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    A 12-month, Open Label, Multicenter Pilot Study Evaluating Fingolimod Treatment in terms of Patient Satisfaction in Relapsing Remitting Multiple Sclerosis Patients FINE Trial
    (Aves, 2019) Akman Demir, Gulsen; Turkoglu, Recai; Saip, Sabahattin; Yuceyar, Nur; Efendi, Husnu; Turan, Omer Faruk; Kocer, Belgin
    Introduction: To assess satisfaction and quality of life in patients with relapsing-remitting multiple sclerosis (RRMS) who were receiving fingolimod (0.5 mg/day) for 12 months as a second-line treatment after switching from injectable agents. Methods: Patients aged 18-65 years with RRMS who fulfilled the eligibility criteria were enrolled from 16 centers throughout Turkey. Treatment Satisfaction Questionnaire for Medication and 36-item Short-Form Health Survey were completed at baseline and four visits to assess patient satisfaction and quality of life. Results: Forty-two patients (62% male; mean age: 35.7 +/- 9.4 years) were eligible for inclusion. Patient satisfaction scores at the end of the study 44.7 +/- 9.9) were significantly higher than those at baseline [32.0 +/- 9.9; (p<0.001)]. The only significant increase in the quality of life survey was in the emotional aspect (p=0.019). There were 124 adverse events and none of the five serious adverse events noted was considered drugrelated. Conclusion: Large-scale comparative studies performed with disease specific quality of life instruments will allow more information on this issue.
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    Assessment of Early Cognitive Impairment in Patients with Clinically Isolated Syndromes and Multiple Sclerosis
    (Hindawi Publishing Corporation, 2014) Kirac, Leyla Baysal; Ekmekci, Ozgul; Yuceyar, Nur; Kocaman, Ayse Sagduyu
    Objective. The aim of our study was to investigate the frequency and pattern of cognitive impairment in patients with clinically isolated syndromes and definite diagnosis of multiple sclerosis within the last 2 years. Methods. We assessed the cognitive status of 46 patients aged 18-49 years with clinically isolated syndromes or definite diagnosis of multiple sclerosis who have onset of their symptoms within the last 2 years. Patients were matched with 40 healthy participants for age, sex, and educational level. Neuropsychological assessment was performed by stroop test, paced auditory serial addition test (PASAT), controlled oral word association test (COWAT), clock drawing test, trail making test (TMT), faces symbol test (FST). Hamilton Depression Scale and Modified Fatigue Impact Scale were used to quantify the severity of any depression and fatigue the subjects might suffer. Results. 19.6% of early MS/CIS group failed at 4 and more tests and had significant cognitive impairment focused on attention, executive functions, memory, and learning. No significant relationship was found between cognitive impairment and disability and fatigue scores. Discussion. Cognitive impairment can be present from the earliest stage of multiple sclerosis. It should be considered among the main manifestations of MS even in the earliest stages of the disease.
