intracranial hypertension is characterized by increased intracranial pressure that is not secondary to space occupying lesions, normal cerebrospinal fluid composition and no focal neurologic signs. The most important clue for the diagnosis is papilledema. But in rare cases, there may be no papilledema. Fourty-eight-year-old male patient was admitted to our hospital with complaints of headache continued for 6 months. Headache did not respond to any treatment. Patient's neurological examination, cranial MRI, cerebral venografi was normal and there was no papilledema. As a result of investigations, the benign intracranial hypertension was found in patients. After treatment, the patient's headaches decreased. In the present case report, we emphasize that bening intracranial hypertension wıthout papilledema must considered as a cause of headache.
[Show abstract][Hide abstract]ABSTRACT: Migraine is more likely to be misdiagnosed in patients with comorbid diseases. Not only primary care physicians, but also specialists might misdiagnose it due to the lack of diagnostic criteria awareness. The ID migraine test is a reliable screening instrument that may facilitate and accelerate migraine recognition. This study aimed to compare the prevalence and characteristics of migraine in a large sample of patients admitted to clinics of ophthalmology (OC), ear, nose and throat diseases (ENTC) and neurology (NC), as well as to validate the use of the ID migraine test in OC and ENTC settings. This was a multicentre (11 cites) study of out-patients admitting either to NC, ENTC or OC of the study sites during five consecutive working days within 1 week. From each of the clinics, 100 patients were planned to be recruited. All recruited patients were interviewed and those having a headache complaint received an ID migraine test and were examined for headache diagnosis by a neurologist, blinded to the ID migraine test result. A total of 2625 subjects were recruited. Only 1.3% of OC patients and 5.4% of ENTC patients have been admitted with a primary complaint of headache, whereas the percentage of NC patients suffering from headache was 37.6%. Whereas 138 patients (19.3%) in OC, 154 (17.3%) in ENTC and 347 (34%) in NC were found to be ID migraine test positive, 149 patients (20.8%) in OC, 142 (16%) in ENTC and 338 (33.1%) in NC were diagnosed with migraine. The sensitivity, specificity, and positive and negative predictive ratios of the ID migraine test were found to be similar in all clinics. An important fraction of the patients admitted to NC, as well as to OC and ENTC, for headache and/or other complaints were found out to have migraine by means of a simple screening test. This study validated the ID migraine test as a sensitive and specific tool in OC and ENTC, encouraging its use as a screening instrument.
[Show abstract][Hide abstract]ABSTRACT: Atopic dermatitis (AD) is a chronic dermatitis characterized by intense itching and excessive skin dryness. The factor most commonly blamed for the pathogenesis of skin dryness in the disease is impaired barrier function of the stratum corneum. However, there are findings indicating that the autonomic nervous system, and the sympathetic nervous system in particular, is affected negatively in AD, and thus, autonomic dysfunction can be an important factor leading to skin dryness.
In this study we aimed to evaluate the functioning of the autonomic nervous system electrophysiologically using R-R interval variation (RRIV) and the sympathetic skin response (SSR) in patients with AD, and to examine whether there is an underlying autonomic nervous system dysfunction.
The study registered a total of 38 (12 males and 26 females) patients with AD, of whom 24 had active and 14 inactive disease, and 20 (10 males and 10 females) healthy control subjects. RRIV was used in our study as the electrophysiological test to evaluate the parasympathetic system. The SSR method, which is a noninvasive electrophysiological test with a significant role in evaluating the sudomotor activity of skin, as well as that of the unmyelinated fibres that take a part in this activity, was employed to assess the sympathetic nervous system.
Our study revealed a significantly prolonged SSR latency and amplitude of the upper extremity in the patient group, relative to the control group (P < 0.05). When the group with active skin lesions was compared with the control group, the former was found to have prolonged SSR latency and amplitude in the upper extremity. The prolongation in SSR latency of the upper extremity was statistically significant (P < 0.05), while the prolongation in amplitude was not (P = 0.5). An evaluation of RRIV results did not show a significant difference between the patient and control groups.
These findings demonstrate that the sudomotor activity controlled by the sympathetic nervous system, as well as unmyelinated fibres that play a role in this activity are affected in patients with AD. We think that the involvement of sudomotor activity may be one of the causes that leads to dysfunction in sweat glands and skin dryness.
