Samuel Komoly - Academia.edu (original) (raw)
Papers by Samuel Komoly
Brain imaging and behavior, Jan 23, 2015
Neuroimaging findings suggest that excessive Internet use shows functional and structural brain c... more Neuroimaging findings suggest that excessive Internet use shows functional and structural brain changes similar to substance addiction. Even though it is still under debate whether there are gender differences in case of problematic use, previous studies by-passed this question by focusing on males only or by using gender matched approach without controlling for potential gender effects. We designed our study to find out whether there are structural correlates in the brain reward system of problematic Internet use in habitual Internet user females. T1-weighted Magnetic Resonance (MR) images were collected in 82 healthy habitual Internet user females. Structural brain measures were investigated using both automated MR volumetry and voxel based morphometry (VBM). Self-reported measures of problematic Internet use and hours spent online were also assessed. According to MR volumetry, problematic Internet use was associated with increased grey matter volume of bilateral putamen and right...
Parkinson's Disease, 2015
Objectives. Our investigation aimed at evaluating if bilateral subthalamic deep brain stimulation... more Objectives. Our investigation aimed at evaluating if bilateral subthalamic deep brain stimulation (DBS) could preserve working capability in Parkinson's disease (PD). Materials. We reviewed the data of 40 young (<60 year-old) PD patients who underwent DBS implantation and had at least 2 years of follow-up. Patients were categorized based on their working capability at time of surgery: "active job" group ( = 20) and "no job" group ( = 20). Baseline characteristics were comparable. Quality of life (EQ-5D) and presence of active job were evaluated preoperatively and 2 years postoperatively. Results. Although similar (approximately 50%) improvement was achieved in the severity of motor and major nonmotor symptoms in both groups, the postoperative quality of life was significantly better in the "active job" group (0.687 versus 0.587, medians, < 0.05). Majority (80%) of "active job" group members were able to preserve their job 2 years after the operation. However, only a minimal portion (5%) of the "no job" group members was able to return to the world of active employees ( < 0.01). Conclusions. Although our study has several limitations, our results suggest that in patients with active job the appropriately "early" usage of DBS might help preserve working capability and gain higher improvement in quality of life.
Movement Disorders, 2015
The pathophysiology of cervical dystonia is poorly understood. Increased brain iron deposition ha... more The pathophysiology of cervical dystonia is poorly understood. Increased brain iron deposition has been described in different movement disorders. Our aim was to investigate brain iron content in patients with cervical dystonia, using R2* relaxation rate, a validated MRI marker of brain iron level. Twelve female patients with primary focal cervical dystonia (mean age: 45.4 ± 8.0 years) and 12 age-matched healthy female subjects (mean age: 45.0 ± 8.0 years) underwent 3T MRI to obtain regional R2* relaxation rates of the thalamus, caudate nucleus, putamen, and globus pallidus (GP). Regions of interest were delineated automatically on T1-weighted MRIs. R2* values in the putamen were positively correlated with age. Patients with cervical dystonia showed elevated R2* values in the GP. This pilot study provides the first quantitative support for increased brain iron deposition in cervical dystonia. Further studies are needed to explore the implications of this finding.
Ideggyógyászati szemle, Jan 30, 2014
The Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Sc... more The Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) has been published in 2008 as the successor of the original UPDRS. The MDS-UPDRS organizing team developed guidelines for the development of official non-English translations consisting of four steps: translation/back-translation, cognitive pretesting, large field testing, and clinimetric analysis. The aim of this paper was to introduce the new MDS-UPDRS and its validation process into Hungarian. Two independent groups of neurologists translated the text of the MDS-UPDRS into Hungarian and subsequently back-translated into English. After the review of the back-translated English version by the MDS-UPDRS translation administration team, cognitive pretesting was conducted with ten patients. Based on the results of the initial cognitive pretesting, another round was conducted. For the large field testing phase, the Hungarian official working draft version of MDS-UPDRS was te...
International Immunology
The diagnosis of neuroborreliosis (NB)--a serious complication of Lyme disease--relies on demonst... more The diagnosis of neuroborreliosis (NB)--a serious complication of Lyme disease--relies on demonstration of intrathecal borrelia antibody production. We hypothesized that if a qualitative difference between the cerebrospinal fluid and the serum immunoblot-banding patterns was observed, then the borrelia antibodies found in the CSF could not be the result of leakage of serum antibodies to the CSF due to blood-brain barrier damage, but rather had to be produced intrathecally. CSF/serum pairs from 69 NB patients and from 85 control patients with other neurological disorders were investigated. All samples were tested blindly by immunoblot and a commercial capture ELISA kit for NB. The concordance between the two methods was 85.7%. When using the other method as reference, the accuracy of the two assays in the two patient materials was similar: 80% for sensitivity and 95% for specificity. Four types of comparative immunoblot-banding patterns that reflected intrathecal borrelia antibody sy...
