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Relationship between structural and functional assessment of the visual system in mildly disabled relapsing-remitting multiple sclerosis patients

Huseyinoglu N. | Ekinci M. | Ozben S. | Buyukuysal C.

Article | 2014 | Neuro-Ophthalmology38 ( 1 ) , pp.1 - 7

Studies that explored the anterior visual pathway in the patients with multiple sclerosis (MS) have demonstrated contradictory results about the correlation between structural and functional status of optic nerve and retina. We aimed to investigate the functional and structural findings in our cohort of mildly disabled relapsing-remitting MS patients. A total of 134 eyes (80 eyes of the patients with MS and 54 eyes of the control group) were investigated. Eyes of MS patients were divided into two groups as eyes with history of optic neuritis (ON group) and without history of optic neuritis (NON group). Ophthalmological investigation . . . including visual evoked potentials, standard automated perimetry, and optical coherence tomography were performed for all participants. Retinal and macular thicknesses were significantly decreased in ON and NON groups compared with controls. Also, visual evoked potential latencies and visual field loss were worse in the both MS groups compared with control group. We did not find any correlation between visual evoked potentials and retinal or macular thickness values but visual field parameters were correlated between retinal and macular layer loss in the NON group. According to our results and some previous studies, although both functional and structural changes were detected in patients with MS, functional status markers do not always show parallelism (or synchrony) with structural changes, especially in eyes with history of optic neuritis. © 2014 Informa Healthcare USA, Inc Daha fazlası Daha az

Optical coherence tomography in patients with relapsing-remitting multiple sclerosis without optic neuritis: A 20-month longitudinal study

Huseyinoglu N. | Ozben S. | Ekinci M. | Buyukuysal C. | Yildirim M. | Safak H. | Huseyin H.

Article | 2013 | Neuro-Ophthalmology37 ( 3 ) , pp.104 - 110

Optical coherence tomography is supported and used as a technique for visualisation of neuro-axonal loss in multiple sclerosis, but there are also a few studies expressing the opposite view. The aim of our study was to investigate retinal nerve fibre layer and optic nerve head parameters in patients with multiple sclerosis without a history of prior optic neuritis and symptoms of a new clinical attack during the follow-up for a total of 20-month period. Full ophthalmic evaluation was performed for all of the participants. The baseline retinal nerve fibre layer and macular thicknesses and focal and global loss of macular volume value . . .s were significantly lower in the eyes of the patients with multiple sclerosis compared with the healthy controls. No significant change between baseline and follow-up scans were found in all optical coherence tomography parameters in the multiple sclerosis group. Statistical analyses revealed significant retinal nerve fibre layer and macular thickness differences between baseline and second measurements in the controls. No significant difference in percent change between baseline and second measurements was observed between the patient and control groups. We conclude that whereas healthy subjects have an age-related tendency toward a decrease in retinal nerve fibre layer thickness, patients with multiple sclerosis patients are likely to pass through different stages of retinal thinning and thickening due to subclinical optic neuritis and, as a result, we could not detect any statistically significant change between baseline and second measurements in our multiple sclerosis patients. © Informa Healthcare USA, Inc Daha fazlası Daha az

Comparison of retinal nerve fibre layer thickness with visual evoked potential and visual field in patients with multiple sclerosis

Alpay A. | Guney T. | Unal A. | Ugurbas S.H.

