Opinions, satisfaction and expectations of individuals with multiple sclerosis about telerehabilitation services.

OBJECTIVE: The opinions, satisfaction, and expectations of telemedicine can provide essential data for remote health services in individuals with Multiple Sclerosis (MS). The study aimed to demonstrate the views (barriers-benefits), satisfaction, and expectations of individuals with MS about telerehabilitation services. METHODS: A prospective cross-sectional was conducted with 82 individuals with MS who received telerehabilitation services for at least one year. The participants have completed SymptoMScreen, Beck Depression Inventory (BDI), Telehealth Usability Questionnaire (TUQ), Telemedicine Satisfaction Questionnaire (TSQ), Telehealth Barriers Questionnaire (TBaQ and Telehealth Benefits Questionnaire (TBeQ). RESULTS: As the age of individuals with MS increased, TUQ (r: -0.517, p < 0.001) and TBeQ (r: -0.383, p < 0.001) decreased, while TSQ (r: 0.405, p < 0.001) and TBaQ (r: 0.390, p < 0.001) increased. SymptoMScreen score (r: -0.288, p < 0.05) was weakly associated with TUQ. In addition, TUQ, TSQ, TBeQ, and TBaQ were strongly correlated (p < 0.001). CONCLUSION: In order to improve usability and satisfaction in telerehabilitation services, the age, symptom severity, and education levels of individuals with MS should be considered. Telehealth methods with high usability should be preferred to increase patient satisfaction.

Agreement between video-based clinician-rated tools and patient-reported outcomes on gait assessment in individuals with multiple sclerosis.

PURPOSE: To our knowledge, no studies compared the video-clinician-based tools and patient-reported questionnaires in assessing gait and balance in people with MS (pwMS). The present study investigated the correlation and agreement between video-clinician-based objective measurement tools and patient-reported outcome measures (PROMs) in gait and balance evaluation. METHODS: A prospective cross-sectional study was conducted with 55 pwMS. Video analysis-based gait was evaluated by the Tinetti Gait Assessment (TGA), Gait Assessment and Intervention Tool (GAIT), and Functional Ambulation Classification Scale (FACS) by the clinician. Participants' self-reported gait and balance were assessed with the Multiple Sclerosis Walking Scale-12 (MSWS-12) and Activity-Specific Balance Confidence Scale (ABC). RESULTS: There was a moderate positive correlation between ABC with TGA and FACS (r1: 0.552, r2: 0.510, p < 0.001). ABC was strongly correlated with GAIT (r: - 0.652, p < 0.001). A moderate positive correlation was observed between MSWS-12 with TGA and FACS (r1: - 0.575, r2: - 0.524, p < 0.001). In addition, there was a strong positive correlation between MSWS-12 and GAIT (r: - 0.652, p < 0.001). Clinician-rated tools and PROMs were within the agreement limits regarding the unstandardized beta values p < 0.001). CONCLUSIONS: Clinician-based gait and balance tools demonstrate consistent results with PROMs in pwMS. Considering the low cost and practical use of PROMs, in cases where video-based clinician-based measurements cannot be provided (time, space, and technical inadequacies), questionnaires can provide concordant results at moderate and severe levels compared with objective tools.

Psychosocial Effects of the Pandemic on MS Patients at a University Hospital Following Patients with Telemedicine, Cross-sectional Study.

Introduction: The psychosocial effect of the pandemic on people with a disease such as multiple sclerosis (MS) that can cause disability and which medications that affect the immune system are used in treatment should be evaluated by physicians. We aimed to determine the psychosocial effects of the pandemic on MS patients and to evaluate the working and treatment continuation status, compliance with pandemic rules, and their perceptions regarding coronavirus disease 2019 (COVID-19). Methods: This study was designed as a cross-sectional and descriptive survey study. A total of 315 MS patients' demographic data, comorbidities, and degrees of disability, Beck Depression Inventory (BDI), Coronavirus Anxiety Scale (CAS), and compliance scores with pandemic restrictions were evaluated. Results: In the first period of the pandemic, approximately one-third of the patients were found to have major depression, and approximately 10% to have COVID anxiety. Both COVID anxiety and BDI scores were significantly higher in patients with symptoms suggestive of an attack during the pandemic process (p:0.0001 and p:0.002). CAS was higher in those who had a COVID-19 contact (p:0.045). BDI scores were significantly higher (respectively p:0.034, p:0.006, p:0.0001) in married/cohabiting patients, in patients who went on unpaid leave or lost their job, and in patients who described worsening of their previous MS-related complaints. Conclusion: Although the pandemic negatively affects the psychosocial status of MS patients, this effect can be reduced by identifying the groups that may be affected via telemedicine and taking necessary interventions.

