1
|
Onder H, Comoglu S. Investigation of the nonmotor symptoms in patients with STN-DBS therapy in comparison with those without STN-DBS. J Neural Transm (Vienna) 2024:10.1007/s00702-024-02778-y. [PMID: 38684577 DOI: 10.1007/s00702-024-02778-y] [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: 01/27/2024] [Accepted: 04/04/2024] [Indexed: 05/02/2024]
Abstract
The impact of STN-DBS on NMS remains rather as an underestimated topic. Besides, the significance of NMSs in QOL indexes of PD subjects with STN-DBS is unknown. We primarily aimed to evaluate the NMSs and their significance in QOL indexes in PD subjects comparatively with and without STN-DBS therapy. We enrolled all consecutive PD subjects with and without STN-DBS who applied to our movement disorders outpatient clinics between January/2023 and September/2023. We performed comprehensive assessments of the motor and nonmotor features including the clinical scales of Movement Disorder Society-sponsored revision of the MDS-UPDRS, NMSS, HAM-A, HAM-D, and the PDQ-39. Overall, 48 PD subjects with STN-DBS and 161 without STN-DBS treatment were included. The comparative analyses revealed that the sub-scores of the MDS-UPDRS-2, -3 and -4 were higher in the STN-DBS group. However, the MDS-UDPRS-1 and the total scores of the NMSS were similar between groups. Among eight subitems of the NMSS, only, the sub scores of the mood/cognition and the gastrointestinal tract differed. Remarkably, the significant correlations between the scores of the QOL and the NMSS scores in the STN-DBS (-) group, did not persist within the STN-DBS group. Remarkably, the correlations between the NMSS and PQQ-39 disappeared for most of the sub scores within the STN-DBS group. We found indirect evidence regarding the benefit of STN-DBS therapy on NMSs in our cross-sectional study. Besides, we found weaker impact of NMSs in QOL indexes in PD subjects with STN-DBS therapy.
Collapse
Affiliation(s)
- Halil Onder
- Neurology Clinic, Etlik City Hospital, Varlık, Halil Sezai Erkut Street. No:5, 06170 Yenimahalle, 06110, Ankara, Turkey.
| | - Selcuk Comoglu
- Neurology Clinic, Etlik City Hospital, Varlık, Halil Sezai Erkut Street. No:5, 06170 Yenimahalle, 06110, Ankara, Turkey
| |
Collapse
|
2
|
Onder H, Dilek SS, Bahtiyarca ZT, Comoglu S. Analyses of the clinical factors and freezing of gait in association with the quality-of-life indexes in Parkinson's disease subjects with and without STN-DBS therapy. Neurol Res 2024; 46:207-212. [PMID: 37856692 DOI: 10.1080/01616412.2023.2265250] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/25/2023] [Indexed: 10/21/2023]
Abstract
INTRODUCTION In this research, paying particular attention to freezıng of gait (FOG), we aimed to investigate the associations between the clinical features and quality of lilfe (QOL) indexes comparatively in our PD subjects with and without STN-DBS therapy. METHODS All consecutive PD subjects with and without STN-DBS who applied to our movement disorders outpatient clinics between January/2022 and September/2022; and accepted to participate in the study were enrolled. The demographic data and clinical features were noted. Besides, the MDS-UPDRS, the FOG Questionnaire (FOGQ) and the Parkinson's Disease Questionnaire (PDQ-39) have also been performed on all individuals. RESULTS Overall, 105 patients with PD participated in this study (34 patients with STN-DBS, 71 patients without STN-DBS). No difference was found in the PDQ-39 scores between patients with and without STN-DBS. The correlation analyses between the PQQ-39 scores and the clinical parameters revealed significant moderate correlations with the FOGQ score and low correlations with MDS-UPDRS scores. The analyses repeated in either patient group showed that there were no correlations between the MDS-UPDRS scores and PDQ-39 indexes in the DBS group. Besides, the correlations between the PDQ-39 scores and the FOG scores were more prominent in patients without DBS therapy. CONCLUSION FOG was found to be associated with worse QOL status in both patients with and without STN-DBS therapy. However, the correlations analyses in either group showed that FOG was a more significant determinant in the QOL indexes in patients without DBS. Future studies evaluating the impact of other clinical features such as falls and gait impairment in QOL of patients with STN-DBS may provide contributions to the current evidence.
Collapse
Affiliation(s)
- Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
- Neurology Clinic, Etlik City Hospital, Ankara, Turkey
| | - Siddika Sena Dilek
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
- Neurology Clinic, Etlik City Hospital, Ankara, Turkey
| | | | - Selcuk Comoglu
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
- Neurology Clinic, Etlik City Hospital, Ankara, Turkey
| |
Collapse
|
3
|
Onder H, Kertmen H, Comoglu S. Illustration of the Dramatic and Dynamic Efficacy of Chronic GPi-DBS Therapy in a Patient with Tardive Dyskinesia/Dystonia. Ann Indian Acad Neurol 2024; 27:90-92. [PMID: 38495233 PMCID: PMC10941891 DOI: 10.4103/aian.aian_799_23] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/19/2023] [Accepted: 10/07/2023] [Indexed: 03/19/2024] Open
Affiliation(s)
- Halil Onder
- Department of Neurology Clinic, Etlik City Hospital, Ankara, Turkey
| | - Hayri Kertmen
- Department of Neurosurgery Clinic, Etlik City Hospital, Ankara, Turkey
| | - Selcuk Comoglu
- Department of Neurology Clinic, Etlik City Hospital, Ankara, Turkey
| |
Collapse
|
4
|
Onder H, Comoglu S. Alternating unilateral blepharospasm with apraxia of eyelid opening in a patient with progressive supranuclear palsy. Neurol Sci 2024; 45:331-333. [PMID: 37736851 DOI: 10.1007/s10072-023-07021-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 08/13/2023] [Indexed: 09/23/2023]
Affiliation(s)
- Halil Onder
- Neurology Clinic, Etlik City Hospital, Varlık, Halil Sezai Erkut Street No: 5, 06170, Yenimahalle, Ankara, Turkey.
