Worldwide prevalence of neuromyelitis optica spectrum disorder (NMOSD) and neuromyelitis optica (NMO): a systematic review and meta-analysis.

BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) is a progressive demyelinating disease of the central nervous system that has overlapping symptoms with multiple sclerosis (MS) but differs from it in a variety of ways. Previous studies have reported conflicting results trying to estimate the number of individuals affected by them which is why we designed this systematic review and meta-analysis to estimate the worldwide prevalence and incidence of NMOSD/NMO based on current evidence. METHODS: We searched PubMed, Scopus, EMBASE, Web of Science, and gray literature including references from the identified studies, review studies, and conference abstracts which were published up to February 1, 2022. We used all MeSH terms pertaining to "NMOSD," "NMO," and all the terms on "prevalence," "incidence," and "epidemiology" to identify the search components. Pooled effect sizes were measured using random-effect model by DerSimonian-Laird. RESULTS: The prevalence and incidence rates of NMOSD/NMO ranged from 0.07 to 10 and 0.029 to 0.880 per 100,000 population, respectively. The overall pooled prevalence of NMO per 100,000 population was 1.54 (I2: 98.4%, 95% CI: 1.13-1.96, P< 0.001) based on the 2006 criteria, 1.51 (I2: 99.4%, 95% CI: 1.21-1.81, P < 0.001) based on the 2015 criteria and 2.16 (I2: 89.4%, 95% CI: 1.46-2.86, P < 0.001) based on the 2006/2015 criteria. The overall annual incidence of NMO per 100,000 population was 0.155 (I2: 95%, 95% CI: 0.115-0.195, P < 0.001) based on the 2006 criteria and 0.278 (I2: 100%, 95% CI: 0.135-0.420, P < 0.001) based on the 2015 criteria. The prevalence rates were highest in French West Indies and South Korea, and lowest in Cuba and Australia, based on the 2006 and 2015 criteria, respectively. Also, the highest annual incidence rates were obtained for Sweden and Slovak republic and the lowest for Cuba and Australia based on the 2006 and 2015 criteria, respectively. All estimated rates were higher among females compared to males. CONCLUSION: Although rare, NMOSD/NMO impact affected individuals in devastating ways. Several large-scale prospective studies are required to reach a comprehension of the epidemiological aspects of these notorious demyelinating conditions.

Risk and severity of SARS-CoV-2 reinfection among patients with multiple sclerosis vs. the general population: a population-based study.

BACKGROUND: We conducted this study to compare the risk of reinfection between multiple sclerosis (MS) patients and a control group without MS. METHOD: In this retrospective study, data of all SARS-CoV-2 tests (n = 793,301) and almost all MS patients (n = 10,639) in Isfahan province were collected from January 01, 2020 to August 22, 2021. Of the 2196 MS patients and 793,301 persons from the general population who had been tested at least once, 3 control for each MS patient were identified, leaving 1560 MS patients and 4680 controls without MS. We compared the risk of reinfection after 90 days of a primary infection between those with and without a previous positive COVID-19 test. RESULTS: 736 (47.2%) MS patients and 2013 (43.0%) control individuals had at least one positive test. A total of 17 (2.3%) and 22 (1.1%) possible reinfections in MS and control groups were observed. The estimated protection against reinfection in all MS patients, MS patients on rituximab, MS patients on DMTs rather than rituximab, and controls were 68.2% (46.2, 81.2%), 57.4% (- 0.1, 83.1%), 71.5% (45.5, 85.2%), and 82.1% (72.1, 88.5%), respectively. We found no statistically significant difference in estimated protection (p = 0.123) and odd of reinfection (adjusted OR: 2.01 [0.98, 4.08]) between all MS patients and control group. Two patients were hospitalized at first infection but none required hospitalization at reinfection event. CONCLUSIONS: MS patients on rituximab may be at a greater risk of reinfection. Further studies are required to assess the risk of the second reinfection among the MS population.

