Ataxia is a significant and often debilitating symptom characterized by the impaired coordination of voluntary muscle movements. It frequently occurs in patients with multiple sclerosis (MS) and profoundly impacts their quality of life. This comprehensive review explores the multifaceted nature of ataxia, including its diverse etiologies such as central nervous system lesions, medication side effects, nutritional deficiencies, and hereditary conditions, as well as its association with various diseases. A detailed examination of ataxia’s correlations with neuroanatomy revealed its complex relationship with cerebellar pathology. This emphasized the critical role of the cerebellum and its associated pathways in coordinating voluntary movements. The manifestation of ataxia in MS were examined, highlighting its prevalence, impact on disability and life quality, and the pathological underpinnings within cerebellar structures. Diagnostic approaches, including the International Cooperative Ataxia Rating Scale, Scale for the Assessment and Rating of Ataxia, and nine-hole peg test for assessing upper limb dexterity, were discussed. Furthermore, the treatment strategies were critically reviewed. Although long-term effective options are currently lacking, specific pharmacological agents and rehabilitation techniques have demonstrated some benefits. The review findings indicate that further studies are required to better understand ataxia’s dynamics, treatment efficacy, and overall impact on patients with MS. Additionally, there is a pressing need for advancements in management and therapeutic approaches.

Multiple sclerosis (MS) is a chronic autoimmune disorder that impacts the central nervous system. It typically develops during young adulthood, substantially impacting the health-related quality of life (HRQoL) through physical, cognitive, and psychosocial dysfunction. Recent breakthroughs in medical and rehabilitative approaches stress the need to enhance HRQoL for MS patients. Motor imagery (MI) training, involving the mental rehearsal of physical movements without actual execution, has emerged as a promising rehabilitation technique. This method activates neural circuits analogous to those during physical movement and improves motor function and psychological well-being in diverse neurological conditions, including MS. This narrative review synthesizes existing research on the effects of MI training on HRQoL in MS patients. Studies consistently report enhancements in motor function, including improved walking and reduced symptoms of fatigue and depression following MI interventions. Despite differing protocols and methodologies, the findings collectively suggest that MI training can enhance HRQoL in MS patients. Implementing MI training presents difficulties, including standardizing protocols, ensuring patient adherence, and addressing cognitive impairments influencing training effectiveness. In conclusion, MI training exhibits potential to enhance HRQoL in MS patients by addressing both physical and psychological aspects of the disease, thereby boosting overall well-being and functional independence.

INTRODUCTION: To investigate cognitive function variability and health-related quality of life in patients with diverse types of multiple sclerosis (MS).
METHODS: This study involved 780 participants diagnosed with various types of MS. Data was collected using the MS quality of life 54 questionnaire, administered online during the coronavirus disease-2019 pandemic.
RESULTS: The cognitive function scores of the various MS types were found to be significantly distinct, with the relapsing-remitting (RR) type exhibiting the greatest variability. Repeated measures analysis of variance revealed a modest improvement in cognitive function over time in RRMS patients. Age and health-related quality of life exhibited a highly significant negative correlation (r=-0.63, p<0.001). Heritability analysis suggested that approximately 45% of cognitive function variability is attributable to genetic factors. Specifically, RRMS patients exhibited higher cognitive function scores compared to patients with primary-progressive type and secondary-progressive type of MS (p<0.01 and p<0.05, respectively).
DISCUSSION AND CONCLUSION: Cognitive function and health-related quality of life differ significantly among the different MS types. Age and genetic factors play critical roles in cognitive health. The findings underscore the need for conducting routine cognitive assessments in MS patients, especially for those with RRMS, to provide early intervention and enhance patient outcomes. Comprehensive mean square care necessitates the integration of cognitive and physical health management strategies.

INTRODUCTION: Natalizumab (NTZ) is an effective immunomodulator therapy (IMT) employed for multiple sclerosis (MS) therapy. This study aimed to investigate the efficacy and safety of NTZ treatment in MS patients.
METHODS: Patients with clinically definite MS who received NTZ treatment were included in the study, and their data were derived from the iMed database. Patient demographics such as age, sex, and disease duration were assessed. The results pertaining to the annual number of attacks, expanded disability status scale (EDSS) results, magnetic resonance data, and no evidence of disease activity-3 (NEDA-3) were obtained.
RESULTS: This study included 153 patients (108 female and 43 male). The patients’ ages ranged from 21.63 to 67.60 years, with a mean age of 44.50 years. Prior to undergoing NTZ treatment, 54.3% of the patients had received at least two other IMTs. The mean annual number of assaults was 1.19, and the number of attacks in the year prior to treatment ranged from 0 to 6. The mean number of attacks in the first year following treatment was 0.07, 0.13 in the second year, and 0.09 in the third year. The baseline EDSS values of the patients varied between 0 and 5.5, and the mean baseline EDSS value was 3.08. During the initial year of treatment, the patient’s mean EDSS value was 2.58, the second year was 2.32, and the third year was 2.34. Recurrence with increased severity of disease activity or rebound development was observed in 14.6% of the patients whose NTZ treatment was terminated for any reason. The NEDA-3 value decreased from 82.8% (n=145) in the first year to 77.3% (n=132) in the second year and 79.0% (n=81) in the third year.
DISCUSSION AND CONCLUSION: Patients received NTZ for three years on average. 14.6% of the patients exhibit a recurrence or rebound of disease activity. Anti-John Cunningham virus antibody was detected in 5% of patients during the course of treatment. Approximately 80% of patient achieved NEDA-3 while receiving NTZ over the three-year period.