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BACKGROUND: Upper extremity strength and function are rarely assessed in routine multiple sclerosis (MS) care. This study aimed to evaluate hand muscle strength and functionality in individuals with MS and investigate correlations with upper extremity function, cognitive status, health-related quality of life (HRQOL), and balance. METHODS: A cross-sectional study was conducted with 45 consecutive individuals with MS between the ages of 18 and 65. Upper limb motor strength was evaluated using a hand grip strength dynamometer. Upper limb functional capacity was assessed using the Nine-Hole Peg Test (9HPT) and the Duruoz Hand Index (DHI). Balance, coordination, and falls were measured with the Berg Balance Scale (BBS), Falls Efficacy Scale (FES), and the 30-Second Chair Stand Test (30CST). Cognitive function was evaluated using the Montreal Cognitive Assessment instrument and the Symbol Digit Modalities Test. Level of HRQOL was assessed using the self-reported 54-item MS Quality of Life-54 questionnaire. RESULTS: Out of the 45 participants (80% women, mean age 36.6 ± 8.6 years), higher hand grip dynamometer measures were strongly correlated with better DHI, 9HPT, BBS, FES, and 30CST scores. In the regression analysis, a 1-unit increase in dynamometer measures led to a 0.383 increase in overall HRQOL score. CONCLUSIONS: This study demonstrates that increased hand grip strength (HGS) is associated with better hand functionality, balance, and HRQOL in individuals with MS. It provides evidence to support more systematic measurement of HGS in the care of people with MS. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Neurology / Turk Noroloji Dergisi 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.)

Introduction: Fingolimod is the first oral immunomodulatory treatment used as secondary care therapy in the treatment of multiple sclerosis for the last 10 years. The objective of our study is to reveal the experiences of the first generic fingolimod active ingredient treatment in different centers across Turkey. Method: The first generic fingolimod efficacy and safety data of patients followed-up in 29 different clinical multiple sclerosis units in Turkey were analyzed retrospectively. Data regarding efficacy and safety of the patients were transferred to the data system both before the treatment and on the 6th, 12th and 24th month following the treatment. The data were analyzed using the IBM SPSS 20.00. P value of <0.05 was considered to be statistically significant. Results: A total of 508 multiple sclerosis patients, 331 of whom were women, were included in the study. Upon comparing the Expanded Disability Status values before and after the treatment, a significant decrease was observed, especially at month 6 and thereafter. Since bradycardia occurred in 11 of the patients (2.3%), the first dose had to be longer than 6 hours. During the observation of the first dose, no issues that could prevent the use of the drug occurred. Side effects were seen in 49 (10.3%) patients during the course of fingolimod treatment. Respectively, the most frequent side effects were bradycardia, hypotension, headache, dizziness and tachycardia. Conclusion: The observed results regarding efficacy and safety were similar to clinical trial data in the literature and real life data in terms of the first equivalent with fingolimod active ingredient. [ABSTRACT FROM AUTHOR]

Introduction: Various restrictions due to the coronavirus infection have affected working life globally. People with multiple sclerosis (pwMS) have several difficulties in social life, patient follow-up, and receiving treatments. In this study, we aimed to evaluate the experiences of pwMS during the COVID-19 pandemic. Method: We developed a 50-question survey aiming to determine fears, anxieties, and the problems experienced by patients regarding their diseases and social lives during the COVID-19 pandemic. The questionnaire was released online via the Turkish MS Society website, local MS societies websites, and social media accounts. Only the answers of the patients who filled out the questionnaire completely were evaluated. Results: In total, 6008 patients took the survey, and 3255 of them completed the questionnaire. Among all, 378 patients (11.6%) were positive for COVID-19. The most common COVID-19-related symptom was fatigue (48.4%). The routine medical follow-up was interrupted in 61.4% and the medication was discontinued in 14% of the patients. Approximately 25% of the patients reported different symptoms related to relapse activity. The main concern of the patients related to the COVID-19 pandemic was the disruption of the health of the ones they loved. Among all the patients, 4.4% lost their jobs. Conclusion: Our data showed that the COVID-19 pandemic strongly affected the working lives of pwMS. Also, the pandemic changed the attitudes of patients and neurologists. Therefore, the long-term effects of the COVID-19 pandemic on disease approach, patient follow-up, social conditions, and working life should be monitored. [ABSTRACT FROM AUTHOR]

