Clinical Neuroscience

[Headache registry in Szeged: Experiences regarding to migraine patients]

PLANDER Máté1, TAJTI János2, VÉCSEI László2,3, SZOK Délia2

MAY 30, 2023

Clinical Neuroscience - 2023;76(5-6)

DOI: https://doi.org/10.18071/isz.76.0205

Journal Article

Szöveg nagyítása:

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[Using patient registries is essential both in clinical research and in medical practice. Headaches, more specifically migraines are one of the most common complaints that can detract the quality of a patient’s life and these complaints also have a significant socio-econo­mic effect. Our goal is to create a national Headache Registry and to also provide the pre-analysis of the registry’s database.

Our research is based on the national Multiple Sclerosis Registry, which we modified using the latest version of diagnostic criteria published by the International Headache Society. This clinical study contains data collected from patients suffering from migraines and currently receiving care at the Headache Outpatient Department at the Neurologic Clinic of the University of Szeged.

The data of 412 patients (363 wo­men and 49 men) suffering from migraine (migraine without aura: n = 313 and migraine with aura: n = 99) were added to the Headache Registry. The average age of participants was 44.1 ± 12.5 SD years. Regarding the attributes of migraine headaches we examined the following characteristics: localization, quality and intensity (based on the Visual Analogue Scale) of the pain, frequency (the number of headache days per month), medications (acute or prophylactic), comorbidities (depression, anxiety, hypertension, asthma, epilepsy and others), family history and the occurrence of stroke among patients.

Based on international expe­rience, patient registries are the most optimal systems for structured patient mo­nitoring. For high level management and long-term follow up of the patients the application of registries is essential. The registries include the detailed medical history and the diagnostic and therapeutic data of the patients, and they trace the changes during the follow up medical visits. Registries are able to record the entire course of the disease in digital way. The numerous data can be set out any time from the digital database. Extensive spread of patients’ registries is fundamental not only in every day clinical practice, but also in clinical research.]

AFFILIATIONS

  1. Kiskunhalasi Semmelweis Kórház, Neurológiai osztály, Kiskunhalas
  2. Szegedi Tudományegyetem, Szent-Györgyi Albert Orvostudományi Kar, Neurológiai Klinika, Szeged
  3. ELKH-SZTE Idegtudományi Kutatócsoport, Szeged

IRODALOMJEGYZÉK

  1. Schwedt TJ, Digre K, Tepper SJ, et al. The American Registry for Migraine Research: Research methods and baseline data for an initial patient cohort. Headache 2020;60:337-47.
    Crossref
  2. Schwedt TJ, Tassorelli C, Silberstein SD, et al. Guidelines of the In- ternational Headache Society for Clinic-Based Headache Registries, 1st edition. Cephalalgia 2022;42:1099-115.
    Crossref

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Clinical Neuroscience

[The new target population of stroke awareness campaign: Kindergarten students ]

FOLYOVICH András, SZABÓ Pál Tamás, MŰHELYI Viktória, PÁPAI György, CSATÓ Gábor, GYŐRFI Pál, FÁBIÁN Dóra, RÓKA Gabriella, KORDA Lívia, JARECSNY Tamás, JAN van der MERWE, PETE Kinga Nedda, BÁTYAI Éva, BÉRES-MOLNÁR Katalin Anna

[ Thrombolysis and/or thrombectomy have been proven effective in the treatment of acute ischemic stroke. Due to the narrow time window, the number of patients suitable for these treatments is low. The main limitation is the pre-hospital stage, few people call an ambulance in time. The delay may be caused by the population’s insufficient health knowledge, but also by the loneliness and isolation of the population most prone to stroke. Among the latter, there are many grandparents who spend considerable time with their grandchildren. This gave rise to the idea of educating even younger children about the symptoms of a stroke, enabling them to call an ambulance if necessary. To this end, we adapted the Angels Initiative project previously tested in Greece. The Hungarian pilot study Budapest District XII. took place in district kindergartens. The Angels’ original role-playing program could not be implemented due to the COVID epidemic, so the necessity called for a new, Hungarian version: the online “Stroke Ovi” program. We introduced this in several stages, and in the third we also carried out an impact study.

 We adapted the Angels Initiative’s international program and its Hungarian translation to our program. We prepared the original, live role-playing form, with a parent meeting in the selected “test kindergarten”. Due to the uncertainly lingering impact of the COVID epidemic, we reevaluated our plan, using the Hungarian storybook and take-home workbook created in the meantime, we developed our own online version in several kindergartens in Budapest. We held 10 and then 25 minute sessions a week for 5 weeks. In the third educational cycle, which always targets new groups, we already examined the impact of the program by taking pre- and post-tests, in which not only the children but also their parents participated. In addition to neurologists and kindergarten teachers, we also included psychologists and speech therapists in our work, because we believed that in a social environment that includes parents and children, results can only be achieved through multidisciplinary cooperation.

 In the third cycle of the program, tests were taken before (pre-test) and after (post-test) among children and their parents. We only took into account those answers where we received an evaluable answer in the survey before and after the program. Our most important results: 1. there was no negative change in any question, so it was not the case that the total score of any question in the pre-test was higher than in the post-test. 2. The children learned that not only adults can call the ambulance. 3. Before the program, all children were already aware that if “someone is very ill”, the ambulance should be called. 4. Among the questions about stroke symptoms, it is important that hemiparesis, facial paresis and speech/language disorder are clear symptoms for children. Based on the parental questionnaires, the knowledge of the adults can be judged to be very good. The same number of correct answers were received during the pre-test and the post-test, on the basis of which we could not calculate a transfer effect. However, it is important that the parents considered the program useful, motivating and important for the children, so cooperation can be expected in the future.

