Handan Işın Özışık

Increased dilator response to nitrate and decreased flow-mediated dilatation in migraineurs.

Background.—It has been known that in a migraine attack intracranial and extracranial arteries on the headache side dilate and when the migraine attack has subsided, the intracranial arteries show segmental narrowing. We hypothesized that patients with migraine had an underlying systemic vasomotion abnormality and there might be an increased nitrate‐mediated vasodilatory response in the brachial artery of migraineurs. Accordingly we aimed to measure endothelium dependent and independent functions of brachial artery in migraineurs and healthy subjects.

Decreased endothelium-dependent vasodilatation in patients with migraine: a new aspect to vascular pathophysiology of migraine.

BackgroundMigraine is a common neurovascular disorder characterized by attacks of severe headache, autonomic and neurological symptoms. We hypothesized that patients with migraine had abnormal endothelial function. The vascular theory of migraine assumes that the major pathophysiological events that initiate the migraine attack occur in the perivascular nerves of the major cerebral vessels. Accordingly, we aimed to measure endothelium-dependent vasodilatation in migraineurs by means of flow-mediated dilatation, which reflects endothelium-dependent vasodilatation capacity. Materials and methodsForty-five patients who fulfilled the diagnostic criteria for migraine and 45 age and sex-matched healthy participants were enrolled in the study. Flow-mediated dilatation of the brachial artery was determined using a high-resolution B-mode ultrasonographic system. Flow-mediated vasodilatation was expressed as the change in post-stimulus diameter as a percentage of the baseline diameter. ResultsMean ages of the patients were 33±10 years in migraineurs (range: 18–52 years, 36 female, 9 male) and 33±9 years in non-migraineurs (range: 17–50 years, 36 female and 9 male). Flow-mediated dilatation of patients with migraine is significantly lower than that of the controls (8.02±4.095% vs. 10.72±3.52%, respectively, P=0.001). ConclusionWe have shown that migraineurs have decreased endothelium-dependent vasodilatation capacity compared with non-migraineurs. Migraine may be a local manifestation of systemic vascular vasomotion abnormalities.

Diffusion-weighted imaging in chronic Behçet patients with and without neurological findings

Our aim was to investigate whether neurological impairment in chronic Behçet’s disease (BD) patients with normal appearing brain can be assessed by means of diffusion-weighted imaging (DWI). The averaged apparent diffusion coefficient (ADC) values were calculated in 22 different radiologically normal appearing brain regions in 32 patients with and without neurological findings and 20 control subjects. The ADC values in bilateral frontal, temporal and occipital normal appearing white matter were significantly higher in the patient groups compared with the control subjects (p<0.05). In these brain regions, DWI revealed differences in the ADC values between patients with neurological findings (including symptomatic and neuro-Behçet patients) and the asymptomatic patient group. The similarity of the ADC values of patients without symptoms to those of the control group allowed clear discrimination between patients with and without neurological findings. DWI may serve to assess subclinical neurological involvement in BD, even when structural changes are absent.

Reduced P50 auditory sensory gating response in professional musicians.

Evoked potential studies have demonstrated that musicians have the ability to distinguish musical sounds preattentively and automatically at the temporal, spectral, and spatial levels in more detail. It is however not known whether there is a difference in the early processes of auditory data processing of musicians. The most emphasized and studied early process, especially for neuropsychiatric purposes, is sensory gating. The suppression percentage of the midlatency auditory evoked potential P50, and rarely the N100, wave is used for sensory gating studies. Our aim in this study was to investigate whether there was a difference in the auditory P50 and N100 suppression of control subjects who were professional musicians with no psychiatric problems. 34 professional musicians and 19 non-musicians (the control group) were included in this study. P50 and N100 measurements were taken, the suppression percentage of P50 and N100 was calculated and the results compared. Musicians showed significantly less P50 suppression when compared to non-musicians. There was no significant difference for N100 suppression. What the decreased P50 suppression in musicians when compared to non-musician subjects means, when we also take into account that N100 suppression is not decreased, and how it may contribute to the music perception and production processes of these persons is discussed.