Comparison of physical performance, gait, balance, falls efficacy, and step reaction time in individuals with multiple sclerosis.

OBJECTIVE: The study aimed to investigate the physical performance, gait, balance, falls efficacy, and step reaction time in individuals with MS. METHODS: A total of 60 individuals (30 individuals with MS and 30 age and sex-matched healthy controls) were enrolled. Individuals' physical performance was evaluated with the Timed Up and Go Test (TUG) and Five-Times-Sit-to-Stand Test (FTSTS). Activities-specific Balance Confidence (ABC) Scale, 12-item Multiple Sclerosis Walking Scale (MSWS-12v2) and Falls Efficacy Scale International (FES-I) were used to assess the balance, gait and fall efficacy of the participants. Individuals' step reaction time (SRT) was calculated with video-based software. The time between the step command and the first contact of the foot with the ground in the first step was recorded. RESULTS: The mean age of the individuals with MS and the control group was 38.5 ± 9.4 years and 33.9 ± 11.7 years, respectively. Significant differences existed between the groups in SRT, FES-I, ABC, and FTSTS (p < 0.05). There was no significant correlation between SRT with any other parameter (p > 0.05). TUG was moderately correlated with MSWS-12 and FES-I (r1 =0.426, r2 =0.495, p < 0.05). Besides, there was a moderate correlation between ABC with TUG and FTSTS (r1 =-0.605, r2 =-0.468, p < 0.05). A high degree correlation was found between MSWS-12 with FES-I and ABC (r1 =0.843, r2 =-0.834, p < 0.05). CONCLUSION: Individuals with MS have decreased SRTs. However, this condition was not found to be related to physical performance. Further studies should focus on the association of SRT with cognitive and psychosocial parameters.

Erratum: Clinical and Demographic Characteristics and Two-Year Efficacy and Safety Data of 508 Multiple Sclerosis Patients with Fingolimod Treatment.

[This corrects the article on p. 23 in vol. 60, PMID: 36911568.].

Clinical and Demographic Characteristics and Two-Year Efficacy and Safety Data of 508 Multiple Sclerosis Patients with Fingolimod Treatment.

Introduction: Fingolimod is the first oral immunomodulatory treatment used as secondary care therapy in the treatment of multiple sclerosis for the last 10 years. The objective of our study is to reveal the experiences of the first generic fingolimod active ingredient treatment in different centers across Turkey. Method: The first generic fingolimod efficacy and safety data of patients followed-up in 29 different clinical multiple sclerosis units in Turkey were analyzed retrospectively. Data regarding efficacy and safety of the patients were transferred to the data system both before the treatment and on the 6th, 12th and 24th month following the treatment. The data were analyzed using the IBM SPSS 20.00. P value of <0.05 was considered to be statistically significant. Results: A total of 508 multiple sclerosis patients, 331 of whom were women, were included in the study. Upon comparing the Expanded Disability Status values before and after the treatment, a significant decrease was observed, especially at month 6 and thereafter. Since bradycardia occurred in 11 of the patients (2.3%), the first dose had to be longer than 6 hours. During the observation of the first dose, no issues that could prevent the use of the drug occured. Side effects were seen in 49 (10.3%) patients during the course of fingolimod treatment. Respectively, the most frequent side effects were bradycardia, hypotension, headache, dizziness and tachycardia. Conclusion: The observed results regarding efficacy and safety were similar to clinical trial data in the literature and real life data in terms of the first equivalent with fingolimod active ingredient.

The comparative effectiveness of fingolimod, natalizumab, and ocrelizumab in relapsing-remitting multiple sclerosis.

