Browsing by Author "Kibaroglu, Seda"

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Aspirin Resistance in Cerebrovascular Disease and the Role of Glycoprotein IIIa Polymorphism in Turkish Stroke Patients
(2016) Derle, Eda; Ocal, Ruhsen; Kibaroglu, Seda; Celikkol, Ceyda; Bayraktar, Nilufer; Verdi, Hasibe; Atac, Belgin F.; Can, Ufuk; https://orcid.org/0000-0002-3964-268X; https://orcid.org/0000-0002-7886-3688; https://orcid.org/0000-0003-0591-009X; https://orcid.org/0000-0001-6868-2165; https://orcid.org/0000-0001-8689-417X; 26809135; V-3553-2017; AAJ-2956-2021; Y-8758-2018; V-5499-2017; ABG-9966-2020; AAJ-2999-2021
Aspirin resistance occurs in 5-45% of high-risk patients, with various mechanisms proposed for its development. This study aimed to determine the relationships among aspirin resistance, aspirin dosage, type of aspirin and glycoprotein IIIa P1A1/A2 polymorphism in patients with vascular risk factors. Two hundred and eight (75 symptomatic, 133 asymptomatic) patients with vascular risk factors who were using aspirin for primary or secondary prevention were prospectively included. The symptomatic group was further classified into two groups according to aspirin use at the time of stroke. Aspirin resistance was measured by the PFA-100 system (collagen/epinephrine cartridge) and glycoprotein IIIa P1A1/A2 polymorphism was determined by PCR. The overall prevalence of aspirin resistance was 32.2%. The mean age of patients with aspirin resistance was significantly higher than that in those who did not have resistance (P=0.009). The prevalence of aspirin resistance was similar for the symptomatic and asymptomatic under aspirin therapy groups. The resistance rate was found to be highest with 100mg enteric-coated preparation use (39.3%). Increasing the aspirin dosage and/or shifting to uncoated preparations caused a change in aspirin sensitivity of 36-60%. Repeated measurements showed development of aspirin resistance in 14% of patients who were sensitive to aspirin in previous measurements. Glycoprotein IIIaP1A1/A2 polymorphism, aspirin resistance and development of atherothrombotic stroke were not significantly related. The effect of aspirin can change by time, dosage and type of preparation used. There are no relationships among glycoprotein IIIa P1A1/A2 polymorphism, aspirin resistance and development of atherothrombotic stroke. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.
The Assessment of Efficiency of Traditional and Complementary Medicine Practices in Neurology
(2018) Kibaroglu, Seda; Caglayan, Hale Zeynep Batur; Ataoglu, Esra Erkoc
Traditional, complementary, and alternative medicine practices are used in the prevention, diagnosis, and treatment of a wide variety of diseases in the world. Such practices in Turkey are regulated by the "Regulation of Traditional and Complementary Medicine Practice" issued by the Ministry of Health in the Official Gazette of the Republic of Turkey (Issue: 29158, 27th October 2014). The appendix of this regulation defines 15 practices that can be applied in units and practice centers. These applications include; 1. Acupuncture, 2. Apitherapy, 3. Phytotherapy, 4. Hypnosis, 5. Leech therapy (Hirudotherapy), 6. Homeopathy, 7. Chiropractic, 8. Cupping, 9. Maggot therapy, 10. Mesotherapy, 11. Prolotherapy, 12. Osteopathy, 13. Ozone therapy, 14. Reflexology, and 15. Music therapy. In this review, the indications of these 15 applications in the field of neurology are examined and current opinions of the evidence-based medical data are summarized.
A Case of Transient Visual Field Defect following Administration of Pfizer-BioNTech COVID-19 Vaccine
(2022) Sezenoz, Almila Sarigul; Gungor, Sirel Gur; Kibaroglu, Seda; https://orcid.org/0000-0002-7030-5454; https://orcid.org/0000-0001-6178-8362; https://orcid.org/0000-0002-3964-268X; 35404749; AAJ-4860-2021; AAD-5967-2021; AAJ-2956-2021
Purpose To report a case of transient visual field (VF) defect after coronavirus disease-19 (COVID-19) vaccination. Case Report A 38-year-old Caucasian, otherwise healthy female patient, presented with a complaint of vision loss in the outer quadrant in her left eye after the second dose of Pfizer (R)-BioNTech (TM) COVID-19 vaccine. The Snellen visual acuity was 20/20 in both eyes. She did not have relative afferent pupillary defect nor disturbance of color vision. Her intraocular pressures, slit lamp and fundus examinations were normal. In the VF test, a temporal hemifield defect in the left eye and a nasal peripheral VF defect in the right eye were detected. Other imaging characteristics and neurological examination were normal. She was followed without any treatment. One week later, the patient was re-evaluated and complete resolution of the VF defect was observed. Conclusion Clinicians should be aware that patients can experience transient visual symptoms following COVID-19 vaccination.
