Background and Aim: Multiple sclerosis (MS) is characterized with inflammation, demyelization and gliosis. It may be relapsing, remitting, or progressive. Cognitive impairment is relatively prevalent in patients with multiple sclerosis and as duration of disease is longer as cognition impairment is more.To understand the cognitive impairment, event related potential can be considered as a valuable tool.This study aimed to investigate the influence of duration of disease and EXPANDED DISABILITY STATUS SCALE (EDSS) on the amplitude and latency of the event related potentials of P300 in patients with multiple sclerosis.Methods: In this cross-sectional and non-intervention study, 21 patients with multiple sclerosis with mean age of 27.8 with SD 7.1 years (between 18 to 50 years) were enrolled. The patients were selected randomly. The correlation of P300 event-related potential and oddball paradigm was assessed, using two 1000 and 2000 Hz tone burst stimulus.Results: There was a significant correlation between the latency of P300 wave and duration of disease and EXPANDED DISABILITY STATUS SCALE (p<0.05), there was high correlation in both electrode sites (r>0.50). The correlation of amplitude of P300 and duration of disease and EXPANDED DISABILITY STATUS SCALE was not significant (p>0.05).Conclusion: Significant correlation between the latency of P300 and the duration of multiple sclerosis and EXPANDED DISABILITY STATUS SCALE can be a sign of central nervous system changes. Besides, there is a relation between physical DISABILITY and cognitive impairments.

Background: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system resulting from demyelination and axonal loss. Although treatment of MS has progressed, patients continue to have attacks and treatment for such episodes remains a subject of ongoing study. The object of this study is to determine the effect of intravenous methylprednisolone (IVMP) on the degree of DISABILITY in MS patients.Methods: This cross-sectional study involved 63 patients with a definite diagnosis of MS, based on the MacDonald criteria, at the Iranian Center for Neurological Research at Imam Khomeini Hospital, Tehran, Iran, from March 2004 through March 2005. After obtaining informed consent, investigators gathered data including each patient's age, gender, pyramidal activity STATUS, cortical, cerebellar and brain stem activity STATUS, sensory signals in the extremities, including vibration, touch, pain, position, visual STATUS, as well as bladder and intestinal activity, and EXPANDED DISABILITY STATUS SCALE (EDSS) score. SPSS version 11 was used for data analysis.Results: A five-day regimen of IVMP (5g) significantly reduced the immediate posttreatment score from 4.595 to 3.635, which represents a 96% improvement in the EDSS. The greatest change in functional system DISABILITY was seen in the pyramidal system with a mean score of 1.13. After treatment, the rate of DISABILITY reduction in the sensory system, cerebellum, vision, bladder and intestinal activity was 0.57, 0.49, 0.46, 0.4, and 0.38, respectively. Patients who had experienced fewer relapses responded better to treatment. There was no statistically significant relationship between patient age and the level of response to treatment. However, the rate of DISABILITY reduction after treatment was greater in males than females (p=0.05).Conclusion: These results show that IVMP treatment induces an immediate posttreatment effect that could partly account for clinical and radiological improvement in MS patients. However, further study is required to determine the possible long-term, or even intermediate-term, effects of methylprednisolone treatment on the course of this disease.

Introduction: Multiple Sclerosis (MS) is a disease of central nerve system which involves brain and spinal cord. The cause of this disease is still unknown. It causes disorders in conducting nerve and electrical current by destroying myelin. The purpose of this study is to investigate the effect of aquatic exercises for 8 weeks on the improvement of balance among female MS patients.materials and methods: This is an applied research study using semi-experimental method. From 100 MS patients, 25 people were randomly selected on the basis of illness degree and age. The criteria applied for the random selection were: Patients’ responses to an EXPANDED DISABILITY STATUS SCALE (EDSS, 1-4), an average illness time of 4±1 and the age range of 20-50 years. They were divided into two groups: The experimental group consisting of 15 patients and the controlled group which consisted consists of 10 patients. The experimental group participated in the exercises with an intensity rate of 40-50 percent of the maximum heartbeat rate for 8 weeks, three sessions per week. Krutzke EDSS questionnaire was used to measure the EDSS in experimental and controlled groups both before and after the exercises. The gathered data were analyzed by using descriptive statistic and dependent sample t- test.results: The research has shown that after 8 weeks of treatment, the balance in the experimental group was significantly improved (P=0.000). A significant difference in their mean scores on EDSS was observed (P=0.000). Also, there was a significant difference in the experimental group’s EDSS scores in the pretest and post-test (P=0.000). However, there was no significant difference between the pre-test and post-test scores of the controlled group (P=0.279, a=0.05). As the findings suggest, exercises of this type could decrease up to 0.5 degree in EDSS scores among MS patients. Such amount of decrease is very valuable for MS patients.Conclusion: Considering the results of this research suggesting an improvement in the balance of MS patients with low EDSS, it seems necessary to apply aquatic exercises for such patients.Therefore, it is recommended that MS patients practice such exercises, under the supervision of specialists, as a supplementary remedy along with the medical treatments.