Prevalence and Risk Factors of Dysphagia in Patients with Multiple Sclerosis.

Dysphagia is one of the most common symptoms in multiple sclerosis (MS) patients. It can reduce the quality of life and increase the risk of mortality by developing complications such as aspiration pneumonia. The present study was conducted to estimate the prevalence of dysphagia in MS patients and investigate the associations between dysphagia and disease characteristics. The Persian version of the DYMUS questionnaire was used to assess dysphagia in 865 patients with MS, including 738 (85.3%) relapsing-remitting MS (RRMS), 106 (12.3%) secondary progressive MS (SPMS), and 21 (2.4%) primary progressive MS (PPMS). Also, demographic and clinical data, including age, sex, smoking status, Expanded Disability Status Scale (EDSS) score, disease duration, disease-modifying therapies exposure, initial symptoms of MS, were recorded. The mean (SD) age was 37.95(9.25) years, and 83.1% of the participants were female. The prevalence of dysphagia was estimated to be 25.4% among all patients. According to the DYMUS questionnaire results, the prevalence of dysphagia in RRMS, SPMS, and PPMS patients was 22.2%, 44.3%, and 42.9%, respectively. After multivariate analysis the current EDSS score (OR = 1.197, CI: 1.062, 1.350, p = 0.003), cerebellar impairment (OR = 1.335, CI: 1.450, 4.716, p = 0.004) and motor dysfunction (OR = 1.651, CI: 1.004, 2.715, p = 0.048) emerged as the risk factors for dysphagia. Since dysphagia, as previously mentioned, is a common symptom in multiple sclerosis, particularly in SPMS and PPMS courses, active screening for this condition is recommended in all patients, particularly those with identified risk factors.

Short report: assessment of coping strategies in patients with neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis.

Neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) are disabling neurological diseases with significant emotional distresses. To better deal with these diseases, patients need to adopt coping strategies. Identifying coping strategies is important in our understanding of the disease burden and management. However, no one to the best of our knowledge has studied coping strategies in NMOSD patients worldwide. We performed this study to evaluate coping strategies in NMOSD and MS patients compared to healthy controls. We assessed coping strategies using Coping Orientation for Problem Experiences (COPE) inventory. Demographic and clinical characteristics were gathered as well. Thirty NMOSD patients, 76 MS patients, and 50 healthy controls were recruited. NMOSD and MS patients adopted acceptance and behavioral disengagement strategies more often compared to healthy control. Furthermore, NMOSD cases were more prone to using mental disengagement strategy. Both NMOSD and MS cases were less prone to substance use. In NMOSD group, patients with basic education had higher scores of focus on and venting emotions compared to those with advance education. No relationship between coping strategies and demographic and clinical characteristics was observed. We found almost similar patterns of coping in NMOSD and MS. NMOSD patients showed utilization of maladaptive coping strategies with more frequent use of mental and behavioral disengagement. We suggest a multidisciplinary approach to manage these patients.

Diagnostic accuracy and prognostic value of lung ultrasound in coronavirus disease (COVID-19).

Purpose: This study aimed to assess the correlation between lung ultrasound (LUS) and computed tomography (CT) findings and the predictability of LUS scores to anticipate disease characteristics, lab data, clinical severity, and mortality in patients with COVID-19. Material and methods: Fifty consecutive hospitalized PCR-confirmed COVID-19 patients who underwent chest CT scan and LUS on the first day of admission were enrolled. The LUS score was calculated based on the presence, severity, and distribution of parenchymal abnormalities in 14 regions. Results: The participants' mean age was 54.60 ± 19.93 years, and 26 (52%) were female. All patients had CT and LUS findings typical of COVID-19. The mean value of CT and LUS severity scores were 11.80 ± 3.89 (ranging from 2 to 20) and 13.74 ± 6.43 (ranging from 1 to 29), respectively. The LUS score was significantly higher in females (p = 0.016), and patients with dyspnoea (p = 0.048), HTN (p = 0.034), immunodeficiency (p = 0.034), room air SpO2 ≤ 93 (p = 0.02), and pleural effusion (p = 0.036). LUS findings were strongly correlated with CT scan results regarding lesion type, distribution, and severity in a region-by-region fashion (92-100% agreement). An LUS score of 14 or higher was predictive of room air SpO2 ≤ 93 and ICU admission, while an LUS score ≥ 12 was predictive of death (p = 0.011, 0.023, and 0.003, respectively). Conclusions: Our results suggested that LUS can be used as a valuable tool for detecting COVID-19 pneumonia and determining high-risk hospitalized patients, helping to triage and stratify high-risk patients, which waives the need to undertake irradiating chest CT and reduces the burden of overworked CT department staff.

