Current Journal of Neurology

Original Article

Factors associated with the number of months of delaying in multiple sclerosis diagnosis: Comparison of count regression models

Abolfazl Hosseinnataj; Roya Nikbakht; Seyed Nouraddin Mousavinasab; Sharareh Eskandarieh; Mohammad Ali Sahraian; Seyed Mohammad Baghbanian

Volume 22, Issue 2 , April 2023, Pages 65-71

https://doi.org/10.18502/cjn.v22i2.13330

Abstract

Background: It may take a long time to diagnose multiple sclerosis (MS) since the emergence of primary symptoms. This study aimed to use count regression models to compare their fit and to identify factors affecting delay in the diagnosis of MS.Methods: Data were collected from the Nationwide MS Registry ... Read More

Original Article

Waterpipe and cigarette smoking and drug and alcohol consumption, and the risk of primary progressive multiple sclerosis: A population-based case-control study

Seyyed Hosein Mortazavi; Abdorreza Naser Moghadasi; Amir Almasi-Hashiani; Mohammad Ali Sahraian; Hooman Goudarzi; Sharareh Eskandarieh

Volume 22, Issue 2 , April 2023, Pages 72-81

https://doi.org/10.18502/cjn.v22i2.13331

Abstract

Background: Multiple sclerosis (MS) is a chronic central nervous system disease, and primary progressive multiple sclerosis (PPMS) is one the main types of MS, which has unknown environmental risk factors. The present study was conducted with the aim to identify the association of waterpipe and ... Read More

Original Article

Fear of re-infection, relapse, and anxiety during COVID-19 pandemic in patients with multiple sclerosis: A multi-center study

Abdorreza Naser Moghadasi; Saeed Vaheb; Sara Hamtaei-Ghashti; Aysa Shaygannejad; Mozhdeh Askari; Vahid Shaygannejad; Mohmmad Ali Sahraian; Mahsa Ghajarzadeh

Volume 22, Issue 2 , April 2023, Pages 82-86

https://doi.org/10.18502/cjn.v22i2.13332

Abstract

Background: Fear of relapse and re-infection during the coronavirus disease 2019 (COVID-19) pandemic can affect people with chronic relapsing diseases, such as multiple sclerosis (MS). We evaluated fear of re-infection, anxiety, and relapse during the COVID-19 pandemic in Iranian people with MS.Methods: ... Read More Background: Fear of relapse and re-infection during the coronavirus disease 2019 (COVID-19) pandemic can affect people with chronic relapsing diseases, such as multiple sclerosis (MS). We evaluated fear of re-infection, anxiety, and relapse during the COVID-19 pandemic in Iranian people with MS.Methods: This multicenter, cross-sectional study was performed in the MS clinic of Sina Hospital, Tehran, Iran, and Hakim Private Hospital, Isfahan, Iran, between January and April 2022. We asked the participants to fill out validated Persian versions of Fear of Relapse Scale (FoR), and Beck Anxiety Inventory (BAI) questionnaires and answer a binary question about their fear of getting reinfected with COVID-19. Results were reported as mean ± standard deviation (SD) for continuous variables or frequencies for categorical variables. For continuous variables which did not have a normal distribution, we reported the median and interquartile range (IQR). Spearman correlation coefficient between anxiety score and FoR score was calculated. An independent samples t-test was used to compare continuous variables.Results: Three hundred and sixty-eight patients participated in this study. The median scores of FoR and BAI were 49.7 and 34.3, respectively. Fifty-three had new relapses in their last infection. Thirty-six percent of the patients had a fear of getting COVID-19 again, and 43% had a fear of relapse during infection. Three hundred and twenty-three had two doses of COVID-19 vaccine; the most frequent type of vaccine was Sinopharm. There was a significant difference between the median FoR scores among patients with and without relapse during the last COVID-19. There was also a significant positive correlation between anxiety score and FoR (r = 0.49, P < 0.001).Conclusion: More than one-third of enrolled cases had fear of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) re-infection. Patients who experienced exacerbation of symptoms even in the form of relapse or pseudo relapse (possible clinical relapse) had a higher fear of infection.

