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    Cognitive event-related potential and neuropsychological findings in Behcet's disease without neurological manifestations
    (Tohoku Univ Medical Press, 2005) Ozisik, HI; Karlidag, R; Hazneci, E; Kizkin, S; Ozcan, C
    Behcet's disease (BD) is a multisystem inflammatory disorder characterized by recurrent oral and genital ulcers and uveitis. BD patients without neurological involvement frequently have mild neurological symptoms. The aim of this study was to evaluate whether BD patients without neurological involvement have any changes in cognitive functions. Twenty BD patients without neurological involvement and 13 control subjects were included in the study and were analyzed by neurophysiological and neuropsychological examinations. The cognitive event- related potentials (P300) were recorded from the frontal, central and parietal areas of the right and left hemispheres of the patients and control subjects. Likewise, all individuals were evaluated with neuropsychological tests. In contrast to a study with similar design, C, we did not find any difference between the cognitive event-related potentials values of BD patients without neurological involvement and the control subjects. All BD patients without neurological involvement exhibit normal results of the neuropsychological test. In conclusion. the results of neuropsychological tests and cognitive event-related potentials values in BD patients without neurological involvement are indistinguishable from those in control subjects and no alteration of cognitive functions is present. (c) 2005 Tohoku University Medical Press.
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    Diffusion-weighted imaging in chronic Behcet patients with and without neurological findings
    (Springer, 2005) Baysal, T; Dogan, M; Karlidag, R; Ozisik, HI; Baysal, O; Bulut, T; Sarac, K
    Our aim was to investigate whether neurological impairment in chronic Behcet's disease (BD) patients with normal appearing brain can be assessed by means of diffusion-weighted imaging (DWI). The averaged apparent diffusion coefficient (ADC) values were calculated in 22 different radiologically normal appearing brain regions in 32 patients with and without neurological findings and 20 control subjects. The ADC values in bilateral frontal, temporal and occipital normal appearing white matter were significantly higher in the patient groups compared with the control subjects (p < 0.05). In these brain regions, DWI revealed differences in the ADC values between patients with neurological findings (including symptomatic and neuro-Behcet patients) and the asymptomatic patient group. The similarity of the ADC values of patients without symptoms to those of the control group allowed clear discrimination between patients with and without neurological findings. DWI may serve to assess subclinical neurological involvement in BD, even when structural changes are absent.
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    Proton MRS in Behcet's disease with and without neurological findings
    (Springer, 2003) Baysal, T; Ozisik, HI; Karlidag, R; Sarac, K; Baysal, O; Dusak, A; Hazneci, E
    Our aim was to investigate whether neurological impairment in Behcet's disease (BD) can be assessed by means of proton MRS and whether it can assist in prognosis. We used single-voxel MRS to measure metabolites in regions of normal-appearing pons, basal ganglia and periventricular white matter (PWM) in 32 patients with chronic BD patients with and without neurological deficits and 29 control subjects. Patients had significantly higher N-acetylaspartate (NAA)/creatine (Cr) and choline (Cho)/Cr ratios in the basal ganglia than the controls. The Cho/Cr ratio in the PWM was also significantly higher in the patients. MRS enabled clear discrimination of patients and controls and also revealed spectral differences between non-neuro-Behcet's disease and neuro-Behcet's disease in the basal ganglia. MRS can be used to assess brain involvement in BD even if structural changes are absent.
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    Stressful life events, anxiety, depression and coping mechanisms in patients with Behcet's disease
    (Wiley, 2003) Karlidag, R; Unal, S; Evereklioglu, C; Sipahi, B; Er, H; Yologlu, S
    Background Behcet's disease is a systemic immunoinflammatory disease of young adults characterized by systemic vasculitis of arteries and veins. Although many studies have been published since its discovery in 1937, the etiopathogenesis of this unique disorder is still unclear. Objective To assess the relationship between stress factors, psychological and somatic symptoms, and coping mechanisms in patients with Behcet's disease. Method Thirty-four patients with Behcet's disease and 43 control subjects were compared by using sociodemographic data collection forms, a psychosocial and environmental problems list, the Beck Anxiety Inventory (BAI), Hamilton Depression Rating Scale (HAM-D) and Toronto Alexithymia Scale (TAS). Results Twenty-four patients (70.6%) defined stress factors in the first stage of the disease. Twenty-seven (79.4%) out of 34 patients stated that the recurrence period of the disease was related to the stress factors. Fear was expressed by 10 (29.4%) patients, sadness by 11 (32.3%), and fear plus sadness by 13 (38.2%) when they first learnt the diagnosis. While coping with these emotions 14 (41.2%) revealed active-reliance strategy. A statistically significant difference was present between the Behcet's patients and control subjects regarding TAS (P < 0.05), HAM-D (P < 0.001) and BAI (P < 0.001) scores. Conclusion It seems that stressful life events have important implications in both relapsing and remission periods of Behcet's disease via secondary problems.
