Background: and Purpose There are controversies regarding the role of presynaptic inhibition (PSI) in the mechanisms underlying the efficacy of deep-brain stimulation (DBS) in Parkinson’s disease (PD). We sought to determine the involvement of PSI in DBS-related mechanisms and clinical correlates. Methods: We enrolled PD subjects who had received subthalamic nucleus DBS (STN-DBS) therapy and had been admitted to our clinic between January 2022 and March 2022. The tibial H-reflex was studied bilaterally during the medication-off state, and all tests were repeated 10 and 20 minutes after the simulation was turned off. Simultaneous evaluations based on the Movement-Disorder-Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale part III (MDS-UPDRS-III) were performed in all of the patients. Results: Ultimately we enrolled 18 patients aged 58.7±9.3 years (mean±standard deviation, 10 females). Fifty percent of the patients showed a decrease in the MDS-UPDRS-III score of more than 60% during the stimulation-on period. Comparative analyses of the repeated measurements made according to the stimulation status revealed significant differences only in the left H-reflex/M-response amplitude ratio (H/M ratio). However, no difference in the left H/M ratio was found in the subgroup of patients with a prominent clinical response to stimulation (n=9). Analyses of the less-affected side revealed differences in the H-reflex amplitude and H/M ratio. Conclusions We found evidence of PSI recovery on the less-affected side of our PD subjects associated with STN-DBS. We hypothesize that the involvement of this spinal pathway and its contribution to the mechanisms of DBS differ between individuals based on the severity of the disease and which brainstem regions and descending tracts are involved.

There is increasing evidence that inflammation is involved in the mechanisms of acute ischemic stroke. The utility of neutrophil-to-lymphocyte ratio (NLR) has recently been reported to help in the prognostication of stroke. The utility of NLR in the diagnosis of stroke remains uncertain. In this retrospective study, patients with acute ischemic stroke who presented within the first 24 hours of symptom onset to our clinic from September to December 2019 were studied, involving 93 patients with stroke and 60 control. The mean age in the stroke group was 71.7 ± 12.2 years whereas it was 72.6 ± 5.7 in the control group (p=0.405). The female/male ratio was 47/46 in the stroke group and it was 26/34 in the control group (p=0.411). The NLR level was higher in patients with ischemic stroke as compared to control (p=0.029) whereas hemoglobin levels were lower in the patient group (p= 0.025). The ROC curve analysis revealed that a NLR cutoff point of 2.34 had 61.3 % sensitivity and 60% specificity in detecting patients with ischemic stroke. The regression analyses also revealed that the NLR and hemoglobin levels were predictors for stroke. In conclusion, NLR and hemoglobin may potentially be paraclinical markers in differential diagnosis of stroke.

Psychogenic movement disorders are commonly seen in neurology clinics which can lead to severe disability. Despite their high prevalence, they constitute a grey area between neurology and psychiatry while neither of the specialists tends to take charge. Psychogenic parkinsonism is an uncommon subtype among psychogenic movement disorders. We report here a man with psychogenic parkinsonism that recovered completely after two years of treatment, showing that an excellent prognosis is possible with appropriate evaluation, diagnosis and treatment. We also discuss the utility of electrophysiological study in differentiating psychogenic tremors from other subtypes and the usefulness of the pronationsupination task.

No abstract available.
Gait Apraxia ; Gait

No abstract available.
Humans ; Hydrocephalus* ; Parkinsonian Disorders*

PURPOSE: This study was to evaluate the effect of grinding of the inner metal surface during the porcelain try-in stage on metal-porcelain bonding considering the maximum temperature and the vibration of samples. MATERIALS AND METHODS: Ninety-one square prism-shaped (1 x 1 x 1.5 mm) nickel-chrome cast frameworks 0.3 mm thick were prepared. Porcelain was applied on two opposite outer axial surfaces of the frameworks. The grinding was performed from the opposite axial sides of the inner metal surfaces with a low-speed handpiece with two types of burs (diamond, tungsten-carbide) under three grinding forces (3.5 N, 7 N, 14 N) and at two durations (5 seconds, 10 seconds). The shear bond strength (SBS) test was performed with universal testing machine. Statistical analyzes were performed at 5% significance level. RESULTS: The samples subjected to grinding under 3.5 N showed higher SBS values than those exposed to grinding under 7 N and 14 N (P<.05). SBS values of none of the groups differed from those of the control group (P>.05). The types of bur (P=.965) and the duration (P=.679) did not affect the SBS values. On the other hand, type of bur, force applied, and duration of the grinding affected the maximum temperatures of the samples, whereas the maximum vibration was affected only by the type of bur (P<.05). CONCLUSION: Grinding the inner metal surface did not affect the metal-porcelain bond strength. Although the grinding affected the maximum temperature and the vibration values of the samples, these did not influence the bonding strength.
Dental Porcelain* ; Dental Prosthesis* ; Hand ; Vibration