Background. In Parkinsons disease (PD), dopamine deficiency is present not only in the nigrostriatal pathway but also in the retinal and visual pathways. Optic coherence tomography (OCT) can be used as morphological evidence of visual influence from early nonmotor symptoms. The aim of this study was to investigate the relationship of OCT and visual evoked potentials (VEPs) of eyes with the severity of clinical findings and ocular findings in PD. Methods. A group of 42 patients diagnosed with idiopathic PD and a control group of 29 people between the ages of 4585 were included in our study. VEP was recorded in the patient and control groups. OCT measurement was made with the Optovue spectral-domain device. Foveal thickness and macular volume were measured in the foveal region and in the parafoveal and perifoveal regions in the temporal, superior, nasal, and inferior quadrants. RNFL (retinal nerve fiber layer) was measured in temporal, superior, nasal, and inferior quadrants. Ganglion cell complex (GCC) was evaluated in the superior and inferior quadrants. Using the UPDRS clinical scale, the relationship between measurements and the differences between the control group and the patient group were evaluated. Results. Among the OCT values in our study, foveal, parafoveal, perifoveal thickness, macular volume, RNFL, and GCC measurements were performed for the right and left eyes, and no difference was found between the patient group and the control group. There was no difference in VEP amplitude and latency values between the patient and control groups. The relationships between UPDRS and modified Hoehn Yahr staging and OCT and VEP measurements in the patient revealed no correlation. Conclusions. Studies on whether OCT measurements can functionally be a marker or which segments are more valuable for disease progression in patients with PD are needed. Visual dysfunction in PD cannot be attributed only to retinal pathology; however, the retina may provide monitoring of the status of dopaminergic neurodegeneration and axonal loss in PD.

Objectives: Parkinson's disease is a chronic, progressive neurodegenerative disorder. Pain is a common symptom in Parkinson's disease, but the prevalence, characteristics, and documentation of its relationship with Parkinson's disease are insufficient. In this study, it was aimed to evaluate the relationship between lumbar spine magnetic resonance imaging (MRI) findings in patients who received and did not receive Parkinson's treatment. Methods: The demographic characteristics of patients with diagnosed Parkinson's disease were retrospectively obtained from the records. Their pain was grouped and the Hoehn Yahr stage at the first examination, and the interventional treatments performed were recorded. MRI measurements were made in the axial plane and sagittal plane of the spinal canal, whereas Ligamentum flavum measurements were made on both the right and left sides. Results: Twenty-six patients were included in the study. The average age was 73.5. Notably, 57.7% of patients were not diagnosed with Parkinson's disease prior to admission, while the Hoehn Yahr stage mostly comprised Stage 2 with 53.8%. Additionally, low back, waist, and hip pain was observed in 84.6% (n = 22), whereas 61.5% (n = 16) of patients experienced radicular pain. Epidural injections accounted for 33.2%. On lumbar MRI, the most narrow spinal segment on axial measurement was shown to be L4-L5. The axial spinal canal measurement of the Hoehn Yahr 1 group was observed to be significantly lower than the Hoehn Yahr 2 group. Conclusions: Optimal management for lumbar pain that increases with age is currently inadequate. There is a need to conduct larger studies on pain complaints, which is one of the frequently experienced non-motor symptoms in Parkinson's disease, as well as the interventional methods applied.

Objective: The role of sedation during cervical interlaminar epidural steroid injections remains controversial in terms of patient comfort and procedural safety. This study aimed to present the early clinical outcomes of cervical interlaminar epidural steroid injections performed under sedation in patients with cervical radiculopathy. Methods: This retrospective observational study included 44 patients who underwent cervical interlaminar epidural steroid injections under sedation. Pain intensity was assessed before the procedure and at 4 hours after the procedure using the NRS-11, and post-procedural patient satisfaction was evaluated using a Likert scale. Cumulative radiation dose, fluoroscopy time, and intra-procedural complications were analyzed. Mild-to-moderate sedation was targeted, and the Modified Observer’s Assessment of Alertness/Sedation Scale (MOAA/S) was used to assess the level of sedation. Results: At 4 hours post-procedure, a significant decrease in NRS-11 scores was observed compared with pre-procedure scores. Most patients reported high post-procedure satisfaction. No major complications were observed during the study period, and the minor side effects were transient. However, due to the retrospective nature of the study and the absence of a comparison group without sedation, the findings cannot be considered to definitively reflect the effect of sedation. Conclusion: Cervical interlaminar epidural steroid injections administered with mild-to-moderate sedation were associated with early pain reduction and high patient satisfaction. However, given the limitations of the present study, these findings should be interpreted with caution, and prospective, controlled studies are required to determine the true contribution of sedation.

