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Öğe Acute sleep deprivation immediately increases serum GDNF, BDNF and VEGF levels in healthy subjects(Springer Japan Kk, 2022) Gorgulu, Yasemin; Caliyurt, Okan; Cinar, Rugul Kose; Sonmez, Mehmet BulentAcute sleep deprivation upregulates hippocampal neurogenesis. Neurotrophic factors such as glial cell line-derived neurotrophic factor (GDNF), brain-derived neurotrophic factor (BDNF), and vascular endothelial growth factor (VEGF) are mediators of neuronal plasticity and neurogenesis. These neurotrophins are involved in sleep and sleep disorders and are associated with sleep deprivation. In this study, it is aimed to investigate the changes of neurotrophin levels with total sleep deprivation in healthy individuals. Seventeen healthy young adults with a mean age of 19.8 (SD = 1.0) years underwent an experimental protocol consisting of 36 h of total sleep deprivation. Venous blood samples were obtained on Day1 at 09.00, on Day2 at 09.00, and at 21.00. Serum levels of neurotrophins were detected using the ELISA method. The participants were asked to mark the scores corresponding to their subjective energy, happiness, depression, tension levels on the visual analog scale; and sleepiness level on the Epworth Sleepiness Scale; during the course of the study. As a result of 36 h of sleep deprivation, serum GDNF, BDNF, and VEGF levels showed a statistically significant increase compared to the baseline values in the participants included in the study (P < 0.0001). While this increase was evident in 24 h, it continued after 36 h. In parallel, sleepiness levels, subjective depression, and tension levels increased, on the other hand, subjective energy and happiness scores decreased at a statistically significant level at the end of the study compared to basal values (P < 0.0001). The results show that acute sleep deprivation significantly affects and increases serum levels of neurotrophic factors, and it seems that these effects are likely to occur as an immediate response to the stress and disruption caused by sleep deprivation.Öğe Alterations of BDNF and GDNF serum levels in alcohol-addicted patients during alcohol withdrawal(European Journal Of Psychiatry, 2016) Sonmez, Mehmet Bulent; Gorgulu, Yasemin; Cinar, Rugul Kose; Kilic, Evnur Kahyaci; Unal, Aycan; Vardar, Mehmet ErdalBackground and Objectives: Brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF) are neurotrophic neuropeptides that play important roles in the synaptic plasticity, neuronal growth, survival and function. A possible neuroprotective role of neurotrophic factors against alcohol-induced cell damage has been suggested, and dysregulations in neurotrophic factors may be involved in the vulnerability to addiction. The aim of this study was to investigate the alterations of BDNF and GDNF serum levels in alcohol-addicted patients during alcohol withdrawal compared to healthy controls. Methods: BDNF and GDNF serum levels of 34 male inpatients diagnosed with alcohol addiction according to DSM-IV-TR were investigated during alcohol withdrawal (day 1, 7 and 14) in comparison to 32 healthy controls using an enzyme-linked immunosorbent assay (ELISA). Severity of alcohol withdrawal was measured by Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar), and intensity of alcohol craving was measured by Penn Alcohol Craving Scale (PACS) during alcohol withdrawal (day 1, 7 and 14). Results: BDNF serum levels increased significantly during alcohol withdrawal (p = 0.020). They were negatively correlated to the severity of alcohol withdrawal, and the correlation was close to being statistically significant (p = 0.058). BDNF and GDNF serum levels did not differ significantly between the patient and control groups. GDNF serum levels did not change significantly during alcohol withdrawal. Conclusions: Our results may provide support for the previously hypothesized role of BDNF in the neuroadaptation during alcohol withdrawal.Öğe Assessment of cardiovascular risk for serious mental disorders(Klinik Psikiyatri Dergisi, 2019) Cinar, Rugul Kose; Durmus, Pelin TasObjective: Incidence and prevalence of cardiovascular diseases in patients with severe mental disorders are higher than the general population. It was aimed to calculate the 10 year cardiovascular disease risk by using Framingham risk scoring (FRS) and investigate the relationship between this score and C-reactive protein in psychiatric inpatients of a university hospital. Method: Inpatients with the diagnosis of major depression, bipolar disorders and psychotic disorders in six months time were included in the study.Participants were assessed based on their gender, age, body mass index, waist circumference, FRS, and CRP levels. Results: The calculated 10 year cardiovascular disease development risk did not differ between the diagnosis (p=0,39), but found to be significantly higher in males than females (p=0,002). FRS levels showed positive correlations with male gender (p=0,002), age (p=0,000), waist circumference (p=0,001), and body mass index (p=0,001). Discussion: We have to evaluate coexisting somatic diseases of psychiatric patients as well as behavioral and psychological problems. Using FRS, evaluating body mass index and waist circumference could help us predict the risky population and we could consider our drug treatment choices accordingly.