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Fide E, Yerlikaya D, Güntekin B, Babiloni C, Yener GG. Coherence in event-related EEG oscillations in patients with Alzheimer's disease dementia and amnestic mild cognitive impairment. Cogn Neurodyn 2023; 17:1621-1635. [PMID: 37974589 PMCID: PMC10640558 DOI: 10.1007/s11571-022-09920-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 11/02/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
Objectives Working memory performances are based on brain functional connectivity, so that connectivity may be deranged in individuals with mild cognitive impairment (MCI) and patients with dementia due to Alzheimer's disease (ADD). Here we tested the hypothesis of abnormal functional connectivity as revealed by the imaginary part of coherency (ICoh) at electrode pairs from event-related electroencephalographic oscillations in ADD and MCI patients. Methods The study included 43 individuals with MCI, 43 with ADD, and 68 demographically matched healthy controls (HC). Delta, theta, alpha, beta, and gamma bands event-related ICoh was measured during an oddball paradigm. Inter-hemispheric, midline, and intra-hemispheric ICoh values were compared in ADD, MCI, and HC groups. Results The main results of the present study can be summarized as follows: (1) A significant increase of midline frontal and temporal theta coherence in the MCI group as compared to the HC group; (2) A significant decrease of theta, delta, and alpha intra-hemispheric coherence in the ADD group as compared to the HC and MCI groups; (3) A significant decrease of theta midline coherence in the ADD group as compared to the HC and MCI groups; (4) Normal inter-hemispheric coherence in the ADD and MCI groups. Conclusions Compared with the MCI and HC, the ADD group showed disrupted event-related intra-hemispheric and midline low-frequency band coherence as an estimate of brain functional dysconnectivity underlying disabilities in daily living. Brain functional connectivity during attention and short memory demands is relatively resilient in elderly subjects even with MCI (with preserved abilities in daily activities), and it shows reduced efficiency at multiple operating oscillatory frequencies only at an early stage of ADD. Supplementary Information The online version contains supplementary material available at 10.1007/s11571-022-09920-0.
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Affiliation(s)
- Ezgi Fide
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Deniz Yerlikaya
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Bahar Güntekin
- Department of Biophysics, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
- REMER Clinical Electrophysiology, Neuroimaging and Neuromodulation Lab, Istanbul Medipol University, Istanbul, Turkey
| | - Claudio Babiloni
- Department of Physiology and Pharmacology “Vittorio Erspamer”, Sapienza University of Rome, Rome, Italy
- Hospital San Raffaele of Cassino, Cassino, Italy
| | - Görsev G. Yener
- Faculty of Medicine, Izmir University of Economics, 35330 Izmir, Turkey
- Brain Dynamics Multidisciplinary Research Center, Dokuz Eylul University, Izmir, Turkey
- Izmir Biomedicine and Genome Center, Izmir, Turkey
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Düzenli-Öztürk S, Hünerli-Gündüz D, Emek-Savaş DD, Olichney J, Yener GG, Ergenç Hİ. Taxonomically-related Word Pairs Evoke both N400 and LPC at Long SOA in Turkish. J Psycholinguist Res 2022; 51:1431-1451. [PMID: 35945467 DOI: 10.1007/s10936-022-09907-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/11/2022] [Indexed: 06/15/2023]
Abstract
Semantic priming in Turkish was examined in 36 right-handed healthy participants in a delayed lexical decision task via taxonomic relations using EEG. Prime-target relations included related- unrelated- and pseudo-words. Taxonomically related words at long stimulus onset asynchrony (SOA) were shown to modulate N400 and late positive component (LPC) amplitudes. N400 semantic priming effect in the time window of 300-500 ms was the largest for pseudo-words, intermediate for semantically-unrelated targets, and smallest for semantically-related targets as a reflection of lexical-semantic retrieval. This finding contributes to the ERP literature showing how remarkably universal the N400 brain potential is, with similar effects across languages and orthography. The ERP data also revealed different influences of related, unrelated, and pseudo-word conditions on the amplitude of the LPC. Attention scores and mean LPC amplitudes of related words in parietal region showed a moderate correlation, indicating LPC may be related to "relationship-detection process".
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Affiliation(s)
- Seren Düzenli-Öztürk
- Department of Speech and Language Therapy, Faculty of Health Sciences, Izmir Bakırçay University, 35660, Izmir, Turkey
| | - Duygu Hünerli-Gündüz
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylül University, 35340, Izmir, Turkey
| | | | - John Olichney
- Department of Neurology, University of California Davis, 95618, Davis, CA, USA
| | - Görsev G Yener
- Faculty of Medicine, Izmir University of Economics, 35330, Izmir, Turkey.
- İzmir Biomedicine and Genome Center, 35340, Izmir, Turkey.
- Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, 35340, Izmir, Turkey.
| | - H İclal Ergenç
- Department of Linguistics, Faculty of Languages, History and Geography, Ankara University, 06100, Ankara, Turkey
- Brain Research Center, Ankara University, 06340, Ankara, Turkey
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3
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Yerlikaya D, Hünerli-Gündüz D, Fide E, Özbek Y, Kıyı İ, Öztura İ, Yener GG. The reliability of P300 and the influence of age, gender and education variables in a 50 years and older normative sample. Int J Psychophysiol 2022; 181:1-13. [PMID: 35988895 DOI: 10.1016/j.ijpsycho.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 08/10/2022] [Accepted: 08/16/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The present study aims to investigate the effects of age, gender, and level of education on P300 in a healthy population, aged 50 years and over; and determine the reliability metrics for different conditions and measurement methods. METHOD Auditory and visual oddball recordings of 171 healthy adults were investigated. A fully automated preprocessing was applied to elicit ERP P300. Maximum peak amplitude, latency and mean amplitudes were measured. Data were stratified by age, gender, and education to determine group-level differences by using repeat measures of ANOVA. The internal consistency of P300 was calculated by a split-half method using odd-even segments. Test-retest reliability was assessed by calculating the intraclass correlation coefficient (ICC). RESULTS Maximum peak P300 amplitudes were higher in the 50-64 years age group compared to the >65 years age group; and females showed increased P300 amplitudes compared to males. P300 measures showed fair to good internal consistency and poor to good test-retest reliability. CONCLUSION Age and gender should be taken into account when designing ERP studies with elderly individuals. P300 showed good internal consistency in general, between gender groups and age groups. Long-term test-retest reliability was lower but acceptable. These findings can be interpreted as the strength of P300 by being an objective and reliable method independent of cultural differences. Here we underline several factors that may affect P300 measures and discuss other possible factors that should be standardized for P300 to be used in clinical settings.
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Affiliation(s)
- Deniz Yerlikaya
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylül University, 35340 Izmir, Turkey
| | - Duygu Hünerli-Gündüz
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylül University, 35340 Izmir, Turkey
| | - Ezgi Fide
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylül University, 35340 Izmir, Turkey
| | - Yağmur Özbek
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylül University, 35340 Izmir, Turkey
| | - İlayda Kıyı
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylül University, 35340 Izmir, Turkey
| | - İbrahim Öztura
- Department of Neurology, Dokuz Eylül University Medical School, 35340 Izmir, Turkey; Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, 35340 Izmir, Turkey.
| | - Görsev G Yener
- Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, 35340 Izmir, Turkey; İzmir University of Economics, Faculty of Medicine, 35330 Izmir, Turkey; Izmir International Biomedicine and Genome Institute, Dokuz Eylul University, Izmir, Turkey.
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4
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Özbek Y, Fide E, Yener GG. Resting-state EEG alpha/theta power ratio discriminates early-onset Alzheimer's disease from healthy controls. Clin Neurophysiol 2021; 132:2019-2031. [PMID: 34284236 DOI: 10.1016/j.clinph.2021.05.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 03/12/2021] [Accepted: 05/17/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The present study aims to compare early-onset Alzheimer's disease (EOAD) patients with healthy controls (HC), and late-onset Alzheimer's disease (LOAD) patients using resting-state delta, theta, alpha, and beta oscillations and provide a cut-off score of alpha/theta ratio to discriminate individuals with EOAD and young HC. METHODS Forty-seven individuals with EOAD, 51 individuals with LOAD, and demographically-matched 49 young and 51 older controls were included in the study. Spectral-power analysis using Fast-Fourier Transformation (FFT) is performed on resting-state electroencephalography (EEG) data. Delta, theta, alpha, and beta oscillations compared between groups and Receiver Operating Characteristic (ROC) curve analysis was conducted. RESULTS Compared to healthy controls individuals with EOAD showed an increase in slow frequency bands and a decrease in fast frequency bands. Frontal alpha/theta power ratio is the best discriminating value between EOAD and young HC with the sensitivity and specificity greater than 80% with area under the curve (AUC) 0.881. CONCLUSIONS EOAD display more widespread and severe electrophysiological abnormalities than LOAD and HC which may reflect more pronounced pathological burden and cholinergic deficits in EOAD. Additionally, the alpha/theta ratio can discriminate EOAD and young HC successfully. SIGNIFICANCE This study is the first to report that resting-state EEG power can be a promising marker for diagnostic accuracy between EOAD and healthy controls.
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Affiliation(s)
- Yağmur Özbek
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Ezgi Fide
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Görsev G Yener
- Izmir Biomedicine and Genome Center, Dokuz Eylul University Health Campus, Izmir, Turkey; Izmir University of Economics, Faculty of Medicine, Izmir, Turkey.