BACKGROUND: Fingolimod, natalizumab, and ocrelizumab are commonly used in the second-line treatment of relapsing-remitting multiple sclerosis (RRMS). However, these have only been compared in observational studies, not in controlled trials, with limited and inconclusive results being reported. A comparison of their effect on relapse and disability in a real-world setting is therefore needed. OBJECTIVES: The objective of this study was to compare the efficacy of fingolimod, natalizumab, and ocrelizumab in reducing disease activity in RRMS. METHODS: This multicenter, retrospective observational study was carried out with prospectively collected data from 16 centers. All consecutive RRMS patients treated with fingolimod, natalizumab, and ocrelizumab were included. Data for relapses, Expanded Disability Status Scale (EDSS) scores, and brain magnetic resonance imaging (MRI) scans were collected. Patients were matched using propensity scores. Annualized relapse rates (ARR), time to first relapse, and disability accumulation were compared. RESULTS: Propensity score matching retained 736 patients in the fingolimod versus 370 in the natalizumab groups, 762 in the fingolimod versus 434 in the ocrelizumab groups, and 310 in the natalizumab versus 310 in the ocrelizumab groups for final analyses. Mean ARR decreased markedly from baseline after treatment in all three treatment groups. Mean on-treatment ARR was lower in natalizumab-treated patients (0.09, 95% confidence interval (CI), 0.07-0.12) than in those treated with fingolimod (0.17, 0.15-0.19, p<0.001), ocrelizumab (0.08, 0.06-0.11), and fingolimod (0.14, 0.12-0.16, p=0.001). No significant difference was observed in mean on-treatment ARR between patients treated with natalizumab (0.08, 0.06-0.11) and ocrelizumab (0.09, 0.07-0.12, p=0.54). Compared to fingolimod, the natalizumab and ocrelizumab groups exhibited a higher percentage of relapse-free patients and a lower percentage of MRI-active patients at year 1. No significance differences in disability accumulation were determined between the therapies. CONCLUSION: Natalizumab and ocrelizumab exhibited similar effects on relapse control, and both were associated with better relapse control than fingolimod. The effects of the three therapies on disability outcomes were similar.

The reliability and validity of the 30-second chair stand test and modified four square step test in persons with multiple sclerosis.

BACKGROUND: The 30-second Chair Stand Test (30s-CST) and Modified Four Square Step Test (mFSST) are used to determine the functional status of individuals with multiple sclerosis (MS). No other studies have demonstrated the reliability and validity of the 30s-CST and mFSST. PURPOSE: To identify the test-retest reliability, concurrent validity and the known-group validity of the 30s-CST and mFSST in persons with MS. METHODS: A total of 64 persons with MS were enrolled. 30s-CST, mFSST, Timed Up and Go Test (TUG) and Five Times Sit to Stand (FTST) tests were performed. 30s-CST and mFSST were conducted again one-hour later. RESULTS: The mean age of the persons with MS were 37.9±11.3 years. The test-retest reliability of the 30s-CST and mFSST were excellent (ICC30s-CST = 0.974, 95%CI: 0.95-0.98; ICCmFSST = 0.992, 95%CI: 0.98-0.99). The 30s-CST was strongly correlated with FTST and TUG (r1 = -0.871, p1 = 0.0001; r2 = -0.741,p2 = 0.0001). There was a strong relationship between mFSST with TUG and FTST (r1 = 0.781,p1 = 0.0001;r2 = 0.788,p2 = 0.0001). The SEM95 and MDC95 values of the 30s-CST and mFSST were 0.41/1.13 and 0.34/0.94, respectively. Besides, there were significant differences between the persons with or without fall history in 30s-CST (MD: 1.66, CI: 0.27 to 3.05, p = .019) and mFSST CST (MD:-2.70, CI: -4.73 to -0.67, p = .010) performances. CONCLUSION: The 30s-CST and mFSST are both valid and reliable in mildly-disabled individuals with MS.

The reliability and validity of the Turkish version of the multiple sclerosis impact scale-29.