Original Article

Association of dietary patterns with migraine: A matched case-control study

Fahimeh Martami; Mansoureh Togha; Mostafa Qorbani; Donya Shahamati; Zhaleh Salami; Sakineh Shab-Bidar

Volume 22, Issue 2 , April 2023, Pages 87-95

https://doi.org/10.18502/cjn.v22i2.13333

Abstract

Background: Little is known about the association between dietary patterns and odds of migraine. We aimed to investigate the association between posteriori dietary patterns and migraine odds and migraine-related outcomes using principal component analysis (PCA).Methods: A total of 500 participants enrolled ... Read More

Original Article

Iranian specialists’ approach to surgery in patients with multiple sclerosis

Fereshteh Ghadiri; Zahra Ebadi; Elnaz Asadollahzadeh; Mohammad Ali Sahraian; Amirreza Azimi; Samira Navardi; Hora Heidari; Zohreh Abna; Marzieh Aboutorabi; Iman Adibi; Seyed Mohammad Baghbanian; Sepideh Paybast; Maryam Poursadeghfard; Samaneh Hosseini; Sareh Shahmohammadi; Mehran Ghaffari; Hamidreza Ghalyanchi-Langroodi; Masoud Ghiasian; Hoda Kamali; Ebrahim Kouchaki; Farzad Mehrabi; Ehsan Mohammadianinejad; Mohammad Ali Nahayati; Abdorreza Naser Moghadasi

Volume 22, Issue 2 , April 2023, Pages 96-102

https://doi.org/10.18502/cjn.v22i2.13336

Abstract

Background: Data on perioperative risk stratification in patients with multiple sclerosis (MS) are limited. In this regard, the present study was conducted to investigate Iranian specialists’ approach to surgical counseling for patients with MS (PwMS).Methods: 21 MS specialists were asked about ... Read More

Original Article

Epidemiological parameters of multiple sclerosis in Chaharmahal and Bakhtiari Province, Iran

Mohammad Amin Omrani; Asghar Bayati; Mohammad Ali Sahraian; Sharareh Eskandarieh

Volume 22, Issue 2 , April 2023, Pages 103-109

https://doi.org/10.18502/cjn.v22i2.13337

Abstract

Background: Multiple sclerosis (MS) is a neurological disease with a high burden and disability. There are reports of various medications’ side effects on patients with MS. The aim of the study is to determine the characteristics and medicine usage distribution among patients with MS in Chaharmahal ... Read More

Review Article

Alternate dosing of fingolimod in relapsing-remitting multiple sclerosis: A systematic review

Fereshteh Ghadiri; Omid Mirmosayyeb; Mohammad Ali Sahraian; Abdorreza Naser Moghadasi; Mahsa Ghajarzadeh

Volume 22, Issue 2 , April 2023, Pages 110-114

https://doi.org/10.18502/cjn.v22i2.13339

Abstract

Background: Fingolimod is approved in relapsing-remitting multiple sclerosis (RRMS) with the recommended dose of 0.5 mg daily. To tackle possible adverse events, some clinicians may reduce the dose of fingolimod, mainly in the alternate-day form. We systematically reviewed the literature for efficacy ... Read More

Review Article

Adverse side effects of Glatiramer acetate and Interferon beta-1a in patients with multiple sclerosis: A systematic review of case reports

Mohsen Rastkar; Mahsa Ghajarzadeh; Mohammad Ali Sahraian

Volume 22, Issue 2 , April 2023, Pages 115-136

https://doi.org/10.18502/cjn.v22i2.13340

Abstract

Background: Glatiramer acetate (GA) and Interferon (IFN) beta-1a are used as first-line disease-modifying treatments for multiple sclerosis (MS). In this systematic review, we summarized case reports and case series of adverse side effects of GA and IFN beta-1a in MS patients.Methods: Without any restrictions, ... Read More

Clinical Notes

Progressive multifocal leukoencephalopathy in a patient with systemic lupus erythematosus, not receiving any immunosuppressant medication

Bardiya Ghaderi; Alaleh vaghefifar; Farideh Darabi; Hajir Sikaroodi

Volume 22, Issue 2 , April 2023, Pages 137-139

https://doi.org/10.18502/cjn.v22i2.13341

Abstract

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Letter to the Editor

Eculizumab in the treatment of neuromyelitis optica spectrum disorder

Fardin Nabizadeh; Abdorreza Naser Moghadasi

Volume 22, Issue 2 , April 2023, Pages 140-143

https://doi.org/10.18502/cjn.v22i2.13342

Abstract

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Guillain-Barre syndrome in patients with coronavirus disease-2019: Report of six cases and review of literature

