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Sample records for active multiple sclerosis

  1. Evidence of platelet activation in multiple sclerosis

    Alexander J Steven

    2008-06-01

    Full Text Available Abstract Objective A fatality in one multiple sclerosis (MS patient due to acute idiopathic thrombocytopenic purpura (ITP and a near fatality in another stimulated our interest in platelet function abnormalities in MS. Previously, we presented evidence of platelet activation in a small cohort of treatment-naive MS patients. Methods In this report, 92 normal controls and 33 stable, untreated MS patients were studied. Platelet counts, measures of platelet activation [plasma platelet microparticles (PMP, P-selectin expression (CD62p, circulating platelet microaggragtes (PAg], as well as platelet-associated IgG/IgM, were carried out. In addition, plasma protein S activity was measured. Results Compared to controls, PMP were significantly elevated in MS (p Conclusion Platelets are significantly activated in MS patients. The mechanisms underlying this activation and its significance to MS are unknown. Additional study of platelet activation and function in MS patients is warranted.

  2. Multiple Sclerosis

    Multiple sclerosis (MS) is a nervous system disease that affects your brain and spinal cord. It damages the ... attacks healthy cells in your body by mistake. Multiple sclerosis affects women more than men. It often begins ...

  3. Activation of Necroptosis in Multiple Sclerosis

    Dimitry Ofengeim

    2015-03-01

    Full Text Available Multiple sclerosis (MS, a common neurodegenerative disease of the CNS, is characterized by the loss of oligodendrocytes and demyelination. Tumor necrosis factor α (TNF-α, a proinflammatory cytokine implicated in MS, can activate necroptosis, a necrotic cell death pathway regulated by RIPK1 and RIPK3 under caspase-8-deficient conditions. Here, we demonstrate defective caspase-8 activation, as well as activation of RIPK1, RIPK3, and MLKL, the hallmark mediators of necroptosis, in the cortical lesions of human MS pathological samples. Furthermore, we show that MS pathological samples are characterized by an increased insoluble proteome in common with other neurodegenerative diseases such as Alzheimer’s disease (AD, Parkinson’s disease (PD, and Huntington’s disease (HD. Finally, we show that necroptosis mediates oligodendrocyte degeneration induced by TNF-α and that inhibition of RIPK1 protects against oligodendrocyte cell death in two animal models of MS and in culture. Our findings demonstrate that necroptosis is involved in MS and suggest that targeting RIPK1 may represent a therapeutic strategy for MS.

  4. Falls and Physical Activity in Persons with Multiple Sclerosis

    Sosnoff, J. J.; Sandroff, B. M.; J. H. Pula; Morrison, S. M.; R. W. Motl

    2012-01-01

    Objectives. To examine the association between fall history and physical activity using an objective measure of physical activity (i.e., accelerometry) in persons with multiple sclerosis. Design. A community-based sample of 75 ambulatory persons with multiple sclerosis volunteered for the investigation. Participants self-reported fall history in the last year, underwent a neurological exam to determine Expanded Disability Status Scale (EDSS) score, and wore an accelerometer around the waist f...

  5. Inflammatory Cytokines and Physical Activity in Multiple Sclerosis

    Margarida Florindo

    2014-01-01

    Background. Besides the functional benefits, physical activity triggers a hormonal pattern of immunologic responses with an anti-inflammatory effect in individuals who suffer from multiple sclerosis. Purpose. To analyze the influence of physical activity on multiple sclerosis and identify the intensity threshold which triggers the anti-inflammatory physiological mechanism. Methodology. A systematic review was made on the databases Medline, PubMed, ScienceDirect, PloS, PEDro, and Web of Scienc...

  6. Multiple sclerosis

    Multiple sclerosis is the most common chronic inflammatory disease of myelin with interspersed lesions in the white matter of the central nervous system. Magnetic resonance imaging (MRI) plays a key role in the diagnosis and monitoring of white matter diseases. This article focuses on key findings in multiple sclerosis as detected by MRI. (orig.)

  7. Falls and Physical Activity in Persons with Multiple Sclerosis

    J. J. Sosnoff

    2012-01-01

    Full Text Available Objectives. To examine the association between fall history and physical activity using an objective measure of physical activity (i.e., accelerometry in persons with multiple sclerosis. Design. A community-based sample of 75 ambulatory persons with multiple sclerosis volunteered for the investigation. Participants self-reported fall history in the last year, underwent a neurological exam to determine Expanded Disability Status Scale (EDSS score, and wore an accelerometer around the waist for 7 consecutive days to determine physical activity. Results. Overall, 37 persons (49.3% of the sample reported falling in the last year with 28 of the 37 falling more than once. Persons who fell in the last year had a significantly lower number of steps/day than nonfallers (3510 versus 4940 steps/day; P.05. Conclusions. Collectively, the findings suggest that fall history may have little impact on current physical activity levels in persons with multiple sclerosis.

  8. Falls and Physical Activity in Persons with Multiple Sclerosis

    Sosnoff, J. J.; Sandroff, B. M.; Pula, J. H.; Morrison, S. M.; Motl, R. W.

    2012-01-01

    Objectives. To examine the association between fall history and physical activity using an objective measure of physical activity (i.e., accelerometry) in persons with multiple sclerosis. Design. A community-based sample of 75 ambulatory persons with multiple sclerosis volunteered for the investigation. Participants self-reported fall history in the last year, underwent a neurological exam to determine Expanded Disability Status Scale (EDSS) score, and wore an accelerometer around the waist for 7 consecutive days to determine physical activity. Results. Overall, 37 persons (49.3% of the sample) reported falling in the last year with 28 of the 37 falling more than once. Persons who fell in the last year had a significantly lower number of steps/day than nonfallers (3510 versus 4940 steps/day; P .05). Conclusions. Collectively, the findings suggest that fall history may have little impact on current physical activity levels in persons with multiple sclerosis. PMID:22966459

  9. Multiple Sclerosis.

    Plummer, Nancy; Michael, Nancy, Ed.

    This module on multiple sclerosis is intended for use in inservice or continuing education programs for persons who administer medications in long-term care facilities. Instructor information, including teaching suggestions, and a listing of recommended audiovisual materials and their sources appear first. The module goal and objectives are then…

  10. Multiple sclerosis

    Eleven patients with a definite diagnosis of multiple sclerosis were examined in terms of correlations between the clinical features and the results of cranial computed tomography (CT), and magnetic resonance imaging (MRI). Results: In 5 of the 11 patients, both CT and MRI demonstrated lesions consistent with a finding of multiple sclerosis. In 3 patients, only MRI demonstrated lesions. In the remaining 3 patients, neither CT nor MRI revealed any lesion in the brain. All 5 patients who showed abnormal findings on both CT and MRI had clinical signs either of cerebral or brainstem - cerebellar lesions. On the other hand, two of the 3 patients with normal CT and MRI findings had optic-nerve and spinal-cord signs. Therefore, our results suggested relatively good correlations between the clinical features, CT, and MRI. MRI revealed cerebral lesions in two of the four patients with clinical signs of only optic-nerve and spinal-cord lesions. MRI demonstrated sclerotic lesions in 3 of the 6 patients whose plaques were not detected by CT. In conclusion, MRI proved to be more helpful in the demonstration of lesions attributable to chronic multiple sclerosis. (author)

  11. Multiple sclerosis

    Stenager, Egon; Stenager, E N; Knudsen, Lone;

    1994-01-01

    , need for structural changes in home and need for pension became greater with increasing physical handicap. No significant differences between gender were found. It is concluded that patients and relatives are under increased social strain, when multiple sclerosis progresses to a moderate handicap....... Ninety-five percent lived in own house or flat and 70 percent received disablement pension. More than half of the patients (56.4 percent) were dependent on help from close relatives, most frequently spouse. The need for help, the risk of divorce, loss of contact with relatives, difficulty in going out...

  12. Multiple sclerosis research

    This volume proceedings contains four contributions which are in INIS scope, dealing with MRI and SPECT in the diagnosis of multiple sclerosis and assessment of disease activity. (H.W.). refs.; figs.; tabs

  13. Physical activity and pediatric multiple sclerosis: Developing a research agenda.

    Yeh, E Ann; Kinnett-Hopkins, Dominique; Grover, Stephanie A; Motl, Robert W

    2015-11-01

    Three-quarters of children with multiple sclerosis (MS) experience fatigue or depression, and progressive neurocognitive decline may be seen as early as two years after MS diagnosis. Furthermore, a higher magnetic resonance imaging disease burden is seen in pediatric-onset MS compared with adult-onset MS. To date, limited knowledge exists regarding behavioral methods for managing symptoms and disease progression in pediatric MS. To that end, this paper builds an evidence-based argument for the possible symptomatic and disease-modifying effects of exercise and physical activity in pediatric MS. This will be accomplished through: (a) a review of pediatric MS and its consequences; (b) a brief overview of physical activity and its consequences in children and adults with MS; and (c) a selective review of research on the neurological benefits of physical activity in pediatric populations. This topical review concludes with a list of 10 questions to guide future research on physical activity and pediatric MS. The objective of this paper is the provision of a research interest, focus and agenda involving pediatric MS and its lifelong management though exercise and physical activity behavior. Such an agenda is critical as the effects and maintenance of physical activity and exercise track across the lifespan, particularly when developed in the early stages of life. PMID:26447061

  14. Depression and Multiple Sclerosis

    Depression - National Multiple Sclerosis Society Skip to navigation Skip to content Menu Navigation National Multiple Sclerosis Society ... Twitter Email Home Symptoms & Diagnosis MS Symptoms Depression Depression Share Smaller Text Larger Text Print In this ...

  15. Multiple sclerosis - discharge

    Your doctor has told you that you have multiple sclerosis. This disease affects the brain and spinal cord ( ... your doctor may prescribe medicine. Some people with multiple sclerosis need to use a urinary catheter . This is ...

  16. Fatigue and Multiple Sclerosis

    Fatigue - National Multiple Sclerosis Society Skip to navigation Skip to content Menu Navigation National Multiple Sclerosis Society ... Twitter Email Home Symptoms & Diagnosis MS Symptoms Fatigue Fatigue Share Smaller Text Larger Text Print In this ...

  17. Multiple Sclerosis in Children

    Soroor INALOO

    2013-06-01

    , Altmann DR, Barkhof F, et al. MRI criteria for multiple sclerosis in patients presenting with clinically isolated syndromes: a multicentre retrospective study. Lancet Neurol 2007 Aug;6(8:677-86.33. Rovira A, Swanton J, Tintore M, Sastre-Garriga J, Horga A, et al. A single, early magnetic resonance imaging study in the diagnosis of multiple sclerosis. Arch Neurol 2009 May;66(5:587-92.34. Poser CM, Paty DW, Scheinberg L, McDonald WI, Davis FA, Ebers GC, et al. New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol 1983 Mar;13(3:227-31.35. Polman CH, Reingold SC, Banwell B, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 2011 Feb; 69(2:292-302.36. Mikaeloff Y, Adamsbaum C. Husson B, Vallee L, Ponsot G, Confavreux C. et al. MRI prognostic factors for relapse after acute CNS inflammatory demyelination in childhood. Brain 2004 Sep;127(Pt9:1942-7.37. Chabas D, Castillo-Trivino T, Mowry EM, Strober JB, Glenn OA, Woubant E, et al. Vanishing MS T2-bright lesions before puberty: a distinct MRI phenotype? Neurology 2008 Sep;71(14:1090-3.38. Krupp LB, Banwell B, Tenembaum S. Consensus definitions proposed for pediatric multiple sclerosis andrelated disorder. Neurology 2007 Apr;68(16 Suppl 2:S7-S12.39. Yeh EA, Chitnis T, Krupp L, Ness J, Chabas D, Kuntz N, et al. Pediatric multiple sclerosis. Nat Rev Neurol 2009 Nov;5(11:621-31.40. Banwell B, Ghezzi A, Bar-Or A, Mikaeloff Y, Tardien M. Multiple sclerosis in children: clinical diagnosis, therapeutic strategies, and future directions. Lancet Neurol 2007 Oct;6(10:887-902.41. Venkateswaran S, Banwell B. Pediatric multiple sclerosis. Neurologist 2010 Mar;16(2:92-105.42. Waubant E, Chabas D, Okuda DT, Glenn O, Mowry E, Henry RG, et al. Difference in disease burden and activity in pediatric patients on brain magnetic resonance imaging at time of multiple sclerosis onset vs adults. Arch Neurol 2009 Aug; 66(8:967-71.43. Ghassemi R, Antel SB

  18. Predicting and preventing the future: actively managing multiple sclerosis.

    Hutchinson, Michael

    2012-02-01

    Relapsing-remitting multiple sclerosis (MS) has a highly variable clinical course but a number of demographic, clinical and MRI features can guide the clinician in the assessment of disease activity and likely disability outcome. It is also clear that the inflammatory activity in the first five years of relapsing-remitting MS results in the neurodegenerative changes seen in secondary progressive MS 10-15 years later. While conventional first-line disease modifying therapy has an effect on relapses, about one third of patients have a suboptimal response to treatment. With the advent of highly active second-line therapies with their evident marked suppression of inflammation, the clinician now has the tools to manage the course of relapsing-remitting MS more effectively. The development of treatment optimisation recommendations based on the clinical response to first-line therapies can guide the neurologist in more active management of the early course of relapsing-remitting MS, with the aim of preventing both acute inflammatory axonal injury and the neurodegenerative process which leads to secondary progressive MS.

  19. CD4 T cell activation and disease activity at onset of multiple sclerosis

    Jensen, J; Langkilde, Annika Reynberg; Fenst, C; Nicolaisen, M. S.; Roed, H. G.; Christensen, M; Sellebjerg, F

    We studied CD4 T cell activation in patients with clinically isolated syndromes (CIS) suggesting an initial attack of multiple sclerosis. The percentage of blood CD26+ CD4 T cells was increased in these patients, and correlated with magnetic resonance imaging disease activity and clinical disease...

  20. Serial MRI studies using gadolinium DTPA in active multiple sclerosis

    It has been suggested that blood brain barrier (BBB) impairment is a necessary early event in the pathogenesis of the multiple sclerosis (MS) lesions. To evaluate such an hypothesis in vivo would require: (1) serial imaging studies using a modality with high sensitivity for detecting plaques; (2) a contrast enhancing agent which demonstrates BBB impairment. A serial magnetic resonance imaging (MRI) study was undertaken of a group of MS patients using the contrast agent gadolinium-DTPA. As it has been suggested that T1 and T2 relaxation times are longer in acute than chronic MS lesions, these were also measured. 3 refs.; 1 figure

  1. Multiple sclerosis

    Rühl, Geraldine; Niedl, Anna G.; Patronov, Atanas; Siewert, Katherina; Pinkert, Stefan; Kalemanov, Maria; Friese, Manuel A.; Attfield, Kathrine E.; Antes, Iris; Hohlfeld, Reinhard

    2016-01-01

    Objective: To identify target antigens presented by human leukocyte antigen (HLA)–A*02:01 to the myelin-reactive human T-cell receptor (TCR) 2D1, which was originally isolated from a CD8+ T-cell clone recognizing proteolipid protein (PLP) in the context of HLA-A*03:01, we employed a new antigen search technology. Methods: We used our recently developed antigen search technology that employs plasmid-encoded combinatorial peptide libraries and a highly sensitive single cell detection system to identify endogenous candidate peptides of mice and human origin. We validated candidate antigens by independent T-cell assays using synthetic peptides and refolded HLA:peptide complexes. A molecular model of HLA-A*02:01:peptide complexes was obtained by molecular dynamics simulations. Results: We identified one peptide from glycerolphosphatidylcholine phosphodiesterase 1, which is identical in mice and humans and originates from a protein that is expressed in many cell types. When bound to HLA-A*02:01, this peptide cross-stimulates the PLP-reactive HLA-A3-restricted TCR 2D1. Investigation of molecular details revealed that the peptide length plays a crucial role in its capacity to bind HLA-A*02:01 and to activate TCR 2D1. Molecular modeling illustrated the 3D structures of activating HLA:peptide complexes. Conclusions: Our results show that our antigen search technology allows us to identify new candidate antigens of a presumably pathogenic, autoreactive, human CD8+ T-cell-derived TCR. They further illustrate how this TCR, which recognizes a myelin peptide bound to HLA-A*03:01, may cross-react with an unrelated peptide presented by the protective HLA class I allele HLA-A*02:01. PMID:27231714

  2. Suicide and multiple sclerosis

    Stenager, E N; Stenager, Egon; Koch-Henriksen, Nils;

    1992-01-01

    In a nationwide investigation the risk of death by suicide for patients with multiple sclerosis (MS) was assessed using records kept at the Danish Multiple Sclerosis Registry (DMSR) and the Danish National Register of Cause of Death. The investigation covers all MS patients registered with DSMR...

  3. Preliminary Evidence that Self-Efficacy Predicts Physical Activity in Multiple Sclerosis

    Motl, Robert W.; McAuley, Edward; Doerksen, Shawna; Hu, Liang; Morris, Katherine S.

    2009-01-01

    Individuals with multiple sclerosis (MS) are less physically active than nondiseased people. One method for increasing physical activity levels involves the identification of factors that correlate with physical activity and that are modifiable by a well designed intervention. This study examined two types of self-efficacy as cross-sectional and…

  4. Activities of daily living and lesion position among multiple sclerosis patients by Bayes network

    Zhifang Pan; Hongtao Lu; Qi Cheng

    2013-01-01

    Magnetic resonance imaging is a highly sensitive approach for diagnosis of multiple sclerosis, and T2-weighted images can reveal lesions in the cerebral white matter, gray matter, and spinal cord. However, the lesions have a poor correlation with measurable clinical disability. In this study, we performed a large-scale epidemiological survey of 238 patients with multiple sclerosis in eleven districts by network member hospitals in Shanghai, China within 1 year. The involved patients were scanned for position and size of lesions by MRI. Results showed that lesions in the cerebrum, spinal cord, or supratentorial position had an impact on the activities of daily living in multiple sclerosis patients, as assessed by the Bayes network. On the other hand, brainstem lesions were very unlikely to influence the activities of daily living, and were not associated with the position of lesion, patient's gender, and patient's living place.

  5. Social Cognitive Correlates of Physical Activity in Inactive Adults with Multiple Sclerosis

    Dlugonski, Deirdre; Wojcicki, Thomas R.; McAuley, Edward; Motl, Robert W.

    2011-01-01

    Persons with multiple sclerosis (MS) are often physically inactive. This observation has prompted the search for modifiable constructs derived from established theories that act as correlates of physical activity. This study investigated self efficacy, outcome expectations, impediments, and goal setting as correlates of physical activity in…

  6. Telephone-Based Physical Activity Counseling for Major Depression in People with Multiple Sclerosis

    Bombardier, Charles H.; Ehde, Dawn M.; Gibbons, Laura E.; Wadhwani, Roini; Sullivan, Mark D.; Rosenberg, Dori E.; Kraft, George H.

    2013-01-01

    Objective: Physical activity represents a promising treatment for major depressive disorder (MDD) in people with multiple sclerosis (MS). We conducted a single-blind, two-arm randomized controlled trial comparing a 12-week physical activity counseling intervention delivered primarily by telephone (n = 44) to a wait-list control group (N = 48).…

  7. Rehabilitation and multiple sclerosis

    Dalgas, Ulrik

    2011-01-01

    In a chronic and disabling disease like multiple sclerosis, rehabilitation becomes of major importance in the preservation of physical, psychological and social functioning. Approximately 80% of patients have multiple sclerosis for more than 35 years and most will develop disability at some point...... of their lives, emphasising the importance of rehabilitation in order to maintain quality of life. An important aspect of multiple sclerosis rehabilitation is the preservation of physical functioning. Hot topics in the rehabilitation of physical function include (1) exercise therapy, (2) robot-assisted training...... and (3) pharmacological interventions. Exercise therapy has for many years been a controversial issue in multiple sclerosis rehabilitation and the advice generally given to patients was not to participate in physical exercise, since it was thought to lead to a worsening of symptoms or fatigue. However...

  8. Levels and Rates of Physical Activity in Older Adults with Multiple Sclerosis

    Klaren, Rachel E; Sebastiao, Emerson; Chiu, Chung-Yi; Kinnett-Hopkins, Dominique; McAuley, Edward; Motl, Robert W.

    2016-01-01

    There is much evidence supporting the safety and benefits of physical activity in adults with multiple sclerosis (MS) and recent evidence of beneficial effects on physical function in older adults with MS. However, there is very little known about physical activity participation in older adults with conditions such as MS. This study compared levels of physical activity (i.e., sedentary behavior, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA)) and rates of mee...

  9. Most Common Types of Physical Activity Self-Selected by People with Multiple Sclerosis

    Weikert, Madeline; Dlugonski, Deirdre; Balantrapu, Swathi; Motl, Robert W.

    2011-01-01

    The promotion of physical activity for people with multiple sclerosis (MS) would benefit from information about the common types of physical activity self-selected by this population. This study examined the most frequent types of physical activity self-reported by a large sample of people with MS. The data were collected as part of the baseline assessment of a longitudinal investigation of physical activity in relapsing-remitting MS (RRMS). The participants (N = 272) were sent a battery of q...

  10. Environmental correlates of physical activity in multiple sclerosis: A cross-sectional study

    McAuley Edward; Motl Robert W; Doerksen Shawna E

    2007-01-01

    Abstract Background Multiple sclerosis (MS) is a chronic neurological disease that is associated with physical inactivity. Understanding the factors that correlate with physical activity is important for developing effective physical activity promotion programs for this population. Thus, we conducted a cross-sectional study that examined the association between features of the built environment with self-reported and objectively measured physical activity behaviour in adults with MS. Methods ...

  11. Outcome Expectations and Physical Activity in Persons with Longstanding Multiple Sclerosis

    Morrison, Janet D.; Stuifbergen, Alexa K.

    2014-01-01

    Research suggests that persons with multiple sclerosis (MS) are much less physically active than the general population and that increased physical activity in persons with MS is associated with numerous benefits such as improvements in fatigue, mobility and quality of life (Motl & Pilutti, 2012). Potentially modifiable theory-based determinants of physical activity behavior need to be identified so that researchers may study their effectiveness in randomized clinical trials and clinicians ma...

  12. Imaging Surrogates of Disease Activity in Neuromyelitis Optica Allow Distinction from Multiple Sclerosis.

    Lucy Matthews

    Full Text Available Inflammatory demyelinating lesions of the central nervous system are a common feature of both neuromyelitis optica and multiple sclerosis. Despite this similarity, it is evident clinically that the accumulation of disability in patients with neuromyelitis optica is relapse related and that a progressive phase is very uncommon. This poses the question whether there is any pathological evidence of disease activity or neurodegeneration in neuromyelitis optica between relapses. To investigate this we conducted a longitudinal advanced MRI study of the brain and spinal cord in neuromyelitis optica patients, comparing to patients with multiple sclerosis and controls. We found both cross-sectional and longitudinal evidence of diffusely distributed neurodegenerative surrogates in the multiple sclerosis group (including thalamic atrophy, cervical cord atrophy and progressive widespread diffusion and myelin water imaging abnormalities in the normal appearing white matter but not in those with neuromyelitis optica, where localised abnormalities in the optic radiations of those with severe visual impairment were noted. In addition, between relapses, there were no new silent brain lesions in the neuromyelitis optica group. These findings indicate that global central nervous system neurodegeneration is not a feature of neuromyelitis optica. The work also questions the theory that neurodegeneration in multiple sclerosis is a chronic sequela to prior inflammatory and demyelinating pathology, as this has not been found to be the case in neuromyelitis optica where the lesions are often more destructive.

  13. Immunopathology of multiple sclerosis.

    Dendrou, Calliope A; Fugger, Lars; Friese, Manuel A

    2015-09-15

    Two decades of clinical experience with immunomodulatory treatments for multiple sclerosis point to distinct immunological pathways that drive disease relapses and progression. In light of this, we discuss our current understanding of multiple sclerosis immunopathology, evaluate long-standing hypotheses regarding the role of the immune system in the disease and delineate key questions that are still unanswered. Recent and anticipated advances in the field of immunology, and the increasing recognition of inflammation as an important component of neurodegeneration, are shaping our conceptualization of disease pathophysiology, and we explore the potential implications for improved healthcare provision to patients in the future. PMID:26250739

  14. Objectively Measured Physical Activity Is Associated with Brain Volumetric Measurements in Multiple Sclerosis

    Klaren, Rachel E; Hubbard, Elizabeth A.; Motl, Robert W.; Pilutti, Lara A.; Wetter, Nathan C.; Sutton, Bradley P.

    2015-01-01

    Background. Little is known about physical activity and its association with volumes of whole brain gray matter and white matter and deep gray matter structures in persons with multiple sclerosis (MS). Purpose. This study examined the association between levels of physical activity and brain volumetric measures from magnetic resonance imaging (MRI) in MS. Method. 39 persons with MS wore an accelerometer for a 7-day period and underwent a brain MRI. Normalized GM volume (NGMV), normalized WM v...

  15. Neurogenic Bladder and Multiple Sclerosis

    Krupin V.N.

    2011-12-01

    Full Text Available There have been presented general information of neurogenic bladder and the data on pathophysiology of lower urinary tract dysfunction in patients with multiple sclerosis. The characteristics of clinical presentations of neurogenic bladder in multiple sclerosis have been stated. There have been considered diagnosis and treatment problems of urinary disorders in patients with multiple sclerosis.

  16. Occupational therapy for multiple sclerosis.

    Steultjens, E.M.J.; Dekker, J.; Bouter, L.M.; Cardol, M.; Nes, J.C.M. van de; Ende, C.H.M. van den

    2003-01-01

    Background: Multiple sclerosis (MS) patients are referred to occupational therapy with complaints about fatigue, limb weakness, alteration of upper extremity fine motor coordination, loss of sensation and spasticity that causes limitations in performance of activities of daily living and social part

  17. Effects of Dietary Pattern on Day to Day Activities in Multiple Sclerosis Patients

    F Rashvand; Moshtagh Eshgh, Z.; M Farvid; M Abtahi; Amiri, Z.; Madani, H

    2011-01-01

    Introduction: Multiple Sclerosis Disease is the most common neurological demyelinization disorder in young adults that leads to their disability. Because of the side effects of treatment drugs, it seems that another method should be used. Correct nutrition is one of these methods. The aim of this research was to determine the effects of nutrition on activity of daily living in MS patients referring to the Iranian MS society in 2010. Methods: In this quasi- experimental study (before and after...

  18. Modeling lesion counts in multiple sclerosis when patients have been selected for baseline activity

    Morgan, CJ; Aban, IB; Katholi, CR; Cutter, GR

    2010-01-01

    The number of new gadolinium-enhancing lesions discovered via magnetic resonance imaging is a well-established outcome for multiple sclerosis studies, especially Phase II Studies. Due to the high cost of magnetic resonance imaging scans, many investigators select participants for the presence of lesions. While this selection procedure is thought to improve the power of inferences, the effect of screening for baseline activity on parameter estimation and interval coverage has not yet been exam...

  19. Chronic progressive multiple sclerosis

    A long-lasting immunological suppression action seems to be produced by total lymphoid irradiation; some authors emphasize the favorable effect of this treatment on chronic progressive multiple sclerosis. In order to evaluate the actual role of TLI, 6 patients affected with chronic progressive multiple sclerosis were submitted to TLI with shaped and personalized fields at the Istituto del Radio, University of Brescia, Italy. The total dose delivered was 19.8 Gy in 4 weeks, 1.8 Gy/day, 5d/w; a week elapsed between the first and the second irradiation course. Disability according to Kurtzke scale was evaluated, together with blood lymphocyte count and irradiation side-effects, over a mean follow-up period of 20.8 months (range: 13-24). Our findings indicate that: a) disease progression was not markedly reduced by TLI; b) steroid hormones responsivity was restored after irradiation, and c) side-effects were mild and tolerable

  20. Metamemory in multiple sclerosis

    Claffey, Austin M

    2010-01-01

    This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University. The concept of metamemory proposes that supplementary to typically measured memory abilities, memory monitoring and control processes are used to optimise learning. Accurate memory monitoring appears to be underpinned by a range of cognitive, and possibly affective, contributions. In populations with these deficits, metamemory has been shown to be impaired. In Multiple Sclerosis (MS), only...

  1. Albumin and multiple sclerosis

    LeVine, Steven M

    2016-01-01

    Leakage of the blood–brain barrier (BBB) is a common pathological feature in multiple sclerosis (MS). Following a breach of the BBB, albumin, the most abundant protein in plasma, gains access to CNS tissue where it is exposed to an inflammatory milieu and tissue damage, e.g., demyelination. Once in the CNS, albumin can participate in protective mechanisms. For example, due to its high concentration and molecular properties, albumin becomes a target for oxidation and nitration reactions. Furth...

  2. Adhesion molecules levels in blood correlate with MRI activity and clinical activity in multiple sclerosis

    Research into pathogenesis of multiple sclerosis (MS) has prompted efforts to identify immunological markers associated with disease activity. Adhesion molecules ICAM-1 and VCAM-1 are associated with inflammatory mediated blood-brain barrier (BBB) dysfunction. In this study investigates the correlation between blood level of circulating ICAM-1 and VCAM-1 and magnetic resonance imaging (MRI) activity in different clinical phases of patients with MS. We show that RRMS and SPMS patients in clinically active phase with Gd-enhancing lesions in CNS had higher blood levels of cICAM-1 and cVCAM-1 compared these parameters levers of RRMS patients in remission stage. These results suggest that cICAM-1 and cVCAM-1 is a sensitive indicator of disease activity associated with BBB inflammatory dysfunction. Elevated blood level of cICAM-1 more strongly correlated with clinical activity and BBB damage, than cVCAM-1 and that could be used as biological marker of disease activity. Circulating VCAM-1 as an early indicator of BBB disturbance, may also serve as marker of beneficial activity in relapses phase of MS course. (authors)

  3. Immune activation in multiple sclerosis and interferon-beta therapy

    Krakauer, Martin

    2007-01-01

    inflammation or secondary lymphatic organs. Chemokine receptors are differentially expressed in T cells in blood and cerebrospinal fluid, indicating their role for in T-cell-recruitment to the CNS. Interferon (IFN)-beta is a first-line treatment for MS. The mechanism of action is unclear, but probably includes...... changes in lymphocyte activation, cytokine secretion, and trafficking. The aim of the studies was to shed more light on T-cell immunology in MS and IFN-beta treatment, as well as identifying putative biomarkers of treatment response and/or disease activity. In one study we identified a Th-cell subset of...

  4. Immunopathogenesis of multiple sclerosis

    Racke Michael

    2009-01-01

    Full Text Available Multiple sclerosis (MS is a suspected autoimmune disease in which myelin-specific CD4+ and CD8+ T cells enter the central nervous system (CNS and initiate an inflammatory response directed against myelin and other components of the CNS. Acute MS exacerbations are believed be the result of active inflammation, and progression of disability is generally believed to reflect accumulation of damage to the CNS, particularly axonal damage. Over the last several years, the pathophysiology of MS is being appreciated to be much more complex, and it appears that the development of the MS plaque involves a large number of cell populations, including CD8+ T lymphocytes, B cells, and Th17 cells (a population of helper T cells that secrete the inflammatory cytokine IL-17. The axonal transection and degeneration that is thought to represent the basis for progressive MS is now recognized to begin early in the disease process and to continue in the progressive forms of the disease. Molecules important for limiting aberrant neural connections in the CNS have been identified, which suppress axonal sprouting and regeneration of transected axons within the CNS. Pathways have also been identified that prevent remyelination of the MS lesion by oligodendrocyte precursors. Novel neuroimaging methodologies and potential biomarkers are being developed to monitor various aspects of the disease process in MS. As we identify the pathways responsible for the clinical phenomena of MS, we will be able to develop new therapeutic strategies for this disabling illness of young adults.

  5. Occupational therapy for multiple sclerosis.

    Steultjens, E.M.J.; Dekker, J.; Bouter, L.M.; Cardol, M.; Nes, J.C.M. van de; Ende, C.H.M. van den

    2003-01-01

    Background: Multiple sclerosis (MS) patients are referred to occupational therapy with complaints about fatigue, limb weakness, alteration of upper extremity fine motor coordination, loss of sensation and spasticity that causes limitations in performance of activities of daily living and social participation. The primary purpose of occupational therapy is to enable individuals to participate in self-care, work and leisure activities that they want or need to perform. Objectives: to determine ...

  6. Tuberous Sclerosis: Multiple Presentations

    M. Sanei Taheri

    2008-01-01

    Full Text Available Introduction: Tuberous sclerosis is an autosomal do-minant genetic disorder that involves multiple or-gans. The predominant lesions are the hamartomas. Classically tuberous sclerosis has been characterized by a classic clinical triad of facial angiofibromas in 90%,retardation in 50-80%,seizure 80-90% and all three in 30%."nThe disease occurs in 1:100,000 persons in all races with nearly equal distribution between the sexes. "nCase Presentation: We had six patients who admitted with different presentations of tuberous sclerosis with a past history of convulsion from childhood, skin le-sions and mental retardation, also with new onset headache and changed pattern of convulsion. In physical examination facial angiofibromas and sub-ungual fibromas apparently detected. Brain CT scan study with contrast showed multiple calcified nod-ules associated with tubers and ventriculomegaly, also an enhancing enlarged nodule at foramen of mo-nro, which was suggestive of subependymal giant cell astrocytoma (SGCA. In abdominal and pelvic CT scan and ultrasonography, massive bilateral angio-myolipomatosis diagnosed. Also Focal hypodense le-sions in liver which were hyperechoic in ultrasono-graphy were diagnosed. With MRI study tubers, white matter lesions and subependymal nodules asso-ciated with SGCA were detected better. After surgery SGCA was proved."nDiscussion: Our patients had different presentations and various findings of this spectrum discussed in this lecture.

  7. Demyelination versus remyelination in progressive multiple sclerosis

    Bramow, Stephan; Frischer, Josa M; Lassmann, Hans;

    2010-01-01

    The causes of incomplete remyelination in progressive multiple sclerosis are unknown, as are the pathological correlates of the different clinical characteristics of patients with primary and secondary progressive disease. We analysed brains and spinal cords from 51 patients with progressive...... multiple sclerosis by planimetry. Thirteen patients with primary progressive disease were compared with 34 with secondary progressive disease. In patients with secondary progressive multiple sclerosis, we found larger brain plaques, more demyelination in total and higher brain loads of active demyelination...... compared with patients with primary progressive disease. In addition, the brain density of plaques with high-grade inflammation and active demyelination was highest in secondary progressive multiple sclerosis and remained ~18% higher than in primary progressive multiple sclerosis after adjustments for...

  8. Multiple sclerosis in magnetic resonance

    The authors analyzed MR examination of 277 patients with multiple sclerosis. White matter hyperintesities in brain were found in 270 of them, in spinal cord in 32. The most frequently they were found in periventricular white matter, in subcortical localization and in the corpus callosum. MR examination allows the estimate the activity of the disease on the basis of the presence of edema around the plaques and their contrast enhancement with Gd-DTPA. About one third of all cases were accompanied by cortical brain atrophy (the most often seen in the frontal lobes), subcortical brain atrophy was less frequent. In about two third of all cases the corpus callosum atrophy was found. MR examination is a highly sensitive method of multiple sclerosis diagnosis, of the assessment of its activity and progression. (author)

  9. Soluble CD163 as a marker of macrophage activity in newly diagnosed patients with multiple sclerosis

    Stilund, Morten; Reuschlein, Ann-Kathrin; Christensen, Tove; Møller, Holger Jon; Rasmussen, Peter Vestergaard; Petersen, Thor

    2014-01-01

    /serum ratio had an area under the curve of 0.72. CONCLUSION: The sCD163 CSF/serum ratio was significantly increased in patients with MS and may reflect macrophage activation in MS lesions. These results suggest that primary progressive MS also is driven by inflammation in which the innate immune system plays......BACKGROUND: Soluble CD163 (sCD163) is a macrophage specific protein known to be up-regulated in serum from patients with multiple sclerosis (MS). OBJECTIVE: To investigate sCD163 in serum and CSF (cerebrospinal fluid) from patients undergoing MS diagnostic work-up and analyse its potential as a...

  10. Inhibition of fatty acid metabolism ameliorates disease activity in an animal model of multiple sclerosis

    Shriver, Leah P.; Manchester, Marianne

    2011-01-01

    Multiple sclerosis is an inflammatory demyelinating disease of the central nervous system and a leading cause of neurological disability. The complex immunopathology and variable disease course of multiple sclerosis have limited effective treatment of all patients. Altering the metabolism of immune cells may be an attractive strategy to modify their function during autoimmunity. We examined the effect of inhibiting fatty acid metabolism in experimental autoimmune encephalomyelitis (EAE), a mo...

  11. Perspectives on Physical Activity Among People with Multiple Sclerosis Who Are Wheelchair Users: Informing the Design of Future Interventions

    Learmonth, Yvonne C.; Rice, Ian M.; Ostler, Teresa; Rice, Laura A.; Motl, Robert W.

    2015-01-01

    Background: People with advanced multiple sclerosis (MS) are less physically active than those with milder forms of the disease, and wheelchair use has a negative association with physical activity participation. Thus, wheelchair users with MS are doubly disadvantaged for accruing the benefits of physical activity and exercise. Appropriate physical activity and exercise interventions are needed for this population.

  12. Multiple Sclerosis and Vitamin D

    ... Editors David C. Spencer, MD Steven Karceski, MD Multiple sclerosis and vitamin D Andrew J. Solomon, MD WHAT IS VITAMIN ... 133:1869 –1888. 8. Solomon AJ, Whitham RH. Multiple sclerosis and vitamin D: a review and recommendations. Curr Neurol Neurosci ...

  13. Multiple sclerosis: evidence and controversies

    Ángela María Gutiérrez-Álvarez

    2006-01-01

    Introduction: Multiple sclerosis is a chronicrecurrent inflammatory disorder of the centralnervous system. The pharmacological treatmentof multiple sclerosis has been evaluated withmultiple controlled clinical trials that allow theclinician to count with evidence based informationto decide the more indicated treatmentfor each patient.Methodology: A review of the scientific literaturewas conducted to clarify controversialissues in a clinical relevant topic.Development: The diagnostic criteria ...