In addition to ocular neurodegeneration in multiple sclerosis (MS), accompanying microvascular changes in the retina are thought to occur. In this study we sought to compare retinal neurodegenerative changes using optical coherence tomography (OCT) and microvascular changes using OCT angiography (OCTA) of MS patients and healthy controls. This cross-sectional study included 164 eyes of 83 MS patients and 114 eyes of 57 healthy control subjects. There were significant differences in retinal nerve fibre layer (RNFL), ganglion cell complex (GCC), and radial peripapillary capillary (RPC) vessel density (VD) between the MS group and the control group, but no significant differences in superficial capillary plexus (SCP) VD and deep capillary plexus (DCP) VD, foveal avascular zone (FAZ), non-flow area (NFA), and choriocapillary flow (CCF) values. Comparing the eyes with and without previous optic neuritis showed no significant differences in the OCT and OCTA measurements. A negative correlation was found between the expanded disability status scale score and disease duration and the RNFL and GCC values. A positive correlation was found between the RNFL and GCC values and the SCP VD and RPC VD. In MS patients, RPC VD values decreased in correlation with decreases in RNFL and GCC. This reduction increased as the disease duration and disability criteria increased. OCT and OCTA may be important biomarkers in MS. [ABSTRACT FROM AUTHOR]

Introduction: Olfactory impairment and cognitive impairment are common non-motor symptoms in Parkinson's disease (PD). Olfactory impairment may be present even many years before the main symptoms of the disease develop. The associations between olfactory loss and cognition in PD are evaluated in this study. Methods: 31 patients with PD and 31 healthy subjects were included in this study. The Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn and Yahr Scale (H&Y Scale) were administered to all subjects. Butanol threshold test and Sniffin'Sticks test were used to assess olfaction. The Mini Mental State Examination (MMSE) and Clock Drawing Test (CDT) and Stroop Color Word Test (SCWT) were used to assess cognition. Results: The Sniffin'Sticks test scores were significantly lower in the Parkinson group in comparison to the control group (p<0.001). The rate of anosmia was 90% in the PD group while this rate was found to be 54.8% in control group (p=0.005). A significant correlation was found between butanol test scores and stoop 5 and 5 errors. Significant correlations were found between the Sniffin'Sticks scores and MMSE scores (p=0.047) and orientation (p=0.041) and language (p=0.003) functions of the MMSE test. Worse olfaction was associated with worse memory. Conclusions: In PD, olfactory impairment correlates with cognitive impairment and olfactory tests may be used to predict the likelihood of developing dementia in this patient population. [ABSTRACT FROM AUTHOR]

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 Bezmialem Science 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.)

