COVID-19 vaccine response in Neuromyelitis Optica Spectrum Disorder.

OBJECTIVES AND AIMS: Neuromyelitis Optica Spectrum Disorder (NMOSD) is a disabling autoimmune disease of the central nervous system that requires immunosuppressants to control the relapses. The latter puts them at risk for more severe COVID-19 infection. Vaccines are an effective way to control the pandemic. However, we do not know how effective they are in immunologically compromised patients. We aimed to evaluate and compare antibody levels in NMOSD patients treated with disease-modifying therapies after two doses of inactivated and mRNA COVID-19 vaccines. METHODS: Patients with NMOSD diagnosis and age-sex matched healthy controls who received two doses of either inactivated and mRNA COVID-19 vaccine were recruited in the study. Serum samples were collected at least two weeks after the second dose. RESULTS: Serum samples from 24 NMOSD patients (Mean age-36.58, Female-70.83%) and 24 healthy controls (Mean age-36.71, Female-70.83%) were evaluated. Mean antibody titer was lower in the NMOSD group (Mean; SD (2.43 ± 1.51) than in healthy controls (Mean; SD 3.23 ± 0.80). Seronegativity was only seen in the rituximab group, there were no such cases in the azathioprine group. (9 vs 0). CONCLUSIONS: The study shows that NMOSD patients treated with rituximab may still be susceptible to severe COVID-19 infection even after both inactivated and mRNA vaccines.

Effects of continuous and pulsed radiofrequency applied for 120 and 240 seconds to rats' sciatic nerve.

OBJECTIVES: Radiofrequency (RF) has been used for many years for pain treatment. The effects of RF on nerves and the underlying mechanism of these effects are not clearly understood. The aim of this study is to show the effects of Pulsed (P-RF) and Continuous (C-RF) RF in light and electron microscopy, and to determine the differences between them. METHODS: In this study, a total of 60 Rattus norvegicus rats were used in 6 groups. No procedure was performed on the control group. In the Sham group, the electrodes were placed but no current was applied. P-RF for 120 seconds, P-RF for 240 seconds, C-RF for 120 seconds, and C-RF for 240 seconds at 42 °C were applied respectively to the other groups. Sections obtained from sciatic nerves were examined with light and electron microscopy. RESULTS: Examinations of the Sham, P120, and C120 groups were normal. In P240, some morphological changes were observed, but when all samples were examined, these abnormalities were evaluated as negligible. In C240, severe deformation of both myelinated and non-myelinated nerve fibers was observed under an electron and light microscope. Dramatic structural deformities in Schwann cells were observed. CONCLUSION: P120, P240, and C120 treatments did not produce any deformities in the sciatic nerve. The application of C-RF for 240 seconds produced pathological alterations in the nerve structure.

Three doses of COVID-19 vaccines in multiple sclerosis patients treated with disease-modifying therapies.

OBJECTIVES AND AIMS: Disease modifying therapies used in multiple sclerosis can decrease humoral response after COVID-19 vaccines. This problem must be adequately addressed because new variants evolve, and COVID-19 still poses a risk to patients with comorbidities and immunosuppression. We aimed to evaluate the antibody response after the third dose of the COVID-19 vaccine in people with multiple sclerosis on disease-modifying therapies. METHODS: People with multiple sclerosis who received the third dose of either mRNA or inactivated vaccine after two doses of inactivated vaccine were recruited for the study. Blood samples were collected at least two weeks after the third dose. RESULTS: Blood samples of 339 (female 72.5%) people with multiple sclerosis and 52 (female 71.2%) healthy controls were evaluated. Healthy controls (mean: 4.07 ± 0.66) have higher antibody titers than people with multiple sclerosis (mean: 2.79 ± 2.95). Seronegative cases were observed only in the fingolimod and ocrelizumab treatment groups. Patients on fingolimod who received mRNA as a third dose had significantly higher antibody titer than those who had inactivated vaccines. Longer disease duration, having inactivated vaccine as a third dose, and DMT use was associated with lower antibody response. CONCLUSIONS: The study shows that even after inactivated vaccine schedule, mRNA still offers more protection in people with multiple sclerosis on disease-modifying therapies.

Relationship between presence of spinal cord lesion and restless legs syndrome in multiple sclerosis.

BACKGROUND: Even though the prevalence of restless leg syndrome in multiple sclerosis (MS) is known to vary between 12.5% and 60%, the underlying pathophysiological mechanism remains unclear. AIM: This study aims to investigate the relationship between spinal cord lesions and restless leg syndrome in MS. MATERIALS AND METHODS: In total, 959 persons with MS were enrolled in this study. Demographic and clinical data of persons with MS were recorded by interviewing and medical records. Neurologists blind to the presence of restless leg syndrome evaluated MRI scans for the presence of demyelinating lesions in the brainstem and spinal cord. RESULTS: The restless leg syndrome was detected in 222 participants (23.15%). Restless leg syndrome was not significantly linked to mean age, body mass index, gender, and MS duration, but persons with MS with restless leg syndrome have a higher disability level (p = 0.044). In addition, no difference in the brainstem and thoracic cord was found between persons with MS with and without restless leg syndrome, while there is a significant relationship between the presence of cervical cord lesion and restless leg syndrome. CONCLUSION: Higher disability scores and characteristics of lesion patterns in the spinal cord could explain higher rates of restless leg syndrome in persons with MS. Considering the negative effects of restless leg syndrome, the increased awareness and treatment of restless leg syndrome among persons with MS is essential for better managing.

Comparison of SARS-CoV-2 antibody response after two doses of mRNA and inactivated vaccines in multiple sclerosis patients treated with disease-modifying therapies.

BACKGROUND: Disease-modifying therapy could weaken the immune system and decrease the immune response to vaccines. It is essential to know which vaccine is more protective against SARS-CoV-2 in the multiple sclerosis population. OBJECTIVE: To assess immune response after messenger RNA BNT162b2 (Pfizer/BioNTech) and inactivated Sinovac vaccines in people with multiple sclerosis (pwMS) treated with a disease-modifying therapy (DMT) compared to healthy controls. METHODS: This single-center cross-sectional study included 526 MS patients treated with DMT, 44 healthy controls, and 21 untreated patients with MS between May 2021 and September 2021. Serum samples were collected at least two weeks after the second dose of the vaccine. RESULTS: Participants vaccinated with BNT162b2 had a higher antibody titer than the Sinovac group (95%CI=1.023 - 1.473; p< .001). No significant difference between antibody titer of pwMS without treatment and HC was found [95%CI= -0.882; - 0.935 p > .99]. In 65 adults without DMT use (HC+pwMSwithout treatment), no seronegative cases were observed in any vaccine group. In patients treated with DMT, BNT162b2 was associated with a 16.3% greater absolute risk of seropositivity than Sinovac. CONCLUSION: The mRNA vaccine could be a preferred choice of protection against SARS-CoV-2 in pMS treated with DMT.