Evaluation of Diffusion Tensor Imaging Findings in Clinically Isolated Syndrome and Relapsing-Remitting Multiple Sclerosis Patients

Objective: To compare diffusion tensor imaging (DTI) findings of the normal-appearing white matter (NAWM) and corpus callosum (CC) in patients with clinically isolated syndrome (CIS) and relapsing-remitting multiple sclerosis (RRMS) and a healthy control (HC) group. Materials and Methods: The CIS (n = 10), RRMS (n = 29), and HC (n = 13) groups were evaluated by DTI in this retrospective study. Mean diffusion (MD) and fractional anisotropy (FA) maps as well as MD and FA measurements were made from the corpus callosum genu (CCG), corpus callosum splenium (CCS), and NAWM areas from the frontal, parietal, occipital and temporal lobes. Results: The mean FA values of the NAWM in the temporal lobes were bilaterally lower in both the CIS and RRMS groups than in the HC group. However, no difference was found between the CIS and RRMS groups. In addition, the CIS group had lower FA values in the CCG, whereas the RRMS group had lower FA values in the CCS compared with the HC group. The MD values were significantly different in the CCG between the RRMS and HC groups. Conclusion: DTI contributes to detecting early changes in the NAWM and CC in patients diagnosed with CIS and RRMS. Additionally, DTI can aid in the follow-up care and management of these patients

Corticosteroid-associated atypical central serous chorioretinopathy in a patient with multiple sclerosis

Letter to the edito

The effects of low and svere disability on walking abilities and quality of Life in multiple sclerosis patients: 6-month follow-up study

WOS: 000316655800005Multipl Skleroz (MS) hastalarında, 12 haftalık gözetimli egzersiz programının (GEP) yaşam kalitesi, yürüme yeteneği, denge bozukluğu ve yorgunluk üzerine etkisini saptamak ve hastaların yeti yitimi şiddetine göre bu sonuçları karşılaştırmaktır. Yön tem ler: Yirmi dört MS hastasının demografik ve tıbbi verileri kaydedildi. Yeti yitimi (EDSS), fonksiyonel denge (Berg Denge Skalası-BDS), aktivite içinde kendine güven (Aktiviteye Spesifik Denge Güvenlik Skalası-ABC_S); yürüme güçlüğü (Multipl Skleroz Yürüme Skalası, MSYS-12), yorgunluk (Yorgunluk Etki Skalası (YES), yaşam kalitesi (Multiple Sclerosis International Quality of Life questionnaireMUSIQOL) tedavi öncesinde, tedavi bitiminde (3. ay) ve kontrolde (6.ay) değerlendirildi. Ayrıca yeti yitimi şiddeti ve hastalık yılına göre hastaların fizyoterapiden faydalanma oranları hesaplandı. Bul gu lar: Yaş ortalaması 45,2±8,6 yıl olan 17 katılımcının (7 hasta akut atak nedeniyle çalışmadan ayrıldı), MSYS-12, BDS ve ABC Skalası ortalamaları arasındaki farkın tedavi bitiminde yapılan ikinci değerlendirmeden kaynaklandığı (p<0,001) ve bu farkın kontrol değerlendirmesinde de korunduğu saptandı (sırasıyla, p<0,001, p=0,003, p=0,001). MUSIQOL ortalamaları arasındaki farkın ise kontrol değerlendirmesinden kaynaklandığı saptandı (p=0,014). Ayrıca MUSIQOL ile YES total ve alt grup skorları arasında, MSYS-12 ile MUSIQOL, BDS, ABC Skalası ve YES total ve alt grupları ve EDSS arasında da anlamlı korelasyon vardı (p<0,05). So nuç: On iki haftalık GEP sonrasında hafif ve şiddetli yeti yitimine sahip olan tüm katılımcılarda yaşam kalitesi ve yürüme yeteneğinde benzer iyileşmelerin ortaya çıkması ve yürüme yeteneğindeki kazanımların yaşam kalitesindeki artışla ilişkili olması nedeniyle rehabilitasyon ekibinin yeti yitimi düzeyinden bağımsız olarak MS hastalarının fiziksel aktivite düzeylerini artırmaları için egzersiz programları içinde yer almaya teşvik etmeleri gerekmektedir.To explore the effects of 12-week supervised exercise program (SEP) on quality of life (QoL), walking abilities, balance impairment and fatigue in patients with multiple sclerosis (MS) and to compare these outcomes according to the severity of the disability. Methods: Demographic characteristics and medical history of a total of 24 MS patients were recorded. Disability [The Expanded Disability Status Scale (EDSS)], functional balance [TheBerg Balance Scale (BBS)], balance confidence [The Activities-pecific Balance Confidence (ABC)_Scale], walking difficulties [The 12-Item Multiple Sclerosis Walking Scale (MSWS-12)], fatigue [The Fatigue Impact Scale (FIS)], QoL [The MS International Quality of Life (MUSIQOL)] were evaluated before, at the end of the treatment (3rd month) and at the 6th month. Additionally, the effectiveness rate of the physiotherapy was calculated according to the disability and disease duration. Results: The outcome results of the 17 participants with a mean age of 45.2 +/- 8.6 years (seven patients were excluded because of acute attacks) showed that the differences between the mean scores of MSWS-12, BBS and ABC_Scale were resulted from the 2nd assessment (p<0.001), and this differences remained at the follow-up measurements (p<0.001, p=0.003, p=0.001, respectively). The differences between the MUSIQOL scores were resulted from the 3rd assessment at the follow-up (p=0.014). There were statistically significant and positive correlation between the scores of MUSIQOL significantly positively correlated with scores of FIS-total and subgroups, in addition, MSWS-12 significantly positively correlated with MUSIQOL, BBS, ABC_Scale, FIS-total and subgroups, and EDSS scores (p<0.05). Conclusion: 12-week SEP was resulted in similar improvements in QoL and walking abilities in both patients with low and severe disabilities. Additionally, these findings strongly suggest that treatment for walking abilities may also extend to improvements in QoL. Therefore, the rehabilitation team should consider the benefits of regular exercise and should focus and encourage people with MS to participate in exercise independent from the disease severity. (Archives of Neuropsychiatry 2013; 50: 23-29)

