Researcher: Özer, Fahriye Feriha
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Özer, Fahriye Feriha
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Publication Metadata only The correlation of non-motor symptoms and sleep on balance in Parkinson's disease patients with normal cognition and mild cognitive impairment(Springer London Ltd, 2021) Sariçaoğlu, Mevhibe; Yılmaz, Nesrin Helvacı; Hanoğlu, Lütfü; N/A; Özer, Fahriye Feriha; Faculty Member; School of Medicine; N/ABackground Parkinson's disease (PD) is characterized by non-motor symptoms (NMS) as well as by motor symptoms. Together with the impairment of cognitive functions, NMS and sleep also affect motor symptoms negatively. The aim of our study is to examine the correlation of NMS and sleep on balance in PD patients with normal cognition (PD-NC) and with mild cognitive impairment (PD-MCI). Methods A total of 69 patients were included in our study. Using the Standardized Mini-Mental State Examination, participants were divided into 2 groups, PD-NC and PD-MCI. Patients were assessed with the Unified Parkinson's Disease Rating Scale (UPDRS), the Berg Balance Scale (BBS), the Tinetti Balance Assessment Tool (TBAT), the Non-Motor Symptoms Questionnaire (NMSQ), and the Parkinson's Disease Questionnaire (PDQ-39). Results PD-MCI patients had statistically significant worse motor symptoms and more balance disorder compared to PD-NC (UPDRS: p = 0.009; BBS: p = 0.010; TBAT: p = 0.004). PD-MCI patients had greater severity of non-motor symptoms and worse sleep quality than the PD-NC group (NMSQ-total: p = 0.02; NMSQ-sleep total: p = 0.01). The evaluation has shown that with a diagnosis of MCI, NMS, and sleeping problems were correlated, and the correlation was associated with impairment of the balance function. While being more pronounced in the PD-MCI group, quality of life was affected in both groups (p < 0.05). Conclusion Our data demonstrate a negative effect on the balance function in patients with cognitive impairment suffering increased NMS and sleeping disorders. Treatment of these patients needs to concentrate on NMS and cognitive functions as much as on motor symptoms.Publication Metadata only Jumping stump(N/A, 2020) N/A; N/A; Çakmak, Özgür Öztop; Eren, İlker; Aygün, Murat Serhat; Özer, Fahriye Feriha; Ertan, Fatoş Sibel; Faculty Member; Faculty Member; Teaching Faculty; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 299358; 168021; 291692; N/A; 112829N/APublication Metadata only Validity and reliability of the Turkish version of the international restless legs syndrome study group rating scale(Alanya Alaaddin Keykubat Üniversitesi, 2019) Ay, Elif; Yılmaz, Nesrin Helvacı; Düz, Özgü Arıcı; N/A; Özer, Fahriye Feriha; Faculty Member; School of Medicine; N/AAim: The purpose of this study is to prepare the Turkish version of the International Restless Legs Syndrome (RLS) Study Group Rating Scale and to investigate its validity and reliability. Materials and Methods: A total of 89 individuals with RLS were included. These subjects were divided into two groups: A pilot study group (n=20) and a study group (n=69). The scale was translated into and adjusted for Turkish and was applied to the groups. Results: In the analysis conducted to test the factor structure of the scale, it was clearly seen that the items were collected under two factors and that the two factors in total accounted for 68.19% of the variance. The Kaiser-Meyer-Olkin (Kaiser-Meyer-Olkin) coefficient for validity of the scale was 0.84 and Bartlett Sphericity index was significant with p<0.05. The Cronbach's Alpha coefficient, which determined the reliability of the scale, was 0.0896. Conclusions: This study demonstrated that the Turkish version of this scale that is frequently used for scientific and clinical trials is valid. / ÖZ Amaç: Bu çalışmanın amacı, Uluslararası Huzursuz Bacaklar Sendromu (HBS) Çalışma Grubu Şiddet Ölçeği’nin Türkçe versiyonunu hazırlayarak geçerlilik ve güvenirliğini araştırmaktır. Materyal ve Metod: Çalışmaya toplamda 89 HBS’li birey alındı. Hastalar iki gruba ayrıldı: pilot çalışma grubu (n=20), çalışma grubu (n=69). Türkçe çeviri ve düzenlemeleri yapılan ölçek gruplara uygulandı. Sonuç: Ölçeğin faktör yapısını test etmek için yapılan analizde maddelerin iki faktör altında toplandığı ve iki faktörün toplamda varyansın %68,19’unu açıkladığı görülmektedir. Ölçeğin geçerliliği için saptanan KMO (Kaiser-Meyer-Olkin) katsayısı 0.84, Bartlett Küresellik indeksi p<0.05 olarak anlamlı bulundu. Ölçeğin güvenilirliğini belirlemek amacıyla elde edilen Cronbach’s Alpha katsayısı 0.896’dır. Tartışma: Bu çalışmada bilimsel ve klinik çalışmalarda sık kullanılan bu ölçeğin Türkçe versiyonu gösterilmiştir.Publication Metadata only The relationship between pain, and freezing of gait and falls in parkinson's disease(Turkish Neuropsychiatry Assoc-Türk Nöropsikiyatri Derneği, 2020) Helvacı Yılmaz, Nesrin; Sarıcaoğlu, Mevhibe; Arıcı Düz, Özge; Polat, Burcu; Eser, Hale Yapıcı; Özer, Fahriye Feriha; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 134359; N/AIntroduction: To investigate the relationship between pain, freezing of gait (FOG) and falls in Parkinson's Disease (PD). Methods: The study included 110 PD patients. The Unified PD Rating Scale (UPDRS) and Hoehn and Yahr Scale were used to evaluate disease severity. The patients self-reported occurrence of FOG and falls, and the FOG Questionnaire was administered to evaluate the severity of FOG. A visual analog scale (VAS) was used to measure the severity of pain and pain localization was self-reported by the patients. Results: Fifty-eight of the patients had FOG and 43 experienced falls. Among the patients, 42 had no pain, whereas 35 had lower extremity pain. Higher UPDRS motor and FOG scores, and advanced-stage disease were noted in significantly more of the patients with FOG and falls. VAS scores were not affected by the presence of FOG or falls. There was a positive correlation between the severity of FOG and VAS score in the male patients (r=0.308; p=0.010). More patients with falls had lower extremity pain than those without falls (r=0.308; p=0.010). Discussion: Patients with FOG and falls had more severe motor findings. Pain is correlated with both FOG and falls. Further investigations should be done to understand the mechanism of this relationship to prevent the motor complications in advanced PD.Publication Open Access Effect of bladder dysfunction on development of depression and anxiety in Parkinson's disease(PAGEpress, 2021) Benli, Erdal; Yılmaz, Nesrin Helvacı; Düz, Özge Arıcı; Yüce, Ahmet; Çırakoğlu, Abdullah; Özcan, Tuba Şaziye; Özer, Fahriye Feriha; Faculty Member; Koç University HospitalObjectives: Parkinson's disease (PD) often presents with movement disorder. However, besides motor complaints, there are many complaints such as anxiety, depression, urinary complaints and constipation. The aim of this study was to investigate whether neurogenic lower urinary dysfunction (NLUD), which is frequently seen in PD, has an effect on the development of anxiety and depression in these patients. Materials and methods: the study included 32 males (66.6%) and 16 females (33.3%); in total 48 subjects were registered. For the diagnosis and severity of PD, the UK Parkinson's Disease Society Brain Bank Criteria, Unified Parkinson's Disease Rating Scale (UPDRS) and the Hoehn-Yahr scale were used. Urological evaluation was performed using history, physical examination, laboratory tests and standard forms such as IPSS and OAB-V8. Results: there was no difference between the genders in terms of duration, severity and NLUD (p > 0.05). The incidence of anxiety and depression in PD patients was 62.8% and 72.1%, respectively. The prevalence of NLUD was 67.4% and depression and anxiety was found to increase (1.06 and 1.28 times, respectively) in relation to NLUD. In particular, there was a relationship between storage lower urinary tract symptoms and anxiety and depression development (p < 0.05). Conclusions: as expected, it was found that the incidence of NLUD, anxiety and depression was increased in PD. In addition, NLUD was found to be a risk factor for the development of anxiety and depression. Therefore, it is concluded that NLUD, which can potentially cause important complications, as well as motor complaints, should be closely monitored and treated in PD patients.Publication Open Access Cognitive impairment in Parkinson's disease is reflected with gradual decrease of EEG Delta Responses during auditory discrimination(Frontiers, 2018) Güntekin, Bahar; Hanoğlu, Lütfü; Güner, Dilan; Yılmaz, Nesrin H.; Çadırcı, Fadime; Mantar, Nagihan; Aktürk, Tuba; Emek-Savaş, Derya D.; Yener, Görsev; Başar, Erol; N/A; Özer, Fahriye Feriha; Faculty Member; School of MedicineParkinson's disease (PD) is a neurodegenerative disease that is characterized by loss of dopaminergic neurons in the substantia nigra. Mild Cognitive impairment (MCI) and dementia may come along with the disease. New indicators are necessary for detecting patients that are likely to develop dementia. Electroencephalogram (EEG) Delta responses are one of the essential electrophysiological indicators that could show the cognitive decline. Many research in literature showed an increase of delta responses with the increased cognitive load. Furthermore, delta responses were decreased in MCI and Alzheimer disease in comparison to healthy controls during cognitive paradigms. There was no previous study that analyzed the delta responses in PD patients with cognitive deficits. The present study aims to fulfill this important gap. 32 patients with Parkinson's disease (12 of them were without any cognitive deficits, 10 of them were PD with MCI, and 10 of them were PD with dementia) and 16 healthy subjects were included in the study. Auditory simple stimuli and Auditory Oddball Paradigms were applied. The maximum amplitudes of each subject's delta response (0.5-3.5 Hz) in 0-600 ms were measured for each electrode and for each stimulation. There was a significant stimulation x group effect [F(df = 6; 88 = 3,21; p < 0.015; eta(2)(p) = 0.180], which showed that the difference between groups was specific to the stimulation. Patients with Parkinson's disease (including PD without cognitive deficit, PD with MCI, and PD with dementia) had reduced delta responses than healthy controls upon presentation of target stimulation (p < 0.05, for all comparisons). On the other hand, this was not the case for non-target and simple auditory stimulation. Furthermore, delta responses gradually decrease according to the cognitive impairment in patients with PD. Conclusion: The results of the present study showed that cognitive decline in PD could be represented with decreased event related delta responses during cognitive stimulations. Furthermore, the present study once more strengthens the hypothesis that decrease of delta oscillatory responses could be the candidate of a general electrophysiological indicator for cognitive impairment.Publication Open Access Parkinson hastalığında apatinin motor ve non-motor bulgularla ilişkisi(Galenos Yayınevi, 2019) Gürbüz, Melek; Akdağ, Gönül; Düz, Özge Arıcı; Çokar, Özlem; Hanoğlu, Lütfü; N/A; Özer, Fahriye Feriha; Faculty Member; School of MedicineAim: it has been shown that motor symptoms, as well as non-motor symptoms, significantly affect the quality of life of patients with idiopathic Parkinson's disease. In our