Does probe's eye subthalamic nucleus length on T2W MRI correspond with microelectrode recording in patients with deep brain stimulation for advanced Parkinson's disease?

AIM

Subthalamic nucleus (STN) deep brain stimulation (DBS) has become a well-accepted treatment for patients with advanced Parkinson's disease (PD). During surgical planning for DBS, the length of the STN is taken into account and verified during microelectrode recording (MER) intraoperatively. Here, we addressed the question to which extent the length of the STN measured with the T2 weighted MRI in the probe's eye view corresponded with the intraoperatively determined length of the STN with MER.

MATERIAL AND METHODS

We included 10 consecutive Parkinson's disease patients who underwent STN DBS surgery. The length of the STN in the probe's eye view mode was calculated along the trajectory of the central MER electrode crossing the STN.

RESULTS

Our analysis showed no statistical difference between the length of the STN measured with the T2 weighted probe's eye view mode and the MER (right STN length 5.8 ± 0.9 mm MRI vs. 6.3 ± 0.5 mm MER, p > 0.05; left STN length 5.6 ± 0.4 mm MRI vs 5.8 ± 1 mm MER, p > 0.05).

CONCLUSION

This means that the entry and the exit of the STN can be adequately estimated using the probe's eye view preoperatively.

The reliability and validity of the Turkish version of the brief infant-toddler social emotional assessment (BITSEA)

In this study the reliability and validity of the Turkish version of the brief infant-toddler social emotional assessment (BITSEA) were investigated in a community sample. The sample consisted of 462 children (mean age: 24.60+/-7.93 [12-42] months) who had applied to Turkish health centers for immunization. Both parents completed the BITSEA; mothers completed the child behavior checklist 2/3 (CBCL). Internal consistencies of the BITSEA-problem (P) and competence (C) scales were good to excellent (Cronbach's alpha=0.82 and 0.72, respectively). Interrater reliability between parents and test-retest reliability were good. BITSEA/P scores were significantly correlated with CBCL internalizing, externalizing and total problem scores (p<0.001). Maternal BITSEA/P cutpoint scores revealed that 30.6% of male toddlers and 28.6% of females were in the subclinical range and 13.1% of males and 17.6% of females were in clinical range. Results reveal that the Turkish version of BITSEA is a reliable, valid and simply applicable instrument for screening social, emotional and behavioral problems among toddlers. Clinical validation of the BITSEA/C and BITSEA/P is warranted.

Prevalence of metabolic syndrome among inpatients with schizophrenia

OBJECTIVE

Cardiovascular disease is one of the most prevalent factors responsible for excess mortality in schizophrenia. Metabolic syndrome (MetS) is associated with the development of coronary heart disease and diabetes mellitus. The aim in this cross-sectional study was to assess the prevalence of MetS in schizophrenic Turkish inpatients.

METHOD

The study was conducted from January 2006 to June 2006, and included 231 patients with schizophrenia. All participants were enrolled from inpatients attending the Samsun Mental Health Hospital psychiatry clinic. All subjects were aged between 18 and 65 and met the DSM IV criteria for schizophrenia. MetS was taken as central obesity (defined as waist circumference: men > or = 94 cm, women > or = 80 cm) and meeting > or = 2 of the following abnormalities described by the International Diabetes Federation (IDF): a serum triglyceride level > 150 mg/dL, high-density lipoprotein (HDL) cholesterol < 40 mg/dL in men and < 50 mg/dL in women, blood pressure > or = 130/85 mm Hg, and a fasting serum glucose level > or = 100 mg/d/L.

RESULTS

The study group consisted of 174 male and 57 female patients. Mean age was 38.5 +/- 10.5 and mean duration of illness was 15.76 +/- 9.95 years. The overall prevalence of MetS diagnosed according to the IDF criteria was 32.0% (n = 74) and was higher in females (61.4%) than in males (22.4%; p = 0.0001). In logistic regression analysis the last step of the regression model was gender (B = 1.70, p = 0.0001, OR = 5.50, 95% CI = 2.90-10.45).

CONCLUSION

This study shows that the prevalence of MetS in Turkish patients with schizophrenia is similar to that of the general population, but lower than in other reports regarding the schizophrenia population.

The effects of temperament and character on the choice of contraceptive methods

OBJECTIVES

To identify the effects of temperament and character on the selection of contraceptive methods.

METHODS

Cross-sectional study carried out in June 2005 at the Ondokuz Mayis University Samsun Health College with the participation of 102 young women. The participants were asked to complete the Contraception Choice Questionnaire devised by the researchers, and the Cloninger Temperament and Character Inventory.

