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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 Dijital nöropsikoloji: yaşlı bireylerin bilişsel işlevlerinin değerlendirilmesinde kullanılan teknolojik yaklaşımlar(İ.Ü. EDEBİYAT FAKÜLTESİ, 2022-04-12) Yıldırım, ElifNüfusun yaşlanması ile paralel olarak demans tanılı kişilerin sayısı artmaktadır. Demans seyrinin iyileştirilmesi için kritik bir öneme sahip olan bilişsel bozuklukların erken saptanmasında nöropsikolojik değerlendirmenin büyük bir rolü olduğu kabul edilmektedir. Sıklıkla klasik kâğıt- kalem testleri ile uygulanan nöropsikolojik değerlendirme, günümüzde gelişen teknoloji ile birlikte dijitalleşmeye başlamıştır. Özellikle de Covid–19 pandemisi ile birlikle bu dijitalleşme ivme kazanmıştır. Bu çalışmada, yaşlı bireylerin nöropsikolojik değerlendirmelerinde kullanılan dijital yaklaşımların incelenmesi amaçlanmaktadır. Bu kapsamda, telenöropsikoloji, bilgisayarlı nöropsikolojik değerlendirme bataryaları, mobil teknoloji ya da web temelli değerlendirme araçları ve sanal gerçeklik, arttırılmış gerçeklik gibi yenilikçi teknolojik yöntemlere dayanan ölçümleri içeren dijital yaklaşımların eleştirel bir değerlendirmesi yapılmıştır. Sıklıkla videokonferans aracılığı ile nöropsikolojik testlerin uzaktan uygulanmasına odaklanan telenöropsikoloji çalışmaları ile ilgili sonuçlar bu yöntemin güvenilir ve geçerli olduğunu belirtmektedir. Bilgisayarlı bataryalar ve mobil teknolojiye dayanan yöntemler, klinik dışı bireysel uygulamaya olanak sağlamakta ve geniş örneklemli takip çalışmaları için altyapı hazırlamaktadır. Sanal gerçeklik gibi yeni teknolojilerin kullanıldığı değerlendirme yöntemler ise henüz emekleme aşamasında olsa da daha hassas ölçümlerin yapılması için büyük potansiyel taşımaktadır. Ulaşılabilirliğin artması ve ölçümlerin standartlaşması gibi avantajlar taşıyan dijital yaklaşımlar içinde sıklıkla kullanılan yöntemlerin büyük bir kısmının klasik kağıt-kalem testleri ve hastaların tanıları ile tutarlı olduğu gösterilmiştir. Fakat dijital yaklaşımların detaylı psikometrik analizlerinin yapılması ve iyi uygulama rehberlerinin geliştirmesi konusunda çeşitli eksiklikler bulunmaktadır. Buna ek olarak, dijital yaklaşımların uzman-hasta ilişkisinde zorluk yaratabileceği ve hastanın test sırasında gözlemlenmesi konusunda kısıtlılıklar taşıdığı belirtilmektedir. Her ne kadar dijital nöropsikoloji uygulamalarının yarattığı kısıtlılıklar mevcut olsa da, dijital yaklaşımlar hastalar, alandaki uzmanlar ve sağlık sistemi açısından önemli faydalar sağlama potansiyeline sahiptir. Bu nedenle, tüm taraflar açısından fayda sağlayacak akademik ve klinik çalışmaların yapılması önem taşımaktadır.Yayın Evaluation of post-swallow residue with visual analysis of swallowing efficiency and safety in patients with idiopathic Parkinson's disease(Sage Publications Inc, 2023-12) Doruk, Can; Çaytemel, Berkay; Şahin, Erdi; Kara, Hakan; Samancı, Bedia; Abay, Sevinç Nisa; Bilgiç, Başar; Hanağası, Haşmet; Başaran, Bora; Enver, Necati; Rameau, AnaisObjectives: Dysphagia is common in idiopathic Parkinson's disease (IPD) and is associated with impairments in both swallowing safety and swallowing efficiency. The goals of this study were to define post-swallow residue patterns in people with IPD and describe pathophysiological endoscopic findings affecting residue accumulation. Methods: This was a prospective single-blinded cross-sectional cohort study of patients with the diagnosis of IPD recruited from a Movement Disorder Clinic. Clinical variables included patient age, cognitive function, and measures of disease severity, and laryngoscopic examinations with a flexible endoscopic evaluation of swallowing (FEES) were completed for each patient. Visual Analysis of Swallowing Efficiency and Safety (VASES) was used to analyze FEES. Post-swallow residue outcomes and non-residue endoscopic outcomes including the Bowing index, Penetration Aspiration Scale (PAS) score, premature leakage, and build-up phenomenon