Mehmet Eryilmaz

Bio: Mehmet Eryilmaz is an academic researcher from Düzce University. The author has contributed to research in topics: Magnetic resonance imaging & Mean platelet volume. The author has an hindex of 3, co-authored 6 publications receiving 49 citations.

Assessment of platelet indices in patients with neurodegenerative diseases: mean platelet volume was increased in patients with Parkinson's disease.

Abstract: Platelets induce chronic inflammation which is a key step in atherosclerosis and may be involved in the progression of neurodegenerative diseases (NDD) We aimed to measure the mean platelet volume (MPV) and platelet count (PLC) in NDD patients The present study was designed to investigate the platelet function by measuring MPV and PLC in NDD A total of 182 outpatients with Alzheimer's (AD) or Parkinson's diseases (PD) were included The control group consisted of 104 healthy subjects Platelet count was similar between groups MPV values of PD patients were higher than those of AD patients and controls (P < 0001) MPV correlated negatively with Heohn and Yahr scale (HYS) score (P < 0001) Increased MPV in patients with PD may point to a platelet dysfunction High-grade inflammation presents with low levels of MPV as seen in PD patients with high HYS scores

Two-point discrimination in diabetic patients (糖尿病患者的两点辨别力)

Abstract: Background Diabetes mellitus (DM) is a common cause of polyneuropathy. The aim of the present study was to evaluate two-point discrimination (TPD) compared with nerve conduction studies in the early stages of DM. Methods Forty-eight patients with early diagnosed (<5 years) type 2 DM and 17 healthy controls were evaluated. Of the patients with DM, 26 had neuropathic pain and 22 were asymptomatic. TPD and electrophysiological evaluations was obtained for all subjects. Results Nerve conduction studies in patients showed findings related to both demyelination and axonal damage. Patients with neuropathic pain had higher TPD values on the plantar surface of the foot and both groups of DM patients had higher TPD values on the outer lateral malleolus compared with the control group (P < 0.05). There was a correlation between TPD and axonal damage in patients with neuropathic pain (P < 0.05). In patients without neuropathic pain, there was a correlation between TPD values and distal latencies of motor or sensory nerves (P < 0.05). In the control group, only third digit TPD values were related to the distal motor latency of the median nerve (P < 0.05). Conclusion In conclusion, the TPD method is a less painful, practical, costeffective, and more easily applicable method that was completed in less timethan nerve conduction studies. Higher TPD values in the lower extremities indicate nerve damage in patients. These findings suggest that increased TPD values can easily determine neuropathy starting in the early stages of diabetes in patients with DM. 摘要 背景 糖尿病是多发性神经病变最常见的病因之一。本研究的目的是在处于早期阶段的糖尿病患者中比较测定两点辨别力（two-point discrimination, TPD）与神经传导研究。 方法 评估了48名早期（< 5年）诊断的2型糖尿病患者以及17名健康对照者。在糖尿病患者中，26名患者有神经性疼痛，22名患者无症状。所有的受试者都要进行TPD与电生理学评估。 结果 患者的神经传导研究结果显示与脱髓鞘以及轴突损害都有关系。与对照组相比较，有神经性疼痛的患者足底面的TPD值更高，并且两组糖尿病患者外踝面的TPD值都更高（P < 0.05）。在有神经性疼痛的患者中，TPD与轴突损害具有相关性（P < 0.05）。在没有神经性疼痛的患者中，TPD值与运动或者感觉神经的远端潜伏期具有相关性（P < 0.05）。在对照组中，只有第三指的TPD值与正中神经的远端运动潜伏期具有相关性（P < 0.05）。 结论 总之，与神经传导研究相比较，测定TPD的方法是一种痛苦少、成本效益高、更容易施行的方法，并且可以在更短的时间内完成。患者下肢TPD值更高意味着神经损害。这些研究结果提示，在处于早期阶段的糖尿病患者中，从升高的TPD值可以很容易地判定是否有神经病变。