study, the association of apathy, one of the NMS, with motor and non-motor symptoms was investigated. Methods: patients with stage 1-3 IPH according to the Hoehn-Yahr Scale (H&Y) were included in the study. Patients who received dementia diagnosis according to the DSM IV criteria were excluded from the study. The patients were evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS), non-motor symptoms Questionnaire (NMSQ), Geriatric Depression Scale (GDS), and the revised diagnostic criteria for apathy. Results: apathy was found in 26 of 68 patients who were included in the study. Patients with and without apathy were compared in terms of age, clinical and demographic characteristics, L-dopa equivalent doses, depression, and NMSQ scores. The group of patients with apathy consisted of nine females and 17 males and the mean age was 64.3 +/- 7.7 years. The non-apathy group included 25 females and 17 males and the mean age was 66.8 +/- 9.1 years. There was no statistically significant difference between the groups in terms of age, education, age at onset, duration of illness and L-dopa equivalent doses. The male-to-female ratio was significantly higher in the apathy group. The mean GDS and NMSQ scores in the apathy group were significantly higher than in the non-apathy group. There was a statistically significant difference between the groups in H&Y stage and total UPDRS and subscales scores. It was noteworthy that the rate of stage 3 patients was higher in the group of patients with apathy. The number of patients having bradykinesia in the apathy group and the number of patients having tremor in the group without apathy was higher. Conclusion: our study showed that apathy, one of the non-motor symptoms, was more prominent in male gender, associated with UPDRS scores, clinical stage and bradykinesia, and accompanied by depression. / Amaç: İdiyopatik Parkinson hastalığında (İPH) motor semptomlar kadar non-motor semptomların (NMS) da yaşam kalitesini önemli ölçüde etkilediği belirlenmiştir. Çalışmamızda, NMS’lerden biri olan “apati”nin motor ve NMS’lerle ilişkisi araştırılmıştır. Yöntemler: çalışmaya, İPH tanısı alan, Hoehn-Yahr Skalasına (H&Y) göre evre 1-3 arası olan hastalar dahil edildi. DSM-IV kriterlerine göre demans tanısı alan hastalar çalışma dışı bırakıldı. Hastalar, Bileşik Parkinson Hastalığı Değerlendirme Ölçeği (BPHDÖ), Non-motor Belirtiler Anketi (NMSQ), Geriatrik Depresyon Ölçeği (GDÖ), Modifiye Apati Klinik Tanı Kriterleri uygulanılarak değerlendirildi. Bulgular: çalışmaya alınan 68 hastanın 26’sında apati varken 42’sinde apati saptanmadı. Her iki grup yaş, klinik, demografik özellikler, aldıkları eşdeğer L-Dopa dozları, depresyon ve NMS test puanları açısından birbiri ile karşılaştırıldı. Apatisi olan grubun dokuzu kadın, 17’si erkekti ve yaş ortalamaları 64,3±7,7 yıl idi. Apatisi olmayan grup 25 kadın, 17 erkek hastadan oluşmaktaydı ve yaş ortalamaları 66,8±9,1 yıl olarak saptandı. Gruplar arasında yaş ortalaması, eğitim düzeyi, hastalık başlangıç yaşı, hastalık süresi ve eşdeğer L-Dopa dozları arasında istatistiksel olarak anlamlı fark saptanmadı. Apatisi olan grupta erkek cinsiyet oranı anlamlı yüksekti, bu grubun GDÖ ve NMSQ ortalamaları diğer gruba göre anlamlı yüksek saptandı. Grupların H&Y evre oranlarında ve BPHDÖ toplam puan ve alt ölçeklerinde apatisi olan grupta istatistiksel olarak anlamlı fark bulundu. Apatisi olan grubun evre 3 yüksekliği dikkati çekmiştir. Apatisi olan grubun bradikinezi oranı, olmayan grubun tremor oranı daha yüksek saptandı. Sonuç: çalışmamızda, NMS’lerinden biri olan apatinin, erkek cinsiyette daha belirgin olduğu, BPHDÖ skorları, klinik evresi ve bradikinezi ile ilişkili olduğu ve depresyonun eşlik ettiği saptanmıştır.Publication Open Access How does entacapon affect homocysteine levels?