  14. Metabolomics in multiple sclerosis.

    Bhargava, Pavan; Calabresi, Peter A

    2016-04-01

    Multiple sclerosis (MS) is a chronic demyelinating disorder of the central nervous system with inflammatory and degenerative components. The cause of MS remains unknown although genetic and environmental factors appear to play a role in its etiopathogenesis. Metabolomics is a new "omics" technology that aims at measuring small molecules in various biological matrices and can provide information that is not readily obtained from genomics, transcriptomics, or proteomics. Currently, several different analytical platforms exist for metabolomics, and both untargeted and targeted approaches are being employed. Methods of analysis of metabolomics data are also being developed and no consensus currently exists on the optimal approach to analysis and interpretation of these data. Metabolomics has the potential to provide putative biomarkers, insights into the pathophysiology of the disease, and to aid in precision medicine for patients with MS. PMID:26754801

  15. Does the Effect of a Physical Activity Behavioral Intervention Vary by Characteristics of People with Multiple Sclerosis?

    Motl, Robert W.; Dlugonski, Deirdre; Pilutti, Lara A.; Klaren, Rachel E

    2015-01-01

    Background: Behavioral interventions have significantly increased physical activity in people with multiple sclerosis (MS). Nevertheless, there has been interindividual variability in the pattern and magnitude of change. This study documented the efficacy and variability of a behavioral intervention for changing physical activity and examined the possibility that efficacy varied by the characteristics of individuals with MS.

  16. Long-term assessment of No Evidence of Disease Activity with natalizumab in relapsing multiple sclerosis.

    Prosperini, Luca; Fanelli, Fulvia; Pozzilli, Carlo

    2016-05-15

    In this study we assessed the proportion of patients with relapsing multiple sclerosis (R-MS) who had No Evidence of Disease Activity (NEDA-3), defined as absence of relapses, absence of confirmed disability worsening, and absence of radiological activity (detected by magnetic resonance imaging of the brain and spinal cord) up to 7years after starting natalizumab. Out of 152 patients considered, 58 were still on treatment and 94 discontinued treatment after a median time of 3years. According to an intention-to-treat approach, 52 (34%) patients maintained the NEDA status at the end of follow-up. The proportion of patients with NEDA increases to 41% after excluding from the analysis 64 patients who discontinued natalizumab due to concerns about progressive multifocal leukoencephalopathy. Our findings suggest that natalizumab may ensure higher proportion of patients achieving sustained long-term disease remission than that previously reported with self-injectable treatments (<10%). PMID:27084235

  17. Pediatric Multiple Sclerosis.

    Lee, Ji Y; Chitnis, Tanuja

    2016-04-01

    Pediatric multiple sclerosis (MS) is a chronic inflammatory neurologic disease that is challenging to diagnose and treat. Although there are many clinical parallels between pediatric-onset MS and adult-onset MS, there is also accumulating evidence of distinguishing clinical features that may, in part, arise from development-specific, neuroimmune processes governing MS pathogenesis in children. Here the authors describe the clinical features, diagnosis, and treatment of pediatric MS, with a particular focus on describing clinical features and highlighting new developments that promise a better understanding of pediatric MS pathogenesis. An important task that lies ahead for pediatric neurologists is better understanding the early gene-environment interaction that precipitates the first demyelinating event in pediatric MS. This area is of particular importance for understanding the MS etiology and the natural history of pediatric MS. Such understanding should in turn inform new developments in diagnostic tools, long-term therapies, and much-needed biomarkers. Such biomarkers are not only valuable for defining the disease onset, but also for monitoring both the treatment response and a disease evolution that spans multiple decades in children with MS. PMID:27116721

  18. Albumin and multiple sclerosis.

    LeVine, Steven M

    2016-01-01

    Leakage of the blood-brain barrier (BBB) is a common pathological feature in multiple sclerosis (MS). Following a breach of the BBB, albumin, the most abundant protein in plasma, gains access to CNS tissue where it is exposed to an inflammatory milieu and tissue damage, e.g., demyelination. Once in the CNS, albumin can participate in protective mechanisms. For example, due to its high concentration and molecular properties, albumin becomes a target for oxidation and nitration reactions. Furthermore, albumin binds metals and heme thereby limiting their ability to produce reactive oxygen and reactive nitrogen species. Albumin also has the potential to worsen disease. Similar to pathogenic processes that occur during epilepsy, extravasated albumin could induce the expression of proinflammatory cytokines and affect the ability of astrocytes to maintain potassium homeostasis thereby possibly making neurons more vulnerable to glutamate exicitotoxicity, which is thought to be a pathogenic mechanism in MS. The albumin quotient, albumin in cerebrospinal fluid (CSF)/albumin in serum, is used as a measure of blood-CSF barrier dysfunction in MS, but it may be inaccurate since albumin levels in the CSF can be influenced by multiple factors including: 1) albumin becomes proteolytically cleaved during disease, 2) extravasated albumin is taken up by macrophages, microglia, and astrocytes, and 3) the location of BBB damage affects the entry of extravasated albumin into ventricular CSF. A discussion of the roles that albumin performs during MS is put forth. PMID:27067000

  19. Multiple sclerosis after infectious mononucleosis

    Nielsen, Trine Rasmussen; Rostgaard, Klaus; Nielsen, Nete Munk; Koch-Henriksen, Nils; Haahr, Sven; Sørensen, Per Soelberg; Hjalgrim, Henrik

    2007-01-01

    BACKGROUND: Infectious mononucleosis caused by the Epstein-Barr virus has been associated with increased risk of multiple sclerosis. However, little is known about the characteristics of this association. OBJECTIVE: To assess the significance of sex, age at and time since infectious mononucleosis......, and attained age to the risk of developing multiple sclerosis after infectious mononucleosis. DESIGN: Cohort study using persons tested serologically for infectious mononucleosis at Statens Serum Institut, the Danish Civil Registration System, the Danish National Hospital Discharge Register, and the...... Danish Multiple Sclerosis Registry. SETTING: Statens Serum Institut. PATIENTS: A cohort of 25 234 Danish patients with mononucleosis was followed up for the occurrence of multiple sclerosis beginning on April 1, 1968, or January 1 of the year after the diagnosis of mononucleosis or after a negative Paul...

  20. Current concepts in multiple sclerosis

    This volume contains 9 articles dealing with the use of nuclear magnetic resonance imaging and positron emitted tomography in the diagnosis and staging of multiple sclerosis. (H.W.). refs.; figs.; tabs

  1. Multiple sclerosis and organic solvents

    Mortensen, J T; Brønnum-Hansen, Henrik; Rasmussen, K

    1998-01-01

    We investigated a possible causal relation between exposure to organic solvents in Danish workers (housepainters, typographers/printers, carpenters/cabinetmakers) and onset of multiple sclerosis. Data on men included in the Danish Multiple Sclerosis Register (3,241 men) were linked with data from...... butchers. Over a follow-up period of 20 years, we observed no increase in the incidence of multiple sclerosis among men presumed to be exposed to organic solvents. It was not possible to obtain data on potential confounders, and the study design has some potential for selection bias. Nevertheless, the...... study does not support existing hypotheses regarding an association between occupational exposure to organic solvents and multiple sclerosis....

  2. Distinguishing active from passive components of ankle plantar flexor stiffness in stroke, spinal cord injury and multiple sclerosis

    Lorentzen, Jakob; Grey, Michael J; Crone, Clarissa;

    2010-01-01

    distinguish the contribution of active reflex mechanisms from passive muscle properties to ankle joint stiffness in 31 healthy, 10 stroke, 30 multiple sclerosis and 16 spinal cord injured participants. The results were compared to routine clinical evaluation of spasticity. METHODS: A computer...

  3. A Formative Evaluation of Customized Pamphlets to Promote Physical Activity and Symptom Self-Management in Women with Multiple Sclerosis

    Plow, Matthew; Bethoux, Francois; Mai, Kimloan; Marcus, Bess

    2014-01-01

    Inactivity is a prevalent problem in the population affected with multiple sclerosis (MS). Thus, there is a need to develop and test physical activity (PA) interventions that can be widely disseminated. We conducted a formative evaluation as part of a randomized controlled trial of a pamphlet-based PA intervention among 30 women with MS. Pamphlets…

  4. Multiple sclerosis - New treatment modalities

    Rocco Totaro; Caterina Di Carmine; Carmine Marini; Antonio Carolei

    2015-01-01

    Ever since the introduction of the first disease modifying therapies, the concept of multiple sclerosis treatment algorithms developed ceaselessly. The increasing number of available drugs is paralleled by impelling issue of ensuring the most appropriate treatment to the right patient at the right time. The purpose of this review is to describe novel agents recently approved for multiple sclerosis treatment, namely teriflunomide, alemtuzumab and dimethylfumarate, focusing on mechanism of acti...

  5. Astrocytes in multiple sclerosis.

    Ludwin, Samuel K; Rao, Vijayaraghava Ts; Moore, Craig S; Antel, Jack P

    2016-08-01

    Recent experimental and clinical studies on astrocytes are unraveling the capabilities of these multi-functional cells in normal homeostasis, and in central nervous system (CNS) disease. This review focuses on understanding their behavior in all aspects of the initiation, evolution, and resolution of the multiple sclerosis (MS) lesion. Astrocytes display remarkable flexibility and variability of their physical structure and biochemical output, each aspect finely tuned to the specific stage and location of the disease, participating in both pathogenic and beneficial changes seen in acute and progressive forms. As examples, chemo-attractive or repulsive molecules may facilitate the entry of destructive immune cells but may also aid in the recruitment of oligodendrocyte precursors, essential for repair. Pro-inflammatory cytokines may attack pathogenic cells and also destroy normal oligodendrocytes, myelin, and axons. Protective trophic factors may also open the blood-brain barrier and modulate the extracellular matrix to favor recruitment and persistence of CNS-specific immune cells. A chronic glial scar may confer structural support following tissue loss and inhibit ingress of further noxious insults and also inhibit migration of reparative cells and molecules into the damaged tissue. Continual study into these processes offers the therapeutic opportunities to enhance the beneficial capabilities of these cells while limiting their destructive effects. PMID:27207458

  6. Matrix Metalloproteinases in patients with Multiple Sclerosis.

    Rebeca A. Fernández Carriera

    2007-05-01

    Full Text Available Fundament: The proteolitic rupture of the extracellular matrix due to metalloproteinase 2 and 9 is one of the aspects that can influence in the alteration of the permeability of the blood-brain barrier (BBB in multiple sclerosis. Objective: To determine metalloproteinase activity with gelatinous activity in patients suffering from multiple sclerosis. Methods: the cerebrospinal fluid (CSF samples taken from 31 patients suffering from multiple sclerosis and a control group formed by 21 patients without neurological disease. The metalloproteinase 2 and 9 activities in the cerebrospinal fluid were determined by zimográfica technique through polyacrylamide gel electrophoresis. The bands were later analysed by their molecular weight and the relative metalloproteinase 9 activity was calculated. Total protein concentrations, albumin and immunoglobulin G (IgG, the IgG rate and the Q rate were assessed to evaluate the IgG intrathecal and the functional state of the blood-brain barrier. Results: metalloproteinase 2 activity was detected in the cerebrospinal fluid of all patients and control group. Metalloproteinase 9 activity was only found in the 61.3 % of the patients. The presence of relative metalloproteinase 9 activity was neither associated with the clinical variables nor the laboratory ones. An association was found between its presence and the oligoclonal bands in patients with multiple sclerosis. In those patients under immunomodular treatment it was presented with less frequency. Conclusions: There is a possible participation of Metalloproteinase 9 in the immunopathological mechanisms of the multiple sclerosis.

  7. Reliability of Accelerometer Scores for Measuring Sedentary and Physical Activity Behaviors in Persons With Multiple Sclerosis.

    Klaren, Rachel E; Hubbard, Elizabeth A; Zhu, Weimo; Motl, Robert W

    2016-04-01

    This brief research note examined the reliability of scores from an accelerometer as measures of sedentary and physical activity behaviors in persons with multiple sclerosis (MS). The analysis was performed on a combined data set from 2 previous longitudinal investigations of physical activity in MS. We focused on the number of days required to reliably estimate sedentary behavior, based on time spent in sedentary behavior per day and number of sedentary breaks, number of long sedentary bouts, and average length of sedentary bouts per day. We further examined the number of days required to reliably estimate physical activity behavior, based on time spent in light and moderate-to-vigorous physical activity and average length of activity bouts per day. Between 4-6 days of monitoring and 3-7 days of monitoring were necessary for good reliability of scores from all sedentary outcomes and physical activity outcomes, respectively. These results should guide research and practice examining sedentary and physical activity behaviors using accelerometry in persons with MS. PMID:27078272

  8. Leisure time activities of Iranian patients with multiple sclerosis: a qualitative study

    Hosseini, Seyed Mohammad Sadegh; Asgari, Ali; Rassafiani, Mehdi; Yazdani, Farzaneh; Mazdeh, Mehrdokht

    2016-01-01

    Background: Leisure time is one of the most important aspects of life, especially for people with chronic diseases. The concept and types of leisure have frequently been evaluated in different socio-cultural populations. The aim of this study was to identify the nature of leisure activities among a sample of Iranian patients with multiple sclerosis (MS) and classify the identified types of activities in the context of Iranian culture. Methods: In this qualitative study, semi-structured interview was applied to gather data from 34 MS patients that were selected through purposive sampling. The interviews were continued up to the point of saturation. Content analysis was used to explore experiences of the interviewees regarding their leisure activities. Results: Six categories of leisure activities were extracted for the studied patients with MS i.e.physical, social, individual, art/cultural, educational and spiritual/religious. Conclusion: The results represented the range and heterogeneity of leisure activities amongst the MS patients. Considering participation in spiritual/religious and social activities as leisure time undertaking might reflect cultural diversity in the perception and use of time for recreation. For mental health promotion purposes, paying special attention to the types of activities that people of different socio-cultural background choose for their refreshment could help health care providers in giving tailored advice for patients with MS and other chronic debilitating disease. PMID:27123437

  9. Indoleamine 2,3 Dioxygenase (IDO Expression and Activity in Relapsing-Remitting Multiple Sclerosis.

    Roberta Mancuso

    Full Text Available Interferon gamma (IFN-γ production induces the transcription of indoleamine 2,3 dioxygenase (IDO resulting in the reduction of T-cell activation and proliferation through the depletion of tryptophan and the elicitation of Treg lymphocytes. IDO was shown to be involved in the pathogenesis of autoimmune diseases; we investigated whether changes in IDO gene expression and activity could be indicative of onset of relapse in multiple sclerosis (MS patients.IDO and interferon-γ (IFN-γ gene expression, serum IDO activity (Kynurenine/Tryptophan ratio and serum neopterin concentration--a protein released by macrophages upon IFN-γ stimulation--were measured in 51 individuals: 36 relapsing remitting (RR-MS patients (21 in acute phase--AMS, 15 in stable phase--SMS and 15 healthy controls (HC. PBMCs samples in AMS patients were collected before (BT-AMS and during glucocorticoids-based therapy (DT-AMS.IDO expression was increased and IFN-γ was decreased (p<0.001 in BT-AMS compared to SMS patients. Glucocorticoids-induced disease remission resulted in a significant reduction of IDO and IFN-γ gene expression, IDO catalytic activity (p<0.001. Serum neopterin concentration followed the same trend as IDO expression and activity.Measurement of IDO gene expression and activity in blood could be a useful marker to monitor the clinical course of RR-MS. Therapeutic interventions modulating IDO activity may be beneficial in MS.

  10. Top 10 Research Questions Related to Physical Activity and Multiple Sclerosis

    Motl, Robert W.; Learmonth, Yvonne C.; Pilutti, Lara A.; Gappmaier, Eduard; Coote, Susan

    2015-01-01

    An estimated 2.5 million people worldwide are living with multiple sclerosis (MS), and this disease may be increasing in prevalence. MS is a disease of the central nervous system that is associated with heterogeneous symptoms and functional consequences, and the current first-line disease-modifying therapies often become ineffective later in the…

  11. Chemokine CCL2 and chemokine receptor CCR2 in early active multiple sclerosis

    Sørensen, Torben Lykke; Ransohoff, R M; Strieter, R M; Sellebjerg, F

    2004-01-01

    The chemokine monocyte chemoattractant protein (MCP)-1/CCL2 and its receptor CCR2 have been strongly implicated in disease pathogenesis in experimental autoimmune encephalomyelitis, an animal model of multiple sclerosis (MS), whereas data on the CCL2-CCR2 axis are scarce in MS. We studied the...

  12. CCR5 delta32, matrix metalloproteinase-9 and disease activity in multiple sclerosis

    Sellebjerg, Finn; Madsen, Hans O; Jensen, Claus V;

    2000-01-01

    Chemokines and matrix metalloproteinases (MMPs) appear to be crucial in leukocyte recruitment to the central nervous system in multiple sclerosis (MS). CCR5 delta32, a truncated allele of the CC chemokine receptor CCR5 gene encoding a non-functional receptor, did not confer protection from MS. CCR5...

  13. Levels and Rates of Physical Activity in Older Adults with Multiple Sclerosis.

    Klaren, Rachel E; Sebastiao, Emerson; Chiu, Chung-Yi; Kinnett-Hopkins, Dominique; McAuley, Edward; Motl, Robert W

    2016-05-01

    There is much evidence supporting the safety and benefits of physical activity in adults with multiple sclerosis (MS) and recent evidence of beneficial effects on physical function in older adults with MS. However, there is very little known about physical activity participation in older adults with conditions such as MS. This study compared levels of physical activity (i.e., sedentary behavior, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA)) and rates of meeting public health guidelines for MVPA (i.e., ≥30 min/day) among young (i.e., ages 20-39 years), middle-aged (i.e., ages 40-59 years) and older adults (i.e., ages ≥60 years) with MS. The sample included 963 persons with MS who provided demographic and clinical information and wore an accelerometer for a 7-day period. The primary analysis involved a between-subjects ANOVA on accelerometer variables (i.e., accelerometer wear time; number of valid days; sedentary behavior in min/day; LPA in min/day; and MVPA in min/day). Collectively, our data indicated that older adults with MS engaged in less MVPA and more sedentary behavior than middle-aged and young adults with MS. Such results highlight the importance of developing physical activity interventions as an effective means for managing the progression and consequences of MS in older adults. PMID:27330842

  14. Physical Activity and Fatigue in Breast Cancer and Multiple Sclerosis: Psychosocial Mechanisms

    McAuley, Edward; White, Siobhan M.; Rogers, Laura Q.; Motl, Robert W.; Courneya, Kerry S.

    2010-01-01

    Objective To examine the role of self-efficacy and depression as potential pathways from physical activity to fatigue in two study samples: breast cancer survivors (BCS; N=192) and individuals with multiple sclerosis (MS; N=292). Methods We hypothesized that physical activity would be indirectly associated with fatigue through its influence on self-efficacy and depressive symptomatology. A cross-sectional path analysis (BCS) and a longitudinal panel model (MS) were conducted within a covariance modeling framework. Results Physical activity had a direct effect on self-efficacy, and in turn, self-efficacy had both a direct effect on fatigue and an indirect effect through depressive symptomatology in both samples. In the MS sample, physical activity also had a direct effect on fatigue. All model fit indices were excellent. These associations remained significant when controlling for demographics and health status indicators. Conclusions Our findings suggest support for at least one set of psychosocial pathways from physical activity to fatigue, an important concern in chronic disease. Subsequent work might replicate such associations in other diseased populations and attempt to determine whether model relations change with physical activity interventions, and the extent to which other known correlates of fatigue such as impaired sleep and inflammation can be incorporated into this model. PMID:19949160

  15. Levels and Rates of Physical Activity in Older Adults with Multiple Sclerosis

    Klaren, Rachel E.; Sebastiao, Emerson; Chiu, Chung-Yi; Kinnett-Hopkins, Dominique; McAuley, Edward; Motl, Robert W.

    2016-01-01

    There is much evidence supporting the safety and benefits of physical activity in adults with multiple sclerosis (MS) and recent evidence of beneficial effects on physical function in older adults with MS. However, there is very little known about physical activity participation in older adults with conditions such as MS. This study compared levels of physical activity (i.e., sedentary behavior, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA)) and rates of meeting public health guidelines for MVPA (i.e., ≥30 min/day) among young (i.e., ages 20-39 years), middle-aged (i.e., ages 40-59 years) and older adults (i.e., ages ≥60 years) with MS. The sample included 963 persons with MS who provided demographic and clinical information and wore an accelerometer for a 7-day period. The primary analysis involved a between-subjects ANOVA on accelerometer variables (i.e., accelerometer wear time; number of valid days; sedentary behavior in min/day; LPA in min/day; and MVPA in min/day). Collectively, our data indicated that older adults with MS engaged in less MVPA and more sedentary behavior than middle-aged and young adults with MS. Such results highlight the importance of developing physical activity interventions as an effective means for managing the progression and consequences of MS in older adults. PMID:27330842

  16. Mobility disability and the pattern of accelerometer-derived sedentary and physical activity behaviors in people with multiple sclerosis

    Victor Ezeugwu; Klaren, Rachel E; Hubbard, Elizabeth A.; Patricia (Trish) Manns; Motl, Robert W.

    2015-01-01

    Objective: Low physical activity and high sedentary behavior levels are major concerns in persons with multiple sclerosis (MS) and these differ depending on the level of mobility disability. However, the manner in which daily activity is accumulated is currently unknown in this population. Methods: A secondary analysis was performed on a combined data set of persons with MS from two previous investigations of physical activity and symptomatic or quality of life outcomes in the United State...

  17. Increasing physical activity in multiple sclerosis: Replicating Internet intervention effects using objective and self-report outcomes

    Deirdre Dlugonski, BS; Robert W. Motl, PhD; Edward McAuley, PhD

    2011-01-01

    Our previous research indicated that an Internet intervention was effective in increasing self-reported physical activity in persons with multiple sclerosis (MS). The present study examined the efficacy of the same Internet intervention in persons with MS by using both objective and self-report measures of physical activity. Participants (N = 21) wore an accelerometer around the waist for 7 days and then completed the International Physical Activity Questionnaire (IPAQ) and Godin Leisure-Time...

  18. Objectively Measured Physical Activity Is Associated with Brain Volumetric Measurements in Multiple Sclerosis

    Klaren, Rachel E.; Hubbard, Elizabeth A.; Motl, Robert W.; Pilutti, Lara A.; Wetter, Nathan C.; Sutton, Bradley P.

    2015-01-01

    Background. Little is known about physical activity and its association with volumes of whole brain gray matter and white matter and deep gray matter structures in persons with multiple sclerosis (MS). Purpose. This study examined the association between levels of physical activity and brain volumetric measures from magnetic resonance imaging (MRI) in MS. Method. 39 persons with MS wore an accelerometer for a 7-day period and underwent a brain MRI. Normalized GM volume (NGMV), normalized WM volume (NWMV), and deep GM structures were calculated from 3D T1-weighted structural brain images. We conducted partial correlations (pr) controlling for demographic and clinical variables. Results. Moderate-to-vigorous physical activity (MVPA) was significantly associated with NGMV (pr = 0.370, p < 0.05), NWMV (pr = 0.433, p < 0.01), hippocampus (pr = 0.499, p < 0.01), thalamus (pr = 0.380, p < 0.05), caudate (pr = 0.539, p < 0.01), putamen (pr = 0.369, p < 0.05), and pallidum (pr = 0.498, p < 0.01) volumes, when controlling for sex, age, clinical course of MS, and Expanded Disability Status Scale score. There were no associations between sedentary and light physical activity with MRI outcomes. Conclusion. Our results provide the first evidence that MVPA is associated with volumes of whole brain GM and WM and deep GM structures that are involved in motor and cognitive functions in MS. PMID:26146460

  19. Objectively Measured Physical Activity Is Associated with Brain Volumetric Measurements in Multiple Sclerosis

    Rachel E. Klaren

    2015-01-01

    Full Text Available Background. Little is known about physical activity and its association with volumes of whole brain gray matter and white matter and deep gray matter structures in persons with multiple sclerosis (MS. Purpose. This study examined the association between levels of physical activity and brain volumetric measures from magnetic resonance imaging (MRI in MS. Method. 39 persons with MS wore an accelerometer for a 7-day period and underwent a brain MRI. Normalized GM volume (NGMV, normalized WM volume (NWMV, and deep GM structures were calculated from 3D T1-weighted structural brain images. We conducted partial correlations (pr controlling for demographic and clinical variables. Results. Moderate-to-vigorous physical activity (MVPA was significantly associated with NGMV (pr=0.370, p<0.05, NWMV (pr=0.433, p<0.01, hippocampus (pr=0.499, p<0.01, thalamus (pr=0.380, p<0.05, caudate (pr=0.539, p<0.01, putamen (pr=0.369, p<0.05, and pallidum (pr=0.498, p<0.01 volumes, when controlling for sex, age, clinical course of MS, and Expanded Disability Status Scale score. There were no associations between sedentary and light physical activity with MRI outcomes. Conclusion. Our results provide the first evidence that MVPA is associated with volumes of whole brain GM and WM and deep GM structures that are involved in motor and cognitive functions in MS.

  20. Environmental correlates of physical activity in multiple sclerosis: A cross-sectional study

    Doerksen, Shawna E; Motl, Robert W; McAuley, Edward

    2007-01-01

    Background Multiple sclerosis (MS) is a chronic neurological disease that is associated with physical inactivity. Understanding the factors that correlate with physical activity is important for developing effective physical activity promotion programs for this population. Thus, we conducted a cross-sectional study that examined the association between features of the built environment with self-reported and objectively measured physical activity behaviour in adults with MS. Methods Participants with MS (n = 196) were sent a questionnaire packet that included self-report measures of the built environment and physical activity and a pedometer in the mail and were instructed to complete the questionnaires and wear the device for seven days. Participants returned the completed questionnaires in a pre-stamped, pre-addressed envelope. Bivariate correlation analysis was conducted for examining associations between items on the environmental questionnaire with the two measures of physical activity. Stepwise regression analysis was conducted for determining the independent contributions of the significant environmental correlates for explaining variation in physical activity. Results Correlational analysis indicated that presence of shops, stores, markets or other places within walking distance (r = .20; ρ = .18), presence of a transit stop within walking distance (r = .20; ρ = .16), and accessibility of free or low-cost recreation facilities (r = .16; ρ = .15) were related to pedometer, but not self-reported, measured physical activity. Regression analysis indicated that the presence of a transit stop within walking distance independently explained 4% of variance in pedometer measured physical activity. Conclusion Physical activity is an important behaviour to promote among individuals with MS. This study indicated that aspects of the built environment are related to this health promoting behaviour among those with MS. Further research should focus on the longitudinal

  1. Environmental correlates of physical activity in multiple sclerosis: A cross-sectional study

    McAuley Edward

    2007-10-01

    Full Text Available Abstract Background Multiple sclerosis (MS is a chronic neurological disease that is associated with physical inactivity. Understanding the factors that correlate with physical activity is important for developing effective physical activity promotion programs for this population. Thus, we conducted a cross-sectional study that examined the association between features of the built environment with self-reported and objectively measured physical activity behaviour in adults with MS. Methods Participants with MS (n = 196 were sent a questionnaire packet that included self-report measures of the built environment and physical activity and a pedometer in the mail and were instructed to complete the questionnaires and wear the device for seven days. Participants returned the completed questionnaires in a pre-stamped, pre-addressed envelope. Bivariate correlation analysis was conducted for examining associations between items on the environmental questionnaire with the two measures of physical activity. Stepwise regression analysis was conducted for determining the independent contributions of the significant environmental correlates for explaining variation in physical activity. Results Correlational analysis indicated that presence of shops, stores, markets or other places within walking distance (r = .20; ρ = .18, presence of a transit stop within walking distance (r = .20; ρ = .16, and accessibility of free or low-cost recreation facilities (r = .16; ρ = .15 were related to pedometer, but not self-reported, measured physical activity. Regression analysis indicated that the presence of a transit stop within walking distance independently explained 4% of variance in pedometer measured physical activity. Conclusion Physical activity is an important behaviour to promote among individuals with MS. This study indicated that aspects of the built environment are related to this health promoting behaviour among those with MS. Further research should

  2. Effects of Dietary Pattern on Day to Day Activities in Multiple Sclerosis Patients

    F Rashvand

    2011-08-01

    Full Text Available Introduction: Multiple Sclerosis Disease is the most common neurological demyelinization disorder in young adults that leads to their disability. Because of the side effects of treatment drugs, it seems that another method should be used. Correct nutrition is one of these methods. The aim of this research was to determine the effects of nutrition on activity of daily living in MS patients referring to the Iranian MS society in 2010. Methods: In this quasi- experimental study (before and after investigation, 40 MS patients were selected on basis of purposive and accessible sampling method. The data was collected via questionnaires. The intervention comprised of correct nutrition algorithm education for 12 weeks. All questionnaires were filled before and after the intervention by subjects and then pre/post intervention data was analyzed with SPSS 16 software. Statistical tests included Student paired and T tests. Results: The statistical analysis showed that there was a significant difference between mean score of ability of activity of daily living of MS patients before and after intervention(P<0.001, thus confirming the hypothesis of the study. Conclusion: According to results, it is recommended that nutrition pattern (simple, cheap without side effects and noninvasive procedure should be used to improve the levels of activity of daily living in MS patients.

  3. Self-efficacy and environmental correlates of physical activity among older women and women with multiple sclerosis

    Morris, Katherine S.; McAuley, Edward; Motl, Robert W.

    2007-01-01

    Physical inactivity is a major health problem in the United States, particularly in elderly and disabled populations. Little research exists examining the relationships between aspects of the built environment and physical activity in older adults and individuals with multiple sclerosis (MS). We adopted a social cognitive perspective to examine the independent roles of perceptions of the environmental, self-efficacy and functional limitations in understanding physical activity levels among el...

  4. MicroRNAs as Active Players in the Pathogenesis of Multiple Sclerosis

    Elio Scarpini

    2012-10-01

    Full Text Available MicroRNAs (miRNAs are a recently discovered group of small noncoding RNAs that regulate gene expression post-transcriptionally. They are highly expressed in cells of the immune system, as well as in the central nervous system, and they are deregulated in various neurological disorders. Emerging evidence underlines an involvement of miRNAs in the pathogenesis of Multiple Sclerosis (MS. A number of miRNAs have been found to be dysregulated in blood cells from MS patients, in brain lesions, as well as in biological fluids such as serum and plasma. Despite miRNA altered expression likely showing a high tissue specificity, some profile similarities could be observed for certain miRNAs such as miR-326—such as upregulation in both active lesions and blood—though not for others such as miR-323, which demonstrated upregulation in whole blood, active brain lesions, and T-reg cells, but not in the serum of MS patients. In this review, the possible role of miRNAs in MS pathogenesis will be discussed according to all the available literature, with a particular emphasis on the possibility of considering extracellular miRNAs as a new source for both biomarker identification and therapeutic target discovery.

  5. Chemokines in the cerebrospinal fluid of patients with active and stable relapsing-remitting multiple sclerosis

    M.A. Moreira

    2006-04-01

    Full Text Available Multiple sclerosis (MS is a chronic inflammatory demyelinating disease of the human central nervous system. Although its etiology is unknown, the accumulation and activation of mononuclear cells in the central nervous system are crucial to its pathogenesis. Chemokines have been proposed to play a major role in the recruitment and activation of leukocytes in inflammatory sites. They are divided into subfamilies on the basis of the location of conserved cysteine residues. We determined the levels of some CC and CXC chemokines in the cerebrospinal fluid (CSF of 23 relapsing-remitting MS patients under interferon-ß-1a therapy and 16 control subjects using ELISA. MS patients were categorized as having active or stable disease. CXCL10 was significantly increased in the CSF of active MS patients (mean ± SEM, 369.5 ± 69.3 pg/mL when compared with controls (178.5 ± 29.1 pg/mL, P < 0.05. CSF levels of CCL2 were significantly lower in active MS (144.7 ± 14.4 pg/mL than in controls (237.1 ± 16.4 pg/mL, P < 0.01. There was no difference in the concentration of CCL2 and CXCL10 between patients with stable MS and controls. CCL5 was not detectable in the CSF of most patients or controls. The qualitative and quantitative differences of chemokines in CSF during relapses of MS suggest that they may be useful as a marker of disease activity and of the mechanisms involved in the pathogenesis of the disease.

  6. Cognitive deficits in multiple sclerosis

    Lund, H; Jønsson, A; Andresen, Jesper Graubæk;

    2012-01-01

    Objectives - Although disease load in multiple sclerosis (MS) often is based on T2 lesion volumes, the changes in T2 of normal appearing brain tissue (NABT) are rarely considered. By means of magnetic resonance, (MR) we retrospectively investigated whether T2 changes in NABT explain part of the...... Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Impairment Scale (MSIS). Voxel-wise T2 estimates and total T2 lesion volume were tested for correlations with eight cognitive domains, a general cognitive dysfunction factor (CDF), and the two clinical scales. Results - We found distinct...

  7. Accelerated Cure Project for Multiple Sclerosis

    ... main content Accelerating research toward a cure for multiple sclerosis Home Contact Us Search form Search Connect Volunteer ... is to accelerate efforts toward a cure for multiple sclerosis by rapidly advancing research that determines its causes ...

  8. Epidemiology of multiple sclerosis.

    Leray, E; Moreau, T; Fromont, A; Edan, G

    2016-01-01

    Multiple sclerosis (MS) is the most frequently seen demyelinating disease, with a prevalence that varies considerably, from high levels in North America and Europe (>100/100,000 inhabitants) to low rates in Eastern Asia and sub-Saharan Africa (2/100,000 population). Knowledge of the geographical distribution of the disease and its survival data, and a better understanding of the natural history of the disease, have improved our understanding of the respective roles of endogenous and exogenous causes of MS. Concerning mortality, in a large French cohort of 27,603 patients, there was no difference between MS patients and controls in the first 20 years of the disease, although life expectancy was reduced by 6-7 years in MS patients. In 2004, the prevalence of MS in France was 94.7/100,000 population, according to data from the French National Health Insurance Agency for Salaried Workers (Caisse nationale d'assurance maladie des travailleurs Salariés [CNAM-TS]), which insures 87% of the French population. This prevalence was higher in the North and East of France. In several countries, including France, the gender ratio for MS incidence (women/men) went from 2/1 to 3/1 from the 1950s to the 2000s, but only for the relapsing-remitting form. As for risk factors of MS, the most pertinent environmental factors are infection with Epstein-Barr virus (EBV), especially if it arises after childhood and is symptomatic. The role of smoking in MS risk has been confirmed, but is modest. In contrast, vaccines, stress, traumatic events and allergies have not been identified as risk factors, while the involvement of vitamin D has yet to be confirmed. From a genetic point of view, the association between HLA-DRB1*15:01 and a high risk of MS has been known for decades. More recently, immunogenetic markers have been identified (IL2RA, IL7RA) and, in particular thanks to studies of genome-wide associations, more than 100 genetic variants have been reported. Most of these are involved in

  9. Anti-Integrin Therapy for Multiple Sclerosis

    Eiji Kawamoto

    2012-01-01

    Full Text Available Integrins are the foremost family of cell adhesion molecules that regulate immune cell trafficking in health and diseases. Integrin alpha4 mediates organ-specific migration of immune cells to the inflamed brain, thereby playing the critical role in the pathogenesis of multiple sclerosis. Anti-alpha4 integrin therapy aiming to block infiltration of autoreactive lymphocytes to the inflamed brain has been validated in several clinical trials for the treatment of multiple sclerosis. This paper provides readers with an overview of the molecular and structural bases of integrin activation as well as rationale for using anti-alpha4 integrin therapy for multiple sclerosis and then chronicles the rise and fall of this treatment strategy using natalizumab, a humanized anti-alpha4 integrin.

  10. Profile of Differential Promoter Activity by Nucleotide Substitution at GWAS Signals For Multiple Sclerosis

    Ryu, Jihye; Woo, Jeyoung; Shin, Jimin; Ryoo, Hyunju; Kim, Younyoung; Lee, Chaeyoung

    2014-01-01

    Abstract This experimental study was conducted with completely randomized design. Genome-wide association studies (GWAS) have revealed a large number of genetic associations of nucleotide sequence variants with susceptibility to multiple sclerosis (MS). Nevertheless, studies to identify the functional relevance of these variants lag far behind identification of the GWAS signals. Expression quantitative trait loci (eQTLs) analysis and promoter activity analysis with the variants filtered by GWAS were conducted to identify their functional alleles and haplotypes. The promoter activity was assayed with reporter constructs containing variants at 8 MS GWAS signals resulted from 18 GWAS. The promoter activity differed by alternative sequence variants at upstream regions of the CYP24A1, CYP27B1, SYK, RAD21L1, PVR, ODF3B, and RGS14 genes (P < 0.05). The transcriptional regulations of sequence variants were also found by identifications of eQTLs for their corresponding genes with lymphoblastoid cells in the current study (SYK, ODF3B, RGS14, and PVR, P < 8.33 × 10−3) and with dendritic cells in a previous study (CYP27B1, P = 1.84 × 10−6). This study identified regulatory nucleotide sequences in the promoters of the CYP24A1, CYP27B1, SYK, RAD21L1, PVR, ODF3B, and RGS14 genes, and their variants differentially affected gene expression. This might result in their associations with MS susceptibility in previous GWAS. Further functional studies are required to understand the process of transcriptional regulation of the variants identified in the current study and the mechanisms underlying susceptibility to MS. PMID:25526461

  11. Genomic regions associated with multiple sclerosis are active in B cells.

    Giulio Disanto

    Full Text Available More than 50 genomic regions have now been shown to influence the risk of multiple sclerosis (MS. However, the mechanisms of action, and the cell types in which these associated variants act at the molecular level remain largely unknown. This is especially true for associated regions containing no known genes. Given the evidence for a role for B cells in MS, we hypothesized that MS associated genomic regions co-localized with regions which are functionally active in B cells. We used publicly available data on 1 MS associated regions and single nucleotide polymorphisms (SNPs and 2 chromatin profiling in B cells as well as three additional cell types thought to be unrelated to MS (hepatocytes, fibroblasts and keratinocytes. Genomic intervals and SNPs were tested for overlap using the Genomic Hyperbrowser. We found that MS associated regions are significantly enriched in strong enhancer, active promoter and strong transcribed regions (p = 0.00005 and that this overlap is significantly higher in B cells than control cells. In addition, MS associated SNPs also land in active promoter (p = 0.00005 and enhancer regions more than expected by chance (strong enhancer p = 0.0006; weak enhancer p = 0.00005. These results confirm the important role of the immune system and specifically B cells in MS and suggest that MS risk variants exert a gene regulatory role. Previous studies assessing MS risk variants in T cells may be missing important effects in B cells. Similar analyses in other immunological cell types relevant to MS and functional studies are necessary to fully elucidate how genes contribute to MS pathogenesis.

