Browsing by Author "Gemici, YI"
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Item Reversible lesion of the corpus callosum associated with COVID-19: A case reportGemici, YI; Tasci, ISevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may affect the central nervous system and peripheral nervous system. Major central nervous system manifestations of SARS-CoV-2 infection include seizures, meningoencephalitis, ischemic stroke, anosmia, and hypogeusia. The reversible splenial lesion syndrome was first described in 2004. Although reversible splenial lesion syndrome was initially recognized as a benign phenomenon, a second type of reversible splenial lesion syndrome was identified in later years, which has a poorer prognosis and potentially serious sequela. Reversible splenial lesion syndrome can be caused by numerous etiologies including viruses. In this report, we present a rare case of COVID-19 with reversible splenial lesion, who presented with ataxia and dizziness.Item Case report: Coexistence of takotsubo syndrome and severe mononeuritis multiplex in rheumatoid vasculitisAcar, EA; Uslu, S; Gemici, YI; Cetin, N; Temiz, P; Gündüz, OSItem TRP Channels in Tension-Type Headache: A Pilot StudyGemici, YI; Tasci, I; Durmu, K; Koç, ATension-type headache (TTH) affects many individuals worldwide. Although the exact pathogenesis of TTH remains unclear, central, and peripheral mechanisms are considered to play a role in TTH 1. This pilot study aimed to investigate the role of transient receptor potential (TRP) channels in the development or chronic inflammation in TTH and to discuss the findings in the light of literature. This pilot study included a patient group comprising three patients with episodic TTH and three patients with chronic TTH (CTTH) aged 18-40 years with no comorbidities and a control group of three patients with no headache. Peripheral blood samples were obtained from all the participants, and both RNA and cDNA were isolated on the same day. The mRNA levels of pain-related TRP channels [TRPA1, TRP vanilloid-1 (TRPV1), TRPV3, TRPV4, TRPM3, and TRPM8] were measured by reverse transcriptase (RT)-quantititave polymerase chain reaction method and were normalized with the levels of glyceraldehyde 3-phosphate dehydrogenase (GAPDH) transcript. Results were analyzed using statistical methods. All three groups were comparable with regard to demographic characteristics. No significant difference was found among the groups with regard to the mRNA levels of the TRP channels normalized by GAPDH, whereas the TRPM8 expression levels were not significantly lower in the CTTH group than in other groups (p = 0.066). This study revealed that TRPM8 is likely to have a role in the pathogenesis of TTH, and this role of TRPM8 may be investigated by further studies.Item Calcitonin gene-related peptide (CGRP) levels in peripheral blood in patients with idiopathic intracranial hypertension and migraineAk, AK; Gemici, YI; Batum, M; Karakas, B; Özmen, EY; Gökçay, F; Çelebisoy, NBackground: Calcitonin gene-related peptide (CGRP) plays a dominant role in migraine. This prospective study was designed to investigate CGRP levels in patients with idiopathic intracranial hypertension (IIH) and compare the results of migraine patients and healthy controls (HC). As a second objective, CGRP levels obtained from IIH patients defining sustained headache after the resolution of papilledema were compared with those not defining post-IIH headache. Methods: Thirty-six patients with IIH, 36 with episodic migraine (EM), 18 with chronic migraine (CM), and 36 HC were included in the study. CGRP levels were studied from blood samples obtained from the antecubital vein by using a commercial ELISA kit. Results: Serum CGRP levels of the patient groups were significantly higher than the HC (p < 0.001). As compared with controls, both CM (p Adj<0.001) and IIH (p Adj=0.039) had significantly increased levels of CGRP. Levels recorded from EM patients did not differ from the HC (p Adj=0.661). In 16 IIH patients, persistent headache was reported after the normalization of intracranial pressure (ICP). Twenty patients did not report post-IIH headaches. Comparison of serum CGRP levels of these two groups revealed significantly higher CGRP levels in patients with sustained headaches obtained from blood samples both at the initial and control visit (p Adj <0.001). Conclusions: CGRP levels of the patient groups were higher than the HC. High levels recorded in patients with IIH indicates the role of CGRP in IIH related headache and even higher levels in patients with sustained headache after normalization of ICP strengthens this finding.Item Cognıtıve functıons in idiopathic intracranial hypertensıonAk, AK; Saritas, AS; Batum, M; Gemici, YI; Karakas, B; Celebisoy, NObjectiveCognitive problems in idiopathic intracranial hypertension (IIH) is generally overlooked in the presence of disabling headache and threat to visual function. The aim of this study was to search for cognitive deficits in patients with IIH using neuropsychologic tests in addition to P300 potential recordings to assess cognition related brain activity.MethodsFifty IIH patients were examined using Montreal Cognitive Assessment Test, Stroop Test and Visual Aural Digit Span Test to measure different domains of cognition