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Objective: Premature Ejaculation (PE) is a common sexual disorder that considerably affects sexual satisfaction, subjective well-being, and quality of life. A clear picture of the pathophysiology of PE has still not been determined. Current research has revealed the involvement of the central nervous system. Alterations in frontal cerebral structures and a discrepancy between the reported and objectively measured intravaginal ejaculatory latency times both point to a possible alteration of time perception. The present study aimed to assess the time perception between individuals with lifelong PE and healthy individuals. Material and Methods: 24 individuals with lifelong PE and 24 healthy volunteers were recruited. Participants were administered both clinical measures and a time perception test battery including time interval estimation tests and time interval production tests for 4,7,32 and 58-second time intervals. Results: Lower predictions for 4-second time intervals were found in individuals with lifelong PE than in healthy controls. No differences were found for 7,32 and 58-second time intervals. The Premature Ejaculation Diagnostic Tool scores correlated negatively with the 4-second and 32-second time interval predictions. Conclusion: The present results indicate a time perception deficit for short intervals in individuals with lifelong PE for the first time. This might be due to a working memory/executive function deficit or disruption of frontal functions on account of impulsivity. A specific deficit in time perception deficit might also occur. Further studies assessing other frontal functions concomitantly are required to draw firm conclusions. [ABSTRACT FROM AUTHOR]

Opioid use disorder (OUD) is a chronic disorder with a considerable amount of morbidity and mortality. Despite remarkable improvement achieved by maintenance programs, an array of treatment goals were still unmet. Mounting evidence suggests that transcranial Direct Current Stimulation (tDCS) improves decision making and cognitive functions in addictive disorders. tDCS paired with a decision making task was depicted to diminish impulsivity as well. The present study aimed to assess the effect of tDCS combined with cognitive training (CT) in OUD for the first time. In this triple-blind randomized sham-controlled pilot study, 38 individuals with OUD from the Buprenorphine-Naloxone Maintenance Therapy program were administered 20-minutes of 2 mA active/sham tDCS over the dorsolateral prefrontal cortex with concomitant cognitive training. A selected test battery evaluating decision making under risk and ambiguity as well as executive functions, verbal fluency and working memory was utilized before and after the intervention. Greater improvements were observed in decision making under ambiguity (p = 0.016), set shifting ability and alternating fluency while no improvements were observed in decision making under risk in the active group, compared to sham. Deficits of decision making and executive functions have a pivotal role in the perpetuation and the relapse of the OUD. Alleviation of these impairments brought tDCS/CT forth as an expedient neuroscientifically-grounded treatment option that merits further exploration in OUD, Trial registration: NCT05568251. [ABSTRACT FROM AUTHOR]

Objective: Epilepsy is a condition characterized by sudden, recurrent epileptic seizures that occur as a result of abnormal and excessive electrical discharge in cortical neurons and are not triggered by an identifiable event. To date, no study has examined prospective memory and medication adherence in patients with focal and generalized epilepsy. This study aimed to examine medication adherence and prospective memory functions in individuals diagnosed with focal and generalized epilepsy Methods: In this study, 51 patients diagnosed with focal and 51 with generalized epilepsy at Muğla Sıtkı Koçman University Faculty of Medicine Epilepsy and Sleep Center were included. In addition to the sociodemographic and clinical data forms, participants were administered the Modified Morisky Scale to evaluate medication adherence and the Prospective and Retrospective Memory Questionnaire to evaluate prospective memory function. Results: No difference was found between patients diagnosed with focal epilepsy and those with generalized epilepsy in prospective memory functions and medication adherence. Near-significant correlations were found between medication adherence and memory function. Conclusion: More comprehensive studies evaluating cognitive functions and other parameters related to medication adherence simultaneously are required to clarify the relationship between memory and medication adherence in epilepsy. [ABSTRACT FROM AUTHOR]

