Person: KOÇ, EMİNE RABİA
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KOÇ
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EMİNE RABİA
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Publication Cladribine responsiveness in switched rrms patients(Sage Publications Ltd, 2023-10-01) Tepe, Nermin; Koç, Emine; Sarıdaş, Furkan; Akkoyun, Fatma; Sarı, Ümmu Serpil; Turan, Ömer Faruk; Kabay, Sibel Canbaz; Tokuçoğlu, Figen; KOÇ, EMİNE RABİA; SARIDAŞ, FURKAN; TURAN, ÖMER FARUK; Tıp Fakültesi; Nöroloji Ana Bilim Dalı; 0000-0001-5945-2317; 0000-0002-6752-1519 ; JAL-2843-2023; HSB-2700-2023; JCO-1811-2023Publication Effects of quarantine applied during the covid-19 pandemic on mental health and quality of life in patients with multiple sclerosis and healthy controls(Springer-verlag Italia Srl, 2022-01-21) Koç, Emine Rabia; KOÇ, EMİNE RABİA; Demir, Aylin Bican; BİCAN DEMİR, AYLİN; Topaloğlu, Ezgi; Turan, Ömer Faruk; TURAN, ÖMER FARUK; Özkaya, Güven; ÖZKAYA, GÜVEN; Tıp Fakültesi; Nöroloji Ana Bilim Dalı; 0000-0002-0264-7284; 0000-0001-6739-8605; A-7083-2015Background The coronavirus outbreak, which emerged in Wuhan, China, in late 2019 and spread to the world, has changed each of our lives. Objective To investigate the effects of quarantine on depression, anxiety, sleep quality, fatigue, and SF-36 of multiple sclerosis (MS) patients during the COVID-19 outbreak and differences between healthy controls (HC). Methods Eighty-six MS patients and 65 HC patients were included in the study. Participants filled out the various scales through face-to-face interviews for mental health assessment from January 15 to February 15, 2021. Results When both groups were compared in terms of BECK-D inventory (p < 0.001), BECK-A inventory (p = 0.010), and FS (p < 0.001), the patient group had significantly higher results. Physical functioning (p < 0.001), physical role limitation (p = 0.001), energy vitality rates (p = 0.010), and general health perception (p < 0.001) were higher in the HC group. When MS patients were divided according to EDSS scores, BECK-A (p < 0.001), BECK-D (p = 0.001), and PSQI (p = 0.006) scores of the patients with EDSS > 3 were higher, while emotional role restriction rates (p = 0.006), energy and vitality (p = 0.018), and pain (p = 0.005) were significantly lower than those with EDSS <= 3. When MS patients were divided into two groups as who had COVID-19 and who did not and compared SF-36 subscale scores, pain, (p = 0.049) and mental status (p = 0.030) were obtained significant differences in the two groups. Conclusions Our study revealed that MS patients, who are more susceptible to the new 'normal' that emerged during the pandemic period, are among the priority groups that should be supported in terms of mental health as well as physical health.Publication Covid-19 infection as a possible risk factor for longitudinally extensive transverse myelitis!(Taylor & Francis Ltd, 2022-07-08) Mengüç, Bedirhan; MENGÜÇ, BEDİRHAN; Koç, Emine Rabia; KOÇ, EMİNE RABİA; Turan, Ömer Faruk; TURAN, ÖMER FARUK; Tıp Fakültesi; Nöroloji Ana Bilim Dalı; 0000-0002-0264-7284; A-7083-2015Introduction There is limited data about the neurological effects of Covid-19 in infected patients. In this report, we present 2 LETM cases that are possibly associated with Covid-19 infection. Methods Here, we present 2 cases that subsequently developed LETM following Covid-19 infection. The first case presented a finding of tetraparesis prominent in the lower extremities that started ten days after the Covid-19 infection. The second patient was admitted with paraparesis and urinary-stool retention on the 12th day from the onset of symptoms of Covid-19 infection. Results In these 2 cases, LETM developing following Covid'19 infection was associated with Covid-19 infection. Although Covid-19 PCR