Article | 2012 | Clinical and Experimental Ophthalmology40 ( 1 ) , pp.104 - 110

Background: To evaluate retinal nerve fibre layer thickness and to compare results with visual evoked potentials and visual field in patients with multiple sclerosis. Design: A prospective, case-control study, university hospital setting. Participants: Seventy-three eyes of 37 multiple sclerosis patients and 74 eyes of 37 healthy subjects. Methods: All patients underwent a complete neurological and ophthalmological examination and peri-papillary retinal nerve fibre layer thickness was evaluated using scanning laser polarimetry (GDx). Furthermore, visual evoked potential and visual field testing were performed. Main Outcome Measures: . . . The ? 2 test, Student's t-test, Mann-Whitney U-test and Pearson's correlation coefficient analysis of the GDx, visual evoked potential and visual field testing parameters. Results: GDx measurements showed significantly more retinal nerve fibre layer damage in the patients than in the control groups. Comparison of the GDx parameters between patients with optic neuritis and non-optic neuritis demonstrated a statistically significant difference in symmetry (P=0.046) and superior/nasal parameters (P=0.009). A correlation was found between the number, superior and inferior ratio parameters, and P100 amplitude obtained with visual evoked potential in patients with non-optic neuritis. Additionally, there was a correlation between the number, inferior ratio and superior/nasal parameters, and the mean deviation of visual field in the non-optic neuritis group. Conclusions: For retinal nerve fibre layer thickness measurements in multiple sclerosis patients, the GDx, along with other techniques, such as visual evoked potential, can be used as a diagnostic and follow-up criterion, particularly in patients without optic neuritis. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists Daha fazlası Daha az

Interleukin 18 gene polymorphism is a risk factor for multiple sclerosis

Karakas Celik S. | Öz Z.S. | Dursun A. | Unal A. | Emre U. | Cicek S. | Keni F.M.

Article | 2014 | Molecular Biology Reports41 ( 3 ) , pp.1653 - 1658

Proinflammatory cytokines with immunosuppressive properties play an important role in the pathogenesis of multiple sclerosis (MS). Interleukin 18 (IL-18) is one of the most important innate cytokines produced from macrophages in the early stages of the inflammatory immune response. The purpose of this study was to determine whether there was any relationship between IL18 gene polymorphisms and MS. IL18 genotyping were performed in 101 MS patients and 164 control subjects by using the PCR-restriction fragment length polymorphism (PCR-RFLP) method. The frequency of MS patients with the CC genotype of the IL18 gene at position -137 was . . . significantly higher than with the GG genotype [p = 0.01, odds ratio (OR) 3.17]. In haplotype analysis of two SNPs in the IL18 gene, frequency of the CC haplotype was significantly higher in MS patients (p = 0.002, OR 3.0). However, the genotype distribution of the IL18 -607 C/A polymorphism in the MS patient group was not significantly different from that of the control group. These data suggest that IL18 gene polymorphisms at position -137 might be a genetic risk factor for MS in the Turkish population. © 2014 Springer Science+Business Media Daha fazlası Daha az

The 20-year history: Change of multiple sclerosis patient profile over 20 years

Ozakbas S. | Cinar B.P. | Kahraman T. | Multiple Sclerosis Research Group

Article | 2019 | Multiple Sclerosis and Related Disorders33 , pp.1 - 4

Background: Patients attending multiple sclerosis (MS) clinics experience less disability compared to previous years. Objective: This study was conducted retrospectively examining the patient records of our MS Clinic. The patient records in 1996 were compared to those in 2016. Methods: Demographic data, duration of disease, time to diagnosis, course of the disease, Expanded Disability Status Scale (EDSS) scores, and whether or not patients used disease modifying therapies were recorded in both 1996 and 2016. Results: The mean frequency of visits were significantly higher in 1996 compared to 2016 (p = 0.003). There were significantly . . . more number of patients with clinically isolated syndrome (p = 0.004) and secondary progressive MS (p = 0.001) in 1996; however, significantly less number of patients with relapsing-remitting MS (p < 0.001). EDSS scores of ?3 were significantly higher in 2016 (p < 0.001). On the other hand, the number of patients with the EDSS scores of 6–6.5 and ?7 were significantly less in 2016 (p < 0.001). Significantly more patients with secondary progressive MS, EDSS scores of 6–6.5 and ?7 (wheel-chair dependent patients) came to the clinic in 1996 compared to 2016. Conclusion: The emergence of treatment options in MS and the increasing availability of new treatment options for patients with no/inadequate treatment response have changed the MS patient profile over the 20 years. The number of wheelchair-dependent patients dramatically reduced. © 201 Daha fazlası Daha az

Novel SNARE complex polymorphisms associated with multiple sclerosis: Signs of synaptopathy in multiple sclerosis

Yalın O.Ö. | Gökdoğan Edgünlü T. | Karakaş Çelik S. | Emre U. | Güneş T. | Erdal Y. | Ünal A.E.

