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Mammadkhanli O, Kehaya S, Solak S, Yağmurlu K. Insular cortex involvement in migraine patients with chronic pain: A volumetric radiological and clinical study. J Clin Neurosci 2024; 123:157-161. [PMID: 38579522 DOI: 10.1016/j.jocn.2024.03.034] [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: 03/02/2024] [Revised: 03/24/2024] [Accepted: 03/29/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND This study aimed to assess abnormalities in the insular cortex of individuals suffering from migraines and examine their associations with pain duration, medication usage, and clinical symptoms. METHODS We analyzed radiological data from 38 migraine patients who had undergone 3D iso T1-weighted brain MRI at our university hospital between 2019 and 2023. Structured questionnaires were used to collect information on participants' age, migraine type, disease duration, clinical symptoms, and medication use. Volumetric analysis was performed on the insular regions using Volbrain and 3DSlicer. The results were statistically analyzed. RESULTS Comparing groups with chronic pain to normal groups revealed significant differences in several insular regions, including the posterior insula (p = 0.034), parietal operculum (p = 0.04), and the entire insular cortex (p = 0.023). Further group comparisons (Group 1, 2, and 3) showed significant differences in specific insular regions. For instance, the anterior insula (p = 0.032) was associated with taste changes, the posterior insula (p = 0.010) with smell-related changes, and the central operculum (p = 0.046) with sensations of nausea. Additionally, significant changes were observed in the parietal operculum concerning nausea, photophobia, phonophobia, and changes in smell. CONCLUSION To the best of our knowledge, there have been no studies investigating the relationship between clinical manifestations and volumetric correlation. This study provides insights into abnormalities in the insular cortex among migraine patients and their potential relevance to pain duration, severity, and migraine type. The results suggest that understanding alterations in insular regions possibly linked to pain could contribute to the development of innovative approaches to managing chronic pain.
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Affiliation(s)
- Orkhan Mammadkhanli
- Trakya University, Department of Neurosurgery, Edirne, Turkey; Hacettepe University, Department of Anatomy, Ankara, Turkey.
| | - Sezgin Kehaya
- Trakya University, Department of Neurology, Edirne, Turkey
| | - Serdar Solak
- Trakya University, Department of Radiology, Edirne, Turkey
| | - Kaan Yağmurlu
- University of Tennessee Health Science Center, Department of Neurosurgery, Memphis, Tennessee, USA
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Doğru Y, Kehaya S. Do Severe Acute Respiratory Syndrome Coronavirus 2 Vaccines Change Creutzfeldt-Jakob Disease Prognosis? Balkan Med J 2022; 39:381-382. [PMID: 35979983 PMCID: PMC9469682 DOI: 10.4274/balkanmedj.galenos.2022.2022-6-83] [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] [Indexed: 12/05/2022] Open
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Kehaya S. Stroke Burden in Agrı: Stroke Situation in Underdeveloped Region of Turkey. Eurasian J Med 2021; 53:174-179. [PMID: 35110092 PMCID: PMC9879219 DOI: 10.5152/eurasianjmed.2021.20034] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE Stroke is the second cause of mortality and the third cause of disability worldwide in adults. There is no published data about stroke in Agrı.We aim to define stroke subtypes and associated risk factors. Thus, we can be aware of stroke burden in rural areas and can develop strategies to reduce the stroke risk. MATERIALS AND METHODS Records of Agrı State Hospital were investigated for a period of 3 years retrospectively. Patients were divided to ischemic and hemorrhagic stroke groups. Hemorrhagic strokes were classified as subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH). Ischemic strokes were classified according to localization and etiology. Vascular risk factors for ischemic stroke were assessed and compared between groups. The differences between variables were evaluated using Pearson κi square test and one-way ANOVA. RESULTS There were 1246 patients evaluated for stroke in Emergency Department and 525 (42% of prediagnosis) patients were diagnosed as stroke. There were 25.3% hemorrhagic (5.1% SAH and 20.1% ICH) versus 74.6% ischemic stroke. Intensive care required for 61.6% of hemorrhagic and 22.4% of ischemic patients. The most prevalent localization was partial anterior circulation infarction, and the most known etiology was cardioembolism after unknown cause in ischemic strokes. The most encountered risk factor was hypertension (HT). Coronary artery disease history, HT, and atrial fibrillation (AF) were risk factors for recurrent stroke (P = .001). CONCLUSION Stroke types in Agrı resembles more to Asian population than Europe. Awareness for stroke, HT, and AF treatment could be the primary targets for stroke reduction in underdeveloped regions.
