The Effects of Rasagiline on Cognitive Deficits in Parkinson's Disease Patients Without Dementia: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Study

Cognitive impairment can occur at all stages of Parkinson's disease. Rasagiline is a selective monoamine oxidase type-B inhibitor that enhances central dopaminergic transmission. Dopamine is thought to be involved in certain cognitive processes such as working memory. We assessed the effects of rasagiline on cognitive deficits in cognitively impaired, nondemented patients with Parkinson's disease. This was a randomized, double-blind, placebo-controlled prospective study. Patients with Parkinson's disease receiving stable dopaminergic treatment were assigned to receive rasagiline 1 mg/day or placebo for 3 months. Patients were eligible if they had impairment in 2 of 4 cognitive domains (attention, executive functions, memory, visuospatial functions) in the screening neuropsychological tests, yet did not fulfill criteria for Parkinson's disease dementia. Fifty-five patients were randomized; 48 patients completed the study. Patients in the rasagiline group showed significant improvement in digit span backward compared with the placebo group (P = .04), with trends favoring rasagiline in digit span total and digit-ordering tests. Verbal fluency total score showed a significant difference in favor of rasagiline (P = .038), with trends favoring rasagiline in semantic fluency test and Stroop spontaneous corrections. The composite cognitive domain Z scores revealed a significant difference in favor of rasagiline compared with placebo in the attentional Z score (P < .005). There were no significant differences between the 2 groups in the other cognitive tests or cognitive domain Z scores. The monoamine oxidase type-B inhibitor rasagiline may exert beneficial effects on certain aspects of attention and executive functions in nondemented patients with Parkinson's disease with cognitive impairment. (C)2011 Movement Disorder Societ

Motor and Non-Motor Symptoms in Turkish Patients With Parkinson's Disease Affecting Family Caregiver Burden and Quality of Life

Parkinson's disease (PD) decreases the quality of life (QoL) of both caregivers and patients by increasing stress and burden, and it has a negative impact on their psychological state. In the present study, the authors examined the impact of PD-patient motor and non-motor clinical symptoms on the psychological health, burden, and QoL of Turkish caregivers. The study included 50 patients with PD and their caregivers. Patients' disease severity and disability, motor and non-motor symptoms, disease complications, sleep disturbances, anxiety, and depressive symptoms were assessed with various scales. Data were analyzed by multiple linear-regression models to identify variables associated with caregiver burden, psychological status, and QoL. Anxiety and depressive symptoms exhibited by the patients significantly affected the psychological state of the caregivers. Caregiver burden was increased by disease severity; the patient's degree of disability, anxiety, and depressive symptoms; and excessive daytime sleepiness. Caregiver QoL was significantly affected by the presence of dyskinesia, sialorrhea, and anxiety symptoms in patients with PD. These findings indicate that caregiving for patients with PD, particularly those in later stages, with psychiatric symptoms, affects caregiver psychological status, QoL, and caregiver burden. These results can be used to develop treatment approaches to improve caregivers' psychological status and QoL and decrease caregiver burden. (The Journal of Neuropsychiatry and Clinical Neurosciences 2012; 24:478-483

Clinical and cognitive profiles of patients with both Parkinson's disease and essential tremor

Although Parkinson's disease (PD) and essential tremor (ET) are distinct clinical disorders, their coexistence can sometimes cause diagnostic problems. In this study, we conducted detailed investigations of patients with both ET and PD (ET-PD) and compared their clinical and cognitive profiles with those of patients with only ET or only PD. This study examined three groups of patients: the first group had ET-PD concomitantly (n = 9); the second group had only ET (n = 9); the third group had only PD (n = 10). The groups were compared in terms of demographic characteristics, clinical features, and cognitive functions. With the exception of positive family histories, which were more common in ET-PD than in PD patients, we found no differences among the groups with respect to demographic characteristics (p = 0.044). PD-only patients had more akinetic-rigid type Parkinsonism (p = 0.016), and their levodopa response was better than that of ET-PD patients (p = 0.017). Patients with ET-PD obtained significantly lower scores than those with pure ET on several cognitive tests, suggesting a prominent frontal-type cognitive dysfunction. In conclusion ET-PD patients differed from PD patients, showing more frequent familial tremor histories and lower levodopa responsiveness. This patient population also demonstrated more severe cognitive impairments than pure-ET patients. This result suggests that ET-PD patients are a subset of ET patients with more widespread neurodegeneration, which may indicate the presence of a syndrome that includes overlap between ET and PD