Behavioural Neurology, 2015
Introduction. Among the nonmotor features of Parkinson's disease (PD), cognitive impairment is on... more Introduction. Among the nonmotor features of Parkinson's disease (PD), cognitive impairment is one of the most troublesome problems. New diagnostic criteria for mild and major neurocognitive disorder (NCD) in PD were established by Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5). The aim of our study was to establish the diagnostic accuracy of widely used screening tests for NCD in PD. Methods. Within the scope of our study we evaluated the sensitivity and specificity of different neuropsychological tests (Addenbrooke's Cognitive Examination (ACE), Mattis Dementia Rating Scale (MDRS), Mini Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA)) in 370 PD patients without depression. Results. MoCA and ACE feature the finest diagnostic accuracy for detecting mild cognitive disorder in PD (DSM-5) at the cut-off scores of 23.5 and 83.5 points, respectively. The diagnostic accuracy of these tests was 0.859 (95% CI: 0.818-0.894, MoCA) and 0.820 (95% CI: 0.774-0.859, ACE). In the detection of major NCD (DSM-5), MoCA and MDRS tests exhibited the best diagnostic accuracy at the cut-off scores of 20.5 and 132.5 points, respectively. The diagnostic accuracy of these tests was 0.863 (95% CI: 0.823-0.897, MoCA) and 0.830 (95% CI: 0.785-0.869, MDRS). Conclusion. Our study demonstrated that the MoCA may be the most suitable test for detecting mild and major NCD in PD.
Journal of Parkinson's disease, Jan 10, 2015
Sleep problems are among the most common non-motor symptoms of Parkinson's disease (PD). The ... more Sleep problems are among the most common non-motor symptoms of Parkinson's disease (PD). The PD Sleep Scale 2nd version (PDSS-2) improved the original PDSS by adding more items on different aspects of sleep problems, making it a more robust tool to evaluate the severity of sleep disturbances. However, previous studies on deep brain stimulation (DBS) have not used the PDSS-2. To determine if the PDSS-2 could detect improvement reliably in sleep problems after bilateral subthalamic nucleus DBS for PD. In this prospective study, 25 consecutive patients undergoing DBS implantation were enrolled. Patients were examined twice: 1 week prior to the DBS implantation (baseline) and 12 months postoperatively. Severity of PD symptoms were assessed by the Movement Disorders Society Unified PD Rating Scale (MDS-UPDRS) and the Non-Motor Symptoms Scale (NMSS). Presence and severity of sleep disturbances were specifically measured by PDSS-2. Total score of MDS-UPDRS improved from 81 (median, int...
Journal of Parkinson's disease, 2014
The aim of the present study was to measure the test-retest validity of Parkinson's Disease S... more The aim of the present study was to measure the test-retest validity of Parkinson's Disease Sleep Scale 2nd version (PDSS-2) on PD patients with stable medication and motor symptoms over the period of 4 weeks. The subject population consisted of 92 PD patients. Besides PDSS-2, Unified PD rating scale, Montgomery-Asberg Depression Rating Scale and EQ-5D were assessed at baseline and 4 weeks later. The total score of PDSS-2 decreased from 19.06 ± 10.78 points to 18.00 ± 9.34 points (p > 0.05). For the total score of PDSS-2 the Intra-class and Lin's Concordance Correlation Coefficients were 0.782 and 0.799. The average difference between the baseline and follow-up total PDSS-2 scores was -1.06 points with the 95% confidence interval of -7.96 and +5.84 points. Our data supports that the items and the total score of PDSS-2 have acceptable test-retest reliability over a four week period on patients with stable PD symptoms and pharmacological therapy.
Ideggyógyászati szemle, Jan 30, 2013
Journal of inherited metabolic disease, 2002
We describe sequence analysis of the mitochondrial DNA of five Hungarian patients diagnosed with ... more We describe sequence analysis of the mitochondrial DNA of five Hungarian patients diagnosed with probable LHON, who do not carry any of the three primary point mutations. We report three novel mutations, one of which might have a pathogenic role.