BACKGROUND: The purpose of the study was to cross-culturally adapt the Multiple Sclerosis Impact Scale-29 (MSIS-29) into Turkish and evaluate its reliability and validity in patients with Multiple Sclerosis (MS). METHODS: A total of 119 individuals with MS were enrolled in the research. The neurologist classified the patients with Expanded Disability Status Scale (EDSS). In the initial evaluation, patients completed the Multiple Sclerosis Impact Scale-29 (MSIS-29), the Multiple Sclerosis International Quality of Life (MusiQoL), EuroQol-5D-3L (EQ-5D-3L), and Beck Depression Scale (BDS), respectively one week later, the MSIS-29 evaluation was repeated. Internal consistency, test-retest reliability, and construct validity were assessed, separately. RESULTS: The mean age of the total sample was 38.2 ± 10.6 years. The test-retest reliability of both subscores of the MSIS-29 was excellent (>0.80). Internal consistency of the MSIS-29 physical and psychological score was 0.968 and 0.914, respectively. Both of the subscores had excellent internal consistency (>0.80). There was a strong relationship between MSIS-29 physical score with MusiQoL, EQ-5D-3L (index), EQ-5D-3L (VAS), and BDS scores (p < 0.01, r > 0.50). MSIS-29 physical was moderately related to EDSS (p < 0.01, r = 0.381). MSIS-29 psychological score was strongly correlated with MusiQoL, EQ-5D-3L (index), EQ-5D-3L (VAS), and BDS scores (p < 0.01, r > 0.50). On the other hand, there was a weak correlation between MSIS-29 psychological score and EDSS (p < 0.01, r = 0.300). DISCUSSION: Turkish version of the MSIS-29 is a reliable and valid tool in individuals with MS.

Successful Rapid Drug Desensitization with A Modified Protocol To Alemtuzumab in A Multiple Sclerosis Patient with Severe Immediate-Type Hypersensitivity Reaction.

Alemtuzumab is a humanized monoclonal antibody targeting the CD52 antigen on lymphocyte surfaces. The intravenous administration of alemtuzumab provokes the depletion of lymphocytes by antibody-dependent and complement-mediated cellular cytotoxicity. Resulting cytotoxicity leads to 'first-dose infusion-related reactions in more than 90% of the patients, fewer than 3% being severe cases. We present the first successful modified rapid drug desensitization (RDD) protocol to alemtuzumab in an active relapsing-remitting multiple sclerosis (RRMS) patient. The forty-year-old female patient had an immunologically-mediated mixed-type (co-occurring IgE-mediated and cytokine release syndromes) hypersensitivity reaction (HSR) verified with a drug skin test. As the patient had severe HSR and there was no other option to treat RRMS at that time; two courses of 12 mg alemtuzumab with one-year intervals were administrated successfully using the modified 12-step intravenous RDD protocol. By experience, RDD is known as a safe and effective therapy option allowing alemtuzumab treatment targeted for the aforementioned type of MS.

Gait assessment in shaped pathways: The test-retest reliability and concurrent validity of the figure of eight test and L test in multiple sclerosis patients without mobility aids.

PURPOSE: To our knowledge, no other studies have demonstrated the reliability and validity of the Figure of Eight Walking Test (F8WT) and L Test in patients with multiple sclerosis (MS). The aim of the study was to prove the test-retest reliability and concurrent validity of the F8WT and L Test in patients with MS. METHODS: A cross-sectional study was conducted with 52 patients with MS. A clinical neurologist evaluated patients by Expanded Disability Status Scale (EDSS). Participants completed the F8WT, L Test, Timed Up and Go Test (TUG), and Timed 25-Foot Walk Test (T25FW) in the first assessment session. Then, the F8WT and L Test was retested one hour later. The same evaluator completed all of the assessments. RESULTS: The ICC of both tests were excellent (ICCF8WT: 0.972, ICCL Test: 0.986). F8WT and L test measurement did not show a systematic bias and were within the agreement limits. The Standard Error of Measurement (SEM95) and Minimal Detectable Change (MDC95) values of the F8WT was 0.58 and 1.60, respectively. Besides, L Test's SEM95 and MDC95 were 0.59 and 1.63. The correlation between F8WT with TUG, T25FW and EDSS was 0.849, 0.810 and 0.453. On the other hand, the L test's correlation coefficient with TUG, T25FW and EDSS 0.682, 0.706 and 0.535, respectively (p < 0.01). Individuals with "EDSS ≤ 1″ had statistically significantly better L-test and F8WT scores than those with "EDSS: 1 to 4.5″ (p < 0.01). CONCLUSION: F8WT and L Test is a valid and reliable physical performance test in MS patients without mobility aids. Both tests demonstrate advanced gait assessment in L and 8 shaped pathways to provide more comprehensive evaluation than horizontal pathways.

Reliability and Validity of the Turkish Version of the Multiple Sclerosis Knowledge Questionnaire.

