Browsing by Author "Calic, Zeljka (56453540500)"

Objectives: metabolic syndrome (MetS) increases risk of cardiovascular diseases and diabetes mellitus type 2. Aim of this study was to investigate frequency and features of MetS in a large cohort of patients with DM2. Materials & methods: this cross-sectional study included 47 DM2 patients. Patients were matched with 94 healthy controls (HCs) for gender and age. MetS was diagnosed according to the new worldwide consensus criteria from 2009. Results: mean age of DM2 patients was 52 ± 11 years, 15 (32%) were males, and mean disease duration was 15 ± 14 years. MetS was present in 53% of DM2 patients and 46% of HCs (p > 0.05). All components of the MetS appeared with the similar frequency in DM2 and HCs, respectively: hypertension 64 vs 52%, central obesity 62 vs 74%, hypertriglyceridemia 49 vs 39%, hyperglycemia 42 vs 33% and low HDL cholesterol 30 vs 42% (p > 0.05). DM2 patients were more commonly on lipid lowering therapy compared to HCs (12 vs 3%, p = 0.05). Fifteen (32%) patients with DM2 and only one (1%) subject from control group had diabetes mellitus (p < 0.01). Insulin resistance was found in thirty (65%) patients with DM2. Presence of MetS was not associated with patient’s gender, age, severity nor duration of the disease (p > 0.05). Conclusions: more than half of DM2 subjects met the criteria for the MetS. We suppose that treatment of metabolic disturbances may reduce cardiovascular complications and improve quality of life in patients with DM2, which is progressive and still incurable disorder. © Gaetano Conte Academy.

Background and Purpose: This study was undertaken to examine vestibulo-ocular reflex (VOR) characteristics in myotonic dystrophy type 1 (DM1) and type 2 (DM2) using video head impulse testing (vHIT). Methods: VOR gain, refixation saccade prevalence, first saccade amplitude, onset latency, peak velocity, and duration were compared in DM1, DM2, age-matched normal controls, and patients with peripheral and central vestibulopathies. Results: Fifty percent of DM1 and 37.5% of DM2 patients demonstrated reduced VOR gain. Refixation saccade prevalence for horizontal canal (HC) and posterior canal (PC) was significantly higher in DM1 (101 ± 42%, 82 ± 47%) and DM2 (70 ± 45%, 61 ± 38%) compared to controls (40 ± 28% and 43 ± 33%, p < 0.05). The first saccade amplitudes and peak velocities were higher in HC and PC planes in DM1 and DM2 compared to controls (p < 0.05). HC slow phase eye velocity profiles in DM1 showed delayed peaks. The asymmetry ratio, which represents the percentage difference between the first and second halves of the slow phase eye velocity response, was therefore negative (−22.5 ± 17%, −2.3 ± 16%, and − 4.7 ± 8% in DM1, DM2, and controls). HC VOR gains were lower and gain asymmetry ratio was larger and negative in patients with DM1 with moderate to severe ptosis and a history of imbalance and falls compared to the remaining DM1 patients (p < 0.05). In peripheral vestibulopathies, saccade amplitude was larger, peak velocity was higher, and onset latency was shorter (p < 0.05) than in DM1. In central vestibulopathy (posterior circulation strokes), saccade peak velocity was higher, but amplitude and onset latency were not significantly different from DM1. Conclusions: VOR impairment is common in DM1 and DM2. In DM1, refixation saccade characteristics are closer to central than peripheral vestibulopathies. Delayed peaks in the vHIT eye velocity profile observed in patients with DM1 may reflect extraocular muscle weakness. VOR impairment and VOR asymmetry in DM1 are associated with imbalance and falls. © 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

Background and Purpose: This study was undertaken to examine vestibulo-ocular reflex (VOR) characteristics in myotonic dystrophy type 1 (DM1) and type 2 (DM2) using video head impulse testing (vHIT). Methods: VOR gain, refixation saccade prevalence, first saccade amplitude, onset latency, peak velocity, and duration were compared in DM1, DM2, age-matched normal controls, and patients with peripheral and central vestibulopathies. Results: Fifty percent of DM1 and 37.5% of DM2 patients demonstrated reduced VOR gain. Refixation saccade prevalence for horizontal canal (HC) and posterior canal (PC) was significantly higher in DM1 (101 ± 42%, 82 ± 47%) and DM2 (70 ± 45%, 61 ± 38%) compared to controls (40 ± 28% and 43 ± 33%, p < 0.05). The first saccade amplitudes and peak velocities were higher in HC and PC planes in DM1 and DM2 compared to controls (p < 0.05). HC slow phase eye velocity profiles in DM1 showed delayed peaks. The asymmetry ratio, which represents the percentage difference between the first and second halves of the slow phase eye velocity response, was therefore negative (−22.5 ± 17%, −2.3 ± 16%, and − 4.7 ± 8% in DM1, DM2, and controls). HC VOR gains were lower and gain asymmetry ratio was larger and negative in patients with DM1 with moderate to severe ptosis and a history of imbalance and falls compared to the remaining DM1 patients (p < 0.05). In peripheral vestibulopathies, saccade amplitude was larger, peak velocity was higher, and onset latency was shorter (p < 0.05) than in DM1. In central vestibulopathy (posterior circulation strokes), saccade peak velocity was higher, but amplitude and onset latency were not significantly different from DM1. Conclusions: VOR impairment is common in DM1 and DM2. In DM1, refixation saccade characteristics are closer to central than peripheral vestibulopathies. Delayed peaks in the vHIT eye velocity profile observed in patients with DM1 may reflect extraocular muscle weakness. VOR impairment and VOR asymmetry in DM1 are associated with imbalance and falls. © 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

