Vortioxetine treatment for neuropathic pain in major depressive disorder: a three-month prospective study.

Introduction and objective: Several studies revealed the therapeutic potential of vortioxetine (Vo) for pain. In this context, we aimed to evaluate the efficacy of Vo as a safe and tolerable novel pharmacologic agent in treating neuropathic pain (NP) in patients with major depressive disorder (MDD). Materials and methods: The population of this cross-sectional prospective study consisted of all consecutive patients who were newly diagnosed with MDD by a neurology doctor at a psychiatric clinic and had NP for at least 6 months. All patients included in the sample were started on Vo treatment at 10 mg/day. They were assessed with Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Self-Reported Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS), Douleur Neuropathique 4 Questions (DN4), Montreal Cognitive Assessment (MoCA), and Neuropathic Pain Impact on Quality of Life (NePIQoL) at the beginning of treatment and during the follow visits conducted at the end of the first, second and third months of the treatment. During these follow-up visits, patients were also queried about any side effects of Vo. Results: The mean age of 50 patients included in the sample, 76% of whom were female, was 45.8 ± 11.2 years. There was a significant reduction in patients' NP complaints based on DN4 and S-LANNS, the subscales of NePIQoL, and significant improvement in MoCA. There was a significant reduction in patients' NP complaints based on DN4 and S-LANNS scores and a significant improvement in scores of the subscales of NePIQoL and MoCA. Conclusion: The study's findings indicate that Vo, with its multiple mechanisms of action, can effectively treat NP independently of its mood-stabilizing effect. Future indication studies for Vo are needed to establish Vo's efficacy in treating NP.

Association between Alzheimer's disease, MAPT gene mutation and some biochemical biomarkers.

Alzheimer's Disease (AD) is a multifactorial neurodegenerative disease and there is still no definitive treatment today. Early diagnosis of the disease is important, but there are almost no biomarkers that can be used in early diagnosis. The cerebrospinal fluid used in the diagnosis of the disease is not sufficient and is very difficult to obtain. Therefore, blood biomarkers that are less costly, less invasive, easily accessible, and can be used in long-term studies would be a better alternative. The aim of this study is to determine the relationship between Alzheimer's Disease and P301L MAPT gene mutation, homocysteine, folate and uric acid. 101 Alzheimer's patients and 101 healthy individuals were included in this study. Mutation analysis was performed using the Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) method with blood samples taken from the subjects. There was no significant difference between the patient and control groups in terms of homocysteine (p = 0.771), folate (p = 0.366) and uric acid (p = 0.860). When the genotypes were compared between the patient and control groups in terms of MAPT gene mutation (P301L), no statistically significant difference was detected (p = 0.081). There are very few studies in the literature investigating the relationship between Alzheimer's disease and P301L MAPT gene mutation. Additionally, there is no study investigating the relationship between Alzheimer's disease and homocysteine, folate, uric acid and P301L MAPT mutation in the Turkish population. We believe that this study has shed light on future studies.

Investigation of the relationship between ACAN gene VNTR polymorphism and Alzheimer's disease in Turkish population.

Alzheimer's disease is one of the most common causes of dementia and is a neurodegenerative disease that occurs with memory loss, loss of language, thinking and problem-solving skills. In this study, it was aimed to reveal the relationship between Alzheimer's disease and the variable number tandem repeat (VNTR) polymorphism in the aggrecan (ACAN) gene. Thus, it is thought that it will contribute to enlightenment about disease by contributing to the pathophysiology of Alzheimer's disease. A total of 203 people, including 102 patients diagnosed with Alzheimer's and 101 healthy individuals, were included in the study. Deoxyribonucleic acid (DNA) extraction was performed from the blood samples taken. The variable number tandem repeat (VNTR) polymorphism of the ACAN gene was determined using the Polymerase Chain Reaction (PCR) method. In our study, the 30 R, 31 R and 33 R alleles were the most repetitive alleles in patients and controls. 30 R, 31 R and shorter alleles were more common in patients than in the control group and were found to be statistically significant (p = 0.042). According to our results, 30 R and 31 R alleles of the VNTR polymorphism in the ACAN gene may be associated with Alzheimer's disease. In addition, having less than 30 repeat alleles increases the risk of the disease by 2,202 times. Our study is the first to investigate the relationship between ACAN gene VNTR polymorphism and Alzheimer's disease. Further studies are needed to definitively relate it.

Evaluation of ganglion cell complex and retinal nerve fiber layer thinning in epilepsy patients.

