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  • Yayın
    Yatarak tedavi görmüş geriyatrik unipolar depresyon ve bipolar bozukluk hastaların klinik ve sosyodemografik özelliklerinin karşılaştırılması
    (Istanbul Universitesi, 2015-12) Cesur, Ender; Fıstıkçı, Nurhan; Dönmezler, Fadime Gizem; Çarpar, Elif; Erten, Evrim; Keyvan, Ali; Saatçioğlu, İbrahim Ömer
    Amaç: Bipolar bozukluk, toplumda %1 oranında görülen kronik bir hastalık olmakla beraber, yaşlılardaki yaygınlık oranı % 0.1 kadar düşüktür. Major depresyonun ise 70-85 yaşından sonra prevalans ve insidansı iki kat artmaktadır. Çalışmanın amacı, yatarak tedavi gören bipolar bozukluk(BB) ve unipolar depresyon(UD) tanılarıyla izlenen geriyatrik hastaların sosyodemografik ve klinik özelliklerinin araştırılmasıdır.Yöntem: Çalışmada Bakırköy Ruh ve Sinir Hastalıkları Hastanesi’nde yatmış olan, 65 yaş ve üzeri BB ve UD hastalarının sosyodemografik ve klinik özellikleri tıbbi kayıtları üzerinden karşılaştırılmıştır. Madde/ilaç, başka bir sağlık durumuna bağlı duygudurum bozukluğu tanısı olanlar ya da demans, deliryum tanısı olan hastalar çalışmaya dahil edilmemiştir. Bulgular: Tüm hastaların yaş ortalaması 69,3’tür. Çalışmaya dahil edilen 93 hastanın 51 tanesinde (%54,8) BB, 42 tanesinde(%45,2) UD tanısı bulunmaktadır. Hastalığın başlangıç yaşı BB için 41,33 iken UD için 59,21 bulunmuştur(p=0,000). UD hasta grubunun yatışındaki intihar fikri oranı %78,6 olup BB hasta grubununki %17,6’dır(p=0,000). UD grubundan 20(%47.6) kişi daha önce en az bir kere intihar girişiminde bulunmuşken bu sayı bipolar hasta grubunda 12(%23.5) olarak saptanmıştır(p=0,03). BB hastalarının ilaç uyumsuzluğu %51,0 iken UD hastalarında (%26,2) anlamlı derecede düşüktür (p=0,000). BB grubunun tedavisinde antipsikotikler (%100), depresyon hastalarına (%76,2) oranla daha sık kullanılmıştır(p=0,000). Sonuçlar: Yatarak tedavi görmüş unipolar ve bipolar geriyatrik hastalarda önemli klinik farklar saptanmıştır.
  • 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 Hakan
    Theory 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
    Associations between cerebral perfusion pressure, hemodynamic parameters, and cognitive test values in normal-tension glaucoma patients, Alzheimer’s disease patients, and healthy controls
    (Multidisciplinary Digital Publishing Institute (MDPI), 2025-05-24) Stoskuviene, Akvile; Chaleckas, Edvinas; Grusauskiene, Evelina; Bartusis, Laimonas; Çelikkaya, Güven; Januleviciene, Ingrida; Vaitkus, Antanas; Ragauskas, Arminas; Hamarat, Yasin
    Background/Objectives: Glaucoma and Alzheimer’s disease (AD) are neurodegenerative conditions with vascular underpinnings. This study aimed to explore the relationship between blood pressure parameters such as mean arterial pressure (MAP), pulse pressure (PP), and cerebral perfusion pressure (CPP) and cognitive performance in patients with AD, normal-tension glaucoma (NTG), and healthy controls. We hypothesized that NTG patients, like those with mild cognitive impairment (MCI), may experience subtle cognitive changes related to vascular dysregulation. Methods: Ninety-eight participants (35 NTG, 17 AD, 46 controls) were assessed for CPP, MAP, OPP, and cognitive performance. Statistical analyses compared groups and examined correlations. Results: AD patients showed lower CPP and MAP (p < 0.001), indicating systemic vascular dysfunction, while NTG patients had higher ocular perfusion pressure (OPP) (p = 0.008), suggesting compensatory mechanisms. CPP correlated with visuospatial abilities in AD (r = 0.492, p = 0.045). MAP correlated with the Clock drawing test (CDT) scores in the NTG group (r = 0.378, p = 0.025). PP negatively correlated with cognition in AD (r = −0.527, p = 0.016 for CDT scores) and controls (r = −0.440, p = 0.002 for verbal fluency and r = −0.348, p = 0.019 for total ACE scores). Conclusions: The study highlights distinct hemodynamic profiles: systemic dysfunction in AD and localized dysregulation in NTG. These findings emphasize the role of vascular dysregulation in neurodegeneration, with implications for personalized treatment approaches targeting vascular health in neurodegenerative conditions.