Article | 2019 | Balkan Medical Journal36 ( 3 ) , pp.174 - 178

Background: It is well known that axonal degeneration plays a role in disability in patients with multiple sclerosis, and synaptopathy has recently become an important issue. Aims: To investigate the possible roles of selected synaptic and presynaptic membrane protein genetic polymorphisms (VAMP2, SNAP-25, synaptotagmin, and syntaxin 1A) in patients with multiple sclerosis. Study Design: Case-control study. Methods: A total of 123 patients with multiple sclerosis and 192 healthy controls were included. The functional polymorphisms of specific SNARE complex proteins (VAMP2, synaptotagmin XI, syntaxin 1A, and SNAP-25) were analyzed by . . . polymerase chain reaction. Results: Significant differences were detected in the genotype and allele distribution of 26-bp Ins/Del polymorphisms of VAMP2 between patients with multiple sclerosis and control subjects; Del/Del genotype and Del allele of VAMP2 were more frequent in patients with multiple sclerosis (p=0.011 and p=0.004, respectively). Similarly, Ddel polymorphism of SNAP-25 gene C/C genotype (p=0.059), syntaxin 1A T/C and C/C genotypes (p=0.005), and synaptotagmin XI gene C allele (p=0.001) were observed more frequently in patients with multiple sclerosis. CC, syntaxin rs1569061 1A gene for 33-bp promoter region TC haplotypes, and synaptotagmin XI gene were found to be associated with an increased risk for multiple sclerosis (p=0.012). Similarly, GC haplotype for rs3746544 of SNAP-25 gene and rs1051312 of SNAP-25 gene were associated with an increased risk for multiple sclerosis (p=0.022). Conclusion: Genetic polymorphisms of SNARE complex proteins, which have critical roles in synaptic structure and communication, may play a role in the development of multiple sclerosis. © 2019 by Trakya University Faculty of Medicine/The Balkan Medical Journal published by Galenos Publishing House Daha fazlası Daha az

Overactive bladder symptoms in patients with multiple sclerosis: Frequency, severity, diagnosis and treatment

Akkoç Y. | Ersöz M. | Yüceyar N. | Tunç H. | Köklü K. | Yoldaş T.K. | Dönmez Ü.

Article | 2016 | Journal of Spinal Cord Medicine39 ( 2 ) , pp.229 - 233

Objective: To determine the frequency and severity as well as the diagnosis and treatment of overactive bladder problems in patients with multiple sclerosis (MS) followed up at five centers in Turkey. Design: Survey study. Setting: Outpatient tertiary clinics of physical medicine and rehabilitation and neurology. Participants: Consecutive MS patients scheduled for outpatient follow-up (n= 309). Intervention: MS patients were asked to complete a questionnaire regarding the frequency and severity, as well as the diagnosis and treatment of their overactive bladder problems. Results: The mean age±SD was 39.3±10.6 years. Urinary urgency . . .was the most common urinary symptom (62%), followed by frequency (50.4%), urge incontinence (44.7%) and nocturia (33%). Residual urine volume was measured using a portable ultrasound instrument in 13.3% of the patients and by catheterization in 16.2% of them. Urodynamic investigations and urinary tract ultrasound were performed on 26.5% and 35.3% of the patients, respectively. Anticholinergic medications were prescribed for 27.5% of the patients. Intermittent catheterization and indwelling catheterization were used on 8.1% and 1.9% of the patients, respectively. The overactive bladder symptom score (OABSS) was significantly higher in patients who had had residual urine measurement ( Daha fazlası Daha az

Psychometric study of Turkish version of Fatigue Impact Scale in multiple sclerosis patients

Armutlu K. | Keser I. | Korkmaz N. | Akbiyik D.I. | Sümbüloglu V. | Güney Z. | Karabudak R.