Ali Asghar Okhovat; Behnaz Ansari; Helia Hemasian; Bahram Haghi-Ashtiani; Soroor Advani; Bentolhoda Ziaadini; Siamak Abdi; Hajir Sikaroudi; Shahriar Nafissi; Farzad Fatehi

Volume 19, Issue 3 , July 2020, , Pages 122-130

https://doi.org/10.18502/cjn.v19i3.5425

Abstract

Background: Few studies have reported the association of Guillain-Barre syndrome (GBS) and coronavirus disease-2019 (COVID-19) infection. In this study, we reported GBS in six patients infected with COVID-19 and reviewed all existing literature about GBS in association with COVID-19. Methods: This study ... Read More

Assessment of computed tomography perfusion RAPID estimated core volume accuracy in patients following thrombectomy

Riwaj Bhagat; Allison Muha; Kerri Remmel; Wei Liu

Volume 21, Issue 1 , January 2022, , Pages 17-22

https://doi.org/10.18502/cjn.v21i1.9356

Abstract

Background: Computed Tomography Perfusion (CTP) maps ischemic core volume (CV) and penumbra following a stroke; however, its accuracy in early symptom onset is not well studied. We compared the accuracy of CTP RAPID estimated CV with diffusion weighted imaging (DWI) infarct volume (IV) in patients following ... Read More

B vitamins and their combination could reduce migraine headaches: A randomized double-blind controlled trial

Shiva Nematgorgani; Soodeh Razeghi-Jahromi; Elham Jafari; Mansoureh Togha; Pegah Rafiee; Zeinab Ghorbani; Zeynab Sadat Ahmadi; Vali Baigi

Volume 21, Issue 2 , April 2022, , Pages 105-118

https://doi.org/10.18502/cjn.v21i2.10494

Abstract

Background: The B vitamins can potentially help prevent migraine. This study was designed to examine the effects of supplementation with thiamine (B1), pyridoxine (B6), cobalamin (B12), folic acid (B9), and a combination of these vitamins on women with episodic migraine (EM).Methods: This study was a ... Read More

Effect of energy conservation strategies on fatigue, function, and quality of life in adults with motor neuron disease: Randomized controlled trial

Hamid Reza Fateh; Reihaneh Askary-Kachoosangy; Niloofar Shirzad; Alireza Akbarzadeh-Baghban; Farzad Fatehi

Volume 21, Issue 2 , April 2022, , Pages 83-90

https://doi.org/10.18502/cjn.v21i2.10491

Abstract

Background: Fatigue is one of the most frequent complaints in patients with motor neuron diseases (MNDs), with a significant impact on the quality of life (QOL). Current pharmacological or non-pharmacological treatments of fatigue in this population lack enough evidence to be applied in the clinical ... Read More

A randomized controlled trial investigating the effects of a mediterranean-like diet in patients with multiple sclerosis-associated cognitive impairments and fatigue

Soodeh Razeghi-Jahromi; Rozita Doosti; Zeinab Ghorbani; Roghayyeh Saeedi; Maryam Abolhasani; Naeemeh Akbari; Fatemeh Cheraghi-Serkani; Abdorreza Naser Moghadasi; Amirreza Azimi; Mansoureh Togha; Mohammad Ali Sahraian