Clinical and Radiological Characteristics of Six Patients with Tumefactive Demyelinating Lesions
(2014) Toprak, Munire Kilinc; Kibaroglu, Seda; Derle, Eda; Benli, Ulku Sibel; https://orcid.org/0000-0001-7979-0276; https://orcid.org/0000-0002-3964-268X; https://orcid.org/0000-0003-2122-1016; https://orcid.org/0000-0002-9975-3170; AAJ-8674-2021; AAJ-2956-2021; AAI-8830-2021; AAJ-4403-2021
Clinical results of carotid artery stenting versus carotid endarterectomy
(2016) Derle, Eda; Akinci, Tuba; Kibaroglu, Seda; Harman, Ali; Kural, Feride; Cinar, Pinar; Kilinc, Munire; Akay, Hakki T.; Can, Ufuk; Benli, Ulku S.; 0000-0002-7386-7110; 0000-0002-4226-4034; 0000-0002-9975-3170; 0000-0003-2122-1016; 0000-0002-3964-268X; 0000-0001-8689-417X; 27744460; AAI-8830-2021; AAJ-2956-2021; K-9824-2013; AAL-9808-2021; AAJ-4403-2021; AAJ-2999-2021
Objective: To review our results of carotid artery stenting (CAS) and carotid endarterectomy (CEA). Methods: We evaluated the medical records of patients undergoing carotid artery revascularization procedure, between 2001 and 2013 in Baskent University Hospital, Ankara, Turkey. Carotid artery stenting or CEA procedures were performed in patients with asymptomatic carotid stenosis (=70%) or symptomatic stenosis (=50%). Demographic data, procedural details, and clinical outcomes were recorded. Primary outcome measures were in 30-day stroke/transient ischemic attacks (TIA)/amaurosis fugax or death. Secondary outcome measures were nerve injury, bleeding complications, length of stay in hospital, stroke, restenosis (ICA patency), and all-cause death during long-term follow-up. Results: One hundred ninety-four CEA and 115 CAS procedures were performed for symptomatic and/or asymptomatic carotid artery stenosis. There is no significant differences 30-day mortality and neurologic morbidity between CAS (13%) and CEA procedures (7.7%). Length of stay in hospital were significantly longer in CEA group (p=0.001). In the post-procedural follow up, only in symptomatic patients, restenosis rate was higher in the CEA group (p=.045). The other endpoints did not differ significantly. Conclusions: Endovascular stent treatment of carotid artery atherosclerotic disease is an alternative for vascular surgery, especially for patients that are high risk for standard CEA. The increasing experience, development of cerebral protection systems and new treatment protocols increases CAS feasibility.
CNN-Based Severity Prediction Of Neurodegenerative Diseases Using Gait Data
(2022) Erdas, Cagatay Berke; Sumer, Emre; Kibaroglu, Seda; https://orcid.org/0000-0003-3467-9923; 35111334; AGA-5711-2022
Neurodegenerative diseases occur because of degeneration in brain cells but can manifest as impairment of motor functions. One of the side effects of this impairment is an abnormality in walking. With the development of sensor technologies and artificial intelligence applications in recent years, the disease severity of patients can be estimated using their gait data. In this way, decision support applications for grading the severity of the disease that the patient suffers in the clinic can be developed. Thus, patients can have treatment methods more suitable for the severity of the disease. The presented research proposes a deep learning-based approach using gait data represented by a Quick Response code to develop an effective and reliable disease severity grading system for neurodegenerative diseases such as amyotrophic lateral sclerosis, Huntington's disease, and Parkinson's disease. The two-dimensional Quick Response data set was created by converting each one-dimensional gait data of the subjects with a novel representation approach to a Quick Response code. This data set was regressed with the convolutional neural network deep learning method, and a solution was sought for the problem of grading disease severity. Further, to demonstrate the success of the results obtained with the novel approach, native machine learning approaches such as Multilayer Perceptron, Random Forest, Extremely Randomized Trees, and K-Nearest Neighbours, and ensemble machine learning methods, such as voting and stacking, were applied on one-dimensional data. Finally, the results obtained on the prediction of disease severity by testing one-dimensional gait data with a convolutional neural network architecture that operates on one-dimensional data were included. The results showed that, in most cases, the two-dimensional convolutional neural network approach performed the best among all methods.
