Browsing by Author "Demir, AB"

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    Validity and reliability of the Turkish version of the Innsbruck RBD-9 diagnostic inventory (IRBD-9-TR)
    Aslan-Kara, K; Ak, AK; Saritas, AS; Yilmaz, H; Metin, KM; Çokal, BG; Agan, K; Aksu, M; Akyildiz, UO; Demir, AB; Çevik, B; Ertürk, AY; Karadeniz, D; Öztura, I; Sünter, G; Tekin, S; Tezer, I; Berktas, DT; Totik, N; Senel, GB
    Background Isolated rapid eye movement (REM) sleep behavior disorder (iRBD) is characterized by loss of the normal atonia of REM sleep accompanied by repetitive motor and behavior phenomena of dream content. Objective To evaluate the reliability and validity of the Turkish version of the original form of the Innsbruck Rapid Eye Movement Sleep Behavior Disorder Diagnostic Inventory (IRBD-9) scale (IRBD-9-TR) and ensure that this screening test can be easily used in the Turkish language. Methods The present is a multicenter and prospective study involving 184 patients: 51 with iRBD and 133 healthy controls. The iRBD patients were not diagnosed before submitted to video polysomnography (vPSG) and filling out the IRBD-9-TR. Results The optimal cut-off value for the IRBD-9-TR symptom score was of 0.28, with a sensitivity of 0.941 and a specificity of 0.947, and 94.4% of the patients were correctly diagnosed. The rotated factor loadings for the diagnostic accuracy of each individual question showed that the short version of the IRBD-9-TR (questions 1, 2, 3, 6, and 8) presented higher specificity and excellent discrimination of iRBD patients from healthy controls. The Cronbach's alpha coefficient for the symptom section of the IRBD-9-TR was of 0.857, and the Kappa coefficient, of 0.885. Conclusion The short version of the IRBD-9-TR presents good validity and reliability to be used as a screening test to assess iRBD patients. It is convenient and potentially useful in both outpatient clinical and epidemiologic research settings.
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    The REM-sleep-related characteristics of narcolepsy: a nation-wide multicenter study in Turkey, the REMCON study
    Akyildiz, UO; Tezer, FI; Koc, G; Ismailogullari, S; Demir, AB; Ak, AK; Sunter, G; Kara, KA; Berktas, DT; Sahin, A; Azman, F; Akcay, BD; Gok, DK; Yilmaz, H; Agan, K; Bekmezci, Y; Yetkin, S; Aksu, M; Karadeniz, D; Senel, GB
    Introduction: Narcolepsy type 1 (NT1) is caused by hypocretin deficiency, the pathophysiology of narcolepsy type 2 (NT2) has not been delineated. Except for the hypocretin deficiency and cataplexy, all clinical and laboratory features used in the diagnosis of NT2 are identical to those used for NT1. The aim of this study was to assess the rapid eye movement (REM) sleep-related characteristics in the patients with narcolepsy; the characteristics of REM sleep in polysomnography (PSG) and multiple sleep latency test (MSLT) recordings, the quantification of REM sleep without atonia (RSWA) and atonia index, and the analysis of rapid eye movements (REMs) during REM sleep. Materials and methods: This study was planned by the Sleep Medicine Study Group of the Turkish Neurology Society, and conducted in 11 centers in eight cities in Turkey. The analysis of RSWA was analyzed by reviewing all REM sleep periods on nocturnal PSG and MSLT recordings per standard criteria. The total duration of the increased muscle tone during REM sleep in the chin and bilateral leg electromyography (EMG) recordings was calculated as RSWA index. The REMs index was also investigated the relation to the RSWA. Results: A total of 274 patients were involved; 147 patients (53.6%) were males and 127 patients (46.4%) were females; the mean age was 29.1 +/- 12.0 years. The diagnosis of NT1 was made in 166 patients (60.6%), and 108 patients (39.4%) were diagnosed as having NT2. The mean Epworth sleepiness scale score was significantly higher in patients with NT1 than the patients with NT2 (P = 0.001). The diagnosis of REM sleep behavior disorder (RBD) was made in 19.3% of the patients with NT1 versus in 2.8% of the patients with NT2 (P < 0.001). The percentage