  12. Psychiatric onset of multiple sclerosis.

    Jongen, P.J.H.

    2006-01-01

    We present a patient with psychotic disorder as onset of relapsing-remitting multiple sclerosis (MS). In this patient, a 26-year-old female, neurological examination revealed only minor abnormalities. As cranial CT scan was normal, her psychosis was diagnosed as psychogenic. Literature on psychiatri

  13. The immunogenetics of multiple sclerosis

    Svejgaard, A.

    2008-01-01

    complex genetic backgrounds. HLA controls immune response genes and HLA associations indicate the involvement of autoimmunity. Multiple sclerosis (MS) was one of the first conditions proven to be HLA associated involving primarily HLA class II factors. We review how HLA studies give fundamental...

  14. [Biological treatment of multiple sclerosis

    Sorensen, P.S.; Sellebjerg, F.

    2008-01-01

    In 1996 interferon (IFN)beta was the first biopharmaceutical product to be approved for the treatment of relapsing-remitting multiple sclerosis (MS). In 2006 the more potent monoclonal antibody natalizumab was approved. Presently, a number of monoclonal antibodies are being studied, including...

  15. Genetics Home Reference: multiple sclerosis

    ... factors associated with an increased risk of developing multiple sclerosis include changes in the IL7R gene and environmental factors, such as exposure to the Epstein-Barr virus, low levels of vitamin D, and smoking. The HLA-DRB1 gene belongs ...

  16. Neuromyelitis optica and multiple sclerosis

    Bennett, J. L.; de Seze, J.; Lana-Peixoto, M.;

    2015-01-01

    Neuromyelitis optica (NMO) is an inflammatory autoimmune disease of the central nervous system that preferentially targets the optic nerves and spinal cord. The clinical presentation may suggest multiple sclerosis (MS), but a highly specific serum autoantibody against the astrocytic water channel...

  17. Uric acid in multiple sclerosis

    Koch, M; De Keyser, J

    2006-01-01

    Peroxynitrite, a reactive oxidant formed by the reaction of nitric oxide with superoxide at sites of inflammation in multiple sclerosis (MS), is capable of damaging tissues and cells. Uric acid, a natural scavenger of peroxynitrite, reduces inflammatory demyelination in experimental allergic encepha

  18. Laboratory diagnosis of multiple sclerosis

    In 26 patients with multiple sclerosis 100% responded abnormally to magnetic resonance imaging of the brain. Lesions in the posterior fossa were observed in 18 patients. The auditory brain stem response was abnormal in 15 patients, and 22 had abnormal immunoglobulins in the cerebrospinal fluid. The correlation between abnormalities of the auditory brain stem response and the magnetic resonance images was greatest in a subgroup where the two investigations were performed within a ten day interval. Results from magnetic resonance imaging, evoked potentials and cerebrospinal fluid investigations were used to reclassify 13 of 15 patients with clinically ''possible'' or ''probable''multiple sclerosis to a higher level using Poser's criteria. Evoked potentials (the auditory brain stem response in particular) correlated best with clinical multiple sclerosis category. The authors recommend that the magnetic resonance imaging is established as a first-hand investigation in evaluation of multiple sclerosis. Evoked potentials and cerebrospinal fluid investigations may prove to be more specific, however, and these investigations should also be performed as a routine. 23 refs., 2 figs., 2 tabs

  19. Cortical deafness in multiple sclerosis

    Tabira, T.; Tsuji, S; Nagashima, T; T. Nakajima; Kuroiwa, Y

    1981-01-01

    Cortical deafness in a patient with multiple sclerosis is reported. Complete recovery from total deafness was seen following stages of auditory agnosia and pure word deafness. The otological and neurophysiological studies suggested lesions in subcortical white matter. This report stresses the rarity of the condition, its subcortical origin and good prognosis.

  20. MR imaging determination of multiple sclerosis activity on non-contrast-enhanced study

    The location of Gd-DTPA-enhancing multiple sclerosis (MS) plaques on MR imaging has been found to correspond to the site of new neurologic deficits; however, characteristics differentiating new from old plaques on nonenhanced T2-weighted images have not been described. In the present study, nonenhanced MS characteristics (mean pixel intensity, size and contour) of plaques that enhanced with gadolinium were compared to characteristics of plaques that did not enhance. The gadolinium-enhancing plaques, in general, had a lower mean pixel value and were less well defined on T2-weighted images than nonenhancing lesions. Their intensity, however, increased relative to adjacent plaques on more heavily weighted T2-images

  1. Chemokine receptor CCR5 in interferon-treated multiple sclerosis

    Sellebjerg, F; Kristiansen, T B; Wittenhagen, P;

    2007-01-01

    To study the relationship between CC chemokine receptor CCR5 expression and disease activity in multiple sclerosis (MS) patients treated with beta-interferon (IFN-beta).......To study the relationship between CC chemokine receptor CCR5 expression and disease activity in multiple sclerosis (MS) patients treated with beta-interferon (IFN-beta)....

  2. Soluble CD163 as a marker of macrophage activity in newly diagnosed patients with multiple sclerosis.

    Morten Stilund

    Full Text Available BACKGROUND: Soluble CD163 (sCD163 is a macrophage specific protein known to be up-regulated in serum from patients with multiple sclerosis (MS. OBJECTIVE: To investigate sCD163 in serum and CSF (cerebrospinal fluid from patients undergoing MS diagnostic work-up and analyse its potential as a diagnostic biomarker. METHODS: After a full MS diagnostic work-up, including collection of paired samples of CSF and serum, 183 patients were evaluated for inclusion in this study. Patients were divided into groups based on their diagnosis. Patients with normal clinical and paraclinical findings were grouped as symptomatic controls. Serum and CSF levels of sCD163 were determined by enzyme-linked immunosorbent assay (ELISA. RESULTS: sCD163 could be measured in all serum and CSF samples. A high sCD163 CSF/serum ratio in relation to molecular weight was found, strongly indicating local production in the CNS. Median levels of sCD163 were significantly decreased in serum and significantly elevated in CSF in patients with relapsing-remitting, and primary-progressive MS. There were, however, some overlaps of the measures between groups. In a receiver operating characteristic (ROC analysis sCD163 CSF/serum ratio had an area under the curve of 0.72. CONCLUSION: The sCD163 CSF/serum ratio was significantly increased in patients with MS and may reflect macrophage activation in MS lesions. These results suggest that primary progressive MS also is driven by inflammation in which the innate immune system plays a pivotal role.

  3. Hypovitaminosis D association with disease activity in relapsing remitting multiple sclerosis in Brazil.

    Becker, Jefferson; Callegaro, Dagoberto; Lana-Peixoto, Marco Aurélio; Talim, Natália; Vidaletti, Tamara; de Paula Corrêa, Marcelo; Gomes, Irenio

    2016-04-15

    Multiple sclerosis (MS) onset is believed to result from a combination of environmental and genetic factors. A prevailing theory addresses the influence of hypovitaminosis D in the development of MS. This research aimed to study the association between vitamin D serum levels and MS, as a prognostic and risk factor for the development and progression of the disease. A cross-sectional multicenter study was conducted in patients with relapsing-remitting MS (n=67), according to the revised McDonald criteria (2010), accompanied in three MS centers in different Brazilian states. A control group consisted of healthy volunteers (n=61). Blood collections were carried out in late summer and late winter. This seems to be the first study of this kind in Latin America. The vitamin D serum levels for MS patients (29.63±8.08) in summer were similar to the controls (29.71±8.28); however, in winter they were lower than the healthy individuals (24.05±7.47 vs 26.56±8.01). No significant difference between the three cities was observed. No association was noted between vitamin D serum levels and gender, race and age, nor correlation of these levels with the EDSS or disease duration. In contrast, a significant association was seen between deficient vitamin D serum levels in late winter with disease activity, characterized by the onset of relapses (19.73±5.69 vs 25.30±6.22) or Gd+ lesions (17.22±3.11 vs 22.79±7.22). PMID:27000256

  4. Multiple sclerosis and herpesvirus interaction

    Guilherme Sciascia do Olival

    2013-09-01

    Full Text Available Multiple sclerosis is the most common autoimmune inflammatory demyelinating disease of the central nervous system, and its etiology is believed to have both genetic and environmental components. Several viruses have already been implicated as triggers and there are several studies that implicate members of the Herpesviridae family in the pathogenesis of MS. The most important characteristic of these viruses is that they have periods of latency and exacerbations within their biological sanctuary, the central nervous system. The Epstein-Barr, cytomegalovirus, human herpesvirus 6 and human herpesvirus 7 viruses are the members that are most studied as being possible triggers of multiple sclerosis. According to evidence in the literature, the herpesvirus family is strongly involved in the pathogenesis of this disease, but it is unlikely that they are the only component responsible for its development. There are probably multiple triggers and more studies are necessary to investigate and define these interactions.

  5. Diagnostic value of macrophage activity MRI in rat model of multiple sclerosis

    Objective: To investigate the value of macrophage activity imaging (MAI) in the diagnosis of brain and spinal cord lesions in rat model of multiple sclerosis (MS). Methods: Twenty LEW rats were divided into 15 model rats and 5 control rats. MS animal model, experimental autoimmune encephalomyelitis (EAE) was induced by the injection of peptide 35-55 of myelin oligodendrocyte glycoprotein (MOG35-55), MRI was performed on the third day of the acute stage of disease. The brain and spinal cord of' rats were scanned by 3.0 T MR scanner (Siemens Trio Tim) with quadrature wrist joint coil. The T2W and T1W images, Gadolinium enhanced T1W images in 3D volume were obtained respectively. The MAI were obtained at 24 hours after intravenous injection of ultra small superparamagnetic iron oxide (USPIO) as contrast medium on T2WI. The workstation with special software was used for the reconstruction images of brain and spinal cord of rat in multiple orientations. Results: Fifteen MOG3555-EAE rats model of' MS were successfully induced. The great majority lesions of central nervous system in acute stage were located in the brain (58/63) and less in the spinal cord (5/63). The main manifestation of EAE lesions presented was hyperintensity on T2WI and hypointensity on T1WI, and some lesions had enhancement after Gd-DTPA injection. The EAE lesions presented as hypointensity on MAI images, but some of them were found to be isointensity on T2WI. The enhancement pattern was discrepant between USPIO and Gd-DTPA. The sensitivity of depicting lesions of MOG35-55-EAE rat at acute stage were higher on T2WI (14/15) and MAI (13/15), and the detection rate was 100% (15/15) if they were combined. Gd-DTPA enhanced T1WI had a lower sensitivity (7/15). All the MAI findings were negative in the control rats. Conclusions: MAI can complement the drawback of conventional MRI techniques by continuously monitoring the inflammatory activity of EAE lesions, and it could raise the detection rate of EAE

  6. Vitamin D Levels Predict Multiple Sclerosis Progression

    ... Research Matters NIH Research Matters February 3, 2014 Vitamin D Levels Predict Multiple Sclerosis Progression Among people ... sclerosis (MS), those with higher blood levels of vitamin D had better outcomes during 5 years of ...

  7. Multiple sclerosis - New treatment modalities

    Rocco Totaro

    2015-01-01

    Full Text Available Ever since the introduction of the first disease modifying therapies, the concept of multiple sclerosis treatment algorithms developed ceaselessly. The increasing number of available drugs is paralleled by impelling issue of ensuring the most appropriate treatment to the right patient at the right time. The purpose of this review is to describe novel agents recently approved for multiple sclerosis treatment, namely teriflunomide, alemtuzumab and dimethylfumarate, focusing on mechanism of action, efficacy data in experimental setting, safety and tolerability. The place in therapy of newer treatment implies careful balancing of risk-benefit profile as well as accurate patient selection. Hence the widening of therapeutic arsenal provides greater opportunity for personalized therapy but also entails a complex trade-off between efficacy, tolerability, safety and eventually patient preference.

  8. Molecular mimicry and multiple sclerosis

    Michael Namaka; Michael R. Mulvey; Sabina Kapoor; Leann Simms; Christine Leong; Amy Grossberndt; Michael Prouta; Emma Frost; Farid Esfahani; Andrew Gomori

    2011-01-01

    Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system. Although the exact underlying mechanism leading to myelin destruction is unknown, the molecular mimicry theory is the most commonly acknowledged elucidation of MS pathology. Although various antigens have been associated with MS induction, this review presents studies focused on key bacterial and viral antigens that lead to the development of MS. The research specific to a molecular mimicry theory of MS via each implicated agent is weak; however, collectively the reports provide credible support for this theory. Given that homologous sequences are not required to lead to antigenic cross-reactivity, it is reasonable to conclude that certain viral and bacterial antigens with 5-10 similar amino acids in sequence can lead to self destruction of similar myelin sequences. Thus, this literature review has provided insight to further the understanding of the etiology of multiple sclerosis.

  9. Iron chelation and multiple sclerosis

    Kelsey J. Weigel; Sharon G. Lynch; Steven M. LeVine

    2014-01-01

    Histochemical and MRI studies have demonstrated that MS (multiple sclerosis) patients have abnormal deposition of iron in both gray and white matter structures. Data is emerging indicating that this iron could partake in pathogenesis by various mechanisms, e.g., promoting the production of reactive oxygen species and enhancing the production of proinflammatory cytokines. Iron chelation therapy could be a viable strategy to block iron-related pathological events or it can confer cellular prote...

  10. Nutrition Facts in Multiple Sclerosis

    Riccio, Paolo; Rossano, Rocco

    2015-01-01

    The question whether dietary habits and lifestyle have influence on the course of multiple sclerosis (MS) is still a matter of debate, and at present, MS therapy is not associated with any information on diet and lifestyle. Here we show that dietary factors and lifestyle may exacerbate or ameliorate MS symptoms by modulating the inflammatory status of the disease both in relapsing-remitting MS and in primary-progressive MS. This is achieved by controlling both the metabolic and inflammatory p...

  11. Cell Therapy for Multiple Sclerosis

    Ben-Hur, Tamir

    2011-01-01

    The spontaneous recovery observed in the early stages of multiple sclerosis (MS) is substituted with a later progressive course and failure of endogenous processes of repair and remyelination. Although this is the basic rationale for cell therapy, it is not clear yet to what degree the MS brain is amenable for repair and whether cell therapy has an advantage in comparison to other strategies to enhance endogenous remyelination. Central to the promise of stem cell therapy is the therapeutic pl...

  12. Vitamin D and Multiple Sclerosis

    Raghuwanshi, Anita; Joshi, Sneha S.; Christakos, Sylvia

    2008-01-01

    Vitamin D is a principal regulator of calcium homeostasis. However, recent evidence has indicated that vitamin D can have numerous other physiological functions including inhibition of proliferation of a number of malignant cells including breast and prostate cancer cells and protection against certain immune mediated disorders including multiple sclerosis (MS). The geographic incidence of MS indicates an increase in MS with a decrease in sunlight exposure. Since vitamin D is produced in the ...

  13. Cognitive Dysfunction in Multiple Sclerosis

    Joana eGuimarães; Maria José eSá

    2012-01-01

    In Multiple Sclerosis (MS) prevalence studies of community and clinical samples, indicate that 45–60% of patients are cognitively impaired. These cognitive dysfunctions have been traditionally described as heterogeneous, but more recent studies suggest that there is a specific pattern of MS-related cognitive dysfunctions. With the advent of disease-modifying medications for MS and emphasis on early intervention and treatment, detection of cognitive impairment at its earliest stage becomes par...

  14. Cranial Neuropathy in Multiple Sclerosis

    Mine Hayriye Sorgun; Bilge Koçer; Funda Kaplan; Nesrin Yılmaz; Nezih Yücemen; Canan Yücesan

    2011-01-01

    OBJECTIVE: It has been reported that cranial neuropathy findings could be seen in the neurologic examination of multiple sclerosis (MS) patients, although brain magnetic resonance imaging (MRI) may not reveal any lesion responsible for the cranial nerve involvement. The aim of this study was to determine the frequency of brainstem and cranial nerve involvement, except for olfactory and optic nerves, during MS attacks, and to investigate the rate of an available explanation for the cranial neu...

  15. Multiple sclerosis and birth order.

    James, W. H.

    1984-01-01

    Studies on the birth order of patients with multiple sclerosis have yielded contradictory conclusions. Most of the sets of data, however, have been tested by biased tests. Data that have been submitted to unbiased tests seem to suggest that cases are more likely to occur in early birth ranks. This should be tested on further samples and some comments are offered on how this should be done.

  16. Magnetic resonance in multiple sclerosis

    Magnetic Resonance Imaging was performed in more than 200 patients with clinical suspicion or knowledge of Multiple Sclerosis. One hundred and forty-seven (60 males and 87 females) had MR evidence of multiple sclerosis lesions. The MR signal of demyelinating plaques characteristically has prolonged T1 and T2 relaxation times and the T2-weighted spin-echo sequences are generally superior to the T1-weighted images because the lesions are better visualized as areas of increased signal intensity. MR is also able to detect plaques in the brainstem, cerebellum and within the cervical spinal cord. MR appears to be an important, non-invasive method for the diagnosis of Multiple Sclerosis and has proven to be diagnostically superior to CT, evoked potentials (EP) and CSF examination. In a selected group of 30 patients, with the whole battery of the relevant MS studies, MR was positive in 100%, CT in 33,3%, EP in 56% and CSF examination in 60%. In patients clinically presenting only with signs of spinal cord involvement or optic neuritis or when the clinical presentation is uncertain MR has proven to be a very useful diagnostic tool for diagnosis of MS by demonstrating unsuspected lesions in the cerebral hemispheres. (orig.)

  17. Natalizumab therapy of multiple sclerosis.

    Hutchinson, Michael

    2010-10-01

    Multiple sclerosis (MS) is the commonest disabling neurological disease of young and middle-aged adults affecting 1 million persons world wide. The illness begins with a relapsing-remitting MS course in 85%–90% of patients; the other 10%–15% have a primary progressive onset MS. Our current understanding is that MS is an autoimmune disorder with an inflammatory T-cell attack on myelin or some component of the oligodendrocyte--myelin structure. Relapses of disease activity result in plaques of demyelination with destruction of myelin and, to a lesser, extent axons. Lymphocytes within the central nervous system tissue recruit more cells leading to an inflammatory cascade that causes myelin damage, axonal disruption, and neuronal death. If the plaque occurs in a vocal area of the central nervous system then symptoms relating to that area result. However, magnetic resonance imaging shows that approximately 10 times more lesions occur in asymptomatic areas of the brain. Recovery from an initial relapse may appear relatively complete but persistent inflammation results in axonal injury and residual disability results. With time and accumulated lesion load, secondary degeneration of denuded axons results in the phase of secondary progressive MS usually 15-20 years after onset. PMID:20874255

  18. Islamic fasting and multiple sclerosis

    2014-01-01

    Background Month-long daytime Ramadan fasting pose s major challenges to multiple sclerosis (MS) patients in Muslim countries. Physicians should have practical knowledge on the implications of fasting on MS. We present a summary of database searches (Cochrane Database of Systematic Reviews, PubMed) and a mini-symposium on Ramadan fasting and MS. In this symposium, we aimed to review the effect of fasting on MS and suggest practical guidelines on management. Discussion In general, fasting is possible for most stable patients. Appropriate amendment of drug regimens, careful monitoring of symptoms, as well as providing patients with available evidence on fasting and MS are important parts of management. Evidence from experimental studies suggests that calorie restriction before disease induction reduces inflammation and subsequent demyelination and attenuates disease severity. Fasting does not appear to have unfavorable effects on disease course in patients with mild disability (Expanded Disability Status Scale (EDSS) score ≤3). Most experts believed that during fasting (especially in summer), some MS symptoms (fatigue, fatigue perception, dizziness, spasticity, cognitive problems, weakness, vision, balance, gait) might worsen but return to normal levels during feasting. There was a general consensus that fasting is not safe for patients: on high doses of anti-convulsants, anti-spastics, and corticosteroids; with coagulopathy or active disease; during attacks; with EDSS score ≥7. Summary These data suggest that MS patients should have tailored care. Fasting in MS patients is a challenge that is directly associated with the spiritual belief of the patient. PMID:24655543

  19. Natalizumab therapy of multiple sclerosis.

    Hutchinson, Michael

    2012-02-01

    Multiple sclerosis (MS) is the commonest disabling neurological disease of young and middle-aged adults affecting 1 million persons world wide. The illness begins with a relapsing-remitting MS course in 85%-90% of patients; the other 10%-15% have a primary progressive onset MS. Our current understanding is that MS is an autoimmune disorder with an inflammatory T-cell attack on myelin or some component of the oligodendrocyte--myelin structure. Relapses of disease activity result in plaques of demyelination with destruction of myelin and, to a lesser, extent axons. Lymphocytes within the central nervous system tissue recruit more cells leading to an inflammatory cascade that causes myelin damage, axonal disruption, and neuronal death. If the plaque occurs in a vocal area of the central nervous system then symptoms relating to that area result. However, magnetic resonance imaging shows that approximately 10 times more lesions occur in asymptomatic areas of the brain. Recovery from an initial relapse may appear relatively complete but persistent inflammation results in axonal injury and residual disability results. With time and accumulated lesion load, secondary degeneration of denuded axons results in the phase of secondary progressive MS usually 15-20 years after onset.

  20. Rehabilitation challenges in multiple sclerosis

    Burks Jack

    2009-01-01

    Full Text Available While current immunomodulating drugs aim to reduce multiple sclerosis (MS exacerbations and slow disease progression, rehabilitation aims to improve and maintain the functional abilities of patients in the face of disease progression. An increasing number of journal articles are describing the value of the many rehabilitation interventions that can be used throughout the course of the disease, from the initial symptoms to the advanced stages. An integrated team of healthcare professionals is necessary to address a myriad of problems to reduce impairments, disabilities, and handicaps. The problems may be related to fatigue, weakness, spasticity, mobility, balance, pain, cognition, mood, relationships, bowel, bladder, sexual function, swallowing, speech, transportation, employment, recreation, and activities of daily living (ADL such as dressing, eating, bathing, and household chores. The team can help prevent complications and secondary disabilities, while increasing patient safety. Improving neurologically related function, maintaining good relationships, and feeling productive and creative adds enormously to the quality of life of people with MS and their families. Rehabilitation is more than an ′extra′ service that is given after medical therapies; it is an integral part of the management of the diverse set of problems encountered throughout the course of the disease. An interdisciplinary team may have many members, including physicians, nurses, physical therapists, occupational therapists, speech and language pathologists, psychotherapists, social workers, recreational therapists, vocational rehabilitation therapists, patients, families, and other caregivers.

  1. Systematic imaging review: Multiple Sclerosis

    Aparna Katdare

    2015-01-01

    Full Text Available Multiple sclerosis (MS is a chronic, inflammatory disease of the central nervous system characterised by immune-mediated demyelination, and is a leading cause of neurological disability worldwide. It has a wide spectrum of clinical presentations which overlap with other neurological conditions many times. Further, the radiological array of findings in MS can also be confused for multiple other conditions, leading to the need to look for the more typical findings, and interpret these in close conjunction with the clinical picture including temporal evolution. This review aims to revisit the MRI findings in MS, including recent innovations in imaging, and to help distinguish MS from its mimics.

  2. Selected extracellular microRNA as potential biomarkers of multiple sclerosis activity--preliminary study.

    Kacperska, Magdalena Justyna; Jastrzebski, Karol; Tomasik, Bartlomiej; Walenczak, Jakub; Konarska-Krol, Maria; Glabinski, Andrzej

    2015-05-01

    Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system (CNS). Four distinct disease courses are known, although approximately 90% of patients are diagnosed with the relapsing-remitting form (RRMS). The name "multiple sclerosis" pertains to the underlying pathology: the presence of demyelinating plaques in the CNS, in particular in the periventricular region, corpus callosum, cervical spine, and the cerebellum. There are ongoing efforts to discover biomarkers that would allow for an unequivocal diagnosis, assess the activity of inflammatory and neurodegenerative processes, or warn of disease progression. At present, small noncoding RNA particles-microRNA (miRNA, miR) seem to be particularly noteworthy, as they take part in posttranscriptional regulation of expression of various genes. Changes in composition as well as function of miRNA found in body fluids of MS patients are subjects of research, in the hope they prove accurate markers of MS activity. This preliminary study aims to evaluate the expression of selected extracellular microRNA particles (miRNA-let-7a, miRNA-92a, miRNA-684a) in patients experiencing MS relapse and remission, with healthy volunteers serving as a control group and to evaluate the correlation between miRNA expression and selected clinical parameters of those patients. Thirty-seven patients suffering from MS formed two examined groups: 20 patients undergoing relapse and 17 in remission. Thirty healthy volunteers formed the control group. All patients who were subjects to peripheral blood sampling had been hospitalized in the Department of Neurology and Stroke(1). Four milliliters of venous whole blood had been collected into EDTA tubes. The basis for the selection of the three particular miRNA investigated in this study (miRNA-let-7a, miRNA-92a, miRNA-684a) was a preliminary bioinformatic analysis of data compiled from several medical databases, including Ovid MEDLINE®, Embase, Cochrane Database of

  3. Activation of Cannabinoid CB2 receptors Reduces Hyperalgesia in an Experimental Autoimmune Encephalomyelitis Mouse Model of Multiple Sclerosis

    Fu, Weisi; Taylor, Bradley K.

    2015-01-01

    Clinical trials investigating the analgesic efficacy of cannabinoids in multiple sclerosis have yielded mixed results, possibly due to psychotropic side effects mediated by cannabinoid CB1 receptors. We hypothesized that a CB2-specific agonist (JWH-133) would decrease hyperalgesia in an experimental autoimmune encephalomyelitis mouse model of multiple sclerosis. 4 weeks after induction of experimental autoimmune encephalomyelitis, we found that intrathecal administration of JWH-133 (10–100 μg...

  4. The relation between inflammation and neurodegeneration in multiple sclerosis brains

    Frischer, J.M.; Bramow, S.; Dal-Bianco, A.;

    2009-01-01

    Some recent studies suggest that in progressive multiple sclerosis, neurodegeneration may occur independently from inflammation. The aim of our study was to analyse the interdependence of inflammation, neurodegeneration and disease progression in various multiple sclerosis stages in relation to...... disease or brain lesions. We found that pronounced inflammation in the brain is not only present in acute and relapsing multiple sclerosis but also in the secondary and primary progressive disease. T- and B-cell infiltrates correlated with the activity of demyelinating lesions, while plasma cell...... infiltrates were most pronounced in patients with secondary progressive multiple sclerosis (SPMS) and primary progressive multiple sclerosis (PPMS) and even persisted, when T- and B-cell infiltrates declined to levels seen in age matched controls. A highly significant association between inflammation and...

  5. The management of multiple sclerosis in children: a European view

    Ghezzi, Angelo; Banwell, Brenda; Boyko, Alexey;

    2010-01-01

    About 3-5% of all patients with multiple sclerosis experience the onset of their disease under the age of 16. A significant proportion of paediatric multiple sclerosis patients develop significant cognitive disturbances and persistent physical disability. The high relapse rate and the morbidity in...... the paediatric multiple sclerosis population has triggered the use of disease-modifying therapies that have been shown to reduce relapse rate, disease progression and cognitive decline in adult patients with multiple sclerosis. Hard evidence for the right treatment and its appropriate timing is scarce...... in paediatric multiple sclerosis. Nevertheless, expertise in this field has grown thanks to recent open-label trials and experience generated in specialized centres. In spring 2009, a first meeting was held in Rotterdam with clinicians from 11 European countries (one from Canada) that are all active...

  6. Vitamin D and multiple sclerosis

    Asghar Amini Harandi; Ali Amini Harandi; Hossein Pakdaman; Mohammad Ali Sahraian

    2014-01-01

    Multiple sclerosis (MS) is a chronic demyelinating disease and also is one of the most common disabling neurological disorders in young and middle-aged adults. The main pathogenesis of MS has long been thought to be an immune mediated disorder of the central nervous system. The function of the immune system is under the influence of vitamin D which as a modulator of immune response could play a role in autoimmune diseases including MS. Deficiency of vitamin D or variations in DNA sequence (po...

  7. Musical identity of patients with multiple sclerosis.

    Moreira, Shirlene Vianna; França, Cecília Cavalieri; Moreira, Marcos Aurélio; Lana-Peixoto, Marco Aurélio

    2009-03-01

    Musical autobiographies consist of a powerful therapeutic tool by which individuals define themselves. The use of this technique may help (re)construction personal identities and improve quality of life of patients with multiple sclerosis (MS). Eight adult patients on treatment at CIEM Multiple Sclerosis Investigation Center after selecting 10 to 15 pieces of music most significant in their lives were interviewed. The data collected were classified according to Even Rudd categories, which reveal how a person expresses his personal, social, temporal and transpersonal identities. We observed that recall of musical history makes MS patients get better perception both of their feelings and body awareness, as well as provide them with an alternative way to express themselves, activate and contextualize affective memories, and achieving a sense of life continuity in spite of the disease. PMID:19330210

  8. Physical Activity and Self-Reported Cardiovascular Comorbidities in Persons with Multiple Sclerosis: Evidence from a Cross-Sectional Analysis

    Motl, Robert W.; Fernhall, Bo; McAuley, Edward; Cutter, Gary

    2011-01-01

    Background This study examined the possibility of a linear, inverse association between physical activity and the number of self-reported cardiovascular comorbidities in persons with multiple sclerosis (MS). Methods The sample included 561 persons with MS who completed demographic, cardiovascular comorbidity, disability status, and physical activity self-report assessments, and then wore an accelerometer for 7 days. The data were analyzed using bivariate correlation and multiple linear regression analyses. Results Bivariate correlation analysis indicated that there were statistically significant, inverse associations between the number of self-reported cardiovascular comorbidities and objectively measured (r = −0.192, p = 0.0001) and self-reported (r = −0.151, p = 0.0001) physical activity. The first multiple linear regression indicated that objectively measured physical activity was significantly associated with the number of self-reported cardiovascular comorbidities (B = −0.003, SE B = 0.001, β = −0.128), even after controlling for confounding variables. The second multiple linear regression indicated that self-reported physical activity, too, was significantly associated with the number of self-reported cardiovascular comorbidities (B = −0.011, SE B = 0.004, β = −0.114), even after controlling for confounding variables. Conclusion Physical activity was associated with the number of self-reported cardiovascular comorbidities, independent of disability status and other possible confounding variables, in persons with MS. PMID:21597305

  9. Cognitive Impairment in Multiple Sclerosis

    Farnaz Etesam

    2014-01-01

    Full Text Available Cognitive impairment can emerge in the earliest phases of multiple sclerosis. It strongly impacts different aspects of Multiple Sclerosis (MS patients' lives, like employment, social relationships and the overall quality of life; thus, its on-time recognition and treatment is mandatory. This paper discusses issues, diagnostic methods and treatment options for cognitive dysfunctions in MS. This paper is a descriptive review of the related studies in the recent 10 years, performing a keyword search in the main databases4T. Cognitive impairment mostly involves aspects of information processing, memory and executive functioning in MS. Neuropsychological tests like MACFIMS and BRB-N are recommended for its assessment. Still, there is no fully efficient treatment for cognitive impairment. Researchers have shown some positive effects, using disease-modifying therapies and cognitive rehabilitation. Depression, pain, fatigue and other factors influencing cognitive functions must be paid attention to4T. Recognizing cognitive impairment as a major symptom for MS, makes studying this subject one of the priorities in dealing with the disease. Therefore, a consecutive research for identification and management of this part of quality of life in MS patients is obligatory4T.4T

  10. The diagnosis of multiple sclerosis

    This thesis describes recently developed research methods for the diagnosis of multiple sclerosis. In Chapter X the use of the CT-scan in the detection of hemispheral or cerebellar lesions is discussed. In chapter XIII the results of the application of all methods to a group of 89 patients with definite, probable or possible multiple sclerosis and to a group of 25 purely optic neuritis patients are presented. With the aid of the CT-scan, hypo- or hyperdense areas in the white matter of the cerebral hemispheres were found in 52% of the 114 patients. Most reports ascribe these lesions to demyelinating cerebral plaques. The CT-scan showed no cerebellar or brainstem lesions. The CT-scan is independent of the duration of, and degree of incapacitation due to, the disease and can be helpful in giving a definite diagnosis in an early stage of the disease. The CT-scan will always play an important role for the differential diagnosis. (Auth.)

  11. Is Multiple Sclerosis CNS Leprosy?

    Noha t. Abokrysha

    2008-05-01

    Full Text Available Multiple sclerosis (MS is widely believed to be an autoimmune disorder. Another exciting idea regarding the aetiology of MS may be that the immune response in MS could result from a chronic infection rather than autoimmunity in the usual sense. M. leprae-induced myelin damage in the early infectious process provides valuable insights into the pathologic mechanisms of multiple sclerosis. However, no research has hypothesized the possible involvement of mycobacterium leprae or its components in pathogenesis of MS. Most of the antigens of mycobacterium leprae and mycobacterium tuberculosis are members of stress protein families. Of the M. leprae and M. tuberculosis antigens identified by monoclonal antibodies, all except the 18-kDa M. leprae antigen and the 19-kDa M. tuberculosis antigen are strongly coded with very similar genes. I hypothesize that MS is a syndrome of diseases, induced by intradermal BCG vaccine which may contain the antigen component resembling that of leprae that can either produce central demyelination by itself, or by delayed hypersensitivity. The hypothesis should be assessed in several experimental and clinical trials. If my hypothesis can be verified experimentally and clinically, then measurements to prevent MS disease could be accomplished.

  12. Reproduction and the risk of multiple sclerosis

    Magyari, Melinda; Koch-Henriksen, Nils Iørgen; Pfleger, Claudia Christina;

    2013-01-01

    The incidence of multiple sclerosis (MS) in Denmark has doubled in women since 1970, whereas it has been almost unchanged in men.......The incidence of multiple sclerosis (MS) in Denmark has doubled in women since 1970, whereas it has been almost unchanged in men....

  13. New management algorithms in multiple sclerosis

    Sorensen, Per Soelberg

    2014-01-01

    complex. The purpose of the review has been to work out new management algorithms for treatment of relapsing-remitting multiple sclerosis including new oral therapies and therapeutic monoclonal antibodies. RECENT FINDINGS: Recent large placebo-controlled trials in relapsing-remitting multiple sclerosis...

  14. Demyelination of subcortical nuclei in multiple sclerosis

    Krutenkova, E.; Aitmagambetova, G.; Khodanovich, M.; Bowen, J.; Gangadharan, B.; Henson, L.; Mayadev, A.; Repovic, P.; Qian, P.; Yarnykh, V.

    2016-02-01

    Myelin containing in basal ganglia in multiple sclerosis patients was evaluated using new noninvasive quantitative MRI method fast whole brain macromolecular proton fraction mapping. Myelin level in globus pallidus and putamen significantly decreased in multiple sclerosis patients as compared with healthy control subjects but not in substantia nigra and caudate nucleus.

  15. Alemtuzumab in the treatment of multiple sclerosis

    Fernandez Ó

    2014-02-01

    Full Text Available Óscar Fernandez Institute of Clinical Neuroscience, Neurology Department, Hospital Regional Universitario Carlos Haya, FIMABIS, Malaga, Spain Abstract: Alemtuzumab (formerly known as Campath-1H has recently been approved by the European Medicines Agency for highly-active, relapsing-remitting multiple sclerosis (MS. The molecule targets the CD52 surface glycoprotein on certain T cells and B cells and is thought to exert its effect in MS through a “resetting” of the lymphocyte population. Approval was granted on the strength of two pivotal studies, Comparison of Alemtuzumab and Rebif® Efficacy in Multiple Sclerosis (CARE-MS-1 in the first-line setting and CARE-MS-2 in patients who had failed first-line therapy. In both studies, alemtuzumab significantly reduced the relapse rate compared to the comparator, interferon beta-1a (44 µg given subcutaneously three-times per week (Rebif®. In the first-line study, alemtuzumab was also found to significantly reduce the number of patients with sustained progression compared to interferon beta-1a therapy. Autoimmune disorders represent the major side effect of alemtuzumab therapy although they can be managed by careful monitoring and early treatment. Overall, alemtuzumab is likely to be a valuable addition to the neurologist´s armamentarium for the treatment of relapsing-remitting MS. Keywords: alemtuzumab, multiple sclerosis, new therapies, interferon beta-1a, monoclonal antibody, treatment

  16. Chromosomal radiosensitivity in patients with multiple sclerosis

    Milenkova, Maria; Milanov, Ivan; Kmetska, Ksenia [III Neurological Clinic, University Hospital Saint Naum, Sofia (Bulgaria); Deleva, Sofia; Popova, Ljubomira; Hadjidekova, Valeria [Laboratory of Radiation Genetics, NCRRP, Sofia (Bulgaria); Groudeva, Violeta [Department of Diagnostic Imaging, University Hospital St. Ekaterina, Sofia (Bulgaria); Hadjidekova, Savina [Department of Medical Genetics, Medical University, Sofia (Bulgaria); Domínguez, Inmaculada, E-mail: idomin@us.es [Department of Cell Biology, Faculty of Biology, University of Seville, Avda. Reina Mercedes 6, 41012 (Spain)

    2013-09-15

    Highlights: • We studied radiosensitivity to in vitro γ-irradiated lymphocytes from MS patients. • Immunotherapy in RRMS patients reduced the yield of radiation induced MN. • The group of treated RRMS accounts for the low radiosensitivity in MS patients. • Spontaneous yield of MN was similar in treated and untreated RRMS patients. - Abstract: Multiple sclerosis is a clinically heterogeneous autoimmune disease leading to severe neurological disability. Although during the last years many disease-modifying agents as treatment options for multiple sclerosis have been made available, their mechanisms of action are still not fully determined. In the present study radiosensitivity in lymphocytes of patients with relapsing–remitting multiple sclerosis, secondary progressive multiple sclerosis and healthy controls was investigated. Whole blood cultures from multiple sclerosis patients and healthy controls were used to analyze the spontaneous and radiation-induced micronuclei in binucleated lymphocytes. A subgroup of patients with relapsing–remitting multiple sclerosis was treated with immunomodulatory agents, interferon β or glatiramer acetate. The secondary progressive multiple sclerosis patients group was not receiving any treatment. Our results reveal that the basal DNA damage was not different between relapsing–remitting and secondary progressive multiple sclerosis patients, and healthy controls. No differences between gamma-irradiation induced micronuclei frequencies in binucleated cells from relapsing–remitting and secondary progressive multiple sclerosis patients, and healthy controls were found either. Nevertheless, when we compared the radiation induced DNA damage in binucleated cells from healthy individuals with the whole group of patients, a reduction in the frequency of micronuclei was obtained in the patients group. Induced micronuclei yield was significantly lower in the irradiated samples from treated relapsing–remitting multiple

  17. Chromosomal radiosensitivity in patients with multiple sclerosis

    Highlights: • We studied radiosensitivity to in vitro γ-irradiated lymphocytes from MS patients. • Immunotherapy in RRMS patients reduced the yield of radiation induced MN. • The group of treated RRMS accounts for the low radiosensitivity in MS patients. • Spontaneous yield of MN was similar in treated and untreated RRMS patients. - Abstract: Multiple sclerosis is a clinically heterogeneous autoimmune disease leading to severe neurological disability. Although during the last years many disease-modifying agents as treatment options for multiple sclerosis have been made available, their mechanisms of action are still not fully determined. In the present study radiosensitivity in lymphocytes of patients with relapsing–remitting multiple sclerosis, secondary progressive multiple sclerosis and healthy controls was investigated. Whole blood cultures from multiple sclerosis patients and healthy controls were used to analyze the spontaneous and radiation-induced micronuclei in binucleated lymphocytes. A subgroup of patients with relapsing–remitting multiple sclerosis was treated with immunomodulatory agents, interferon β or glatiramer acetate. The secondary progressive multiple sclerosis patients group was not receiving any treatment. Our results reveal that the basal DNA damage was not different between relapsing–remitting and secondary progressive multiple sclerosis patients, and healthy controls. No differences between gamma-irradiation induced micronuclei frequencies in binucleated cells from relapsing–remitting and secondary progressive multiple sclerosis patients, and healthy controls were found either. Nevertheless, when we compared the radiation induced DNA damage in binucleated cells from healthy individuals with the whole group of patients, a reduction in the frequency of micronuclei was obtained in the patients group. Induced micronuclei yield was significantly lower in the irradiated samples from treated relapsing–remitting multiple

  18. Association between systemic lupus erythematosus and multiple sclerosis: lupoid sclerosis

    Multiple sclerosis (MS) and Systemic Lupus Erythematosus (SLE) with/without antiphospholipid syndrome are autoimmune illnesses. It has been described in many occasions the association of these two illnesses and the clinical picture of MS with characteristics of laboratory of SLE. When they affect to the central nervous system they can make it in a defined form for each illness or they can also make it in interposed or combined form of the two illnesses what has been called lupoid sclerosis; making that in some cases difficult the differentiation of the two illnesses and therefore to address the treatment. We present four cases of lupoid sclerosis, discuss the clinical and laboratory characteristics of this entity and we make a differentiation of the multiple sclerosis with the neurological affectation of SLE especially for images and laboratory results.

