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Öğe Auditory P300 event-related potential in tobacco smokers(ELSEVIER SCI LTD, 2009) Guney, Figen; Genc, Bulent Oguz; Kutlu, Ruhusen; Ilhan, Bilge CetinThe aim of this study was to elucidate the chronic effects of tobacco smoking on the P300, a neurophysiological index of cognitive function. Prospective study participants were recruited from a family medicine polyclinic. We selected 32 right-handed smokers who had smoked more than 15 cigarettes per day, by inhalation, for more than 2 years. The control population consisted of 32 right-handed, age-matched healthy individuals who had never smoked. Event-related potentials (ERPs) were recorded with the auditory "oddball" two-tone discrimination task. The data from the central (Cz) and frontal (Fz) electrodes were analyzed. The P300 and NI amplitudes at Fz were lower in the study population compared to the control group. The early component of ERP, the measure of mental speed (N1) latency at Fz was prolonged in the study group compared to the controls, possibly because early cognitive processes such as sensory input or initial encoding of sensory information were delayed in this group. For those who smoke, a decreased NI amplitude might indicate delayed information processing and possibly short-term memory disturbance. Thus, chronic tobacco smoking may produce prefrontal cognitive dysfunction. (C) 2009 Elsevier Ltd. All rights reserved.Öğe Blink Reflex Alterations in Chronic Renal Failure(AVES, 2012) Kozak, Hasan Huseyin; Demir, Orhan; Guney, FigenObjective: The purpose of this study was to investigate the effects of hemodialysis and peritoneal dialysis on the peripheral and central nervous system in patients with uremia associated with chronic renal failure. Method: In this study, 35 hemodialysis and 35 peritoneal dialysis patients were compared with 70 healthy controls by working in blink reflex after assessment of peripheral neuropathy by neurological examination and performing EMG. Results: Ipsilateral R2 (R2i) and contralateral R2 (R2c) response latencies were found to be significantly prolonged in patients with chronic renal failure compared to those of controls. Also, latencies of R2 responses in hemodialysis patients, in whom polyneuropathy was detected, were significantly longer than those of the peritoneal dialysis patients, while latencies of R1 responses were unaffected. Conclusion: For extraaxial lesions, R2 is less sensitive than R1, but in intraaxial lesions abnormality of R2 is as frequent as short latency responses, the R2 being more complex and spreads to the caudal medulla. Hence, in chronic renal failure patients sparing of the R1 and prolongation of the R2 indicates a subclinical intraaxial involvement. There was no significant difference in R1, R2i and R2c values between peritonal dialysis patients with polyneuropathy and controls. R1 values in hemodialysis patients with polyneuropathy were found to be within normal range while R2i and R2c values were significantly prolonged when compared to controls; suggesting that intraaxial subclinical involvement is more frequently seen in hemodialysis patients. (Archives of Neuropsychiatry 2012; 49: 102-107)Öğe Blink reflex alterations in diabetic patients with or without polyneuropathy(TAYLOR & FRANCIS LTD, 2008) Guney, Figen; Demir, Orhan; Gonen, Mustafa SaitThe main aim of this study is to evaluate the role of blink reflex for early diagnosis of cranial neuropathy in diabetic patients with or without polneuropathy. Ninety-five diabetic patients were included in the present study for the evaluation of blink reflex. The diabetic patients were divided into two groups according to having diabetic neuropathy or not. Both R1, R2i and R2c latencies in all diabetic patients with or without polyneuropathy were prolonged relative to controls and the differences were statistically significant (p < .001). R1 latencies in diabetic patients with polyneuropathy were prolonged relative to diabetic patients without polyneuropathy and the differences were statistically significant (p < .001). These findings presumably reflect that facial nerve is severly involved in diabetic polyneuropathy. Finally blink reflex is of value in detection of clinically silent intraaxial brainstem functional abnormalities or extraaxial lesions in diabetic patients before peripheral neuropathy.Öğe Correlation with Neuropsychological Tests and Movement Related Cortical Potentials in Assesing Mild Cognitive Impairment and Middle Stage Alzheimer's Disease(GALENOS YAYINCILIK, 2013) Mutluer, Muzaffer; Guney, Figen; Ilhan, SuleymanObjective: Alzheimer's disease (AD), the most common cause of dementia, has become an important public health issue. There is no definite cure for AD, however, early diagnosis can slow the course of the disease. Mild cognitive impairment (MCI) is a clinical entity defined as the transition between dementia and normal aging in which memory and other cognitive abilities can be affected. MCI is an active process that can convert to different forms of dementia at a rate of approximately 15% per year. Currently, the use of electrophysiological techniques in diagnosing and clinical monitoring of MCI and AD, and during the clinical course of progression from MCI to AD, is limited as compared with structural and functional imaging techniques. In the current study, we aimed to demonstrate that the movement-related cortical potential (MRCP) test is an electrophysiological test that can be used in the above-mentioned