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Öğe Anterior cerebral artery infarcts; Two years follow-up study(Literatura Medica, 2018) Hanoğlu, Lütfü; Khanmammadov, Elmir; Demirci, Sema; Altın, Ummuhan; Kırbaş, Dursun; Hanoğlu, Taha; Yuluğ, BurakObjectives - Anterior cerebral infarct (ACA) infarcts are reported very rare that is due to the compensatory collateral circulation provided by the anterior communicating artery. There are very few studies reporting the long-term follow-up results of ACA infarcts regarding their aetiology, clinical features and prognosis. Most studies reported in the literature vary between several months to one year. Patients and methods - A total of 27 patients with ACA infarcts were registered (14 women and 13 men). The mean age of the patients was 68.5 (age range: 45-89 years). Results - Bilateral ACA infarcts were reported in four patients (14.8%), right ACA infarct in 11 (40%) patients and left ACA infarct in 12 patients (44%). During the initial examination 15 patients (55.5%) were found to have apathy, 13 patients (48%) had incontinence, nine patients (33.3%) had primitive reflexes, 11 patients (40.7%) had aphasia, while six patients (22.2%) were found to suffer from neglect. At the end of one-year follow-up, five patients (22.7%) were reported to have apathy, 6 patients (27.2%) had incontinence, one patient (4.5%) had primitive reflexes, while one patient (4.5%) was found to have permanent aphasia, and no patients was found to suffer from neglect. Conclusion - Here we present our clinical data regarding the aetiology, specific clinical characteristics (including the speech disorders) and prognosis of 27 patients with ACA infarcts during a relatively longer follow-up period (3 months - 30 months) in compared to previous literature. We show that there are differences in the etiological factors of ACA infarcts between the Asian and European communities. Regarding speech disorders which are frequently reported during ACA infarcts, our study results are in agreement with other studies suggesting that this clinical picture is more than a real aphasia and associated with general hypokinesia and reduction in psychomotor activity.Öğe Beyond the therapeutic effect of rTMS in alzheimer's disease: A possible neuroprotective role of hippocampal BDNF?: A minireview(Bentham Science Publ Ltd, 2018) Yuluğ, Burak; Hanoğlu, Lütfü; Khanmammadov, Elmir; Düz, Özge Ariel; Polat, Burcu; Hanoğlu, Taha; Kılıç, ErtuğrulRepetitive transcranial magnetic stimulation (rTMS) is a well known non-invasive brain stimulation procedure which is capable of inducing the expression of the hippocampal BDNF that has been already shown to exert significant neuroprotective and pro-cognitive effects in AD. However, it is nearly impossible directly to evaluate the BDNF expression in humans after rTMS application. Here we summarized the underlying mechanisms of the neuroprotective and procognitive effect of BDNF that can be induced through a region-specific rTMS approach. Additionally, we have also evaluated the role of Magnetic Resonance Spectroscopy in monitoring the BDNF response after rTMS application in Alzheimer's Disease. We have provided strong evidence that rTMS exerts significant neuroprotective and pro-cognitive effects through the expression of hippocampal BDNF. Furthermore, Magnetic Resonance Spectroscopy might play a critical role in monitoring the BDNF response after rTMS application in AD patients. Such a sophisticated approach might be able to enlighten us on the time-dependent cognitive and neuroprotective correlates of the rtMS application in AD patients.