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    Normative Values of Transcranial Magnetic Stimulation-Evoked Parameters for Healthy Developing Children and Adolescents
    (Wolters Kluwer Medknow Publications, 2021) Tekgul, Hasan; Saz, Ulas; Polat, Muzaffer; Tekgul, Nurdan; Kose, Timur
    Context: Normative data-containing transcranial magnetic stimulation (TMS) evoked parameters are essential for correctly interpreting healthy development and assessing neuroplastic changes in certain neurologic disorders. Aims: The aim is to investigate corticospinal pathways by applying TMS to healthy developing children and adolescents. Settings and Design: In this cross-sectional study, we measured TMS evoked parameters associated with cortical and spinal stimulation obtained from the four extremities of 46 healthy children and adolescents (21 boys and 25 girls; mean +/- standard deviation age: 6.4 +/- 1.2 years; range: 3.0-20.5 years). Statistical Analysis: Spearman's correlation coefficients were calculated for each variable (weight and height) as a function of motor evoked potential (MEP) response latency and central motor conduction time (CMCT). Pearson's Chi-square test was used to determine the inter-variable correlations. Results: Latencies of MEPs were correlated with age (P < 0.001, r = 0.6948) and height (P < 0.006, r = 0.7994). Amplitudes of active-state MEPs were significantly higher than those of resting-state MEPs associated with the upper and lower extremities. The mean values for active-state MEP latencies were lower than those for resting-state MEPs. The CMCT and magnitudes of latency jumps were calculated using reliable MEP data for children and adolescents. Additionally, the unresponsiveness rates were significantly higher for children aged below 7 years. Conclusion: The TMS evoked parameters investigated in this study are necessary to accurately assess corticospinal pathway development in healthy children and adolescents.
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    Secular trend of menarche age in an immigrant urban city in Turkey: Izmir
    (Turkish J Pediatrics, 2014) Tekgul, Nurdan; Saltik, Dilek; Vatansever, Kevser
    The purpose of this study was to investigate the secular trend of menarche age within the last 35 years in an immigrant urban city in Turkey-Izmir. We found the mean age at menarche as 13.10 +/- 1.18 years for 121,257 women. The reported mean age at menarche showed a decreasing trend over time. For women born before 1963 (>= 40 years of age), the mean age at menarche was 13.08 +/- 1.21 years. For women born from 1964-1973 (30-39 years of age), the mean age at menarche was 13.12 +/- 1.19 years. For women born from 1974-1983 (20-29 years of age), the mean age at menarche was 13.11 +/- 1.18 years, and for those born after 1984 (15-19 years of age), the mean age at menarche was 13.06 +/- 1.16 years (p=0.000). When divided according to socioeconomic status, the mean age at menarche was 13.11 +/- 1.11 in the high socioeconomic group, 13.22 +/- 1.25 in the middle socioeconomic group, and 12.75 +/- 1.02 in the low socioeconomic group (p=0.000). In conclusion, in the Turkish population, the mean age at menarche has decreased from 13.12 to 13.06 over the past 30 years, and the mean age at menarche was lower in the low socioeconomic group.
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    A transcranial magnetic stimulation study for the characterization of corticospinal pathway plasticity in children with neurological disorders
    (Elsevier Sci Ltd, 2022) Tekgul, Hasan; Saz, Ulas; Polat, Muzaffer; Kose, Timur; Tekgul, Nurdan; Kitis, Omer
    We aimed to investigate cortical and radicular TMS-evoked motor evoked potentials (MEPs) in children with neurological disorders (n = 57, mean age: 5.45 years) and agematched healthy controls (n = 46). Four TMS parameters were analyzed: MEP amplitudes, the latencies of MEP, the latency jump (cortical MEP latency at rest - cortical active-MEP latency at with slightly contracted targeted muscle), and central motor conduction time. Children with neurological disorders were categorized according to the two major types of neuronal plasticity; excessive plasticity: 29 children with cerebral palsy and impaired plasticity: 28 children with neurodegenerative diseases, stroke, and central nervous system infections. The active-MEP abnormalities (absent and prolonged latencies) were correlated with the location of cortical involvement on MRI patterns. We obtained a significantly increased rate of abnormal cortical activeMEPs in children with impaired plasticity (21/28, 75%) compared with excessive plasticity (18/29, 62%). The rate of absent MEP response is three times more in children with impaired plasticity (43%) than in children with excessive plasticity (14%). A more reduced latency jump was measured in children with impaired plasticity compared to children with excessive plasticity. TMS-evoked active-MEPs and latency jumping are valuable parameters for characterizing neuronal plasticity in children with neurological disorders. (c) 2021 Published by Elsevier Ltd.