OCJENA MNOGOSTRUKIH PODRUČJA NA SREDNJESAGITALNIM SLIKAMA MAGNETSKE REZONANCIJE MOZGA U BOLESNIKA S MULTIPLOM SKLEROZOM

The aim of the study was to compare the first and last magnetic resonance images (MRIs) in patients diagnosed with multiple sclerosis (MS) with MRIs of normal subjects. We wanted to investigate the region initially involved in MS patients. In this retrospective study, midsagittal plane was explored on brain MRIs taken at the time when MS diagnosis was established and the last MRI was obtained following treatment for MS. Comparison was done between healthy subjects and patients diagnosed with MS. The measures included the area of corpus callosum, cerebrum, cerebellum, pons, bulbus, fourth ventricle and pituitary gland. As a result, while there was growth in the fourth ventricle area, there was shrinkage in the other areas in MS patients. In women, the tissues involved at the beginning of the disease were pituitary gland, cerebrum and bulbus, and in men corpus callosum and cerebrum. Atrophy was not time-dependent. Assessment of the correlation between the Expanded Disability Status Scale (EDDS) and atrophy revealed an increase in EDDS (disease progression) to be associated with a decrease in the area of cerebrum and corpus callosum in men, and an increase in the fourth ventricular area in women. In conclusion, we demonstrated that pituitary gland atrophy develops in the early stage of MS, especially in women. Additional studies are needed to investigate the phenomenon of early pituitary and bulbus atrophy in women versus late atrophy of these tissues in men.Cilj rada bio je usporediti prve i posljednje slike magnetske rezonancije (MR) u bolesnika s multiplom sklerozom (MS) sa slikama zdravih osoba. Kod bolesnika s MS htjeli smo ispitati najranije zahvaćeno područje. U ovoj studiji se srednjesagitalno područje kod bolesnika s postavljenom dijagnozom MS pregledalo na slikama MR mozga u vrijeme postavljanja dijagnoze i nakon liječenja. Uspoređivalo se zdrave osobe s bolesnicima kojima je dijagnosticirana MS. Mjerenje je uključilo područje korpusa kalozuma, mozga, malog mozga, ponsa, bulbusa, četvrtog ventrikula i hipofi ze. Kod bolesnika s MS došlo je do porasta na području četvrtog ventrikula, a do smanjenja u drugim područjima. Utvrđeno je da su zahvaćena tkiva u žena na početku bolesti bila hipofi za, mozak i bulbus, a kod muškaraca korpus kalozum i mozak. Otkriveno je da atrofi ja ne ovisi o vremenu. Kada se promatralo korelaciju između zbira na Expanded Disability Status Scale (EDDS) i atrofi je, vidjelo se da s povećanjem EDDS (kada bolest napreduje) dolazi do smanjenja područja malog mozga i korpusa kalozuma u muškaraca, a povećanja područja četvrtog ventrikula u žena. Pokazali smo da se atrofi ja hipofi ze razvija u ranoj fazi MS, osobito u žena. Pozornost privlači rana atrofi ja hipofi ze i bulbusa u žena te kasna atrofi ja ovih tkiva u muškaraca

Relationship between intracellular pathogens Toxoplasma gondii and Borrelia burgdorferi infections and migraine

Aim: In this study, the serological values of our patients followed up with a diagnosis of migraine were compared with the results of healthy controls in terms of possible association with intracellular pathogens, Toxoplasma gondii and Borrelia burgdorferi. Methods: Fifty patients with migraine, randomly selected among migraine patients without any additional disease, who applied to Bolu Abant Izzet Baysal Training and Research Hospital between January 1, 2015 and August 31, 2019 were included in the study. Fifty subjects without headache were included as control group. The history of infectious diseases of the patient and control groups (Toxoplasma gondii, Borrelia burgdorferi- causing Lyme disease) was determined by serological diagnostic methods. Results: The study group consisted of 64 women with a mean age of 45.5±13.1 (15-76) years. Migraine and control groups were found to be similar in terms of age (p=0.059) and gender (p=0.211) distributions. The frequency of Toxoplasma gondii positivity in the migraine group was 28% (n=14) and 10% (n=5) in the control group. The frequency of Lyme was 19.6% (n=11) in the migraine group and 14.3% (n=8) in the control group. The frequency of Toxoplasma gondii positivity was statistically significantly higher in the migraine group (p=0.022), while the frequency of Lyme was found to be similar in the migraine and control groups (p=0.450). Conclusion: The results of our study suggest that there are statistically significant differences between migraine and control groups only in terms of Toxoplasma gondii positivity rates, not Lyme. However, we believe that larger sample studies are needed to determine the detailed relationship between migraine and Toxoplasma gondii infection