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Affiliation(s)
- Sezgin Kehaya
- Department of Neurology, Trakya University School of Medicine, Edirne, Turkey,Correspondence to: Sezgin Kehaya
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Ayaz G, Güldiken B, Kehaya S, Aynacı Ö. Lesion Patterns on Early Diffusion-weighted Magnetic Resonance Imaging and Ischemic Stroke Subtypes. tnd 2020. [DOI: 10.4274/tnd.2019.86846] [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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Alkanli N, Ay A, Kehaya S, Sut N. Investigation of The Relationship Between IL-18 (-607 C/A), IL-18 (-137 G/C) Gene Variations and Ischemic Stroke Disease Development in Thrace Region of Turkey. Immunol Invest 2020; 50:634-645. [PMID: 32573302 DOI: 10.1080/08820139.2020.1782932] [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: 10/24/2022]
Abstract
BACKGROUND Ischemic stroke is a clinical condition characterized by focal or global cerebral dysfunction resulting from inhibition of brain blood flow. Genetic factors play an important role in the pathogenesis of ischemic stroke. As a result of IL-18 (-607 C/A, -137 G/C) gene variations, it is thought that binding of transcription factors may be affected and IL-18 mRNA expression can be modulated. Therefore, the purpose of our study is to investigate the roles of IL-18 (-607 C/A), IL-18 (-137 G/C) gene variations in the development of ischemic stroke in Trakya Region of Turkey. METHODS Our study was performed with 90 ischemic stroke patients and 89 healthy controls. Genotype distributions of IL-18 (-607 C/A, -137 G/C) gene variations were determined using polymerase chain reaction (PCR) method. RESULTS GC genotype and CA genotype of IL-18 (-137 G/C) and IL-18 (-607 C/A) gene variations were determined higher significantly in patent group as compared with other genotypes. However, the statistically significant difference was not determined between patients with ischemic stroke and healthy control groups in terms of IL-18 (-137 G/C) and IL-18 (-607 C/A) gene variations (p > 0,05). Allele frequencies of IL-18 (-137 G/C) and IL-18 (-607 C/A) in patient and control groups were significantly different from the Hardy-Weinberg distribution (p < .001 for all). CONCLUSION Although these gene variations' genotype distributions were not determined as a genetic risk factor for the development of ischemic stroke, allele frequencies of IL-18 (-137 G/C) and IL-18 (-607 C/A) in patient and control groups were significantly different from the Hardy-Weinberg distribution.
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Affiliation(s)
- Nevra Alkanli
- Department of Biophysics, Faculty of Medicine, T.C. Halic University, Istanbul, Turkey
| | - Arzu Ay
- Department of Biophysics, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Sezgin Kehaya
- Department of Neurology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Necdet Sut
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Trakya University, Edirne, Turkey
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Ozkan H, Cakar M, Akpinar M, Kehaya S, Guldiken B. Nonconvulsive status epilepticus presented with wernicke aphasia: Case report. NEUROL SCI NEUROPHYS 2020. [DOI: 10.4103/nsn.nsn_17_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ozkan H, Cakar M, Akpinar M, Kehaya S, Guldiken B. Nonconvulsive status epilepticus presented with Wernicke aphasia: Case report. NEUROL SCI NEUROPHYS 2019. [DOI: 10.5152/nsn.2019.12602] [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: 11/22/2022] Open
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Aynaci O, Tekataş A, Aynaci G, Kehaya S, Utku U. Effects of CHADS2 score, echocardiographic and haematologic parameters on stroke severity and prognosis in patients with stroke due to nonvalvular atrial fibrillation. Ideggyogy Sz 2019; 72:241-256. [PMID: 31517456 DOI: 10.18071/isz.72.0241] [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] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND PURPOSE The aim of this study is to evaluate utility of CHADS2 score to estimate stroke severity and prognosis in patients with ischemic stroke due to non-valvular atrial fibrillation (AF) in addition to evaluate effects of hematologic and echocardiographic findings on stroke severity and prognosis. METHODS This prospective study included 156 ischemic stroke cases due to non-valvular AF in neurology ward of Trakya University Medical School between March 2013-March 2015. National Institute of Health Stroke (NIHS) score was used to evaluate severity of stroke at admission. Carotid and vertebral Doppler ultrasonography findings, brain computed tomography (CT) and magnetic resonance imaging (MRI) of the cases were evaluated. Left atrial diameter and ejection fraction (EF) values were measured. CHADS2 score was calculated. Modified Rankin Scale was used to rate the degree of dependence. Effects of age and sex of the patients, presence of diabetes mellitus (DM), Congestive Heart Failure (CHF), Cerebrovascular Disease (CVD) and C-reactive protein (CRP) levels on CHADS2, NIHS, and mRS were evaluated. RESULTS In patients with age ≥75, mean NIHS score was 3.3 points and mean mRS score was 1.02 points higher, than in patient below 75 years of age. Compared with the mild risk group, cases in the high risk group had older age, higher serum D-dimer, fibrinogen and CRP levels and lower EF. A positive relation was detected between stroke severity and Hemorrhagic Transformation (HT), previous CVD history, and presence of CHF. A significant association was found between increased stroke severity and Early Neurological Deterioration (END) development. Older age, higher serum fibrinogen, D-dimer, CRP and lower EF values were associated with poor prognosis. History of CVD and presence of CHF were associated with poor prognosis. END development was found to be associated with poor prognosis. In the high-risk group, 30.3% (n = 33) had END. Among those in the high-risk group according to the CHADS2 score, END development rate was found to be significantly higher than in the moderate risk group (p <0.05). There was a strong positive correlation between CHADS2 and NIHS scores. mRS score increased with increasing CHADS2 score and there was a strong correlation between them. Effect of stroke severity on prognosis was assessed and a positive correlation was found between NIHS score and mRS value. CONCLUSION Our study demonstrated the importance of CHADS2 score, haemostatic activation and echocardiographic findings to assess stroke severity and prognosis. Knowing factors which affect stroke severity and prognosis in patients with ischemic stroke may be directive to decide primary prevention and stroke management.
