Background

MS is an autoimmune central nervous system (CNS) disease, characterized by inflammation, demyelination and axon damage. Although the etiology of MS is still not known clearly, the disease is thought to occur as a result of autoimmune response developed in CNS, with the contribution of environmental factors, especially viral infections, smoking, vitamin D levels and salt consumption in individuals with genetic predisposition. Salt consumption, which is emphasized while examining the autoimmunity-diet relationship, is an important issue. In two studies on salt and MS, in animals with experimental autoimmune encephalomyelitis (animal model of MS), high salt consumption has been shown to increase the symptoms of the disease by increasing the pathological T helper 17 response.

Objectives

We planned a retrospective cross-sectional study with patients who applied to our clinic and who were under follow-up to evaluate the relationship of the disease with environmental factors. We aimed to examine whether there is a relation between salt consumption of the patients and disability, disease activity and radiological images.

Methods

Statistical evaluation was done with IBM SPSS 20.0 (SPSS Inc., Chicago, IL, USA) package program. Relations between numerical variables were evaluated by Spearman correlation analysis, and relationships between categorical variables were evaluated by Chi-square analysis. p <0.05 was considered statistically sufficient for significance.

In this study, we analyzed 250 patients with complete data from 607 patients that we examined. We divided the patients into two groups according to their eating habits, eating salty and unsalted meals.

Results

Of the patients 139 (55.6%) had a salty, 111 (44.4%) salt-free history. We compared both groups in terms of EDSS, number of attacks, T2 and T1 lesions. No significant relation was found with salt consumption, T1 lesion presence, contrast-enhancing lesion number, T2 lesion number, MS clinical subtype and EDSS. However, in our study, 20 of 25 people with EDSS score of 4 and above were eating salty foods. Although it did not seem statistically significant (p = 0.070), there was a significant arithmetical difference. Statistically insignificant reason was thought to be insufficient of the sample.

Conclusions

It has been demonstrated in both animal and human models that the high amount of salt in the diet causes induction in Th17 lymphocytes. Th17 lymphocytes exposed to high salt have been reported to be associated with proinflammatory cytokines and show high pathogenicity. Farez et al examined 70 RR MS patients for two years; found that the risk of attacks increased by 2.75 times and the risk of developing new lesions increased by 3.4 times compared to those who did not take the medium-high salt areas.

As a result of these data, it can be easily advised that patients should not smoke and reduce their salt consumption.

Background

Multiple sclerosis is a disease characterized by chronic, inflammatory demyelination of the central nervous system. It is the most common neurological disease in young adults that causes morbidity. . MS is most common between the ages of 20-40. It is rarely detected before the age of 10 and after the age of 60. It is more common in women than in men, and the female male rate is 2-3/1.

Objectives

In this study, we wanted to investigate whether there is a difference between gender and the regions leading to the first clinical attack symptom known to affect prognosis. The study was planned as cross-sectional, 250 patients over the age of 18 who were followed up in the spectrum of MS and diagnosis of MS in Kocaeli University Faculty of Medicine Neurology Outpatient Clinic were included. Approval was obtained from Kocaeli University Faculty of Medicine Ethics Committee for the study. The patients participating in the study were informed about the study and an informed consent form was signed.

Methods

In this study, we wanted to investigate whether there is a difference between gender and the regions leading to the first clinical attack symptom known to affect prognosis. The study was planned as cross-sectional, 250 patients over the age of 18 who were followed up in the spectrum of MS and diagnosis of MS in Kocaeli University Faculty of Medicine Neurology Outpatient Clinic were included.

Results

Of the 250 patients included in the study, 181 were female (72.4%) and 69 (27.6%) were male. While the average age of female patients was 38.20 ± 10.74; The mean age of male patients was 37.93 ± 10.67. There was no significant difference between the mean age of the patients. (P = 0.885). The first attack symptoms of 92 (38.7%) patients included in the study were due to supratentorial lesions. In other patients, it was due to 32.4% brainstem involvement, 22.3% optic nerve involvement and 6.7% spinal region involvement, respectively. Since 12 patients had radiological isolated syndrome, there was no first attack symptom. Relations between numerical variables were evaluated by Spearman correlation analysis, and relationships between categorical variables were evaluated by Chi-square analysis. p <0.05 was considered statistically sufficient for significance.

Conclusions

In our study, a significant relationship was found between gender and the region where the first attack symptom depends. (p value: p = 0.007) While the region where the first attack symptom is most frequently associated with female patients is 42% supratentorial, male patients have a brain stem with 40.6%. The region that has the least cause of first attack symptoms is the spinal region in both groups. We concluded that the disease has a worse prognosis in patients with brainstem involvement, male gender-brainstem involvement becomes statistically significant.