The effects of weak transcranial direct current stimulation on i waves: Single motor unit recording study

Motor korteks uyarımı ile elde edilen I dalgaları, farmakolojik yöntemlerle veya doğru akımla kolaylıkla modülasyonu sağlanabilen kortikospinal eksitabiliteyi çalışmada oldukça elverişli olan, fizyolojik parametrelerdir. Bu çalışmada tek uyarı TMS tekniği kullanarak, tDCS'nin kortikospinal inen aktivitenin bir komponenti olan I dalgaları üzerine olan etkisi, tek motor ünite kaydı yöntemiyle yani indirek yoldan incelenmiştir. 1 mA şiddetinde 10 dakika süreli, anodal ve katodal polaritede iki ayrı seansta uygulanan tDCS'in öncesinde, uyarım esnasında ve sonrasında rasgele 100-150 manyetik uyarı karşı motor korteks bölgesinden verilmiş ve sağ el 1. dorsal interosseoz kasından kayıtlama yapılmıştır. Stimulusla ilişkili boşalımlar peristimulus zaman histogramları (PSTH) ile değerlendirilmiştir ki; PSTH'da manyetik olarak uyartılan subpiklerin I dalgaları aracılığı ile ardışık gelen impulsları temsil ettiği düşünülmektedir. tDCS öncesi, uygulama esnası, ve sonrasında ateşleme değerleri ortaya konulmuş ve toplam pik süresi, erken pik latansı, erken pik süresi, verilen uyarı/toplam boşalım oranı, erken pik/ toplam pik boşalım oranı, geç pik latans(lar)ı, geç pik/ toplam pik boşalım oranı gibi ilişkili parametreler hesaplanmıştır. Anodal uyarımda, erken pik boşalım yüzdesi değerleri tDCS öncesinde %65.6±24.5 iken tDCS sonrasında %76.7±18.4; katodal uyarımda ise tDCS öncesinde %75.2±29.4 iken, tDCS sonrasında %45.4±38 olarak hesaplanmıştır. Anodal uyarım sonrası erken I (I1) dalgasında fasilitasyona; katodal uyarım sonrasında ise erken I (I1) dalgasında inhibisyona işaret eden bulgular, istatistiksel olarak anlamlıdır (sırası ile p değeri anodal:0.035, katodal:0,017). Sonuçlarımız, kortikospinal eksitabilitenin yüzeyel MEP kayıtlamaları ve epidural/spinal elektrodlarla yapılan kortikospinal traktus aktivitesi kayıtları ile değerlendirildiği literatürdeki diğer çalışmalarla uyumludur.I waves are useful physiological parameters, which can be modulated by pharmacological interventions or transcranial direct current stimulation, in order to evaluate corticospinal excitability. Here we studied the effects of tDCS on I waves indirectly, via using the method of single motor unit recording with single pulse magnetic stimulation technique. While recording from the right first dorsal interosseal muscle, we applied continuous tDCS of 1mA intensity and ten minutes duration on the opposite hemisfer motor cortex area and 100-150 random magnetic stimuli were given before, during and after the stimulation period. Stimulus related motor evoked potantials were interpreted within the peristimulus time histograms, in which magnetically evoked subpeaks represent the sequantial arrival of impulses via I waves. Firing status of the related motor neuron was evaluated before, during and after tDCS; and the values of total peak duration, early peak latency, early peak duration, late peak latencies were estimated, as well as the the ratio of number of the given stimulus/total MEPs, firing value of the early peak /total peak and the late peak/ total peak. The proportion of the firing rate was %65.6±24.5 before anodal stimulation and %76.7±18.4 after that, while it was %75.2±29.4 before cathodal stimulation and %45.4±38 after that. The findings, which indicate facilitation of the early I(I1) waves after anodal stimulation and that of inhibition after cathodal modality, were statistically significant (p values: 0.035 and 0,017 respectively). Our results were similar with previous studies in the literature, which evaluate corticospinal excitability through superficial MEP recordings or corticospinal volleys via epidural implanted electrodes