The prevalence of COVID-19 infection in patients with multiple sclerosis (MS): a systematic review and meta-analysis.

BACKGROUND: The prevalence of COVID-19 is different in studies conducted in different countries. The aim of this systematic review and meta-analysis is to estimate the pooled prevalence of COVID-19 in patients with MS. METHODS: Two independent researchers independently searched PubMed, Scopus, EMBASE, Web of Science, and google scholar along with gray literature up to April 2021. The search strategy included the MeSH and text words as (((coronavirus OR Wuhan coronavirus OR novel coronavirus OR coronavirus disease OR COVID-19 OR 2019 novel coronavirus infection OR 2019-nCOV OR severe acute respiratory syndrome coronavirus 2 OR SARS-CoV-2) AND (Multiple Sclerosis OR Sclerosis, Multiple) OR Sclerosis, Disseminated) OR Disseminated Sclerosis) OR MS (Multiple Sclerosis)) OR Multiple Sclerosis, Acute Fulminating). RESULTS: We found 1466 articles by literature search, and after deleting duplicates, 1029 remained. Twelve articles remained for meta-analysis. Totally, 101,462 patients were evaluated and the total number of possible/confirmed cases was 1394. Mean age ranged from 35 to 54 years. Totally, 49 patients died. The pooled prevalence of suspected COVID-19 in MS patients was 4% (95% CI: 3-4%) (I2 = 98.5%, P < 0.001). The pooled prevalence of hospitalization in infected cases was 10% (95% CI: 7-12%) (I2 = 95.6%, P < 0.001). The pooled prevalence of death in hospitalized cases was 4% (95% CI: 1-6%) (I2 = 82.4%, P < 0.001). CONCLUSION: Hospitalization rate is higher among MS patients based on COVID-19 infection while the pooled infection rate is estimated as 4%.

Prevalence and incidence of multiple sclerosis in Isfahan, Iran between 1996 and 2021: A population-based study.

BACKGROUND: There has been no recent comprehensive epidemiological study on a large and stable population of multiple sclerosis (MS) in Isfahan. Therefore, we conducted this study to estimate the incidence and prevalence of MS in Isfahan province from 1996 to 2021. METHOD: In this population-based study, we utilized the dataset from the Vice-Chancellor's Office of Isfahan University of Medical Sciences, which registers all people diagnosed with MS (PDWM) in Isfahan province, excluding those residing in Kashan city. We measured crude incidence and prevalence of MS, separated by sex, and based on age of MS onset, as well as changes in age of MS onset during observation. RESULTS: A total of 9,909 PDWM were included in our study. The incidence during the time period of 1996-2000 was 5.4/100,000 (1.1/100,000 per year), which subsequently increased to 14.1 (2.8/100,000 per years) and 31.1 per 100,000 (6.2/100,000 per year) during 2001-2005 and 2006-2010, respectively. There was a further increase to 70.9/100,000 (14.2/100,000 per year) in 2011-2015, but it remained stable at 71.8/100,000 (12/100,000 per year) during the period of 2016-2021. In 2016, the age-standardized incidence rates of pediatric-onset, adult-onset, and late-onset MS were 1.8/100,000, 31.4/100,000, and 17.5/100,000, respectively. The prevalence of MS in 2021 was 183.9/100,000. The female/male new case ratio was 4.5 during 1996-2000, decreasing to 4.0, 3.9, 3.9, and 2.9 in the subsequent four five-year periods. The mean age of RRMS onset was 26.3 ± 8.1 between 1990 and 1999, 28.5 ± 8.3 during 2000-2009, and increased to 32.8 ± 9.6 in 2010-2019. CONCLUSION: This study shows that Isfahan has one of the highest incidence rate and prevalence ratio of MS in the region. We observed an increase in the incidence rate during the first decade, followed by stability in the last two five- and six-year periods. Further studies are needed to identify the reasons behind the change in incidence of MS in Iran.

