الفهرس 
Introduction and Aim of the workOnly 14 pages are availabe for public view
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Abstract
Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system (CNS).It is the leading cause of non-traumatic neurological disability in young adults. It affects mostly young women between ages 20 and 40 years.
BDNF is the most abundant and widely distributed neurotrophin in CNS. It cross talk between the nervous and immune systems and plays an important role in brain related disorders including Huntington’s disease, Alzheimer’s disease and depression.
The aim of this work was to study the serum levels of BDNF in Relapsing Remitting (RR) Multiple Sclerosis patients and the relation between BDNF and disease activity and severity in Beni-Suef governorate, north Upper Egypt.
This study is a case control study and was conducted in department Department of neu¬rologyNeu¬rology, Beni-Suef university University hospital Hospital during the period between from December 2017 to June 2018.
The study included 60 Egyptian patients with Relapsing–Remitting Multiple Sclerosis , 30 in relapse , 30 in remission and 30 Control subjects.
All patients were subjected to:
1. History taking: focusing on risk factors including family history ,environmental, infectious and clinical course of previous attacks.
2. Thorough medical examination: including vital signs and cardiac, chest and abdominal assessment.
3. Neurological assessment: guided by Multiple Sclerosis sheet of neurology Neurology departmentDepartment; Beni-Suef University including Cognitive assessment using the Mini-Mental State Examination(MMSE).
4. The assessment of neurological disability by expanded disability status score (EDSS).
4. 5- The assessment of fatigue by Modified Fatigue Impact Scale(MFIS)
5. Magnetic Resonance Imaging: Patient group was subjected to Magnetic Resonance Imaging (MRI) for brain and spinal cord, at the Radiology Department, Beni Suef University Hospital.
The following protocols were used:
T1- weighted images (axial, sagittal).
T2- weighted images (axial, coronal).
Fluid attenuated inversion recovery (FLAIR) sequence.
6. Electrophysiological evoked potentials:
Patient group was subjected to:
1-Visual Evoked Potential(VEP).
2-Somato Sensory Evoked Potential(SSEP).
Performed at the Clinical Neurophysiology Department, Beni- Suef University Hospital f University Hospital.
7. 7.Laboratory Investigations:
Blood samples were taken from patients and controls to measure the Serum level of brain derived neurotropic factor (BDNF).
Patients and controls were subjected to the measurement of serum level of brain derived neurotropic factor (BDNF).
The results of this work can be summarized in these points:
The serum level of BDNF was significantly higher in MS patients in relapse than those in remission (P-value=0.003).
There was no statistical significant difference of BDNF level between patients in relapse and control or between patients in remission and control.
There was no significant correlation between different MS patients’ characteristics including age of patients, age of onset, disease duration, number of relapses in last 2 years and total Number number of relapses with BDNF level.
There was no significant correlation between EDSS and BDNF level.
There was no significant correlation between the number of supratentorial , infratentorial or spinal cord T2 lesions in all 60 MS patients and BDNF level, but There was a positive linear correlation between the number of T2 infratentorial lesions in the patient group in remission with BDNF level.
There was a negative linear correlation between BDNF level and number of relapses in the last 2 years and this explains the protective role of BDNF.
Our study has found no correlation between patients administered different immunomodulatory therapy for MS either in relapse or in remission group and the serum level of BDNF. Immunomodulatory therapy in our patients included monthly methyle prednisolone, IM interferon beta-1a ,Interferon beta-1b, SC interferon beta-1a and azathioprine.
In our study, we found a significant positive linear correlation between modified Modified fatigue Fatigue impact Impact scale Scale (MFIS) with EDSS, age, disease duration and number of relapses.
There was a significant positive linear correlation between the number of T2 supratentorial and infratentorial lesions with EDSS in all MS patients.
There was no significant correlation between cognitive affection and BDNF level in RRMS patients.