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Background: Difficulties of self-management in people with MS (pwMS) is considered as one of the most important factors contributing to low rehabilitation efficacy, more severe long-term complications and increase in healthcare costs. Despite the emergence of research in the last decade documenting causes, types, and course of cognitive difficulties in MS disease subtypes, limited evidence is available in the literature for direct comparison of self-management and cognitive deficits. In this study we aimed to investigate the relationship between cognitive performance and self-management in pwMS., Methods: PwMS who applied to neurology out-patient clinics of seven different centers were included into study. Multiple Sclerosis Self-Management Scale- Revised (MSSM-R) was used for the assessment of self-management behaviors and Multiple Sclerosis inventory cognition scale (MUSIC) was used for the assessment of cognitive performance and fatigue., Results: In this study, 194 (144 female and 50 male) pwMS participated (mean age = 38.9 years). The course of the disease was RRMS in 173 patients and mean EDSS was 2.0. 68.5% of the participants were married, 32.5% were employed, and 57.2% had secondary education. The MSSM-R mean score of the study group was 42.6 ± 10.4 (1-81). There was a positive correlation between MSSM-R and MUSIC-cog scores (r = 0.21, p = 0.003). A hierarchical multiple regression revealed that income level (β = 0.196, t = 2.692, p = 0.008) and cognitive performance (β = 0.167, t = 2.063, p = 0.041) together with control variables (gender, age, educational status, employment status, duration of disease, EDSS and fatigue) explained 5.5% of the variance in self-management., Conclusion: Cognitive performance is a predictor of self-management in pwMS. Better self-management behavior is also related with employment and income level in pwMS. Studies evaluating patients' cognitive abilities and evaluating the effectiveness of adapted self-management training programs are needed., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Since December 2020, a significantly higher number of people worldwide have been vaccinated for coronavirus disease 2019 (COVID-19). Neurological complications have been reported after these vaccines, although a definitive causal relationship has not been proven in the available literature. We describe a 51-year-old man presenting with anti-glutamic acid decarboxylase (anti-GAD) antibody positive autoimmune encephalitis with progressive cognitive impairment and behavioral abnormalities, presenting shortly after the second dose of mRNA COVID-19 vaccine, possibly representing a serious vaccinerelated adverse event. Response to high-dose steroid and intravenous immunoglobulin treatment was positive. As many people around the world have been vaccinated against COVID-19, this case shows that autoimmune encephalitis and even anti-GAD antibody positive autoimmune encephalitis can develop as a side effect after this new vaccine, but with early diagnosis and appropriate treatment, the clinic can have a good prognosis. Observational studies with large numbers of patients are needed to explain causality. [ABSTRACT FROM AUTHOR]

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