Clarifying the relationship between sarcopenia and depression in geriatric outpatients.

OBJECTIVE: We investigate the relationship between sarcopenia components and depression in geriatric outpatients, considering the effects of potential confounding factors. METHODS: Adults ≥60 years of age were selected from outpatient clinics. Muscle strength was assessed using handgrip strength (HGS) measured using a hydraulic hand dynamometer and chair stand test (CSST). Physical performance was evaluated by usual gait speed (UGS), nutritional status, and frailty were screened by mini-nutritional assessment (MNA) questionnaire and FRAIL scale. Depression was diagnosed through a psychiatric interview and the administration of the Geriatric Depression Scale (GDS). RESULTS: Participants with depression were similar to participants without depression regarding age (p = .055), education (p = .095), frailty (p = .857), and HGS scores (p = .053). The group with depression had longer CSST duration (p = .023), slower UGS (p = .027), and more malnutrition (p = .001). Multivariate regression analysis revealed that only the malnutrition was independently associated factor with depression after adjusting for confounding factors. CONCLUSIONS: Depression is associated with malnutrition and some components of sarcopenia in geriatric outpatients. Our results revealed that sarcopenia might be associated with depression through malnutrition. If malnutrition lasts for a long time, sarcopenia may become evident in the later stages of depression.

Multicenter study of levodopa carbidopa intestinal gel in Parkinson's disease: the Turkish experience

Background/aim: Our purpose was to determine the efficacy of levodopa carbidopa intestinal gel (LCIG) in a series of Turkish patients with Parkinson's disease (PD). Materials and methods: We had telephone calls with 54 patients from 11 neurology centers who were on LCIG treatment, and 44 patients or their caregivers were included in an eight-item survey between September 2015 and June 2016. The reliability and validity of the survey were evaluated with intraclass correlation coefficients for every question separately. Results: Average age of the patients were 63.48 and the duration of PD was 12.79 years. Average LCIG treatment period was 15.63 months. Percentages of the patients who reported they were 'better' after LCIG treatment were as follows: 80% for time spent off, 55% for dyskinesia, 65% for tremor, 85% for gait disorder, 50% for pain, 50% for sleep disorders, 42.5% for depression, 32.5% for incontinence, and 70% for activities of daily living. Cronbach's alpha was 0.795 and the intraclass correlation coefficient was reliable for the items. Conclusion: As detected by a survey performed by telephone calls with good interrater reliability, patients with PD improve with LCIG treatment in many aspects of the disease.

Behçet's disease as a causative factor of cerebral venous sinus thrombosis: subgroup analysis of data from the VENOST study.

OBJECTIVE: This study was performed to determine the rate of cerebral venous sinus thrombosis (CVST) among cases of Behçet's disease (BD) included in a multicentre study of cerebral venous sinus thrombosis (VENOST). METHODS: VENOST was a retrospective and prospective national multicentre observational study that included 1144 patients with CVST. The patients were classified according to aetiologic factors, time of CVST symptom onset, sinus involvement, treatment approach and prognosis. RESULTS: BD was shown to be a causative factor of CVST in 108 (9.4%) of 1144 patients. The mean age of patients in the BD group was 35.27 years and 68.5% were men, whereas in the non-BD CVST group, the mean age was 40.57 years and 28.3% were men (P < 0.001). Among the aetiologic factors for patients aged 18-36 years, BD was predominant for men, and puerperium was predominant for women. The onset of symptoms in the BD group was consistent with the subacute form. The transverse sinuses were the most common sites of thrombosis, followed by the superior sagittal sinuses. The most common symptom was headache (96.2%), followed by visual field defects (38%). CONCLUSIONS: BD was found in 9.4% of patients in our VENOST series. Patients with BD were younger and showed a male predominance. The functional outcome of CVST in patients with BD was good; only 12% of patients presenting with cranial nerve involvement and altered consciousness at the beginning had a poor outcome (modified Rankin Score ⩾2).