| | - Selcuk Comoglu
- Neurology Clinic, Etlik City Hospital, Varlık, Halil Sezai Erkut Street No: 5, 06170, Yenimahalle, Ankara, Turkey
| |
Collapse
|
5
|
Onder H, Comoglu S. Is Subthalamic Nucleus Deep Brain Stimulation Efficacious in Treating Axial Symptoms in Patients with a Suboptimal Levodopa Response? Turk Neurosurg 2024; 34:171. [PMID: 38282596 DOI: 10.5137/1019-5149.jtn.44315-23.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Affiliation(s)
- Halil Onder
- Ankara Etlik City Hospital, Neurology Clinic, Ankara, Türkiye
| | | |
Collapse
|
6
|
Onder H, Comoglu S. Resting and re-emergent jaw tremor as the presenting symptom of Parkinson's disease. Neurol Sci 2024; 45:329-330. [PMID: 37740147 DOI: 10.1007/s10072-023-07041-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 08/24/2023] [Indexed: 09/24/2023]
Affiliation(s)
- Halil Onder
- Neurology Clinic, Etlik City Hospital, Varlık, Halil Sezai Erkut Street, No:5, 06170, Yenimahalle, Ankara, 06110, Turkey.
| | - Selcuk Comoglu
- Neurology Clinic, Etlik City Hospital, Varlık, Halil Sezai Erkut Street, No:5, 06170, Yenimahalle, Ankara, 06110, Turkey
| |
Collapse
|
7
|
Onder H, Kertmen H, Comoglu S. Dramatic improvement of a rare patient with PARK-14 linked young-onset parkinsonism after STN-DBS therapy. Neurol Sci 2023; 44:4541-4543. [PMID: 37644343 DOI: 10.1007/s10072-023-07027-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023]
Affiliation(s)
- Halil Onder
- Neurology Clinic, Etlik City Hospital, Varlık, Turkey.
| | - Hayri Kertmen
- Neurosurgery Clinic, Etlik City Hospital, Ankara, Turkey
| | | |
Collapse
|
8
|
Onder H, Kertmen H, Comoglu S. A Rare Patient with STN-DBS Presenting with Delayed-onset and Persistent Peri-lead Edema. Ann Indian Acad Neurol 2023; 26:1038-1040. [PMID: 38229653 PMCID: PMC10789397 DOI: 10.4103/aian.aian_668_23] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/23/2023] [Accepted: 10/07/2023] [Indexed: 01/18/2024] Open
Affiliation(s)
- Halil Onder
- Neurology Clinic, Etlik City Hospital, Ankara, Turkey
| | - Hayri Kertmen
- Neurosurgery Clinic, Etlik City Hospital, Ankara, Turkey
| | | |
Collapse
|
9
|
Onder H, Korkmaz B, Comoglu S. Temporal Investigations of the Changes in Presynaptic Inhibition Associated With Subthalamic Nucleus-Deep-Brain Stimulation. J Clin Neurol 2023; 19:539-546. [PMID: 37488958 PMCID: PMC10622716 DOI: 10.3988/jcn.2022.0439] [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: 11/16/2022] [Revised: 01/27/2023] [Accepted: 02/17/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND AND PURPOSE There are controversies regarding the role of presynaptic inhibition (PSI) in the mechanisms underlying the efficacy of deep-brain stimulation (DBS) in Parkinson's disease (PD). We sought to determine the involvement of PSI in DBS-related mechanisms and clinical correlates. METHODS We enrolled PD subjects who had received subthalamic nucleus DBS (STN-DBS) therapy and had been admitted to our clinic between January 2022 and March 2022. The tibial H-reflex was studied bilaterally during the medication-off state, and all tests were repeated 10 and 20 minutes after the simulation was turned off. Simultaneous evaluations based on the Movement-Disorder-Society-sponsored revision of the Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS-III) were performed in all of the patients. RESULTS Ultimately we enrolled 18 patients aged 58.7±9.3 years (mean±standard deviation, 10 females). Fifty percent of the patients showed a decrease in the MDS-UPDRS-III score of more than 60% during the stimulation-on period. Comparative analyses of the repeated measurements made according to the stimulation status revealed significant differences only in the left H-reflex/M-response amplitude ratio (H/M ratio). However, no difference in the left H/M ratio was found in the subgroup of patients with a prominent clinical response to stimulation (n=9). Analyses of the less-affected side revealed differences in the H-reflex amplitude and H/M ratio. CONCLUSIONS We found evidence of PSI recovery on the less-affected side of our PD subjects associated with STN-DBS. We hypothesize that the involvement of this spinal pathway and its contribution to the mechanisms of DBS differ between individuals based on the severity of the disease and which brainstem regions and descending tracts are involved.
Collapse
Affiliation(s)
- Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
| | - Bektas Korkmaz
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Selcuk Comoglu
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
10
|
Onder H, Comoglu S. A Rare Case of Reversible Splenial Lesion Syndrome with Extracallosal Lesions in the Setting of Deep Anemia. Asian J Neurosurg 2023; 18:684-687. [PMID: 38152507 PMCID: PMC10749833 DOI: 10.1055/s-0043-1771320] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023] Open
Affiliation(s)
- Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Selcuk Comoglu
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
11
|
Onder H, Kocer B, Comoglu S. The effect of Alzheimer's disease comorbidity in tap test response in idiopathic normal pressure hydrocephalus? Int Psychogeriatr 2023; 35:529-530. [PMID: 35118937 DOI: 10.1017/s1041610221002726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Bilge Kocer
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Selcuk Comoglu
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
12
|
Onder H, Kertmen H, Kocer B, Ercan E, Comoglu S. Bilateral Posteroventral GPi-DBS in a Patient with Tourette's Syndrome - A Rapidly Effective But Under-utilized Therapy. Ann Indian Acad Neurol 2023; 26:574-577. [PMID: 37970248 PMCID: PMC10645202 DOI: 10.4103/aian.aian_489_23] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 11/17/2023] Open
Affiliation(s)
- Halil Onder
- Department of Neurology, Neurology Clinic, Etlik City Hospital, Ankara, Turkey
| | - Hayri Kertmen
- Department of Neurosurgery, Neurosurgery Clinic, Etlik City Hospital, Ankara, Turkey
| | - Bilge Kocer
- Department of Neurology, Neurology Clinic, Etlik City Hospital, Ankara, Turkey
| | - Elif Ercan
- Department of Neurology, Neurology Clinic, Etlik City Hospital, Ankara, Turkey
| | - Selcuk Comoglu
- Department of Neurology, Neurology Clinic, Etlik City Hospital, Ankara, Turkey
| |
Collapse
|
13
|
Onder H, Bahtiyarca ZT, Comoglu S. Subjective Assessments of Voice in Parkinson's Disease Subjects with and without STN-DBS Therapy. Ann Indian Acad Neurol 2023; 26:491-495. [PMID: 37970309 PMCID: PMC10645232 DOI: 10.4103/aian.aian_1_23] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/19/2023] [Accepted: 03/10/2023] [Indexed: 11/17/2023] Open
Abstract
Introduction The causal relation between STN-DBS and speech problems and the associated clinical features are in the incipient stages of being investigated. Methods All the Parkinson's disease (PD) subjects with and without STN-DBS who applied to our movement disorders outpatient clinics between January 2022 and June 2022 and agreed to participate in the study were enrolled. The demographic data and clinical features were noted. Besides, the MDS-UPDRS was administered during the medication off-state in all subjects. All the participants completed the voice handicap index (VHI). Besides, the Freezing of Gait Questionnaire (FOGQ) and the quality of life (QoL) scales including the Parkinson's Disease Questionnaire (PDQ-39) and the Schwab and England Activities of Daily Living (ADL) scale were also administered to all the individuals. Results We have included 66 patients with PD (F/M = 23/43). Thirty-five patients were those with DBS therapy whereas 31 patients were without. The results of the comparative analyses between the patients with and without DBS therapy revealed that the DBS group had a higher disease duration (P = 0.006) and FOGQ scores (P = 0.008). The VHI scores did not differ between groups (P = 0.577), and the correlation analyses did not reveal an association between the VHI scores and the duration of DBS therapy. However, the VHI scores correlated with the disease duration as well as the FOG scores. Conclusion We did not find convincing evidence supporting the increased risk of speech disturbance with STN-DBS therapy. We suggest that the frequent existence of speech disturbance in this patient subgroup with STN-DBS is associated with the classical nature of PD.
