Hossein Maroufi; Seyyed Hosein Mortazavi; Mohammad Ali Sahraian; Sharareh Eskandarieh
Articles in Press, Accepted Manuscript, Available Online from 21 August 2021
Abstract
Background: The environmental factors play a role as risk factors of multiple sclerosis (MS). This study aimed at gathering environmental risk factors of MS in the Middle East and North Africa (MENA). Methods: We used MEDLINE and EMBASE databases by a systematic review method. Out of a total of 123 studies, ...
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Background: The environmental factors play a role as risk factors of multiple sclerosis (MS). This study aimed at gathering environmental risk factors of MS in the Middle East and North Africa (MENA). Methods: We used MEDLINE and EMBASE databases by a systematic review method. Out of a total of 123 studies, 16 studies met the eligibility criteria. Results: Totally, 47 risk factors were assessed as follows: six studies found sunlight exposure as a protective factor with the odds ratio (OR) ranging from 0.06 to 0.57. Six studies evaluated smoking as a risk factor with the OR ranging from 1.69 in all patients to 6.48 in female patients. Four studies supported measles infection as a risk factor with the OR ranging from 1.60 to 3.77, and in 3 studies, stressful events had a significant association with the OR of 1.80, 1.90, and 32.57. Conclusion: Among 47 assessed risk factors, sunlight exposure, cigarette smoking, measles infection, Epstein-Barr virus (EBV) infection, and stressful events had a significant association with MS.
Nayyereh Ayati; Saeed Taheri; Mohammad Ali Sahraian; Shekoufeh Nikfar
Articles in Press, Accepted Manuscript, Available Online from 24 July 2021
Abstract
Background: The current study desired to conduct an economic analysis on ocrelizumab (OCR), a new relapsing multiple sclerosis (RMS) treatment strategy, in comparison to natalizumab (NTL), as one of the mostly-used disease-modifying therapies (DMTs) in Iran. Methods: A 31-health-state Markov model, based ...
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Background: The current study desired to conduct an economic analysis on ocrelizumab (OCR), a new relapsing multiple sclerosis (RMS) treatment strategy, in comparison to natalizumab (NTL), as one of the mostly-used disease-modifying therapies (DMTs) in Iran. Methods: A 31-health-state Markov model, based on Expanded Disability Status Scale (EDSS), containing patients on- and off-treatment with annual cycles was developed. Baseline demographics and utility scores were extracted from OPERA 1 and 2 trials. Confirmed disability progression (CDP) and annualized relapse rates (ARR) were extracted from the literature. Mortality was calculated based on age, sex, and disease state. Quality-adjusted life years (QALYs) and life years gained (LYG) were measurements of efficacy. Direct and indirect costs were identified and calculated based on the national book of tariffs in Iranian Rial (IRR) rates, then converted to the 2020 United States Dollar (USD). Final results were reported in terms of incremental cost-effectiveness ratio (ICER), which showed extra costs required for one additional QALY. Robustness of the model was analyzed through deterministic sensitivity analysis (DSA) and probabilistic sensitivity analysis (PSA). Results: OCR dominated NTL and was associated with cost-savings of 6971 USD, longer LYG (0.004), and higher QALYs (0.27). Although OCR had higher acquisition costs, which was the main component in both comparator arms, it was associated with lower total costs, due to lower disability progression and productivity loss. Results remained robust in DSA and PSA (93.5% cost-effectiveness in Iran’s pharmacoeconomic threshold, 2709 USD). Conclusion: Results suggested that OCR was a more cost-effective option than NTL for the treatment of patients with RMS in Iran.
Fereshteh Ghadiri; Mohammad Ali Sahraian; Abdorreza Naser Moghadasi
Articles in Press, Accepted Manuscript, Available Online from 03 August 2021
Aikaterin Papa; Ioannis Koutelekos; Spyridoula Stefanidou; Chrysa Chrysovitsanou; Maria Polikandrioti
Abstract
Background: Multiple sclerosis (MS) is an inflammatory chronic disease of the central nervous system (CNS) which is related with unpredictable course and increasing disability. Social support as an available interpersonal resource may help patients with MS. The purposeof the present studywas to evaluate ...
