Papers by mehmet zarifoğlu
Turkiye Klinikleri Neurology - Special Topics, 2017
DergiPark (Istanbul University), Aug 1, 1990
After the description of Progressive Supranuclear Palsy (PSP) by Steel-Richardson and Olszewski, ... more After the description of Progressive Supranuclear Palsy (PSP) by Steel-Richardson and Olszewski, in 1964 even though there are many publications about the clinical state and the morphology of the disease the pathogenesis of the disorder is still unclear. In this study. 5 PSP patients were investigated clinically. by using the neuroscientific method and the morphological parameters and the etiopathogenesis has been discussed in the light of the new investigation methods.
Turkish Neurosurgery, Jul 1, 2009
AIM: Recent experimental and clinical studies on Parkinson's disease point out the pivotal role o... more AIM: Recent experimental and clinical studies on Parkinson's disease point out the pivotal role of inflammation in the pathogenesis of neurodegeneration and the possible positive effects of nonsteroidal anti-inflammatory drug therapies. Our aim in this study was to investigate the preventive effects of nonsteroidal anti-inflammatory drugs in the 6-hydroxydopamine (6-OHDA) induced rat model of Parkinson's disease. MATERIAL and METHODS: Twenty-one female Wistar-Albino rats (200-250g) were used in this study. The rats were divided in three groups: Saline group (n: 7, 2 ml), Acetylsalicylic acid group (n: 7, 100 mg/kg), and Meloxicam group (n: 7, 50 mg/kg). An hour after administration, the rats received a unilateral intranigral injection of 6-OHDA to produce the Parkinson model lesion. Rotational tests were performed two weeks later as follow-up. Immunohistochemical tests were performed in all groups to determine the severity of the lesion in the substantia nigra. RESULTS: Administration of drugs an hour before the lesions were created did not protect the degeneration of dopaminergic neurons in the substantia nigra. CONCLUSION: Oral usage of low repeated doses of nonsteroidal anti-inflammatory drugs may possibly slow down the progression of the disease.
Nuclear Medicine Communications, 1996
Movement Disorders, 1998
I YYX Movement Disorder Socicly Clinical/Scientific Notes Treatment of Hereditary Trembling Chin ... more I YYX Movement Disorder Socicly Clinical/Scientific Notes Treatment of Hereditary Trembling Chin With Botulinum Toxin Familial trembling chin is an autosomal-dominant and uncommon disorder with an intermittent trembling of mentalis muscle and rarely affecting the adjacent muscle^.'^ The tremor
Turkiye Klinikleri Journal of Internal Medical Sciences, 2006
Türkiye klinikleri tıp bilimleri dergisi, 2013
The aim of this study was to investigate the shape differences in the corpus callosum and cerebel... more The aim of this study was to investigate the shape differences in the corpus callosum and cerebellum of migraine patients compared with healthy controls and to assess whether migraine attack frequency and disease duration are indicators for brain abnormalities in migrain cases. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : This study included magnetic resonance imaging scans of 25 control subjects and 38 migraine patients. The data were obtained from the coordinate of landmarks analyzed with statistical shape analysis. A generalized Procrustes analysis was used to investigate shape differences. Witelson subdivision was used to further assess the regional shape differences in corpus callosum. R Re es su ul lt ts s: : The shape of the corpus callsoum in controls was significantly different from the shape in migraine patients. Migraine patients had deformations in corpus callosum compared to control patients where the most prominent deformations were seen in the posterior midbody of corpus callosum. According to Witelson subdivions deformation in in the rostral body was less prominent. There was no global or regional shape difference between patients with migraine and controls for cerebellum. No significant correlation was recognized between the size and disease duration or frequency of migraine attacks, both for corpus callosum and cerebellum. C Co on nc cl lu us si io on n: : The data suggest that migraine sufferers have global structural changes in corpus callosum but not in cerebellum, and that deformations did not vary with the disease progress. K Ke ey y W Wo or rd ds s: : Cerebellum; corpus callosum; geometric morphometrics; migraine; statistical shape analysis Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmanın amacı, kontrollerle karşılaştırıldığında migren hastalarının korpus kallozum ve serebellumundaki şekil farklılıklarını araştırmak ve migren atak frekansı ile hastalık süresinin migren hastalarında beyin anormalliklerini etkileyip etkilemediğini değerlendirmektir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Çalışma, 25 kontrol ve 38 migren hastasından elde edilen manyetik rezonans görüntüleri kullanılarak