Volume 19, Issue 3 , July 2020, , Pages 112-121

https://doi.org/10.18502/cjn.v19i3.5424

Abstract

Background: Among multiple sclerosis (MS) related symptoms and complications, fatigue might impact roughly 90% of patients. Decline in cognitive function is one of the other complications that occur in the first years after disease onset. The Mediterranean diet is one of the well-known anti-inflammatory ... Read More Background: Among multiple sclerosis (MS) related symptoms and complications, fatigue might impact roughly 90% of patients. Decline in cognitive function is one of the other complications that occur in the first years after disease onset. The Mediterranean diet is one of the well-known anti-inflammatory dietary approaches. Therefore, this study aimed to explore the effects of a modified Mediterranean-like diet on cognitive changes and fatigue levels in comparison with a conventional standard diet over a 1-year follow-up. Methods: In the current single-blind randomized controlled trial, 34 MS patients in the Mediterranean- like diet group and 38 patients in the standard healthy diet group were studied for 1 year. The dietary interventions were modified each month by an expert nutritionist. MS-associated fatigue level was evaluated using the Modified Fatigue Impact Scale (MFIS). Cognitive assessment was also performed using Minimal Assessment of Cognitive Function in MS (MACFIMS). Results: Intergroup ‎comparisons demonstrated that after considering confounding variables in ANCOVA, fatigue scores appeared significantly lower in patients who were treated with the Mediterranean-like diet than those in the standard healthy diet group [Mean 95% confidence interval (CI)}: 33.93 (32.97-34.89) and 37.98 (36.99-38.97), respectively; P < 0.001]. However, the intergroup ‎analysis of cognitive status only showed a difference in the mean score of Brief Visuospatial Memory Test-Revised (BVMT-R) subtest of the MACFIMS. The BVMT-R‎ was higher among standard healthy diet patients compared to the Mediterranean-like diet group after the intervention following adjustment for covariates [Mean (95% CI): 23.73 (21.88-25.57) and 20.56 (18.60-22.51), respectively; P = 0.020]. Conclusion: In conclusion, the results of this study highlighted the higher protective effects of the Mediterranean-like diet against MS-related fatigue than the standard healthy diet. However, no significant improvement was observed in the cognitive status of MS patients after a 1-year treatment with the Mediterranean-like diet. More randomized clinical trials with larger sample sizes are needed to elucidate the effects of dietary modifications on MS-associated symptoms and complications.

Original Article

Prognosis and outcome in patients with chronic inflammatory demyelinating polyradiculoneuropathy in a tertiary center in Oman

Mai Elrayes; Abdullah AlSalti

Articles in Press, Accepted Manuscript, Available Online from 20 June 2023

Abstract

Background: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an immune-mediated condition with variable clinical characteristics and different treatment modalities. We aim to present different clinical and demographic features of all patients with CIDP presented to the neuromuscular ... Read More

Original Article

The effect of atomoxetine on cognitive function in patients with multiple sclerosis

Ehsan Mohammadian Nejad; Effat Amouzadeh; Davood Kashipazha; Gholamreza Shamsaei; Bahman Cheraghian

Articles in Press, Accepted Manuscript, Available Online from 27 June 2023

Abstract

Background: Recent research shows that most of the patients with multiple sclerosis (MS) have cognitive-like disorders. Due to the beneficial effects of atomoxetine on improving cognition in limited animal and human surveys, the aim of the present study was to investigate the effect of the atomoxetine ... Read More

Original Article

The role of transcranial direct current stimulation in diminishing the risk of pneumonia in patients with dysphagia: A double-blinded randomized clinical trial

Sima Farpour; Majid Asadi-Shekaari; Afshin Borhani-Haghighi; Hamid Reza Farpour; Mahtab Rostamihosseinkhani

Articles in Press, Accepted Manuscript, Available Online from 28 August 2023

Abstract

Background: Dysphagia can be a life-threatening issue for post-stroke patients, with aspiration pneumonia (AP) being a common risk. However, there is hope through the potential combination of transcranial direct current stimulation (tDCS) and classical behavior therapy. Our study aims to investigate ... Read More

Original Article

Abnormalities of brain imaging in COVID-19 patients with neurological symptoms

Soroor Advani; Seyyed Mohammad Mahdi Hosseini; Rama Bozorgmehr; Arash Khameneh-Bagheri; Sevda Mohammadzadeh; Taha Hasanzadeh; Laya Jalilian; Mohammad Vahidi; Amir Hasan Nofeli; Zahra Hooshyari

Articles in Press, Accepted Manuscript, Available Online from 17 July 2023

Abstract

Background: Coronavirus disease 2019 (COVID-19) is a multisystem disease, manifested by several symptoms of various degrees. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) can affect the central nervous system (CNS) through several mechanisms and brain imaging plays an essential role in ... Read More

Original Article

Watershed infarction in COVID-19: The necessity of neuroimaging in patients with subtle neurological symptoms

Mohammad Amin Najafi; Alireza Zandifar; Mohsen Kheradmand; Luis Octavio Tierradentro-Garcia; Fariborz Khorvash; Arastoo Vossough; Mohammad Saadatnia