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Background: Multiple sclerosis (MS) is an inflammatory chronic disease of the central nervous system (CNS) which is related with unpredictable course and increasing disability. Social support as an available interpersonal resource may help patients with MS. The purposeof the present studywas to evaluate perceived social support in patients with MS as well as the associated factors. Methods: The sample of this cross-sectional study included 200 patients with MS. Data collection was performed by the completion of the Multidimensional Scale of Perceived Social Support (MSPSS) and a questionnaire which included patients' characteristics. Results: Patients reported to perceive high support from significant others and their family (median: 24.0 and 23.5, respectively) and less from their friends (median: 20). Moreover, a statistically significant association was found between social support from significant others and marital status (P = 0.010), modification of daily activities (P = 0.018), difficulties with social and family environment (P ≤ 0.001 and P ≤ 0.001, respectively), frequent urination (P = 0.015), and whether they easily forgot (P = 0.049), characterized themselves as anxious (P = 0.049), and believed in God (P = 0.002). Also, a statistically significant association was fond between social support from family and relation with health professionals (P = 0.041), difficulties with social and family environment (P = 0.003 and P ≤ 0.001, respectively), and whether they considered themselves as anxious (P = 0.050), and they believed in God (P ≤ 0.001). Furthermore, a statistically significant association was found between support from friends and modification of daily activities (P = 0.010), help in daily activities (P = 0.016), need for movement assistance (P = 0.001), difficulties with social and family environment (P ≤ 0.001 and P = 0.005, respectively), and whether they considered themselves anxious (P = 0.046). Conclusion: Factors associated with perceived social support should be evaluated when planning holistic care to patients with MS.
Elham Manouchehri; Morteza Saeedi; Khadijeh Mirzaei-Najmabadi
Abstract
Background: In chronic illnesses, sexual dysfunction (SD) is one of the most prevalent complaints. Sexual self-efficacy (SSE) is an individual’s beliefs about his/her ability to perform an effective sexual function and be favorable to their partner. The aim of the present study was to assess SSE ...
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Background: In chronic illnesses, sexual dysfunction (SD) is one of the most prevalent complaints. Sexual self-efficacy (SSE) is an individual’s beliefs about his/her ability to perform an effective sexual function and be favorable to their partner. The aim of the present study was to assess SSE and sexual function in women with multiple sclerosis (MS). Methods: This cross-sectional study was carried out in 2019 on 260 married women referring to the MS clinic and MS society of Khorasan-Razavi in Mashhad, Iran. The research population was selected using convenience sampling. The Sexual Self-Efficacy Questionnaire (SSEQ), Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19), and the Female Sexual Function Index (FSFI) were completed by the participants who had the inclusion criteria. The collected data were analyzed using descriptive statistics and Spearman's rank correlation coefficient in SPSS software. Results: The participants had a mean age of 35.2 ± 8.4 years and their mean duration of MS was 4.46 ± 3.71 years. The findings showed a negative correlation between SSE and SD (r = -0.606; P = 0.001) and a positive correlation between SSE and sexual function (r = 0.644; P = 0.001). Moreover, MSISQ-19 and FSFI scores supported each other (r = -0.675; P = 0.001). Conclusion: SD is prevalent among women with MS. Moreover, sexual function is substantially associated with SSE in these women.
Mohammad Ali Sahraian; Abdorreza Naser Moghadasi; Sharareh Eskandarieh
Abstract
Background: After intensified economic sanctions against Iran, decreased welfare of patients were more recognizable. The present study was aimed at identifying the challenges and stress level experienced by patients with multiple sclerosis (MS) regarding treatment and health care services in 2018-2019 ...
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Background: After intensified economic sanctions against Iran, decreased welfare of patients were more recognizable. The present study was aimed at identifying the challenges and stress level experienced by patients with multiple sclerosis (MS) regarding treatment and health care services in 2018-2019 after strengthening of economic sanctions against Iran. Methods: A cross-sectional study was conducted on MS patients in Tehran, Iran. A structured questionnaire was designed to measure the main variables addressing the challenges and stress level of MS patients with respect to receiving care and treatment services. Results: In total, 1039 MS patients were enrolled into the study. Among the patients who answered yes to the selected questions, 873 (85.8%) and 837 (86%) were concerned about medicine unavailability and supply and purchase of internationally branded medicine, respectively. Moreover, 671 (70.3%) subjects were concerned about replacing their medicines with cheaper alternatives due to financial problems and 427 (41.4%) were unwilling to continue their treatment due to the economic burden of MS. In total, 795 (82%) were concerned about the effectiveness of Iranian drugs in comparison with internationally branded drugs. Generally, 970 (93.53%) subjects had experienced increased current living costs and 711 had experienced (68.82%) reduced nutrition quality, which (OR: 2.68; 95% CI: 1.99, 3.60) was significantly higher among subjects who had an income of less than or equal to 250 US$ per month Conclusion: The sanctions can impose greater stress and hardship on patients due to the unavailability and costs of medicines. Iran should manage health care quality and provide services to prevent the adverse effects of sanctions on MS patients and guarantee patients’ right to receive well-established medication and health services.
