Clinical and electrophysiological follow-up of modafinil treatment for multiple sclerosis patients with fatigue symptom

Authors : Özlem AKDOĞAN, Cemile HAKİ, Ömer Faruk TURAN, Özlem TAŞKAPILIOĞLU

Pages : 326-336

Doi:10.18621/eurj.493073

View : 13 | Download : 6

Publication Date : 2020-07-04

Article Type : Research Paper

Abstract :Objectives: In our study, we investigated the effects of modafinil therapy on clinical and neurophysiological tests of multiple sclerosis insert ignore into journalissuearticles values(MS); patients with fatigue. Methods: The study was performed on 18 MS patients insert ignore into journalissuearticles values(16 females, 2 males); at Uludağ University School of Medicine, Department of Neurology, who are followed up according to Mc Donald’s criteria, who had 36 points or above based on the fatigue assesment scala insert ignore into journalissuearticles values(FAS);, whose Beck depression inventory points were 16 and below, whose thyroid, liver and renal functions were evaluated as normal, and who had no systemic disorder. All patients had neurological examination and their expanded disability status scale insert ignore into journalissuearticles values(EDSS);, fatigue impact scala insert ignore into journalissuearticles values(FIS); and multiple sclerosis quality of life insert ignore into journalissuearticles values(MSQoL-54); were evaluated. Somatosensory evoked potential insert ignore into journalissuearticles values(SEP);, visual evoked potential insert ignore into journalissuearticles values(VEP);, brainstem auditory evoked potential insert ignore into journalissuearticles values(BAEP);, visual event related evoked potential insert ignore into journalissuearticles values(visual P300); were performed in our neurophysiology laboratory. After that the patients were given modafinil 100 mgr 1×1 insert ignore into journalissuearticles values(morning); for 1 week, the following weeks 2×1 insert ignore into journalissuearticles values(morning and noon);. At the end of the 6 weeks of therapy the patients were called to the neurology polyclinic, and their neurological examinations, EDSS, FIS, MSQoL-54, SEP, VEP, BAEP and visual P300 were repeated. Results: When the patients’ previous and subsequent FIS and MSQoL-54 total scores were compared, a significant statistical difference was found. When all 3 subgroups of FIS insert ignore into journalissuearticles values(consciousness, physical and social); were evaluated after the modafinil therapy, a significant statistical decrease in previous and successive scores were found. It is found out that modafinil therapy improves life quality which is evaluated due to MSQoL-54 insert ignore into journalissuearticles values( p < 0.05);. A significant statistical relation between the number of MS disease attacks and the three subgroups of MFIS was not figured out insert ignore into journalissuearticles values( p > 0.05);. There were no statistically significant relation between the FAS, EDSS and Beck depression inventory scores before the modafinil therapy had been applied insert ignore into journalissuearticles values( p > 0.05);. There was a statistically correlation between Beck depression inventory score and FIS’s social subgroup insert ignore into journalissuearticles values( p = 0.017);. When the patient’s SEP, VEP, BAEP, visual P300 average test values before and after the modafinil therapy were compared, a statistically significant difference was not observed. Conclusions: In our study, it is found that modafinil therapy, which is used against fatigue, one of the MS disase’s most common symptom, has a positive impact on MS life quality and patients’ clinical symptoms of fatigue, although it has no effect on patients’ evoked potential methods insert ignore into journalissuearticles values(BAEP, SEP, VEP, visual P300); performed in neurophysiology laboratory. 
Keywords : multiple sclerosis, fatigue, modafinil, evoked potential, fatigue severity scala