Giriş: Şu ana kadar ailevi Akdeniz ateşine (FMF) eşlik edebilen pek çok komorbid hastalık rapor edilmiştir. Bunlar arasında; sistemik amiloidoz, spondiloartropatiler, Henoch Schönlein purpurası, poliarteritis nodoza ve multipl skleroz (MS) gibi hastalıklar bulunmaktadır. Biz burada FMF'ye eşlik eden spondiloartropati, amiloidoz ve MS komorbid hastalıkları olan ve tüm klinik bulgularda anakinra tedavisi ile gerileme eğiliminin görüldüğü bir olguyu sunmak istedik. Olgu: Kırk beş yaşındaki kadın hasta yaklaşık 8 yıldır FMF ve eşlik eden spondiloartrit, amiloidoz ile takip edilmekte ve kolşisin 0,5 mg 2x2, diklofenak sodyum 75 mg 1x1 kullanmaktadır. Hasta ani gelişen alt ekstremite kas güçsüzlüğü (kas gücü 3/5), eşlik eden bel ağrısı, günde 5-6 kere olan sık dışkılama olması nedeniyle yatırıldı. Hastada M694V mutasyonu homozigot pozitifti, sakroiliak MR'de solda hafif sağda minimal kemik iliği ödemi mevcuttu. Yirmi dört saatlik idrarda 2,6 gram/gün proteinüri tespit edildi. Servikal MR görüntülemesinde spinal kordda lineer T2 hiperintens lezyonlar tespit edildi. Hem serum hem beyin omurilik sıvısında (BOS) identik, BOS'de de oligoklonal bantlar saptandı. Anti-aquaporin-4 (AQP4) ve myelin oligodendrosit glikoprotein antikorları negatif bulunan hastaya MS tanısı kondu. On gün 1 gram pulse steroid tedavisi verildi. Fizik muayenede (FM) kas gücünde hafif iyileşme tespit edildi (4/5) ancak yürüme zorluğu, karın ağrısı, ishal ve bel ağrısı şikayetleri devam eden hastaya anakinra tedavisi başlandı. Anakinra tedavisinin 1. ayında bel ağrısı ve inatçı ishalinin tamamen gerilediği, 24 saatlik idrarda proteinürinin 1 gram/güne gerilediği görüldü. FM'de kas gücünün 5/5 olduğu ve hastanın rahatlıkla yürüyebildiği görüldü. Kontrol servikal MR incelemesinde sebat etseler de lezyonların belirgin olarak silikleştiği görüldü (Şekil 1). Sonuç: Otoenflamatuvar hastalıklar doğal immün sistem disregülasyonu sonucunda oluşmaktadır. Son yıllarda bu disregülasyonun diğer bazı otoimmün hastalıkların oluşumunda etiyolojik bir rol üstlenebileceği düşünülüyor olsa da bu düşünceyi destekleyecek yeterli kanıt yoktur. Sunduğumuz olguda FMF patofizyolojik yolağı üzerinde en etkili ilaç olan anakinra ile diğer komorbid hastalıkların kliniğinde düzelmenin görülmesi bu hipotezi destekler niteliktedir. [ABSTRACT FROM AUTHOR]

Objective: To evaluate sociodemographic profile, clinical characteristics, disability and treatment status of multiple sclerosis (MS) patients in Turkey with respect to patient perspectives and expectations. Methods: A total of 2,176 MS patients participated in this cross-sectional questionnaire survey including items on sociodemographic, disease and treatment characteristics, daily life and perspectives and expectations. Results: Mean (SD) patient age was 36.4(9.4) years and 76.3% of patients were females. The numbness/weakness in the extremities (57.3%) was the most common presenting symptom. Overall, 56.8% reported treatment switch (due to attacks in 47.3%), while 22.2% reported physical disability and 39.7% reported work-related problems. Males had higher rate of MS-related physical disability (33.0% vs. 19.0%, p<0.001) than females. Use of an assistive device was a more common in patients with longer disease duration (≥15 years; 39.0%) and in those under IV treatment (64.0%). Nearly half of patients reported significant concerns related to uncertainty of the future and impaired quality of life as well as lack of hope for future improvement. The majority of patients reported that they would prefer less frequent SC injection dosing and 43.3% reported preference for monthly highefficacy SC injection. Conclusion: This nationwide questionnaire-based study in Turkish MS patients revealed the altered disability status with respect to sociodemographic profile, and altered treatment expectations specific to the route of administration, in addition to significant concerns regarding the uncertainty of the future, impaired quality of life and lack of hope for future improvement in nearly half of patients. [ABSTRACT FROM AUTHOR]