Hot Water Epilepsy: A Review with Five Cases

Hot water epilepsy is a kind of reflex epilepsy in which seizures are initiated by exposure of the head and/or body to hot water. Presently described are 5 cases from an epilepsy outpatient clinic that were diagnosed between 2012 and 2018. None of the patients had a history of cranial trauma, febrile convulsion, or a family history of epilepsy/hot water epilepsy. Two of patients were men and the remaining 3 were women. Both of the male patients described an aura of pleasure during the seizure; only 1 had a history of self-induction. Interictal electroencephalographies were normal in 4 cases and demonstrated mild hemispheric asymmetry in the fifth patient. All of the patients had a normal cranial magnetic resonance imaging result. One patient experienced non-reflex seizures during sleep. A noteworthy fact was that non-reflex seizures always occurred while she was dreaming of bathing. She had a suicide attempt in 2017. In 3 patients, seizure control was achieved via antiepileptic medications, while changing the bathing habits was sufficient in 2 cases. These cases of hot water epilepsy represent 2 types of seizures (focal seizures with impaired awareness and unknown onset impaired awareness seizures). One of the patients experienced recurrent seizures because of a drug import problem

Lacosamide add-on Treatment in Refractory Focal Epilepsy: The Experience of a Single Tertiary Center

Objectives:Lacosamide is a third-generation antiepileptic agent that selectively enhances slow inactivation of sodium channels that take part in generation and propagation of action potentials and results in the diminution of neuronal excitability. Because of this new mechanism of action, it is expected to be efficacious in patients with drug-resistant epilepsy. In this study, we aimed to assess the efficacy and tolerability of lacosamide add-on treatment in refractory epilepsy patients by presenting our experience in a tertiary referral center.Methods:Medical records of refractory focal epilepsy patients who were followed in epilepsy outpatient clinic between October 2014 and May 2017 were retrospectively reviewed in this study. Patients who were treated with add-on lacosamide and completed minimum of six months follow-up period were included. ≥50% reduction in seizure frequency was defined as treatment response.Results:In this study, 88 patients were included. The percentage of seizure-free patients after six months follow-up was 4.6% and the treatment response rate was 55.6%. We also evaluated the effect of concomitant use of sodium channel blockers, the presence of abnormal findings on magnetic resonance imaging and the introduction stage of lacosamide. No significant difference was observed in the response rate regarding the mentioned parameters. 19% of the patients reported side effects, the majority of which were dizziness, vertigo and somnolence. None of them discontinued treatment because of side effects.Conclusion:Our findings suggest that lacosamide add-on therapy is effective in refractory focal epilepsy and has an appropriate tolerability and safety profile since none of the patients stopped treatment due to side effects

A case of sarcoidosis of the central nervous system and orbita.

Sarcoidosis is a multisystemic disease characterized by granulomatous inflammation. Lung or lymph node involvement is common. We present a rare case of sarcoidosis that began with orbital involvement, and a month later, due to insufficient treatment, it involved the central nervous system. A 49-year-old female patient began suffering from swelling in her right eye, redness, ptosis, and limited eye movements two months ago. Gadolinium-enhanced orbital magnetic resonance imaging showed thickening of the lacrimal gland and the right medial rectus muscle. After three weeks of local antibiotic and steroid treatments, her symptoms were resolved. One month ago, the patient reported sudden weakness in her right arm and leg. After laboratory tests and imaging studies, the patient was diagnosed with probable neurosarcoidosis using the Zajicek criteria and treated with prednisone (1 mg/kg/day). Although sarcoidosis frequently presents with lung and lymph node involvement, it is rarely accompanied by orbital involvement. Patients with orbital symptoms may receive a late diagnosis and insufficient central nervous system treatment. Involvement of the central nervous system in sarcoidosis leads to high morbidity and mortality rates. Therefore, early diagnosis and treatment are very important

Effects of maternal taurine supplementation on maternal dietary intake, plasma metabolites and fetal growth and development in cafeteria diet fed rats

Background Maternal obesity may disrupt the developmental process of the fetus during gestation in rats. Recent evidence suggests that taurine can exert protective role against detrimental influence of obesogenic diets. This study aimed to examine the effect of maternal cafeteria diet and/or taurine supplementation on maternal dietary intake, plasma metabolites, fetal growth and development. Methods Female Wistar rats were fed a control diet (CON), CON supplemented with 1.5% taurine in drinking water (CONT), cafeteria diet (CAF) or CAF supplemented with taurine (CAFT) from weaning. After 8 weeks all animals were mated and maintained on the same diets during pregnancy and lactation. Results Dietary intakes were significantly different between the groups. Both CAF and CAFT fed dams consumed less water in comparison to CON and CONT dams. Taurine supplementation only increased plasma taurine concentrations in CONT group. Maternal plasma adiponectin concentrations increased in CAF and CAFT fed dams compared to CON and CONT fed dams and there was no effect of taurine. Hyperleptinemia was observed in CAF fed dams but not in CAFT fed dams. Malondialdehyde was significantly increased only in CAF fed dams. Litter size, sex ratio and birth weight were similar between the groups. There was an increase in neonatal mortality in CONT group. Discussion This study showed that maternal taurine supplementation exerted modest protective effects on cafeteria diet induced maternal obesity. The increased neonatal mortality in CONT neonates indicates possible detrimental effects of taurine supplementation in the setting of normal pregnancy. Therefore, future studies should investigate the optimal dose of taurine supplementation and long term potential effects on the offspring