was negative in the CSF of both patients, the Covid-19 PCR test was positive in the samples taken from the oropharynx. Conclusion The mechanism of LETM caused by Covid-19 infection is not clearly known. However, both direct infection of the spinal cord and excessive inflammatory response to primary Covid-19 infection may cause spinal cord damage. Therefore, possible Covid-19-associated myelitis should be kept in mind in cases of long segment transverse myelitis grouped under the title of NMOSD and without any etiological factor.Publication Pituitary involvement as a primary manifestation of granulomatosis with polyangiitis(Wolters Kluwer Medknow Publications, 2022-05-01) Koç, Emine R.; KOÇ, EMİNE RABİA; Güllü, Gizem; GÜLLÜ, GİZEM; Güner, Altuğ; GÜNER, ALTUĞ; Tolunay, Şahsine; TOLUNAY, ŞAHSİNE; Özpar, Rifat; ÖZPAR, RİFAT; Dalkılıç, Hüseyin E.; DALKILIÇ, HÜSEYİN EDİZ; Tıp Fakültesi; Nöroloji Ana Bilim Dalı; 0000-0002-0264-7284; 0000-0001-6649-9287; A-7083-2015Granulomatosis with polyangiitis is a systemic necrotizing granulomatous vasculitis that can predominantly affect systemic small- and medium-sized vessels. Isolated pituitary gland involvement at the onset of the disease is extremely rare in granulomatosis with polyangiitis and usually associated with other organ involvement, especially upper and lower respiratory tract and kidneys. This report highlights granulomatosis with polyangiitis -related pituitary dysfunction with clinical, radiological, and laboratory findings.Publication The effect of pregnancy on neuromyelitis optica spectrum disorder and myelin oligodendrocyte associated disease activity and progression: A multi-center retrospective study from turkey(Sage Publications Ltd, 2023-10-01) Uzunköprüü, Cihat; Şen, Sedat; Altıntaş, Ayşe; Çakan, Melike; Bunul, Sena Destan; Demir, Gülşen Akman; Balcı, Fatma Belgin; Gürsoy, Esra Azize; Arslan, Gökhan; Gündüz, Tuncay; Gümüş, Haluk; Acar, Nazire Pınar; Zaim, Onur Can; Yetkin, Mehmet Fatih; Boz, Cavit; Demir, Serkan; Çelik, Rabia Gökçen Gözübatik; Köseoğlu, Meşrure; Güler, Sibel; Yüceyar, Nur; Sevim, Serhan; Kurtuncu, Murat; Terzi, Murat; Turan, Ömer Faruk; Efendi, Hüsnü; Beckmann, Yeşim; Karabudak, Rana; Tuncer, Meryem Aslı; Koç, Emine; KOÇ, EMİNE RABİA; Turan, Ömer Faruk; 0000-0002-6752-1519; JCO-1811-2023; JAL-2843-2023Publication The effect of smoking on inactivated and mRNA vaccine responses applied to prevent COVID-19 in multiple sclerosis(Turkish Neuropsychiatry Assoc-Türk Noropsikiyatri Derneği, 2023-09-01) Şen, Sedat; Arslan, Gökhan; Tütüncü, Melih; Demir, Serkan; Dinç, Öykü; Gündüz, Tuncay; Uzunköprü, Cihat; Gümüş, Haluk; Tütüncü, Mesude; Akçin, Rüveyda; Özakbaş, Serkan; Köseoğlu, Mesrure; Bunul, Sena Destan; Gezer, Ozan; Çetinkaya Tezer, Damla; Baba, Cavid; Acar Özen, Pınar; Koç, Rabia; Elverdi, Tuğrul; Uygunoğlu, Uğur; Kurtuncu, Murat; Beckmann, Yeşim; Güngör Doğan, İpek; Turan, Ömer Faruk; Boz, Cavit; Terzi, Murat; Tuncer, Aslı; Saip, Sabahattin; Karabudak, Rana; Kocazeybek, Bekir; Efendi, Hüsnü; Bilge, Uğur; Siva, Aksel; KOÇ, EMİNE RABİA; Tıp Fakültesi; Nöroloji Bölümü; JHW-7556-2023Introduction: Coronavirus disease 2019 (COVID-19) is the biggest health challenge of recent times. Studies so far reveal that vaccination is the only way to prevent this pandemic. There may be factors that decrease or increase vaccine effectiveness. In multiple sclerosis (MS), some of these factors may cause changes in the effectiveness of the vaccine, depending on the nature of the disease and disease-modifying treatments (DMT). In this study, we aimed to investigate the relationship between antibody titer and smoking in non-treated and DMT-treated MS patients who received inactivated vaccine (Sinovac) and messenger RNA BNT162b2 (BioNTech) mRNA vaccines.Method: Vaccine antibody responses were measured between 4-12 