  19. Impact of Sativex(®) on quality of life and activities of daily living in patients with multiple sclerosis spasticity.

    Arroyo, Rafael; Vila, Carlos; Dechant, Kerry L

    2014-07-01

    In individuals with multiple sclerosis (MS) spasticity, associated symptoms such as spasms, pain, mobility restrictions and sleep disturbances can interfere with the ability to perform activities of daily living and reduce quality of life (QoL). Recent cross-sectional studies from Europe have confirmed that advancing severity of MS spasticity correlates directly with worsening QoL. The treatment effect of Sativex(®) (GW Pharmaceuticals PLC, Porton Down, UK; Laboratorios Almirall, SA, Barcelona, Spain) on QoL has been evaluated in randomized controlled trials, observational studies conducted under everyday clinical practice conditions and a survey in long-term users. Symptomatic relief of MS spasticity in responders to Sativex was associated with quantifiable improvements in QoL and activities of daily living that were maintained over time. Benefits were perceived by both patients and caregivers. PMID:25275238

  20. Activity-Dependent and Experience-Driven Myelination Provide New Directions for the Management of Multiple Sclerosis.

    Jensen, Samuel K; Yong, V Wee

    2016-06-01

    Despite an appreciation of the importance of myelination and the consequences of pathological demyelination, the fundamental mechanisms regulating myelination are only now being resolved. Neuronal activity has long been considered a plausible regulatory signal for myelination. However, controversy surrounding its dispensability in certain contexts and the difficulty in determining to what degree it influences myelination has limited its widespread acceptance. Recent studies have shed new light on the role of neuronal activity in regulating oligodendrogenesis and myelination. Further, the dynamics of myelin in adulthood and the association between skilled learning and myelination have become increasingly well characterized. These advances present new considerations for the management of multiple sclerosis and open up new approaches to facilitate remyelination following pathological demyelination. PMID:27113322

  1. Suicide attempts in multiple sclerosis

    Stenager, Elsebeth Nylev; Jensen, Børge; Stenager, Maria;

    2011-01-01

    The purposes of the study were (1) to estimate the risk of suicide attempts in multiple sclerosis (MS) patients in Denmark and compare the risk to the background population in the County of Funen, Denmark; (2) to estimate the risk of suicide attempts in MS patients receiving immunomodulating...... therapy compared with untreated patients. The Danish MS Registry, the Danish MS Treatment Registry and the Suicide Attempt Registry are linked and merged together using a person identification number given to all persons residing in Denmark. Among 404 MS patients, 15 patients had attempted suicide......, although no increased risk for suicide attempts was found in MS patients. No difference in number of suicide attempts in treated and untreated patients was found....

  2. [Cognitive Impairment in Multiple Sclerosis].

    Niino, Masaaki; Miyazaki, Yusei

    2016-04-01

    While cognitive impairment is a major symptom of multiple sclerosis (MS), it is commonly overlooked. This may be explained by the fact that it is difficult to evaluate cognitive function in patients with MS using screening batteries for the detection of dementia such as the mini-mental state examination. Further more, cognitive impairment in MS typically involves domain-specific deficits such as imparement of sustained attention and information processing speed rather than global cognitive decline. Cognitive impairment may influence the daily living and social lines of affected patients. This review discusses the characteristics of cognitive impairment, appropreate tests to evaluate its symptoms, and the current status of clinical trials for the treatment of MS. PMID:27056855

  3. Autonomic Dysregulation in Multiple Sclerosis.

    Pintér, Alexandra; Cseh, Domonkos; Sárközi, Adrienn; Illigens, Ben M; Siepmann, Timo

    2015-01-01

    Multiple sclerosis (MS) is a chronic, progressive central neurological disease characterized by inflammation and demyelination. In patients with MS, dysregulation of the autonomic nervous system may present with various clinical symptoms including sweating abnormalities, urinary dysfunction, orthostatic dysregulation, gastrointestinal symptoms, and sexual dysfunction. These autonomic disturbances reduce the quality of life of affected patients and constitute a clinical challenge to the physician due to variability of clinical presentation and inconsistent data on diagnosis and treatment. Early diagnosis and initiation of individualized interdisciplinary and multimodal strategies is beneficial in the management of autonomic dysfunction in MS. This review summarizes the current literature on the most prevalent aspects of autonomic dysfunction in MS and provides reference to underlying pathophysiological mechanisms as well as means of diagnosis and treatment. PMID:26213927

  4. [Emerging therapies for multiple sclerosis].

    de Lorenzo-Pinto, Ana; Rodríguez-González, Carmen Guadalupe; Ais-Larisgoitia, Arantza

    2013-01-19

    Multiple sclerosis (MS) is an immune-mediated inflammatory disease of the central nervous system considered the second cause of disability in young adults. The prognosis of MS has improved significantly since the approval of the first interferon β in 1993 but, compared to other diseases, few new therapeutic products have been commercialized in the last years. However, currently, there are more than 600 ongoing clinical trials and new drugs that aim to improve efficacy and a more convenient schedule of administration, will appear shortly on the market. On the other hand, new safety issues will arise as well as a significant economic impact on the health system. The main efficacy and safety results of these drugs are reviewed in this paper. They can be classified into 2 groups: oral (fingolimod, laquinimod, teriflunomide, BG-12 [dimethyl fumarate], oral cladribine, dalfampridine) and monoclonal antibodies (rituximab, ocrelizumab, ofatumumab, daclizumab, alemtuzumab). PMID:22766059

  5. 2014 Multiple Sclerosis Therapeutic Update

    Cree, Bruce A. C.

    2014-01-01

    Rapid advances are occurring in multiple sclerosis disease modifying therapies. Recent therapeutic advances include modifications to improve tolerability of existing products (e.g. interferon beta and glatiramer acetate), development of novel anti-neuroinflammatory medications (e.g. fingolimod, teriflunomide and dimethyl fumarate, daclizumab, alemtuzumab, ocrelizumab) and investigation of treatments in progressive MS (e.g. natalizumab, mastinib, natalizumab, siponimod). The impact of vitamin D supplementation on the disease course in relapsing MS patients is also being studied in several clinical trials. This article reviews the current state of the field with a forward look to the next phase of MS research that could focus on strategies to promote remyelination and provide neuronal protection. PMID:24707333

  6. Personality aspects in multiple sclerosis.

    Diana, R; Grosz, A; Mancini, E

    1985-12-01

    To test the claim that peculiar personality bias is detectable in multiple sclerosis (MS) we used the Szondi test to investigate the psychodynamic aspects of 110 MS patients in comparison with 200 healthy subjects. MS patients appeared to have a greater need for love in a passive form than normal people, rigid defense mechanisms, difficulty in resolving their inner conflicts either by sublimation or by internalization of satisfactory new emotional experiences, feelings of autoaggressiveness, and many symptoms of depression. Some of these aspects correlate with the severity of the disease, others seem to date back to early childhood as peculiar personality patterns. An investigation of childhood events in 110 controls confirmed that MS patients had had many more unhappy experiences in childhood than might commonly be expected. Further, the oft-reported psychiatric troubles preceding MS clinical onset suggest that at least in some MS patients there are specific gaps in personality structure dating back to early phases of their development. PMID:4086262

  7. Implicit Memory in Multiple Sclerosis

    G. Latchford

    1993-01-01

    Full Text Available A number of neuropsychological studies have revealed that memory problems are relatively common in patients with multiple sclerosis (MS. It may be useful to compare MS with conditions such as Huntington's disease (HD, which have been referred to as subcortical dementia. A characteristic of these conditions may be an impairment in implicit (unconscious memory, but not in explicit (conscious memory. The present study examined the functioning of explicit and implicit memory in MS. Results showed that implicit memory was not significantly impaired in the MS subjects, and that they were impaired on recall but not recognition. A correlation was found between implicit memory performance and disability status in MS patients. Findings also suggest the possibility of long-term priming of implicit memory in the control subjects. The implications of these results are discussed.

  8. Oral agents in multiple sclerosis.

    Lorefice, L; Fenu, G; Frau, J; Coghe, G C; Marrosu, M G; Cocco, E

    2015-01-01

    Multiple sclerosis (MS) is a complex autoimmune disease of the central nervous system. Disease-modifying drugs licensed for MS treatment have been developed to reduce relapse rates and halt disease progression. The majority of current MS drugs involve regular, parenteral administration, affecting long-term adherence and thus reducing treatment efficacy. Over the last two decades great progress has been made towards developing new MS therapies with different modes of action and biologic effects. In particular, oral drugs have generated much interest because of their convenience and positive impact on medication adherence. Fingolimod was the first launched oral treatment for relapsing-remitting MS; recently, Teriflunomide and Dimethyl fumarate have also been approved as oral disease-modifying agents. In this review, we summarize and discuss the history, pharmacodynamics, efficacy, and safety of oral agents that have been approved or are under development for the selective treatment of MS. PMID:25924620

  9. [Vitamin D in Multiple Sclerosis].

    Niino, Masaaki; Miyazaki, Yusei

    2015-11-01

    The geographic epidemiology of multiple sclerosis (MS) suggests that low vitamin D levels are a modifiable risk factor. Previous studies have shown that patients with MS have significantly lower vitamin D levels compared with healthy controls. Vitamin D is a potent immunomodulator important for immune function and development, and it offers potential benefits by reducing inflammation. Vitamin D has beneficial effects in experimental autoimmune encephalomyelitis, an animal model of MS. In summation, these studies suggest that vitamin D may have therapeutic potential for MS. This has not been established although preliminary clinical trials for vitamin D in MS look promising. Genetic studies suggest that genes associated with vitamin D are critical susceptible genes for MS. In this review, we discuss current research investigating the association between vitamin D and MS and the issues that need to be resolved. PMID:26560958

  10. Vitamin D and multiple sclerosis.

    Asghar Amini Harandi

    2014-03-01

    Full Text Available Multiple sclerosis (MS is a chronic demyelinating disease and also is one of the most common disabling neurological disorders in young and middle-aged adults. The main pathogenesis of MS has long been thought to be an immune mediated disorder of the central nervous system. The function of the immune system is under the influence of vitamin D which as a modulator of immune response could play a role in autoimmune diseases including MS. Deficiency of vitamin D or variations in DNA sequence (polymorphism of vitamin D receptor gene diminishes its optimal function on immune system that consequently could lead to increasing risk of MS. However, its role in development and modulating the course of MS is still under investigation. In this review we aimed to discuss the role of vitamin D in body, immune system and consequently altering the risk of MS.

  11. Cognitive dysfunction in Multiple Sclerosis

    JoanaGuimarães

    2012-05-01

    Full Text Available In Multiple Sclerosis (MS prevalence studies of community and clinical samples, indicate that 45–60% of patients are cognitively impaired. These cognitive dysfunctions have been traditionally described as heterogeneous, but more recent studies suggest that there is a specific pattern of MS-related cognitive dysfunctions. With the advent of disease-modifying medications for MS and emphasis on early intervention and treatment, detection of cognitive impairment at its earliest stage becomes particularly important. In this review the authors address: the cognitive domains most commonly impaired in MS (memory, attention, executive functions, speed of information processing and visual spatial abilities; the physiopathological mechanism implied in MS cognitive dysfunction and correlated brain MRI features; the importance of neuropsychological assessment of MS patients in different stages of the disease and the influence of its course on cognitive performance; the most used tests and batteries for neuropsychological assessment; therapeutic strategies to improve cognitive abilities.

  12. COX-2, CB2 and P2X7-immunoreactivities are increased in activated microglial cells/macrophages of multiple sclerosis and amyotrophic lateral sclerosis spinal cord

    Bountra Chas

    2006-03-01

    Full Text Available Abstract Background While multiple sclerosis (MS and amyotrophic lateral sclerosis (ALS are primarily inflammatory and degenerative disorders respectively, there is increasing evidence for shared cellular mechanisms that may affect disease progression, particularly glial responses. Cyclooxygenase 2 (COX-2 inhibition prolongs survival and cannabinoids ameliorate progression of clinical disease in animal models of ALS and MS respectively, but the mechanism is uncertain. Therefore, three key molecules known to be expressed in activated microglial cells/macrophages, COX-2, CB2 and P2X7, which plays a role in inflammatory cascades, were studied in MS and ALS post-mortem human spinal cord. Methods Frozen human post mortem spinal cord specimens, controls (n = 12, ALS (n = 9 and MS (n = 19, were available for study by immunocytochemistry and Western blotting, using specific antibodies to COX-2, CB2 and P2X7, and markers of microglial cells/macrophages (CD 68, ferritin. In addition, autoradiography for peripheral benzodiazepine binding sites was performed on some spinal cord sections using [3H] (R-PK11195, a marker of activated microglial cells/macrophages. Results of immunostaining and Western blotting were quantified by computerized image and optical density analysis respectively. Results In control spinal cord, few small microglial cells/macrophages-like COX-2-immunoreactive cells, mostly bipolar with short processes, were scattered throughout the tissue, whilst MS and ALS specimens had significantly greater density of such cells with longer processes in affected regions, by image analysis. Inflammatory cell marker CD68-immunoreactivity, [3H] (R-PK11195 autoradiography, and double-staining against ferritin confirmed increased production of COX-2 by activated microglial cells/macrophages. An expected 70-kDa band was seen by Western blotting which was significantly increased in MS spinal cord. There was good correlation between the COX-2 immunostaining

  13. Multiple sclerosis and other white matter diseases

    The diagnosis of multiple sclerosis (MS) by computerized tomography and nuclear magnetic resonance are shown, including the examination of cerebral spinal fluid. Lymphocytic, foamy histiocytic perivascular cuffing, degenerated oligodendrocytes, and microglia proliferation with relative axonal sparing are presented. In the latter stage of the chronic MS plaque there is sclerosis with microcystic formation with complete demyelination and organization. (author)

  14. Class II HLA antigens in multiple sclerosis.

    Miller, D H; Hornabrook, R W; Dagger, J; Fong, R

    1989-01-01

    HLA typing in Wellington revealed a stronger association of multiple sclerosis with DR2 than with DQw1. The association with DQw1 appeared to be due to linkage disequilibrium of this antigen with DR2. These results, when considered in conjunction with other studies, are most easily explained by the hypothesis that susceptibility to multiple sclerosis is influenced by multiple risk factors, with DR2 being an important risk factor in Caucasoid populations. PMID:2732726

  15. Exercise and disease progression in multiple sclerosis: can exercise slow down the progression of multiple sclerosis?

    Dalgas, Ulrik; Stenager, Egon

    2012-01-01

    It has been suggested that exercise (or physical activity) might have the potential to have an impact on multiple sclerosis (MS) pathology and thereby slow down the disease process in MS patients. The objective of this literature review was to identify the literature linking physical exercise (or activity) and MS disease progression. A systematic literature search was conducted in the following databases: PubMed, SweMed+, Embase, Cochrane Library, PEDro, SPORTDiscus and ISI Web of Science. Di...

  16. PK11195 binding to the peripheral benzodiazepine receptor as a marker of microglia activation in multiple sclerosis and experimental autoimmune encephalomyelitis

    Vowinckel, E; Reutens, D; Becher, B;

    1997-01-01

    Activated glial cells are implicated in regulating and effecting the immune response that occurs within the CNS as part of multiple sclerosis (MS) and its animal model experimental autoimmune encephalomyelitis (EAE). The peripheral benzodiazepine receptor (PBR) is expressed in glial cells. We exa...

  17. Vitamin D tweets light to genes in multiple sclerosis

    LOMMERS, Emilie; Lecrompe, Laurence; MOONEN, Gustave; PHAN BA, Remy; Belachew, Shibeshih

    2012-01-01

    The relationship between sunlight exposure and the incidence of multiple sclerosis and the understanding of immunomodulatory effects of vitamin D triggered, in recent years, a broad range of investigations. Immunological studies performed in vitro and in vivo have demonstrated how tolerogenic vitamin D can be. Epidemiological studies confirmed an increased incidence of multiple sclerosis in vitamin D deficient subjects and signs of increased disease activity in such MS ...

  18. Registers of multiple sclerosis in Denmark

    Koch-Henriksen, N; Magyari, M; Laursen, B

    2015-01-01

    There are two nationwide population-based registers for multiple sclerosis (MS) in Denmark. The oldest register is The Danish Multiple Sclerosis Registry (DMSR), which is an epidemiological register for estimation of prevalence and incidence of MS and survival, and for identifying exposures earlier...... between a number of different environmental exposures in the past and the subsequent risk of MS. Some of these studies have been able to exonerate suspected risk factors. The other register, the nationwide Danish Multiple Sclerosis Treatment Register, is a follow-up register for all patients who have...

  19. Multiple sclerosis and sexual dysfunction

    Zhen-Ni Guo; Si-Yuan He; Hong-Liang Zhang; Jiang Wu; Yi Yang

    2012-01-01

    Multiple sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system characterized by episodic and progressive neurologic dysfunction resulting from inflammatory and autoimmune reactions.The underlying pathogenesis of MS remains largely unclear.However,it is currently accepted as a T cell-mediated autoimmune disease.Among other clinical manifestations,sexual dysfunction (SD) is a painful but still underreported and underdiagnosed symptom of the disorder.SD in MS patients may result from a complex set of conditions and may be associated with multiple anatomic,physiologic,biologic,medical and psychological factors.SD arises primarily from lesions affecting the neural pathways involved in physiologic function.In addition,psychological factors,the side effects of medications and physical symptoms such as fatigue,muscular weakness,menstrual changes,pain and concerns about bladder and bowel incontinence may also be involved.Since MS primarily affects young people,SD secondary to MS may have a great impact on quality of life.Thus,maintaining a healthy sexual life with MS is an important priority.The treatment of SD requires multidisciplinary teamwork and cooperation among specialists,individual patients,partners and the society.

  20. B cell follicle-like structures in multiple sclerosis-with focus on the role of B cell activating factor

    Morten, Haugen; Frederiksen, Jette L; Vinter, Matilda Degn

    B lymphocytes play an important role in the pathogenesis of multiple sclerosis (MS). Follicle-like structures (FLS) have recently been found in the subarachnoid space in the leptomeninges in some patients with secondary progressive MS (SPMS). They contain proliferating B lymphocytes, plasma cells...

  1. Self-efficacy and environmental correlates of physical activity among older women and women with multiple sclerosis

    Morris, Katherine S.; McAuley, Edward; Motl, Robert W.

    2008-01-01

    Physical inactivity is a major health problem in the United States, particularly in elderly and disabled populations. Little research exists examining the relationships between aspects of the built environment and physical activity in older adults and individuals with multiple sclerosis (MS). We adopted a social cognitive perspective to examine the independent roles of perceptions of the environmental, self-efficacy and functional limitations in understanding physical activity levels among elderly women and women with MS. Older women (n = 136) and women diagnosed with MS (n = 173) were recruited to participate in separate cross-sectional studies. Individuals completed a battery of questionnaires and wore an activity monitor for 7 days. All measures were issued and collected through the mail with the use of self-addressed, pre-paid envelopes. Initial correlational analyses indicated that self-efficacy, functional limitations and environmental perceptions were significantly related to physical activity. Among older women, self-efficacy, functional limitations and street connectivity demonstrated independent contributions to physical activity behavior. Only self-efficacy and functional limitations demonstrated significant associations among women with MS. The prospective contributions of the environment and individual factors to changes in physical activity need to be determined. PMID:17962232

  2. Increasing physical activity in multiple sclerosis: Replicating Internet intervention effects using objective and self-report outcomes

    Deirdre Dlugonski, BS

    2011-11-01

    Full Text Available Our previous research indicated that an Internet intervention was effective in increasing self-reported physical activity in persons with multiple sclerosis (MS. The present study examined the efficacy of the same Internet intervention in persons with MS by using both objective and self-report measures of physical activity. Participants (N = 21 wore an accelerometer around the waist for 7 days and then completed the International Physical Activity Questionnaire (IPAQ and Godin Leisure-Time Exercise Questionnaire (GLTEQ before and after receiving the 12-week Internet intervention. The Internet intervention resulted in moderate increases in accelerometer activity counts (d = 0.68 and steps counts (d = 0.60, and this was paralleled by small increases in IPAQ (d = 0.43 and GLTEQ (d = 0.34 scores. The number of weeks that persons logged on was correlated with change in accelerometer activity counts (r = 0.42 and step counts (r = 0.37 but not change in IPAQ (r = 0.10 or GLTEQ (r = 0.08 scores. The novel contribution of this study was the observation that an Internet intervention was efficacious for increasing physical activity in persons with MS by using both objective and self-report measures.

  3. Mobility disability and the pattern of accelerometer-derived sedentary and physical activity behaviors in people with multiple sclerosis

    Ezeugwu, Victor; Klaren, Rachel E.; A. Hubbard, Elizabeth; Manns, Patricia (Trish); Motl, Robert W.

    2015-01-01

    Objective Low physical activity and high sedentary behavior levels are major concerns in persons with multiple sclerosis (MS) and these differ depending on the level of mobility disability. However, the manner in which daily activity is accumulated is currently unknown in this population. Methods A secondary analysis was performed on a combined data set of persons with MS from two previous investigations of physical activity and symptomatic or quality of life outcomes in the United States over a two year period (2007–2009). Mobility disability status was determined using the Patient Determined Disease Steps (PDDS) while activity behavior was objectively monitored using an ActiGraph accelerometer for 7 days. Results Persons with MS who have mobility disability were involved in sedentary behavior, light and moderate intensity activity for 65%, 34% and 1% of the day, respectively compared to 60%, 37%, and 3%, respectively in those without mobility disability (p < 0.05). Breaks in sedentary time did not differ by mobility disability status. Compared to those without mobility disability, the average number of sedentary bouts longer than 30 min was greater in those with mobility disability (p = 0.016). Conclusion Persons with MS with mobility disability are less active, engage in more sedentary behavior and accumulate prolonged sedentary bouts. PMID:26844077

  4. Defining the clinical course of multiple sclerosis

    Lublin, Fred D; Reingold, Stephen C; Cohen, Jeffrey A;

    2014-01-01

    Accurate clinical course descriptions (phenotypes) of multiple sclerosis (MS) are important for communication, prognostication, design and recruitment of clinical trials, and treatment decision-making. Standardized descriptions published in 1996 based on a survey of international MS experts...

  5. Recent advances in multiple sclerosis therapy

    Seven papers in this volume are in INIS scope, one dealing with autoradiographic detection of multiple sclerosis plaques with radiologands, and the others with magnetic resonance imaging of MS lesions. (H.W.). refs.; figs.; tabs

  6. Complementary and Alternative Medicine for Multiple Sclerosis

    ... of multiple sclerosis (MS). The American Academy of Neurology (AAN) is the world’s largest association of neurologists ... modifying and symptomatic treatments. ©2014 American Academy of Neurology AAN. com What is CAM therapy? How does ...

  7. Management of acute exacerbations in multiple sclerosis

    Ontaneda Daniel

    2009-01-01

    Full Text Available A key component of multiple sclerosis is the occurrence of episodes of clinical worsening with either new symptoms or an increase in older symptoms over a few days or weeks. These are known as exacerbations of multiple sclerosis. In this review, we summarize the pathophysiology and treatment of exacerbations and describe how they are related to the overall management of this disease.

  8. Anti-Integrin Therapy for Multiple Sclerosis

    Motomu Shimaoka; Hiroshi Imai; Takayuki Okamoto; Susumu Nakahashi; Eiji Kawamoto

    2012-01-01

    Integrins are the foremost family of cell adhesion molecules that regulate immune cell trafficking in health and diseases. Integrin alpha4 mediates organ-specific migration of immune cells to the inflamed brain, thereby playing the critical role in the pathogenesis of multiple sclerosis. Anti-alpha4 integrin therapy aiming to block infiltration of autoreactive lymphocytes to the inflamed brain has been validated in several clinical trials for the treatment of multiple sclerosis. This paper pr...

  9. The initiation and prevention of multiple sclerosis

    Ascherio, Alberto; Munger, Kassandra L; Lünemann, Jan D.

    2012-01-01

    Although there are strong genetic determinants of multiple sclerosis, the results of migration studies support a role for the environment, and through rigorous epidemiological investigation, Epstein-Barr virus infection, vitamin D nutrition, and cigarette smoking have been identified as likely causal factors for multiple sclerosis. In this review, we discuss the strength of this evidence, as well as the potential biological mechanisms underlying these associations. Both vitamin D nutrition an...

  10. Axon damage and repair in multiple sclerosis.

    Perry, V.H.; Anthony, D. C.

    1999-01-01

    It is well known that within long-standing multiple sclerosis (MS) lesions there is axonal loss but whether it is an early or late event has been more difficult to establish. The use of immunocytochemical methods that reveal axonal end-bulbs is a valuable approach to investigating acute axonal injury in human pathological material. The application of these techniques to multiple sclerosis tissue reveals evidence of axonal injury in acute lesions; the distribution of the end-bulbs in acute and...

  11. Multiple sclerosis in pregnancy- a case report

    Vedavathy Nayak; Sreelatha S; Sahana Punneshetty

    2012-01-01

    Multiple sclerosis is primarily a disease of women in their reproductive years. Relapse rate decreases during pregnancy and rises after delivery. Pregnancy and puerperium have opposite effects on the course of the disease. The case presented is that of a second gravida who was a known case of multiple sclerosis. She was managed conservatively during pregnancy and puerperium. [Int J Reprod Contracept Obstet Gynecol 2012; 1(1.000): 67-68

  12. SOME NEUROCHEMICAL DISTURBANCES IN MULTIPLE SCLEROSIS

    Vladimir V. Markelov; Maxim V. Trushin

    2006-01-01

    ABSTRACTThe data presented in this manuscript suggest a pivotal role of the central nervous system (CNS) in the regulation of immune status. We describe here that some neurochemical disturbances may provoke development of various diseases including multiple sclerosis. Some theoretic and practical backgrounds, how to improve the multiple sclerosis sufferers and patients with other autoimmune disorders, are also given.RESUMENLos datos que presentamos en este manuscrito, sugieren un papel guia d...

  13. Reproductive history and risk of multiple sclerosis

    Nielsen, Nete Munk; Jørgensen, Kristian Tore; Stenager, Egon; Jensen, Allan; Pedersen, Bo V; Hjalgrim, Henrik; Kjær, Susanne Krüger; Frisch, Morten

    2011-01-01

    It has been suggested that reproductive factors may be involved in the etiology of multiple sclerosis (MS). We studied associations of reproductive history with MS risk in a population-based setting.......It has been suggested that reproductive factors may be involved in the etiology of multiple sclerosis (MS). We studied associations of reproductive history with MS risk in a population-based setting....

  14. Alteration of prolyl oligopeptidase and activated α-2-macroglobulin in multiple sclerosis subtypes and in the clinically isolated syndrome.

    Tenorio-Laranga, Jofre; Peltonen, Iida; Keskitalo, Salla; Duran-Torres, Gilberto; Natarajan, Renuka; Männistö, Pekka T; Nurmi, Antti; Vartiainen, Nina; Airas, Laura; Elovaara, Irina; García-Horsman, J Arturo

    2013-06-15

    Prolyl oligopeptidase (PREP) has been considered as a drug target for the treatment of neurodegenerative diseases. In plasma, PREP has been found altered in several disorders of the central nervous system including multiple sclerosis (MS). Oxidative stress and the levels of an endogenous plasma PREP inhibitor have been proposed to decrease PREP activity in MS. In this work, we measured the circulating levels of PREP in patients suffering of relapsing remitting (RR), secondary progressive (SP), primary progressive (PP) MS, and in subjects with clinically isolated syndrome (CIS). We found a significantly lower PREP activity in plasma of RRMS as well as in PPMS patients and a trend to reduced activity in subjects diagnosed with CIS, compared to controls. No signs of oxidative inactivation of PREP, and no correlation with the endogenous PREP inhibitor, identified as activated α-2-macroglobulin (α2M*), were observed in any of the patients studied. However, a significant decrease of α2M* was recorded in MS. In cell cultures, we found that PREP specifically stimulates immune active cells possibly by modifying the levels of fibrinogen β, thymosin β4, and collagen. Our results open new lines of research on the role of PREP and α2M* in MS, aiming to relate them to the diagnosis and prognosis of this devastating disease. PMID:23643808

  15. Alemtuzumab for the treatment of multiple sclerosis

    Willis MD

    2015-03-01

    Full Text Available Mark D Willis, Neil P Robertson Institute of Psychological Medicine and Clinical Neuroscience, Cardiff University, University Hospital of Wales, Heath Park, Cardiff, UK Abstract: Alemtuzumab is an anti-CD52 monoclonal antibody, recently approved for the treatment of active, relapsing multiple sclerosis (MS. Administration of alemtuzumab causes a rapid and dramatic reduction in circulating lymphocytes, with a predictable subsequent pattern of immune reconstitution. Although the precise mode of action remains unclear, treatment results in a marked reduction in annualized relapse rates, slowing of disability progression compared with an active comparator, and may even cause disability reversal. Although conferring clear clinical benefits, alemtuzumab carries a significant long-term risk of autoimmune disease (AID, which has a particular predilection for the thyroid gland, although a wide range of other disorders have also been reported. However, risks of AID can usually be anticipated and treated successfully, provided rigorous monitoring and surveillance protocols are followed by clinicians and patients alike. Despite its immunosuppressive mechanism of action serious infections are rare and malignancies commonly associated with immunodeficiency have not been observed to date. Alemtuzumab’s unique mode of administration, as well as it’s durability of effect, provides an important addition to currently available therapeutic interventions for MS, and in particular is a valuable treatment option in recent onset and highly active relapsing disease. Keywords: multiple sclerosis, alemtuzumab, autoimmune disease

  16. Neuroendocrine Immunoregulation in Multiple Sclerosis

    Nathalie Deckx

    2013-01-01

    Full Text Available Currently, it is generally accepted that multiple sclerosis (MS is a complex multifactorial disease involving genetic and environmental factors affecting the autoreactive immune responses that lead to damage of myelin. In this respect, intrinsic or extrinsic factors such as emotional, psychological, traumatic, or inflammatory stress as well as a variety of other lifestyle interventions can influence the neuroendocrine system. On its turn, it has been demonstrated that the neuroendocrine system has immunomodulatory potential. Moreover, the neuroendocrine and immune systems communicate bidirectionally via shared receptors and shared messenger molecules, variously called hormones, neurotransmitters, or cytokines. Discrepancies at any level can therefore lead to changes in susceptibility and to severity of several autoimmune and inflammatory diseases. Here we provide an overview of the complex system of crosstalk between the neuroendocrine and immune system as well as reported dysfunctions involved in the pathogenesis of autoimmunity, including MS. Finally, possible strategies to intervene with the neuroendocrine-immune system for MS patient management will be discussed. Ultimately, a better understanding of the interactions between the neuroendocrine system and the immune system can open up new therapeutic approaches for the treatment of MS as well as other autoimmune diseases.

  17. Multiple sclerosis: Prospects and promise.

    Hauser, Stephen L; Chan, Jonah R; Oksenberg, Jorge R

    2013-09-01

    We have entered a golden era in multiple sclerosis (MS) research. Two decades ago, our understanding of the disease was largely descriptive and there were no approved therapies to modify the natural history of MS. Today, delineation of immune pathways relevant to MS have been clarified; a comprehensive map of genes that influence risk compiled; clues to environmental triggers identified; noninvasive in vivo monitoring of the MS disease process has been revolutionized by high-field MRI; and many effective therapies for the early, relapsing, component of MS now exist. However, major challenges remain. We still have no useful treatment for progressive MS (the holy grail of MS research), no means to repair injured axons or protect neurons, and extremely limited evidence to guide treatment decisions. Recent advances have set in place a foundation for development of increasingly selective immunotherapy for patients; application of genetic and genomic discoveries to improve therapeutic options; development of remyelination or neuroprotection therapies for progressive MS; and integrating clinical, imaging and genomic data for personalized medicine. MS has now advanced from the backwaters of autoimmune disease research to the front-line, and definitive answers, including cures, are now realistic goals for the next decade. Many of the breakthrough discoveries in MS have also resulted from meaningful interactions across disciplines, and especially from translational and basic scientists working closely with clinicians, highlighting that the clinical value of discoveries are most often revealed when ideas developed in the laboratory are tested at the bedside. PMID:23955638

  18. Pediatric multiple sclerosis in Venezuela

    Joaquín A. Peña

    2012-04-01

    Full Text Available OBJECTIVE: To describe the epidemiological and clinical characteristics of Venezuelan pediatric patients with multiple sclerosis (MS. METHODS: Database records from the National Program for MS were searched for patients with an established diagnosis of MS whose first symptoms appeared before age 18. RESULTS: The national database held records of 1.710 patients; 3.8% had onset of the first symptoms before age 18. 46.7% were boys, yielding an F:M ratio of 1.13:1. Many children had a disease onset characterized by motor impairment (30.7%, brainstem/cerebellum and spinal cord affectation (27.6%, headache (26%. Less frequent symptoms were sensory symptoms (8% and optic neuritis (7%. DISCUSSION: Pediatric MS patients in Venezuela represent a significant proportion of all MS cases. The clinical pattern is characterized by motor symptoms at onset, and predominantly monosymptomatic presentation with a relapsing-remitting pattern. This is the first systematic attempt to estimate the prevalence of pediatric MS in Venezuela.

  19. Evaluation of Delta-Aminolevulinic Dehydratase Activity, Oxidative Stress Biomarkers, and Vitamin D Levels in Patients with Multiple Sclerosis.

    Polachini, Carla Roberta Nunes; Spanevello, Roselia Maria; Zanini, Daniela; Baldissarelli, Jucimara; Pereira, Luciane Belmonte; Schetinger, Maria Rosa Chitolina; da Cruz, Ivana Beatrice Mânica; Assmann, Charles Elias; Bagatini, Margarete Dulce; Morsch, Vera Maria

    2016-02-01

    Multiple sclerosis (MS) is an autoimmune neurological disorder of unknown etiology. Oxidative stress and alterations in vitamin D levels have been implicated in the pathophysiology of MS. The aim of this study was to investigate δ-aminolevulinate dehydratase (δ-ALA-D) activity as well as the levels of vitamin D, lipid peroxidation levels, carbonyl protein content, DNA damage, superoxide dismutase (SOD) and catalase (CAT) activities, and the vitamin C, vitamin E, and non-protein thiol (NPSH) content in samples from patients with the relapsing-remitting form of MS (RRMS). The study population consisted of 29 RRMS patients and 29 healthy subjects. Twelve milliliters of blood was obtained from each individual and used for biochemical determinations. The results showed that δ-ALA-D and CAT activities were significantly increased, while SOD activity was decreased in the whole blood of RRMS patients compared to the control group (P vitamin C, vitamin E, NPSH, and vitamin D were significantly decreased in RRMS patients in relation to the healthy individuals (P vitamin D levels may contribute to the pathophysiology of MS. PMID:26690779

  20. MRI diagnosis of multiple sclerosis

    Objective: It's a study of MRI diagnosis and differential diagnosis of multiple sclerosis (MS) in 49 cases. Methods: 49 patients were diagnosed as MS of brain or/and spinal cord in the year of 1995 to 2002. All cases had clinical informations, including evoked potential. MR brain scan was done in 49 patients, and spinal cord scan was performed in 10 cases out of 49. Enhanced scan were done in 29 cases. A follow-up examination was done in 17 patients within 30 days after the initial study. Results: Multiple brain lesions, located in peri-ventricular region, semi-elliptical center, cerebellum and brain stem, were revealed in 47 patients, MS plaques were speckle or patchy and the largest one was 2.2 x 5.0 cm. Simple spinal Cord lesions involving at least 2 sections were revealed in 2 patients. Two cases were initially misdiagnosed as encephalitis. Another case was defined as tumor because of the brainstem swelling and enhanced plaques. Optic nerve impairment was found in a case besides the brain lesions. Complicated brain and spinal Cord lesions were shown in 4 cases. Enhanced MRI scan was performed in 29 cases: non-enhanced lesions were revealed in 7 cases and lesions were enhanced in the rest 22. Mottling or plaque enhancement was presented in 20 cases, while ring enhancement was presented in 2. Follow-up study showed the improvement in 17 cases. Conclusion: Brain and spinal cord MS plaques can be demonstrated on MRI, while clinical manifestation is necessary for MRI diagnosis in atypical lesions. Serial study is helpful for differential diagnosis

  1. Mental toughness, sleep disturbances, and physical activity in patients with multiple sclerosis compared to healthy adolescents and young adults

    Sadeghi Bahmani D

    2016-06-01

    Full Text Available Dena Sadeghi Bahmani,1 Markus Gerber,2 Nadeem Kalak,1 Sakari Lemola,3 Peter J Clough,4 Pasquale Calabrese,5 Vahid Shaygannejad,6 Uwe Pühse,2 Edith Holsboer-Trachsler,1 Serge Brand1,2 1Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, 2Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland; 3Department of Psychology, University of Warwick, Coventry, 4Department of Psychology, Manchester Metropolitan University, Manchester, UK; 5Division of Molecular and Cognitive Neuroscience, University of Basel, Basel, Switzerland; 6Department of Neurology and Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Background: Multiple sclerosis (MS is the most common chronic autoimmune demyelinating and inflammatory disease of the central nervous system, afflicting both the body and mind. The risk of suffering from MS is 2.5–3.5 times greater in females than in males. While there is extant research on fatigue, depression, and cognitive impairment in patients with MS during its clinical course, there is a lack of research focusing on sleep, psychological functioning, and physical activity (PA at the point of disease onset. The aims of the present study were therefore, to assess the markers of mental toughness (MT as a dimension of psychological functioning, sleep disturbances (SD, and PA among patients at the moment of disease onset and to compare these with the corresponding values for healthy adolescents and young adults. Methods: A total of 23 patients with MS at disease onset (mean age =32.31 years; 91% females, 23 healthy adolescents (mean age =17.43 years; 82% females, and 25 healthy young adults (mean age =20.72 years; 80% females took part in the study. They completed questionnaires covering sociodemographic data, MT, SD, and PA. Results: Patients with MS had similar scores for MT traits as those in healthy

  2. Physical activity and quality of life in multiple sclerosis: Intermediary roles of disability, fatigue, mood, pain, self-efficacy and social support

    Motl, Robert W.; McAuley, Edward; Snook, Erin M.; Gliottoni, Rachael C.