Introduction: Multiple Sclerosis Knowledge Questionnaire (MSKQ) is a self-administered inventory assessing patients' knowledge about Multiple Sclerosis. In this study, we aimed to test the reliability and validity of MSKQ in Turkish patients. Methods: Patients with Multiple Sclerosis who attended an education seminar in our university hospital were enrolled in the study. Results: Fifty-eight patients completed and returned the questionnaire twice, before and after the seminar. Mean number of items that were answered correctly in the first round was 12.8 (5.2), which increased to 18.7 (3.2) in the second round after the seminar. This increase was found to be significant (p<0.01). Conclusion: Questions regarding general characteristics of the disease were found to be answered correctly more often than those questions regarding diagnostic and treatment options. This finding indicates that patients may be more interested in the general characteristics of the disease and in the factors that may have started the disease process. Higher number of incorrect answers regarding diagnostic and treatment strategies may be caused by a lack of interest on the part of the patient who may perceive these subjects to be too complex or who may choose to leave decision-making to healthcare professionals. Also, physicians may be unable to inform patients in these areas because of a lack of time or resources. New molecules developed for the treatment of Multiple Sclerosis makes it even more difficult for patients to follow and form their own opinions about the treatment process. These results show us that patient education is essential and our patients need more educational resources, especially regarding treatment options. The significant increase in the number of correct answers after the education seminar supports the need for broader patient education (p<0.01). Turkish version of MSKQ is a reliable and valid measure for assessing patients' level of knowledge.

Cross-cultural adaptation, validation, and the reliability of the Sleep-Related Behaviors Questionnaire in patients with multiple sclerosis.

PURPOSE: Examining sleep-related behavioral disorder strategies in detail for MS patients provides an essential assessment to address specific disease findings. The aim of the study was to demonstrate the reliability and validity of the Turkish Sleep-Related Behaviors Questionnaire in patients with multiple sclerosis (MS). METHODS: A total of 100 MS patients were filled Sleep-Related Behaviors Questionnaire (SRBQ), Beck Depression Inventory (BDI), Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI). One week later, 30 randomly selected patients were refilled the SRBQ. The test-retest reliability, internal consistency, and contruct validity were determined. RESULTS: The mean age of the individuals included in the study was 38.9 ± 11.0 years. The ICC value of the reproducibility of SRBQ was calculated as 0.877 (CI: 0.74-0.94). The test-retest reliability of the SRBQ was excellent (ICC > 0.80). Cronbach's alpha value of the SRBQ was 0.877, which indicates excellent consistency. The SRBQ had correlation coefficients of 0.573, 0.509, and 0.523 with ISI, PSQI, and BDI, respectively. The SRBQ had high validity (r > 0.50, p < 0.01). CONCLUSION: The Turkish SRBQ was found to be valid and reliable in patients with MS. Owing to the long but comprehensive nature of the SRBQ, a low-cost detailed measurement could be obtained in clinical practice.

Cross-cultural adaptation, reliability and validity of the Turkish version of the Fear of Relapse Scale (FoR) in individuals with multiple sclerosis.

OBJECTIVE: The study aimed to translate and cross-culturally adapt the Fear of Relapse Scale (FoR) into Turkish and determine its psychometric properties. METHODS: International guidelines were used for the translation and adaptation process. The patients were asked to fill the FoR, Intolerance of Uncertainty (IUS-12) and Depression Anxiety and Stress Scale (DASS-21). One week later, participants refilled the FoR. The test-retest reliability, internal consistency, and construct validity of the FoR were analyzed. RESULTS: A total of 101 MS patients (37.6 ± 10.0 years, 81.2% women) were included in the research. The test-retest reliability of the FoR was excellent (ICC:0.883; CI:0.64-0.92). The reproducibility of the items of the FoR ranged from 0.2 to 0.8. The Cronbach's alpha coefficient of the FoR was 0.914. The internal consistency of the items was ranged between 0.90 and 0.91 The relationship between FoR with IUS-12, DASS-21 (depression), DASS-21 (anxiety), DASS-21 (stress) was 0.609, 0.641, 0.648 and 0.631, respectively. The correlation coefficients were greater than 0.50 (p < 0.01). CONCLUSION: The Turkish version of the FoR is a reliable and valid tool to measure relapse fear in patients with MS.

Coexistence of restless legs syndrome and multiple sclerosis aggravates anxiety and depression.

