Can Lamina Cribrosa Indicate Optic Neuritis in Multiple Sclerosis?

Background: In this study, we aimed to evaluate the association of lamina cribrosa thickness (LCT) and lamina cribrosa depth (LCD), as determined by spectral domain optical coherence tomography (SD-OCT), with visual evoked potentials (VEPs) in patients with multiple sclerosis (MS). Materials and Methods: Patients enrolled in this prospective, cross-sectional study were divided into three groups. Group 1 consisted of 25 relapsing-remitting MS patients with VEP pathology in one or both eyes. In patients with VEP pathology in both eyes, one eye was chosen randomly. Group 2 comprised 25 relapsing-remitting MS patients with no VEP pathology or optic neuritis history. A randomly selected single eye of each patient was evaluated. Group 3 consisted of 25 age- and sex-matched healthy volunteers; a randomly selected single eye of these participants was examined. LCT, LCD, and retinal nerve fiber layer (RNFL) thickness measurements were determined in four quadrants (superior, inferior, nasal, and temporal) by SD-OCT. Results: The three groups were similar in terms of age and sex. The mean LCT was lower in Group 1 than in Group 2, but the difference was not statistically significant (268.80 ± 36.69 µm [min-max = 222-394 µm] versus 285.80 ± 12.00 µm [min-max = 249-338 µm]; P = 0.148). The mean LCT was significantly lower in Group 1 than in Group 3 (268.80 ± 36.69 µm [min-max = 222-394 µm] versus 294.80 ± 12.00 µm [min-max = 232-351 µm]; P = 0.012). There was a weak positive correlation between LCT and RNFL-inferior, RNFL-nasal, and RNFL-temporal. Conclusion: We found that the lamina cribrosa was thinner in MS patients with VEP pathology. To the best of our knowledge, this is a novel finding. Our results imply that LCT could be used as an indicator of optic neuritis in MS patients.

Is working in the emergency department a risk factor for sleep disorders for healthcare workers?

OBJECTIVE: This study aims to investigate the relationship between work-related stress and sleep disorders in healthcare personnel working in emergency department and in other departments. MATERIAL AND METHODS: This cross-sectional study included 34 emergency department healthcare personnel (emergency group [EG]) and 35 healthcare personnel working in other departments (non-emergency group [NEG]) and was conducted between November 10, 2019 and March 1, 2020. All participants were administered the following questionnaires: work-related strain inventory (WRSI), Epworth sleepiness scale (ESS), Berlin questionnaire, insomnia severity index (ISI), Pittsburgh sleep quality index (PSQI), Beck depression inventory (BDI), and Beck anxiety inventory (BAI). RESULTS: While the mean WRSI score of EG was 39.53±7.77, the mean WRSI score of NEG was 30.06±7.26 (t=5.236, p<0.001). According to PSQI, 79.4% of EG and 57.1% of NEG were found to have poor sleep quality (X2=3.938, df=1, p=0.047). Median PSQI overall score was 12 (IQR 25th-75th percentiles: 10-14) in EG, and 7 (IQR 25th-75th percentiles: 4-9) in NEG (U=285.5, p<0.001). While the mean anxiety score of EG was 13.35±5.70, the mean anxiety score of NEG was 9.06±6.00 (t=3.046, p=0.003). Median depression score was 12 (IQR 25th-75th percentiles: 10-16) in EG, and was 8 (IQR 25th-75th percentiles: 4-12) in NEG (U=354, p=0.004). A significant positive correlation was found between work-related strain scores and sleep quality, sleepiness, and insomnia severity scores (r=0.541, p<0.001; r=0.310, p=0.010; r=0.357, p=0.004; respectively). CONCLUSION: It was determined that healthcare personnel working in the emergency department were at higher risk of developing sleep disorders compared to healthcare personnel working in other departments and that there was a significant relationship between sleep disorders and work-related stress.

Is ocular vascularity affected in young migraine patients? A pilot study.

