Clinical Neuroscience

[Account about scientific meeting of Környey Society in 2014]

KOPA János

SEPTEMBER 30, 2014

Clinical Neuroscience - 2014;67(09-10)

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Clinical Neuroscience

[Grey matter atrophy in patients suffering from multiple sclerosis]

KINCSES Tamás Zsigmond, TÓTH Eszter, BANKÓ Nóra, VERÉB Dániel, SZABÓ Nikoletta, CSETE Gergő, FARAGÓ Péter, KIRÁLY András, BENCSIK Krisztina, VÉCSEI László

[White matter lesions are defining characteristics of multiple sclerosis (MS), whereas grey matter involvement is a less recognised attribute. Recent investigations using dedicated imaging approaches have made it possible to depict cortical lesions. Additionally, grey matter atrophy may be estimated using various methods. Several studies have suggested that grey matter atrophy closely correlates to clinical disability. In this review we have collected information on grey matter atrophy in MS and the effect of disease modifying therapies upon brain atrophy.]

Clinical Neuroscience

[The relevance of traumatic life events in schizophrenia spectrum disorders]

KOCSIS-BOGÁR Krisztina, PERCZEL FORINTOS Dóra

[The central goal of this manuscript was to review literature about the interconnections of traumatic life events and symptoms of schizophrenia spectrum of the last 15 years. First of all, the stress-diathesis model and the traumagenic neurodevelopmental model are shortly presented. Psychological effects of traumas and specific psychotic symptoms in connection with traumatic events are discussed. The course of the disease in patients affected by previous traumas and possible mediating factors are also addressed. Studies of both clinical and community samples are cited. It was also our aim to review literature about the neurobiological and neurocognitive processes in people affected by schizophrenia and/or traumatic life events. The role of prefrontal and medial temporal regions are explored with a special emphasis on contextual memory and hippocampal functioning. Finally, the possible effects of exploring traumatic life events on the treatment of schizophrenia are discussed.]

Clinical Neuroscience

[Complex approaches to study complex trait genetics in multiple sclerosis]

BERNADETTE Kalman

[Multiple sclerosis (MS) is a complex trait disorder defined by several genes and their interactions with environmental factors. A comprehensive exploration of the susceptibility variants had not been feasible until recently when new developments in biotechnology and bioinformatics made possible sequencing of the whole human genome, cataloguing of nucleotide variants and alignments of these variants in haplotypes. Earlier observations from epidemiological, candidate gene and linkage studies provided ample evidence to support a complex genetic determination of MS. New biotechnology and bioinformatics resources have been recently applied to further successful explorations of the disease. These efforts were paralleled by more careful and reliable ascertainments of disease phenotypes, collaborations among specialized centers to generate sufficient sample size and involvement of clinician-scientists capable of working both on the clinical and scientific study sides. Data obtained from the whole genome association studies (GWAS) elevated our understanding of MS genetics to a new level by identifying an extensive list of genetic determinants. Pathway analyses of MS-associated variants provided evidence to support the immune etiology of the disease. Future research will likely explore how environmental factors interact with the genome, and contribute to the abnormal immune activation and inflammation. This review summarizes the outcomes of MS genetic explorations including those of recent GWAS, and highlights practical consequences of genetic and genomic studies by pointing out as to how the derived data facilitate further elucidation of MS pathogenesis. A better understanding of disease processes is necessary for future advancements in therapeutics and the development of disease prevention strategies.]

Clinical Neuroscience

[Mechanism of the “dark” axonal degeneration in the central nervous system]

PÁL József, GALLYAS Ferenc

[Background and purpose - In the central nervous tissue, two types of transsection-resulted axonal degeneration are generally accepted: “watery” and “dark”. The present paper deals with the assumption that the mechanism of this kind of “dark” axonal degeneration has a relationship with that of the “dark” neuronal degeneration. Methods - A minute stab wound is inflicted in the parietal cortex of the rat brain. From 1 h to 3 months postinjury, the resulted ultrastructural events in two distant regions of the corticospinal tract (internal capsule and C3 region of the corticospinal tract) are studied. Results - As a novel finding, the first morphological process of “dark” axonal degeneration was found to consists in a striking reduction of the distances between neighboring neurofilaments, which were readily distinguishable and apparently undamaged. This pattern (compacted ultrastructure) persisted for hours. By day 1 postinjury, the compacted axoplasmic elements aggregated into a homogenous and dense (“dark”) mass in which hardly any ultrastructural elements could be distinguished. Surrounded by apparently normal or mildly abnormal myelin sheat, this mass underwent a non-isotropic shrinkage during the next three months. Morphological signs of phagocytosis were insignificant. Conclusion - The ultrastructural events during the first day post-injury suggest a non-enzymatic mechanism as an alternative to the prevailing molecular-biological mechanism.]