conditions. Methods: In the current study, MRCPs were recorded in 20 patients diagnosed with AD according to the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria and, 20 patients diagnosed with MCI according to the Petersen criteria, by using a neuropsychological battery, including the mini-mental state examination, verbal memory processes test, clock-drawing test, geriatric depression scale, Stroop test, functional activities questionnaire, Benton facial recognition test, and the global deterioration scale. Latency and amplitude values of the MRCPs in patients were compared with latency and amplitude values of the MRCPs in 25 normal control cases. Results: Comparison of the AD, MCI and control groups revealed that MRCP wave occurred later in the MCI group than in the control group, and occurred later in the AD group than in the MCI group. Motor potential (MP) amplitude in the AD group was lower as compared with the MCI and control groups. Conclusion: In conclusion, the MRCP test can be used as an electrophysiological test in the diagnosis and monitoring of AD as well as in the monitoring of the clinical course of progression from MCI to AD. (Archives of Neuropsychiatry 2013; 50: 9-14)Öğe Cross-Over, Open-Label Trial of the Effects of Gabapentin versus Pregabalin on Painful Peripheral Neuropathy and Health-Related Quality of Life in Haemodialysis Patients(ADIS INT LTD, 2013) Atalay, Huseyin; Solak, Yalcin; Biyik, Zeynep; Gaipov, Abduzhappar; Guney, Figen; Turk, SuleymanPainful peripheral neuropathy (PPN) is common in haemodialysis patients and associated with impaired health-related quality of life (HR-QoL). Gabapentin and pregabalin have not been fully investigated in haemodialysis patients. Therefore, we compared the effects of gabapentin and pregabalin on intensity of pain and associated HR-QoL in haemodialysis patients with PPN. Gabapentin and pregabalin were administered after each haemodialysis session at doses of 300 and 75 mg, respectively. Patients were randomized into two groups; after 6 weeks patients underwent a 2-week washout and crossover and received another 6 weeks of treatment. All patients underwent electromyography at the outset. The short-form McGill pain questionnaire (SF-MPQ) for assessment of pain, and short-form medical outcomes study for assessment of HR-QoL at baseline and at the end of the study were applied. Forty patients completed the 14-week study period. Gabapentin and pregabalin significantly improved SF-MPQ total scores compared with pretreatment values (mean +/- A SD) [from 18.9 +/- A 4.3 to 9.3 +/- A 4.3 for gabapentin, p < 0.001, and from 18.5 +/- A 3.9 to 9.8 +/- A 3.6 for pregabalin, p < 0.001]. There was no significant difference between the study drugs in terms of efficacy against neuropathic pain (p > 0.05). Both gabapentin and pregabalin significantly improved HR-QoL at the end of the study compared with pretreatment scores (p < 0.001). Our results showed strong efficacy of gabapentin and pregabalin on pain intensity in the given doses. HR-QoL was also significantly improved by both drugs.Öğe Digital Neuropathy of the Median and Ulnar Nerves Caused by Dupuytren's Contracture Case Report(LIPPINCOTT WILLIAMS & WILKINS, 2009) Guney, Figen; Yuruten, Betigul; Karalezli, NazimIntroduction: Digital neuropathy is a pure sensory neuropathy of a digital nerve. It may be caused by acute or chronic local trauma or pressure, or accompany systemic illnesses such as rheumatoid disease, leprosy, Raynaud disease, dysproteinemia, or diabetes mellitus. We describe an extraordinary case of digital neuropathy of the median and ulnar nerves caused by Dupuytren contracture. Case Report: A 56-year-old right-handed man was presented with numbness and tingling of the little finger of the right and ring finger of the left hand. The clinical and EMG findings in this patient were consistent with a lesion of the median and ulnar palmar digital nerves of the right and left ring and little fingers. Conclusion: Dupuytren tissue usually affects: the palmar fascia, superficial to the digital nerves, and it may rarely affect the spiral cord in the digits. A spiral cord may cause sensory loss due to impingement of digital nerves or Dupuytren tissue may have been compressing the palmar digital nerves against the relatively inelastic deep transverse metacarpal ligament. As a result, digital neuropathy can develop in those with Dupuytren's contracture, and nerve conduction studies should also be performed to determine the condition. New Studies are needed to provide better diagnostic criteria for the condition.Öğe First case report of neurobrucellosis associated with hydrocephalus(ELSEVIER SCIENCE BV, 2008) Guney, Figen; Gumus, Haluk; Ogmegul, Aysegul; Kandemir, Bahar; Emlik, Dilek; Arslan, Ugur; Tuncer, InciBrucellosis is a common zoonosis in many parts of the world, including Mediterranean and Middle Eastern countries. The disease is primarily related to occupations at risk, such as veterinarians, farmers, laboratory technicians, abattoir workers, and others working with animals and their products. Neurologic complications of brucellosis are quite rare, ranging from 1.7 to 10% of those infected. To date, no cases of neurobrucellosis with hydrocephalus have been reported. A 38-year-old right-handed farmer complained of headaches, nausea, vomiting, gait disturbance, and sweating for 2 days. He also complained of bilateral hearing loss of 4 months duration. On neurologic examination, dysmmetry, dysdiadochokinesis, ataxia on the left, and bilateral sensorineural hearing loss existed. On cranial MRI, a communicating hydrocephalus was noted. Because the patient consumed fresh sheep cheese and was a farmer, brucellosis was considered in the differential diagnosis. Brucella agglutination was positive with a 1/320 titer in the blood and a 1/80 titer in the cerebrospinal fluid. Ceftriaxone, doxycycline, and rifampicin were administered and by the fourth week of treatment, the ataxia was markedly improved, and the patient was able to walk without support. His cranial MRI demonstrated a total regression of the hydrocephalus. As a result, we suggest that neurobrucellosis should be considered in patients with hydrocephalus, especially if they live in an endemic area for brucellosis, even in the absence of other systemic signs. (c) 2008 Elsevier B.V. All rights reserved.