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WOS: 000435398900004 Objective: Restless Legs syndrome (RLS) is a frequent neurological disease. Levetiracetam (LEV) is an effective and broad-spectrum anticonvulsant drug. The aim of this study is to investigate the frequency of RLS in patients diagnosed with epilepsy who took LEV monotherapy. Materials and Methods: Two neurologists were reviewed the files of 1680 patients, who were followed in epilepsy outpatient clinic. One hundred seven patients under LEV monotherapy for at least six months and 120 healthy controls were included in the study. The criteria for the International Restless Legs Syndrome Study Group were taken into consideration for the assessment of RLS. Results: The mean age of patient group was 38.26 +/- 17.39 years, while the mean age of healthy controls was 39.17 +/- 16.12 years. There were no statistically significant differences in terms of age and sex between each two groups. The mean duration of LEV usage was 28.34 months. The LEV usage dose was between 500-3000 mg/day. RLS was seen in 7 (5.83%) healthy controls, whereas 4 patients (3.73%) had RLS in patient group before LEV treatment. The symptom of RLS in two patients disappeared after LEV treatment started and this rate decreased to 1.87%. The biochemical parameters were normal in all patient groups, after LEV treatment, peripheral neuropathy was detected in one patient whose symptoms were not relieved. Conclusion: LEV may have therapeutic effect on RLS. It may be preferred especially in comorbid situations where epilepsy and RLS are seen together. Longitudinal and prospective studies are needed to manifest better the therapeutic effects of LEV on RLS.

WOS: 000427323200003 Objective: Obstructive Sleep Apnea syndrome (OSAS) is a disease commonly seen in the community, causing labor loss and neuropsychiatric symptoms. The aim of the study is to compare the symptoms of depression and anxiety with those of healthy controls in patients with OSAS and to investigate the relationship between OSAS severity with anxiety and depression. Materials and Methods: Two hundred and thirteen patients with OSAS who underwent polysomnographic examination and 116 healthy controls were included in the study. The patient group was classified as mild, moderate and severe OSAS. Beck Anxiety and Beck Depression Scales were administered to the patients and healthy controls. Results: There was a significant difference between the patient group and the control group in the mean scores of Beck Depression and Beck Anxiety Scales. The mean scores of depression of the OSAS group were 11.16 +/- 8.87 (mild depression); 6.85 +/- 6.15 of the control group (p0.05). Conclusion: In our study; although there was a significant difference between depression and anxiety mean scores in patient and control group; there was no significant difference in anxiety and depression mean scores among mild, moderate and severe OSAS patients. Patients with OSAS were found to have mild anxiety and depressive symptoms. In these patients, there was no correlation between AHI values and depression and anxiety scores.

WOS: 000474456600009 Objectives: Psychiatric symptoms such as anxiety, depressive symptoms, psychotic symptoms, and mental retardation are much more common among patients with epilepsy (PWE) than the general population. This study aimed to evaluate psychiatric symptoms in patients with epilepsy. Methods: Symptom Checklist 90-R Revised (SCL-90-R) was given to all consecutive patients with epilepsy in outpatient Epilepsy Department. Participants completed the SCL-90-R questionnaire. One neurologist and one psychiatrist evaluated these forms. Subscales of somatization, obsessive-compulsive thoughts, interpersonal sensitivity, depression, anxiety, phobic anxiety, psychoticism, paranoid ideation, and hostility were evaluated. Results: A total of 111 PWE and 92 sex- and age- matched control subjects were included.The mean age of the patient group was 34.05 +/- 10.90 years. Of the patients, 43 were male and 68 were female. Fourteen (12.61%) patients were diagnosed with mental retardation. Based on our results of mean SCL-90-R score for each item, somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism were significantly higher in the patient group than the control subjects. Conclusion: SCL-90-R is an easy test to evaluate psychiatric symptoms. It can be used for PWE to raise awareness of psychiatric symptoms. Once the clinicians become more aware of such symptoms, more accurate approach to the patients will be possible. In terms of follow-up of PWE, not only seizure frequency and severity but also other psychiatric symptoms are important.