The effect of the HMGB1/RAGE/TLR4/NF-?B signalling pathway in patients with idiopathic epilepsy and its relationship with toxoplasmosis

This study aims to investigate the relationship between toxoplasmosis and this pathway, which may be effective in the formation of epilepsy by acting through the HMGB1/RAGE/TLR4/NF-kappa B signalling pathway in patients with idiopathic epilepsy. In the study, four different experimental groups were formed by selecting Toxoplasma gondii IgG positive and negative patients with idiopathic epilepsy and healthy controls. Experimental groups were as follows: Group 1: Epilepsy+/Toxo- (E+, T-) (n = 10), Group 2: Epilepsy-/Toxo- (E-, T-) (n = 10), Group 3: Epilepsy-/Toxo+ (E-, T+) (n = 10), Group 4: Epilepsy+/Toxo+ (E+, T+) (n = 10). HMGB1, RAGE, TLR4, TLR1, TLR2, TLR3, IRAK1, IRAK2, IKBKB, IKBKG, BCL3, IL1 beta, IL10, 1 L8 and TNF alpha mRNA expression levels in the HMGB/RAGE/TLR4/NF-kappa B signalling pathway were determined by quantitative simultaneous PCR (qRT-PCR) after collecting blood samples from all patients in the groups. Statistical analysis was performed by one-way ANOVA followed by LSD post-hoc tests, and p < 0.05 was considered to denote statistical significance. The gene expression levels of HMGB1, TLR4, IL10, IL1B, IL8, and TLR2 were significantly higher in the G1 group than in the other groups (p < 0.05). In the G3 group, RAGE and BCL3 gene expression levels were significantly higher than in the other groups (p < 0.05). In the G4 group, however, IRAK2, IKBKB, and IKBKG gene expression levels were significantly higher than in the other groups (p < 0.05). HMGB1, TLR4, IRAK2, IKBKB, IL10, IL1B, IL1B, and IL8 in this signalling pathway are highly expressed in epilepsy patients in G1 and seizures occur with the stimulation of excitatory mechanisms by acting through this pathway. The signalling pathway in epilepsy may be activated by HMGB1, TLR4, and TLR2, which are considered to increase the level of proinflammatory cytokines. In T. gondii, this pathway is activated by RAGE and BCL3.Turkiye Bilimsel ve Teknolojik Arastirma Kurumu [317S052]Turkiye Bilimsel ve Teknolojik Arastirma Kurumu, Grant/Award Number: 317S05

Optical coherence tomography findings in Parkinson's disease

The aim of this study is to compare optical coherence tomography (OCT) findings of retinal thickness (RT) and retinal nerve fiber layer thickness (RNFLT) of idiopathic Parkinson's disease (IPD) patients to those of healthy subjects, and to investigate whether there is any relationship between the severity of the disease and the RNFLT values. This prospective study was included 25 IPD patients and 29 healthy controls. In the IPD group, the Hoehn and Yahr (H&Y), Unified Parkinson's Disease Rating Scale (UPDRS), and Mini-Mental State Exam (MMSE) were performed. Intraocular pressure (IOP), visual acuity (VA), spherical equivalent, axial length (AL), and central corneal thickness (CCT) were measured using OCT in both groups. The RT was measured in the central retinal (RTc), nasal (RTn), and temporal (RTt) segments. Nasal (RNFLTn), nasal superior (RNFLTns), nasal inferior (RNFLTni), temporal (RNFLTt), temporal superior (RNFLTts), and temporal inferior (RNFLTti) measurements were made and mean RTFLT was calculated (RNFLTg) for each individual. In the patient group, IOP and VA values were statistically significantly lower The RTn and RNFLTg were significantly thinner in the patient group. There was no statistically significant relationship between the severity of IPD and these findings. In our study, RNFLTg and RTn were found to be thinner in the IPD group, which may have caused lower VA scores. The effects of retinal dopamine depletion on RT and RNFLT, and lower IOP values in the non-glaucomatous IPD patients should be further investigated