Objectives: Evaluate preoperative and postoperative electrophysiological changes related to the accessory nerve with reference to dissection technique, modified radical neck dissection, and lateral neck dissection. Study Design: Prospective electrophysiological analysis of accessory nerve function in a total of 20 laryngeal carcinoma patients after neck dissection, 12 being lateral neck dissection (4 bilateral) and 8 being modified radical neck dissection. Methods: Distal latencies, compound muscle action potentials, and electromyography findings were investigated before surgery and, in early and late postoperative periods in 20 laryngeal carcinoma patients. Results were evaluated by Student t test and "x2 test for intragroup and intergroup differences. Results: In the lateral neck dissection group, postoperative distal latencies were longer, without statistical significance, whereas in the modified radical neck dissection group postoperative latencies were statistically longer. Postoperative compound muscle action potentials were significantly lower in both groups. Electromyographic work-up showed deterioration in early postoperative periods and improvement in late postoperative periods. When intergroup differences were compared, both postoperative compound muscle action potential and electromyographic findings were worse in the lateral neck dissection group. Conclusions: The accessory nerve function after modified radical neck dissection is better than function after lateral neck dissection because of increased stress applied to the nerve during retraction of the sternocleidomastoid muscle for achievement of a better exposed surgical field in lateral neck dissection.
Brain F-FDG PET findings in subcortical nuclei and cerebellum were found to be useful in differential diagnosis of patients with parkinsonism. The extent of cerebral cortical and basal ganglia hypometabolism showed correlation with the presentation and severity of clinical findings.
Background and aim The effect of epigenetic modifications in the genes related to Parkinson's disease (PD) is still unclear. In the present study, we investigated methylation status of SNCA and PARK2 genes in patients with early-onset Parkinson's disease (EOPD). Materials and methods The promoter region methylation status of SNCA and PARK2 genes was evaluated by methylation specific-PCR (MSP) in 91 patients with EOPD and 52 healthy individuals. Results The methylation of SNCA and PARK2 promoter regions were significantly lower in EOPD patients compared to the control group (P = 0.013 and P = 0.03, respectively). We also found that the methylation status of the SNCA might be associated with positive family history of PD (P = 0.042). Conclusion Although it should be supported by further analysis, based on the results of the present study, the methylation status of SNCA and PARK2 genes might contribute to EOPD pathogenesis.
Introduction Parkinson's disease (PD) is a progressive and degenerative disorder characterized by an inadequate production of dopamine due to pathology in the substantia nigra. Rigidity, bradykinesia, and postural instability are the cardinal features that lead to gait impairment and functional limitations [1]. Gait and balance impairments are important determinants of disability and quality of life in PD [2]. Overall, fatigue is one of the most common and disabling nonmotor symptoms and can be seen at all stages of the disease [3]. Aerobic training with treadmill training (TT) is effective in improving the gait, balance, and quality of life and relieving fatigue in subjects with PD [4,5]. Body weight-supported treadmill training (BWSTT) allows safe walking practice by supporting a portion of the body weight mechanically and stimulates activity-dependent neural plasticity [6]. Furthermore, physical performance and aerobic activities can be performed at higher intensities when the body weight is partially supported during walking compared to conventional TT [7]. This is especially beneficial in the rehabilitation of neurologically Background/aim: Body weight-supported treadmill training (BWSTT) might have greater effects than conventional treadmill training (TT) in neurological diseases such as Parkinson's disease (PD). The aim of this study was to evaluate the effects of different percentages of BWSTT on gait, balance, quality of life, and fatigue in PD. Materials and methods: Thirty-five patients with moderate to advanced PD were randomized into three BWSTT groups according to the supported percentage of body weight: 0% BWSTT (control group; unsupported TT), 10% BWSTT, or 20% BWSTT. Five patients were excluded due to early discharge and 30 patients completed BWSTT sessions lasting 30 min, 5 days a week, for 6 weeks during their inpatient rehabilitation stay. The primary outcome was 6-min walk distance (6MWD). Secondary outcomes were Unified Parkinson's Disease Rating Scale (UPDRS), Berg Balance Scale (BBS), Nottingham Health Profile (NHP), Fatigue Impact Scale, and Fatigue Severity Scale scores. Measurements were performed before and after the training. Results: The unsupported TT group demonstrated no significant improvement in the outcome measures after a 6-week training except for BBS and NHP emotional subscores. Moreover, the NHP pain subscore increased in the unsupported TT group after training. The 10% and 20% supported BWSTT groups demonstrated significant improvements in 6MWD (P = 0.004 and P < 0.001, respectively), UPDRS-motor score (P = 0.012 and P = 0.005, respectively), NHP pain subscore (P = 0.003 and P = 0.002, respectively), and fatigue (P = 0.005 for both) after training. The 20% BWSTT provided the highest improvement in balance among the three groups (P < 0.001) and greater relief of fatigue than 10% BWSTT (P = 0.002). Conclusion: Six weeks of BWSTT improved walking distance and balance ability, relieved fatigue, and additionally reduced pain in patients with moderate to advanced PD.
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Background: To investigate the accessory nerve function in lateral selective neck dissections (LSND) performed in laryngeal squamous cell carcinoma patients without dissection of level IIB. Methods: Fifteen LSND were performed in 11 N0 laryngeal carcinoma patients with preservation of level IIB. Distal latencies, compound muscle action potentials (CMAP), and electromyography findings were investigated before surgery, during the 3rd postoperative week, and 3 months thereafter to compare the effects of the procedure on the accessory nerve. Results: Distal latencies and CMAP values were significantly lower in the early and late postoperative periods when compared with preoperative values. In 8 patients, there was no motor unit potential (MUP) in the early postoperative period. However, in the late postoperative period, there was no MUP loss. Conclusions: Only temporary functional deterioration of the accessory nerve was seen in patients in whom LSND was performed with undissected level IIB.
<b><i>Background:</i></b> Coronavirus disease 2019 (COVID-19) pandemic and lockdown period may induce an impairment in quality of life (QoL), disruption in treatment (DIT), and posttraumatic stress disorder (PTSD) in chronic neurological diseases (CNDs). To reach this information, a multicenter, cross-sectional study (COVQoL-CND) was planned. Parkinson’s disease (PD), headache (HA), multiple sclerosis (MS), epilepsy (EP), polyneuropathy (PNP), and cerebrovascular disease (CVD) were selected as the CND. <b><i>Methods:</i></b> The COVQoL-CND study includes demographic data, the World Health Organization Quality of Life short form (WHOQOL-BREF), and Impact of Event Scale-Revised (IES-R) forms. <b><i>Results:</i></b> The mean age of a total of 577 patients was 49 ± 17 (19–87 years), and the ratio of female/male was 352/225. The mean age of patients with PD, HA, MS, EP, PNP, and CVD were 65 ± 11, 39 ± 12, 38 ± 10, 47 ± 17, 61 ± 12, and 60 ± 15 years, respectively. The IES-R scores were found to be higher in the younger group, those with comorbid disease, contacted with COVID-19 patients, or diagnosed with COVID-19. In the group with a high IES-R score, the rate of DIT was found to be high. IES-R scores were negatively correlated with QoL. IES-R total scores were found highest in the CVD group and lowest in the PD group. The ratio of DIT was found highest in the PNP group and the lowest in the EP group. Contact with COVID-19 patients was high in the EP and HA group. <b><i>Conclusions:</i></b> The results of the COVQoL-CND study showed that lockdown causes posttraumatic stress and deterioration in the QoL in CND.
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