WOS: 000465507100013 PubMed ID: 30759289 The etiology of juvenile myoclonic epilepsy (JME) is still unknown and the process of elaboration of multiple genetic mechanisms is ongoing. The aim of this study was to investigate the potential role of NKCC1 (SCL12A2) and KCC2 (SCL12A5) in JME by comparing their DNA methylation status in patients with JME versus healthy controls. Forty-nine patients with JME and 39 healthy individuals were compared for DNA methylation at the 5CpG islands. A total of 71 (81%) samples were found to have methylation in the NKCC1 gene, 36 (73%) from patients and 35 (90%) from healthy individuals. Out of the KCC2 samples, 50 (57%) were found to have methylation, 33 (67%) from patients and 17 (44%) from healthy individuals. In patients with JME, methylation of NKCC1 (73%) was lower than its methylation in the controls (90%) (p=0.047). On the other hand, methylation of KCC2 in patients with JME (67%) was greater than the methylation in the controls (44%) (p=0.022). Twenty-eight patients were treated with VPA and ongoing medications were not found to be associated with methylation (p>0.05). In the present study, we determined significantly lower NKCC1 DNA methylation and significantly higher KCC2 DNA methylation levels in patients with JME compared with the healthy controls. This implies that NKCC1 expression can be higher and KCC2 expression can be reduced in affected people. Further studies that investigate the potential effect of DNA methylation mechanisms regulating gene expression on seizure activity and how they change JME network activity will be helpful.

