Fakülteler / Faculties
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Item Effects of Attachment Styles, Childhood Traumas, and Alexithymia in Turkish Patients with Epilepsy and Functional Seizures(2023) Keskin, Ahmet Onur; Altintas, Ebru; Yerdelen, Vahide Deniz; Demir, Bireyluel; Colak, Meric Yavuz; 37844436Introduction: In this cross-sectional study, we used self-report scales to compare childhood traumas, attachment styles, and alexithymia among patients with functional seizures (FS) to patients with epilepsy and healthy controls. We also investigated risk factors associated with FS.Material and methods: A total of 44 patients with epilepsy, 14 patients with FS, and 25 healthy controls were included. All participants were over the age of 18 and were referred to the Baskent University Adana Epilepsy and Video-EEG Center. The patients underwent neurological examinations, brain MRIs, and video-EEG evaluations. Epileptic seizures were classified based on video EEG. The control group consisted of healthy individuals without neurological or psychiatric illness and a history of epileptic seizures or syncope. Beck Depression Inventory (BDI), Childhood Trauma Questionnaire (CTQ), Adult Attachment Scale (AAS), and Toronto Alexithymia Scale-20 (TAS-20) were applied to all participants.Results: Patients with FS had lower educational levels, higher rates of unemployment and single-marital status. The FS group had higher depression, childhood trauma, and alexithymia scores than the other groups. Furthermore, FS patients had a higher prevalence of avoidant attachment. The alexithymia and childhood trauma scores were both correlated with depression. Through the logistic regression analysis, childhood trauma scores and alexithymia were significant risk factors for FS.Conclusion: The use of video-EEG for diagnosing FS can reduce the risk of misdiagnosis and inappropriate antiepileptic treatment. Psychiatric comorbidities, childhood traumas, and alexithymia are prevalent in patients with FS. Therefore, implementing a multidisciplinary treatment approach that addresses the psychological, medical, and social aspects of FS can significantly improve outcomes.(c) 2023 Elsevier Inc. All rights reserved.Item 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, EgemenObjective: 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.Item The effects of menstrual cycle on sympathetic skin response and strength-duration properties(2021) Keskin, Ahmet Onur; Yerdelen, Vahide DenizBackground: Sympathetic control of the circulation is considerably affected by female reproductive hormones. Sudomotor function can be easily evaluated with sympathetic skin response (SSR). Although studies reveal that SSR amplitude decreases with hormone replacement therapy, the effect of estrogen on SSR is unclear. Measuring axonal excitability provides information about the physiological and physical properties of axonal ion channels and nerves. Axonal excitability tests may also give valuable information about the pathophysiology underlying neuronal disorders. In this study, we investigate the influence of female hormones, especially estrogen, on neuronal excitability and the sympathetic nervous system. Methods: SSR and strength-duration time constant (SDTC) tests were conducted on healthy women with a mean age of 26 +/- 4 years with regular menstrual cycles. The tests were performed during the first 3 days of the menstrual cycle when the level of estrogen is at its lowest and 2 days before ovulation when the estrogen is at its highest level. Results: SDTC, rheobase, and the latency of SSR were found to be relatively shorter at 2 days before ovulation when compared with the values of the first 3 days of the menstrual cycle. However, the difference was not statistically significant (P > 0.05). Discussion: The SDTC and SSR values in the 2 days before ovulation and the first 3 days of the menstrual cycle did not show any significant differences. We suggested that these parameters do not affect neuronal excitability associated with varied estrogen levels. Conclusion: Further research will be required to fully understand the influence of sex hormones on the nervous system in menstrual cycles, which can suggest underlying mechanisms of various diseases that are linked with autonomic and hormonal alterations.