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    Association of Urinary Incontinence with Sensory-Motor Performance in Women with Multiple Sclerosis
    (Springer London Ltd, 2024) Ozden, Fatih; Ozkeskin, Mehmet; Sari, Zubeyir; Ekici, Ece; Yuceyar, Nur
    Introduction and HypothesisThe relationship between somatosensory and motor components of urinary incontinence in individuals with MS has not been extensively addressed. The study was aimed at investigating the association of urinary incontinence severity with motor and sensory performance in women with multiple sclerosis (MS). MethodsA cross-sectional single-center prospective study was conducted in 337 women with MS. The severity of MS symptoms was assessed using the SymptoMScreen questionnaire. The urinary incontinence status of the participants was evaluated using the Urinary Incontinence Inventory (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7). Physical performance was considered with the Timed Up and Go (TUG) test and the 5-Times Sit-to-Stand (5TSTS) test. In addition, the sensory performance of the individuals with MS was queried using the Somatosensory Amplification Scale (SSAS) and Sensory Sensitivity Scale (SeSS). ResultsThe UDI-6 (r=0.685, p<0.05) and IIQ-7 (r=0.759, p<0.05) correlated highly with SymptoMScreen. Among the physical performance measures, TUG (r=0.012, p<0.05) and 5TSTS (r=0.096, p<0.05) were weakly associated with UDI-6, but not statistically significantly. Similarly, there was a low correlation between IIQ-7 and TUG (r=-0.005, p<0.05) and 5TSTS (r=0.068, p<0.05). UDI-6 (0.360, p<0.05) and IIQ-7 (0.378, p<0.05) correlated moderately with SASS. On the other hand, SeSS had a low correlation coefficient with UDI-6 (0.305, p<0.05) and IIQ-7 (0.272, p<0.05). ConclusionsThe results revealed that sensory performance was more associated with urinary incontinence in women with MS than physical performance. The urinary incontinence severity was also related to MS symptoms (bladder control, walking, spasticity, stiffness cognitive function). Future studies should consider the potential impact of sensory performance on urinary incontinence and focus on explaining the mechanism behind this relationship.
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    Cervical vestibular-evoked myogenic potentials in patients with multiple sclerosis: sensitive in detecting brainstem involvement?
    (Springer-Verlag Italia Srl, 2018) Kavasoglu, Gokce; Gokcay, Figen; Yuceyar, Nur; Celebisoy, Nese
    Cervical vestibular-evoked myogenic potentials (cVEMPs) are accepted to demonstrate the vestibulo-collic reflex. However, the brainstem pathway is still not fully understood. The aim of the study was to evaluate the contribution of cVEMPs to detection of brainstem involvement in multiple sclerosis (MS). Thirty patients fulfilling the criteria for definite MS were included in the study. All were newly diagnosed cases, admitted due to an attack with active lesions on MRI. Thirty-one age- and sex-matched healthy controls constituted the control group. The latencies of peaks p13 and n23 and peak-to-peak amplitude of p13-n23 were measured. Brainstem lesions on MRI were present in 13 of the patients (43.4%). Comparison of the overall results recorded from patients with the healthy controls did not reveal a statistically significant difference in any of the parameters studied (p > 0.05). A significant inter-side difference was not also present between groups (p > 0.05). When p13 and n23 latencies exceeding 2.5 standard deviations (SD) were taken into consideration, it was seen that there were seven patients (23.3%) with prolonged latencies mainly involving the p13 peak. Five of them had brainstem signs on examination and had brainstem lesions on MRI. In the other eight patients with abnormal MRI, normal results were recorded indicating that in only 38% of patients with brainstem lesions, cVEMPs were altered. Absence of a correlation between cVEMPs and brainstem clinical or MRI lesions defies their role in identifying lower brainstem involvement.
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    Clinical and Histopathological Study of Patients With Mitochondrial Abnormalities
    (Journal Neurological Sciences, 2012) Ekmekci, Ozgul; Karasoy, Hatice; Yuceyar, Nur
    Objective: Mitochondrial diseases are clinically heterogenous group of disorders with widely varying clinical features. Diagnosis can be difficult and requires synthesis of clinical, biochemical, histopathological and molecular data. These investigations may not be available in most medical centers. Muscle biopsy provides an important information to confirm a mitochondrial disease. Ragged red fibers and cytochrome oxidase negative fibers are the morphological hallmark of mitochondrial diseases. In this study, we aimed to analyze clinical features and histopathological findings of patients with mitochondrial abnormalities on muscle biopsy. Methods: We retrospectively evaluated demographic and neurologic features, presenting symptoms, additional systemic manifestations, syndromic features of patients with mitochondrial abnormalities on muscle biopsy, according to diagnostic criteria for mitochondrial cytopathies. Results: Among 936 muscle biopsy sample, 118 showed mitochondrial abnormalities. Eighty four patients were considered as primary mitochondrial disease based on clinical and histopathologic features. The diagnosis of 34 patients was nonmitochondrial diseases according to their clinical features and additional histopathologic findings. The most common syndrome was chronic progressive external ophtalmoplegia in 61 patients. Fifteen patients had isolated proximal myopathy and 4 patients had Kearns Sayre syndrome, 2 patients had SANDO, 1 patient had MNGIE, 1 patient had MLASA. Conclusion: Mitochondrial abnormalities occur in both mitochondrial diseases and many nonmitochondrial diseases. The majority of patients with primary mitochondrial disorders have ophtalmologic abnormalities or neuromuscular manifestations. The accurate diagnosis of mitochondrial diseases relies on a multidisciplinary approach and muscle biopsy is useful in both accurate diagnosis and differential diagnosis.
