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Background: Fingolimod was approved and reimbursed by the healthcare provider in Hungary for the treatment of highly active relapsing-remitting multiple sclerosis (RRMS) in 2012. The present study aimed to assess the effectiveness, safety profile, and persistence to fingolimod in a real-life setting in Hungary in RRMS patients who were either therapy naïve before enrollment or have changed to fingolimod from another disease-modifying therapy (DMT) for any reason. Methods: This cross-sectional, observational study with prospective data collection was performed nationwide at 21 sites across Hungary. To avoid selection bias, sites were asked to document eligible patients in consecutive chronological order. Demographic, clinical, safety and efficacy data were analysed for up to 5 years from 570 consenting adult patients with RRMS who had received treatment with fingolimod for at least one year. Results: 69.6% of patients remained free from relapses for the whole study duration; in the first year, 85.1% of patients did not experience a relapse, which rose to 94.6% seen in the 5th year. Compared to baseline at study end, 28.2% had higher, and 9.1% had lower, meanwhile, 62.7% of the patients had stable EDSS scores. Overall, the annualized relapse rate decreased from 0.804 observed at baseline to 0.185, 0.149, 0.122, 0.091, and 0.097 (77.0%, 82.1%, 85.2%, 89.7%, and 89.0% relative reduction, respectively) after 1, 2, 3, 4, and 5 years of treatment. The greatest reduction rate was seen in the group of therapy naïve patients. Treatment persistence on fingolimod after 60 months was 73.4%. Conclusion: In this nationwide Hungarian cohort, most patients under fingolimod treatment were free from relapses and disability progression. In addition, fingolimod has proven to be a well-tolerated DMT that has sustained its manageable safety profile, high efficacy, and positive benefit/risk ratio for up to 5 years in a real-life setting. [ABSTRACT FROM AUTHOR]

Background: In December 2019, pneumonia caused by coronavirus Disease-19 (COVID-19) occurred in Wuhan, Hubei Province, China. Currently, COVID-19 has spread worldwide. In accordance with the restrictions of the Hungarian Government, several epidemic hospitals and centers have been established in Hungary. The first infected patient was detected on 4th March, 2020 in our country, who was not a Hungarian citizen. The first patient died of pneumonia caused by COVID-19 was on 15th March. The Hungarian epidemic curve is flattened and more prolonged. We aimed to report our computer tomography (CT) findings in correlation with clinical status in patients with COVID-19 infection. Material and methods: All patients with laboratory-identified Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection by real-time polymerase chain reaction (PCR) and who underwent chest CT were collected between March 26, 2020, and April 20, 2020, in our hospital. In our centre we had 107 PCR confirmed COVID-19 positive patients in this period. 52 patient (male: female 1:2, average age: 67.94) were admitted to our central epidemic hospital, according to their complains: fever, dyspnoea, hypoxaemia, altered mental status, comorbidity, sepsis or if patient isolation could not be performed. In case of every patient we took blood test, nasopharyngeal sample and a chest CT without contrast agent. In our CT report we used a score system to characterize the severity. Results: The majority of infected patients had a history of exposure in nursing homes and mostly presented with fever and cough. The present study confirmed the findings about results of other researches. The COVID-19 pneumonia affected the elderly patients, caused hypoxia, cough and sepsis. On the CT scan, typical signs were seen in the cases of PCR confirmed patients. Conclusion: The limitations of the present study include the low number of patients. Collectively, our results appear consistent with previous studies. Chest CT examination plays an important role in the diagnosis and estimation of the severity of the novel coronavirus pneumonia. Future research should examine strategically the features of the Hungarian population. [ABSTRACT FROM AUTHOR]

Background and Purpose: Therapeutic strategy of relapse-remitting multiple sclerosis has changed significantly during the past decade. While earlier escalating therapy was widely applied, recently, in case of high disease activity, induction therapy has become available., Methods: In our study, we processed the data of our alemtuzumab treated patients from our register. Alte-ra-tions in relapse rate and MRI activity due to the treatment were determined. These data were compared in patients treated with alemtuzumab as an escalating and as an induction therapy. We noted the observed side effects., Results: The 49 patients observed in the study had undergone two cycles of alemtuzumab therapy. The drug was applied as an induction therapy in 9 cases. Average relapse rate during the two years was 1.4±1.0, which decreased to 0.1±0.3 in the two years following the therapy. The average EDSS before therapy was 2.7±2.2 in the induction therapy group and 2.7±1.7 in the escalating therapy group. After the treatment, this score decreased to 1.6±0.6 and 2.5±1.8 in the induction and the escalating therapy group, respectively. We found clinical and MRI progression in case of 4 patients. As regards to side effects, cytokine release was detected in 51.0% of the patients following the first cycle, and 24.5% of the patients following the second cycle of the therapy. Infection related to the therapy was observed in 28.6%, while autoimmune thyreoiditis was diagnosed in 18.3% of the patients., Conclusion: The tight follow-up of the treated patients and the precise documentation of the register enable the comparison of results yielded by placebo controlled clinical studies with daily practice, as well as to gain information on the benefits of induction therapy as a paradigm shift in treating MS patients.

The aim of our study was to provide electrophysiological evidence about the modulation of the categorization process by task requirements in the human brain. Event-related potentials (ERP) were recorded during three different categorization tasks using matched stimulus sets. In all cases, the subjects were required to differentiate between "animal" and "non-animal" stimuli. In the first task (two-choice task), they were asked to press corresponding buttons to each stimulus types. The second task was a go/no-go paradigm, only animal stimuli required motor response. The third task was a counting task; participants had to count the animal stimuli without any motor response. The reaction times in the go/no-go paradigm were significantly shorter. ERP differences between animal and non-animal pictures in the go/no-go task also appeared earlier and were localized at more posterior scalp positions compared to the two-choice task. Comparing animal responses in the two-choice task and in the go/no-go paradigm, we found a significant difference in the 130- to 170-ms time window over the fronto-central, centro-parietal regions. Similar differences were found between the responses to animal pictures in the two-choice task and in the counting paradigm. We used brain electric source analysis (BESA) algorithm on difference waves to localize the best fitting dipoles and determine the localization of brain areas contributing to scalp potential differences. The results show that different task requirements evoke different activity in the medial part of the temporal pole. The data we provided here draw attention to the careful handling of results obtained from categorization experiments, because different task requirements can affect the early categorization process itself.

The aim of this study was to investigate the temporal stability of moving phosphenes and to assess whether moving phosphene thresholds (PTs) correlate with motor thresholds (MTs). Small moving sensations, so-called moving phosphenes, are perceived when V5, an area important for visual motion analysis, is stimulated by transcranial magnetic stimulation (TMS). However, it is still a matter of debate if V5 phosphenes are stable sensations across measurements and if they are a reasonable index of the cortical excitability of V5. Currently, MT is more commonly used as an index of global cortical excitability. However, previous studies have indicated that stationary PTs are suitable alternatives when the primary visual cortex is stimulated by TMS. Using paired-pulse TMS, stationary and moving PTs and applying single pulse TMS, MTs were measured in 11 subjects. PTs were retested in nine subjects 5-7 days later. Stationary and moving PTs were stable within subjects across the two sessions and showed a high inter-correlation. Conversely, PTs and MTs did not correlate. Our results are in agreement with previous studies showing that excitatory measurements of one specific cortex cannot be generalized to the excitability of the whole cortex. Thus, we propose specific measures for cortices of interest: PT for visual experiments and MT for motor experiments.