Significant advancements have been achieved in delineating the progress of the Global PROMS (PROMS) Initiative. The PROMS Initiative, a collaborative endeavor by the European Charcot Foundation and the Multiple Sclerosis International Federation, strives to amplify the influence of patient input on MS care and establish a cohesive perspective on Patient-Reported Outcomes (PROs) for diverse stakeholders. This initiative has established an expansive, participatory governance framework launching four dedicated working groups that have made substantive contributions to research, clinical management, eHealth, and healthcare system reform. The initiative prioritizes the global integration of patient (For the purposes of the Global PROMS Initiative, the term "patient" refers to the people with the disease (aka People with Multiple Sclerosis - pwMS): any individual with lived experience of the disease. People affected by the disease/Multiple Sclerosis: any individual or group that is affected by the disease: E.g., family members, caregivers will be also engaged as the other stakeholders in the initiative). insights into the management of MS care. It merges subjective PROs with objective clinical metrics, thereby addressing the complex variability of disease presentation and progression. Following the completion of its second phase, the initiative aims to help increasing the uptake of eHealth tools and passive PROs within research and clinical settings, affirming its unwavering dedication to the progressive refinement of MS care. Looking forward, the initiative is poised to continue enhancing global surveys, rethinking to the relevant statistical approaches in clinical trials, and cultivating a unified stance among 'industry', regulatory bodies and health policy making regarding the application of PROs in MS healthcare strategies., Competing Interests: LuC was employed by Hoffmann-La Roche. LoC was employed by Ad Scientiam. PK was employed by Merck KGaA. ACV has received reimbursement for developing educational presentations, educational and research grants, consultation fees, and/or travel stipends from Biogen Colombia, Genzyme Colombia, Merck Colombia, Roche Colombia, Novartis Colombia. CB has received travel support and/or research grants and/or lecture fees and/or advisory services by Novartis, Merck, Genesis, Sanofi, Teva, Roche, Biogen, Mylan, Tikun Europe ECC has received reimbursement for developing educational presentations, educational and research grants, consultation fees, and/or travel stipends from Biogen Argentina and LATAM, Genzyme Argentina, Merck Argentina and LATAM, Roche Argentina and LATAM, Raffo, Novartis Argentina, AstraZeneca Argentina, Horizon therapeutics, LACTRIMS, Harvard Medical School MP has received reimbursement for developing educational presentations from Biogen and Merck. SG has received reimbursement for developing educational presentations, research grants, consultation fees, and/or travel stipends from Roche, Merck and the Sumaira Foundation. VC received a grant from the European Charcot Foundation, received support for scientific meetings from Biogen, Janssen, Novartis, BMS, Roche and speaking honoraria from Novartis and Alexion. VR reports fees for traveling from Novartis, Merck, Biogen and Roche, speaker’s honoraria from Novartis, Sandoz, Merck, Biogen, consulting fees from Biogen, Merck, Novartis, Janssen, M3 Global Research and Atheneum Partners, all outside of the submitted work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. H-PH declared that he was an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Zaratin, Samadzadeh, Seferoğlu, Ricigliano, dos Santos Silva, Tunc, Brichetto, Coetzee, Helme, Khan, McBurney, Peryer, Weiland, Baneke, Battaglia, Block, Capezzuto, Carment, Cortesi, Cutter, Leocani, Hartung, Hillert, Hobart, Immonen, Kamudoni, Middleton, Moghames, Montalban, Peeters, Sormani, van Tonder, White, Comi and Vermersch.)

Introduction: Fingolimod is the first oral immunomodulatory treatment used as secondary care therapy in the treatment of multiple sclerosis for the last 10 years. The objective of our study is to reveal the experiences of the first generic fingolimod active ingredient treatment in different centers across Turkey., Method: The first generic fingolimod efficacy and safety data of patients followed-up in 29 different clinical multiple sclerosis units in Turkey were analyzed retrospectively. Data regarding efficacy and safety of the patients were transferred to the data system both before the treatment and on the 6th, 12 th and 24 th month following the treatment. The data were analyzed using the IBM SPSS 20.00. P value of <0.05 was considered to be statistically significant., Results: A total of 508 multiple sclerosis patients, 331 of whom were women, were included in the study. Upon comparing the Expanded Disability Status values before and after the treatment, a significant decrease was observed, especially at month 6 and thereafter. Since bradycardia occurred in 11 of the patients (2.3%), the first dose had to be longer than 6 hours. During the observation of the first dose, no issues that could prevent the use of the drug occured. Side effects were seen in 49 (10.3%) patients during the course of fingolimod treatment. Respectively, the most frequent side effects were bradycardia, hypotension, headache, dizziness and tachycardia., Conclusion: The observed results regarding efficacy and safety were similar to clinical trial data in the literature and real life data in terms of the first equivalent with fingolimod active ingredient., Competing Interests: Conflict of Interest: The authors declared that there is no conflict of interest., (Copyright: © 2023 Turkish Neuropsychiatric Society.)