HAREKET BOZUKLUKLARI TANI VE TEDAVİ REHBERİ

Hareket hastalıkları nöroloji pratiğindeki en dinamik nöroloji alt dallarından biridir. Hastanın istemsiz hareketininsaptanması, tanımlanması ve ayrıntılı öykü ile birleştirildiğinde hareket hastasına yaklaşım sistematik düşünceyeşiddetle ihtiyaç duyar. Basamaklı algoritmik yaklaşım ile fazla tetkik yapmadan iyi bir ayırıcı tanı ve takiben ön tanı ilehastalar çözümlenmeye çalışılır. Kesin tanı için laboratuvar incelemeleri, görüntüleme ve genetik çalışmalar gerekebilir.Güncelleme yapılan Hareket Hastalıklarında Tanı ve Tedavi Rehberi’inde hastaya yaklaşımdan başlayarak hiperkinetik veakinetik paternli pek çok tabloya değinildi ve deneyimli çalışma arkadaşlarımız tarafından kaleme alındı.TND Hareket Bozuklukları Çalışma Grubunun değerli üyelerine ve ilk baskıdaki editörümüz Prof. Dr. Raif Çakmur’ a çokteşekkür ediyorum. Türkiye Parkinson Hastalığı Derneği ile ortak hazırlanan güncellenmiş Hareket Bozukluklarında Tanıve Tedavi Rehberi’nin hareket hastalıklarını öğrenmek isteyen, öğrenen ve geliştirmek isteyen meslektaşlarımıza faydalıolması dileğiyle.Prof. Dr. Dilek İnce GünalTND Hareket Hastalıkları Çalışma Grubu Moderatörü</p

The changing roles and women in ads used by electronic kitchenware manufacturing sector in Turkey, since beginning to present

Hocaoğlu, Dilek (Dogus Author) -- Conference full title: 8. 5T Türkiye Tasarım Tarihi Topluluğu Toplantıları (pp. 1-12.). Yaşar University, İzmir, 09-10 May 2013.Product ranges constantly expand and increase in number along with brands in our day, demanding more and more importance placed in product design and marketing. Consumption of designed and manufactured products reaches beyond the limits of requirement and advertising emphasizes on a different manner of consumption. Advertisements are targeted on women based on the assumption that women are more prone to shopping than men. Based on this perception, this paper discusses the relationship of product-gender in printed advertising, which has a key role in promotion and sales of products manufactured in Turkey. The subject is exemplified with printed advertisements designed for electronic kitchen appliances manufactured by the Turkish corporation Arçelik. How the role of woman is fictionalized, the fashion in which the image of woman is used, its influence on promotion and relationship to the marketed product are examined through examples under the heading of advertising

Bilateral striopallidodentate calcinosis presenting with psychiatric symptoms and speech disorders

Ozdilek B, Uluc K, Gunal DI. Bilateral striopallidodentate calcinosis presenting with psychiatric symptoms and speech disorders. Background: Bilateral striopallidodentate calcinosis (BSPDC), also known as Fahr's disease, is a rare neurodegenerative disorder characterised by the deposition of calcium and other minerals in the basal ganglia, centrum semiovale and cerebellum. It is usually idiopathic. Its clinical manifestations vary from asymptomatic individuals to neuropsychiatric abnormalities, movement disorders, cerebellar symptoms and cognitive impairments. Methods: Five cases of BSPDC all of which include psychiatric symptoms and speech problems from two families are documented in this article. Conclusion: The most important diagnostic marker is the demonstration of symmetrical intracranial calcifications. Computerised tomography of the brain is the most frequently used radiologic method to diagnose BSPDC

The Complex Genetic Landscape of Hereditary Ataxias in Turkey and Implications in Clinical Practice

Background The genetic and epidemiological features of hereditary ataxias have been reported in several populations; however, Turkey is still unexplored. Due to high consanguinity, recessive ataxias are more common in Turkey than in Western European populations. Objective To identify the prevalence and genetic structure of hereditary ataxias in the Turkish population. Methods Our cohort consisted of 1296 index cases and 324 affected family members. Polymerase chain reaction followed by Sanger sequencing or fragment analysis were performed to screen for the trinucleotide repeat expansions in families with a dominant inheritance pattern, as well as in sporadic cases. The expansion in the frataxin (FXN) gene was tested in all autosomal recessive cases and in sporadic cases with a compatible phenotype. Whole-exome sequencing was applied to 251 probands, selected based on the family history, age of onset, and phenotype. Results Mutations in known ataxia genes were identified in 30% of 1296 probands. Friedreich's ataxia was found to be the most common recessive ataxia in Turkey, followed by autosomal recessive spastic ataxia of Charlevoix-Saguenay. Spinocerebellar ataxia types 2 and 1 were the most common dominant ataxias. Whole-exome sequencing was performed in 251 probands with an approximate diagnostic yield of 50%. Forty-eight novel variants were found in a plethora of genes, suggesting a high heterogeneity. Variants of unknown significance were discussed in light of clinical data. Conclusion With the large sample size recruited across the country, we consider that our results provide an accurate picture of the frequency of hereditary ataxias in Turkey. (c) 2021 International Parkinson and Movement Disorder Societ

PSYCHOTIC DEPRESSION: A PECULIAR PRESENTATION FOR MULTIPLE SCLEROSIS

Multiple sclerosis (MS) is frequently associated with a number of different psychiatric syndromes. Solely psychiatric syndrome may be the first clinical presentation of multiple sclerosis. We report a patient whose first attack was psychotic depression. The present case emphasizes that psychiatric symptoms can occur at any time during the course of the disease and, moreover, may be the presenting feature