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Background: Optic neuritis, myelitis, and neuromyelitis optica spectrum disorder (NMOSD) have been associated with antibodies against myelin oligodendrocyte glycoprotein-immunoglobulin G (anti-MOG-IgG). Furthermore, patients with radiological and demographic features atypical for multiple sclerosis (MS) with optic neuritis and myelitis also demonstrate antibodies against aquaporin-4 and anti-MOG-IgG. However, data on the diagnosis, treatment, follow-up, and prognosis in patients with anti-MOG-IgG are limited. Aims: To evaluate the clinical, radiological, and demographic characteristics of patients with anti-MOG-IgG. Study Design: Multicenter, retrospective, observational study. Methods: Patients with blood samples demonstrating anti-MOG-IgG that had been evaluated at the Neuroimmunology laboratory at Ondokuz Mayıs University’s Faculty of Medicine were included in the study. Results: Of the 104 patients with anti-MOG-IgG, 56.7% were women and 43.3% were men. Approximately 2.4% of the patients were diagnosed with MS, 15.8% with acute disseminated encephalomyelitis (ADEM), 39.4% with NMOSD, 31.3% with isolated optic neuritis, and 11.1% with isolated myelitis. Approximately 53.1% of patients with spinal involvement at clinical onset demonstrated a clinical course of NMOSD. Thereafter, 8.8% of these patients demonstrated a clinical course similar to MS and ADEM, and 28.1% demonstrated a clinical course of isolated myelitis. The response to acute attack treatment was lower and the disability was higher in patients aged > 40 years than patients aged < 40 years at clinical onset. Oligoclonal band was detected in 15.5% of the patients. Conclusion: For patients with NMOSD and without anti-NMO antibodies, the diagnosis is supported by the presence of anti-MOG-IgG. Furthermore, advanced age at clinical onset, Expanded Disability Status Scale (EDSS) score at clinical onset, spinal cord involvement, and number of attacks may be negative prognostic factors in patients with anti-MOG-IgG.

In this study, we introduce a transformative approach to achieve high-accuracy classification of distinct health categories, including Parkinson's disease, Multiple Sclerosis (MS), healthy individuals, and other categories, utilizing a transformer-based neural network. The cornerstone of this approach lies in the innovative conversion of human speech into spectrograms, which are subsequently transformed into visual images. This transformation process enables our network to capture intricate vocal patterns and subtle nuances that are indicative of various health conditions. The experimental validation of our approach underscores its remarkable performance, achieving exceptional accuracy in differentiating Parkinson's disease, MS, healthy subjects, and other categories. This breakthrough opens doors to potential clinical applications, offering an innovative, non-invasive diagnostic tool that rests on the fusion of spectrogram analysis and transformer-based models.

Background: The relationship between coronavirus disease 2019 (COVID-19) infection and multiple sclerosis (MS) relapse and disease progression remains unclear. Previous studies are limited by small sample sizes and most lack a propensity-matched control cohort. Objective: To evaluate the effect of COVID-19 infection on MS disease course with a large propensity-matched cohort. Design: This multi-centre cohort study analysed relapse and disability outcomes post-COVID-19 infection after balancing covariates using a propensity score matching method. The study period was from the 11th of September 2019 to the 16th of February 2023. The mean follow-up period was 1.7 years. Methods: Data were retrieved from the MSBase Registry. Propensity scores were obtained based on age, sex, disease duration, baseline Expanded Disability Status Scale (EDSS), MS course, relapses pre-baseline, disease-modifying therapy (DMT) class and country. Primary outcomes were time to first relapse, annualised relapse rate (ARR) and time to confirm EDSS progression. Secondary outcomes were time to EDSS of 3, 4 or 6. Sensitivity analyses with baseline DMT classes were performed. Results: The study included 2253 cases and 6441 controls. After matching, there were 2161 cases and an equal number of matched controls. Cases had a significantly higher ARR (ARR = 0.10 [95% CI 0.09–0.11]) compared to controls (ARR = 0.07 [95% CI 0.06–0.08]). Cases had a significantly greater hazard of time to first relapse compared to controls (hazard ratio (HR) = 1.54 [95% CI 1.29–1.84]). There was no association between COVID-19 infection and 24-week EDSS progression (HR = 1.18 [95% CI 0.92–1.52]), or time to EDSS of 3, 4 or 6. For patients on interferons and glatiramer acetate (BRACE), COVID-19 infection was associated with a greater hazard of time to first relapse (HR = 1.83 [95% CI 1.25–2.68]) and greater hazard of time to EDSS of 3 (HR = 2.04 [95% CI 1.06–3.90]) compared to patients on BRACE therapy without COVID-19 infection. Conclusion: COVID-19 infection was associated with a significantly increased MS relapse rate and a shorter time to first relapse. There was no effect on confirmed EDSS progression over the short term. These results support ongoing COVID-19 risk minimisation strategies to protect patients with MS.