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5
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Boyle R, Jollans L, Rueda-Delgado LM, Rizzo R, Yener GG, McMorrow JP, Knight SP, Carey D, Robertson IH, Emek-Savaş DD, Stern Y, Kenny RA, Whelan R. Brain-predicted age difference score is related to specific cognitive functions: a multi-site replication analysis. Brain Imaging Behav 2021; 15:327-345. [PMID: 32141032 DOI: 10.1007/s11682-020-00260-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Brain-predicted age difference scores are calculated by subtracting chronological age from 'brain' age, which is estimated using neuroimaging data. Positive scores reflect accelerated ageing and are associated with increased mortality risk and poorer physical function. To date, however, the relationship between brain-predicted age difference scores and specific cognitive functions has not been systematically examined using appropriate statistical methods. First, applying machine learning to 1359 T1-weighted MRI scans, we predicted the relationship between chronological age and voxel-wise grey matter data. This model was then applied to MRI data from three independent datasets, significantly predicting chronological age in each dataset: Dokuz Eylül University (n = 175), the Cognitive Reserve/Reference Ability Neural Network study (n = 380), and The Irish Longitudinal Study on Ageing (n = 487). Each independent dataset had rich neuropsychological data. Brain-predicted age difference scores were significantly negatively correlated with performance on measures of general cognitive status (two datasets); processing speed, visual attention, and cognitive flexibility (three datasets); visual attention and cognitive flexibility (two datasets); and semantic verbal fluency (two datasets). As such, there is firm evidence of correlations between increased brain-predicted age differences and reduced cognitive function in some domains that are implicated in cognitive ageing.
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Affiliation(s)
- Rory Boyle
- Trinity College Institute of Neuroscience, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland
| | - Lee Jollans
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, München, Germany
| | - Laura M Rueda-Delgado
- Trinity College Institute of Neuroscience, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland
| | - Rossella Rizzo
- Physics Department, University of Calabria, Rende, CS, Italy
| | - Görsev G Yener
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, İzmir, Turkey
- Department of Neurology, Dokuz Eylul University Medical School, İzmir, Turkey
- Brain Dynamics Multidisciplinary Research Center, Dokuz Eylul University, İzmir, Turkey
| | - Jason P McMorrow
- Centre for Advanced Medical Imaging, St. James's Hospital, Dublin 8, Ireland
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Silvin P Knight
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin 2, Ireland
| | - Daniel Carey
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin 2, Ireland
- Department of Medical Gerontology, Trinity College Dublin, Dublin 2, Ireland
| | - Ian H Robertson
- Trinity College Institute of Neuroscience, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland
- Global Brain Health Institute, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland
| | - Derya D Emek-Savaş
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, İzmir, Turkey
- Global Brain Health Institute, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland
- Department of Psychology, Faculty of Letters, Dokuz Eylul University, İzmir, Turkey
| | - Yaakov Stern
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, USA
| | - Rose Anne Kenny
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin 2, Ireland
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin 8, Ireland
| | - Robert Whelan
- Trinity College Institute of Neuroscience, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland.
- Global Brain Health Institute, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland.
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7
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Kayserili G, Yıldırım Z, Vupa Çilengiroğlu Ö, Yener GG. A Practical Tool for the Detection of Limbic-type-memory Deficit: 5-Word-Test. tnd 2019. [DOI: 10.4274/tnd.2019.39269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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8
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Eraslan Boz H, Limoncu H, Zygouris S, Tsolaki M, Giakoumis D, Votis K, Tzovaras D, Öztürk V, Yener GG. A new tool to assess amnestic mild cognitive impairment in Turkish older adults: virtual supermarket (VSM). Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2019; 27:639-653. [PMID: 31482749 DOI: 10.1080/13825585.2019.1663146] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The purpose of this study was to investigate cognitive functioning by administering the Virtual Supermarket (VSM) test in patients with amnestic mild cognitive impairment (aMCI, N = 37) and age and education-matched healthy controls (HCs, N = 52). An extensive neuropsychological test battery and the VSM were administered to all participants. The aMCI group exhibited lower performance and required more time to complete the VSM compared to HCs. Also, aMCI-Multiple Domain (aMCI-MD) patients performed worse in the "Correct Types", "Correct Quantities", "Bought Unlisted", "Correct Money" variables compared to HCs. Moreover, aMCI-SD patients displayed lower performance in "Bought Unlisted" and "Correct Money" variables compared to HCs. The VSM variables correlated with established neuropsychological test scores. The VSM test was found to discriminate between aMCI and HCs with a correct classification rate (CCR) of 81%. This is a preliminary study showing that the VSM is a valid, brief and user-friendly test. .
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Affiliation(s)
- Hatice Eraslan Boz
- Department of Neurology, School of Medicine, Dokuz Eylul University , Izmir, Turkey.,Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University , Izmir, Turkey
| | - Hatice Limoncu
- Department of Neurology, School of Medicine, Dokuz Eylul University , Izmir, Turkey
| | - Stelios Zygouris
- Department of Neurology, School of Medicine, Aristotle University of Thessaloniki , Greece, Greece.,Network Aging Research, Heidelberg University , Heidelberg, Germany
| | - Magda Tsolaki
- Department of Neurology, School of Medicine, Aristotle University of Thessaloniki , Greece, Greece.,Greek Association of Alzheimer's Disease and Related Disorders , Thessaloniki, Greece
| | - Dimitrios Giakoumis
- Centre for Research & Technology Hellas/Information Technologies Institute (CERTH/ITI) , Thessaloniki, Greece
| | - Konstantinos Votis
- Centre for Research & Technology Hellas/Information Technologies Institute (CERTH/ITI) , Thessaloniki, Greece
| | - Dimitrios Tzovaras
- Centre for Research & Technology Hellas/Information Technologies Institute (CERTH/ITI) , Thessaloniki, Greece
| | - Vesile Öztürk
- Department of Neurology, School of Medicine, Dokuz Eylul University , Izmir, Turkey.,Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University , Izmir, Turkey
| | - Görsev G Yener
- Department of Neurology, School of Medicine, Dokuz Eylul University , Izmir, Turkey.,Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University , Izmir, Turkey
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9
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Fide E, Emek-Savaş DD, Aktürk T, Güntekin B, Hanoğlu L, Yener GG. Electrophysiological evidence of altered facial expressions recognition in Alzheimer's disease: A comprehensive ERP study. Clin Neurophysiol 2019; 130:1813-1824. [PMID: 31401490 DOI: 10.1016/j.clinph.2019.06.229] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 05/24/2019] [Accepted: 06/18/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The present study aims to evaluate the amplitude and latency of event-related potentials (ERPs) P100, N170, VPP and N230 in individuals with Alzheimer's disease (AD) compared to healthy elderly controls, using a passive viewing task of emotional facial expressions. METHODS Twenty-four individuals with mild to moderate AD and 23 demographically matched healthy elderly controls were included in the study. ERP P100, N170, VPP and N230 amplitude and latency values were compared between groups. RESULTS The categorization of emotional facial expressions was intact; yet, increased P100 amplitude and latency, decreased N170 amplitude, and increased VPP amplitude were observed in AD compared to controls. Increased N230 amplitude and latency were observed in response to angry expressions, while neutral expressions elicited decreased amplitude and latency. CONCLUSIONS Increased P100 amplitude and latency may reflect reduced amygdala volume and disruptions in the visual system, while decreased N170 and increased VPP amplitudes may reflect impaired perceptual processing, mitigated by a greater involvement of prefrontal areas for task performance in AD. SIGNIFICANCE This study is the first to report a complex pattern of ERPs to emotional facial expressions in individuals with AD.
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Affiliation(s)
- Ezgi Fide
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Derya Durusu Emek-Savaş
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey; Department of Psychology, Dokuz Eylul University, Izmir, Turkey; Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland.
| | - Tuba Aktürk
- Istanbul Medipol University, Vocational School, Program of Electroneurophysiology, Istanbul, Turkey; Istanbul Medipol University, Graduate School of Health Sciences, Department of Neuroscience, Istanbul, Turkey
| | - Bahar Güntekin
- Istanbul Medipol University, International School of Medicine, Department of Biophysics, Istanbul, Turkey; REMER, Clinical Electrophysiology, Neuroimaging and Neuromodulation Lab, Istanbul Medipol University, Istanbul, Turkey
| | - Lütfü Hanoğlu
- REMER, Clinical Electrophysiology, Neuroimaging and Neuromodulation Lab, Istanbul Medipol University, Istanbul, Turkey; Istanbul Medipol University, School of Medicine, Department of Neurology, Istanbul, Turkey
| | - Görsev G Yener
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey; Dokuz Eylul University Medical School, Department of Neurology, Izmir, Turkey; Dokuz Eylul University, Brain Dynamics Multidisciplinary Research Center, Izmir, Turkey
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10
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Hünerli D, Emek-Savaş DD, Çavuşoğlu B, Dönmez Çolakoğlu B, Ada E, Yener GG. Mild cognitive impairment in Parkinson’s disease is associated with decreased P300 amplitude and reduced putamen volume. Clin Neurophysiol 2019; 130:1208-1217. [DOI: 10.1016/j.clinph.2019.04.314] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/18/2019] [Accepted: 04/22/2019] [Indexed: 12/28/2022]
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11
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Güntekin B, Hanoğlu L, Aktürk T, Fide E, Emek-Savaş DD, Ruşen E, Yıldırım E, Yener GG. Impairment in recognition of emotional facial expressions in Alzheimer's disease is represented by EEG theta and alpha responses. Psychophysiology 2019; 56:e13434. [PMID: 31264726 DOI: 10.1111/psyp.13434] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 06/10/2019] [Accepted: 06/13/2019] [Indexed: 12/20/2022]
Abstract
Behavioral studies have shown that the recognition of facial expressions may be impaired in patients with Alzheimer's disease (AD). The identification and recognition of a facial expression might be represented by event-related brain oscillations. The present study aims to analyze EEG event-related oscillations and determine the electrophysiological indicators of impaired facial expression recognition in AD patients. EEGs of 30 healthy controls and 30 AD patients were recorded during their perception of three different facial expressions (angry, happy, neutral). Event-related power spectrum and phase locking were analyzed in the theta (4-7) and alpha (8-13 Hz) frequency bands with the EEGLAB open toolbox. There was a significant facial Expression × Group interaction (p < 0.05) for the theta power spectrum; the healthy control group had higher theta power than the AD group during the perception of angry facial expressions (p < 0.05). There was a significant hemisphere difference between the two groups (p < 0.05). There was a right hemisphere alpha power dominance in healthy subjects. However, AD patients did not have this alpha power asymmetry. The present study, for the first time in the literature, presents the electrophysiological indicators of impaired recognition of facial expression in AD patients. The current study could be a basis for future studies that will analyze emotional processing in different kinds of dementia patients, and this study may have provided indicators of electrophysiological correlates of behavioral problems observed in clinical practice.
