The effects of menstrual cycle on sympathetic skin response and strength–duration properties
Ahmet Onur Keskin, Vahide Deniz Yerdelen DOI:10.4103/nsn.nsn_184_20
Background: Sympathetic control of the circulation is considerably affected by female reproductive hormones. Sudomotor function can be easily evaluated with sympathetic skin response (SSR). Although studies reveal that SSR amplitude decreases with hormone replacement therapy, the effect of estrogen on SSR is unclear. Measuring axonal excitability provides information about the physiological and physical properties of axonal ion channels and nerves. Axonal excitability tests may also give valuable information about the pathophysiology underlying neuronal disorders. In this study, we investigate the influence of female hormones, especially estrogen, on neuronal excitability and the sympathetic nervous system. Methods: SSR and strength–duration time constant (SDTC) tests were conducted on healthy women with a mean age of 26 ± 4 years with regular menstrual cycles. The tests were performed during the first 3 days of the menstrual cycle when the level of estrogen is at its lowest and 2 days before ovulation when the estrogen is at its highest level. Results: SDTC, rheobase, and the latency of SSR were found to be relatively shorter at 2 days before ovulation when compared with the values of the first 3 days of the menstrual cycle. However, the difference was not statistically significant (P > 0.05). Discussion: The SDTC and SSR values in the 2 days before ovulation and the first 3 days of the menstrual cycle did not show any significant differences. We suggested that these parameters do not affect neuronal excitability associated with varied estrogen levels. Conclusion: Further research will be required to fully understand the influence of sex hormones on the nervous system in menstrual cycles, which can suggest underlying mechanisms of various diseases that are linked with autonomic and hormonal alterations.
The role of electrophysiology in the diagnosis of radiculopathy and its comparison with magnetic resonance imaging
Ebru Boluk, Cansu Uzunoğlu, Yaprak Seçil, Yusuf Kenan Çetinoğlu, Şehnaz Arıcı, Mustafa Fazıl Gelal, Tülay Kurt-İncesu DOI:10.4103/nsn.nsn_14_21
Objectives: Patients are frequently referred to electrophysiology laboratories by physicians from various specialties with a presumptive diagnosis of radiculopathy. Recent advances in spinal imaging techniques have led to an increase in magnetic resonance imaging (MRI) studies in the diagnosis of radiculopathy. This study aimed to compare these two techniques in the diagnosis of radiculopathy. Subjects and Methods: Data of 170 patients who were diagnosed as having radiculopathy using electrophysiologic studies in our laboratory by defining a myotome level and who had spinal MRI examinations in our hospital database were included in the study. Results: Among the 170 patients in our study, 40% (n = 68) had cervical radiculopathy and 60% (n = 102) had lumbar radiculopathy. In the electrophysiologic diagnosis of radiculopathy, the most sensitive root level of electromyography (EMG) was the C7 radix level in the cervical region and the L5 level in the lumbar region. Correlations between radiologic grading based on foraminal assessments for radicular involvement at the cervical region using MRI and EMG data showed fair agreement in C5, C7, and C8 radix levels (κ: 0.21–0.40), and the lumbar region showed fair agreement in L4 and L5 radix levels (κ: 0.21–0.40). Conclusion: Although EMG has indisputable importance in the diagnosis of radiculopathy, its use with MRI significantly increases the diagnostic power at most spinal levels.
The relationship between early neurological deterioration, poor clinical outcome, and venous collateral score in cerebral venous sinus thrombosis
Yasemin Dinc, Rıfat Özpar, Bahattin Hakyemez, Mustafa Bakar DOI:10.4103/nsn.nsn_223_20
Background and Purpose: Cerebral venous sinus thrombosis (CVST) is one of the rare causes of cerebrovascular disease and has an extremely heterogeneous prognosis. The aim of this study was to investigate the potential relationship between early neurological deterioration, poor clinical outcome in CVST and the venous collateral score. Materials and Methods: A total of 121 patients diagnosed with CVST between 2010 and 2020 were retrospectively included. The demographic, clinical, and radiological findings related to venous sinus thrombosis and early neurological deterioration were investigated in relation to the clinical outcome. Results: The factors associated with early neurological deterioration were superior sagittal sinus thrombosis (P < 0.001), sinus rectus thrombosis (P = 0.031), parenchymal lesions (P < 0.001), and venous collateral score (P < 0.001). The factors associated with poor clinical outcome were superior sagittal sinus thrombosis (P < 0.001), cortical vein thrombosis (P < 0.001), venous collateral score (P < 0.001), and initial clinical symptoms. Binary logistic regression analyses revealed poor clinical outcome as a significant variable, with a venous collateral scale of 0 or 1 as a risk factor for a poor outcome (significance of the model P < 0.001). Conclusion: Early neurologic deterioration and poor clinical outcome may occur due to poor collateralization in CVST. Identifying the subgroup of CVST patients at risk of clinical deterioration is therefore important. This study highlights the clinical importance of venous collaterals; however, larger prospective multicenter studies are required to confirm the relationship with venous collaterals in patients with CVST.
