Association of Polymorphisms within the Serotonin Receptor Genes 5-HTR1A, 5-HTR1B, 5-HTR2A and 5-HTR2C and Migraine Susceptibility in a Turkish Population.

OBJECTIVE: Migraine, a highly prevelant headache disorder, is regarded as a polygenic multifactorial disease. Serotonin (5-HT) and their respective receptors have been implicated in the patogenesis. METHODS: We investigated the 5-HT1A, 5-HT1B, 5-HT2A, and 5-HT2C receptor gene polymorphisms and their association with migraine in Turkish patients. The rs6295, rs1300060, rs1228814, rs6311, rs6313, rs6314, rs6318, rs3813929 (-759C/T) and rs518147 polymorphisms were analyzed in 135 patients with migraine and 139 healthy subjects, using a BioMark 96.96 dynamic array system. RESULTS: We found no difference in the frequency of the analyzed eight out of nine polymorpisms between migraine and control groups. However, a significant association was found between the rs3813929 polymorphism in the promoter region of 5-HTR2C gene and migraine. Also, the allele of rs3813929 was more common in the migraine group. CONCLUSION: This result suggests that the 5-HTR2C rs3813929 polymorphism can be a genetic risk factor for migraine in a Turkish population.

Contribution of polymorphisms in ESR1, ESR2, FSHR, CYP19A1, SHBG, and NRIP1 genes to migraine susceptibility in Turkish population.

Migraine, a highly prevalent headache disorder, is regarded as a polygenic multifactorial disease. Single-nucleotide polymorphisms (SNPs) in the genes that involved in sex hormone metabolism may comprise risk for migraine, but the results of previous genetic association studies are conflicting. The aim of this study was to evaluate genetic variants in genes involved in oestrogen receptor and oestrogen hormone metabolism in a Turkish population. A total of 12 SNPs in the ESR1, ESR2, FSHR, CYP19A1, SHBG and NRIP1 genes were genotyped in 142 migraine cases and 141 nonmigraine controls, using a BioMark 96.96 dynamic array system. In addition, gene-gene interactions were analysed using generalized multifactor dimensionality reduction (GMDR) methods. According to GMDR analysis, our results indicated that there was a significant association between migraine and gene-gene interaction among the CYP19A1, FSHR, ESR1 and NRIP1. Single-gene variant analysis showed that a significant association was observed between the TT genotype of rs10046 and migraine susceptibility.When the analysis was performed only in women, the GG genotype of rs2229741 was different between migraineurs and controls.When the female migraine patients were divided into two groups, migraine related to menstruation (MRM) or migraine not related to menstruation (MNRM), GG genotype of rs726281 was significantly associated with MRM. These results suggested that rs10046 could play a potential role in migraine susceptibility in Turkish population. Also, the rare GG genotype of rs726281 appears to influence migraine susceptibility in a recessive manner in MRM subgroup of female patients. In addition, variant GG genotype of rs2229741 may reduce the risk of migraine in Turkish women.

Effects of intrathecal caffeic acid phenethyl ester and methylprednisolone on oxidant/antioxidant status in traumatic spinal cord injuries.

PURPOSE: To examine the effect of intrathecally given caffeic acid phenethyl ester (CAPE) on peroxidation and total oxidant and antioxidant systems, and the effect of intrathecally given methylprednisolone (MP) in spinal cord injury (SCI) models. MATERIALS AND METHODS: Four groups of 10 rats were formed: (1) Laminectomy, intrathecal saline injection, no SCI (sham: S); (2) Laminectomy, intrathecal saline injection, SCI (control: SCI); (3) Laminectomy, intrathecally given single dose of 3 mg/kg MP, SCISCI (SCI + MP). 4) Laminectomy, intrathecally given single dose of 1 µg/kg CAPE, SCI (SCI + CAPE). Malondialdehyde (MDA), total oxidant activity (TOA), total antioxidant capacity (TAC), superoxide dismutase (SOD), and glutathione peroxidase (GPx) values in the spinal cord tissue were evaluated. RESULTS: When group S and group SCI were compared, MDA, TOA, and SOD parameters increased post-SCI (p < 0.01). When compared with group SCI, it was observed that CAPE and MP decreased the MDA, TOA, and SOD levels (p < 0.01). This decrease was more pronounced in the SCI + CAPE group. When group S and group SCI were compared, a statistically substantial decrease was observed in the post-SCI TAC levels. When compared with group SCI, it was shown that CAPE and MP treatment substantially increased TAC levels (p < 0.001). CONCLUSION: Intrathecal injection of both CAPE and MP inhibits lipid peroxidation and increase of oxidants in SCIs.