Objective: Different mechanisms such as psychological, neurobiological, autonomic, and genetic factors might be involved in the etiology of lifelong Premature Ejaculation (PE). Albeit cortical activity changes have been reported, the relationship between PE and impulsivity/decision-making has been minimally studied to date. The present study aimed to assess impulsivity and risky decision-making in individuals with lifelong PE for the first time. Methods: 26 lifelong PE patients were diagnosed by the International Society for Sexual Medicine (ISSM-2014) criteria and 26 healthy volunteers were recruited. The Premature Ejaculation Diagnostic Tool, International Erectile Function Index, Barratt Impulsiveness Scale-11, Patient Health Questionnaire-9, Balloon Analogue Risk Task, and Monetary Choice Questionnaire-27 were administered. Results: The mean age was 37. No differences were found between groups in risky decision-making and impulsivity. Conclusions: No alterations of impulsivity and risky decision-making were found in lifelong PE patients. Impulsivity may only exist in a subset of individuals with lifelong PE or may only be evident in neural levels or specific subtypes of impulsivity. [ABSTRACT FROM AUTHOR]

Although a vast amount of research efforts including a plethora of distinct methodologies have been put forth, the pathophysiology of obstructive sleep apnea syndrome (OSAS) has not been compromised and multidimensional aspects of biological rhythm disruptions has not been evaluated yet. Twenty individuals with severe OSAS and 20 individuals without OSAS were administered. The Biological Rhythm Interview of Assessment In Neuropsychiatry and the Emotion Recognition Task to evaluate biological rhythm disruptions multidimensionally and emotion recognition abilities dynamically for the first time in OSAS. More disrupted eating patterns (p = 0.03), diminished durations of non-REM 1 and 3 sleep stages, and preserved emotion recognition abilities were found in severe OSAS, thus emphasizing the role of eating patterns in OSAS. Allowing for the multifactorial nature of biological rhythm disruptions and emotion recognition abilities, the content and the course and the interplay between them should be pegged away before arriving at firm judgments. [ABSTRACT FROM AUTHOR]

Objective: Episodic migraine is a common primary headache syndrome and its pathophysiology has not been fully elucidated. Interoception is the process of the perception and the evaluation of the signals from the inner body that has been considered to have a key role in the emergence and the chronification of pain. It has been mainly maintained by the insula, which is a multimodal integration area between the prefrontal cortex and the descending pain pathways. Interoceptive accuracy has been depicted to decrease in chronic pain syndromes like fibromyalgia, musculoskeletal pain, and neuropathic disorders. Dysfunctions in descending pain pathways and insula have also been observed in episodic migraine and insula response to interoceptive awareness has been associated with migraine attack frequency in a recent study though interoceptive accuracy has not been evaluated. The present study aimed to evaluate interoceptive accuracy in individuals with episodic migraine and healthy individuals. Methods: After obtaining approval from the Haydarpaşa Numune Research and Training Hospital Ethical Committee, 24 individuals with episodic migraine and 24 healthy adult volunteers were recruited. Heartbeat Counting Task was administered to all individuals. Two group means were compared using the Independent Samples t-test. Correlations were performed using Pearson tests. Results: The mean age of the sample was 24.18. The interoceptive accuracy index was lower (p=0.002) in individuals with episodic migraine (0.572) than in healthy volunteers (0.756). Relationships between interoceptive accuracy index and age (p=0.045) as well as body mass index (p=0.016) were found. Conclusion: Similar to other chronic pain syndromes, a lower interoceptive accuracy index was found in individuals with migraine than in healthy volunteers. Electrophysiology and neuroimaging studies were warranted to delineate the mechanisms underlying the observed effect. The present results were contemplated to contribute to the development of interoception-oriented therapies like yoga and interoceptive training in individuals with episodic migraine. [ABSTRACT FROM AUTHOR]