Collapse
Affiliation(s)
- Halil Onder
- Deparment of Neurology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Zeynep Tuba Bahtiyarca
- Deparment of Physical Therapy and Rehabilitation, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Selcuk Comoglu
- Deparment of Neurology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
14
|
Onder H, Comoglu S. Controlled-Release Levodopa for the Treatment of Rapid Motor Fluctuations in Parkinson's Disease Subjects with Subthalamic Nucleus Deep Brain Stimulation. Asian J Neurosurg 2023; 18:321-326. [PMID: 37397033 PMCID: PMC10310439 DOI: 10.1055/s-0043-1769757] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023] Open
Abstract
Objectives We aimed to investigate the efficiency of controlled-release levodopa/benserazide (Madopar HBS) use during daytime in our pilot study on advanced-stage Parkinson's disease (PD) subjects with deep brain stimulation of the subthalamic nucleus (STN-DBS) therapy. Methods We have evaluated all PD subjects with STN-DBS who had admitted to our outpatient polyclinic between February 2022 and March 2022. Among these patients, those who were taking levodopa therapy at least five times throughout the day and the efficiency of levodopa lasted less than 3 hours were detected. The standard levodopa therapy was switched to Madopar HBS in all patients who accepted the therapy chance and the clinical evaluation of the patients on Madopar HBS therapy was performed in the second month of the therapy. Results Ultimately, the follow-up of all four patients in whom the levodopa therapy was changed to Madopar HBS yielded a significant reduction in the "off" periods and improvement in the PSQ-39 scores. Conclusion We suggest the use of Madopar HBS in PD patients with STN-DBS surgery suffering from motor fluctuations, particularly in the subgroup with milder dyskinesias. Future study results of a large number of PD subjects with STN-DBS therapy are warranted to confirm our observations. The results of these studies may provide critical applications in clinical practice.
Collapse
Affiliation(s)
- Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Selcuk Comoglu
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
15
|
Onder H, Dinc E, Yucesan K, Comoglu S. The gait parameters in patients with Parkinson's Disease under STN-DBS therapy and associated clinical features. Neurol Res 2023:1-7. [PMID: 37139777 DOI: 10.1080/01616412.2023.2208478] [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] [Indexed: 05/05/2023]
Abstract
OBJECTIVE We aimed to investigate the gait parameters in patients with subthalamic nucleus deep brain stimulation (STN-DBS) therapy using quantitative gait analyses and reveal the associated clinical features. METHODS Parkinson's disease (PD) subjects with STN-DBS who applied to our movement disorders outpatient clinics between December/2021 and March/2022 were enrolled. In addition to the evaluation of the demographic data and the clinical features; clinical scales measuring the freezing of gait (FOG), falls and quality of life were performed. A gait analyzer program was used to perform gait analysis. RESULTS Thirty patients with a mean age of 59.4 ± 8.3 (F/M = 7/23) were enrolled. The comparative analyses between the tremor-dominant and akinetic-rigid (AR) subtype patients showed that the step time asymmetry measures were higher in the AR group. The comparative analyses according to the symptom onset side showed that the step length was smaller in those with left-side symptom onset. The correlation analyses showed that there were correlations between the quality-of-life indexes and FOG questionnaire and falls efficacy scale (FES) scores. Finally, the correlation analyses between clinical scales and gait parameters revealed that there were significant correlations between the FES scores and the step length asymmetry (SLA). CONCLUSION We found a strong relationship between falls and quality of life indexes of our patients under STN-DBS therapy. In this patient group, particular evaluation of fallings and the follow-up of SLA in gait analysis may constitute important points during the evaluation of patients in routine clinical practice.
Collapse
Affiliation(s)
- Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Ege Dinc
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Kubra Yucesan
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Selcuk Comoglu
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
16
|
Onder H, Comoglu S. Investigation of the factors associated with hemichorea/hemiballismus in post-stroke patients. J Neural Transm (Vienna) 2023; 130:679-685. [PMID: 37010612 DOI: 10.1007/s00702-023-02628-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/26/2023] [Indexed: 04/04/2023]
Abstract
Classical knowledge highlights the role of lesions of the subthalamic nuclei (STN) in the pathophysiology of hemichorea/hemiballismus (HH). However, the published reports indicate various other lesion regions in the majority of post-stroke cases with HH. Ergo, we aimed to investigate the significance of the lesion site and clinical features for developing HH in post-stroke patients. Overall, we retrospectively scanned all the patients with stroke who were hospitalized between 01/06/2022 and 31/07/2022 in our neurology clinic. The data regarding the demographic features, comorbidities, stroke etiologies, and laboratory findings, including serum glucose and HBA1C were retrospectively recruited using the electronic-based medical record system. The cranial magnetic resonance imaging (MRI) and computed tomography images have been systematically evaluated for the presence of lesions in localizations that are previously associated with HH. We conducted comparative analyses between patients with and without HH to reveal the discrepancies between groups. The logistic regression analyses were also performed to reveal the predictive values of some features. Overall, the data of 124 post-stroke patients were analyzed. The mean age was 67.9 ± 12.4 years (F/M = 57/67). Six patients were determined to develop HH. The comparative analyses between patients with and without HH revealed that the mean age tended to be higher in the HH group (p = 0.08) and caudate nucleus involvement was more common in the HH group (p = 0.005). Besides cortical involvement was absent in all subjects developing HH. The logistic regression model revealed the presence of a caudate lesion and advanced age as factors associated with HH. We found that the caudate lesion was a crucial determinant of the occurrence of HH in post-stroke patients. With the significance of the other factors of increased age and cortical sparring, we observed differences in the HH group may be investigated also in future-related studies on larger groups.