Therapeutic effects of thymoquinone in a model of neuropathic pain.

BACKGROUND: The goal of our study was to determine the therapeutic effects of thymoquinone in a dose-dependent manner in a model of neuropathic pain following an experimentally applied spinal cord injury (SCI). METHODS: Fifty female adult Wistar albino rats weighing between 220 and 260 g were included in the study and were divided into 5 groups as follows: Group S (sham), Group C (control), Group T100 (100 mg/kg thymoquinone), Group T200 (200 mg/kg thymoquinone), and Group T400 (400 mg/kg thymoquinone). To begin the experiment, SCI was applied to all groups (with the exception of the sham group) following a mechanical and heat-cold test. Two weeks later, the mechanical and heat-cold tests were repeated, and a single normal saline dose was given to the sham and control groups, whereas 3 varying doses of thymoquinone were given to the other groups. The mechanical and heat-cold tests were repeated at 30, 60, 120, and 180 minutes after receiving thymoquinone. Finally, the animals were put to death via the removal of intracardiac blood. The levels of nitric oxide, total oxidant status, total antioxidant status, paraoxonase, malondialdehyde, tumor necrosis factor-α, and interleukin-1ß were determined in all of the blood samples. RESULTS: The withdrawal threshold and withdrawal latency values recorded from the mechanical and heat-cold allodynia measurements for all 3 thymoquinone groups were higher than that of the control group at all time points (ie, 30, 60, 120, and 180 minutes). There were no differences in these results between the 3 thymoquinone groups. The paraoxonase and total antioxidant status serum levels of all 3 thymoquinone groups were higher than those of the control group, whereas total oxidant status, nitric oxide, malondialdehyde, interleuken-1ß, and tumor necrosis factor-α levels were lower in the 3 thymoquinone groups than in the control group. CONCLUSIONS: Thymoquinone is beneficial for decreasing experimental neuropathic pain following SCI. However, increasing the dose does not change the effect.

The role of oxidative stress and inflammatory response in high-fat diet induced peripheral neuropathy.

OBJECTIVE: Earlier studies suggest that high-calorie diet is an important risk factor for neuronal damage resulting from oxidative stress of lipid metabolism. In our experimental study of rats under high-fat diet, oxidative stress markers and axonal degeneration parameters were used to observe the sciatic nerve neuropathy. The aim of this study is to evaluate the pathophysiology of neuropathy induced by high-fat diet. METHODS: A total of 14 male rats (Wistar albino) were randomly divided into two experimental groups as follows; control group (n=7) and the model group (n=7); while control group was fed with standard diet; where the model group was fed with a high-fat diet for 12 weeks. At the end of 12 weeks, the lipid profile and blood glucose levels, interleukin-1ß (IL-1), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and transforming growth factor-ß (TGF-ß) levels were studied. Tissue malondialdehyde (MDA), nitric oxide (NO) levels and super-oxide dismutase (SOD), paraoxonase-1 (PON-1) and glutathione peroxidase (GPx) activities were studied. The distal blocks of the left sciatic nerves were evaluated for histomorphological analysis (including mean axon area, axon numbers, nerve fiber diameters, axon diameters, and thickness of myelin sheets). RESULTS: Body weights, serum glucose and high-density lipoprotein (HDL) levels of rats were found not statistically significantly different compared between the model and the control groups (p>0.05). Serum cholesterol, triglyceride, TGF-ß and TNF-α levels were significantly higher in the model group when compared with the control group (p<0.05). IL-1 and IL-6 levels were not statistically significantly different compared between the model group and the control group (p>0.05). The MDA and NO levels and the SOD and GPx activities of the sciatic nerves in model group were statistically significantly higher than the control group (p<0.05). In addition, the activities of PON-1 were statistically significantly lower in the model group when compared with the control group (p<0.05). The difference in the total number of myelinated axons between the control group and the model group was not statistically significant (p>0.05). The nerve fiber diameter and the thickness of the myelin sheet were statistically significantly lower in the model group when compared with the control group (p<0.05). The axon diameter and area were significantly decreased in the model group when compared with the control group (p<0.05). CONCLUSION: Our results support that dyslipidemia is an independent risk factor for the development of neuropathy. In addition, we postulated that oxidative stress and inflammatory response may play an important role in the pathogenesis of high-fat diet induced neuropathy.