AIM: Lumbar spinal stenosis (LSS) is one of the most common reasons for spinal surgery in geriatric individuals. Transcranial Direct Current Stimulation (tDCS) is a neurophysiological treatment that was indicated to be efficacious in chronic pain syndromes. In this study, we aim to assess the efficacy of tDCS on pain and physical functions in individuals with LSS for the first time. METHODS: In this double-blind study, 30 individuals with LSS (15 active, 15 sham) were administered 10 sessions of active/sham tDCS over the primary motor cortex consecutively on weekdays of 2 weeks. The pain was evaluated with the Visual Analogue Scale (VAS) and walking distance and duration were assessed with Self-Paced Walking Test before the first session, immediately after the last session and 3-months after the last session. Mann-Whitney U and Fisher's tests were utilized to assess baseline group differences and Friedman tests were utilized to assess treatment effect. RESULTS: No baseline group differences were observed. Mean resting VAS (p<0,001), maximum resting VAS (p=0.001), mean VAS during walking (p<0.001) and maximum VAS during walking (p<0.001) were lower while symptomless walking duration after tDCS (p=0.004) and at 3-month follow-up (p=0.001), symptomless walking distance after tDCS (p=0.002), at 1-month follow-up (p<0.001) and at 3-month follow-up (p=0.006) were higher in the active tDCS group. No significant differences were found in other assessed variables. CONCLUSION: Similar to other chronic pain syndromes, the present results highlight tDCS as a promising approach in LSS. Efficacy was considered to be achieved via both increased enkephaline release in descending pain modulatory pathway and increased emotional and cognitive control over pain. New studies evaluating treatment mechanisms using neuroimaging techniques are warranted. [ABSTRACT FROM AUTHOR]

The impact of cognitive aging on brain function and structure is complex, and the relationship between aging-related structural changes and cognitive function are not fully understood. Physiological and pathological changes to the aging brain are highly variable, making it difficult to estimate a cognitive trajectory with which to monitor the conversion to cognitive decline. Beyond the information on the structural and functional consequences of cognitive aging gained from brain imaging and neuropsychological studies, non-invasive brain stimulation techniques such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) can enable stimulation of the human brain in vivo, offering useful insights into the functional integrity of intracortical circuits using electrophysiology and neuromodulation. TMS measurements can be used to identify and monitor changes in cortical reactivity, the integrity of inhibitory and excitatory intracortical circuits, the mechanisms of long-term potentiation (LTP)/depression-like plasticity and central cholinergic function. Repetitive TMS and tDCS can be used to modulate neuronal excitability and enhance cortical function, and thus offer a potential means to slow or reverse cognitive decline. This review will summarize and critically appraise relevant literature regarding the use of TMS and tDCS to probe cortical areas affected by the aging brain, and as potential therapeutic tools to improve cognitive function in the aging population. Challenges arising from intra-individual differences, limited reproducibility, and methodological differences will be discussed.