Collapse
Affiliation(s)
- Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Şehit Ömer Halisdemir Street. No: 20 Altındag, 06110, Ankara, Turkey.
| | - Selcuk Comoglu
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Şehit Ömer Halisdemir Street. No: 20 Altındag, 06110, Ankara, Turkey
| |
Collapse
|
17
|
Onder H, Kocer BG, Turan A, Comoglu S. The utility of quantitative MRI parameters in discriminating progressive supranuclear palsy from Parkinson's disease. Neurol Res 2023:1-7. [PMID: 37068211 DOI: 10.1080/01616412.2023.2203612] [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] [Indexed: 04/19/2023]
Abstract
OBJECTIVE We sought to re-evaluate the utility of all the quantitative neuroimaging parameters attributed to progressive supranuclear palsy (PSP) in discrimination between PSP and Parkinson' s disease (PD) subjects in our cohort. We aimed to propose some practical clinical remarks in this field. METHODS In our retrospective study, 19 patients with 'probable' PSP and 37 patients with PD were enrolled. The radiological measurements of PSP, described in the previous reports, have been calculated in all subjects. The comparisons between the groups were performed and the measures regarding the accuracy of these parameters in the differentiation of PSP from PD subjects were analyzed. RESULTS We found that the values of magnetic resonance parkinsonism index-2 (MRPI-2), pontine-to-midbrain area (P/M) ratio, P/M 2 ratio, and 3rdV/bifrontal width ratio had high AUC values and very good discriminative powers. The analyses revealed that; for the discrimination of PSP from PD subjects, a 3rdvent/bifrontal width cut-off value of 0.30 had 42.1 % sensitivity and 97.3 % specificity; a P/M cut-off value of 6.03 had a 52.6 % sensitivity and 97.3 % specificity; and an MRPI-2 cut-off value of 7.43 had 57.9 % sensitivity and 97.3 % specificity. Remarkably, we also found that the presence of high values for both P/M and 3rdV/bifrontal ventricle rate had a positive predictive value of 100% for the diagnosis of PSP. CONCLUSION Our study results support the utility of previously defined neuroimaging parameters in distinguishing PSP and PD subjects. Besides, combined use of a high P/M ratio and 3rdV/bifrontal width may be practical and present strictly high evidence for the diagnosis of PSP.
Collapse
Affiliation(s)
- Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Bilge Gonenli Kocer
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Aynur Turan
- Radiology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Selcuk Comoglu
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
18
|
Onder H, Kocer B, Turan A, Comoglu S. Illustration of the long‐term efficacy of
VIM‐DBS
in a patient with Holmes tremor secondary to stroke. Mov Disord Clin Pract 2023. [DOI: 10.1002/mdc3.13741] [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: 04/07/2023] Open
Affiliation(s)
- Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital Ankara Turkey
| | - Bilge Kocer
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital Ankara Turkey
| | - Aynur Turan
- Radiology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital Ankara Turkey
| | - Selcuk Comoglu
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital Ankara Turkey
| |
Collapse
|
19
|
Onder H, Comoglu S. A Rare Patient with Hereditary Spastic Paraparesis with Parkinsonism. Asian J Neurosurg 2023; 18:216-218. [PMID: 37056881 PMCID: PMC10089727 DOI: 10.1055/s-0043-1764117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
AbstractHerein, we present a rare patient with hereditary spastic paraparesis (HSP) in whom significant parkinsonism was involved in the clinic. Besides, the dopamine transport single-photon emission computed tomography scan also showed decreased tracer uptake in the bilateral striatum. Via the presentation of this patient, we discuss the parkinsonian findings in patients with HSP. We think that the observations of dopaminergic neuron vulnerability in HSP patients raise the possibility that degeneration of central dopaminergic neurons may contribute to the phenotype of HSP. The documentation of these rare variants will aid to understand the unknown pathophysiology of the disease course.
Collapse
Affiliation(s)
- Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Selcuk Comoglu
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
20
|
Onder H, Comoglu S. The association between the Subthalamic nucleus deep brain stimulation programming settings and Parkinson's disease severity? Acta Neurochir (Wien) 2023; 165:759-760. [PMID: 36136167 DOI: 10.1007/s00701-022-05371-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 09/15/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Şehit Ömer Halisdemir Street. No: 20 Altındag, Ankara, 06110, Turkey.
| | - Selcuk Comoglu
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Şehit Ömer Halisdemir Street. No: 20 Altındag, Ankara, 06110, Turkey
| |
Collapse
|
21
|
Onder H, Korkmaz B, Comoglu S. The rapid recovery of the sympathetic skin response in a patient with Parkinson's disease with STN-DBS. Neurol Sci 2023; 44:1077-1079. [PMID: 36427102 DOI: 10.1007/s10072-022-06504-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Şehit Ömer Halisdemir Street. No: 20, 06110, Altındag, Ankara, Turkey.