Low fetuin-A level in migraine: a case-control study.

Migraine is a type of primary headache which is caused by the alterations in trigeminovascular system. Migraine attacks are associated with neurovascular inflammation of the cerebral and extracerebral vessels, but its pathophysiological mechanisms have not still been fully delineated. Also, migraine has been found to be associated with higher risks for various metabolic disorders. Thus, we aimed to investigate the matrix metalloproteinases (MMP), fetuin-A, ghrelin, and omentin levels which have important roles in metabolic disorders and inflammation, and to examine their relationship with migraine subtypes and attack frequency. Forty-nine migraine patients and 30 age- and sex-matched healthy control subjects were enrolled. Migraine diagnosis was confirmed according to the International Classification of Headache Disorders-II diagnostic criteria. Analyses of MMP9,MMP3, ghrelin, omentin, and fetuin-A were performed by the ELISA method. Fetuin-A, MMP-9, and MMP-3 levels were significantly lower in migraine than controls (p < 0.05). There were no significant differences between groups with respect to omentin and ghrelin (p > 0.05). In migraine patients, serum fetuin-A levels were positively correlated with MMP-9 and negatively correlated with MMP-3. MMP-3, MMP-9, fetuin-A, omentin and ghrelin levels did not correlate with age, disease duration, or frequency of migraine headache (p > 0.05). Migraine patients have lower fetuin-A, MMP-3 and MMP-9 levels than healthy individuals. Migraine patients have low fetuin-A levels, which may be related to the pathogenesis of migraine. The importance and impact of our findings on the pathogenesis, characteristics, and treatment of migraine needs to be investigated in further detailed studies.

The increase of mean platelet volume in patients with Alzheimer disease.

BACKGROUND/AIM: Vascular risk factors play an important role in the progression of Alzheimer disease (AD). Mean platelet volume (MPV) is a determinant of platelet functionality and increased MPV is associated with an increased risk of vascular inflammation. Here we aimed to examine whether MPV could be used as a marker of vascular damage in AD and to discuss the relation between MPV and other vascular risk factors. MATERIALS AND METHODS: A total of 109 outpatients with AD and 81 healthy controls were included in this study. Diagnosis of AD was made according to defined criteria. The Turkish version of the Mini Mental State Examination (MMSE) was used for cognitive assessment. According to the test results, patients were divided into 2 subgroups, mild (MMSE ≥ 18) and moderate (MMSE < 18), and their MPV levels were compared. RESULTS: MPV levels were higher in the AD group. There was no statistically significant difference between the moderate group and the mild group according to MPV values. CONCLUSION: Increased MPV in patients with AD may point to platelet dysfunction. MPV is an indicator of increased in vivo platelet activation. Hence, platelets could be the link between vascular risk factors and AD. The assessment of MPV in patients with AD may help identify the patients that could benefit from additional antiplatelet therapy.

Three-dimensional analysis of foramen magnum and its adjacent structures.

