E ISSN 2791-7851
Volume : 2 Issue : 2 Year : 2023
Volume: 2  Issue: 2 - August 2022

Pages I - IX

2.Psychiatric Disorders in Multiple Sclerosis
Yılmaz Inanc, Tugba Kaya
doi: 10.4274/jmsr.galenos.2022.2022-8-1  Pages 31 - 35
Multiple sclerosis (MS) is an autoimmune, inflammatory, neurodegenerative disease of the central nervous system, characterised by demyelinisation and axonal damage. The probability of MS patients experiencing psychiatric disorders is much greater than that of the population not diagnosed with MS. The symptoms of MS, the side-effects of pharmacological treatments, family history, and psychosocial factors can cause the possibility of psychiatric disorders developing, such as depression, anxiety, adjustment disorder, psychosis, bipolar mood disorder, chronic stress, and suicidal thoughts. Literature search for original articles and review in the databases, including PubMed, Google scholar and Scopus from 1996 to 2021. Studies suitable for the purpose of this review were selected and reported. The frequency of psychiatric disorders in MS and the radiological findings in these cases were evaluated. Depression has been reported to be the psychiatric disorder with the highest prevalence as a comorbidity in individuals diagnosed with MS. Depression affects an average of 30% of MS patients, which is a rate 2-5-fold higher than in the general population. The presence of additional psychiatric diagnoses has a high prevalence in MS disease, but the majority are overlooked in the diagnosis and treatment process.

3.Relationship Between Fatigue and Helicobacter pylori Infection in Patients with Multiple Sclerosis
Mustafa Cam, Alper Akcalı
doi: 10.4274/jmsr.galenos.2022.2022-6-1  Pages 36 - 40
INTRODUCTION: One of the common complaints in patients with multiple sclerosis (MS) is fatigue. Studies have reported that 75-87% of patients complain of fatigue. In our study, the possible relationship between fatigue severity and Helicobacter pylori (H. pylori) infection in patients with MS was investigated.
METHODS: The fatigue severity scale was applied to patients who presented to the neurology clinic during the study to assess fatigue. The Beck Depression Inventory was used to evaluate depression, and the Epworth sleepiness scale was used to assess sleepiness. Serum quantitative Immunoglobulin G (IgG) levels for H. pylori were measured using the enzyme-linked immunoassay. IBM SPSS Statistics version 26.0 was used for analysis.
RESULTS: The MS and control groups consisted of 105 and 79 people, respectively. H. pylori seropositivity was not significant in the intergroup analysis. In the MS group, H. pylori IgG level was significantly higher in patients with fatigue than in patients without fatigue. The Beck Depression Scale and Expanded Disability Status Scale scores were significantly higher in the MS group.
DISCUSSION AND CONCLUSION: Individual, environmental, and developmental factors were thought to play a role in fatigue, which is common in patients with MS. Another factor could be depression. In our study, H. pylori IgG levels were significantly higher in patients with fatigue in the MS group. This result suggests that H. pylori may be a factor in the pathophysiology of fatigue.

4.Relationship Between Upper Extremity Functions and Gait in People with Multiple Sclerosis
Seda Dastan, Sinem Ozcelik, Ipek Yavas, Asiye Tuba Ozdogar, on behalf of Multiple Sclerosis Research Group
doi: 10.4274/jmsr.galenos.2022.2022-7-1  Pages 41 - 45
INTRODUCTION: Approximately 66% of people with multiple sclerosis (pwMS) have upper extremity dysfunction that is underestimated in the evaluation and treatment process. Gait interference is another important motor problem identified. In pwMS, changes seen in gait parameters include decreased stride length, decreased cadence, and decreased joint range of motion. Although the relationship between gait and arm swing has been investigated in the general population, the existing relationship has not been clearly demonstrated for pwMS. This study aimed to examine the relationship between upper extremity function and gait in pwMS.
METHODS: The study included 29 pwMS followed at the outpatient Multiple Sclerosis Clinic of Dokuz Eylul University Hospital. The arm function in MS questionnaire (AMSQ), nine-hole peg test (N-HPT), and Jamar hand dynamometer were used for upper extremity assessment. Gait was assessed with weekly step count according to the SenseWear armband (SWA) and preference-based MS index (PMSI) walking subparameter. The Expanded Disability Status Scale (EDSS), age, sex, and disease duration were recorded. The partial correlation controlling for the EDSS, age, sex, and disease duration was used.
RESULTS: The clinical and demographic profiles of the participants were as follows: mean age, 44.41±11.30; mean EDSS score, 3.34±1.68; mean disease duration, 12.44±9.63; mean N-HPT, 25.72±7.13; mean Jamar score, 20.94±9.12; mean PMSI, 0.65±0.24; mean step count, 29037.9±18638.62; mean AMSQ score, 68.86±32.40. A moderately negative correlation was found between SWA and AMSQ (r=-0.483, p=0.017). Moreover, a moderately positive correlation was found between AMSQ and PMSI walking sub parameter (r=0.430, p=0.036).
DISCUSSION AND CONCLUSION: The results of this study revealed no significant relationship between upper extremity performance-based measurement and gait, whereas a significant relationship was noted between upper extremity function and gait in the self-reported assessment.