Article | 2007 | Journal of the Neurological Sciences255 ( 01.Feb ) , pp.64 - 68

Background: The aims of this study were to test the validity, test-retest reliability, and internal consistency of Turkish version of FIS; the variables affecting FIS score. Materials and methods: 71 MS patients and 68 healthy subjects were included to the study. Results: Total FIS score and subscale scores were different statistically between MS patients and healthy volunteers in both first and second FIS applications (p < 0.001). These results showed that FIS is validated in divergent direction. BDI score was higher in MS patients than healthy volunteers (p < 0.001). There was no statistically significant difference between two st . . .udy groups for cognitive subscale scores, after the effect of depression was eliminated (p > 0.05). To assess the test-retest reliability, the scores of two FIS applications did not differ statistically (cognitive t = 1.948 p > 0.05, physical t = 1.420 p = 0.160, social t = 1.470 p = 0.146, total t = 1.990 p = 0.05). Intraclass correlation coefficients were 0.89 (99% confidence interval: 0.79-0.94) for cognitive, 0.95 (0.91-0.97) for physical, 0.91 (0.83-0.95) for social, and 0.93 (0.86-0.96) for total FIS scores (p < 0.001). EDSS correlated with physical subscores in both applications of FIS. Conclusion: Turkish version of FIS, which is valid and reliable, seems an appropriate tool for the assessment of the effects of fatigue in Turkish MS population. © 2007 Elsevier B.V. All rights reserved Daha fazlası Daha az


Unal A. | Sutlas P.N. | Kuscu D.Y. | Emre U. | Yazar T. | Ankarali H. | Kirbas D.

Article | 2009 | Neurology Psychiatry and Brain Research16 ( 2 ) , pp.69 - 74

Background: Glucocorticoid treatment is recommended as the first-line treatment of MS relapses, however there is still no clear evidence supporting an optimum therapeutic regime. The high dose (HD) consisted of at least 500 mg/day, but the total dose of intravenous MP administered and the regimen varied among studies. The aim of this study was to assess the improvement following a standard regime of IVMP (1 g/day MP given for 10 days, without tapering) for MS relapses. A second objective was to search baseline predictors of outcome. Method: Consecutive treatments with IVMP for ten days (1 g/day, single dose in 150cc. saline, over 40 . . . min) administered at our Neurology clinic for an episode of acute neurological deterioration in 44 patients (55 relapses) diagnosed with RR MS were recruited retrospectively. Results: Attack severity was mild in three, moderate in 28 and severe in 24 relapses. Significant improvement (? 1.0 EDSS point) occurred in 81 % of attacks at one month. The rate of improvement at ten days was 83.6%, and 85.5% at six months. There was no difference in means of latency to treatment between the patients that responded well to therapy and responded poor, at the first month. However response to therapy was higher at the sixth month in patients with latency to treatment shorter than fifteen days (68.4%, 94.4%). Conclusions: In conclusion the results of our retrospectively designed clinical study support that HD MP, 1 g/day for ten days administered IV can accelerate the recovery from MS relapses. This regimen with proper early timing for starting therapy might determine the optimum benefit. © Universitätsverlag Ulm GmbH 2009 Daha fazlası Daha az

The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients

Armutlu K. | Cetisli Korkmaz N. | Keser I. | Sumbuloglu V. | Irem Akbiyik D. | Guney Z. | Karabudak R.

Article | 2007 | International Journal of Rehabilitation Research30 ( 1 ) , pp.81 - 85

The aims of this study were to investigate the Fatigue Severity Scale's Turkish version's validity, reproducibility, internal consistency and parameters. Multiple sclerosis patients' disability levels were determined by the Expended Disability Status Scale and depression status was established with the Beck Depression Inventory. The Fatigue Severity Scale and Beck Depression Inventory were administered through self-report methods and assistance, without guidance, given where needed. An interval of 1 week was allowed between the applications. Seventy-two definitely diagnosed multiple sclerosis patients and matched 76 healthy controls . . . were included. The multiple sclerosis patients' median Expended Disability Status Scale score was 4.0 (1.0-9.5). There were statistically significant differences between multiple sclerosis patients' and healthy controls' Fatigue Severity Scale scores ( Daha fazlası Daha az

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