weeks after two doses of inactivated vaccine and mRNA vaccines. Patients were separated into 6 groups as: patients with MS without treatment PwMS w/o T, ocrelizumab, fingolimod, interferons (interferon beta-1a and interferon beta-1b), dimethyl fumarate, and teriflunomide. Antibody titers of smokers and non-smokers were compared for both vaccines and for each group.Results: The study included 798 patients. In the mRNA vaccine group, smokers (n=148; 2982 & PLUSMN;326 AU/mL) had lower antibody titers compared to the non-smokers (n=244; 5903 & PLUSMN;545 AU/mL) in total (p=0.020). In the inactivated vaccine group, no significant difference was detected between smokers (n=136; 383 & PLUSMN;51 AU/mL) and non-smokers (n=270; 388 & PLUSMN;49 AU/mL) in total (p=0.149). In both vaccine groups, patients receiving ocrelizumab and fingolimod had lower antibody titers than those receiving other DMTs or PwMS w/o T. In untreated MS patients, antibody levels in smokers were lower than in non-smokers in the mRNA vaccine group. No difference was found between antibody levels of smokers and non-smokers in any of the inactivated vaccine groups.Conclusion: Ocrelizumab and fingolimod have lower antibody levels than PwMS w/o T or other DMTs in both mRNA and inactivated vaccine groups. Smoking decreases antibody levels in the mRNA vaccine group, while it has no effect in the inactivated vaccine group.Publication Efficacy of accelerated vaccination against hbv to achieve antibody formation in multiple sclerosis patients receiving anti-cd20 therapy(Wolters Kluwer Medknow Publications, 2023-09-01) KOÇ, EMİNE RABİA; SARIDAŞ, FURKAN; TURAN, ÖMER FARUK; Turan, Omer Faruk; Özkaya, Güven; ÖZKAYA, GÜVEN; Mengüç, Bedirhan; MENGÜÇ, BEDİRHAN; Minaz, Sema Nur; MİNAZ, SEMA NUR; Tıp Fakültesi; Bioistatistik Ana Bilim Dalı; 0000-0002-0264-7284; 0000-0001-5945-2317; 0000-0003-0297-846X; HSB-2700-2023; JCO-1811-2023Aim:Ocrelizumab is a monoclonal antibody that has been approved for use in both relapsing-remitting multiple sclerosis (RRMS) and primary progressive multiple sclerosis (PPMS). Since ocrelizumab acts on B cells, it also affects humoral immunity, thus reducing the vaccine response. In this study, we aimed to elucidate the relationship between the antibody response following rapid vaccination against hepatitis B virus (HBV) in multiple sclerosis (MS) patients receiving ocrelizumab treatment, and the time of vaccination.Materials and Methods:A total of 220 MS patients were included in this retrospective analysis. The patients' baseline HBV serostatuses (HbsAg, Anti-HbsAb, Anti-HbcAb), previous drug history for MS, whether they were vaccinated against HBV in the past, vaccination status before or after ocrelizumab treatment, and protective antibody titers according to vaccination times, occult HBV incidence and initiation of antiviral treatment were evaluated.Results:Forty-nine percent of MS patients using ocrelizumab were not vaccinated against HBV. The patients were divided into three groups according to their vaccination status as: individuals vaccinated in the past (7.3%, n = 16), vaccinated before treatment (4.5%, n = 10), and vaccinated after treatment (22.3%, n = 49). The antibody titers of the patients in the 6th month after ocrelizumab treatment were measured as 78 mIU/ml, 193 mIU/ml, and 0, respectively. The number of patients with occult HBV infection was 38.Conclusion:In patients with a suspected diagnosis of MS, HBV serostatus should be evaluated at the beginning and if necessary, patients should be vaccinated in the early period. Vaccinating patients at least 1 month before initiating multiple sclerosis treatment is more effective in terms of protective antibody formation.Publication Index of cardiac-electrophysiological balance in relapsing-remitting multiple sclerosis patients treated