Digital Danger in Our Pockets: Effect of Smartphone Overuse on Mental Fatigue and Cognitive Flexibility.

ABSTRACT: Smartphones have become essential to life in Western society. This situation reached its peak, especially during the pandemic period. The possibility that smartphone use has negative impact on brain activity has attracted increasing interest among researchers. Medical faculty students were contacted via e-mail and invited to participate in the study. Participants completed the Smartphone Addiction Scale (SAS), the Mental Fatigue Scale (MFS), and the Cognitive Flexibility Inventory (CFI). The total SAS scores of participants with mental fatigue were significantly higher than those of participants without mental fatigue ( p < 0.001). In the smartphone addiction tendency group, the total MFS scores were significantly higher, and the total CFI scores were significantly lower than the scores of the control group ( p < 0.001 for both). In the logistic regression analysis, the total SAS score was associated with the development of mental fatigue ( B coefficient, 0.031, p < 0.001). This study identified potential relationships between smartphone addiction, mental fatigue, and cognitive flexibility. We suggest that smartphone overuse may be an independent risk factor for the development of mental fatigue.

Evaluation of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in essential tremor.

Background and purpose: Although essential tremor (ET) is the most common cause of tremor, the pathology and underlying mechanisms have not fully understood yet. In addition to kinetic tremor, patients may present several types of tremor, gait ataxia, hearing deficits and eye movement abnormalities. Non-motor symptoms and signs have also added to definition of ET. There is significant evidence indicating the neurodegenerative nature of the disease. New studies indicate that inflammation may have a place in the etiology. The neutrophil-to lymphocyte ratio (NLR) and the platelet-to lymphocyte ratio (PLR) have recently begun to be used as a marker of systemic inflammation. Our study aims at finding a clue for systemic inflammation in ET. Methods: 67 patients with ET and 40 healthy controls were recruited for the study. The total white blood cells (WBC), absolute neutrophil count, lymphocyte count and platelet count were retrieved. The NLR was calculated by dividing the neutrophil count by the lymphocyte count and the PLR was calculated by dividing the platelet count by the lymphocyte count. Results: Patient and control groups were similar in terms of age and gender. The mean age of patient group was 25.29 ± 8.24 years and that of control group was 26.77 ± 6.73 years. The NLRs were 1.85 ± 0.58 in the patient group and 1.96 ± 0.53 in the control group. For the patient group and the control group the PLRs were 103.52 ±32.80 and 91.26 ± 31.57 respectively. There were no statistically significant differences between the participants for both NLR and PLR. Conclusion: The pathophysiological mechanism for essential tremor (ET) remains unclear. However, there is an increasing amount of research being conducted on the subject. Discussions about ET's definition as a neurodegenerative disease are ongoing. Although previous studies showed that neuroinflammation could be a part of etiology of disease, this study has failed to demonstrate systemic inflammation in ET.

Comparison of optic coherence tomography results in patients with diagnosed epilepsy: Findings in favor of neurodegeneration.

BACKGROUND: Epilepsy is a chronic neurological disease characterized with recurrent seizures. Progressive neuronal degeneration is a common consequence of long-term and/or recurrent seizure activity in epilepsy. Optical coherence tomography (OCT) is a new medical imaging technique that displays biological tissue layers as high-resolution tomographic sections. The aim of our study was to evaluate OCT findings in patients with epilepsy and to compare OCT findings in terms of disease duration, presence of status, seizure frequency, and drug use. METHODS: Forty-three patients who had epilepsy according to the Commission on Classification and Terminology of the International League Against Epilepsy (ILAE) in 2010 and 40 healthy controls were recruited for the study. Disease duration, seizure frequency, status history, and multiple drug use were noted. Retinal nerve fiber layer (RNLF), ganglion cell layer (GCL), inner-plexiform layer (IPL), and choroid thinning were analyzed by using spectral OCT. RESULTS: The mean RNFL values are 101.48 ±â€¯11.33 in the patient group and 108.76 ±â€¯8.37 in the control group (p = 0.001). The mean GCL thickness values in the patient and control groups are 1.14 ±â€¯0.12 and 1.22 ±â€¯0.05, (p < 0.001). The mean IPL thickness is 0.93 ±â€¯0.09 in the patient group and 0.97 ±â€¯0.05 in the control group (p = 0.02). Choroid thickness is significantly increased in the patient group (p < 0.001). CONCLUSIONS: Demonstration of RNFL, IPL, and GCL thinning might indicate neurodegeneration, and choroid thickening indicates neuroinflammation. We found no association between disease duration, seizure frequency, status history, and multiple drug use and OCT parameters. Further studies with larger patient groups should clarify the matter.