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Affiliation(s)
- Bahar Güntekin
- Department of Biophysics, School of Medicine, Istanbul Medipol University, Istanbul, Turkey.,Clinical Electrophysiology, Neuroimaging and Neuromodulation Lab, REMER, Istanbul Medipol University, Istanbul, Turkey
| | - Lütfü Hanoğlu
- Clinical Electrophysiology, Neuroimaging and Neuromodulation Lab, REMER, Istanbul Medipol University, Istanbul, Turkey.,Department of Neurology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Tuba Aktürk
- Program of Electroneurophysiology, Vocational School, Istanbul Medipol University, Istanbul, Turkey.,Program of Neuroscience, Graduate School of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Ezgi Fide
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylül University, Izmir, Turkey
| | - Derya Durusu Emek-Savaş
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylül University, Izmir, Turkey.,Department of Psychology, Faculty of Letters, Dokuz Eylül University, Izmir, Turkey.,Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
| | - Ece Ruşen
- Program of Neuroscience, Graduate School of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Ebru Yıldırım
- Program of Neuroscience, Graduate School of Health Sciences, Istanbul Medipol University, Istanbul, Turkey.,Department of Biophysics, Istanbul Medipol University, Istanbul, Turkey
| | - Görsev G Yener
- Department of Neurology, International School of Medicine, Dokuz Eylül University Medical School, Izmir, Turkey.,Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, Izmir, Turkey
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12
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Yener GG, Fide E, Özbek Y, Emek-Savaş DD, Aktürk T, Çakmur R, Güntekin B. The difference of mild cognitive impairment in Parkinson's disease from amnestic mild cognitive impairment: Deeper power decrement and no phase-locking in visual event-related responses. Int J Psychophysiol 2019; 139:48-58. [DOI: 10.1016/j.ijpsycho.2019.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 11/28/2022]
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13
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Durusu Emek Savaş D, Yerlikaya D, Yener GG. Validity, Reliability and Turkish Norm Values of the Clock Drawing Test for Two Different Scoring Systems. tnd 2018. [DOI: 10.4274/tnd.26504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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14
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Yerlikaya D, Emek-Savaş DD, Bircan Kurşun B, Öztura İ, Yener GG. Electrophysiological and neuropsychological outcomes of severe obstructive sleep apnea: effects of hypoxemia on cognitive performance. Cogn Neurodyn 2018; 12:471-480. [PMID: 30250626 DOI: 10.1007/s11571-018-9487-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 05/03/2018] [Accepted: 05/16/2018] [Indexed: 10/16/2022] Open
Abstract
Obstructive sleep apnea syndrome (OSAS) is a sleep disorder characterized with upper airway obstructions. Some studies showed cognitive and electrophysiological changes in patients with OSAS; however, contradictory results were also reported. The purpose of the present study was twofold: (1) to investigate cognitive changes in severe OSAS patients by using neuropsychological tests and electrophysiological methods together, (2) to investigate influence of hypoxemia levels on cognition. Fifty-four severe OSAS patients and 34 age-, gender- and education matched healthy subjects were participated. OSAS patients were further divided into two subgroups according to minimum oxygen saturation levels. All participants underwent a detailed neuropsychological test battery. A classical visual oddball task was used to elicit ERP P300 and mean P300 amplitudes were measured from Fz, Cz and Pz electrode sites. OSAS patients showed reduced mean P300 amplitudes up to 43-51% on all electrode sites compared to healthy controls. Subgroup analysis revealed significant differences in neuropsychological test scores between healthy controls and high hypoxemia OSAS group, as well as between low and high hypoxemia groups. Moreover, both low and high hypoxemia OSAS groups had lower P300 amplitudes compared with healthy controls. P300 amplitudes showed a gradual decline in parallel with increasing hypoxemia severity; however, the difference between high and low hypoxemia OSAS groups did not reach significance. Moderate correlations were found between sleep parameters, neuropsychological test scores and P300 amplitudes. These results suggest that electrophysiological measures could be better indicators of cognitive changes than neuropsychological tests in OSAS, particularly in mildly affected patients.
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Affiliation(s)
- Deniz Yerlikaya
- 1Department of Neurosciences, Institute of Health Sciences, Dokuz Eylül University, 35340 Izmir, Turkey
| | - Derya Durusu Emek-Savaş
- 1Department of Neurosciences, Institute of Health Sciences, Dokuz Eylül University, 35340 Izmir, Turkey.,2Department of Psychology, Faculty of Letters, Dokuz Eylül University, 35160 Izmir, Turkey.,3Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
| | - Behice Bircan Kurşun
- 4Department of Neurology, Dokuz Eylül University Medical School, 35340 Izmir, Turkey
| | - İbrahim Öztura
- 4Department of Neurology, Dokuz Eylül University Medical School, 35340 Izmir, Turkey
| | - Görsev G Yener
- 1Department of Neurosciences, Institute of Health Sciences, Dokuz Eylül University, 35340 Izmir, Turkey.,4Department of Neurology, Dokuz Eylül University Medical School, 35340 Izmir, Turkey.,5Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, 35340 Izmir, Turkey
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Emek-Savaş DD, Özmüş G, Güntekin B, Dönmez Çolakoğlu B, Çakmur R, Başar E, Yener GG. Decrease of Delta Oscillatory Responses in Cognitively Normal Parkinson's Disease. Clin EEG Neurosci 2017; 48:355-364. [PMID: 27582502 DOI: 10.1177/1550059416666718] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Parkinson's disease (PD) is a common progressive neurodegenerative disorder. This study aims to compare sensory-evoked oscillations (SEOs) and event-related oscillations (EROs) of visual modality in cognitively normal PD patients and healthy controls. Sixteen PD and 16 age-, gender-, and education-matched healthy controls participated in the study. A simple flashlight was used for SEO and a classical visual oddball paradigm was used for target ERO. Oscillatory responses in the delta frequency range (0.5-3.5 Hz) were examined. Significantly lower delta ERO and SEO responses were found in PD patients than healthy controls. Delta ERO responses were decreased at all frontal, central and parietal locations, whereas delta SEO responses were decreased over mid and right central locations in PD. According to the notion that SEO reflects the activity of sensory networks and ERO reflects cognitive networks, these findings indicate that PD patients have impairments in both cognitive and sensory networks of visual modality. Decreased delta ERO responses indicate that the subliminal cognitive changes in PD can be detected by electrophysiological methods. These results demonstrate that brain oscillatory responses have the potential to be studied as a biomarker for visual cognitive and sensory networks in PD.
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Affiliation(s)
- Derya Durusu Emek-Savaş
- 1 Department of Psychology, Dokuz Eylül University, Izmir, Turkey.,2 Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
| | - Gülin Özmüş
- 2 Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
| | - Bahar Güntekin
- 3 Department of Biophysics, Istanbul Medipol University, Istanbul, Turkey
| | | | - Raif Çakmur
- 4 Department of Neurology, Dokuz Eylül University Medical School, Izmir, Turkey.,5 Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, Izmir, Turkey
| | - Erol Başar
- 6 Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kultur University, Istanbul, Turkey
| | - Görsev G Yener
- 2 Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey.,4 Department of Neurology, Dokuz Eylül University Medical School, Izmir, Turkey.,5 Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, Izmir, Turkey.,6 Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kultur University, Istanbul, Turkey.,7 Izmir International Biomedicine and Genome Institute, Dokuz Eylül University Health Campus, Izmir, Turkey
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Abstract
Social cognitive abilities are impaired in Alzheimer disease and other dementias. Recent studies suggested that social cognitive abilities might be also impaired in mild cognitive impairment (MCI). Current meta-analysis aimed to summarize available evidence for deficits in theory of mind (ToM) and emotion recognition in MCI. In this meta-analysis of 17 studies, facial emotion recognition and ToM performances of 513 individuals with MCI and 693 healthy controls were compared. Mild cognitive impairment was associated with significant impairments falling in the medium effect sizes range in ToM ( d = 0.63) and facial emotion recognition ( d = 0.58). Among individual emotions, recognition of fear and sadness were particularly impaired. There were no significant between-group differences in recognition of disgust, happiness, and surprise. Social cognitive deficits were more severe in multidomain MCI. There is a need for longitudinal studies investigating the potential role of social cognitive impairment in predicting conversion to dementia.
