Depression and Sleep Quality in Patients with Restless Legs Syndrome

Objective Restless Legs Syndrome (RLS) is a common neurological disorder that affects patients’ sleep, emotional state and daily life negatively. In this study it was aimed to determine the sleep quality, daytime sleepiness and depression frequency in patients with RLS and their relation with duration and severity of illness. Materials and Methods In our center, 41 patients with primary RLS diagnosis were included in the study. Patients were divided into groups as mild, moderate, severe and very severe, according to the RLS severity scale of the International Restless Legs Syndrome Study Group. Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Beck Depression Inventory were filled in by all the patients, including identity and sociodemographic data with illness information. Statistical analysis was performed among groups divided according to disease severity. Depressive symptoms of the disease duration and its relation with sleep problems were investigated. Results In this study 41 patients, 30 (73.2%) female, 11 (26.8%) male, were included. Of the patients participating in the study, 2 patients (4.9%) had mild RLS while 7 (17.1%) were very severely ill. Fourteen patients (34.1%) had moderate disease and 18 (43.9%) had severe disease. Bad sleep quality was found in 68.3% (n=28) of patients with RLS, excessive daytime sleepiness in 14.6% (n=6) severe depression in 7.3% (n=3) and totally 29.3% of patients (n=12) depressive symptoms were observed. As the severity of illness increased, sleep quality deteriorated and depressive symptoms increased (p<0.01). Conclusion Most of the RLS patients had poor sleep quality, a significant amount of daytime excessive sleepiness, and about one third of them had depression. As the duration and severity of the disease increases, the intensity of depressive symptoms increases. Remembering that RLS may have serious consequences and effective treatment of depression when accompanied should be planned without losing time

Relationship Between Plasma Homocystein Levels and Polyneuropaty in Patients Using Levodopa For Idiopathic Parkinson’s Disease

Objective: Recent studies showed high plasma homocysteine levels in patients treated with Levodopa for Parkinson’s disease (PD). Homocysteine, due to its exotoxic effect, might be the cause of polyneuropathy seen in PD. In this study, our aim was to show the correlation between high concentration of plasma homocysteine levels and polyneuropathy associated with PD.. Material and Methods: Forty-one patients with PD receiving levodopa treatment (patient group) and 30 healthy subjects (control group) were included in this study. We compared the two groups in terms of electrophysiological findings. Twelve patients had high plasma homocysteine levels and 29 of them had low plasma homocysteine levels. Results: Six of the 41 patients had sensorial polyneuropathy and decreased compound muscle action potantiel amplitude compared to controls. Two patients had high plasma homocysteine levels, two patients had nearly high plasma homocysteine levels, two patients had low plasma homocysteine levels who had sensorial polyneuropathy. Conclusion: Although in our study, we did not show any correlation between polyneuropathy and high plasma homocysteine levels, further studies including homogeneous groups of younger patients with PD are needed. (The Me di cal Bul - le tin of Ha se ki 2012; 50: 53-8

Erken evre Parkinson hastalığında olfaktör disfonksiyon ve epizodik verbal bellek arasındaki İlişki