Öğe Combined metabolic activators improve cognitive functions in Alzheimer’s disease patients: a randomised, double-blinded, placebo-controlled phase-II trial(2023) Yuluğ, Burak; Altay, Özlem; Li, Xiangyu; Hanoğlu, Lütfü; Çankaya, Şeyda; Lam, Simon; Velioğlu, Halil Aziz; Yang, Hong; Coşkun, Ebru; İdil, Ezgi; Nogaylar, Rahim; Özşimşek, Ahmet; Bayram, Cemil; Bolat, İsmail; Öner, Sena; Tozlu, Özlem Özdemir; Arslan, Mehmet Enes; Hacımüftüoğlu, Ahmet; Yıldırım, Serkan; Arif, Muhammad; Shoaie, Saeed; Zhang, Cheng; Nielsen, Jens; Turkez, Hasan; Boren, Jan; Uhlen, Mathias; Mardinoğlu, AdilAbstract Background Alzheimer’s disease (AD) is associated with metabolic abnormalities linked to critical elements of neurodegeneration. We recently administered combined metabolic activators (CMA) to the AD rat model and observed that CMA improves the AD-associated histological parameters in the animals. CMA promotes mitochondrial fatty acid uptake from the cytosol, facilitates fatty acid oxidation in the mitochondria, and alleviates oxidative stress. Methods Here, we designed a randomised, double-blinded, placebo-controlled phase-II clinical trial and studied the efect of CMA administration on the global metabolism of AD patients. One-dose CMA included 12.35 g L-serine (61.75%), 1 g nicotinamide riboside (5%), 2.55 g N-acetyl-L-cysteine (12.75%), and 3.73 g L-carnitine tartrate (18.65%). AD patients received one dose of CMA or placebo daily during the frst 28 days and twice daily between day 28 and day 84. The primary endpoint was the diference in the cognitive function and daily living activity scores between the placebo and the treatment arms. The secondary aim of this study was to evaluate the safety and tolerability of CMA. A comprehensive plasma metabolome and proteome analysis was also performed to evaluate the efcacy of the CMA in AD patients. Results We showed a signifcant decrease of AD Assessment Scale-cognitive subscale (ADAS-Cog) score on day 84 vs day 0 (P=0.00001, 29% improvement) in the CMA group. Moreover, there was a signifcant decline (P=0.0073) in ADAS-Cog scores (improvement of cognitive functions) in the CMA compared to the placebo group in patients with higher ADAS-Cog scores. Improved cognitive functions in AD patients were supported by the relevant alterations in the hippocampal volumes and cortical thickness based on imaging analysis. Moreover, the plasma levels ofÖğe Different metabolic and clinical profiles between patients with pure Alzheimer dementia and epileptic Alzheimer dementia: a metabolic study(2022) Oktem, Ece Ozdemir; Kadak, Kübra Soğukkanlı; Cakır, Tansel; Özşimşek, Ahmet; Cankaya, Seyda; Hanoğlu, LütfüAim: To investigate the clinical characteristics and cerebral FDG PET metabolisms of dementia patients who were also diagnosed with epilepsy and compare the differences with pure Alzheimer dementia patients.Methods: In this case-control study, a total of 14 patients, 7 patients with pure Alzheimer disease as a control group and 7 age and gender-matched patients with Alzheimer disease and concomitant epilepsy as a study group, were included. Detailed neurocognitive battery and brain fludeoxyglucose positron emission tomography (FDG PET-CT) were performed for all subjects.Results: In comparison of neurocognitive test scores, there was no significant difference between the study and control groups. However, geriatric depression scale scores were significantly lower in study group than the controls (p= 0.026). In cerebral FDG-PET CT profiles of subjects we detected significantly lower metabolism in left and right cerebellum, left lentiform nucleus, right thalamus and vermis in the study group (p=0.008, p=0.023, p=0.003, p=0.002, p=0.002, respectively). In the right parietotemporal cortex and right and left associative visual cortex, we found higher metabolism in the study group than controls (p=0.023, p=0.012, p=0.003, respectively).Conclusion: Epileptic patients with Alzheimer’s dementia may have distinct clinical and metabolic profiles, than pure Alzheimer’s disease patients. Even if there is no difference in the neurocognitive clinical scores of the patients, depression and related functional abnormalities may be a biomarker of epileptic AD.