Abdulkadir Koçer

Erdosteine ameliorates PTZ-induced oxidative stress in mice seizure model.

The role of oxygen-derived free radicals has been suggested in genesis of epilepsy and in the post seizure neuronal death. The aim of this study was to investigate whether erdosteine has a preventive effect against epilepsy and postepileptic oxidative stress. The mice (n=27) were divided into three groups: (i) PTZ-induced-epilepsy group (n=9); (ii) PTZ-induced-epilepsy+erdosteine group (n=9); (iii) control group (n=9). The animals were observed for a period of 30 min for latency to first seizure onset, total seizure duration, the number of seizure episodes. Then they were sacrificed and the brains were quickly removed, and frozen for biochemical analysis. Malondialdehyde (MDA), nitric oxide (NO), superoxide dismutase (SOD) and xanthine oxidase (XO) activities were carried out in the brain tissue. The latent period between PTZ induction and seizure are longer in the PTZ+erdosteine group than in PTZ-induced-epilepsy group (P<0.05). Biochemical analyses of brain tissue, revealed a significant increase in the MDA, XO and NO levels in the PTZ group according to erdosteine group. SOD level did not change in this group. While MDA and XO levels are significantly lower, SOD level is significantly higher in the PTZ+erdosteine group compared to PTZ and control groups (P<0.01). The present study demonstrated that erdosteine treatment both may increase latent interval between seizures and may decrease oxidative stress, thus may ameliorate neuronal death in brain during seizures. It may be used as an adjunct therapy in epilepsy.

IL-6 Levels in Migraine Patients Receiving Topiramate

There is considerable evidence suggesting that cytokines play important roles in pain and in mediating neurovascular inflammation associated with migraine headaches. Although consensus exists to recommend topiramate (TPM) for migraine prevention, the mechanism of action in this regard is unknown. We measured serum interleukin‐6 (IL‐6) levels in 66 migraine patients. Of these patients, 23 (34.9%) were taking TPM for migraine, and 43 (65.1%) were not. The IL‐6 levels were compared with those of healthy controls without migraine, from the population living in the same region. The mean IL‐6 levels in migraine patients taking TPM and patients who did not were 67.06 ± 92.09 pg/mL and 44.09 ± 59.19 pg/mL, respectively (P > 0.05). The IL‐6 levels were higher in the patients taking TPM. The IL‐6 level in the controls was 8.60 ± 7.36 pg/mL, which was significantly lower than the patient group using TPM (P = 0.001). Our results show that, although IL‐6 may be involved in pain induction or inflammatory mechanisms of migraine attacks, the serum IL‐6 level was not reduced in migraine patients receiving TPM therapy. In conclusion, we found high IL‐6 levels in migraine patients both with and without TPM therapy, suggesting that high IL‐6 levels during pain‐free periods could be a conditioning factor, making patients more vulnerable to pain attacks in chronic migraine. Further studies investigating the possible mechanism of TPM in migraine are needed.

Thyrotoxic hypokalaemic periodic paralysis in a Turkish population: three new case reports and analysis of the case series

Objective  Thyrotoxic hypokalaemic periodic paralysis (THPP) is an uncommon condition with intermittent episodes of muscle weakness and occasionally severe paralysis. THPP is a common complication of hyperthyroidism in Asian populations, and has also been reported in other ethnic groups including Caucasians. This study aimed to conduct an analysis of THPP in a Turkish population, and is to our knowledge the first analysis of a homogeneous Caucasian group.

Interleukin-6 Levels in Tension Headache Patients

ObjectiveCytokines are pain mediators in neurovascular inflammation. This study examined interleukin 6 (IL-6) levels in the serum of tension-type headache (TTH) patients, to determine if inflammation plays a role in the pathogenesis of this condition. MethodsSerum IL-6 levels were studied in 42 patients and 37 healthy controls from the same region. Of the patients, 20 (47.6%) experiencing TTH less than 15 days per month were placed in episodic tension-type headache (ETTH) group, and 22 (52.3%) with TTH more than 15 days per month were placed in chronic tension-type headache (CTTH) group. ResultsThe IL-6 level was significantly higher in the patients than in the controls. The IL-6 level of CTTH patients was higher than the controls (P<0.01). The IL-6 level was similar between ETTH and CTTH patients. Correlation analysis revealed a positive relationship only between age and IL-6 level in the patients. ConclusionsCTTH and ETTH patients had an elevated serum IL-6 level compared with controls. Therefore, we believe that IL-6 may be involved in pain induction or inflammatory mechanisms in TTH. Furthermore studies of the possible connection between chronicity of headaches and cytokine levels are needed.

Assessment of Platelet Indices in Patients with Neurodegenerative Diseases: Mean Platelet Volume Was Increased in Patients with Parkinson’s Disease

Platelets induce chronic inflammation which is a key step in atherosclerosis and may be involved in the progression of neurodegenerative diseases (NDD). We aimed to measure the mean platelet volume (MPV) and platelet count (PLC) in NDD patients. The present study was designed to investigate the platelet function by measuring MPV and PLC in NDD. A total of 182 outpatients with Alzheimers (AD) or Parkinsons diseases (PD) were included. The control group consisted of 104 healthy subjects. Platelet count was similar between groups. MPV values of PD patients were higher than those of AD patients and controls (P < 0.001). MPV correlated negatively with Heohn and Yahr scale (HYS) score (P < 0.001). Increased MPV in patients with PD may point to a platelet dysfunction. High-grade inflammation presents with low levels of MPV as seen in PD patients with high HYS scores.