Prevalence of dysphagia in patients with multiple sclerosis: A systematic review and meta-analysis.

BACKGROUND: Dysphagia is a major disorder observed in patients with multiple sclerosis (MS), yet different prevalence rates are reported for it. Therefore, we designed this study to estimate the pooled prevalence of dysphagia in patients with MS. METHOD: We searched PubMed, Scopus, EMBASE, Web of Science, and gray literature including references from the identified studies, reviews studies, and conference abstracts which were published up to May 2022. Articles that were relevant to our topic and could provide information regarding the prevalence of dysphagia among MS patients were included; however, articles with self-report screening strategies were excluded. RESULTS: The literature search found 997 articles. After eliminating duplicates, 672 articles remained. Two conference abstracts were included for final analysis. A total of 11,266 MS cases and 5047 MS patients with dysphagia were included in the meta-analysis. The overall prevalence of dysphagia across all 54 studies was 44.8 % (95 % CI: [40.4 %-49.2 %]), with a high level of heterogeneity between countries (Q=; I2 = 94.96 %; p < 0.001). CONCLUSION: The results of this systematic review shows that the prevalence of dysphagia in MS patients is 45% which is greatly higher compared to the general population.

Demographic and Clinical Characteristics of Familial and Sporadic Multiple Sclerosis Patients.

Background: Multiple sclerosis (MS) is a chronic, inflammatory, demyelinating, immune-mediated disease of the central nervous system. It is still unestablished whether heredity correlates with the disease's progression and severity. Methods: This study includes the patients with MS seen in the MS clinic of Kashani Hospital, affiliated with Isfahan University of Medical Sciences, from January 2019 to January 2020. We gathered data regarding the demographic and clinical characteristics, such as type of disease and family history of MS. Patients were grouped based on having relatives with MS. We compared demographic and clinical characteristics between those with a family history of MS (familial MS: FMS) and those without a family history of MS (sporadic MS: SMS). Results: We included 2,929 MS patients, 523 (17.2%) with FMS and 2,406 (82.8%) with SMS. Patients with FMS were found to have active lesions in the thoracic spine more frequently than those with SMS (P = 0.022). We also found differences in the distribution of gender (P = 0.036) and the frequency of having active brain lesions (P = .024) among patients with FMS and SMS. No difference was found between the demographic/clinical characteristics and the number of affected relatives in the family. Conclusions: Significant differences were found among different groups of patients in terms of demographical and clinical characteristics.

Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease and COVID-19: A Systematic Review.

Background: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an uncommon neurological disease affecting the central nervous system (CNS). Numerous neurological disorders, including multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), acute transverse myelitis (ATM), and MOGAD, have been reported following the COVID-19 infection during the current COVID-19 pandemic. On the other hand, it has been suggested that patients with MOGAD may be at greater risk for infection (particularly in the current pandemic). Objective: In this systematic review, we gathered separately 1) MOGAD cases following COVID-19 infection as well as 2) clinical course of patients with MOGAD infected with COVID-19 based on case reports/series. Methods: 329 articles were collected from 4 databases. These articles were conducted from inception to March 1st, 2022. Results: Following the screening, exclusion criteria were followed and eventually, 22 studies were included. In 18 studies, a mean ± SD time interval of 18.6 ± 14.9 days was observed between infection with COVID-19 and the onset of MOGAD symptoms. Symptoms were partially or completely recovered in a mean of 67 days of follow-up.Among 4 studies on MOGAD patients, the hospitalization rate was 25%, and 15% of patients were hospitalized in the intensive care unit (ICU). Conclusion: Our systematic review demonstrated that following COVID-19 infection, there is a rare possibility of contracting MOGAD. Moreover, there is no clear consensus on the susceptibility of MOGAD patients to severe COVID-19. However, obtaining deterministic results requires studies with a larger sample size.