Word count for text: 705, Word count for abstract: none, character count for title: 94 Running ti... more Word count for text: 705, Word count for abstract: none, character count for title: 94 Running title: Status dystonicus in tardive dystonia
International journal of developmental neuroscience : the official journal of the International Society for Developmental Neuroscience, 2008
Oligodendroglial cells differ in their ultrastructural appearance depending on their myelin produ... more Oligodendroglial cells differ in their ultrastructural appearance depending on their myelin producing and maintaining activity. To better understand the relationship between light and electron microscopic features of myelination, myelin formation in the corpus callosum was studied in young postnatal mice. Immunostaining for myelin basic protein (MBP), which has an important role in myelin compaction, was compared with conventional Luxol Fast Blue myelin staining and with electron microscopic images of unlabeled tissue. MBP-immunostaining labeled a few oligodendroglial cells at postnatal day (P)3, and a few axons at P7 in the corpus callosum, below the fronto-parietal somatosensory cortex. By P10 there were more myelinated axons below the somatosensory cortex and the first MBP-immunoreaction appeared in the cingulum: labeling appeared even later in the remaining areas of corpus callosum. Electron microscopy revealed numerous medium oligodendroglial cells at P7 in the corpus callosum,...
Journal of the Neurological Sciences, 2015
Our goal was to identify brain structures responsible for pain-related autonomic changes by the c... more Our goal was to identify brain structures responsible for pain-related autonomic changes by the correlation of simultaneously acquired functional magnetic resonance imaging (fMRI) and electrocardiogram (ECG) data. Eighteen healthy men (age: 22.89 ± 1.96) were involved. Painful sensation was evoked by heat. Simultaneously recorded brain fMRI and ECG data during pain were compared to data acquired during a non-painful heat sensation. From the ECG data, time- and frequency domain parameters of heart rate variability (HRV) were extracted. We found that: (1) among the common elements of both pain network and central autonomic network (CAN) only the medial prefrontal frontal cortex (MPFC) showed significant correlation with HRV; (2) the parasympathetic response to the painful stimuli showed a positive, while the sympathetic response a negative association with pain related BOLD-signal change observed in MPFC; (3) time domain parameters of HRV were negatively associated with MPFC activation. The novelty of our study-compared to previous ECG-fMRI studies-is that we used pain as stimulus and investigated both frequency- and time-domain parameters of HRV. Compared to other stimuli used in earlier studies to activate the CAN, pain sensation can be standardized easier and might allow us to better understand the functional organization of CAN. The results of the current ECG-fMRI study may have direct clinical relevance in understanding the pathomechanisms of several clinical conditions. There are some simultaneous ECG-fMRI and ECG-Positron Emission Tomography (PET) studies, but limited information is available about the pain-related brain function-HRV relations. The novelty of our study is that we used pain as stimulus to activate the central autonomic network and investigated both frequency- and time-domain parameters of HRV.
Parkinson's Disease, 2014
Movement Disorder Society-sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) has sepa... more Movement Disorder Society-sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) has separate items for measuring sleep problems (item 1.7) and daytime sleepiness (1.8). The aim of our study was to evaluate the screening sensitivity and specificity of these items to the PD Sleep Scale 2nd version (PDSS-2) and Epworth Sleepiness Scale (ESS). In this nationwide, cross-sectional study 460 PD patients were enrolled. Spearman's rank correlation coefficients were calculated between the individual items, domains, and the total score of PDSS-2 and item 1.7 of MDS-UPDRS. Similarly, the items and the total score of ESS were contrasted to item 1.8 of MDS-UPDRS. After developing generalized ordinal logistic regression models, the transformed and observed scores were compared by Lin's Concordance Correlation Coefficient. Only item 3 difficulties staying asleep and the "disturbed sleep" domain of PDSS-2 showed high correlation with "sleep problems" item 1.7 of the MDS-UPDRS. Total score of PDSS-2 had moderate correlation with this MDS-UPRDS item. The total score of ESS showed the strongest, but still moderate, correlation with "daytime sleepiness" item 1.8 of MDS-UPDRS. As intended, the MDS-UPDRS serves as an effective screening tool for both sleep problems and daytime sleepiness and identifies subjects whose disabilities need further investigation.
