Sibel Canbaz Kabay

OBJECTIVE: This study aimed to evaluate the independent and combined effects of fatigue and walking impairment on multiple sclerosis (MS)-specific quality of life (QoL) and to explore the influence of sociodemographic and clinical factors on these associations.MATERIAL AND METHODS: A multicenter, cross-sectional study was conducted including 181 individuals with MS from four tertiary care centers in Turkey. Patients completed the Fatigue Severity Scale (FSS), the 12-item MS Walking Scale (MSWS-12), and the Multiple Sclerosis Impact Scale (MSIS-29). Sociodemographic and clinical data were collected. Correlation analyses, subgroup comparisons, and multivariate linear regressions were performed to identify predictors of QoL.RESULTS: MSIS-29 scores were strongly associated with MSWS-12 (r=0.81) and moderately associated with FSS (r=0.54) (p<0.001 for both). Multivariate regression demonstrated that walking impairment (β=0.772) and fatigue (β=0.179) were independent predictors of QoL, jointly explaining 70% of the variance in MSIS-29 total scores (R²=0.703). MSWS-12 was the primary predictor of physical QoL, while both MSWS-12 and FSS contributed to psychological QoL. Lower education and comorbidities were associated with worse outcomes in univariate analyses, and female sex was associated with greater disease impact in the multivariable model.CONCLUSIONS: Fatigue and walking limitations are major determinants of reduced QoL in MS, with walking impairment exerting a stronger effect on physical functioning. These results highlight the importance of multidimensional care strategies that address both motor and non-motor symptoms, alongside sociodemographic and clinical characteristics, to optimize individualized MS management.

Amaç: Bu çalışmada, Türkiye'de İdiyopatik Parkinson Hastalığı (İPH) olan hastalarda uyku bozukluklarının yaygınlığının araştırılması ve bu bozuklukların hastaların uyku ve yaşam kalitesini nasıl etkilediğinin belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: Türkiye'de yürütülen bu çok merkezli çalışmada, 451 IPH hastası değerlendirildi. Hastaların demografik ve klinik verileri kaydedildi. Değerlendirmeler Parkinson Hastalığı Uyku Ölçeği, Parkinson Hastalığı Anketi ve Beck Depresyon Envanteri kullanılarak yapıldı. Bulgular: IPH tanısı olan 451 hastanın ortalama yaşı 69,13±11,27 yıldı. Modifiye Hoehn Yahr Ölçeği'ne göre en sık görülen hastalık evresi %24,8 ile evre 1 iken, en az görülen evre ise %1,3 ile evre 5 idi. Hastaların %30,6’sında orta şiddette depresyon, %29,9’unda minimal depresyon, %24,6’sında hafif depresyon, %14,9’unda ise ağır depresyon saptandı. Hasta yaşı arttıkça uyku başlangıcı ve uyku faydası puanları anlamlı derecede azaldı. Hastalık süresi ve evresi arttıkça uyku kalitesinin tüm alt parametrelerinde azalma görüldü. Yaşam kalitesi alt parametreleri ve toplam puanları arttıkça depresyon puanı da artmaktaydı. Yaşam kalitesi alt parametrelerinin tümü ile depresyon arasında güçlü pozitif korelasyon vardı (p<0,001). Sonuç: Uyku bozuklukları IPH hastalarında yaygındır ve depresyon ve yaşam kalitesini büyük ölçüde olumsuz etkiler. Parkinson hastalarında uyku bozukluklarının kontrol altına alınmasıyla yaşam kalitesi artırılabilir.

Objective: To evaluate the real-world effectiveness and safety of eculizumab in patients with AQP4-IgG–positive neuromyelitis optica spectrum disorder (NMOSD) and to identify predictors of disability outcomes. Methods: This multinational, retrospective cohort study analyzed data from 46 patients across 26 centers. The outcomes included the annualized relapse rate (ARR), relapse-free status, change in expanded disability status scale (EDSS) scores, and adverse events. To identify predictors of EDSS improvement or worsening, patients were stratified into subgroups (improved vs. stable/worsened) at each follow-up time point and compared based on demographic, clinical, and radiological variables. Results: This retrospective cohort study included 46 patients with AQP4-IgG-positive NMOSD from 26 centers, followed for a mean of 27.3 months. The mean ARR significantly decreased from 1.1 in the 2 years pre-treatment to 0.1 during eculizumab therapy. The relapse-free rate increased from 6.5% pre-treatment to 80.4%. Mean EDSS scores improved from 4.2 at baseline to 3.6 at 24 months. The presence of area postrema syndrome was associated with a favorable prognosis, while the presence of spinal attacks was associated with a poor prognosis at 12 months. Adverse events occurred in 7 patients (18.9%), leading to permanent discontinuation in only two. Conclusion: Eculizumab demonstrated robust real-world effectiveness in reducing relapse rates and stabilizing disability, with an acceptable safety profile. Clinical outcomes may be influenced by attack phenotype, underscoring the importance of early intervention.

Objective: This study aims to investigate the effect of routine laboratory parameters on clinical outcomes in patients with acute ischemic stroke (AIS). Materials and Methods: Our study was designed as retrospective and cross-sectional. 94 patients with AIS who received inpatient treatment in our clinic with a diagnosis of AIS were included in the study. Laboratory data, demographic, and clinical characteristics were recorded at the time of admission. Neurological disabilities of the patients 3 months after treatment were evaluated with the modified Rankin Scale (mRS). Patients were divided into two groups (good prognosis (mRS 0-2) and poor prognosis (mRS 3-6)). Results:Of the 94 patients included in the study, 47 were men and 47 were women. The mean age was 71.18±11.92 years. Laboratory parameters hemoglobin, eosinophil, triglyceride, total-cholesterol, and ldl-cholesterol values were significantly lower in the group with mRS≥3. As a result of ROC analysis, the area under the curve of hemoglobin, eosinophil, total-cholesterol, ldl-cholesterol, and triglyceride was significantly higher[(AUC: 0.710 95%CI: 0.60-0.81); Sensitivity=67.6%, Specificity=67.9%, p=0.001]. In the multivariable logistic regression model, only the NIHSS score (National Institutes Of Health Stroke Scale Scores) was independently associated with the degree of disability (p=0.001). NIHSS is an independent factor in predicting stroke outcomes. Conclusion: It was determined that there was a significant inverse relationship between the routine laboratory parameters hemoglobin level, eosinophil level, LDL and total cholesterol levels, and infarct volume with the NIHSS scores of hemoglobin and LDL-cholesterol.

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. To evaluate the clinical, radiological, and demographic characteristics of patients with anti-MOG-IgG. Multicenter, retrospective, observational study. 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. 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. 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.

Health-related quality of life shows how a person is affected physically, emotionally, perceptually, and socially by the disease, the consequent disability, and treatment and rehabilitation processes. It is important to evaluate the quality of life of patients and their caregivers with generic or specific scales during the diagnosis, treatment, and follow-up stages of neurological diseases. In studies conducted in our country, scales with Turkish validity and reliability must be used. Additionally, it should be noted that quality-of-life scales do not measure every parameter with the same sensitivity.