Ozge Yilmaz Kusbeci

The probable relation between Toxoplasma gondii and Parkinson's disease

Parkinsons disease (PD), a chronic progressive neurodegenerative disorder, has a mainly unknown multifactorial etiology. Neuroinflammatory mechanisms might contribute to the cascade of events leading to neuronal degeneration. Toxoplasmosis can be associated with various neuropsychiatric disorders. The most commonly affected central nervous system (CNS) region in toxoplasmosis is the cerebral hemisphere, followed by the basal ganglia, cerebellum and brain stem. Therefore, in this study, we aimed to investigate the possible association between Toxoplasma infection and PD by evaluating the serum anti-Toxoplasma gondii IgG antibodies. There were no difference between the socioeconomic status of the patients and control subjects and magnetic resonance images of the patients were normal. Serum anti-T. gondii IgG levels were measured using ELISA. There was no statistically significant differences among the patients and control subjects with respect to age (66.01+/-12.14 years, 62.42+/-5.93 years, p=0.089; respectively) and gender. The sero-positivity rate for anti-T. gondii IgG antibodies in PD patients and control groups were 42.3 and 22.5%, respectively, and they were statistically significant (p=0.006). These results suggest that Toxoplasma infection may be involved in the pathogenetic mechanisms of PD. If confirmed, this hypothesis would represent a valuable advancement in care of patients with Parkinsons disease.

Could Toxoplasma gondii have any role in Alzheimer disease

BackgroundAlzheimer disease (AD), a chronic progressive neurodegenerative disorder, has a mainly unknown multifactorial etiology. Neuroinflammatory mechanisms might contribute to the cascade of events leading to neuronal degeneration. Central nervous system infections have been previously suggested as possible etiological agents in the development of sporadic AD. Toxoplasmosis can be associated with various neuropsychiatric disorders. In this study, we aimed to investigate the possible association between toxoplasma infection and AD. MethodsThis study evaluated the serum anti-Toxoplasma gondii IgG levels. It included an age-matched and sex-matched study and control groups that consisted of 34 patients with AD and 37 healthy individuals, respectively. There were no difference between the socio economic states of the patients and control subjects. serecm anti – I – gondi IgG levels were measured by using ELISA. ResultsAccording to the statistical analysis, there were no significant differences among the patients and the control participants with respect to age (68.05±15.98, 62.91±5.89 y, P=0.072; respectively) and sex. The seropositivity rate for anti-T. gondii IgG antibodies among AD patients and control groups were 44.1% and 24.3%, respectively, and there was significant difference between the serum anti-T. gondii IgG levels (P=0.005). ConclusionsOur findings suggest that toxoplasma infection may be involved in the pathogenetic mechanisms of AD. If confirmed, a positive correlation between toxoplasmosis and AD may lead to new approaches for the management of AD.

Magnetic resonance imaging findings of shoulders in Parkinson's disease

The aim of this study is to evaluate shoulder disturbances in Parkinsons disease (PD) patients using magnetic resonance imaging (MRI) which is the best tool in the demonstration of complex shoulder pathologies; and to determine probable relations between shoulder pathologies and PD clinical features. Twenty‐eight PD patients with a total of 56 shoulders were used as the study group while 13 age‐matched cases with 26 shoulders were used as the control group (CG) in the study. Both patients with PD and the CG underwent shoulder MRI. The Hoehn and Yahr (H&Y) disability scale and Unified Parkinsons Disease Rated Scale (UPDRS) were used to determine the severity of the disease. Our results showed that patients with full‐thickness supraspinatus (SSP) tear have statistically significant higher UPDRS (P = 0.012), tremor (P = 0.023), rigidity (P = 0.023), and total (P = 0.002) scores. Mild group patients (P = 0.045) showed significantly higher frequency resting tremor and subcoracoid effusion than those of severe group patients (P = 0.002). Subcoracoid effusion was observed in patients with significantly higher UPDRS (P = 0.045) and rigidity (P = 0.022) scores. When the resting tremor and subcoracoid effusion groups were compared according to the severity of the resting tremor but not according to the H&Y, higher frequency of full‐thickness tear in SSP tendon was detected in the group of resting tremor (P = 0.053). Longer duration of disease was also observed in patients with full‐thickness SSP tear (P = 0.029) and acromioclavicular joint changes (P = 0.018). Higher UPDRS, tremor, rigidity and total scores and longer PD duration appear as the predisposing factors for the development of shoulder disturbances in PD in this study.