Öğe Decreased interoceptive awareness in patients with substance use disorders(Taylor & Francis Inc, 2017) Sonmez, Mehmet Bulent; Kilic, Evnur Kahyaci; Col, Isil Ates; Gorgulu, Yasemin; Cinar, Rugul KoseIntroduction: The current study was prepared based on the assumption that awareness of the interoceptive processes may be disturbed in addicted individuals, Methods: The participants in the study included 84 abstinent male inpatients who were addicted to alcohol (n = 33), heroin (n = 29), or synthetic cannabinoids (n = 22) according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), and 35 healthy male volunteers. Interoceptive awareness (IA) was measured using the heartbeat perception (HBP) task. Addiction severity was assessed using the addiction profile index (API). Alexithymia was assessed using the Toronto alexithymia scale (TAS-20). Results: Patients addicted to alcohol, heroin, or synthetic cannabinoids had similar IA, and their HBP scores were significantly lower than those of healthy control subjects. There was a significant negative correlation between HBP scores and TAS-20 subscores, thus indicating difficulties in identifying feelings. HBP scores were not significantly correlated with API scores. API scores were significantly correlated with total alexithymia scores and subscores, thus indicating difficulties in identifying and describing feelings. Discussion: As our main finding, a decrease in IA in addicted patients in comparison to healthy controls may provide support for the hypothesis that awareness of the interoceptive processes may be disturbed in addiction.Öğe Effects of Selective Serotonin Reuptake Inhibitors on Macular Ganglion Cell Complex Thickness and Peripapillary Retinal Nerve Fiber Layer Thickness(Taylor & Francis Inc, 2018) Guclu, Hande; Gorgulu, Yasemin; Gurlu, Vuslat Pelitli; Cinar, Rugul Kose; Ozal, Sadik Altan; Caliyurt, OkanPurpose: To evaluate macular ganglion cell complex (GCC) thickness and peripapillary retinal nerve fiber layer (RNFL) thickness in patients treated with SSRIs.Methods: The present study included 62 eyes of 31 patients who were using SSRIs and 60 eyes of 30 healthy, age- and gender-matched control subjects. All patients underwent a full ophthalmological examination in which macular thickness, GCC thickness, and peripapillary RNFL thickness were measured using optical coherence tomography (OCT). The Mann-Whitney U test was used to compare the patients' group with the age- and gender-matched control group. Pearson correlation analyses were also performed to assess the relationships between macular thickness, GCC thickness, RNFL thickness, and the duration of SSRI usage.Results: The mean duration of SSRI usage was 29.9627.19 (range 6-120) months. The foveal thickness was 253.48 +/- 22.77 mu m in the patients' group and 266.60 +/- 20.64 mu m in the control group; the difference between the groups was statistically significant. In addition, the perifoveal GCC thickness in the inferonasal and inferotemporal quadrant were significantly smaller thinner in the patient group (Mann-Whitney U test, p=0.021and p=0.013, respectively).Conclusions: Our results suggest a relation between SSRIs and decreased retinal GCC thickness and RNFL thickness. Future long-term prospective studies should elucidate the actual effect of SSRIs on GCC and RNFL thickness.Öğe Evaluation of phosphatidylethanol by ELISA for detection of excessive alcohol use compared with traditional biomarkers: a case-control study(Taylor & Francis Ltd, 2017) Sonmez, Mehmet Bulent; Cinar, Rugul Kose; Gorgulu, Yasemin; Kilic, Evnur Kahyaci; Unal, AycanObjective: The highly sensitive chromatographic methods for quantifying phosphatidylethanol (PEth) require high levels of expertice and expensive instrumentation. Enzyme-linked immunosorbent assay (ELISA) kits have been developed for research purposes, but the implementation of PEth immunoassays to screen alcohol consumption has not been applied to the analysis of clinical samples. Our aim was to examine the ELISA method for PEth analysis in clinical samples. Methods: We examined the alterations of the PEth serum levels of 22 male inpatients diagnosed with alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, during alcohol withdrawal (at days 1, 7, and 14) compared to 32 healthy controls using ELISA. All patients were admitted for detoxification treatment at the Alcohol and Substance Addiction Treatment and