Amaç: Parkinson hastalığı bradikinezi, tremor, rijidite ve postural instabilite ile karakterize, nörodejeneratif bir hastalıktır. Geleneksel olarak motor sistem hastalığı olarak ele alınmaktaysa da, bugün artık motor ve non motor (otonomik, davranışsal, bilişsel ve duysal) tutulum nedeni ile daha kompleks bir sendrom olduğu kabul edilmektedir. Non motor semptomlardan kognitif değişiklikler de oldukça sıktır. Patofizyolojisinde ise substantia nigranın pars kompakta bölümündeki dopaminerjik nöronların progresif kaybı yatmakta olup, postmortem çalışmalarda dopaminerjik nigral nöronlardaki nöronal dejenerasyonda oksidatif stresin önemli rol oynadığı gösterilmiştir. Nesfatin-1 ve glukagon-like peptit-1 (GLP-1) son yıllarda nöroprotektif özelliği olan ve oksidatif stresi azaltan moleküller olarak bildirilmektedir. Biz de nöroprotektif özelliği olan nesfatin-1 ve GLP-1'in Parkinson hastalarında kan düzeylerini, oksidatif süreçlere etkisini, Parkinson hastalığında klinik ağırlığa ve nonmotor semptomlardan kognisyona etkisini belirlemeyi amaçladık.Gereç ve yöntem: Çalışmamıza Muğla Sıtkı Koçman Üniversitesi Eğitim ve Araştırma Hastanesi Nöroloji Kliniğinde takipli Parkinson hastalığı tanısı almış 40 hasta, yaş ve cinsiyet olarak olarak benzer 40 olgu kontrol grubu olarak alındı. Parkinson hastalığının klinik ağırlığı ve derecelendirmesi için Birleşik Parkinson Hastalığı Derecelendirme Ölçeği (UPDRS), kognitif değerlendirme için Addenbrooke Kognitif Değerlendirme Bataryası (ACE-R) uygulandı. Hasta ve kontrol grubundan alınan kan örneklerinde nesfatin-1, GLP-1, total oksidan status (TOS) ve total antioksidan status (TAS) düzeylerine bakıldı. Nesfatin-1 ve GLP-1 düzeyleri için ELİSA (Enzyme-Linked Immunosorbent Assay) yöntemi, TAS ve TOS düzeyleri için spektrofotometrik ölçüm yöntemi kullanıldı. Bulgular: Parkinson hastalarında kontrol grubuna göre nesfatin-1 ve GLP-1 düzeyleri düşük, TOS düzeyleri ise yüksek saptandı. Parkinson hastaları ile kontrol grubu arasında TAS düzeyleri arasında anlamlı fark yoktu. Parkinson hastalarında ve kontrol grubunda hem nesfatin-1, hem GLP-1'in TAS ve TOS ile korelasyonu saptanmadı. Tüm vakalarda nesfatin-1 ile GLP-1'in pozitif korelasyonu, nesfatin-1 ve GLP-1'in TOS ile negatif korelasyonu izlendi. Nesfatin-1 ve GLP-1'in UPDRS ve ACE-R skorları ile korelasyonu izlenmedi.Sonuç: Parkinson hastalarında nesfatin-1 ve GLP-1 düzeylerinin kontrol grubuna göre düşük, TOS değerlerinin yüksek olması nesfatin-1 ve GLP-1'in Parkinson hastalarında azalması ile oksidatif süreçlerin arttığını ve moleküllerinin nöroprotektif etkilerinin oksidatif süreçler ile bağlantılı olabileceğini düşündürmüştür.Anahtar Sözcükler: Parkinson Hastalığı, Nesfatin-1, GLP-1, Oksidatif Stres Objective: Parkinson's disease (PD) is a neurodegenerative disorder characterized by bradykinesia, tremor, rigidity, and postural instability. Although it has conventionally been handled as a motor system disorder, today PD is recognized as a much more complex syndrome with a motor and non-motor (autonomic, behavioral, cognitive, and sensorial) involvement pattern. Among non-motor symptoms, cognitive changes are quite common. Progressive loss of dopaminergic neurons at the substantia nigra pars compacta is responsible for the pathophysiology. Postmortem studies have shown the essential role of oxidative stress in neuronal degeneration of the dopaminergic nigral neurons. Recent reports describe nesfatin-1 and glucagon-like peptide-1 (GLP-1) as molecules with neuroprotective property that relieve oxidative stress. To this end, we aimed to determine the blood levels of neuroprotectives nesfatin-1 and GLP-1 in PD patients, their effects on oxidative processes as well as their impact on the clinical severity of PD and on the cognition, one of the non-motor symptoms.Material and method: In this study, 40 patients with Parkinson, followed-up at the Department of Neurology of Mugla Sitki Kocman University Training and Research Hospital were enrolled, as well as 40 age- and sex-matched cases as a control group. For the purpose of clinical evaluation and staging of PD, Unified Parkinson's Disease Rating Scale (UPDRS) was applied while Addenbrooke's Cognitive Examination Battery was used to conduct a cognitive assessment. Blood samples collected from patient and control groups were tested to measure nesfatin-1, GLP-1, TAS (total antioxidant status), and TOS (total oxidant status) levels. ELISA method was used to determine nesfatin-1 and GLP-1 levels; TAS and TOS levels were detected by a spectrophotometric measurement. Results: Nesfatin-1 and GLP-1 levels detected in Parkinson patients were lower than those of the control group, whereas their TOS levels were higher. There was not any statistically significant difference between the patient group and the control group in terms of their TAS levels. Both in Parkinson patients and the control group, neither nesfatin-1 nor GLP-1 was found to have a correlation with TAS and TOS. In all cases, there was a positive correlation between nesfatin-1 and GLP-1 while nesfatin-1 and GLP-1 were negatively correlated with TOS. Nesfatin-1 and GLP-1 were not found to be correlated with UPDRS or ACE-R scores.Conclusion: The lower nesfatin-1 and GLP-1 levels, in addition to higher TOS levels, in Parkinson patients compared to those of control group suggest that oxidative processes are enhanced by the decrease of nesfatin-1 and GLP-1 in Parkinson patients and the neuroprotective effects of these molecules might be related to the oxidative processes.Key Words: Parkinson's Disease, Nesfatin-1, GLP-1, Oxidative Stress 95

WOS: 000438303700008 Sudden unexpected death in epilepsy (SUDEP) is a serious problem, and its importance has increased in recent years. It is responsible for the death of 17% of epilepsy patients. As the age of onset rises, the risk increases. Patients with refractory epilepsy are particularly at risk. Likewise, male gender, early age of onset, polytherapy, nocturnal seizures, generalized tonic-clonic seizures (GTCS) are also among the risk factors. Respiratory, cardiac, autonomic and brain stem related pathologies are held to be responsible for its pathophysiology.