Evaluation of Cerebellar Asymmetry in Alzheimer's Disease: A Stereological Study

Objectives: Alzheimer’s disease (AD) is the most common cause of dementia and, as previous studies have indicated, degenerative changes in the cerebellum occur in AD. It is well known that the cerebellum does not have a symmetric morphology and some pathological disorders, such as schizophrenia, epilepsy, autism and alcoholism, can cause asymmetrical changes in the cerebellum. In this study, we aimed to evaluate whether or not patients with AD show cerebellar asymmetry. We also intended to depict the probable volumetric asymmetry by using a stereological technique. Materials and Methods: The study evaluated the volu- metric measurements of each cerebellar hemisphere by applying a stereological method to MR images. This age- and gender-matched study was composed of 15 patients with probable AD and 14 healthy subjects (controls). MR images were analyzed by using the point-counting approach, holding to Cavalieri’s principle. Results: Although there was significant cerebellar atrophy in AD patients, the study showed no statistically significant cerebellar asymmetry according to age and gender, both in the study and control groups (p > 0.05). Conclusions: There was no difference in cerebellar asymmetry associated with age and gender between the AD patients and control subjects. The stereological evaluation of cerebellar asymmetry correlating with gender is of importance to both clinicians and anatomists. The technique is simple, inexpensive, reliable and unbiased.

Conjunctival Flora in Patients with Parkinson's Disease

Purpose: To identify the conjunctival flora in patients with Parkinsons disease (PD) and compare it with the conjunctival flora of healthy subjects. Methods: One hundred six eyes of 106 patients with PD and 102 eyes of 102 age-matched healthy subjects were included in the study. All subjects had a detailed anterior segment examination, including eye blink rate and conjunctival cultures. Conjunctival cultures were taken with a sterile cotton-tipped dry swab without topical anesthesia. The culture samples were inoculated onto 5% sheep blood agar and chocolate agar, as well as brain heart infusion broth. The bacterial growth was evaluated in a quantitative manner as colony-forming units (CFU). All bacterial isolates were identified, and statistical analyses were performed by chi-square test to determine if there were differences in flora between PD and control groups. Results: Eighty-six (81.1%) of the 106 eyes in patients with PD and 73 (71.5%) of the 102 eyes in control group were found to have positive conjunctival cultures (p = 0.144). Coagulase-negative Staphylococcus was the most commonly isolated bacterial species in both groups, found in 45 (42.4%) and 49 (48%) of eyes in patients with PD and control group, respectively (p = 0.503). Among all bacterial isolates, only Staphylococcus aureus was found to be statistically different between the two groups, noted in 32 (30.1%) and 10 (9.8%) of eyes in patients with PD and control group, respectively (p = 0.001). Conclusions: Coagulase-negative Staphylococcus, Staphylococcus aureus, and Corynebacterium species were the most commonly isolated bacterial species in the PD group. Among all bacterial isolates, only Staphylococcus aureus was significantly higher in the conjunctival flora of patients with PD than in those in the control group.

Stereological Evaluation of the Optic Nerve Volume in Alzheimer Disease.

AbstractOptic nerve damage occurs in Alzheimer disease (AD) related to the loss of the retinal ganglion cells that contribute fibers to the optic nerve and reduction of the density of axons of the optic nerve. In this study the authors evaluated optic nerve volume changes and the relation between the cerebrum and optic nerve volumes in AD patients.The study evaluated the volumetric measurements of optic nerve by applying the stereological method on magnetic resonance images (MRI). It included age-matched study and control groups, which were composed of 20 patients with probable AD and 20 healthy subjects, respectively. MRIs were analyzed by using the point-counting approach holding Cavalieri principle.There were statistically significant optic nerve volume reduction and cerebral atrophy in AD patients when compared with the age-matched control subjects (P = 0.013, P < 0.001, respectively) but there was no correlation between the optic nerve volume and cerebral volume in AD patients (r = 0.326, P = 0.160).There was a difference between optic nerve volumes of AD and control subjects. The stereological evaluation of optic nerve volume is of importance for both clinicians and anatomists and it can provide valuable information in the evaluation of morphological changes of AD in vivo.

