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

A case of peduncular hallucinosis presenting as a primary psychiatric disorder

Peduncular hallucinosis usually occurs due to vascular or infectious midbrain lesions or brain stem compression by tumors. We present a peduncular hallucinosis case in a 63-year-old female with brain stem infarction, which can easily be misdiagnosed as a psychiatric disorder

Development and validation of the stigma scale for epilepsy in Turkey

Objective: Epilepsy is a chronic disease with an increased risk of stigma. The aim of this study was to investigate the efficacy of a scale developed by the authors to determine the level of stigma in Turkish patients with epilepsy and their relatives

Who is the bigger stigmatizor?: The loved one or the society

Objective: Epilepsy has long been considered by the society as a dangerous and frightening spiritual possession or even a contagious disease. This results in an unavoidable embarrassment for both the patient and the family leading to social isolation, seclusion, and secretiveness about the diagnosis. The aim of this study was to determine the stigmatizing level of the general Turkish population and to compare these results with the stigmatizing level of the patients' relatives group (PRG)

Ulnar Nerve Compression at the Wrist: Diagnostic Role of Palmar Stimulation

Objective:Electrophysiological diagnosis of ulnar nerve entrapment at the wrist is sometimes difficult. The aim was to evaluate the diagnostic role of ulnar nerve stimulation above and below the Guyon channel in ulnar nerve entrapment at the wrist.Methods:Supramaximal ulnar nerve stimulation at the wrist and palm, in addition to the standard nerve conduction studies, in 10 patients with ulnar nerve entrapment at the wrist and 40 controls.Results:Motor latencies to the first dorsal interosseous muscle with wrist stimulation were prolonged unilaterally in six and bilaterally in four patients. Palmar stimulation showed partial conduction blocks on the more symptomatic side in all. In two bilateral cases, there were 28.8% and 44.3% amplitude loss on the less symptomatic side. Motor responses elicited with palm stimulation were also found to have prolonged latencies and decreased amplitudes.Conclusions:Stimulation of the deep branch of the ulnar nerve can expand the information about ulnar nerve entrapment at the wrist by providing evidence about its nature, prognosis, precise localization, and distal extent

Assessment of serum MMP-9, TIMP-1 levels and MMP-9/TIMP-1 ratio in migraine patients with and without aura = A szérum MMP-9- és TIMP-1-szintjei, valamint az MMP-9/TIMP-1 arány aurával vagy a nélkül migrénben szenvedő betegek esetén

Background and purpose – Matrix metalloproteinases (MMP) are the enzymes responsible for proteolytic ac tivity of extracellular matrix proteins. Tissue inhibitors of metalloproteinases (TIMPs) are their endogenous inhibitors. MMP-9 acts on the basal membrane of cerebellar epithe - lium and is antagonized by TIMP-1. MMP-9/TIMP-1 ratio exhibits the net activity of MMP-9. These enzymes are thought to have a role in migraine physio pathogenesis. Methods – Total of 50 treatment-naive migraine patients (25 with aura and 25 without aura) with no other diseases, were included. 25 healthy control subjects of cor - responding age and gender were enrolled. For MMP-9 and TIMP-1 analysis, one serum sample from control group and two samples from patients were collected (during headache and headache-free periods). The enzyme levels were quantitatively analyzed by competitive ELISA method. Duration and severity of the pain and duration of the disease were recorded. Results – There was no significant difference in MMP-9 levels between patient and control groups during headache and headache-free periods (p: 0,746, p: 0,243). TIMP-1 levels were significantly lower and MMP9/TIMP ratios were higher comparing with the control group (p: 0.001). Positive correlation was obtained between the duration of pain and MMP-9 levels in the headache-free period for both patient groups (p<0.05). There was also a positive correlation between MMP9/TIMP-1 ratio and severity of pain (p<0.05). Conclusion – In our study, low TIMP-1 levels of patients in both headache and headache-free periods suggest that disturbance of proteolytic protection has a role in neuroinflammation and pain in migraine. Therefore, these enzymes could be potential targets in migraine therapies. = Háttér és cél – A mátrix metalloproteinázok (MMP) fele lô - sek az extracelluláris mátrix fehérjéinek proteolyticus akti - vitásáért. Az MMP-k endogén inhibitorai a szöveti metalloproteináz-inhibitorok (TIMP). Az MMP-9 a cerebellaris epithelium bazális membránjára hat, és a TIMP-1 antagonizálja. Az MMP-9/TIMP-1 arány az MMP-9 nettó aktivi tá - sát mutatja. A jelenlegi elképzelés szerint ezeknek az enzi - meknek szerepük van a migrén patogenezisében. Módszerek – Összesen 50, korábban nem kezelt, egyéb betegségben nem szenvedô migrénbeteget (25 fô aurával, 25 aura nélkül) vontunk be vizsgálatunkba. A kontroll - csoportot 25, életkorban és nemben illeszkedô egészséges személy képezte. Az MMP-9- és TIMP-1-szintek elem zé sé - hez a kontrollcsoport tagjaitól egy, a betegektôl két (fej - fájásos, illetve fejfájásmentes idôszakban) szérummintát gyûjtöttünk. Az enzimek mennyiségét kompetitív ELISA módszerrel elemeztük. Rögzítettük a fájdalom idôtartamát és erôsségét, valamint a betegség fennállásának idôtartamát. Eredmények – Nem volt szignifikáns különbség a be - tegek (fejfájásos, illetve fejfájásmentes idôszakban mérve), valamint a kontrollszemélyek között az MMP-9-szintekben (p: 0,746, p: 0,243). A betegek TIMP-1-szintje szignifikánsan alacsonyabb, MMP-9/TIMP-1 aránya magasabb volt, mint a kontrollszemélyeké (p: 0,001). Pozitív korrelációt találtunk mindkét betegcsoport fejfájásmentes periódusban mért MMP-9-szintje és a fájdalom idôtartama között p < 0,05). Szintén pozitív korrelációt találtunk az MMP9/TIMP-1 arány és a fájdalom erôssége között (p < 0,05). Következtetés – Vizsgálatunk során a betegek fejfájásos, illetve fejfájásmentes idôszakaiban mért alacsony TIMP-1- szint arra utal, hogy a proteolyticus védelem zavarai szerepet játszanak a migrén kapcsán jelentkezô neuroinflammációban és fájdalomban. Ebbôl következôen, ezek az enzimek a jövôbeli migrénellenes gyógyszerek támadáspontjaiként szerepelhetnek

