Validation of the Arabic Version of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale.

BACKGROUND: The Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) has become the gold standard for evaluating different domains in Parkinson's disease (PD), and it is commonly used in clinical practice, research, and clinical trials. OBJECTIVES: The objectives are to validate the Arabic-translated version of the MDS-UPDRS and to assess its factor structure compared with the English version. METHODS: The study was carried out in three phases: first, the English version of the MDS-UPDRS was translated into Arabic and subsequently back-translated into English by independent translation team; second, cognitive pretesting of selected items was performed; third, the Arabic version was tested in over 400 native Arabic-speaking PD patients. The psychometric properties of the translated version were analyzed using confirmatory factor analysis (CFA) as well as exploratory factor analysis (EFA). RESULTS: The factor structure of the Arabic version was consistent with that of the English version based on the high CFIs for all four parts of the MDS-UPDRS in the CFA (CFI ≥0.90), confirming its suitability for use in Arabic. CONCLUSIONS: The Arabic version of the MDS-UPDRS has good construct validity in Arabic-speaking patients with PD and has been thereby designated as an official MDS-UPDRS version. The data collection methodology among Arabic-speaking countries across two continents of Asia and Africa provides a roadmap for validating additional MDS rating scale initiatives and is strong evidence that underserved regions can be energically mobilized to promote efforts that apply to better clinical care, education, and research for PD. © 2022 International Parkinson and Movement Disorder Society.

Total Antioxidant Capacity Predicts Outcome in Acute Ischemic Stroke Subtypes in Egyptian Patients.

BACKGROUND: Oxidative stress after ischemic stroke contributes to neuronal cell injury. We tried to demonstrate an association between total antioxidant capacity (TAC) levels and outcomes after acute ischemic stroke (AIS). METHODS: We enrolled 60 patients (36 females and 24 males) who were admitted to our hospital due to AIS, in addition to 30 age and sex-matched healthy controls. TAC levels were measured on day 1 of stroke onset, the relationships between TAC levels, stroke subtypes, and clinical outcomes based on the National Institutes of Health Stroke Scale and modified Rankin scale upon discharge were evaluated. RESULTS: TAC levels were significantly lower in AIS patients than control (P < .001) being much lower in patients with large-vessel cerebral infarction than in those with small-vessel infarction. We investigated whether TAC concentrations reflected the severity and outcome of ischemic stroke and we found a significantly lower concentration of TAC in the poor outcome group than in the good outcome group (P < .001). CONCLUSIONS: Our findings suggested that the biochemical changes related to TAC and oxidative stress may be considered a marker of ischemic brain injury and clinical outcome of ischemic stroke.

Serum malondialdehyde as a lipid peroxidation marker in multiple sclerosis patients and its relation to disease characteristics.

Introduction Oxidative stress has been suggested to play a key role in pathogenesis of multiple sclerosis (MS), but clinical data on oxidative stress markers in MS patients and their influence on clinical and radiologic characteristics of the disease are inconsistent. The aim of this study is to assess the serum levels of malondialdehyde (MDA) as a measure of lipid peroxidation in MS patients and its relation to disease characteristics. Methods This case control study included 120 patients with clinically definite relapsing remitting multiple sclerosis (RRMS) compared to 120 age and sex -matched healthy controls. MDA levels were measured using thiobarbituric acid reactive substances (TBARS) assay. Results MDA levels are significantly higher in patients with MS than those in control (P<0.001) especially during relapse, MDA levels are higher in patients taking no disease modifying therapy (DMT) than those taking interferon (IFN-ß). MDA levels significantly correlate with expanded disability status scale (EDSS) (P<0.001). Conclusions The results of this study can provide evidence about the incrimination of oxidative stress in MS pathogenesis and disease disability and support the use of antioxidants as a new target of treatment that focuses on neutralizing free radicals and increases antioxidant capacity.

Risk of obstructive sleep apnea in multiple sclerosis: Frequency, clinical and radiological correlates.

BACKGROUND: Primary sleep disorder, especially, obstructive sleep apnea (OSA), are noted to occur in MS patients at higher frequency than the general population. OBJECTIVES: Our objectives are: (1) To assess the frequency of OSA risk among MS patients. (2) To evaluate the relationship between OSA risk and self-reported fatigue and sleepiness. (3) To evaluate the relationship between OSA risk and clinical disability, radiological findings and treatment status. METHODS: We enrolled 124 patients with multiple sclerosis, there were 53 men and 71 women with mean age (31.12 ±â€¯7.48) All participants completed questionnaires: STOP-Bang, Berlin, Fatigue Severity Scale (FSS) and Epworth sleepiness scale (ESS) and their disability was assessed using Expanded Disability Status Scale (EDSS). RESULTS: Among the completed surveys, 46.8% screened as high risk for OSA based on STOP-BANG questionnaire, and 45.2% based on Berlin questionnaire. About 64.5% of subjects screened positive for fatigue using FSS and 38.7% reported excessive day time sleepiness. Comparing MS patients diagnosed with high risk of OSA and those without, there was significant difference between the two groups regarding age (P < 0.001), gender (P < 0.001), disease duration, (P = 0.04), presence of brainstem lesions (0.04) and disease modifying therapy (DMT) use (P = 0.002). ESS and FSS positive scores were each significantly correlated with positive STOP BANG and Berlin outcomes (p < 0.001). EDSS showed significant correlation with positive STOP-Bang and Berlin scores. CONCLUSIONS: OSA risk appears to be high in MS patients with increased risk of fatigue and increasing disability.