gerçekleştirilmiştir. Mirengi noktası koordinatlarından elde edilen veriler, istatistiksel şekil analizi ile incelenmiştir. Şekil farklılıklarını değerlendirmede genelleştirilmiş Procrustes analizi kullanılmıştır. Korpus kallozumdaki bölgesel şekil farklılıklarını daha iyi değerlendirebilmek için Witelson alt bölgelendirme analizi dikkate alınmıştır. B Bu ul lg gu ul la ar r: : Korpus kallozumun şekli açısından kontrol olguları ve migren hastaları arasında anlamlı bir fark bulunmuştur. Korpus kallozum için, migren hastalarında kontrollere oranla deformasyonlar olduğu gözlenmiştir. En belirgin deformasyonlar korpus kallozumun posterior orta gövdesinde gözlenmiştir. Witelson alt bölgelendirme analizine göre, korpus kallozumun rostral gövdesinde çok daha az miktarda deformasyon gözlenmiştir. Diğer taraftan, serebellum açısından, migren hastaları ve kontroller arasında genel ya da bölgesel bir şekil farklılığı gözlenmemiştir. Ayrıca, hem korpus kallozum hem de serebellum için, büyüklük ile hastalık süresi ve büyüklük ile atak frekansı arasında anlamlı bir ilişki bulunmamıştır. S So on nu uç ç: : Bu veri seti, migren hastalarında korpus kallozumda bölgesel yapısal değişiklikler olduğunu, fakat serebellumda farklılık bulunmadığını ve hastalık süreciyle deformasyonların değişmediğini göstermektedir. A An na ah ht ta ar r K Ke el li im me el le er r: : Serebellum; korpus kallozum; geometrik morfometri; migren; istatistiksel şekil analizi T Tu ur rk ki iy ye e K Kl li in ni ik kl le er ri i J J M Me ed d S Sc ci i 2 20 01 13 3; ;3 33 3((1 1
DergiPark (Istanbul University), Mar 1, 1995
Pseudoxanthoma elasticum is a genetic disorder. It most frequently involves the skin, eyes and ar... more Pseudoxanthoma elasticum is a genetic disorder. It most frequently involves the skin, eyes and arteries. The neurological manifestations of pseudoxanthoma elasticum are not frequent. In this article a case of pseudoxanthoma elasticum with multiple cerebral infarcts is presented.
Neurological Sciences and Neurophysiology
Introduction: Recent research into multiple sclerosis (MS) has focused on the role of microRNAs (... more Introduction: Recent research into multiple sclerosis (MS) has focused on the role of microRNAs (miRNAs) in the development of the disease. This study was designed to analyze miR-146a expression in whole blood and fecal samples of patients with MS. The study aimed to analyze clinical data using the miR-146a expression values obtained. Subjects and Methods: This study included patients with relapsing–remitting MS (RRMS) (n = 53), clinically isolated syndrome (CIS) (n = 15), and healthy controls (n = 26). Total RNA was isolated from the participants' whole blood and fecal samples. RNA extraction was performed using QIAamp RNA Blood Mini Kits for blood samples and RNeasy PowerMicrobiome Kits for feces. miR-146a expressions were studied using real-time polymerase chain reaction. Finally, relative expression was correlated with clinicopathologic factors. Results: MiR-146a expression was significantly decreased in the whole blood (P < 0.001) and fecal samples (P = 0.036) of patient...
Neurological Research, 2021
ABSTRACT Multiple sclerosis (MS) is an inflammatory, autoimmune demyelinating, and neurodegenerat... more ABSTRACT Multiple sclerosis (MS) is an inflammatory, autoimmune demyelinating, and neurodegenerative disorder of the central nervous system. Interactions between environmental factors, predisposition genes, and determining genes appear to be involved in its etiology. Epigenetic mechanisms such as microRNA-mediated gene regulation can determine the susceptibility and severity of autoimmune diseases. Therefore, to determine the role of miR-146a and miR-155 in MS and its developmental stages, the expression levels in the serum of MS and clinically isolated syndrome (CIS) patients were compared with those of healthy controls. In the present study, the expression levels of miR-146a and miR-155 were assessed using quantitative Real-Time PCR in blood samples of 15 CIS patients and 61 relapsing-remitting multiple sclerosis (RRMS) patients alongside 32 healthy patients as controls. Furthermore, any associations with the clinicopathologic variables of the patients were also evaluated. Dysregulations were found only in the miR-146a and miR-155 expressions in the RRMS-Control group. When the RRMS patients were evaluated in terms of the characteristics of sex, annual attack rate, age of diagnosis, duration of follow-up, and immunomodulatory treatments used, no significant differences were observed. However, significant dysregulations were identified in miRNA expression in the vitamin D level, EDSS values, and the number of attacks. ROC curve analysis showed that miR-146a and miR-155 were significant in the RRMS-Control group for the area under the curve (AUC). It is possible that miR-146a may be associated with vitamin D deficiency and disease disability, while miR-155 may be associated with the number of attacks.