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Affiliation(s)
- Emre Bora
- 1 Department of Psychiatry, Dokuz Eylül University Medical School, Izmir, Turkey.,2 Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
| | - Görsev G Yener
- 3 Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey.,4 Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kültür University, Istanbul, Turkey.,5 Department of Neurology, Dokuz Eylül University Medical School, Izmir, Turkey.,6 Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, Izmir, Turkey.,7 İzmir Biomedicine and Genome Institute, Izmir, Turkey
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17
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Bosco P, Redolfi A, Bocchetta M, Ferrari C, Mega A, Galluzzi S, Austin M, Chincarini A, Collins DL, Duchesne S, Maréchal B, Roche A, Sensi F, Wolz R, Alegret M, Assal F, Balasa M, Bastin C, Bougea A, Emek-Savaş DD, Engelborghs S, Grimmer T, Grosu G, Kramberger MG, Lawlor B, Mandic Stojmenovic G, Marinescu M, Mecocci P, Molinuevo JL, Morais R, Niemantsverdriet E, Nobili F, Ntovas K, O'Dwyer S, Paraskevas GP, Pelini L, Picco A, Salmon E, Santana I, Sotolongo-Grau O, Spiru L, Stefanova E, Popovic KS, Tsolaki M, Yener GG, Zekry D, Frisoni GB. The impact of automated hippocampal volumetry on diagnostic confidence in patients with suspected Alzheimer's disease: A European Alzheimer's Disease Consortium study. Alzheimers Dement 2017; 13:1013-1023. [PMID: 28263741 DOI: 10.1016/j.jalz.2017.01.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 10/25/2016] [Accepted: 01/23/2017] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Hippocampal volume is a core biomarker of Alzheimer's disease (AD). However, its contribution over the standard diagnostic workup is unclear. METHODS Three hundred fifty-six patients, under clinical evaluation for cognitive impairment, with suspected AD and Mini-Mental State Examination ≥20, were recruited across 17 European memory clinics. After the traditional diagnostic workup, diagnostic confidence of AD pathology (DCAD) was estimated by the physicians in charge. The latter were provided with the results of automated hippocampal volumetry in standardized format and DCAD was reassessed. RESULTS An increment of one interquartile range in hippocampal volume was associated with a mean change of DCAD of -8.0% (95% credible interval: [-11.5, -5.0]). Automated hippocampal volumetry showed a statistically significant impact on DCAD beyond the contributions of neuropsychology, 18F-fluorodeoxyglucose positron emission tomography/single-photon emission computed tomography, and cerebrospinal fluid markers (-8.5, CrI: [-11.5, -5.6]; -14.1, CrI: [-19.3, -8.8]; -10.6, CrI: [-14.6, -6.1], respectively). DISCUSSION There is a measurable effect of hippocampal volume on DCAD even when used on top of the traditional diagnostic workup.
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Affiliation(s)
- Paolo Bosco
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Alberto Redolfi
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Martina Bocchetta
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Clarissa Ferrari
- IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Anna Mega
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Samantha Galluzzi
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | | | - D Louis Collins
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada; True Positive Medical Devices Inc., Quebec City, Quebec, Canada
| | - Simon Duchesne
- True Positive Medical Devices Inc., Quebec City, Quebec, Canada
| | - Bénédicte Maréchal
- Advanced Clinical Imaging Technology (HC CMEA SUI DI BM PI), Siemens Healthcare AG, Lausanne, Switzerland; Department of Radiology, University Hospital (CHUV), Lausanne, Switzerland; LTS5, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Alexis Roche
- Advanced Clinical Imaging Technology (HC CMEA SUI DI BM PI), Siemens Healthcare AG, Lausanne, Switzerland; Department of Radiology, University Hospital (CHUV), Lausanne, Switzerland; LTS5, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | | | | | - Montserrat Alegret
- Alzheimer Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Frederic Assal
- University Hospitals and University of Geneva, Geneva, Switzerland
| | - Mircea Balasa
- Alzheimer's and Other Cognitive Disorder Unit, Hospital Clinic, Barcelona, Spain
| | - Christine Bastin
- GIGA-CRC In vivo Imaging and Memory Clinic, University of Liège, Liège, Belgium
| | - Anastasia Bougea
- First Department of Neurology, Eginition Hospital Kapodistrian University, Medical School of Athens, Athens, Greece
| | - Derya Durusu Emek-Savaş
- Department of Psychology, Dokuz Eylül University, Izmir, Turkey; Izmir International Biomedicine and Genome Center, Dokuz Eylul University, Izmir, Turkey
| | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium; Memory Clinic and Department of Neurology, Hospital Network Antwerp (ZNA) Hoge Beuken and Middelheim, Antwerp, Belgium
| | - Timo Grimmer
- Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Galina Grosu
- Radiology and Medical Imagery, Elias University Clinical Hospital, Bucharest, Romania
| | - Milica G Kramberger
- Department of Neurology, Centre for Cognitive Impairments, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Brian Lawlor
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
| | | | - Mihaela Marinescu
- Department of Geriatrics-Gerontology and Old Age Psychiatry, Elias University Clinic, Bucharest, Romania
| | - Patrizia Mecocci
- Istituto di Gerontologia e Geriatria, Università degli Studi di Perugia, Perugia, Italy
| | - José Luis Molinuevo
- Alzheimer's and Other Cognitive Disorder Unit, Hospital Clinic, Barcelona, Spain
| | - Ricardo Morais
- Medical Imaging Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Ellis Niemantsverdriet
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium
| | - Flavio Nobili
- Clinical Neurology (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Konstantinos Ntovas
- 3rd Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sarah O'Dwyer
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
| | - George P Paraskevas
- First Department of Neurology, Eginition Hospital Kapodistrian University, Medical School of Athens, Athens, Greece
| | - Luca Pelini
- Istituto di Gerontologia e Geriatria, Università degli Studi di Perugia, Perugia, Italy
| | - Agnese Picco
- Clinical Neurology (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Eric Salmon
- GIGA-CRC In vivo Imaging and Memory Clinic, University of Liège, Liège, Belgium
| | - Isabel Santana
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Oscar Sotolongo-Grau
- Alzheimer Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Luiza Spiru
- Carol Davila University of Medicine, Bucharest, Romania; Ana Aslan Intl Foundation-Memory Clinic, Bucharest, Romania
| | - Elka Stefanova
- Institute of Neurology, CCS, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Magda Tsolaki
- 3rd Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Görsev G Yener
- Izmir International Biomedicine and Genome Center, Dokuz Eylul University, Izmir, Turkey; Department of Neurology, Dokuz Eylül University, Izmir, Turkey; Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, Izmir, Turkey
| | - Dina Zekry
- Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Giovanni B Frisoni
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland.
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Başar E, Femir B, Emek-Savaş DD, Güntekin B, Yener GG. Increased long distance event-related gamma band connectivity in Alzheimer's disease. Neuroimage Clin 2017; 14:580-590. [PMID: 28367402 PMCID: PMC5361871 DOI: 10.1016/j.nicl.2017.02.021] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 02/06/2017] [Accepted: 02/24/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Brain oscillatory responses can be used for non-invasive analyses of cortico-cortical connectivity, local neuronal synchronization, and coherence of oscillations in many neuropsychiatric conditions including Alzheimer's disease (AD). In the present paper, we examine sensory-evoked and event-related gamma coherences elicited by visual stimuli in three sub-gamma bands in two sub-groups of patients with AD (i.e., acetylcholinesterase-inhibitor treated and untreated) and healthy controls. METHODS We studied a total of 39 patients with probable mild AD (according to NINCDS-ADRDA criteria) who had been sub-divided into untreated (n = 21) and treated (n = 18) (patients either on cholinergic monotherapy or combined therapy with memantine) AD groups, and 21 age-, gender-, and education-matched healthy elderly controls. A simple flash visual paradigm was applied for the acquisition of sensory-evoked coherences. Event-related coherences were elicited using a classical visual oddball paradigm. Both sensory-evoked and event-related gamma coherences were calculated for long-distance intrahemispheric pairs for three frequency ranges: 25-30 Hz, 30-35 Hz, and 40-48 Hz in post-stimulus 0-800 ms duration. The long-distance intrahemispheric pairs from both sides were fronto-parietal, fronto-temporal, fronto-temporoparietal, fronto-occipital, centro-occipital and parieto-occipital. RESULTS The sensory-evoked or event-related gamma coherences revealed that both treated and untreated AD patients had significantly increased values compared to healthy controls in all three sub-gamma bands. Moreover, the treated AD patients demonstrated significantly higher fronto-parietal gamma coherences during both sensory stimulation and oddball paradigm and lower occipito-parietal coherences during oddball paradigm in comparison to untreated AD patients. CONCLUSION The present study demonstrated that an increase of gamma coherences was present in response to both visual sensory and cognitive stimulation in AD patients in all gamma sub-bands. Therefore, gamma oscillatory activity seems to be fundamental in brain functions at both the sensory and cognitive levels. The increase of gamma coherence values was not due to cholinergic treatment to any significant extent, as both treated and untreated AD patients had increased gamma coherence values compared to healthy controls. The use of coherence values reflecting brain connectivity holds potential for neuroimaging of AD and understanding brain dynamics related to the effects of medication.
