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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 An investigation of affective theory of mind ability and its relation to neuropsychological functions in Alzheimer's disease(John Wiley and Sons Ltd., 2020-09) Yıldırım, Elif; Soncu Büyükişcan, Ezgi; Demirtaş Tatlıdede, Aslı; Bilgiç, Başar; Gürvit, İbrahim HakanAlthough cognitive theory of mind (ToM) has been largely studied within neurodegenerative disorders including Alzheimer's disease (AD), studies focusing on affective ToM are relatively limited, yielding inconsistent findings. The current study aimed at investigating affective ToM abilities within different stages of AD (mild AD dementia [ADD], mild cognitive impairment [MCI], and subjective cognitive impairment [SCI]), together with its relationship with neuropsychological functioning. Eighty-one participants were tested with two different ToM tasks (Faux Pas Recognition Test [FPR] and Reading Mind in the Eyes Test [RMET]) and tests of attention, executive functions, episodic memory, and facial recognition. Our results showed two different affective ToM profiles in AD continuum: while ADD group performed poorly on both tasks of ToM, MCI group displayed deteriorated performance on RMET but not on FPR. In addition, ToM performance was significantly related to episodic memory and verbal fluency within the overall sample. These findings suggest that impairment in the decoding process of emotional cues could begin even in the prodromal stage of AD. In contrast, the reasoning process of emotional information, as measured with FPR, could be preserved until the dementia stage. Moreover, the relation of affective ToM with amnestic functions and verbal abilities could provide evidence of a domain-general ToM impairment in AD.Yayın An investigation of affective personality traits in Alzheimer’s disease: seeking as a possible predictor for early-stage Alzheimer’s dementia(Routledge, 2023-09) Soncu Büyükişcan, Ezgi; Yıldırım, Elif; Demirtaş Tatlıdede, Aslı; Bilgiç, Başar; Gürvit, HakanObjective: The aim of the current study was to investigate affective personality traits in Alzheimer’s disease, a neurodegenerative condition mainly characterized by episodic memory impairment. Method: The sample included 69 participants from 3 diagnostic categories. Twenty-five participants were diagnosed with subjective cognitive impairment (SCI), 26 participants were diagnosed with mild cognitive impairment of the amnestic type (aMCI), and the remaining 18 participants were diagnosed with early-stage Alzheimer’s dementia (ADD). Diagnostic labels were given as a result of detailed neurological, neuropsychological, and neuroradiological assessment. Affective personality traits were assessed via Affective Neuroscience Personality Scales (ANPS). Results: The only significant intergroup difference was obtained for the SEEKING subscale of ANPS. Here, ADD group scored significantly lower compared to the SCI group. The results of logistic regression analysis also indicated that SEEKING score successfully predicted early-stage ADD diagnosis. Conclusion: The results suggest that a specific personality constellation characterized by reduced investment in the outside world might be associated with Alzheimer’s disease, either as a risk factor or a byproduct of the neurodegenerative process initiated by AD pathology.Yayın Alzheimer hastalığında olağan durum ağı bağlantısallığı(Türkiye Sinir Ve Ruh Sağlığı Derneği, 2019-12) Yıldırım, Elif; Soncu Büyükişcan, EzgiAmaç: Alzheimer hastalığı (AH) beyinde yapısal ve işlevsel değişimler meydana getiren nörodejeneratif bir hastalıktır. Gelişen beyin görüntüleme yöntemleri sayesinde AH patolojisine eşlik eden yapısal ve işlevsel bağlantılardaki bozulmalar gitgide daha görünür hale gelmiştir. AH’de dinlenim durumu bağlantısallığında, özellikle de olağan durum ağı (default mode network - DMN) olarak adlandırılan içsel bağlantısallık ağında farklılaşmalar görülmektedir. Bu çalışmada DMN bağlantısallık bulgularının incelenmesi ve tartışılması amaçlanmıştır. Yöntem: İşlevsel manyetik rezonans görüntüleme (fMRI) çalışmalarında en yaygın kullanılan 2 temel metodoloji (tohum temelli ve bağımsız bileşen analizi) temel alınarak alanda yapılan çalışmalar incelenmiştir. Bulgular: Çalışmalar genel olarak, DMN bağlantısallığının AH süreci boyunca ilerleyici bir şekilde bozulduğunu göstermektedir. DMN alt sistemlerinin AH’nin preklinik ve prodromal evrelerinde farklı bağlantısallık örüntüleri gösterdiği de belirtilmektedir. DMN’deki bozulmanın diğer bağlantısallık ağlarındaki farklılaşma ile ilişkili olabileceğini öne süren kanıtlar da mevcuttur. Buna ek olarak, bulgular DMN’nin