Re-emergent tremor in Parkinson's disease: Clinical and accelerometric properties.

Re-emergent tremor (RET) and the classical parkinsonian rest tremor were considered as two different phenomena of the same central tremor circuit. However, clinical and accelerometric characteristics of these tremors were not previously compared in a single study. We evaluated disease characteristics and accelerometric measurements of two tremor types in 42 patients with Parkinson's disease. Disease specific features and accelerometric measurements of peak frequency, amplitude at peak frequency and the root mean square (RMS) amplitude of two tremor types were compared. Eighteen patients had RET and the mean latency of the RET was 9.48 (±9.2)s. Groups of only rest tremor and RET did not differ significantly in age of disease onset, disease duration and severity and mean levodopa equivalent dose. Comparison of peak frequency and amplitude at peak frequency were not different between the groups, but RMS amplitude was significantly higher in the RET group (p=0.03). RMS amplitude of RET was also correlated with disease severity (r=.48, p=0.04). These results support the previous notion that rest tremor and RET are analogue, both are triggered by the same central ossilator with RET being only the suppression of the rest tremor due to arm repositioning.

Structural Changes in the Cerebrum, Cerebellum and Corpus Callosum in Migraine Patients.

PURPOSE: The purpose of this study was to demonstrate the relationship among the cerebrum, cerebellum and corpus callosum in migraine patients. METHODS: This work was conducted with cooperation of the Turgut Özal Medical Faculty, Department of Anatomy and Neurology. Migraine patients were divided into four groups: new patients; 1-5 years; 5-10 years; and, more than 10 years. All patients (n=75) and control subjects (n=20) underwent Magnetic Resonance Imaging (MRI) and brain images were processed by ONIS and Image J. Data were analyzed using the planimetric method. RESULTS: Cerebrum, cerebellum and corpus callosum volume were calculated for all subjects. The footprints of the callosum were as follows: healthy control subjects, new patients and 1-year patients: 12.8%, 5 years: 11.7% and more than 10 years: 10.7%. The cerebrum volume was as follows: healthy control subjects: 1152 cm3, 5-10 years: 1102 cm3 and more than 10 years: 1002 cm3. DISCUSSION: The results of our study showed atrophy in the cerebrum, cerebellum and corpus callosum of chronic migraine patients. This atrophy was greater in the patients with aura migraines. CONCLUSION: Our study confirmed that a migraine is an episodic disease that seriously affects the CNS.

The relationship between 25-hydroxyvitamin D levels and ambulatory arterial stiffness index in newly diagnosed and never-treated hypertensive patients.

OBJECTIVES: Vitamin D insufficiency has been shown to be associated with cardiac dysfunctions, such as cardiac hypertrophy and hypertension, in animal studies. Arterial stiffness is a prognostic marker for cardiovascular disease. Previous studies have demonstrated that 25-hydroxyvitamin D [25(OH)D] levels were negatively correlated with arterial stiffness index. The aim of this study was to investigate the relationship between 25(OH)D levels and arterial stiffness, which is evaluated using an ambulatory arterial stiffness index (AASI), in patients who have untreated and newly diagnosed essential hypertension. DESIGN: A total of 123 consecutive patients with newly diagnosed and untreated essential hypertension were included. Patients were divided into two groups according to their 25(OH)D levels. Vitamin D insufficiency was defined by 25(OH)D levels less than 20 ng/ml. All patients were referred for ambulatory blood pressure monitoring. The regression slope of diastolic and systolic blood pressure was computed for each individual on the basis of ambulatory blood pressure readings. AASI was described as one minus the respective regression slope. RESULTS: The mean AASI was significantly higher in patients with 25(OH)D levels less than 20 as compared with patients with 25(OH)D levels greater than or equal to 20 (0.50±0.20 vs. 0.34±0.17, P<0.001). In Pearson's correlation analysis, AASI had a significantly strong negative correlation with vitamin D levels (r=-0.385, P<0.001). In multivariate linear regression analysis, vitamin D levels were found to be significantly and independently associated with AASI (ß=-0.317, P=0.035). CONCLUSION: Arterial stiffness measured by AASI in newly diagnosed and untreated patients with essential hypertension were significantly related to vitamin D levels.

The effects and interactions of APOE and APH-1A polymorphisms in Alzheimer disease.

BACKGROUND/AIM: Alzheimer disease (AD) is characterized by the accumulation of senile plaques composed of amyloid ß-peptide, which is derived from ß-amyloid precursor protein through degradation by ß-secretase and y-secretase complexes. One of the major components of y-secretase complex, anterior pharynx-defective-1 (APH-1), is responsible for the activity of the γ-secretase complex. In this study, we searched for not only the most known common genetic risk factor, APOE, but also the APH-1a gene polymorphism in AD patients in a Turkish population. MATERIALS AND METHODS: In this study, 49 AD patients and 45 healthy controls were included. The genetic polymorphisms and allele frequencies of APOE and APH-1a were investigated. Patients were evaluated for behavioral, cognitive, and functional domains by detailed neurocognitive tests, and comparison between the above-mentioned polymorphisms and disease severity was made. RESULTS: Although there was an increased tendency of the APO ε4 allele in the AD group, no statistically significant difference was detected either in APOE or APH-1a polymorphisms, not suggesting a strong susceptibility to the development of AD. CONCLUSION: While searching for the pathogenesis of AD in order to develop novel diagnostic as well as therapeutic approaches, analysis of other genes with a possible role in AD is warranted.