Tıbbi Görüntüleme Teknikleri Bölümü Koleksiyonu
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- ItemExploring Cognitive Enhancements and Default Mode Network Connectivity in Relapsing-Remitting Multiple Sclerosis: Insights from a Prospective Study Investigating the MIND Diet(Sage, 2024-09) Demirel, Mert; Daşgın, Hacer; Acar, Nazire Pınar; Özçelik-Eroğlu, Elçin; Atabilen, Büşra; Ertuğrul, Aygün; Akdevelioğlu, Yasemin; Oğuz, Kader Karlı; Tuncer, Meryem Aslı; 396621The potential therapeutic impact of the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet on relapsing-remitting multiple sclerosis (RRMS) remains an underexplored area. Objectives/Aims: This study aims to evaluate the influence of the MIND diet on RRMS by examining neurological, cognitive, and functional magnetic resonance imaging (fMRI) parameters. Methods: Seventeen early-stage RRMS patients (aged 20-40, disease duration < 10 years, Beck Depression Inventory Score < 17) underwent MRI at baseline and following a 9-month adherence to the MIND diet. They were matched with 10 healthy controls. Diet adherence was assessed using the MIND Diet scale score. MRI encompassed structural and resting-state fMRI (RS-fMRI) sequences. Neurological evaluation (Expanded Disability Status Scale [EDSS], Timed 25-Foot Walk [T25W], 9-Hole Peg Test [9HPT]), and cognitive assessments (Mini-Mental State Examination [MMSE], Rey Auditory Verbal Learning Test [AVLT], phonemic and semantic fluency, forward and backward digit span tests [FDST, BDST]) were conducted. Functional connectivity was assessed using seed-based correlation (SBC) and global correlation by general linear model (GLM), focusing on Default Mode Network (DMN), Central Executive Network (CEN), Dorsal Attention Network (DAN), Salience Network (SN), Visual Network (VN), and Sensorimotor Network (SMN). Results: Patients exhibited high adherence to the diet throughout the 9-month period. Significant improvements were observed in dominant hand 9-HPT (p=0.023) and AVLT parameters (p<0.001), except delayed recall (p=0.982), following the intervention. Increased connectivity within the whole brain was noted in the left frontal orbital cortex of the 9th-month group compared to healthy controls (p=0.000005). Moreover, RRMS patients in the 9th-month group displayed enhanced functional connectivity in the bilateral caudate, bilateral pallidum, and right putamen within the DMN compared to baseline (p=0.000034). Conclusion: The findings of this study suggest potential cognitive benefits of the MIND diet, as evidenced by improvements in AVLT scores. Furthermore, the observed alterations in Default Mode Network (DMN) connectivity in RRMS patients following the dietary intervention indicate a promising avenue for further investigation into cognitive deficit management in this population
- ItemThe Relationship between Resistant Hypertension and Advanced Glycation End-Product Levels Measured Using the Skin Autofluorescence Method: A Case–Control Study(MDPI, 2023-10) Peker, Tezcan; Boyraz, Bedrettin; 313898Resistant hypertension is hypertension that cannot be controlled despite the use of three antihypertensive drugs, one of which is a diuretic. Resistant hypertension often coexists with advanced age, obesity, smoking, and diabetes. Advanced glycation end products (AGEs) are substances that are generated as a result of the glycation of proteins, lipids, and nucleic acids due to conditions such as hyperlipidemia, oxidative stress, and hyperglycemia. There are studies showing the relationships between AGE levels and aortic stiffness, hypertension, and microvascular and macrovascular complications in diabetes. In our study, we examined the relationship between resistant hypertension and AGE levels. Our study was planned as a case–control study, and 88 patients with resistant hypertension were included in the focus group, while 88 patients with controlled hypertension were included in the control group. The AGE levels of the patients were measured using the skin autofluorescence method. AGE levels were found to be significantly higher in patients with resistant hypertension than those recorded in the control group. A significant increase in AGE levels was also observed in patients with resistant hypertension and without diabetes compared with the control group. The levels of AGEs, which can be measured cheaply, noninvasively, and quickly with the skin autofluorescence method, may provide benefits in identifying these patients with resistant hypertension.