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    Clinical Features and Course in Pediatric Onset Multiple Sclerosis
    (Journal Neurological Sciences, 2012) Ekmekci, Ozgul; Yuceyar, Nur; Kocaman Sagduyu, Ayse
    Objective: Multiple Sclerosis is uncommon in children and adolescents. Two to 5 % of all patients with MS have onset before age 16. Although the clinical profile of MS appears similar to adults some features may differ. The disease may lead to significant disability at a younger age. Our aim is to determine the clinical features and, disease course in pediatric onset multiple sclerosis. Methods: In this study, we evaluated 21 patients with pediatric onset (before age 18). The records of patients were reviewed retrospectively. The following variables were evaluated; sex, age at onset, presenting symptoms, disease course, relapse rate, immunomodulatory treatment. Results: Twenty one patients were included to study. The mean age at onset was 15.2 (ranged 8-17). The female/male ratio was 1.3. The median follow up period was 5 years. The major presenting symptoms were pyramidal (9 patients), brainstem (8 patients) and optic neuritis (4 patients). The initial disease course was relapsing remitting in 19 patients but in 3 patients, secondary progression was observed before age 30. Two patients were with clinically isolated syndrome. Nineteen patients were treated with immunomodulatory drugs. In 4 patients Mitoxantrone was used because of progressive course and relapses. Conclusion: The clinical presentation of multiple sclerosis with pediatric onset is usually benign but in the long term, patients with pediatric onset can become disabled at a younger age.
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    Coexistence of restless legs syndrome and multiple sclerosis aggravates anxiety and depression
    (Assoc Arquivos Neuro- Psiquiatria, 2022) Sevim, Serhan; Demirkiran, Meltem; Terzi, Murat; Yuceyar, Nur; Tasdelen, Bahar; Idiman, Egemen; Kurtuncu, Murat
    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.
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    The comparison of fatigue, sleep quality, physical activity, quality of life, and psychological status in multiple sclerosis patients with or without COVID-19
    (Elsevier Sci Ltd, 2021) Ozkeskin, Mehmet; Ozden, Fatih; Karaman, Bedriye; Ekmekci, Ozgul; Yuceyar, Nur
    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 (IPAQSF), 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). FCV19S 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.
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    Congenital Myasthenic Syndromes (CMS) Due to Impaired Principal Coupling Pathway in the. Subunit of Muscle Acetylcholine Receptor (AChR)
    (Lippincott Williams & Wilkins, 2018) Shen, Xin-Ming; Brengman, Joan; Shen, Shelley; Durmus, Hacer; Preethish-Kumar, Veeramani; Yuceyar, Nur; Vengalil, Seena; Nalini, Atchayaram; Deymeer, Feza; Sine, Steven; Engel, Andrew
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    Cross-cultural adaptation, reliability and validity of the Turkish version of the Fear of Relapse Scale (FoR) in individuals with multiple sclerosis
    (Elsevier, 2022) Ozden, Fatih; Ozkeskin, Mehmet; Yuceyar, Nur
    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.
