This study aimed to investigate the presence of neuropathic pain and its associated factors in patients diagnosed with the hemoglobinopathies thalassemia major (TM) and sickle cell disease (SCD). This study included 27 patients with TM and 30 patients with SCD who presented to the neurology clinic between 2022 and 2023. All participants had normal electromyography (EMG) findings and nerve conduction studies. Patients aged between 20 and 50 years were evaluated for neuropathic pain using the Neuropathic Pain Scale (DNET-4). Data were analyzed in relation to age, sex, smoking status, hemoglobin levels, platelet count, ferritin levels, presence of depression, use of hydroxyurea and chelation therapy, and splenectomy status. Depression was assessed using the Beck Depression Inventory. Patients with neuropathy due to anatomical pathology, lumbar disc herniation, diabetes mellitus, prior use of neurotoxic drugs, or clinical signs of peripheral nerve involvement were excluded from the study. The mean age was 29.22 years in the TM group and 32.03 years in the SCD group (p = 0.010). Neuropathic pain was reported by 37.1% of patients with TM and 46.7% of those with SCD, with higher pain scores tending to occur in the sickle cell group (p = 0.069). A statistically significant difference and moderate positive correlation were found between neuropathic pain and hydroxyurea treatment (p < 0.01). No significant difference was observed between the groups in terms of depression levels (p = 0.63); however, a strong positive correlation was found between depression severity and neuropathic pain scores (p < 0.001). As depression levels increased, neuropathic pain severity also increased. The TM group had significantly lower hemoglobin levels (8.21 ± 0.92 g/dL) compared to the SCD group (10.03 ± 1.45 g/dL) (p < 0.001). Ferritin levels were significantly higher in the TM group (2678 ± 1689 ng/mL) than in the sickle cell group (580 ± 689 ng/mL) (p < 0.001). No statistically significant associations were observed between neuropathic pain and chelation therapy, splenectomy, or smoking status. Neuropathic pain in patients with TM and SCD was significantly associated with depression severity. Hydroxyurea treatment showed a moderate association with neuropathic pain in patients with SCD, potentially reflecting greater disease burden. These findings underscored the importance of comprehensive clinical evaluation, including both neurological and psychological assessments, in the management of these patients.

Background: This study aims to investigate the impact of the February 6 earthquake on brain structures, particularly mood centers, using MRI volumetric analysis. Materials and Methods: In this retrospective study, 20 neurology clinic patients who were treated at a neurology clinic and underwent brain MRI both before and after the earthquake (2022–2023). MRI scans were analyzed within one year prior to and after the disaster. Patient data included age, gender, MRI indications and medical history. Inclusion criteria required participants to have experienced headaches but excluded those with neurodegenerative diseases, head trauma, or other structural brain pathologies. The volBrain method was used to assess total brain, white and grey matter, cerebrospinal fluid, limbic system (hippocampus, parahippocampal gyrus, amygdala, hypothalamus, cingulate gyrus, entorhinal cortex), pref-rontal cortex, cerebellum, and thalamus via 3T MRI T1 sequences. All participants had experienced first-degree relative loss or home destruction. Results: The study group comprised 65% women and 35% men, with a mean age of 42.15 ± 8.41 years. Significant volumetric changes were observed in several brain regions post-earthquake. White matter volume decreased significantly (p=0.011), while CSF volume increased (p=0.017), and total brain volume showed a significant reduction (p=0.025). The cerebellum exhibited significant volume reductions, inclu-ding total volume (p=0.023), as well as the right (p=0.021) and left hemispheres (p=0.029). Similarly, the thalamus demonstrated significant reductions in total volume (p=0.008), right hemisphere (p=0.009), and left hemisphere (p=0.010). Conversely, the posterior cingulate gyrus (PCgG) showed significant volume increases in total (p=0.007), right (p=0.023), and left hemispheres (p=0.012). Conclusions: The findings reveal significant volumetric changes in specific brain regions suggesting neurobi-ological effects of acute stressor trauma caused by the earthquake. These changes highlight the need for further studies to understand the mechanisms underlying these alterations and to develop interventions aimed at mitigating the long-term effects of such traumatic events. Keywords: Limbic system, Mrı volumetric analysis, Earthquake, Disaster, Massive trauma, Neuroimaging