Öğe Differentiation of claustrum resting-state functional connectivity in healthy aging, Alzheimer's disease, and Parkinson's disease(2023) Ayyıldız, Sevilay; Velioğlu, Halil Aziz; Ayyıldız, Behçet; Sütçübaşı, Bernis; Hanoğlu, Lütfü; Bayraktaroğlu, Zübeyir; Yıldırım, Süleyman; Atasever, Alper; Yuluğ, BurakThe claustrum is a sheet-like of telencephalic gray matter structure whose function is poorly understood. The claustrum is considered a multimodal computing network due to its reciprocal connections with almost all cortical areas as well as subcortical structures. Although the claustrum has been involved in several neurodegenerative diseases, specific changes in connections of the claustrum remain unclear in Alzheimer's disease (AD), and Parkinson's disease (PD). Resting-state fMRI and T1-weighted structural 3D images from healthy elderly (n = 15), AD (n = 16), and PD (n = 12) subjects were analyzed. Seed-based FC analysis was performed using CONN FC toolbox and T1-weighted images were analyzed with the Computational Anatomy Toolbox for voxel-based morphometry analysis. While we observed a decreased FC between the left claustrum and sensorimotor cortex, auditory association cortex, and cortical regions associated with social cognition in PD compared with the healthy control group (HC), no significant difference was found in alterations in the FC of both claustrum comparing the HC and AD groups. In the AD group, high FC of claustrum with regions of sensorimotor cortex and cortical regions related to cognitive control, including cingulate gyrus, supramarginal gyrus, and insular cortex were demonstrated. In addition, the structural results show significantly decreased volume in bilateral claustrum in AD and PD compared with HC. There were no significant differences in the claustrum volumes between PD and AD groups so the FC may offer more precise findings in distinguishing changes for claustrum in AD and PD. © 2022 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.Öğe DLPF Targeted Repetitive Transcranial Magnetic Stimulation Improves Brain Glucose Metabolism Along with the Clinical and Electrophysiological Parameters in CBD Patients(2022) Toprak, Güven; Hanoğlu, Lütfü; Çakır, Tansel; Gümtekin, Bahar; Velioğlu, Halil Aziz; Yuluğ, BurakBackground: Corticobasal Degeneration (CBD) is a rare neurological disease caused by the pathological accumulation of tau protein. The primary pathological features of CBD include progressive neurodegenerative processes resulting in remarkable frontoparietal and basal ganglia atrophy. Objective: Like in many other neurodegenerative disorders, there is still no effective disease-modifying drug therapy in CBD. Therefore, the development of new treatment methods is of great importance. In this study, we aimed to assess the stimulating effects of high-frequency DLPFC rTMS on the motor, cognitive and behavioral disturbances in four CBD patients. Methods: Four (three females, one male) CBD patients who had been diagnosed as CBD were enrolled in this study. Patients were evaluated before and after the rTMS procedure regarding the motor, neuropsychometric and behavioral tests. The results of statistical analysis of behavioral and neuropsychometric evaluation were assessed via SPSS 18.0 package program. Data are expressed as mean, standard deviation. Before and after values of the groups were compared with the Wilcoxon sign rank test, and p<0.05 was considered significant. Results: We have provided strong preliminary evidence that the improvement in clinical parameters was associated with the normalizations of the theta activity and glucose metabolism. Conclusion: Our current results are consistent with some previous trials showing a strong association between DLPFC targeted rTMS and electrophysiological normalizations in the left DLPFC.Öğe FDG-PET scanning shows distributed changes in cortical activity associated with visual hallucinations in eye disease(Bentham Science Publ Ltd, 2019) Hanoğlu, Lütfü; Yıldız, Sultan; Çakır, Tansel; Hanoğlu, Taha; Yuluğ, BurakBackground and Objective: Charles Bonnet Syndrome (CBS) has been defined as complex visual hallucinations (CVH) due to visual loss. The underlying mechanism of CBS is not clear and the underlying pathophysiology of the visual hallucinations in CBS patients and pure visually impaired patients is still not clear. Methods: In our study, we have scanned three patients with eye disease and CBS (VH+) and three patients with eye disease without CBS (VH-) using FDG-PET. Results: Our results showed underactivity in the pons and overactivity in primary right left visual cortex and inferior parietal cortex in VH- patients and underactivity in left Broca, left inf frontal primary visual cortex and anterior and posterior cingulate cortex in VH+ patients relative to the normative 18F-FDG PET data that was taken from the database consisting of 50 age-matched healthy adults without neuropsychiatric disorders. Conclusion: From this distributed pattern of activity changes, we conclude that the generation of visual hallucination in CBS is associated with bottom-up and top-down mechanism rather than the generally accepted visual deafferentation-related hyperexcitability theory.