The goal of this effort is to evaluate the anatomy of the foramen magnum (FM) using 3-dimensional computed tomography (3D CT), and determine whether or not the anatomical features of vascular structures and condylar foramen (CF) affect the types of FM.The CT angiography records of 101 patients (44 men and 57 women) were retrospectively examined in this study. Details of the FM, CF, and the vertebral and basilar arteries were examined using maximum intensity projection and 3D rendering images. The average age of the 101 patients was 45.28 ± 16.3 years. The 8 types of FM, in order of their frequency of occurrence, are as follows: round (19 cases; 18.8%), 2 semicircles (18; 17.8%), egg-shaped (15; 14.9%), hexagonal (14; 13.9%), tetragonal (11; 10.9%), oval (11; 10.9%), pentagonal (9; 8.9%), and irregular (4; 4%). There was no statistically significant relationship between the anatomical features of the vertebral and basilar arteries and the CF with the different types of FM (P ≥ 0.05). In our study, the diameter of the anteroposterior (AP) FM was 34.7 ± 3.6 mm, and the transverse (T) diameter was 29.5 ± 2.5 mm. The AP and T diameters were significantly higher in men than in women (P = 0.006 and P ≤ 0.001, respectively).Our study revealed that 3D CT is a safe and easy method for visualizing the anatomical structure of the FM and neighboring structures. Furthermore, this study was the first to demonstrate that there is no correlation between the 8 types of FM and the vertebral artery, basilar artery, and CF.

Increased fibrinogen, D-dimer and galectin-3 levels in patients with migraine.

There are limited studies evaluating the fibrinogen levels in patients with migraine. It remains unknown whether the levels of the haematological marker of thromboembolism, D-dimer, and the levels of galectin-3, which plays an important role in inflammation as a proinflammatory mediator, change during the attacks in patients with migraine. The present study aims to compare galectin-3, fibrinogen and D-dimer levels in patients with migraine during the attacks and interictal periods, and to compare galectin-3, fibrinogen and D-dimer levels between patients with migraine and healthy controls to investigate the role of these parameters in the pathogenesis of migraine. Fifty-nine patients with migraine and 30 age-gender matched healthy control subjects were enrolled in the study. Blood galectin-3, fibrinogen and D-dimer levels were measured in patients with migraine. Patients with migraine had higher levels of galectin-3, fibrinogen and D-dimer compared to the healthy controls (p < 0.05). No statistically significant difference was found between galectin-3 and fibrinogen levels during the attacks and interictal period in the migraine group (p > 0.05). Migraine patients had higher D-dimer levels during the attacks compared to the patients in the interictal period in the migraine group (p = 0.05). In conclusion, we found increased levels of fibrinogen, D-dimer and galectin-3 in patients with migraine compared to the healthy control group. Furthermore, we showed increased galectin-3 levels in patients with migraine, and higher D-dimer levels during migraine attacks compared to the interictal periods for the first time. These findings may be associated with the hypercoagulability and neurogenic inflammation during migraine headaches.

Relation between electrophysiological findings and diffusion weighted magnetic resonance imaging in ulnar neuropathy at the elbow.

AIM: As only a limited number of studies have used diffusion-weighted imaging (DWI) and conventional magnetic resonance imaging (MRI) in patients with ulnar neuropathy at the elbow (UNE), the present study aimed to investigate the diagnostic value of the non-invasive DWI technique in patients with UNE. METHODS: A total of 26 elbows in 19 healthy controls (age range: 22-56 years) with no symptoms and 24 elbows in 21 symptomatic patients (age range: 21-46 years) with cubital tunnel syndrome underwent DWI. The electrophysiological and clinical criteria for the diagnosis of UNE were examined. RESULTS: No pathological signal from the ulnar nerve was detected in the healthy controls, whereas there was an increase in signals on DWI in all patients with UNE. On T2-weighted (T2W) imaging, there was increased signal intensity in 20 elbows, while low signal intensity was observed in the remaining four. A positive correlation was found between disease duration and presence of hyperintensity (P=0.044, r=0.42) on T2W images. CONCLUSION: DWI can be used together with electrophysiological methods for the diagnosis of UNE. Furthermore, DWI might be preferred in some cases, as it is non-invasive compared with the electrophysiological method for UNE diagnosis.

Evaluation of serum oxidant/antioxidant balance in multiple sclerosis.