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Affiliation(s)
- Erol Başar
- Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kultur University, Istanbul 34156, Turkey
- Corresponding author at: Istanbul Kültür University, Brain Dynamics, Cognition and Complex Systems Research Center, Faculty of Science and Letters, Ataköy Campus, Bakırköy, 34156 Istanbul, Turkey.Istanbul Kültür UniversityBrain Dynamics, Cognition and Complex Systems Research CenterFaculty of Science and LettersAtaköy Campus, BakırköyIstanbul34156Turkey
| | - Banu Femir
- Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kultur University, Istanbul 34156, Turkey
| | - Derya Durusu Emek-Savaş
- Department of Psychology, Faculty of Letters, Dokuz Eylül University, Izmir 35160, Turkey
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylül University, Izmir 35340, Turkey
| | - Bahar Güntekin
- Department of Biophysics, Istanbul Medipol University International School of Medicine, Istanbul 34810, Turkey
- REMER Clinical Electrophysiology, Neuroimaging and Neuromodulation Laboratory, Istanbul Medipol University, Istanbul 34810, Turkey
| | - Görsev G. Yener
- Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kultur University, Istanbul 34156, Turkey
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylül University, Izmir 35340, Turkey
- Department of Neurology, Dokuz Eylül University Medical School, Izmir 35340, Turkey
- Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, Izmir 35340, Turkey
- Izmir International Biomedicine and Genome Institute, Dokuz Eylül University Health Campus, Izmir 35340, Turkey
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Özmüş G, Yerlikaya D, Gökçeoğlu A, Emek Savaş DD, Çakmur R, Dönmez Çolakoğlu B, Yener GG. Demonstration of Early Cognitive Impairment in Parkinson's Disease with Visual P300 Responses. Noro Psikiyatr Ars 2017; 54:21-27. [PMID: 28566954 DOI: 10.5152/npa.2016.12455] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 12/26/2015] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease. Cognitive changes in PD are less observable than motor symptoms; thus, research on cognitive processes, which are known to be impaired from the early stages of PD, is minimal. The purpose of this study is to research the brain dynamics of cognitively normal PD patients and healthy elderly controls using event-related potentials (ERPs) and to evaluate their relationships with neuropsychological tests. METHODS Eighteen cognitively normal PD patients and 18 age-, gender-, and education-matched healthy controls were included in the study. Detailed neuropsychological tests were applied to all participants. Electroencephalography (EEG) was performed according to the international 10-20 system, and a classical visual oddball paradigm was used in the experiments. ERP responses in the 0.5 to 25 Hz frequency range were examined. P300 amplitude and latency values were measured from the F3, Fz, F4, C3, Cz, C4, P3, Pz, P4, O1, Oz, and O2 electrode sites. In addition, the correlations between P300 responses and neuropsychological test scores were analyzed. RESULTS Significant differences were found between the P300 amplitudes of cognitively normal PD patients and healthy elderly controls [F(1,31)=9.265; p=0.005]. P300 amplitudes were significantly lower for PD patients at the F3, FZ, Cz, C4, Pz, and P4 electrode sites than for healthy elderly controls. Moderate correlations were found between Stroop test score and P4 amplitude, digit span forward and C3 and Pz amplitude, and digit span backward and O1 amplitude. CONCLUSION The major finding of this study was the detection of cognitive changes by electrophysiological methods in PD patients who were indicated to be cognitively normal by neuropsychological tests. These finding suggests that cognitive changes in PD patients, which are not yet reflected in neuropsychological tests, may be detected by electrophysiological methods in earlier stages.
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Affiliation(s)
- Gülin Özmüş
- Department of Neurosciences, Dokuz Eylül University Institute of Health Sciences, İzmir, Turkey
| | - Deniz Yerlikaya
- Department of Neurosciences, Dokuz Eylül University Institute of Health Sciences, İzmir, Turkey
| | - Arife Gökçeoğlu
- Department of Neurosciences, Dokuz Eylül University Institute of Health Sciences, İzmir, Turkey
| | | | - Raif Çakmur
- Department of Neurology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | | | - Görsev G Yener
- Department of Neurology, Dokuz Eylül University School of Medicine, İzmir, Turkey
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Yerlikaya D, Kurşun BB, Gökçeoğlu A, Emek-Savaş DD, Öztura İ, Yener GG. Evaluating cognitive changes in severe OSAS: Neuropsychological tests may not be as efficient as electrophysiological methods. Int J Psychophysiol 2016. [DOI: 10.1016/j.ijpsycho.2016.07.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Travassos M, Santana I, Baldeiras I, Tsolaki M, Gkatzima O, Sermin G, Yener GG, Simonsen A, Hasselbalch SG, Kapaki E, Mara B, Cunha RA, Agostinho P, Blennow K, Zetterberg H, Mendes VM, Manadas B, de Mendon A. Does Caffeine Consumption Modify Cerebrospinal Fluid Amyloid-β Levels in Patients with Alzheimer's Disease? J Alzheimers Dis 2016; 47:1069-78. [PMID: 26401784 DOI: 10.3233/jad-150374] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Caffeine may be protective against Alzheimer's disease (AD) by modulating amyloid-β (Aβ) metabolic pathways. The present work aimed to study a possible association of caffeine consumption with the cerebrospinal fluid (CSF) biomarkers, particularly Aβ. The study included 88 patients with AD or mild cognitive impairment. The consumption of caffeine and theobromine was evaluated using a validated food questionnaire. Quantification of caffeine and main active metabolites was performed with liquid chromatography coupled to tandem mass spectrometry. The levels of A(1-42), total tau, and phosphorylated tau in the CSF were determined using sandwich ELISA methods and other Aβ species, Aβ(X-38), Aβ(X-40), and Aβ(X-42), with the MSD Aβ Triplex assay. The concentration of caffeine was 0.79±1.15 μg/mL in the CSF and 1.20±1.88 μg/mL in the plasma. No correlation was found between caffeine consumption and Aβ42 in the CSF. However, a significant positive correlation was found between the concentrations of theobromine, both in the CSF and in the plasma, with Aβ42 in the CSF. Theobromine in the CSF was positively correlated with the levels of other xanthines in the CSF, but not in the plasma, suggesting that it may be formed by central metabolic pathways. In conclusion, caffeine consumption does not modify the levels of CSF biomarkers, and does not require to be controlled for when measuring CSF biomarkers in a clinical setting. Since theobromine is associated with a favorable Aβ profile in the CSF, the possibility that it might have a protective role in AD should be further investigated.
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Affiliation(s)
- Maria Travassos
- Institute of Molecular Medicine and Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Isabel Santana
- Department of Neurology, Coimbra University Hospital, Coimbra, Portugal
| | - Inês Baldeiras
- Faculty of Medicine and Center for Neurosciences and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Magda Tsolaki
- Memory and Dementia Center, Aristotle University, Thessaloniki, Greece
| | - Olymbia Gkatzima
- Memory and Dementia Center, Aristotle University, Thessaloniki, Greece
| | - Genc Sermin
- Dokuz Eylul University, Department of Neurology and Brain Dynamics Center, Izmir, Turkey
| | - Görsev G Yener
- Dokuz Eylul University, Department of Neurology and Brain Dynamics Center, Izmir, Turkey
| | - Anja Simonsen
- Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Steen G Hasselbalch
- Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Elisabeth Kapaki
- Department of Neurology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Bourbouli Mara
- Department of Neurology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Rodrigo A Cunha
- Faculty of Medicine and Center for Neurosciences and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Paula Agostinho
- Faculty of Medicine and Center for Neurosciences and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Vera M Mendes
- Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Bruno Manadas
- Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Alexandreça de Mendon
- Institute of Molecular Medicine and Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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Başar E, Emek-Savaş DD, Güntekin B, Yener GG. Delay of cognitive gamma responses in Alzheimer's disease. Neuroimage Clin 2016; 11:106-115. [PMID: 26937378 PMCID: PMC4753813 DOI: 10.1016/j.nicl.2016.01.015] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 01/05/2016] [Accepted: 01/18/2016] [Indexed: 11/29/2022]
Abstract
Event-related oscillations (EROs) reflect cognitive brain dynamics, while sensory-evoked oscillations (SEOs) reflect sensory activities. Previous reports from our lab have shown that those with Alzheimer's disease (AD) or mild cognitive impairment (MCI) have decreased activity and/or coherence in delta, theta, alpha and beta cognitive responses. In the current study, we investigated gamma responses in visual SEO and ERO in 15 patients with AD and in 15 age-, gender- and education-matched healthy controls. The following parameters were analyzed over the parietal-occipital regions in both groups: (i) latency of the maximum gamma response over a 0-800 ms time window; (ii) the maximum peak-to-peak amplitudes for each participant's averaged SEO and ERO gamma responses in 3 frequency ranges (25-30, 30-35, 40-48 Hz); and (iii) the maximum peak-to-peak amplitudes for each participant's averaged SEO and ERO gamma responses over a 0-800 ms time block containing four divided time windows (0-200, 200-400, 400-600, and 600-800 ms). There were main group effects in terms of both latency and peak-to-peak amplitudes of gamma ERO. However, peak-to-peak gamma ERO amplitude differences became noticeable only when the time block was divided into four time windows. SEO amplitudes in the 25-30 Hz frequency range of the 0-200 ms time window over the left hemisphere were greater in the healthy controls than in those with AD. Gamma target ERO latency was delayed up to 138 ms in AD patients when compared to healthy controls. This finding may be an effect of lagged neural signaling in cognitive circuits, which is reflected by the delayed gamma responses in those with AD. Based on the results of this study, we propose that gamma responses should be examined in a more detailed fashion using multiple frequency and time windows.
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Affiliation(s)
- Erol Başar
- Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kultur University, Istanbul 34156, Turkey.