Objective: Vestibular impairment may be present in and contribute to imbalance in patients with hereditary neuropathies. We examined the vestibulo-ocular reflex (VOR) characteristics in peripheral myelin protein 22 neuropathies using the video head-impulse test (vHIT). Methods: 23 patients with Charcot-Marie-Tooth disease 1A (CMT1A) and 17 with hereditary neuropathy with liability to pressure palsies (HNPP) were recruited. Three-dimensional vHIT was performed. VOR-gain and latency, refixation-saccade prevalence and first-saccade amplitude, onset-latency, peak-velocity and duration were examined and compared against age-matched controls. Results: In CMT1A and HNPP gait imbalance was reported in 78.3 % and 58.8 % of patients, resulting in recurrent falls in 65.2 % and 23.5 %. Reduced VOR-gain affecting the posterior-canals (PCs) was found in 47.8 % of CMT1A and 11.7 % of HNPP patients. First saccade amplitude and peak-velocities higher in horizontal-canal (HC) and PC in the CMT1A group compared to controls (p < 0.05). In HNPP, first saccades were larger in HC and anterior-canal (AC) planes; saccade peak-velocity was higher in AC and PC planes compared to controls (p < 0.05). In CMT1A, VOR-gain impairment was associated with higher Charcot-Marie-Tooth Examination Score, longer disease duration, and higher total Overall Neuropathy Limitation Scale score (p < 0.05) and VOR-gain was lower for PC in patients with a history of recurrent falls (p < 0.05). VOR-latency was significantly longer in HC and PCs in CMT1A compared to controls (p < 0.05). Conclusions: VOR impairment and slowing of the VOR-latency is found in CMT1A but not the HNPP cohort. These findings may relate to demyelinating processes affecting the vestibular nerves and thus the VOR pathways. Significance: VHIT allows detection of VOR impairment which could be an additional contributor to imbalance and falls in patients with CMT1A. © 2025

Objective: Vestibular impairment may be present in and contribute to imbalance in patients with hereditary neuropathies. We examined the vestibulo-ocular reflex (VOR) characteristics in peripheral myelin protein 22 neuropathies using the video head-impulse test (vHIT). Methods: 23 patients with Charcot-Marie-Tooth disease 1A (CMT1A) and 17 with hereditary neuropathy with liability to pressure palsies (HNPP) were recruited. Three-dimensional vHIT was performed. VOR-gain and latency, refixation-saccade prevalence and first-saccade amplitude, onset-latency, peak-velocity and duration were examined and compared against age-matched controls. Results: In CMT1A and HNPP gait imbalance was reported in 78.3 % and 58.8 % of patients, resulting in recurrent falls in 65.2 % and 23.5 %. Reduced VOR-gain affecting the posterior-canals (PCs) was found in 47.8 % of CMT1A and 11.7 % of HNPP patients. First saccade amplitude and peak-velocities higher in horizontal-canal (HC) and PC in the CMT1A group compared to controls (p < 0.05). In HNPP, first saccades were larger in HC and anterior-canal (AC) planes; saccade peak-velocity was higher in AC and PC planes compared to controls (p < 0.05). In CMT1A, VOR-gain impairment was associated with higher Charcot-Marie-Tooth Examination Score, longer disease duration, and higher total Overall Neuropathy Limitation Scale score (p < 0.05) and VOR-gain was lower for PC in patients with a history of recurrent falls (p < 0.05). VOR-latency was significantly longer in HC and PCs in CMT1A compared to controls (p < 0.05). Conclusions: VOR impairment and slowing of the VOR-latency is found in CMT1A but not the HNPP cohort. These findings may relate to demyelinating processes affecting the vestibular nerves and thus the VOR pathways. Significance: VHIT allows detection of VOR impairment which could be an additional contributor to imbalance and falls in patients with CMT1A. © 2025