Since the first cases of neuromyelitis optica (NMO) had been described by Eugene Devic in 1894, the understanding of pathogenesis and clinical presentations of the disease broadened considerably (Wingerchuk et al., 2015). The discovery of an association of NMO with the presence of serum antibodies against aquaporin 4 (AQP4) facilitated the diagnostic process of the disease and allowed for better differentiation between NMO and multiple sclerosis (MS) variants. In the central nervous system (CNS), the water channel AQP4, involved in the processes of osmoregulation, is highly expressed on astrocytic end-feet (forming part of the blood-brain barrier)

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Purpose: The aim of the work is characterization of psychiatric disorders mostly observed in patients with vertigo/dizziness and imbalance. Views: Anxiety and depression are common symptoms associated with vertigo and balance disorders. It is underlined that emotional problems may be the main cause or may aggravate the symptoms of dysfunction of the vestibular system and the balance system. On the other hand, damage to these systems is associated with a higher risk of psychiatric disorders. It is estimated that dizziness in approximately 10-15% of patients may be psychogenic (functional) and their main cause is emotional disorder, especially anxiety and depression. Determination of psychogenic aetiology may be difficult as patients with vertigo usually refer their complaints as somatic disorder and do not spontaneously mention emotional problems. The coexistence of dizziness and psychiatric disorders is also an important problem. It is assessed that almost half of patients with dysfunction of the vestibular system also presents significant psychopathological symptoms. Various mechanisms of these relationships are considered. Conclusions: There is a high correlation between dizziness and impaired balance and the presence of psychiatric disorders (mainly anxiety and depression). The coexistence of dizziness and psychiatric disorders leads to persistence of symptoms, higher level of handicap and difficulties in the functioning of patients.

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IntroductionMultiple sclerosis (MS) is a chronic autoimmune-mediated demyelinating disease of the central nervous system (CNS). A clinical presentation of the disease is highly differentiated even from the earliest stages of the disease. The application of stratifying tests in clinical practice would allow for improving clinical decision-making including a proper assessment of treatment benefit/risk balance.MethodsThis prospective study included patients with MS diagnosed up to 1 year before recruitment. We analyzed serum biomarkers such as CXCL13, CHI3L1, OPN, IL-6, and GFAP and neurofilament light chains (NfLs); brain MRI parameters of linear atrophy such as bicaudate ratio (BCR), third ventricle width (TVW); and information processing speed were measured using the Symbol Digit Modalities Test (SDMT) during the 2 years follow-up.ResultsThe study included a total of 50 patients recruited shortly after the diagnosis of MS diagnosis (median 0 months; range 0–11 months), and the mean time of observation was 28 months (SD = 4.75). We observed a statistically significant increase in the EDSS score (Wilcoxon test: Z = 3.06, p = 0.002), BCR (Wilcoxon test: Z = 4.66, p < 0.001), and TVW (Wilcoxon test: Z = 2.84, p = 0.005) after 2 years of disease. Patients who had a significantly higher baseline level of NfL suffered from a more severe disease course as per the EDSS score (Mann–Whitney U-test: U = 107, Z = −2,74, p = 0.006) and presence of relapse (Mann–Whitney U-test: U = 188, Z = −2.01, p = 0.044). In the logistic regression model, none of the parameters was a significant predictor for the achieving of no evidence of disease activity status (NEDA). In the model considering all assessed parameters, only the level of NfL had a significant impact on disease progression, measured as the increase in EDSS (logistic regression: β = 0.002, p = 0.017).ConclusionWe confirmed that NfL levels in serum are associated with more active disease. Moreover, we found that TVW at the time of diagnosis was associated with an impairment in cognitive function measured by information processing speed at the end of the 2-year observation. The inclusion of serum NfL and TVW assessment early in the disease may be a good predictor of disease progression independent of NEDA.