with fingolimod(Elsevier Sci Ltd, 2023-06-16) Günay-Polatkan, S.; GÜNAY POLATKAN, ŞEYDA; SIĞIRLI, DENİZ; Güllü, G.; GÜLLÜ, GİZEM; Sığırlı, Deniz; Koç, E. R.; KOÇ, EMİNE RABİA; Aydınlar, A.; AYDINLAR, ALİ; Turan, O. F.; TURAN, ÖMER FARUK; Tıp Fakültesi; Kardiyoloji Ana Bilim Dalı; 0000-0002-0264-7284; A-7083-2015Background: Fingolimod is indicated for the treatment of relapsing-remitting multiple sclerosis (RRMS) and also targets cardiovascular system due to receptors on cardiomyocytes. Results of previous studies are controversial for the effect of fingolimod in terms of ventricular arrhythmias. Index of cardio-electrophysiological balance (iCEB) is a risk marker for predicting malignant ventricular arrhythmia. There is no evidence on the effect of fingolimod on iCEB in patients with relapsing-remitting multiple sclerosis (RRMS). The aim of this study was to evaluate iCEB in patients with RRMS treated with fingolimod .Methods: A total of 86 patients with RRMS treated with fingolimod were included in the study. All patients underwent a standard 12-lead surface electrocardiogram at initiation of treatment and 6 h after treatment. Heart rate, RR interval, QRS duration, QT, QTc (heart rate corrected QT), T wave peak-to-end (Tp-e) interval, Tp-e/QT, Tp-e/QTc, iCEB (QT/QRS) and iCEBc (QTc/QRS) ratios were calculated from the electrocardiogram. QT correction for heart rate was performed using both the Bazett and Fridericia formulas. Pre-treatment and posttreatment values were compared.Results: Heart rate was significantly lower after fingolimod treatment (p< 0.001). While the post-treatment values of RR and QT intervals were significantly longer (p< 0.001) and post-treatment iCEB was higher (median [Q1Q3], 4.23 [3.95-4.50] vs 4.53 [4.18-5.14]; p< 0.001), it was found that there was no statistically significant change in iCEB and other study parameters derived using QT after correcting for heart rate using both of two formulas.Conclusions: In this study, it was found that fingolimod did not statistically significantly change any of the heart rate-corrected ventricular repolarization parameters, including iCEBc, and it is safe in terms of ventricular arrhythmia.Publication mRNA versus inactivated virus COVID-19 vaccines in multiple sclerosis: Humoral responses and protectivity-Does it matter?(Elsevier Sci Ltd, 2023-05-27) Tutuncu, Melih; Demir, Serkan; Arslan, Gokhan; Dinç, Öykü; Şen, Sedat; Gündüz, Tuncay; Uzunköpru, Cihat; Gümüş, Haluk; Tutuncu, Mesude; Akcin, Rueveyda; Özakbas, Serkan; Koseoglu, Mesrure; Bunul, Sena Destan; Gezen, Ozan; Tezer, Damla Çetinkaya; Baba, Cavid; Özen, Pinar Acar; Koc, Rabia; Elverdi, Tugrul; Uygunog, Ugur; Kuertuencue, Murat; Beckmann, Yesim; Dogan, Ipek Guengor; Turan, Ömer Faruk; Boz, Cavit; Terzi, Murat; Tuncer, Asli; Saip, Sabahattin; Karabudak, Rana; Kocazeybek, Bekir; Efendi, Husnu; Bilge, Ugur; Siva, Aksel; KOÇ, EMİNE RABİA; TURAN, ÖMER FARUK; Siva, Aksel; Tıp Fakültesi; Nöroloji Ana Bilim Dalı; 0000-0002-8340-6641 ; JHW-7556-2023; JHM-3244-2023; A-5132-2016Background: COVID-19 vaccines are recommended for people with multiple sclerosis (pwMS). Adequate humoral responses are obtained in pwMS receiving disease-modifying therapies (DMTs) after vaccination, with the exception of those receiving B-cell-depleting therapies and non-selective S1P modulators. However, most of the reported studies on the immunity of COVID-19 vaccinations have included mRNA vaccines, and information on inactivated virus vaccine responses, long-term protectivity, and comparative studies with mRNA vaccines are very limited. Here, we aimed to investigate the association between humoral vaccine responses and COVID-19 infection outcomes following mRNA and inactivated virus vaccines in a large national cohort of pwMS receiving DMTs.Methods: This is a cross-sectional