| | - Bektas Korkmaz
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Şehit Ömer Halisdemir Street. No: 20, 06110, Altındag, Ankara, Turkey
| | - Selcuk Comoglu
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Şehit Ömer Halisdemir Street. No: 20, 06110, Altındag, Ankara, Turkey
| |
Collapse
|
22
|
Onder H, Comoglu S. Deep Brain Stimulation of the Subthalamic Nucleus and the Postoperative Levodopa Response? Turk Neurosurg 2023; 33:176. [PMID: 36622184 DOI: 10.5137/1019-5149.jtn.37641-22.1] [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: 02/03/2023]
Affiliation(s)
- Halil Onder
- Diskapi Yildirim Beyazit Training and Research Hospital, Neurology Clinic, Ankara, Turkey
| | | |
Collapse
|
23
|
Onder H, Kilic A, Comoglu S. Illustration of a patient with stroke developing ipsilateral tremor-like grasp phenomenon. Arq Neuropsiquiatr 2023; 81:212-213. [PMID: 36948204 PMCID: PMC10033187 DOI: 10.1055/s-0043-1763488] [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] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Affiliation(s)
- Halil Onder
- Diskapi Yildirim Beyazit Training and Research Hospital, Neurology Clinic, Ankara, Turkey
| | - Asim Kilic
- Diskapi Yildirim Beyazit Training and Research Hospital, Neurology Clinic, Ankara, Turkey
| | - Selcuk Comoglu
- Diskapi Yildirim Beyazit Training and Research Hospital, Neurology Clinic, Ankara, Turkey
| |
Collapse
|
24
|
Onder H, Comoglu S. Letter regarding the article entitled: 'Normal Pressure Hydrocephalus Overshadowed by Traumatic and Degenerative Spinal Diseases: A New Assessment Proposal'. Turk Neurosurg 2023; 33:919-920. [PMID: 37614215 DOI: 10.5137/1019-5149.jtn.44299-23.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Affiliation(s)
- Halil Onder
- Ankara Etlik City Hospital, Neurology Clinic, Ankara, Turkey
| | | |
Collapse
|
25
|
Onder H, Comoglu S. Letter to the Editor Regarding “Impact of Subjective Evaluations in Predicting Response to Ventriculoperitoneal Shunt for Idiopathic Normal-Pressure Hydrocephalus”. World Neurosurg 2022; 168:314-315. [DOI: 10.1016/j.wneu.2022.08.081] [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] [Received: 08/14/2022] [Accepted: 08/16/2022] [Indexed: 12/15/2022]
|
26
|
Önder H, Kocer B, Turan A, Kertmen H, Comoglu S. The Overlap in Neuroimaging Findings Between Idiopathic Normal Pressure Hydrocephalus and Progressive Supranuclear Palsy. Ann Indian Acad Neurol 2022; 25:1087-1091. [PMID: 36911446 PMCID: PMC9996473 DOI: 10.4103/aian.aian_208_22] [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: 02/27/2022] [Revised: 05/15/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022] Open
Abstract
Background The neuroimaging findings of brain stem atrophy resembling progressive supranuclear palsy (PSP) radiology are common in idiopathic normal pressure hydrocephalus (iNPH) subjects. Besides, recent studies report the existence of iNPH-like MRI findings in PSP subjects. We aimed to comparatively investigate the neuroimaging indices of iNPH and PSP in our patient groups in a detailed methodology. Methods Ultimately, 19 probable PSP patients and 18 patients with a definite diagnosis of iNPH were enrolled. The subjects were recruited retrospectively from those who had been admitted between 2017 and 2021 to the Movement Disorders Polyclinic and the Neurosurgery Clinic of the Diskapi Yildirim Beyazit Training and Education Hospital. MRI-based DESH score, Evans index, and the callosal angle (CA) have been calculated in all the individuals. Besides, quantitative MRI parameters of PSP were evaluated in every subject. Statistical analyses were performed using IBM SPSS Statistics 26. Results The comparative analyses regarding the radiological parameters of PSP did not reveal any difference between patient groups. On the other hand, the comparisons of the neuroimaging parameters of iNPH, yielded differences in the CA, CA score, and the total DESH score. However, the ROC curve analyses did not reveal a discriminative power at a value of "very good" or "excellent" in any of the indices. Conclusions We found that the neuroimaging features of iNPH and PSP highly overlapped between these patient groups. These results may provide indirect evidence regarding the coexistence of PSP and iNPH pathophysiology that has been deliberated in several recent reports.
Collapse
Affiliation(s)
- Halil Önder
- Department of Neurology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Bilge Kocer
- Department of Neurology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Aynur Turan
- Department of Radiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Hayri Kertmen
- Department of Neurosurgery, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Selcuk Comoglu
- Department of Neurology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
27
|
Onder H, Poyraz U, Comoglu S. The investigation of the gait parameter alterations in response to levodopa therapy and tap test in patients with idiopathic normal pressure hydrocephalus. Neurol Sci 2022; 43:6813-6820. [DOI: 10.1007/s10072-022-06361-9] [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] [Received: 07/19/2022] [Accepted: 08/18/2022] [Indexed: 12/01/2022]
|
28
|
Onder H, Kocer B, Dinc E, Poyraz U, Comoglu S. Marked response to levodopa in a patient with multiple system atrophy presenting with orthostatic hypotension: should reduced DAT uptake on DaTSCAN be a criterion for response to levodopa? Neurol Sci 2022; 43:5107-5110. [DOI: 10.1007/s10072-022-06101-z] [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] [Received: 03/10/2022] [Accepted: 04/26/2022] [Indexed: 11/24/2022]
|
29
|
Onder H, Dinc E, Comoglu S. Ventriculomegaly in Prodromal Idiopathic Normal Pressure Hydrocephalus? Mov Disord Clin Pract 2022; 9:850-851. [DOI: 10.1002/mdc3.13498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/09/2022] [Accepted: 03/24/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital Ankara Turkey
| | - Ege Dinc
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital Ankara Turkey
| | - Selcuk Comoglu
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital Ankara Turkey
| |
Collapse
|
30
|
Onder H, Korkmaz B, Kocer BG, Comoglu S. Investigation of the changes in the presynaptic inhibition in association with the subthalamic nucleus stimulation in Parkinson's disease. Neurol Res 2022; 44:969-974. [PMID: 35658895 DOI: 10.1080/01616412.2022.2084812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 10/18/2022]
Abstract
BACKGROUND AND PURPOSE Presynaptic inhibition (PSI) is a critical spinal inhibitory mechanism for modulating muscle coordination by adjusting both supraspinal motor commands and sensory feedback at the spinal level. The literature data regarding the role of PSI in the efficiency of STN-DBS therapy in Parkinson's disease (PD) are limited. We aimed to investigate the possible alteration in this pathway in association with the STN stimulation (STIM) within the very early period after the STIM is off. METHODS We performed the H-reflex investigation on 8 PD subjects with STN-DBS who applied to our polyclinic for routine clinical evaluations. The investigations were initially performed at the STIM-on period and repeated after the STIM set is off for 5 min. A within-subjects ANOVA was used to test for a significant difference between the STIM-on and -off states for the variables of (repeated measures) H-latency, H amplitude, M amplitude, H/M amplitude, H threshold, and M threshold. RESULTS The results of the analyses did not reveal marked changes in the variables of the H-reflex between the STIM-on and -off states. CONCLUSION PSI do not alter in the very early period after the STIM is off. Taken together with the related literature data and our study results, it can be hypothesized that the PSI might involve in the DBS efficiency in the later phase of the STIM as a compensatory mechanism. Further prospective studies including a larger number of patients with serial electrophysiological recordings to investigate the temporal course of the underlying dynamics are required to clarify these discussions.