Öğe Minocycline increases in-vitro cortical neuronal cell survival after laser induced axotomy(Bentham Science Publ Ltd, 2020) Yuluğ, Burak; Ozansoy, Mehmet; Alökten, Merve; Ozansoy, Muzaffer; Çankaya, Şeyda; Hanoğlu, Lütfü; Kılıç, ErtuğrulBackground: Antibiotic therapies targeting multiple regenerative mechanisms have the potential for neuroprotective effects, but the diversity of experimental strategies and analyses of non-standardised therapeutic trials are challenging. In this respect, there are no cases of successful clinical application of such candidate molecules when it comes to human patients. Methods: After 24 hours of culturing, three different minocycline (Sigma-Aldrich, M9511, Germany) concentrations (1 mu M, 10 mu M and 100 mu M) were added to the primary cortical neurons 15 minutes before laser axotomy procedure in order to observe protective effect of minocycline in these dosages. Results: Here, we have shown that minocycline exerted a significant neuroprotective effect at 1 and 100 mu M doses. Beyond confirming the neuroprotective effect of minocycline in a more standardised and advanced in-vitro trauma model, our findings could have important implications for future studies that concentrate on the translational block between animal and human studies. Conclusion: Such sophisticated approaches might also help to conquer the influence of humanmade variabilities in critical experimental injury models. To the best of our knowledge, this is the first study showing that minocycline increases in-vitro neuronal cell survival after laser-axotomy.Öğe More evidence for headache and spontaneous glabellar ecchymosis: Does the headache type or the treatment response matter? A neurovascular hypothesis(Wiley, 2019) Yuluğ, Burak; Işık, Doğan; Çankaya, Şeyda; Öktem, Ece O.; Hanoğlu, Lütfü[No abstract available]Öğe Power spectral density and coherence analysis of eye disease with and without visual hallucination(Elsevier Ireland Ltd, 2021) Yıldız, Sultan; Yuluğ, Burak; Kocabora, Mehmet Selim; Hanoğlu, LütfüObjectives: Charles Bonnet Syndrome (CBS) is a rare clinical condition which has been defined as complex visual hallucinations (CVH) due to visual loss. This study investigated differences in the EEG power spectral density (PSD) and magnitude-squared coherences between patients with eye disease and hallucinations (VH+), and the control subjects with eye disease without hallucinations (VH-). Methods: 19 scalp channels EEG was recorded in four VH+ (CBS) and four VH- subjects during an eyes-closed resting condition. Artefact-free epochs were analyzed to obtain PSD values in the delta, theta, alpha1, alpha2, beta1, beta2 and gamma frequency bands. Coherence values were calculated through inter-hemispheric and intra-hemispheric electrodes pairs of interest. All subjects were performed with neuropsychological and behavioral assessments to evaluate cognitive functions. Results: The VH + group had increase PSD in theta, beta2 and gamma bands in central, parietal and occipital (O2) areas. The synchronicity was altered particularly in parietal and frontal-parietal regions especially at theta and alpha1 respectively. Conclusions: The aberrant activity in occipital and parietal regions suggest the mechanism of CBS. This is a major electrophysiological study of understanding CBS and visual hallucinations.