Journal of Neurology, Neurosurgery & Psychiatry, 2010
A 23-year-old female patient presented with a 3-day history of dysarthria and gait impairment. He... more A 23-year-old female patient presented with a 3-day history of dysarthria and gait impairment. Her medical history was significant for peptic ulcus for which she was receiving ornidazole (1 g/day), amoxicillin (2 g/day) and lansoprazol (60 mg/day) treatment for 5 weeks. After consumption of a total dose of 35 g ornidazole, her neurological signs and symptoms appeared. There was no family history of neurological or autoimmune disorders. On examination at admission to hospital, she was alert, oriented to person, place and time, but emotionally labile. She had moderate scanning dysarthria, horizontal gaze-evoked nystagmus and bilateral severe limb dysmetria and dysdiadochokinesia. Her gait was ataxic. The rest of the general and neurological examination was unremarkable. Routine biochemistry and urine analysis findings were unremarkable. The values for peripheral blood leucocytes, erythrocyte sedimentation rate and analysis of cerebrospinal fluid obtained by lumbar puncture were normal. A brain MRI demonstrated markedly increased signal intensity symmetrically involving the dentate nuclei, dorsal pontine tegmentum lying in the …
Cephalalgia, Jun 4, 2019
The aim of this population-based validated study was to determine the course of tension-type head... more The aim of this population-based validated study was to determine the course of tension-type headache and migraine and to evaluate the predictors of persistence. Methods: We evaluated the course of headache in a large population from the first assessment in 2008 through a second assessment in 2013. Then we examined the factors associated with persistent migraine and persistent tensiontype headache. Results: Our study in 2013 revealed that only 42.9% of definite migraineurs in 2008 received the same diagnosis again, and of the remaining migraineurs 23.3% were newly diagnosed as definite tension-type headache; 11.6% evolved into probable tension-type headache, 6.4% changed to probable migraine, and 15.8% were headache free. The 17.7% of patients with definite tension-type headache in 2008 were newly diagnosed as having probable tension-type headache, 14.7% as having definite migraine, 6.4% as having probable migraine, and 28.9% as headache free in 2013, and only 32.3% received the definite tension-type headache diagnosis again. Binary logistic regression analysis showed nausea, throbbing and severe headache were the significant parameters for persistent migraine. A multiple regression analysis model with stepwise variable selection revealed that nausea, throbbing and severe headache and osmophobia remained in the final model as predictors of migraine persistence. We found no predictive factor for persistent tension-type headache. Conclusion: Migraine and tension-type headache did not seem to show a simple bidirectional linear worsening from headache-free state to definite migraine or vice versa, hence the transitions between them are more chaotic, reflecting that there are still unknown modifiers and modulators. Certain headache characteristics of migraine might predict persistent migraine.
OBJECTIVE:To investigate the stability and possible changes of migraine and TTH diagnoses in a la... more OBJECTIVE:To investigate the stability and possible changes of migraine and TTH diagnoses in a large nationwide study. BACKGROUND: Migraine and tension-type headache (TTH) might show shared characteristics and change into each other during their courses. These facts resulted in “headache spectrum” theory; TTH and migraine representing two ends of this spectrum METHODS:The Turkish headache prevalence study has been completed in 2008 as a face-to-face, nationwide, randomized, home-based study. Five years later, a second study with an optimized survey was performed to evaluate the course of headache in migraine and TTH sufferers in the previous study. Two validation studies for this survey were performed prior and after the study, each in 100 subjects by comparing the survey with expert diagnosis, showing high rate of reliability (Crohnbach alpha: 0.911 and 0.706, respectively). RESULTS:3012 subjects could have been contacted, with a 56.4[percnt] responder rate. 15.8[percnt] of those who had been diagnosed with definite migraine in 2008, were migraine free now and 49.3[percnt] were still suffering from migraine (definite+probable). However, the remaining 34.9[percnt] of definite migraine sufferers’ headache evolved into TTH (definite+probable). In probable migraineurs, change rates were even higher; 31.1[percnt] were headache free, 42.2[percnt] had evolved into TTH. 28.9[percnt] of TTH sufferers were headache free in 2013 whereas TTH diagnosis remained same in 50[percnt] and the remaining 21.1[percnt] reported migraine headache. Evolution of probable TTH into migraine was higher than that of definite TTH (26.7[percnt]). Moreover 46.2[percnt] of chronic migraine (CM) sufferers were headache free in 2013 and 53.9[percnt] of CM sufferers’ headache regressed to episodic migraine. CONCLUSIONS:Our results further showed that migraine and TTH might change into each other. Particularly, probable headache categories are more prone to evolve into the counterpart of headache type. We believe that our findings support the headache spectrum theory. Study Supported by:Ibrahim Ethem Menarini Disclosure: Dr. Necdet has nothing to disclose. Dr. Baykan has nothing to disclose. Dr. Zarifoglu has nothing to disclose. Dr. Ertas has nothing to disclose. Dr. Uluduz has nothing to disclose. Dr. Uygunoglu has received personal compensation for activities with Merck Serono and Biogen Idec. Dr. Ekizoglu has nothing to disclose. Dr. Orhan has nothing to disclose. Dr. Saip has received research support from The Scientific and Technological Research Council Of Turkey-Health Sciences. Dr. Siva has received personal compensation for activities with Biogen Idec.