WOS: 000348845400013PubMed ID: 28360659Introduction: Olfactory dysfunction is an early and common symptom in idiopathic Parkinson's disease (IPD). Recently, the relation between olfactory dysfunction and cognitive loss in IPD has been reported. In our study, we aimed to investigate the relation between olfactory dysfunction and cognitive impairments in early IPD related with this theory. Methods: In this study, we included 28 patients with stage 1 and stage 2 IPD according to the Hoehn-Yahr (H-Y) scale and 19 healthy participants. The University of Pennsylvania Smell Identification Test (UPSIT) was performed for evaluating olfactory function. For cognitive investigation in participants, the clock drawing test, Stroop test, verbal fluency test, Benton face recognition test (BFR), Benton line judgment orientation test (BLO), and Auditory Verbal Learning Test (AVLT) were performed. Results: We found significantly lower UPSIT scores in the patient group compared to controls (p=0.018). In the neuropsychological investigation, only Stroop test and BLOT test scores were significantly lower in the patient group compared to controls (p=0.003, p=0.002, respectively). We found a negative correlation between UPSIT scores and Stroop time (p=0.033) and Stroop error (p=0.037) and a positive correlation between UPSIT scores and SBST long-term memory scores (p=0.016) in patients. Conclusion: In our study, we found mild cognitive impairment related with visuospatial and executive functions in early-stage IPD compared to controls. But, in the patient group, we detected a different impairment pattern of memory and frontal functions that correlated with hyposmia. This different pattern might be indicating a subgroup of IPD characterized by low performance in episodic verbal memory, with accompanying olfactory dysfunction in the early stage.Giriş: Olfaktör disfonksiyon, İdyopatik Parkinson Hastalığının (IPH) erken ve sık görülen bir semptomudur. Son zamanlarda, olfaktör disfonksiyon ile kognitif kayıp arasında ilişki olduğu bildirilmiştir. Çalışmamızda, bu teori ile ilişkili olarak, erken evre IPH’da olfaktör disfonksiyon ve kognitif bozukluklar arasındaki ilişkiyi araştırmayı amaçladık. Yöntem: Bu çalışmaya, Hoehn- Yahr (H-Y) evrelemesine göre evre 1 ve evre 2 IPH tanısı almış 28 hasta ve 19 sağlıklı birey dahil ettik. Olfaktör fonksiyonu değerlendirmek için University of Pennsylvania Smell Identification Test (UPSIT) uygulandı. Hastalarda kognitif fonksiyonu değerlendirmek için, Saat çizme testi, Stroop testi, verbal akıcılık testi, Benton face recognition testi (BFR), Benton line judgement orientation test (BLO), Sözel bellek süreçleri testi (SBST) uygulandı. Bulgular: Kontroller ile mukayese edildiğinde hasta grubunda UPSIT skorlarını anlamlı olarak daha düşük bulduk (p=0.018). Nöropsikolojik değerlendirmede sadece Stroop testi ve BLOT testi kontroller ile mukayese edildiğinde hasta grubunda anlamlı olarak daha düşüktü (sırasıyla p=0,003, p=0,002). UPSIT skorları ile Stroop zamanı ve Stroop hata skorları arasında negatif korelasyon (p=0,037), UPSIT skorları ile SBST uzun süreli bellek skorları arasında pozitif korelasyon bulduk. Sonuç: Çalışmamızda, daha önceki çalışmalardaki gibi, erken evre IPH’da vizyospasyal ve yürütücü fonksiyonlarla ilişkili hafif kognitif bozukluk saptadık. Fakat hasta grubunda hiposmi ile korele şekilde bellek ve frontal fonksiyonlarda farklı bir bozulma paterni saptadık. Bu farklı patern, IPH’ın erken döneminde koku bozukluğu eşliğinde epizodik verbal bellekte performans düşüklüğü görülmesi şeklinde bir alt gruba işaret ediyor olabili

A Case of Wernicke’s Encephalopathy Induced by Pyloric Stenosis

Wernicke’s encephalopathy is a neurological syndrome that develops due to thiamine deficiency. Although it has a significantly high mortality rate, it responds well to thiamine treatment, especially in its early stages. Because of its common association with alco- holism and the fact that its clinical triad is seen in only a small portion of patients (10-20%), diagnosis is difficult, especially in cases without a history of alcoholism. Herein we present a patient that drank bleach (sodium carbonate) in an effort to commit suicide and developed pyloric stenosis, which was followed by confusion, ophthalmoparesis, and ataxi

Advanced oxidation protein products and ischaemia-modified albumin in obstructive sleep apnea

WOS: 000344525600003PubMed ID: 25223839BackgroundSeveral studies have shown that obstructive sleep apnea increases incidence of cardiovascular morbidity and mortality. The high systemic oxidative stress in obstructive sleep apnea has been considered as a major pathogenic mechanism leading to cardiovascular disease. Oxidative stress-related lipid and DNA oxidation in obstructive sleep apnea have been reported in the previous studies. In contrast, there is limited and contradictory information regarding protein oxidation in obstructive sleep apnea patients such as ischaemia-modified albumin and advanced oxidation protein products. Therefore, we aimed to investigate plasma ischaemia-modified albumin and advanced oxidation protein products and their correlation with total oxidative status and total antioxidative capacity in the obstructive sleep apnea patients. MethodsPlasma ischaemia-modified albumin, advanced oxidation protein products, total oxidative status and total antioxidative capacity were measured in 25 healthy volunteers and 59 obstructive sleep apnea patients diagnosed with polysomnography. ResultsPlasma total antioxidative capacity was significantly lower (P=0012) and total oxidative status was significantly higher (P<0001) in the patients compared to the controls demonstrating increased oxidative stress in the patients. Plasma advanced oxidation protein products were significantly higher in the patients than the controls (P=0024). Plasma ischaemia-modified albumin levels were not statistically different between the obstructive sleep apnea patients and controls (P=074). ConclusionsWe conclude that high systemic oxidative stress in obstructive sleep apnea is reflected by increased advanced oxidation protein products without causing an increase in ischaemia-modified albumin.Akdeniz UniversityThe study was supported by a research grant from Akdeniz University Research Funds