Öğe Preliminary findings on the role of high-frequency (5Hz) rTMS stimulation on M1 and pre-SMA regions in Parkinson's disease(Elsevier Ireland Ltd, 2020) Hanoğlu, Lütfü; Sarıcaoğlu, Mevhibe; Toprak, Güven; Yılmaz, Nesrin Helvacı; Yuluğ, BurakIt has been already shown that the motor symptoms of the Parkinson's Disease (PD) have been improved with high frequency rTMS although there is no consensus on the most suitable target brain localization for a maximal therapeutic efficacy. Here, we aimed to compare the therapeutic effect of high frequency (5Hz) rTMS stimulation on primary motor cortex (M1) and pre-supplementary (pre SMA) regions in patients with PD who were still on pharmacological treatment. The study included right-hand dominant16 patients with PD (5 females, 11 males) with demographically and clinically similar characteristics which were randomly assigned to group 1 (n=8) and group 2 (n=8) and received left M1 and the left pre-SMA rTMS procedure, respectively. Total and sequential motor scores of the Unified Parkinson's Disease Rating Scale (UPDRSmotor) were applied to all patients at the baseline and the patients were re-evaluated under the same clinical conditions one week after the end of the sessions. Comparisons of the UPDRS-motor scores between two groups yielded significant improvements after the rTMS on pre-SMA compared to M1 (M1 p=0.14; pre-SMA p=0.01). which were especially significant for the bradykinesia (p=0.04) and axial score related items (p=0.01). This is the first study that shows the effect of rTMS on pre-SMA and it appears to be a promising option in the treatment of PD.Öğe Repetitif Transkraniyal Manyetik Stimülasyon ile Alzheimer Hastalığında Hipokampal N-Asetilaspartat Düzeyinin ve Görsel Hafıza Skorlarının İyileştirilmesi(2024) Velioglu, Halil Aziz; Sayman, Dila; Hanoğlu, Lütfü; Ertan, Gulhan; Cankaya, Seyda; Yuluğ, BurakAlzheimer hastalığının (AH) patofizyolojisine yönelik yapılan son çalışmalar, hipokampal işlevsellikle ilgili çeşitli kognitif bozuklukları içermektedir. Bununla birlikte, mevcut klinik araştırmalar, AH’nin heterojen bilişsel spektrumunun tam kapsamını göz önünde bulunduramamakta ve kesin tanısal ve terapötik sonuçlar çıkarmak için gereken spesifik yöntemlerin eksikliğine neden olmaktadır. Bu, aynı zamanda AH’li insanlarda tanı ve tedavi rejimlerini uyarlamak için in-vivo metabolik ölçümlerini de içermektedir. Manyetik rezonans spektroskopisi ve tekrarlayan transkraniyal manyetik stimülasyon (rTMS), AH tedavisinde modifiye edilmesi gereken iki yeni tanı ve tedavi yaklaşımıdır. Bu çalışmada, rTMS tedavisi öncesi ve sonrası in-vivo hipokampal metabolitleri değerlendirerek AH’li kişilerde rTMS’nin altta yatan terapötik rolünü araştırmayı amaçladık. Önceki çalışmamızda fMRI verileri kullanılarak elde edilen verilere ve literatürde bildirilen referanslara dayanarak, bu çalışmada rTMS stimülasyonundan sonra hipokampal NAA verilerini kullanmaya karar verdik ve NAA seviyelerinin anlamlı derecede yükseldiğini gördük. Bildiğimiz kadarıyla, başka hiçbir çalışma, rTMS’nin AH’li insanlarda hipokampal metabolitler üzerindeki etkisini değerlendirmemiştir.Öğe The association between Hba1c levels, olfactory memory and cognition in normal, pre-diabetic and diabetic persons(Bentham Science Publishers, 2020) Yuluğ, Burak; Saatçi, Özlem; Işıklar, Aysun; Hanoğlu, Lütfü; Kılıç, Ulkan; Ozansoy, Mehmet; Kılıç, ErtuğrulBackground and Aim: Recent data have shown that olfactory dysfunction is strongly related to Alzheimer’s Disease (AD) that is often preceded by olfactory deficits suggesting that olfactory dysfunction might represent an early indicator of future cognitive in prediabetes. Methods: We have applied to a group of normal (n=15), prediabetic (n=16) and type 2 diabetic outpatients (n=15) olfactory testing, 1.5-T MRI scanner and detailed cognitive evaluation including the standard Mini-Mental State Examination (MMSE) form, Short Blessed Test (SBT), Letter Fluency Test (LFT) and the category fluency test with animal, Fruit and Vegetable Naming (CFT). Results: We have shown that Odour Threshold (OT), Discrimination (OD), and Identification (OI) scores and most cognitive test results were significantly different in the prediabetes and diabetes group compared to those in the control group. OD and OT were significantly different between the prediabetes and diabetes group, although the cognitive test results were only significantly different in the prediabetes and diabetes group compared to those in the control group. In