Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Parkinson Hastalarında Kognitif ve Duyu İşlemleme Süreçlerinin İncelenmesi
Investigation of Cognitive and Sensory Processes in Individuals with Parkinson Disease
Zeynep ÇORAKCIa, Lütfü HANOĞLUb
aBezmiâlem Vakıf Üniversitesi Sağlık Bilimleri Fakültesi, Ergoterapi Bölümü, İstanbul, TÜRKİYE
bİstanbul Medipol Üniversitesi Tıp Fakültesi, Nöroloji ABD, İstanbul, TÜRKİYE
Turkiye Klinikleri J Health Sci. 2021;6(3):467-75
doi: 10.5336/healthsci.2020-77606
Article Language: TR
Full Text
ÖZET
 Amaç: Çalışmamızda, Parkinson hastalarının kognitif ve duyusal işlemleme süreçlerindeki değişimlerin incelenmesi ve bu 2 sürecin birbiriyle olan bağıntısının anlaşılması hedeflenmiştir. Gereç ve Yöntemler: Bezmiâlem Vakıf Üniversitesi Nöroloji Polikliniği ve Ergoterapi Bölümü iş birliği ile 34 gönüllü 65 yaş üstü Parkinson hastası çalışmaya katıldı. Hastalara, nöropsikolojik ve duyusal işlemleme değerlendirmeleri uygulandı. Sayı Dizisi Testleri ve Sözel Akıcılık Testleri ile dikkat/yürütücü işlevler, Öktem Sözel Bellek Süreçleri Testi (Öktem-SBST) ile bellek, Benton Yüz Tanıma Testi (BYTT) ve Benton Çizgi Yönü Testi (BÇYT) ile görsel algısal işlemler değerlendirildi. Katılımcıların duyusal işlemleme paternlerini belirlemek için Adölesan/Yetişkin Duyu Profili kullanıldı. Duyusal işlemleme paternleri ve nöropsikolojik bulgular arası korelasyon analizi incelendi. Bulgular: Katılımcıların yaş ortalaması 73±6,6 yıl olarak bulundu. Hastaların nöropsikolojik değerlendirmelerine ait alt testlerin tamamında bozulma olduğu tespit edildi. Duyusal kaçınma ve düşük kayıt paternleri 'çoğu insanla benzer' aralıktadır. Duyusal hassasiyet 'çoğu insandan daha fazla (%59)', duyusal arayış paterni 'çoğu insandan daha az (%38)'olarak normal aralıktan sapma göstermektedir. Nöropsikolojik testler ile duyusal işlemleme paternleri arası korelasyonlar incelendiğinde; duyusal kaçınma ile Geri Sayı Menzili (p=0,002), hayvan sayma (p=0,001) Öktem-SBST hatırlama (p=0,005), Öktem-SBST toplam öğrenme (p=0,004), BYTT (p=0,016) ve BÇYT (p=0,000) arasında orta derecede korelasyonlar bulundu. Duyusal hassasiyet ve İleri Sayı Menzili (p=0,034) arasında düşük orta derecede korelasyon tespit edildi. Sonuç: Parkinson hastalarında genel bilişsel kapasitenin azaldığı, duyusal işlemleme cevaplarına göre pasif davranışın geliştiği ve bu 2 sürecin birbiriyle bağıntılı olduğu gösterilmiştir.

Anahtar Kelimeler: Parkinson hastalığı; nöropsikoloji; nörobilişsel bozukluklar; duyu bozuklukları; ergoterapi
ABSTRACT
 Objective: In our study, it was aimed to examine the changes in the cognitive and sensory processing of individuals with Parkinson's disease and to understand the relationship between these 2 processes. Material and Methods: In collaboration with Bezmiâlem Vakıf University Neurology Clinic and Occupational Therapy Department, 34 volunteer individuals with Parkinson's disease over the age of 65 participated in the study. Neuropsychological and sensory processing evaluations were applied to the patients. Attention/executive function was tested by Number Range and Verbal Fluency Tests, memory was tested by Öktem Verbal Memory Process Test (Öktem-VMPT) and visual perceptual process was evaluated by Benton Face Recognition Test (BFRT) and Benton Line Direction Test (BLDT). Adolescent/Adult Sensory Profile (AASP) was used to determine the sensory processing patterns of the participants. Correlation analysis between sensory processing patterns and neuropsychological findings was examined. Results: The average age of the participants was 73±6.6 years. Impairment was found in all subtests of the neuropsychological evaluations of the patients. Sensory avoidance and low registration patterns are in the 'similar to most people' range. Sensory sensitivity 'more than most people (59%)' and sensory seeking patterns 'less than most people (38%)' deviate from the normal range. When the correlations between neuropsychological tests and sensory processing patterns are examined; moderate correlations were found between sensory avoidance and back digit range (p=0.002), counting animals (p=0.001), Öktem-VMPT recall (p=0.005), Öktem-VMPT total learning (p=0.004), BFRT (p=0.016), BLDT (p=0.000). A low to moderate correlation was found between sensory sensitivity and forward digit range (p=0.034). Conclusion: It has been shown that general cognitive capacity decreases and passive behavior develops according to sensory processing responses in individuals with Parkinson's disease and these 2 processes are interrelated.