OBJECTIVE: This study aimed to evaluate ocular vascularity in young adult migraine patients with visual aura and without visual aura. MATERIAL AND METHODS: The study included 30 patients with migraine with visual aura (MWVA), 30 patients with migraine without visual aura (MWOVA), and 30 healthy control subjects, all between ages ≥18 and <45. Migraine patients were applied Headache Impact Test (HIT) and Migraine Disability Assessment Scale (MIDAS). Retinal nerve fiber layer thickness and ocular vascularity of all participants were evaluated with optical coherence tomography (OCT) and OCT angiography (OCTA). RESULTS: The MWVA group had significantly lower superficial and deep foveal vascular density values compared to the control group (p = 0.039, p = 0.028, respectively). The foveal avascular zone was significantly enlarged in the MWVA group compared to the control group (p = 0.033). MWVA patients had significantly lower whole optic disc, optic disc inside, peripapillary, superior hemisphere, inferior hemisphere, superior quadrant, and temporal quadrant vascular density values compared to the control group (p < 0.05 all), while there was no significant difference in the nasal quadrant (p = 0.083). Migraine attack frequency, MIDAS, and HIT were negatively correlated with ocular vascular density values. CONCLUSION: The results of our study indicate that young adult patients with MWVA are at risk of decreased ocular vascularity and that this risk may increase with frequency and severity of migraine attacks.

Nasolacrimal transition time in patients with multiple sclerosis.

PURPOSE: To measure the duration of nasolacrimal transition in patients with Multiple Sclerosis (MS), to compare the findings with the healthy population and to investigate the relationship between MS-related disability and nasolacrimal transition time. METHODS: A total of 73 individuals including 37 patients with relapsing-remitting MS and 36 healthy volunteers were included in the study. In both groups the nasolacrimal transition time was measured using flurosein drops. The degree of disability of MS patients was calculated according to the Expanded Disability Status Scale (EDSS). RESULTS: There was a significant difference between MS patients and control group in terms of the median value of nasolacrimal transition time in (240 s (min: 85, max: 724) and 58.5 s (min: 21, max: 428), respectively) (p < 0.001). A positive correlation was found between EDSS scores and nasolacrimal transition time of MS patients (r = 0.384, p = 0.019). CONCLUSION: This study showed that nasolacrimal transition time is prolonged in MS patients and there is a relationship between the degree of MS-related disability and the nasolacrimal transition time. This is the first study in the literature on this subject and the results of our study have the potential to shed light on the causes of common infections in MS patients. Long-term prospective studies are needed to further investigate the relationship between prolonged nasolacrimal transition and infections in MS patients.

Ultrasonographic measurement of the optic nerve sheath in the differential diagnosis and follow-up of migraine with and without aura: A pilot study.

OBJECTIVE: Headache continues to be a common cause of emergency admissions. At first glance, primary headaches may not be distinguished from secondary headaches. This study aimed to evaluate the use of ultrasonic measurement of optic nerve sheath diameter (ONSD) in the clinical diagnosis of migraine patients during attack and during periods without attacks. PATIENTS AND METHODS: This prospective study was conducted at the emergency department and neurology outpatient clinic of a tertiary hospital between October 2019 and January 2020. Patients diagnosed with episodic migraine and between ages 18-60 were included in the study. Migraine diagnosis and classification were based on criteria from the 2018 International Classification of Headache Disorders. ONSD measurement was performed with ultrasonography. ONSD measurements of the same migraine patients during attack and attack-free periods were compared with measurements of healthy volunteers. RESULTS: A total of 82 participants consisting of 42 migraine patients and 40 control subjects were evaluated. In the control group, mean ONSD of the right eye was 4.88 ±â€¯0.31 mm and mean ONSD of the left eye was 4.86 ±â€¯0.31 mm. Mean ONSD measurement of the left eye was 4.80 ±â€¯0.36 mm and mean ONSD of the right eye was 4.82 ±â€¯0.37 during the attack period of the migraine patients. There was no significant difference between the migraine patients and the control group according to right and left eye ONSD measurements (attack-free period: p = 0.200, p = 0.448; attack period: p = 0.338, p = 0.660, respectively). There was no significant difference between ONSD measurements during the attack period and attack-free period in migraine patients (right eye p = 0.32; left eye p = 0.532). CONCLUSION: The results of our study indicate that ONSD measurements may provide clinical insight into differential diagnosis preceding neuroimaging in migraine patients. On the other hand, since our study is the first on this topic, it should be noted that further studies are needed to come to a conclusion.

Can personality traits, obesity, depression, anxiety, and quality of life explain the association between migraine and disordered eating attitudes? / Traços de personalidade, obesidade, depressão, ansiedade e qualidade de vida podem explicar a associação entre migrânea e hábitos alimentares inadequados?

