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Attention deficit and hyperactivity symptoms in adult migraine patients
(2019) Alpua, Murat; Say, Bahar; Yavuz, Esra Turgut; Ergün, Ufuk; Buturak, Şadiye Visal
Aim: To screen the symptoms of attention deficit and hyperactivity disorder in adult migraine patients.Material and Methods: Our study included 102 migraine patients and 93 sex- and age-matched healthy volunteers. Gender, age, levelof education and duration of disease were recorded. We used the adult attention deficit/hyperactivity disorder self-report scale toevaluate the symptoms of adult attention deficit / hyperactivity disorder. In addition, the short form-36 and the hospital anxiety anddepression scale were applied to the patients and the healthy controls.Results: The mean scores of attention deficit hyperactivity disorder were significantly higher in migraine patients compared to thecontrol group. There was no significant relationship between the Adult Attention Deficit and Hyperactivity Disorder Self-Report Scalescores and the duration of the disease. There was a negative correlation between the SF-36 health questionnaire scores and theAdult Attention Deficit and Hyperactivity Disorder Self-Report Scale scores. There was a positive correlation between the MigraineDisability Assessment scores, the number of migraine attacks and the Adult Attention Deficit and Hyperactivity Disorder Self-ReportScale scores.Conclusion: Attention-deficit and hyperactivity symptoms can develop in adult migraine patients and cause psychosocial morbidityand poor quality of life.
BİR ORTA ANADOLU ÖRNEĞİ OLARAK KIRIKKALE ÜNİVERSİTESİ TIP FAKÜLTESİ NÖROLOJİ KLİNİK VERİLERİ
(2019) Say, Bahar; Ergun, Ufuk; Yardımcı, İlknur; Alpua, Murat
Amaç: Nörolojik hastalıklar, görülme oranlarındaki artış,özürlülük ve sağlık giderlerindeki payı nedeniyle önemli biryere sahiptir. Bu çalışma, orta Anadolu örneği olarakKırıkkale Üniversitesi Tıp Fakültesi Hastanesi Nörolojikliniğinde gördüğümüz nörolojik hastalıklar spektrumunu veoranlarını belirlemek amacıyla planlanmıştır.Gereç ve Yöntem: Bu retrospektif çalışmada, Ağustos2016- Ağustos 2018 tarihleri arasında nöroloji kliniğindeyatırılan hastaların dosyaları incelendi. Dosyalar ve tanıkodları doktor tarafından düzenlenmiş olup, InternationalClassification of Diseases kodlamasına göre olan ana tanı,demografik özellikler dikkate alındı.Bulgular: Toplam 805 (422 kadın, 383 erkek) hasta dosyasıtarandı Servisteki hasta sayısı 712, yoğun bakımdaki ise93’di. Kadın hastalardan 50’si (%10.7), erkek hastalardan43‘ü (%10) yoğun bakımda takip edildi. Yaş dağılımında 70yaş üzeri hasta sayısı fazlaydı. Tanılara göre 413 (%51.3)serebrovasküler hastalık, 119 (%14.7) epilepsi, 62 (%7.7)senkop, 60 (%7.4) başdönmesi, 51 (%6.3) baş ağrısı diğersendromlar, 44 (%5.4) multipl skleroz, 17 (%2.1)enflamatuar polinöropatiler, diğeri, 11 (%1.3) Parkinson, 7(%0.8) Miyastenia Gravis, 7 (%0.8) bunama, 5 (%0.6)normal basınçlı hidrosefali, 4 (%0.4) Guillian BarreSendromu (GBS), 3 (%0.3) motor nöron hastalığı, 1 (%0.1)Lambert Eaton sendromu ve 1 (0.1) Herpes virüs ensefalitigörüldü.Sonuç: Bu çalışma da örneklem sayısı az olsa da ortaAnadolu’da başkentin yanı başındaki bir üniversitehastanesinin iki yıllık klinik verileri analiz edildi. Bulgularliteratür ile uyumlu olup en sık serebrovasküler hastalık,sonra epilepsi izlendi. Hastaların çoğunluğu 70 yaş üzeriydi.Ayrıca solunum kasları tutulumu ile tehlike yaratabilecekMiyastenia Gravis ve GBS olguları dikkat çekiciydi.