Background and Objectives: This study aimed to identify asymptomatic brain lesions in patients with β-thalassemia major (TM) and sickle cell anemia (SCA) and evaluate the correlation of these lesions with factors such as splenectomy, thrombocytosis, and blood transfusions. Materials and Methods: A total of 26 patients with thalassemia major and 23 patients with sickle cell anemia were included. Ischemic lesions were categorized as lacunar, small vessel, or multifocal. Variables including age, years of education, presence and type of MRI-detected ischemia, smoking status, hemoglobin, hematocrit, platelet count, ferritin levels, vitamin B12 levels, fasting blood sugar, splenectomy status, chelation therapy, and hydroxyurea treatment were compared between the two groups. Results: The mean age was 27.33 years in the thalassemia major group and 32.65 years in the sickle cell anemia group (p = 0.010). No statistically significant difference was observed in the distribution of ischemia types between the groups (p = 0.303). The thalassemia major group had a lower mean hemoglobin level (8.37 g/dL) compared to the sickle cell anemia group (9.57 g/dL) (p = 0.003). Ferritin levels were significantly higher in the thalassemia major group (2018.92 ng/mL) than in the sickle cell anemia group (660.39 ng/mL) (p < 0.001). Conclusions: Although ischemic lesions were more frequently observed in patients with sickle cell anemia, the difference was not statistically significant. These findings emphasize the importance of ongoing surveillance and individualized management to mitigate cerebrovascular risks in both patient populations.

Objective: This research intends to investigate the relationship between selective serotonin reuptake inhibitors (SSRIs) and the occurrence rate of Restless Legs Syndrome (RLS) among pediatric and adolescent populations diagnosed with depression and/or anxiety disorders. Materials and Methods: This retrospective study examined patients between the ages of 10 and 17 who had been prescribed one of the following selective serotonin reuptake inhibitors (SSRIs): fluoxetine, sertraline, or escitalopram. Exclusion criteria included patients with iron deficiency anemia, diabetes mellitus, renal disorders, spinal cord conditions, those receiving antihistaminic or antipsychotic medications, and individuals with other psychiatric or neurological disorders. The study meticulously recorded demographic information, medical histories, ferritin levels, vitamin B12 levels, and a family history of restless legs syndrome (RLS). Furthermore, the severity of RLS was evaluated using a specific scale for patients diagnosed with the condition. Results: Among the 40 children analyzed, 10% developed RLS. The results indicated a potential link between SSRI use and the onset of RLS symptoms. No significant relationship was found between RLS and hemoglobin, ferritin, or vitamin B12 levels. Half of the RLS patients had a family history of RLS. Conclusion: The results indicate a possible association between the administration of SSRIs and the emergence of RLS in pediatric and adolescent populations. It is advisable to conduct additional studies with an expanded sample size.

Objectives: This study aimed to demonstrate the change in pain intensity, frequency of attacks, and life quality before and after treatment in patients with chronic migraine who underwent greater occipital nerve (GON) pulsed radiofrequency (PRF). Patients and methods: This prospective, cross-sectional study was conducted with 30 patients (1 male, 29 females; mean age: 43.7±9.8 years; range, 26 to 64 years) with chronic migraine diagnosed according to the beta version of the third edition of the International Classification of Headache Disorders. Patients who did not respond to conventional treatments were enrolled in the study. The PRF procedure on the proximal GON at the C2 vertebra level was performed under the guidance of ultrasound at 5 Hz and 5 msec pulsed width for 360 sec at 45 V. The Visual Analog Scale (VAS), pain frequency (per week), analgesic consumption frequency (per week), and the SF-12 (12-item Short-Form Health Survey) were used to compare pain intensity and quality of life (QoL) before and three months after treatment. Results: There was significant decrease in pain frequency (5.5 to 2.0), analgesic consumption frequency (7.0 to 2.0), and VAS scores (9.0 to 7.0) three months after the intervention compared to baseline (p<0.001). At the end of the first month, 17 patients reported more than 50% reduction in pain. In this study, a prominent improvement was observed in mental and physical components of QoL scores, indicating that disability rates of chronic migraine patients decreased with PRF compared to pretreatment. Conclusion: According to the results, PRF can be considered an effective treatment option in patients with refractory chronic migraine.