Electrophysiological assessment of the effects of obstructive sleep apnea on cognition.

We used electrophysiological measures to investigate the effects of obstructive sleep apnea on attention, learning, and memory. Thirty subjects (OSA group, n = 15, control group n = 15) participated in n-back tests, accompanied by P300 recordings, to investigate working memory and attention. The mirror-drawing test was used to study procedural memory, and the trail-making test (TMT) was used to evaluate divided attention and executive function. No significant group difference in reaction time was found in the 0-back and 1-back tests. In the 2-back test, reaction times of patients were longer than those of the control group. No P300 wave was obtained in the OSA group in any (0-, 1-, or 2-back) n-back test. In contrast, in the control group, significant P300 waves were recorded except for the 2-back test. The mirror-drawing scores were unaffected by sleep apnea. There was no difference between groups in the TMT-A test on any of the trials. Although no group difference was found in the first or second trials of the TMT-B test, OSA patients were less successful in learning on the third trial. According to our study results, OSA affects attention and executive function adversely however, we could not detect a significant effect on working or procedural memory.

The relationship between CPAP usage and corneal thickness.

The purpose of this study was to determine whether there is a correlation between CPAP usage and corneal thickness in patients with sleep disordered breathing. Full-night polysomnography (PSG) recordings were collected. Ten patients had undergone PSG recordings with continuous positive airway pressure (CPAP), and seven patients had undergone PSG recordings without CPAP. We measured corneal thickness by ultrasonic pachymeter before sleep and ten minutes after waking. We also measured visual acuity with a routine ophthalmologic eye chart before and after sleep. We asked patients to fill out a post-sleep questionnaire to get their subjective opinions. In the without-CPAP group, corneal thickness increased significantly during sleep in both eyes (left, p = 0.0025; right, p<0.0001). In the with-CPAP group, corneal thickness did not increase significantly (p>0.05 for both left and right cornea). There was no significant difference in visual acuity tests (p>0.05 for both left and right eye) between the two groups. According to our results, there is a significant increase in corneal thickness in the without-CPAP group. Our data show that a low percentage of Rapid Eye Movement (REM) sleep may cause an increase in corneal thickness, which can indicate poor corneal oxygenation. In fact, many sleep-disordered breathing (SDB) patients have low REM. Since a contact lens may cause low corneal oxygenation, SDB patients with contact lenses should be monitored carefully for their corneal thickness.

Advanced analysis of finger-tapping performance: a preliminary study.

BACKGROUND: The finger-tapping test is a commonly employed quantitative assessment tool used to measure motor performance in the upper extremities. This task is a complex motion that is affected by external stimuli, mood and health status. The complexity of this task is difficult to explain with a single average intertap-interval value (time difference between successive tappings) which only provides general information and neglects the temporal effects of the aforementioned factors. AIMS: This study evaluated the time course of average intertap-interval values and the patterns of variation in both the right and left hands of right-handed subjects using a computer-based finger-tapping system. STUDY DESIGN: Cross sectional study. METHODS: Thirty eight male individuals aged between 20 and 28 years (Mean±SD = 22.24±1.65) participated in the study. Participants were asked to perform single-finger-tapping test for 10 seconds of test period. Only the results of right-handed (RH) 35 participants were considered in this study. The test records the time of tapping and saves data as the time difference between successive tappings for further analysis. The average number of tappings and the temporal fluctuation patterns of the intertap-intervals were calculated and compared. The variations in the intertap-interval were evaluated with the best curve fit method. RESULTS: An average tapping speed or tapping rate can reliably be defined for a single-finger tapping test by analysing the graphically presented data of the number of tappings within the test period. However, a different presentation of the same data, namely the intertap-interval values, shows temporal variation as the number of tapping increases. Curve fitting applications indicate that the variation has a biphasic nature. CONCLUSION: The measures obtained in this study reflect the complex nature of the finger-tapping task and are suggested to provide reliable information regarding hand performance. Moreover, the equation reflects both the variations in and the general patterns associated with the task.

A high-precision, low cost system for evaluating finger-tapping tasks.

Finger-tapping test is extensively employed to assess motor asymmetry in brain damaged patients and also to study the relationship between handedness and performance in normal subjects. The aim of this study was to develop a computer based finger-tapping system that could provide quantitative measures of finger-tapping performance. The system is designed to be used in a standard personnel computer without the need of any other hardware. The software is written in Borland Delphi 6.0 for Microsoft Windows 98 and higher operating systems. Beginning with the Pentium processor, it could be possible to access a time-stamp counter. The time-stamp counter is a 64-bit machine specific register that is incremented by every clock cycle, and keeps an accurate count of every cycle that occurs on the processor. By using a computer with 1 GHz processor speed it is possible to reach a high precision time resolution of 1 mus in finger-tapping tests. Our future prospects for the system are to improve it with various tools such as synchronized recording of electromyography, tapping force monitoring, monitoring of finger angle, and the response to different stimulus parameters by adding appropriate hardware and procedure.

L-Arginine and melatonin interaction in rat intestinal ischemia--reperfusion.