BackgroundDisability progression is a key milestone in the disease evolution of people with multiple sclerosis (PwMS). Prediction models of the probability of disability progression have not yet reached the level of trust needed to be adopted in the clinic. A common benchmark to assess model development in multiple sclerosis is also currently lacking.MethodsData of adult PwMS with a follow-up of at least three years from 146 MS centers, spread over 40 countries and collected by the MSBase consortium was used. With basic inclusion criteria for quality requirements, it represents a total of 15, 240 PwMS. External validation was performed and repeated five times to assess the significance of the results. Transparent Reporting for Individual Prognosis Or Diagnosis (TRIPOD) guidelines were followed. Confirmed disability progression after two years was predicted, with a confirmation window of six months. Only routinely collected variables were used such as the expanded disability status scale, treatment, relapse information, and MS course. To learn the probability of disability progression, state-of-the-art machine learning models were investigated. The discrimination performance of the models is evaluated with the area under the receiver operator curve (ROC-AUC) and under the precision recall curve (AUC-PR), and their calibration via the Brier score and the expected calibration error. All our preprocessing and model code are available at https://gitlab.com/edebrouwer/ms_benchmark, making this task an ideal benchmark for predicting disability progression in MS.FindingsMachine learning models achieved a ROC-AUC of 0⋅71 ± 0⋅01, an AUC-PR of 0⋅26 ± 0⋅02, a Brier score of 0⋅1 ± 0⋅01 and an expected calibration error of 0⋅07 ± 0⋅04. The history of disability progression was identified as being more predictive for future disability progression than the treatment or relapses history.ConclusionsGood discrimination and calibration performance on an external validation set is achieved, using only routinely collected variables. This suggests machine-learning models can reliably inform clinicians about the future occurrence of progression and are mature for a clinical impact study.

Objective: To determine the contribution of gait analysis to the differentiation and diagnosis of these diseases by examining the walking videos of individuals diagnosed with multiple sclerosis (MS) and Parkinson's disease (PD) using the deep learning method. Materials and Methods: A hybrid system based on Convolutional Neural Networks was developed for the detection of MS and PD based on gait analysis. The patients were walked on a flat surface of approximately 14 meters and video recordings were taken from the front, back and both sides during walking. Videos of a total of 28 patients, 12 PD and 16 MS patients, were used in the study. Results: In the study, the data was analyzed using machine learning techniques and the best accuracy score was obtained as 87.5%. Conclusion: The accuracy rate of machine learning models in the diagnosis, follow-up and treatment process of patients such as MS, PD and other neurological diseases has been examined and it has been concluded that it is inevitable that these methods will be used much more over time.

