The relationship between white matter abnormalities and cognitive functions in new-onset juvenile myoclonic epilepsy.

Diffusion tensor imaging (DTI) has revealed evidence of subcortical white matter abnormalities in the frontal area in juvenile myoclonic epilepsy (JME). Decreased fractional anisotropy (FA) and increased mean diffusivity (MD) in the corticothalamic pathway have been detected in adult patients with JME. It has been demonstrated that, in adult patients with JME, frontal dysfunction is related to subcortical white matter damage and decreased volume in frontal cortical gray matter and the thalamus. Many studies have focused on adult patients. Twenty-four patients and 28 controls were evaluated. The group with JME had significantly worse results for the word fluency, trail-B, and Stroop tests that assessed executive functions. A significant decrease in FA values in the dorsolateral prefrontal cortex (DLPFC), the supplementary motor area (SMA), the right thalamus, the posterior cingulate, the corpus callosum anterior, the corona radiata, and the middle frontal white matter (MFWM) and an increase in ADC values in patients with JME were detected. The correlation between FA values in DLPFC and the letter fluency test results was positive, and the correlation with the Stroop and trail-B test results was negative. We found a negative correlation between SMA, anterior thalamus, and MFWM FA values and the trail-B test results and a positive correlation between the SMA, anterior thalamus, and MFWM FA values and the letter fluency test results. We detected white matter and gray matter abnormalities in patients with new-onset JME using DTI. In addition, we determined the relationship between cognitive deficit and microstructural abnormalities by evaluating the correlation between the neuropsychological test battery results and DTI parameters. We evaluated newly diagnosed patients with JME in our study. That leads us to believe that microstructural abnormalities exist from the very beginning of the disease and that they result from the genetic basis of the disease.

Long-Term Substance Use Can Cause Irreversible Photopic Vision Changes in Substance Use Disorder in Remission.

OBJECTIVE: Substance use has such effects on pupil diameter. Although there is knowledge about the acute effects of substances on pupils, studies showing their chronic effects are limited. The aim of the present study was to evaluate the effect of long-term substance use on scotopic, mesopic, and photopic vision. METHODS: The present study with cross-sectional desgn was conducted at the Adiyaman Training and Research Hospital for Psychiatry in Adiyaman. This study involved 110 substance use disorder (SUD) patients and 46 healthy volunteers as the control. The parameters were measured and recorded automatically by a device. RESULTS: The mean age was 23.44±5.53 years in the SUD group and 24.26±5.38 years in healthy controls (p=0.420). The mean age of onset of the substance was 17.74±3.89 years and the mean duration of substance use was 3.54±2.9 years. It was determined that the patients had not used any substance for a mean of 121.73±117.49 days. There was no significant difference between patient and control groups in terms of scotopic and mesopic measurements of both eyes (p>0.05). Photopic measurements were significantly higher in the patient group than in the control group (p<0.05). Photopic measurements were significantly higher in the opioid, cannabis, ecstasy, and multiple substance use groups than in the control group (p<0.05). CONCLUSION: The most important topic of this study is that photopic vision is permanently impaired in patients with a history of chronic substance use. This was attributed to disrupted sympathetic-parasympathetic hierarchy.

Increases in retinal nerve fiber layer thickness may represent the neuroprotective effect of cannabis: an optical coherence tomography study.

Although optical coherence tomography (OCT) has been used in many neuropsychiatric disorders, data on substance use disorders (SUD) are not available. The aim of this study was to evaluate ganglion cell layer (GCL), inner plexiform layer (IPL), retinal nerve fiber layer (RNFL), and choroidal layer thickness in patients diagnosed with SUD especially cannabis use disorder (CUD). RNFL, GCL, IPL, and the choroidal layers of 111 patients diagnosed with SUD and 45 healthy controls were retrospectively analyzed. Fifty patients were diagnosed with CUD and 50 patients had multiple drug use (MDU). The mean age of the patient and control groups were 23.39 ± 5.53 and 28.48 ± 5.21 years, respectively. The mean duration of substance use was 3.53 ± 2.95 years. The patients had not used any substance for a mean of 121.45 ± 116.99 days. When the RNFL values of the SUD, MDU, and control groups were compared, no significant difference was found except for such components. However, there were significant differences in terms of right naso-superior (p = 0.020), right temporo-inferior (p = 0.024), right temporo-superior (p = 0.002), left naso-superior (p = 0.005), left naso-inferior (p = 0.043), and left temporo-superior (p = 0.008) between CUD and control groups. That is, RNFL values were higher in the CUD group than in the control group. Cannabis has medical uses because of its possible neuroprotective properties. Our study supports the possible neuroprotective effects associated with cannabis through RNFL data. According to our best knowledge, this is the first study investigating the association between RNFL and drugs, particularly cannabis.