Case with atrophy and proximal muscle weakness: seronegative Lambert Eaton Myasthenic Syndrome
(Pamukkale University, 2019) Say, Bahar; Ergün, Ufuk; Karaca, Gülten
Lambert Eaton Myasthenic Syndrome (LEMS) is a rare neuromuscular junction disease characterized by proximal muscle weakness, decrease or loss of reflexes, moderate ocular and autonomic findings with antibody development to presynaptic voltage-dependent calcium channels. It can be paraneoplastic or autoimmun. Paraneoplastic LEMS is most commonly associated with small-cell lung cancer. Primary autoimmune may be associated with diabetes, rheumatoid arthritis, systemic lupus erythematosus, autoimmune thyroid diseases. Diagnosis is based clinical findings and electrophsyologic studies include repetetif nerve stimulation or single fiber electromyelography. Treatment includes 3,4 diaminopyridine, intravenous immunglobulin, plasmapheresis, prednisolone and azothiopurine according to the case. © 2019, Pamukkale University. All rights reserved.
Coexistence of Ankylosing Spondylitis and Multiple Sclerosis: Trigger with TNF-alpha Antagonist Therapy or Coincidental?
(Turkish Neurological Soc, 2019) Say, Bahar; Ergun, Ufuk
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Cold effect in median nerve conductions in clinical carpal tunnel syndrome with normal nerve conduction studies
(Elsevier Sci Ltd, 2019) Say, Bahar; Ergün, Ufuk; Turgal, Ebru; Yardımcı, İlknur
Clinical diagnosis of carpal tunnel syndrome (CTS) is confirmed by nerve conduction studies (NCS). In some cases, NCS may be normal. We aimed to demonstrate changes of distal motor latency (DML) and nerve conduction velocity (NCV) pathology of demyelination in entrapment neuropathy with cold application in case of clinical CTS with normal NCS. This prospective, cross-sectional, randomise, case-control involved 15 patients (25 hands) with clinically definite unilateral or bilateral CTS and normal nerve conduction studies (NCS), and 11 controls (22 hands). Ice pack was applied to median nerve trasse at wirst with monitoring skin temperature. NCS of median nerve were examinated again. Increases of DML, decrease of velocity of median nerve were observed in two groups after post-cooling. The change in NCV was greater than the change in DML. Cold effect was evident in DML and NCV in the patient group. This could be sign of the demyelination pathology. We think that cold application is influential to determine electrophysiologic abnormalities in clinic CTS with normal NCS. (C) 2018 Elsevier Ltd. All rights reserved.
Covid-19 perception and self reported impact of pandemic on Parkinson's disease symptoms of patients with physically independent Parkinson's disease
(Asean Neurological Assoc, 2020) Say, Bahar; Ozenc, Betul; Ergun, Ufuk
Objective: The novel coronavirus disease 2019 (Covid-19) pandemic has affected many people with chronic diseases, including Parkinson's disease (PD). We aimed to investigate the perception of Covid-19 and the self-reported impact of the pandemic on PD symptoms of a group of patients with physically independent PD from Turkey. Methods: We applied a questionnaire to idiopathic PD patients aged >= 65 years, who did not have known dementia, who were physically independent and who had at least one visit in the year before the telephone interview. The study patients were selected from the medical records of two different centers in Kirikkale, Turkey. Two neurologists conducted a semi-structured telephone interview to evaluate the perception of Covid-19 and new or worsening PD symptoms after the home quarantine. Results: In total, 86 patients were included in the study. Although most of the patients (97.7%) knew of Covid-19, knowledge of the Covid-19 symptoms was moderate ( 54.7%). Most patients reported that they washed their hands often (100%) and wore a mask (98.8%); 76 (88.4%) of them stayed at home. Compliance with other preventive measures was above 80%. In total, 40 (46.5%) patients (28 male, 12 female) reported worsening bradykinesia. Fatigue (24.4%), daytime sleepiness (20.9%), pain (20.9%) and anxiety (15.2%) were the most common new or worsening non-motor symptoms. Conclusions: The Covid-19 knowledge in a group of patients with PD from Turkey can be considered adequate. They have a high compliance with preventive measures. However, reduced non-exercise physical activity due to the pandemic affected both their motor symptoms and non-motor symptoms.