BackgroundTreatment switching is a common challenge and opportunity in real-world clinical practice. Increasing diversity in disease-modifying treatments (DMTs) has generated interest in the identification of reliable and robust predictors of treatment switching across different countries, DMTs, and time periods.ObjectiveThe objective of this retrospective, observational study was to identify independent predictors of treatment switching in a population of relapsing-remitting MS (RRMS) patients in the Big Multiple Sclerosis Data Network of national clinical registries, including the Italian MS registry, the OFSEP of France, the Danish MS registry, the Swedish national MS registry, and the international MSBase Registry.MethodsIn this cohort study, we merged information on 269,822 treatment episodes in 110,326 patients from 1997 to 2018 from five clinical registries. Patients were included in the final pooled analysis set if they had initiated at least one DMT during the relapsing-remitting MS (RRMS) stage. Patients not diagnosed with RRMS or RRMS patients not initiating DMT therapy during the RRMS phase were excluded from the analysis. The primary study outcome was treatment switching. A multilevel mixed-effects shared frailty time-to-event model was used to identify independent predictors of treatment switching. The contributing MS registry was included in the pooled analysis as a random effect.ResultsEvery one-point increase in the Expanded Disability Status Scale (EDSS) score at treatment start was associated with 1.08 times the rate of subsequent switching, adjusting for age, sex, and calendar year (adjusted hazard ratio [aHR] 1.08; 95% CI 1.07–1.08). Women were associated with 1.11 times the rate of switching relative to men (95% CI 1.08–1.14), whilst older age was also associated with an increased rate of treatment switching. DMTs started between 2007 and 2012 were associated with 2.48 times the rate of switching relative to DMTs that began between 1996 and 2006 (aHR 2.48; 95% CI 2.48–2.56). DMTs started from 2013 onwards were more likely to switch relative to the earlier treatment epoch (aHR 8.09; 95% CI 7.79–8.41; reference = 1996–2006).ConclusionSwitching between DMTs is associated with female sex, age, and disability at baseline and has increased in frequency considerably in recent years as more treatment options have become available. Consideration of a patient's individual risk and tolerance profile needs to be taken into account when selecting the most appropriate switch therapy from an expanding array of treatment choices.

In the literature, there is a positive correlation between sexual and marital satisfactions. When the current literature is examined, there is no study examining the marriage satisfaction in patients with Multiple Sclerosis (PwMS). This study was conducted with 100 married PwMS. The majority of participants (n=71) are females. Demographic Information Form, Marital Life Scale (MLS), Life Satisfaction Scale (LSS), and Arizona Sexual Experiences Scale (ASEX) were used to collect data. Compared to other demographic variables, the median score of the marital life scale differs according to the type of marriage with the spouse (p = 0.008). The difference arises from the fact that the median score of the group getting married by introducing friends is low compared to the ones who get married by means of meeting and agreement. Marital life scale score did not differ according to other demographic characteristics (p> 0.05). Life satisfaction scale scores did not differ according to demographic characteristics (p> 0.05). The mean score of the ASEX differed by gender (p = 0.015). The mean value was found to be 13.8 for women and 17 for men. The mean score of the Arizona Sexual Experiences Scale differs according to age (p = 0.019). The mean score in the 25-34 age range was 14.2, in the 35-44 age range 16.2, in the 45-54 age range 16.1 and in the 55-64 age range 22.3. There was a significant positive relationship between marital life scale and life satisfaction (p [Med-Science 2021; 10(3.000): 976-81]

ABSTRACT Background: Among the comorbidities that accompany multiple sclerosis (MS), restless legs syndrome (RLS) is one of the most common. Anxiety and depression are common psychological comorbidities that impact the quality of life of patients with MS (PwMS), as well as patients with RLS. Objective: To investigate the psychiatric burden of MS and RLS coexistence, we conducted a nationwide, multicenter and cross-sectional survey. Methods: Participants were assessed by using demographic and clinical parameters along with the Hamilton Anxiety and Hamilton Depression Scales (HAM-A and HAM-D). Results: Out of the 1,068 participants, 173 (16.2%) were found to have RLS [RLS(+)] and 895 (83.8%) did not [RLS(-)]. The mean scores for HAM-A and HAM-D were significantly higher among RLS(+) subjects than among RLS(-) subjects (p

Central pontine myelinolysis is a neurological disorder characterized by loss of myelin in the central pons as well as in the other parts of the brain like basal ganglia, lateral geniculate bodies, external and internal capsules, and cerebellum. We report the clinical and radiological findings of three patients with central pontine myelinolysis and one patient with both pontine and extrapontine myelinolysis.