were evaluated. Multiple regression models were used to evaluate factors affecting the residue at different anatomic levels. Results: Overall 53 patients completed the study. The multiple regression analyses showed a relation between (1) the presence of residue at the level of oropharynx and epiglottis with premature leakage, (2) the presence of residue at the level of the laryngeal vestibule and vocal folds with build-up phenomenon, and (3) the presence of residue at the level of the hypopharynx, laryngeal vestibule, and subglottis with airway invasion. Conclusion: Residue pattern during FEES is associated with specific swallow dysfunctions in IPD. Using residue localization and quantification may be a helpful tool in assessing the impact of targeted swallowing interventions in patients with IPD and dysphagia.Yayın The relationships of neuropsychological factors and loneliness preference in children with attention deficit hyperactivity disorder and cognitive disengagement syndrome(Routledge Journals, Taylor & Francis Ltd, 2025-04-03) İzmir, Sevim Berrin İnci; Aktan, Zekeriya Deniz; Ercan, Eyüp SabriThis study aimed to examine emotion dysregulation and internalizing disorders mediating the relationship between selective and sustained attention and loneliness preference in children diagnosed with attention deficit hyperactivity disorder (ADHD) and Cognitive Disengagement Syndrome (CDS). This study included 176 children and adolescents between ages 8 and 12. The solitude scale for children, Difficulties in Emotion Regulation Scale, Child Behavior Checklist, Barkley Sluggish Cognitive Tempo Scale, and CNS Vital Signs test were used. The results suggest that difficulties in emotion regulation and having an internalizing disorder had a mediating effect between difficulties in selective attention and preference for the loneliness of children with ADHD + CDS. Also, it was likely that the association between sustained attention and preference for loneliness is mediated by internalizing disorders. The results suggest that the social problems commonly exhibited by children with ADHD + CDS may be related to deficits in sustained and selective attention.Yayın Reliability of direct-to-home teleneuropsychological assessment: a within-subject design study(Routledge, 2025-07-04) Yıldırım, Elif; Soncu Büyükişcan, Ezgi; Akça Kalem, Şükriye; Gürvit, HakanObjective: During the COVID-19 pandemic, the need to continue diagnosis and treatment processes, in addition to scientific research, led to a rapid shift towards direct-to-home tele-neuropsychology administrations, the reliability and validity of which had not been clearly established then. This study, therefore, aimed to examine the reliability of direct-to-home tele-neuropsychological assessment (TNP). Method: The sample included 105 cognitively healthy individuals aged between 50–83 years, and 47 patients diagnosed with neurocognitive disorders (mild cognitive impairment and early-stage Alzheimer’s type dementia). All participants underwent both face-to-face and teleneuropsychological assessments in a counterbalanced order. Results: The results revealed that performances across measures of attention, working memory, verbal fluency, verbal and visual memory, and visual perception were comparable across assessment modalities. Intraclass correlation coefficients of the tests ranged from.54 to.92. Conclusions: The findings of the study provide support for direct-to-home teleneuropsychological assessment among patients with neurocognitive disorders. Neuropsychological tests relying on verbal administration and independent of motor performance may represent a reliable alternative for this patient group when administered in settings where external distractions or technological limitations are controlled. For cognitively healthy individuals, on the other hand, the reliability of the TNP application is more questionable for memory and some executive function tests and therefore needs further exploration.