Clinical Immunology, 2010
Oligodendrocyte loss and demyelination are major pathological hallmarks of multiple sclerosis. In... more Oligodendrocyte loss and demyelination are major pathological hallmarks of multiple sclerosis. In pattern III lesions, inflammation is minor in the early stages, and oligodendrocyte apoptosis prevails, which appears to be mediated at least in part through mitochondrial injury. Here, we demonstrate poly(ADP-ribose) polymerase activation and apoptosis inducing factor nuclear translocation within apoptotic oligodendrocytes in such multiple sclerosis lesions. The same morphological and molecular pathology was observed in an experimental model of primary demyelination, induced by the mitochondrial toxin cuprizone. Inhibition of poly(ADP-ribose) polymerase in this model attenuated oligodendrocyte depletion and decreased demyelination. Poly(ADP-ribose) polymerase inhibition suppressed c-Jun N-terminal kinase and p38 mitogenactivated protein kinase phosphorylation, increased the activation of the cytoprotective phosphatidylinositol-3 kinase-Akt pathway and prevented caspase-independent apoptosis inducing factor-mediated apoptosis. Our data indicate that poly(ADP-ribose) polymerase activation plays a crucial role in the pathogenesis of pattern III multiple sclerosis lesions. Since poly(ADP-ribose) polymerase inhibition was also effective in the inflammatory model of multiple sclerosis, it may target all subtypes of multiple sclerosis, either by preventing oligodendrocyte death or attenuating inflammation.
Psychiatry Research: Neuroimaging, 2008
Voxel-based morphometry and functional magnetic resonance imaging demonstrated severe atrophy and... more Voxel-based morphometry and functional magnetic resonance imaging demonstrated severe atrophy and decreased activation of visual attention areas and occipital lobes in a patient with early posterior cortical atrophy compared with healthy controls and patients with early Alzheimer&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease. Our complex approach indicates that structures responsible for attention can be damaged early in posterior cortical atrophy and may contribute to the characteristic decline in higher visual functions.
Proceedings of the National Academy of Sciences, 1992
To investigate insulin-like growth factor I (IGF-I) and IGF-I receptor gene expression during exp... more To investigate insulin-like growth factor I (IGF-I) and IGF-I receptor gene expression during experimental demyelination and myelin regeneration, young mice were fed cuprizone (( bis(cyclohexanone) oxaldihydrazone )). This copper-chelating agent produces demyelination in the corpus callosum and superior cerebellar peduncles, and when treatment is stopped, there is rapid remyelination. At intervals during cuprizone treatment and recovery, brain sections were hybridized with specific probes and immunostained with antibodies to determine the localization and relative amounts of IGF-I and IGF-I receptor mRNAs and peptides. In untreated littermates, IGF-I and IGF-I receptor mRNAs and peptides were not detected in white matter. In cuprizone-treated mice, high levels of both IGF-I mRNA and peptide were expressed by astrocytes in areas of myelin breakdown. Astrocyte IGF-I expression decreased rapidly during recovery and oligodendroglial expression of myelin-related genes increased. In severely demyelinated areas, immature oligodendroglia exhibited a transient increase in IGF-I receptor mRNA and peptide immunoreactivity during early recovery. This highly specific pattern of IGF-I induction in astrocytes during demyelination and the expression of the IGF-I receptor in regenerating oligodendrocytes during recovery suggest that IGF-I functions in the regulation of oligodendrocyte and myelin metabolism in vivo.
Phytomedicine, 2009
Introduction: Hemorheological factors play an important role in the pathomechanism of ischemic ce... more Introduction: Hemorheological factors play an important role in the pathomechanism of ischemic cerebrovascular disorders. Abnormal rheological conditions in patients with chronic cerebrovascular disease predispose for recurrent strokes. Vinpocetine (VP), a synthetic ethyl esther of apovincamine, has successfully been used in the treatment of cerebrovascular diseases, in part because of its favourable rheological effects.
Neuroscience Letters, 2008
The interleukin (IL) -23/IL-17 cytokine axis has been suggested to play an important role in the ... more The interleukin (IL) -23/IL-17 cytokine axis has been suggested to play an important role in the development of several autoimmune diseases including multiple sclerosis. Here, we compared the prevalence of C2370A single nucleotide polymorphism (SNP) in the 3 untranslated region (3 UTR) of the IL-23 receptor (IL23R) between 223 patients with relapsing-remitting multiple sclerosis (RRMS) and 200 healthy controls. The A2370A genotype was significantly over-represented among patients with RRMS (10.8%) and RRMS exhibiting oligoclonal bands in the cerebrospinal fluid (12.9%) when compared to healthy subjects (5.50%). Multiple regression analysis revealed that presence of AA genotype provides a two-fold risk for the development of multiple sclerosis (OR = 2.072, 95% CI: 0.988-4.347, p < 0.05). These data indicate that IL23R represents a novel shared susceptibility gene as its association with inflammatory bowel disease (IBD) has recently been verified.