Clinical Neuroscience

[P-wave dispersion doesn’t increase in patients with epilepsy]

SENOL Güney Mehmet, ÖZMEN Namik, YASAR Halit, TEKELI Hakan, ÖZDAG Fatih, SARACOGLU Mehmet

[Aim - Epileptic seizures have occasionally been associated with cardiac conditions as atrioventricular blocks, long QT syndrome etc. P-wave dispersion (PWD), which is the difference between the longest (P max) and shortest P-wave duration (P min), is considered as a forerunner of atrial fibrillation. In this study, we investigated P-wave dispersion (PWD) in epileptic patients; based on the hypothesis that microthromboembolism may occur in atrial fibrillation. Methods - Seventy five patients with mixed types of epilepsy and 50 age and sex matched healthy individuals were included into the study. P max, P min and PWD values were calculated for each subject from an ECG. Results - The mean age of subjects in the epilepsy group and control group were similar (p>0.05). P max in patients with epilepsy was 125.1±0.7 ms, P min was 67.3±10.3 ms, and PWD was 57.6±8.3 ms while these values in the control group were 116.8±11.0 ms, 66.5±5.5 ms and 46.8±7.1 ms, respectively. There were no statistically significant difference between two groups (p>0.05). Conclusions - PWD does not increase in patients with mixed types of epilepsy. Therefore we believe that microthromboembolism duo to atrial fibrillation can’t cause epileptic seizures in patients with no structural heart disease.]

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Hypertension and nephrology

[Association between cyclothymic affective temperament and hypertension]

NEMCSIK János, BATTA Dóra, KŐRÖSI Beáta, RIHMER Zoltán

[Affective temperaments (cyclothymic, hypertymic, depressive, anxious, irritable) are stable parts of personality and after adolescent only their minor changes are detectable. Their connections with psychopathology is well-described; depressive temperament plays role in major depression, cyclothymic temperament in bipolar II disorder, while hyperthymic temperament in bipolar I disorder. Moreover, scientific data of the last decade suggest, that affective temperaments are also associated with somatic diseases. Cyclothymic temperament is supposed to have the closest connection with hypertension. The prevalence of hypertension is higher parallel with the presence of dominant cyclothymic affective temperament and in this condition the frequency of cardiovascular complications in hypertensive patients was also described to be higher. In chronic hypertensive patients cyclothymic temperament score is positively associated with systolic blood pressure and in women with the earlier development of hypertension. The background of these associations is probably based on the more prevalent presence of common risk factors (smoking, obesity, alcoholism) with more pronounced cyclothymic temperament. The scientific importance of the research of the associations of personality traits including affective temperaments with somatic disorders can help in the identification of higher risk patient subgroups.]

Lege Artis Medicinae

[Focus on Lege Artis Medicinae (LAM)]

VASAS Lívia, GEGES József

[Three decades ago, LAM was launched with the goal of providing scientific information about medicine and its frontiers. From the very beginning, LAM has also concerned a special subject area while connecting medicine with the world of art. In the palette of medical articles, it remained a special feature to this day. The analysis of the history of LAM to date was performed using internationally accepted publication guidelines and scientific databases as a pledge of objectivity. We examined the practice of LAM if it meets the main criteria, the professional expectations of our days, when publishing contents of the traditional printed edition and its electronic version. We explored the visibility of articles in the largest bibliographic and scientific metric databases, and reviewed the LAM's place among the Hun­ga­rian professional journals. Our results show that in recent years LAM has gained international reputation des­pite publishing in Hungarian spoken by a few people. This is due to articles with foreign co-authors as well as references to LAM in articles written exclusively by foreign researchers. The journal is of course full readable in the Hungarian bibliographic databases, and its popularity is among the leading ones. The great virtue of the journal is the wide spectrum of the authors' affiliation, with which they cover almost completely the Hungarian health care institutional sys­tem. The special feature of its columns is enhanced by the publication of writings on art, which may increase Hungarian and foreign interest like that of medical articles.]