Collapse
Affiliation(s)
- Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Bektas Korkmaz
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Bilge Gonenli Kocer
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Selcuk Comoglu
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
31
|
Onder H, Kocer B, Duzkale N, Comoglu S. Niemann–Pick disease type B and Parkinson’s disease: a coexistence or an etiological association? Neurol Sci 2022; 43:2867-2869. [DOI: 10.1007/s10072-021-05860-5] [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] [Received: 10/29/2021] [Accepted: 12/25/2021] [Indexed: 11/30/2022]
|
32
|
Onder H, Kocer B, Comoglu S. Idiopathic normal pressure hydrocephalus-like MRI features in patients with progressive supranuclear palsy: a comparative case-control study. Neurol Res 2022; 44:807-813. [PMID: 35297741 DOI: 10.1080/01616412.2022.2052622] [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] [Indexed: 10/18/2022]
Abstract
BACKGROUND The occurrence of neurodegenerative disease in patients with normal pressure hydrocephalus (NPH) is emphasized in recent reports. Based on this common co-occurrence, some of the hydrocephalic disorders appearing in late adulthood have been hypothesized to result from initially unapparent parenchymal abnormalities of neurodegenerative origin. Among these diseases, progressive supranuclear palsy (PSP) has been specifically remarked on. We aimed to comparatively investigate the neuroimaging clues of iNPH in our PSP subjects. METHODS Eighteen patients with a clinical diagnosis of PSP, 44 with Parkinson's disease (PD), and 44 healthy control (HC) individuals were enrolled. The disproportionately enlarged subarachnoid space hydrocephalus (DESH) score, the Evans' index (EI), and the callosal angle (CA) were measured on the conventional magnetic resonance imaging (MRI). The comparative analyses were performed using IBM SPSS Statistics 26. RESULTS We found that dilated Sylvian fissures score (p = 0.016) and focal sulcal dilatation score (p = 0.037) were higher in the PSP group in comparison to HC whereas the CA score was higher in PSP subjects in comparison to both PD patients and HC (p = 0.000). Remarkably, the DESH score was also found to be higher in the PSP group in comparison to the age-matched HC group (p = 0.024). CONCLUSIONS We found that the NPH-like MRI features were more common in PSP subjects in comparison to PD subjects and age-matched HC. These results may provide critical contributions to the literature regarding the overlap between PSP and NPH.
Collapse
Affiliation(s)
- Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Bilge Kocer
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Selcuk Comoglu
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
33
|
Onder H, Ertugrul B, Eren Y, Yılmaz Can F, Comoglu S. Temporal lobe parenchyma herniation: An etiological cause of headache or coexistence? Nep J Neurosci 2022. [DOI: 10.3126/njn.v19i1.39152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This report illustrates a patient presenting with a unilateral headache at whom brain magnetic resonance imaging showed temporal lobe parenchyma herniation. In our patient, there were no clinical or neuroimaging findings of increased intracranial pressure (ICP) that might lead to a headache. On the other hand, considering the dynamic nature of headache in our patient, we cannot exclude a mechanism of possible episodic ICP increments that might be related to encephalocele. We think that the detailed illustration of this case may present substantial perspectives for further deliberations regarding the headache pathophysiology.
Collapse
|
34
|
Onder H, Vural A, Duzkale N, Kocer B, Comoglu S. Illustration of a rare case of hereditary spastic paraplegia type 30 associated with a missense variant in the non-motor domain of KIF1A. J Neurol 2022; 269:3343-3346. [PMID: 34999958 DOI: 10.1007/s00415-021-10924-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/24/2021] [Accepted: 11/29/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Şehit Ömer Halisdemir Street. No: 20 Altındag, Ankara, 06110, Turkey.
| | - Atay Vural
- Koc University School of Medicine, Koc University Research Center for Translational Medicine (KUTTAM), Istanbul, Turkey
| | - Neslihan Duzkale
- Department of Medical Genetics, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Bilge Kocer
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Şehit Ömer Halisdemir Street. No: 20 Altındag, Ankara, 06110, Turkey
| | - Selcuk Comoglu
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Şehit Ömer Halisdemir Street. No: 20 Altındag, Ankara, 06110, Turkey
| |
Collapse
|
35
|
Onder H, Comoglu S. Letter Regarding the Article Entitled: "The Effect of Dual Tasking and Deep Brain Stimulation Frequency Parameters on Gait in Advanced Parkinson's Disease". Ann Indian Acad Neurol 2022; 25:938-939. [PMID: 36561025 PMCID: PMC9764918 DOI: 10.4103/aian.aian_270_22] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 03/24/2022] [Accepted: 03/28/2022] [Indexed: 12/25/2022] Open
Affiliation(s)
- Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey,Address for correspondence: Dr. Halil Onder, Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Şehit Ömer Halisdemir Street. No: 20 Altındag, Ankara - 06110, Turkey. E-mail:
| | - Selcuk Comoglu
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
36
|
Onder H, Kocer B, Comoglu S. Dramatic recovery of freezing of gait with subthalamic nucleus deep brain stimulation. Ann Indian Acad Neurol 2022; 25:743-744. [PMID: 36211167 PMCID: PMC9540945 DOI: 10.4103/aian.aian_980_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/15/2022] [Accepted: 02/06/2022] [Indexed: 12/02/2022] Open
|
37
|
Onder H, Kocer B, Comoglu S. The temporal course of the mri findings of inferior oliver hypertrophy: The clinicoradiologic presentation of a rare patient with holmes tremor and palatal myoclonus. Ann Indian Acad Neurol 2022; 25:565-567. [PMID: 35936580 PMCID: PMC9350743 DOI: 10.4103/aian.aian_983_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/23/2021] [Accepted: 01/16/2022] [Indexed: 11/06/2022] Open
|
38
|
Onder H, Comoglu S, Kocer B, Kertmen H. The detailed investigation of eyelid-opening apraxia after subthalamic nucleus deep brain stimulation. Ann Indian Acad Neurol 2022; 25:775-776. [PMID: 36211184 PMCID: PMC9540911 DOI: 10.4103/aian.aian_1_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 04/04/2022] [Accepted: 04/15/2022] [Indexed: 11/17/2022] Open
|
39
|
Onder H, Kocer B, Comoglu S. Early recurrence of holmes tremor after radiofrequency thalamotomy. Ann Indian Acad Neurol 2022; 25:755-756. [PMID: 36211142 PMCID: PMC9540960 DOI: 10.4103/aian.aian_1107_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/15/2022] [Accepted: 03/06/2022] [Indexed: 11/18/2022] Open
|
40
|
Onder H, Kocer B, Comoglu S. The significance of the loss of presynaptic inhibition for step initiation in parkinsonian individuals with freezing of gait. J Physiol 2021; 600:419-420. [PMID: 34859440 DOI: 10.1113/jp282365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Bilge Kocer
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Selcuk Comoglu
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
41
|
Onder H, Comoglu S. Alexia without agraphia: a disconnection syndrome or a primary involvement of a visual language center? Neurol Sci 2021; 43:709-711. [PMID: 34718896 DOI: 10.1007/s10072-021-05678-1] [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] [Received: 08/15/2021] [Accepted: 10/15/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Şehit Ömer Halisdemir Street. No: 20 Altındag, Ankara, 06110, Turkey.