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    Cross-cultural adaptation, reliability, and validity of the Turkish version of the SymptoMScreen
    (Elsevier Sci Ltd, 2021) Ozkeskin, Mehmet; Ozden, Fatih; Bakirhan, Serkan; Yuceyar, Nur
    Purpose: The study aimed to translate and cross-culturally adapt the SymptoMScreen into Turkish and evaluate its reliability and validity. Methods: One hundred nine MS patients were included in the study. SymptoMScreen was translated into Turkish according to the standardized guidelines and cross-culturally adapted. For construct validity, SymptoMScreen was compared with the Expanded Disability Status Scale (EDSS), Multiple Sclerosis-Related Symptom Checklist (MS-RS), and Beck Depression Scale (BDS) by Spearman?s correlation coefficient. Thirty patients refilled SymptoMScreen one week later, and the test-retest reliability was analyzed by the Intraclass Correlation Coefficient (ICC). Internal consistency was evaluated with Cronbach?s alpha coefficient. The standard error of measurement (SEM95) and the minimum detectable change (MDC95) were calculated. Results: Test-retest reliability and internal consistency of the SymptoMScreen were excellent (ICC = 0.925, ? = 0.914). SEM95 and MDC95 were 3.28 and 9.29, respectively. There was a strong correlation between the SymptoMScreen with the MS-RS and EDSS (r1= 0.908, p < 0.00; r2= 0.511, p < 0.001). Besides, the SymptoMScreen was moderately correlated with BDS (r = 0.584, p < 0.001). Conclusion: The Turkish version of the SymptoMScreen is a reliable and valid questionnaire for multiple sclerosis patients.
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    Cross-cultural adaptation, validation, and the reliability of the Sleep-Related Behaviors Questionnaire in patients with multiple sclerosis
    (Springer-Verlag Italia Srl, 2022) Ozden, Fatih; Ozkeskin, Mehmet; Yuceyar, Nur
    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.
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    Diagnostic value of "dysphagia limit'' for neurogenic dysphagia: 17 years of experience in 1278 adults
    (Elsevier Ireland Ltd, 2015) Aydogdu, Ibrahim; Kiylioglu, Nefati; Tarlaci, Sultan; Tanriverdi, Zeynep; Alpaydin, Sezin; Acarer, Ahmet; Baysal, Leyla; Arpaci, Esra; Yuceyar, Nur; Secil, Yaprak; Ozdemirkiran, Tolga; Ertekin, Cumhur
    Objective: Neurogenic dysphagia (ND) is a prevalent condition that accounts for significant mortality and morbidity worldwide. Screening and follow-up are critical for early diagnosis and management which can mitigate its complications and be cost-saving. The aims of this study are to provide a comprehensive investigation of the dysphagia limit (DL) in a large diverse cohort and to provide a longitudinal assessment of dysphagia in a subset of subjects. Methods: We developed a quantitative and noninvasive method for objective assessment of dysphagia by using laryngeal sensor and submental electromyography. DL is the volume at which second or more swallows become necessary to swallow the whole amount of bolus. This study represents 17 years experience with the DL approach in assessing ND in a cohort of 1278 adult subjects consisting of 292 healthy controls, 784 patients with dysphagia, and 202 patients without dysphagia. A total of 192 of all patients were also reevaluated longitudinally over a period of 1-19 months. Results: DL has 92% sensitivity, 91% specificity, 94% positive predictive value, and 88% negative predictive value with an accuracy of 0.92. Patients with ALS, stroke, and movement disorders have the highest sensitivity (85-97%) and positive predictive value (90-99%). The clinical severity of dysphagia has significant negative correlation with DL (r = -0.67, p < 0.0001). Conclusions: We propose the DL as a reliable, quick, noninvasive, quantitative test to detect and follow both clinical and subclinical dysphagia and it can be performed in an EMG laboratory. Significance: Our study provides specific quantitative features of DL test that can be readily utilized by the neurologic community and nominates DL as an objective and robust method to evaluate dysphagia in a wide range of neurologic conditions. (C) 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
