Correlation of metal ions with specific brain region volumes in neurodegenerative diseases.

Background/aim: There are reports stating that deteriorations in metal homeostasis in neurodegenerative diseases promote abnormal protein accumulation. In this study, the serum metal levels in Alzheimer's disease (AD) and Parkinson's disease (PD) and its relationship with the cortical regions of the brain were investigated. Materials and methods: The patients were divided into 3 groups consisting of the AD group, PD group, and healthy control group (n = 15 for each). The volumes of specific brain regions were measured over the participants' 3-dimensional magnetic resonance images, and they were compared across the groups. Copper, zinc, iron, and ferritin levels in the serums were determined, and their correlations with the brain region volumes were examined. Results: The volumes of left hippocampus and right substantia nigra were lower in the AD and PD groups, while the volume of the left nucleus caudatus (CdN) and bilateral insula were lower in the AD group compared to the control group. Serum zinc levels were lower in the AD and PD groups, while the iron level was lower in the PD group in comparison to the control group. In addition, the serum ferritin level was higher in the AD group than in the control group. Serum zinc and copper levels in the AD group were positively correlated with the volumes of the right entorhinal cortex, thalamus, CdN, and insula. Serum zinc and copper levels in the PD group showed a negative correlation with the left nucleus accumbens (NAc), right putamen, and right insula volumes. While the serum ferritin level in the PD group displayed a positive correlation with the bilateral CdN, putamen, and NAc, as well as the right hippocampus and insula volumes, no area was detected that showed a correlation with the serum ferritin level in the AD group. Conclusion: A relationship was determined between the serum metal levels in the AD and PD groups and certain brain cortical regions that showed volumetric changes, which can be important for the early diagnosis of neurodegenerative diseases.

Comparative study of the volume of the temporal lobe sections and neuropeptide effect in Alzheimer's patients and healthy persons.

AIM: The aim of this study was to make a volumetric comparison of some medial temporal lobe structures and neuropeptides between the patients of Alzheimer's disease (AD) and healthy individuals. METHOD: The study comprised of a group of patients diagnosed with mild AD (n:15) and a Control group (n:15) (16 females, 14 males, mean age:72.90 ± 4.50). Voxel-based morphometry and MRICloud analyses were performed on the MR images taken in 3D measurements of gray matter volumes of all subjects. Following a 10-minute hug test, blood samples were taken from all participants for oxytocin (OT) and arginine vasopressin (AVP) analyses. RESULTS: The patient group had a statistically lower right hippocampus volume (p = 0.004) and OT values (p = 0.028) than the Control group. OT signal values increased with a volume increase in the right parahippocampal gyrus (PHG_R), and OT conc. and AVP conc. values increased with increasing volume of the PHG_R. CONCLUSION: It is suggested that the right hippocampus, right fusiform gyrus, left amygdala, left parahippocampal gyrus, and left entorhinal cortex atrophies can be used as predictors in the early diagnosis of AD. The positive correlation between PHG_R and neuropeptides showed the need to investigate the PHG and OT function more deeply.

Caffeic acid phenethyl ester decreases the level of S-100B protein after middle cerebral artery [correction for after] occlusion in rabbits.

Effects of caffeic acid phenethyl ester (CAPE) on the serum S-100B levels were studied as an index for brain damage after permanent middle cerebral artery (MCA) occlusion in rabbits. Twenty rabbits were divided into four groups (n=5): control, sham, non-treatment and CAPE. The right MCA was occluded using a microsurgical procedure with bipolar coagulation and was then transected in non-treatment and CAPE groups. The rabbits in the sham group underwent a surgical procedure but the MCA was not occluded. No surgery was performed in the control group. CAPE was administered after MCA occlusion at the dose of 10 microg/kg, once a day intraperitoneally for 7 days in the CAPE group. Serum S-100B levels were determined on days 1, 2, 4 and 7. Serum S-100B level was significantly increased following permanent MCA occlusion. Posttreatment of CAPE significantly reduced the serum S-100B level. This study demonstrated that CAPE is capable of attenuating increased serum S-100B level induced by MCA occlusion in rabbits. CAPE may be useful as a neuroprotective agent.

Macrocephaly and bitemporal arachnoid cysts not associated with glutaric aciduria type I in a child.

A 45-month-old child who had bitemporal arachnoid cysts and macrocephaly unrelated to glutaric aciduria type 1 (GA 1) was reported. The patient was admitted to the emergency unit after head trauma at 11 months of age. CT and MRI showed bitemporal arachnoid cysts (BACs). Acylcarnitine profile was normal in serum using tandem mass spectrometry. Urine and blood screening tests were within normal range for metabolic disorders. There were no unusual organic acids in urine and blood samples. No additional clinical findings of metabolic disorders such as GA 1 developed during follow-up. The majority of children affected with GA 1 have macrocephaly and BACs on CT or MRI. These signs should alert neurosurgeons to the possibility of GA 1. Neurosurgeons evaluating patients with head trauma or suspected non-accidental head injury should include GA 1 in the differential diagnosis of BACs associated with macrocephaly, and an evaluation should be performed.

[The effectiveness of the Epley maneuver for the treatment of BPPV and the role of nystagmus direction as an early indicator of successful treatment]. / BPPV tedavisinde Epley manevrasinin etkinligi ve uygulamada ortaya çikan nistagmus yönünün tedavi basarisi için erken bir gösterge olarak rolü

OBJECTIVES: We investigated the role of the direction of nystagmus that might occur during the Epley maneuver as an early indicator for treatment success in benign paroxysmal positional vertigo (BPPV). PATIENTS AND METHODS: The study included 47 patients (24 males, 23 females; mean age 46+/-12 years; range 29 to 70 years) who underwent the Epley maneuver for BPPV. The occurrence and the direction of nystagmus were observed. RESULTS: Nystagmus occurred in 16 patients during the maneuver, being ipsilateral in nine patients and contralateral in seven patients. The treatment was successful in seven patients (77.8%) with ipsilateral nystagmus, whereas none of the patients with contralateral nystagmus benefited from the maneuver. While there was no significant relationship between ipsilateral nystagmus and the success of the treatment (p=0.625), a significant correlation was found between contralateral nystagmus and treatment failure (p=0.000). CONCLUSION: The occurrence of contralateral nystagmus during the Epley maneuver may be a sign of an unsuccessful result.

Co-existince of sickle cell disease and hemidiaphragm paralysis.

Sickle cell anemia is a disease caused by production of abnormal hemoglobin. Infection, acute splenic sequestration crisis, aplastic crises, acute chest syndrome, stroke, cholelithiasis, renal disease and pain are the major complications. Unilateral or bilateral diaphragm paralysis maybe seen following phrenic nerve injury and with a variety of motor-neuron diseases, myelopathies, neuropathies, and myopathies. Prominent right hemi-diaphragma elevation was observed on chest radiograph of a 14 years' old female patient with sickle cell disease. Her medical history yielded neither trauma nor intra-thoracic surgery. She didn't have either motor deficit or sensation disorder on any region of her body. Thorax CT yielded no lesion except the significantly elevated right diaphragm. Her cranial CT showed no lesion, too. Diagnosis of right hemidiaphragm paralysis was confirmed by positive Hitzenberg Sniff test on fluoroscopy. Although several pathophysiologic mechanisms are known to be involved and lead to central neurologic complications in sickle cell disease, involvement of peripheric nerves have not been reported. Here we present a 14 years' old female patient with sickle cell anemia and unilateral diaphragm paralysis, co-existence of which have not been reported so far.