The total oxidative status (TOS)/total anti-oxidative status (TAS) ratio can provide information on an individual's absolute oxidative stress index (OSI). We investigated the alterations in the oxidant-antioxidant balance by measuring the oxidant parameters OSI, TOS, and malondialdehyde (MDA) together with the antioxidant parameters such as TAS, and superoxide dismutase (SOD) in patients with relapsing remitting multiple sclerosis (MS). To our knowledge, this is the first study to evaluate OSI in patients with relapsing remitting MS. 35 ambulatory patients with relapsing-remitting MS (35.8 ± 8.7 years) and 32 age- and activity-matched healthy control subjects (35.1 ± 3.7 years) that participated in the study. Serum TAS and TOS levels were determined using new automated methods. MS patients had higher concentrations of MDA (151.5 ± 51.1 vs. 111.3 ± 27.4 nmol/g protein, respectively; p < 0.001), TOS (148.1 ± 162.5 vs. 48.3 ± 46.4 mmol H(2)O(2) Equiv./g protein, respectively; p = 0.002), OSI (21124 ± 32543 vs. 5294 ± 5562, respectively; p = 0.008), and SOD (4.5 ± 0.7 vs. 3.4 ± 0.6 U/L, respectively; p < 0.001) compared with healthy controls. On the other hand, MS patients had lower concentrations of NO (12.3 ± 6.9 vs. 17.4 ± 2.5 µmol/g protein, respectively; p < 0.001) and TAS (0.82 ± 0.27 vs. 0.26 ± 0.15, respectively; p = 0.011) compared with healthy controls. In conclusion, these findings indicate that the oxidative stress plays an important role in the pathogenesis of MS.

Protective effects of beta glucan and gliclazide on brain tissue and sciatic nerve of diabetic rats induced by streptozosin.

There have not been yet enough studies about effects of beta glucan and gliclazide on oxidative stress created by streptozotocin in the brain and sciatic nerve of diabetic rats. The aim of this paper was to investigate the antioxidant effects of gliclazide and beta glucan on oxidative stress and lipid peroxidation created by streptozotosin in brain and sciatic nerve. Total of 42 rats were divided into 6 groups including control, diabetic untreated (DM) (only STZ, diabetic), STZ (DM) + beta glucan, STZ (DM) + gliclazide, only beta glucan treated (no diabetic), and only gliclazide treated (no diabetic). The brain and sciatic nerve tissue samples were analyzed for malondialdehyde (MDA), total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), and paraoxonase (PON-1) levels. We found a significant increase in MDA, TOS, and OSI along with a reduction in TAS level, catalase, and PON-1 activities in brain and sciatic nerve of streptozotocin-induced diabetic rats. Also, this study shows that in terms of these parameters both gliclazide and beta glucan have a neuroprotective effect on the brain and sciatic nerve of the streptozotocin-induced diabetic rat. Our conclusion was that gliclazide and beta glucan have antioxidant effects on the brain and sciatic nerve of the streptozotocin-induced diabetic rat.

Diagnostic value of F-wave inversion in patients with early carpal tunnel syndrome.

Routine electrophysiological studies usually give normal results in patients with early stage carpal tunnel syndrome (CTS). Diagnostic significance of the F-wave inversion (the median of F-wave minimal latencies (FWML) exceeds a normal ipsilateral ulnar FWML by 1ms) has not been previously reported in early stage CTS. In this study, our primary aim was to investigate the diagnostic value of F-wave inversion in early stage CTS. Additionally, we aimed to demonstrate any possible relationship between F-wave inversion and symptom scores of the Boston questionnaire and functional capacity in early stage CTS. The study included 60 early stage CTS patients who presented with a median sensory nerve conduction velocity of ≥50m/s. The symptom severity and functional status of the patients were assessed by using the Boston questionnaire. The control group consisted of 45 healthy volunteers. We compared early stage CTS patients and healthy control subjects in terms of the results obtained from median-ulnar FWML. Existence of F-wave inversion was found in 32 (53.3%) of the early stage CTS patients and in 3 (8.7%) of the healthy controls (p=0.001). It was also found to be positively correlated with the Boston questionnaire scores (p=0.001, r=0.41) and functional capacity scores (p=0.001, r=0.41). The sensitivity and specificity of F-wave inversion for the diagnosis of early stage CTS were calculated as 53.3% and 93.3%, respectively. The addition of F-wave inversion measurement to the set of the routine nerve conduction studies can increase the reliability of the electrophysiological studies in patients with early stage CTS.