| | - Selcuk Comoglu
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Şehit Ömer Halisdemir Street. No: 20 Altındag, Ankara, 06110, Turkey
| |
Collapse
|
42
|
Ozturk EA, Gundogdu I, Tonuk B, Kocer BG, Tombak Y, Comoglu S, Cakci A. Bone mass and vitamin D levels in Parkinson's disease: is there any difference between genders? J Phys Ther Sci 2016; 28:2204-9. [PMID: 27630398 PMCID: PMC5011562 DOI: 10.1589/jpts.28.2204] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 04/26/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of this study was to determine the bone mineral density, vitamin D level, and frequencies of osteopenia and osteoporosis in patients with Parkinson's disease and to compare male and female patients with the controls separately. [Subjects and Methods] One hundred fifteen Parkinson's disease patients (47 males, 68 females; age range: 55-85 years) and 117 age- and gender-matched controls (47 males, 70 females) were enrolled in the study. Bone mineral density measured by dual-energy X-ray absorptiometry and serum D vitamin levels of each participant were recorded. [Results] The mean lumbar spine, femur neck, and total femur bone mineral density levels, T-scores, and vitamin D levels were found to be significantly lower in Parkinson's disease patients in both genders. Furthermore, osteoporosis rates were found be significantly higher only in female Parkinson's disease patients compared with female controls. [Conclusion] Data from the present study revealed that while osteoporosis was significantly higher only in female Parkinson's disease patients, all Parkinson's disease patients had lower bone mineral density scores and vitamin D levels compared with the controls regardless of gender, suggesting that clinicians should pay attention to the osteoporosis risk in Parkinson's disease and that adequate preventive measures should be taken in order to limit the future risk due to osteoporotic fractures.
Collapse
Affiliation(s)
- Erhan Arif Ozturk
- Physical Medicine and Rehabilitation Clinic, Ministry of Health Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Turkey
| | - Ibrahim Gundogdu
- Physical Medicine and Rehabilitation Clinic, Ministry of Health Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Turkey
| | - Burak Tonuk
- Department of Physical Medicine and Rehabilitation, Abant Izzet Baysal University Faculty of Medicine, Turkey
| | - Bilge Gonenli Kocer
- Neurology Clinic, Ministry of Health Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Turkey
| | - Yasemin Tombak
- Physical Medicine and Rehabilitation Clinic, Ministry of Health Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Turkey
| | - Selcuk Comoglu
- Neurology Clinic, Ministry of Health Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Turkey
| | - Aytul Cakci
- Physical Medicine and Rehabilitation Clinic, Ministry of Health Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Turkey
| |
Collapse
|
43
|
Ozturk EA, Gundogdu I, Kocer B, Comoglu S, Cakci A. Chronic pain in Parkinson's disease: Frequency, characteristics, independent factors, and relationship with health-related quality of life. J Back Musculoskelet Rehabil 2016; 30:BMR720. [PMID: 27284853 DOI: 10.3233/bmr-160720] [Citation(s) in RCA: 21] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although there are studies evaluating pain in Parkinson's disease (PD), to our knowledge, there is no study evaluating the following topics in a cohort of PD patients; (1) frequency of chronic pain, (2) characteristics of chronic pain, (3) severity of chronic pain, (4) types of chronic pain, (5) independent predictors of chronic pain, (6) impact of chronic pain on health-related quality of life (HRQoL), and (7) the role of chronic pain among the independent predictors of HRQoL. OBJECTIVE The purpose of this study was to evaluate the frequency, characteristics, severity, types, and independent factors of chronic pain, as well as the relationship of chronic pain with HRQoL in a cohort of PD patients. METHODS One-hundred and thirteen individuals with a confirmed diagnosis of PD who were consecutively referred to the Ministry of Health Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Movement Disorders Outpatient Clinic were included in the study. Demographic variables, disease characteristics, disease-related motor symptoms and motor complications, comorbid conditions, and health-related quality of life were evaluated and recorded. Pain lasting longer than three months was defined as `chronic pain' and participants were questioned relating to the characteristics of the chronic pain. The Visual Analogue Scale was used for assessment of pain. RESULTS Seventy-three patients (64.6%) suffered from chronic pain. Of these, 12 (16.4%) had previous pain at the time of diagnosis of PD. The sources of pain experienced by patients were 89.0% musculoskeletal, 31.5% radicular/peripheral neuropathic, 15.1% dystonic, and 4.1% central parkinsonian, respectively. Twenty-six patients (35.6%) had different types of pain simultaneously. The pain type with the highest severity was a central parkinsonian pain.The independent predictors of chronic pain included gender (female), Unified Parkinson's Disease Rating Scale (UPDRS) part II (activities of daily living), UPDRS part III (motor symptoms) rigidity subscore, and depression.When compared with individuals not having chronic pain, Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) Physical Component Summary and Mental Component Summary scores were lower in patients with chronic pain. Also, it was shown that the most significant factor on SF-36 was chronic pain. CONCLUSIONS This study demonstrated that chronic pain is a common problem in patients with PD, that different pain types may co-exist, and that they may negatively affect the HRQoL of patients. Chronic pain was correlated with both disease-related factors such as rigidity and daily living activities and also general factors such as gender and depression. We found that chronic pain is the most significant predictor of quality of life in PD patients. We believe, that in addition to treating motor symptoms and complications associated with them, treatment of comorbid conditions such as pain and depression bear significance for improving the quality of life in PD patients. The study indicates that PD patients who are optimally treated, may require additional rehabilitation treatment for non-motor associated pain and thus improve their HRQoL.