5.Investigation of Neuropathic Pain Distribution and Related Factors in People with Multiple Sclerosis
Hilal Karakas, Ergi Kaya, Zuhal Abasiyanik, Asiye Tuba Ozdogar
doi: 10.4274/jmsr.galenos.2022.2022-7-2  Pages 46 - 51
INTRODUCTION: The primary aim of the study was to examine the distribution of neuropathic pain according to body areas in people with multiple sclerosis (pwMS) with neuropathic pain. The secondary aim was to examine the relationship between neuropathic pain and psychosocial (fatigue, sleepiness, anxiety, and depression levels) parameters in pwMS.
METHODS: This study analyzed 70 pwMS. The PainDETECT questionnaire was used to assess neuropathic pain. Psychosocial parameters such as fatigue, sleepiness, anxiety, and depression were assessed.
RESULTS: The most frequently reported neuropathic pain areas were the neck (58.6%), foot/ankle (50%), and knee (48.6%). In addition, in every 1-point increase in the depression survey, the likelihood of having neuropathic pain increases 0.66 times, and in every 1-point increase in the psychosocial parameter of the fatigue survey, the likelihood of having neuropathic pain increases 2.12 times (p<0.05).
DISCUSSION AND CONCLUSION: The results of this study reveal that neuropathic pain is frequently seen in the neck, foot/ankle, and knee areas in pwMS. In addition, the psychosocial parameter of fatigue and depression increases the likelihood of having neuropathic pain in pwMS.

6.Neuromyelitis Optica Following COVID-19 Infection
Damla Cetinkaya Tezer, Ipek Gungor Dogan, Serkan Demir
doi: 10.4274/jmsr.galenos.2022.2022-4-2  Pages 52 - 53
The coronavirus disease-2019 (COVID-19) may be a trigger for acquired demyelinating central or peripheral nervous system disorders like other viral infections. We present a clinical image of a patient who was diagnosed with neuromyelitis optica (NMO) following COVID-19 infection. A 25-year-old woman presented with progressive loss of strength and numbness in her left upper extremity and bilateral lower extremities and sphincter involvement on the second week of isolation. Spinal magnetic resonance imaging revealed extensive long-segment demyelinating lesion. NMO-immunoglobulin G antibody was positive. It is one of the first cases of long extensive transverse myelitis with seropositivity among the long-segment myelitis cases in the literature.

7.Altitudinal Visual Defect as the Initial Sign of Optic Neuritis: A Case Report
Rana Cagla Akduman, Cigdem Bayram, Seyma Calik, Hakan Silek
doi: 10.4274/jmsr.galenos.2022.2022-3-3  Pages 54 - 56
Optic neuritis (ON) is the most common optic neuropathy in adults and is frequently seen together with multiple sclerosis, manifesting itself mainly as painful diffuse field loss or central scotomas. However, it could be encountered in various other inflammatory, demyelinating, infectious, and autoimmune conditions that could be broadly classified into two groups: typical and atypical ON. On the contrary, painless vision loss, especially altitudinal visual field defects (AVD), is commonly observed in ischemic optic neuropathies (ION), mostly in patients with vascular risk factors or history of giant cell arteritis. Although rare, AVD can be the initial sign of ON and inflammatory demyelinating process. Herein, we report a case of a 17-year-old patient with ON presenting with painless AVD and provide a brief review of the mechanisms involved in typical and atypical ON and ION.

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