Browsing by Author "Idiman, Fethi"

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Effects of Body Temperature Lowering on Visual Evoked Potentials in Patients with Multiple Sclerosis
(2021) Poyraz, Turan; Idiman, Fethi; Keskin, Ahmet Onur; Karaoglan, Leyla Iyilikci; Idiman, Egemen
Objective: Aggravation of neurologic symptoms in patients with multiple sclerosis (MS) due to heating is well known. This phenomenon, known as Uhthoff phenomenon (UP), is explained by transient conduction block in demyelinated nerve fibers and transected axons. The threshold of conduction block dependent on temperature is probably proportional to the degree of demyelination or axonal injury. On the other hand, about half of all patients reported improvement in a cold bath (anti-UP effect). This study aimed to assess the effects of body cooling on clinical parameters lneuro-opthalmologic examination and contrast sensitivity in visual acuity/Sloan letter rest, and the Expanded Disability Status Scale (EDSS)] and electrophysiologic measurements [visual evoked potentials (VEP)] in patients with MS previously clinically affected by optic neuritis. Materials and Methods: Twenty patients who described a UP or anti-UP effect with definite MS according to the McDonald and Poser criteria were enrolled in the study. Before the cooling process, all patients with a history of optic neuritis (at least once) were examined clinically, neurologically and neuro-ophthalmologically, and electrophysiologically. Body cooling was achieved using a "Medivance Arctic Sun Temperature Management System" and the body temperature was decreased by about 1 degrees C. After that, all patients were re-evaluated clinically and electrophysiologically. Results: After the cooling process, P100 latency significantly shortened at the 1st, 6th and 24th hours (p<0.001, p<0.001, p<0.001) and EDSS scores improved significantly (p<0.001). Visual acuity, including contrast sensitivity and color vision, significantly improved in both affected and unaffected eyes (p<0.001). Conclusion: These results suggest that heat caused a conduction block in demyelinated or transected axons in the visual pathways. Our results also demonstrate that the cool: o process had beneficial effects on clinical disability scores (EDSS) and the visual system based on clinical and electrophysiologic (VEP) evaluations. These find suggest that the cooling process may be used for symptomatic therapy and increasing life quality of patients with MS.
Evaluation of Diffusion Tensor Imaging Findings in Clinically Isolated Syndrome and Relapsing-Remitting Multiple Sclerosis Patients
(2023) Alatas, Ozkan; Cavusoglu, Berrin; Caylak, Ali; Keskin, Onur; Idiman, Egemen; Idiman, Fethi; Ada, Emel
Objective: To compare diffusion tensor imaging (DTI) findings of the normal-appearing white matter (NAWM) and corpus callosum (CC) in patients with clinically isolated syndrome (CIS) and relapsing-remitting multiple sclerosis (RRMS) and a healthy control (HC) group. Materials and Methods: The CIS (n = 10), RRMS (n = 29), and HC (n = 13) groups were evaluated by DTI in this retrospective study. Mean diffusion (MD) and fractional anisotropy (FA) maps as well as MD and FA measurements were made from the corpus callosum genu (CCG), corpus callosum splenium (CCS), and NAWM areas from the frontal, parietal, occipital and temporal lobes. Results: The mean FA values of the NAWM in the temporal lobes were bilaterally lower in both the CIS and RRMS groups than in the HC group. However, no difference was found between the CIS and RRMS groups. In addition, the CIS group had lower FA values in the CCG, whereas the RRMS group had lower FA values in the CCS compared with the HC group. The MD values were significantly different in the CCG between the RRMS and HC groups. Conclusion: DTI contributes to detecting early changes in the NAWM and CC in patients diagnosed with CIS and RRMS. Additionally, DTI can aid in the follow-up care and management of these patients.
Importance of Optical Coherence Tomography Angiography in Differential Diagnosis of NMOSD and RRMS
(2019) Tiftikcioglu, B. Irem; Emre, Sinan; Idiman, Fethi; Idiman, Egemen
Optical Coherence Tomography Angiography (OCTA) In Differential Diagnosis Of Aquaporin-4 Antibody Seronegative NMOSD And Multiple Sclerosis
(2022) Tiftikcioglu, Bedile Irem; Emre, Sinan; Idiman, Fethi; Idiman, Egemen; 35030370
Backround: Optic neuritis(ON) is a common feature of both relapsing-remitting multiple sclerosis(RRMS) and neuromyelitis optica spectrum disorders(NMOSD). It is crucial to early differentiate these two diseases, as they differ in pathophysiology and treatment.& nbsp;Objective: To compare NMOSD and RRMS patients using optical coherence tomography(OCT) and OCT angiography(OCTA) to assess retinal microvascular network differences.& nbsp;Methods: Fourteen RRMS (28 eyes) and 9 NMOSD patients(18 eyes), and 11 controls were enrolled. Seropositivity for aquaporin-4 antibody (anti-AQP4 Abs) was 44.4%. Peripapillary and macular retinal nerve fiber layer (RNFL) thickness, superficial peripapillary and macular vessel density(VD), area, perimeter and circularity of foveal avascular zone(FAZ) were analyzed.& nbsp;Results: OCTA showed reduction in peripapillary and macular VD and FAZ size in NMOSD+ON compared to RRMS+ON and controls (p = 0.001, p < 0.001 and p = 0.010, p < 0.001 respectively). Peripapillary VD was similar in RRMS +ON and controls. Peripapillary VD in monophasic seronegative NMOSD+ON eyes was significantly lower than monophasic RRMS+ON eyes (p = 0.030), which was no different from controls. FAZ area was smaller in unaffected eyes in NMOSD than RRMS and controls.& nbsp;Conclusions: Both OCT and OCTA revealed considerable differences between RRMS and NMOSD patients, providing promising results in favor of clinical utility of OCTA in differential diagnosis of ON, particularly in antiAQP4 antibody negative patients. OCTA might be a useful biomarker in differentiating NMOSD from MS.