| | - Derya Durusu Emek-Savaş
- Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kultur University, Istanbul 34156, Turkey; Department of Psychology, Dokuz Eylül University, Izmir 35160, Turkey; Department of Neurosciences, Dokuz Eylül University, Izmir 35340, Turkey
| | - Bahar Güntekin
- Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kultur University, Istanbul 34156, Turkey
| | - Görsev G Yener
- Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kultur University, Istanbul 34156, Turkey; Department of Neurosciences, Dokuz Eylül University, Izmir 35340, Turkey; Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, Izmir 35340, Turkey; Department of Neurology, Dokuz Eylül University Medical School, Izmir 35340, Turkey
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Lizio R, Del Percio C, Marzano N, Soricelli A, Yener GG, Başar E, Mundi C, De Rosa S, Triggiani AI, Ferri R, Arnaldi D, Nobili FM, Cordone S, Lopez S, Carducci F, Santi G, Gesualdo L, Rossini PM, Cavedo E, Mauri M, Frisoni G, Babiloni C. Neurophysiological Assessment of Alzheimer’s Disease Individuals by a Single Electroencephalographic Marker. J Alzheimers Dis 2015; 49:159-77. [DOI: 10.3233/jad-143042] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Roberta Lizio
- IRCCS San Raffaele Pisana, Rome, Italy
- Department of Physiology and Pharmacology, University of Rome “La Sapienza”, Rome, Italy
| | | | | | - Andrea Soricelli
- IRCCS SDN, Naples, Italy
- Department of Studies of Institutions and Territorial Systems, University of Naples Parthenope, Naples, Italy
| | - Görsev G. Yener
- Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kültür University, Istanbul, Turkey
- Department of Neurosciences, Brain Dynamics Multidisciplinary Research Center, Department of Neurology, Dokuz Eylül University, Izmir, Turkey
| | - Erol Başar
- Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kültür University, Istanbul, Turkey
| | - Ciro Mundi
- Department of Neurology, Ospedali Riuniti, Foggia, Italy
| | | | | | | | - Dario Arnaldi
- Service of Clinical Neurophysiology (DiNOGMI; DipTeC), IRCCS AOU S Martino-IST, Genoa, Italy
| | - Flavio Mariano Nobili
- Service of Clinical Neurophysiology (DiNOGMI; DipTeC), IRCCS AOU S Martino-IST, Genoa, Italy
| | - Susanna Cordone
- Department of Physiology and Pharmacology, University of Rome “La Sapienza”, Rome, Italy
| | - Susanna Lopez
- Department of Physiology and Pharmacology, University of Rome “La Sapienza”, Rome, Italy
| | - Filippo Carducci
- Department of Physiology and Pharmacology, University of Rome “La Sapienza”, Rome, Italy
| | - Giulia Santi
- Department of Physiology and Pharmacology, University of Rome “La Sapienza”, Rome, Italy
| | - Loreto Gesualdo
- Dipartimento Emergenza e Trapianti d’Organi (D.E.T.O), University of Bari, Bari, Italy
| | - Paolo M. Rossini
- IRCCS San Raffaele Pisana, Rome, Italy
- Department of Geriatrics, Neuroscience & Orthopedics, Institute of Neurology, Catholic University, Rome, Italy
| | - Enrica Cavedo
- LENITEM (Laboratory of Epidemiology, Neuroimaging and Telemedicine), IRCCS Centro “S. Giovanni di Dio-F.B.F.”, Brescia, Italy
| | - Margherita Mauri
- LENITEM (Laboratory of Epidemiology, Neuroimaging and Telemedicine), IRCCS Centro “S. Giovanni di Dio-F.B.F.”, Brescia, Italy
- Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Giovanni B. Frisoni
- LENITEM (Laboratory of Epidemiology, Neuroimaging and Telemedicine), IRCCS Centro “S. Giovanni di Dio-F.B.F.”, Brescia, Italy
- Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Claudio Babiloni
- IRCCS San Raffaele Pisana, Rome, Italy
- Department of Physiology and Pharmacology, University of Rome “La Sapienza”, Rome, Italy
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Yener GG, Emek-Savaş DD, Lizio R, Çavuşoğlu B, Carducci F, Ada E, Güntekin B, Babiloni CC, Başar E. Frontal delta event-related oscillations relate to frontal volume in mild cognitive impairment and healthy controls. Int J Psychophysiol 2015; 103:110-7. [PMID: 25660300 DOI: 10.1016/j.ijpsycho.2015.02.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Amnesic mild cognitive impairment (MCI) represents a risk of developing Alzheimer's disease (AD), but not all MCI subjects progress to dementia of AD type. Magnetic resonance imaging (MRI) of cortical and hippocampal atrophy supports early diagnosis of AD in MCI subjects, while frontal event-related oscillations (EROs) at delta frequencies (<4Hz) are appealing markers for this purpose, as they are both cost-effective and largely available. The present study tested the hypothesis that these EROs reflect cortical frontal neurodegeneration in the continuum between normal and amnesic MCI subjects. EROs and volumetric MRI data were recorded in 28 amnesic MCI and in 28 healthy elderly controls (HCs). EROs were collected during a standard visual oddball paradigm including frequent (66.6%) and rare (33.3%; targets to be mentally counted) stimuli. Peak-to-peak amplitude of delta target EROs (<4Hz) was measured. Volume of frontal cortex was estimated from MRIs. Frontal volume was lower in MCI compared to the HC group. Furthermore, widespread delta target EROs were lower in amplitude in the former than in the latter group. Finally, there was a positive correlation between frontal volume and frontal delta target EROs in MCI and HC subjects as a whole group. These results suggest that frontal delta EROs reflect frontal neurodegeneration in the continuum between normal and amnesic MCI subjects.
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Affiliation(s)
- Görsev G Yener
- Department of Neurology, Dokuz Eylül University Medical School, Izmir 35340, Turkey; Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, Izmir 35340, Turkey; Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kultur University, Istanbul 34156, Turkey; Department of Neurosciences, Dokuz Eylül University, Izmir 35340, Turkey.
| | - Derya Durusu Emek-Savaş
- Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kultur University, Istanbul 34156, Turkey; Department of Neurosciences, Dokuz Eylül University, Izmir 35340, Turkey; Department of Psychology, Dokuz Eylül University, Izmir 35160, Turkey
| | | | - Berrin Çavuşoğlu
- Department of Neurosciences, Dokuz Eylül University, Izmir 35340, Turkey
| | - Filippo Carducci
- Laboratory of Neuroimaging, Department of Physiology and Pharmacology, University of Rome "La Sapienza", Rome, Italy
| | - Emel Ada
- Department of Radiology, Dokuz Eylül University Medical School, Izmir 35340, Turkey
| | - Bahar Güntekin
- Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kultur University, Istanbul 34156, Turkey
| | - Claudio C Babiloni
- IRCCS San Raffaele Pisana, Roma, Italy; Laboratory of High resolution EEG, Department of Physiology and Pharmacology, University of Rome "La Sapienza", Rome, Italy
| | - Erol Başar
- Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kultur University, Istanbul 34156, Turkey
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Başar E, Durusu Emek-Savaş D, Güntekin B, Yener GG. Event-related oscillatory gamma responses appear late in Alzheimer disease. Int J Psychophysiol 2014. [DOI: 10.1016/j.ijpsycho.2014.08.914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Yener GG, Emek-Savaş DD, Güntekin B, Başar E. The visual cognitive network, but not the visual sensory network, is affected in amnestic mild cognitive impairment: a study of brain oscillatory responses. Brain Res 2014; 1585:141-9. [PMID: 25152459 DOI: 10.1016/j.brainres.2014.08.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 08/13/2014] [Accepted: 08/14/2014] [Indexed: 11/17/2022]
Abstract
Mild Cognitive Impairment (MCI) is considered in many as prodromal stage of Alzheimer's disease (AD). Event-related oscillations (ERO) reflect cognitive responses of brain whereas sensory-evoked oscillations (SEO) inform about sensory responses. For this study, we compared visual SEO and ERO responses in MCI to explore brain dynamics (BACKGROUND). Forty-three patients with MCI (mean age=74.0 year) and 41 age- and education-matched healthy-elderly controls (HC) (mean age=71.1 year) participated in the study. The maximum peak-to-peak amplitudes for each subject's averaged delta response (0.5-3.0 Hz) were measured from two conditions (simple visual stimulation and classical visual oddball paradigm target stimulation) (METHOD). Overall, amplitudes of target ERO responses were higher than SEO amplitudes. The preferential location for maximum amplitude values was frontal lobe for ERO and occipital lobe for SEO. The ANOVA for delta responses showed significant results for the group Xparadigm. Post-hoc tests indicated that (1) the difference between groups were significant for target delta responses, but not for SEO, (2) ERO elicited higher responses for HC than MCI patients, and (3) females had higher target ERO than males and this difference was pronounced in the control group (RESULTS). Overall, cognitive responses display almost double the amplitudes of sensory responses over frontal regions. The topography of oscillatory responses differs depending on stimuli: visualsensory responses are highest over occipitals and -cognitive responses over frontal regions. A group effect is observed in MCI indicating that visual sensory and cognitive circuits behave differently indicating preserved visual sensory responses, but decreased cognitive responses (CONCLUSION).
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Affiliation(s)
- Görsev G Yener
- Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, Izmir 35340, Turkey; Department of Neurosciences, Dokuz Eylül University, Izmir 35340, Turkey; Department of Neurology, Dokuz Eylül University Medical School, Balçova, Izmir 35340, Turkey; Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kultur University, Istanbul 34156, Turkey.
| | - Derya Durusu Emek-Savaş
- Department of Neurosciences, Dokuz Eylül University, Izmir 35340, Turkey; Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kultur University, Istanbul 34156, Turkey
| | - Bahar Güntekin
- Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kultur University, Istanbul 34156, Turkey
| | - Erol Başar
- Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kultur University, Istanbul 34156, Turkey
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Sayın S, Çakmur R, Yener GG, Yaka E, Uğurel B, Uzunel F. Low-frequency repetitive transcranial magnetic stimulation for dyskinesia and motor performance in Parkinson’s disease. J Clin Neurosci 2014; 21:1373-6. [DOI: 10.1016/j.jocn.2013.11.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 09/09/2013] [Accepted: 11/10/2013] [Indexed: 10/25/2022]
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Yener GG, Kurt P, Emek-Savaş DD, Güntekin B, Başar E. Reduced visual event-related δ oscillatory responses in amnestic mild cognitive impairment. J Alzheimers Dis 2014; 37:759-67. [PMID: 23948923 DOI: 10.3233/jad-130569] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Mild cognitive impairment (MCI) is considered as a prodromal stage for Alzheimer's disease (AD) in the majority of cases. Event-related oscillations might be used for detection of cognitive deficits. Our group's earlier results showed diminished delta visual and auditory target oscillatory responses in AD, and we investigated whether this prevails for MCI. Eighteen MCI subjects and 18 age-matched healthy elderly controls were investigated. The maximum peak-to-peak amplitudes of oscillatory responses for each subject's averaged oscillatory target responses in delta, theta, and alpha frequency bands upon application of visual oddball paradigm were measured. Repeated measures of ANOVA was used to analyze four locations (frontal, central, parietal, occipital), at three coronal (left, midline, right) sites. Independent t tests were applied for post-hoc analyses. The oddball target delta response (0.5-3.0 Hz) was 26-32% lower in MCI than healthy controls over fronto-central-parietal regions [F(1.34) = 4.562, p = 0.04]. Without a group effect, theta oscillatory responses (4-7 Hz) showed significant differences in coronal electrodes indicating highest values over mid-electrode sites, and a anteriorposterior x coronal effect, being maximum at mid-central. Alpha frequency band analyses indicated no statistical differences. Peak-to-peak amplitudes of visual target delta oscillatory responses were lower in fronto-central-parietal regions in MCI than in healthy controls. This supports our earlier findings in AD, showing hypoactive delta fronto-central-parietal regions during cognitive tasks. These results indicate that event-related oscillations may detect early changes of brain dynamics in MCI, and deserves to be investigated as a candidate biomarker in further studies using multimodal techniques.
