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Öğe Development of restless legs syndrome severity prediction models for people with multiple sclerosis using machine learning(Galenos Publ House, 2025) Kaya, Ergi; Emec, Murat; Ozdogar, Asiye Tuba; Zengin, Eta Simay; Karakas, Hitat; Dastan, Seda; Ozakbas, SerkanObjectives: This study aimed to develop an artificial intelligence-supported restless legs syndrome (RLS) severity prediction model for people with multiple sclerosis using machine learning methods. Patients and methods: Twenty-three individuals (14 females, 7 males; mean age: 40.6 +/- 10.9 years; range, 33 to 44 years) with multiple sclerosis with RLS were included in this observational study between March 2022 and March 2023. The International Restless Legs Syndrome Study Group Rating Scale was used to determine the RLS severity of the participants. The age, sex, body mass index, regular exercise habits, disease duration, Expanded Disability Status Scale (EDSS), estimated maximal aerobic capacity (VO2max), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, Multiple Sclerosis International Quality of Life Questionnaire, Multiple Sclerosis Walking Scale-12 (MSWS-12), and timed 25-foot walk test were determined as predictive variables. A correlation matrix was created. DecisionTree, RandomForest, and XGBoost machine learning methods were used to develop a model for predicting the RLS severity. Results: According to the obtained correlation matrix, PSQI scores strongly correlated with RLS severity (Pearson r=0.76). Meanwhile, EDSS scores (0.49), MSWS-12 scores (0.45), and disease duration (0.45) showed moderate correlations with RLS. Among the three different meachine learning methods, XGBoost demonstrated the best performance in predicting the severity of RLS, with a mean absolute error of 1.94, mean squared error of 4.58, mean absolute percentage error of 0.0735, and a test accuracy of 92.65%. The results showed that the severity of RLS could be estimated with 92.65% accuracy. Conclusion: This study showed a strong correlation between PSQI scores and RLS severity and that RLS severity could be predicted using machine learning methods.Öğe Effect of Telerehabilitation-Based Motor Imagery Training on Pain and Related Factors in People With Multiple Sclerosis: Randomized Controlled Pilot Trial(W B Saunders Co-Elsevier Inc, 2025) Karakas, Hilal; Kahraman, Turhan; Ozdogar, Asiye Tuba; Baba, Cavid; Ozakbas, SerkanObjectives: To investigate the effect of telerehabilitation-based graded motor imagery (MI, GMI) training on pain and pain-related factors in people with multiple sclerosis (MS). Design: Randomized controlled, assessor-blind pilot trial with repeated-measure design. Setting: Neurology outpatient clinic. Participants: Thirty-two people with MS were randomly allocated to intervention (n=16) and control (n=16) groups. Interventions: During the 8-week GMI training period, the first 2 weeks involved implicit MI training while 6 weeks of explicit MI training were conducted. Main Outcome Measures: The primary outcome was the general pain intensity over the past 2 days, assessed with a visual analog scale, with a minimum clinically important difference (MCID) of 23 mm. Secondary outcomes included general pain and specific body parts' pain intensity over the past 7 days, neuropathic pain intensity, MI ability, fatigue, depression, anxiety, quality of life, sleep quality, daytime sleepiness, and cognitive functions scores. Assessments were conducted at baseline, at weeks 8 (post-treatment) and 12 (follow-up). Results: The intervention group demonstrated a significant reduction in pain intensity over the past 2 days compared with control group (P<.05). Furthermore, at the 8-week assessment, the intervention group surpassed the MCID in pain intensity over the past 2 and 7 days (P<.05), whereas no significant change was observed in the control group (P>.05). Significant effects were observed post-treatment on general pain over the past 7 days, neuropathic pain, MI ability, fatigue, depression, quality of life, processing speed, and visuospatial memory within intervention group compared with control group (P<.05). However, the effect on anxiety, sleep quality, daytime sleepiness, and verbal memory between groups was not significant (P>.05). Conclusions: Telerehabilitation-based GMI training stands out as viable for the management of chronic pain and pain-related psychosocial symptoms for people with MS.