Full-text Article · Sep 2008 · British Journal of Dermatology
[Show abstract][Hide abstract]ABSTRACT: Stroke is one of the most important diseases causing severe disability and death. The incidence of ischemic stroke increases by age. Since the life expectancy is longer among the young population with stroke and due to economic and social challenges, research has focused on the causes of the disease. This study was planned to define the etiologic factors for stroke among young adults. Patients who had referred to the Firat University Firat Medical Center between March 2004 and March 2005 and were diagnosed as ischemic stroke were included. The ages of the patients were between 17 and 45. A detailed medical history was taken including personal and family history and risk factors and a detailed neurological evaluation was performed. Computed tomography (CT), magnetic resonance (MR) imaging, Doppler USG examination of the carotid and vertebral arteries, cardiac investigations, and detailed laboratory investigations were carried out for each patient. Of the 32 patients, 14 (43.8%) were males and 18 (56.2%) were females. The factors described for the etiology of stroke were atherothrombotic vasculopathy in 9 (28%) cases, emboli originating from the heart in 7 (21.9%), hematological disorders in 6 (19%), non-atherosclerotic vasculopathies in 5 (15.6%), other determined causes in 6 (18.8%), undetermined causes in 4 (12.5%), and lacunar stroke in 1 (0.3%). The most common risk factors for the etiology of young-age stroke are reported as atherothrombotic vasculopathy, non-atherosclerotic vasculopathies, and emboli originating from the heart. Similarly, in our study, vasculopathies were the most common causes followed by cardioembolic events and other determined causes. Stroke is an important neurological disease with regard to preventable risk factors at young age. Studies carried out for the prevention of conditions that cause stroke with a high risk of neurological deficits will be of great benefit for the young population, which make up the most active group of socio-economic life.
Article · Oct 2007 · Turkiye Klinikleri Journal of Medical Sciences
[Show abstract][Hide abstract]ABSTRACT: The tricyclic antidepressant amitriptyline (AMT) and the calcium channel blocker flunarizine are frequently used in the preventive treatment of migraine, but the side-effect of prominent weight gain that frequently emerges during preventive treatment of migraine with these agents often leads to the discontinuation of therapy. In this study, we aimed to investigate the possible relationship between the weight gain associated with the use of these agents and serum levels of leptin, C-peptide and insulin in patient with migraine. Forty-nine migraine patients with a body mass index (BMI) < 25 and without any endocrinological, immunological or chronic diseases were randomly divided into two groups, receiving AMT or flunarizine. There was a statistically significant increase in serum levels of leptin, C-peptide, insulin and measures of BMI in both groups when measured at the 12th week of therapy compared to their respective basal levels. To our knowledge this is the first study investigating the effects of AMT and flunarizine on serum leptin levels in preventive use of migraine treatment. A result from this study indicates that AMT and flunarizine may cause leptin resistance possibly by different mechanisms and thereby result in increase in serum leptin levels and BMI.
[Show abstract][Hide abstract]ABSTRACT: Objective: The aim of the study was to investigate whether serum neuron specific enolase (NSE) levels can be utilized as a non-invasive technique to determine early-stage morbidity after acute intracerebral hemorrhage. Material and Methods: 40 patients presenting with acute intracerebral hemorrhage and 20 age and sex-matched healthy volunteers were examined in the Neurology Department of the Firat University Faculty of Medicine. Serum NSE levels at 48 hours, 5 days, and 10 days were analyzed and corresponding clinical status according to the Glasgow Coma Scale were determined. Intracerebral hemorrhage volumes after 48 hours were measured. Clinical status according to functional independence measure (FIM) was determined after 30 days. Results: Positive correlations were seen at 48 hours, 5 days, and 10 days between serum NSE values and intracerebral hemorrhage volumes (r= 0.55, p< 0.001; r= 0.67, p< 0.001; P= 0.57, p< 0.001; r= 0.58, p< 0.001, respectively). In contrast, negative correlations were noted at 48 hours and 5 days between serum NSE levels and clinical condition (r= -0.42, p< 0.01; r= -0.38, p< 0.01, respectively). Conclusion: NSE levels, as a neuro-biochemical marker of post-stroke acute cerebral damage, can be utilized as a non-invasive method of early-stage determination of morbidity following intracerebral hemorrhage.
Article · Feb 2005 · Turkiye Klinikleri Journal of Medical Sciences
[Show abstract][Hide abstract]ABSTRACT: Objective: Cellular immune system activation functions as a triggering factor in the formation of demyelination plagues in multiple sclerosis (MS). Our aim was to study the levels of neopterin, an important activation marker of the cellular immune response in patients with Relapsing-Remitting MS (RR-MS), during attack and remission periods and to determine its efficacy as a laboratory marker or predictor of imminent periods of disease activation. Material and Methods: 39 age and sex matched healthy patients diagnosed with RR-MS were investigated in the Neurology Department of Firat University Faculty of Medicine. Neopterin levels were determined by ELISA. Patients were classified according to clinical status with the Expanded Disability Status Scale (EDSS). Results: Neopterin levels were 18.77 ± 2.36 nmol/L and 11.79 ± 3.35 ng/mL in the patient and control groups, respectively (p< 0.05). During attack and remission periods, Neopterin levels were 24.42 ± 7.56 mmol/L and 15.95 ± 3.41 nmol/L, respectively (p< 0.01). There was a positive correlation between EDSS scores and neopterin levels of the MS patients (r= 0.4, p< 0.05). Conclusion: We conclude that neopterin levels might be used as an objective criterion in the evaluation of attack periods of RR-MS patients.
Article · Jan 2005 · Turkiye Klinikleri Journal of Medical Sciences
[Show abstract][Hide abstract]ABSTRACT: Conversion disorder (CD) is a common disease and its importance still continues in Turkey and particularly in Eastern Turkey. The aim of this study is to examine sociodemographic and clinical characteristics of CD.