Articles in Press, Accepted Manuscript, Available Online from 20 July 2023

Abstract

Background: Cerebrovascular diseases comprise a significant portion of neurological disorders related to coronavirus disease 2019 (COVID-19). We evaluated the clinical and imaging characteristics of a cohort of COVID-19 patients with stroke and also identified patients with watershed infarcts.Methods: ... Read More Background: Cerebrovascular diseases comprise a significant portion of neurological disorders related to coronavirus disease 2019 (COVID-19). We evaluated the clinical and imaging characteristics of a cohort of COVID-19 patients with stroke and also identified patients with watershed infarcts.Methods: In this cross-sectional study, seventy-three COVID-19 patients with ischemic stroke were included between October 2020 and January 2021. Patients were evaluated based on the following clinical and imaging features: severity of COVID-19 (critical/non-critical), stroke type, presence/absence of clinical suspicion of stroke, medical risk factors, Fazekas scale, atherothrombosis, small vessel disease, cardiac pathology, other causes, and dissection (ASCOD) criteria classification, and presence or absence of watershed infarction. Clinical outcomes were assessed based on Modified Rankin Scale (MRS) and mortality.Results: Most cases of ischemic stroke were due to undetermined etiology (52.1%) and cardioembolism (32.9%). In terms of imaging pattern, 17 (23.0%) patients had watershed infarction. Watershed infarction was associated with the clinically non-suspicious category [odds ratio (OR) = 4.67, P = 0.007] and death after discharge (OR = 7.1, P = 0.003). Patients with watershed infarction had a higher odds of having high Fazekas score (OR = 5.17, P = 0.007) which was also shown by the logistic regression model (adjusted OR = 6.87, P = 0.030). Thirty-one (42%) patients were clinically non-suspected for ischemic stroke. Critical COVID-19 was more common among patients with watershed infarct and clinically non-suspicious patients (P = 0.020 and P = 0.005, respectively). Patients with chronic kidney disease (CKD) were more prone to having stroke with watershed pattern (P = 0.020).Conclusion: Watershed infarct is one of the most common patterns of ischemic stroke in patients with COVID-19, for which clinicians should maintain a high index of suspicion in patients with critical COVID-19 without obvious clinical symptoms of stroke.

Original Article

An assessment of Martin-Gruber anastomosis discrepancies between healthy individuals and patients with carpal tunnel syndrome in motor nerve conduction studies

Ayfer Ertekin

Articles in Press, Accepted Manuscript, Available Online from 24 August 2023

Abstract

Background: The Martin-Gruber anastomosis (MGA) represents a nerve innervation anomaly in the upper extremity, potentially leading to misinterpretation during standard nerve conduction studies (NCSs). This study aims to characterize the electrophysiological attributes of MGA in both healthy subjects ... Read More Background: The Martin-Gruber anastomosis (MGA) represents a nerve innervation anomaly in the upper extremity, potentially leading to misinterpretation during standard nerve conduction studies (NCSs). This study aims to characterize the electrophysiological attributes of MGA in both healthy subjects and individuals diagnosed with carpal tunnel syndrome (CTS).Methods: This case-control study involved the electrophysiological assessment of 506 forearms, segregated into two distinct groups: a CTS positive (+) case group and a CTS negative (-) control group. The evaluations were conducted over an average period of 8 months in the neurophysiology laboratory. The study encompassed 294 forearms from 147 healthy individuals without CTS and 212 forearms from 106 patients diagnosed with CTS, both clinically and electrodiagnostically.Results: The relationship between the presence of type I MGA and the CTS (+) group was statistically significant (P = 0.002). Similarly, the relationship between the presence of type II MGA and the CTS (+) group was statistically significant (P = 0.013). On the other hand, the relationship between the presence of type III MGA and the CTS (+) group was not statistically significant (P = 0.208). Likewise, the relationship between the presence of type IV MGA and the CTS (+) group was not statistically significant (P = 0.807). The correlation between the side of type I MGA and the groups did not reach statistical significance (P = 0.770). The relationship between the side of type II MGA and the groups also did not attain statistical significance (P = 0.990). Similarly, the side of type III MGA and its association with the groups did not yield statistical significance (P = 0.402). Finally, the relationship between the side of type IV MGA and the groups was not statistically significant (P = 0.166).Conclusion: The MGA represents a relatively frequent anatomical variation observed in the upper extremity. Notably, its presence demonstrated significance in the first dorsal interosseous (FDI) muscle (type II) and the abductor digiti minimi (ADM) muscle (type I) among patients with CTS. The present study emphasizes the importance of recognizing this variation during upper extremity NCSs for a correct diagnostic approach and treatment plan to avoid misdiagnosis of median-ulnar peripheral neuropathy.