Rehabilitation Center, Trakya University School of Medicine, Edirne, Turkey. Control subjects were assessed with an initial clinical interview and screened with the Alcohol Use Disorder Identification Test (AUDIT), and they included 16 nondrinkers (AUDIT score = 0) and 16 social drinkers (AUDIT score < 8). We examined the diagnostic accuracy of PEth compared to the traditional biomarkers according to the receiver operating characteristic curve analysis. Results: The patients undergoing detoxification had higher baseline PEth levels than the nondrinkers and social drinkers; the difference between groups showed a marginal trend towards significance (p = 0.052). PEth was correlated with the self-reported drinking amount in the past month and AUDIT scores, and the correlations showed marginal trends towards significance (r(s) = 0.269, p = 0.049; and rs = 0.266, p = 0.052; respectively). The PEth levels were statistically significantly correlated with gamma-glutamyl transferase (GGT) (r(s) = 0.355, p = 0.010), the correlations with alanine aminotransferase (ALT) and aspartate aminotransferase (AST) trended towards statistical significance (r(s) = 0.230, p = 0.095; and r(s) = 0.261, p = 0.056, respectively), and PEth was not statistically significantly correlated with mean corpuscular volume (MCV) (r(s) = 0.100, p = 0.478). PEth levels decreased statistically significantly during alcohol withdrawal (p = 0.002). PEth levels of the nondrinkers and social drinkers did not differ statistically significantly (p = 1.000). The area under the curve (AUC) for PEth measured by ELISA was statistically significantly higher than 0.5 (AUC = 0.691, p = 0.024), but PEth had poorer diagnostic efficacy than GGT (AUC = 0.933, p < 0.001), AST (AUC = 0.931, p < 0.001), MCV (AUC = 0.803, p < 0.001), and ALT (AUC = 0.789, p < 0.01). Conclusions: The AUC of 0.69 shows that the diagnostic accuracy of the assay was poor, regardless of a statistical comparison to 0.5. The use of serum might have led to low concentrations that have not differed much between heavy drinkers and social drinkers or abstainers. Whole blood ELISA implementation for the quantification of PEth may increase its diagnostic efficacy.Öğe Impact of Experiencing Acute Coronary Syndrome Prior to Open Heart Surgery on Psychiatric Status(Soc Brasil Cirurgia Cardiovasc, 2016) Yuksel, Volkan; Gorgulu, Yasemin; Cinar, Rugul Kose; Huseyin, Serhat; Sonmez, Mehmet Bulent; Canbaz, SuatObjective: The incidence of depression and anxiety is higher in patients with acute coronary syndrome. The aim of this study is to determine whether experiencing acute coronary syndrome prior to open heart surgery affects patients in terms of depression, hopelessness, anxiety, fear of death and quality of life. Methods: The study included 63 patients who underwent coronary bypass surgery between January 2015 and January 2016. The patients were divided into two groups: those diagnosed after acute coronary syndrome (Group 1) and those diagnosed without acute coronary syndrome (Group 2). Beck depression scale, Beck hopelessness scale, Templer death anxiety scale and death depression scale, State-Trait anxiety inventory and WHOQOL-Bref quality of life scale were applied. Results: There was no significant difference between the two groups in terms of the total score obtained from Beck depression scale, Beck hopelessness scale - future-related emotions, loss of motivation, future-related expectations subgroups, death anxiety scale, the death depression scale, State-Trait Anxiety Inventory social and environmental subgroups. The mental quality of life sub-scores of group 2 were significantly higher. The patients in both groups were found to be depressed and hopeless about the future. Anxiety levels were found to be significantly higher in all of the patients in both groups. Conclusion: Acute coronary syndrome before coronary artery bypass surgery impairs more the quality of life in mental terms. But unexpectedly there are no differences in terms of depression, hopelessness, anxiety and fear of death.Öğe Late-onset clozapine-induced neutropenia treated with lithium(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2019) Durmus, Pelin Tas; Gorgulu, Yasemin; Sonmez, Mehmet Bulent; Cinar, Rugul KoseClozapine is a second-generation antipsychotic drug, proven to be effective in treatment-resistant schizophrenia. Among patients using clozapine; the incidence of neutropenia is approximately 3% and the incidence of agranulocytosis is approximately 1%. This side effect is diminishing after 18 weeks of drug initiation. Here, we present a case of clozapine-induced neutropenia in a schizophrenic patient seen after 7 years of clozapine use and its treatment with lithium supplementation.