Purpose: This study aimed to compare the perimacular ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (RNFL) thickness measurements of epileptic and healthy individuals. Methods: The right eyes of 38 epileptic and 38 healthy individuals who had been using antiepileptic drugs (AEDs) for at least 1 year were included in the study. Central macular thickness, perimacular GCC thickness and volume, and peripapillary retinal nerve fiber layers were measured by optical coherence tomography (OCT) device. Perimacular 1, 3, and 6 mm circle diameters of Early Treatment of Diabetic Retinopathy Study (ETDRS. ): were selected for GCC measurements. Results: In epilepsy patients, GCC was significantly lower in the 3 mm superior quadrant and 6 mm in all quadrants compared to the control group (P < 0.05). RNFL was significantly thinner in epilepsy patients only in the temporal-inferior quadrant (P < 0.05). There was no significant difference between the patients who received AEDs as monotherapy and polytherapy (P > 0.05). Conclusion: We found that epilepsy patients had significant thinning in the GCC layers and temporal-inferior quadrant of RNFL compared to the control group. Our findings from the study show that early retinal changes in epilepsy patients, especially perimacular GCC layers, can be followed up with OCT.

Comparative assessment of choroidal thickness and choroidal vascularity index in patients with restless legs syndrome.

BACKGROUND: Increased sympathetic activity has been emphasized in the pathophysiology of restless legs syndrome (RLS). This study aims to evaluate the choroidal thickness (CT) and choroidal vascularity index (CVI) values of individuals with RLS. METHODS: A total of 60 volunteers, 30 individuals with RLS and 30 healthy individuals, were included in the study. The central macular thickness, subfoveal CT, and the CTs 1000 µm away from the fovea in the temporal and nasal regions were measured by optical coherence tomography. Total choroidal area (TCA), luminal area (LA) and stromal area (SA) were calculated using the binarization method. CVI was calculated as the ratio of lumen area to total choroidal area (LA/TCA). RESULTS: There was no significant difference between the participants in terms of age, gender, spherical equivalent, intraocular pressure, and axial length (p>0.05). The mean LA/SA was 1.56%±0.05 in RLS group and 1.99%±0.28 in the control group. The mean CVI was 0.64%±0.02% in RLS group and 0.66%±0.03 in the control group. There was no significant difference between the groups in terms of CT, TCA and LA values. There were significant differences between the groups in SA, LA/SA and CVI values (p = 0.017, p<0.001, and p = 0.004, respectively). CONCLUSION: SA values were significantly higher in RLS group than in control group. The LA/SA and CVI values were significantly lower in RLS group than in control group. These findings suggests that there is vascular narrowing due to sympathetic overactivity in RLS patients.

What are the trends in the treatment of multiple sclerosis in recent studies? - A bibliometric analysis with global productivity during 1980-2021.

BACKGROUND: There is no bibliometric analysis in the literature on the subject of the treatment of multiple sclerosis (MS), which is a disease with increasing prevalence, severely affecting the life and quality of life of patients. The purpose of this study was to analyze the scientific articles published on the subject of MS treatment, using bibliometric approaches and statistical methods, and thereby show the trend subjects and global productivity. METHODS: From 14,443 publications on the subject of MS between 1980 and 2021, 5010 in the category of article were retrieved from the Web of Science and analyzed statistically. Bibliometric network visualization diagrams were created to determine trend subjects, collaborations between countries and citation analyzes. Exponential Smoothing estimation was used to predict the number of articles to be published in the next 5 years. Correlations were determined using Spearman's correlation analysis. RESULTS: The 3 countries contributing the most to literature were found to be the USA (1385, 37.6%), Italy (700, 13.9%), and Germany (694, 13.8%). The most productive author was Hartung Hans-Peter (n = 82) and the most productive institution was the University of London (n = 198). The three most productive journals were the Multiple Sclerosis Journal (n = 354), Multiple Sclerosis and Related Disorders (n = 224), and Neurology (n = 204). The most studied subjects can be listed from past to present as interferon beta, disease-modifying treatment or drugs, relapsing, natalizumab, fingolimod, glatiramer acetate, fatigue, alemtuzumab, cytokines, mitoxantrone, MRI, adherence, depression, experimental autoimmune encephalomyelitis, quality of life, and biomarkers. CONCLUSION: The scientific production related to MS treatment shows growth chronologically over the years. According to the findings of the analysis done to identify trending subjects, the key words studied in recent years were determined to be fingolimod, alemtuzumab, disease-modifying therapy, ocrelizumab, teriflunomide, rituximab, dimethyl fumarate, safety, biomarkers, COVID-19, oxidative stress, inflammation, vitamin D, relapsing multiple sclerosis, cost-effectiveness, cladribine tablets, and medication adherence. Western countries, especially European countries, the USA, and Canada lead the way in research and scientific collaboration on the subject of MS treatment. These findings can contribute to a better understanding of this subject and can help provide new ideas for further studies.

Effects of Chronic Migraine on Male Sexual Health.