Detecting pain severity with full cup test in painful diabetic peripheral neuropathy
(2020) Say, Bahar; Ergün, Ufuk; Yıldız, Ayşe; Alpua, Murat; Arıkan, Şenay Durmaz; Turgal, Ebru
Objectives: The aim of this study was to test the utility and validity of the full cup test (FCT) to assess the severity of pain in subjects with painful diabetic peripheral neuropathy (PDPN). Methods: Subjects with diabetic PDPN were enrolled for this prospective, cross-sectional study. Other causes of PDPN and subjects with cognitive impairment were excluded. The diagnosis of neuropathic pain was made using the results of a physical examination and the Douleur Neuropathique 4 questionnaire. Pain severity was assessed with a FCT and a visual analog scale (VAS) administered before and after treatment. The correlation of FCT with VAS was evaluated to examine validity. Results: A total of 43 (33 female, 10 male) subjects were included. The mean age was 61.9±8.25 years and the mean disease duration was 13.02±7.6 years. Type I diabetes mellitus (DM) was present in 2 (4.7%) subjects and Type II DM in 41 (95.3%) subjects. The mean glycated hemoglobin level was 8.9±1.9 mmol/mol. When the mean VAS and FCT scores were analyzed, the results were 6.7±2.05 and 66.35±23.2, respectively, pretreatment and 4.6±2.2 and 41.36±23.5 posttreatment, which were both statistically significant (p<0.001, p<0.001). The mean control period was 23.4 days (min–max: 15-30 days). The VAS and FCT scores in pretreatment and posttreatment demonstrated a high positive correlation (rs =0.86, p<0.001; rs =0.843, p<0.001). Conclusion: The FCT can be useful to detect pain severity in PDPN.
Electrocardiography abnormality in a suicide attempt with levetiracetam
(Asean Neurological Assoc, 2021) Comertpay, Ertan; Say, Bahar; Eroglu, Oguz; Deniz, Turgut; Coskun, Figen
We present a case of suicide attempt with levetiracetam (LEV) in an epilepsy patient. Multifocal ventricular contractions were observed together with bradycardia in this patient due to LEV overdose. Reported patient of LEV overdose in the literature rarely show electrocardiography findings. Although LEV is less toxic than other antiseizure medications, clinicians should be aware of its potential cardiac side effects.
Electroencephalography (EEG) and Syncope: A Retrospective Study
(2020) Say, Bahar; Yıldız, Ayşe; Alpua, Murat; Ergun, Ufuk
Objectives: Electroencephalography (EEG) is one of the most vital tools in neurology practice. It is used for the diagnosis and differential diagnosis of several clinical conditions. One of them is syncope. In this study, it was planned that a retrospective evaluation of EEGs performed due to syncope in our laboratory and determine the rate of abnormal EEGs. Methods: EEG recordings performed due to syncope were reviewed over a two-years period in this study. The EEG findings were classified as normal and abnormal. The abnormal EEG findings were classified into focal epileptiform discharge, generalized epileptiform discharge, focal slowing and generalized slowing subgroups and analyzed. Results: The results of 298 EEGs were analyzed, which involved 174 (58.3%) female and 124 (41.6%) male subjects, with a mean age of 38.84±17.83 (min-max: 17–90) years. Among subjects with syncope, 90.6% of the EEGs were normal and 9.4% showed abnormal findings. The most common abnormal finding was focal epileptiform discharge (5.03%). Generalized epileptiform discharge was observed in three (1%), focal slowing in seven (2.3%) and generalized slowing in two (0.6%) subjects. Among the EEG results with no abnormal findings, 38 (12.7%) had sleep-deprived EEG and six (2.1%) were found to have focal epileptiform discharge. A total of 113 (37.9%) subjects had electrocardiogram recording and results were normal. Conclusion: The rate of abnormal findings in EEGs performed due to syncope is low. EEG may be helpful in some selected subjects with syncope referred to the laboratory with a good history and neurological examination. EEG may be repeated if necessary
Emotion dysregulation in migraine patients: can it be a hallmark the probability of the transformation from episodİc to chronic?