Background and aim: Multiple sclerosis is a chronic and debilitating nervous system, leading to demyelination of the central nervous system (brain and spinal cord). Regular exercise and general physical activity is important to maintain health and prevent disease, already well known. Therefore the aim of this study was to evaluate the effect of 12 weeks of combined exercises (strength training, Strengthening Exercises, cardio respiratory endurance, a variety of static and dynamic balance exercises, exercises of the trunk (pilates training) and walking on the treadmill training with body weight support) on interferon gamma and EXPANDED DISABILITY STATUS SCALE women with multiple sclerosis.Methods: In the present experimental rsearch, female patients who were admitted to the MS Society of Shahrekord, Iran, were divided into three groups based on physical DISABILITY scores. In the first group (physical DISABILITY SCALE less than 4.5), 44 people were randomly selected to one experimental group (22 patients) and control group (n=22). In the second group (SCALE physical DISABILITY between 5 and 5.6), 26 patients were enrolled and randomly assigned to an experimental group (n =13) and control group (n=13). The third (Physical DISABILITY SCALE-up to 6.5), 26 patients were enrolled and randomly assigned to an experimental group (n=13) and control group (n=13). A total of 96 patients were participated in this study.Experimental groups of first, second and third were done its own intervention separately. While the control group received stretching exercises, workout schedule for the experimental group was of 12 weeks, three sessions of lasted one hour.Anthropometric factors and interferon-gamma were measured before and after training with the appropriate tools. Serum levels of INF-g was determind using a commercial ELISA kit and EDSS scores were measured using the measure of DISABILITY in patients with MS. Data analysis was performed using descriptive statistics and ANOVA and paired t-test and dependent.Results: The results showed that no significant differences were seen in the INF-g subjects with low DISABILITY before and after exercise in the intervention group (p=1.017), whereas, there was no significant difference in the control group (p=0.229). In comparison, no significant difference was observed between intervention and control groups in terms of INF-g (p=0.09). The results indicated that significant differences INF-g subjects with low DISABILITY before and after exercise was observed in the intervention group (p=0.309 Conclusion: Although combinated exercise training did not change on serum levels of IFN, but it casued asignificant changes in EDSS of the patients with M.S at different levels Regarding these results, it can be suggested that rehabilitation specialists use of these exercises as a complementary treatment along with drug therapy for MS patients.

Introduction: The purpose of this study was to investigate the effectiveness of Lazarus multimodal therapy on EXPANDED DISABILITY STATUS of patients with multiple sclerosis.Materials and Methods: This study was a quasi experimental research administered in 2009. All convenience participants were selected from MS outpatient clinic of Qazvin city. For this aim, some of the patients in Qazvin were selected by convenience sampling. After primary assessments, 40 patients were selected and randomly allocated in two groups (20 in experiment group and 20 in control group). From 20 patients of experiment group, 16 patients completed the treatment. During 3 month Lazarus multimodal therapy was administered in the experiment group in twelve sessions each of them length 90 minutes. EXPANDED DISABILITY STATUS of patients was evaluated by a neurologist before and after treatment. Data were analyzed by Mann-Whitney U test.Results: The results indicated that Lazarus multimodal therapy had significant effect on EDSS score (P=0.035), bowel-bladder (P<0.0005), and cerebral functional systems (P=0.014). This treatment had not significant effect on pyramidal and visual systems.Conclusion: Lazarus multimodal therapy is effective in decreasing DISABILITY of patients with multiple sclerosis.