ABSTRACT Background: Few studies have explored the coexistence of migraine and disordered eating attitudes. Furthermore, the underlying pathophysiological mechanisms of migraine and disordered eating attitude comorbidity are not clearly understood. Objective: This study aimed to investigate the association between migraine and disordered eating attitudes in relation to personality traits, obesity, quality of life, migraine severity, depression, and anxiety. Methods: This study included 91 patients with episodic migraine and 84 healthy control subjects. Self-report questionnaires were used to evaluate anxiety, depression, migraine-related disability, personality traits, quality of life, and eating disorders. Results: The Eating Attitude Test (EAT) showed disordered eating attitudes in 21 patients (23.1%) in the migraine group and eight patients (9.5%) in the control group. Migraine-related disability, anxiety, depression, neuroticism, and quality of life scores were significantly worse in migraine patients with disordered eating attitudes compared to migraine patients without disordered eating attitudes. In migraine patients, eating attitude test scores were positively correlated with migraine-related disability, anxiety, depression, and neuroticism scores, and negatively correlated with quality of life scores. Conclusion: The association of migraine and disordered eating attitudes was shown to be related to depression, anxiety, quality of life and personality traits and may also indicate a more clinically severe migraine. To the best of our knowledge, there is no literature study that deals with all these relevant data together. However, neuropsychiatry-based biological studies are required to better understand this multifaceted association.

RESUMO Introdução: Poucos estudos exploraram a coexistência de migrânea e hábitos alimentares inadequados. Além disso, os mecanismos fisiopatológicos subjacentes da migrânea e da comorbidade da atitude alimentar inadequada não são claramente entendidos. Objetivo: Este estudo teve como objetivo investigar a associação entre migrânea e atitudes alimentares inadequadas em relação aos traços de personalidade, obesidade, qualidade de vida, gravidade da migrânea, depressão e ansiedade. Métodos: Este estudo incluiu 91 pacientes com migrânea episódica e 84 indivíduos saudáveis. Questionários de autorrelato foram utilizados para avaliar ansiedade, depressão, incapacidade relacionada à enxaqueca, traços de personalidade, qualidade de vida e distúrbios alimentares. Resultados: O Teste de Hábito Alimentar (THA) mostrou hábitos alimentares inadequados em 21 pacientes (23,1%) no grupo com migrânea e 8 pacientes (9,5%) no grupo controle. Os índices de incapacidade, ansiedade, depressão, neuroticismo e qualidade de vida relacionados à migrânea foram significativamente piores em pacientes com migrânea com hábitos alimentares inadequados em comparação com pacientes com migrânea sem hábitos alimentares inadequados. Em pacientes com migrânea, os escores dos testes de hábito alimentar foram correlacionados positivamente com os escores de incapacidade, ansiedade, depressão e neuroticismo relacionados à migrânea e negativamente com os escores de qualidade de vida. Conclusão: A associação de migrânea e atitudes alimentares inadequadas mostrou-se relacionada à depressão, ansiedade, qualidade de vida e traços de personalidade, podendo também indicar uma migrânea mais clinicamente grave. Até onde sabemos, não há estudo de literatura que lide com todos esses dados relevantes juntos. No entanto, são necessários estudos biológicos baseados em neuropsiquiatria para entender melhor essa associação multifacetada.

Can personality traits, obesity, depression, anxiety, and quality of life explain the association between migraine and disordered eating attitudes?

BACKGROUND: Few studies have explored the coexistence of migraine and disordered eating attitudes. Furthermore, the underlying pathophysiological mechanisms of migraine and disordered eating attitude comorbidity are not clearly understood. OBJECTIVE: This study aimed to investigate the association between migraine and disordered eating attitudes in relation to personality traits, obesity, quality of life, migraine severity, depression, and anxiety. METHODS: This study included 91 patients with episodic migraine and 84 healthy control subjects. Self-report questionnaires were used to evaluate anxiety, depression, migraine-related disability, personality traits, quality of life, and eating disorders. RESULTS: The Eating Attitude Test (EAT) showed disordered eating attitudes in 21 patients (23.1%) in the migraine group and eight patients (9.5%) in the control group. Migraine-related disability, anxiety, depression, neuroticism, and quality of life scores were significantly worse in migraine patients with disordered eating attitudes compared to migraine patients without disordered eating attitudes. In migraine patients, eating attitude test scores were positively correlated with migraine-related disability, anxiety, depression, and neuroticism scores, and negatively correlated with quality of life scores. CONCLUSION: The association of migraine and disordered eating attitudes was shown to be related to depression, anxiety, quality of life and personality traits and may also indicate a more clinically severe migraine. To the best of our knowledge, there is no literature study that deals with all these relevant data together. However, neuropsychiatry-based biological studies are required to better understand this multifaceted association.

