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Öğe Coexistence of restless legs syndrome and multiple sclerosis aggravates anxiety and depression(Assoc Arquivos Neuro- Psiquiatria, 2022) Sevim, Serhan; Demirkiran, Meltem; Terzi, Murat; Yuceyar, Nur; Tasdelen, Bahar; Idiman, Egemen; Kurtuncu, MuratBackground: Among the comorbidities that accompany multiple sclerosis (MS), restless legs syndrome (RLS) is one of the most common. Anxiety and depression are common psychological comorbidities that impact the quality of life of patients with MS (PwMS), as well as patients with RLS. Objective: To investigate the psychiatric burden of MS and RLS coexistence, we conducted a nationwide, multicenter and cross-sectional survey. Methods: Participants were assessed by using demographic and clinical parameters along with the Hamilton Anxiety and Hamilton Depression Scales (HAM-A and HAM-D). Results: Out of the 1,068 participants, 173 (16.2%) were found to have RLS [RLS(+)] and 895 (83.8%) did not [RLS(-)]. The mean scores for HAM-A and HAM-D were significantly higher among RLS(+) subjects than among RLS(-) subjects (p<0.001 for all variables). Conclusions: According to our data, the presence of RLS in PwMS may increase the occurrence of both anxiety and depression symptoms. Awareness and treatment of RLS in PwMS could possibly reduce the symptoms of psychiatric comorbidities originating from RLS.Öğe Effects of bosentan, sildenafil and their combination on T-wave amplitude and QT ınterval in a rat model of pulmonary hypertension(2017) Karpuz, Derya; Hallioglu, Olgu; Buyukakilli, Belgin; Gurgul, Serkan; Tasdelen, BaharAim: Although, bosentan and sildenafil have been used to treat PAH, the effect of these drugs on electrocardiographic (ECG) changes are still unclear. The aim of this study is to evaluate the effects of bosentan, sildenafil, and their combination on T-wave amplitude and QT interval in rats with monocrotaline (MCT)-induced PAH. Materials and Methods: Saline (control) or MCT were applied to sixty-six male Wistar rats. By the development of PAH (4th week), MCT-given rats were randomized into 4 groups and were treated orally with bosentan, sildenafil and combination of sildenafil and bosentan or placebo for 3 weeks. Echocardiographic (ECHO) and ECG examinations were performed three times on baseline, 4th and 7th week. Results: ECHO results showed that the application of MCT developed PAH in all injected rats. Usually, T-wave changes and QTc prolongation in ECG began after PAH and T-wave amplitudes, T-repolarization time as well as QTc intervals significantly increased in all groups after treatment (p<0.001). Conclusion: Our experimental study suggest that T-wave changes and QTc prolongation to be more clear in combined treatment than the single use of sildenafil or bosentan in MCT-induced PAH. The most interesting finding in this research was that it could be predicted serious arrythmia with ECG changes (probably QTc interval) - clearly a future direction.Öğe Impact of a new migraine-specific comorbidity index on prognosis: A methodology study(Wolters Kluwer Medknow Publications, 2018) Yildirim, Didem Derici; Tasdelen, Bahar; Uluduz, Derya; Ozge, Aynur; Yologlu, SaimObjective: To develop and validate a comorbidity index to estimate the prognosis of migraine, defined as the severity of headache measured longitudinally in a heterogeneous population. Methods: The study data were collected from a computer-based Turkish Headache Database with 15-year's follow-up data. The primary outcome was defined as the severity of headache [visual analog scale (VAS)] obtained from baseline to the 7th visit. The procedure was multistage: First, latent subgroups were determined using group-based trajectory modeling (GBTM) because the change in outcomes over time were different for each patient. Second, group-based trajectory modeling analysis was applied with the purpose of understanding how to evaluate comorbidities. Lastly, according to the results obtained from the GBTM analysis and physicians viewpoints, a migraine-specific comorbidity index was developed and validated. Results: Out of all weighting methods to evaluate comorbidities, the three-group model and quadratic form of all groups fitted the data best. After deciding the number of groups and functional form, the information criteria and minimum group percentage of the weighting methods were compared. The best method was the posterior probabilities obtained from latent class analysis (LCA) taken as weights. At the same time, age was effective in the separation of the second and third groups from the first group for severity (p=0.047, p=0.007). Sex difference had no effect on the prognosis of migraine (p=0.99, p=0.16). Conclusion: According to these results, an index formula was developed to evaluate the effect of covariates on migraine severity prognosis. A migraine-specific comorbidity index called the Migraine Comorbidity Index (MCI) was created by applying the formula.Öğe 'Is RLS a harbinger and consequence of MS?: Striking results of the 'RELOMS-T' study'(Elsevier Sci Ltd, 2020) Sevim, Serhan; Demirkiran, Meltem; Terzi, Murat; Yuceyar, Nur; Tasdelen, Bahar; Idiman, Egemen; Kurtuncu, MuratBackground: Although studies report a high prevalence rate of restless legs syndrome (RLS) among patients with multiple sclerosis (PwMS) ranging from 13.3 to 65.1%, little is known about the causes of this relationship. Methods: To ascertain the prevalence, features and impact of RLS among PwMS a nation-wide, multicenter, prospective and a cross-sectional survey, designed to reflect all of the PwMS throughout Turkey, was conducted in 13 centers. Exploring the relationship of the two conditions could possibly contribute to the understanding of the causes of the high and wide-ranging prevalence rates and the pathophysiology of both diseases. Results: Of the 1068 participants 173 (16,2%) found to have RLS [RLS(+)] and 895 (83,8%) did not [RLS(-)]. Among the RLS(+) 173, all but 8 patients (4,6%) were underdiagnosed in terms of RLS. More than half of the patients with RLS had 'severe' or 'very severe' RLS. The onset of RLS was before or synchronous with the onset of MS in about a half of our patients. Conclusion: We conclude that RLS should be meticulously investigated in PwMS and MS can be a direct cause of RLS at least in part of PwMS. Our data about the timing of the onset of MS and RLS, along with the high prevalence of RLS in PwMS suggest that the pathologic changes in the initial phases of MS can possibly trigger RLS symptoms.Öğe Let's raise the awareness of MS specialists concerning the frequency and impact of RLS in MS and consequently the life quality of patients with MS: Striking results of the 'RELOMS-T' Study(Lippincott Williams & Wilkins, 2018) Sevim, Serhan; Demirkiran, Meltem; Terzi, Murat; Yuceyar, Nur; Tasdelen, Bahar; Idiman, Egemen; Kurtuncu, Murat[Abstract Not Available]