Masoud Etemadifar; Ahmad Chitsaz; Sahebeh Rajabkhah; Hossein Tavakoli; Arezoo Shafieyoun; Pegah Noorshargh; Mahdieh Afzali
Abstract
Background: The aim of this study was to evaluate the status of anti-myelin oligodendrocyte glycoprotein (MOG) antibodies in patients with transverse myelitis (TM) and compare the clinical and imaging characteristics of MOG immunoglobulin G (IgG)-positive with negative cases. Methods: This cohort study ...
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Background: The aim of this study was to evaluate the status of anti-myelin oligodendrocyte glycoprotein (MOG) antibodies in patients with transverse myelitis (TM) and compare the clinical and imaging characteristics of MOG immunoglobulin G (IgG)-positive with negative cases. Methods: This cohort study enrolled 71 patients diagnosed with new-onset of TM who were being followed at a referral university clinic in Isfahan, Iran, from November 2016 to January 2019. Magnetic resonance imaging (MRI) images and blood samples for anti-MOG, anti-aquaporin 4 (anti-AQP4) (using the cell-based technique), and vasculitis-related antibodies were collected from patients. Outcomes were assessed by the evolution of the Expanded Disability Status Scale (EDSS) score and brain and spinal cord imaging findings within three months. All patients underwent imaging and clinical assessment during a mean period of one year as a follow-up. We compared the characteristics of clinical and radiological outcomes in MOG-IgG-positive and negative cases. Results: Of the total population studied, there were 26.8% men and 73.2% women, with a mean age of 33 ± 10 years. 12 (16.9%) patients were seropositive for MOG antibody and 17 (89.5%) were positive for anti-AQP4 antibodies. There was no significant association between anti-MOG antibody seropositivity and age, gender distribution, the presence of other autoimmune diseases, and number and interval of relapses. However, the involvement site of the spine at first imaging was significantly different between seronegative and seropositive patients. Conclusion: In patients with MOG antibody disease (MOG-AD) TM, the MRI findings suggest a preferential involvement of the cervical-thoracic section in seropositive cases which may help differentiate from non-MOG demyelination TM.
Fatemeh Sadat Asgarian; Ali Keyhani; Abdorreza Naser Moghadasi; Moahammad Ali Sahraian; Farnaz Etesam
Abstract
Background: Considering the high probability of suicidal behaviors in multiple sclerosis (MS) population of other countries and the unlikeliness of its diagnosis in patients with MS by specialists, the current research targets the frequency of suicidal thoughts and mood symptoms in a group of patients ...
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Background: Considering the high probability of suicidal behaviors in multiple sclerosis (MS) population of other countries and the unlikeliness of its diagnosis in patients with MS by specialists, the current research targets the frequency of suicidal thoughts and mood symptoms in a group of patients with MS in Iran. Also, we investigated the relationships among suicidal thoughts, anxiety, depression, anticipated stigma, social support, some disease characteristics, and sociodemographic factors. Methods: A sample of 276 subjects were selected from community-based MS clinics and referral out-patient MS clinic of Sina Hospital affiliated to Tehran University of Medical Sciences, Tehran, Iran. Participants completed the Patient Health Questionnaire (PHQ), the Hospital Anxiety and Depression Scale (HADS), the Chronic Illness Anticipated Stigma Scale (CIASS), the Multidimensional Scale of Perceived Social Support (MSPSS), and a personal information questionnaire. Results: 36.2% of the participants had suicidal thoughts. Suicidal ideation was significantly more likely among people who reported higher anxiety and depression scores or anticipated stigma from their friends and families. Women and patients with higher education experienced suicidal ideation more frequently than others. Conclusion: The importance of comorbidities of suicidal thoughts with anticipated stigma, depression, and anxiety in patients with MS, emphasizing the need for paying attention to it, and considering effective therapeutic interventions focused on alleviating perceived stigma as well as mood symptoms.
Sama Bitarafan; Elmira Karimi; Abdorreza Naser Moghadasi; Razieh Sadat Kazemi-Mozdabadi; Zinat Mohammadpour; Mohammad Ali Sahraian
Abstract
Background: Multiple sclerosis (MS) is an inflammatory disease of the central nervous system (CNS) with the most common complaint of fatigue. A high number of patients with MS are interested in taking dietary supplements as a complementary therapy. We propose a specially formulated supplement for patients ...