Meme kanseri hastalarının kemoterapi öncesinde, sırasında ve sonrasında beslenme durumu, oksidatif parametreler ve yaşam kalitesi ilişkisi

Aim: Monitoring the nutritional status of cancer patients is crucial. We aimed to assess the associations between nutritional status, oxidative parameters and quality of life before, during, and after chemotherapy (CT) in breast cancer patients. Material and Method: Clinical, anthropometric, demographic, quality of life, laboratory (i.e., blood oxidative marker level) and dietary intake data of breast cancer patients who planned to have two cycles of CT were recorded. All collected data were compared between pre-CT, mid-CT, and post-CT time points. Results: Fifty women who were diagnosed with breast cancer and would start CT treatment were included in the study. Post-CT body weight and BMI was significantly lower than the pre-CT values (p˂0.001). They both turned back to pre-CT levels at the end of CT with a decrease in total daily caloric and macronutrient intake. Consumption of specific food groups such as milk or yogurt, cheese, eggs, and sugar significantly decreased compared to their pre-CT consumption levels (p˂0.001, p˂0.001, p=0.017, and p=0,01). Blood oxidative stress marker analysis revealed a significant reduction in GPx levels with CT (p=0.007). Analysis of the quality-of-life scores revealed that post-CT scores were significantly higher than the pre-CT scores while the life quality was lowest in the mid-CT period. Conclusion: Breast cancer patients have a lower dietary intake during CT, which is associated with a lower intake of specific food groups. Adequate caloric intake and antioxidant intake should be recommended to these patients during CT via dietary counseling to maintain healthy anthropometric measures and oxidative hemostasis.Amaç: Meme kanserli hastalarda kemoterapi (KT) öncesi, sırası ve sonrasında beslenme durumu, oksidatif parametreler ve yaşam kalitesi arasındaki ilişkileri değerlendirilmesi amaçlandı. Gereç ve Yöntem: KT planlanan meme kanserli hastaların klinik, antropometrik, demografik, yaşam kalitesi, kan oksidatif belirteç düzeyi ve diyet alım verileri kaydedildi. Toplanan tüm veriler, KT öncesi, KT ortası ve KT sonrası zaman noktaları arasında karşılaştırıldı. Bulgular: Çalışmaya meme kanseri tanısı konan ve KT tedavisine başlanacak 50 kadın dahil edildi. KT sonrası vücut ağırlığı ve beden kütle indeksi, KT öncesi değerlerden anlamlı derecede düşüktü (p˂0,001). Her ikisi de KT'nin sonunda toplam günlük kalori ve makro besin alımında bir düşüşle KT öncesi seviyelere döndüler. Belirli gıda gruplarının tüketimi, KT öncesi tüketim düzeylerine göre önemli ölçüde azaldı (p˂0,001). Kan oksidatif stres belirteç analizi, KT ile glutatyon peroksidaz düzeylerinde önemli bir azalma olduğunu ortaya koydu (p=0,007). Yaşam kalitesi puanlarının analizi, KT sonrası puanların KT öncesi puanlardan anlamlı derecede yüksek olduğunu, KT ortasında ise en düşük olduğunu ortaya koydu. Sonuç: Sağlıklı antropometrik ölçümler, oksidatif denge ve yaşam kalitesi sağlamak için bu hastalara KT sırasında diyet danışmanlığı yoluyla yeterli enerji alımı ve antioksidan alımı önerilmelidir.No sponso

Olfactory functioning in early multiple sclerosis: Sniffin' Sticks Test study.

Previous studies have shown that olfactory functioning is affected by multiple sclerosis (MS). This study assessed the level of the olfactory impairment in early MS by using the Sniffin' Sticks Test