Comparative study of multiple sclerosis patients based ondistance from the advanced health center

Aim: There are several reasons for presenting to a hospital for multiple sclerosis (MS), a neurodegenerative disorder. We aimed todetermine how distance affects presentation by patients with MS to an advanced health center in Malatya, Turkey. Materials and Methods: The study was performed on 109 patients at the Neurology Department of Inonu University Hospital in 2017.The patients were divided into group-1, who lived in Malatya, and group-2, who live in the upstate region. Demographic and clinicaldata were analyzed retrospectively from medical records. Chi-square tests, independent sample T-tests, and Mann–Whitney U-testswere used to analyze the data. Results: The duration of the disease was longer among patients who lived in Malatya. In terms of mean expanded disability statusscale scores, patients who lived in Malatya had higher scores and patients who lived upstate exhibited more clinical complaints.Among patients who lived upstate, there were more motor problems, vertigo, cognitive impairment, psychiatric disturbances, andvisits for blood tests. Conclusion: Distance affected admission to MS outpatient clinics. We should be more careful in terms of attack when assessingthe reasons of patients present from outside the province. More meaningful results can be obtained by following more patients forlonger periods.

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1. MacNee W. Pathology, pathogenesis, and pathophysiology. Bmj Brit Med J 2006;332:1202- 7551.
2. Multiple Sclerosis International Federation. Atlas of MS. Retrieved from https://www.atlasofms.org/map/ global/epidemiology/number-of-people-with-ms access date 16.02.2021
3. Marin CE, Kfouri PP, Callegaro D, et al. Patients and neurologists have different perceptions of multiple sclerosis symptoms, care and challenges. Multiple Sclerosis and Related Disorders 2021;50.
4. Milo R, Kahana E. Multiple sclerosis: geoepidemiology, genetics and the environment. Autoimmun Rev 2010;9:5-387.
5. Rice CM, Cottrell D, Wilkins A, Scolding NJ. Primary progressive multiple sclerosis: progress and challenges. J Neurol Neurosur Ps 2013;84:10-1100.
6. Amato MP, Prestipino E, Bellinvia A, et al. Cognitive impairment in multiple sclerosis: An exploratory analysis of environmental and lifestyle risk factors. PLoS One 2019;14:10-e0222929.
7. Alirezaei M, Forouzannia SM, Yarahmadi P, et al. Demographic features, behavioral measures, and clinical factors as predictors of cognitive function in patients with multiple sclerosis. Mult Scler Relat Disord 2021;49:102758.
8. Emre M. Neurology Basic Book. 1st edition. Gunes Tip Kitabevleri, Istanbul, 2012
9. Compston A, Coles A. Multiple Sclerosis. The Lancet 2008;372: 1502-9648.
10. Zivadinov R, De Masi R, Nasuelli D, et al. MRI techniques and cognitive impairment in the early phase of relapsing-remitting multiple sclerosis. Neuroradiology 2001;43:4-272.
11. Rosti-Otajarvi E, Ruutiainen J, Huhtala H, Hamalainen P. Cognitive performance profile in different phenotypes of MS with cognitive complaints. Mult Scler Relat Dis 2014;3:4-463.
12. Bulut S, Kilic H, Demir CF. Clinical and demographic characteristics of patients with multiple sclerosis in the Upper Euphrates region. Fırat Med J 2011;16:2-84.
13. Turner AP, Chapko MK, Yanez D, et al. Access to multiple sclerosis specialty care. PM&R 2013;5:12- 1044.
14. Bencsik K, Rajda C, Fuvesi J, et al. The prevalence of multiple sclerosis, distribution of clinical forms of the disease and functional status of patients in Csongrad County, Hungary. Eur Neurol 2001;46:4-206.
15. McDonnell G, Hawkins S. Multiple sclerosis in Northern Ireland: A historical and global perspective. Ulster Med J 2000;69:97.
16. Birgili O. Epidemiological and demographic characteristics of patients followed up with the diagnosis of multiple sclerosis in the Department of Neurology, Faculty of Medicine, Trakya University Ph.D. thesis, Trakya University, Edirne, 2004.
17. Totaro R, Marini C, Cialfi A, et al. Prevalence of multiple sclerosis in the L'Aquila district, central Italy. J Neurol Neurosur Ps 2000;68:3-349.
18. Benito-Leon J, Martin E, Vela L, et al. Multiple sclerosis in Mostoles, central Spain. Acta Neurol Scand 1998;98:4-238.
19. Houzen H, Niino M, Kikuchi S, et al. The prevalence and clinical characteristics of MS in northern Japan. J Neurol SCI 2003;211:1-2-49.
20. Modrego PJ, Pina MA. Trends in prevalence and incidence of multiple sclerosis in Bajo Aragon, Spain. J Neurol Sci 2003;216:1-89.
21. Bufill E, Blesa R, Galan I, Dean G. Prevalence of multiple sclerosis in the region of Osona, Catalonia, northern Spain. J Neurol Neurosur Ps 1995;58:5-577.
22. Tola MA, Yugueros MI, Fernandez-Buey N, et al. Prevalence of multiple sclerosis in Valladolid, northern Spain. J Neurol 1999;246:3-170.
23. Kantarci O, Siva A, Eraksoy M, et al. Survival and predictors of disability in Turkish MS patients. Turkish Multiple Sclerosis Study Group (TUMSSG). Neurology 1998;51:3-765.
24. Rao SM, Leo GJ, Ellington L, et al. Cognitive dysfunction in multiple sclerosis. II. Impact on employment and social functioning. Neurology 1991;41:5-692.
25. Patti F, Amato MP, Trojano M, et al. Cognitive impairment and its relation with disease measures in mildly disabled patients with relapsing-remitting multiple sclerosis: baseline results from the Cognitive Impairment in Multiple Sclerosis (COGIMUS) study. Mult Scler J 2009;15:7-779.
26. Langdon DW. Cognition in multiple sclerosis. Curr Opin Neurol 2011;24:3-244.
27. Chiaravalloti ND, DeLuca J. Cognitive impairment in multiple sclerosis. Lancet Neurol 2008;7:12-1139.
28. Tallantyre EC, Causon EG, Harding KE, Pickersgill TP, Robertson NP. The aetiology of acute neurological decline in multiple sclerosis: experience from an open-access clinic. Mult Scler J 2015;21:1-67.