Apilarnil: A Novel Neuroprotective Candidate.

PURPOSE: This study was designed to investigate the effect of apilarnil on neuronal damage and related mechanisms in a sepsis model in order to demonstrate whether or not apilarnil has neuroprotective effect. METHODS: In this study, 64 adult male Sprague-Dawley species rats were randomly divided into eight groups. The rats were administered apilarnil and/or lipopolysaccharide (LPS). Superoxide dismutase (SOD), catalase (CAT), malondialdehyde (MDA), xanthine oxidase (XOD) and testican-1 levels were measured in the brain tissue. Proinflammatory cytokines (tumor necrosis factor alpha [TNF-α], interleukin 1 beta [IL-1ß], interleukin 6 [IL-6]) were measured in brain tissue. Histological examinations were performed on hippocampus and cortex tissues in all groups. Apoptotic cell count was estimated using the Tunel method to observe the apilarnil's effect on apoptosis. Purkinje cells were counted in the hippocampus to measure the protective effect of apilarnil on the hippocampus. RESULTS: Apilarnil reduced the decrease in SOD and CAT levels in the brain developing sepsis. Apilarnil reduced the increase in MDA, XOD, and testican-1 levels in the septic brain. It was observed that the number of degenerated neurons due to sepsis decreased as apilarnil dose increased. Apilarnil reduced the elevated levels of proinflammatory cytokines (IL-6, TNF-α, IL-1ß) induced by sepsis. Apilarnil prevented sepsis-related apoptosis in the brain. CONCLUSION: The neuroprotective potential of apilarnil against brain damage in the sepsis model was demonstrated and suggested that it has the potential to contribute to new therapeutic targets against various neurological disorders.

Why do multiple sclerosis and migraine coexist?

BACKGROUND: Migraine coexistence, which is high in multiple sclerosis (MS), is reported. To better understand the etiology of the coexistence of MS and migraine and the outcomes of this relationship, the vitamin D, vitamin D-binding protein (VITDBP), vitamin D receptor (VITDR), high-sensitivity C-reactive protein (hs-CRP), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), total antioxidant status (TAS), total oxidant status (TOS), and Oxidative Stress Index (OSI) values were examined in patients with the coexistence of relapsing-remitting multiple sclerosis (RRMS) and migraine. METHODS: This study was conducted between January 1, 2019, and July 25, 2019, at the neurology and biochemistry clinics of two different tertiary hospitals simultaneously. Overall, 50 RRMS patients with migraine, 50 RRMS patients without migraine, and 50 healthy volunteers were included in the study. The participants' vitamin D, VITDBP, VITDR, hs-CRP, SOD, CAT, GSH-Px, TAS, TOS, and OSI values were measured. RESULTS: The vitamin D and VITDR values of the RRMS patients with migraine were lower than those of the RRMS patients without migraine (respectively, p = 0.014, p < 0.001). There was no significant difference between the RRMS patients with and without migraine in terms of their VITDBP values (p = 0.570). The SOD, CAT, GSH-Px, and TAS values of the RRMS patients with migraine were lower than those without migraine (all p < 0.001). The hs-CRP and TOS values of the RRMS patients with migraine were higher than those without migraine (all p < 0.001). CONCLUSION: To the best of our knowledge, this is the first study on this topic to date. Based on the results, our study may shed light on the etiopathogenesis of the coexistence of MS and migraine and new treatments. However, more studies are needed to better understand the etiology of this relationship and its negative effects.

Cognitive impairment profile differences in patients with psychogenic non-epileptic seizures and epilepsy patients with generalized seizures.