Ellagic acid attenuates oxidative stress on brain and sciatic nerve and improves histopathology of brain in streptozotocin-induced diabetic rats.

The aim of this study was to investigate the possible effects of ellagic acid in brain and sciatic nerve tissues of diabetic rats. Also, the impact of ellagic acid on catalase and paraoxonase (PON-1) activities, total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), malondialdehyde (MDA) and nitric oxide (NO) were examined. The rats were randomly divided into four groups, with eight rats each: Normal controls (not diabetic), only ellagic acid treated (ellagic acid controls, not diabetic), Diabetic controls (streptozotocin, diabetic), ellagic acid-treated diabetic (streptozotocin + ellagic acid). After a 4 week experiment, rats were sacrificed, and biomarkers for oxidative stress in the brain and sciatic nerve tissues of the rats were measured. There was significant depletion in the PON-1, catalase, and TAS levels in the brain and sciatic nerve tissues compared to the control groups (for both parameters, p<0.05). The values of catalase, PON-1 and TAS reversed back to normal levels in ellagic acid-treated diabetic rats compared to untreated diabetic rats (for both parameters, p<0.05). The levels of MDA, TOS, NO and, OSI in the brain and sciatic nerve tissues were higher in untreated diabetic rats compared to control group (for both parameters p<0.05). However, MDA, TOS, OSI, and NO levels were found to be significantly reduced in the ellagic acid-treated diabetic group compared to the untreated diabetic group in these tissues (for both parameters, p<0.05). In conclusion, the results of the present study suggested that ellagic acid exhibits neuroprotective effects against oxidative damage in diabetic rats.

Serum levels of calcification inhibitors in patients with intracerebral hemorrhage.

The vascular calcification regulators and inflammatory markers including fetuin-A, osteopontin (OPN), and matrix Gla protein (MGP) may play an important role in the development of intracerebral hemorrhages (ICHs). So far, the relationship between these parameters and ICH has not been studied. Therefore, this study was designed to elucidate whether fetuin-A, MGP, and OPN are involved in the pathophysiology of ICH. The ICH group consisted of 27 consecutive patients with spontaneous ICH evaluated in the neurology intensive care unit within the first 24 hours from the onset of the stroke. The serum OPN levels were significantly increased in patients with ICH compared to the controls. On the other hand, the serum MGP and fetuin-A levels were significantly decreased in the patients with ICH in comparison to the controls. In the patients with ICH, the serum MGP levels of the nonsurvivors were statistically significantly lower than the MGP levels of the survivors. In conclusion, the change in serum fetuin-A, MGP, and OPN levels after ICH indicates that these parameters play a role in the pathophysiological processes leading to an ICH. Measurement of the serum MGP levels may also be of value to estimate mortality.

The anti-oxidant and anti-apoptotic effects of nebivolol and zofenopril in a model of cerebral ischemia/reperfusion in rats.

The aim of this experiment was to investigate whether nebivolol and zofenopril have protective effects against oxidative damage and apoptosis induced by cerebral ischemia/reperfusion (I/R). There were seven groups of rats, with each containing eight rats. The groups were: the control group, I/R group, I/R plus zofenopril, I/R plus nebivolol, I/R plus nebivolol and zofenopril, zofenopril only and nebivolol only. Cerebral I/R was induced by clamping the bilateral common carotid artery and through hypotension. The rats were sacrificed 1h after ischemia, and histopathological and biochemical analyses were carried out on their brains. The total antioxidant capacity was evaluated by using an automated and colorimetric measurement method developed by Erel. I/R produced a significant increase in the levels of total oxidant status and malondialdehyde levels, the number of caspase-3 immunopositive cells and activities of prolidase and paraoxonase in brain when compared with the control group (p<0.05). A significant decrease in brain total antioxidant capacity and nitric oxide levels were found in I/R group when compared with the control group (p<0.05). Both nebivolol and zofenopril treatment prevented decreasing of the total antioxidant capacity and nitric oxide levels, produced by I/R in the brain (p<0.05). Both nebivolol and zofenopril treatment prevented the total oxidant status, malondialdehyde levels, activities of paraoxonase and prolidase from increasing in brains of rats exposed to I/R (p<0.05). In conclusion, both nebivolol and zofenopril protected rats from ischemia-induced brain injury. The protection may be due to the indirect prevention of oxidative stress and apoptosis.