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Affiliation(s)
- Görsev G Yener
- Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, Izmir, Turkey Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey Department of Neurology, Dokuz Eylül University Medical School, Izmir, Turkey Brain Dynamics, Cognition and Complex Systems Research Center, Istanbul Kültür University, Istanbul, Turkey
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Yener GG, Gökçe G, Tanburoğlu A, Çavuşoğlu B, Demir N, Emek‐Savaş DD, Ada E. P2‐181: MAGNETIC RESONANCE IMAGING VOLUMETRIC ANALYSES IN EARLY ONSET ALZHEIMER DEMENTIA AND FRONTOTEMPORAL DEMENTIA SUBJECTS. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.05.857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | | | | | | | | | | | - Emel Ada
- Dokuz Eylül UniversityIzmirTurkey
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Eren E, Keskinoglu P, Tufekci KU, Gökçe G, Tanburoglu A, Demir N, Emek‐Savas DD, Yener GG, Genç Å. P1‐169: THE NEW CUT‐OFF FOR CEREBROSPINAL FLUID BIOMARKER OF ALZHEIMER'S DISEASE IN THE DIFFERENTIATION BETWEEN FTLD AND CONTROL SUBJECTS FOR A TURKISH POPULATION. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.05.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Erden Eren
- Dokuz Eylul University Institute of Health SciencesIzmirTurkey
| | | | | | - Gülsah Gökçe
- Dokuz Eylul University Medical SchoolIzmirTurkey
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Basar E, Yener GG, Emek‐Savas DD, Güntekin B. P2‐180: GAMMA EVENT‐RELATED OSCILLATORY RESPONSES APPEAR LATE IN ALZHEIMER DISEASE. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.05.856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Erol Basar
- Istanbul Kultur UniversityIstanbulTurkey
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Yener GG, Başar E. Brain oscillations as biomarkers in neuropsychiatric disorders: following an interactive panel discussion and synopsis. Suppl Clin Neurophysiol 2013; 62:343-63. [PMID: 24053048 DOI: 10.1016/b978-0-7020-5307-8.00016-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This survey covers the potential use of neurophysiological changes as a biomarker in four neuropsychiatric diseases (attention deficit hyperactivity disorder (ADHD), Alzheimer's disease (AD), bipolar disorder (BD), and schizophrenia (SZ)). Great developments have been made in the search of biomarkers in these disorders, especially in AD. Nevertheless, there is a tremendous need to develop an efficient, low-cost, potentially portable, non-invasive biomarker in the diagnosis, course, or treatment of the above-mentioned disorders. Electrophysiological methods would provide a tool that would reflect functional brain dynamic changes within milliseconds and also may be used as an ensemble of biomarkers that is greatly needed in the evaluation of cognitive changes seen in these disorders. The strategies for measuring cognitive changes include spontaneous electroencephalography (EEG), sensory evoked oscillation (SEO), and event-related oscillations (ERO). Further selective connectivity deficit in sensory or cognitive networks is reflected by coherence measurements. Possible candidate biomarkers discussed in an interactive panel can be summarized as follows: for ADHD: (a) elevation of delta and theta, (b) diminished alpha and beta responses in spontaneous EEG; for SZ: (a) decrease of ERO gamma responses, (b) decreased ERO in all other frequency ranges, (c) invariant ERO gamma response in relation to working memory demand; for euthymic BD: (a) decreased event-related gamma coherence, (b) decreased alpha in ERO and in spontaneous EEG; for manic BD: (a) lower alpha and higher beta in ERO, (b) decreased event-related gamma coherence, (c) lower alpha and beta in ERO after valproate; and for AD: (a) decreased alpha and beta, and increased theta and delta in spontaneous EEG, (b) hyperexcitability of motor cortices as shown by transcortical magnetic stimulation, (c) hyperexcitability of visual sensory cortex as indicated by increased SEO theta responses, (d) lower delta ERO, (e) lower delta, theta, and alpha event-related coherence, (f) higher theta synchrony and higher alpha event-related coherence in cholinergically treated AD subjects. In further research in the search for biomarkers, multimodal methods should be introduced to electrophysiology for validation purposes. Also, providing the protocols for standardization and harmonization of user-friendly acquisition or analysis methods that would be applied in larger cohort populations should be used to incorporate these electrophysiologic methods into the clinical criteria. In an extension to conventional anatomical, biochemical and brain imaging biomarkers, the use of neurophysiologic markers may lead to new applications for functional interpretrations and also the possibility to monitor treatments tailored for individuals.
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Affiliation(s)
- Görsev G Yener
- Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, Izmir 35340, Turkey.
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Yener GG, Güntekin B, Örken DN, Tülay E, Forta H, Başar E. Auditory delta event-related oscillatory responses are decreased in Alzheimer's disease. Behav Neurol 2012; 25:3-11. [PMID: 22207418 PMCID: PMC5294260 DOI: 10.3233/ben-2012-0344] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Visual delta event-related (ERO) and evoked oscillations (EO) of Alzheimer patients (AD) are different than healthy. In the present study, the analysis is extented to include auditory ERO and EO in AD. The rationale is to reveal whether the auditory ERO delta responses are also reduced, and whether this is a general phenomenon in Alzheimer patients upon applying stimuli with cognitive load. METHODS Thirty-four mild AD subjects [17 de-novo and 17 medicated (cholinergic)] and seventeen healthy controls were included. Auditory oddball paradigm and sensory auditory stimuli were applied to the subjects. Oscillatory responses were analyzed by measuring maximum amplitudes in delta frequency range (0.5-3.5 Hz). RESULTS Auditory delta ERO (0.5-3.5 Hz) responses of healthy controls were higher than either de-novo AD or medicated AD group, without a difference between two AD subgroups. Furthermore, the auditory EO after presentation of tone bursts yielded no group difference. CONCLUSION Our findings imply that delta ERO is highly unstable in AD patients in comparison to age-matched healthy controls only during the cognitive paradigm. Our results favor the hypothesis that neural delta networks are activated during cognitive tasks and that the reduced delta response is a general phenomenon in AD, due to cognitive impairment.
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Affiliation(s)
- G G Yener
- Department of Neurology, Dokuz Eylül University, Izmir, Turkey.
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Yener GG, Başar E. Sensory evoked and event related oscillations in Alzheimer's disease: a short review. Cogn Neurodyn 2010; 4:263-74. [PMID: 22132038 DOI: 10.1007/s11571-010-9138-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Revised: 09/26/2010] [Accepted: 09/29/2010] [Indexed: 11/29/2022] Open
Abstract
Diagnosis and treatment of Alzheimer's disease (AD) depend on clinical evaluation and there is a strong need for an objective tool as a biomarker. Our group has investigated brain oscillatory responses in a small group of AD subjects. We found that the de novo (untreated) AD group differs from both the cholinergically-treated AD group and aged-matched healthy controls in theta and delta responses over left frontal-central areas after cognitive stimulation. On the contrary, the difference observed in AD groups upon a sensory visual stimulation includes response increase over primary or secondary visual sensorial areas compared to controls. These findings imply at least two different neural networks, depending on type of stimulation (i.e. cognitive or sensory). The default mode defined as activity in resting state in AD seems to be affected electrophysiologically. Coherences are also very valuable in observing the group differences, especially when a cognitive stimulus is applied. In healthy controls, higher coherence values are elicited after a cognitive stimulus than after a sensory task. Our findings support the notion of disconnectivity of cortico-cortical connections in AD. The differences in comparison of oscillatory responses upon sensory and cognitive stimulations and their role as a biomarker in AD await further investigation in series with a greater number of subjects.
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Yaka E, Egrilmez MY, Keskinoglu P, Cavdar Z, Genc S, Genc K, İyilikci L, Yener GG. Biological markers in cerebrospinal fluid (CSF) and evaluation ofin vitroeffect of CSF on PC12 cell line viability in Alzheimer's disease. Cell Biochem Funct 2009; 27:395-401. [DOI: 10.1002/cbf.1588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Abstract
Vitamin B12 deficiency can manifest with various neuropsychiatric symptoms. We report a case of an individual with vitamin B12 deficiency presenting with personality, emotional and behavioral changes. Neuropsychological tests revealed disproportionate disturbance of executive functions. Single photon emission tomography (Tc99m HMPAO) showed right fronto-temporo-parietal hypoperfusion. After vitamin B12 injections, the patient's executive and behavioral dysfunction disappeared and performance on neuropsychological tests was once again in the normal range.
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Affiliation(s)
- Gülden Akdal
- Department of Neurology, School of Medicine, Dokuz Eylul University Inciralti, Izmir, Turkey.
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Abstract
Eye movement disorders are rarely reported in vitamin B12 deficiency. We describe two cases with eye movement disorder and vitamin B12 deficiency; one with bilateral internuclear ophthalmoplegia and the other with downbeat nystagmus. Both of the patients received replacement therapy but their eye movement disorders did not respond to treatment. We also review the nine previously reported cases.
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Affiliation(s)
- G Akdal
- Department of Neurology Inciralti, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey.