(Galenos Yayınevi, 2021) Akdağ, Gönül; Bedir, Mithat; Çokar, Özlem; Balcı, Belgin Petek; Gül, Gülsün; Özer, Fahriye Feriha; Faculty Member; Koç University HospitalObjective: to determine homocysteine, vitamin B12, and folate levels in patients with Parkinson's disease and to investigate the effect of entacapone use on homocysteine levels. Materials and methods: the records of patients who were followed up in our outpatient clinic between 2009 and 2010 were reviewed retrospectively. The demographic, clinical characteristics, and laboratory findings of the patients were recorded. The control group consisted of healthy subjects with similar demographic characteristics. The patients were divided into two groups according to the treatment they received. Results: the control group consisted of 22 healthy subjects (group 1), group 2 comprised 22 patients [entacapone (+)], and group 3 constitued 50 patients [entacapone (-)]. The homocysteine levels of the control group were significantly lower than the entacapone (-) and entacapone (+) groups. The vitamin B12 level of the control group was significantly higher than in the entacapone (-) group. The folate levels of the control group were significantly higher than those of the entacapone (-) group. There was no significant difference between the entacapone (-) and entacapone (+) groups in terms of homocysteine, vitamin B12, and folate levels. Conclusion: levodopa treatment affects homocysteine levels in patients with Parkinson's disease. The effect of levodopa + entacapone on plasma homocysteine levels should be evaluated together with basal vitamin B12 and folate levels and genetic features. / Amaç: parkinson hastalarında homosistein, vitamin B12 ve folat düzeylerinin belirlenmesi ve entakapon kullanımının homosistein düzeylerine etkisinin araştırılması amaçlanmıştır. Gereç ve yöntem: hareket bozuklukları polikliniğimizde 2009-2010 tarihleri arasında takipli olan hastaların dosyaları retrospektif olarak incelendi. Hastaların demografik, klinik özellikleri ve laboratuvar bulguları kayıt edildi. Benzer demografik özelliklere sahip laboratuvar değerleri incelenmiş olan sağlıklı kişiler kontrol grubunu oluşturdu. Hastalar aldıkları tedaviye göre 2 gruba ayrılarak değerlendirme yapıldı. Bulgular: grup 1: Yirmi iki sağlıklı kişiden (kontrol grubu), grup 2: Yirmi iki hastadan [entakapon (+)], grup 3: Elli hastadan [entakapon (-)] oluşmaktadır. Kontrol grubunun homosistein düzeyi entakapon (-) ve entakapon (+) gruba göre anlamlı derecede düşük saptandı. Kontrol grubunun vitamin B12 düzeyi entakapon (-) grupa göre anlamlı olarak yüksek saptandı. Kontrol grubunun folat düzeyi entakapon (-) gruba göre anlamlı olarak yüksek saptandı. Entakapon (-) ve entakapon (+) gruplar arasında homosistein, vitamin B12 ve folat düzeyleri açısından anlamlı fark saptanmadı. Sonuç: Parkinson hastalarında levodopa tedavisi homosistein düzeyini etkilemektedir. Levodopa + entakapon kullanımının plazma homosistein düzeylerine etkisinin plazmanın bazal vitamin B12 ve folat düzeyleri ve genetik özelliklerle birlikte değerlendirilmesi gerektiği düşünülmüştür.Publication Open Access The relationship between quality of life, depression and sexual function in epileptic patients(Kare Yayıncılık, 2019) YIlmaz, Ayşe; Mutlu, Aytül; Çokar, Ayşe Özlem; Gözübatık Çelik, Rabia Gökçen; İslam, Serkan; Yılmaz, Enver Demirel; Ünal, Özge; N/A; Özer, Fahriye Feriha; School of MedicineObjectives: epilepsy is defined as a chronic neurological disease that results from increased excitability of nerve cells in the brain and requires prolonged or lifelong treatment. Epilepsy is the most common disease seen in neurology practice in childhood and adolescence, and is the second most common disease after cerebrovascular disease in the elderly. In recent years, quality of life for patients with many diseases