evaluating the association between OI, OT, OD scores and specific cognitive tests, we have found, that impaired olfactory identification was the only parameter that correlated significantly with the SBT both in the pre-diabetes and diabetes group. Although spot glucose values were only correlated with OT, HbA1c levels were correlated with OT, OD, and OI, as well as results of the letter fluency test suggesting that HbA1c levels rather than the spot glucose values play a critical role in specific cognitive dysfunction. Conclusion: To the best of our knowledge, this is the first prospective study to demonstrate a strong association between olfactory dysfunction and specific memory impairment in a population with prediabetes and diabetes suggesting that impaired olfactory identification might play an important role as a specific predictor of memory decline. © 2020 Bentham Science Publishers.Öğe The effect of rifampicin on the neuronal cell survival in primary cortical neuron culture after laser axotomy(Alanya Alaaddin Keykubat Üniversitesi, 2019) Ozansoy, Mehmet; Coşkun, Ebru; Ozansoy, Muzaffer Beyza; Çankaya, Şeyda; Günal, Mehmet Yalçın; Bayraktaroğlu, Zübeyir; Hanoğlu, LütfüAim: Neurodegeneration caused by the axonal injury is a widely seen phenomenon in spinal cord and traumatic brain injuries. Due to the disintegration of the synaptic connection neurotrophic factors could not be transported retrogradely towards the cell body and the deprivation of the trophic factors lead to the degeneration and death of the injured neuron. Rifampicin is an antibiotic exhibiting several neuroprotective functions in various neurodegenerative conditions. Here we aim to investigate the acute neuroprotective effect of rifampicin in primary cortical neuron culture in which neurons are axotomized by laser axotomy. Methods: Neonatal male mice were used in order to isolate cortical neurons. Isolated primary cortical neurons were cultured. After 24 hours three different rifampicin concentrations (1 µM, 10 µM and 100 µM) were applied to the neurons and after 15 minutes of rifampicin addition, neurons were laser axotomized. Viability of the cells was evaluated by propidium iodide staining after 24 hours of axotomy. Results: Laser axotomy decreases the cortical neuron viability significantly by 80.45%, while rifampicin pre-treatment increases their viability in all three dosages in a statistically significant manner. Conclusion: Rifampicin has an acute neuroprotective effect on the viability of the laser axotomized cortical neurons.Öğe The Multifactorial Role of Pre-supplementary Motor Area Stimulation in the Freezing of Gait: An Alternative Strategy to the Classical Drug-Target Approach(2022) Sarıcaoğlu, Mevhibe; Hanoğlu, Lütfü; Toprak, Güven; Helvacı Yılmaz, Nesrin; Yuluğ, BurakIntroduction: The pre-supplementary motor area (Pre-SMA) plays a pivotal role in the control of voluntary motor control and freezing of gait (FOG) pathophysiological mechanism. Here, we aimed to modulate if the pre-SMA would have beneficial effects on motor and behavioural outcomes in freezing of gait. To test this hypothesis, we examined the left pre-SMA stimulating effect of repetitive Transcranial Magnetic Stimulation (rTMS) on motor, cognitive and behavioural parameters in Parkinson's patients with FOG. Methods: The study included 20 Parkinson's patients with FOG (3 females, 17 males) who received the left Pre-SMA rTMS procedure. The clinical assessments were performed on all patients at the baseline and the patients were re-evaluated under the same clinical conditions one week after the end of the sessions. Results & discussion: We found significant improvements in motor, cognitive and behavioural symptoms (p<0.05). The main finding of our study is that Pre-SMA is an attractive stimulation area leading to critical improvement of symptoms of Parkinson's patients with FOG. Conclusion: The high-frequency rTMS stimulation over the left preSMA has a restorative effect on the motor, cognitive and behavioural symptoms of Parkinson's patients with FOG.