(Taylor and Francis Ltd., 2023) Kocakaya, Hanife; Say, Bahar; Yörübulut, Serap; Ergün, Ufuk
Objective: The main aim of this study was to examine patients with migraine in terms of emotional dysregulation and to evaluate whether the emotion dysregulation is effective on chronicity in migraine. Materials and Methods: A total of 85 migraine patients and 61 healthy participants were included in this study. All participants were evaluated using Migraine Disability Scale (MIDAS), Visual Analog Scale (VAS), Depression, Anxiety, and Stress Scale (DASS-21), Difficulties in Emotion Regulation Scale (DERS), Pain Catastrophizing Scale (PCS), and the Discomfort Intolerance Scale (DIS). Then, all results were compared between the migraine patients and healthy individuals. In addition, the migraine patients were separated into three groups as patients without an aura, patients with an aura and patients with chronic migraine and then their results were compared among them. Finally, the predictive markers of chronic migraine were explored using regression analyses. Results: Among 85 migraine patients, the mean age was 31.5 (SD = 7.98); 83.5% were women. The total and subscale scores of DERS, PCS, DIS, and DASS-21 were significantly higher in patients than in healthy individuals (p < 0.01). Subscale scores of DERS, DIS, and DASS-21 in the chronic migraine patients were found to be higher than in the other two patient groups (p < 0.01). Logistic regression analysis showed that chronic migraine could be associated with ‘lack of emotional clarity’ (OR = 1.229; p = 0.042), ‘lack of awareness’ (OR = 1.187; p = 0.032), ‘migraine associated disability’ (OR = 1.128; p = 0.033), and ‘stress’ (OR = 1.292; p = 0.027). Conclusion: This study results showed that chronic migraine could be associated with the emotional dysregulation. To our knowledge, this study is the preliminary study in the literature and, therefore, new studies with large samples are needed. © 2023 Informa UK Limited, trading as Taylor & Francis Group.
Emotion dysregulation in migraine patients: can it be a hallmark the probability of the transformation from episodIc to chronic?
(Taylor & Francis Ltd, 2023) Kocakaya, Hanife; Say, Bahar; Yorubulut, Serap; Ergun, Ufuk
ObjectiveThe main aim of this study was to examine patients with migraine in terms of emotional dysregulation and to evaluate whether the emotion dysregulation is effective on chronicity in migraine.Materials and MethodsA total of 85 migraine patients and 61 healthy participants were included in this study. All participants were evaluated using Migraine Disability Scale (MIDAS), Visual Analog Scale (VAS), Depression, Anxiety, and Stress Scale (DASS-21), Difficulties in Emotion Regulation Scale (DERS), Pain Catastrophizing Scale (PCS), and the Discomfort Intolerance Scale (DIS). Then, all results were compared between the migraine patients and healthy individuals. In addition, the migraine patients were separated into three groups as patients without an aura, patients with an aura and patients with chronic migraine and then their results were compared among them. Finally, the predictive markers of chronic migraine were explored using regression analyses.ResultsAmong 85 migraine patients, the mean age was 31.5 (SD = 7.98); 83.5% were women. The total and subscale scores of DERS, PCS, DIS, and DASS-21 were significantly higher in patients than in healthy individuals (p < 0.01). Subscale scores of DERS, DIS, and DASS-21 in the chronic migraine patients were found to be higher than in the other two patient groups (p < 0.01). Logistic regression analysis showed that chronic migraine could be associated with 'lack of emotional clarity' (OR = 1.229; p = 0.042), 'lack of awareness' (OR = 1.187; p = 0.032), 'migraine associated disability' (OR = 1.128; p = 0.033), and 'stress' (OR = 1.292; p = 0.027).ConclusionThis study results showed that chronic migraine could be associated with the emotional dysregulation. To our knowledge, this study is the preliminary study in the literature and, therefore, new studies with large samples are needed.