Keywords: Parkinson disease; neuropsychology; neurocognitive disorders; sensation disorders; occupational therapy
REFERENCES:
  1. Jankovic J. Parkinson's disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatry. 2008;79(4):368-76. [Crossref] [PubMed] 
  2. Akbayır E, Şen M, Ay U, Şenyer S, Tüzün E, Küçükali Cİ. [Etiopathogenesis of Parkinson's disease]. Deneysel Tıp Dergisi. 2007;7(13):1-23. [Link] 
  3. Barrett KE, Barman SM, Boltano S, Brooks HL, eds. Gökbel H, çeviri editörü. [Voluntary Control of Reflex, Posture, and Movement]. Ganong'un Tıbbi Fizyolojisi. 24. Baskı. İstanbul: Nobel Tıp Kitabevleri; 2015. p.227-54.
  4. Biundo R, Fiorenzato E, Antonini A. Nonmotor symptoms and natural history of Parkinson's disease: evidence from cognitive dysfunction and role of noninvasive interventions. Int Rev Neurobiol. 2017;133:389-415. [Crossref] [PubMed] 
  5. Brønnick K, Alves G, Aarsland D, Tysnes OB, Larsen JP. Verbal memory in drug-naive, newly diagnosed Parkinson's disease. The retrieval deficit hypothesis revisited. Neuropsychology. 2011;25(1):114-24. [Crossref] [PubMed] 
  6. Munhoz RP, Moro A, Silveira-Moriyama L, Teive HA. Non-motor signs in Parkinson's disease: a review. Arq Neuropsiquiatr. 2015;73(5):454-62. [Crossref] [PubMed] 
  7. Caviness JN, Lue L, Adler CH, Walker DG. Parkinson's disease dementia and potential therapeutic strategies. CNS Neurosci Ther. 2011;17(1):32-44. [Crossref] [PubMed] [PMC] 
  8. Vancea R, Simonyan K, Petracca M, Brys M, Di Rocco A, Ghilardi MF, et al. Cognitive performance in mid-stage Parkinson's disease: functional connectivity under chronic antiparkinson treatment. Brain Imaging Behav. 2019;13(1):200-9. [Crossref] [PubMed] [PMC] 
  9. Schneider JS, Diamond SG, Markham CH. Parkinson's disease: sensory and motor problems in arms and hands. Neurology. 1987;37(6):951-6. [Crossref] [PubMed] 
  10. Wolters ECh. Non-motor extranigral signs and symptoms in Parkinson's disease. Parkinsonism Relat Disord. 2009;15 Suppl 3:S6-12. [Crossref] [PubMed] 
  11. Akamatsu T, Fukuyama H, Kawamata T. The effects of visual, auditory, and mixed cues on choice reaction in Parkinson's disease. J Neurol Sci. 2008;269(1-2):118-25. [Crossref] [PubMed] 
  12. Kesayan T, Lamb DG, Falchook AD, Williamson JB, Salazar L, Malaty IA, et al. Abnormal tactile pressure perception in Parkinson's disease. J Clin Exp Neuropsychol. 2015;37(8):808-15. [Crossref] [PubMed] 
  13. Lukhanina EP, Kapustina MT, Berezetskaya NM, Karaban IN. Reduction of the postexcitatory cortical inhibition upon paired-click auditory stimulation in patients with Parkinson's disease. Clin Neurophysiol. 2009;120(10):1852-8. [Crossref] [PubMed] 
  14. Konczak J, Corcos DM, Horak F, Poizner H, Shapiro M, Tuite P, et al. Proprioception and motor control in Parkinson's disease. J Mot Behav. 2009;41(6):543-52. [Crossref] [PubMed] 
  15. Cao H, Xu X, Zhao Y, Long D, Zhang M. Altered brain activation and connectivity in early Parkinson disease tactile perception. AJNR Am J Neuroradiol. 2011;32(10):1969-74. [Crossref] [PubMed] 
  16. Pieruccini-Faria F, Ehgoetz Martens KA, Silveira CR, Jones JA, Almeida QJ. Interactions between cognitive and sensory load while planning and controlling complex gait adaptations in Parkinson's disease. BMC Neurol. 2014;14:250. [Crossref] [PubMed] [PMC] 
  17. Sjödahl Hammarlund C, Nilsson MH, Hagell P. Measuring outcomes in Parkinson's disease: a multi-perspective concept mapping study. Qual Life Res. 2012;21(3):453-63. [Crossref] [PubMed] 
  18. Jerome EM, Liss M. Relationships between sensory processing style, adult attachment, and coping. Personality and Individual Differences. 2005;38(6):1341-52. [Crossref] 