Antiviral microRNA expression signatures are altered in subacute sclerosing panencephalitis
Kemal Ugur Tufekci, Jens Allmer, Kürşat Bora Çarman, Erhan Bayram, Yasemin Topçu, Semra Hız, Şermin Genç, Uluç Yiş DOI:10.4103/nsn.nsn_57_21
Background: Subacute sclerosing panencephalitis (SSPE) is a chronic, progressive disease caused by a persistent infection of the measles virus. Despite extensive efforts, the exact neurodegeneration mechanism in SSPE remains unknown. MicroRNAs (miRNAs) have emerged as an essential part of cellular antiviral defense mechanisms and can be modulated by antiviral cytokines Such as interferon-beta (IFN-β). Aims and Objectives: In this study, we aimed to elucidate the role of antiviral miRNAs in the pathogenesis of SSPE and analyze the interaction between host antiviral miRNAs and virus genes. Materials and Methods: Thirty-seven patients who were followed with SSPE and age-matched healthy children were included in the study. Peripheral blood mononuclear cell levels of miR-196b, miR-296, miR-431, and miR-448 were analyzed using quantitative polymerase chain reaction. Target predictions and pathway constructions of deregulated miRNAs were assessed. Results: Here, we showed that IFN-β-modulated miR-196b, miR-296, and miR-431 were significantly upregulated in patients with SSPE compared with healthy controls. Besides, sequence complementarity analysis showed that miR-296 and miR-196b predicted binding regions in measles virus genomic RNA. Conclusion: Our findings suggest that antiviral miRNAs are upregulated in patients with SSPE, which could be a part of the host antiviral defense mechanism.
The reliability and validity of the Turkish version of the telehealth usability questionnaire and the telemedicine satisfaction questionnaire in patients with multiple sclerosis
Fatih Ozden, Mehmet Özkeskin, Zübeyir Sarı, Özgül Ekmekçi, Nur Yüceyar DOI:10.4103/nsn.nsn_41_21
Objective: The aim of the study was to translate and cross-culturally adapt the Telehealth Usability Questionnaire (TUQ) and the Telemedicine Satisfaction Questionnaire (TSQ) into Turkish and also to analyze the reliability and validity of both questionnaires. Materials and Methods: A total of 107 multiple sclerosis (MS) patients were recruited. The department clinician monitored all participants with telemedicine for 4 years. Internal consistency was evaluated with Cronbach's alpha coefficient. The test–retest reliability was calculated with intraclass correlation coefficient by analyzing the scores of retested 52 patients 1 week later. The construct validity was examined by Pearson's correlation coefficient (r). Besides, the internal consistency for the subscores of the TUQ and exploratory factor analysis of the TSQ was analyzed. Results: The mean age was 40.5 ± 11.0 years. Internal consistency of all items and the total score of the TUQ were excellent (>0.80; ranged: 0.976–0.979). On the other hand, the internal consistency of all items and total score of the TSQ was excellent, either (>0.80; ranged: 0.969–0.973). The reproducibility of the total score for the TUQ was excellent (>0.80). The test–retest reliability of all items and the total score of the TSQ were within limits ranging from acceptable to excellent (0.617–0.860). The reliability of the total score for the TSQ was excellent (>0.80). The internal consistency of all subscales of the TUQ was excellent (>0.80). The correlation between TUQ and TSQ was strong (r = 0.882, P < 0.001). The factor loading scores of the TSQ were high (0.814–0.919). Conclusions: The Turkish version of the TUQ and the TSQ are valid and reliable in MS patients.