Öğe Gabapentin versus pregabalin in improving sleep quality and depression in hemodialysis patients with peripheral neuropathy: a randomized prospective crossover trial(SPRINGER, 2013) Biyik, Zeynep; Solak, Yalcin; Atalay, Huseyin; Gaipov, Abduzhappar; Guney, Figen; Turk, SuleymanIn dialysis patients, painful peripheral neuropathy (PPN) is associated with sleep disturbance and mood disorders. Our goal was to compare the effects of gabapentin and pregabalin on improving sleep quality and depression among hemodialysis patients with PPN. Fifty hemodialysis patients with PPN were randomized into 2 groups, to receive gabapentin and pregabalin, respectively. After 6 weeks of treatment, patients underwent a 2-week washout period, followed by crossover and another 6 weeks of treatment. All patients underwent electromyography (EMG) at the outset and completed the modified Short Form of McGill Pain Questionnaire (SF-MPQ), the Beck Depression Inventory (BDI) and the Pittsburgh Sleep Quality (PSQI) assessment at baseline and at the end of the study. Forty out of 50 patients completed the 14-week study period. Thirty-one out of 40 patients (77.5 %) had EMG-proven PPN. Both gabapentin and pregabalin significantly improved SF-MPQ, BDI and PSQI scores at the end of the study compared with pretreatment scores (p < 0.001). There was no significant difference between the two drugs in any studied parameter. Our results showed for the first time a good and similar efficacy of both drugs on pain intensity, quality of sleep and depression in hemodialysis patients with PPN.Öğe Serum Neuroinflammatory Markers' Levels and Evaluation of Peripheral Large Nerve Fibre Function in Patients with Psoriasis(GALENOS YAYINCILIK, 2016) Balevi, Ali; Ozdemir, Mustafa; Guney, Figen; Tol, Huseyin; Okudan, Nilsel; Belviranli, Muaz; Sahin, Kemal TahirObjective: Currently, tumor necrosis factor-alpha (TNF-alpha) inhibitors are widely used all over the world, especially in the treatment of severe psoriasis. However, multiple sclerosis (MS) and peripheral neuropathy occurrence associated with TNF-a inhibitors have been reported in the treatment of patients with psoriasis. It is not known whether TNF-a inhibitors reveal underlying neurological disorders in patients with psoriasis. The aim of this study was to investigate whether there is an association between psoriasis and MS or peripheral neuropathy. Methods: In this study, 50 psoriasis patients and 25 healthy controls were enrolled. Neurological examination and needle electromyography test were performed. Serum levels of matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), S-100 calcium-binding protein (S100B) and neuron specific enolase (NSE), which are involved in neuroinflammatory process, were measured. Results: Serum MMP-9 levels were higher in psoriasis patients compared to healthy controls. Serum MMP-2 and NSE levels were decreased in psoriasis patients compared to healthy controls. There was no significant difference in S100B levels between two groups. All neurophysiological parameters in each individual patient and control were found to be within normal limits and there was no difference between groups. Conclusion: NSE and MMP-9 might play role in the occurrence of MS in psoriasis patients. Especially, we are in the opinion that it might be useful to measure the serum levels of these markers before the administration of TNF-a inhibitors in psoriasis patients with family history of MS.Öğe Treatment of Faun-Tail Naevus with Intense Pulsed Light(MARY ANN LIEBERT INC, 2010) Ozdemir, Mustafa; Balevi, Ali; Engin, Burhan; Guney, Figen; Tol, HueseyinBackground: Faun tail is a rare cutaneous marker of spinal dysraphism. This neurological abnormality may lead to difficulties such as severe pain and burning sensations in treatment of hypertrichosis of faun tail with laser or laser-like devices. Objective: We evaluated outcomes of an intense pulsed light source in two patients with faun tail. Methods: The Lumina intense pulsed light system [650-nm handpiece (550-1100 nm)] was used for the treatment. Magnetic resonance imaging and neurological examination were done. Results: Tethered cord syndrome was detected as a neurological abnormality. The patients were treated with an energy fluence of 18-26 J/cm(2), pulse sequencing of 3 to 4, and a delay time of 20-35 ms. Local anesthesia was applied in one patient during treatment for severe pain sensation. A mean of 85% hair reduction was achieved. Conclusion: A good cosmetic result with intense pulsed light treatment was achieved in the patients with faun tail. Local anesthesia may be required before treatment of faun tail with laser or laser-like systems due to associated neurological abnormalities.