A comparison of sural nerve conduction studies in patients with impaired oral glucose tolerance test

Objective –  Monitoring of the sural nerve is a sensitive method for detection of neuropathies. We examined different methods of studying sural nerve conduction in a group of patients with impaired glucose tolerance (IGT) in the same study.

Association between smoking and cognitive impairment in multiple sclerosis.

Purpose Although smoking is known to cause various symptoms in multiple sclerosis (MS) patients, there have been no reports regarding the relationship between smoking and cognitive impairment in MS. Studying the effects of cigarette smoking in MS patients is imperative as there is a high prevalence of cognitive impairment in MS patients. In this study we examined the potentially deleterious effects of heavy smoking on mentation of patients with MS. Patients and methods MS patients receiving care at the Neurology Clinic at Bezmialem Vakıf University, between the ages of 18–65 years who have at least graduated elementary school were included in the study. The Brief Repeatable Battery of Neuropsychological Tests (BRB-N) is a commonly used method to assess cognitive function in MS patients and was utilized in our study. Patients that smoked for at least 10 pack-years were considered heavy smokers. Results All the patients were stratified into two groups: heavy smokers (n=20) and nonsmokers (n=24). For heavy smokers, their cognitive functioning was more impaired than that of nonsmokers (P=0.04, χ2=4.227). For patients with cognitive impairment, 78.9% of the Paced Auditory Serial Addition Test and 63.2% of the Symbol Digit Modalities Test scores were found to be lower. Conclusion Previous reports have suggested that smoking increases the frequency of relapse among individuals with relapsing-remitting MS and accelerates disease progression in patients with progressive MS. According to the results of our study, heavy smokers had increased cognitive impairment when compared to nonsmokers. Extensive studies are necessary to further elucidate the relationship between smoking and cognitive impairment in MS patients.

P wave duration and dispersion in multiple sclerosis.

BackgroundMultiple sclerosis (MS) has been reported to be associated with extensive autonomic dysfunction as well as to involve the cardiovascular system. In this study we compared P wave duration and dispersion (PWD) of MS patients to healthy control subjects.MethodThirty-one MS patients (mean age 35±9 years) and 33 healthy control subjects (mean age 34±7 years) were included in the study. Twelve-lead surface ECG recording (paper speed of 50 mm/s) was obtained from all participants. The change in maximum and minimum P wave duration was measured manually and the difference between the two values was defined as PWD.ResultsThere was no difference between the two groups in terms of baseline demographic characteristics. Maximum P wave duration was higher in MS patients than controls (126±6 vs. 122±5 ms, p=0.004). Minimum P wave duration was found to be similar in MS patients and healthy controls (72±8 vs. 75±8 ms, p=0.2).Mean PWD value of MS patients was also found to be higher than those of controls (53±10 vs. 47±10 ms, p=0.01).ConclusionP wave duration and PWD was found to be statistically different in patients with MS and control subjects.

Dry Eye Related to Commonly Used New Antidepressants.

Abstract Antidepressants may have an impact on the course of eye dryness. The aim of this study was to investigate the effects of commonly used new antidepressants on eye wetting. Fifty-four patients using new antidepressants and 57 controls were recruited. The Beck Depression Scale and Beck Anxiety Scale questionnaires were completed by the patients, and drug use time and dosages were recorded. The Schirmer test was performed without prior instillation of topical anesthesia to the ocular surface, and the wetting result was recorded for each eye. Escitalopram, duloxetine, and venlafaxine were used by 27, 13, and 14 patients, respectively. The Schirmer test results in the patients were significantly lower than in the controls (P < 0.001). The patients using selective serotonin reuptake inhibitors (SSRIs) displayed lower wetting measurements (⩽5 mm) compared with those using serotonin-norepinephrine reuptake inhibitors, which was independent of the duration of antidepressant usage (P < 0.05). Although SSRIs do not have anticholinergic adverse effects except paroxetine, we found that both SSRIs and serotonin-norepinephrine reuptake inhibitors increased the risk for eye dryness. The lower Schirmer test results of the SSRIs may be associated with a mechanism other than the anticholinergic system. An awareness of the drugs that contribute to dry eye will allow ophthalmologists, optometrists, and other physicians to better manage patients who have this problem.

The Evaluation of Atherosclerosis in Migraine Patients

Abstract  A potential association might exist between atherosclerosis and migraine. Carotid intima‐media thickness (CIMT) is a marker of generalized atherosclerosis; hence, we aimed to assess CIMT in migraine patients. This study included 30 patients and 60 healthy controls aged between 20 and 40 years. Episodic migraine diagnosis was made according to the criteria of International Headache Society (IHS). Healthy controls who do not suffer any headache problems were selected from among hospital and laboratory staffs. All subjects were evaluated regarding some parameters and features known to be associated with migraine and vascular changes, that is, gender, age, body mass index, blood pressure, cholesterol, smoking habits, used hormonal contraceptives, and history of disease. The left common carotid arteries of the subjects were examined, and CIMT was measured with real‐time gray‐scale sonography. Mean values and standard deviations were calculated. All measurements were made in migraine‐free periods. Migraine patients and control subjects were well matched for those parameters known to be associated with vascular changes, that is, gender, age, BMI, blood pressure, and cholesterol. CIMT values were higher in patients. The results showed that the mean CCA IMT values were 0.493 ± 0.074 mm and 0.409 ± 0.053 mm in migraine patients and controls, respectively (P < 0.001). There is a relationship between atherosclerosis and inflammation in migraine patients. The risk of cranial inflammatory arteriopathy increases in repeated attacks of migraine. Our study also supports that high number of attacks and attack duration are important in the development of atherosclerosis.