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Yayın Neuropsychiatric outcomes and caregiver distress in primary progressive aphasia(Wiley, 2023-01) Seçkin, Mustafa; Yıldırım, Elif; Demir, İlayda; Orhun, Ömer; Bülbül, Ezgi; Velioğlu, H. Aziz; Öget, Öktem; Yeşilot, Nilüfer; Çoban, Oğuzhan; Gürvit, HakanBackground: In this study, we aimed to outline the neuropsychiatric consequences of primary progressive aphasia (PPA) and to understand how neuropsychiatric symptomatology affects distress in caregivers. Methods: The Neuropsychiatric Inventory (NPI) including the distress index (NPI-Distress) was used. Additional information about the caregiver burden was obtained using Zarit Burden Interview (ZBI). NPI, NPI-Distress, and ZBI data from 17 patients with a clinical diagnosis of PPA were compared with 10 stroke aphasia patients. Neuropsychiatric symptomatology was investigated based on three clusters; Mood, Frontal/Comportmental, and Psychotic/Disruptive. Additionally, the Activities of Daily Living Questionnaire (ADLQ) was used to outline the functional impairment. Twelve healthy controls were included to compare the neurocognitive test scores with PPA and stroke aphasia groups. Results: A greater number of neuropsychiatric symptoms were observed in the PPA group compared to the stroke aphasia group. The number of symptoms in Mood, and Frontal/Comportmental clusters were greater than the number of symptoms in Psychotic/Disruptive clusters in the PPA group, whereas no significant relationship between the number of symptoms and symptom clusters was found in the stroke aphasia group. In the PPA group, a strong correlation was found between the NPI-Frequency × Severity scores and the NPI-Distress scores. Moreover, the NPI-Distress scores in the PPA group strongly correlated with the ZBI scores. Scores for anxiety, irritability/lability, and apathy had a stronger correlation with the NPI-Distress scores compared to the other NPI symptoms. The Communication subscale was the most impaired domain in the PPA group. Travel, and Employment and Recreation subscales showed greater functional impairment in the stroke aphasia group compared to the PPA group. Conclusions: Neuropsychiatric symptoms in PPA in our study were more frequent than previously reported. Furthermore, the distress index of the NPI was not only correlated with the severity of the neuropsychiatric symptoms but also reflected the overall burden on the caregivers in the PPA group.Yayın Posterior atrophy is a neuroimaging marker of mild cognitive impairment in Parkinson's disease(Türk Nöropsikiyatri Derneği, 2026-02-02) Ay, Ulaş; Yıldırım, Zerrin; Kıcik, Ani; Erdoğdu, Emel; Bilgiç, Başar; Hanağası, Haşmet; Öztürk Işık, Esin; Demiralp, Tamer; Gürvit, HakanIntroduction: Although there are several studies on the neuroanatomical mechanisms underlying Parkinson's disease (PD)-associated cognitive impairment, the clinical usefulness of the findings from these investigations is limited. In this study, we aimed to identify magnetic resonance imaging (MRI) markers that can be practically utilized for diagnosing PD-associated cognitive impairment using a visual rating scale (VRS). Methods: Anatomical MRIs of cognitively normal (PD-CN), and PD with mild cognitive impairment (PD-MCI) patients were visually evaluated for six bilateral cortical regions. Then, hypothesis-driven cortical thickness analysis (CTA) was performed in the regions obtained from VRS. Results: As a consequence of VRS, a significant difference was found between the two groups with regards to right posterior atrophy (PA) scores (pFDR-corr = 0.042, Cohen's d= 1.06). Hypothesis-driven CTA confirmed the result of VRS by revealing cortical thinning at the precuneus and parieto-occipital sulcus junction (Max. T= 6.171, P= 0.0006, MNIx, y,z = 11.0,-62.2, 25.4). The area under the curve was 0.75, showing a good association between the PD-MCI and the right PA score. The cut-off for maximum accuracy was >= 2, based on the highest sum of sensitivity (0.68) and specificity (0.72). Conclusions: Our findings indicate that right PA atrophy may be helpful for clinicians in the diagnosis of PD-associated cognitive impairment.