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Background: Multiple sclerosis (MS) is an inflammatory disease of the central nervous system (CNS) with the most common complaint of fatigue. A high number of patients with MS are interested in taking dietary supplements as a complementary therapy. We propose a specially formulated supplement for patients with MS and aim to evaluate its effects on fatigue. Methods: This study was a triple-blind, randomized, placebo-controlled trial using a stratified randomization method according to sex. 46 eligible patients participated in the study, 23 in the placebo group and 23 in the intervention group. The intervention group received two capsules of multivitamin-mineral (MVM) daily for 3 months. Measurements of fatigue and cytokines were performed in all patients at the baseline and after the 3-month intervention Results: Finally, information of 41 participants was used for data analysis. However, fatigue was decreased after supplementation than before, in the intervention group (P = 0.005). There was no significant difference (P = 0.090) between the change of fatigue score in the MVM group (-3.00 ± 4.42) and the control group (-0.40 ± 5.14). Among cytokines, Interleukin 4 (IL-4) significantly increased in the intervention group compared to the placebo (P = 0.030). Conclusion: Our study showed that the present MVM probably could improve the inflammatory state and fatigue in patients with MS.
Nastaran Majdinasab; Mitra Sadrian; Davood Kashipazha; Maryam Moradi
Abstract
Background: The study aimed to judge the safety and possible side effects of rituximab (RTX) drug in patients with multiple sclerosis (MS). Methods: This retrospective observational study was performed on 91 patients with MS who had been treated with RTX between 2016 and 2019. Each patient was visited ...
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Background: The study aimed to judge the safety and possible side effects of rituximab (RTX) drug in patients with multiple sclerosis (MS). Methods: This retrospective observational study was performed on 91 patients with MS who had been treated with RTX between 2016 and 2019. Each patient was visited and examined a minimum of once. The side effects of the drug and therefore the drug-related reactions to the injection were asked via phone calls, which were recorded separately as mild, moderate, and severe modes with the necessity for hospitalization. Results: A total of 91 patients were enrolled within the study: 80 patients with relapsing-remitting MS (RRMS), 6 patients with secondary progressive MS (SPMS), and 5 patients with primary progressive MS (PPMS). The mean age of the patients was 32.18 ± 8.71 years (18 to 60 years). The injection-related side effects occurred in 30.8% of the injections, most of which were mild and one of the mild complications was urinary tract infection (UTI). Two cases of complications with moderate severity were recorded. Conclusion: The observations from this study demonstrated that RTX did not cause serious complications in patients with MS.
Rahil Sadat Shahtaheri; Shekoufeh Nikfar; Elahe Khorasani; Mansoureh Sabbagh-Baniazad; Zahra Goudarzi; Maziar Emamikhah
Abstract
Background: Although widely used, first-line injectable medicines for the treatment of multiple sclerosis (MS) remain an issue of efficacy and adherence. Recently, new oral medications for MS have contributed to dramatic improvements in MS treatment. This study aims to evaluate the safety and efficacy ...
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Background: Although widely used, first-line injectable medicines for the treatment of multiple sclerosis (MS) remain an issue of efficacy and adherence. Recently, new oral medications for MS have contributed to dramatic improvements in MS treatment. This study aims to evaluate the safety and efficacy of oral disease-modifying drugs (DMDs) used in relapsing-remitting MS (RRMS). Methods: A systematic review was conducted on related databases including PubMed, Scopus, Cochrane, and Web of Science up to April 2020. The screening of the studies and their quality assessment was carried out independently by the two authors. Results: Three studies fulfilled the predefined criteria of inclusion. One of them compared teriflonomide with subcutaneous interferon beta-1a (IFN β-1a), another compared oral fingolimod with intramuscular (IM) IFN β-1b, and the third article compared oral fingolimod with IM IFN β-1a. No eligible study was found for dimethyl fumarate (DMF). The results indicated that while the efficacy of fingolimod was more than IFN β (IM β-1a and β-1b), teriflunomide 7 mg had less efficacy than subcutaneous IFN β-1a. Regarding safety, the results indicated that the proportion of diabetic patients with adverse events (AEs) in the fingolimod group was higher than in the IFN β-1b group and the overall occurrence of AEs was similar between teriflunomide and IFN β-1a groups. Conclusion: There is evidence for the effectiveness of fingolimod in reducing annualized relapse rates (ARRs) and improving magnetic resonance imaging (MRI) findings, but the evidence does not support the effectiveness of teriflunomide and further studies are required to determine its efficacy. Also, fingolimod is associated with more side effects than IFN β-1b, but there is no evidence to suggest any difference in side effects between teriflunomide and IFN β-1a.
