Relationship of fatigue and cognitive functions with magnetic resonance findings and thyroid hormones and autoantibodies in multipl sclerosis

Relationship of fatigue and cognitive functions with magnetic resonance findings and thyroid hormones and autoantibodies in multipl sclerosis. İzzet Baysal Medical Faculty, Neurology Department, Speciality Thesis, Bolu 2010. Multipl sclerosis is a chronic generalize demyelinating disease of CNS usually affecting young adults. Fatigue, cognitive impairment and other autoimmune disorders can accompany MS since the beginning of this disease. In this study, the relation of cognitive impairment and fatigue with cranial imaging findings and thyroid autoantibodies (in the follow up period, monitoring the progression of fatigue and cognitive impairment) was investigated in relatively earlier MS (RRMS) patients. Relation of thyroid hormone and autoantibodies with Fatigue Severity Scale (FSS), Standardized Mini Mental Test (MMST), Multiple Sclerosis Functinal Composite (MSFC), Hamilton Depression Scale (HAM-D) in 21 patients who were diagnosed as RRMS and also in the control group who were composed of 22 healthy volunteer subjects, and cranial imaging findings and Expanded Disability Status Scale (EDSS) in the patient group were assessed. MMST scores were not statistically different in the patients group compared with the control group. However, MMST scores decreased significantly with increasing attach number. MSFC scores were not statistically different between groups. In the Timed 25 feet Walking Test (T25W) which is a component of MSFC, significantly longer durations were obtained. Similarly, the durations of dominant and non-dominant hand Hole Pole Test (9HPT) which assess the upper extremity functions were significantly longer in patients group. However, third component which investigates the cognitive functions, the Paced Auditory Serial Additional Test (PASAT3) was not different between two groups. HAM-D scores were found significantly higher in patients group. In the patients group, FSS scores were found significantly higher in patient group in comparison with controls. FSS scores increased significantly with increasing EDSS scores, and also a correlation between FSS and HAM-D was observed. Any relation between HAM-D and FSS scores with thyroid functions was not obtained. In this thesis study, thyroid autoantibodies were found to be higher in the patients group in comparison with the control group. However, this finding was interpreted as a sub-clinical abnormality. Total lesion number was only weakly correlated with HAM-D in this study. In the patients group, FSS and HAM-D scores were found to be higher. Cranial lesion load and thyroid functions tests were not found to be related.In conclusion, significant cognitive impairment was not found in early MS patients, and the lesion load was not found to be related with thyroid autoantibodies in this thesis study.