Depression, Anxiety, Burden and Coping Mechanisms in The Family Caregivers of Alzheimer's Dementia Patients in A Turkish Sample
(2014) Aki, Ozlem Erden; Kaya, Yildiz; Isikli, Sedat; Kibaroglu, Seda; Ciftci, Eda Derle; Can, Ufuk Anik; https://orcid.org/0000-0002-3964-268X; https://orcid.org/0000-0003-2122-1016; AAJ-2956-2021; AAI-8830-2021
Does Renal Function Affect Gadolinium Deposition in the Brain?
(2018) Rahatli, Feride Kural; Donmez, Fuldem Yildirim; Kibaroglu, Seda; Kesim, Cagri; Haberal, Kemal Murat; Turnaoglu, Hale; Agildere, Ahmet Muhtesem; 0000-0002-4226-4034; 0000-0003-4502-106X; 0000-0002-3964-268X; 0000-0002-8964-291X; 0000-0002-8211-4065; 0000-0002-0781-0036; 0000-0003-4223-7017; 29857863; AAL-9808-2021; AAE-5528-2021; AAJ-2956-2021; AAD-5996-2021; R-9398-2019; AAK-8242-2021; AAB-5802-2020
Objective: Was to compare T1 signal intensity ratios of dentate nucleus to cerebellar white matter (DN/cerebellum), dentate nucleus to pons (DN/pons) and globus pallidus to thalamus (GP/thalamus) in patients with normal renal function and in patients on chronic hemodialysis. To find out if renal function affects the deposition of gadolinium in brain after administration of linear gadolinium based contrast agents (GBCA). Methods: Seventy eight contrast enhanced brain MRIs (Magnetic Resonance Imaging) with linear GBCA of 13 patients on chronic hemodialysis and 13 patients with normal renal function retrospectively evaluated. The DN/ pons, DN/cerebellum and GP/thalamus signal intensity ratios were measured from each brain MRI on unenhanced axial T1 weighted images. Results: In hemodialysis group statistically significant increase in the signal intensity ratios of DN/pons, DN/ cerebellum and GP/thalamus were found between the first and the last brain MRIs (p = .001). The increase in the signal intensity ratios of DN/pons, DN/cerebellum and GP/thalamus between the first and the last brain MRIs in control group were not significant (p > 0.05). The signal intensity increase in DN and globus pallidus were significantly higher in hemodialysis group than control group (p < 0.05). Conclusions: Patients on hemodialysis had significantly higher DN and GP signal intensity increase compared to the patients with normal renal function. Renal function affects the rate of gadolinium deposition in the brain after administration of linear GBCA.
Intralesional triamcinolone acetonide in notalgia paresthetica: Treatment outcomes in five patients
(2020) Ozcan, Deren; Seckin, Deniz; Kibaroglu, Seda; Bernhard, Jeffrey D.; 0000-0002-7450-6886; 0000-0002-3964-268X; 32338414; AAQ-6649-2021; AAJ-2956-2021
Numerous treatment modalities have been tried with diverse results for pruritus due to notalgia paresthetica (NP). Corticosteroids suppress ectopic neural discharges from injured nerve fibers and also have short-lived suppressive effect on transmission in normal C-fibers. Herein, we evaluated the efficacy of intralesional triamcinolone acetonide in the treatment of NP. The medical reports of five patients who had been diagnosed with NP and treated with intralesional triamcinolone acetonide injections were retrospectively evaluated. Triamcinolone acetonide solution was injected intradermally (10 mg/mL; 0.1 mL/cm(2)) every 3 weeks for a maximum of four treatments. The severity of itch was scored by the patients on a combined numerical and visual analogue scale. After treatment, reduction in itch severity scores varied between 33% and 100%.
