Comparison of Orexin-A and neurofilament light chain levels in patients with relapsing-remitting multiple sclerosis: A pilot study = Orexin-A- és neurofilamentum-könnyűlánc fehérjeszintek relapszáló-remittáló sclerosis multiplexben szenvedőknél: pilot vizsgálat

Multiple sclerosis is an autoimmune disease of the central nervous system, with myelin degeneration and Relapsing-Remitting Multiple Sclerosis (RRMS) as the most common type. The aim of this study was to determine the levels of Neurofilament Light Chain (NFL) and Orexin-A (OXA) in patients with RRMS and compare it with healthy control subjects’ data. In this case-control study of 61 subjects, serum and cerebrospinal fluid samples were collected from 23 RRMS patients and 38 healthy control subjects. NFL and OXA levels were determined in cerebrospinal fluid and serum samples using enzyme-linked immunosorbent assay kits. Self-reported questionnaires were also administered to evaluate fatigue severity and impact. Receiver operating characteristic curve analysis was used to determine the optimal cut-off value of NFL and OXA. The NFL and OXA concentrations in cerebro­spinal fluid of RRMS patients were significantly higher than those of the control group (p < 0.001), but no sig­nificant difference was found in the serum concentrations (p = 0.842, p = 0.597, respectively). The cut-off values were found to be 1.194 ng/ml for NFL and 77.81 pg/ml for OXA in cerebrospinal fluid. A positive correlation was found between the Expanded Disability Status Scale and Epworth Sleepiness Scale in RRMS patients (ρ = 0.49, p = 0.045). These results suggest that increased levels of both NFL and OXA in cerebrospinal fluid reflect neuronal destruction in RRMS. Further research of neurodegeneration should focus on neuropeptides to determine the possible roles in RRMS pathogenesis

The frequency of buccopalpebral reflex in Parkinson disease

Background/aim: This study aimed to define the frequency of a primitive reflex, the buccopalpebral reflex (BPR), and its association with the clinical situation in patients with Parkinson disease. Materials and methods: Between May 2010 and May 2011, 222 patients, 115 with Parkinson disease and 107 patients without any sign of neurodegenerative disease, were included in the study. All included patients were examined for BPR and snout reflex and were also evaluated with the Mini Mental State Examination. All patients with Parkinson disease were classified with the Unified Parkinson's Disease Rating Scale (UPDRS) and the Hoehn and Yahr Score to determine their clinical severity. Results: Sixteen patients with Parkinson disease (13.9%) had a BPR (+) and 4 patients in the control group (3.7%) (P < 0.001). The UPDRS score, UPDRS daily life activities score, and UPDRS motor system score were all higher in the group with BPR (+). All patients with a BPR also had a positive snout reflex. Conclusion: BPR is more frequent in patients with Parkinson disease than in patients without a neurodegenerative disease

The Effect of Sugammadex on Time of Sciatic Block by Perineural Bupivacaine in Rats

Objectives We aimed to investigate the effect of sugammadex on the motor, sensory and deep sensory block in the sciatic nerve created by bupivacaine in rats. Materials and Methods 18 Sprague-Dawley adult male rats treated with unilateral sciatic nerve block by bupivacaine (0.2 ml) were randomly divided into three groups. Control group (Group C, n = 6, 1.5 mL saline) perineural sugammadex group (Group PNS, n = 6, 16 mg/kg) and intraperitoneal sugammadex group (Group IPS, n = 6, 16 mg/kg) Motor, sensory, and deep sensory functions were evaluated every 10 minutes by a blind researcher. 6 tissue samples each belonging to the sciatic nerve, 1.5 cm in length and 0.2 cm in diameter, were taken from paraffin blocks. Sections of 3-4 micrometers were stained with Hematoxylin + Eosin, Masson Trichrome dyes and examined under a light microscope. Results There was no statistically significant difference between 3 groups in terms of the time to return to normal motor, sensory and deep sensory function. There was also no significant difference in edema, extracellular matrix, and myelin. Inflammatory cells were seen in all groups, mainly epineurium, epineurium, and perineurium. Conclusion There are findings of no histological effects or effects on local block of sugammadex in rats undergoing sciatic nerve block

Efficacy of Valproate in Partial Epilepsy and Patient Compliance and Satisfaction with Long Acting Valproate Form

Objective: The aims of this multi-centre cross-over study were to evaluate the efficacy of valproate in patients with partial epilepsy and compliance with the controlled-release formulation (valproate-CR). Patients and Methods: Ninety-four patients were included in ten centres and 81.9% completed the study. Clinical and demographic features were assessed at baseline, treatment compliance and satisfaction, efficacy and adverse events were evaluated at four visits. Seizure frequency, incidence of adverse events, treatment compliance and patient satisfaction differed significantly between the two treatment periods, with significant improvements in all measures following the switch to valproate-CR. Results: At first visit, 30.5% of patients were either seizure free or experienced rare seizures and were 62.5% at the fifth visit (p<0.001). Adverse events were observed in 35 (37.6%) at the second visit, while this number was 19 patients (25%) at the fifth visit. Treatment compliance was 82.2% at the second visit and this ratio increased to 97.4% at the fifth visit after the transition to long acting valproate form (p=0.001). At study-end, 84.9% of patients were satisfied with the treatment and 74.4% of patients were highly improved. Conclusion: In conclusion, use of valproate-CR was associated with a lower incidence of side-effects and improved patient compliance and satisfaction