has gained importance, to increase patient satisfaction and standard of living, but also to reduce costs, and a number of assessment scales have been developed. The aim of this study was to evaluate the quality of life of epilepsy patients and related factors in order to determine the appropriate treatment methods to improve psychosocial findings. Methods: patients aged 18 to 65 years who had experienced a complex partial or generalized epileptic seizure in the previous year and had been definitively diagnosed with epilepsy were included in the study. Demographic data were noted and evaluated. The Quality of Life in Epilepsy-31 (QOLIE-31) inventory and the Hamilton Depression Rating Scale were administered to all of the patients, as well as the Arizona Sexual Experience Scale. The statistical analysis was performed using NCSS 2007 and PASS 2008 statistical software (NCSS, LLC, Kaysville, UT, USA). Results: a total of 72 patients were included in the study; 45 were female. The mean age was 28.93 +/- 10.72 years and the mean duration of treatment was 8.14 +/- 8.40 years. In all, 34 patients (47.2%) had multiple seizures per year. The Hamilton Depression Rating Scale scores and QOLIE-31 measurement of anxiety related to seizures, total quality of life, emotional well-being, energy/fatigue, cognitive status, and social function were analyzed. There was a negative correlation between the total scores of 52.8% (p <= 0.005). Sexual dysfunction negatively affected all subscales of quality of life in female patients, while total quality of life subscores were negatively affected in males (p<0.005). Conclusion: pilepsy patients and their families should be well informed about the disease and trained extensively about living with seizures beginning at the diagnosis stage. A multidisciplinary approach to treatment that includes the various factors that can affect quality of life will lead to more effective treatment and follow-up. / Giriş ve amaç: Epilepsi nöroloji pratiğinde çocukluk ve ergenlik çağında en sık, ileri yaşta ise beyin damar hastalıklarının ardından ikinci en sık rastlanan hastalıktır. Son dönemlerde epilepsi hastalarında memnuniyeti ve yaşam standartını yükseltmek, hastalığın maliyetini azaltmak amacıyla hastaların yaşam kalitesi önem kazanmış, çeşitli ölçekler geliştirilmiştir. Çalışmamızda epilepsi hastalarının yaşam kalitesinin tespiti ve etkileyen faktörlerin belirlenip hastaların psikososyal bulguların iyileştirilmesi amaçlanmıştır. Yöntem ve gereçler: Çalışmaya 18–65 yaş arası en az bir yıldır kompleks parsiyel veya jeneralize tipte epileptik nöbet geçiren ve kesin epilepi tanısı alan hastalar dahil edildi. Demografik verileri excel formatında not edilerek değerlendirildi; araştırmacılar (psikolog) tarafından tüm hastalara, epilepsi yaşam kalitesi testi Qolie-31, Hamilton depresyon değerlendirme ölçeği ve cinsiyetlerine göre Arizona cinsel işlev bozukluğu testleri uygulandı. Bulgular: Kırk beşi kadın toplam 72 hasta çalışmaya dahil edildi. Ortalama yaş 28.93±10.72 yıl; ortalama tedavi süreleri 8.14±8.40 yıldı. Otuz dört hasta (%47.2) yılda birden fazla nöbet geçirmekteydi. Hamilton depresyon değerlendirme ölçeği skorları ile QOLIE-31’in nöbete ilişkin kaygılar; toplam yaşam kalitesi, emosyonel iyilik, enerji/yorgunluk, bilişsel durum ve sosyal fonksiyon skorları arasında; ölçek toplam skorları arasında negatif yönde %52.8 düzeyinde ilişki gözlenmiştir (p≤0.005). Tüm hastalarda cinsel işlev bozukluğunun yaşam kalitesinin alt skorlarını negatif yönde etkilendiği izlendi (p≤0.005). Tartışma ve sonuç: Epilepsi hastaları multidisipliner yaklaşımla ele alınmalıdır; hastaların psikososyal ve cinsel fonksiyon bozukluğu gibi yaşam kalitesini etkileyen faktörler gözönüne alındığında tanı, tedavi ve takiplerinde daha etkili olunabilineceği unutulmamamlıdır.