Objective: This study aimed to compare cognitive skills in epilepsy patients and psychogenic non-epileptic seizures (PNES) patients who have no history of frequent seizures to those of a healthy control group.Methods: This prospective cross-sectional study was conducted between January 2017 and June 2019 and included 103 epilepsy patients, 100 PNES patients, and 101 healthy controls, aged 18 to 60 years. Patients with fewer than 12 annual seizure episodes and no history of seizures during the last 30 days were added to the study. A sociodemographic data form, the Beck Anxiety and Depression Scales, Montreal Cognitive Assessment, Digit Span test, and Stroop Color-Word Interference Test were used.Results: Compared to the control group, sub-component scores were significantly lower in naming, attention, abstract thinking, and delayed recall for the epilepsy and PNES groups. Sub-component scores in orientation, executive functioning, and delayed recall were significantly lower in the epilepsy group compared to the PNES group. Digits Backward subtest scores and total Digit Span test scores were significantly lower in the epilepsy and PNES groups. Patients in the epilepsy and PNES groups took longer to complete the Stroop test and made more errors and corrections compared to the healthy controls. There was a negative correlation between the duration of the disease and the total Digit Span score in the epilepsy group.Conclusion: These findings suggest that the epilepsy group showed reduced cognitive scores even though they did not suffer from frequent seizures and were not drug-resistant.

Measurement of mucociliary clearance in the patients with multiple sclerosis.

OBJECTIVES: The aim of the present study was to measure nasal mucociliary clearance (NMC) time in the patients with MS and to compare the findings with healthy population. METHODS: Totally 97 individuals including 47 patients with relapsing-remitting multiple sclerosis and 50 healthy volunteers were enrolled into the study. Saccharin clearance test was performed on both groups and NMC time was measured. Data analysis was performed by SPSS version 24.0 statistics program (SPSS Inc., Chicago, Illinois, USA). Statistical tests were interpreted at p < 0.05 significance level. RESULTS: The NMC time averages in MS patients and healthy control group were 12.43 ± 4.05 min and 8.14 ± 2.87 min, respectively; the difference between the groups was significant (p < 0.001). There was a statistically strong association between NMC time values and Expanded Disability Status Scale (EDSS) values in MS patients (r = 0.817, p < 0.001). CONCLUSION: We found nasal mucociliary transport time longer in MS patients than healthy population in the present study. To the best of our knowledge, there is not any study conducted about this topic in the literature. We believe that our findings would shed a light on further studies.

Visual evoked potentials follow-up in idiopathic intracranial hypertension.

OBJECTIVE: To demonstrate the importance of visual evoked potential (VEP) in determining the severity and prognosis of the disease and in monitoring the clinical course in patients with idiopathic intracranial hypertension (IIH). METHODS: This is a prospective cross-sectional study conducted covering the period between March 2014 and January 2015. The study included 32 patients recently diagnosed with IIH and 30 healthy volunteers. The initial VEP values of the IIH patients were compared to the VEP values of the healthy control group. Furthermore, the initial VEP values of the IIH patients were compared with their VEP values after one month of treatme RESULTS: The mean age of the IIH patients was 37.8+/-12.02 years. Of the IIH patients, 27 (84%) were females and 5 (16%) were males. There was a statistically significant association of the initial VEP values with the visual field findings (p=0.011) and visual acuity (p=0.040). Moreover, a statistically significant difference was found between the control group and IIH patients in terms of right (p less than 0.001) and left P100 values (p less than 0.001). While 18 (56%) of the initial VEPs of IIH patients were pathological, 14 (44%) of the second VEPs were pathological, and this difference was not statistically significant (p=0.125). CONCLUSION: A relationship between the VEP P100 values and the severity of the disease was detected, while the importance of monitoring VEP values in the follow-up of IIH patients was not demonstrated.

Comorbid fibromyalgia in migraine patients: clinical significance and impact on daily life.

Objective: Herein, we aimed to investigate the impact of FM in migraine patients and the specific features and discriminations of this group of migraineurs with FM according to patients without FM. Methods: 102 consecutive migraine patients among 18-50 years old who accepted to involve in the study were included. All patients were asked to complete the following self-report questionnaires for the assessment of pain-related disability, migraine-related disability, anxiety, depression, sleep disturbance and quality of life. All statistical analyses were performed using the SPSS statistics 20 program. Results: 92% of the patients were diagnosed with episodic migraine, whereas 8% of them was diagnosed with chronic migraine (CM). Comorbid FM which was detected to present in 30.3% of the patients. FM was more frequent in CM patients and in migraine patients with aura. The analyses comparing FM (+) and FM (-) migraineurs revealed that headache frequency, migraine disease duration, headache impact test, MIDAS scores were significantly higher in FM (+) migraineurs. Furthermore, the vitality and role-emotional domains of the SF-36 resulted in worse scores in the group of FM (+) migraineurs. Conclusion: The results of our study may suggest the presence of FM as a clinical sign of a more severe migraine. However, the long-term prospective studies including these group of patients are needed to understand the prognostic impact and importance of the comorbid FM in migraine. Abbreviations: FM: Fibromyalgia; MIDAS: Migraine Disability Assessment.