Lege Artis Medicinae

[A short chronicle of three decades ]

KAPRONCZAY Katalin

[Hungarian professional periodicals started quite late in European context. Their publish­ing, editing and editorial philosophy were equally influenced by specific historical and political situations. Certain breaking points of history resulted in termina­tion of professional journals (War of In­de­pendence 1848-1849, First and Se­cond World Wars), however there were pe­riods, which instigated the progress of sciences and founding of new scientific journals. Both trends were apparent in years after the fall of former Hungarian regime in 1990. The structure of book and journal publishing has changed substantially, some publishers fell “victim” others started successfully as well. The latters include the then-established publishing house Literatura Medica and its own scientific journal, Lege Artis Me­di­cinae (according to its subtitle: New Hun­garian Medical Herald) issued first in 1990. Its appearance enhanced significantly the medical press market. Its scientific publications compete with articles of the well-established domestic medical journals however its philosophy set brand-new trends on the market. Concerning the medical community, it takes on its problems and provides a forum for them. These problems are emerging questions in health care, economy and prevention, in close interrelation with system of public health institutions, infrastructure and situation of those providing individual health services. In all of them, Lege Artis Medicinae follows consequently the ideas of traditional social medicine.]

Clinical Neuroscience

[Interdisciplinary approach of vestibular system impairment]

PONGRÁCZ Endre

[In the first part of this review the definition of vertigo/dizziness was discussed. The major difference between the two signs is the exsistence of the direction, which is specific for vertigo. Dizziness is a frequent complaint in the clinical practice. Its frequency is increasing with advance of age, to intimate the play of declining cognitive process in the pathogenesis of its. The popular health significance of vertigo is in the rowing number of the patients. The onset of the most cases with acute vertigo appears between secundums and minutes so the patients will be provided in circumstances of emergency department. First of all three form schould be take into account: neuronitis vestibularis, benign paroxysmal positional vertigo and Meniere syndrome. Without tipical periferal signs of vertigo, central cause should be searched, principally stroke (lysis possibility). The differential diagnose of the different dizzeness/vertigo forms according to the elapsed time of the onset or congenital and acquired nystagmus was created in tables. The recommendations of the therapy of acute and chronic dizziness/ vertigo syndroms are, lack of results of evidence based trials doubtful. The more often used drugs based on clinical trials are discussed as vinpocetine, betahistine and piracetam. The in vitro and in vivo data suggest that the last molecule is eligible to use both in periferal and central type of vertigo syndroms.]

Clinical Neuroscience

Evaluation of anxiety, depression and marital relationships in patients with migraine

DEMIR Fıgen Ulku, BOZKURT Oya

Aim - The aim of this study was to evaluate the frequency and characteristics of attacks in patients with migraine, to determine the effects of anxiety or depressive symptoms, and to evaluate the marital relationships of patients with migraine. Method - Thirty patients who were admitted to the neurology outpatient clinic of our hospital between July 2018 and October 2018 and were diagnosed with migraine according to the 2013 International Headache Society (IHS) diagnostic criteria were included in this cross-sectional study. Age, sex, headache frequency and severity, depressive traits, marital satisfaction and anxiety status were examined. We used the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Maudsley Marital Questionnaire (MMQ) and Visual Analogue Scale (VAS) for measuring relevant parameters. Results - The mean severity of migraine pain according to VAS scale was 6.93 ± 1.41 and the mean number of migraine attacks was 4.50 ± 4.24. The mean BDI score of the patients was 12.66 ± 8.98, the mean MMQ-M score was 19.80 ± 12.52, the mean MMQ-S score was 13.20 ± 9.53, the mean STAI-state score was 39.93 ± 10.87 and the mean STAI-trait score was 45.73 ± 8.96. No significant correlation was found between age, number of migraine attacks, migraine duration, migraine headache intensity, and BDI, STAI and MMQ scores (p>0.05). But there was a positive correlation between MMQ-S and scores obtained from the BDI and STAI-state scales (p<0.05). Conclusion - In this study more than half of the migraine patients had mild, moderate or severe depression. A positive correlation was found between sexual dissatisfaction and scale scores of depression and anxiety.