Health-related quality of life in patients with conversion disorder with seizures

Objective. The concept of Health-Related Quality of Life (HRQOL) is important for both the prevention and progress of psychiatric diseases. In the literature, we are aware that there are a few studies on HRQOL among patients with conversion disorder with seizure. Our aim is to measure the HRQOL in Turkey among patients with conversion disorder with seizure and to compare the quality of life of this study group to a healthy control group and to different types of epileptic patient groups. Methods. A total of 330 subjects was included in this study; 102 patients were included in the conversion disorder group, 121 patients were included in the epileptic group and 93 subjects were included in the healthy control group. WHOQOL-100 scale and Trait Anxiety Inventory (TAI) were administered to these groups. Results. HRQOL for the patients with conversion disorder was worse than the control group except for the environment and social relations domains. The generalized epilepsy patients had better physical and psychological health, compared with the patients with conversion disorder. Compared with the partial epilepsy group, HRQOL for the patients with conversion disorder was better in psychological, environmental, social relationship domains. Conclusion. Considering these disorders, patients with conversion disorder need long-term psychiatric treatment. Carrying out this study in our country will be an advantage for the cross-cultural studies which will be undertaken out in the future.

Cerebral artery hemodynamics in polycystic ovary syndrome

Objective. The aim of the present study was to investigate hemodynamic changes in the medial cerebral artery and also the internal carotid artery in young women with polycystic ovary syndrome (PCOS) and polycystic ovaries (PCO). Methods. Twenty-eight patients with PCOS, 16 patients with PCO and 24 healthy control subjects were included in the study. Blood flow rate, pulsatility index and back pressure of both the medial cerebral artery and the internal carotid artery were determined by transcranial Doppler ultrasonography and the results compared between groups. Results. There were no significant differences between the groups in bilateral medial cerebral artery and internal carotid artery blood flow rate, pulsatility index and back pressure. Conclusion. Our results do not indicate whether the risk of cerebrovascular events will increase for PCOS patients in middle and advanced age, but do show that changes in cerebral hemodynamics are not likely in PCOS at an early stage.

Sympathetic skin response in premenstrual syndrome

Premenstrual syndrome is a term which includes a broad group of emotional, behavioral and physical symptoms that occur for several days before menses and subside following the menstrual period. Many women experience premenstrual syndrome symptoms, particularly physical ones such as breast tenderness and swelling. Approximately 5–10% women suffer from severe premenstrual syndrome and another 30–40% have moderate symptoms. Premenstrual syndrome continues to be an unsolved problem.In this study, we evaluated 24 premenstrual syndrome patients and 20 healthy women in the control group. The ages of the women were 22–34 years (mean ± SD: 25±3) for the premenstrual syndrome group and 23–34 (25±3) for the control group. The sympathetic skin response was recorded from the palms, soles and genital regions by using electrical stimuli to the median nerve at the wrist.The sympathetic skin response was recorded twice, in the follicular and late luteal phases of menstruation.The follicular and late luteal phase sympathetic skin response of the two groups were compared. The amplitudes and latency values of the late luteal and follicular phase sympathetic skin response from the premenstrual syndrome group and control group women were statistically similar. We also did not find any latency or amplitude difference in the sympathetic skin response obtained from the three regions of the premenstrual syndrome patients and the control group.We checked sympathetic skin response in the symptomatic (late luteal phase) and asymptomatic (follicular phase) periods of patients with premenstrual syndrome, a disorder known to have many autonomic symptoms, to determine whether there was sudomotor sympathetic involvement.The results of our PMS patients indicate at the very least that there is no difference with the control subjects as regards peripheral sudomotor functions.

Single-voxel magnetic resonance spectroscopy of brain tissue adjacent to arachnoid cysts of epileptic patients.

Intracranial arachnoid cysts (ACs) are usually asymptomatic, benign developmental anomalies. The most frequent clinical manifestations are cranial expansion, hydrocephaly, headache, epileptic seizures, psychomotor retardation, and aphasia. It is unknown whether there is a correlation between intracranial AC and epileptic seizures without obvious intracranial pressure signs. In vivo magnetic resonance spectroscopy is a technique used for the noninvasive investigation of the various metabolites of cerebral biochemical reactions. Magnetic resonance spectroscopy is also being used increasingly commonly in epileptogenic situations as a noninvasive technique. The purpose of this study was to evaluate the proton magnetic resonance spectroscopic pattern of the contents of tissue adjacent to AC and to determine whether there are any characteristic spectral patterns that may be helpful in evaluating whether these lesions are epileptogenic foci. In conclusion, although the number of cases was limited, this finding may be seen as indicating that there is no association between AC and epilepsy.