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Affiliation(s)
- Ozer Aynaci
- Trakya University, Medical Faculty, Department of Neurology, Edirne, Turkey
| | - Aslan Tekataş
- Trakya University, Medical Faculty, Department of Neurology, Edirne, Turkey
| | - Gülden Aynaci
- Trakya University, Health Science, Department of Obstetric Gynecology. Edirne, Turkey
| | - Sezgin Kehaya
- Trakya University, Medical Faculty, Department of Neurology, Edirne, Turkey
| | - Ufuk Utku
- Trakya University, Medical Faculty, Department of Neurology, Edirne, Turkey
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Çakar MM, Kehaya S, Özkan H, Güldiken BF. Posterior Reversible Encephalopathy Syndrome in the Late Postpartum Period: A Case Report. tnd 2018. [DOI: 10.4274/tnd.65481] [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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Sibel G, Kurtoglu HS, Kehaya S, Pamuk N, Celik Y. Cerebral vasomotor reactivity in fibromyalgia patients and its relationship to central neuropathic pain. Ideggyogy Sz 2016; 69:341-348. [PMID: 29638096 DOI: 10.18071/isz.69.0341] [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] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background - Cerebral vasomotor reactivity, defined as the cerebral vasculature response to hypoxia, is not wellunderstood in fibromyalgia (FM) patients. This study investigated the difference in the cerebrovascular reactivity (i.e., responsiveness to hypercapnia was evaluated by use of breath- holding index) to the breath-holding index (BHI) between patients with fibromyalgia and a group of normal controls. Methods - The study included 40 FM patients and 40 healthy subjects. Cerebrovascular reactivity was evaluated using the BHI, which is a nonaggressive, well-tolerated, real-time, reproducible screening method to study cerebral haemodynamics. Insonation depth and basal velocity were symmetrical and not significantly different between the two groups (p>0.05). All patients completed the Revised Fibromyalgia Impact Questionnaire (FIQR), Hospital Anxiety and Depression Scale (HADS), visual analogue scale (VAS), and the somatization subscale of the SCL-90-R symptom checklist. Results - The BHI ranged from 0.30 to 2.20 (mean 1.11±0.45) in the FM patients and 1.10 to 2.80 (mean 1.90±0.35) in the control group (p<0.001). Disease duration and right BHIaverage and left BHIaverage values exhibited a significant negative correlation (r=-0.877; p<0.001, r=-0.842; p<0.001, respectively). As pain and fatigue scores increased, the right BHIaverage and left BHIaverage values decreased (r=-0.431; p=0.005, r=-0.544; p<0.001, r=-0.341; p=0.031, r=-0.644; p<0.001, respectively). Conclusions - BHI values showed that cerebrovascular reactivity in FM patients decreased in comparison to healthy individuals. BHI decreased as disease duration and severity increased. Cerebrovascular reactivity decreased in FM patients, and this phenomenon should be accepted as an abnormality. Additionally, this outcome may have been the result of a mechanism responsible for central neuropathic pain.
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Affiliation(s)
- Guler Sibel
- Department of Neurology, Trakya University Faculty of Medicine, Edirne
| | - Hakan S Kurtoglu
- Department of, Physical Medicine and Rehabilitation, Trakya University Faculty of Medicine, Edirne
| | - Sezgin Kehaya
- Department of Neurology, Trakya University Faculty of Medicine, Edirne
| | - Nuri Pamuk
- Department of Rheumatology, Trakya University Faculty of Medicine, Edirne
| | - Yahya Celik
- Department of Neurology, Trakya University Faculty of Medicine, Edirne
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Tekatas A, Kehaya S, Cagli B, Akdemir V, Aynaci O, Dogru Y, Aksu F. A Case of Uncorrected Tetralogy of Fallot Presenting with Acute Ischemic Stroke. Istanbul Med J 2014. [DOI: 10.5152/imj.2014.34635] [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: 11/22/2022] Open
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Guler S, Deniz C, Utku U, Kehaya S. A case of cerebral venous thrombosis accompanying with intracranial hypotension: Headache that changing character. Agri 2013; 25:141-4. [DOI: 10.5505/agri.2013.41275] [Citation(s) in RCA: 4] [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: 11/04/2022]
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