Long‐term depression is a stroke risk factor

Abstract: Kocer E, Kocer A, Degirmenci Y, Eryilmaz M. Long-term depression is a stroke risk factor. Background and Aim: Only a few studies have evaluated depression prevalence in pre-stroke period in comparison to controls. We investigated this association based on a hospitalised stroke population. Methods: One hundred and forty-eight stroke patients were evaluated. The presence of depression was compared with those of 100 healthy controls without stroke, from the same region. Depression was accepted as present or not present after history and clinical evaluation according to Diagnostic and Statistical Manual of Mental Disorders-IV. Socio-demographic variables, other stroke risk factors and the time of diagnosis of depression (how many year or month they got depression) were recorded. Results: Gender and mean age of patients and controls were similar in comparison. Depression was diagnosed in 27 patients and 24 controls (p > 0.05). The time period passed after diagnosis of depression was longer in stroke patients in comparison to controls (p < 0.001). Conclusions: The risk of stroke should be considered in elderly with long-term depression. This indicates that treatment of depression is another factor which should be considered in prevention of brain stroke.

Thioctacid is effective for neuropathy symptoms and hyperglycemia control without pronounced electromyographic changes.

Abstract: T acid (TA) is a natural and strong antioxidant agent.1 It is well-known that antioxidant therapy has good effects on nerve conduction in diabetic sensorial polyneuropathy (DSPN).1 The DSPN is a frequently seen complication of diabetes. Metabolic causes result in axonal degeneration, and we know that short-term trials with the antioxidant TA appear to improve neuropathic symptoms in diabetic patients.1 Treatment with TA 600 mg intravenous (iv) daily for 3 weeks represents a welltolerated, and effective therapy for DSPN. Similarly, an oral dose of 600 mg daily administered for up to 5 weeks could offer benefits in symptoms and signs of DSPN without significant side effects.2 Nerve conduction studies (NCS) are objective and reliable examinations in diabetics. The NCS give information regarding not only clinical changes, but also the effectiveness of the drugs.2 In placebo-controlled trials studying the efficacy of parenteral, and oral alpha lipoic acid in the treatment of symptoms, clinical signs, and electrophysiology of diabetic sensor motor polyneuropathy, only one study revealed electrophysiological improvement.3,4 In this study, we aimed to investigate the effectiveness of TA, and the relationship between therapy and nerve conduction studies in the treatment of symptomatic DSPN within a short period of one month. In this before and after study, metabolically stable type 2 diabetic patients admitted to the Internal Medicine Department of Düzce Medical Faculty, Düzce, Turkey between April and July 2009 were evaluated. The DSPN has been accepted as present, if the patients have an abnormal NCS, and a symptom or symptoms (decreased sensation, positive neuropathic sensory symptoms predominantly in the toes, feet, or legs), or a sign or signs (symmetric decrease of distal sensation, or unequivocally decreased or absent ankle reflexes, or decreased vibration sense in great toe) of sensory motor polyneuropathy. Twenty volunteers who accepted the study protocol and completed visits were included in the study. Diabetic neuropathy symptom scores (DNSS), and attributes of NCS were recorded for every patient. The patients were randomly assigned to the treatment regimen: 1 x 600 mg TA/day (Gen Drug Company, Istanbul, Turkey) for one month, in addition to routine follow-up and therapy of other previous oral anti-diabetic agents. After one month, we assessed the DNSS and NCS once more. Then, the results of the patients (n=20) with DSPN, and completed one month follow-up period were statistically analyzed in this prospective study. After approval of the ethics committee of the Düzce University Medical Faculty, the present research was conducted in accordance with the Declaration of Helsinki. All subjects provided written informed consent before participation. The DNSS was evaluated by a questionnaire, which was a 4-item symptom score scale for diabetic neuropathy.5 The DNSS has the following items: (i) unsteadiness in walking; (ii) pain, burning, or aching of legs or feet; (iii) prickling sensations in legs or feet; and (iv) numbness in legs or feet. Every item has been scored as one point, and score indicating ≥1 were considered abnormal. Electrophysiological attributes of bilateral sural, median, and ulnar sensory nerves, and left-sided tibial, peroneal, and median motor nerves were evaluated. All patients underwent conventional sensory and motor NCS. All studies were performed following standard techniques using an electromyography tool (Artoscan, Esaote Biomedica, Genoa, Italy) with surface recording and stimulating electrodes. The dorsal skin surface temperature of hands and feet was measured before each NCS. If the temperature was below 30°C, hot water, or an infrared heat source was used to raise it. The distribution of nerve conduction values was tested by Kolmogorov-Smirnov Z due to the small number of groups, and was found normal in each group. Statistical analysis was performed to evaluate the changes between the first and second examination. Statistical analyses were performed by mean and standard deviation, and Student’s t-test for the parametric data and intergroup comparisons. Frequency distributions were analyzed by means of χ2 tests. A p<0.05 was considered significant. In addition, the relationship between DNSS, NCS results, and sociodemographic and clinical variables, that is age, gender, other diseases, diabetes duration, blood glucose levels, and glycosylated hemoglobin (HbA1c) levels were evaluated. Brief Communication