Effectiveness of BBIBP-CorV vaccine in preventing SARS-CoV2 infection and severe outcomes in people living with multiple sclerosis: A population-based study.

BACKGROUND: The objective of the present study was to estimate the effectiveness of the BBIBP-CorV vaccine (VE) in preventing SARS-CoV-2 infection, related hospitalization, and death among people living with multiple sclerosis (PLWMS). METHODS: In this population-based retrospective observational study, data on all PLWMS, vaccination, SARS-CoV-2 tests, hospitalization, and deaths were collected in Isfahan, Iran between February 9, 2021, and November 4, 2021. We estimated the hazard ratio between vaccinated (partially and fully) and unvaccinated groups using the Andersen-Gill extension of the Cox proportional hazards model. We also performed Cox proportional hazards analysis to identify risk factors for breakthrough infection and COVID-19-related hospitalization in fully-immunized group. RESULTS: Of the 9869 PLWMS, 1368 were in partially-vaccinated group, 4107 were in the fully-vaccinated group, and 3794 were in the unvaccinated group. In the partially-vaccinated group, the estimated VE against COVID-19 infection was 39.3% (16%, 56.1%), hospitalization was 64.9% (1.3%, 87.5%), and mortality was 92.7% (88.8%, 100%). The respective results for the fully-vaccinated group were 63.9% (56%, 70.3%), 75.7% (57.5%, 86.1%), and 100%. Progressive MS was independently associated with a greater risk of breakthrough infection (HR=1.952, 95%CI: 1.174-3.246, p = 0.010). Older adults (≥50 years vs. 18-49 years, HR=3.115, 95%CI: 1.145-8.470, p = 0.026) and those on rituximab (HR=7.584; 95% CI: 1.864-30.854; p = 0.005) were at an increased risk of COVID-19-related hospitalization. CONCLUSION: This study showed that two doses of the BBIBP-CorV vaccine can effectively prevent COVID-19 infection and hospitalization among PLWMS. Old PLWMS and those who treating with rituximab are at increased risk of hospitalization after receiving two doses of the vaccine.

Multiple sclerosis is associated with worse COVID-19 outcomes compared to the general population: A population-based study.

BACKGROUND: We carried out the current study to compare COVID-19-related hospitalization and mortality rates between people living with multiple sclerosis (PLWMS) and MS-free controls from the Isfahan general population. METHOD: In this retrospective population-based study, we used available data from four datasets of Isfahan University of Medical Sciences from January 1, 2020, to August 22, 2021. Data on all PLWMS, SARS-CoV-2 polymerase chain reaction (PCR) and rapid antigen test, hospitalization, and death were included. We compared the odds of COVID-19-related hospitalization and mortality between PLWMS and the control group before and after adjustment for age and sex. We categorized all people into young (18-49 years) and old age (50-79 years) groups and compared the hospitalization rate between people with and without MS. RESULTS: In total, 829 PLWMS and 2494 MS-free controls with confirmed COVID-19 were included. Hospitalization rates among PLWMS and MS-free controls were 16.2% and 16.5% (crude OR= 0.978, 95%CI: 0.79, 1.21). In the adjusted model, PLWMS with COVID-19 had 56% increased odds of hospitalization (OR=1.56, 95%CI: 1.23, 1.97). During follow-up, there were 11 (1.3%) and 49 (2%) COVID-19-related deaths among PLWMS and MS-free controls, respectively. No significant difference between people with and without MS in COVID-19-related mortality rate was observed (crude OR= 0.678, 95%CI: 0.351, 1.31; adjusted OR=2.013, 95%CI: 0.95, 4.26). We found increased odds of hospitalization in young PLWMS compared to those without MS at the same age (OR=1.699, 95%CI: 1.289, 2.240). But, no difference between older people with and without MS was detected (OR=1.005, 95%CI: 0.662, 1.524). CONCLUSION: This study revealed higher odds of hospitalization and mortality due to COVID-19 among PLWMS in comparison to age- and sex-matched controls from the general population. Nevertheless, it remains unclear whether the elevated odds are directly associated with MS itself or if they are influenced by factors such as rituximab using, comorbidity, and disease severity.

