Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system, predominantly affecting the white matter, but also the grey matter. Aim of this study was to detect MS lesions with double inversion recovery (DIR), fluid-attenuated inversion recovery (FLAIR) and T2-weighted magnetic resonance (MR) techniques and determine the sensitivity of these techniques, and the correlation between the number of lesions and expanded disability state scale (EDSS) scores. Thirty-four patients with MS (20 females and 14 males) were included in this study. DIR and conventional MR (T2-A, FLAIR) sequences were obtained. Lesions were counted and classified as belonging to one of seven anatomical regions: cortical, juxtacortical, deep grey matter, deep white matter, mixed white matter-grey matter, periventricular white matter and infratentorial. The correlation between lesion number and EDSS scores was investigated. DIR images showed more intracortical and mixed white matter-grey matter lesions in comparison with both FLAIR and T2 sequences (p=0, p=0 respectively). There was a significant difference between mean lesion numbers at the juxtacortical region, obtained with DIR and T2-weighted images (p = 0.002). The total number of lesions obtained with all methods was similar. DIR brain imaging had the highest sensitivity in the detection of cortical and mixed white matter - grey matter lesions, compared with FLAIR and T2 sequences. In addition, the lesions obtained with DIR images were more easily visualized.
Recent studies have shown that oxidative stress is the one of the molecular changes underlying the pathogenesis of Alzheimer's disease. In this study, we have investigated the dynamic thiol-disulphide homeostasis in patients with Alzheimer's disease, using a novel method.
Dynamic thiol-disulfide homeostasis plays a critical role in the cellular protection provided by antioxidation. The aim of this study was to investigate whether there is a change in thiol-disulfide homeostasis in acute ischemic stroke patients. Patients diagnosed with acute ischemic stroke that had undergone magnetic resonance diffusion-weighted imaging within the first 24 h were prospectively included in this study. The thiol, disulfide, and total thiol levels were measured during the first 24 and 72 h, and the National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), and Barthel Index (BI) of the patients were recorded. Overall, the relationships between the thiol-disulfide levels of the patients and the infarct volumes, NIHSS, mRS, and BI scores were investigated. In this study, 54 patients and 53 healthy controls were included. The mean of the native thiol levels in the stroke group was 356.572 ± 61.659 μmol/L (min/max 228.00/546.40), while it was 415.453 ± 39.436 μmol/L (min/max 323.50/488.70) in the control group (p< 0.001). A negative, significant correlation was observed between the infarct volumes and native thiol levels (ρ = -0.378; p = 0.005), and the disulfide levels were similar between the groups (Z = 0.774; p = 0.439). Significant difference was found between the thiol levels of the mild and moderate-severe NIHSS groups (p = 0.026). The changes in the thiol levels under oxidative stress may be associated with the severity of the stroke. Substitution of thiol deficiency and correction of thiol-disulfide imbalance may be beneficial in ischemic stroke.
Plasma levels of the oxidants xanthine oxidase, nitric oxide and malondialdehyde and the antioxidants superoxide dismutase, glutathione peroxidase and glutathione reductase, together with total superoxide scavenger activity and nonenzymatic superoxide scavenger activity, were determined in 19 patients with acute ischaemic stroke and 20 controls. Compared with controls, superoxide dismutase, total superoxide scavenger activity, glutathione peroxidase and glutathione reductase activities were significantly lower, and nitric oxide and malondialdehyde levels significantly higher, in acute stroke patients.Xanthine oxidase showed a slight but non-significant increase in stroke patients compared with controls. There was no significant difference in non-enzymatic superoxide scavenger activity between the two groups. There was a positive correlation between glutathione reductase levels and Glasgow Coma Scale scores, and a negative correlation between malondialdehyde levels and nonenzymatic superoxide scavenger activity. These findings suggest that oxidative stress in patients with acute ischaemic stroke may be the result of an imbalance in oxidant/antioxidant homeostasis.
Migraine is more likely to be misdiagnosed in patients with comorbid diseases. Not only primary care physicians, but also specialists might misdiagnose it due to the lack of diagnostic criteria awareness. The ID migraine test is a reliable screening instrument that may facilitate and accelerate migraine recognition. This study aimed to compare the prevalence and characteristics of migraine in a large sample of patients admitted to clinics of ophthalmology (OC), ear, nose and throat diseases (ENTC) and neurology (NC), as well as to validate the use of the ID migraine test in OC and ENTC settings. This was a multicentre (11 cites) study of out-patients admitting either to NC, ENTC or OC of the study sites during five consecutive working days within 1 week. From each of the clinics, 100 patients were planned to be recruited. All recruited patients were interviewed and those having a headache complaint received an ID migraine test and were examined for headache diagnosis by a neurologist, blinded to the ID migraine test result. A total of 2625 subjects were recruited. Only 1.3% of OC patients and 5.4% of ENTC patients have been admitted with a primary complaint of headache, whereas the percentage of NC patients suffering from headache was 37.6%. Whereas 138 patients (19.3%) in OC, 154 (17.3%) in ENTC and 347 (34%) in NC were found to be ID migraine test positive, 149 patients (20.8%) in OC, 142 (16%) in ENTC and 338 (33.1%) in NC were diagnosed with migraine. The sensitivity, specificity, and positive and negative predictive ratios of the ID migraine test were found to be similar in all clinics. An important fraction of the patients admitted to NC, as well as to OC and ENTC, for headache and/or other complaints were found out to have migraine by means of a simple screening test. This study validated the ID migraine test as a sensitive and specific tool in OC and ENTC, encouraging its use as a screening instrument.
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