Among 198 consecutive patients having CD diagnosed by structured DSM-III-R clinical interview, the psychosocial characteristics of the patients were clinically investigated.
The most common subtype of CD was non-epileptic seizure (NES) (41.4 %). The psychosocial stress factors were found in the initiation or at the last episode of the disorder (88.9 %). The most prominent problem related with primary support group was traumatic event (37.9 %) followed by problems associated with migration and related economical problems which are the most important problems of the study area. The incidence of depressive disorders was high in patients with CD, and the histrionic personality disorder was the most prominent personality pathology among the patients. Direct referral to psychiatry clinics appeared to be low (12.1 %).
Our findings have shown that traumatic events may have an important role in the occurrence, severity and duration of CD, and most of the patients seek help from religious healers. The study has also revealed that lower education level and socioeconomic and sociocultural problems may play a role in the occurrence of the disorder as well as regarding its course.
Article · Mar 2003 · Social Psychiatry and Psychiatric Epidemiology
[Show abstract][Hide abstract]ABSTRACT: It is well known that the training level of a muscle belongs to the parameters that affect the H-reflex response amplitude. The aim of this study was to investigate the effects of training type on H- and T-reflex response parameters. For this purpose, 20 long-distance athletes (group I, test group), 18 short-distance athletes (group II, test group) and 20 non-trained subjects (group III, control group) were involved in this study in which the H- and T-reflex amplitude and latency values were measured. The H-reflex amplitude and latency values found in groups I, II and III were 3.64 +/- 0.28 mV and 26.88 +/- 1.45 ms, 3.17 +/- 0.26 mV and 26.19 +/- 1.89 ms, and 6.07 +/- 0.34 mV and 26.77 +/- 1.32 ms, respectively. The T-reflex amplitude and latency values of the groups I, II and III were 3.30 +/- 0.18 mV and 32.01 +/- 1.02 ms, 3.11 +/- 0.20 mV and 31.47 +/- 1.16 ms, 4.24 +/- 0.21 mV and 31.47 +/- 1.16 ms, respectively. There was no statistically significant difference between the groups with respect to latencies of H- and T-reflexes (p>0.05). In both test groups, the amplitudes of the H-reflex and T-reflex were significantly smaller than the control group (p<0.05). The results of this study suggest that training of muscles affect the H- and T-reflex response parameters.
Article · Feb 2002 · Physiological research / Academia Scientiarum Bohemoslovaca
[Show abstract][Hide abstract]ABSTRACT: ZET Elektrofizyoloji laboratuvarlarında proksimal segmentlerinin klasik sinir iletim çalışması teknikleriyle değerlen dirilmesi yeterli olmamaktadır. Bu çalışmada düzenli sportif faaliyetlerin H-refleks ve T-refleks latans ve amp-litödünû etkileyen bir değişken olup olmadığı araştırıldı. Bu amaçla ortalama 8.73 ± 4.45 yıldır spor yapmakta olan 20 öğrenci (10 futbolcu ve 10 voleybolcu) ile spor yapmayan 20 öğrencinin 80 alt ekstremitesinde H-ref leks ve T-refleks latans ve amplitüdleri, uygun koşullar sağlanarak ölçüldü. Çalışma grubunun H-refleks amp-litüdü 3.71 ±1.6 mV, latansı 27.98±2.16 ms, kontrol grubunun H-refleks amplitüdü 6.83±2.23 mV, latansı 27.69+2.0 ms bulundu. Gruplar arasında H-refleks latans ortalaması açısından fark gözlenmedi (p>0.05). Spor yapmayanlarda amplitüdün yaklaşık iki kat daha büyük olduğu ve gruplar arası farkın istatistiksel olarak anlam lı olduğu gözlendi (p<0.05). Çalışma grubunun ortalama T-refleks amplitüdü 3.78±1.99 mV, latansı 32.08±2.04 ms iken kontrol grubunda amplitüd 4.31 ±1.43 mV, latansı 31.52±2.27 ms bulundu. Spor yapmayanlarda amp litüd daha büyük olmakla birlikte, iki grup arasında T-refleks amplitüd ve latans ortalamaları farklı bulunmadı. (p>0.05). Çalışma grubu spor tipine göre karşılaştırıldığında futbolcular ve voleybolcuların H-refleks ve T-ref leks verileri arasında fark bulunmadı (p>0.05). Sonuç olarak antrenmanlı kastan elde edilen H-refleks amplitüdünün antrenmansız kasa göre daha küçük bu lunması tip la lifleri tarafından uyarılan motor nöron sayısının azlığına bağlı olabilir. Bu da spor yapanlarda tip la eksitatör afferentlerin ara motornöronlar üzerindeki etkisinin az olmasından kaynaklanabilir. Bu nedenle ref leks testlerin değerlendirilmesinde amplitüdü etkileyen değişkenler arasında kasın antrenman düzeyi de dikka te alınması gereken faktörlerdendir.