EVALUATION OF COGNITIVE IMPAIRMENT IN PATIENTS WITH MULTIPLE SCLEROSIS USING GEORGIAN LANGUAGE MONTREAL COGNITIVE ASSESSMENT.

The main objective of the study was to evaluate the prevalence and risk factors of cognitive impairment in patients with multiple sclerosis. Fifty-three patients with multiple sclerosis were enrolled in this cross-sectional study. Study participants underwent neurological status examination and cognitive screening with Montreal Cognitive Assessment. Beck Depression Inventory was used to assess mental health. Statistical analysis was performed using SPSS software, version 26.0. The overall prevalence of cognitive impairment in our group was 42%. We found that higher physical disability and progressive disease course are main risk-factors for cognitive decline in patients with multiple sclerosis.

Primary headache disorders in the Republic of Georgia: prevalence and risk factors.

OBJECTIVE: To estimate the 1-year prevalences of migraine and tension-type headache (TTH), and identify their principal risk factors, in the general population of the Republic of Georgia. METHODS: In a community-based door-to-door survey, 4 medical residents interviewed all biologically unrelated adult members (>/=16 years) of 500 adjacent households in Tbilisi, the capital city, and 300 in rural Kakheti in eastern Georgia, using a previously validated questionnaire based on International Headache Society diagnostic criteria. RESULTS: The target population included 1,145 respondents, 690 (60%) women, mean age 45.4 +/- 12.0 years. The 1-year prevalences were as follows: migraine 6.5% (95% confidence interval 5.0-7.9), probable migraine 9.2% (7.5-10.8), all migraine 15.6% (13.5%-17.7%), TTH 10.0% (8.2-11.7), probable TTH 27.3% (24.8-29.9), all TTH 37.3% (34.5%-40.1%). Female gender and low socioeconomic status were risk factors for migraine but not for TTH. Headache on >/=15 days/month was reported by 87 respondents, a prevalence of 7.6% (6.1-9.1). Female gender, low socioeconomic status, and frequent use (>/=10 days/month) of acute headache drugs were risk factors. The likely prevalence of medication overuse headache was 0.9% (0.3-1.4), of chronic migraine 1.4% (0.7-2.1), and of chronic TTH 3.3% (2.3-4.4), but caution is needed in interpreting these estimates. CONCLUSIONS: While the prevalences of migraine and tension-type headache are comparable with those in Europe and the United States, a remarkably high percentage of the population of Georgia have headache on >/=15 days/month. This study demonstrates the importance of socioeconomic factors in a developing country and unmasks the unmet needs of people with headache disorders.

Prevalence of cluster headache in the Republic of Georgia: results of a population-based study and methodological considerations.

We present a study of the general-population prevalence of cluster headache in the Republic of Georgia and discuss the advantages and challenges of different methodological approaches. In a community-based survey, specially trained medical residents visited 500 adjacent households in the capital city, Tbilisi, and 300 households in the eastern rural area of Kakheti. They interviewed all (n = 1145) biologically unrelated adult occupants using a previously validated questionnaire. The household responses rates were 92% in Tbilisi and 100% in Kakheti. The survey identified 32 persons with possible cluster headache, who were then personally interviewed by one of two headache-experienced neurologists. Cluster headache was confirmed in one subject. The prevalence of cluster headache was therefore estimated to be 87/100,000 (95% confidence interval < 258/100,000). We used a conservative approach, which has an obvious advantage of high-quality data collection, but is very demanding of manpower and time.

Validation of a german language questionnaire for screening for migraine, tension-type headache, and trigeminal autonomic cephalgias.

BACKGROUND: To develop a German language questionnaire for screening for migraine, tension-type headache, and trigeminal autonomic cephalgias. OBJECTIVE: Aim of the study was to develop a German language self-administered headache questionnaire for screening for migraine (MIG), tension-type headache (TTH), and trigeminal-autonomic cephalgias (TAC). METHODS: Questionnaire-based diagnoses were blindly compared with those of headache experts. RESULTS: Overall 278 headache patients (MIG = 97, TTH = 60, TAC = 98, MIG plus TTH = 23) as well as 42 patients with low back pain without headache and 47 healthy subjects were studied. The Cohen's kappa for 7 headache syndromes including all combination diagnoses was 0.64 (95% CI 0.58-0.70). Sensitivity and specificity for migraine were 0.73 and 0.96, for TTH 0.85 and 0.98, for TAC 0.63 and 0.99, and for MIG plus TTH 0.62 and 0.97, respectively. Ignoring all combination diagnoses, the kappa-coefficient for the monodiagnoses MIG, TTH, and TAC (193 out of 278 patients) was 0.93 (CI 0.83-1.0). The retest-reliability (4 weeks later) was 0.95. CONCLUSION: We present the first questionnaire in German language including 3 most common primary headaches for use in epidemiological research.

Medication overuse headache: rates and predictors for relapse in a 4-year prospective study.

We present a prospective 4-year follow-up study of 96 patients with medication overuse headache following withdrawal. Complete datasets were available from 85 patients (89%) 6 months, from 79 patients (82%) 1 year and from 75 patients (78%) 4 years after withdrawal. Twenty-six patients (31%) relapsed within the first 6 months after withdrawal. The number of relapses increased to 32 (41%) 1 year and to 34 (45%) 4 years after withdrawal. The 4-year relapse rate was lower in migraine than in tension-type headache (32% vs. 91%, P