A Reason for Admission to the Sleep Outpatient Clinic during COVID-19 Pandemic: Insomnia

Aim: Sleep can be affected for various reasons such as social isolation, online education, shiftwork, etc. during the coronavirus disease 2019 (COVID-19) pandemic. People who havecomorbid psychiatric or sleep disorders before the pandemic are thought to be more affected.The aim of this study was to investigate the effect of the COVID-19 pandemic on sleep qualityand insomnia.Material and Methods: Our study was a retrospective study, and patients who admitted to thesleep outpatient clinic with insomnia complaints during the COVID-19 pandemic wereincluded. The complaints, sociodemographic characteristics, and diagnosis of the patients wereobtained from medical records.Results: Fifty-three patients diagnosed with insomnia according to the InternationalClassification of Sleep Disorders third edition (ICSD-3) were included in the study. The meansleep time before the pandemic was 6.8±1.2 hours, while it was 5.9±1.7 hours after thepandemic. After the pandemic, 13 (24.5%) patients had shortened sleep duration. There wasno difference in clinical features between those whose sleep duration decreased and did notchange during the pandemic. Twenty (37.7%) patients' complaints of insomnia started duringthe pandemic. Most of the patients whose complaints started during the pandemic were male(n=12, 60.0%). Their main complaint was difficulty in falling asleep (n=18, 90.0%). Theanxiety symptoms were remarkable.Conclusion: Sleep disorders during the pandemic are an important problem for everyone.However, some individuals have a higher risk of sleep problems. Therefore, the results of ourstudy may contribute to the interventions aimed at improving sleep quality during pandemic

A Reason for Admission to the Sleep Outpatient Clinic during COVID-19 Pandemic: Insomnia

Aim: Sleep can be affected for various reasons such as social isolation, online education, shiftwork, etc. during the coronavirus disease 2019 (COVID-19) pandemic. People who havecomorbid psychiatric or sleep disorders before the pandemic are thought to be more affected.The aim of this study was to investigate the effect of the COVID-19 pandemic on sleep qualityand insomnia.Material and Methods: Our study was a retrospective study, and patients who admitted to thesleep outpatient clinic with insomnia complaints during the COVID-19 pandemic wereincluded. The complaints, sociodemographic characteristics, and diagnosis of the patients wereobtained from medical records.Results: Fifty-three patients diagnosed with insomnia according to the InternationalClassification of Sleep Disorders third edition (ICSD-3) were included in the study. The meansleep time before the pandemic was 6.8±1.2 hours, while it was 5.9±1.7 hours after thepandemic. After the pandemic, 13 (24.5%) patients had shortened sleep duration. There wasno difference in clinical features between those whose sleep duration decreased and did notchange during the pandemic. Twenty (37.7%) patients' complaints of insomnia started duringthe pandemic. Most of the patients whose complaints started during the pandemic were male(n=12, 60.0%). Their main complaint was difficulty in falling asleep (n=18, 90.0%). Theanxiety symptoms were remarkable.Conclusion: Sleep disorders during the pandemic are an important problem for everyone.However, some individuals have a higher risk of sleep problems. Therefore, the results of ourstudy may contribute to the interventions aimed at improving sleep quality during pandemic

Parkinson Hastalarında Parmakvuru Performansının Kantitatif Değerlendirilmesi

Amaç: Parkinson hastalarında motor semptomların kantitatif yöntemlerle objektif olarak değerlendirilmesi hem tanı hem de hastaların takipleri aşamasında önemlidir. Bu amaca yönelik yöntemlerin, günlük pratikte ya da klinik araştırmalarda rutin olarak kullanılabilmesi için, basit ve kolay kullanabilen bir yöntem olması ve ölçüm yapan kişiler arasında minimum farklılıkla uygulanabilmesi gerekmektedir. Parmak vuru testi Parkinson hastalarında nörolojik muayenenin bir parçası olarak, üst ekstremite motor becerileri hakkında oldukça iyi bilgi vermektedir. Bu çalışmada Parkinson hastalarının motor becerilerini değerlendiren parmak vuru hızı, bilgisayar destekli bir yöntemle kantitatif olarak ölçülmüştür. Yöntem: 25 Parkinson hastası ve 25 kontrol olgusunda parmak vuru hızı bir software yardımı ve bir klavye kullanılarak ölçülmüştür. Parmak vuru performansını değerlendirmek amacı ile tek parmak (TP) ve çift parmak alternan (AP) hareket hızı ölçülmüş ve parmak vuru hızını etkileyebilecek yaş, cinsiyet, eğitim ve kognisyon gibi faktörler değerlendirilmiştir. Bulgular: Parkinson hastalarında, hastalığın belirgin olduğu tarafta hem TP hem de AP vuru hızları anlamlı olarak yavaş bulunmuştur. Parkinson hastalarında kullandığımız bu yöntemin yaş, eğitim ve kognisyondan bağımsız olarak bradikineziyi değerlendirmede yeterli olduğu belirlenmiştir. AP vuru hızının hastalık derecesinin belirlenmesinde daha hassas olduğu gözlenmiştir. Sonuç: Bilgisayar yardımı ile değerlendirilen parmak vuru hızının Parkinson hastalarında üst ekstremite becerilerinin ve hastalık şiddetinin değerlendirilmesinde kullanılabilecek hassas, pratik ve objektif bir yöntem olduğu düşünülmektedir. Sonuç olarak bu yöntemin günlük pratik ve klinik araştırmalarda PH'nın değerlendirilmesinde faydalı olabileceği sonucuna varılmıştır.Objective: The objective, quantitative assessment of patients with Parkinson's disease (PD) is essential for both the diagnosis and follow-up. To be of value in clinical trials and daily clinical practice, the method should be simple and easy, with minimal inter-rater observer variation. The finger-tapping (FT) test is an informative measure of upper-extremity motor skills as a part of the neurological assessment of patients with PD. Therefore, this study evaluated the motor skills of patients with PD by using a computer-based system that quantifies FT performance. Method: Software to measure FT performance was assessed in 25 patients with PD and 25 normal controls by using two FT testing procedures: single FT (SFT) and alternate FT (AFT). Confounding factors that had the potential to affect the performance were considered, including age, sex, education, and cognition. Results: The SFT and AFT scores for the affected side of patients with PD were significantly lower than the corresponding scores for the dominant side of control subjects. In PD patients, our method appeared to be adequate for evaluating bradykinesia independent of age, cognition and education. AFT was a more sensitive tool for determining the disease severity. Conclusion: This method is a sensitive, practical, and objective tool for evaluating upper- extremity motor skills in patients with PD. It also reflects the disease severity. We hope that this method might be useful in both daily practice and clinical studies