    2009-01-01

    Physical activity has been associated with a small improvement in quality of life (QOL) among those with multiple sclerosis (MS). This relationship may be indirect and operate through factors such as disability, fatigue, mood, pain, self-efficacy and social support. The present study examined variables that might account for the relationship between physical activity and QOL in a sample (N = 292) of individuals with a definite diagnosis of MS. The participants wore an accelerometer for 7 days...

  3. Taste dysfunction in multiple sclerosis.

    Doty, Richard L; Tourbier, Isabelle A; Pham, Dzung L; Cuzzocreo, Jennifer L; Udupa, Jayaram K; Karacali, Bilge; Beals, Evan; Fabius, Laura; Leon-Sarmiento, Fidias E; Moonis, Gul; Kim, Taehoon; Mihama, Toru; Geckle, Rena J; Yousem, David M

    2016-04-01

    Empirical studies of taste function in multiple sclerosis (MS) are rare. Moreover, a detailed assessment of whether quantitative measures of taste function correlate with the punctate and patchy myelin-related lesions found throughout the CNS of MS patients has not been made. We administered a 96-trial test of sweet (sucrose), sour (citric acid), bitter (caffeine) and salty (NaCl) taste perception to the left and right anterior (CN VII) and posterior (CN IX) tongue regions of 73 MS patients and 73 matched controls. The number and volume of lesions were assessed using quantitative MRI in 52 brain regions of 63 of the MS patients. Taste identification scores were significantly lower in the MS patients for sucrose (p = 0.0002), citric acid (p = 0.0001), caffeine (p = 0.0372) and NaCl (p = 0.0004) and were present in both anterior and posterior tongue regions. The percent of MS patients with identification scores falling below the 5th percentile of controls was 15.07 % for caffeine, 21.9 % for citric acid, 24.66 % for sucrose, and 31.50 % for NaCl. Such scores were inversely correlated with lesion volumes in the temporal, medial frontal, and superior frontal lobes, and with the number of lesions in the left and right superior frontal lobes, right anterior cingulate gyrus, and left parietal operculum. Regardless of the subject group, women outperformed men on the taste measures. These findings indicate that a sizable number of MS patients exhibit taste deficits that are associated with MS-related lesions throughout the brain. PMID:26810729

  4. Nutrition facts in multiple sclerosis.

    Riccio, Paolo; Rossano, Rocco

    2015-01-01

    The question whether dietary habits and lifestyle have influence on the course of multiple sclerosis (MS) is still a matter of debate, and at present, MS therapy is not associated with any information on diet and lifestyle. Here we show that dietary factors and lifestyle may exacerbate or ameliorate MS symptoms by modulating the inflammatory status of the disease both in relapsing-remitting MS and in primary-progressive MS. This is achieved by controlling both the metabolic and inflammatory pathways in the human cell and the composition of commensal gut microbiota. What increases inflammation are hypercaloric Western-style diets, characterized by high salt, animal fat, red meat, sugar-sweetened drinks, fried food, low fiber, and lack of physical exercise. The persistence of this type of diet upregulates the metabolism of human cells toward biosynthetic pathways including those of proinflammatory molecules and also leads to a dysbiotic gut microbiota, alteration of intestinal immunity, and low-grade systemic inflammation. Conversely, exercise and low-calorie diets based on the assumption of vegetables, fruit, legumes, fish, prebiotics, and probiotics act on nuclear receptors and enzymes that upregulate oxidative metabolism, downregulate the synthesis of proinflammatory molecules, and restore or maintain a healthy symbiotic gut microbiota. Now that we know the molecular mechanisms by which dietary factors and exercise affect the inflammatory status in MS, we can expect that a nutritional intervention with anti-inflammatory food and dietary supplements can alleviate possible side effects of immune-modulatory drugs and the symptoms of chronic fatigue syndrome and thus favor patient wellness. PMID:25694551

  5. Iron chelation and multiple sclerosis

    Kelsey J. Weigel

    2014-01-01

    Full Text Available Histochemical and MRI studies have demonstrated that MS (multiple sclerosis patients have abnormal deposition of iron in both gray and white matter structures. Data is emerging indicating that this iron could partake in pathogenesis by various mechanisms, e.g., promoting the production of reactive oxygen species and enhancing the production of proinflammatory cytokines. Iron chelation therapy could be a viable strategy to block iron-related pathological events or it can confer cellular protection by stabilizing hypoxia inducible factor 1α, a transcription factor that normally responds to hypoxic conditions. Iron chelation has been shown to protect against disease progression and/or limit iron accumulation in some neurological disorders or their experimental models. Data from studies that administered a chelator to animals with experimental autoimmune encephalomyelitis, a model of MS, support the rationale for examining this treatment approach in MS. Preliminary clinical studies have been performed in MS patients using deferoxamine. Although some side effects were observed, the large majority of patients were able to tolerate the arduous administration regimen, i.e., 6–8 h of subcutaneous infusion, and all side effects resolved upon discontinuation of treatment. Importantly, these preliminary studies did not identify a disqualifying event for this experimental approach. More recently developed chelators, deferasirox and deferiprone, are more desirable for possible use in MS given their oral administration, and importantly, deferiprone can cross the blood–brain barrier. However, experiences from other conditions indicate that the potential for adverse events during chelation therapy necessitates close patient monitoring and a carefully considered administration regimen.

  6. Hearing disorders in multiple sclerosis.

    Furst, Miriam; Levine, Robert A

    2015-01-01

    Multiple sclerosis (MS) is a disease that is both a focal inflammatory and a chronic neurodegenerative disease. The focal inflammatory component is characterized by destruction of central nervous system myelin, including the spinal cord; as such it can impair any central neural system, including the auditory system. While on the one hand auditory complaints in MS patients are rare compared to other senses, such as vision and proprioception, on the other hand auditory tests of precise neural timing are never "silent." Whenever focal MS lesions are detected involving the pontine auditory pathway, auditory tests requiring precise neural timing are always abnormal, while auditory functions not requiring such precise timing are often normal. Azimuth sound localization is accomplished by comparing the timing and loudness of the sound at the two ears. Hence tests of azimuth sound localization must obligatorily involve the central nervous system and particularly the brainstem. Whenever a focal lesion was localized to the pontine auditory pathway, timing tests were always abnormal, but loudness tests were not. Moreover, a timing test that included only high-frequency sounds was very often abnormal, even when there was no detectable focal MS lesion involving the pontine auditory pathway. This test may be a marker for the chronic neurodegenerative aspect of MS, and, as such could be used to complement the magnetic resonance imaging scan in monitoring the neurodegenerative aspect of MS. Studies of MS brainstem lesion location and auditory function have led to advances in understanding how the human brain processes sound. The brain processes binaural sounds independently for time and level in a two-stage process. The first stage is at the level of the superior olivary complex (SOC) and the second at a level rostral to the SOC. PMID:25726295

  7. High fat diet exacerbates neuroinflammation in an animal model of multiple sclerosis by activation of the Renin Angiotensin system.

    Timmermans, Silke; Bogie, Jeroen; Vanmierlo, Tim; Lütjohann, Dieter; Stinissen, Piet; Hellings, Niels; Hendriks, Jerome J.A.

    2014-01-01

    Epidemiological studies suggest a positive correlation between the incidence and severity of multiple sclerosis (MS) and the intake of fatty acids. It remains to be clarified whether high fat diet (HFD) indeed can exacerbate the disease pathology associated with MS and what the underlying mechanisms are. In this study, we determined the influence of HFD on the severity and pathology of experimental autoimmune encephalomyelitis (EAE), an animal model of MS. Mice were fed either normal diet (ND...

  8. Distinct and common cerebral activation changes during mental time travel in relapsing-remitting multiple sclerosis patients.

    Ernst, A; Noblet, V; Denkova, E; Blanc, F; De Seze, J; Gounot, D; Manning, L

    2016-03-01

    Mental time travel (MTT) entails the ability to mentally travel into autobiographical memory (AM) and episodic future thinking (EFT). While AM and EFT share common phenomenological and cerebral functional properties, distinctive characteristics have been documented in healthy and clinical populations. No report, to our knowledge, has informed on the functional underpinnings of MTT impairment in multiple sclerosis (MS) patients, hence the aim of this work. We studied 22 relapsing-remitting MS patients and 22 matched controls. Participants underwent an AM/EFT assessment using the Autobiographical Interview (Levine et al. 2002), followed by a functional MRI session. The latter consisted in AM and EFT tasks, distinguishing the construction and elaboration phases of events. The results showed impaired performance for AM and EFT in patients, accompanied by increased cerebral activations mostly located in the frontal regions, which extended to the parietal, lateral temporal and posterior regions during AM/EFT tasks, relative to healthy controls. Enhanced brain activations in MS patients were particularly evident during the EFT task and involved the hippocampus, frontal, external temporal, and cingulate regions. The construction phase required greater fronto-parieto-temporal activations in MS patients relative to both healthy controls, and the elaboration phase. Taking together, our results suggested the occurrence of cerebral activation changes in the context of MTT in MS patients, expressed by distinct and common mechanisms for AM and EFT. This study may provide new insights in terms of cerebral activation changes in brain lesion and their application to clinical settings, considering AM/EFT's central role in everyday life. PMID:25972116

  9. Randomized controlled trial of a teleconference fatigue management plus physical activity intervention in adults with multiple sclerosis: rationale and research protocol

    Plow Matthew; Finlayson Marcia; Motl Robert W; Bethoux Francois

    2012-01-01

    Abstract Background Chronic fatigue and inactivity are prevalent problems among individuals with multiple sclerosis (MS) and may independently or interactively have detrimental effects on quality of life and ability to participate in life roles. However, no studies to date have systematically evaluated the benefits of an intervention for both managing fatigue and promoting physical activity in individuals with MS. This study involves a randomized controlled trial to examine the effectiveness ...

  10. Development of Activity-Related Muscle Fatigue during Robot-Mediated Upper Limb Rehabilitation Training in Persons with Multiple Sclerosis: A Pilot Trial

    Johanna Renny Octavia; Peter Feys; Karin Coninx

    2015-01-01

    Robot-assisted rehabilitation facilitates high-intensity training of the impaired upper limb in neurological rehabilitation. It has been clinically observed that persons with Multiple Sclerosis (MS) have difficulties in sustaining the training intensity during a session due to the development of activity-related muscle fatigue. An experimental observational pilot study was conducted to examine whether or not the muscle fatigue develops in MS patients during one session of robot-assisted train...

  11. Therapeutic use of sport climbing for patients with multiple sclerosis

    Ana Ožura

    2009-05-01

    Full Text Available Sport climbing is a form of exercise that requires complex and variable movement. Because of the use of the so-called "top-rope system", this is a safe activity appropriate for individuals with physical disabilities. Therefore, climbing might prove to be an effective form of therapy for patients with multiple sclerosis. Multiple sclerosis is a chronic neurological disease that may include motor and cognitive deficits as well as affective disturbances. The illness is characterized by multifocal areas of brain damage (plaques, as consequence of autoimmune inflammation. Sport climbing might be a potentially useful activity for treating spasticity, improving a person's self image and certain aspects of cognition, such as attention and executive functions, as well as for managing emotional disturbances. All of the above are areas where patients with multiple sclerosis might be in need of assistance. The article also describes the experience of a patient with multiple sclerosis who was enrolled in our climbing program. Future research is needed to evaluate the effect of climbing therapy for patients with multiple sclerosis.

  12. Monoclonal antibodies in treatment of multiple sclerosis

    Rommer, P S; Dudesek, A; Stüve, O; Zettl, UK

    2014-01-01

    Monoclonal antibodies (mAbs) are used as therapeutics in a number of disciplines in medicine, such as oncology, rheumatology, gastroenterology, dermatology and transplant rejection prevention. Since the introduction and reintroduction of the anti-alpha4-integrin mAb natalizumab in 2004 and 2006, mAbs have gained relevance in the treatment of multiple sclerosis (MS). At present, numerous mAbs have been tested in clinical trials in relapsing–remitting MS, and in progressive forms of MS. One of the agents that might soon be approved for very active forms of relapsing–remitting MS is alemtuzumab, a humanized mAb against CD52. This review provides insights into clinical studies with the mAbs natalizumab, alemtuzumab, daclizumab, rituximab, ocrelizumab and ofatumumab. PMID:24001305

  13. Therapeutic interference with leukocyte recirculation in multiple sclerosis

    Sellebjerg, F; Sørensen, P S

    2015-01-01

    Multiple sclerosis (MS) is an immune-mediated disease where T cells are thought to initiate an inflammatory reaction in the brain and spinal cord, resulting in demyelination and axonal pathology. Interfering with the activation and recruitment of immune cells reduces disease activity in MS. We...

  14. Vitamin D and Multiple Sclerosis: Correlation, Causality, and Controversy

    Joost Smolders

    2010-01-01

    The last years, many studies reported associations between correlates of vitamin D exposure and several correlates of multiple sclerosis (MS) disease activity. This review discusses studies on vitamin D status, Expanded Disability Status Scale (EDSS) score, and relapse activity of MS. Furthermore, several considerations for intervention studies on vitamin D supplementation in MS are provided.

  15. Underlying cause of death in Danish patients with multiple sclerosis

    Koch-Henriksen, Nils; Brønnum-Hansen, Henrik; Stenager, Egon

    1998-01-01

    To determine the underlying causes of death in a large population based register series of patients with multiple sclerosis.......To determine the underlying causes of death in a large population based register series of patients with multiple sclerosis....

  16. Multiple Sclerosis, Personal Stories | NIH MedlinePlus the Magazine

    ... of this page please turn Javascript on. Feature: Multiple Sclerosis Personal Stories: Nicole Lemelle, Iris Young, Michael Anthony, ... something quite different for a person living with multiple sclerosis, such as his girlfriend's brother, Chuy. The more ...

  17. Diagnostic challenges in combined multiple sclerosis and centronuclear myopathy

    Olsen, D.B.; Langkilde, Annika Reynberg; Schmalbruch, H;

    2000-01-01

    The first case of combined centronuclear myopathy and multiple sclerosis is reported. The difficulties of diagnosing multiple sclerosis in patients with muscular disorders associated with the central nervous system involvement are discussed......The first case of combined centronuclear myopathy and multiple sclerosis is reported. The difficulties of diagnosing multiple sclerosis in patients with muscular disorders associated with the central nervous system involvement are discussed...

  18. Leisure time activities of Iranian patients with multiple sclerosis: a qualitative study

    Seyed Mohammad Sadegh Hosseini

    2016-03-01

    Conclusion: The results represented the range and heterogeneity of leisure activities amongst the MS patients. Considering participation in spiritual/religious and social activities as leisure time undertaking might reflect cultural diversity in the perception and use of time for recreation. For mental health promotion purposes, paying special attention to the types of activities that people of different socio-cultural background choose for their refreshment could help health care providers in giving tailored advice for patients with MS and other chronic debilitating disease.

  19. Glatiramer acetate antibodies, gene expression and disease activity in multiple sclerosis

    Sellebjerg, Finn Thorup; Hedegaard, Chris Juul; Krakauer, M; Hesse, D; Lund, H; Nielsen, Claus Henrik; Søndergaard, Helle Bach; Sørensen, Per Soelberg

    2011-01-01

    transcription factors was reduced during long-term treatment, but there was no relationship between the expression of cytokines and transcription factors and anti-GA antibodies. High expression of mRNA encoding GATA3 and lymphotoxin-ß (LT-ß) was associated with low disease activity in Gd-enhanced MRI studies......RNA encoding GATA3 and LT-ß expression and MRI disease activity deserves further analysis in future studies. The development of anti-GA antibodies was observed in all patients treated with GA, but this was not related with measures of cellular immunity, clinical or MRI disease activity....

  20. Elevated type I interferon-like activity in a subset of multiple sclerosis patients: molecular basis and clinical relevance

    Hundeshagen Alexander

    2012-06-01

    Full Text Available Abstract Background A subset of patients with multiple sclerosis (MS shows an increased endogenous IFN-like activity before initiation of IFN-beta treatment. The molecular basis of this phenomenon and its relevance to predict individual therapy outcomes are not yet fully understood. We studied the expression patterns of these patients, the prognostic value of an elevated IFN-like activity, and the gene regulatory effects of exogenously administered IFN-beta. Methods Microarray gene expression profiling was performed for 61 MS patients using peripheral blood mononuclear cells obtained before and after 1 month of IFN-beta therapy. Expression levels of genes involved in pathways either inducing or being activated by IFN-beta were compared between patients with high (MX1high cohort and low (MX1low cohort endogenous IFN-like activity. Patients were followed for 5 years and relapses as well as progression on the expanded disability status scale (EDSS were documented. Results Before the start of therapy, 11 patients presented elevated mRNA levels of IFN-stimulated genes indicative of a relatively high endogenous IFN-like activity (MX1high. In these patients, pathogen receptors (for example, TLR7, RIG-I and IFIH1 and transcription factors were also expressed more strongly, which could be attributed to an overactivity of IFN-stimulated gene factor 3 (ISGF3, a complex formed by STAT1, STAT2 and IFN regulatory factor 9. After 1 month of IFN-beta therapy, the expression of many pathway genes was significantly induced in MX1low patients, but remained unaltered in MX1high patients. During follow-up, relapse rate and changes in EDSS were comparable between both patient groups, with differences seen between different types of IFN-beta drug application. Conclusions Therapeutic IFN-beta induces the transcription of several genes involved in IFN-related pathways. In a subgroup of MS patients, the expression of these genes is already increased before therapy

  1. Plasminogen Activator Inhibitor-1 Antagonist TM5484 Attenuates Demyelination and Axonal Degeneration in a Mice Model of Multiple Sclerosis.

    Nicolas Pelisch

    Full Text Available Multiple sclerosis (MS is characterized by inflammatory demyelination and deposition of fibrinogen in the central nervous system (CNS. Elevated levels of a critical inhibitor of the mammalian fibrinolitic system, plasminogen activator inhibitor 1 (PAI-1 have been demonstrated in human and animal models of MS. In experimental studies that resemble neuroinflammatory disease, PAI-1 deficient mice display preserved neurological structure and function compared to wild type mice, suggesting a link between the fibrinolytic pathway and MS. We previously identified a series of PAI-1 inhibitors on the basis of the 3-dimensional structure of PAI-1 and on virtual screening. These compounds have been reported to provide a number of in vitro and in vivo benefits but none was tested in CNS disease models because of their limited capacity to penetrate the blood-brain barrier (BBB. The existing candidates were therefore optimized to obtain CNS-penetrant compounds. We performed an in vitro screening using a model of BBB and were able to identify a novel, low molecular PAI-1 inhibitor, TM5484, with the highest penetration ratio among all other candidates. Next, we tested the effects on inflammation and demyelination in an experimental allergic encephalomyelitis mice model. Results were compared to either fingolimod or 6α-methylprednisolone. Oral administration of TM5484 from the onset of signs, ameliorates paralysis, attenuated demyelination, and axonal degeneration in the spinal cord of mice. Furthermore, it modulated the expression of brain-derived neurotrophic factor, which plays a protective role in neurons against various pathological insults, and choline acetyltransferase, a marker of neuronal density. Taken together, these results demonstrate the potential benefits of a novel PAI-1 inhibitor, TM5484, in the treatment of MS.

  2. Mental toughness, sleep disturbances, and physical activity in patients with multiple sclerosis compared to healthy adolescents and young adults

    Sadeghi Bahmani, Dena; Gerber, Markus; Kalak, Nadeem; Lemola, Sakari; Clough, Peter J; Calabrese, Pasquale; Shaygannejad, Vahid; Pühse, Uwe; Holsboer-Trachsler, Edith; Brand, Serge

    2016-01-01

    Background Multiple sclerosis (MS) is the most common chronic autoimmune demyelinating and inflammatory disease of the central nervous system, afflicting both the body and mind. The risk of suffering from MS is 2.5–3.5 times greater in females than in males. While there is extant research on fatigue, depression, and cognitive impairment in patients with MS during its clinical course, there is a lack of research focusing on sleep, psychological functioning, and physical activity (PA) at the point of disease onset. The aims of the present study were therefore, to assess the markers of mental toughness (MT) as a dimension of psychological functioning, sleep disturbances (SD), and PA among patients at the moment of disease onset and to compare these with the corresponding values for healthy adolescents and young adults. Methods A total of 23 patients with MS at disease onset (mean age =32.31 years; 91% females), 23 healthy adolescents (mean age =17.43 years; 82% females), and 25 healthy young adults (mean age =20.72 years; 80% females) took part in the study. They completed questionnaires covering sociodemographic data, MT, SD, and PA. Results Patients with MS had similar scores for MT traits as those in healthy adolescents and healthy young adults, and equivalent levels of moderate-intensity PA and SD as young adults. MS patients reported lower levels of vigorous PA compared to both healthy adolescents and young adults. Conclusion The pattern of the results of the present study suggests that the onset of MS is not associated with poor MT, poor sleep, or reduced moderate-intensity PA. Lower levels of vigorous PA were observed in MS patients. Low levels of vigorous PA may lead to decreased cardiorespiratory fitness in patients with MS and, in the long run, to reduced cardiovascular health and degraded psychological functioning. PMID:27390520

  3. Plasminogen Activator Inhibitor-1 Antagonist TM5484 Attenuates Demyelination and Axonal Degeneration in a Mice Model of Multiple Sclerosis.

    Pelisch, Nicolas; Dan, Takashi; Ichimura, Atsuhiko; Sekiguchi, Hiroki; Vaughan, Douglas E; van Ypersele de Strihou, Charles; Miyata, Toshio

    2015-01-01

    Multiple sclerosis (MS) is characterized by inflammatory demyelination and deposition of fibrinogen in the central nervous system (CNS). Elevated levels of a critical inhibitor of the mammalian fibrinolitic system, plasminogen activator inhibitor 1 (PAI-1) have been demonstrated in human and animal models of MS. In experimental studies that resemble neuroinflammatory disease, PAI-1 deficient mice display preserved neurological structure and function compared to wild type mice, suggesting a link between the fibrinolytic pathway and MS. We previously identified a series of PAI-1 inhibitors on the basis of the 3-dimensional structure of PAI-1 and on virtual screening. These compounds have been reported to provide a number of in vitro and in vivo benefits but none was tested in CNS disease models because of their limited capacity to penetrate the blood-brain barrier (BBB). The existing candidates were therefore optimized to obtain CNS-penetrant compounds. We performed an in vitro screening using a model of BBB and were able to identify a novel, low molecular PAI-1 inhibitor, TM5484, with the highest penetration ratio among all other candidates. Next, we tested the effects on inflammation and demyelination in an experimental allergic encephalomyelitis mice model. Results were compared to either fingolimod or 6α-methylprednisolone. Oral administration of TM5484 from the onset of signs, ameliorates paralysis, attenuated demyelination, and axonal degeneration in the spinal cord of mice. Furthermore, it modulated the expression of brain-derived neurotrophic factor, which plays a protective role in neurons against various pathological insults, and choline acetyltransferase, a marker of neuronal density. Taken together, these results demonstrate the potential benefits of a novel PAI-1 inhibitor, TM5484, in the treatment of MS. PMID:25915660

  4. Glatiramer acetate antibodies, gene expression and disease activity in multiple sclerosis

    Sellebjerg, Finn Thorup; Hedegaard, Chris Juul; Krakauer, M;

    2011-01-01

    . Objectives: We studied the immunological response to GA and its relationship with disease activity. Methods: Anti-GA antibodies in plasma and the expression of genes encoding cytokines and T-cell-polarizing transcription factors in blood cells were analysed by flow cytometric bead array and polymerase chain...... transcription factors was reduced during long-term treatment, but there was no relationship between the expression of cytokines and transcription factors and anti-GA antibodies. High expression of mRNA encoding GATA3 and lymphotoxin-β (LT-β) was associated with low disease activity in Gd-enhanced MRI studies......RNA encoding GATA3 and LT-β expression and MRI disease activity deserves further analysis in future studies. The development of anti-GA antibodies was observed in all patients treated with GA, but this was not related with measures of cellular immunity, clinical or MRI disease activity....

  5. Pharmacological inhibition of MALT1 protease activity protects mice in a mouse model of multiple sclerosis

    Mc Guire, Conor; Elton, Lynn; Wieghofer, Peter; Staal, Jens; Voet, Sofie; Demeyer, Annelies; Nagel, Daniel; Krappmann, Daniel; Prinz, Marco; Beyaert, Rudi; van Loo, Geert

    2014-01-01

    Background: The paracaspase mucosa-associated lymphoid tissue lymphoma translocation protein 1 (MALT1) is crucial for lymphocyte activation through signaling to the transcription factor NF-kappa B. Besides functioning as a scaffold signaling protein, MALT1 also acts as a cysteine protease that specifically cleaves a number of substrates and contributes to specific T cell receptor-induced gene expression. Recently, small molecule inhibitors of MALT1 proteolytic activity were identified and sho...

  6. Multiple sclerosis: general features and pharmacologic approach

    Multiple sclerosis is an autoimmune, inflammatory and desmyelinization disease central nervous system (CNS) of unknown etiology and critical evolution. There different etiological hypotheses talking of a close interrelation among predisposing genetic factors and dissimilar environmental factors, able to give raise to autoimmune response at central nervous system level. Hypothesis of autoimmune pathogeny is based on study of experimental models, and findings in biopsies of affected patients by disease. Accumulative data report that the oxidative stress plays a main role in pathogenesis of multiple sclerosis. Oxygen reactive species generated by macrophages has been involved as mediators of demyelinization and of axon damage, in experimental autoimmune encephalomyelitis and strictly in multiple sclerosis. Disease diagnosis is difficult because of there is not a confirmatory unique test. Management of it covers the treatment of acute relapses, disease modification, and symptoms management. These features require an individualized approach, base on evolution of this affection, and tolerability of treatments. In addition to diet, among non-pharmacologic treatments for multiple sclerosis it is recommended physical therapy. Besides, some clinical assays have been performed in which we used natural extracts, nutrition supplements, and other agents with promising results. Pharmacology allowed neurologists with a broad array of proved effectiveness drugs; however, results of research laboratories in past years make probable that therapeutical possibilities increase notably in future. (Author)

  7. Multiple Sclerosis: From Molecules to Treatment

    Simon A. Broadley

    2013-04-01

    Full Text Available The treatment of multiple sclerosis has been radically transformed over the past 20 years and this special issue of IJMS, focusing on the molecular aspects of the disease, highlights the growing conformity of the various investigative approaches. It is a very exciting time to be involved in the research of this disease.

  8. Nuclear magnetic resonance relaxation in multiple sclerosis

    Larsson, H B; Barker, G J; MacKay, A

    1998-01-01

    OBJECTIVES: The theory of relaxation processes and their measurements are described. An overview is presented of the literature on relaxation time measurements in the normal and the developing brain, in experimental diseases in animals, and in patients with multiple sclerosis. RESULTS AND CONCLUS...

  9. The risk of multiple sclerosis in nurses

    Stenager, Egon; Brønnum-Hansen, Henrik; Koch-Henriksen, Nils

    2003-01-01

    The incidence of multiple sclerosis (MS) in nurses during the period 1980-1996 was calculated in a nationwide study. The cohort consisted of 69,428 nurses, 2185 men and 67,243 women. Sixty (two men and 58 women) with definite MS were observed, whereas 69.3 were expected. We found no significant...

  10. The role of diet in multiple sclerosis

    Klaudia Konikowska

    2014-03-01

    Full Text Available Multiple sclerosis is a demyelinating disease of the central nervous system, occurs most commonly in adults between 20 and 40 years of age. Etiology of this disease is still not known, and one of the analyzed environmental factors is food. In this study, based on literature, discusses the impact of dietary intake of food on the occurrence and development of the disease. This study demonstrated that patients with multiple sclerosis less than healthy people ate bread and cereal products, fish, some vegetables and fruits. While patients often consumed an animal products, whole milk and sweets. It also discusses Swank’s diet, which suggest that the severity of symptoms disease may be responsible food of animal origin, which is rich in saturated fatty acids. The author found that patients who comply a diet, after 34 years of application, the risk of death due to multiple sclerosis was three times lower than in those who have not complied with all the dietary recommendations. Moreover, research demonstrated a correlation between deficiency of omega-3, vitamin D, B12, antioxidant vitamins and folic acid in diet, and the development and exacerbation of symptoms of multiple sclerosis. Results of research concerning the relationship between dietary factors and the occurrence and development of this disease are inconclusive why the need is greater the amount thereof in this field. Patients may consider using a diet or supplements, if pharmacotherapy and other alternative and complementary methods do not bring expected effects.

  11. Concordance for multiple sclerosis in Danish twins

    Hansen, T; Skytthe, Axel; Stenager, Egon;

    2005-01-01

    The occurrence of multiple sclerosis (MS) in twins has not previously been studied in complete nationwide data sets. The existence of almost complete MS and twin registries in Denmark ensures that essentially unbiased samples of MS cases among twins can be obtained. In this population-based study...

  12. Intravenous polyclonal human immunoglobulins in multiple sclerosis

    Sørensen, Per Soelberg

    2008-01-01

    Intravenous immunoglobulin (IVIG) is an established therapy for demyelinating diseases of the peripheral nervous system. IVIG exerts a number of effects that may be beneficial in multiple sclerosis (MS). Four double-blind IVIG trials have been performed in relapsing-remitting MS. A meta-analysis of...

  13. Gender and autoimmune comorbidity in multiple sclerosis

    Magyari, Melinda; Koch-Henriksen, Nils; Pfleger, Claudia C;

    2014-01-01

    BACKGROUND: The female preponderance in incidence of multiple sclerosis (MS) calls for investigations into sex differences in comorbidity with other autoimmune diseases (ADs). OBJECTIVES: To determine whether male and female patients with MS have a higher frequency of autoimmune comorbidity than...

  14. Etiology and pathogenesis of multiple sclerosis

    Sørensen, Torben Lykke; Ransohoff, R M

    1998-01-01

    The cause of multiple sclerosis (MS) remains unknown despite decades of intense research. The major research disciplines that have been brought to bear on this question include genetics, epidemiology, neuropathology, immunology, and virology. Recent advances in the understanding of the inflammatory...

  15. Onset symptoms in paediatric multiple sclerosis

    Boesen, Magnus Spangsberg; Sellebjerg, Finn; Blinkenberg, Morten

    2014-01-01

    INTRODUCTION: Paediatric multiple sclerosis (MS) carries a relatively higher mortality and morbidity than adult MS. Paediatric MS symptoms and paraclinical findings at the first demyelinating event have never before been characterised in a Danish setting. The aim of this study was to compare...

  16. Cigarette smoking and progression in multiple sclerosis

    Koch, Marcus; van Harten, Annemarie; Uyttenboogaart, Maarten; De Keyser, Jacques

    2007-01-01

    OBJECTIVE: To investigate the influence of cigarette smoking on progression and disability accumulation in multiple sclerosis (MS). METHODS: Information on past and present smoking of 364 patients with MS was obtained through a structured questionnaire survey. We used Kaplan-Meier analyses and Cox r

  17. Psychiatric co-morbidity in multiple sclerosis

    Hoang, Huong; Laursen, Bjarne; Stenager, Elsebeth N; Stenager, Egon

    2015-01-01

    BACKGROUND: Studies of depression and anxiety in multiple sclerosis (MS) patients have reported higher rates in MS patients than the general population. OBJECTIVE: To estimate the risk of depression and anxiety and the use of tricyclic antidepressant and selective serotonin reuptake inhibitors...

  18. Vitamin D Status and Multiple Sclerosis Relapse

    J Gordon Millichap

    2010-01-01

    Researchers at University of California, San Francisco, and State University of New York at Stony Brook, NY consecutively recruited patients with pediatric-onset multiple sclerosis into a prospective cohort to determine if vitamin D status is associated with the rate of subsequent clinical relapses.

  19. Cerebrospinal Fluid Proteomics of Multiple Sclerosis Patients

    M.P. Stoop (Marcel)

    2010-01-01

    textabstractMultiple sclerosis (MScl) is a highly heterogeneous disease of the central nervous system, and its pathology is characterized by a combination of factors such as inflammation, demyelination and axonal damage [1, 2]. Cerebrospinal fluid (CSF) is a relatively interesting body fluid in whic

  20. Myeloproliferative neoplasms in five multiple sclerosis patients

    Thorsteinsdottir, Sigrun; Bjerrum, Ole Weis

    2013-01-01

    The concurrence of myeloproliferative neoplasms (MPNs) and multiple sclerosis (MS) is unusual. We report five patients from a localized geographic area in Denmark with both MS and MPN; all the patients were diagnosed with MPNs in the years 2007-2012. We describe the patients' history and treatment...

  1. Hematopoietic stem cell transplantation in multiple sclerosis

    Rogojan, C; Frederiksen, J L

    2009-01-01

    Intensive immunosuppresion followed by hematopoietic stem cell transplantation (HSCT) has been suggested as potential treatment in severe forms of multiple sclerosis (MS). Since 1995 ca. 400 patients have been treated with HSCT. Stabilization or improvement occurred in almost 70% of cases at least...

  2. Walking Speed and Brain Glucose Uptake are Uncoupled in Patients with Multiple Sclerosis

    Kindred, John H.; Tuulari, Jetro J.; Bucci, Marco; Kalliokoski, Kari K.; Rudroff, Thorsten

    2015-01-01

    Motor impairments of the upper and lower extremities are common symptoms of multiple sclerosis (MS). While some peripheral effects like muscle weakness and loss of balance have been shown to influence these symptoms, central nervous system activity has not been fully elucidated. The purpose of this study was to determine if alterations in glucose uptake were associated with motor impairments in patients with multiple sclerosis. Eight patients with multiple sclerosis (four men) and eight sex m...

  3. Walking speed and brain glucose uptake are uncoupled in patients with multiple sclerosis

    Tuulari, Jetro J.; Thorsten Rudroff

    2015-01-01

    Motor impairments of the upper and lower extremities are common symptoms of multiple sclerosis (MS). While some peripheral effects like muscle weakness and loss of balance have been shown to influence these symptoms, central nervous system activity has not been fully elucidated. The purpose of this study was to determine if alterations in glucose uptake were associated with motor impairments in patients with multiple sclerosis. Eight patients with multiple sclerosis (4 men) and 8 sex match...

  4. Dendritic cell, monocyte and T cell activation and response to glatiramer acetate in multiple sclerosis

    Sellebjerg, F; Hesse, D; Limborg, S;

    2012-01-01

    patients, the latter followed prospectively for one year. Gd-enhanced magnetic resonance imaging (MRI) studies were conducted in all patients. Disease activity was assessed as relapses. Results: The median percentage of DCs expressing CD40 was 10% in untreated MS patients and 5.9% in GA-treated patients...... associated with regulatory, naïve or central memory T cell populations, but CD4+ T cell activation was not related with relapse risk. Conclusions: MS patients treated with GA show prominent changes in circulating antigen-presenting cells and CD4+ T cells. Expression of CD40 on DCs is significantly lower and...

  5. Lung volume recruitment in multiple sclerosis.

    Nadim Srour

    Full Text Available INTRODUCTION: Pulmonary function abnormalities have been described in multiple sclerosis including reductions in forced vital capacity (FVC and cough but the time course of this impairment is unknown. Peak cough flow (PCF is an important parameter for patients with respiratory muscle weakness and a reduced PCF has a direct impact on airway clearance and may therefore increase the risk of respiratory tract infections. Lung volume recruitment is a technique that improves PCF by inflating the lungs to their maximal insufflation capacity. OBJECTIVES: Our goals were to describe the rate of decline of pulmonary function and PCF in patients with multiple sclerosis and describe the use of lung volume recruitment in this population. METHODS: We reviewed all patients with multiple sclerosis referred to a respiratory neuromuscular rehabilitation clinic from February 1999 until December 2010. Lung volume recruitment was attempted in patients with FVC <80% predicted. Regular twice daily lung volume recruitment was prescribed if it resulted in a significant improvement in the laboratory. RESULTS: There were 79 patients included, 35 of whom were seen more than once. A baseline FVC <80% predicted was present in 82% of patients and 80% of patients had a PCF insufficient for airway clearance. There was a significant decline in FVC (122.6 mL/y, 95% CI 54.9-190.3 and PCF (192 mL/s/y, 95% 72-311 over a median follow-up time of 13.4 months. Lung volume recruitment was associated with a slower decline in FVC (p<0.0001 and PCF (p = 0.042. CONCLUSION: Pulmonary function and cough decline significantly over time in selected patients with multiple sclerosis and lung volume recruitment is associated with a slower rate of decline in lung function and peak cough flow. Given design limitations, additional studies are needed to assess the role of lung volume recruitment in patients with multiple sclerosis.

