Investigation of the effect of early diagnosis on attacksevere and lesion spread in individuals with multiple sclerosiscross-sectional operation

Multiple sclerosis (MS) is an inflammatory and demyelinating disease of the central nervous system. The cause of the disease is not known precisely, but some genetic and environmental risk factors are thought to play a role in developing the disease. One of the most studied environmental risk factors today is the Epstein Barr Virus (EBV). EBV is a virus that affects 90% of the healthy population. Seroepidemiological studies have shown that individuals with previous EBV exposure are at a higher risk of developing MS. In seronegative patients, the risk of MS is very low. Another issue that has been emphasized recently is the relationship of EBV antibody positivity with the severity and activity of MS disease, but this issue is still controversial. Studies examining the relationship between MS EBV antibodies in the literature generally focused on the relationship between antibody positivity and response to treatment. The effect of early diagnosis on prognosis in individuals with positive EBV antibodies is unknown. The aim of the study is to compare EBV antibody positivity levels in individuals with early and late-diagnosed MS and to investigate the effect of EBV antibody titer on attack severity. Secondarily, we aimed to examine the effect of a high titer of EBNA antibody on prognosis in patients with early diagnosis. 69 RRMS patients were included in the study. Physical: 9 Hole Peg Test (9HPT), 25 Foot Time Walk Test (25FTW) cognitive: Brief Visuospatial Memory Test (BVMT), California Verbal Learning Test (CVLT), Symbol Digit Modalities Test (SDMT) tests were applied at the first admission to the hospital. The Expanded Disability Status Scale (EDSS) was examined in terms of the assessment of disability. The lesion loads and lesion locations in the last MRIs were examined. Attack classification was made. The effects of age and gender were examined from the demographic data. P-value <0.05 was considered significant. As a result of our analysis, we found that the increase in the number of attacks in MS correlated with the high EBNA titer, but the late diagnosis did not significantly affect the EBNA titer. EBNA titers were found to be significantly higher in patients with episodes or spinal lesions on MRI. A significant decrease in EBNA titers of patients who received IVMP in the last month and an increase in EBNA titers of patients diagnosed close to the attack period were found. In order to fully understand the relationship of MS with EBV antibodies, more data and more studies are needed. In our study, we examined the effects of EBNA titers on the MRI burden in MS, the type of attack, the disease's activity, and emphasized its importance.