Review Article

The effect of induced hypertension in aneurysmal subarachnoid hemorrhage: A narrative review

Amirhossein Azari Jafari; Seyyedmohammadsadeq Mirmoeeni; William Chase Johnson; Muffaqam Shah; Maryam Sadat Hassani; Shahrzad Nazari; Tristan Fielder; Ali Seifi

Articles in Press, Accepted Manuscript, Available Online from 05 August 2023

Abstract

Aneurysmal subarachnoid hemorrhage ‎(aSAH) ‎accounts for 2–5% of all strokes, and 10%‐15% of ‎aSAH patients will not survive until hospital admission. Induced hypertension (IH) is an emerging therapeutic option being used for the treatment of vasospasm in ‎aSAH. For patients with ... Read More

Clinical Notes

Horner syndrome: A new hypothesis for signaling pathway of enophthalmos sign

Auob Rustamzadeh; Daryoush Afshari; Hamid Reza Alizadeh-Otaghvar; Reza Ahadi; Amir Raoofi; Ronak Shabani; Armin Ariaei; Fatemeh Moradi

Articles in Press, Accepted Manuscript, Available Online from 13 June 2023

Abstract

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Clinical Notes

Characteristic brain computed tomography of infective endocarditis after thrombolysis for ischemic stroke: A clinical note

Bardiya Ghaderi-Yazdi; Hajir Sikaroodi

Articles in Press, Accepted Manuscript, Available Online from 21 June 2023

Abstract

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Neuroimage/Video

Stealthily growing large sinonasal lymphoma with intracranial extension

Shyma Markose; Shriram Varadharajan; Haritha Vasudevan; Virna M. Shah

Articles in Press, Accepted Manuscript, Available Online from 22 July 2023

Abstract

Original Article

Evaluation of obsessive-compulsive disorder prevalence in Iranian patients with multiple sclerosis and its relationship with demographic characteristics

Ali Keyhani; Mohammad Javad Shabani; Farnaz Etesam; Nasim Rezaeimanesh; Amirreza Azimi; Abdorreza Naser Moghadasi

Articles in Press, Accepted Manuscript, Available Online from 04 July 2023

Abstract

Background: The present study examined the prevalence of obsessive-compulsive disorder (OCD) among Iranian patients with multiple sclerosis (MS) and the relationship between OCD and the patient’s demographic characteristics.Methods: The present study used a cluster sampling method to randomly select ... Read More Background: The present study examined the prevalence of obsessive-compulsive disorder (OCD) among Iranian patients with multiple sclerosis (MS) and the relationship between OCD and the patient’s demographic characteristics.Methods: The present study used a cluster sampling method to randomly select 297 patients with MS from the patients referred to the MS Clinic and Research Center of Sina University Hospital, Tehran, Iran, during 2018-2019. To gather the required data, a questionnaire consisting of demographic characteristics and disease information sections was used. Moreover, Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Obsessive-Compulsive Inventory-Revised (OCI-R), and Hospital Anxiety and Depression Scale (HADS) were employed in the present study. The comparison of qualitative and quantitative values between OCD-positive and negative groups was examined with chi-square test and independent samples t-test, respectively. Binary logistic regression was used as multivariate modeling to adjust the effects of potential confounders that could distort the relation of OCD with intended variables. Data were analyzed using SPSS software. The significance level was considered lower than 0.05.Results: Of the total of 297 patients, 77.8% were women. Moreover, analysis of the data obtained from the HADS questionnaire revealed that 11.44% (n = 34) and 15.15% (n = 45) of patients had severe depression and severe anxiety, respectively. The results of Y-BOCS indicated that the prevalence of severe OCD among patients was 19.9%. The OCI-R questionnaire revealed that the prevalence of OCD was 47.8%, which was consistent with the total of moderate, severe, and extreme values of Y-BOCS (47.9%). Furthermore, the subscales of ordering-arranging with 69 patients (22.9%) and obsessing with 46 patients (15.5%) indicated the highest frequencies as compared to other subscales. Moreover, OCD had a significant relationship with depression, anxiety, and type of MS in this regard.Conclusion: In this study, the prevalence rate of OCD among patients with MS was higher than its rate among the general population.