  6. Regulatory Cell Populations in Relapsing-Remitting Multiple Sclerosis (RRMS) Patients: Effect of Disease Activity and Treatment Regimens.

    Rodi, Maria; Dimisianos, Nikolaos; de Lastic, Anne-Lise; Sakellaraki, Panagiota; Deraos, George; Matsoukas, John; Papathanasopoulos, Panagiotis; Mouzaki, Athanasia

    2016-01-01

    Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS) of autoimmune etiology that results from an imbalance between CNS-specific T effector cells and peripheral suppressive mechanisms mediated by regulatory cells (RC). In this research, we collected blood samples from 83 relapsing remitting MS (RRMS) patients and 45 healthy persons (HC), to assess the sizes of their RC populations, including CD4⁺CD25(high)Foxp3⁺ (nTregs), CD3⁺CD4⁺HLA(-)G⁺, CD3⁺CD8⁺CD28(-), CD3⁺CD56⁺, and CD56(bright) cells, and how RC are affected by disease activity (acute phase or remission) and types of treatment (methylprednisolone, interferon, or natalizumab). In addition, we isolated peripheral blood mononuclear cells (PBMC) and cultured them with peptides mapping to myelin antigens, to determine RC responsiveness to autoantigens. The results showed decreased levels of nTregs in patients in the acute phase ± methylprednisolone and in remission + natalizumab, but HC levels in patients in remission or receiving interferon. Patients + interferon had the highest levels of CD3⁺CD4⁺HLA(-)G⁺ and CD3⁺CD8⁺CD28(-) RC, and patients in the acute phase + methylprednisolone the lowest. Patients in remission had the highest levels of CD3⁺CD56⁺, and patients in remission + natalizumab the highest levels of CD56(bright) cells. Only nTregs responded to autoantigens in culture, regardless of disease activity or treatment. The highest suppressive activity was exhibited by nTregs from patients in remission. In conclusion, in RRMS disease activity and type of treatment affect different RC populations. nTregs respond to myelin antigens, indicating that it is possible to restore immunological tolerance through nTreg induction. PMID:27571060

  7. Chemokine receptor CCR5 in interferon-treated multiple sclerosis

    Sellebjerg, F; Kristiansen, Thomas Birk; Wittenhagen, P;

    2007-01-01

    OBJECTIVE: To study the relationship between CC chemokine receptor CCR5 expression and disease activity in multiple sclerosis (MS) patients treated with beta-interferon (IFN-beta). METHODS: The CCR5 Delta32 allele and a CCR5 promoter polymorphism associated with cell surface expression of CCR5 were...

  8. Prediction of response to interferon therapy in multiple sclerosis

    Sellebjerg, F; Søndergaard, Helle Bach; Koch-Henriksen, N;

    2014-01-01

    OBJECTIVE: Single nucleotide polymorphisms (SNPs) in the genes encoding interferon response factor (IRF)-5, IRF-8 and glypican-5 (GPC5) have been associated with disease activity in multiple sclerosis (MS) patients treated with interferon (IFN)-β. We analysed whether SNPs in the IRF5, IRF8 and GPC5...

  9. Leg Spasticity and Ambulation in Multiple Sclerosis

    Swathi Balantrapu; Sosnoff, Jacob J.; Pula, John H.; Brian M. Sandroff; Motl, Robert W.

    2014-01-01

    Background. Spasticity of the legs is common in multiple sclerosis (MS), but there has been limited research examining its association with ambulatory outcomes. Objective. This study examined spasticity of the legs and its association with multiple measures of ambulation in persons with MS. Methods. The sample included 84 patients with MS. Spasticity of the legs was measured using a 5-point rating scale ranging between 0 (normal) and 4 (contracted). Patients completed the 6-minute walk (6 MW)...

  10. Bone Health in Patients with Multiple Sclerosis

    Vit Zikan

    2011-01-01

    Multiple sclerosis (MS) is a gait disorder characterized by acute episodes of neurological defects leading to progressive disability. Patients with MS have multiple risk factors for osteoporotic fractures, such as progressive immobilization, long-term glucocorticoids (GCs) treatment or vitamin D deficiency. The duration of motor disability appears to be a major contributor to the reduction of bone strength. The long term immobilization causes a marked imbalance between bone formation and reso...

  11. Possibilities of computer tomography in multiple sclerosis

    Computer tomography was performed in 41 patients with multiple sclerosis, the average age of patients being 40.8 years. Native examinations were made of 17 patients, examinations with contrast medium of 19, both methods were used in the examination of 5 patients. In 26 patients, i.e. in almost two-thirds, cerebral atrophy was found, in 11 of a severe type. In 9 patients atrophy affected only the hemispheres, in 16 also the stem and cerebellum. The stem and cerebellum only were affected in 1 patient. Hypodense foci were found in 21 patients, i.e. more than half of those examined. In 9 there were multiple foci. In most of the 19 examined patients the hypodense changes were in the hemispheres and only in 2 in the cerebellum and brain stem. No hyperdense changes were detected. The value and possibilities are discussed of examinations by computer tomography multiple sclerosis. (author)

  12. Natalizumab in relapsing-remitting multiple sclerosis.

    Outteryck, Olivier

    2016-05-01

    Natalizumab is the first humanized moclonal antibody indicated in the treatment of relapsing-remitting multiple sclerosis (RRMS). Based on its remarkable efficacy in reducing disease activity and reducing the risk of disability progession in RRMS, and the risk of a serious adverse event (progressive multifocal leukoencephalopathy [PML]), natalizumab was indicated in active RRMS, mostly as a second-line therapy. With natalizumab and other recent anti-inflammatory therapies, the concept of no evidence of disease activity has emerged and may sometimes be achievable. Use of natalizumab in other inflammatory diseases of the nervous system has been less encouraging than in MS. PML remains the main serious adverse event occuring during natalizumab therapy. PML risk stratification according to JCV serology and JCV index is now being applied more often. Other PML risk biomarkers are being evaluated. If stopping natalizumab is planned, the wash-out period needs to be less than 12 weeks and probably closer to 4-8 weeks with efficient validated immunomodulatory or immunosuppressive therapies in RRMS. PMID:27008031

  13. Excercise and disease progression in multiple sclerosis - can exercise slow down the progression of multiple sclerosis

    Dalgas, Ulrik; Stenager, Egon

    2012-01-01

    (3) and data from the EAE model (4) indicate a possible disease-modifying effect of exercise, but the strength of the evidence limits definite conclusions. It was concluded that some evidence supports the possibility of a disease-modifying potential of exercise (or physical activity) in MS patients......It has been suggested that exercise (or physical activity) might have the potential to have an impact on multiple sclerosis (MS) pathology and thereby slow down the disease process in MS patients. The objective of this literature review was to identify the literature linking physical exercise (or...... studies evaluating the effects on clinical outcome measures, (2) cross-sectional studies evaluating the relationship between fitness status and MRI findings, (3) cross-sectional and longitudinal studies evaluating the relationship between exercise/physical activity and disability/relapse rate and, finally...

  14. Multiple sclerosis--new treatment modalities.

    Totaro, Rocco; Di Carmine, Caterina; Marini, Carmine; Carolei, Antonio

    2015-12-01

    Ever since the introduction of the first disease modifying therapies, the concept of multiple sclerosis treatment algorithms developed ceaselessly. The increasing number of available drugs is paralleled by impelling issue of ensuring the most appropriate treatment to the right patient at the right time. The purpose of this review is to describe novel agents recently approved for multiple sclerosis treatment, namely teriflunomide, alemtuzumab and dimethylfumarate, focusing on mechanism of action, efficacy data in experimental setting, safety and tolerability. The place in therapy of newer treatment implies careful balancing of risk-benefit profile as well as accurate patient selection. Hence the widening of therapeutic arsenal provides greater opportunity for personalized therapy but also entails a complex trade-off between efficacy, tolerability, safety and eventually patient preference. PMID:26831413

  15. Type 1 diabetes and multiple sclerosis

    Nielsen, Nete M; Westergaard, Tine; Frisch, Morten; Rostgaard, Klaus; Wohlfahrt, Jan; Koch-Henriksen, Nils; Melbye, Mads; Hjalgrim, Henrik

    2006-01-01

    BACKGROUND: Type 1 diabetes mellitus (T1D) and multiple sclerosis (MS) contribute considerably to the burden of autoimmune diseases in young adults. Although HLA patterns of T1D and MS are considered mutually exclusive, individual and familial co-occurrence of the 2 diseases has been reported...... Multiple Sclerosis Register were used to identify patients with T1D, defined as patients in whom diabetes was diagnosed before age 20 years (N = 6078), and patients with MS (N = 11 862). First-degree relatives (N = 14,771) of patients with MS were identified from family information in the Danish Civil......, 1.63; 95% confidence interval, 1.26-2.12; n = 56) for development of T1D. However, adjusting for familial relationship to patients with T1D reduced the excess risk to 44% (relative risk, 1.44; 95% confidence interval, 1.11-1.88; n = 56). CONCLUSION: The present nationwide cohort study demonstrates...

  16. SOME NEUROCHEMICAL DISTURBANCES IN MULTIPLE SCLEROSIS

    Vladimir V. Markelov

    2006-04-01

    Full Text Available ABSTRACTThe data presented in this manuscript suggest a pivotal role of the central nervous system (CNS in the regulation of immune status. We describe here that some neurochemical disturbances may provoke development of various diseases including multiple sclerosis. Some theoretic and practical backgrounds, how to improve the multiple sclerosis sufferers and patients with other autoimmune disorders, are also given.RESUMENLos datos que presentamos en este manuscrito, sugieren un papel guia del sistema nervioso central (SNC en la regulación del estado inmune. Describimos aquí que varias alteraciones neuroquímicas pueden provocar el desarrollo de varias enfermedades, incluyendo esclerosis múltiple. También se comenta acerca del trasfondo teórico y práctico, y cómo mejorar a víctimas y pacientes con esclerosis múltiple y otras alteraciones autoinmunes.

  17. Endocannabinoids in Multiple Sclerosis and Amyotrophic Lateral Sclerosis.

    Pryce, Gareth; Baker, David

    2015-01-01

    There are numerous reports that people with multiple sclerosis (MS) have for many years been self-medicating with illegal street cannabis or more recently medicinal cannabis to alleviate the symptoms associated with MS and also amyotrophic lateral sclerosis (ALS). These anecdotal reports have been confirmed by data from animal models and more recently clinical trials on the ability of cannabinoids to alleviate limb spasticity, a common feature of progressive MS (and also ALS) and neurodegeneration. Experimental studies into the biology of the endocannabinoid system have revealed that cannabinoids have efficacy, not only in symptom relief but also as neuroprotective agents which may slow disease progression and thus delay the onset of symptoms. This review discusses what we now know about the endocannabinoid system as it relates to MS and ALS and also the therapeutic potential of cannabinoid therapeutics as disease-modifying or symptom control agents, as well as future therapeutic strategies including the potential for slowing disease progression in MS and ALS. PMID:26408162

  18. Rehabilitation of multiple sclerosis patients in India

    Nirmal Surya

    2015-01-01

    Multiple sclerosis (MS) is a chronic progressive disease which is one of the leading causes of handicap in young subjects. The large range of symptoms associated with MS lead to continuing decline in neurologic status and quality of life. The coexistence of physical and cognitive impairments, together with the imprevisible evolution of the disease makes MS rehabilitation very challenging. The main objective of rehabilitation is, therefore, to ease the burden of symptoms by improving self-perf...

  19. Isolated cranial nerve palsies in multiple sclerosis

    Zadro, Ivana; Barun, Barbara; Habek, Mario; Brinar, Vesna V.

    1997-01-01

    During a 10 year period 24 patients with definite multiple sclerosis with isolated cranial nerve palsies were studied (third and fourth nerve: one patient each, sixth nerve: 12 patients, seventh nerve: three patients, eighth nerve: seven patients), in whom cranial nerve palsies were the presenting sign in 14 and the only clinical sign of an exacerbation in 10 patients. MRI was carried out in 20 patients and substantiated corresponding brainstem lesions in seven patients (...

  20. Dietary pattern and risk of multiple sclerosis

    Mahdi Aloosh; Mansoureh Toghae; Mohammad Jamal Razeghi Jahromi; Soodeh Razeghi Jahromi

    2012-01-01

    Background It has been suggested that nutrition might play a role in the etiology of multiple sclerosis (MS). However, dietary patterns associated with MS risk are unknown. This study was conducted to compare the dietary patterns of patients with MS and healthy controls to find the relationship between dietary patterns and MS. Methods Usual dietary intake of 75 women with relapsing/remitting MS (RRMS) and 75 healthy controls were assessed with a food frequency questionnaire consisting of 168 ...

  1. Neuronal degeneration in spinal multiple sclerosis

    Bernhardt, Lydia

    2010-01-01

    To elucidate neuronal degeneration in spinal multiple sclerosis the spinal cord of 27 post mortem patients of the years 1997 to 2000 was investigated in comparison to 29 controls matched for sex, age and year of death. In addition to immunohistochemical examinations and demonstration of pathological cell changes, we also quantified the neurons of the cervical and thoracic spinal cord. In comparison to controls, MS-patients show a significant loss of 43% of the cervical neurons and a signif...

  2. Diagnosis and management of multiple sclerosis.

    Calabresi, Peter A

    2004-11-15

    Multiple sclerosis, an idiopathic inflammatory disease of the central nervous system, is characterized pathologically by demyelination and subsequent axonal degeneration. The disease commonly presents in young adults and affects twice as many women as men. Common presenting symptoms include numbness, weakness, visual impairment, loss of balance, dizziness, urinary bladder urgency, fatigue, and depression. The diagnosis of multiple sclerosis should be made by a physician with experience in identifying the disease. Diagnosis should be based on objective evidence of two or more neurologic signs that are localized to the brain or spinal cord and are disseminated in time and space (i.e., occur in different parts of the central nervous system at least three months apart). Magnetic resonance imaging with gadolinium contrast, especially during or following a first attack, can be helpful in providing evidence of lesions in other parts of the brain and spinal cord. A second magnetic resonance scan may be useful at least three months after the initial attack to identify new lesions and provide evidence of dissemination over time. It is critical to exclude other diseases that can mimic multiple sclerosis, including vascular disease, spinal cord compression, vitamin B12 deficiency, central nervous system infection (e.g., Lyme disease, syphilis), and other inflammatory conditions (e.g., sarcoidosis, systemic lupus erythematosus, Sjögren's syndrome). Symptom-specific drugs can relieve spasticity, bladder dysfunction, depression, and fatigue. Five disease-modifying treatments for multiple sclerosis have been approved by the U.S. Food and Drug Administration. These treatments are partially effective in reducing exacerbations and may slow progression of disability. PMID:15571060

  3. Impaired neurosteroid synthesis in multiple sclerosis

    Noorbakhsh, Farshid; Ellestad, Kristofor K.; Maingat, Ferdinand; Warren, Kenneth G; Han, May H.; Steinman, Lawrence; Baker, Glen B.; Power, Christopher

    2011-01-01

    High-throughput technologies have led to advances in the recognition of disease pathways and their underlying mechanisms. To investigate the impact of micro-RNAs on the disease process in multiple sclerosis, a prototypic inflammatory neurological disorder, we examined cerebral white matter from patients with or without the disease by micro-RNA profiling, together with confirmatory reverse transcription–polymerase chain reaction analysis, immunoblotting and gas chromatography-mass spectrometry...

  4. Stimulation of motor tracts in multiple sclerosis.

    Berardelli, A; Inghilleri, M; Cruccu, G.; Fornarelli, M; Accornero, N; Manfredi, M.

    1988-01-01

    Percutaneous electrical stimulation of the motor cortex was used to evaluate corticospinal conduction to upper-limb motoneurons in 29 patients with multiple sclerosis. Central motor conduction abnormalities were correlated with clinical signs and somatosensory evoked potentials. Muscle responses to cortical stimulation were altered in 20 patients. The most common abnormality was increased central motor conduction time; in two cases the responses to cortical stimulation were absent. Abnormalit...

  5. Update in vitamin D and multiple sclerosis

    Alharbi, Fatimah M.

    2015-01-01

    Multiple sclerosis (MS) is a common neurological disease, and its etiology remains unknown. In recent years, increasing attention has been paid to the possible association between MS and vitamin D deficiency. Here, we review the current literature between MS and vitamin D, showing clear evidence that vitamin D deficiency is a risk factor for MS despite the lack of direct evidence for the effects of vitamin D in MS progression.

  6. Vitamin D and multiple sclerosis: an update

    Cantorna, Margherita T.

    2008-01-01

    Observational studies document a positive relationship between vitamin D from the environment (sunlight or diet), circulating vitamin D status, and improved symptoms or prevention of multiple sclerosis (MS). Experimental animal models of MS reproduce the beneficial effects of vitamin D and 1,25(OH)2D3. The geographical distribution of MS can be explained by both the hygiene hypothesis and the vitamin D hypothesis. It therefore seems more likely that both hypotheses may be correct and that the...

  7. Update in vitamin D and multiple sclerosis.

    Alharbi, Fatimah M

    2015-10-01

    Multiple sclerosis (MS) is a common neurological disease, and its etiology remains unknown. In recent years, increasing attention has been paid to the possible association between MS and vitamin D deficiency. Here, we review the current literature between MS and vitamin D, showing clear evidence that vitamin D deficiency is a risk factor for MS despite the lack of direct evidence for the effects of vitamin D in MS progression. PMID:26492110

  8. Cluster headache attacks and multiple sclerosis

    Gentile, Salvatore; Ferrero, Margherita; Vaula, Giovanna; Rainero, Innocenzo; Pinessi, Lorenzo

    2007-01-01

    We report the case of a patient who developed typical cluster headache attacks and was diagnosed as having multiple sclerosis (MS) at the same time. The headache attacks resolved after i.v. treatment with methylprednisolone. MR imaging showed a pontine demyelinating lesion involving the trigeminal nerve root inlet area, on the same side as the pain. The association between cluster headache and MS has been rarely described before. This case suggests that in patients with cluster headache neuro...

  9. Therapeutic potential of LIF in multiple sclerosis

    Slaets, Leen; Hendriks, Jerome J. A.; STINISSEN, Piet; Kilpatrick, Trevor J.; Hellings, Niels

    2010-01-01

    Therapies for multiple sclerosis (MS) reduce the relapse rate but are unable to stop neurological decline. Here, we evaluate the potential of leukemia inhibitory factor (LIF) as a novel therapeutic in diseases with a neurodegenerative and inflammatory component, such as MS. LIF, which can be a proinflammatory cytokine, can also modulate the immune response in a beneficial way. Recent evidence demonstrates a crucial role of LIF in neuroprotection and axonal regeneration as well as the preventi...

  10. Matrix metalloproteinases, synaptic injury, and multiple sclerosis

    ArekSzklarczyk

    2010-10-01

    Full Text Available Multiple sclerosis (MS is a disease of the central nervous system in which immune mediated damage to myelin is characteristic. For an overview of this condition and its pathophysiology, please refer to one of many excellent published reviews. To follow, is a discussion focused on the possibility that synaptic injury occurs in at least a subset of patients, and that matrix metalloproteinases (MMPs play a role in such.

  11. Matrix Metalloproteinases, Synaptic Injury, and Multiple Sclerosis

    Szklarczyk, Arek; Conant, Katherine

    2010-01-01

    Multiple sclerosis (MS) is a disease of the central nervous system in which immune mediated damage to myelin is characteristic. For an overview of this condition and its pathophysiology, please refer to one of many excellent published reviews (Sorensen and Ransohoff, 1998; Weiner, 2009). To follow, is a discussion focused on the possibility that synaptic injury occurs in at least a subset of patients, and that matrix metalloproteinases (MMPs) play a role in such.

  12. Fatigue in Multiple Sclerosis: (An update

    Hossein Zarei

    2007-10-01

    Full Text Available BACKGROUND:To study the dimensions of fatigue in multiple sclerosis, its pathophysiology, the efficacy, tolerability and safety of drug and non-drug treatments and measurement of fatigue. METHODS: Relevant articles from PubMed and Google scholar search engines from January 1987 until September 2006 were studied to compose a short clinical update (not a systematic review and make the required clinical information available for the clinicians. RESULTS: There is evidence that fatigue is very common in all types and stages of multiple sclerosis, but its pathophysiology is not well explained. Consequently, few drug options have been offered for its treatment. Amantadine is the bestknown drug, though its efficacy and duration of action are limited. Pemoline and modafinil are alternatives and have
    some effects on fatigue. DAP (diaminopyridine, ASA (acetylsalicylic acid, methylphenidate and fluoxetine are other possible options but await further confirmation. Neurorehabilitation, regular exercise and cooling are confirmed to be of value in MS treatment. Measurement of fatigue is a complicated issue. At present fatigue does not have a laboratory marker. CONCLUSIONS: The results of this short clinical update provide guidelines for diagnosing MS-related fatigue and differentiating
    it from other similar physical and psychological conditions. It also examines prescription drug options and other therapies for MS patients with fatigue.
    KEYWORDS: Multiple sclerosis, fatigue, pathophysiology, treatment, measurement.

  13. Magnetic resonance imaging in multiple sclerosis

    In 1983 the Multiple Sclerosis Society of Great Britain and Northern Ireland set up the Multiple Sclerosis NMR Research Group at the Institute of Neurology and the National Hospital, Queen Square. The first aim of the Group was to define the role of MRI in the diagnosis and differential diagnosis of multiple sclerosis, and this Atlas represents a summary of that work. Our strategy was to determine the pattern of MRI abnormalities in clinically definite MS and to compare it with those of isolated clinical syndromes of the kind seen in MS (e.g. optic neuritis) and of other disorders with which MS can be confused clinically or radiologically. We have also been involved in a major program of experimental work designed to elucidate the origin of the abnormal signals in MRI. To describe this in full detail would go beyond the scope of the Atlas, but we have incorporated such results as far as they illuminate our clinical problems. The imager used was a 0.5 Tesla Picker superconducting system. Technical advances have been rapid since we began. Nevertheless, the quality of the images obtained at our relatively low field has enabled us to establish the patterns of abnormality in the brain in MS and the diseases which must be distinguished from it. (orig./MG)

  14. Persistent activation of microglia is associated with neuronal dysfunction of callosal projecting pathways and multiple sclerosis-like lesions in relapsing--remitting experimental autoimmune encephalomyelitis

    Rasmussen, Stine; Wang, Yue; Kivisäkk, Pia;

    2007-01-01

    Cortical pathology, callosal atrophy and axonal loss are substrates of progression in multiple sclerosis (MS). Here we describe cortical, periventricular subcortical lesions and callosal demyelination in relapsing-remitting experimental autoimmune encephalomyelitis in SJL mice that are similar to...

  15. Potential immunological consequences of pharmacological suppression of gastric acid production in patients with multiple sclerosis

    Biswas Sangita

    2012-06-01

    Full Text Available Abstract Corticosteroids are standard treatment for patients with multiple sclerosis experiencing acute relapse. Because dyspeptic pain is a common side effect of this intervention, patients can be given a histamine receptor-2 antagonist, proton pump inhibitor or antacid to prevent or ameliorate this disturbance. Additionally, patients with multiple sclerosis may be taking these medications independent of corticosteroid treatment. Interventions for gastric disturbances can influence the activation state of the immune system, a principal mediator of pathology in multiple sclerosis. Although histamine release promotes inflammation, activation of the histamine receptor-2 can suppress a proinflammatory immune response, and blocking histamine receptor-2 with an antagonist could shift the balance more towards immune stimulation. Studies utilizing an animal model of multiple sclerosis indicate that histamine receptor-2 antagonists potentially augment disease activity in patients with multiple sclerosis. In contrast, proton pump inhibitors appear to favor immune suppression, but have not been studied in models of multiple sclerosis. Antacids, histamine receptor-2 antagonists and proton pump inhibitors also could alter the intestinal microflora, which may indirectly lead to immune stimulation. Additionally, elevated gastric pH can promote the vitamin B12 deficiency that patients with multiple sclerosis are at risk of developing. Here, we review possible roles of gastric acid inhibitors on immunopathogenic mechanisms associated with multiple sclerosis.

  16. Role of pathogens in multiple sclerosis.

    Libbey, Jane E; Cusick, Matthew F; Fujinami, Robert S

    2014-01-01

    Multiple sclerosis (MS) is an inflammatory demyelinating autoimmune disease of the central nervous system (CNS). Although the etiology of MS is unknown, genetic and environmental factors play a role. Infectious pathogens are the likely environmental factors involved in the development of MS. Pathogens associated with the development or exacerbation of MS include bacteria, such as Mycoplasma pneumoniae and Chlamydia pneumoniae, the Staphylococcus aureus-produced enterotoxins that function as superantigens, viruses of the herpes virus (Epstein-Barr virus and human herpesvirus 6) and human endogenous retrovirus (HERV) families and the protozoa Acanthamoeba castellanii. Evidence, from studies with humans and animal models, supporting the association of these various pathogens with the development and/or exacerbation of MS will be discussed along with the potential mechanisms including molecular mimicry, epitope spreading and bystander activation. In contrast, infection with certain parasites such as helminthes (Schistosoma mansoni, Fasciola hepatica, Hymenolepis nana, Trichuris trichiura, Ascaris lumbricoides, Strongyloides stercolaris, Enterobius vermicularis) appears to protect against the development or exacerbation of MS. Evidence supporting the ability of parasitic infections to protect against disease will be discussed along with a brief summary of a recent Phase I clinical trial testing the ability of Trichuris suis ova treatment to improve the clinical course of MS. A complex interaction between the CNS (including the blood-brain barrier), multiple infections with various infectious agents (occurring in the periphery or within the CNS), and the immune response to those various infections may have to be deciphered before the etiology of MS can be fully understood. PMID:24266364

  17. Esclerosis múltiple: alteraciones cognitivas y actividades de la vida diaria = Multiple sclerosis : cognitive impairments and activities of daily living

    Alegre Ayala, Jorge

    2008-02-01

    Full Text Available RESUMENLas alteraciones cognitivas ocasionadas por la Esclerosis Múltiple (EM dificultan el desempeño ocupacional de estos pacientes. No existe un patrón específico de deterioro cognitivo aunque son comunes las afectaciones de la memoria, los procesos atencionales, la velocidad de procesamiento de la información, las funciones ejecutivas, la fluidez verbal y la capacidad visuoespacial. Pese a no ser tan conocidos como los problemas físicos, los déficit cognitivos provocan limitaciones en la capacidad de estas personas para realizar sus actividades de la vida diaria (AVD. El artículo muestra explicaciones sobre las principales alteraciones cognitivas de la enfermedad y ejemplos de actividades de la vida diaria dañadas por éstas. SUMMARY Cognitive impairments caused by Multiple Sclerosis make these patients´ occupational performance difficult. It is not exist a specific pattern of cognitive injury although they are usual the affections in memory, attention process, speed of information processing, executive functions, verbal fluency and visual and spatial skills. Though are not so known like physical problems, the cognitive deficits provokes limitations in the ability of these persons to realize their activities of daily living. Article shows explains about principal cognitive impairments and examples of damage in the activities of daily living caused by Multiple Sclerosis.

  18. African Americans and Multiple Sclerosis

    ... is critical to living well with MS. Healthy nutrition, proper exercise, getting enough sleep, managing stress, a strong support network, and an active social life are all important to living well with MS.

  19. Statin treatment in multiple sclerosis

    Pihl-Jensen, Gorm; Tsakiri, Anna; Frederiksen, Jette Lautrup

    2015-01-01

    candidates for MS treatment due to reliable safety profiles and favorable costs. Studies of statins in a murine MS model and in open-label trials in MS have shown decreased disease severity. OBJECTIVE: Our objective was to assess current evidence to support statin treatment in MS and clinically isolated......)-β treatment in RRMS, one of statin monotherapy in CIS, one of statin monotherapy in optic neuritis (ON)/CIS, and one of statin monotherapy in secondary progressive MS (SPMS)]. Three trials with eligible characteristics had not been published in peer-reviewed journals and were therefore not included. Due to...... activity or risk of MS between statin monotherapy and placebo. In acute ON, statin monotherapy produced better visual outcome but no difference in relapse activity, MRI activity, or risk of MS. CONCLUSIONS: The pleiotropic effects and effects in the murine model of MS could not be converted to a proven...

  20. The management of multiple sclerosis in children: a European view

    Ghezzi, Angelo; Banwell, Brenda; Boyko, Alexey; Amato, Maria Pia; Anlar, Banu; Blinkenberg, Morten; Boon, Maartje; Filippi, Massimo; Jozwiak, Sergiusz; Ketelslegers, Immy; Kornek, Barbara; Lim, Ming; Lindstrom, Eva; Nadj, Congor; Neuteboom, Rinze; Rocca, Maria A; Rostasy, Kevin; Tardieu, Marc; Wassmer, Evangeline; Catsman-Berrevoets, Coriene; Hintzen, Rogier

    2010-01-01

    the paediatric multiple sclerosis population has triggered the use of disease-modifying therapies that have been shown to reduce relapse rate, disease progression and cognitive decline in adult patients with multiple sclerosis. Hard evidence for the right treatment and its appropriate timing is scarce......About 3-5% of all patients with multiple sclerosis experience the onset of their disease under the age of 16. A significant proportion of paediatric multiple sclerosis patients develop significant cognitive disturbances and persistent physical disability. The high relapse rate and the morbidity in...

  1. The Danish Multiple Sclerosis Registry. History, data collection and validity

    Koch-Henriksen, N; Rasmussen, S; Stenager, E;

    2001-01-01

    The Danish Multiple Sclerosis Registry was formally established in 1956 but started operating in 1949 with a nationwide prevalence survey. Since then, the Registry has continued collecting data on new and old cases of multiple sclerosis (MS) or suspected MS from multiple sources. The Registry...

  2. Targeting synaptic pathology in multiple sclerosis: fingolimod to the rescue?

    Gillingwater, Thomas H

    2012-01-01

    Multiple sclerosis (MS) is an inflammatory disorder affecting the brain and spinal cord. Major hallmarks of MS typically include inflammation, demyelination and axon degeneration, although recent studies have also implicated synaptic dysfunction and degeneration in disease pathogenesis. The discovery that treatment with the orally active immunomodulatory drug fingolimod (FTY720) confers benefits in animal models and human patients has opened up new avenues for the treatment of MS. In the pres...

  3. Resveratrol Neuroprotection in a Chronic Mouse Model of Multiple Sclerosis

    Zoe eFonseca-Kelly; Mayssa eNassrallah; Jorge eUribe; Khan, Reas S.; Kimberly eDine; Mahasweta eDutt; Shindler, Kenneth S.

    2012-01-01

    Resveratrol is a naturally-occurring polyphenol that activates SIRT1, an NAD-dependent deacetylase. SRT501, a pharmaceutical formulation of resveratrol with enhanced systemic absorption, prevents neuronal loss without suppressing inflammation in mice with relapsing experimental autoimmune encephalomyelitis (EAE), a model of multiple sclerosis. In contrast, resveratrol has been reported to suppress inflammation in chronic EAE, although neuroprotective effects were not evaluated. The current st...

  4. Pain is Associated with Prospective Memory Dysfunction in Multiple Sclerosis

    Miller, Ashley K.; Basso, Michael R.; Candilis, Philip J.; Combs, Dennis R.; Woods, Steven Paul

    2014-01-01

    Prospective memory (PM) pertains to the execution of a future goal or behavior. Initial research implies that people with multiple sclerosis (MS) are apt to show impaired prospective memory for activities of daily living (Rendell, Jensen, & Henry, 2007; Rendell et al., 2012). Yet, PM impairment does not occur in all people with MS. Thus, some other variable besides disease status alone may contribute to PM dysfunction in people with MS. Chronic pain may be such a variable. Approximately 50-70...

  5. "Disease modifying nutricals" for multiple sclerosis.

    Schmitz, Katja; Barthelmes, Julia; Stolz, Leonie; Beyer, Susanne; Diehl, Olaf; Tegeder, Irmgard

    2015-04-01

    The association between vitamin D and multiple sclerosis has (re)-opened new interest in nutrition and natural compounds in the prevention and treatment of this neuroinflammatory disease. The dietary amount and type of fat, probiotics and biologicals, salmon proteoglycans, phytoestrogens and protease inhibitor of soy, sodium chloride and trace elements, and fat soluble vitamins including D, A and E were all considered as disease-modifying nutraceuticals. Studies in experimental autoimmune encephalomyelitis mice suggest that poly-unsaturated fatty acids and their 'inflammation-resolving' metabolites and the gut microflora may reduce auto-aggressive immune cells and reduce progression or risk of relapse, and infection with whipworm eggs may positively change the gut-brain communication. Encouraged by the recent interest in multiple sclerosis-nutrition nature's pharmacy has been searched for novel compounds with anti-inflammatory, immune-modifying and antioxidative properties, the most interesting being the scorpion toxins that inhibit specific potassium channels of T cells and antioxidative compounds including the green tea flavonoid epigallocatechin-3-gallate, curcumin and the mustard oil glycoside from e.g. broccoli and sulforaphane. They mostly also inhibit pro-inflammatory signaling through NF-κB or toll-like receptors and stabilize the blood brain barrier. Disease modifying functions may also complement analgesic and anti-spastic effects of cannabis, its constituents, and of 'endocannabinoid enhancing' drugs or nutricals like inhibitors of fatty acid amide hydrolase. Nutricals will not solve multiple sclerosis therapeutic challenges but possibly support pharmacological interventions or unearth novel structures. PMID:25435020

  6. Epileptic Seizures in Multiple Sclerosis Patients

    Kamber Zeqiraj

    2013-06-01

    Full Text Available Objective: The presence of epileptic seizures in patients with multiple sclerosis (MS is a well-known phenomenon. The aims of our study, performed in our clinic are to point out the correlation of the mean age/gender and age of MS patients with the onset of seizures, to identify the types of epileptic seizures in MS patients by sex/age, to identify the correlation between relapses and seizures, and to identify the main electrophysiological / imaging changes. Material and Met-hod: The medical records of 300 MS patients observed between January 2000 and December 2009 in the Neurological Clinic of University Clinical Centre of Kosova were reviewed. All patients fulfilled the McDonald MS criteria Epilepsy diagnosis was based on the ILAE (International League against Epilepsy (1983 criteria while epileptic seizures were classified based on the ILAE classification (1981. Results: Out of 300 MS patients enrolled in this study, 49 (16.33% were identified with seizures or epilepsy. In 23 (47% patients out of 49, seizures or epilepsy appeared after the MS diagnosis. In 6 patients (12.2%, epileptic attacks preceded the MS diagnosis, while in 20 patients (40.8%, epilepsy was diagnosed before multiple sclerosis. These patients were treated with antiepileptics. Out of 23 patients (47% in whom the epileptic seizures appeared after the MS diagnosis, 17 (74% had simple partial seizures, and 6 (26% had complex partial seizures. Based to our study, the epileptic seizures in MS patients appeared about 2.2 years after the MS diagnosis. Discussion: Simple partial seizures were 2.8 times more frequent compared to complex partial seizures. In female patients the prevalence of complex partial seizures was higher than in male patients with multiple sclerosis. (Turkish Journal of Neurology 2013; 19: 40-3

  7. Reproductive History and Risk of Multiple Sclerosis

    Nielsen, N. M.; Jorgensen, K. T.; Stenager, E.; Jensen, A.; Pedersen, B. V.; Hjalgrim, H.; Kjaer, S. K.; Frisch, M.

    2011-01-01

    Background: It has been suggested that reproductive factors may be involved in the etiology of multiple sclerosis (MS). We studied associations of reproductive history with MS risk in a population-based setting. Methods: Using national databases, we established a cohort comprising 4.4 million......% confidence interval = 0.71-0.82]; in men, 0.89 [0.80-0.98]). RRs were inversely associated with number of children, age at first childbirth, and proximity in time since most recent birth. Among women, MS risk was unrelated to histories of pregnancy loss, pregnancy complications, or infertility. A...

  8. Multiple sclerosis with caudate lesions on MRI.

    Hashiguchi, S; Ogasawara, N; Mine, H; Kawachi, Y

    2001-04-01

    A 31-year-old woman displayed sleepiness and impairment of recent memory. T2-weighted MRI revealed high signal intensity lesions in the bilateral basal ganglia, thalamus, and brainstem. Although remission was achieved with corticosteroid therapy, she again displayed memory dysfunction and emotional disturbance one year later, at which time MRI disclosed new lesions in the right caudate nucleus and left frontal white matter. Corticosteroid therapy lead to improvement, and she suffered no recurrence on maintenance steroid therapy. These findings suggest that caudate lesions do occur in multiple sclerosis, the manifestations of which can be abulia and memory dysfunction, as in the present case. PMID:11334400

  9. Autoantigens and autoantibodies in multiple sclerosis.

    Abbas Mirshafiey

    2013-12-01

    Full Text Available Multiple sclerosis (MS is an autoimmune disease characterized by recurrent episodes of demyelination and axonal lesion mediated by CD4+ T cells with a proinflammatory T helper (Th1 and Th17 phenotypes, macrophages, and soluble inflammatory mediators. The overactive pro-inflammatory Th1 cells and clonal expansion of B cells initiate an inflammatory cascade with several cellular and molecular immune components participating in MS pathogenic mechanisms. In this scenario, autoantibodies and autoantigens have a significant role in immunopathogenesis, diagnosis and therapeutic targets of MS. In this review, we try to introduce the autoantigens and autoantibodies and explain their roles in pathogenesis of MS.