Cognitive Functioning and Silent Neurological Manifestations in Behcet's Disease with Ocular Involvement

Introduction: Various reports have revealed a cognitive dysfunction in Behcet's disease (BD). In this study, we aimed to assess the silent neurological manifestations, behavioral and neuropsychiological impairments of Behcet's disease patients with ocular involvement

The effects of very early mirror therapy on functional improvement of the upper extremity in acute stroke patients

[Purpose] The aim of the study was to evaluate the effects of a very early mirror therapy program on functional improvement of the upper extremity in acute stroke patients. [Subjects] Eight stroke patients who were treated in an acute neurology unit were included in the study. [Methods] The patients were assigned alternatively to either the mirror therapy group receiving mirror therapy and neurodevelopmental treatment or the neurodevelopmental treatment only group. The primary outcome measures were the upper extremity motor subscale of the Fugl-Meyer Assessment, Motricity Index upper extremity score, and the Stroke Upper Limb Capacity Scale. Somatosensory assessment with the Ayres Southern California Sensory Integration Test, and the Barthel Index were used as secondary outcome measures. [Results] No statistically significant improvements were found for any measures in either group after the treatment. In terms of minimally clinically important differences, there were improvements in Fugl-Meyer Assessment and Barthel Index in both mirror therapy and neurodevelopmental treatment groups. [Conclusion] The results of this pilot study revealed that very early mirror therapy has no additional effect on functional improvement of upper extremity function in acute stroke patients. Multicenter trials are needed to determine the results of early application of mirror therapy in stroke rehabilitation

Independent effect of fatigue on health-related quality of life in patients with idiopathic Parkinson's disease

albay, vasfiye burcu/0000-0003-0428-981XWOS: 000365711100009PubMed: 26198763Nonmotor symptoms (NMS) of idiopathic Parkinson's disease (IPD), specifically fatigue, depression and sleep disturbances, are important contributors for worse quality of life and poor patient outcomes. the aim of this research is to determine the relationship between fatigue and other NMS and the independent effect of fatigue on health-related quality of life (HRQoL) in patients with IPD. 86 IPD patients and 85 healthy individuals were included in our study. Participants were evaluated by their answers to the Beck Depression Inventory, Fatigue Severity Scale, Epworth Sleepiness Scale and Parkinson's Disease Questionnaire-39. Hoehn-Yahr stage, disease duration, medications and demographical characteristics were also noted. ROC analysis was used to determine the cutoff point for HRQoL. Nonparametric Spearman correlation analysis was used for determining the relationship between variables. Independent factors which affect HRQoL were detected by multiple forward stepwise logistic regression analysis. NMS were associated with each other and with HRQoL when they act concomitantly (p 0.05). the stage of IPD and levodopa-entacapone treatment had independent effects on HRQoL too (p < 0.05). Fatigue was found as the most important factor which affects HRQoL among all investigated NMS. So, it is important to ask about fatigue in routine controls of IPD patients and try to treat it for improving life quality