  19. Brown C, Tollefson N, Dunn W, Cromwell R, Filion D. The Adult Sensory Profile: measuring patterns of sensory processing. Am J Occup Ther. 2001;55(1):75-82. [Crossref] [PubMed] 
  20. Ranford J, MacLean J, Alluri PR, Comeau O, Godena E, Curt LaFrance W Jr, et al. Sensory processing difficulties in functional neurological disorder: a possible predisposing vulnerability? Psychosomatics. 2020;61(4):343-52. [Crossref] [PubMed] [PMC] 
  21. Mesulam MM, ed. Gürvit İH, çeviri editörü. Davranışsal ve Kognitif Nörolojinin İlkeleri. Weintraub S. [Neuropsychological Assessment of Mental State]. 2. Baskı. İstanbul: Yelkovan Yayıncılık; 2004. p.121-73.
  22. Doğutepe Dinçer E, Karakaş S. [Modelling the relationship between the neuropsychological tests of attention]. Bulletin of Clinical Psychopharmacology. 2008;18:31-40. [Link] 
  23. Öktem Ö. Öktem Sözel Bellek Süreçleri Testi (Öktem-SBST) El Kitabı. 2. Baskı. Ankara: Türk Psikologlar Derneği Yayınları; 2016. p.1-21.
  24. Benton AL, Sivan AB, deS Hamsher K, Varney NR, Spreen O, eds. Contributions to Neuropsychological Assessment: A Clinical Manual. [Facial Recognition]. 2nd ed. USA: Oxford University Press; 1994. p.35-64.
  25. Lawton MP, Kleban MH, Rajagopal D, Dean J. Dimensions of affective experience in three age groups. Psychol Aging. 1992;7(2):171-84. [Crossref] [PubMed] 
  26. Brown LA, Cooper SA, Doan JB, Dickin DC, Whishaw IQ, Pellis SM, et al. Parkinsonian deficits in sensory integration for postural control: temporal response to changes in visual input. Parkinsonism Relat Disord. 2006;12(6):376-81. [Crossref] [PubMed] 
  27. Jacobs JV, Horak FB. Abnormal proprioceptive-motor integration contributes to hypometric postural responses of subjects with Parkinson's disease. Neuroscience. 2006;141(2):999-1009. [Crossref] [PubMed] 
  28. Brown A, Fisher C. Optimising occupational performance through sensory modulation interventions: case reports of two young adults diagnosed with juvenile Huntington's disease. British Journal of Occupational Therapy. 2015;78(12):767-71. [Crossref] 
  29. Sturkenboom IHWM, Nott MT, Bloem BR, Chapparo C, Steultjens EMJ. Applied cognitive strategy behaviours in people with Parkinson's disease during daily activities: a cross-sectional study. J Rehabil Med. 2019;52(1):jrm00010. [Crossref] [PubMed] 
  30. Scammell EM, Bates SV, Houldin A, Polatajko HJ. The Cognitive Orientation to daily Occupational Performance (CO-OP): a scoping review. Can J Occup Ther. 2016;83(4):216-25. [Crossref] [PubMed] 
  31. Van Keulen-Rouweler BJ, Sturkenboom IH, Kottorp A, Graff MJ, Nijhuis-Van der Sanden MW, Steultjens EM. The Perceive, Recall, Plan and Perform (PRPP) system for persons with Parkinson's disease: a psychometric study. Scand J Occup Ther. 2017;24(1):65-73. [Crossref] [PubMed] 
  32. Rice RR, Johnson SB. A collaborative approach to music therapy practice in sensorimotor rehabilitation. Music Therapy Perspectives. 2013;31(1):58-66. [Crossref] 
  33. Li M, Kuroiwa Y, Wang L, Kamitani T, Takahashi T, Suzuki Y, et al. Early sensory information processes are enhanced on visual oddball and S1-S2 tasks in Parkinson's disease: a visual event-related potentials study. Parkinsonism Related & Disorders. 2003;9(6):329-40. [Crossref] 
  34. Hill E, Stuart S, Lord S, Del Din S, Rochester L. Vision, visuo-cognition and postural control in Parkinson's disease: an associative pilot study. Gait Posture. 2016;48:74-6. [Crossref] [PubMed] 
  35. Welsby E, Berrigan S, Laver K. Effectiveness of occupational therapy intervention for people with Parkinson's disease: systematic review. Aust Occup Ther J. 2019;66(6):731-8. [Crossref] [PubMed] 

.: Up To Date

.: Process List

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com