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
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 ...
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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.
Nazanin Ershadinia; Nader Mortazavinia; Sepideh Babaniamansour; Mahdi Najafi-Nesheli; Parto Babaniamansour; Ehsan Aliniagerdroudbari
Abstract
Background: Multiple sclerosis (MS) is one of the most common autoimmune diseases worldwide and various autoimmune comorbidities are reported with MS. The objective of this study is to estimate the prevalence of the autoimmune diseases’ comorbidity in patients with MS. Methods: In this cross-sectional ...
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Background: Multiple sclerosis (MS) is one of the most common autoimmune diseases worldwide and various autoimmune comorbidities are reported with MS. The objective of this study is to estimate the prevalence of the autoimmune diseases’ comorbidity in patients with MS. Methods: In this cross-sectional study, we investigated a group of patients with MS in terms of age, gender, duration of MS, presence of simultaneous autoimmune diseases, such as Graves’ disease, Hashimoto’s thyroiditis, type 1 diabetes mellitus (DM), and systemic lupus erythematous (SLE). Results: This study included 1215 patients with MS, of which 70.8% were women. The mean age of participants was 33.70 ± 27.63 years. 55 patients (4.5%) had at least one autoimmune disease. The most common comorbidity was for Hashimoto’s thyroiditis (30 patients). The frequency of simultaneous autoimmune disease was higher in women. Mean age (P = 0.01), mean duration of MS (P = 0.03), and mean age on MS diagnosis (P = 0.02) were significantly higher in simultaneous MS and other autoimmune diseases. Conclusion: Our study revealed that the probability of autoimmune diseases co-occurrence in patients with MS could be higher in older patients, in longer duration of disease, and also in patients with higher age at time of MS diagnosis.
Yasaman Rezaei; Malahat Akbarfahimi; Mojtaba Azimian; Fahimeh Mohaghegh; Mehdi Moghaddasi
Abstract
Background: Optic neuritis (ON) is a common visual sign in multiple sclerosis (MS). Although ON is recovered in most cases, other visual functions such as visual perception are affected and are not fully recovered. The aim of this study is to investigate the relationship between visual evoked potential ...
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Background: Optic neuritis (ON) is a common visual sign in multiple sclerosis (MS). Although ON is recovered in most cases, other visual functions such as visual perception are affected and are not fully recovered. The aim of this study is to investigate the relationship between visual evoked potential (VEP) P100 and N70 latencies and visual perception using the Developmental Test of Visual Perception-Adolescent and Adult (DTVP-A) in people with MS. Methods: In this cross-sectional study, 24 people with ON due to MS, aged 18-50 years old took part. In order to assess the visual perception and optic nerve conductivity, the DTVP-A and the VEP were accomplished, respectively. Pearson’s product-moment correlation coefficient was used to analyze the data. Results: There was a significant negative correlation between right VEP P100 latency and total score of DTVP-A (r = -0.450, P < 0.05) as well as a significant negative correlation between right VEP P100 latency with visual-motor integration (VMI) subtest of DTVP-A (r = -0.485, P < 0.05). Conclusion: The visual perception has an important role in safety and independent daily activities. Therefore, determining the related factors is essential. Although the findings of the current study revealed a moderatestatistical correlation between visual perception and right VEP P100 latency, the small sample size might limit the generalization of our findings; therefore, further study is required to confirm our results.
Omid Mirmosayyeb; Mahdi Barzegar; Nasim Nehzat; Soroush Najdaghi; Behnaz Ansari; Vahid Shaygannejad
Abstract
Background: Multiple sclerosis (MS) is a common autoimmune inflammatory disease in the central nervous system (CNS) without exact pathology. Environmental factors such as infections have a causal or protective role in MS. Helicobacter pylori (HP) is one of the infections in digestive diseases and previous ...