Öğe The therapeutic role of repetitive transcranial magnetic stimulation (rTMS) in parkinsonian visual hallucinations: Electrophysiological correlates(Elsevier Sci Ltd, 2019) Hanoğlu, Taha; Hanoğlu, Lütfü; Güntekin, Bahar; Aktürk, Tuba; Yuluğ, BurakWe have evaluated an 82 years old PD patient who has acutely developed VH secondary to acute visual loss that was associated with increased electroencephalographic activity in the gamma range over the parietal, occipital and frontal regions. In this respect, we have tested the therapeutic effect of occipital lobe oriented rTMS application and its electrophysiological correlates that led to significant improvement in the hallucinatory symptomatology of the patient after two weeks. We have revealed that the improved hallucinatory symptoms after rTMS application resolved completely after switching from the pramipexole treatment to L-Dopa indicating that there could be a combined therapeutic effect of L-Dopa and rTMS. Furthermore, Quantitative-Electroencephalography analysis has shown that the therapeutic effects of rTMS and L-Dopa were seen with the improvement of impaired gamma power spectrum. Although the main limitation of this report is that this a single case study and that these findings need to be replicated in a larger sample, e.g., as part of a controlled trial, our present findings help us to enlighten the unknown pathophysiological overlapping between the visual hallucinations in PD and Charles Bonnet Syndrome. Finally, our study revealed increased gamma coherence and power spectrum which is seen with visual hallucinations and improved after the application of 1 Hz rTMS on the occipital lobe. These findings together suggest that rTMS could be used as a therapeutic tool for parkinsonian complex VH and probably due affecting gamma coherence and power spectrum. (C) 2019 Elsevier Ltd. All rights reserved.Öğe Therapeutic Role of Repetitive Transcranial Magnetic Stimulation in Alzheimer's and Parkinson's Disease: Electroencephalography Microstate Correlates(2022) Hanoğlu, Lütfü; Toplutaş, Eren; Sarıcaoğlu, Mevhibe; Velioğlu, Halil Aziz; Yıldız, Sultan; Yuluğ, BurakIntroduction: The microstate analysis is a method to convert the electrical potentials on the multi-channel electrode array to topographical electroencephalography (EEG) data. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive method that can modulate brain networks. This study explores the pathophysiological changes through microstate analysis in two different neurodegenerative diseases, Alzheimer's (AD) and Parkinson's disease (PD), characterized by motor and cognitive symptoms and analysis the effect of rTMS on the impaired cognitive and motor functions. Materials and methods: We included 18 AD, 8 PD patients, and 13 age-matched controls. For both groups, we applied 5 Hz rTMS on the left pre-SMA in PD patients while 20 Hz rTMS on the left lateral parietal region in AD patients. Each patient was re-evaluated 1 week after the end of the sessions, which included a detailed clinical evaluation and measurement of EEG microstates. Results: At the baseline, the common findings between our AD and PD patients were altered microstate (MS) B, MS D durations and transition frequencies between MS A-MS B, MS C-MS D while global explained variance (GEV) ratio and the extent and frequency of occurrence of MS A, MS B, and MS D were separately altered in AD patients. Although no specific microstate parameter adequately differentiated between AD and PD patients, we observed significant changes in MS B and MS D parameters in PD patients. Further, we observed that Mini-Mental State Examination (MMSE) performances were associated with the transition frequencies between MS A-MS B and MS C-MS D and GEV ratio. After left parietal rTMS application, we have observed significantly increased visual memory recognition and clock drawing scores after left parietal rTMS application associated with improved microstate conditions prominent, especially in the mean duration of MS C in AD patients. Also, pre-SMA rTMS resulted in significant improvement in motor scores and frequency of transitions from MS D to MS C in PD patients. Conclusion: This study shows that PD and AD can cause different and similar microstate changes that can be modulated through rTMS, suggesting the role of MS parameters and rTMS as a possible combination in monitoring the treatment effect in neurodegenerative diseases.