Role of Platelet Mitochondria: Life in a Nucleus-Free Zone.

Abstract: Platelets are abundant, small, anucleate circulating cells, serving many emerging pathophysiological roles beyond hemostasis; including active critical roles in thrombosis, injury response, and immunoregulation. In the absence of genomic DNA transcriptional regulation (no nucleus), platelets require strategic prepackaging of all the needed RNA and organelles from megakaryocytes, to sense stress (e.g., hyperglycemia), to protect themselves from stress (e.g., mitophagy), and to communicate a stress response to other cells (e.g., granule and microparticle release). Distinct from avian thrombocytes that have a nucleus, the absence of a nucleus allows the mammalian platelet to maintain its small size, permits morphological flexibility, and may improve speed and efficiency of protein expression in response to stress. In the absence of a nucleus, platelet lifespan of 7-10 days, is largely determined by the mitochondria. The packaging of 5-8 mitochondria is critical in aerobic respiration and yielding metabolic substrates needed for function and survival. Mitochondria damage or dysfunction, as observed with several disease processes, results in greatly attenuated platelet survival and increased risk for thrombovascular events. Here we provide insights into the emerging roles of platelets despite the lack of a nucleus, and the key role played by mitochondria in platelet function and survival both in health and disease.

Platelets in Neurodegenerative Conditions-Friend or Foe?

Abstract: It is now apparent that platelet function is more diverse than originally thought, shifting the view of platelets from blood cells involved in hemostasis and wound healing to major contributors to numerous regulatory processes across different tissues. Given their intriguing ability to store, produce and release distinct subsets of bioactive molecules, including intercellular signaling molecules and neurotransmitters, platelets may play an important role in orchestrating healthy brain function. Conversely, a number of neurodegenerative conditions have recently been associated with platelet dysfunction, further highlighting the tissue-independent role of these cells. In this review we summarize the requirements for platelet-neural cell communication with a focus on neurodegenerative diseases, and discuss the therapeutic potential of healthy platelets and the proteins which they release to counteract these conditions.

Prevalence of pre-stroke depression and its association with post-stroke depression: a systematic review and meta-analysis.

