Brain Diseases and Disorders

17

is affected by the edaravone molecule, which is used to treat ALS patients.

This results in a 33% decline in the ALS functional assessment scale, which

measures motor and bulbar functions, when compared to placebo [109].

1.6.5

Multiple Sclerosis (MS)

Multiple sclerosis (MS) is an autoimmune, multifocal, and neurodegenerative

disease that affects the brain, spinal cord, and optic nerves. In MS, demyeli-

nation, axonal loss, and a glial scar (sclerosis) develop in the white matter

of the CNS, and neurological dysfunctions are present in the related systems

[110]. Viral infections, environmental factors such as the immune system and

climate play a role in the etiology of the disease [111]. It is a chronic dis-

ease that can affect the patient’s life in physical, economic, psychological, and

social aspects, and often leads to disability. Due to the presence of various

symptoms and their unpredictable nature, patients are faced with uncertainty

about their future [112]. Since there is no definitive treatment, it can create a

financial burden on the patient and their families [113].

In MS, diagnosis is made using the clinical features of the cases, the course

of the disease, and auxiliary laboratory methods [114]. Although the diagnosis

is based on clinical findings, para-clinical tests, especially MRI examination,

are very helpful in making the diagnosis. To conclude the diagnosis, the neu-

rologist must examine clinical parameters, and results of evaluations such as

MRI, CSF, and evoked potential studies [115]. The disease can be seen in three

different clinical types: symptoms that worsen from the beginning (primary

progressive), progressive course after recurrent-remission attacks (secondary

progressive) or recurrent-progressive (relapsing-progressive) attacks [116].

Somatosensory findings, motor findings, fatigue, vision loss, brain stem

findings, cerebellar findings, cognitive problems, bladder, bowel, and sexual

disorders are the most prevalent symptoms of multiple sclerosis [117]. So-

matosensory symptoms constitute the majority of the initial manifestations

of MS [118]. Stress is an important factor affecting the onset and course of

MS [119, 120]. Negative perspective, ineffective coping, depression, and in-

sufficient social support together with stress affect the trigger of MS attacks,

and the importance of effective coping with stress in adaptation to illness is

emphasized [121].

Treatments in MS include treatment of attacks, disease-modifying treat-

ments, and management of various symptoms and complications. The aim

of relapse treatment is to shorten the recovery time in the acute period, to

reduce the severity of the attack, and to control, reduce, or cope with the

symptoms that occur in the attack [122, 123]. Early diagnosis is very impor-

tant in controlling the disability and its negative effects on quality of life.

Planning interventions for individuals diagnosed with MS from a holistic per-

spective requires understanding the coping strategies used by these patients

as well as defining the psychological symptoms that have been identified [124].