Amaç: Obstrüktif uyku apne sendromu (OUAS), uyku sırasında hava yollarının kollapsı sonucunda hava yollarının tam olarak ya da kısmi olarak tıkanıklığına bağlı olarak gündüz uykululuğu, yorgunluk, bilişsel işlevlerde azalma, gündüz konsantrasyon güçlüğü ve gece horlaması gibi belirtilerle karakterize olan bir hastalıktır. OUAS ile ilgili yapılan birçok çalışma; meydana gelen tekrarlayan apnelerin, gece uykuda meydana gelen hipoksemilerin, gece uyku bölünmelerinin ve gündüz uykululuğunun hastalarda dikkat, çalışma belleği, epizodik bellek, psikomotor işlevler ve yürütücü işlevler gibi çok sayıda bilişsel alanda bozulmaya yol açtığını ortaya koymuştur. İnsanlarda zaman algısı; uyku-uyanıklık döngüsü gibi fizyolojik süreçlerin yanı sıra konuşma, spor yapma gibi günlük aktiviteler için kritik öneme sahip olan bir bilişsel işlevdir. Zaman algısı ile ilgili modellerde dikkat ve bellek gibi farklı bilişsel alanlar da önemli bir rol oynamaktadır. Bu bağlamda OUAS hastalarında zaman algısı işlevinin de bozuk olabileceği hipotez edilmiş ve ilk kez sağlıklı gönüllüler ile OUAS hastalarında zaman algısının karşılaştırılması amaçlanmıştır. Yöntem: Uyku polikliniğine başvuran ve tıbbi endikasyonlara göre uyku laboratuvarına yatışına karar verilen 40 hasta ve 10 sağlıklı gönüllü katılımcıya polisomnografik değerlendirme yapıldı. Apne-Hipopne İndeksine (AHİ) göre Sağlıklı - Hafif OUAS - Orta OUAS ve Ağır OUAS olarak sınıflandırıldı. Hastalara standart bir bilgisayarda zaman algısını değerlendirmek için Ritmik Motor Zamanlama Testi (RMZT), Zaman Aralığı Karşılaştırma Testi (ZAKT), Zaman Aralığı Yeniden Üretme Testi (ZAYÜT), Zaman Aralığı Tahmin Testi (ZATT) yapıldı. Shapiro-Wilk testleri ile verilerin normal dağılıma uyup uymadığı değerlendirildi. Kategorik (yüzdelik) veriler Ki-kare/Fisher kesinlik testleri ile karşılaştırıldı. Normal dağılıma uyan verilerde tek yönlü varyans analizi ile gruplar arası farklılıklar karşılaştırıldı. Normal dağılıma uymayan verilerde gruplar arası farklılıklar Kruskal-Wallis testleri ile karşılaştırıldı. Gruplar arası farklılıklar için yapılan post hoc analizler normal dağılıma uyanlarda bağımsız örneklemler t-testleri ile, uymayanlarda Mann-Whitney U testleri ile incelendi. OUAS şiddetini gösteren parametreler ile zaman algısı testlerindeki parametreler arasında Pearson/Spearman bağıntı analizleri yapıldı. Bulgular ve Sonuçlar: Katılımcıların yaş ortalaması 43,14 olup %72'si erkekti (n=36). Ortalama eğitim süresi 11,58 yıldı. Hastaların 15'i hafif, 14'ü orta ve 11'i ağır OUAS olarak sınıflandırıldı. Gruplar arasında sosyodemografik değişkenler ve AHI skoru dışındaki klinik değişkenler açısından farklılık saptanmadı. RMZT'de 2000 milisaniye (p = 0,003) ve 4000 milisaniye (p = 0,01) intertap intervali ve ZATT'deki Teta değerleri (p = 0,012) açısından anlamlı farklılık saptandı. 3.evre uyku süresi ile ZAKT'de 1000 ms Weber katsayısı arasında ters yönde bir ilişki saptandı (r =-0,345; p = 0,015). AHI ile ZAYÜT'te 5000 ms mutlak hata değeri arasında ilişki saptandı (r = 0,327; p = 0,021). Tartışma: Mevcut çalışmada elde edilen öncül sonuçlar, zaman algısı işlevlerinin bir bölümünün sağlıklı gönüllülere göre azalmış olduğunu ve OUAS şiddeti ile zaman algısının bazı bileşenlerindeki etkilenme arasında bir ilişki olduğunu göstermektedir. Bu durumun zaman algısında doğrudan bir etkilenmeyi yansıtıyor olabileceği gibi zaman algısının yerine getirilmesi sırasında rol oynayan dikkat ve çalışma belleği gibi işlevlerde etkilenmeye bağlı da olabileceği düşünülmüştür. Dikkat, çalışma belleği gibi diğer ilişkili bilişsel işlevleri de eşzamanlı değerlendiren çalışmaların yapılmasına ve hastalığa maruziyetin ve OUAS tedavilerinin zaman algısı üzerine etkisini inceleyen uzunlamasına çalışmalara gereksinim bulunmaktadır. [ABSTRACT FROM AUTHOR]