BACKGROUND: Among the comorbidities that accompany multiple sclerosis (MS), restless legs syndrome (RLS) is one of the most common. Anxiety and depression are common psychological comorbidities that impact the quality of life of patients with MS (PwMS), as well as patients with RLS. OBJECTIVE: To investigate the psychiatric burden of MS and RLS coexistence, we conducted a nationwide, multicenter and cross-sectional survey. METHODS: Participants were assessed by using demographic and clinical parameters along with the Hamilton Anxiety and Hamilton Depression Scales (HAM-A and HAM-D). RESULTS: Out of the 1,068 participants, 173 (16.2%) were found to have RLS [RLS(+)] and 895 (83.8%) did not [RLS(-)]. The mean scores for HAM-A and HAM-D were significantly higher among RLS(+) subjects than among RLS(-) subjects (p<0.001 for all variables). CONCLUSIONS: According to our data, the presence of RLS in PwMS may increase the occurrence of both anxiety and depression symptoms. Awareness and treatment of RLS in PwMS could possibly reduce the symptoms of psychiatric comorbidities originating from RLS.

The Turkish experience of COVID-19 infection in people with NMOSD and MOGAD: A milder course?

BACKGROUND: COVID-19 is a multisystemic infection with variables consequences depending on individual and comorbid conditions. The course and outcomes of COVID-19 during neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disorders (MOGAD) are not clearly known. OBJECTIVE/METHODS: The aim of this study was to examine the features and outcomes of COVID-19 infection in NMOSD and MOGAD patients. The patients' demographic and clinical factors, disease modifying treatment (DMT) used and disease information of COVID-19 infection were recorded. Conditions leading to hospitalization and severe exposure to COVID-19 infection were also analyzed. RESULTS: The study included 63 patients from 25 centers. Thirty-two patients (50.8%) belong to AQP-4 seropositive group, 13 (20.6%) and 18 (28.6%) were in MOG-positive and double-seronegative groups, respectively. Risk factors for severe COVID-19 infection and hospitalization were advanced age, high disability level and the presence of comorbid disease. Disease severity was found to be high in double-seronegative NMOSD and low in MOGAD patients. No statistically significant effect of DMTs on disease severity and hospitalization was found. CONCLUSION: In NMOSD and MOGAD patients, advanced age, high disability and presence of comorbid disease pose risks for severe COVID-19 infection. There was no direct significant effect of DMTs for COVID-19 infection.

Coexistence of restless legs syndrome and multiple sclerosis aggravates anxiety and depression / A coexistência da síndrome das pernas inquietas e esclerose múltipla agrava ansiedade e depressão

ABSTRACT Background: Among the comorbidities that accompany multiple sclerosis (MS), restless legs syndrome (RLS) is one of the most common. Anxiety and depression are common psychological comorbidities that impact the quality of life of patients with MS (PwMS), as well as patients with RLS. Objective: To investigate the psychiatric burden of MS and RLS coexistence, we conducted a nationwide, multicenter and cross-sectional survey. Methods: Participants were assessed by using demographic and clinical parameters along with the Hamilton Anxiety and Hamilton Depression Scales (HAM-A and HAM-D). Results: Out of the 1,068 participants, 173 (16.2%) were found to have RLS [RLS(+)] and 895 (83.8%) did not [RLS(-)]. The mean scores for HAM-A and HAM-D were significantly higher among RLS(+) subjects than among RLS(-) subjects (p<0.001 for all variables). Conclusions: According to our data, the presence of RLS in PwMS may increase the occurrence of both anxiety and depression symptoms. Awareness and treatment of RLS in PwMS could possibly reduce the symptoms of psychiatric comorbidities originating from RLS.

RESUMO Antecedentes: Considerando-se as comorbidades que acompanham a esclerose múltipla (EM), a síndrome das pernas inquietas (SPI) é uma das mais comuns, e ansiedade e depressão são comorbidades psicológicas comuns que afetam a qualidade de vida de pacientes com EM, bem como de pacientes com SPI. Objetivo: Investigar a carga psiquiátrica da coexistência de EM e SPI por meio de uma pesquisa nacional, multicêntrica e transversal. Métodos: Os participantes foram avaliados por parâmetros demográficos e clínicos, além da versão turca das escalas de ansiedade e depressão de Hamilton (HAM-A e HAM-D). Resultados: Dos 1.068 participantes, 173 (16,2%) apresentaram SPI [SPI (+)] e 895 (83,8%) não [SPI (-)]. As pontuações médias no HAM-A e no HAM-D foram significativamente maiores em indivíduos com SPI (+) do que naqueles com SPI (-) (p <0,001 para todas as variáveis). Conclusões: De acordo com nossos dados, a presença de SPI na EM pode aumentar a ocorrência de sintomas de ansiedade e depressão. A conscientização e o tratamento da SPI na EM podem reduzir os sintomas de comorbidades psiquiátricas originadas da SPI.