Intrathecal Methotrexate-Induced Posterior Reversible Encephalopathy Syndrome (PRES)
(2014) Guler, Tulay; Cakmak, Ozden Yener; Toprak, Selami Kocak; Kibaroglu, Seda; Can, Ufuk; 24764745
Lentiform Fork Sign in A Case with End-Stage Renal Disease and Metabolic Acidosis
(2015) Derle, Eda; Kibaroglu, Seda; Cinar, Pinar; Ocal, Ruhsen; Can, Ufuk; 0000-0002-3964-268X; 0000-0001-8689-417X; 0000-0003-2122-1016; 25381213; AAJ-2956-2021; V-3553-2017; AAJ-2999-2021; AAI-8830-2021
Neurodegenerative disease detection and severity prediction using deep learning approaches
(2021) Erdas, Cagatay Berke; Sumer, Emre; Kibaroglu, Seda; 0000-0002-3964-268X; AAJ-2956-2021; AGA-5711-2022
Neurodegenerative diseases (NDDs) such as amyotrophic lateral sclerosis (ALS), Huntington's disease (HD), and Parkinson's disease (PD) can manifest themselves anatomically by degeneration in the brain as well as motor symptoms. The motor symptoms can affect walking dynamics in a disease-specific fashion; characteristically they disrupt gait. As the severity of the disease increases, walking ability deteriorates. We examined the effect of NDDs such as ALS, HD, and PD on gait and developed a convolutional long short-term memory (ConvLSTM) and threedimensional convolutional learning network (3D CNN)-based approach to detecting neurodegenerative conditions and predicting disease severity.
Neurologic Complications After Liver Transplant: Experience at a Single Center
(2015) Derle, Eda; Kibaroglu, Seda; Ocal, Ruhsen; Kirnap, Mahir; Can, Ufuk; Benli, Sibel; Haberal, Mehmet; 0000-0003-2122-1016; 0000-0002-3964-268X; 0000-0001-8689-417X; 0000-0002-3462-7632; 0000-0002-9975-3170; 25894184; V-3553-2017; AAH-9198-2019; AAI-8830-2021; AAJ-2956-2021; AAJ-2999-2021; AAJ-8097-2021; AAJ-4403-2021
Objectives: Neurologic complications occur frequently after liver transplants. Up to 43% of patients experience severe postsurgical neurologic complications. These complications are significantly associated with longer hospital stay, morbidity, and mortality. The aim of this retrospective study was to evaluate the type and incidence of neurologic complications after liver transplants in adult patients. Materials and Methods: We retrospectively evaluated the medical records of 176 adult patients who had undergone liver transplants between 1995 and 2013. We recorded the demographic data, type of neurologic complications, type, and level of immunosuppressive treatment, and cause of liver failure. Results: Our study sample consisted of 48 deceased-donor liver transplants and 128 living-donor transplants (n = 176). Fifty-three of the patients (30.1%) were female. The age range of the total sample was 18 to 66 years (mean age, 43.1 +/- 13.7 y). As immunosuppressive treatment, most patients received tacrolimus alone (52%) or tacrolimus combined with mycophenolate mofetil (33%). Neurologic complications occurred in 74 of the patients (42%). The most common neurologic complications were diffuse encephalopathy (22.2%) and seizure (14.2%). Other neurologic complications were posterior reversible encephalopathy (1.7%), peripheral neuropathy (1.7%), cerebrovascular disease (1.1%), and central nervous system infection (1.1%). Age, cause of liver failure, and type of transplant were not associated with occurrence of neurologic complications. Conclusions: There was a high incidence of neurologic complications after liver transplants. Diffuse encephalopathy and seizure were common complications. Physicians should be aware of the high risk of neurologic complications after liver transplants. Factors such as immunosuppressive toxicity and metabolic imbalance that predispose patients to neurologic complications after liver transplants should be evaluated immediately, and treatment of postoperative neurologic complications should be initiated as early as possible.
