Evaluation of silent cerebral ischemia and cognitive functions in young and middle- aged patients with metabolic syndrome

Aim: Metabolic syndrome (MetS) risk factors and accompanying silent cerebral ischemia (SCI) may cause cognitive decline. The aim of this study is to investigate the characteristics and association between SCIs and cognitive functions in young and middle- aged patients with MetS. Methods: A total of 91 patients who were aged between 20-60 years with a diagnosis of metabolic syndrome were prospectively enrolled. Silent cerebral infarcts (SCIs) were analyzed by performing 3 Tesla magnetic resonance imaging (MRI) of the brain. Attention and executive functioning were assessed with the Wechsler Adult Intelligent scale-Revised (WAIS-R), verbal fluency, Stroop, and clock drawing test. Wechsler Memory Scale-Revised (WMS-R) visual reproduction and Öktem verbal memory processes tests were conducted to determine visual and verbal memory performance, whereas visuospatial functions were evaluated by the Benton judgment of line orientation test. Results: Diagnosis of hypertension and diabetes mellitus were significantly higher, while educational level was lower in patients with SCIs than without SCIs. (p <0.001, p=0.034, p=0.05, respectively). Cognitive test scores regarding attention and executive functioning, verbal, visual, and visuospatial memory showed no significant difference between patients with SCIs and without SCIs. However, hyperhomocysteinemia was negatively correlated with executive functions in MetS patients with SCI (p= 0.038). Conclusions: SCIs may be associated with hypertension and diabetes mellitus in young and middle-aged patients with MetS. In addition, controlling homocysteine levels might be beneficial in MetS patients with SCI in terms of improving cognitive functions

Correlations between alexithymia and pain severity, depression, and anxiety among patients with chronic and episodic migraine

WOS: 000277917200002PubMed: 20602723Aims: Some studies have found elevated alexithymia among patients with chronic pain, but the correlations between alexithymia and the severity of pain, depression, and anxiety among migraine patients are unclear. The aims of the present study were to investigate whether individuals suffering from episodic migraine (EM) differ from those with chronic migraine (CM) in regards to depression, anxiety, and alexithymia measures and to investigate the association of alexithymia with the results of depression and anxiety test inventories and illness characteristics. Methods: A total of 165 subjects with EM and 135 subjects with CM were studied. The Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Toronto Alexithymia Scale (TAS) were administered to all subjects. The correlation between alexithymia and sociodemographic variables, family history of migraine and illness characteristics (pain severity, frequency of episode, duration of illness) were evaluated. Results: Compared with EM patients, the CM patients had significantly higher scores on measures of depression but not alexithymia and anxiety. There was a positive correlation between TAS scores and age and education in both migraine groups, but there was no correlation between TAS scores and other demographic variables. Depression and anxiety were significantly correlated with alexithymia in both migraine groups. Conclusion: Our results indicate that CM patients are considerably more depressive than EM patients. In this study, depression and anxiety were significantly correlated with alexithymia in both migraine groups. Our results demonstrate a positive association between depression, anxiety, and alexithymia in migraine patients

Influence of the long term use of a computer on median, ulnar and radial sensory nerves in the wrist region

Objectives: Repetitive microtrauma or overuse injuries may often affect upper extremities of the long term computer users. The aim of this study was to compare sensory nerve conduction velocities (SNCV) for median, radial and ulnar nerves in the wrist of computer users with the same parameters in controls who do not use computers regularly. Material and Methods: Twenty one male computer users (age: mean (M) = 28.3 years ± standard deviation (SD) = 7.5 years) and 21 male control subjects (age: M±SD = 24.1±4.6 years) were recruited for the study. Limb length and the perimeters of the dominant arm and forearm were measured for each subject. The neurophysiological study consisted of measuring sensory nerve conduction of the median, ulnar and radial nerves. Results: The sensory conduction velocities of both median and ulnar nerves were significantly delayed in the dominant arm of the computer users compared to the controls. In addition, sensory conduction velocity of the median nerve was significantly delayed in the dominant extremity of the computer users compared to their non-dominant extremity. Conclusions: This study shows that computer users have a tendency toward developing median and ulnar sensory nerve damage in the wrist region. Mechanism of delayed SNCV in the median and ulnar nerves may be due to sustained extension and ulnar deviation of the wrist during computer mouse use and typing. Reduced SNCV changes were more apparent on the dominant side of the median nerve. This may indicate the increased neural deficits related to an increased use of the dominant side. Further investigation is needed to determine how to reduce potential risk factors at this stage in order to prevent development of median or ulnar neuropathy in the long term computer users