A comparative ID migraine screener study in ophthalmology, ENT and neurology out-patient clinics

Migraine is more likely to be misdiagnosed in patients with comorbid diseases. Not only primary care physicians, but also specialists might misdiagnose it due to the lack of diagnostic criteria awareness. The ID migraine test is a reliable screening instrument that may facilitate and accelerate migraine recognition. This study aimed to compare the prevalence and characteristics of migraine in a large sample of patients admitted to clinics of ophthalmology (OC), ear, nose and throat diseases (ENTC) and neurology (NC), as well as to validate the use of the ID migraine test in OC and ENTC settings. This was a multicentre (11 cites) study of out-patients admitting either to NC, ENTC or OC of the study sites during five consecutive working days within 1 week. From each of the clinics, 100 patients were planned to be recruited. All recruited patients were interviewed and those having a headache complaint received an ID migraine test and were examined for headache diagnosis by a neurologist, blinded to the ID migraine test result. A total of 2625 subjects were recruited. Only 1.3% of OC patients and 5.4% of ENTC patients have been admitted with a primary complaint of headache, whereas the percentage of NC patients suffering from headache was 37.6%. Whereas 138 patients (19.3%) in OC, 154 (17.3%) in ENTC and 347 (34%) in NC were found to be ID migraine test positive, 149 patients (20.8%) in OC, 142 (16%) in ENTC and 338 (33.1%) in NC were diagnosed with migraine. The sensitivity, specificity, and positive and negative predictive ratios of the ID migraine test were found to be similar in all clinics. An important fraction of the patients admitted to NC, as well as to OC and ENTC, for headache and/or other complaints were found out to have migraine by means of a simple screening test. This study validated the ID migraine test as a sensitive and specific tool in OC and ENTC, encouraging its use as a screening instrument.Pfizer-Türkiy