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Background: Optic neuritis, myelitis, and neuromyelitis optica spectrum disorder (NMOSD) have been associated with antibodies against myelin oligodendrocyte glycoprotein-immunoglobulin G (anti-MOG-IgG). Furthermore, patients with radiological and demographic features atypical for multiple sclerosis (MS) with optic neuritis and myelitis also demonstrate antibodies against aquaporin-4 and anti-MOG-IgG. However, data on the diagnosis, treatment, follow-up, and prognosis in patients with anti-MOG-IgG are limited. Aims: To evaluate the clinical, radiological, and demographic characteristics of patients with anti-MOG-IgG. Study Design: Multicenter, retrospective, observational study. Methods: Patients with blood samples demonstrating anti-MOG-IgG that had been evaluated at the Neuroimmunology laboratory at Ondokuz Mayıs University’s Faculty of Medicine were included in the study. Results: Of the 104 patients with anti-MOG-IgG, 56.7% were women and 43.3% were men. Approximately 2.4% of the patients were diagnosed with MS, 15.8% with acute disseminated encephalomyelitis (ADEM), 39.4% with NMOSD, 31.3% with isolated optic neuritis, and 11.1% with isolated myelitis. Approximately 53.1% of patients with spinal involvement at clinical onset demonstrated a clinical course of NMOSD. Thereafter, 8.8% of these patients demonstrated a clinical course similar to MS and ADEM, and 28.1% demonstrated a clinical course of isolated myelitis. The response to acute attack treatment was lower and the disability was higher in patients aged > 40 years than patients aged < 40 years at clinical onset. Oligoclonal band was detected in 15.5% of the patients. Conclusion: For patients with NMOSD and without anti-NMO antibodies, the diagnosis is supported by the presence of anti-MOG-IgG. Furthermore, advanced age at clinical onset, Expanded Disability Status Scale (EDSS) score at clinical onset, spinal cord involvement, and number of attacks may be negative prognostic factors in patients with anti-MOG-IgG.

Objective: The course of relapsing–remitting multiple sclerosis (RRMS) is highly variable and there is a lack of effective prognostic biomarkers. This study aimed to assess the potential prognostic value of the chemokines B lymphocyte chemoattractant molecule (CXCL13), eotaxin-1 (CCL11), and macrophage inflammatory protein 3-alpha (CCL20) in RRMS. Methods: Forty-two patients with MS were enrolled, along with 22 controls, 12 of the controls were idiopathic intracranial hypertension (IIH) patients, and 10 of the controls were other neurologic diseases (OND). Chemokine levels were measured using enzyme-linked immunosorbent assay (ELISA) in serum and cerebrospinal fluid (CSF) samples. Results: No significant differences were observed among the groups in serum levels of CXCL13, CCL11, and CCL20 (p = 0.509, p = 0.979, p = 0.169, respectively). CSF CXCL13 levels were significantly higher in the OND group (p = 0.016). A PATH analysis showed CSF CXCL13 was significantly associated with new T2 hyperintense lesions on brain magnetic resonance imaging (p < 0.001), and baseline serum CCL11 levels were associated with EDSS (p = 0.030), implying its potential role in indicating neurodegenerative processes and possible progression risk. Serum CCL20 correlated with EDSS (p = 0.002) and lesion burden (p < 0.001), reflecting disease severity. Conclusions: These findings suggest that CSF CXCL13 could serve as a useful biomarker for predicting active disease in RRMS, while follow-up serum CCL11 may assist in identifying progression. Although these chemokines are not specific to MS, higher levels may signal disease activity, severity, and transition to more progressive stages.

Objective: Multiple sclerosis (MS) is a chronic degenerative and inflammatory disease leading to axonal damage and demyelination in the central nervous system. Although the pathogenesis is still controversial, it is accepted that there is an immune-mediated inflammatory response. Endothelial cell specific molecule-1 (ESM-1) (endocan) is expressed by endothelial cells under the control of cytokines, and increases in inflammatory processes involving the vascular endothelium. In this study, we aimed to compare serum endocan levels along with other hematologic inflammatory markers [such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)] in patients with relapsing-remitting MS (RRMS) and healthy controls. We also aimed at investigating the role of vascular endothelial dysfunction in RRMS. Materials and Methods: We enrolled 64 patients with RRMS in the remission period, and 37 healthy controls in the study. We investigated hematologic parameters (ESR, CRP) and serum ESM-1 levels by enzyme-linked immunosorbent assay. Results were compared between two groups statistically. Results: The CRP and ESR had no significant difference between patients and controls (p=0.861 and p=0.76 respectively). Serum endocan levels of the patient group were significantly higher than the healthy controls (p=0.045). RRMS patients with or without treatment and comorbid diseases showed no significant difference in serum endocan levels (p=0.565 and p=0.169 respectively). The predictive value of endocan was 62.0%, cut-off value was 9124.7326 pg/l, sensitivity was 68.8%, and specificity was 54.1%. Conclusion: We demonstrated higher serum endocan levels in patients with RRMS in remission period, confirming the role of vascular inflammation. Further studies including larger patient cohorts are needed to support our results.