  10. Developing a community multiple sclerosis nursing service.

    Quinn, Debbie; Adams, John

    2014-05-20

    Reforms to the NHS following the passing of the Health and Social Care Act 2012 have created new purchaser organisations with responsibility for planning the configuration of healthcare services in their geographic areas. If a community multiple sclerosis (MS) nursing service is to survive in this environment, it must demonstrate its ability to contribute to achieving the purchaser organisations' objectives. Evaluation data, such as hospital admission avoidance and patient satisfaction, will be crucial in demonstrating the community MS nursing service's clinical and economic effectiveness. A strengths, weaknesses, opportunities and threats (SWOT) analysis of the issues facing a community MS service in this environment is provided. PMID:24823591

  11. The socioeconomic consequences of multiple sclerosis

    Jennum, Poul; Wanscher, Benedikte; Frederiksen, Jette;

    2012-01-01

    Multiple sclerosis (MS) has serious negative effects on health-, social-, and work-related issues for the patients and their families, thus causing significant socioeconomic burden. The objective of the study was to determine healthcare costs and indirect illness costs in MS patient in a national...... rates of health-related contact and medication use and very low employment rate which incurred a higher socioeconomic cost. The income level of employed MS patients was significantly lower than that of control subjects. The annual total health sector costs and productivity costs were €14,575 for MS...

  12. Multiple Sclerosis and Dentistry: A Contemporary Evaluation

    Hasan Hatipoğlu

    2015-03-01

    Full Text Available Multiple sclerosis (MS is an inflammatory, demyelinating condition affecting the central nervous system. MS exhibits characteristics of an auto-immune disease. Etiology of this condition remains unknown but environmental and genetic factors are often thought to be responsible. A possible relationship between dentistry and MS has often been mentioned in the literature. Special attention and interdisciplinary cooperation are required in the diagnosis of MS and the application of dental treatments in order to optimize general and dental health status of patients with MS. In this review, MS-dental related studies and recommendations for dental treatment approaches for individuals with MS are discussed.

  13. Ultraviolet radiation, vitamin D and multiple sclerosis.

    Lucas, Robyn M; Byrne, Scott N; Correale, Jorge; Ilschner, Susanne; Hart, Prue H

    2015-10-01

    There is compelling epidemiological evidence that the risk of developing multiple sclerosis is increased in association with low levels of sun exposure, possibly because this is associated with low vitamin D status. Recent work highlights both vitamin D and non-vitamin D effects on cellular immunity that suggests that higher levels of sun exposure and/or vitamin D status are beneficial for both MS risk and in ameliorating disease progression. Here we review this recent evidence, focusing on regulatory cells, dendritic cells, and chemokines and cytokines released from the skin following exposure to ultraviolet radiation. PMID:26477548

  14. Epileptic Seizures in Multiple Sclerosis Patients

    Kamber Zeqiraj; Nexhat Shatri; Jera Kruja; Afrim Blyta; Enver Isaku; Nazim Dakaj

    2013-01-01

    Objective: The presence of epileptic seizures in patients with multiple sclerosis (MS) is a well-known phenomenon. The aims of our study, performed in our clinic are to point out the correlation of the mean age/gender and age of MS patients with the onset of seizures, to identify the types of epileptic seizures in MS patients by sex/age, to identify the correlation between relapses and seizures, and to identify the main electrophysiological / imaging changes. Material and Met-hod: The medi...

  15. MRI differential diagnosis of suspected multiple sclerosis.

    Chen, J J; Carletti, F; Young, V; Mckean, D; Quaghebeur, G

    2016-09-01

    Diagnosing multiple sclerosis (MS) can be very challenging owing to its variable clinical features and lack of a definitive test. Magnetic resonance imaging (MRI) is a core diagnostic tool in the detection of MS lesions and demonstration of spatial and temporal distribution of disease. Moreover, MRI plays a crucial role in the exclusion of alternative diagnoses of MS. The aim of this review is to describe the typical MRI features of MS and to present a series of common mimics of MS with emphasis on their distinguishing features from MS. PMID:27349475

  16. Sphingolipids: Important Players in Multiple Sclerosis

    Ramona Halmer

    2014-06-01

    Full Text Available Multiple Sclerosis (MS is the most common cause for permanent disability in young adults. Current pathophysiological understanding has identified an autoaggressive immune reaction with infiltration of immune cells into the central nervous system and local inflammatory and demyelinating reactions. The current therapy focuses on a modulation or suppression of immune functions. Sphingolipids, main components of nervous tissue, have been linked to MS already 60 years ago with the description of an unusual myelin lipid distribution in diseased patients. There is tremendous information developing on the role of different sphingolipids in MS. Antibodies against sphingomyelin, sulfatide or galacosylceramide have been detected in serum or CSF of MS patients, although up to now, this knowledge did not find its way into clinical use. Ceramide and the enzymes linked to its production have been described to play a pivotal role in oligendrocyte damage and demyelination. Nowadays, especially sphingosine-1-phosphate (S1P is in the focus of pathophysiological research and therapy development. A S1P analogue, FTY720, is a widely distributed therapy against relapsing-remitting MS, attenuating the emigration of activated, autoreactive lymphocytes from lymph nodes, thereby preventing new inflammatory infiltration into the central nervous system. Beside, there is more and more evidence, that especially S1P receptors on oligodendrocytes and astrocytes are involved in demyelination processes and subsequent axonal degeneration, important features of chonic progressive MS disease course. Further information and research on the manifold role of sphingolipids are needed to prepare the ground for further clinical trials. This review focuses on the current knowledge of the role of sphingolipids in MS and describes the current therapeutical implications.

  17. Multiple sclerosis:New insights and trends

    Khaled Mohamed Mohamed Koriem

    2016-01-01

    Multiple sclerosis (MS) is the most famous autoimmune disease attacking the central nervous system. It attacks people from age 20–50 years old and the females' attacks double than males' attacks. MS is an autoimmune disease affecting principally the central nervous system that cause nerve sheath demyelination followed by axon damage and paralysis. MS symptoms include muscle weakness, weak reflexes, muscle spasm, difficult in move, miss-coordination and unbalance with others. There are many factors may be responsible for MS:microbial, viral, smoking, stress, environmental toxins, contaminated diet, and gout. MS is wide spread in the populations in North Europe and this related to lack of vitamin D due to decrease of sunlight exposure. MS biomarkers include nitric oxide, interleukin-6, nitric oxide synthase, fetuin-A and osteopontin. MS is not a genetic disease where MS occurs when human leukocyte antigen system related genes are changed in chromosome 6. The physiology of MS is monitored by activation of immune-inflammatory, oxidative, and nitrosative stress pathways. MS is including two main steps:(1) myelin sheath destruction and formation of lesions and, (2) inflammation. Four types of MS can be distinguished: relapsing-remitting, primary progressive, secondary pro-gressive and progressive relapsing. Nine treatments have been accepted for relapsing-remitting MS type: interferon b-1a, interferon b-1b, mitoxantrone, natalizumab, glatir-amer acetate, fingolimod, dimethyl fumarate, teriflunomide, and alemtuzumab, however, the only treatment used is mitoxantrone for progressive MS but many of MS treatments side effects are recorded. Complementary treatments also used in MS treatments such as:vitamin D, Yoga, medicinal plants, oxygen therapy, acupuncture and reflexology.

  18. Multiple sclerosis: New insights and trends

    Khaled Mohamed Mohamed Koriem

    2016-05-01

    Full Text Available Multiple sclerosis (MS is the most famous autoimmune disease attacking the central nervous system. It attacks people from age 20–50 years old and the females' attacks double than males' attacks. MS is an autoimmune disease affecting principally the central nervous system that cause nerve sheath demyelination followed by axon damage and paralysis. MS symptoms include muscle weakness, weak reflexes, muscle spasm, difficult in move, miss-coordination and unbalance with others. There are many factors may be responsible for MS: microbial, viral, smoking, stress, environmental toxins, contaminated diet, and gout. MS is wide spread in the populations in North Europe and this related to lack of vitamin D due to decrease of sunlight exposure. MS biomarkers include nitric oxide, interleukin-6, nitric oxide synthase, fetuin-A and osteopontin. MS is not a genetic disease where MS occurs when human leukocyte antigen system related genes are changed in chromosome 6. The physiology of MS is monitored by activation of immune-inflammatory, oxidative, and nitrosative stress pathways. MS is including two main steps: (1 myelin sheath destruction and formation of lesions and, (2 inflammation. Four types of MS can be distinguished: relapsing-remitting, primary progressive, secondary progressive and progressive relapsing. Nine treatments have been accepted for relapsing-remitting MS type: interferon β-1a, interferon β-1b, mitoxantrone, natalizumab, glatiramer acetate, fingolimod, dimethyl fumarate, teriflunomide, and alemtuzumab, however, the only treatment used is mitoxantrone for progressive MS but many of MS treatments side effects are recorded. Complementary treatments also used in MS treatments such as: vitamin D, Yoga, medicinal plants, oxygen therapy, acupuncture and reflexology.

  19. Identifying responders and nonresponders to interferon therapy in multiple sclerosis

    Prosperini L

    2014-04-01

    Full Text Available Luca Prosperini,1 Marco Capobianco,2 Costanza Giannì31Department of Neurology and Psychiatry, Sapienza University, Rome, Italy; 2Regional Multiple Sclerosis Centre, University Hospital San Luigi Gonzaga, Orbassano, Italy; 3Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USAAbstract: Interferon beta is a well established disease-modifying agent used for relapsing-remitting multiple sclerosis. Despite treatment, a relevant proportion of patients continue to experience clinical (ie, relapses, worsening of disability and magnetic resonance imaging (MRI activity. Early identification of responders and nonresponders to interferon beta is strongly recommended to select patients who need a prompt switch to another disease-modifying agent and to ultimately avoid accumulation of fixed disability over time. Detecting responders and nonresponders to interferon beta can be challenging, mainly because of the lack of a clear and shared clinical definition of response to treatment. Clinical features at the start of treatment should be considered as prognostic factors, but MRI parameters assessed during treatment, such as contrast-enhancing lesions or new T2-hyperintense lesions, may be sensitive markers of response to interferon beta. Quantitative scoring systems derived from a combination of relapses and MRI activity have recently been proposed as practical tools for use in the everyday clinical setting. Blood biomarkers, such as neutralizing antibodies to interferon beta and Myxovirus resistance protein A, provide further useful information for detecting responders and nonresponders to interferon beta. However, since the presence of neutralizing antibodies can only partially explain the nonresponse to interferon beta, biomarkers of interferon beta activity possibly related to the pathogenesis of the disease could represent a future step toward a tailored, long-lasting effective treatment against multiple sclerosis

  20. Expression of ß2 adrenoreceptors on peripheral blood mononuclear cells in patients with primary and secondary progressive multiple sclerosis: a longitudinal six month study

    Zoukos, Y; Thomaides, T; Kidd, D; Cuzner, M; Thompson, A.

    2003-01-01

    Background: ß2 Adrenoreceptor expression on peripheral blood mononuclear cells is increased in progressive multiple sclerosis. This increase has been correlated with disease activity in relapsing-remitting multiple sclerosis.

  1. [A review of multiple sclerosis (2). Diagnosis and treatment].

    Martinez-Altarriba, M C; Ramos-Campoy, O; Luna-Calcaño, I M; Arrieta-Antón, E

    2015-09-01

    Multiple sclerosis is a major demyelinating disease of the central nervous system. It has a significant economic and social impact. Its etiology is unclear, although there are several hypotheses, such as infections or genetics. In its pathophysiology, it seems that immune activation attacks the myelin sheath, causing a progressive and irreversible axonal degeneration. The disease produces a variety of symptoms, and diagnosis requires fulfilling a number of criteria and the exclusion of other possible causes. The role of neuroimaging is very important, especially Magnetic Resonance Imaging. Despite the availability of disease-modifying drugs, none of them are able to halt its progress, and the most useful drugs are those designed to alleviate the symptoms of outbreaks. Overall, multiple sclerosis requires a significant effort in research to clarify not only why and how it occurs, as well as the development of new measures to improve quality of life of affected patients. PMID:25442466

  2. Diffusion weighted MR imaging in the diagnosis of multiple sclerosis

    Magnetic resonance (MR) imaging is one of the best methods in diagnosis of multiple sclerosis, particularly in disclosure of active demyelinating lesions. Aim of this study was to compare diffusion weighted imaging and contrast enhancement in the detection of active lesions. A MR study with a contrast enhanced T1-weighted pulse sequence with magnetization transfer presaturation and a diffusion weighted echoplanar pulse sequence (b=1000 s/mm2) was performed in 17 patients (11 women, 6 men) with multiple sclerosis. 29 of 239 lesions showed an increased signal intensity in diffusion weighted imaging, 24 lesions a contrast enhancement, but only 16 lesions were visible in both pulse sequences. In patients with short clinical symptomatology significant more lesions could be detected with diffusion-weighted pulse sequence in comparison to patients with long standing symptomatology showing more lesions with contrast enhancement. Hence it is likely, that both pulse sequences detect different histopathologic changes. The early detection of demyelinating lesions in diffusion weighted imaging is attributed to the extracellular edema, however the contrast enhancement is caused by a blood brain barrier abnormality. It can be expected that diffusion weighted imaging will have a high impact on imaging of multiple sclerosis not only in therapeutic trials, but also in clinical routine. (orig.)

  3. Job satisfaction among multiple sclerosis certified nurses.

    Gulick, Elsie E; Halper, June; Costello, Kathleen

    2007-08-01

    Several studies document high levels of job satisfaction among certified nurses, but no study has examined job satisfaction and factors influencing job satisfaction of certified multiple sclerosis (MS) nurses. This study tested a theoretical model proposing that two organizational factors, colleague relationships and benefits, will predict job satisfaction. Job satisfaction was represented by four factors: autonomy, professional status, professional growth, and time efficiency. Participants included MS nurses certified for 6 months or more practicing mostly in three countries (Canada, Great Britain, and the United States) who anonymously completed the Misener Nurse Practitioner Job Satisfaction Scale, an overall job satisfaction rating, and demographic information. Findings indicate that colleague relationships and benefits significantly estimated organization structure and that autonomy, professional status, professional growth, and time efficiency significantly estimated job satisfaction; furthermore, organization factors such as colleague relationships and benefits significantly predict job satisfaction. Among the countries, several statistically significant differences were observed between job satisfaction factors as well as items in both organization and job satisfaction subscales. Average factor scores among the countries were mostly rated satisfactory. The International Organization of Multiple Sclerosis Nurses Executive Board plans to use the study findings to see how it needs to focus efforts as an organization toward enhancing and standardizing MS care and develop MS nurse professionalism worldwide. PMID:17847673

  4. Natalizumab in the treatment of multiple sclerosis

    Brandon A Brown

    2009-07-01

    Full Text Available Brandon A BrownDepartment of Pharmacy, Brigham and Women’s Hospital, Boston, MA, USAAbstract: Natalizumab is a monoclonal antibody, representing a new class of medication for treating relapsing multiple sclerosis (MS. Conventional treatments include interferons, glatiramer acetate and chemotherapies such as mitoxantrone and cyclophosphamide. These therapies offer only modest clinical benefits and are commonly not tolerated due to side effects. Natalizumab has been proven in large-scale, blinded, randomized, controlled trials to have an exceptional effect on preventing relapses, decreasing the risk of sustained progression of disability, and increasing the rate of disease-free patients over a 24-month period compared to placebo. These trials led to the speedy approval of natalizumab for treating relapsing MS, but its use was halted a few months after its induction after several cases of progressive multifocal leukoencephalopathy (PML, a fatal demyelinating disease affecting the central nervous system. After a long deliberation by an FDA advisory panel and strong support from the MS community, natalizumab was reapproved with stringent restrictions including patient, provider and site registration. Natalizumab is now considered second-line therapy for patients who have failed first-line agents such as interferon or glatiramer acetate. As little is known about additional risk factors for PML and other potential infections, patients and providers must work together to carefully decide if potential benefits outweigh these rare but potentially devastating complications.Keywords: natalizumab, multiple sclerosis, progressive multifocal leukoencephalopathy

  5. Supporting work for people with multiple sclerosis.

    Doogan, Catherine; Playford, E Diane

    2014-05-01

    People with multiple sclerosis experience some of the highest rates of unemployment among groups of individuals with severe and chronic disabilities. While unpredictable relapses, physical and cognitive symptoms all may play a role in job loss, it is more likely that job loss can be attributed to a complex interaction between disease-related factors and contextual factors, such as the working environment, and employer attitudes. This interaction leads to the concept of work instability, that is, the mismatch between work demands and the individual's capacity to meet these demands. Vocational rehabilitation services aim to provide people with multiple sclerosis vocational assessment, rehabilitation and support to enable them to find, regain or remain in work and access other occupational and educational opportunities. Such services consist of a multidisciplinary team with the ability to provide education around disclosure, and work-place accommodations, offer emotional support, maintain work performance, liaise with employers, and support to re-enter the workplace. Helpful interventions include early disclosure, proper workplace accommodation, education of employers, and government-funded initiatives to support disabled employees. Future research needs to agree on methods of recording outcomes and evaluate specific vocational rehabilitation interventions. PMID:24526662

  6. Serum prolactin level in multiple sclerosis patients

    Mohammad Ali Shafa

    2006-12-01

    Full Text Available BACKGROUND: Multiple Sclerosis (MS is the most common demyelinating disease. An autoimmune basis has been confirmed for pathogenesis of MS. Prolactin (PRL has roles in these mechanisms. Its serum levels change in MS according to some reports. The purpose of this study was to survey these changes in MS patients. METHODS: Sixty MS patients were included in this cross-sectional study. The same number of controls matched for sex and age were studied. Pregnant, lactating women, consumers of specific medications and patients with underlying diseases were excluded from our study. RIA was used for determination of serum levels of PRL. RESULTS: In this study, PRL level in male patients was 14.23 ± 11.47 ng/ml compared to controls with mean level of 7.21 ± 4.12 ng/ml (P value <0.001. Mean PRL level in female patients was 20.18 ± 11.04 ng/ml whereas controls had a mean level of 14.45 ± 6.93 ng/ml (one-tailed P value <0.05. So there were significant differences in serum PRL level between case and control groups in both men and women CONCLUSIONS: PRL has a positive relation with MS in both sexes. Further studies for determination of causality relation and drug effect in endocrine system on MS pathogenesis are suggested. KEY WORDS: Multiple Sclerosis, prolactin, male, female

  7. Update on treatments in multiple sclerosis.

    Michel, Laure; Larochelle, Catherine; Prat, Alexandre

    2015-04-01

    While there is no cure for multiple sclerosis (MS), numerous disease-modifying drugs are now available to treat MS patients. In fact, the therapeutic strategies are now more and more complex, directly impacting the management of patients. Despite the good safety profile of the first-line immunomodulatory drugs, the clinical response is often suboptimal. Important questions remain about the right timing to switch for a second-line agent and whether escalation therapy is an appropriate therapeutic strategy. In this review, we conducted a systematic search by PubMed using the terms: treatment, multiple sclerosis, therapeutic, DMT and treatment response. Randomized trials and reviews addressing MS, DMTs and management strategies were selected and included in this review. Herein, we present the currently approved and emerging drugs used for the treatment of MS with their relative benefit/risk profiles, and their respective positions in the therapeutic arsenal. We then focused on the different therapeutic strategies and criteria available to evaluate the response to disease-modifying therapies (DMTs). PMID:25813102

  8. [Spatial contrast sensitivity in multiple sclerosis].

    Vighetto, A; Grochowicki, M; Cousin, J

    1990-01-01

    Spatial contrast sensitivity was measured in 110 patients with multiple sclerosis (definite = 72, probable = 22, possible = 16) as part of a routine evaluation in a neuro-ophthalmological clinic. Results were compared with those of 37 normal controls matched for age. The test was abnormal in 71 p. 100 of patients. Contrast sensitivity was attenuated for 97 p. 100 of the eyes with optic neuritis and visual acuity drop, for 60 p. 100 of the eyes with recovered optic neuritis and for 36 p. 100 of the non affected eyes in the cases of unilateral optic neuritis. Among the 57 patients with normal visual acuity and no history of optic neuritis, 62 p. 100 had abnormal findings. Globally, contrast sensitivity was reduced on the whole spatial frequency range in cases of current optic neuritis, and mostly on the high or high and medium frequencies in the other cases. Our study confirms that spatial contrast sensitivity is the most sensitive of psychophysical methods to detect subclinical visual impairement in multiple sclerosis. Comparison with VEP's was performed in 66 patients. Both tests were roughly equally sensitive, but findings were concordant in only 63 p. 100 of the cases. The use of both VEP's and spatial contrast sensitivity increases the detection of latent optic neuritis. PMID:2359900

  9. Complementary and alternative medicine for multiple sclerosis.

    Schwarz, S; Knorr, C; Geiger, H; Flachenecker, P

    2008-09-01

    We analyzed characteristics, motivation, and effectiveness of complementary and alternative medicine in a large sample of people with multiple sclerosis. A 53-item survey was mailed to the members of the German Multiple Sclerosis Society, chapter of Baden-Wuerttemberg. Surveys of 1573 patients (48.5 +/- 11.7 years, 74% women, duration of illness 18.1 +/- 10.5 years) were analyzed. In comparison with conventional medicine, more patients displayed a positive attitude toward complementary and alternative medicine (44% vs 38%, P job, and higher education (P < 0.05). Compared with conventional therapies, complementary and alternative medicine rarely showed unwanted side effects (9% vs 59%, P < 0.00001). A total of 52% stated that the initial consultation with their physician lasted less than 15 min. To conclude, main reasons for the use of complementary and alternative medicine include the high rate of side effects and low levels of satisfaction with conventional treatments and brief patients/physicians contacts. PMID:18632773

  10. Changes in Blood B Cell-Activating Factor (BAFF Levels in Multiple Sclerosis: A Sign of Treatment Outcome.

    Karin Kannel

    Full Text Available Multiple sclerosis (MS is mediated primarily by autoreactive T cells. However, evidence suggesting the involvement of humoral immunity in brain diseases has increased interest in the role of B cells and their products during MS pathogenesis. The major survival factor for B cells, BAFF has been shown to play a role in several autoimmune conditions. Elevated BAFF levels have been reported in MS animal model and during MS relapse in patients. Moreover, disease-modifying treatments (DMT reportedly influence blood BAFF levels in MS patients, but the significance of these changes remains unclear. The present study addresses how blood BAFF levels are associated with the clinical course of relapsing-remitting MS and the effectiveness of DMT and short-term steroid treatment. During a prospective longitudinal follow-up of 2.3 years, BAFF was measured in the blood of 170 MS patients in the stable phase and within 186 relapses. BAFF levels were significantly higher in MS patients compared to healthy controls. However, stable MS patients without relapses exhibited significantly higher BAFF levels than relapsing patients. Treatment with interferon-β and immunosuppressants raised BAFF blood levels. Interestingly, a similar effect was not seen in patients treated with glatiramer acetate. Short-term treatment with high doses of intravenous methylprednisolone did not significantly alter plasma BAFF levels in 65% of relapsing-remitting MS patients. BAFF were correlated weakly but significantly with monocyte and basophil counts, but not with other blood cell types (neutrophils, lymphocytes, or eosinophils or inflammatory biomarkers. To our knowledge, this is the first report demonstrating that higher blood BAFF levels may reflect a more stable and effective MS treatment outcome. These results challenge hypotheses suggesting that elevated blood BAFF levels are associated with more severe disease presentation and could explain the recent failure of pharmaceutical

  11. Correlations Between Serum Uric Acid Level and Disease Activity, Intrathecal Inflammation Reactivity in Patients with Multiple Sclerosis

    Cai-yan Liu; Yan Xu; Li-ying Cui; Bin Peng; Li-zhen Zhong; Xing-wang Chen; Jian-ming Wang

    2012-01-01

    Objective To explore the correlations between serum uric acid (UA) levels and the clinical and cerebrospinal fluid (CSF) parameters of multiple sclerosis (MS).Methods The medical reports of 47 MS patients admitted to Peking Union Medical College Hospital during 2008 and 2010 were reviewed.And 49 age- and gender-matched cerebral infarction patients were enrolled as control.The mean serum UA level of the MS patients was compared with that of the control group.The correlations betveen the UA levels and the clinical parameters including gender,disease duration,relapse rate,and disease disabilities as assessed by the Expanded Disability Status Scale score,were explored.Forty-one patients had CSF examinations.The correlations between the UA levels and the CSF parameters reflecting inflammation and tissue damage,including CSF protein,white blood cell count,oligoclonal band,24-hour IgG index,and myelin basic protein,were also investigated.Results The mean serum UA level in the MS patients was lower than that in the control group (247.75 ± 52.59 μmol/L vs.277.94 ± 74.33 μmol/L,P=0.025) and inversely correlated with the relapse rate (P=0.049).MS patients with lower serum UA levels tended to have higher white blood cell counts and myelin basic protein level.But there was no correlation between CSF protein levels (r=0.165,P=0.273),white blood cell counts (r=0.051,P=0.732),IgG index (r =0.045,P=0.802),or myelin basic protein level (r =0.248,P=0.145) and the serum UA level,respectively.Conclusion In MS patients,UA levels might partly reflect the extent of disability and inflammation.

  12. New oral disease-modifying therapies for multiple sclerosis

    Bagert, Bridget A; Bourdette, Dennis

    2009-01-01

    Several promising, oral disease-modifying therapies for multiple sclerosis are currently being evaluated in clinical trials. The arrival of effective oral agents for multiple sclerosis will be a major advance in the global effort to alter the natural history of this chronic disease.

  13. INVIVO PHOSPHORUS MAGNETIC-RESONANCE SPECTROSCOPY IN MULTIPLE-SCLEROSIS

    MINDERHOUD, JM; MOOYAART, EL; KAMMAN, RL; TEELKEN, AW; HOOGSTRATEN, MC; VENCKEN, LM; GRAVENMADE, EJ; VANDENBURG, W

    1992-01-01

    Localized phosphorus magnetic resonance spectroscopy at 1.5 T was performed in 39 patients with multiple sclerosis and in 15 healthy controls. The multiple sclerosis spectra showed increased creatine phosphate levels. This increase was correlated with the severity of the handicap and was greater in

  14. Temporal lobe lesions and psychosis in multiple sclerosis

    Yadav, R; Zigmond, A S

    2010-01-01

    Lesions in the temporal lobe are associated with psychiatric manifestations in multiple sclerosis. The authors describe this case of a young man with multiple sclerosis who presented with first-episode psychosis and had acute lesions in the temporal lobe. He was successfully treated with olanzapine and β-interferon.

  15. Multiple sclerosis with clinical and radiological features of cerebral tumour

    Sagar, HJ; Warlow, CP; Sheldon, PWE; Esiri, MM

    1982-01-01

    Three cases of multiple sclerosis, all confirmed pathologically, are described in whom both the unusual clinical features and the CT scan appearances suggested cerebral tumours. The failure of mass effect reliably to differentiate plaques and tumours on a CT scan is stressed and the literature relating to CT scanning in multiple sclerosis is reviewed.

  16. The risk of multiple sclerosis in bereaved parents

    Li, J; Johansen, C; Brønnum-Hansen, Henrik;

    2004-01-01

    Previous studies have suggested that psychological stress may play a role in the risk of multiple sclerosis (MS), but the evidence is very limited.......Previous studies have suggested that psychological stress may play a role in the risk of multiple sclerosis (MS), but the evidence is very limited....

  17. Incidence of multiple sclerosis in Denmark 1948-1982

    Koch-Henriksen, Nils; Brønnum-Hansen, Henrik; Hyllested, K

    1992-01-01

    The incidence rates of multiple sclerosis (MS) in Denmark were estimated as a result of a continuous nationwide epidemiological survey since 1948 by the Danish Multiple Sclerosis Registry (DMSR). Among cases notified to the DMSR, 6,478 met the diagnostic criteria and had onset of MS from 1948...

  18. Clustering of multiple sclerosis in Galion, Ohio, 1982-1985

    Ingalls, T.H. (Boston Univ. School of Medicine, MA (USA))

    1989-09-01

    Epidemiologic evidence indicates that the outbreak of 30-40 cases of multiple sclerosis and other demyelinating syndromes in Galion, Ohio, USA, during 1982-1985 was related to an excess concentration of heavy-metal wastes, especially of cadmium and chromium in sewage and river water. Both multiple sclerosis and myasthenia gravis were diagnosed by board-certified neurologists.

  19. Endogenous Task Shift Processes in Relapsing-Remitting Multiple Sclerosis

    Stablum, F.; Meligrana, L.; Sgaramella, T.; Bortolon, F.; Toso, V.

    2004-01-01

    This paper reports a study that was aimed to evaluate executive functions in relapsing-remitting multiple sclerosis patients. The groups tested comprised 22 relapsing-remitting multiple sclerosis patients, and 22 non-brain damaged controls. When one is engaged in two speeded tasks, not simultaneously but with some form of alternation, it is slower…

  20. Magnetic resonance imaging in the diagnostics of multiple sclerosis

    Multiple sclerosis is an important and frequent neurological disease and the diagnosis might be difficult. The clinical criteria of multiple sclerosis and the role of laboratory examinations in the diagnosis of the disease are discussed. In particular the help offered by the magnetic resonance imaging method is the subject of this paper. Three patients are reported and discussed

  1. Disconnection as a Mechanism for Cognitive Dysfunction in Multiple Sclerosis

    Dineen, R. A.; Vilisaar, J.; Hlinka, J.; Bradshaw, C. M.; Morgan, P. S.; Constantinescu, C. S.; Auer, D. P.

    2009-01-01

    Disconnection of cognitively important processing regions by injury to the interconnecting white matter provides a potential mechanism for cognitive dysfunction in multiple sclerosis. The contribution of tract-specific white matter injury to dysfunction in different cognitive domains in patients with multiple sclerosis has not previously been…

  2. Gender issues in multiple sclerosis: an update.

    Jobin, Céline; Larochelle, Catherine; Parpal, Hélène; Coyle, Patricia K; Duquette, Pierre

    2010-11-01

    Although multiple sclerosis (MS) affects both women and men, women are more susceptible to MS than men. Accumulating evidence indicates that the incidence and prevalence of MS is increasing, more so in women than in men. Owing to pregnancy, differing hormonal states and distinct social roles, the impact of MS differs between women and men. Since Patricia K Coyle published a review on gender issues in MS, multiple studies have added to the body of knowledge. This update will summarize the current thinking on gender-related issues in MS and we will address incidence and prevalence, hormonal factors, pregnancy and breastfeeding, genetics, course and prognosis, imaging, treatment and psychosocial aspects. Future progression within this field will help elucidate the cause of and define the treatment of MS. PMID:21118039

  3. A typical MR imaging of multiple sclerosis

    MR imaging is very useful in detecting the intracranial lesion of multiple sclerosis (MS). We present six patients of MS with atypical MR imaging findings. Six patients aged 27-56 years (mean 36 years), and sexuality of six patients were 2 men and 4 females. Three patient's clinical course had episodes of optic neuritis. The plaque's size of the predominant lesion of the patients ranged from 3.0 to 9.0 cm in diameter. The plaques were oval, elliptically and other shaped. At acute stage, MR imaging detected perfocal edema and focal mass effect in three cases of our study. Two out of six cases showed multiple irregularly enhancing lesion with Gadolinium-DTPA. Plaques of all cases did not disappear completely in final MR imaging study. (author)

  4. MicroRNA Dysregulation in Multiple Sclerosis

    Omar ede Faria Jr.

    2013-01-01

    Full Text Available Multiple Sclerosis (MS is a chronic inflammatory disease characterized by central nervous system (CNS demyelination and axonal degeneration. Although the cause of MS is still unknown, it is widely accepted that novel drug targets need to focus on both decreasing inflammation and promoting CNS repair. In MS and experimental autoimmune encephalomyelitis (EAE non-coding small microRNAs (miRNAs are dysregulated in the immune and central nervous systems. Since individual miRNAs are able to downregulate multiple targeted mRNA transcripts, even minor changes in miRNA expression may lead to significant alterations in post-transcriptional gene expression. Herein, we review miRNA signatures reported in CNS tissue and immune cells of MS patients and consider how altered miRNA expression may influence MS pathology.

  5. A typical MR imaging of multiple sclerosis

    Katagiri, Shinako; Kan, Shinichi; Ikeda, Toshiaki; Nishiyama, Syougo; Nishimaki, Hiroshi; Matsubayashi, Takashi; Hata, Takashi [Kitasato Univ., Sagamihara, Kanagawa (Japan). School of Medicine

    1995-06-01

    MR imaging is very useful in detecting the intracranial lesion of multiple sclerosis (MS). We present six patients of MS with atypical MR imaging findings. Six patients aged 27-56 years (mean 36 years), and sexuality of six patients were 2 men and 4 females. Three patient`s clinical course had episodes of optic neuritis. The plaque`s size of the predominant lesion of the patients ranged from 3.0 to 9.0 cm in diameter. The plaques were oval, elliptically and other shaped. At acute stage, MR imaging detected perfocal edema and focal mass effect in three cases of our study. Two out of six cases showed multiple irregularly enhancing lesion with Gadolinium-DTPA. Plaques of all cases did not disappear completely in final MR imaging study. (author).

  6. Leg Spasticity and Ambulation in Multiple Sclerosis

    Swathi Balantrapu

    2014-01-01

    Full Text Available Background. Spasticity of the legs is common in multiple sclerosis (MS, but there has been limited research examining its association with ambulatory outcomes. Objective. This study examined spasticity of the legs and its association with multiple measures of ambulation in persons with MS. Methods. The sample included 84 patients with MS. Spasticity of the legs was measured using a 5-point rating scale ranging between 0 (normal and 4 (contracted. Patients completed the 6-minute walk (6 MW, timed 25 foot walk (T25FW, and timed up-and-go (TUG, and O2 cost of walking was measured during the 6 MW. The patients undertook two walking trials on a GAITRite (CIR systems, Inc. for measuring spatial and temporal parameters of gait. The patients completed the Multiple Sclerosis Walking Scale-12 (MSWS-12 and wore an accelerometer over a seven-day period. Results. 52% (n=44 of the sample presented with spasticity of the legs. Those with leg spasticity had significantly worse ambulation as measured by 6 MW (P=0.0001, d=-0.86, T25FW (P=0.003,d=0.72, TUG (P=0.001, d=0.84, MSWS-12 (P=0.0001,d=1.09, O2 cost of walking (P=0.001, d=0.75, average steps/day (P<0.05, d=-0.45, and walking velocity (P<0.05, d=-0.53 and cadence (P<0.05, d=-0.46. Conclusion. Leg spasticity was associated with impairments in ambulation, including alterations in spatiotemporal parameters and free-living walking.

  7. Leg Spasticity and Ambulation in Multiple Sclerosis

    Balantrapu, Swathi; Sosnoff, Jacob J.; Pula, John H.; Sandroff, Brian M.; Motl, Robert W.

    2014-01-01

    Background. Spasticity of the legs is common in multiple sclerosis (MS), but there has been limited research examining its association with ambulatory outcomes. Objective. This study examined spasticity of the legs and its association with multiple measures of ambulation in persons with MS. Methods. The sample included 84 patients with MS. Spasticity of the legs was measured using a 5-point rating scale ranging between 0 (normal) and 4 (contracted). Patients completed the 6-minute walk (6 MW), timed 25 foot walk (T25FW), and timed up-and-go (TUG), and O2 cost of walking was measured during the 6 MW. The patients undertook two walking trials on a GAITRite (CIR systems, Inc.) for measuring spatial and temporal parameters of gait. The patients completed the Multiple Sclerosis Walking Scale-12 (MSWS-12) and wore an accelerometer over a seven-day period. Results. 52% (n = 44) of the sample presented with spasticity of the legs. Those with leg spasticity had significantly worse ambulation as measured by 6 MW (P = 0.0001, d = −0.86), T25FW (P = 0.003, d = 0.72), TUG (P = 0.001, d = 0.84), MSWS-12 (P = 0.0001, d = 1.09), O2 cost of walking (P = 0.001, d = 0.75), average steps/day (P < 0.05, d = −0.45), and walking velocity (P < 0.05, d = −0.53) and cadence (P < 0.05, d = −0.46). Conclusion. Leg spasticity was associated with impairments in ambulation, including alterations in spatiotemporal parameters and free-living walking. PMID:24999434

  8. Effects of oral glatiramer acetate on clinical and MRI-monitored disease activity in patients with relapsing multiple sclerosis: a multicentre, double-blind, randomised, placebo-controlled study.

    Filippi, M.; Wolinsky, J.S.; Comi, G.

    2006-01-01

    BACKGROUND: Parenterally administered glatiramer acetate reduces the frequency of relapses and the formation of active brain lesions seen with MRI in multiple sclerosis. This study assessed whether two doses of glatiramer acetate given orally could improve clinical and MRI measures of inflammation a

  9. Randomized controlled trial of a teleconference fatigue management plus physical activity intervention in adults with multiple sclerosis: rationale and research protocol

    Plow Matthew

    2012-10-01

    Full Text Available Abstract Background Chronic fatigue and inactivity are prevalent problems among individuals with multiple sclerosis (MS and may independently or interactively have detrimental effects on quality of life and ability to participate in life roles. However, no studies to date have systematically evaluated the benefits of an intervention for both managing fatigue and promoting physical activity in individuals with MS. This study involves a randomized controlled trial to examine the effectiveness of a telehealth intervention that supports individuals with MS in managing fatigue and increasing physical activity levels. Methods/Design A randomly-allocated, three-parallel group, time-series design with a social support program serving as the control group will be used to accomplish the purpose of the study. Our goal is to recruit 189 ambulatory individuals with MS who will be randomized into one of three telehealth interventions: (1 a contact-control social support intervention, (2 a physical activity-only intervention, and (3 a physical activity plus fatigue management intervention. All interventions will last 12 weeks and will be delivered entirely over the phone. Our hypothesis is that, in comparison to the contact-control condition, both the physical activity-only intervention and the physical activity plus fatigue management intervention will yield significant increases in physical activity levels as well as improve fatigue and health and function, with the physical activity plus fatigue management intervention yielding significantly larger improvements. To test this hypothesis, outcome measures will be administered at Weeks 1, 12, and 24. Primary outcomes will be the Fatigue Impact Scale, the Godin Leisure-Time Exercise Questionnaire (GLTEQ, and Actigraph accelerometers. Secondary outcomes will include the SF-12 Survey, Mental Health Inventory, Multiple Sclerosis Impact Scale, the Community Participation Indicator, and psychosocial constructs (e

  10. Risk factors for suicide in multiple sclerosis

    Stenager, E N; Koch-Henriksen, N; Stenager, E

    1996-01-01

    BACKGROUND: The purpose of the present study was to identify risk factors for suicide in patients with multiple sclerosis (MS). METHODS: The study is based on available information about MS patients identified in the Danish MS Registry (DMSR) with onset in the period 1950-1985. We compared the MS...... suicides with the 1950-1985 onset cohort patients in the DSMR as to distribution of age at onset, presenting symptoms, and time from onset to diagnosis. We reviewed sociodemographic data, age of onset, the course of the disease, recent deterioration, type of deterioration, Kurtzke Disability Status Scale...... (DSS) score, previous mental disorder, type of mental disorder, previous suicide attempts, expression of suicidal intentions, circumstances at suicide, and suicide method for all MS patients who had committed suicide. In order to characterize MS suicides with respect to risk factors, comparisons were...