Evaluation of emotional dysregulation in patients with restless legs syndrome
(Springer Japan Kk, 2023) Kocakaya, Hanife; Say, Bahar
The aim of this study is to examine patients with restless legs syndrome (RLS) in terms of difficulty in emotion regulation and insomnia. A total of 52 patients with RLS and 57 healthy volunteers were enrolled. Difficulties in Emotion Regulation Scale Short Form (DERS-16), Insomnia Severity Index (ISI), Hospital Anxiety and Depression Scale (HADS), and International Restless Legs Syndrome rating scale were applied to participants. The mean age was 34.00 +/- 8.27 years in patients and 31.70 +/- 9.12 years in control. The scores of DERS-16, ISI, HADS-A, and HADS-D were significantly higher in the patients than the controls (p = 0.000). The DERS-16 total score showed a significant correlation with age (r = 0.404, p = 0.003), ISI (r = 0.281, p = 0.043), IRLS score (r = 0.422, p = 0.002), HADS-A (r = 0.409, p = 0.003), and HADS-D (r = 0.416, p = 0.002). The factors (age, gender, ferritin, ISI, and IRLS scores) that may be associated with the DERS-16 total scores were assessed with stepwise regression analysis. It was seen that the IRLSs variable had the most ability and could predict 45% (beta = 0.625, p < 0.001, increment R2 = 0.450) of difficulty in emotion regulation. In addition, the variable of insomnia could predict difficulty in emotion regulation by 17% (beta = 0.097, p = 0.001, increment R2 = 0.170). Patients with RLS may experience more emotion regulation difficulties than healthy controls. RLS severity and insomnia may be factors affecting emotion regulation difficulties in patients with RLS. According to our knowledge and our literature review, this finding seems to be the first report in the literature.
Evaluation of peripheral and central olfactory regions by MRI in patients with idiopathic intracranial hypertension
(Taylor & Francis Ltd, 2023) Asal, Nese; Muluk, Nuray Bayar; Ozdemir, Adnan; Say, Bahar
Objectives We investigated the peripheral and central smell regions in patients with idiopathic intracranial hypertension (IIH) by cranial MRI. Methods In this retrospective study, cranial MRI images of 43 adult patients with IIH (Group 1) and 43 healthy adults without IIH (Group 2) were included. In both groups, peripheral [Olfactory bulb (OB) volume and Olfactory sulcus (OS) depth] and central smell regions (insular gyrus and corpus amygdala area, and thalamus volume) were measured in cranial MRI. Results Bilateral OB volume and insular gyrus area, and right corpus amygdala and thalamus volumes of the IIH group were significantly lower than those of the control group (p < 0.05). In the IIH group, OB volume of the right side was significantly lower, and insular gyrus area of the right side was significantly higher than those of the left side (p < 0.05). In the IIH group, there were positive correlations between OB volumes; OS depths; insular gyrus areas; corpus amygdala areas; and thalamus volumes bilaterally (p < 0.05). In older patients, right OS depth and right corpus amygdala area decreased (p < 0.05). Conclusion In conclusion, IIH may be related to olfactory impairment. Cranial MRI images showed a decrease in peripheral (OB volume) and central (insular gyrus and corpus amygdala area and thalamus volume) smell regions. To prevent olfactory impairment in IIH patients, treatment should be done in IIH patients to decrease intracranial pressure. It is very important to prevent the circulation of CSF with increased pressure between the sheets of the olfactory nerve in IIH patients.
Evaluation of putamen area and cerebral peduncle with surrounding cistern in patients with Parkinson's disease: is there a difference from controls in cranial MRI?