Brain imaging and behavior, Jan 23, 2015
Neuroimaging findings suggest that excessive Internet use shows functional and structural brain c... more Neuroimaging findings suggest that excessive Internet use shows functional and structural brain changes similar to substance addiction. Even though it is still under debate whether there are gender differences in case of problematic use, previous studies by-passed this question by focusing on males only or by using gender matched approach without controlling for potential gender effects. We designed our study to find out whether there are structural correlates in the brain reward system of problematic Internet use in habitual Internet user females. T1-weighted Magnetic Resonance (MR) images were collected in 82 healthy habitual Internet user females. Structural brain measures were investigated using both automated MR volumetry and voxel based morphometry (VBM). Self-reported measures of problematic Internet use and hours spent online were also assessed. According to MR volumetry, problematic Internet use was associated with increased grey matter volume of bilateral putamen and right...
Parkinson's Disease, 2015
Objectives. Our investigation aimed at evaluating if bilateral subthalamic deep brain stimulation... more Objectives. Our investigation aimed at evaluating if bilateral subthalamic deep brain stimulation (DBS) could preserve working capability in Parkinson's disease (PD). Materials. We reviewed the data of 40 young (<60 year-old) PD patients who underwent DBS implantation and had at least 2 years of follow-up. Patients were categorized based on their working capability at time of surgery: "active job" group ( = 20) and "no job" group ( = 20). Baseline characteristics were comparable. Quality of life (EQ-5D) and presence of active job were evaluated preoperatively and 2 years postoperatively. Results. Although similar (approximately 50%) improvement was achieved in the severity of motor and major nonmotor symptoms in both groups, the postoperative quality of life was significantly better in the "active job" group (0.687 versus 0.587, medians, < 0.05). Majority (80%) of "active job" group members were able to preserve their job 2 years after the operation. However, only a minimal portion (5%) of the "no job" group members was able to return to the world of active employees ( < 0.01). Conclusions. Although our study has several limitations, our results suggest that in patients with active job the appropriately "early" usage of DBS might help preserve working capability and gain higher improvement in quality of life.
Movement Disorders, 2015
The pathophysiology of cervical dystonia is poorly understood. Increased brain iron deposition ha... more The pathophysiology of cervical dystonia is poorly understood. Increased brain iron deposition has been described in different movement disorders. Our aim was to investigate brain iron content in patients with cervical dystonia, using R2* relaxation rate, a validated MRI marker of brain iron level. Twelve female patients with primary focal cervical dystonia (mean age: 45.4 ± 8.0 years) and 12 age-matched healthy female subjects (mean age: 45.0 ± 8.0 years) underwent 3T MRI to obtain regional R2* relaxation rates of the thalamus, caudate nucleus, putamen, and globus pallidus (GP). Regions of interest were delineated automatically on T1-weighted MRIs. R2* values in the putamen were positively correlated with age. Patients with cervical dystonia showed elevated R2* values in the GP. This pilot study provides the first quantitative support for increased brain iron deposition in cervical dystonia. Further studies are needed to explore the implications of this finding.
Ideggyógyászati szemle, Jan 30, 2014
The Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Sc... more The Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) has been published in 2008 as the successor of the original UPDRS. The MDS-UPDRS organizing team developed guidelines for the development of official non-English translations consisting of four steps: translation/back-translation, cognitive pretesting, large field testing, and clinimetric analysis. The aim of this paper was to introduce the new MDS-UPDRS and its validation process into Hungarian. Two independent groups of neurologists translated the text of the MDS-UPDRS into Hungarian and subsequently back-translated into English. After the review of the back-translated English version by the MDS-UPDRS translation administration team, cognitive pretesting was conducted with ten patients. Based on the results of the initial cognitive pretesting, another round was conducted. For the large field testing phase, the Hungarian official working draft version of MDS-UPDRS was te...
International Immunology
The diagnosis of neuroborreliosis (NB)--a serious complication of Lyme disease--relies on demonst... more The diagnosis of neuroborreliosis (NB)--a serious complication of Lyme disease--relies on demonstration of intrathecal borrelia antibody production. We hypothesized that if a qualitative difference between the cerebrospinal fluid and the serum immunoblot-banding patterns was observed, then the borrelia antibodies found in the CSF could not be the result of leakage of serum antibodies to the CSF due to blood-brain barrier damage, but rather had to be produced intrathecally. CSF/serum pairs from 69 NB patients and from 85 control patients with other neurological disorders were investigated. All samples were tested blindly by immunoblot and a commercial capture ELISA kit for NB. The concordance between the two methods was 85.7%. When using the other method as reference, the accuracy of the two assays in the two patient materials was similar: 80% for sensitivity and 95% for specificity. Four types of comparative immunoblot-banding patterns that reflected intrathecal borrelia antibody sy...