Assessment of intelligence quotient in patients with neuromyelitis optica spectrum disease and multiple sclerosis.

BACKGROUND: Cognitive impairment is common in people living with neuromyelitis optica spectrum disease (NMOSD) and multiple sclerosis (MS). However, there is little published data on intelligence quotient (IQ) in NMOSD patients. Therefore, we performed the present study to compare IQ scores across NMOSD, MS, and control groups. METHOD: In this cross-sectional study, 49 NMOSD (30 with positive aquaporin4 antibody), 41 MS, and 20 control individuals were recruited. The IQ score for each person was measured using Wechsler Adult Intelligence Scale-Revised (WAIS-R). Participants were reported on eleven scores of subsets, verbal IQ (VIQ), performance IQ (PIQ), and full score IQ (FSIQ). RESULT: The scores of FSIQ, VIQ, PIQ, vocabulary, similarities, and digit-symbol in NMOSD and MS individuals were lower than the control group. Relative to control, NMOSD patients reported a lower score of information. We found no difference between NMOSD and MS groups, except in vocabulary and similarities. No significant difference between seropositive and seronegative NMOSD groups was observed except for the information and block design. In NMOSD group, a greater EDSS score was associated with decreased scores of FSIQ, VIQ, and PIQ. Being employed and being married were associated with greater scores of VIQ and PIQ, respectively. In both NMOSD and MS groups, advanced education was associated with increased scores of FSIQ and VIQ. CONCLUSION: Our study showed decreased IQ scores in NMOSD and MS. Further studies are required to examine intellectual quotient in people with NMOSD and MS.

Bell's palsy after Sputnik V COVID-19 (Gam-COVID-Vac) vaccination.

A possible association between Bell's palsy and COVID-19 vaccination has been suggested previously. Here, we report two cases of facial nerve hemiparalysis following the Sputnik V COVID-19 vaccination in a 27-year-old female patient and a 58-year-old male patient who were both clinically diagnosed with Bell's palsy.

Olfactory dysfunction in patients with multiple sclerosis; A systematic review and meta-analysis.

BACKGROUND: The importance and prevalence of olfactory dysfunction is recently gaining attention in patients with multiple sclerosis (MS) as a result of their chronic inflammatory disease, yet different prevalence rates are reported for it. Therefore, we have designed this systematic review to estimate the pooled prevalence of olfactory dysfunction in patients with MS. To our knowledge, this is the first systematic review and meta-analysis on the prevalence of olfactory dysfunction in MS patients. METHODS: We searched PubMed, Scopus, EMBASE, Web of Science, ProQuest, and gray literature including references from the identified studies, review studies, and conference abstracts which were published up to January 2021. Articles that were relevant to our topic and could provide information regarding the prevalence of olfactory dysfunction, or the scores of smell threshold, discrimination, or identification (TDI) among MS patients and healthy individuals were included. The pooled prevalence was calculated using a random-effects model and a funnel plot and Egger's regression test were used to see publication bias. RESULTS: The literature search found 1630 articles. After eliminating duplicates, 897 articles remained. Two conference abstracts were included for final analysis. A total of 1099 MS cases and 299 MS patients with olfactory dysfunction were included in the analysis. The pooled prevalence of olfactory dysfunction in the included studies was 27.2%. Also, the overall TDI score in MS patients was lower than that in the control group, and the level of Threshold, Discrimination, and Identification per se were lower in MS compared with control respectively. CONCLUSION: The results of this systematic review show that the prevalence of olfactory dysfunction in MS patients is high and more attention needs to be drawn to this aspect of MS.