We investigated the combinative effects of L-arginine and melatonin on the contractile responses of terminal ileum after the intestinal ischemia-reperfusion (I/R), in vivo. Male rats were subjected to mesenteric ischemia (30 min) followed by reperfusion (180 min). We have observed a dramatic decrease in spontaneous basal activity and Ach-induced contractile response. Our data clearly showed that the contractility decrease was ameliorated by L-arginine but not by L-NAME. Melatonin has reversed the inhibition of contractility caused by I/R injury in part. We did not observe an augmentation in the contractility of ileum when we use melatonin and L-arginine in combination, in fact, melatonin decreased the protective effect of L-arginine in intestinal I/R injury.

Effect of rapid-eye-movement sleep deprivation on rat hypothalamic prostaglandins.

In this study, we investigated thyroid hormones, thyroid stimulating hormone (TSH), prostaglandin D(2) (PGD(2)) and prostaglandin E(2) (PGE(2)) levels in rapid-eye-movement (REM) sleep-deprived rats compared with controls. The aim of the present study was to detect the effect of REM sleep deprivation (RSD) especially on hypothalamic prostaglandin levels. Twenty-seven male rats were randomly assigned in three groups as dry cage control, yoked control, and RSD. RSD rats were sleep deprived for 10 consecutive days. At the end of 10th day all rats were sacrificed for measurement. Our results indicated that total triiodothyronine (T(3)) and thyroxine (T(4)) decreased in the RSD group while there was no change in TSH. We also measured hypothalamic PGD(2) and PGE(2) levels, but we could not find any significant change between groups.

A questionnaire survey among Turkish physicians about sleep disorders.

We aimed to assess the knowledge of Turkish physicians about sleep disorders and the attitude of the physicians towards sleep medicine. We prepared a 24-item-questionnaire, 7 of the questions were about the attitudes of the physicians and 17 of them were about the knowledge of the physicians. We applied the questionnaire in all university and educational hospitals in Ankara, which is the capital city and the second largest city of Turkey. Two-hundred-fifteen medical doctors from 5 different specialties accepted to answer the questionnaire, and 168 (78%) of them completed the questionnaire. 47% of the physicians rated themselves as they had little knowledge about sleep disorders, and 45% as they had enough knowledge about sleep disorders, however, the overall score was not high. They answered only 45.3% of the questions correctly. In the light of this survey, we concluded that medical education on sleep disorders should be extended both in length and in content to improve the quality of sleep disorders medicine in Turkey.

Adaptation of functional outcomes of sleep questionnaire (FOSQ) to Turkish population.

Turkish version of functional outcomes of sleep questionnaire (FOSQ.tr) was examined for its psychometric properties in patients with obstructive sleep apnoea hypopnoea syndrome (OSAHS). The FOSQ was translated into Turkish using a forward-backward translation. For the psychometric evaluation, 73 consecutive patients were selected along with 73 control subjects. Internal consistency, test-retest reliability, concurrent and discriminant validity were investigated. Values of Cronbach's alpha for the total FOSQ.tr (alpha= 0.92) and its sub-scales (alpha= 0.76-0.80) suggest that the questionnaire was consistent internally. Test-retest reliability of the FOSQ.tr was significant for the total score (r= 0.7) and the sub-scales apart from social outcome (r= 0.5 to 0.8, all p< 0.01). FOSQ.tr correlated moderately with Epworth sleepiness scale (ESS), with coefficients ranging from r= -0.5 to -0.62, (all p< 0.05) for the sub-scales, and r= -0.64 (p< 0.01) for total score. Discriminant analysis showed that FOSQ.tr could significantly distinguish the patients from normal subjects (p< 0.03). The psychometric properties of the FOSQ.tr suggest that it is a valid and reliable instrument for the assessment of the impact of disorders of excessive sleepiness on daily behaviour.

Targeted expression of IGF-1 transgene to skeletal muscle accelerates muscle and motor neuron regeneration.

Currently, there is no known medical treatment that hastens the repair of damaged nerve and muscle. Using IGF-1 transgenic mice that specifically express human recombinant IGF-1 in skeletal muscle, we test the hypotheses that targeted gene expression of IGF-1 in skeletal muscle enhances motor nerve regeneration after a nerve crush injury. The IGF-1 transgene affects the initiation of the muscle repair process after nerve injury as shown by increased activation of SCA-1positive myogenic stem cells. Increased satellite cell differentiation and proliferation are observed in IGF-1 transgenic mice, shown by increased expression of Cyclin D1, MyoD, and myogenin. Expression of myogenin and nicotinic acetylcholine receptor subunits, initially increased in both wild-type and IGF-1 transgenic mice, are restored to normal levels at a faster rate in IGF-1 transgenic mice, which indicates a rescue of nerve-evoked muscle activity. Expression of the IGF-1 transgene in skeletal muscle results in accelerated recovery of saltatory nerve conduction, increased innervation as detected by neurofilament expression, and faster recovery of muscle mass. These studies demonstrate that local expression of IGF-1 augments the repair of injured nerve and muscle.