Visual Hallucination, Visual Evoked Potentials and Cognitive Dysfunction in Idiopathic Parkinson’s Disease

OBJECTIVE: In this study, we aimed to investigate the relation between possible visual evoked potentials (VEP) pathologies and visual hallucinations (VH) seen in idiopathic Parkinson’s disease (IPD) and the role of cognitive dysfunctions in VHs, moving through visual processing defect considered to be related to VHs could be demonstrated with VEP to some extent. METHODS: Two groups followed in the Movement Disorders outpatient clinic of Haseki Training and Research Hospital were included in our study. Group 1 included 14 IPD patients with VH and a mean age of 65.31 ± 7.49 years, while Group 2 (as control group) included 12 IPD patients without VH and a mean age of 68.17 ± 7.46 years. RESULTS: : While dosage of levodopa was found to be significantly higher in the group with VH (p= 0.048), it was observed that Unified Parkinson's Disease Rating Scale (UPDRS) cognitive scores were also significantly greater in this group (p< 0.001). No difference was observed between the two groups regarding the rate of pathological VEP latency (p= 0.64). In our study, Stroop Color-Word Test, among other executive functioning tests, was statistically significantly worse for duration/error in the group with VH (p= 0.016/0.003). CONCLUSION: In Group 1, VEP results may have been worse due to the higher dosage of levodopa and higher UPDRS cognitive scores. VEP studies before and after dopaminergic therapy may be useful to understand the contribution of VEP investigations on the etiopathogenesis of VHs in IPD

Determinants of sexual dysfunction in male and female patients with parkinson's disease

Objective: Due to the complex nature of Parkinson's disease (PD) and distinct sexual physiologies, male and female patients might have different patterns of sexual dysfunction (SD) in PD. The aim of this study was to assess determinants of SD in female and male patients with PD. Methods: Seventy nine outpatients with idiopathic PD (46 male, 33 female; mean age: 67.51 +/- 8.27) were recruited between December 2007 and February 2011. Unified Parkinson's Disease Rating Scale and Hoehn-Yahr stages, Hamilton depression and anxiety scales, Mini-Mental State Examination and Arizona Sexual Experiences scale were the measures. Results: Determinants of SD in the whole group were age and anxiety. Age at disease onset and anxiety designated SD in female group, while age and severity of motor symptoms designated SD in male group. Conclusion: Both in males and females, gonadal steroids decline with advancing age. Dopamine has role in desire, erection, reward-seeking behavior phases of sexuality. Dopamine depletion may cause SD with its dual effects, including erectile dysfunction as well as motor disturbances in PD in male patients. Anxiety effect females more than males due to affected body image and perception of the self

Does Ability to Identify Odors Differ Among Clinical Subtypes of Parkinson's Disease?

OBJECTIVE: Parkinson's disease (PD) is characterized by motor dysfunction, whereas it is also a non-motor disorder. Olfactory dysfunction (OD) is a non-motor symptom in PD. In this study, we aimed to investigate whether OD varies among subtypes of PD. METHODS: Patients comprised 28 patients with idiopathic PD (23 male and 5 female) with a mean age 64.96±7.49 years. The patients were divided into tremor-dominant type (TDT), akinetic-rigid type (ART) and mixed type (MT) by means of part III of Unified Parkinson Disease Rating Scale. Patients were asked whether they had a relative with tremor or PD. University of Pennsylvania Smell Identification Test-40 (UPSIT) was used for testing olfactory function. Patients with any factor may influence olfactory function were excluded. RESULTS: Fourteen patients were classified into TDT, 12 into ART, and 2 into MT. There were no significant differences in mean age, UPDRS part III, UPDRS total. The UPSIT scores were highest in MT group and lowest in ART group, but it did not show statistically difference. CONCLUSION: Our results do not prove the differencies of OD between subtypes of PD, but it makes a suspicion that ART patients might have poor ability to identify odor