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    Sympathetic skin response in premenstrual syndrome
    (Springer Heidelberg, 2005) Ozisik, HI; Kamisli, O; Karlidag, R; Kizkin, S; Ozcan, C
    Premenstrual syndrome is a term which includes a broad group of emotional, behavioral and physical symptoms that occur for several days before menses and subside following the menstrual period. Many women experience premenstrual syndrome symptoms, particularly physical ones such as breast tenderness and swelling. Approximately 5-10% women suffer from severe premenstrual syndrome and another 30-40% have moderate symptoms. Premenstrual syndrome continues to be an unsolved problem. In this study, we evaluated 24 premenstrual syndrome patients and 20 healthy women in the control group. The ages of the women were 22-34 years (mean +/- SD: 25 +/- 3) for the premenstrual syndrome group and 23-34 (25 +/- 3) for the control group. The sympathetic skin response was recorded from the palms, soles and genital regions by using electrical stimuli to the median nerve at the wrist. The sympathetic skin response was recorded twice, in the follicular and late luteal phases of menstruation. The follicular and late luteal phase sympathetic skin response of the two groups were compared. The amplitudes and latency values of the late luteal and follicular phase sympathetic skin response from the premenstrual syndrome group and control group women were statistically similar. We also did not find any latency or amplitude difference in the sympathetic skin response obtained from the three regions of the premenstrual syndrome patients and the control group. We checked sympathetic skin response in the symptomatic (late luteal phase) and asymptomatic (follicular phase) periods of patients with premenstrual syndrome, a disorder known to have many autonomic symptoms, to determine whether there was sudomotor sympathetic involvement. The results of our PMS patients indicate at the very least that there is no difference with the control subjects as regards peripheral sudomotor functions.
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    Topographic abnormalities in event-related potentials in children with monosyptomatic nocturnal enuresis
    (Wiley, 2004) Karlidag, R; Ozisik, HI; Soylu, A; Kizkin, S; Sipahi, B; Unal, S; Ozcan, C
    Aims: A functional maturational delay in the central nervous system is dwelled upon in the pathogenesis of monosymptomatic nocturnal enuresis (NINE). In this study we studied whether according to controls N200 and P300, components of the event-related potential (ERP), which is related to aspects of cognitive processing, showed any difference in its topographic distribution in children within the age group 10-13 with monosymptomatic nocturnal enuresis and discussed its relation to the pathogenesis of MNE. Methods: We performed P300 in 18 patients with MNE and in 16 age-matched healthy subjects. P300 were evoked by an auditory oddball paradigm consisting of 150 tone bursts (80% 1 kHz; 20% 2 kHz). The latencies of the N200 and the P300 waves and the amplitude of the P300 wave were measured. Results: There was no statistical difference between the enuretic group and the controls in N200 and P300 latency and amplitude in the midline frontal (Fz), central (Cz), and parietal (Pz) recording site of the 10-20 International System. In the enuretic group while P300 amplitude in the Fz site was significantly less than the P300 amplitude in the Cz site, there was no statistical difference between the Fz and Pz P300 amplitude values. Conclusions: When different levels of maturational delay are considered in NINE, it may be claimed that maturational delay in children whose enuresis lasts until older ages will be different from those whose enuresis ends at an early age. The determination of P300 amplitude in parietal records being less in enuretics when compared to the controls may show that there are regional differences in stimuli processing rate/quality. (C) 2004 Wiley-Liss, Inc.