Öğe Neuroserpin in Bipolar Disorder(Bentham Science Publ Ltd, 2020) Cinar, Rugul KoseObjective: Neuroserpin is a serine protease inhibitor predominantly expressed in the nervous system functioning mainly in neuronal migration and axonal growth. Neuroprotective effects of neuroseipin were shown in animal models of stroke, brain, and spinal cord injury. Postmortem studies confirmed the involvement of neuroserpin in Alzheimer's disease. Since altered adult neurogenesis was postulated as an aetiological mechanism for bipolar disorder, the possible effect of neuroserpin gene expression in the disorder was evaluated. Methods: Neuroserpin mRNA expression levels were examined in the peripheral blood of bipolar disorder type I manic and euthymic patients and healthy controls using the polymerase chain reaction method. The sample comprised of 60 physically healthy, middle-aged men as participants who had no substance use disorder. Results: The gene expression levels of neuroserpin were found lower in the bipolar disorder patients than the healthy controls (p=0.000). The neuroserpin levels did not differ between mania and euthymia (both 96% down-regulated compared to the controls). Conclusion: Since we detected differences between the patients and the controls, not the disease states, the dysregulation in the neuroserpin gene could be interpreted as a result of the disease itself.Öğe Peripheral blood mRNA expressions of stress biomarkers in manic episode and subsequent remission(Pergamon-Elsevier Science Ltd, 2016) Cinar, Rugul Kose; Sonmez, Mehmet Bulent; Gorgulu, YaseminTheoretical models of the neuroprogressive nature of bipolar disorder (BD) are based on the hypothesis that it is an accelerated aging disease, with the allostatic load playing a major role. Glucocorticoids, oxidative stress markers, inflammatory cytokines and neurotrophins play important roles in BD. The messenger ribonucleic acid (mRNA) expressions of brain-derived neurotrophic factor (BDNF), tissue plasminogen activator (tPA), glucocorticoid receptor (GR), heat shock protein 70 (HSP70), tumour necrosis factor alpha (TNF-alpha) were examined in the peripheral blood of 20 adult male, drug-free BD patients during manic and remission periods and in 20 adult male, healthy controls. mRNA expression was measured using the quantitative real-time polymerase chain reaction (qRT-PCR). Compared to the controls, the expressions of BDNF and tPA mRNA were down-regulated in mania. In remission, BNDF and tPA mRNA levels increased, but they were still lower than those of the controls. Between mania and remission periods, only the change in mRNA levels of BDNF reached statistical significance. The results suggest that BDNF and tPA may be biomarkers of BD and that proteolytic conversion of BDNF may be important in the pathophysiology of BD. The change in BDNF levels between mania and remission could be adaptive and used to follow the progression of BD. (C) 2016 Elsevier Ltd. All rights reserved.Öğe Psychotic depression after obesity surgery and recovery with vitamin B12 replacement(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2019) Sozer, Kubra; Gorgulu, Yasemin; Sonmez, Mehmet Bulent; Cinar, Rugul KoseWhile obesity surgery can improve obesity and its complications, it may decrease the absorption of some foods in the stomach. It is known that from the first day after gastric bypass operation, the blood level of B12 start to decrease. However, the change of B12 levels can be measurable after 6 months. B12 deficiency may cause several psychiatric and neurological disorders or aggravate psychiatric symptoms. In this case report, we present a patient who had been in remission before gastric surgery but developed major depression with psychotic features and to describe the course of treatment.Öğe Serum agouti-related protein (AgRP) levels in bipolar disorder: Could AgRP be a state marker for mania?(Elsevier Ireland Ltd, 2018) Parlak, Naci; Gorgulu, Yasemin; Cinar, Rugul Kose; Sonmez, Mehmet Bulent; Parlak, EbruOrexigenic and anorexigenic peptides, especially agouti-related protein (AgRP) and leptin, play important roles in the regulation of energy homeostasis in bipolar disorder. AgRP regulates energy metabolism by increasing appetite and decreasing energy expenditure. The resting energy expenditures of patients with manic bipolar disorder are higher than those of controls. Due to the effects of AgRP on energy expenditure and the increased physical activity of manic patients, we hypothesised that serum AgRP levels may be lower in manic patients than in euthymic patients and controls. There was a total of 112 participants, including 47 patients in the manic group, 35 patients in the euthymic group and 30 healthy controls. For this study, serum AgRP, leptin, cholesterol, and cortisol levels were measured and compared between the groups. The serum AgRP, leptin, and cholesterol levels were significantly different between the groups. The serum AgRP levels of manic group were significantly lower than those of euthymic and control groups. The lower serum AgRP levels of manic patients could be indicators of impaired energy homeostasis during manic episodes. Since the serum AgRP levels of manic patients are lower than those of euthymic patients and controls, AgRP could be a state marker for manic episodes.