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    Anti-GAD Encephalitis Following COVID-19 Vaccination: A Case Report
    (Turkish Neuropsychiatry Assoc-Turk Noropsikiyatri Dernegi, 2023) Deniz, Cigdem; Altunan, Bengu; Unal, Aysun
    Since December 2020, a significantly higher number of people worldwide have been vaccinated for coronavirus disease 2019 (COVID-19). Neurological complications have been reported after these vaccines, although a definitive causal relationship has not been proven in the available literature. We describe a 51-year-old man presenting with anti-glutamic acid decarboxylase (anti-GAD) antibody positive autoimmune encephalitis with progressive cognitive impairment and behavioral abnormalities, presenting shortly after the second dose of mRNA COVID-19 vaccine, possibly representing a serious vaccine related adverse event. Response to high-dose steroid and intravenous immunoglobulin treatment was positive. As many people around the world have been vaccinated against COVID-19, this case shows that autoimmune encephalitis and even anti-GAD antibody positive autoimmune encephalitis can develop as a side effect after this new vaccine, but with early diagnosis and appropriate treatment, the clinic can have a good prognosis. Observational studies with large numbers of patients are needed to explain causality.
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    Effect of 24-hour Sleep Deprivation on Visual Reactivity in Healthcare Professionals
    (Galenos Publ House, 2023) Unlu, Nevroz; Deniz, Cigdem; Asil, Talip
    Objective: The effects of sleep deprivation on cerebral metabolism and blood flow have been investigated using different methods. To evaluate cerebral blood flow (CBF) changes and reactivity using transcranial Doppler (TCD) sonography in response to visual stimulation before and after sleep deprivation.Materials and Methods: The study included twenty healthcare professionals. For each cerebral hemisphere, the flow velocities of the two posterior cerebral arteries (PCA) were measured using TCD with eyes closed before and after sleep deprivation. Again, before and after sleep deprivation, visual stimulation was given with eyes open and flow velocity in PCA was recorded. The visual reactivity value was calculated for the right and left hemispheres before and after sleep deprivation. Reactivity is calculated as relative changes in blood flow velocity [?BFv = 100*( Vs-Vr)/Vr].Results: It was found that CBF velocity increased significantly in response to visual stimulus before and after sleep deprivation in the right and left hemispheres (p<0.001).In both hemispheres, CBF velocities measured after sleep deprivation without visual stimulus increased compared with those measured before sleep deprivation, but this increase showed statistical significance only for the right hemisphere (p=0.008). It was observed that the visual reactivity value calculated after sleep deprivation from the right and left hemispheres significantly decreased compared with that before sleep deprivation (p<0.001).Conclusion: We found that visual reactivity values in healthcare professionals were significantly reduced after sleep deprivation. This decrease in visual reactivity value may cause decreased attention and prolongation of reaction time in healthcare professionals.
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    Evaluation of Cerebral Vasomotor Reactivity by Transcranial Doppler Ultrasound in Patients with Diabetic Retinopathy
    (Taylor & Francis As, 2023) Kula, Asli Yaman; Deniz, Cigdem; Gultekin, Tugce Ozdemir; Altinisik, Muhammed; Asil, Talip
    The aim of this study was to assess the correlation between cerebral vasomotor reactivity (CVR) and the grade of diabetic retinopathy. A total of 43 diabetic patients with matched severity of diabetic retinopathy between their right and left eyes were included in this study. Diabetic retinopathy was graded in three groups. Right and left middle cerebral artery CVR was assessed by the breath-holding index (BHI) using transcranial Doppler ultrasound (TCD). The mean age of the patients was 56.51 +/- 9.34 years with a mean duration of having diabetes mellitus of 14.49 +/- 8.06 years. Diabetic retinopathy was graded as mild, moderately severe, and severe in 27.9%, 34.9%, and 37.2% of the patients, respectively. The grade of diabetic retinopathy was associated with the HbA1c level (p < .049), microalbuminuria (p < .024), and BHI (p = .001). In patients with severe diabetic retinopathy, the right-sided BHI was significantly lower as compared to those with mild or moderately severe retinopathy (p = .001 and p = .008, respectively). The left-sided BHI value in patients with severe diabetic retinopathy was significantly lower as compared to those with mild or moderately severe retinopathy (p = .001 and p = .012, respectively). In subjects with moderately severe diabetic retinopathy, both-sided BHI was significantly reduced compared to those with mild retinopathy (p = .001). Our results indicate that the grade of diabetic retinopathy was associated with impaired CVR.
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    Neurobrucellosis Presenting with Tumor-Like Lesion and Vasculitic Involvement
    (Galenos Publ House, 2024) Sunal, Baran Serdar; Ozgur, Cihan; Deniz, Cigdem; Altin, Elif
    [Abstract Not Available]
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    Novel Approach to Investigate the Effect of High-Dose Methylprednisolone on Erythrocyte Morphology: White Light Diffraction Microscopy
    (Sciendo, 2023) Deniz, Cigdem; Kocahan, Ozlem; Altunan, Bengu; Unal, Aysun
    The present study focuses on quantitative phase imaging of erythrocytes with the aim to evaluate the effects of high-dose methylprednisolone (HDMP) on erythrocytes in vivo under physiological conditions in human blood samples. Samples from ten patients, prescribed to be treated with 1000 mg/day intravenous methylprednisolone for 5 days, were analyzed by white light diffraction phase microscopy (WDPM) for quantitative imaging. WDPM, an optical measurement technique, enables single shot measurement and low speckle noise using white light. Quantitative phase imaging performed with this experimental setup allowed the determination of erythrocyte morphology with 9 different parameters. In vivo quantitative analysis of erythrocytes by WDPM, which is a simple and reliable method, shows that HDMP treatment has no significant effect on erythrocyte morphology. With the developing technology, interdisciplinary studies on individuals under treatment should play an important role in elucidating the interaction between steroids and erythrocytes.
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    Rare combo: moyamoya and lupus in men
    (Springer London Ltd, 2024) Gokten, Dilara Bulut; Gokten, Murat; Deniz, Cigdem; Mercan, Ridvan
    Moyamoya syndrome (MMS) is a rare, chronic, progressive cerebrovascular disorder characterized by stenosis at the apices of the intracranial internal carotid arteries, including the proximal anterior cerebral arteries and middle cerebral arteries. Cerebral angiography images are used for detection through measurement. Systemic lupus erythematosus (SLE) is an autoimmune disease that can cause multisystemic involvement. The coexistence of SLE and MMS has been rarely reported in the literature. A 46-year-old male patient with malar rash, Raynaud phenomenon presented to the hospital with a complaint of weakness in the left lower extremity, which began 3 days before the date of the visit. In the diffusion magnetic resonance imaging, multiple diffusion restrictions were observed in the right frontal region. The patient underwent MR angiography, revealing stenosis in the terminal and supraclinoid segments of the right internal carotid artery, which made us consider moyamoya disease. This patient, with a malar rash and Raynaud's, a positive antibody profile, was diagnosed as a male with SLE accompanied by MMS.