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    Factors Affecting the Adherence to Disease-Modifying Therapy in Patients With Multiple Sclerosis
    (Lippincott Williams & Wilkins, 2018) Erbay, Oznur; Yesilbalkan, Oznur Usta; Yuceyar, Nur
    Background: Adherence to medication treatment in patients with multiple sclerosis (MS) is important to increase its effectiveness, reduce patient disability, prevent attacks, and increase the quality of life. Aim: This study investigated factors that influence adherence to disease-modifying therapy in patients with MS. Methods: This descriptive study was conducted with 198 patients with MS who met the inclusion criteria and agreed to participate between July 2016 and February 2017. Data were collected using an Individual Identification Form that included sociodemographic characteristics, the Multiple Sclerosis Treatment Adherence Questionnaire, the Fatigue Severity Scale, the Self-Efficacy Scale, and the Brief COPE. Results: We found that 59.6% of the patients were adherent to therapy. Patients were significantly more adherent to Avonex than other treatments, and memory problems was the most common reason for missing or forgetting medication in nonadherent patients. There was a significant difference between medication adherence and some sociodemographic characteristics and disease characteristics (P < .05). There was no significant difference between coping attitudes, fatigue, and self-efficacy level and medication adherence (P > .05). Conclusion: Patients' adherence to medication treatment was low and may be associated with social, physical, and cognitive measures.
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    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
    (Elsevier Sci Ltd, 2022) Ozden, Fatih; Ozkeskin, Mehmet; Ar, Ege; Yuceyar, Nur
    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.
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    Is customized vestibular rehabilitation effective in patients with multiple sclerosis? A randomized controlled trial
    (Edizioni Minerva Medica, 2016) Ozgen, Gulnur; Karapolat, Hale; Akkoc, Yesim; Yuceyar, Nur
    BACKGROUND: Balance disorders are among the most common problems encountered by patients diagnosed with multiple sclerosis (MS). AIM: The purpose of this randomized, controlled trial was to investigate the effects of customized vestibular rehabilitation (VR) on balance, functional capacity, quality of life, and depression in patients with MS. DESIGN: This study was designed as a prospective, randomized, controlled trial. SETTING: The study was carried out in a single tertiary referral center. POPULATION: Forty consecutive patients referred with a diagnosis of MS were randomized into two groups: an exercise group (N.=20) and a control group (N.=20). METHODS: The experimental group underwent customized VR and the wait-listed control group received the usual medical care. All of the patients were assessed with objective balance tests (Romberg Test, Tandem Romberg Test, Foam Romberg Test, Static Posturography, Six-Meter Walk Test, Five Times Sit-to-Stand Test, Berg Balance Scale, Timed Up and Go Test, Functional Gait Assessment, and Dynamic Gait Index), subjective balance parameters (Activities-Specific Balance Confidence Scale and Dizziness Handicap Inventory), and functional capacity (Six Minute Walking Test), quality of life (Multiple Sclerosis Quality of Life-54), and depression (Beck Depression Inventory) scales. RESULTS: At the end of the trial, the exercise group exhibited significant changes in most of the evaluated parameters compared to the control group [except the Tandem Romberg with eyes closed and the Foam Romberg, standing with eyes open (P<0.05). No significant differences were observed in any of the parameters in the control group (P>0.05). The intergroup comparisons of differences indicated significant recoveries in favor of the exercise group in all of the evaluated parameters (P<0.05). CONCLUSIONS: This study confirms the effects of customized VR programs on balance, quality of life, and functional capacity in patients with MS. CLINICAL REHABILITATION IMPACT: Customized VR is an effective method for treating balance disorders in patients with MS.