Morphometric Analysis of Hemicerebellar Asymmetryn with Central Vertigo Cases: A Stereological Study

Nuestro objetivo fue evaluar los metodos relevantes de estereologia para estimar la asimetria hemicerebellar segun el genero, tanto en adultos diestros, casos de vertigo y al compararlos con casos control. El estudio incluyo a 14 sujetos adultos como control y 18 pacientes con vertigo. Los volumenes de los hemisferios del cerebelo se determinaron en la RM utilizando el recuento de los puntos del metodo de estereologia. La media (± DE) de los hemisferios derecho del cerebelo en los pacientes con vertigo fueron 52,49 ± 5,42 cm3 en los hombres, 50,11 ± 4,02 cm3 en las mujeres. La media (± DE) de los hemisferios izquierdo del cerebelo en los pacientes con vertigo fueron 53,11 ± 3,70 cm3 en los hombres, 49,73 ± 4,69 cm3 en las mujeres. No hubo evidencia cuantitativa importante detectada en cuanto a la asimetria entre las estimaciones del cerebelo entre plano sagital en los casos con vertigo en ambos sexos (p> 0,05). No hubo diferencias estadisticamente significativas segun los generos entre ambos el vertigo y los sujetos control (p> 0,05). Solo hubo significancia estadistica entre los hemisferios derecho e izquierdo en los sujetos control masculino (p = 0,039). No hubo asimetria entre el cerebelo control y de los casos el vertigo de acuerdo a los generos. La evaluacion de la asimetria estereologica o atrofia del cerebelo en el ser humano se correlaciona con el genero es de importancia para los clinicos y anatomicos. La tecnica es simple, confiable, de bajo costo e imparcial.

An evaluation of neuropsychiatric symptoms in Parkinson's disease patients

Objective: We aimed to examine neuropsychiatric symptoms of patients with early and advanced stage Parkinsons disease (PD). Materials and Methods: The study was performed at Kocatepe University Neurology Department in Turkey, comprised 46 PD patients and 46 controls. Hoehn-Yahr (HY) scale was used to evaluate the clinical stages of PD and Unified Parkinsons Disease Rating Scale (UPDRS) was used to evaluate the severity of clinical signs. Cognitive functions were evaluated by Mini-Mental State Examination (MMSE) and neuropsychiatric findings were evaluated by Beck Depression Inventory (BDI), Scale for the Assessment of Positive Symptoms (SAPS), and Scale for the Assessment of Negative Symptoms (SANS). Results: Significant difference was determined between BDI values of patients (13.28 ± 9.04) and control group (9.71 ± 5.19) (P = 0.02). Significant difference was determined with SANS (23.84 ± 15.42, 2.58 ± 3.13, P < 0.001) but not with SAPS (1.36 ± 4.16, 0.15 ± 0.43, P = 0.07). The patients were evaluated according to the HY stages and there was no significant difference between mild and severe symptom groups in respect of BDI, SAPS, and SANS values (P = 0.91, P = 0.31, and P = 0.29). According to gender, no significant difference was found between groups in respect of BDI, SAPS, and SANS values (P = 0.60, P = 0.54, and P = 0.67). No correlation was found between BDI, SAPS, SANS values, and HY stages. Conclusion: Higher rates of depression and negative symptoms were observed in patients with PD compared with healthy individuals. Results did not differ with different stages of PD. Therefore, it should be kept in mind that neuropsychiatric symptoms can be seen from the early stages of the disease and should be treated earlier.

FPL tendon thickness, tremor and hand functions in Parkinson’s disease

Abstract Introduction In Parkinson’s disease (PD), a resting tremor of the thumb may affect the flexor pollicis longus (FPL) and influence hand functions. We investigated the relationship between FPL tendon thickness and hand function in PD patients and compared these characteristics with those in healthy controls. Methods The hand grip and pinch strengths were measured. The participants completed the Duruöz hand index, the Sollerman’s hand function test, and the Nine Hole Peg Test. The thickness of the FPL tendon was measured using ultrasonography Results The FPL tendon was thicker in PD patients but was not associated with tremor severity. In PD patients, despite functional performance of the hands are impaired and grip strength is decreased, pinch strengths are preserved. FPL thickness was not correlated with grip and pinch strengths. Conclusion The thicker FPL tendon may be associated with greater pinch and grip strengths and manual dexterity in healthy individuals. The presence of tremor is associated with a thicker FPL tendon.