Amplitude of Accommodation in Patients with Multiple Sclerosis.

Purpose: To evaluate the effect of multiple sclerosis (MS) on the amplitude of accommodation (AA) and retinal nerve fiber layer (RNFL) thickness.Materials and Methods: A total of 25 MS patients with visual-evoked potential (VEP) abnormalities (MS/+VEP Group), 25 MS patients without VEP abnormalities (MS/-VEP Group), and 25 controls (Control Group) were enrolled. Only findings from the right eye of the participants were included in the analysis. Each participant underwent a pattern-reversal visual-evoked potential (PVEP) recording, an RNFL thickness analysis by optic coherence tomography (OCT) in all quadrants, and a measurement of amplitude of accommodation (AA) with minus lens technique. The AA and the RNFL thickness were compared between the groups.Results: The mean age and sex distributions did not differ significantly across the groups (p= .788, p= .906, respectively). The mean AA was 5.36 ± 0.7 D in MS/+VEP group, 6.06 ± 1.4 D in MS/-VEP group, and 6.4 ± 0.9 D in control group (p= .002). The difference in the mean AA values between MS/+VEP and control groups were significant (p = .002). AA was significantly correlated with age, P100 latency and amplitude values in MS/+VEP group (r = -0.832, p < .001; r = -0.596, p = .002 and r = 0.498, p = .011, respectively). In a multivariable regression model, age and P100 latency were significant parameters for affecting AA in patients with MS (p < .001 and p = .001). In another multivariable regression model, age and average RNFL thickness were significant parameters for affecting AA in patients with MS (p < .001 and p = .010).Conclusions: We found that the AA was lower in MS patients with VEP abnormalities compared to age-matched healthy individuals. P100 latency was a significant parameter for predicting AA in MS/+VEP group. These results suggest that MS patients with VEP abnormalities might experience presbyopia earlier in life than people without MS, probably due to the chronic demyelination of neural pathways.

Evaluation of sleep quality in spouses of people with epilepsy.

OBJECTIVE: The objective of this study was to evaluate the spouses of people with epilepsy with and without a history of seizures during sleep in terms of depression, anxiety, and sleep quality. METHODS AND MATERIALS: This prospective, cross-sectional study was conducted in three groups of 18-55 year olds, who were at least primary school graduates. The 1st group consisted of healthy spouses of 30 healthy volunteers with age and sex matched with the other groups. The 2nd group comprised spouses of 30 people with epilepsy who had been married for at least one year and had no history of seizures during sleep. The 3rd group consisted of spouses of 30 people with epilepsy who had been married for at least one year and had a history of at least one seizure during sleep in the course of the previous year. The questionnaire including demographic data, Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI) was applied to all participants. RESULTS: The mean age of the 1st group was 35.07 ±â€¯8.33 years, that of the 2nd group was 36.47 ±â€¯7.63 years, and that of the 3rd group was 35.33 ±â€¯6.05 years. There was no significant age difference between the groups (p = 0.740). The depression scores of the 2nd and the 3rd groups were significantly higher than that of the 1st group (p < 0.001, for both). The anxiety scores of the 3rd group were significantly higher than those of the 1st and the 2nd groups (p < 0.001 and p = 0.001, respectively). Thirty percent (n = 9) of the 1st group, 40% (n = 12) of the 2nd group, and 70% (n = 21) of the 3rd group had poor sleep quality. The sleep disorder rate in the 3rd group was significantly higher than in the 1st and the 2nd groups (p = 0.002 and p = 0.020, respectively). When the PSQI subscales were examined, the sleep quality, sleep latency, usual sleep efficiency, daytime dysfunction, and the total sleep total score were significantly higher in the 3rd group than the 1st and the 2nd groups. The patients in the third group had significantly higher scores of sleep duration, sleep disturbance, and sleep medication use than those in the 1st group. CONCLUSION: We found out that the PSQI score, which reflected the sleep quality, was poor in the spouses of people with epilepsy, who had seizures during sleep. To the best of our knowledge, these findings are the first in the literature on this subject.