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Yener GG, Güntekin B, Oniz A, Başar E. Increased frontal phase-locking of event-related theta oscillations in Alzheimer patients treated with cholinesterase inhibitors. Int J Psychophysiol 2006; 64:46-52. [PMID: 17011650 DOI: 10.1016/j.ijpsycho.2006.07.006] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2006] [Revised: 06/24/2006] [Accepted: 07/13/2006] [Indexed: 10/24/2022]
Abstract
This is a pilot study describing event-related oscillations in patients with Alzheimer-type dementia (AD). Theta responses of 22 mild probable AD subjects according to NINCDS-ADRDA criteria (11 non-treated, 11 treated by cholinesterase inhibitors), and 20 healthy elderly controls were analyzed by using the conventional visual oddball paradigm. We aimed to compare theta responses of the three groups in a range between 4-7 Hz at the frontal electrodes. At F(3) location, theta responses of healthy subjects were phase locked to stimulation and theta oscillatory responses of non-treated Alzheimer patients showed weaker phase-locking, i.e. average of Z-transformed means of correlation coefficients between single trials was closer to zero. In treated AD patients, phase-locking following target stimulation was two times higher in comparison to the responses of non-treated patients. The results indicate that the phase-locking of theta oscillations at F(3) in the treated patients is as strong as the control subjects. The F(4) theta responses were not statistically significant between the groups. Our findings imply that the theta responses at F(3) location are highly unstable in comparison to F(4) in non-treated mild AD patients and cholinergic agents may modulate event-related theta oscillatory activities in the frontal regions.
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Affiliation(s)
- G G Yener
- Dokuz Eylül University, Faculty of Medicine Departments of Neurology and Neural Sciences, 35340, Izmir, Turkey.
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40
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Abstract
OBJECTIVE Previous studies have provided evidence from event-related potentials (ERPs) and neuropsychological testing of abnormal cognitive processing in obsessive-compulsive disorder (OCD). The aim of this study was to further characterize the cognitive functions of the patients with OCD by utilizing ERPs and neuropsychological tests. METHODS ERPs were recorded in a group of 31 drug-free OCD patients without depression and 30 normal controls following verbal auditory stimuli using an oddball paradigm. The specific neuropsychological tests administered to assess cognitive functions in all participants were the Stroop Test, Trail Making Test, Design Fluency Test, Controlled Word Association Test (Verbal Fluency test). RESULTS The patient group showed shorter P300 duration compared to normal controls. In neuropsychological tests, no significant differences were found between the two groups. Negative correlations between Stroop duration and P300 amplitudes in occipital, parietal, and temporal anterior regions were observed. CONCLUSION Shorter P300 duration may indicate an acceleration in the P300 process, and speeding of cognitive processing, dysfunction of cortico-subcortical circuits, or some combination of all of the above.
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Affiliation(s)
- Berna Binnur Kivircik
- Department of Psychiatry, Dokuz Eylül University School of Medicine, Inciralti, Izmir, Turkey.
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41
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Abstract
Cerebral sinus thrombosis (CST) is known to be related to a number of underlying aetiologies including otitis media, trauma, pregnancy, birth control pills, tumours, malnutrition, dehydration, haematologic disorders and malignancy (Fishman, 2000; Raizer and Abbott, 2000). We present the case of a patient with breast cancer receiving the antioestrogen drug tamoxifen who developed CST. A 40-year-old female presented as an emergency with a 10-day history of headache and left sided weakness. On questioning her past medical history included a diagnosis of breast cancer 3 years ago treated by radical mastectomy and tamoxifen 20 mg daily. At the time of admission, neurologic examination revealed a mild left sided hemiparesis and a present Babinksi sign. Non-contrast enhanced tomography was normal. Magnetic resonance imaging (MRI) showed thrombosis in the superior sagittal sinus, right lateral sinus and jugular vein in addition venous infarction in the right temporal lobe was present (Figs 1a and b). Routine haematology and biochemistry was normal. Anticoagulation tests, antithrombin III, protein S and C levels were also found to be normal. She was treated with anticoagulation therapy and her hemiparesis improved within 3 days. Control MRI showed the resorption of the venous infarction and resolution of the thrombosis (Fig. 1c).
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Affiliation(s)
- G Akdal
- Department of Neurology, Dokuz Eylül University, School of Medicine, Izmir-Turkey.
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Yener GG, Guiochon-Mantel A, Obuz F, Baklan B, Oztürk V, Kovanlikaya I, Cakmur R, Genç A. Phe 84 deletion of the PMP22 gene associated with hereditary motor and sensory neuropathy HMSN III with multiple cranial neuropathy: clinical, neurophysiological and magnetic resonance imaging findings. J Neurol 2001; 248:193-6. [PMID: 11355152 DOI: 10.1007/s004150170225] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Hereditary motor and sensory neuropathy (HMSN) is a heterogeneous group of peripheral neuropathies which are diagnosed on the basis of clinical, electrophysiological and neuropathological findings. Among the hypertrophic demyelinating neuropathies, HMSN III is the most severe. It is often associated with de novo mutations in the genes encoding for peripheral myelin proteins. While peripheral nerve hypertrophy is an expected finding in HMSN III, cranial nerve hypertrophy is exceptional. Here we describe a mutation in the PMP22 gene in a 19-year-old man with infantile onset of sensory motor polyneuropathy without family history and multiple cranial nerve hypertrophy shown by cranial magnetic resonance imaging.
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Affiliation(s)
- G G Yener
- Department of Neurology, Dokuz Eylul University Medical Faculty, Izmir 35340, Turkey.
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Cakmur R, Idiman F, Akalin E, Genç A, Yener GG, Oztürk V. Dermatomal and mixed nerve somatosensory evoked potentials in the diagnosis of neurogenic thoracic outlet syndrome. Electroencephalogr Clin Neurophysiol 1998; 108:423-34. [PMID: 9780011 DOI: 10.1016/s0168-5597(97)00098-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
To evaluate the diagnostic utility of dermatomal and mixed nerve somatosensory evoked potentials (SEPs) in patients with thoracic outlet syndrome (TOS) and to compare their value with routine electrodiagnostic methods, we studied a group of 44 patients with neurogenic TOS and 30 healthy controls. In addition to bilateral median and ulnar SEPs, evoked potentials were recorded after stimulation of C6 and C8 dermatomes from the first and fifth digits, respectively. The patients were classified into 3 groups according to the nature of their clinical condition. The abnormality rate for both ulnar and C8 dermatomal SEPs was 100% in a small group of patients with severe neurological signs like atrophy. In groups of patients with lesser degrees of neurogenic damage, abnormality rates for ulnar and C8 dermatomal SEPs on affected limb(s) were 67 and 50%, respectively. Same abnormality rates were 25 and 18% in patients with only subjective symptoms. In patients with objective neurological signs, the major increase in sensitivity was with electromyography (EMG). Abnormalities of routine nerve conduction studies and F-wave latency were observed in patients with severe neurogenic damage. We concluded that the most useful tests in the diagnosis of neurogenic TOS are needle EMG and ulnar SEPs.
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Affiliation(s)
- R Cakmur
- Department of Neurology, Dokuz Eylül University, Medical School (Tip Fakultesi), Inciralti, Izmir, Turkey.
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Abstract
Accurate diagnosis of the major degenerative dementias continues to be problematic. Although diagnostic precision for Alzheimer's disease (AD) approaches 90%, for Frontotemporal dementias (FTD) it has been less than 20%. Previous work has shown that AD patients have both focal and generalized slowing, while in FTD the EEG is normal. We studied 26AD,13FTD and 27 health control subjects with Quantitative Electroencephalography (QEEG). Using only five QEEG measures with stepwise discriminant function analysis, we distinguished the AD from FTD groups each with 84.6% accuracy, and controls (100%) from FTD groups (84.6%) with high accuracy. The most informative QEEG variables for distinguishing FTD and AD were relative power from the temporal region in beta-2 band, and from the parietal region in the theta and alpha and beta-2 bands. These results suggest that QEEG may be helpful in distinguishing subjects with AD from subjects with FTD.
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Affiliation(s)
- G G Yener
- Department of Neurology, Dokuz Eylul University Faculty of Medicine, Izmir Turkey
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Abstract
The occurrence of weight gain, sweet and carbohydrate craving, hyposexuality, and compulsions in frontal lobe dementia (FLD) compared to Alzheimer's disease (AD) was evaluated. FLD is a progressive dementia with a high rate of misdiagnosis and therefore better diagnostic criteria for FLD are needed. Fourteen patients meeting research criteria for AD were compared to 14 with suspected FLD. All had cerebral perfusion measured with xenon-133 and imaged with HMPAO using brain-dedicated SPECT. The FLD group showed frontotemporal and AD posterior temporoparietal hypoperfusion. The primary caregivers were queried regarding weight gain, sweet/carbohydrate preference, sexual drive, and compulsions. Differences were compared with Fisher's exact test. The following was found in FLD versus AD: Weight gain in FLD patients amounted to 64% (AD 7%), carbohydrate craving was 79% (vs. 0%) and compulsive behavior 64% (vs. 14%). The differences for these symptoms were statistically significant, whereas for the symptoms increased sexual drive (8 vs. 8%) and reduced sexual drive (54 vs. 23%) no significant difference could be found. In FLD the first symptoms were often dietary changes or hyposexuality. Compulsions were more bizarre and severely disabling in FLD than in AD. Dietary changes, hyposexuality, and disabling compulsions are prominent early symptoms in FLD but not AD. The cause of these symptoms may be due to both frontal and subcortical serotonin loss and dysfunction of the anterior temporal lobes.
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Affiliation(s)
- B L Miller
- Department of Neurology, Harbor-UCLA Medical Center, Torrance 90509, USA
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Idiman F, Baklan B, Damlaçik GA, Yener GG, Idiman E. A multiple sclerosis patient presenting with only complaint of diplopia and only sign of bilateral INO. J Neuroimmunol 1995. [DOI: 10.1016/0165-5728(95)98953-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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