Neurologic Complications in Heart Transplant Recipients Readmitted to the Intensive Care Unit
(2021) Sahinturk, Helin; Yurtsever, Beyza Meltem; Ersoy, Ozgur; Kibaroglu, Seda; Zeyneoglu, Pinar; 34926017
Introduction Neurologic complications after transplantation surgery are major causes of morbidity, and the incidence of neurologic complications among heart transplant recipients varies from 7% to 81%. In our study, we aimed to determine the incidence, etiologies, and risk factors of neurologic complications among patients readmitted to the intensive care unit (ICU) after heart transplantation. Method In this retrospective cohort study, the medical records of all patients who underwent cardiac transplantation from February 2003 to July 2019 were reviewed, and those admitted to the ICU due to neurologic complications during the early and late postoperative period were evaluated. The patients were divided into two groups based on the development of neurologic complications to compare demographic and other characteristics. Results A total of 130 heart transplant recipients were analyzed. We excluded 33 patients from the study because they either had neurologic complications or died postoperatively without discharge from the intensive care unit. The mean age of the cohort was 35.4 +/- 18.5 years, and 74 (76.3%) were male. Out of those 97 heart transplant recipients, 22 (22.7%) developed neurologic complications. Five patients (22.7% ) were admitted to the ICU in the first month, six patients (27.3%) were admitted to the ICU between one and six months, and 11 patients (50%) were admitted to the ICU six months after transplantation due to neurologic complications. The most common diagnosis was posterior reversible encephalopathy syndrome (PRES) (n = 6, 27.3%). The other diagnoses were calcineurin inhibitor toxicity (n = 5, 22.7%), intracranial hemorrhage (n = 3, 13.6%), seizures (n = 2, 9.2%), stroke (n = 2, 9.2%), femoral neuropathy (n = 1, 4.5%), myopathy (n = 1, 4.5%), phrenic nerve damage (n = 1, 4.5%), and cerebral abscess (n = 1, 4.5%). The rate of neurologic complications was higher in males when compared with females (p = 0.03). Both groups were similar in terms of the etiologies of cardiac failure, coexisting disease, and anticoagulant and immunosuppressive usage. The requirement for mechanical ventilation, renal replacement therapy, and the incidence of acute kidney injury were similar in both groups (p > 0.05). The incidence of sepsis was significantly higher in patients with neurologic complications (n = 8, 36.4%, versus n = 5, 6.7%; p < 0.001). The mean length of hospital stay was significantly higher in patients with neurologic complications (21.4 +/- 15.8 versus 11.1 +/- 13.3 days, p = 0.01). The risk of developing neurologic complications is 3.036 times higher in males, and this is statistically significant (odds ratio (OR), 3.036; 95% confidence interval (CI), 1.078-8.444; p = 0.036). Conclusion Our results suggest that neurologic complications develop in 22.7% of heart transplant recipients admitted to the ICU, and half of them are seen after six months postoperatively. PRES was the most frequent (27.3%) neurologic complication. The risk of neurologic complications is three times higher for males. The mean length of hospital stay and incidence of sepsis were significantly higher in heart transplant recipients who developed neurologic complications.
Neutrophil to lymphocyte ratio, stroke severity and short term clinical outcomes in acute ischemic stroke
(2021) Iyigundogdu, Ilkin; Derle, Eda; Kibaroglu, Seda; Can, Ufuk; 0000-0001-7860-040X; 0000-0002-3964-268X; AAJ-2053-2021; AAJ-2956-2021
Background: Neutrophil to lymphocyte ratio is an easily evaluated systemic inflammation indicator. However, there are limited reports on neutrophil to lymphocyte ratio and functional outcome in ischemic stroke. In this study, we aimed to evaluate the association of neutrophil to lymphocyte ratio and stroke severity, short term functional outcomes and mortality in patients with acute ischemic stroke. Methods: The clinical data of patients who were > 18 age-old and hospitalized with acute ischemic stroke in Baskent University Hospital, Ankara, Turkey between January 2018 and May 2019 were studied retrospectively. Neutrophil to lymphocyte ratio were measured. The neutrophil to lymphocyte ratio and National Institute of Health Stroke Scale (NIHSS) score at admission, mortality during hospitalization and Modified Rankin Scale (mRS) score at discharge of the patients with acute ischemic stroke were correlated. Results: Among the acute ischemic stroke patients due to the exclusion criteria, the data of 134 patients were evaluated. Median age of the patients were 76 +/- 12.5 years and 82 patients (61.2%) were male. The median NIHSS scores of the patients at admission was 5 +/- 4.5. Mortality during the hospitalization was seen in 8 patients (6%). The median neutrophil to lymphocyte ratio value of the patients at admission were found to be 2.6 +/- 3.4. Neutrophil to lymphocyte ratio and NIHSS scores of the patients at admission, duration of the hospitalization, mRS scores at discharge and mortality during hospitalization were found to be positively correlated. Conclusion: Neutrophil to lymphocyte ratio is a simple and easily measured marker and can be used as a potential indicator for prognosis in acute ischemic stroke. However further prospective multicenter investigations are required to confirm the role of neutrophil to lymphocyte ratio for predicting the prognosis in acute ischemic stroke patients.
