Voice Analysis in Patients with Essential Tremor.

OBJECTIVE: The objective of this study was to reveal the phonetic characteristics of patients with or without voice tremor in patients with essential tremor (ET), determine whether these phonetic features are ET specific, and test the influence of ET on vocal tremor. METHODS: The study included a total of 30 patients with ET and 29 healthy volunteers. The severity of ET was evaluated using the Washington Heights Inwood Genetic Study of Essential Tremor (WHIGET) tremor rating scale. Patients with major tremor complaints for at least 3years, WHIGET scoring scores below 15, and patients newly diagnosed in our clinic and for whom drug therapy has not yet been started were selected. RESULTS: A total of 59 participants (n = 34 with ET and n = 25 as control) were included in the study. The ages of the participants ranged from 20 to 82years, with a mean age of 54.50 ± 15.04years. The gender distribution was 57.6% male and 42.4% female, and there was no statistically significant difference between the two groups in terms of age and gender. The study found that individuals with ET had significantly higher jitter, shimmer, S/Z, Pataka, frequency tremor intensity index, amplitude tremor intensity index, and frequency tremor power index values than the control group. However, there was no statistically significant difference between the two groups in terms of MPT, frequency tremor cyclicality, amplitude tremor cyclicality, frequency tremor frequency, and amplitude tremor frequency values. CONCLUSION: Our study shows that, even in the absence of essential voice tremor, there is an effect of ET on voice quality. These findings contribute to the understanding of the nonmotor symptoms of ET and may aid in the diagnosis and management of this condition. Further research is needed to explore the potential use of acoustic analysis parameters in the diagnosis and monitoring of ET.

Clinical experience: Outcomes of mesenchymal stem cell transplantation in five stroke patients.

Stem cell therapy, which has promising results in acute disorders such as stroke, supports treatment by providing rehabilitation in the chronic stage patients. In acute stroke, thrombolytic medical treatment protocols are clearly defined in neurologic emergencies, but in neurologic patients who miss the "thrombolytic treatment intervention window," or in cases of hypoxic-ischemic encephalopathy, our hands are tied, and we are still unfortunately faced with hopeless clinical implementations. We consider mesenchymal stem cell therapy a viable option in these cases. In recent years, novel research has focused on neuro-stimulants and supportive and combined therapies for stroke. Currently, available treatment options are limited, and only certain patients are eligible for acute treatment. In the scope of our experience, five stroke patients were evaluated in this study, who was treated with a single dose of 1-2 × 106 cells/kg allogenic umbilical cord-mesenchymal stem cells (UC-MSCs) with the official confirmation of the Turkish Ministry of Health Stem Cell Commission. The patients were followed up for 12 months, and clinical outcomes are recorded. NIH Stroke Scale/Scores (NIHSS) decreased significantly (p = 0.0310), and the Rivermead Assessment Scale (RMA) increased significantly (p = 0.0234) for all patients at the end of the follow-up. All the patients were followed up for 1 year within a rehabilitation program. Major clinical outcome improvements were observed in the overall clinical conditions of the UC-MSC treatment patients. We observed improvement in the patients' upper extremity and muscle strength, spasticity, and fine motor functions. Considering recent studies in the literature together with our results, allogenic stem cell therapies are introduced as promising novel therapies in terms of their encouraging effects on physiological motor outcomes.

Analysis of YouTube videos as a source of information for reliability and effectiveness of cannabidiol oil in treatment of epilepsy.

OBJECTIVE: Cannabidiol (CBD) oil has been used for the treatment of refractory epilepsy for a long time. In this study, we aimed to investigate the quality and reliability of YouTube videos pertaining to the use of CBD oil in the treatment of epilepsy. METHODS: A total of 100 videos were reviewed. Evaluation of the videos were performed by two experienced neurologists at the same time, but in different settings in order to prevent bias. Videos' image type, video content, video length, upload date, daily view count, comment and like counts, qualification of uploaders, DISCERN, and GQS scores were recorded. RESULTS: The videos were found to be uploaded by physicians (46 %), health channels (33 %), TV channels (7 %), patients (2 %), and other persons (12 %). The mean DISCERN score was found as 3.71 ± 1.17 and the mean GQS score was found as 3.21 ± 1.05 in all videos. According to the DISCERN scale, the videos uploaded by doctors were scored as 3.82 ± 1.02 and the videos uploaded by non-doctors as 3.07 ± 1.12 (p < 0.001). According to the GQS scale, the videos uploaded by doctors were scored as 3.51 ± 1.02 and the videos uploaded by non-doctors as 3.01 ± 1.17 (p < 0.001). CONCLUSION: Thirty-two (32%) videos were poor, 43 (43%) videos were moderate, and only 25 (25%) videos were good in terms of quality and reliability. YouTube videos related to health issues need to be audited strictly before they can become publicly accessible.

Cerebral Amyloid Angiopathy Related Inflammation Presenting as Steroid Responsive Brain Mass.

Cerebral amyloid angiopathy (CAA) is a common but often asymptomatic disease, characterized by the deposition of amyloid proteins within brain parenchyma and leptomeningeal-cortical vessels. It can occur as a sporadic disorder or accompany Alzheimer disease (AD). The usual presentation of CAA is spontaneous lobar hemorrhage, Unlike CAA, cerebral amyloid angiopathy-related inflammation (CAA-ri), a subtype of CAA, can show various presentations and responds to steroid (or immuno suppressive) treatment. We report a patient with mixed dementia who showed subacute progression in cognitive impairment and had a mass lesion on brain magnetic resonance imaging (MRI). The lesion was identified as CAA related inflammation and the cognitive status of the patient improved significantly after steroid treatment. In this case report, we aimed to emphasize that CAA-ri is one of the possible diagnoses that should be considered in demented patients with rapid cognitive deterioration and showing brain lesions resembling neoplasms on the MRI. Therefore, steroids or other immunosuppresive treatments, which may lead to a dramatic clinical improvement, could be administered without delay.