(Taylor & Francis Ltd, 2024) Say, Bahar; Muluk, Nuray Bayar; Inal, Mikail; Goncuoglu, Alper; Yorubulut, Serap; Ergun, Ufuk
Objectives Nigrostriatal dopaminergic neuron loss is essential in pathogenesis of Parkinson's disease (PD). The purpose of this study was to evaluate nigrostriatal structures including the putamen, cerebral peduncle, widths of interpeduncular cistern, and ambient cistern around the midbrain with conventional cranial magnetic resonance images (MRI) in patients with PD.Methods The MRI of 56 subjects was included, which was selected from the radiological data system for this retrospective study. The 29 patients with idiopathic PD were included and their disease duration, Hoehn&Yahr stage, and Levodopa equivalent dose (LED) were recorded. The 27 controls had a normal neurologic examination and cranial MRI. All subjects in the patient and control groups had right-hand dominance. Putamen and cerebral peduncle areas and widths of interpeduncular and ambient cisterns were measured in T2 sequences of MRI. Further statistical analysis was applied to exclude gender and age effect on areas.Results The areas of putamen and cerebral peduncles were significantly reduced in patients with PD compared to the control bilaterally (p < 0.001). Enlargement of interpeduncular and ambient cisterns in patients was higher than in controls, and it was significant (p < 0.001). A correlation was not observed between measurement results and clinical characteristics of patients with PD. Only the cerebral peduncle area/ambient cistern width ratio was significantly correlated with disease duration positively (right r = 0.46 p = 0.012, left r = 0.389 p = 0.037).Conclusion Clinicians should be careful with conventional MRIs of patients with idiopathic PD in practice. It may be different from controls without any neurological disorder, particularly putamen, cerebral peduncles, interpeduncular, and ambient cisterns.
Evaluation of putamen area and cerebral peduncle with surrounding cistern in patients with Parkinson’s disease: is there a difference from controls in cranial MRI?
(Taylor and Francis Ltd., 2024) Say, Bahar; Bayar Muluk, Nuray; İnal, Mikail; Göncüoğlu, Alper; Yörübulut, Serap; Ergün, Ufuk
Objectives: Nigrostriatal dopaminergic neuron loss is essential in pathogenesis of Parkinson’s disease (PD). The purpose of this study was to evaluate nigrostriatal structures including the putamen, cerebral peduncle, widths of interpeduncular cistern, and ambient cistern around the midbrain with conventional cranial magnetic resonance images (MRI) in patients with PD. Methods: The MRI of 56 subjects was included, which was selected from the radiological data system for this retrospective study. The 29 patients with idiopathic PD were included and their disease duration, Hoehn&Yahr stage, and Levodopa equivalent dose (LED) were recorded. The 27 controls had a normal neurologic examination and cranial MRI. All subjects in the patient and control groups had right-hand dominance. Putamen and cerebral peduncle areas and widths of interpeduncular and ambient cisterns were measured in T2 sequences of MRI. Further statistical analysis was applied to exclude gender and age effect on areas. Results: The areas of putamen and cerebral peduncles were significantly reduced in patients with PD compared to the control bilaterally (p < 0.001). Enlargement of interpeduncular and ambient cisterns in patients was higher than in controls, and it was significant (p < 0.001). A correlation was not observed between measurement results and clinical characteristics of patients with PD. Only the cerebral peduncle area/ambient cistern width ratio was significantly correlated with disease duration positively (right r = 0.46 p = 0.012, left r = 0.389 p = 0.037). Conclusion: Clinicians should be careful with conventional MRIs of patients with idiopathic PD in practice. It may be different from controls without any neurological disorder, particularly putamen, cerebral peduncles, interpeduncular, and ambient cisterns. © 2023 Informa UK Limited, trading as Taylor & Francis Group.