A novel electroencephalography based approach for Alzheimer's disease and mild cognitive impairment detection
(2021) Oltu, Burcu; Aksahin, Mehmet Feyzi; Kibaroglu, Seda; 0000-0002-3964-268X; AAJ-2956-2021
Background and objective: Alzheimer's disease (AD) is characterized by cognitive, behavioral and intellectual deficits. The term mild cognitive impairment (MCI) is used to describe individuals whose cognitive impairment departing from their expectations for the age that does not interfere with daily activities. To diagnose these disorders, a combination of time-consuming, expensive tests that has difficulties for the target population are evaluated, moreover, the evaluation may yield subjective results. In the presented study, a novel methodology is developed for the automatic detection of AD and MCI using EEG signals. Methods: This study analyzed the EEGs of 35 subjects (16 MCI, 8 AD, 11 healthy control) with the developed algorithm. The algorithm consists of 3 methods for analysis, discrete wavelet transform(DWT), power spectral density (PSD) and coherence. In the first approach, DWT is applied to the signals to obtain major EEG sub-bands, afterward, PSD of each sub-band is calculated using Burg's method. In the second approach, interhemispheric coherence values are calculated. The variance and amplitude summation of each sub-bands' PSD and the amplitude summation of the coherence values corresponding to the major sub-bands are determined as features. Bagged Trees is selected as a classifier among the other tested classification algorithms. Data set is used to train the classifier with 5-fold cross-validation. Results: As a result, accuracy, sensitivity, and specificity of 96.5%, 96.21%, 97.96% are achieved respectively. Conclusion: In this study, we have investigated whether EEG can provide efficient clues about the neuropathology of Alzheimer's Disease and mild cognitive impairment for early and accurate diagnosis. Accordingly, a decision support system that produces reproducible and objective results with high accuracy is developed.
Rare Presentation of Midbrain Infarction: Isolated Medial Rectus Palsy
(2015) Derle, Eda; Ocal, Ruhsen; Kibaroglu, Seda; Can, Ufuk; 0000-0001-8689-417X; 0000-0002-3964-268X; 0000-0003-2122-1016; 26183888; AAJ-2999-2021; AAJ-2956-2021; AAI-8830-2021; V-3553-2017
A 69-year-old woman presented with sudden onset of diplopia. In neurologic examination left medial rectus palsy without abduction nystagmus was detected. Brain magnetic resonance imaging revealed acute ischemic lesion in mesencephalon on diffusion-weighted images. Sponteneous resolution was observed after 1 month. Medial rectus palsy is a rare presention of acute ischemic stroke and early neuroimaging is important to establish such lesions. (C) 2015 S. Karger AG, Basel
The Relationship Between the Degree of Cognitive Impairment and Retinal Nerve Fiber Layer Thickness
(2015) Oktem, Ece Ozdemir; Derle, Eda; Kibaroglu, Seda; Oktem, Caglar; Akkoyun, Imren; Can, Ufuk; 0000-0002-2860-7424; 0000-0003-2122-1016; 0000-0001-8689-417X; 0000-0002-3964-268X; 25575807; AAK-7713-2021; AAI-8830-2021; AAJ-2999-2021; AAJ-2956-2021
The goal of the present study is to investigate the relationship between the degree of cognitive impairment and retinal nerve fiber layer (RNFL) thickness which is measured by the optical coherence tomography (OCT). Thirty-five patients with Alzheimer's disease (AD), 35 patients with mild cognitive impairment (MCI), and 35 healthy volunteers, between the ages of 60-87, who were examined in the neurology outpatient clinic among 2012-2013 were prospectively involved in our study. Mini mental state examination (MMSE) test, montreal cognitive assessment (MOCA), and also neuropsychological test batteries were used for the neurocognitive evaluation. RNFL thickness was measured by the OCT technique and the differences among groups were studied. The relationship between RNFL thickness and MMSE scores with demographic characteristics was investigated. RNFL thickness was significantly lower in AD and MCI groups compared with the control group (p < 0.01). No significant differences of RNFL were found between the MCI and the AD groups (p > 0.05). Significant correlation was found between MMSE scores and the RNFL values (p < 0.05). Significant thinning in RNFL along with age was detected (p < 0.05). In our study, it is thought that retinal nerve fiber degeneration and central nervous system degeneration may be concurrent according to the thinning of RNFL measured by OCT in AD and MCI groups. RNFL measurement may also be useful for early diagnosis and evaluation of the disease progression. Further studies are needed to optimize the utility of this method as an ocular biomarker in AD.