of SOREMP in PSG recordings was significantly higher in patients with NT1 (37.1%) than those with NT2 (18.9%, P = 0.001). MSLT showed that the mean sleep latency was shorter in patients with NT1 compared to those with NT2 (P < 0.001). The total duration of REMs on electrooculography recordings was also significantly higher in patients with RSWA in comparison with the patients without RSWA (P = 0.002). Total duration of REMs was significantly and positively correlated with the duration of RSWA on chin-EMG and leg-EMG recordings (P = 0.001). ROC analyses showed an RSWA index of >= 2% for the RSWA on chin-EMG with a sensitivity of 86.7% and a specificity of 71.3% (P < 0.001). The REMs index >= 20% was associated with the presence of RSWA with a sensitivity of 70.0% and a specificity of 57.1% (P = 0.008). Conclusions: In this nation-wide study, we identified for the first time that the increase in REMs density during REM sleep may be a major correlate of the RSWA. Significant positive correlations were demonstrated between the total duration of REMs on electrooculography recordings and the mean durations of RSWA in both chin and leg EMG recordings. A REMs index of >20% was demonstrated to have a moderate sensitivity and specificity in the diagnosis of RSWA. As observed in chin RSWA index, REMs index also showed a significantly high association with RBD, in comparison to RSWA per standard criteria. (C) 2022 Elsevier B.V. All rights reserved.
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    Distinctive sleep complaints and polysomnographic findings in antibody subgroups of autoimmune limbic encephalitis
    Küçükali, CI; Yilmaz, V; Karadeniz, D; Akyildiz, UO; Algin, DI; Saritas, AS; Ak, AK; Demir, AB; Yilmaz, H; Domaç, FM; Elmali, AD; Hos, ÜD; Gözübatik-Çelik, RG; Kabeloglu, V; Bilgin, B; Berktas, DT; Türk, BG; Delil, S; Dilber, C; Öztürk, ST; Yeni, SN; Özkara,Ç; Aksu, M; Tüzün, E; Senel, GB
    Introduction Sleep disturbances are being increasingly recognized in association with autoimmune encephalitis (AIE). We investigated the prevalence of sleep-related symptoms and polysomnographic features of patients with AIE and the long-term outcomes in these patients in a multi-center, prospective study from Turkey.Methods We prospectively evaluated patients with definite AIE in a common database including demographics, AIE-related and sleep-related symptomatology. Maximum and latest modified Rankin scores (mRS) and Liverpool Outcome Score (LOS) were noted.Results Of 142 patients, 87 patients (61.3%) fulfilled the criteria for definite AIE (mean age, 46.8+18.8 years; 51.7% women; mean disease duration, 21.0+38.4 months). 78.9% of patients had at least one or more new onset or worsened sleep-related symptomatology: insomnia (55.3%), excessive daytime sleepiness (EDS, 28.0%), sleep apnea (18.7%), REM sleep behavior disorder (RBD, 17.3%), restless legs syndrome (10.7%) and oneiric stupor (9.3%). Sleep efficiency, N3 and REM sleep were decreased and N1 sleep was increased in patients with Ab[+] AIE. LOS points were highest in those with insomnia and sleep apnea, and lowest in those with EDS, RBD and oneiric stupor. RBD and sleep apnea were more common in anti-LG1 Ab[+] group than anti-NMDAR Ab[+] group. Index of periodic leg movements was highest in anti-LG1 Ab[+] group. Patients with EDS and oneiric stupor had more common memory problems. Maximum and latest mRS scores were positively correlated with EDS and oneiric stupor. EDS, RBD and oneiric stupor were negatively correlated with LOS points.Conclusion Our study emphasizes the presence and importance of early diagnosis of sleep disturbances in AIE in regard to their deteriorative influences on disease prognosis.
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    THE REM-SLEEP RELATED CHARACTERISTICS OF NARCOLEPSY: A NATION-WIDE MULTI-CENTER STUDY IN TURKEY, THE REMCON STUDY
    Akyildiz, UO; Tezer, I; Koç, G; Ismailogullari, S; Demir, AB; Kisabay, A; Sünter, G; Kara, KA; Berktas, DT; Sahin, A; Azman, F; Akçay, BD; Gök, DK; Yilmaz, H; Agan, K; Bekmezci, Y; Yetkin, S; Aksu, M; Karadeniz, D; Senel, GB