Do Comorbidities and Triggers Expedite Chronicity in Migraine?

Background and Aim: Several factors are suggested to be associated with an increased risk of transforming from episodic migraine (EM) to chronic migraine (CM). We aimed to examine whether some specific attack triggers and comorbidities were associated with CM. Methods: Patients followed up with a diagnosis of definite migraine for at least 1 year were divided into two groups, EM (15 attacks per month). The demographic and clinical data, attack‑triggering factors, and comorbid diseases were compared between the groups. Results: A total of 403 (286 females) patients were analyzed; 227 (56.3%) of the migraineurs had EM and 176 (43.7%) had CM. The mean age was 40.9 ± 11.3 years in EM, and 42.2 ± 11.7 years in CM. Disease duration was longer in CM compared with EM (P = 0.007). Missing meals (P = 0.044), exposure to heavy scents/perfumes (P = 0.012), intense physical activity (P = 0.037), and withdrawal of caffeine (P = 0.012) were reported significantly higher in CM than in EM. Comorbid history of medication overuse (P < 0.001), hypertension (P = 0.048), hyperlipidemia (P = 0.025), depression (P = 0.021), chronic painful health problems (P = 0.003), iron deficiency anemia (P = 0.006), and history of surgery (P = 0.006) were found significantly high in CM. Conclusion: This study demonstrates that attack‑triggering factors, vascular comorbidities, depression, medication overuse, and chronic painful health problems pose significant risks for CM. Vascular comorbidities are independent risk factors for chronification in migraine and might increase the patient’s lifetime morbidity and mortality. Therefore, prompt diagnosis of migraine before the transformation to chronicity and effective early management have the utmost importance

Real-life experiences with galcanezumab and predictors for treatment response in Turkey

Abstract Background The complexity of clinical practice extends far beyond the controlled settings of trials, and there is a need for real-world studies aimed at identifying which patients will respond to anti-CGRP monoclonal antibodies in different countries. This study aimed to investigate the efficacy and safety of galcanezumab in treating migraine in a real-life setting in Turkey, as well as identify predictors of treatment response. Methods A total of 476 patients who diagnosed with migraine according to ICHD-3 criteria and treated with galcanezumab by headache specialists were voluntarily participated in this cross-sectional study. Galcanezumab is indicated for the prevention of migraine in adults who have at least 4 monthly migraine days in Turkey. All patients filled out a survey on Google Form that comprised 54 questions, addressing various aspects such as demographics, migraine characteristics, previous use of acute symptomatic medication, failures with preventive drug classes, comorbidities, most bothersome symptoms, as well as the interictal burden of migraine. Results Among the participants, 89.3% reported that galcanezumab treatment was beneficial for them. A decrease in the frequency (80.0%), severity (85.7%), and acute medication usage for migraine attacks (71.4%) was reported with galcanezumab treatment. An adverse effect related to galcanezumab was reported in 16.3% of cases, but no serious adverse reactions were observed. Remarkably, 14.3% of participants reported no longer experiencing any headaches, and 18.9% did not require any acute treatment while receiving galcanezumab treatment. A logistic regression model showed that male gender, lack of ictal nausea, and previous failure of more than 2 prophylactic agents may predict the non-responders. Conclusions The first large series from Turkey showed that galcanezumab treatment is safe and effective in most of the patients diagnosed with migraine by headache experts in the real-life setting. Patients reported a significant decrease in both ictal and interictal burden of migraine and expressed satisfaction with this treatment