Evaluation of the therapeutic effects of calcium dobesilate in sciatic nerve crush injury in rats
(Elsevier Sci Ltd, 2022) Akkaya, Suleyman; Ogden, Mustafa; Kartal, Bahar; Say, Bahar; Ceylan, Asli Fahriye; Akkaya, Merva Aydemir; Bakar, Bulent
Introduction: Proinflammatory cytokines released from nerve endings and surrounding injured tissue af-ter nerve damage can prolong the inflammation process, delay nerve healing or result in poor quality nerve healing. In this case, due to the loss of function in the muscles innervated by the damaged nerve, the patient may have neurological and functional difficulties which may reduce the patient's quality of life and create an economic burden. Although the attempts of many pharmacological agents to heal crush injury of peripheral nerves have been recorded in literature, a drug that can provide adequate recovery of the crushed nerve and can be applied in daily life has not been defined as yet. This study aimed to assess the effects of calcium dobesilate on sciatic nerve crush injury in a rat model. Methods: A total of 26 male Wistar albino rats were separated into four groups as follows: CONTROL group (healthy subjects, n = 6); SHAM group (crush injury was created, n = 6); MP group (after created crush injury, methylprednisolone was administered, n = 7); and CAD group (after created crush injury, cal-cium dobesilate was administered, n = 7). A crush injury was created, then the electrophysiological find-ings and sciatic nerve functional index (SFI) were recorded before euthanasia. After the euthanasia of all the rats, samples of the crushed nerve and gastrocnemius muscle were evaluated histopathologically, immunohistochemically, and biochemically. Results: Both pharmacological agents were histopathologically effective in axon regeneration and repair. Calcium dobesilate did not preserve total muscle mass but was seen to prevent atrophy microscopically. Immunohistochemistry and biochemistry results showed that calcium dobesilate and methylprednisolone had anti-inflammatory, anti-oxidant, anti-apoptotic, and anti-autophagic activity in the crushed sciatic nerve. Neither calcium dobesilate nor methylprednisolone improved the nerve conductance level. SFI val-ues obtained on day 30 from the CAD group were numerically closer to the values of the healthy animals but not at a statistically significant level. Conclusion: The study results demonstrated that calcium dobesilate could suppress inflammatory pro-cesses and provide histopathological and functional improvements in the injured nerve in rats. Therefore, further clinical studies are recommended to investigate in detail the therapeutic effects of calcium dobe-silate on peripheral nerve crush injury. (c) 2022 Elsevier Ltd. All rights reserved.
First Admission Neutrophil-Lymphocyte Ratio May Indicate Acute Prognosis of Ischemic Stroke
(Rambam Health Care Campus, 2021) Alpua, Murat; Say, Bahar; Yardimci, Ilknur; Ergun, Ufuk; Kisa, Ucler; Ceylan, Ozlem Dogan
Objectives: Our study aimed to determine the relationship between serum periostin levels, and the neutrophil-lymphocyte ratio (NLR) with ischemic stroke subtypes, clinical stroke scales, and acute prognosis in patients with acute ischemic stroke. Materials and Methods: Forty-two ischemic stroke patients and 39 age- and sex-matched healthy volunteers were included in our study. Demographic characteristics including age and gender were recorded. Blood serum periostin and NLR values were evaluated in the first 24 hours after admission. Serum periostin levels were compared with healthy controls of similar age and sex. Lesion localization was determined by cranial CT or diffusion MRI of the patients. Stroke scales were recorded on days 1 and 7 of hospitalization in the study group. Results: The mean serum periostin levels were higher than in the control group, but no statistically significant difference was found. There was no correlation between serum periostin levels and prognosis of stroke. First admission NLRs were statistically higher than in the control group. The first admission NLRs were positively correlated with the first admission National Institute of Health Stroke Scale score and the day 7 modified Rankin score. Conclusion: Our study is the first study to evaluate both NLR and serum periostin levels in all types of acute ischemic stroke. While our study did not show that first admission serum periostin levels can be used as a biomarker in ischemic stroke, it did indicate that the first admission NLR can be used for acute prognosis of ischemic stroke.