AH ile ilişkili nöropatoloji ve genetik risk faktörleri ile olan ilişkisine de işaret etmektedir. Sonuç: AH’nin beyinde başta DMN olmak üzere diğer dinlenim durumu ağlarında işlevsel bozulmalara yol açan yaygın bir diskonneksiyon sendromu olduğu öne sürülebilir. Buna ek olarak, preklinik vakalarda ve risk taşıyan kişilerde de saptanabilen AH ile ilişkili işlevsel bağlantısallık değişimleri AH için muhtemel bir biyo-belirteç olabilir.Yayın White-matter changes in early and late stages of mild cognitive impairment(Churchill Livingstone, 2020-08) Femir Gürtuna, Banu; Kurt, Elif; Ulaşoğlu Yıldız, Çiğdem; Bayram, Ali; Yıldırım, Elif; Soncu Büyükişcan, Ezgi; Bilgiç, BaşarMild Cognitive Impairment (MCI) is characterized by cognitive deficits that exceed age-related decline, but not interfering with daily living activities. Amnestic type of the disorder (aMCI) is known to have a high risk to progress to Alzheimer's Disease (AD), the most common type of dementia. Identification of very early structural changes in the brain related to the cognitive decline in MCI patients would further contribute to the understanding of the dementias. In the current study, we target to investigate whether the white-matter changes are related to structural changes, as well as the cognitive performance of MCI patients. Forty-nine MCI patients were classified as Early MCI (E-MCI, n = 24) and Late MCI (L-MCI, n = 25) due to their performance on The Free and Cued Selective Reminding Test (FCSRT). Age-Related White-Matter Changes (ARWMC) scale was used to evaluate the white-matter changes in the brain. Volumes of specific brain regions were calculated with the FreeSurfer program. Both group and correlation analyses were conducted to show if there was any association between white-matter hyperintensities (WMHs) and structural changes and cognitive performance. Our results indicate that, L-MCI patients had significantly more WMHs not in all but only in the frontal regions compared to E-MCI patients. Besides, ARWMC scores were not correlated with total hippocampal and white-matter volumes. It can be concluded that WMHs play an important role in MCI and cognitive functions are affected by white-matter changes of MCI patients, especially in the frontal regions.Yayın Cognitive functions among healthy older adults using online social networking(Routledge, 2023-07-04) Yıldırım, Elif; Ögel Balaban, HaleOnline social network sites provide possibilities to enhance social relationships and engage in cognitive activities for older adults. The present study aimed to investigate the relationship between the use of one social network site, Facebook, and cognitive functions in older adults considering different dimensions of Facebook use together with different cognitive functions. Seventy healthy older adults completed the use of Facebook form, Multidimensional Scale of Perceived Social Support, and Social Network Index. Their cognitive functions were measured with Digit Span Tasks, Free and Cued Selective Reminding Test, Letter and Category Fluency Tests, Stroop Test, Digit Symbol Substitution Test, and Trail Making Test (TMT-A and TMT-B). After controlling for age, gender, education level, we found that Facebook users performed better on TMT-A compared to non-users. Among Facebook users, the length of having an account, the network size, the daily duration of use, and the frequency of active and passive use correlated with cognitive performance after controlling offline sociality. These findings, which need confirmation by experimental and longitudinal studies, suggested that being connected to a larger network via more prolonged and active use of social media might be associated with higher cognitive functioning.Yayın Affective theory of mind in human aging: is there any relation with executive functioning?(Routledge, 2019-04) Yıldırım, Elif; Soncu Büyükişcan, Ezgi; Gürvit, İbrahim HakanTheory of Mind (ToM) refers to the ability to make inferences on other’s mental or emotional states. Although there is evidence suggesting that impaired executive functions due to aging could have a negative impact on cognitive ToM, there is still controversy about the effect of age and age-related executive dysfunctions on affective ToM. To investigate affective ToM in healthy aging and its relationship with executive functions, we examined Reading Mind in the Eyes Test (RMET) performance and executive functions among young and older adults. There was no significant difference between age groups regarding their RMET scores. While affective ToM was correlated to executive functioning within the younger group, short term memory was found to be associated with RMET performance among older