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Bipolar bozukluk hastaları ve etkilenmemiş birinci derece yakınlarında optik koherens tomografi bulgularının oksidatif stres parametreleri ile ilişkisi / The relation of optical coherence tomography findings with oxidative stress parameters in bipolar disorder patients and unaffected first-degree relatives

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dc.contributor.advisorProf. Dr. İsmet KIRPINAR
dc.contributor.authorKILIÇARSLAN, TEZER
dc.date.accessioned2020-10-21T07:17:31Z
dc.date.available2020-10-21T07:17:31Z
dc.date.issued2020-08
dc.descriptionThesis (Medical)--Bezmialem Vakıf University, Faculty of Medicine, Department of Mental Health and Diseases, Istanbul, 2020.tr_TR
dc.description.abstractIntroduction: Neuroimaging studies have revealed that there are some structural changes such as gray matter volume reduction, ventriculer enlargement in patients with bipolar disorder, which support the neurodegenerative hypothesis of the disease. Optical Coherence Tomography (OCT) is a noninvasive imaging technique used in the psychiatric patient group. Decreased thickness of retinal sublayers has been reported in patients with bipolar disorder and it has been tought that these changes might be a sign of central nervous system (CNS) neurodegeneration. Oxidative stress, which means increased reactive oxygen species, also plays a role in the pathopyhsiology of bipolar disorder. In this study, firstly it is aimed to investigate the relationship between bipolar disorder patients and unaffected first degree relatives of optical coherence tomography findings with oxidative stress parameters, secondly to investigate OCT findings and oxidative stress parameters as potential endophenotype candidates. Method: Fifty patients who were diagnosed with bipolar disorder according to DSM-5 and age and sex matched fourty bipolar disorder first degree relatives and fifty healthy controls were recruited in the study. The participants had Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS). Retinal nerve fiber layer (RNFL), choroid, macular thickness and ganglion cell layer (GCL), inner plexiform layer (IPL) volume were measured and recorded automatically by a spectral OCT device. 4 hydroxy 2 nonenal, total thiol, native thiol, disulfide, total oxidant status (TOS), total antioxidant status (TAS) were measured from serum samples. Oxidative stres index (OSI) was calculated by dividing the total oxidant status by the total antioxidant status. Fasting glucose, triglycerides, HDL cholesterol and CRP levels were also measured in all subjects. Results: In our study, the total oxidant status was found to be significantly higher in the patients compared to the first degree relatives and the controls group (p<.001), while it was found significantly higher in the first degree relatives than the controls (p= .012). Oxidative stress index, disulfide value, 4 hydroxy 2 nonenal levels were significantly higher the patients than the first degree relatives and controls, similarly higher the first degree relatives than controls (p<.001 for all binary comparisons). Total antioxidant status, total thiol, native thiol levels were significantly higher the controls than the first degree relatives and patients, similarly higher first degree relatives than the patients (p<.001 for all binary comparisons). There was no significant between the groups in the global RNFL measurement. On the nasal superior RNFL quadrant; it was observed that there was a significant thinning the patients compared to the first degree relatives (p= .03). Minimum foveal thickness (MFT); was significantly thinner the patients compared to the controls (p= .001). Central macular thickness (CMT); while it was found thinner in the patients compared to the controls (p= .006), it was observed that the CMT the first degree relatives were thinner than the controls, but this difference did not reach the statistical significance level (p= .07). In terms of choroid thickness; it was found that the first degree relatives was significantly thinner than the controls (p= .008). High total antioxidant status were associated with an increase in IPL volume (p= .02), apart from this relationship, there was no significant relationship between OCT findings and oxidative stres parameters. Conclusion: The results we obtained from our study show oxidative processes in bipolar disorder pathophysiology. In addition, it has been revealed that TOS, TAS, OSI, disulfide, 4 hydroxy 2 nonenal, total thiol, native thiol can be powerful endophenotype candidates in bipolar disorder. Among the OCT findings, the minimum foveal thickness was significantly thinner in the patients compared to the controls. CMT while it was found thinner in the patients compared to the controls, it was observed that the CMT the first degree relatives were thinner than the controls, but this difference did not reach the statistical significance level. These findings support the hyphothesis that OCT parameters might reflect central neurodegeneration. In our study, central macular thickness, was determined as the closest parameter to being an endophenotype candidate. These findings, it is revealed that biochemical parameters are more valuable and effective in endophenotype studies than OCT findings. Keywords: optical coherence tomography, oxidative stres, endophenotypetr_TR
dc.description.abstract{{abstract}}
dc.identifier.urihttp://hdl.handle.net/20.500.12645/23134
dc.language.isotrtr_TR
dc.publisherBezmialem Vakıf Universitytr_TR
dc.rightsinfo:eu-repo/semantics/openAccesstr_TR
dc.subjectPsikiyatri = Psychiatrytr_TR
dc.subjectRuh Sağlığı ve Hastalıkları Anabilim Dalıtr_TR
dc.subjectDepartment of Mental Health and Diseasestr_TR
dc.subjectOxidative strestr_TR
dc.subjectBipolar bozukluktr_TR
dc.titleBipolar bozukluk hastaları ve etkilenmemiş birinci derece yakınlarında optik koherens tomografi bulgularının oksidatif stres parametreleri ile ilişkisi / The relation of optical coherence tomography findings with oxidative stress parameters in bipolar disorder patients and unaffected first-degree relativestr_TR
dc.typeThesistr_TR
dc.typeThesis
dspace.entity.typePublication
local.thesis.programnameRuh Sağlığı ve Hastalıkları Anabilim Dalıtr_TR
local.thesis.programnameDepartment of Mental Health and Diseasesen
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