Sneddon syndrome (SNS), characterized by livedo racemosa and stroke, is a rare disease, especially in young adults. Livedo racemosa are large lesions, widespread on the extremities and the body, that are violet-colored and have a good appearance and ambiguous limits. A 33-years-old female presented to our clinic for headache. She had a two-year history of blue-purple skin marks on her body and legs. The skin lesions were consistent with livedo racemosa. She had experienced right hemiparesis according to her medical history. Factor V Leiden (G1691A) mutation was heterozygote-positive. Methylenetetrahydrofolate reductase (MTHFR) C677T and FMF gene (MEFV) V726A mutations were determined. SNS is the cause of stroke, rarely seen in young adults. We considered this case to be of value since it is the first SNS case having factor V Leiden, MTHFR and MEFV mutations concomitantly

OBJECTIVE: The clinical progress of multiple sclerosis (MS), initial symptoms and problems during the course of a disease that can be seen, may vary among the patients. Therefore, different applications occurs in the disease diagnosis and treatment plan. The difficulties of diagnosis, treatment and progress of MS disease, experienced by the neurology residents and experts from different regions of the Turkey is intended to introduce. METHODS: Interactive meetings was arrenged in total 11 cities from different regions of Turkey, between March 2008 and June 2008. The data obtained as a result of the responses of participants were evaluated. RESULTS: Neurology specialist and research assistant, total of 242 persons participated. It was observed that 14 percent of visual evoked potential, 40 percent of cerebrospinal fluid (CSF) oligoclonal band review and one percent of magnetic resonance imaging examinations used in diagnosis of MS can’t be done. There was significant differences between regions about feasibility of CSF OCB. Sixty one percent of participants thought to start immunomodulatory treatment to typical relapsing-remitting multiple sclerosis patients, filled in the Mc Donald diagnostic criteria and had two attack story. CONCLUSION: As all the world, in Turkey being very much difference about clinical, radiological and laboratory features of MS lead to the neurology experts work hard and the emergence of different applications about the disease diagnosis and treatment plan

Mucormycosis is the common name for diseases caused by fungi of the genera Rhizopus, Mucor, and Absidia of the family Mucora- les: Mucoraceae, which affect many systems. Rhino-orbitocerebral infection is the most common form. In mucormycosis the nose and sinuses are the initial regions of infection. Orbital pain, sudden loss of vision, chemosis, periorbital cellulitis, ophthalmoplegia, and proptosis can be seen. We report the clinical and radiological findings of a mucormycosis case that presented with ophthalmop- legia and central nervous system involvement

OBJECTIVE: Multiple Sclerosis (MS) is an autoimmune disease that could be seen simultaneously with other diseases with autoimmune origin. OBJECTIVE: In this descriptive study, it was aimed to evaluate the relationship between MS and other autoimmune diseases among MS patients and their first degree relatives in two different centers, Ankara and Samsun. METHODS: 784 MS were included in the study. The data was gathered via interviews and patient record reviews. MS patients and their first degree relatives were asked for 13 specific autoimmune diseases which have been supposed to occur more frequently in MS patients. Data was evaluated seperately as patient record reviews and questionare interview. Ankara and Samsun center results were compared with each other. RESULTS: Among the interviewed subjects, 9 (5.3%) had co-occurrent autoimmune disease while the relatives of 26 (15.3%) was found to have autoimmune disease in Ankara. These figures were respectively 8 (17.4%) and 21 (45.7%) in Samsun. Both comorbid autoimmune disease among patients and autoimmune disease among relatives were observed to be higher in Samsun. Psoriasis was the mostly seen disease in Samsun and one of the mostly seen diseases in Ankara (1.2% in Ankara, 8.7% in Samsun). Multiple sclerosis (5.9%) and rheumatoid arthritis (32.6%) were the mostly seen diseases among relatives in Ankara and Samsun, respectively. According to the patient record reviews, the proportion of comorbid autoimmune disease in MS patients was 2.9% in Ankara and 5.2% in Samsun. In the whole group the proportion of the autoimmune diseases among female patients (17.4%) and their relatives was higher than male patients (5.3%) and their relatives. In Ankara, autoimmune thyroid disease (Graves and Hashimoto disease) was mostly seen whereas Behçet's disease was the most prominent in Samsun. CONCLUSION: In the study it was observed that among MS patients the percentage of having a comorbid disease was high. Besides, among the patients’ relatives, percentage of autoimmnue diseases, especially MS was observed to be high. Psoriasis was among the mostly seen diseases in both groups. MS and rheumatoid arthritis were observed to be the mostly seen autoimmune diseases among relatives