Objective: Handgrip force is an important indicator of body's general health and plays a crucial role in many daily and sportive activities. The aim of this study was to investigate the effects of 10 Hz frequency modulated transcranial sinusiodal direct current stimulation (ts-DCS) on handgrip exercise performance. Methods: Twenty-four healthy young volunteers without neuromuscular disorders or drug use, participated in this study. In order to measure the handgrip exercise performance, maximal intermittent grip endurance (MIGE) protocol was used. First day, baseline handgrip force values of participants were measured from two minutes of MIGE. Second day, electrical or sham stimulation was applied to participants for 20 minutes. During last two minutes of this stimulation final handgrip force values of participants were measured with the same MIGE protocol.The stimulation parameters were defined as 0.35 mA sinusoidal amplitude and 1.70 mA offset. Frequency modulation was set at 10 Hz. Maximal force and mean force values of participants were recorded during the MIGE protocol. Participants' fatigue index results were calculated by using their force values. Results: Statistical analyses revealed significant differences between maximal force values (p=0.026) and mean force values (p=0.013) of 10 Hz ts-DCS and sham groups of left primary motor cortex stimulation. 10 Hz ts-DCS compared to sham condition did not show any significant effect on fatigue index values. Conclusion: 10 Hz ts-DCS had a positive effect on maximal force values and mean forces values. In the literature, it is already shown that alpha synchronization is correlated with successful motor performance. We propose that 10 Hz ts-DCS may cause alpha synchronization and enhance neural efficiency of cerebral cortex. [ABSTRACT FROM AUTHOR]

Objectives: Migraine is a common and substantially debilitating disorder that may associate with allodynia, a marker of central sensitization in the pain circuits. Several unmet needs, like limited adherence to drugs due to adverse events and cost-effectivity, still occur in the prophylactic treatment of migraine. Transcranial direct current stimulation (tDCS) has recently been indicated to be beneficial in individuals with migraine with and without allodynia. However, to our knowledge, there are no studies evaluating the efficacy of six-month tDCS in migraine., Materials and Methods: This study was a randomized double-blind parallel-group sham-controlled five-month extension study after a one-month lead-in trial of tDCS in individuals with migraine. A total of 23 individuals with migraine with allodynia who completed the lead-in trial were recruited after their consent and were administered three consecutive sessions of 2-mA anodal 20-minute tDCS over the left primary motor cortex every month for an additional five months. Pain-related outcomes were determined using monthly headache diaries. Allodynia, depression, anxiety, and disability because of migraine also were assessed throughout the study., Results: Improvements in allodynia levels, attack frequency, number of rescue medications, and attack duration were higher, and mostly gradual during the trial, in the active group. Migraine Disability Scale grades also were lower in the active group, whereas no between-group differences were found in depression and anxiety scores. Higher responder rates of migraine attack frequency (56.8% vs 25%), number of headache days (56% vs 16.7%), and migraine attack duration (90.9% vs 8.3%) were observed after six-month tDCS in the active group than in the sham group., Conclusions: Long-term extended tDCS is shown to be a safe, efficacious, and plausible modality for prophylactic treatment in individuals with migraine with allodynia., Significance: Long-term extended tDCS can alleviate allodynia, which is an indicator of drug resistance and chronicity, and meet the goals of prophylactic treatment in individuals with migraine with allodynia., (Copyright © 2022 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.)

Objectives: Anesthetic applications may cause increased neuronal damage in infants and children. Commonly cognitive or learning disability tests were used to investigate the neurological progress in children. Visual Evoked Potential is a gross electrical signal generated by the occipital regions of the cerebral cortex in response to visual stimulation and an objective assessment of brain function. In this study, to acquire more objective results, Visual Evoked Potential responses of children who had multiple exposures to anesthesia during the treatment of corrosive esophagitis were compared to children who have never received anesthesia before., Methods: In this prospective, single-blinded, randomized, controlled study, 25 children, who were admitted to our pediatric surgery clinic because of corrosive esophagitis and who received general anesthesia more than 15 times composed Group-P; 25 children, who admitted to our well-child-clinic and who had never received anesthesia before consisted Group-C. The flash and pattern VEP responses of both groups were measured at the electrophysiology laboratory without any anesthetic drug application. The VEP responses of children in Group-P were recorded at least three days after the last exposure to anesthesia., Results: Latencies and amplitudes of the N2 and P2 components of the pattern and flash VEP responses were statistically significantly different between the two groups (p=0.000)., Conclusion: This study shows that in children who had repeated anesthetic applications VEP parameters are significantly altered. We believe that VEP responses may be a reliable objective criterion for the evaluation of anesthesia neurotoxicity., Competing Interests: Conflict of interest: None declared., (Copyright: © 2019 by The Medical Bulletin of Sisli Etfal Hospital.)