Evaluation of Optical Coherence Tomography Results and Cognitive Functions in Patients with Restless Legs Syndrome.

INTRODUCTION: The aim of this study was to evaluate whether retinal neural network was impaired and cognitive functions were disturbed in restless legs syndrome (RLS) considering the hypothesis that there may be a dysfunction in dopaminergic pathways in RLS like in Parkinson's disease. Therefore, we evaluated retinal neural network with optical coherence tomography (OCT) and presence of cognitive impairment with Montreal Cognitive Assessment (MOCA). METHODS: OCT evaluations were performed for 30 RLS patients and 30 healthy controls. Ganglion cell complex was segmented to retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL) automatically by the device, and recorded. Additionally, all the patients and the controls were evaluated using MOCA. RESULTS: No statistically significant difference was detected between RLS and controls in RNFL, GCL, IPL, and choroidal thicknesses. However, total MOCA score and all of its subscale scores were significantly lower in the RLS patients compared with the controls. No significant correlation was detected between OCT and MOCA parameters. CONCLUSION: No degeneration was detected in retinal neurons (RNFL, GCL, and IPL) of RLS patients. However, impairments were seen in MOCA total and subscale scores of these patients. On the other hand, no significant correlation was detected between MOCA scores and RNFL, GCL, or IPL thicknesses. These findings suggest decrease in cognitive functions of RLS patients probably due to dopaminergic dysfunction regardless of anatomical neural degeneration. Longitudinal follow-up studies are warranted to evaluate whether neuronal degeneration will develop.

Evaluation of diffusion tensor imaging changes and neurocognitive effects of asymptomatic vitamin B12 deficiency.

Vitamin B12 plays an important role in the mechanisms which are responsible for myelinization in the central nervous system. It can particularly lead to hematological and neuropsychiatric symptoms when serum levels fall due to insufficient intake with diet or absorption problems. The purpose of this study was to show the cognitive effects in vitamin B12 deficiency cases that have not reached clinical symptom level using neuropsychological tests, and to show possible cerebral neuronal damage using diffusion tensor imaging (DTI) method. A total of 62 asymptomatic vitamin B12 deficiency patients and 40 healthy subjects were included in the study and both groups were subjected to Standardized Mini-Mental State Examination, Montreal Cognitive Assessment Test, Rey Auditory Verbal Learning Test, forward and backward digit span (WMS-R forward and backward), Visual Reproduction Subtest (WMS-III), Category Fluency Test, Trail Making (Trail A-B) (21) and Similarities (BENZ) tests. DTI examinations were performed on both groups. Patient group was determined to get lower scores in all neuropsychological tests compared to control group. In DTI examination, a significant decrease in FA values of bilateral hippocampus and a prominent increase in apparent diffusion coefficient (ADC) values were determined in the patient group compared to control group. In this study, it was determined that there was microstructural damage in the brain in the presence of vitamin B12 deficiency even in the asymptomatic period, and the patients revealed cognitive decline. In accordance with this result, early treatment of the easily diagnosed and treated vitamin B12 deficiency may prevent possible irreversible damage in the future.