Prevalence of trigeminal neuralgia in multiple sclerosis: A systematic review and meta-analysis.

BACKGROUND: The prevalence of Trigeminal Neuralgia (TN) in patients diagnosed with multiple sclerosis (MS) is insufficiently understood and controversially reported. This study focused on providing a better understanding of the prevalence of TN in MS patients. METHOD: We systematically searched PubMed, Scopus, EMBASE, Web of Science, and Google Scholar to identify studies published from January 1, 1990, to December 30, 2020. We included studies reporting the TN prevalence among MS patients and exclude case reports/series and editorial studies, review studies, and non-English written articles. We used pooled prevalence estimates to determine the TN prevalence among MS patients. RESULTS: Pooled overall TN prevalence among 19 studies and 30,348 MS patients was estimated as 3.4% (95% CI: 1.5%-5.9%) with a high level of heterogeneity among studies (I2=98.92%; p<0.001). The pooled prevalence of TN in male and female patients across 9 surveys was 2.4% (95% CI: 0.5%-5.4%) and 3.8% (95% CI: 0.8%-8.7%), respectively. No heterogeneity between the two groups was observed (p = 0.558). A meta-regression was performed to explore the source of the heterogeneity. None of the candidate covariates, including the year of a study publication, the sample size, the average age of patients, and the disease duration, were significant in the model. CONCLUSION: Our results showed that TN is a common problem among patients with MS, predominantly male patients. Future studies should target the general prevalence of pain in MS patients.

Sociodemographic and Illness-Related Indicators to Predict the Status of Neuromyelitis Optica Spectrum Disorder (NMOSD) Five Years after Disease Onset.

BACKGROUND: Neuromyelitis Optica Spectrum Disorder (NMOSD) is an autoimmune demyelinating disease of the central nervous system. Currently, no factors have been identified to predict the long-term course of NMOSD. To counter this, we analyzed data of 58 individuals with NMOSD at disease onset and about five years later. METHODS: Medical records of 58 individuals with NMOSD (mean age: 31.13 years at disease onset; 86.2% female) were retrospectively analyzed. At baseline, a thorough medical and disease-related examination was performed; the same examination was repeated about five years later at follow-up, including treatment-related information. Mean outcome measure was the difference in EDSS (Expanded Disease Severity Scale) scores between baseline and follow-up. RESULTS: Mean disease duration was 4.67 years. Based on the differences of the EDSS scores between baseline and follow-up, participants were categorized as improving (n = 39; 67.2%), unchanged (n = 13; 22.4%) and deteriorating (n = 6; 10.3%). Deteriorating was related to a higher progression index, and a higher number of attacks, while the annualized relapse rate reflecting the number of attacks per time lapse did not differ between the three groups. Improving was related to a higher intake of rituximab, and to a higher rate of seropositive cases. Unchanged was related to a lower rate of seropositive cases. Factors such as age, gender, somatic and psychiatric comorbidities, symptoms at disease onset, relapse rates, number and location of cervical plaques, or brain plaques and thoracolumbar plaques at baseline did not differ between those improving, deteriorating or remaining unchanged. CONCLUSIONS: Among a smaller sample of individuals with NMOSD followed-up about five years later, individuals deteriorating over time reported a higher progression index, while the annualized relapse rate was unrelated to the progress of disease. Overall, it appears that the course of NMOSD over a time lapse of about five years after disease onset is highly individualized. Accordingly, treatment regimen demands a highly individually tailored approach.

Post COVID-19 infection neuromyelitis optica spectrum disorder (NMOSD): A case report-based systematic review.