The Hungarian “Stroke Ovi” program has so far proven to be clearly effective. This was proven by the impact assessments even if, instead of the original role-playing game, we implemented it “only” online due to the COVID epidemic. This constraint also forced and created a new “Hungarian version”. Despite the small number of samples caused by the circumstances, we consider this positive effect to be measurable. However, as the main result and evidence, we evaluated the children’s reaction, which took shape in spontaneous drawings and displayed professional values in addition to positive emotional reactions, such as the drawing of ambulances, the recurring representation of the 112 number. With the involvement of the media, we think online education is also a good option in the series of stroke campaigns, but we think the original role-playing form is really effective. At the same time, we can see that the application of the new method requires great caution due to the education of developing children. For this reason, results can only be achieved through social and multidisciplinary cooperation involving neurologists, psychologists, kindergarten teachers, and parents.]

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Effects of the combined treatment of bilateral subthalamic nucleus stimulation and levodopa on balance and mobility in Parkinson’s disease

NAZAN ŞIMŞEK ERDEM, GÖKÇE Yağmur GÜNEŞ GENCER, TANJU UÇAR, SEHUR Sibel ÖZKAYNAK

Background and purpose – To evaluate the efficacy of the combined therapy of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) and dopaminergic medication on balance and mobility in patients with Parkinson’s disease (PD).

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[Verbal Episodic Memory Test]

RACSMÁNY Mihály, PAJKOSSY Péter, SZANDRA László, SZŐLLŐSI Ágnes

[The decline of episodic memory is one of the earliest cognitive markers of mild cognitive impairment and various types of dementia. Until today, however, there is no standardized Hun­garian episodic memory test that takes into account the characteristics of the Hungarian language. The study presents the structure and standardized use of a new memory test (Verbal Episodic Memory Test, VEMT) as well as normative data in Hungary. 

The VEMT is suitable for the comprehensive examination of verbal learning abilities in a broader sense, and more specifically, for the neuropsychological measurement of verbal list learning abilities. In the present study, we constructed a normative database consisting of data from 385 participants.

We showed that the VEMT is sensitive to demographic factors (e.g., age) which are linked to differences in episodic memory performance. Open access to the test is provided, and the normative scores are presented as well. 

The indicators of the test are suitable for drawing a learning curve, for showing the interaction of new and previously learned information (interference effects), and for measuring differences between free recall and cued recall. Furthermore, the test scores are appropriate for distinguishing the effects of different types of memory encoding forms (phonological, semantic, and episodic), for measuring the ability to reconstruct the presentation of a sequence (memory order information), for detecting the rate of forgetting, for measuring recognition abilities, and for detecting hippocampus-related mnemonic pattern separation and completion functions. ]

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Reliability and validity of the Turkish version of the 39-item Parkinson Disease Questionnaire

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This study aims to investigate the validity and reliability of the Turkish Version of the 39-item Parkinson Disease Questionnaire. A total of 100 patients with Parkinson’s disease who were admitted to the outpatient neurology clinic in Koc University and Istanbul University were enrolled. 39- item Parkinson Disease Questionnaire, Parkinson Disease Quality of Life Questionnaire, Unified Parkinson’s Disease Rating Scale, Hoehn-Yahr Scale, and Short Form Health Survey-36 were administered to all participants.

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Is autism spectrum disorder an inflammation?

NARALAN Sümeyra Yüksel , GÜL Hasan Abdulhakim , ALTUNKAYNAK Konca

In our study, we aimed to evaluate inflammation by measuring serum Adenosine deaminase and dipeptidyl peptidase IV levels of individuals diagnosed with autism spectrum disorder and to determine its relationship with the Childhood Autism Rating Scale.

37 children aged 2-12 years with a diagnosis of autism spectrum disorder and 27 children aged 2-12 years without any psychiatric disease were included in the study. Psychiatric examination and clinical evaluation according to DSM-5 diagnostic criteria for the diagnosis of autism spectrum disorder were performed on the children included in the study. The Childhood Autism Rating Scale was filled in by the researcher by interviewing the parents of the children diagnosed with autism spectrum disorder. 5 ml of venous blood samples were taken from the children in both groups in the morning on a full stomach.

There was no statistically significant difference between the groups in terms of age, gender, and sociodemographic data. While serum adenosine deaminase levels were found to be statistically significantly higher in the group with autism spectrum disorder, serum dipeptidyl peptidase IV levels were found to be significantly lower. A positive correlation was found between dipeptidyl peptidase IV and Childhood Autism Rating Scale.

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Are more nerve injections in the same session more effective in migraine treatment? 3-month follow-up results

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Peripheral nerve blockade techniques have been developed for both acute and pro- phylactic treatment of migraine. Our aim was to compare pain parameters between the groups of patients who only had greater occipital nerve blockade (GON), and those who also had blockade to the supraorbital nerve (SON) and infraorbital nerve (ION) together with greater occipital nerve blockade, in order to reduce pain more effectively in migraine patients.

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