Background: Multiple sclerosis (MS) is an inflammatory disease while there are controversies regarding the role of vitamin D supplements in controlling relapse and DISABILITY improvement during treatment. Objective: The goal of this systematic review and meta‑, analysis was to evaluate the effect of vitamin D supplements on MS‑, related relapse and the EXPANDED DISABILITY STATUS SCALE (EDSS). Methods: We searched databases to include randomized clinical trials (RCTs) which were published up to October 2018. We included RCTs, being single‑, blinded or double‑, blinded or open‑, label trials in which one of the main outcomes was EDSS and/or relapse after vitamin D supplementation. All statistical analyses were performed using RevMan 5. 3. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for relapse between treatment arms. The mean difference was calculated for EDSS comparisons. Results: Nine articles were included for analysis. Of these nine studies, five compared vitamin D supplement groups with placebo (group 1 studies), and four compared high‑,and low‑, dose vitamin D groups. A total of 561 patients were analyzed. Being treated with vitamin D instead of placebo showed no effect on relapse rate (OR = 0. 66, 95% CI = 0. 28–, 1. 54) as well as EDSS (mean difference = 0. 06, 95%CI [‑, 0. 31, 0. 42]). The results of studies comparing high‑,vs. low‑, dose vitamin D interventions showed no significant effect on relapse rate (OR = 1. 08, 95%CI [0. 29–, 4. 08] as well as final EDSS (mean difference = 0. 17, 95% CI = ‑, 0. 73, 1. 07). Conclusions: Our findings show that vitamin D supplements (high or low dose) have no significant effect on relapse rate and DISABILITY during treatment in MS patients.

Background: Multiple sclerosis (MS) represents one of the most common disorders of the central nervous system, which leads to the dysfunction of different body systems and generates a myriad of problems for the affected individuals. Given the progressive nature of this disease, it can divide into several levels. The progression rate of the disease at each stage is essential for specialists, as it can help them to adopt appropriate therapeutic measures. Methods: One of the methods used in many MS neurological treatments is EXPANDED DISABILITY STATUS SCALE (EDSS), which allows physicians to give an estimate of the severity of the disease to patients, learn about the stage of the patient’ s disease and prescribe appropriate medicines accordingly. Given the importance and impact of this disease on the quality of life of patients, researchers look for inexpensive and simple models with minimum side effects for examining different levels of MS and providing treatment solutions. Results: In this study, patients were asked to stand on a force plate. Then, the time series of the center of pressure and body oscillations of patients at various levels were recorded using a motion analyzer device, and a closed loop control system was proposed using the reverse pendulum (representing human body) and reinforcement learning. Conclusion: Based on the feedback received from the environment, the necessary rules for maintaining the balance of pendulum obtained, and, by observing the ankle torque at the output, a model presented that could examine different levels of MS.

Background: Previous studies have shown that people with a family history are more likely to develop multiple sclerosis (MS). The purpose of this study was to investigate the relationship between positive familial history and DISABILITY rates based on the Extended DISABILITY STATUS SCALE (EDSS) among the patients with MS. Methods: This cross-sectional study was performed on 320 patients with MS referred to MS Clinic in Kashani hospital, Isfahan, ran, who were randomly selected and divided into two groups with and without familial history. Data related to patients' demographic characteristics and data related to age of onset, number of attacks per year, and EDSS were supplemented by face-to-face interviews and examinations performed by a physician. The EDSS ranking criterion was determined based on neurological function and functional systems (cerebral, pyramidal, brainstem, etc. ). Findings: There was no significant difference between the average number of attacks per year in both groups of with or without positive family history. In addition, there was no significant difference in the mean of primary and secondary EDSS between two study groups. Conclusion: Our study showed that the age of patients with familial type of MS was significantly lower than the age of patients with non-familial type. However, there was no significant difference in the degree of DISABILITY between the group of patients with or without familial history.

Background and Objectives: Multiple sclerosis (MS) is a disease that involves an individual's central nervous system and can affect many aspects of his/her life. This study was conducted to evaluate the safety and efficacy of fingolimod compared to placebo in the treatment of relapsing MS. Methods: A detailed research was carried out on Medline, Web of Sciences, the Cochran Library, Embase, and Scopus databases within January-December 2020. The studies were evaluated regarding the effectiveness of the EXPANDED DISABILITY STATUS SCALE (EDSS) and the safety of complications. A random model with a 95% confidence interval was used for data analysis. To evaluate the heterogeneity of the studies I2 test was used in this research. The Cochrane risk of bias tool checklist was applied to assess the quality of the study methodology. Results: The results indicated that in 3 and 1 studies fingolimod was used at a dose of 1. 25 and 0. 5 mg, respectively. Based on the findings, the use of fingolimod at a dose of 0. 59 mg was effective in improving patients. The patients receiving fingolimod 1. 25 mg were more likely to have lymphopenia than patients taking placebo. Conclusion: Finally, the findings of this study showed that the use of fingolimod was effective on the EDSS index, compared to placebo. Doctors can use this drug to improve EDSS and the quality of life of patients.