Behavioural Neurology, 2015
Introduction. Among the nonmotor features of Parkinson's disease (PD), cognitive impairment is on... more Introduction. Among the nonmotor features of Parkinson's disease (PD), cognitive impairment is one of the most troublesome problems. New diagnostic criteria for mild and major neurocognitive disorder (NCD) in PD were established by Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5). The aim of our study was to establish the diagnostic accuracy of widely used screening tests for NCD in PD. Methods. Within the scope of our study we evaluated the sensitivity and specificity of different neuropsychological tests (Addenbrooke's Cognitive Examination (ACE), Mattis Dementia Rating Scale (MDRS), Mini Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA)) in 370 PD patients without depression. Results. MoCA and ACE feature the finest diagnostic accuracy for detecting mild cognitive disorder in PD (DSM-5) at the cut-off scores of 23.5 and 83.5 points, respectively. The diagnostic accuracy of these tests was 0.859 (95% CI: 0.818-0.894, MoCA) and 0.820 (95% CI: 0.774-0.859, ACE). In the detection of major NCD (DSM-5), MoCA and MDRS tests exhibited the best diagnostic accuracy at the cut-off scores of 20.5 and 132.5 points, respectively. The diagnostic accuracy of these tests was 0.863 (95% CI: 0.823-0.897, MoCA) and 0.830 (95% CI: 0.785-0.869, MDRS). Conclusion. Our study demonstrated that the MoCA may be the most suitable test for detecting mild and major NCD in PD.
Journal of Parkinson's disease, Jan 10, 2015
Sleep problems are among the most common non-motor symptoms of Parkinson's disease (PD). The ... more Sleep problems are among the most common non-motor symptoms of Parkinson's disease (PD). The PD Sleep Scale 2nd version (PDSS-2) improved the original PDSS by adding more items on different aspects of sleep problems, making it a more robust tool to evaluate the severity of sleep disturbances. However, previous studies on deep brain stimulation (DBS) have not used the PDSS-2. To determine if the PDSS-2 could detect improvement reliably in sleep problems after bilateral subthalamic nucleus DBS for PD. In this prospective study, 25 consecutive patients undergoing DBS implantation were enrolled. Patients were examined twice: 1 week prior to the DBS implantation (baseline) and 12 months postoperatively. Severity of PD symptoms were assessed by the Movement Disorders Society Unified PD Rating Scale (MDS-UPDRS) and the Non-Motor Symptoms Scale (NMSS). Presence and severity of sleep disturbances were specifically measured by PDSS-2. Total score of MDS-UPDRS improved from 81 (median, int...
Journal of Parkinson's disease, 2014
The aim of the present study was to measure the test-retest validity of Parkinson's Disease S... more The aim of the present study was to measure the test-retest validity of Parkinson's Disease Sleep Scale 2nd version (PDSS-2) on PD patients with stable medication and motor symptoms over the period of 4 weeks. The subject population consisted of 92 PD patients. Besides PDSS-2, Unified PD rating scale, Montgomery-Asberg Depression Rating Scale and EQ-5D were assessed at baseline and 4 weeks later. The total score of PDSS-2 decreased from 19.06 ± 10.78 points to 18.00 ± 9.34 points (p > 0.05). For the total score of PDSS-2 the Intra-class and Lin's Concordance Correlation Coefficients were 0.782 and 0.799. The average difference between the baseline and follow-up total PDSS-2 scores was -1.06 points with the 95% confidence interval of -7.96 and +5.84 points. Our data supports that the items and the total score of PDSS-2 have acceptable test-retest reliability over a four week period on patients with stable PD symptoms and pharmacological therapy.
Ideggyógyászati szemle, Jan 30, 2013
Journal of inherited metabolic disease, 2002
We describe sequence analysis of the mitochondrial DNA of five Hungarian patients diagnosed with ... more We describe sequence analysis of the mitochondrial DNA of five Hungarian patients diagnosed with probable LHON, who do not carry any of the three primary point mutations. We report three novel mutations, one of which might have a pathogenic role.