at the time of diagnosis. P300 potentials were recorded by using an oddball paradigm. Hospital Anxiety and Depression Scale was used to determine anxiety and depression. Quality of life (QoL) was assessed by SF-36. The results were compared with fifty healthy controls with matching age, gender and body mass index.ResultsNeuropsychologic tests revealed wide cognitive impairment including attention, working memory, executive function, naming, language, delayed recall and orientation in IIH patients. In addition, quality of life was affected in the sub-parameters of general health perceptions, emotional role functioning, vitality, mental health and bodily pain. P300 potential latencies were long and the amplitudes were reduced indicating deficits in attention and working memory. Anxiety scores were high, and health-related QoL was low mainly involving vitality, emotional and mental health. Cognitive dysfunction was not correlated with the levels of anxiety and the correlation with headache severity was mild.ConclusionA multidomain cognitive decline mainly involving attention and working memory was recorded in IIH patients. It was not correlated with anxiety and only a mild correlation with headache severity was present which may indicate a casual relationship between raised intracranial pressure and cognitive deficits. Screening is important as neuropsychological rehabilitation might be relevant in these patients.Item Epigenetic analysis of heat shock activator complex in the peripheral blood of Parkinson's disease patients and its clinical significanceGemici, YI; Tasci, I; Dundar, M; Ozgen, N; Danis, N; Gozukara, HG; Koc, AObjectives: This study aimed to investigate the methylation changes of related genes in the peripheral blood and their clinical significance in Parkinson's disease (PD) and whether the methylation change of the gene encoding long noncoding RNA was different in the blood of patients and controls. Patients and methods: This prospective cross-sectional, controlled study was conducted with 45 participants (22 males, 23 females; mean age: 60.7 +/- 5.9 years; range, 53 to 75 years) between June 2020 and June 2021. Drug-naive patients diagnosed with PD were included in this study. Those with PD and a Mini-Mental State Examination (MMSE) score >23 were defined as Group 1 (n=15), and those with PD and an MMSE score <= 23 were defined as Group 2 (n=15). Controls were included in Group 3 (n=15). The methylation changes of genes HSP70, HSP90, heat shock factor 1 (HSF1), heat shock RNA 1 (HSR1), and eukaryotic translation elongation factor 1 alpha (eEF1a) a ) were investigated with methylation-specific real-time quantitative polymerase chain reaction analysis. Results: The eEF1a a was significantly more hypermethylated in Group 1. In Group 2, HSP70, HSP90 HSF1, HSR1, and eEF1a a were significantly hypomethylated compared to Group 1 and Group 3 (for all genes p<0.001). The HSF1 hypomethylation was negatively correlated with MMSE and positively correlated with depression scores (p=0.03 and p=0.013, respectively). The correlation of eEF1a a with MMSE and depression was the opposite of HSF1 (p<0.001 and p=0.013, respectively). Conclusion: Cell line and autopsy studies indicate that eEF1a a hypermethylation might be one of the main molecules triggering alpha-synuclein aggregation in the pathogenesis of PD. Therefore, eEF1a a may be a molecule that can be used as a peripheral biomarker. The findings supported this idea as it was more hypermethylated in PD patients than in controls, whereas its negative regulator HSF1 was hypomethylated and correlated with the clinic. Furthermore, the worsening of cognitive functions and depression in PD patients may affect methylation levels of chaperone genes in the peripheral blood.Item Oligoclonal Band Number Affect On Cognitive Function Of Multiple Sclerosis PatientsGemici, YI; Batum, M; Saritas, AS; Kisabay, A; Mavioglu, HItem Clinical Approach Hypersomnia of Central Origin and Differential DiagnosisAk, AK; Saritas, AS; Gemici, YI; Yilmaz, HHypersomnia and excessive daytime sleepiness are commonly encountered by physicians dealing with sleep medicine. Although these are common symptoms associated with sleep disorders, they can be ignored. The tendency of excessive daytime sleepiness, which might be caused by sleep deprivation that continues for a while in our society, makes it difficult to diagnose diseases with hypersomnia. Hypersomnia is used as a comprehensive definition for excessive daytime sleepiness and/or excessive need for sleep or increased amount of sleep. Clinically, it presents with prolonged sleep times at night, falling asleep easily and everywhere, recurrent sleep attacks, and excessive daytime sleepiness. Hypersomnia can be either a symptom of neurological and metabolic diseases, especially sleep disorders, or develop due to substance, drug use, and trauma. Sleep attacks occurring during the day can affect individuals' academic or professional performance, disrupt their cognitive functions and social relations, and cause life-threatening traffic or work accidents. It is crucial to examine this symptom, which causes a significant deterioration in the quality of life of people, and to diagnose and treat the diseases causing it. This review article plans to address the