Araştırma Çıktıları
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Item Differences Between General Neurologists and Multiple Sclerosis Specialists in the Management of Multiple Sclerosis Patients: A National Survey(AVES, 2019-01-01) Kurtuncu, Murat; Tuncer, Asli; Uygunoglu, Ugur; Caliskan, Zeynep; Kokenli Paksoy, Aysenur; Efendi, Husnu; Sagduyu Kocaman, Ayse; Ozcan, Cemal; Terzi, Murat; Turan, Omer Faruk; Saip, Sabahattin; Karabudak, Rana; Siva, AkselIntroduction: The management of multiple sclerosis (MS) has become more complicated after the introduction of new diagnostic and treatment options. Despite the abundance of guidelines, the experience of physicians still plays a major role in the management of patients. This study aimed to define differences in behavior patterns between general neurologists (GNs) and MS specialists (MSSs). Methods: We conducted a survey of 36 questions to 318 neurologists, including 33 MSSs. The survey covered topics including laboratory investigations, pregnancy, and treatment. Results: Our study found many differences between GNs and MSSs in terms of management, the most important being treatment initiation and switching. GNs had a tendency to initiate treatment later than MSSs however, they tended to switch treatment faster. Our study also showed that GNs ordered magnetic resonance imaging (MRI) more frequently than MSSs, even if patients were clinically stable. Moreover, although GNs more frequently relied on MRI, they did not consider brain atrophy as an important measure in the follow-up of their patients. Furthermore, GNs considered replacement therapy less often than MSSs, even in patients with vitamin D deficiency. Discussion: Our study revealed important discrepancies between the management patterns of GNs and MSSs in MS patients. These findings suggest the need for a national education program for GNs on MSSs.Item Investigating the role of common and rare variants in multiplex multiple sclerosis families reveals an increased burden of common risk variation(NATURE PORTFOLIO, 2022-01-01) Everest, Elif; Ahangari, Mohammad; Uygunoglu, Ugur; Tutuncu, Melih; Bulbul, Alper; Saip, Sabahattin; Duman, Taskin; Sezerman, Ugur; Reich, Daniel S.; Riley, Brien P.; Siva, Aksel; Turanli, Eda TahirMany multiple sclerosis (MS)-associated common risk variants as well as candidate low-frequency and rare variants have been identifiedItem CSF Proteomics Identifies Specific and Shared Pathways for Multiple Sclerosis Clinical Subtypes(PUBLIC LIBRARY SCIENCE, 2015-01-01) Avsar, Timucin; Durasi, Ilknur Melis; Uygunoglu, Ugur; Tutuncu, Melih; Demirci, Nuri Onat; Saip, Sabahattin; Sezerman, O. Ugur; Siva, Aksel; Turanli, Eda TahirMultiple sclerosis (MS) is an immune-mediated, neuro-inflammatory, demyelinating and neurodegenerative disease of the central nervous system (CNS) with a heterogeneous clinical presentation and course. There is a remarkable phenotypic heterogeneity in MS, and the molecular mechanisms underlying it remain unknown. We aimed to investigate further the etiopathogenesis related molecular pathways in subclinical types of MS using proteomic and bioinformatics approaches in cerebrospinal fluids of patients with clinically isolated syndrome, relapsing remitting MS and progressive MS (n=179). Comparison of disease groups with controls revealed a total of 151 proteins that are differentially expressed in clinically different MS subtypes. KEGG analysis using PANOGA tool revealed the disease related pathways including aldosterone-regulated sodium reabsorption (p=8.02x10(-5)) which is important in the immune cell migration, renin-angiotensin (p=6.88x10(-5)) system that induces Th17 dependent immunity, notch signaling (p=1.83x10(-10)) pathway indicating the activated remyelination and vitamin digestion and absorption pathways (p=1.73x10(-5)). An emerging theme from our studies is that whilst all MS clinical forms share common biological pathways, there are also clinical subtypes specific and pathophysiology related pathways which may have further therapeutic implications.Item Investigation of multiple sclerosis-related pathways through the integration of genomic and proteomic data(PEERJ INC, 2021-01-01) Everest, Elif; Ulgen, Ege; Uygunoglu, Ugur; Tutuncu, Melih; Saip, Sabahattin; Sezerman, Osman Ugur; Siva, Aksel; Turanli, Eda TahirBackground. Multiple sclerosis (MS) has a complex pathophysiology, variable clinical presentation, and unpredictable prognosis