participants. Furthermore, within the older group, women performed better than men. Our findings suggest a preserved ability of affective ToM in healthy aging, which appears to be independent of executive functioning.Yayın The effect of psychotic proneness and psychopathy on theory of mind(Wiley, 2024-02) Atakan, Begüm; Yıldırım, ElifThis study aimed to investigate the interaction between positive psychotic experiences and psychopathic traits on the theory of mind in a non-clinical sample. The results showed that distinct constructs of psychopathy can lead to distinct theory of mind profiles when interacting with psychotic proneness.Yayın Elevated sTREM2 and NFL levels in patients with sepsis associated encephalopathy(Taylor & Francis, 2023-03-04) Orhun, Günseli; Esen, Figen; Yılmaz, Vuslat; Ulusoy, Canan; Şanlı, Elif; Yıldırım, Elif; Gürvit, İbrahim Hakan; Ergin Özcan, Perihan; Sencer, Serra; Bebek, Nerses; Tüzün, ErdemPurpose: Sepsis-associated encephalopathy (SAE) is a common manifestation of sepsis that may lead to cognitive decline. Our aim was to investigate whether the neurofilament light chain (NFL) and soluble triggering receptor expressed on myeloid cells 2 (sTREM2) could be utilized as prognostic biomarkers in SAE. Materials and methods: In this prospective observational study, baseline serum levels of sTREM2 and cerebrospinal fluid (CSF) levels of sTREM2 and NFL were measured by ELISA in 11 SAE patients and controls. Patients underwent daily neurological examination. Brain magnetic resonance imaging (MRI) and standard electroencephalography (EEG) were performed. Cognitive dysfunction was longitudinally assessed after discharge in 4 SAE patients using the Mini-Mental State Examination (MMSE) and Addenbrooke’s Cognitive Examination-Revised (ACE-R) tests. Results: SAE patients showed higher CSF sTREM2 and NFL levels than controls. sTREM2 and NFL levels were not correlated with the severity measures of sepsis. Three months after discharge, 2 SAE patients displayed ACE-R scores congruent with mild cognitive impairment (MCI), persisting in one patient 12 months after discharge. SAE patients with MCI showed higher CSF NFL levels, bacteremia, and abnormal brain MRI. Patients with increased serum/CSF sTREM2 levels showed trends towards displaying poorer attention/orientation and visuo-spatial skills. Conclusions: sTREM2 and NFL levels may serve as a prognostic biomarker for cognitive decline in SAE. These results lend further support for the involvement of glial activation and neuroaxonal degeneration in the physiopathology of SAE.Yayın Uzaktan nöropsikolojik değerlendirme: telenöropsikoloji(BAYT Yayıncılık, 2024-05-25) Yıldırım, Elif; Soncu Büyükişcan, Ezgi; Akça Kalem, Şükriye; Gürvit, İ. HakanAmaç: Nöropsikolojik testlerin hastalara uzaktan, telefon ve videokonferans aracılığı ile yapılan uygulamalarını içeren telenöropsikoloji, uzakta yaşayan ya da hareket kısıtlılığı bulunan hastaların sağlık hizmetlerine ulaşım imkânını genişletebilmektedir. Covid-19 pandemisinin ortaya çıkması ile kognitif değerlendirmelerde telenöropsikoloji kullanımı önemli bir artış göstermiştir. Bu derlemede telenöropsikoloji ile ilgili yapılan çalışmaların sonuçlarının ve telenöropsikolojik değerlendirme ile ilgili temel esasların eleştirel bir şekilde gözden geçirilmesi amaçlanmıştır. Buna ek olarak, bu derlemede Türkiye uygulamaları için geliştirilmiş “ev temelli telenöropsikoloji uygulama rehberi” genel hatları ile paylaşılmıştır. Yöntem: Web of Science ve Pubmed veri tabanları kullanılarak konu ile ilgili erişilebilen tüm makale türlerini kapsayan bir şekilde literatür taraması yapılmıştır. Bulgular: Klinik temelli ve ev temelli telenöropsikolojik değerlendirme ile ilgili çalışmaların sonuçları dikkat, bellek, yürütücü işlevler ve dil gibi kognitif işlevleri değerlendiren ve özellikle sözel uygulamaya dayanan nöropsikolojik testlerin telenöropsikolojik değerlendirmede güvenilir bir şekilde uygulanabileceğini göstermektedir. Fakat telenöropsikolojik değerlendirmeye alınacak hastaların yönlendirilmesinde, değerlendirmede kullanılacak testlerin seçiminde ve etik konularda dikkat edilmesi gereken unsurlar bulunmaktadır. Buna ek olarak, telenöropsikolojik değerlendirmenin etkili bir şekilde yürütülmesi için görüşme öncesinde ve sırasında hem klinisyenin hem de hasta ve/veya hasta yakınının uygulanması önerilen adımların takip edilmesi önemlidir. Sonuç: Her ne kadar klinik nöropsikoloji pratiğinde hasta ile doğrudan temas kurmak önemli bir unsur olsa da gerekli durumlarda ve yetkin uzmanlar tarafından uygun uygulama prosedürleri takip edilerek yapılan telenöropsikolojik değerlendirmeler yüz yüze değerlendirmeler için iyi bir alternatif olabilir.