- ItemThe effect of being married on heart rate variability, an indicator of autonomic dysfunction: A retrospective study(Lippincott Williams & Wilkins, 2023) Akgümüş, Alkame; Balun, Ahmet; Peker, Tezcan; Boyraz, Bedrettin; 313898Heart rate variability (HRV) is a noninvasive assessment that reflects the autonomic functions of the heart and is known to be impaired in many diseases. In our study, we aimed to investigate the relationship between HRV and being married. The study included 104 patients, between the aged 20 to 40 years were included in the study. The patients were divided into 2 groups as 53 healthy married (group 1) and 51 healthy unmarried (group 2). 24-hour rhythm Holter recordings were performed on all married and unmarried patients. Group 1 had a mean age of 32 ± 5 years and 47.2% men, and group 2 had a mean age of 30 ± 5 years and 54.9% men. Standard deviation of normal to normal (SDNN) was 150 ± 40 versus 128 ± 30 (P = .003), SDNN index was 66 ± 20 versus 56 ± 12 (P = .004), the square root of the mean of the squares of the differences of the adjacent root mean square of successive differences (RMSSD) was 37 ± 10 versus 30 ± 10 (P < .001), percentage of successive R-R intervals that differ by more than 50 milliseconds (PNN50) was 13.5 ± 7 versus 8.5 ± 7 (P = .001), HF was 450 ± 270 versus 225 ± 130 (P < .001) found to be significantly less in the group 2. LF/HF ratio was 1.68 ± 0.65 versus 3.31 ± 1.56 (P < .001) found to be significantly higher in the group 2. In our study, it is possible to say that the sympathetic system effect on the heart was more dominant and the HRV was lower in the unmarried group.
- ItemThe role of advanced glycation end-product levels measured by skin autofluorescence in the development of mitral annular calcification(MDPI, 2023) Boyraz, Bedrettin; Peker, Tezcan; 313898As a person ages, mitral annular calcification develops in the mitral annulus with increasing frequency. Lipid deposition, inflammation, and aging-related degeneration have been cited as potential causes of this pathophysiology, though there is currently no conclusive evidence to support this. AGEs accumulate in tissues due to the glycation of proteins and lipids, increasing the release of proinflammatory cytokines secondary to oxidative stress through the AGE receptor. The AGE levels increase in diabetic microvascular complications and degenerative aortic valve disease. Our study was planned prospectively as a case–control study involving 94 MAC-positive patients and 94 MAC-negative patients. The demographics, echocardiographic data and AGE levels of the patients were measured and recorded using the skin autofluorescence method. AGE levels were significantly higher in the MAC-positive patient group (3.2 vs. 2.7; p < 0.001). The AGE levels were observed as an independent predictor of MAC development in a regression analysis (OR: 8.05, 95% CI: 3.74–17.33, p < 0.001). In a ROC-curve analysis, the AUC was 0.79 (95% CI: 0.72–0.85). At a cut-off value of 2.7, 79.7% sensitivity and 69.1% specificity were observed. AGE levels can be used to cheaply, easily and non-invasively identify patients at risk of developing MAC.
- ItemShort-term prognostic value of the culprit-SYNTAX score in patients with acute myocardial infarction(MDPI, 2023) Peker, Tezcan; Boyraz, Bedrettin; 313898Background: The SYNergy between Percutaneous Coronary Intervention with TAXus and Cardiac Surgery (SYNTAX) score is a scoring system that helps to decide on surgery or percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (MI), and studies are showing the prognostic value of this scoring system in both MI and coronary artery disease patients undergoing PCI. In acute coronary syndrome (ACS) patients, the infarct-related artery and the complexity of the lesions are also important in terms of mortality and morbidity. Our study aimed to determine the prognostic value of the culprit vessel’s SYNTAX score (cul-SS) in patients presenting with MI. Methods: In our study, 1284 patients presenting with MI were analyzed retrospectively. The SYNTAX scores and cul-SS of the patients were calculated. In-hospital and 30-day deaths and major complications were accepted as primary outcomes. The SYNTAX scores and cul-SS were compared in terms of predicting primary outcomes. Conclusions: Major complications were observed in 36 (2.8%) patients, death in 42 (3.3%) patients, and stent thrombosis in 24 (1.9%) patients. The area under the curves for SYNTAX and cul-SS for predicting primary outcomes is 0.64 and 0.68 (p = 0.026), respectively. Cul-SS was as successful as the SYNTAX score in predicting stent thrombosis and was superior in predicting short-term death and major complications.