Öğe Substance Use and Parent Characteristics Among High School Students: Edirne Sample in Turkey(Routledge Journals, Taylor & Francis Ltd, 2016) Sonmez, Mehmet Bulent; Cakir, Digdem; Cinar, Rugul Kose; Gorgulu, Yasemin; Vardar, ErdalThe current study on substance use and family characteristics of adolescents is a part of the extensive research on substance use characteristics among high school students in Edirne, Turkey. This cross-sectional study was conducted with 8,483 high school students within the 2010-2011 academic year. Self-administered questionnaires were completed anonymously by the participants. The lifetime prevalence of alcohol use was 24.6% and tobacco use was 21.4%. The most commonly used illicit substance was cannabis (1%), followed by inhalants (0.5%) and ecstasy (0.4%). The use of alcohol, tobacco, and nearly all the illegal substances was significantly higher among males compared to females. The rates of lifetime substance use varied by family-related factors such as family structure, perceived parental attitudes and intrafamilial relationships, parental socioeconomic status, and parental substance use. The limitations and implications of these findings are discussed.Öğe Telomere length and hTERT in mania and subsequent remission(Assoc Brasileira Psiquiatria, 2018) Cinar, Rugul KoseObjective: The findings of telomere length (TL) studies in bipolar disorder (BD) are controversial. The aim of the present study was to detect TL, human telomerase reverse transcriptase (hTERT), and brain derived neurotrophic factor (BDNF) in severe mania and subsequent remission. Methods: Twenty-one medication-free male patients and 20 age and gender matched controls were recruited. The patients were followed in the inpatient clinic, and comparisons were made between the same patients in their remission state and controls. Patients received lithium plus antipsychotics during the follow-up period. Quantitative real-time polymerase chain reaction was performed to verify leukocyte TL and whole blood hTERT gene expression levels. Serum BDNF levels were verified by enzyme-linked immunosorbent assay (ELISA). Results: Compared to controls, manic patients presented shorter telomeres (p < 0.001) whose length increased with treatment (p = 0.001). Patients in the late stages showed shorter TL than those in the early stages and controls (p < 0.001). hTERT gene expression levels were up-regulated in mania and remission compared to controls (p = 0.03 and p = 0.01, respectively). BDNF changes did not reach statistically significant levels. Conclusions: TL and hTERT gene expression might reflect a novel aspect of BD pathophysiology and TL might represent a novel biomarker for BD staging.Öğe Transient changes in inflammatory and oxidative stress markers with total sleep deprivation(Springer Japan Kk, 2016) Cinar, Rugul Kose; Gorgulu, Yasemin; Caliyurt, Okan; Sonmez, BulentSleep deprivation (SD) is known to modulate inflammatory and oxidative stress markers. How these markers change over the SD period have seldom been studied in healthy young adults. Seventeen healthy young adults with a mean age of 19.8 +/- 1.0 years underwent an experimental protocol consisting of 36 h of total SD. We tested whether the stress response was towards adaptation or a worsening of the response. We analysed blood for gene expression levels of interleukins (IL-1 beta, IL-6, IL-33), tumour necrosis factor-alpha (TNF-alpha), glutathione (GSH), heat-shock protein 70 (HSP70), and a member of the signal transducers and activators of transcription (STAT3) family with quantitative real-time polymerase chain reaction (qRT-PCR). We also measured plasma levels of cortisol and malondialdehyde (MDA) with a spectrophotometer. All measurements were made at baseline and at the 24th and 36th hour of the study. IL-1 beta, IL-6, and GSH gene expression levels were up-regulated at the 24th hour and down-regulated at the 36th hour (p < 0.05 for all). IL-33 gene expression levels showed no change at the 24th hour and down-regulation at the 36th hour. TNF-alpha gene expression levels were down-regulated at the 24th hour and up-regulated at the 36th hour. Cortisol levels showed a gradual increase at all the measurement points (p < 0.05 for all). HSP70, MDA, and STAT3 had no significant changes. The present study demonstrated that the hyperactivation of the hypothalamic-pituitary-adrenal (HPA) and sympathetic-adrenal-medullary (SAM) axes shown by the up-regulation of genes seen after a sleepless night is a normal response to acute stress, and by increasing the time spent sleepless, the HPA and SAM axes may return to their normal functioning levels.