Frequency of Total Abdominal Hysterectomy-Bilateral Salpingo-Oophorectomy (TAH-BSO) History in Women with Parkinson's Disease
(Gazi Univ, Fac Med, 2021) Say, Bahar; Unal, Yasemin; Akbostanci, Muhittin Cenk
Objective: Estrogen is thought to play a protective role in a predisposition to the Parkinson's disease (PD). It was aimed to investigate the frequency of total abdominal hysterectomy-bilateral salpingo-oophorectomy (TAH-BSO) history causing withdrawal estrogen in women with PD in this study. Methods: The electronic records of the Movement Disorders Unit of the Neurology Department were reviewed. Female with PD were selected and compared with agematched controls without movement disorders. The patients were divided into two groups (<45 years and >= years) according to their age at TAH-BSO to investigate the effect of premature estrogen withdrawal. Characteristics of PD were evaluated in these groups. Results: Total 675 patients and 125 controls were included. The frequency of TAHBSO was found higher in patients (15.3%) than controls (12%) but it was not significantly (p=0.34). Age of symptom onset, disease severity and daily levodopa dose were not different in patients (n=30) with age at TAH-BSO <45 years compared with the patients (n=73) with those >= 45 years at TAH-BSO. Risk of PD was found to be slightly increased in patients aged <40 years at the time of surgery (OR=1.94, 95% CI: 0.19-19.59, p=0.57) compared with those aged 40-44 years (OR=0.39, 95% CI: 0.10-1.49, p=0.17) and >45 years (OR=1.58, 95% CI: 0.32-7.80, p=0.57). Conclusion: The frequency of TAH-BSO history in women with PD is not different compared to the control group. Risk of PD may slightly increased in patients aged <40 years of TAH-BSO. Age of TAH-BSO did not affect the analyzed clinical parameters of PD.
Full cup test (FCT) for symptom severity assessment in carpal tunnel syndrome/comparing scores with clinical and neurophysiological findings
(2020) Say, Bahar; Ergun, Ufuk; Agir, Hatice; Karaca, Gulten; Keskin, Esra Dilek
Abstract Aim: Carpal tunnel syndrome (CTS) is a compression neuropathy. There is neuropathic pain in the clinic. Treatment is planned according to electrodiagnostic testing (EDX) and symptom severity. This study was planned to evaluate of full cup test (FCT) to demonstrate symptom severity in CTS and investigate the relationship between FCT and EDX. Material and Methods: This study included patients with idiopathic CTS. The self-administered Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) and FCT were used to determine the severity of clinical symptoms. The severity of CTS was classified as mild, moderate and severe according to EDX. Results: A total of 97 hands (55 right, 42 left) were evaluated. 29 patients had bilateral symptoms. The severity of CTS was 51.5% mild, 44.3% moderate, and 4.1% severe. The mean FCT score was 51.13 ± 20.80 (min: 6.6-max: 100). The mean symptom severity scale (SSS) of the BCTQ was 24.25 ± 7 and the functional severity scale (FSS) was 13.26 ± 4.55. The score of FCT was significantly correlated with SSS and the FSS (r=0.60 p <0.001, r=0.65 p <0.001). Significant correlation was observed between FCT and EDX (r=0.57, p=0.001). Conclusion: FCT can be used to assess the severity of neuropathic pain in CTS and may be a guide in planning treatment.
Genome-wide association and whole exome sequencing studies reveal a novel candidate locus for restless legs syndrome
(Elsevier, 2021) Ergun, Ufuk; Say, Bahar; Ergun, Sezen Guntekin; Percin, Ferda Emriye; Inan, Levent; Kaygisiz, Sukran; Asal, Pinar Gelener
Introduction: The restless legs syndrome (RLS) is a common heritable neurologic disorder which is characterized by an irresistible desire to move and unpleasant sensations in the legs. Methods: We aim to identify new variants associated with RLS by performing genome-wide linkage and subsequent association analysis of forty member's family with history of RLS. Results: We found evidence of linkage for three loci 7q21.11 (HLOD = 3.02), 7q21.13-7q21.3 (HLOD = 3.02) and 7q22.3 (HLOD = 3.09). Fine-mapping of those regions in association study using exome sequencing identified SEMA3A (p-value = 8.5.10(-)(4)), PPP1R9A (p-value = 7.2.10(-4)), PUS7 (p-value = 8.7.10(-4)), CDHR3 (p-value = 7.2.10(-4)), HBP1 (p-value = 1.5.10(-4)) and COGS (p-value = 1.5.10(-4)) genes with p-values below significance threshold. Conclusion: Linkage analysis with subsequent association study of exome variants identified six new genes associated with RLS mapped on 7q21 and q22.

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