Journal of Headache and Pain, Dec 1, 2015
Background: The incidence of migraine has been investigated only in a few studies worldwide and i... more Background: The incidence of migraine has been investigated only in a few studies worldwide and it is not known in our country. We, therefore, aimed to estimate the migraine incidence in a previously accomplished population-based prevalence study sample of 5323 individuals in the year 2008. Methods: The former Turkish headache prevalence study has been completed as a nationwide, randomized, home-based study of face-to-face examination by physicians trained for headache diagnosis by using ICHD criteria. Five years after this study an optimized survey including 50 questions was performed to estimate the migraine incidence in migraine-free individuals in the previous study, with a 56.4 % responder rate. Two validation studies for this survey were performed prior and after the study each in 100 subjects by comparing the gold standard of expert diagnosis of headache, showing high rate of reliability (Crohnbach alpha: 0.911 and 0.706, respectively). Results: Migraine incidence was estimated as 2.38 % (2.98 % in women and 1.93 % in men) per year in 2563 migraine-free individuals; if the population at risk is defined as the group without any headaches, the migraine incidence decreased to 1.99 %. The chronic migraine (CM) incidence [without medication overuse (MOH)] was 0.066 % and that of MOH was 0.259 %. We found a significant burden of the disease on the occupational functionality as well as on social and family life, even in the early years of the migraine. The family history of headaches especially in the fathers could be useful to predict new cases of migraine, besides the well-known risk factor, diagnosis of depression, whereas income and education did not seem to relate to migraine onset. Conclusions: Our study with a large population-based nationwide sample, using ICHD-II criteria, with structured headache interviews as well as blinded re-validation of the questionnaire diagnoses showed a 2.38 % incidence rate of migraine in Turkey, higher than most of the other previous reports; a finding which could be related to genetic factors and also to the methodological differences in the study designs. Moreover the incidence of CM was found to be 0.066 %.
The Clinical Journal of Pain, Jul 1, 2016
Objective: Allodynia reflects the clinical correlate of central sensitization, but it is usually ... more Objective: Allodynia reflects the clinical correlate of central sensitization, but it is usually neglected in clinical headache management. We aimed to report the prevalence and previously unnoticed associations of allodynia in migraineurs by a nationwide face-to-face questionnaire-based study by physicians. Methods: A total of 5323 households were examined for headache according to the diagnostic criteria of International Classification of Headache Disorders-II. Detailed headache features, premonitory signs, demographics, socio-economic status, and hormonal status of female individuals were analyzed with regard to the presence of allodynia in patients with definite migraine. Results: Allodynia was present in 61.1% of migraineurs in the general population of Turkey. The duration and severity of attacks (P&lt;0.0001), photophobia (P=0.001), phonophobia, and also osmophobia (P&lt;0.0001), as well as premonitory signs (P=0.018), showed significant associations with allodynia. Migraineurs with aura or family history of migraine more often reported allodynia in comparison with those without (P=0.001 and 0.028, respectively). Allodynic migraineurs had a higher rate of physician consults and high levels on the Migraine Disability Assessment questionnaire, reflecting increased burden of headache. Furthermore, migraineurs with allodynia had high probability of attacks close to menses. Migraine improved during pregnancy, but it worsened after menopause or during oral contraceptive use in individuals experiencing allodynia when compared with those without allodynia. Discussion: The duration, severity, and disability of migraine attacks, photophobia, phonophobia, and osmophobia, as well as premonitory signs, showed significant associations with allodynia in the general population. Moreover, migraineurs with aura or family history of migraine more often reported allodynia, and allodynic migraneurs were more sensitive to hormonal changes. Allodynia, which seems to indicate higher tendency to central sensitization, should be implemented in daily headache practice to predict the prognosis and high levels of migraineous involvement.
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Papers by mehmet zarifoğlu