OBJECTIVE: To investigate the clinical implication of the sexual functions of male patients diagnosed with chronic migraine (CM) compared with the healthy population. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Departments of Urology and Neurology, Hitit University Hospital, Turkey, from August 2019 to August 2020. METHODOLOGY: A total of 179 patients (92 subjects diagnosed with CM and 87 control healthy volunteers) were included in this study. Demographic descriptive data including age, height, weight, and body mass index (BMI) of all patients were recorded. A 5-question version of the international index of erectile function questionnaire (IIEF-5) was applied to evaluate their sexual functions. Furthermore, a migraine identification test was performed for CM patients for the diagnosis of migraine in accordance with the International Headache Society's (IHS) definition of chronic migraine. Visual analog scale (VAS) scores between 0-10 points were recorded for the qualitative assessment of migraine pain. RESULTS: The IIEF-5 scores of CM patients [16 (11 - 21)] were lower compared to the control patients [21 (19 - 23), p <0.001)]. A negative correlation was found between the VAS scores and IIEF-5 scores of CM patients (rho -0.582, p <0.001). In the regression analysis, it was found that a 1-unit increase in the VAS score led to a 1.5 point decrease in the IIEF-5 score (p <0.001). CONCLUSION: Migraine pain in male patients with CM adversely affected erectile functions. A more detailed investigation of the pathophysiological mechanisms may be helpful in the treatment of ED. KEY WORDS: Erectile dysfunction, Chronic migraine, IIEF-5, Erectile functions.

The significance of ONSD, ONSD/ETD ratio, and other neuroimaging parameters in idiopathic intracranial hypertension.

Background: The measurement of the optic nerve sheath diameter (ONSD) has been suggested to be used in the evaluation of intracranial pressure of several etiologies. However, its potential utility in the clinical evaluation of patients with idiopathic intracranial hypertension (IIH) needs to be clarified.Methods: We recruited all the IIH patients who had been admitted to our neurology clinics and had a cranial MRI before lumbar puncture investigation. A control group of patients with migraine was also included. Studies were reviewed blindly by a radiologist, and ONSD and ONSD/ eyeball transverse diameter (ETD) for both eyes were measured.Results: Ultimately, we have enrolled 50 patients with IIH and 53 migraineurs. The right ONSD values were higher in the IIH group (p = 0.024) whereas the values of ONSD/ETD were found to be both higher in the IIH group (right: p = 0.006, left: p = 0.043). The ROC curve demonstrated an area under the curve of 0.620 (95% CI = 0.508 to 0.731) for ONSD, and it was 0.642 for ONSD/ETD. Using a cut-off of 6.3 mm, ONSD had the following performance characteristics: sensitivity 18%, specificity 81%.Conclusions: The ONSD and ONSD/ETD values may be utilizable in the evaluation processes of IIH patients; however, they do not solely reach sufficient discriminative accuracy. The potential significance of these parameters in rather monitoring the IIH patients may constitute a strictly crucial topic of interest for future research.

Clinical Manifestations of Overactive Bladder With Migraine as a Comorbidity: A Prospective Cross-Sectional Study.

PURPOSE: The aim of this study was to investigate the clinical manifestations of overactive bladder (OAB) with migraine as a comorbidity and to shed light on possible new treatment strategies. METHODS: This study included patients aged 18 years and older who were admitted to urology and neurology outpatient clinics between March 1, 2019 and March 1, 2020 for OAB and migraine. The study questionnaire contained 3 sections: (1) questions on demographic characteristics, (2) a migraine ID test, and (3) the Overactive Bladder Inquiry Form - V8 (OAB-V8) form. RESULTS: A total of 265 patients participated in the study. The average age of the participants was 39.75±11.93 years. The patients were divided into 3 groups according to the coexistence of OAB with migraine: group 1, OAB(+)/migraine(+); group 2, OAB(+)/migraine(-); and group 3, OAB(-)/migraine(+). The mean OAB-V8 score was 22.82 ±8.15 in group 1 and 25.64±7.49 in group 2. The mean OAB-V8 score of OAB patients with migraine as a comorbidity was statistically significantly lower than that of OAB patients without migraine (P=0.015). The median visual analogue scale (VAS) score was 7.11 (range, 2-10) in group 1 and 5.95 (range, 2-10) in group 3. This finding indicates that in patients with migraine, having OAB was associated with significantly higher VAS scores (P<0.001). CONCLUSION: OAB and migraine may be comorbid conditions coexisting in a single patient. This comorbidity may lead to a lower perception of OAB symptoms in OAB patients or, conversely, to a higher perception of migraine pain. Further studies are needed to elucidate how treatments for each of these diseases can affect the other disease.

Acute myocardial infarction and concomitant ischemic stroke as an unusual presentation of native mitral valve endocarditis.

ST-elevation myocardial infarction (STEMI) due to septic coronary embolism is a rare complication of infective endocarditis (IE) and is associated with high mortality rates. When common signs of IE are often overlooked on admission, the diagnosis may be established through complications, which may cause prominent symptoms. Here, we report a case of native mitral valve endocarditis with an unusual presentation with STEMI and concomitant ischemic stroke, which was due to multiple coronary and cerebral septic embolisms.