Öğe Factors related to restless leg syndrome in neuromyelitis optica spectrum disorder(Elsevier Sci Ltd, 2025) Ozdogar, Asiye Tuba; Karakas, Hilal; Dastan, Seda; Kaya, Ergi; Sagici, Ozge; Ozcelik, Sinem; Ozakbas, SerkanObjective: Although the feeling of unrest in the legs is frequently reported as a sensory symptom by people with Neuromyelitis Optica Spectrum Disorder (NMOSD, pwNMOSD), there are limited studies to investigate the relationship between Restless Legs Syndrome (RLS) and NMOSD. The study's primary aim is to determine the frequency and severity of RLS in pwNMOSD. The other aim is to compare the sleep quality, daytime sleepiness level, quality of life, fatigue, magnetic resonance imaging results, and cognitive functions in RLS-positive and negative pwNMOSD. Methods: The RLS diagnosis was performed with RLS-Diagnostic Index criteria. The patient-reported outcomes were RLS Severity Rating Score, The Preference-Based Multiple Sclerosis Index (PBMSI), the Modified Fatigue Impact Scale (MFIS), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). Cognitive function was assessed with The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery. The neurologist recorded the demographic and clinical characteristics of the participants. Results: The RLS was detected in 17 (21.5 %) of the 79 pwNMOSD participants. Fifty-six pwNMOSD were reached to assess cognitive functions and patient-reported outcomes. The rate of RLS was 60.71 % in this group. The PBMSI, PSQI, MFIS, and ESS scores were significantly different in RLS-positive participants than in RLS-negative (p < 0.05). Moreover, while participants' visuospatial and verbal learning was similar, the processing speed was slow in the RLS-positive group (p > 0.05). Conclusions: Our preliminary results have shown that the RLS frequency is high in pwNMOSD. This study suggests a connection between the presence of RLS and worse sleep quality, fatigue level, processing speed, and quality of life in the NMOSD population. However, our results should be considered with the fact that the study has a small sample size and needs future studies to confirm our results for solid evidence.Öğe Yeni teşhis konulan multipl sklerozlu bireylerde servikal omurilik lezyonunun üst ekstremite fonksiyonu üzerindeki etkisinin değerlendirilmesi(Ege Üniversitesi, 2025) Özdoğar, Asiye Tuba; Kaya, Ergi; Cinar, Bilge Piri; Aygündüz, Nurbanu; Daştan, Seda; Karakaş, Hilal; Ozakbas, SerkanAmaç: Çok erken evre multipl skleroz (MS) hastalarında servikal kord lezyonlarının üst ekstremite fonksiyonları üzerindeki etkisini değerlendirmek ve bu popülasyonda üst ekstremite fonksiyonlarını etkileyen faktörleri tanımlamak. Gereç ve Yöntem: Çalışmaya 245 ilk semptomlardan 24 ay geçmiş ve 378 tanıdan sonraki altı ay içinde hastalık modifiye edici tedaviye (DMT) başlamış MS’li bireyler dahil edilmiştir. Üst ekstremite fonksiyonlarını değerlendirmek için Dokuz Çivi Peg Testi (N-HPT) uygulanmıştır. Servikal kord lezyonunun varlığına göre katılımcılar iki gruba ayrıldı. Bulgular: Gruplar arasında yaş, cinsiyet, hastalık süresi ve atak sayısı açısından anlamlı bir fark bulunmamıştır. Ancak, toplam Genişletilmiş Engellilik Durumu Ölçeği (EDSS) skoru, piramidal ve duyusal fonksiyonel sistem skorları, servikal kord lezyonları olan MS’li bireylerde olmayanlara göre daha yüksek bulunmuştur. Tanıdan sonraki altı ay içinde DMT başlatılan katılımcılarda, dominant ve ortalama N-HPT performans süreleri, servikal kord lezyonu olan MS’li bireylerde olmayanlara göre anlamlı derecede daha uzun bulunmuştur. Ancak, ilk semptomlardan 24 ay sonra tanı konulan katılımcılar arasında gruplar arasında anlamlı bir fark gözlenmemiştir. Yaş, hastalık süresi ve tanıdan tedaviye kadar geçen süre, N-HPT performansını etkileyen önemli faktörler olarak belirlenmiştir. Daha genç, daha kısa hastalık süresine sahip ve tanı sonrası daha erken tedavi alan MS’li bireyler, diğerlerine göre daha iyi performans göstermiştir. Sonuç: Çalışmamız, MS’in erken evrelerinde bile servikal kord lezyonlarının üst ekstremite fonksiyonları üzerindeki etkisini vurgulamakta ve erken tanı ile DMT’lerin hızlı bir şekilde başlatılmasının önemini ortaya koymaktadır.