Abstract: Background: Depression is a common post-stroke complication. Pre-stroke depression may be an important contributor, however the epidemiology of pre-stroke depression is poorly understood. Using systematic review and meta-analysis, we described the prevalence of pre-stroke depression and its association with post-stroke depression. Methods: We searched multiple cross-disciplinary databases from inception to July 2017 and extracted data on the prevalence of pre-stroke depression and its association with post-stroke depression. We assessed the risk of bias (RoB) using validated tools. We described summary estimates of prevalence and summary odds ratio (OR) for association with post-stroke depression, using random-effects models. We performed subgroup analysis describing the effect of depression assessment method. We used a funnel plot to describe potential publication bias. The strength of evidence presented in this review was summarised via ‘GRADE’. Results: Of 11 884 studies identified, 29 were included (total participants n = 164 993). Pre-stroke depression pooled prevalence was 11.6% [95% confidence interval (CI) 9.2–14.7]; range: 0.4–24% (I2 95.8). Prevalence of pre-stroke depression varied by assessment method (p = 0.02) with clinical interview suggesting greater pre-stroke depression prevalence (~17%) than case-note review (9%) or self-report (11%). Pre-stroke depression was associated with increased odds of post-stroke depression; summary OR 3.0 (95% CI 2.3–4.0). All studies were judged to be at RoB: 59% of included studies had an uncertain RoB in stroke assessment; 83% had high or uncertain RoB for pre-stroke depression assessment. Funnel plot indicated no risk of publication bias. The strength of evidence based on GRADE was ‘very low’. Conclusions: One in six stroke patients have had pre-stroke depression. Reported rates may be routinely underestimated due to limitations around assessment. Pre-stroke depression significantly increases odds of post-stroke depression. Protocol identifier: PROSPERO identifier: CRD42017065544.

Plasma and White Blood Cells Show Different miRNA Expression Profiles in Parkinson’s Disease

Abstract: Parkinson's disease (PD) diagnosis is based on the assessment of motor symptoms, which manifest when more than 50% of dopaminergic neurons are degenerated To date, no validated biomarkers are available for the diagnosis of PD The aims of the present study are to evaluate whether plasma and white blood cells (WBCs) are interchangeable biomarker sources and to identify circulating plasma-based microRNA (miRNA) biomarkers for an early detection of PD We profiled plasma miRNA levels in 99 L-dopa-treated PD patients from two independent data collections, in ten drug-naive PD patients, and in unaffected controls matched by sex and age We evaluated expression levels by reverse transcription and quantitative real-time PCR (RT-qPCR) and combined the results from treated PD patients using a fixed effect inverse-variance weighted meta-analysis We revealed different expression profiles comparing plasma and WBCs and drug-naive and L-dopa-treated PD patients We observed an upregulation trend for miR-30a-5p in L-dopa-treated PD patients and investigated candidate target genes by integrated in silico analyses We could not analyse miR-29b-3p, normally expressed in WBCs, due to the very low expression in plasma We observed different expression profiles in WBCs and plasma, suggesting that they are both suitable but not interchangeable peripheral sources for biomarkers We revealed miR-30a-5p as a potential biomarker for PD in plasma In silico analyses suggest that miR-30a-5p might have a regulatory role in mitochondrial dynamics and autophagy Further investigations are needed to confirm miR-30a-5p deregulation and targets and to investigate the influence of L-dopa treatment on miRNA expression levels

Prospective Study of Depressive Symptoms and Risk of Stroke Among Japanese

Abstract: Background and Purpose—We sought to examine the relationship between depressive symptoms and the incidence of stroke among Japanese men and women. Methods—A 10.3-year prospective study on the relationship between depressive symptoms and the incidence of stroke was conducted with 901 men and women aged 40 to 78 years in a rural Japanese community. Depressive symptoms were measured at baseline with the use of the Zung Self-Rating Depression Scale (SDS). The incidence of stroke was ascertained under systematic surveillance. Results—During the 10-year follow-up, 69 strokes (39 ischemic strokes, 10 intracerebral hemorrhages, 10 subarachnoid hemorrhages, and 10 unclassified strokes) occurred. Age- and sex-adjusted prevalence of mild depression (SDS scores ≥40) at baseline was 25% among subjects with incident stroke and 12% among subjects without stroke (P<0.01). Persons with SDS scores in the high tertile had twice the age- and sex-adjusted relative risk of total stroke as those with scores in the low tertile. ...