Nedim Ongun

Ocular pulse amplitude and retina nerve fiber layer thickness in migraine patients without aura

BackgroundTo evaluate the ocular pulse amplitude (OPA), the posterior pole asymmetry analysis (PPAA), the peripapillary retinal nerve fiber layer (RNFL) thickness, the ganglion cell layer (GCL) thickness, macular thickness and visual field testing in migraine patients without aura.MethodsIn this prospective, cross-sectional and comparative study 38 migraine patients and 44 age and sex matched controls were included. OPA was measured by dynamic contour tonometry (DCT), PPAA, RNFL, GCL and macular thickness were measured by Heidelberg Spectral Domain Optical Coherence Tomography (SD-OCT) and standard perimetry was performed using the Humphrey automated field analyzer.ResultsThe difference in OPA was not statistically significant between the two groups (p ≥ 0.05). In the PPAA there was no significant difference between two hemispheres in each eye (p ≥ 0.05). The RNFL thickness was significantly reduced in the temporal and nasal superior sectors in the migraine group (p ≤ 0.05). The GCL and macular thickness measurements were thinner in migraine patients but the difference between groups was not statistically significant (p ≥ 0.05). There was no correlation between RNFL, GCL, macular thickness measurements and OPA values. There was no significant difference in the mean deviation (MD) and pattern standard deviation (PSD) between the two groups (p ≥ 0.05).ConclusionsMigraine patients without aura have normal OPA values, no significant asymmetry of the posterior pole and decreased peripapillary RNFL thickness in the temporal and nasal superior sectors compared with controls. These findings suggest that there is sectorial RNFL thinning in migraine patients without aura and pulsative choroidal blood flow may not be affected during the chronic course of disease.

A Bibliometric Analysis of Optic Coherence Tomography Studies in Multiple Sclerosis

Objective: Optical coherence tomography (OCT) is a non-invasive, non-contact diagnostic tool that provides high-resolution cross-sectional images of the retina that has been used for ten years in multiple sclerosis (MS) related optic neuropathies. The objective of this study is to determine the scientific output in use of OCT in multiple sclerosis between 1982 and 2012 using ISI Web of Knowledge. Methods: The ISI Web of Knowledge was searched for articles on OCT published between 1982 and February 2012 using appropriate terms. Articles were characterized each year by publication type. Results: Search yielded 154 publications after the search for keywords “optical coherence tomography and multiple sclerosis and 167 publications after the search for the keywords “optical coherence tomography and optic neuritis”. After eliminating the conflicting publications total 193 publications were analyzed. A cubic increase in the number of publications over time was observed. Conclusions: The number of scientific publications in the field of OCT in MS has increased significantly over the past years. The United States, England and Spain have dominated the field of OCT in MS.

Mi a pregabalin valódi hatása diabeteses neuropathiás fájdalom esetén? (Kevesebb fájdalommal küzdenek a betegek vagy kevésbé zavarja őket a fájdalom?)

Background and purpose Depression and anxiety are frequent in patients with chronic diseases such as diabetic neuropathic pain. The pain seems to be more severe in patients in whom depressive findings accompanied pain symptoms. Pregabalin was reported to have positive effects on anxiety and depression. This brings out the question, whether the pain relief effect of pregabalin is due to its analgesic effect or to its effects on mood? The aim of this study is to find out whether the positive effect of pregabalin in patients with diabetic neuropathic pain is limited to its effect on pain. Thus the question - do patients suffer from less pain or do they less care about pain? - should be answered. Methods With this aim the NRS scores of 46 patients with diabetic neuropathic pain, whose HADS scores did not change with pregabalin treatment were compared with their baseline levels, retrospectively. Results The NRS scores of the group were reduced with pregabalin treatment. Conclusion This results suggests that the reduced pain in pregabalin treatment should be independent from its effects on depression and anxiety.

Comparison of the Nerve Conduction Parameters in Proximally and Distally Located Muscles Innervated by the Bundles of Median and Ulnar Nerves

Objective: The aim of this study was to investigate and compare the conduction parameters of nerve bundles of median and ulnar nerves that innervate proximal and distal muscles. Subjects and Methods: Thirty male and 30 female healthy volunteers between 18 and 70 years of age were enrolled in the study. The conduction parameters were recorded from the proximally located flexor carpi ulnaris, pronator teres and the flexor carpi radialis muscles to the distally located abductor digiti minimi and abductor pollicis brevis muscles for the ulnar and median nerves. Each nerve was stimulated at the region above the elbow and at the axillary region separately. The Student t test was used for statistical analysis, and Levenes test was used to assess whether or not the group variances exhibited a uniform distribution. Results: The conduction velocities were faster (78.27 ± 6.55 vs. 67.83 ± 6.76 m/s, and 74.57 ± 5.66 and 74.23 ± 5.88 vs. 66.38 ± 6.85 m/s) and the durations of compound muscle action potential (CMAP) response were longer (15.65 ± 2.43 vs. 13.55 ± 1.78 ms, and 16.38 ± 2.39 and 16.04 ± 2.34 vs. 13.40 ± 1.79 ms) in proximally located muscles than in distally located muscles that are innervated either by ulnar or median nerves (p < 0.001). However, the CMAP amplitudes were smaller (2.52 ± 1.16 vs. 5.81 ± 3.13 mV, and 2.90 ± 1.20 and 3.59 ± 1.66 vs. 6.88 ± 2.77 mV) in proximal muscles than in distal muscles (p < 0.001). There was no significant difference (p > 0.05) between males and females regarding conduction velocities and CMAP amplitudes recorded from proximal and distal muscles. Conclusion: Proximal muscles innervated by median or ulnar nerves had lower CMAP amplitude values, longer CMAP durations and higher conduction velocities than distal muscles. These findings could reveal a temporal dispersion and phase cancellation due to desynchronized conduction during nerve stimulation.

An alternative nerve conduction study method to evaluate early diabetic neuropathy: Ratio of different diameter nerve fibers in peroneal nerve

Different nerve fibers may have disparate conduction parameters even though they are in the same peripheral nerve. Hyperglycemia can have differential effects on nerve fibers, depending on diameter. In diabetes, conventional nerve conduction studies have allowed us to classify a peripheral nerve as normal or not. But, there may be differential involvement in disparate nerve fibers of the same peripheral nerve. This study evaluated the effects of hyperglycemia on nerve fibers of peroneal nerve by diameter. Thirty-five diabetic patients with normal nerve conduction studies and thirty-two healthy controls were included to the study. The peroneal nerve was stimulated from two points (upper and below the fibula head) and recorded from the tibialis anterior (TA) and extensor digitorum brevis (EDB) muscles. Then the ratios of conduction velocity parameters recorded in these sides were compared between the diabetic and control groups. The conduction velocity recorded from EDB seemed to be faster in both groups. But there were no significant differences among the ratios between the groups. Our study has demonstrated the conduction parameters of two nerve fibers with different diameters in the peroneal nerve. The ratios of conduction parameters were similar in both groups, suggesting that fibers in the peroneal nerve are similarly affected by hyperglycemia.