Background: This study aims to investigate whether moderate sedation (MOAA/S 3-4) affects procedural efficiency, radiation exposure, patient–physician satisfaction, and clinical outcomes during lumbar transforaminal epidural steroid injections (L-TFESI). Patients and Methods: Between January 2021 and January 2024, a total of 201 patients with unilateral, single-root compression who underwent L-TFESI either with (Group S, n = 99) or without sedation (Group NS, n = 102) were retrospectively analyzed. In the sedation group, midazolam and fentanyl were titrated to a target Modified Observer's Assessment of Alertness/Sedation (MOAA/S) score of 3-4. The primary outcomes were cumulative radiation dose (mGy), fluoroscopy time, and procedural complications. Additional outcomes included Numeric Rating Scale-11 (NRS-11) scores (baseline, Day 4, Week 4) and Likert satisfaction scales. Results: Of a total of 201 patients, 143 were male and 58 were female with a mean age of 47.22 ± 10.03 (range, 22 to 65) years. Both groups were comparable in terms of baseline demographics and pain scores. The sedation group had significantly lower cumulative radiation exposure (3.92 ± 0.30 mGy vs. 4.31 ± 0.40 mGy) and shorter fluoroscopy times (28.13 ± 2.79 sec vs. 33.13 ± 3.95 sec). Minor procedural complications (commonly vasovagal reactions and hypertension) were more frequent in the non-sedated group (21.6% vs. 2.0%). Group S reported lower pain scores on Day 4 (1.11 ± 1.29 vs. 1.88 ± 1.25), although outcomes were similar at Week 4. Patient and physician satisfaction were higher in the sedation group. Conclusion: Moderate sedation (MOAA/S 3-4) during L-TFESI is associated with lower radiation exposure, shorter procedure times and fewer minor complications, while improving both patient satisfaction and procedural conditions. These findings suggest that sedation is a potentially useful adjunct in selected patients that may contribute to improved procedural quality in interventional pain management.

Background/Objectives: Fibromyalgia is a painful syndrome with biopsychosocial components that predominantly affects middle-aged women. This study aimed to evaluate changes in sleep quality and quality of life following intravenous (IV) lidocaine treatment in patients with fibromyalgia (FM). Methods: This retrospective observational study included patients diagnosed with fibromyalgia who underwent intravenous lidocaine treatment at a tertiary pain clinic between June 2023 and June 2024 and had a Pittsburgh Sleep Quality Index (PSQI) score > 5. The patients’ demographic data, Fibromyalgia Impact Questionnaire (FIQ) scores at baseline and at 1 and 3 months post-treatment, Numerical Rating Scale (NRS-11) scores, Short Form-12 (SF-12) mental and physical component scores (MCS-12, PCS-12), and PSQI scores were recorded. Results: Overall, 51 patients were included. 92.2% of the patients were women, with a mean age of 41.6 ± 9.5 years. Statistically significant reductions in NRS-11, FIQ, and PSQI scores and increases in SF-12 component scores were observed at 1 and 3 months compared with baseline (p < 0.001). Negative correlations were found between NRS-11 and PCS-12 and MCS-12, and a positive correlation was found between FIQ and PSQI. Sleep quality showed a marked improvement at 1 month; however, attenuation of this benefit was observed at the 3-month follow-up. Conclusions: Sleep quality appeared to be associated with short-term functional outcomes, whereas pain intensity was associated with mid-term clinical status in patients with fibromyalgia. Prospective randomized controlled trials are required to confirm these findings and to determine optimal dosing and treatment schedules.