Morphometric analysis of hemicerebellar asymmetryn with central vertigo cases: a stereological study / Análisis morfométrico de la asimetría hemicerebelar en casos de vértigo central: un estudio estereológico

We aimed to evaluate the relevant methods of stereology to estimate hemicerebellar asymmetry according to sex in both adult right handed vertigo cases and comparing with healthy cases. The study included 14 adult control subjects and 18 patients with vertigo. The volumes of the cerebellar hemispheres were determined by MRI using the point-counting approach of stereological methods. The mean ( +/- SD) of the right cerebellar hemispheres in the patients with vertigo were 52.49 +/-5.42 cm3 in males, 50.11 +/- 4.02 cm3 in females. The mean ( +/- SD) of the left cerebellar hemispheres in the patients with vertigo were 53.11 +/- 3.70 cm3 in males, 49.73 +/- 4.69 cm3 in females. There was not significant quantitative evidence detected in terms of cerebella asymmetry between sagittal plane estimates in the cases with vertigo in both genders (p>0.05). There were no statistically significant differences according to the genders between both vertigo and control subjects (p>0.05). There was only statistical significance between right and left hemispheres in male control subjects (p=0.039). There was no cerebella asymmetry between control and vertigo cases according to genders. The stereological evaluation of cerebella asymmetry or atrophy in humans correlate with gender is of importance for both clinicians and anatomists. The technique is simple, reliable, inexpensive and unbiased.

Nuestro objetivo fue evaluar los métodos relevantes de estereología para estimar la asimetría hemicerebellar según el género, tanto en adultos diestros, casos de vértigo y al compararlos con casos control. El estudio incluyó a 14 sujetos adultos como control y 18 pacientes con vértigo. Los volúmenes de los hemisferios del cerebelo se determinaron en la RM utilizando el recuento de los puntos del método de estereología. La media ( +/- DE) de los hemisferios derecho del cerebelo en los pacientes con vértigo 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 vértigo 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 asimetría entre las estimaciones del cerebelo entre plano sagital en los casos con vértigo en ambos sexos (p> 0,05). No hubo diferencias estadísticamente significativas según los géneros entre ambos el vértigo y los sujetos control (p> 0,05). Sólo hubo significancia estadística entre los hemisferios derecho e izquierdo en los sujetos control masculino (p = 0,039). No hubo asimetría entre el cerebelo control y de los casos el vértigo de acuerdo a los géneros. La evaluación de la asimetría estereológica o atrofia del cerebelo en el ser humano se correlaciona con el género es de importancia para los clínicos y anatómicos. La técnica es simple, confiable, de bajo costo e imparcial.

Evaluation of cerebellar and cerebral volume in migraine with aura: a stereological study.

Migraine is associated with an increased risk of deep white matter lesions and subclinical posterior circulation infarcts. A significant association between deep white matter hyperintensities and cerebral atrophy is true for various neurological diseases; it was not specifically proven in migraine. The aim of this study was to evaluate the cerebellar and cerebral volume and volume ratios for cerebellum using the Cavalieri principle. We also aimed to examine whether migraine with aura causes cerebellar and cerebral atrophy. Twenty three right-handed patients with migraine with aura diagnosed by means of the International Headache Society criteria and 24 age-matched subjects whose only health problem was headache due to rhinosinusitis and tension type headache were included in the study. Measurements of the cerebellar and cerebral volumes as well as cerebellar/cerebral volume ratios were made using Cavalieri's principle by utilizing the point-counting methods. There were no significant differences between the volumes of cerebrum, cerebellum, and the ratio of cerebellum to cerebrum for males (p = 0.05, p = 0.10, and p = 0.64, respectively) and for females (p = 0.18, p = 0.89, and p = 0.24, respectively). Our results suggest that patients with migraine with aura do not have a significant difference in cerebellar and cerebral volumes and cerebellar/cerebral volume ratios compared to the non-migraine group.