Evaluation of several classification methods in carpal tunnel syndrome.

OBJECTIVE: To investigate the performance and effectiveness of 4 classification methods including support vector machine, naive Bayes, classification tree, and artificial neural network in the detection of carpal tunnel syndrome. METHODS: This retrospective study was conducted at Yuzuncu Yil University, Van, Turkey, and comprised record of patients suspected of having carpal tunnel syndrome between January and December 2013. The evaluations included age, gender, and 6 electromyography variables, including right/left median nerve sensory velocity, right/left fourth finger peak latency difference, and right/left median nerve motor distal latency. We investigated the performance of classification methods such as support vector machine, naive Bayes, classification tree and artificial neural network in the patients using data obtained from electromyography scan. A total of 6 criteria were used for the assessment of performance, including: true positive rate, false positive rate, true negative rate, false negative rate, accuracy, and preciseness. RESULTS: Of the 109 patients, 88(80.7%) were women and 21(19.3%) men. Besides, 67(61.5%) participants had carpal tunnel syndrome and 42(38.5%) did not have it. On classification tree, only 2 variables, i.e. left fourth finger peak latency difference and right/left median nerve sensory velocity, were found to be statistically significant (p<0.001). Naive Bayes had the highest detection score (91.04%), followed by support vector machine (89.55%). CONCLUSIONS: Naive Bayes yielded better performance than all the other methods in the diagnosis of carpal tunnel syndrome, followed by support vector machine.

Dissociative experiences in patients with epilepsy.

A few studies have explored dissociative experiences in epilepsy patients. We investigated dissociative experiences in patients with epilepsy using the dissociative experiences scale (DES). Ninety-eight patients with epilepsy and sixty healthy controls were enrolled in this study. A sociodemographic questionnaire and the Dissociative Experiences Scale (DES), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were administered to the participants. The DES scores were significantly higher for the patients with epilepsy than the healthy individuals. The number of individuals with pathological dissociation (DES ≥ 30) was higher in the epilepsy group (n = 28) than in the control group (n = 8). Also, higher levels of dissociation were significantly associated with frequency of seizures, but were not associated with duration of epilepsy and age at onset of the disorder. These findings demonstrate that patients with epilepsy are more prone to dissociation than controls. The high rate of dissociative experiences among patients with epilepsy suggest that some epilepsy-related factors are present.

Dissociative experiences in patients with epilepsy / Experiências dissociativas em pacientes com epilepsia

ABSTRACT A few studies have explored dissociative experiences in epilepsy patients. We investigated dissociative experiences in patients with epilepsy using the dissociative experiences scale (DES). Ninety-eight patients with epilepsy and sixty healthy controls were enrolled in this study. A sociodemographic questionnaire and the Dissociative Experiences Scale (DES), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were administered to the participants. The DES scores were significantly higher for the patients with epilepsy than the healthy individuals. The number of individuals with pathological dissociation (DES ≥ 30) was higher in the epilepsy group (n = 28) than in the control group (n = 8). Also, higher levels of dissociation were significantly associated with frequency of seizures, but were not associated with duration of epilepsy and age at onset of the disorder. These findings demonstrate that patients with epilepsy are more prone to dissociation than controls. The high rate of dissociative experiences among patients with epilepsy suggest that some epilepsy-related factors are present.

RESUMO Poucos estudos exploraram as experiências dissociativas em pacientes com epilepsia. Investigamos as experiências dissociativas em pacientes com epilepsia através da Escala de Experiências Dissociativas (EED). Noventa e oito pacientes com epilepsia e 60 controles saudáveis foram incluídos neste estudo. Um questionário sócio-demográfico, a EED, o Beck Depression Inventory (BDI) e o Beck Anxiety Inventory (BAI) foram administrados aos participantes. Os valores de EED foram significativamente maiores nos pacientes com epilepsia em relação aos controles saudáveis. O número de indivíduos com doença dissociativa (EED ≥ 30) foi maior no grupo de epilepsia (n = 28) todo que no grupo controle (n = 8). Além disto, altos níveis de dissociação estavam associados à frequência de crises epilépticas, mas não à duração da epilepsia ou idade de início da doença. Estes achados demonstram que pacientes com epilepsia são maus susceptíveis à dissociação do que os controles. O alto índice de experiências dissociativas entre os pacientes com epilepsia sugere que alguns fatores específicos da epilepsia possam estar relacionados aos achados.