Relationship Between White Matter Hyperintensities and Retinal Nerve Fiber Layer, Choroid, and Ganglion Cell Layer Thickness in Migraine Patients
(2018) Iyigundogdu, Ilkin; Derle, Eda; Asena, Leyla; Kural, Feride; Kibaroglu, Seda; Ocal, Ruhsen; Akkoyun, Imren; Can, Ufuk; 0000-0001-7860-040X; 0000-0003-2122-1016; 0000-0002-6848-203X; 0000-0002-4226-4034; 0000-0002-3964-268X; 0000-0002-2860-7424; 0000-0001-8689-417X; 28952336; AAJ-2053-2021; AAI-8830-2021; E-5914-2016; AAL-9808-2021; AAJ-2956-2021; V-3553-2017; AAK-7713-2021; AAJ-2999-2021
Aim To compare the relationship between white matter hyperintensities (WMH) on brain magnetic resonance imaging and retinal nerve fiber layer (RNFL), choroid, and ganglion cell layer (GCL) thicknesses in migraine patients and healthy subjects. We also assessed the role of cerebral hypoperfusion in the formation of these WMH lesions. Methods We enrolled 35 migraine patients without WMH, 37 migraine patients with WMH, and 37 healthy control subjects examined in the Neurology outpatient clinic of our tertiary center from May to December 2015. RFNL, choroid, and GCL thicknesses were measured by optic coherence tomography. Results There were no differences in the RFNL, choroid, or GCL thicknesses between migraine patients with and without WMH (p>0.05). Choroid layer thicknesses were significantly lower in migraine patients compared to control subjects (p<0.05), while there were no differences in RFNL and GCL thicknesses (p>0.05). Conclusions The only cerebral hypoperfusion' theory was insufficient to explain the pathophysiology of WMH lesions in migraine patients. In addition, the thinning of the choroid thicknesses in migraine patients suggests a potential causative role for cerebral hypoperfusion and decreased perfusion pressure of the choroid layer.
Seizure as a Neurologic Complication After Liver Transplant
(2015) Derle, Eda; Kibaroglu, Seda; Ocal, Ruhsen; Kirnap, Mahir; Kilinc, Munire; Benli, Sibel; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0001-7979-0276; 0000-0003-2122-1016; 0000-0002-3964-268X; 0000-0002-9975-3170; 25894183; AAJ-8097-2021; AAJ-8674-2021; AAI-8830-2021; AAJ-2956-2021; AAH-9198-2019; AAJ-4403-2021; V-3553-2017
Objectives: Seizure is a common complication after liver transplant and has been reported to occur in up to 42% of patients in different case series. Multiple factors can trigger seizures, including immunosuppressive toxicity, sepsis, metabolic imbalance, and structural brain lesions. The aim of this retrospective study was to evaluate seizure types and associated factors in adult liver transplant patients. Materials and Methods: We retrospectively evaluated the medical records of 142 adult patients who received a liver transplant between 2005 and 2013. We recorded demographic data, immunosuppressive treatment, seizure type, cause, recurrence, and treatment. Results: Of the 146 patients, 23 (15.7%) had a seizure after the liver transplant. This group included 10 females and 13 males, with ages ranging between 18 and 63 (39.9 +/- 14.8 y). Generalized tonic-clonic seizures were the most common, occurring in 20 patients (87%). We observed complex partial seizure and status epilepticus in 1 and 2 patients. Immunosuppressive drug-related seizure occurred in 8 patients (34.8%) with normal drug blood levels, and all but 1 of these patients experienced seizure within the first week after transplant. Multiple factors (26.1%), metabolic imbalance (17.4%), structural lesion (13%), and sepsis (8.7%) were the other factors identified as underlying conditions. Conclusions; In conclusion, seizure occurred in a significant proportion of patients who underwent liver transplant. Immunosuppressive drugs were the most common factor associated with seizure occurrence and drug cessation prevented seizure recurrence.