Collapse
Affiliation(s)
- Erhan Arif Ozturk
- Physical Medicine and Rehabilitation Clinic, Ministry of Health Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Ibrahim Gundogdu
- Physical Medicine and Rehabilitation Clinic, Ministry of Health Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Bilge Kocer
- Neurology Clinic, Ministry of Health Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Selcuk Comoglu
- Neurology Clinic, Ministry of Health Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Aytul Cakci
- Physical Medicine and Rehabilitation Clinic, Ministry of Health Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
44
|
Aydogan E, Comoglu T, Pehlivanoglu B, Dogan M, Comoglu S, Dogan A, Basci N. Process and formulation variables of pregabalin microspheres prepared by w/o/o double emulsion solvent diffusion method and their clinical application by animal modeling studies. Drug Dev Ind Pharm 2014; 41:1311-20. [DOI: 10.3109/03639045.2014.948452] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
45
|
Erdem H, Ozturk-Engin D, Yesilyurt M, Karabay O, Elaldi N, Celebi G, Korkmaz N, Guven T, Sumer S, Tulek N, Ural O, Yilmaz G, Erdinc S, Nayman-Alpat S, Sehmen E, Kader C, Sari N, Engin A, Cicek-Senturk G, Ertem-Tuncer G, Gulen G, Duygu F, Ogutlu A, Ayaslioglu E, Karadenizli A, Meric M, Ulug M, Ataman-Hatipoglu C, Sirmatel F, Cesur S, Comoglu S, Kadanali A, Karakas A, Asan A, Gonen I, Kurtoglu-Gul Y, Altin N, Ozkanli S, Yilmaz-Karadag F, Cabalak M, Gencer S, Umut Pekok A, Yildirim D, Seyman D, Teker B, Yilmaz H, Yasar K, Inanc Balkan I, Turan H, Uguz M, Kilic S, Akkoyunlu Y, Kaya S, Erdem A, Inan A, Cag Y, Bolukcu S, Ulu-Kilic A, Ozgunes N, Gorenek L, Batirel A, Agalar C. Evaluation of tularaemia courses: a multicentre study from Turkey. Clin Microbiol Infect 2014; 20:O1042-51. [PMID: 24975504 DOI: 10.1111/1469-0691.12741] [Citation(s) in RCA: 22] [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: 04/19/2014] [Revised: 06/25/2014] [Accepted: 06/26/2014] [Indexed: 11/30/2022]
Abstract
In this multicentre study, which is the largest case series ever reported, we aimed to describe the features of tularaemia to provide detailed information. We retrospectively included 1034 patients from 41 medical centres. Before the definite diagnosis of tularaemia, tonsillitis (n = 653, 63%) and/or pharyngitis (n = 146, 14%) were the most frequent preliminary diagnoses. The most frequent clinical presentations were oropharyngeal (n = 832, 85.3%), glandular (n = 136, 13.1%) and oculoglandular (n = 105, 10.1%) forms. In 987 patients (95.5%), the lymph nodes were reported to be enlarged, most frequently at the cervical chain jugular (n = 599, 58%), submandibular (n = 401, 39%), and periauricular (n = 55, 5%). Ultrasound imaging showed hyperechoic and hypoechoic patterns (59% and 25%, respectively). Granulomatous inflammation was the most frequent histological finding (56%). The patients were previously given antibiotics for 1176 episodes, mostly with β-lactam/β-lactamase inhibitors (n = 793, 76%). Antituberculosis medications were provided in seven (2%) cases. The patients were given rational antibiotics for tularaemia after the start of symptoms, with a mean of 26.8 ± 37.5 days. Treatment failure was considered to have occurred in 495 patients (48%). The most frequent reasons for failure were the production of suppuration in the lymph nodes after the start of treatment (n = 426, 86.1%), the formation of new lymphadenomegalies under treatment (n = 146, 29.5%), and persisting complaints despite 2 weeks of treatment (n = 77, 15.6%). Fine-needle aspiration was performed in 521 patients (50%) as the most frequent drainage method. In conclusion, tularaemia is a long-lasting but curable disease in this part of the world. However, the treatment strategy still needs optimization.
Collapse
Affiliation(s)
- H Erdem
- Department of Infectious Diseases and Clinical Microbiology, GATA Haydarpasa Training Hospital, Istanbul, Turkey
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Ergonul O, Guven T, Ugurlu K, Celikbas AK, Gok SE, Comoglu S, Baykam N, Dokuzoguz B. Reply to Kesav et al. Clin Infect Dis 2013; 57:1057-8. [DOI: 10.1093/cid/cit399] [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: 11/13/2022] Open
|
47
|
Guven T, Ugurlu K, Ergonul O, Celikbas AK, Gok SE, Comoglu S, Baykam N, Dokuzoguz B. Neurobrucellosis: clinical and diagnostic features. Clin Infect Dis 2013; 56:1407-12. [PMID: 23446629 DOI: 10.1093/cid/cit072] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We describe the neurological involvement in brucellosis and revisited diagnostic criteria for neurobrucellosis. METHODS Patients with laboratory-confirmed brucellosis who were consequently hospitalized were observed prospectively in a brucellosis-endemic region. The neurobrucellosis was diagnosed by any one of the following criteria: (1) symptoms and signs consistent with neurobrucellosis; (2) isolation of Brucella species from cerebrospinal fluid (CSF) and/or presence of anti-Brucella antibodies in CSF; (3) the presence of lymphocytosis, increased protein, and decreased glucose levels in CSF; or (4) diagnostic findings in cranial magnetic resonance imaging or CT. RESULTS Lumbar puncture was performed in 128 laboratory-confirmed brucellosis cases who had neurological symptoms and signs, and 48 (37.5%) were diagnosed as neurobrucellosis. The sensitivity of tube agglutination (TA) in CSF was 0.94, specificity 0.96, positive predictive value 0.94, and negative predictive value 0.96. Brucella bacteria were isolated from CSF in 7 of 48 patients (15%). The mean age of 48 neurobrucellosis patients was 42 years (SD, 19 years), and 16 (33%) were female. The most common neurological findings were agitation (25%), behavioral disorders (25%), muscle weakness (23%), disorientation (21%), and neck rigidity (17%). Cranial nerves were involved in 9 of 48 patients (19%). One patient was left with a sequela of peripheral facial paralysis and 2 patients with sensorineural hearing loss. CONCLUSIONS Patients with severe and persistent headache and other neurologic symptoms and signs should be considered for neurobrucellosis in endemic regions and to possibly receive longer therapy than 6 weeks. Brucella TA with Coombs test in CSF is sensitive and specific by using a cutoff of ≥1:8.
Collapse
Affiliation(s)
- Tumer Guven
- Infectious Diseases and Clinical Microbiology Clinic, Ataturk Training and Research Hospital, Ankara, Turkey
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Comoglu T, Dogan A, Comoglu S, Basci N. Formulation and evaluation of diclofenac potassium fast-disintegrating tablets and their clinical application in migraine patients. Drug Dev Ind Pharm 2010; 37:260-7. [DOI: 10.3109/03639045.2010.505929] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|