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    'Is RLS a harbinger and consequence of MS?: Striking results of the 'RELOMS-T' study'
    (Elsevier Sci Ltd, 2020) Sevim, Serhan; Demirkiran, Meltem; Terzi, Murat; Yuceyar, Nur; Tasdelen, Bahar; Idiman, Egemen; Kaya, Derya
    Background: Although studies report a high prevalence rate of restless legs syndrome (RLS) among patients with multiple sclerosis (PwMS) ranging from 13.3 to 65.1%, little is known about the causes of this relationship. Methods: To ascertain the prevalence, features and impact of RLS among PwMS a nation-wide, multicenter, prospective and a cross-sectional survey, designed to reflect all of the PwMS throughout Turkey, was conducted in 13 centers. Exploring the relationship of the two conditions could possibly contribute to the understanding of the causes of the high and wide-ranging prevalence rates and the pathophysiology of both diseases. Results: of the 1068 participants 173 (16,2%) found to have RLS [RLS(+)] and 895 (83,8%) did not [RLS(-)]. Among the RLS(+) 173, all but 8 patients (4,6%) were underdiagnosed in terms of RLS. More than half of the patients with RLS had 'severe' or 'very severe' RLS. the onset of RLS was before or synchronous with the onset of MS in about a half of our patients. Conclusion: We conclude that RLS should be meticulously investigated in PwMS and MS can be a direct cause of RLS at least in part of PwMS. Our data about the timing of the onset of MS and RLS, along with the high prevalence of RLS in PwMS suggest that the pathologic changes in the initial phases of MS can possibly trigger RLS symptoms.
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    Let's raise the awareness of MS specialists concerning the frequency and impact of RLS in MS and consequently the life quality of patients with MS: Striking results of the 'RELOMS-T' Study
    (Lippincott Williams & Wilkins, 2018) Sevim, Serhan; Demirkiran, Meltem; Terzi, Murat; Yuceyar, Nur; Tasdelen, Bahar; Idiman, Egemen; Kurtuncu, Murat; Boz, Cavit; Tuncel, Deniz; Karabudak, Rana; Siva, Aksel; Ozcan, Cemal; Neyal, Munife; Goksel, Basak Karakurum; Balal, Mehmet; Sen, Sedat; Ekmekci, Ozgul; Kara, Derya
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    The life balance inventory in patients with multiple sclerosis: Cross-cultural adaptation, reliability and validity of the Turkish version
    (Sage Publications Ltd, 2022) Ozden, Fatih; Ozkeskin, Mehmet; Yuceyar, Nur
    Introduction: The aim of the study was to present the psychometric properties of the Turkish version of the life balance inventory in individuals with multiple sclerosis. Methods: Life balance inventory was translated and adapted considering common suggestions. Participants were cross-sectionally evaluated twice with life balance inventory, with a 1-week interval. Expanded Disability Status Scale, Beck Depression Scale, and Short Form-12 were used to assess the convergent validity. Results: A total of 113 individuals with multiple sclerosis were enrolled in the study. Test-retest reliability of the total score and all subscores of the life balance inventory were excellent (intraclass correlation coefficient > 0.80). The internal consistency of the life distress inventory was excellent (alpha = 0.73-0.95). The correlation of Expanded Disability Status Scale with life balance inventory and its subscores was low in the scope of divergent validity, as expected (r < 0.35). The correlation between life balance inventory total score and Expanded Disability Status Index was -0.337 (p < 0.01). Life balance inventory scores were moderately correlated (p < 0.01), except life balance inventory health score. Life balance inventory scores were correlated with SF-12 physical-subscales and mental-subscales, in a low and moderate degree, respectively. The life balance inventory total score was highly correlated with the life balance inventory subscores (r = 0.69-0.96, p < 0.01). Conclusion: The Turkish life balance inventory is a reliable and valid inventory in patients with multiple sclerosis. Life balance inventory comprehensively evaluates the life balance parameters of multiple sclerosis patients.