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Background Most of the patients with Parkinson’s disease (PD) suffer from non-motor symptoms (NMS). Despite their marked effect on patients’ quality of life, NMS remain under-estimated by physicians, patients and caregivers. The aim of this study was to suggest a battery to screen for the presence of NMS in PD patients in the setting of an outpatient clinic and to assess the NMS of PD in Egyptian patients and factors affecting them. Results This study was conducted on 50 patients with PD, 35 males (70%) and 15 females (30%) whom their age ranged from 36 to 80 years with a mean of 62.88 ± 8.74 years. All patients were assessed using the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), Apathy Scale (AS), Montreal Cognitive Assessment (MOCA), Hamilton Depression Rating Scale (HDRS) and Parkinson’s Disease Sleep Scale (PDSS). The mean age at disease onset was 59.10 ± 9.34 years and the mean disease duration was 3.76 ± 3.16 years. 98% of patients (49 out of 50) had at least one non-motor symptom. The mean MDS-UPDRS scores were 15.74 ± 7.93 for part I, 17.94 ± 11.61 for part II and 42.32 ± 22.74 for part III. The mean score for AS was 9.90 ± 10.66 with 70% of patients considered apathetic. The mean MOCA score was 21.12 ± 4.73 with 38 patients (76%) found to be cognitively impaired. The mean HDRS score was 12.26 ± 8.52 with 34 patients (68%) found to be depressed. The mean PDSS score was 92.22 ± 32.53 with sleep disturbances found in 38 patients (76%). A statistically significant negative correlation was found between the HDRS and PDSS scores (P value Conclusions Most of the patients with PD were found to suffer from NMS including apathy, cognitive impairment, depression and sleep disturbances. Physicians need to screen their PD patients for NMS on regular basis using the appropriate tools. Self-administered questionnaires could function as reliable screening tools for NMS in PD patients.

Background Given the diversity of multiple sclerosis (MS) symptoms including cognitive impairment in certain domains, the need to develop a rapid and at the same time thorough tool for cognitive assessment is mandatory and represents an unmet need in the clinical and research fields of MS. The Brief International Cognitive Assessment for MS (BICAMS) is a good and practical tool to achieve this mission but is not present in the Arabic language for Arabic speaking countries yet. Objectives To assess the reliability and validity of Arabic version of the BICAMS (Egyptian dialect). Methods Ninety Egyptian MS patients and 85 matched healthy controls underwent neuropsychological testing using the BICAMS Arabic version (Egyptian dialect) battery including the Symbol Digit Modality Test (SDMT), California Verbal Learning Test 2nd edition (CVLT-II), and revised Brief Visuospatial Retention Test- (BVRT-R). Test–retest data were obtained from MS patients 2 weeks after the initial assessment. Mean differences between both groups were assessed controlling for age, gender, and educational level. Results The MS patients scored significantly lower on the SDMT, CVLT-II, and BVMT-R tests compared to healthy controls (pr values of 0.85, 0.61, and 0.68, respectively. Conclusion BICAMS Arabic version is a reliable and valid tool for cognitive assessment of Arabic speaking MS patients in different clinical and research settings.

Background The prevalence of cognitive impairment (CI) can reach up to 65% among multiple sclerosis (MS) patients. Self-administered screening questionnaires can offer a valuable solution for screening MS patients for cognitive complaints. The cognitive screening questionnaire for neurological disorders (CSQND) is an Arabic self-administered questionnaire that has been developed to screen patients with various neurological disorders attending neurology clinics. The aim of this study was to assess cognitive complaints and to validate the CSQND as a screening tool among Egyptian MS patients. Results Four-hundred MS patients and 400 controls were included in this study. All 400 patients and 400 controls were subjected to the CSQND, only 50 out of the 400 patients and 50 out of the 400 controls retook the CSQND 1 week later to establish test–retest reliability. Fifty patients and 50 controls were assessed by the symbol digit modalities test (SDMT) to establish concurrent validity. Thirty-four percent of patients complained of memory problems, 51% complained of concentration difficulties, 34% complained of language difficulties and 22.5% complained of space and time disorientation. Multiple sclerosis patients had significantly more cognitive complaints (12.4 ± 12.6) compared to controls (6.2 ± 6.8) when screened using the CSQND (P r = 0.14; 0.275; 0.3; 0.167, respectively), P R = 0.9, P = 0.0001) and controls (R = 0.85, P = 0.0001). Conclusions The CSQND was found to be a simple, valid, and reliable self-administered questionnaire to screen for cognitive complaints in MS patients.