Word count for text: 705, Word count for abstract: none, character count for title: 94 Running ti... more Word count for text: 705, Word count for abstract: none, character count for title: 94 Running title: Status dystonicus in tardive dystonia
International journal of developmental neuroscience : the official journal of the International Society for Developmental Neuroscience, 2008
Oligodendroglial cells differ in their ultrastructural appearance depending on their myelin produ... more Oligodendroglial cells differ in their ultrastructural appearance depending on their myelin producing and maintaining activity. To better understand the relationship between light and electron microscopic features of myelination, myelin formation in the corpus callosum was studied in young postnatal mice. Immunostaining for myelin basic protein (MBP), which has an important role in myelin compaction, was compared with conventional Luxol Fast Blue myelin staining and with electron microscopic images of unlabeled tissue. MBP-immunostaining labeled a few oligodendroglial cells at postnatal day (P)3, and a few axons at P7 in the corpus callosum, below the fronto-parietal somatosensory cortex. By P10 there were more myelinated axons below the somatosensory cortex and the first MBP-immunoreaction appeared in the cingulum: labeling appeared even later in the remaining areas of corpus callosum. Electron microscopy revealed numerous medium oligodendroglial cells at P7 in the corpus callosum,...
Journal of the Neurological Sciences, 2015
Our goal was to identify brain structures responsible for pain-related autonomic changes by the c... more Our goal was to identify brain structures responsible for pain-related autonomic changes by the correlation of simultaneously acquired functional magnetic resonance imaging (fMRI) and electrocardiogram (ECG) data. Eighteen healthy men (age: 22.89 ± 1.96) were involved. Painful sensation was evoked by heat. Simultaneously recorded brain fMRI and ECG data during pain were compared to data acquired during a non-painful heat sensation. From the ECG data, time- and frequency domain parameters of heart rate variability (HRV) were extracted. We found that: (1) among the common elements of both pain network and central autonomic network (CAN) only the medial prefrontal frontal cortex (MPFC) showed significant correlation with HRV; (2) the parasympathetic response to the painful stimuli showed a positive, while the sympathetic response a negative association with pain related BOLD-signal change observed in MPFC; (3) time domain parameters of HRV were negatively associated with MPFC activation. The novelty of our study-compared to previous ECG-fMRI studies-is that we used pain as stimulus and investigated both frequency- and time-domain parameters of HRV. Compared to other stimuli used in earlier studies to activate the CAN, pain sensation can be standardized easier and might allow us to better understand the functional organization of CAN. The results of the current ECG-fMRI study may have direct clinical relevance in understanding the pathomechanisms of several clinical conditions. There are some simultaneous ECG-fMRI and ECG-Positron Emission Tomography (PET) studies, but limited information is available about the pain-related brain function-HRV relations. The novelty of our study is that we used pain as stimulus to activate the central autonomic network and investigated both frequency- and time-domain parameters of HRV.
Parkinson's Disease, 2014
Movement Disorder Society-sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) has sepa... more Movement Disorder Society-sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) has separate items for measuring sleep problems (item 1.7) and daytime sleepiness (1.8). The aim of our study was to evaluate the screening sensitivity and specificity of these items to the PD Sleep Scale 2nd version (PDSS-2) and Epworth Sleepiness Scale (ESS). In this nationwide, cross-sectional study 460 PD patients were enrolled. Spearman's rank correlation coefficients were calculated between the individual items, domains, and the total score of PDSS-2 and item 1.7 of MDS-UPDRS. Similarly, the items and the total score of ESS were contrasted to item 1.8 of MDS-UPDRS. After developing generalized ordinal logistic regression models, the transformed and observed scores were compared by Lin's Concordance Correlation Coefficient. Only item 3 difficulties staying asleep and the "disturbed sleep" domain of PDSS-2 showed high correlation with "sleep problems" item 1.7 of the MDS-UPDRS. Total score of PDSS-2 had moderate correlation with this MDS-UPRDS item. The total score of ESS showed the strongest, but still moderate, correlation with "daytime sleepiness" item 1.8 of MDS-UPDRS. As intended, the MDS-UPDRS serves as an effective screening tool for both sleep problems and daytime sleepiness and identifies subjects whose disabilities need further investigation.