epidemiological, pathophysiological, clinical aspects of sleep disorders that cause hypersomnia, treatment and emphasize the critical points in the differential diagnosis.Item Familial Mediterranean fever gene variations could trigger VPS16-associated early-onset dystonia and diabetes mellitus: clinical identification of a family with MEFV and VPS16 genetic variation associationGemici, YI; Ekici, C; Batum, M; Akbostanci, C; Koc, A; Mavioglu, HObjectives We describe the clinical pictures of an index case with dystonia and his family resulting from VPS16 and MEFV genetic variations based on previously published data and discuss the mechanisms that may have brought out the clinical findings. Methods A 17-year-old male had generalized dystonia that started at age 6 years, non-febrile abdominal pain attacks and was diagnosed with type 1 diabetes at age 14 years. Meanwhile, his 13-year-old sister had the same clinical presentation. His father was diabetic and his mother was asymptomatic. There was no consanguinity between the parents. Genetic variations were detected with whole exome sequencing. Results VPS16 c.1513C>T/p.Arg505* (likely pathogenic), MEFV c.2080A>G p.Met694val (pathogenic) and MEFV c.1772T>C p.Ile591Thr (unknown significance) heterozygous variants were detected in his siblings. The father had VPS16 c.1513C>T/p.Arg505* and MEFV c.2080A>G p Met694val variations and the mother had MEFV c.1772T>C p.Ile591Thr variations. Conclusions The occurrence of these diseases in siblings but their absence in the parents suggests the idea that the coexistence of two separate variations in the VPS16 and MEFV genes determines the phenotype. In addition, the increase in MEFV variation load in this family and the fact that DM occurs at an earlier age suggest that inflammation may cause an early diabetic clinical presentation.Item A preliminary study evaluating the response to greater occipital nerve (GON) blockage therapy in patients with vestibular migraineKisabay, AAK; Saritas, AS; Gemici, YI; Çag, EC; Çelebisoy, NItem Anaplastic Ependymoma and Atypical Refractory Longitudinal Expansive Transverse Myelitis Due to Immune Reaction After COVID-19-A Case Discussion That Raises Many Unknown Questions About Covid-19Gemici, YI; Çelik, F; Göz, ZZ; Isisag, A; Ovali, GY; Zileli, M; Barutçuoglu, M; Mavioglu, HInflammatory neurologic manifestations, both infectious and noninfectious, have been reported secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19). However, the relationship of spinal tumor and COVID-19 longitudinally extensive transverse myelitis (LETM) coexistence has never been reported in our knowledge. The clinical presentation and response to treatment of a 24-year-old female patient diagnosed with COVID-19 LETM and anaplastic ependymoma are described in this case report. The Patient's cerebrospinal fluid COVID-19 antibody level was higher than serum , she was resistant to immunosuppressive treatment. The interaction between COVID-19 and spinal tumor was discussed in the light of the literature. It is thought that COVID-19 infection could trigger tumor growth in this patient. Also, this is the first case of anaplastic ependymoma and COVID-19 myelitis coexistence in the literature.Item Cognitive functions in idiopathic intracranial hypertensionAk, AK; Saritas, AS; Batum, M; Gemici, YI; Karakas, B; Çelebisoy, NObjective Cognitive problems in idiopathic intracranial hypertension (IIH) is generally overlooked in the presence of disabling headache and threat to visual function. The aim of this study was to search for cognitive deficits in patients with IIH using neuropsychologic tests in addition to P300 potential recordings to assess cognition related brain activity. Methods Fifty IIH patients were examined using Montreal Cognitive Assessment Test, Stroop Test and Visual Aural Digit Span Test to measure different domains of cognition at the time of diagnosis. P300 potentials were recorded by using an oddball paradigm. Hospital Anxiety and Depression Scale was used to determine anxiety and depression. Quality of life (QoL) was assessed by SF-36. The results were compared with fifty healthy controls with matching age, gender and body mass index. Results Neuropsychologic tests revealed wide cognitive impairment including attention, working memory, executive function, naming, language, delayed recall and orientation in IIH patients. In addition, quality of life was affected in the sub-parameters of general health perceptions, emotional role functioning, vitality, mental health and bodily pain. P300 potential latencies were long and the amplitudes were reduced indicating deficits in attention and working memory. Anxiety scores were high, and health-related QoL was low mainly involving vitality, emotional and mental health. Cognitive dysfunction was not correlated with the levels of anxiety and the correlation with headache severity was mild. Conclusion A multidomain cognitive decline mainly involving attention and working memory was recorded in IIH patients. It was not correlated with anxiety and only a mild correlation with headache severity was present which may indicate a casual relationship between raised intracranial pressure and cognitive deficits. Screening is important as neuropsychological rehabilitation might be relevant in these patients.