BACKGROUND: One of the rare neuroinflammatory disorders is Neuromyelitis optica spectrum disorder (NMOSD) which involves the central nervous system (CNS), and develops by various etiologies. There is evident that viral infections could cause neurological disorders. In this regard, novel coronavirus (COVID-19) triggers NMOSD, based on reports. We performed this systematic review to evaluate NMOSD patients following COVID-19 infection. METHODS: We collected 345 studies from PubMed (Medline), Embase, Scopus, and Web of Science databases from inception to 20 October 2021, and our inclusion criteria were English case reports/case series. Other types of Coronaviridae virus studies, review articles, articles written in any language other than English were excluded as well. RESULTS: 11 case reports were selected from 345 studies and data was extracted according to inclusion criteria. In all cases, NMOSD was reported following COVID-19 infection, and various symptoms such as blurring or loss of vision, weakness, and numbness were common, and the COVID-19 infection was confirmed by different tests such as PCR test, immunoglobulin assay and chest imaging. CONCLUSION: Review regarding case reports showed that NMOSD is conceivable following COVID-19.

Hearing loss among patients with multiple sclerosis (PwMS): A systematic review and meta-analysis.

BACKGROUND: Multiple sclerosis (MS) is a kind of autoimmune disorder that has swept more than 2 million people worldwide and has caused multiple disabilities in the patients. Hearing loss(HL) is also one of the disabilities that numerous patients with multiple sclerosis (PwMS) experience. METHODS: We searched four databases: PubMed (Medline), Scopus, Web of Science, and Embase, from 1970 to July 2021. The gray literature containing the conference abstracts, review studies, and references of the articles was also investigated. We included any studies that reported PwMS with HL. RESULTS: Out of 1875 articles, 1042 articles remained following eliminating duplicates. Afterward, all articles were screened, and 953 were eliminated based on exclusion criteria. Full texts of 89 articles were collected. Finally, eight articles were selected based on inclusion and exclusion criteria. The pooled prevalence of HL in PwMS was 1.1% (95% CI: [0.2%, 2.4%]; I2=80.11%; p<0.001) among 5187 MS population. CONCLUSION: Our analysis suggests that MS might increase the risk of HL , and it might be an indicator for MS diagnosis. More research with larger sample sizes is required.

Incidence, prevalence, and characteristics of heart failure among patients with multiple sclerosis: A systematic review and meta-analysis.

INTRODUCTION: Multiple sclerosis (MS) is the most common neurological autoimmune disease. Although it primarily harms the central nervous system, other organs are liable to be affected by it as well. There is a growing body of evidence suggesting that heart failure should be considered as a potential suspect for cardiac dysfunction and insufficiency among MS patients. As such, we designed this systematic review and meta-analysis to elaborate more on the incidence, prevalence, and characteristics of HF among MS patients. METHODS: We conducted a systematic computerized search using four data banks: PubMed (MEDLINE), Scopus, web of science, and Embase (via Elsevier). The literature search found 930 articles. After eliminating duplicates, 695 articles remained, from which 42 articles were assessed for inclusion eligibility, and eventually 8 full-text articles were included in the final data extraction table. RESULTS: The overall prevalence of heart failure was 1% (95% CI: 0.6%-1.5%), which ranged from 0.6% observed in UK to 1.8% for Taiwan study. The overall incidence of heart failure was also 0.7% (95% CI: 0.4%-1.2%), ranging from 0.2% observed in UK to 1.4% in USA. The pooled odds ratio for the association between heart failure and multiple sclerosis calculated based on 4 studies, using random effect model was 1.29 (95% CI: 0.74-2.26; I2=82.5%), but not significant. CONCLUSION: In conclusion, this study demonstrates that patients with MS are at an elevated risk of developing heart failure compared to the general population, which highlights the importance of regular and thorough checkups in PwMS in an effort to better detect any cardiovascular abnormality, dysfunction, or disease as soon as possible to help improve the prognosis.