OBJECTIVE: MRI. Diffusion-weighted MRI (DW-MRI) offers the possibility of differentiating such lesions from ischaemic lesions by using objective data as well as determining active MS plaque in particular. OBJECTIVES: This present study investigated diffusion alterations in MS patients in plaques and the normal-appearing white matter. METHODS: A total of 45 patients had been diagnosed with MS according to Mc Donald’s criteria were enrolled in the study. Cranial MRI examination consisted of number of lesions in PD/T2 transverse, T2 sagittal, T2 FLAIR transverse, diffusion-weighted MRI and ADC mapping, heavy IR-T1 transverse, T1 transverse, postcontrast T1 transverse imaging, incidence ratio in all sequences as well as assessment of contrasting characteristics. Visual characteristics of the lesions were determined in diffusion-weighted MRI and ADC mapping. RESULTS: Mean ADC values measured in the normal appearing white matter according to clinical forms were as follows: 0.79 ± 0.15x10-3 mm2/sec for RRMS, 0.8 ± 0.15x10-3 mm2/sec PPMS and 0.82 ± 0.15x10-3 mm2/sec for SPMS. The differences between clinical forms in terms of mean ADC values measured in the normal appearing white matter were statistically significant (p0.05). Mean ADC values measured in T1 hypointense lesions were 1.106 ± 0.15x10-3 mm2/sec for RRMS, 1.119 ± 0.15x10-3 mm2/sec for PPMS and 1.132 ± 0.15x10-3 mm2/sec for SPMS. The differences between the groups were statistically significant (p

Background. To investigate the frequency of restless leg syndrome (RLS), sleep quality impairment, depression, fatigue, and sleep behavior disorder and to determine the effects of surgery on these parameters in radiculopathy patients resistant to conservative treatment. Methods. The present study included 66 lumbar radiculopathy patients, who were resistant to conservative treatment and had indication of surgery. Five different questionnaires were performed to assess depression (the Beck Depression Inventory (BDI)), sleep quality (the Pittsburgh Sleep Quality Index (PSQI)), fatigue (the Fatigue Severity Scale (FSS)), and presence of RLS and rapid eye movement sleep behavior disorder (RBD). The same questionnaires were also performed on a control group (n=61). Results. Of the radiculopathy patients, 68.1% had RLS and 92.4% had fatigue. Of the controls, 16.4% had RLS and 59% had fatigue. RBD was present in 8 (12.1%) patients and 3 (4.9%) controls. The PSQI revealed that sleep quality was impaired in 46 (69.7%) patients and 35 (57.4%) controls (P>0.05). The number of individuals having substantial depression according to the BDI was significantly higher in the patients than in the controls. Conclusions. There was a significant increase in the frequency of RLS, which was significantly decreased in the postoperative period in the radiculopathy patients.

Although hypothyroid myopathy is seen frequently and the relationship with autoimmune hypothyroidism and myasthenia gravis is well known, specific forms of hypothyroid myopathy such as Hoffman's syndrome (HS) are rarely described. Here we describe a 40-year-old patient with Hashimoto thyroiditis showing symptoms and signs of two discrete forms of hypothyroid myopathy (HS and myasthenic syndrome) together. To our knowledge this is the first reported case with features of both of these syndromes. We discuss the diagnosis, speculate whether this patient may represent a unique form of hypothyroid myopathy, and report the 6-month follow-up of the patient both clinically and electrophysiologically. [ABSTRACT FROM AUTHOR]