RESULTS

The mean age of the participants was 22.30 +/- 1.27 years; 39 participants (38.2%) mentioned Norplant, 30 (29.4%) condoms, 17 (16.6%) intrauterine devices (IUDs) and 16 (15.7%) oral contraceptives (OCs) as the method they would consider using in the future. The mean scores of self-directedness and self-transcendence of the groups differed significantly (p < 0.05). Students who indicated they would choose OCs had higher average scores for self-directedness than those choosing IUDs; the mean self-transcendence scores of students choosing IUDs were significantly higher than the scores of those selecting condoms (p < 0.01). Subjects choosing Norplant cited ease of use; those choosing condoms cited their eliciting fewer side effects; those choosing IUDs cited their high levels of safety; and those choosing OCs cited ease of use and high reliability as the reasons for their choices.

CONCLUSIONS

We think that identifying the roles of temperament and character in the selection process of a contraceptive method will help in achieving a wider application of contraception.

Association of Serotonin 2A Receptor and Lack of Association of CYP1A2 Gene Polymorphism with Tardive Dyskinesia in a Turkish Population

The aim of this study was to investigate the possible association of serotonin 2A receptor gene (HTR2A) -1438 G/A polymorphism and CYP1A2 gene 163C/A polymorphism with tardive dyskinesia (TD) in a Turkish population. A total of 47 patients with persistent TD, 80 patients who were consistently without TD, and 100 healthy controls were included in this study. The polymorphic regions of -1438 G/A polymorphism of HTR2A receptor gene (rs6311) and 163C/A of CYP1A2 (rs762551) gene were amplified using polymerase chain reaction (PCR), followed by digestion with restriction enzymes MspI and Bsp1201. Genotype and allele frequencies were calculated by the chi(2)-test. Crude and adjusted odds ratios (ORs) were estimated, and 95% confidence intervals (CIs) were computed by multivariate logistic regression analysis. The genotype and allele frequencies of HTR2A and CYP1A2 gene were similar in schizophrenia with TD, schizophrenia without TD, and healthy controls. The logistic regression analysis showed that cumulative exposure to antipsychotic drugs for every year (p = 0.003; OR = 1.15; CI = 1.07-1.23), and AA genotype of HTR2A gene (p = 0.0258; OR = 4.34; CI = 1.19-15.81) are risk factors for TD. The same logistic regression model showed no association between CYP1A2 polymorphism and TD. The results of the present study seem to indicate that HTR2A gene polymorphism influences the tendency to express TD following prolonged antipsychotic drug exposure in Turkish schizophrenia patients.

Schizophrenia in Turkish newspapers : retrospective scanning study

The attitude of mass media is a strong determinant for stigmatisation since the majority of the society gets exposed to psychiatric disorders via either written or visual media. In this study we explored to demonstrate the meaning attributed to the word schizophrenia in Turkish written printed media. We screened the online sites of 12 national newspapers which allow word scanning between the dates January 1, 2001 and May 1, 2006. The searched terms appeared in a total of 878 texts. In all twelve newspapers, the terms "Schizophrenia", "Schizophrene", or "Schizophrenic" appeared once every 2.2 days. While a positive referral appeared once in every 12.2 days, a negative referral or metaphoric use was seen once every 3.1 days. Among the 878 texts scanned, in 491(55.9%) the searched terms appeared with reference to the disease and in 387 (44.1%) the searched terms were used metaphorically. Considering the assumption the negative reporting may have a stronger impact than positive reporting, it is possible to suggest that Turkish newspapers are raising stigmatisation. It is meaningful that the name of a disease is used almost with equal frequency as a metaphoric term. In our study, higher rates of metaphoric use observed can be explained with the fact that in Turkey the word Schizophrenia is attributed with strong negative perception.

The attitude of medical students to psychiatric patients and their disorders and the influence of psychiatric study placements in bringing about changes in attitude

The aim of this study was to determine the general attitude of final year medical students towards psychiatric patients and psychiatric disorders and to reveal the influence of psychiatric study experience in changing the behavior and perception of students. The study comprised 172 final year medical students undergoing a period of placement at the Ondokuz Mayis University Medical School Department of Psychiatry who agreed to participate. They were asked to fill in the Opinions about Mental Illness Ideology Scale (OMI) the day before they commenced, on the last day of their placement and three months after completing it. The students reported the highest and lowest scores from the benevolence and social restrictiveness sub-dimensions of the OMI, respectively. The mean authoritarianism score was significantly higher in males than in females. The means of the OMI scores obtained over the three different periods were not statistically different. Medical school psychiatry departments need to develop new curricula to convey scientific information to students and play a pivotal role in developing, implementing and evaluating suitable programs leading to appropriate attitude development.