The reliability and validity of the Turkish version of the Telemedicine Satisfaction and Usefulness Questionnaire (TSUQ) and Telemedicine Patient Questionnaire (TPQ) in individuals with multiple sclerosis.

OBJECTIVE: The study was aimed to translate and adapt the Telemedicine Satisfaction and Usefulness Questionnaire (TSUQ) and Telemedicine Patient Questionnaire (TPQ) into Turkish, thereafter to analyze the psychometric properties of both questionnaires. METHODS: A total of 149 multiple sclerosis (MS) patients were recruited in the study. For 4 years, all patients were supervised by a department clinician using telemedicine. Cronbach's alpha coefficient was used to assess internal consistency. By evaluating the scores of 41 retested patients 1 week later, the test-retest reliability was determined using the intraclass correlation coefficient (ICC). Pearson's correlation coefficient was used to assess the construct validity (r). RESULTS: A total of 149 patients (103 women, 46 men) with a mean age of 40.9±10.9 years were included in the study. MS duration of the patients was 9.15±6.24 years. Internal consistency of all items and the total score of the TSUQ were excellent (>0.80; ranged 0.971-0.974). On the other hand, the internal consistency of all items and total score of the TPQ was excellent, either (>0.80; ranged 0.878-0.890). The ICC of the TSUQ's and TPQ's total score was excellent (>0.80). The correlation between TSUQ and TPQ was strong (r=0.734, p<0.01). In addition, there was moderate relationship between the TSUQ and the Beck Depression Scale (BDS) (r=-0.363, p<0.01). On the other hand, there was low correlation between TPQ and BDS (r=-0.217, p<0.05). CONCLUSION: The Turkish version of the TSUQ and the TPQ is valid and reliable in individuals with MS.

The comparison of fatigue, sleep quality, physical activity, quality of life, and psychological status in multiple sclerosis patients with or without COVID-19.

PURPOSE: The study was purposed to investigate the effect of COVID-19 disease on fatigue, sleep quality, physical activity, quality of life, and psychological status in people with MS. METHODS: A total of 104 people with MS, including 46 of them with COVID-19 disease history, were enrolled in the study. All patients were evaluated with the Expanded Disability Status Scale (EDSS), Fatigue Severity Scale (FSS), Pittsburgh Sleep Quality Index (PSQI), International Physical Activity Questionnaire Short Form (IPAQ-SF), the EuroQoL Instrument (EQ-5D-3L), the Fear of COVID-19 Scale (FCV-19S) and the Coronavirus Anxiety Scale (CAS). RESULTS: People with MS in the COVID-19 positive group had a significantly lower IPAQ-Total score (p = 0.014). Besides, the FCV-19S scores of COVID-19 positive patients were significantly higher (p = 0.006). EQ-5D-3L Index and EQ-5D-3L VAS scores were higher in the group with COVID-19 (p1 = 0.021, p2 = 0.014, respectively). FCV-19S had a moderate correlation with EDSS (r = -0.362). IPAQ-Total was moderately associated with MS duration, EDSS and FSS (r1 = -0.471, r2 = -0.389, r3 = -0.388, respectively). The EQ-5D-3L Index was moderately correlated with FSS (r1 = -0.404). There was a weakly significant relationship between EQ-5D-3L Index and BMI, MS duration, PSQI and CAS (r1 = -0.471, r2 =-0.389, r3 = -0.388, r4 = -0.326, respectively). On the other hand, EQ-5D-3L was moderately associated with VAS and EDSS and PSQI (r1 = -0.393, r2 = -0.357, respectively). CONCLUSION: COVID-19 negatively affected the people with MS's physical activity and coronavirus related fear parameters. However, the causality of this influence should be investigated in detail.