Clinical Immunology, 2010
Oligodendrocyte loss and demyelination are major pathological hallmarks of multiple sclerosis. In... more Oligodendrocyte loss and demyelination are major pathological hallmarks of multiple sclerosis. In pattern III lesions, inflammation is minor in the early stages, and oligodendrocyte apoptosis prevails, which appears to be mediated at least in part through mitochondrial injury. Here, we demonstrate poly(ADP-ribose) polymerase activation and apoptosis inducing factor nuclear translocation within apoptotic oligodendrocytes in such multiple sclerosis lesions. The same morphological and molecular pathology was observed in an experimental model of primary demyelination, induced by the mitochondrial toxin cuprizone. Inhibition of poly(ADP-ribose) polymerase in this model attenuated oligodendrocyte depletion and decreased demyelination. Poly(ADP-ribose) polymerase inhibition suppressed c-Jun N-terminal kinase and p38 mitogenactivated protein kinase phosphorylation, increased the activation of the cytoprotective phosphatidylinositol-3 kinase-Akt pathway and prevented caspase-independent apoptosis inducing factor-mediated apoptosis. Our data indicate that poly(ADP-ribose) polymerase activation plays a crucial role in the pathogenesis of pattern III multiple sclerosis lesions. Since poly(ADP-ribose) polymerase inhibition was also effective in the inflammatory model of multiple sclerosis, it may target all subtypes of multiple sclerosis, either by preventing oligodendrocyte death or attenuating inflammation.
Psychiatry Research: Neuroimaging, 2008
Voxel-based morphometry and functional magnetic resonance imaging demonstrated severe atrophy and... more Voxel-based morphometry and functional magnetic resonance imaging demonstrated severe atrophy and decreased activation of visual attention areas and occipital lobes in a patient with early posterior cortical atrophy compared with healthy controls and patients with early Alzheimer&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease. Our complex approach indicates that structures responsible for attention can be damaged early in posterior cortical atrophy and may contribute to the characteristic decline in higher visual functions.
Proceedings of the National Academy of Sciences, 1992
To investigate insulin-like growth factor I (IGF-I) and IGF-I receptor gene expression during exp... more To investigate insulin-like growth factor I (IGF-I) and IGF-I receptor gene expression during experimental demyelination and myelin regeneration, young mice were fed cuprizone (( bis(cyclohexanone) oxaldihydrazone )). This copper-chelating agent produces demyelination in the corpus callosum and superior cerebellar peduncles, and when treatment is stopped, there is rapid remyelination. At intervals during cuprizone treatment and recovery, brain sections were hybridized with specific probes and immunostained with antibodies to determine the localization and relative amounts of IGF-I and IGF-I receptor mRNAs and peptides. In untreated littermates, IGF-I and IGF-I receptor mRNAs and peptides were not detected in white matter. In cuprizone-treated mice, high levels of both IGF-I mRNA and peptide were expressed by astrocytes in areas of myelin breakdown. Astrocyte IGF-I expression decreased rapidly during recovery and oligodendroglial expression of myelin-related genes increased. In severely demyelinated areas, immature oligodendroglia exhibited a transient increase in IGF-I receptor mRNA and peptide immunoreactivity during early recovery. This highly specific pattern of IGF-I induction in astrocytes during demyelination and the expression of the IGF-I receptor in regenerating oligodendrocytes during recovery suggest that IGF-I functions in the regulation of oligodendrocyte and myelin metabolism in vivo.
Phytomedicine, 2009
Introduction: Hemorheological factors play an important role in the pathomechanism of ischemic ce... more Introduction: Hemorheological factors play an important role in the pathomechanism of ischemic cerebrovascular disorders. Abnormal rheological conditions in patients with chronic cerebrovascular disease predispose for recurrent strokes. Vinpocetine (VP), a synthetic ethyl esther of apovincamine, has successfully been used in the treatment of cerebrovascular diseases, in part because of its favourable rheological effects.
Neuroscience Letters, 2008
The interleukin (IL) -23/IL-17 cytokine axis has been suggested to play an important role in the ... more The interleukin (IL) -23/IL-17 cytokine axis has been suggested to play an important role in the development of several autoimmune diseases including multiple sclerosis. Here, we compared the prevalence of C2370A single nucleotide polymorphism (SNP) in the 3 untranslated region (3 UTR) of the IL-23 receptor (IL23R) between 223 patients with relapsing-remitting multiple sclerosis (RRMS) and 200 healthy controls. The A2370A genotype was significantly over-represented among patients with RRMS (10.8%) and RRMS exhibiting oligoclonal bands in the cerebrospinal fluid (12.9%) when compared to healthy subjects (5.50%). Multiple regression analysis revealed that presence of AA genotype provides a two-fold risk for the development of multiple sclerosis (OR = 2.072, 95% CI: 0.988-4.347, p < 0.05). These data indicate that IL23R represents a novel shared susceptibility gene as its association with inflammatory bowel disease (IBD) has recently been verified.