Introduction: Various restrictions due to the coronavirus infection have affected working life globally. People with multiple sclerosis (pwMS) have several difficulties in social life, patient follow-up, and receiving treatments. In this study, we aimed to evaluate the experiences of pwMS during the COVID-19 pandemic., Method: We developed a 50-question survey aiming to determine fears, anxieties, and the problems experienced by patients regarding their diseases and social lives during the COVID-19 pandemic. The questionnaire was released online via the Turkish MS Society website, local MS societies websites, and social media accounts. Only the answers of the patients who filled out the questionnaire completely were evaluated., Results: In total, 6008 patients took the survey, and 3255 of them completed the questionnaire. Among all, 378 patients (11.6%) were positive for COVID-19. The most common COVID-19-related symptom was fatigue (48.4%). The routine medical follow-up was interrupted in 61.4% and the medication was discontinued in 14% of the patients. Approximately 25% of the patients reported different symptoms related to relapse activity. The main concern of the patients related to the COVID-19 pandemic was the disruption of the health of the ones they loved. Among all the patients, 4.4% lost their jobs., Conclusion: Our data showed that the COVID-19 pandemic strongly affected the working lives of pwMS. Also, the pandemic changed the attitudes of patients and neurologists. Therefore, the long-term effects of the COVID-19 pandemic on disease approach, patient follow-up, social conditions, and working life should be monitored., Competing Interests: Conflict of Interest: The authors declared that there is no conflict of interest., (Copyright: © 2022 Turkish Neuropsychiatric Society.)

Introduction: Olfactory impairment and cognitive impairment are common non-motor symptoms in Parkinson's disease (PD). Olfactory impairment may be present even many years before the main symptoms of the disease develop. The associations between olfactory loss and cognition in PD are evaluated in this study., Methods: 31 patients with PD and 31 healthy subjects were included in this study. The Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn and Yahr Scale (H&Y Scale) were administered to all subjects. Butanol threshold test and Sniffin'Sticks test were used to assess olfaction. The Mini Mental State Examination (MMSE) and Clock Drawing Test (CDT) and Stroop Color Word Test (SCWT) were used to assess cognition., Results: The Sniffin'Sticks test scores were significantly lower in the Parkinson group in comparison to the control group (p<0.001). The rate of anosmia was 90% in the PD group while this rate was found to be 54.8% in control group (p=0.005). A significant correlation was found between butanol test scores and stoop 5 and 5 errors. Significant correlations were found between the Sniffin'Sticks scores and MMSE scores (p=0.047) and orientation (p=0.041) and language (p=0.003) functions of the MMSE test. Worse olfaction was associated with worse memory., Conclusions: In PD, olfactory impairment correlates with cognitive impairment and olfactory tests may be used to predict the likelihood of developing dementia in this patient population., (Copyright: © 2020 Turkish Neuropsychiatric Society.)

Introduction: Our aim was to conduct a retrospective review to demonstrate the clinical, radiological, and electrophysiological features of patients with sporadic Creutzfeldt-Jacob disease (sCJD)., Method: A total of 10 patients (5 female and 5 male, with a mean age of 45 years from a range of 40 to 67 years) out of 8.259 adult patients hospitalized from January 2000 to December 2008 were diagnosed with sCJD., Results: Eight of the patients were diagnosed on the basis of clinical, radiological, electroencephalography (EEG), and cerebrospinal fluid (CSF) findings. Two other patients also had a pathological diagnosis. The most common signs and symptoms were behavioral disturbances, movement disorders, cognitive decline, myoclonus, psychosis, focal neurological deficit, and aphasia. Nine of the patients had periodic sharp wave discharges on EEG. Seven patients were positive for the 14.3.3 protein in the CSF. Five patients had pulvinar signs-a bilateral increased signal in the pulvinar thalami-on cranial magnetic resonance imaging. Eight patients were diagnosed with probable sCJD; two were diagnosed with definite sCJD. All of the patients died as a result of the disease within 24 months after the onset of symptoms., Discussion: sCJD should be considered in the diagnosis of patients who present with rapidly progressive dementia. Clinical and radiological data appear to be sufficient for the diagnosis. However, detailed molecular examinations of the subtypes of the disease may be required for early diagnosis of cases given the wide spectra of CJD., Competing Interests: Conflict of interest: The authors reported no conflict of interest related to this article. Çıkar çatışması: Yazarlar bu makale ile ilgili olarak herhangi bir çıkar çatışması bildirmemişlerdir.