Objective:It has been shown that pain, depression, and fatigue related to Obstructive Sleep Apnea syndrome (OSAS) results in a significant socioeconomic burden. We aimed to determine the prevalence, demographic, and clinical properties of pain symptoms in OSAS patients.Materials and Methods:We evaluated 84 OSAS patients diagnosed after full-night polysomnography with the Brief Pain Inventory, Beck Depression Rating scale (BDS), Pittsburg Sleep Quality index (PSQI), Epworth Sleepiness scale (ESS), Fatigue Impact scale (FIS), and Fatigue Severity scale (FSS).Results:A total of 84 patients (62 males, 22 females) with a mean age of 54.37±11.03 years were included. Headache in 25 (43.1%), myofascial pain in 22 (37.9%), and other types of pain in 11 patients were defined. ESS, FSS, FIS total, physical, cognitive, and psychosocial scores were found to be significantly higher in patients with pain. The presence of pain did not differ according to the severity of OSAS, and no significant difference was found in any parameters between mild, moderate, and severe OSAS except for minimal O2 saturation. A positive correlation between last week pain severity and BDS scores, a negative correlation between PSQI scores and the decrease in pain rate as a result of the treatment, and a weak positive correlation between FIS-cognitive sub-score and pain intensity scores were found.Conclusion:In our study, excessive daytime sleepiness and the impact and severity of fatigue were found to be higher in patients with pain than in those without pain. The most obvious difference was seen in terms of cognitive, and psychosocial fatigue. Contrary to expectations, it was observed that OSAS severity did not affect pain according to our data.

Objective: Multiple sclerosis (MS) is a chronic demyelinating/degenerative disease of the central nervous system that causes disability in young adults. Complementary medicine (CM) and alternative medicine (AM) as a concept is outside the scope of traditional medicine and generally includes all diagnostic and treatment methods for which scientific data are insufficient. Facilitating access to alternative-complementary therapies makes their use widespread. The aim of this study was to evaluate the knowledge level of patients with MS by using a questionnaire and the knowledge of the perception of AM. Materials and Methods: Patients who were definitively diagnosed as having MS-clinically isolated syndrome in the clinic of our hospital were included on a voluntary basis. Sociodemographic characteristics, type of MS, date of diagnosis, number of attacks, and MS disability scale were recorded. The questionnaire, which was prepared for alternative or complementary therapies used, was completed by the same researcher. Data were analysed using SPSS 21 program Results: Two hundred ten patients with MS were included in our study. It was determined that all patients were aware of AM/CM treatments, the highest rate of information was obtained from the internet (76%), 1.4% AM, 49% CM was used. Ninety-seven % of the patients received TT for the purpose of relieving their symptoms (p≤0.005). Mostly garlic (83.4%), caper (79.6%), ginger (69.9%), and goat’s milk (60%) was used. CM was statistically significantly higher in the first decade (p≤0.005). It was observed that 32% of the patients used TT after the 2nd MS attack without any significance. Conclusion: Our study showed that patients with MS used CM temporarily and with high rates. In contrast to the literature, the rate of use in the first period of the disease was found to be significantly higher. This condition was interpreted as the fact that at the beginning of the disease it could be made with the hope of fighting MS and fully recovering, but after the understanding of the nature of the disease, the use of AM/CM decreased.

Objective: To evaluate the effect of continuous positive airway pressure (CPAP) treatment on metabolic syndrome and insuline resistance in patients with obstructive sleep apnea syndrome (OSAS). Materials and Methods: This study evaluated retrospectively with 30 patients who received OSAS diagnosis following polysomnography between the years January 2016 - January 2017, whose Respiratory Disturbance Index were above 15, and who were between the ages of 18-78, having no diabetes, chronic liver and kidney disease, malignancy and mental retardation. The anthropometric measures and blood values of these patients before the CPAP treatment and 3 months afterwards were evaluated in their controls. The effect of CPAP treatment on metabolic syndrome and insulin resistance assessed by homeostatic model assessment index was investigated. Results: It has been observed that the body mass index (BMI) decreases significantly following the CPAP treatment. No significant changes were found in the anthropometric measurements including the neck circumference, waist circumference, hip circumference, and waist/hip ratios as well as insulin resistance and metabolic syndrome parameters (before of treatment BMI: 31.33±5.58, post treatment BMI: 30.83±7.13, p=0.03). The ESS evaluating the subjective daytime sleepiness following the CPAP treatment has decreased significantly. Conclusion: Although this study didn’t improve insulin resistance with assessed homeostatic model assessment, and metabolic syndrome, a significant improvement in BMI and ESS was demonstrated in post treatment. Long-term studies with more cases and with high compliance are needed to demonstrate the effects of CPAP treatment on metabolic syndrome in OSAS patients.

Copyright of Journal of Turkish Sleep Medicine is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Turkish Sleep Medicine is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective Restless Legs Syndrome (RLS) is a common neurological disorder that affects patients’ sleep, emotional state and daily life negatively. In this study it was aimed to determine the sleep quality, daytime sleepiness and depression frequency in patients with RLS and their relation with duration and severity of illness. Materials and Methods In our center, 41 patients with primary RLS diagnosis were included in the study. Patients were divided into groups as mild, moderate, severe and very severe, according to the RLS severity scale of the International Restless Legs Syndrome Study Group. Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Beck Depression Inventory were filled in by all the patients, including identity and sociodemographic data with illness information. Statistical analysis was performed among groups divided according to disease severity. Depressive symptoms of the disease duration and its relation with sleep problems were investigated. Results In this study 41 patients, 30 (73.2%) female, 11 (26.8%) male, were included. Of the patients participating in the study, 2 patients (4.9%) had mild RLS while 7 (17.1%) were very severely ill. Fourteen patients (34.1%) had moderate disease and 18 (43.9%) had severe disease. Bad sleep quality was found in 68.3% (n=28) of patients with RLS, excessive daytime sleepiness in 14.6% (n=6) severe depression in 7.3% (n=3) and totally 29.3% of patients (n=12) depressive symptoms were observed. As the severity of illness increased, sleep quality deteriorated and depressive symptoms increased (p