Background Drug-resistant epilepsy (DRE) accounts for nearly 30% of patients with epilepsy, which is associated with high incidence of cognitive comorbidity. The aim of this work was to study the role of neuropsychological assessment in patients with epilepsy, and different factors that affect their performance in patients with multiple factors (focal onset DRE). Methods 118 patients were recruited from Kasr Alainy hospital, epilepsy outpatient clinic with focal DRE. The patients’ demographic and clinical data were collected, Electroencephalograph (EEG) interictal/ictal (when available), and brain imaging (MRI epilepsy protocol). Neuropsychological assessment by Wechsler Adult Intelligence Scale (WAIS-IV), proposed neurocognitive assessment battery and mood assessment was done. Their performance in neuropsychological assessment was correlated with the collected data. Concordance between different assessment modalities and brain lesion were done. Results Among recruited patients, 67.3% of patients showed Full-scale Intelligence Quotient (FSIQ) was less than average. FSIQ score significantly correlated with years of education, and number of anti-seizure medications (ASMs). Neurocognitive assessment battery could achieve cognitive profile of the patients but with poor lateralizing value. Executive function was the most affected cognitive domain. History of status epilepticus significantly affect FSIQ and executive function performance. Fifty-six percent of patients had depression. Among the analyzed factors, FSIQ and lesional brain imaging significantly affected neurocognitive performance of studied patients. Clinical semiology had better concordance in lateralization (74.7%) and localization (69.5%) with brain imaging compared to ictal EEG. Among patients who had ictal EEG recording, 36.4% patients (25% were temporal lobe) had complete concordance, while 38.6% patients had partial concordance. Conclusions Among analyzed factors, FSIQ was the most significant determinant of studied population’s neurocognitive performance. Clinical semiology were the best correlated with brain lesion. Complete concordance was best detected at the temporal lobe.

Background The traditional paper and pencil method for EDSS calculation (pEDSS) is the cornerstone of multiple sclerosis practice; however, it requires an expert for an accurate calculation, and it takes a lot of time to perform the function scores. A new algorithmic approach (aEDSS) has been developed for easier and faster assessment. Objective To determine if using aEDSS can achieve good inter-rater agreement and save time compared to pEDSS. Subjects and methods This study was conducted on 200 MS patients; EDSS was performed twice for each patient by two neurologists on the same day; one used the pEDSS, and the other used the aEDSS in a random order to test the inter-rater agreement regarding functional system scores and the final EDSS score and to detect the difference in the time needed for calculation between both methods. Results The new algorithmic approach achieved excellent agreement with the traditional method (Kappa > 0.81) with a shorter calculation time (16 ± 2.67 min for aEDSS vs 31 ± 4.3 min for pEDSS, P < 0.0001). Conclusion The new algorithmic approach could represent a suitable alternative to the traditional method, making EDSS calculation easier and faster.

Background Aging is associated with changes in cognitive functions. However, many other factors may affect cognitive functions and this interaction needs further assessment. Objectives To detect gender differences in sleep quality, nutritional status, and health-related quality of life and their impact on performance in verbal fluency tasks among apparently healthy elderly. Subjects and methods The study was conducted on 102 normal aged subjects, 51 males and 51 females. Subjects were divided according to age into group ≥ 60 years and group Results Among the older group, females had significantly poorer physical and mental health, sleep quality and nutritional status than males (p value 0.001, 0.003, 0.012, and 0.014, respectively). Older females had significantly lower performance in verbal fluency (girls’ names) compared to younger females (p value 0.013), but no significant gender difference was found among the older group. Verbal fluency tasks are correlated to the level of education in both males and females (r 0.392 and 0.42, p value 0.029 and 0.019, respectively), However, in older males, it is also correlated to sleep latency (r 0.41 and p value 0.021). Conclusion Older females had poorer sleep quality, lower health-related quality of life and lower nutritional status. No gender difference was found in verbal fluency tasks. Although no single variable could independently affect verbal fluency, education remains the main player in the difference in performance.