Serum prolidase activity and oxidative status in patients with diabetic neuropathy.

We found no data in the literature related to oxidative stress index (OSI), total oxidative status (TOS) and prolidase activity in patients with diabetic neuropathy (DN). In this study, we aimed to evaluate the oxidative status of DN patients via measurement of TOS and serum total antioxidant status (TAS) and estimation of OSI using new automated methods. Thirty-eight healthy participants, 40 diabetic patients without neuropathy, and 39 patients with DN were included. Electrophysiological and neurological examinations were performed. The activity of prolidase and levels of TOS and TAS were determined in the serum of patients. The level of TAS was lower, while the levels of TOS and OSI, and activity of prolidase were higher in both DN and diabetic control groups compared with the healthy subjects (p < 0.05). Prolidase activity was found to be higher in the DN group than in the diabetic control group (p = 0.001). In conclusion, the presence of high TOS and OSI levels together with low levels of TAS in diabetic patients with or without neuropathy may support a role of oxidative stress in the pathogenesis of diabetes mellitus. In addition, increased serum prolidase activity in DN may be interpreted as evidence of increased collagen turnover.

Primary headaches associated with sexual activity respond to topiramate therapy: a case report.

Primary headaches are rarely associated with orgasms. Indomethacin at doses of 25-50 mg/day taken 30-60 minutes prior to sexual activity may prevent headaches. Propranolol and metoprolole have been used for headaches that consistently emerge during frequent sexual activity of any type. It is also known that topiramate is useful for treating migraines, but it is rarely used for other primary headaches. The role of topiramate in the treatment of headaches associated with sexual activity is unclear. Indomethacin and propranolol could not be used in our patient who, besides sexual activity-associated headaches, suffered from gastritis and diabetes mellitus. Thus, topiramate (50 mg/day) was used prophylactically, and sexual activity-associated headaches did not recur during 6 months of topiramate therapy. This is the first report of positive response to topiramate as prophylactic treatment against sexual activity-associated headaches when propranolol and indomethacin are contraindicated.

Increased asymmetric dimethylarginine and nitric oxide levels in patients with migraine.

Asymmetric dimethylarginine (ADMA) has been found as correlated with endothelial dysfunction and oxidative stress. There are few studies regarding ADMA and nitric oxide (NO) levels in patients with migraine and alterations of ADMA and NO levels during migraine attack are not well-known. Therefore, in present study, we aimed to measure NO and ADMA levels in patients with migraine and compare them with the control group to investigate the correlation between migraine, oxidative stress and endothelial dysfunction. The migraine group consisted of 59 patients, including 22 suffering from migraine with aura and 37 suffering from migraine without aura. The control group consisted of 31 healthy volunteers without headache. The patients in migraine group were divided into subgroups based on whether attack period was present or not and whether it was migraine with or without aura. Plasma ADMA levels were measured using an enzyme-linked immunosorbent assay method. Migraine patients had higher concentrations of NO (35.6±7.7, 31.0±6.2 µmol/L, respectively, p=0.005) and ADMA (0.409±0.028, 0.381±0.044 µmol/L, respectively, p = 0.001) levels when compared with the healthy controls. During migraine attack, NO and ADMA levels were found to be significantly higher in migraine group as compared to control group (respectively, p=0.015, p=0.014). Similarly, NO and ADMA levels in the patients with migraine in the interictal period were found to be significantly higher as compared to control group (p=0.011, p=0.003). In conclusion, higher ADMA and NO levels of patients with migraine supported that oxidative stress and endothelial dysfunction may have a role in migraine pathogenesis.

A patient with progressive headache and partial optic chiasm involvement.

A 69-year-old woman presented with a 2-month history of bilateral throbbing daily headaches and a 2-week history of progressive visual loss. Radiologic imaging, visual field test, and cerebrospinal fluid analysis findings are discussed. After treatment, the symptoms were resolved without deficit.