Öğe Therapeutic role of repetitive transcranial magnetic stimulation in alzheimer's and parkinson's disease: Electroencephalography microstate correlates(2022) Hanoğlu, Lütfü; Toplutaş, Eren; Sarıcaoğlu, Mevhibe; Velioğlu, Halil Aziz; Yıldız, Sultan; Yuluğ, BurakIntroductionThe microstate analysis is a method to convert the electrical potentials on the multi-channel electrode array to topographical electroencephalography (EEG) data. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive method that can modulate brain networks. This study explores the pathophysiological changes through microstate analysis in two different neurodegenerative diseases, Alzheimer's (AD) and Parkinson's disease (PD), characterized by motor and cognitive symptoms and analysis the effect of rTMS on the impaired cognitive and motor functions. Materials and MethodsWe included 18 AD, 8 PD patients, and 13 age-matched controls. For both groups, we applied 5 Hz rTMS on the left pre-SMA in PD patients while 20 Hz rTMS on the left lateral parietal region in AD patients. Each patient was re-evaluated 1 week after the end of the sessions, which included a detailed clinical evaluation and measurement of EEG microstates. ResultsAt the baseline, the common findings between our AD and PD patients were altered microstate (MS) B, MS D durations and transition frequencies between MS A-MS B, MS C-MS D while global explained variance (GEV) ratio and the extent and frequency of occurrence of MS A, MS B, and MS D were separately altered in AD patients. Although no specific microstate parameter adequately differentiated between AD and PD patients, we observed significant changes in MS B and MS D parameters in PD patients. Further, we observed that Mini-Mental State Examination (MMSE) performances were associated with the transition frequencies between MS A-MS B and MS C-MS D and GEV ratio. After left parietal rTMS application, we have observed significantly increased visual memory recognition and clock drawing scores after left parietal rTMS application associated with improved microstate conditions prominent, especially in the mean duration of MS C in AD patients. Also, pre-SMA rTMS resulted in significant improvement in motor scores and frequency of transitions from MS D to MS C in PD patients. ConclusionThis study shows that PD and AD can cause different and similar microstate changes that can be modulated through rTMS, suggesting the role of MS parameters and rTMS as a possible combination in monitoring the treatment effect in neurodegenerative diseases.Öğe Visual Object and Space Perception” Testinin Türkçe Versiyon Geçerlik ve Güvenirliği(Alanya Alaaddin Keykubat Üniversitesi, 2023) Dağlı, Beyza; Oğul, Özden Erkan; Tanrıverdi, Müberra; Hanoğlu, Lütfü; Altaş, Mustafa; Özdemir, GökhanAmaç: Klinikte görsel algısal bozukluğu değerlendiren birçok test geliştirilmiş olmasına rağmen Türkçe geçerlilik ve güvenilirliği bulunan testlerin yetersiz kaldığı görülmektedir. Görsel ve uzaysal algıyı ayrı ayrı değerlendiren “Visual Object and Space Perception (VOSP/Görsel Nesne ve Uzaysal Algı) Testi” hassas bir batarya olarak diğer görsel algısal testlerden ayrılmaktadır. Çalışmamızda inme geçiren bireyler ve sağlıklı bireylerde görsel-uzaysal işlevleri değerlendiren VOSP Testinin Türkçe kültürel adaptasyon, geçerlilik ve güvenilirlik analizinin yapılması amaçlanmıştır. Yöntem: Çalışmamıza sağ hemisfer lezyonuna bağlı inme tanısı almış 27 hasta birey ve 54 sağlıklı birey dahil edildi. Geçerliliğin incelenmesinde kriter geçerliği yönteminden yararlanıldı. Testin güvenilirliği için; iç tutarlılık, Cronbach Alpha ve test-tekrar test yöntemlerine başvuruldu. Bulgular: 81 katılımcı [45 (%55,6) kadın] dahil edildi. Yaş ortalaması 46,04±14,74 idi. VOSP testinin Türkçe versiyonu Cronbach Alfa katsayısına göre yeterli ve güvenilir bulundu (ICC=0,923). Sonuç: Çalışmamızın bulguları ışığında, VOSP Testinin Türkçe versiyonunun geçerli ve güvenilir bir ölçme aracı olduğu, bilimsel ve klinik çalışmalarda bu ölçekten yarar sağlanabileceği sonucuna ulaşıldı.