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Background: Multiple sclerosis (MS) is a common autoimmune inflammatory disease in the central nervous system (CNS) without exact pathology. Environmental factors such as infections have a causal or protective role in MS. Helicobacter pylori (HP) is one of the infections in digestive diseases and previous studies reported controversial findings of this infection role in MS. So, we conducted this study to assess the frequency of HP infection in patients with MS in comparison to the healthy population. Methods: This cross-sectional study was undertaken between 2015 and 2019. 191 participants including 58 patients with clinically isolated syndrome (CIS), 57 patients with relapsing-remitting MS (RRMS), 39 patients with secondary progressive MS (SPMS), and 39 age- and sex-matched healthy controls (HCs) were tested for the presence of HP immunoglobulin G (IgG) and IgM antibodies (Abs) in their serum sample. Results: The frequency of HP IgG seropositivity in patients with SPMS was significantly higher than patients with CIS [Odds ratio (OR): 6.333, 95% confidence interval (CI): 2.522-15.906, P < 0.001], patients with RRMS (OR: 4.583, 95% CI: 1.842-11.407, P = 0.001), and HCs (OR: 8.485, 95% CI: 3.058-23.540, P < 0.001). We did not find a significant difference among other study groups regarding IgG seropositivity. No significant difference among groups regarding HP IgM seropositivity was evident. On univariate model, Expanded Disability Status Scale (EDSS) score (OR: 1.038, 95% CI: 1.038-1.460, P = 0.017) and SPMS (OR: 4.583, 95% CI: 1.842-11.407, P = 0.001) were predictor for HP IgG seropositivity. On multivariate model, only SPMS had higher risk for HP IgG seropositivity compared to RRMS (OR: 5.554, 95% CI: 1.327-23.253, P = 0.019). We did not find a significant association between clinical and demographic variables with HP IgM seropositivity. Conclusion: Based on our findings, progressive MS and HP infection may have association. Further longitudinal studies with large sample size are needed to determine the role of HP infection in MS.
Seyed Alireza Derakhshanrad; Emily Piven
Abstract
Background: The literature speculates that there may be a relationship between cognitive capacities and levels of fatigue in people with multiple sclerosis (MS), which has been under reported. This study has investigated one aspect of cognition by evaluating the association between problem-solving ability ...
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Background: The literature speculates that there may be a relationship between cognitive capacities and levels of fatigue in people with multiple sclerosis (MS), which has been under reported. This study has investigated one aspect of cognition by evaluating the association between problem-solving ability and the severity of fatigue. Methods: A cross-sectional, descriptive study was used to investigate the association between levels of problem-solving ability and degrees of fatigue severity. Eighty-five participants living in the city of Shiraz, Iran, completed Cassidy Problem-Solving Inventory (PSI) and the Fatigue Severity Scale (FSS). Pearson’s Product Moment Correlation Coefficient was used to analyze the data. Results: Problem-solving was inversely associated with fatigue (r = -0.381, P = 0.009), whereby higher levels of problem-solving ability were associated with lower degrees of fatigue. Conclusion: The results of this study contributed to the ongoing debate about the linkage between cognition and fatigue in people with MS, suggesting an association between problem-solving ability and fatigue severity. A possible implication would be the importance of problem-solving training for people with MS.
Habib Ahmadi; Vahid Reza Yassaee; Reza Mirfakhraie; Feyzollah Hashemi-Gorji
Abstract
Background: Multiple sclerosis (MS) is a complex incurable neurodegenerative disease featuring demyelination of neurons, resulting in impairment of neuron impulses. Recently, an association of two single nucleotide polymorphisms (SNP) (rs2104286 and rs12722489) in interleukin 2 receptor subunit alpha ...
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Background: Multiple sclerosis (MS) is a complex incurable neurodegenerative disease featuring demyelination of neurons, resulting in impairment of neuron impulses. Recently, an association of two single nucleotide polymorphisms (SNP) (rs2104286 and rs12722489) in interleukin 2 receptor subunit alpha (IL2RA) gene was found to be a risk factor of MS in white European population. Therefore, we performed a study to investigate the contribution of these two intronic variations in Iranian patients with MS. Methods: We determined the genotypes of rs2104286 and rs12722489 in patients with MS (n = 100) and in the control group (n = 111). The SNPs were genotyped using tetra-primer amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR) for both of SNPs. Statistical analysis was performed by SPSS software. Also, odds ratios (ORs) and 95% confidence interval (CI) were calculated. Results: Logistic regression revealed that various genotypes of rs12722489, regarding sex-adjusted effect, yielded meaningful association with MS risk in Iranian patients (OR = 2.67, 95% CI: 1.03-6.90). However, no association was obtained for rs2104286 and rs12722489 with MS. Conclusion: The results confirmed partially the reports in white European population performed recently. However, further investigation in larger scale is necessary to validate our study.