and prospective multicenter study on COVID-19-vaccinated pwMS. Blood samples of pwMS with or without DMTs and healthy controls were collected after two doses of inactivated virus (Sinovac) or mRNA (Pfizer-BioNTech) vaccines. PwMS were sub-grouped according to the mode of action of the DMTs that they were receiving. SARS-CoV-2 IgG titers were evaluated by chemiluminescent microparticle immunoassay. A representative sample of this study cohort was followed up for a year. COVID-19 infection status and clinical outcomes were compared between the mRNA and inactivated virus groups as well as among pwMS subgroups.Results: A total of 1484 pwMS (1387 treated, 97 untreated) and 185 healthy controls were included in the an-alyses (male/female: 544/1125). Of those, 852 (51.05%) received BioNTech, and 817 (48.95%) received Sino-vac. mRNA and inactivated virus vaccines result in similar seropositivity; however, the BioNTech vaccination group had significantly higher antibody titers (7.175 +/- 10.074) compared with the Sinovac vaccination group (823 +/- 1.774) (p<0.001). PwMS under ocrelizumab, fingolimod, and cladribine treatments had lower humoral responses compared with the healthy controls in both vaccine types. After a mean of 327 +/- 16 days, 246/704 (34.9%) of pwMS who were contacted had COVID-19 infection, among whom 83% had asymptomatic or mild disease. There was no significant difference in infection rates of COVID-19 between participants vaccinated with BioNTech or Sinovac vaccines. Furthermore, regression analyses show that no association was found regarding age, sex, Expanded Disability Status Scale score (EDSS), the number of vaccination, DMT type, or humoral antibody responses with COVID-19 infection rate and disease severity, except BMI Body mass index (BMI).Conclusion: mRNA and inactivated virus vaccines had similar seropositivity; however, mRNA vaccines appeared to be more effective in producing SARS-CoV-2 IgG antibodies. B-cell-depleting therapies fingolimod and cla-dribine were associated with attenuated antibody titer. mRNA and inactive virus vaccines had equal long-term protectivity against COVID-19 infection regardless of the antibody status.Publication Sectoral and quadrant evaluation of the peripapillary retinal nerve fiber layer and ganglion cell-inner plexiform layer thickness in patients with multiple sclerosis(Galenos Publ House, 2023-12-01) Yazici, Alper; Koç, Emine Rabia; KOÇ, EMİNE RABİA; Sarıdaş, Furkan; SARIDAŞ, FURKAN; Turan, Ömer Faruk; 0000-0002-1367-240X; 0000-0001-5945-2317; JCO-1811-2023; HSB-2700-2023Objective: To evaluate the peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell-inner plexiform layer thickness (GC-IPL) in patients with multiple sclerosis (MS) by sector and quadrant.Materials and Methods: Seventy-eight eyes of 39 patients with MS and 82 eyes of 41 healthy participants were analyzed using spectral domain optical coherence tomography. Our study defined MS eyes with optic neuritis (ON) as MS ON eyes and those without ON as MS non-ON eyes. Comparisons of the GC- IPL and pRNFL thicknesses were assessed and the measurements compared with healthy controls (HCs).Results: The comparison of the average and three quadrants (superior, inferior, and temporal) measurements of the pRNFL thickness and the average and six quadrant measurements of the GC-IPL thickness between the MS ON eyes and the MS non-ON eyes revealed statistically significant differences (P < 0.05). The average and four quadrants thickness of pRNFL and the average and six quadrants thickness of GC-IPL were significantly reduced in a comparison of MS ON vs. HC with MS non-ON vs. HC eyes (P < 0.05).Conclusion: The evaluation of pRNFL and GC-IPL thicknesses in MS ON and MS non-ON eyes may be beneficial in determining the central nervous system axonal integrity.