WOS: 000377916300006 PubMed ID: 27303237 Epicardial fat, a metabolically active tissue, has emerged as a risk factor and active player in metabolic and cardiovascular diseases. We investigated epicardial fat thickness in patients who had sustained an acute ischemic stroke, and we evaluated the relationship of epicardial fat thickness with other prognostic factors. We enrolled 61 consecutive patients (age, >= 18 yr) who had sustained a first acute ischemic stroke and had been admitted to our hospital within 24 hours of the onset of stroke symptoms. The control group comprised 82 consecutive sex-and age-matched patients free of past or current stroke who had been admitted to our cardiology clinics. Blood samples were taken for measurement of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels at admission. Aortic stiffness indices and epicardial fat thickness were measured by means of transthoracic echocardiography within the first 48 hours. In comparison with the control group, the patients with acute ischemic stroke had significantly higher epicardial fat thickness (4.8 +/- 0.9 vs 3.8 +/- 0.7 mm; P < 0.001), lower aortic distensibility (2.5 +/- 0.8 vs 3.4 +/- 0.9 cm(2).dyn(-1); P < 0.001) and lower aortic strain (5.5% +/- 1.9% vs 6.4% +/- 1.8%; P=0.003). We found a significant association between epicardial fat thickness, NT-proBNP levels, and arterial dysfunction in patients who had sustained acute ischemic stroke. Increased epicardial fat thickness might be a novel risk factor and might enable evaluation of subclinical target-organ damage in these patients. department of Scientific Research Projects, Mugla Sitki Kocman University This research was financially supported by the department of Scientific Research Projects, Mugla Sitki Kocman University.

WOS: 000389053000033 PubMed ID: 27966319 Background/aim: This study aimed to define the frequency of a primitive reflex, the buccopalpebral reflex (BPR), and its association with the clinical situation in patients with Parkinson disease. Materials and methods: Between May 2010 and May 2011, 222 patients, 115 with Parkinson disease and 107 patients without any sign of neurodegenerative disease, were included in the study. All included patients were examined for BPR and snout reflex and were also evaluated with the Mini Mental State Examination. All patients with Parkinson disease were classified with the Unified Parkinson's Disease Rating Scale (UPDRS) and the Hoehn and Yahr Score to determine their clinical severity. Results: Sixteen patients with Parkinson disease (13.9%) had a BPR (+) and 4 patients in the control group (3.7%) (P < 0.001). The UPDRS score, UPDRS daily life activities score, and UPDRS motor system score were all higher in the group with BPR (+). All patients with a BPR also had a positive snout reflex. Conclusion: BPR is more frequent in patients with Parkinson disease than in patients without a neurodegenerative disease.

23rd World Congress of Neurology (WCN) - SEP 16-21, 2017 - Kyoto, JAPAN WOS: 000427450302038 Parkinson's disease (PD) is a neurodegenerative disorder characterized by bradykinesia, tremor, rigidity, and postural instability which progress through the loss of dopaminergic neurons (1). Progressive loss of dopaminergic neurons at the substantia nigra pars compacta is responsible for the pathophysiology (2). Postmortem studies have shown the essential role of oxidative stress in neuronal degeneration of the dopaminergic nigral neurons (3). Recent reports describe nesfatin-1 and glucagon-like peptide-1 (GLP-1) as molecules with neuroprotective property that relieve oxidative stress. Here we aimed to determine the blood levels of nesfatin-1 and GLP-1 in PD and their effect on oxidative processes. World Federat Neurol

WOS: 000410870800004 PubMed ID: 29042878 Objective Stroke is the second most common cause of death and the leading cause of adult disability. Both stroke patients and their family can therefore experience increased traumatic stress level. Methods The participants are close relatives of patients (n=65) who had a first time stroke (CRPWS) hospitalized. A control group (CG) (n=61), who had no history of chronic illness in their family and had at least one traumatic life event experience. The National Institutes of Health Stroke Scale, Modified Rankin Scale, Personal Information Form, Life Events Checklist, Traumatic Stress Symptom Scale, and Multidimensional Scale of Perceived Social Support, were used in the study. Results We found no significant association between NIHSS and MRS of patients and traumatic stress level of the family member. The traumatic stress level was significantly higher in the CRPWS group than in the CG group. Traumatic stress level was higher in women than men and was not associated with perceived social support in the CRPWS group. Conclusion The traumatic stress level of the relatives was not associated with the clinical features of the stroke patients. In the early phase, after the diagnosis of stroke, psychological support may be important to prevent CRPWS from PTSD.