  • Yayın
    Investigation of symptom-specific functional connectivity patterns in Parkinson’s disease
    (Springer-Verlag Italia S.R.L., 2025-06-14) Kıçik, Ani; Bayram, Ali; Erdoğdu, Emel; Kurt, Elif; Sarıdede, Dilek Betül; Cengiz, Sevim; Bilgiç, Başar; Hanağası, Haşmet; Öztürk Işık, Esin; Gürvit, Hakan; Tüzün, Erdem; Demiralp, Tamer
    Parkinson’s disease (PD) is a complex neurodegenerative disease, characterized by pronounced heterogeneity in symptoms. This study investigates the functional connectivity (FC) patterns associated with distinct symptom clusters, aiming to elucidate the heterogeneity in PD and uncover the neural mechanisms underlying its motor and cognitive symptoms. Resting-state functional MRI (rs-fMRI) data from 55 non-demented PD patients and 24 healthy controls (HC) were used to perform seed-to-seed FC analyses. A clustering algorithm was applied to the cognitive and motor scores of all PD patients to generate relatively homogeneous symptomatic subgroups. PD patients exhibited a general decrease in FC within a network comprising the sensorimotor network (SMN) and the visual network (VN) regions. Symptom-based clustering revealed three relatively homogeneous subgroups, exhibiting a gradient pattern: patients with greater motor deficits showed significant disconnection within the SMN, whereas patients with greater visuospatial deficits exhibited reduced FC in an extended subnetwork, with pronounced disconnections between the VN and SMN areas. Our study demonstrated a notable disconnection between the SMN and VN, indicating impaired visual-motor integration in PD. Stronger disconnection within the SMN was associated with greater motor dysfunction, and stronger visual-sensorimotor disconnections were associated with greater visuospatial deficits. These findings suggest that at least two separate routes of functional disconnection may be responsible for the inhomogeneous symptom distribution in PD.
  • Yayın
    Treatment and long-term outcome of mental disorders: The grim picture from a quasi-epidemiological investigation in 54,826 subjects from 40 countries
    (Elsevier Ireland Ltd, 2025-06) Fountoulakis, Konstantinos N.; Karakatsoulis, Gregory; Abraham, Seri; Adorjan, Kristina; Uddin Ahmed, Helal; Alarcòn, Renato Daniel; Arai, Kiyomi; Auwal, Sani Salihu; Berk, Michael; Levaj, Sarah; Yılmaz Kafalı, Helin
    Introduction: This study registered rates of specific treatment options for mental disorders as well as their long-term outcome. Material and methods: The history of mental disorders was used as a proxy for diagnosis. The data came from the COMET-G study (40 countries; 54,826 subjects, 64.73 % females, 35.45±13.51 years old). The analysis included descriptive statistics, Risk Ratios, t-tests, and ANCOVA's. Results: 24.14 % reported a history of any mental disorder (depression >12 %, non-affective psychosis and Bipolar disorder 1 % each, >20 % self-injury, >10 % had attempted suicide, 7.17 % illegal substance abuse). Most patients were not under any kind of treatment (59.44 %) and most were not receiving treatment as recommended (e.g. 90 % of Bipolar and 2/3 of psychotic patients). No treatment at all and psychotherapy as monotherapy were consistently related to poorer outcomes. In anxiety or depression, only antidepressant monotherapy and benzodiazepines, in Bipolar disorder only antipsychotic monotherapy in males and antidepressant monotherapy in females and in non-affective psychosis antipsychotics and psychotherapy in females only, were related to good outcomes. No treatment modality was related to a good outcome in those with a history of self-harm, suicidal attempts, or illegal substance use. Only depression and treatment with antidepressants were related to metabolic syndrome. Discussion: In the community, the overwhelming majority of mental patients do not receive appropriate treatment or, even worse, no treatment at all. The outcome is unfavourable for the majority and only a few selective treatment options seem to make a difference.
  • 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, Hakan
    Objective: 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.