  11. [Cannabinoids for symptomatic therapy of multiple sclerosis].

    Husseini, L; Leussink, V I; Warnke, C; Hartung, H-P; Kieseier, B C

    2012-06-01

    Spasticity represents a common troublesome symptom in patients with multiple sclerosis (MS). Treatment of spasticity remains difficult, which has prompted some patients to self-medicate with and perceive benefits from cannabis. Advances in the understanding of cannabinoid biology support these anecdotal observations. Various clinical reports as well as randomized, double-blind, placebo-controlled studies have now demonstrated clinical efficacy of cannabinoids for the treatment of spasticity in MS patients. Sativex is a 1:1 mix of delta-9-tetrahydocannabinol and cannabidiol extracted from cloned Cannabis sativa chemovars, which recently received a label for treating MS-related spasticity in Germany. The present article reviews the current understanding of cannabinoid biology and the value of cannabinoids as a symptomatic treatment option in MS. PMID:22080198

  12. Rehabilitation of multiple sclerosis patients in India

    Nirmal Surya

    2015-01-01

    Full Text Available Multiple sclerosis (MS is a chronic progressive disease which is one of the leading causes of handicap in young subjects. The large range of symptoms associated with MS lead to continuing decline in neurologic status and quality of life. The coexistence of physical and cognitive impairments, together with the imprevisible evolution of the disease makes MS rehabilitation very challenging. The main objective of rehabilitation is, therefore, to ease the burden of symptoms by improving self-performance and independence. Inpatient, outpatient and Home rehabilitation with multidisciplinary team has been shown to be beneficial in improving disability. Individualized programs elaborated by a multidisciplinary team of experts are the key to success of rehabilitation. Family plays a big role and Family Based Rehabilitation will be important in long term rehab program in MS.

  13. Neuropsychology in Multiple Sclerosis: A literature review.

    Rodneys Mauricio Jiménez Morales

    2011-11-01

    Full Text Available Multiple sclerosis is an inflammatory disease of the central nervous system that is characterized by demyelination and degeneration. The objective of this article is to offer a review of the latest scientific discoveries in the field of neuropsychology in ME. A description is presented of the most frequent neuropsychological manifestations and their probable association with other factors such as: school level, fatigue, disability, cerebral dysfunction, time and clinical form of evolution, as well as depression and other states of mind starting from recent evidences in the scientific community. Also addressed is the development of tests and valid sensitive neuropsychological sets to evaluate cognitive functions. The use of sensitive and specific test facilitates the evaluation of neuropsychological alterations associated to ME, besides other socio-demographic and clinical-evaluative factors to contemplate in the exploration.

  14. Benefits of Exercise Training in Multiple Sclerosis.

    Motl, Robert W; Sandroff, Brian M

    2015-09-01

    Exercise training represents a behavioral approach for safely managing many of the functional, symptomatic, and quality of life consequences of multiple sclerosis (MS). This topical review paper summarizes evidence from literature reviews and meta-analyses, supplemented by recent individual studies, indicating that exercise training can yield small but important improvements in walking, balance, cognition, fatigue, depression, and quality of life in MS. The paper highlights limitations of research on exercise training and its consequences and future research directions and provides an overview for promotion of exercise training in MS based on recent prescriptive guidelines. Collectively, the evidence for the benefits of exercise training in MS suggests that the time is ripe for the promotion of exercise by healthcare providers, particularly neurologists as a central part of the clinical care and management of MS patients. PMID:26223831

  15. Multiple sclerosis in India: An overview

    Bhim S Singhal

    2015-01-01

    Full Text Available Multiple sclerosis (MS is being increasingly diagnosed in India mainly due to increase in the number of practicing neurologists and easy and affordable availability of magnetic resonance imaging (MRI. The clinical features and course are largely similar to those seen in the West. The term optico-spinal MS (Asian MS was coined in the pre-MRI days. Many such patients turn out to be cases of neuromyelitis optica - a distinct disorder and not a variant of MS. Others have shown the classical features of MS on MRI scan. Several of the disease-modifying agents, not all, are now available in India. Their use, however, has been limited in view of the high cost.

  16. Modifiable environmental factors in multiple sclerosis

    Yara Dadalti Fragoso

    2014-11-01

    Full Text Available Potential environmental modifiable factors involved in multiple sclerosis (MS include low adherence to treatment, smoking, obesity, low levels of liposoluble vitamins A and D, high consumption of salt, and a sedentary lifestyle. Chronic tobacco use, obesity, sedentarism and insufficient levels of these vitamins all contribute to maintenance of a proinflammatory state. It is unlikely that there will be noticeable improvement in the inflammatory condition of MS if stopping smoking, reducing weight, exercising, increasing vitamin levels are done in an isolated and erratic manner. Modification of each and every one of these environmental risk factors is likely to be an important approach in the management of MS. The present review presents the arguments for an association between these hazardous modifiable factors and the chronic inflammatory state observed in MS.

  17. Astrocytes in the tempest of multiple sclerosis.

    Miljković, Djordje; Timotijević, Gordana; Mostarica Stojković, Marija

    2011-12-01

    Astrocytes are the most abundant cell population within the CNS of mammals. Their glial role is perfectly performed in the healthy CNS as they support functions of neurons. The omnipresence of astrocytes throughout the white and grey matter and their intimate relation with blood vessels of the CNS, as well as numerous immunity-related actions that these cells are capable of, imply that astrocytes should have a prominent role in neuroinflammatory disorders, such as multiple sclerosis (MS). The role of astrocytes in MS is rather ambiguous, as they have the capacity to both stimulate and restrain neuroinflammation and tissue destruction. In this paper we present some of the proved and the proposed functions of astrocytes in neuroinflammation and discuss the effect of MS therapeutics on astrocytes. PMID:21443873

  18. Chemokines and Chemokine Receptors in Multiple Sclerosis

    Wenjing Cheng

    2014-01-01

    Full Text Available Multiple sclerosis is an autoimmune disease with classical traits of demyelination, axonal damage, and neurodegeneration. The migration of autoimmune T cells and macrophages from blood to central nervous system as well as the destruction of blood brain barrier are thought to be the major processes in the development of this disease. Chemokines, which are small peptide mediators, can attract pathogenic cells to the sites of inflammation. Each helper T cell subset expresses different chemokine receptors so as to exert their different functions in the pathogenesis of MS. Recently published results have shown that the levels of some chemokines and chemokine receptors are increased in blood and cerebrospinal fluid of MS patients. This review describes the advanced researches on the role of chemokines and chemokine receptors in the development of MS and discusses the potential therapy of this disease targeting the chemokine network.

  19. Pelvic floor rehabilitation in multiple sclerosis.

    De Ridder, D; Vermeulen, C; Ketelaer, P; Van Poppel, H; Baert, L

    1999-03-01

    Although primarily used for treatment of stress incontinence, pelvic floor rehabilitation has been reported to have some value in the treatment of detrusor instability and urgency. In neurogenic bladder dysfunction due to Multiple Sclerosis, many authors have suggested the possible use of pelvic floor rehabilitation as a treatment modality. Therefore, we designed an open prospective trial to look at the possible role of pelvic floor rehabilitation in voiding dysfunction due to MS, concentrating upon the clinical and neurological parameters in relation to the outcome. A new scoring system for pelvic floor dysfunction is introduced. Thirty female patients were evaluated. In 25, the strength of the pelvic floor was significantly improved after one month (p rehabiltation has a place in the treatment of MS patients with a low Kurtzke score and without pelvic floor spasticity. PMID:10218095

  20. Total lymphoid irradiation for multiple sclerosis

    Although chemical immunosuppression has been shown to benefit patients with chronic progressive multiple sclerosis (MS), it appears that chemotherapy has an appreciable oncogenic potential in patients with multiple sclerosis. Accordingly, we developed a modified total lymphoid irradiation (TLI) regimen designed to reduce toxicity and applied it to a randomized double blind trial of TLI or sham irradiation in MS. Standard TLI regimens were modified to reduce dose to 1,980 rad, lowering the superior mantle margin to midway between the thyroid cartilage and angle of the mandible (to avert xerostomia) and the lower margin of the mantle field to the inferior margin of L1 (to reduce gastrointestinal toxicity by dividing abdominal radiation between mantle and inverted Y), limiting spinal cord dose to 1,000 rad by custom-made spine blocks in the mantle and upper 2 cm of inverted Y fields, and also protecting the left kidney even if part of the spleen were shielded. Clinical efficacy was documented by the less frequent functional scale deterioration of 20 TLI treated patients with chronic progressive MS compared to to 20 sham-irradiated progressive MS patients after 12 months (16% versus 55%, p less than 0.03), 18 months (28% versus 63%, p less than 0.03), and 24 months (44% versus 74%, N.S.). Therapeutic benefit during 3 years follow-up was related to the reduction in lymphocyte count 3 months post-irradiation (p less than 0.02). Toxicity was generally mild and transient, with no instance of xerostomia, pericarditis, herpes zoster, or need to terminate treatment in TLI patients. However, menopause was induced in 2 patients and staphylococcal pneumonia in one

  1. Recurrent myelinoclastic diffuse sclerosis: a case report of a child with Schilder's variant of multiple sclerosis

    Myelinoclastic diffuse sclerosis (MDS, Schilder's disease) is a rare CNS demyelinating disorder affecting mainly children and usually presenting as an intracranial mass lesion. We report the first case of recurrent intracranial MDS where the third episode of demyelination involved the cervical spinal cord. This may represent a subset of the disease, which should be considered as Schilder's variant (childhood form) of multiple sclerosis. (orig.)

  2. Gene-environment interactions in multiple sclerosis: Innate and adaptive immune responses to human endogenous retrovirus and herpesvirus antigens and the lectin complement activation pathway

    Christensen, Tove; Petersen, Thor; Thiel, Steffen; Brudek, Tomasz; Ellermann-Eriksen, S.; Møller-Larsen, Anne

    Aspects of gene-environment interactions in multiple sclerosis (MS) were analysed in serum samples from 46 MS families (25 sporadic MS cases and 42 familial MS cases): antibodies to the MS-associated human endogenous retrovirus HERV-H, and levels of three components in the innate pathogen-associa...

  3. Gene-environment interactions in multiple sclerosis: innate and adaptive immune responses to human endogenous retrovirus and herpesvirus antigens and the lectin complement activation pathway

    Christensen, Tove; Petersen, Thor; Thiel, Steffen; Brudek, Tomasz; Ellermann-Eriksen, Svend; Møller-Larsen, Anné

    Aspects of gene-environment interactions in multiple sclerosis (MS) were analysed in serum samples from 46 MS families (25 sporadic MS cases and 42 familial MS cases): antibodies to the MS-associated human endogenous retrovirus HERV-H, and levels of three components in the innate pathogen-associa...

  4. Is it Possible to Actively and Purposely make use of Plasticity and Adaptibility in the Neurorehabilitation Treatment of Multiple Sclerosis Patients? A Pilot Project

    Řasová, K.; Krásenský, J.; Havrdová, E.; Obenberger, J.; Seidel, Z.; Doležal, O.; Rexová, Patrícia; Zálišová, M.

    2005-01-01

    Roč. 19, - (2005), s. 170-181. ISSN 0269-2155 Institutional research plan: CEZ:AV0Z10300504; CEZ:MSM 111100001 Keywords : neurorehabilitation * multiple sclerosis * functional magnetic resonance * CNS plasticity and adaptability * motor learning Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 1.447, year: 2005

  5. Ipsilateral Uveitis and Optic Neuritis in Multiple Sclerosis

    Eric Thouvenot

    2012-01-01

    Full Text Available Background. Uveitis is 20 times more frequent in multiple sclerosis (MS patients than in the general population. Methods. A retrospective study of local multiple sclerosis (n=700 and uveitis cohorts (n=450 described the ophthalmological and neurological characteristics of patients with multiple sclerosis and uveitis. Results. Uveitis and multiple sclerosis were associated in seven patients. The time intervals between diagnoses of MS and uveitis ranged from 6 months to 15 years. Analysis of the patients’ characteristics revealed that multiple sclerosis was associated with an older age of onset than usually expected, that is, 39 years. Uveitis was bilateral in three cases and mainly posterior (5/10. Five patients presented with acute optic neuritis (two in one eye and three in both eyes. All eyes presenting with acute optic neuritis were also affected by uveitis (P=0.02, though not simultaneously. Conclusion. The ipsilateral association between optic neuritis and uveitis in this series of patients with multiple sclerosis may suggest a reciprocal potentiation between optic neuritis and uveitis in multiple sclerosis.

  6. Antioxidant use as dietary therapy in patients with multiple sclerosis

    Laura González-González

    2015-01-01

    Full Text Available INTRODUCTION Multiple sclerosis is an immune-mediated disease that produces chronic inflammation and neural degeneration. The disease progresses with acute attacks that result in myelin inflammation. This in turn increases oxidative stress and favors the appearance of reactive oxygen species. Reactive oxygen species damage neural cells causing apoptosis. The etiology of multiple sclerosis remains unknown and current therapy is aggressive and expensive. Recently, complementary and alternative medicine therapies have been proposed to control pathogenesis and symptoms of this disease. It is believed that these therapies help slow the progression of multiple sclerosis and improve survival. METHODS We conducted a MEDLINE/PubMed search using the following MeSH terms: diet, multiple sclerosis, antioxidants. We selected the main articles containing multiple sclerosis and diet. RESULTS We analyzed three case control studies that evaluated different dietary approaches in multiple sclerosis. For this review, we also included five experimental studies that studied the efficacy of lipoic acid in humans and rodents in diseases like multiple sclerosis, experimental autoimmune encephalomyelitis, and breast cancer.

  7. Weight Status in Persons with Multiple Sclerosis: Implications for Mobility Outcomes

    Pilutti, Lara A.; Deirdre Dlugonski; Pula, John H.; Motl, Robert W.

    2012-01-01

    The accumulation of excess body weight may have important health and disease consequences for persons with multiple sclerosis (MS). This study examined the effect of weight status on mobility using a comprehensive set of mobility outcomes including ambulatory performance (timed 25-foot walk, T25FW; 6-minute walk, 6MW; oxygen cost of walking, C w; spatiotemporal parameters of gait; self-reported walking impairment, Multiple Sclerosis Walking Scale-12 (MSWS-12); and free-living activity, accele...

  8. A Passive Exoskeleton Can Push Your Life Up: Application on Multiple Sclerosis Patients

    Di Russo, Francesco; Berchicci, Marika; Perri, Rinaldo Livio; Ripani, Francesca Romana; Ripani, Maurizio

    2013-01-01

    In the present study, we report the benefits of a passive and fully articulated exoskeleton on multiple sclerosis patients by means of behavioral and electrophysiological measures, paying particular attention to the prefrontal cortex activity. Multiple sclerosis is a neurological condition characterized by lesions of the myelin sheaths that encapsulate the neurons of the brain, spine and optic nerve, and it causes transient or progressive symptoms and impairments in gait and posture. Up to 50...

  9. Tyrosine Kinase Inhibitors Ameliorate Autoimmune Encephalomyelitis in a Mouse Model of Multiple Sclerosis

    Crespo, Oliver; Kang, Stacey C.; Daneman, Richard; Lindstrom, Tamsin M.; Ho, Peggy P.; Sobel, Raymond A.; Steinman, Lawrence; Robinson, William H.

    2011-01-01

    Multiple sclerosis is an autoimmune disease of the central nervous system characterized by neuroinflammation and demyelination. Although considered a T cell-mediated disease, multiple sclerosis involves the activation of both adaptive and innate immune cells, as well as resident cells of the central nervous system, which synergize in inducing inflammation and thereby demyelination. Differentiation, survival, and inflammatory functions of innate immune cells and of astrocytes of the central ne...

  10. Potential immunological consequences of pharmacological suppression of gastric acid production in patients with multiple sclerosis

    Biswas Sangita; Benedict Stephen H; Lynch Sharon G; LeVine Steven M

    2012-01-01

    Abstract Corticosteroids are standard treatment for patients with multiple sclerosis experiencing acute relapse. Because dyspeptic pain is a common side effect of this intervention, patients can be given a histamine receptor-2 antagonist, proton pump inhibitor or antacid to prevent or ameliorate this disturbance. Additionally, patients with multiple sclerosis may be taking these medications independent of corticosteroid treatment. Interventions for gastric disturbances can influence the activ...

  11. Differential Micro RNA Expression in PBMC from Multiple Sclerosis Patients

    David Otaegui; Baranzini, Sergio E; Ruben Armañanzas; Borja Calvo; Maider Muñoz-Culla; Puya Khankhanian; Iñaki Inza; Lozano, Jose A.; Tamara Castillo-Triviño; Ana Asensio; Javier Olaskoaga; Adolfo López de Munain

    2009-01-01

    Differences in gene expression patterns have been documented not only in Multiple Sclerosis patients versus healthy controls but also in the relapse of the disease. Recently a new gene expression modulator has been identified: the microRNA or miRNA. The aim of this work is to analyze the possible role of miRNAs in multiple sclerosis, focusing on the relapse stage. We have analyzed the expression patterns of 364 miRNAs in PBMC obtained from multiple sclerosis patients in relapse status, in rem...

  12. A biopsychosocial model of resilience for multiple sclerosis.

    Black, Rebecca; Dorstyn, Diana

    2015-11-01

    The concept of resilience remains under-researched in the multiple sclerosis literature. Consequently, current understanding of the unique and joint contribution of disability-specific variables, cognitive-behavioural skills and social resources to this dynamic process is limited. A holistic model of resilience was therefore developed and tested. Results of an online survey completed by 196 adults with multiple sclerosis revealed both direct and indirect pathways to resilience, with positive affect and self-efficacy being the strongest predictors. The findings lend support to psychological interventions which focus on promoting the personal resources and assets needed to cope effectively with multiple sclerosis. PMID:24323335

  13. Update on immunopathogenesis and immunotherapy in multiple sclerosis

    Selter RC

    2013-04-01

    Full Text Available Rebecca C Selter,1 Bernhard Hemmer1–3 1Department of Neurology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany; 2Munich Cluster for Systems Neurology (SyNergy, Munich, Germany; 3Competence Network on Multiple Sklerosis, Munich, Germany Abstract: Multiple sclerosis is a chronic inflammatory demyelinating disease of the central nervous system. Both genetic and environmental factors are believed to contribute to the pathogenesis of the disease. Histopathological findings suggest that multiple sclerosis is an immune-mediated disease, involving both the cellular and humoral immune systems. Within the last 20 years, several disease-modifying therapies for the treatment of multiple sclerosis were established. Moreover, promising new substances are currently being tested in clinical trials and will likely broaden the therapeutic opportunities available within the upcoming years. Keywords: multiple sclerosis, immunopathogenesis, disease-modifying therapy

  14. The symptomatic management of multiple sclerosis

    Schapiro Randall

    2009-01-01

    Full Text Available The management of multiple sclerosis (MS revolves around disease management, symptom management, and person management. Of these, symptom management takes up the bulk of the time of the practicing physician. Some symptoms are easily managed whereas others are more difficult. Decisions have often to be made on whether to treat or to wait and watch. This article discusses the varied symptoms of MS and the approaches to management, which involves rehabilitation, pharmacological treatments, and surgical procedures. The skilled physician managing MS should be familiar with the multiple approaches to improving the quality of life of those with MS. After the diagnosis has been established and the decisions regarding treatment approaches have been made, the talk in a typical office appointment for MS usually turns to symptom management. Thus, the majority of management decisions made by the clinician revolve around that important topic. It is symptom management that will determine quality of life for those with MS, It is the basis for improving function, and, up until twenty years ago, it was the only basis for treating MS. Now, however, we can approach treatment by disease management, symptom management, and person management. The MS specialist must be well versed in all three areas.

  15. Bone Health in Patients with Multiple Sclerosis

    Vit Zikan

    2011-01-01

    Full Text Available Multiple sclerosis (MS is a gait disorder characterized by acute episodes of neurological defects leading to progressive disability. Patients with MS have multiple risk factors for osteoporotic fractures, such as progressive immobilization, long-term glucocorticoids (GCs treatment or vitamin D deficiency. The duration of motor disability appears to be a major contributor to the reduction of bone strength. The long term immobilization causes a marked imbalance between bone formation and resorption with depressed bone formation and a marked disruption of mechanosensory network of tightly connected osteocytes due to increase of osteocyte apoptosis. Patients with higher level of disability have also higher risk of falls that combined with a bone loss increases the frequency of bone fractures. There are currently no recommendations how to best prevent and treat osteoporosis in patients with MS. However, devastating effect of immobilization on the skeleton in patients with MS underscores the importance of adequate mechanical stimuli for maintaining the bone structure and its mechanical competence. The physical as well as pharmacological interventions which can counteract the bone remodeling imbalance, particularly osteocyte apoptosis, will be promising for prevention and treatment of osteoporosis in patients with MS.

  16. Multiple sclerosis and positive lyme serology

    Marco Aurélio Lana-Peixoto

    1994-12-01

    Full Text Available As Lyme neuroborreliosis (LNB may clinically mimick multiple sclerosis (MS the presence of antibodies to Borrelia burgdorferi in serum of patients with a MS-like disease in non-edemic areas for Lyme disease may be troublesome. We report the case of a 45-year-old white female with the diagnosis of relapsing/ remitting form of MS due to a 15-year history of optic neuritis and recurrent episodes of motor and sensation disturbance in the upper right limb and in both lower extremites associated with bladder dysfunction. A magnetic resonance imaging of the brain revealed multiple high intensity periventricular white matter lesions. The patient had been exposed to ticks but did not recall the presence of erythema migrans. ELISA for Lyme disease was positive in two different laboratories and the positive serology was confirmed by Western blotting. No convincing reponse followed treatment with ceftriaxone. Although it is clear that the patient had been infect by Borrelia burgdorferi the relationship of this spirochetal infection with the neurological disease could not be ascertained.

  17. How multiple sclerosis is related to animal illness, stress and diabetes

    Warren, S.A.; Warren, K.G.; Greenhill, S.; Paterson, M.

    1982-02-15

    At the University of Alberta's multiple sclerosis research clinic 100 patients with multiple sclerosis were matched to control patients for age, sex, race and zone of residence before the age of 15 years. Case and control subjects were interviewed and information was collected by questionnaire on factors that might play a role in the development of multiple sclerosis. The only factors found to be significantly associated with the development of this disorder were a history of leisure time spent in physical activities before the onset of symptoms, exposure to animal illness -- specifically canine distemper -- and a history of severe or prolonged emotional stress. The study also confirmed a familial predisposition to multiple sclerosis and suggested a relation between the disorder and a personal or family history of diabetes mellitus.

  18. Oxidative Stress is Increased in Serum from Mexican Patients with Relapsing-Remitting Multiple Sclerosis

    Ortiz, Genaro Gabriel; Macías-Islas, Miguel Ángel; Pacheco-Moisés, Fermín P.; Cruz-Ramos, José A.; Sustersik, Silvia; Barba, Elías Alejandro; Aguayo, Adriana

    2009-01-01

    Objective: To determine the oxidative stress markers in serum from patients with relapsing-remitting multiple sclerosis. Methods: Blood samples from healthy controls and 22 patients 15 women (7 aged from 20 to 30 and 8 were > 40 years old) and 7 men (5 aged from 20 to 30 and 2 were > 40 years old) fulfilling the McDonald Criteria and classified as having Relapsing-Remitting Multiple Sclerosis accordingly with Lublin were collected for oxidative stress markers quantification. Results: Nitric oxide metabolites (nitrates/nitrites), lipid peroxidation products (malondialdehyde plus 4-hidroxialkenals), and glutathione peroxidase activity were significantly increased in serum of subjects with relapsing-remitting multiple sclerosis in comparison with that of healthy controls. These data support the hypothesis that multiple sclerosis is a component closely linked to oxidative stress. PMID:19242067

  19. Oxidative Stress is Increased in Serum from Mexican Patients with Relapsing-Remitting Multiple Sclerosis

    Genaro Gabriel Ortiz

    2009-01-01

    Full Text Available Objective: To determine the oxidative stress markers in serum from patients with relapsing-remitting multiple sclerosis. Methods: Blood samples from healthy controls and 22 patients 15 women (7 aged from 20 to 30 and 8 were > 40 years old and 7 men (5 aged from 20 to 30 and 2 were > 40 years old fulfilling the McDonald Criteria and classified as having Relapsing-Remitting Multiple Sclerosis accordingly with Lublin were collected for oxidative stress markers quantification. Results: Nitric oxide metabolites (nitrates/nitrites, lipid peroxidation products (malondialdehyde plus 4-hidroxialkenals, and glutathione peroxidase activity were significantly increased in serum of subjects with relapsing-remitting multiple sclerosis in comparison with that of healthy controls. These data support the hypothesis that multiple sclerosis is a component closely linked to oxidative stress.

  20. Body composition and physical function in women with multiple sclerosis

    Christie L. Ward, MS; Yoojin Suh, PhD; Abbi D. Lane, PhD; Huimin Yan, MS; Sushant M. Ranadive, PhD; Bo Fernhall, PhD; Robert W. Motl, PhD; Ellen M. Evans, PhD

    2013-01-01

    Persons with multiple sclerosis (MS) have reduced physical activity (PA) and lower-limb physical function and potentially disordered body composition compared with their peers without MS. The aim of this study was to determine whether PA and body composition were differentially associated with lower-limb physical function in persons with MS compared with controls. Females with MS and age- and body mass index-matched female controls (n = 51; average age 48.1 +/– 9.7 yr) were measured for PA wi...

  1. Role of cytokine p40 family in multiple sclerosis

    Brahmachari, S.; Pahan, K.

    2008-01-01

    Over the last couple of decades of neuro-immunological research, the p40 family of cytokines has emerged out as one of the most intriguing areas of interest because of multi-faceted roles of these cytokine in immune-modulation and inflammation. The IL-12, the most widely studied cytokine of this family, is well-characterized for its Th1-favoring activity, and therefore plays a key role in the pathophysiology of Th1-mediated autoimmune diseases like multiple sclerosis (MS). On the other hand, ...

  2. Vitamin D, Multiple Sclerosis and Inflammatory Bowel Disease

    Cantorna, Margherita T.

    2011-01-01

    It has now been more than 20 years since the vitamin D receptor was identified in cells of the immune system. The immune system has now been established as an important target of vitamin D. Vitamin D receptor knockout and vitamin D deficient mice have a surplus of effector T cells that have been implicated in the pathology of multiple sclerosis (MS) and inflammatory bowel disease (IBD). The active form of vitamin D directly and indirectly suppresses the function of these pathogenic T cells wh...

  3. Lymphocyte radiosensitivity in multiple sclerosis patients

    The purpose of the study was to characterize the radiosensitivity of the peripheral blood lymphocytes from Secondary Progressive Multiple Sclerosis (MS) patients in order to get insights in the ability of these cells to deal with DNA damage. Genetic defects in the repair mechanisms of DNA have not been systematically observed in MS but they have been found in other autoimmune diseases such as lupus erythematosus and rheumatoid arthritis, as well as in several disorders of the nervous system. Up to now investigations into cellular radio-sensitivity in MS patients comparative to healthy controls have yielded contradictory results. The following methods were used: The chromosomal radiosensitivity of lymphocytes was assessed after in vitro 2 Gy gamma irradiation in G0 phase of the cell cycle, using the micronucleus (MN) assay. The MN assay was performed on whole blood cultures, separated PBMC cultures, and CD4+ and CD8+ subsets of T lymphocytes from blood samples of the MS (n=26) patients and on concurrent samples of healthy individuals (n=22). The results obtained are summarized as follows: The spontaneous MN induction was found significantly higher in whole blood and PBMC cultures for MS patients comparatively to controls. The differences had statistical significance for total lymphocyte population and also for separated CD4+ and CD8+ lymphocytes. No correlation has been observed between the spontaneous MN yield and illness duration for the group of MS patients. No difference in radiosensitivity was observed between patients and controls after 2 Gy irradiation of whole blood. In irradiated PBMC cultures, a slightly lower induction of MN was observed in the case of MS patients. For the MS patients, lymphocyte radiosensitivity was significantly higher in whole blood culture environment compared to PBMC culture environment. The CD4+ lymphocyte subset from MS patients was significantly less radiosensitive compared to healthy controls. On the other hand, CD8+ lymphocytes

  4. Direct and indirect economic consequences of multiple sclerosis in Ireland

    Fogarty, Emer

    2014-09-01

    Multiple sclerosis (MS) has significant financial consequences for healthcare systems, individual patients and households, and the wider society. This study examines the distribution of MS costs and resource utilisation across cost categories and from various perspectives, as MS disability increases.

  5. Multiple sclerosis after infectious mononucleosis: record linkage study

    Goldacre, M.; Wotton, C.; Seagroatt, V; Yeates, D

    2004-01-01

    Objective: To ascertain if infectious mononucleosis is a risk factor for the development of multiple sclerosis (MS); and, if it is, whether its effect is close to or remote in time from the onset of MS.

  6. Cognitive analysis of multiple sclerosis utilizing fuzzy cluster means

    Imianvan Anthony Agboizebeta

    2012-01-01

    Full Text Available Multiple sclerosis, often called MS, is a disease that affects the central nervous system (the brain and spinal cord. Myelin provides insulation for nerve cells improves the conduction of impulses along the nerves and is important for maintaining the health of the nerves. In multiple sclerosis, inflammation causes the myelin to disappear. Genetic factors, environmental issues and viral infection may also play a role in developing the disease. Ms is characterized by life threatening symptoms such as; loss of balance, hearing problem and depression. The application of Fuzzy Cluster Means (FCM or Fuzzy CMean analysis to the diagnosis of different forms of multiple sclerosis is the focal point of this paper. Application of cluster analysis involves a sequence of methodological and analytical decision steps that enhances the quality and meaning of the clusters produced. Uncertainties associated with analysis of multiple sclerosis test data are eliminated by the system

  7. Cognitive analysis of multiple sclerosis utilizing fuzzy cluster means

    Imianvan Anthony Agboizebeta

    2012-02-01

    Full Text Available Multiple sclerosis, often called MS, is a disease that affects the central nervous system (the brain andspinal cord. Myelin provides insulation for nerve cells improves the conduction of impulses along thenerves and is important for maintaining the health of the nerves. In multiple sclerosis, inflammationcauses the myelin to disappear. Genetic factors, environmental issues and viral infection may alsoplay a role in developing the disease. Ms is characterized by life threatening symptoms such as; loss ofbalance, hearing problem and depression. The application of Fuzzy Cluster Means (FCM or Fuzzy CMeananalysis to the diagnosis of different forms of multiple sclerosis is the focal point of this paper.Application of cluster analysis involves a sequence of methodological and analytical decision stepsthat enhances the quality and meaning of the clusters produced. Uncertainties associated withanalysis of multiple sclerosis test data are eliminated by the system

  8. Depression and Sub-clinical Markers of Multiple Sclerosis

    GH Salehpoor

    2014-05-01

    Full Text Available Abstract Background & aim: Multiple sclerosis is a chronic neurological disease that depression has been found in more than 40% of its patients and by several sub-clinical markers associated with disease the opportunity will appearance. Aim of this present study was investigation depression and multiple sclerosis sub-clinical markers. Methods: In this analytical cross-sectional study, 162 patients with multiple sclerosis were selected by consecutive sampling and using the clinical and demographic variables inventory, Depression, Anxiety and Stress Scale, Short Form Health Survey questionnaire, Fatigue Severity Scale along with identical analog-spring balance were examined. The data were analyzed by pearson correlation coefficient, one way analysis of variance, Tukey's test and stepwise multiple regression. Results: Patients with 3 or more times the number of relapses and hospitalizations experienced, received significantly more depression scores than patients with lower frequent relapse and hospitalization. In addition, sub-clinical markers of the disease together could explain 30% of the shared variance of depression. Overall in final step limitations due to physical problems, fatigue and bodily pain could significantly predicts depression scores in patients (P <0.0001. Conclusion: This study highlighted the impact of multiple sclerosis sub-clinical markers in depression of patients. Hence, is requirement that identified key predictors of this research be considered as possible risk factors in development of depression associated with multiple sclerosis and used for the regular management of the disease. Key words: Multiple Sclerosis, Depression, Fatigue, Pain

  9. Multiple sclerosis among patients with previous diagnosis of leishmaniasis

    Mehrdad Farrokhi; Mosoud Etemadifar; Ali Rezaei; Ali Amani Beni

    2015-01-01

    Leishmaniasis is a protozoan parasitic disease which is caused by leishmania genus and is transmitted by sand flies. Multiple sclerosis (MS), however, is a chronic inflammatory disease of central nervous system (CNS). Since co-existence of these two diseases in an individual is rare, we aimed to evaluate prevalence of leishmaniasis among MS patients. At first, total Isfahan MS (TIMS) records of 5123 MS patients who registered in Isfahan multiple sclerosis society (IMMS) from April 2003 till J...

  10. Neuroprotection in a Novel Mouse Model of Multiple Sclerosis

    Katie Lidster; Samuel J Jackson; Zubair Ahmed; Peter Munro; Pete Coffey; Gavin Giovannoni; Baker, Mark D.; David Baker

    2013-01-01

    Multiple sclerosis is an immune-mediated, demyelinating and neurodegenerative disease that currently lacks any neuroprotective treatments. Innovative neuroprotective trial designs are required to hasten the translational process of drug development. An ideal target to monitor the efficacy of strategies aimed at treating multiple sclerosis is the visual system, which is the most accessible part of the human central nervous system. A novel C57BL/6 mouse line was generated that expressed transge...

  11. Epidemiology of multiple sclerosis in Tehran: a three year study

    Ghabaae M; Qelichnia Omrani H; Roostaeizadeh M

    2007-01-01

    Background: Multiple sclerosis is the most common demyelinating disease of central nervous system. We prepared this study to find its epidemiologic pattern in the Iranian society.Methods: This case-series study involved 70 patients diagnosed with multiple sclerosis according to the McDonald criteria and admitted to the Iranian Center of Neurological Research at Imam Khomeini Hospital from 2002 to 2004. Informed consent was obtained prior to patients completing a questionnaire, which included ...

  12. Meditation as an Adjunct to the Management of Multiple Sclerosis

    Levin, Adam B.; Hadgkiss, Emily J.; Weiland, Tracey J.; Jelinek, George A.

    2014-01-01

    Background. Multiple sclerosis (MS) disease course is known to be adversely affected by several factors including stress. A proposed mechanism for decreasing stress and therefore decreasing MS morbidity and improving quality of life is meditation. This review aims to critically analyse the current literature regarding meditation and MS. Methods. Four major databases were used to search for English language papers published before March 2014 with the terms MS, multiple sclerosis, meditation, a...

  13. The effect of exercise therapy on fatigue in multiple sclerosis

    Andreasen, A; Stenager, E; Dalgas, U

    2011-01-01

    Fatigue occurs in the majority of patients with multiple sclerosis (MS) and therapeutic possibilities are few. Exercise therapy is a therapeutic option but no studies have systematically reviewed the existing literature evaluating the effect of exercise therapy on MS fatigue.......Fatigue occurs in the majority of patients with multiple sclerosis (MS) and therapeutic possibilities are few. Exercise therapy is a therapeutic option but no studies have systematically reviewed the existing literature evaluating the effect of exercise therapy on MS fatigue....

  14. Serum levels of tumor necrosis factor-α and soluble adhesion molecules in relation to magnetic resonance imaging results and clinical activity in multiple sclerosis

    One direction of research in pathogenesis of multiple sclerosis (MS) has been to identify immunological markers associated with disease activity that are capable of predicting subsequent course of disease and are sensitive to intervention by immunomodulatory therapies. Adhesion molecules and tumor necrosis factor-α of the cytokine superfamily are associated with inflammation-mediated blood-brain barrier dysfunction and demyelination in the central nervous system (CNS). This study investigates the relationship between the serum level of soluble vascular adhesion molecule-1 (sVCAM), soluble intercellular adhesion molecule-1 (alCAM), tumor necrosis factor-α (TNF-α) and magnetic resonance imaging (MRI) activity in 18 patients with relapsing-remitting (RR) MS with different clinical activity. Patients with active gadolinium (Gd)-enhanced lesions on MRI showed a higher serum level of TNF-α, sVCA-1, slCAM-1 than RR MS patients without Gd-enhanced lesions. Control individuals (n=10) without MRI abnormalities had significantly lower serum levels of the above immunological parameters. These results suggest that serum levels of TNF-α and adhesion molecules slCAM-1 in RR MS patients are correlated with Gd-enhanced MRI and disease clinical activity and that they can be used as biological markers of disease activity. The soluble form of VCAM levels in peripheral blood did not correlate with disease activity and Gd-enhanced lesions of MRI. sVCAM as an early indicator of blood-brain barrier dysfunction may also serve as marker of beneficial activity in the relapsing phase of MS course. (authors)

  15. Acute form of multiple sclerosis in a child simulation encephalitis

    Multiple sclerosis (MS) is considered the most common demyelinating process involving the CNS. Although usually considered an adult disease multiple sclerosis can begin to manifest during childhood. The clinical presentation of the disease in early childhood can range from paraesthesias to dramatic presentations, suggesting diffuse encephalopathy with cerebral oedema, meningismus and impaired consciousness. Multiple sclerosis is usually characterized by a typical relapsing-remitting clinical course. But there are acute, clinically fulminant forms with atypical. neurologic symptoms and death in months. MRI has become increasingly relevant in the diagnosis of multiple sclerosis in the past years. Yet, the specificity is limited. Atypical forms of MS and other diseases of CNS may show similar patterns on MRI. We report a case of 7 years old boy with clinically fulminant Marburg type of multiple sclerosis that ended with death in two months. The patient was a diagnostic problem despite the certain degree of clinical and radiological suspicion. The postmortem diagnosis is based on pathomorphologic changes (gross pathologic and microscopic features) in CNS.The present case is of clinical, radiological and pathomorphologic interest because of its early onset in childhood, unusual clinical course and acute progression. Awareness of the MRI features of multiple sclerosis and MS-variants (subtypes) may help in such atypical presentations in childhood. (authors)

  16. MRI parameters in multiple sclerosis patients

    Magnetic resonance imaging (MRI) findings of 20 patients with clinically definite multiple sclerosis (MS) are presented. The studies were performed on a 0.5 Tesla magnet using spin-echo technique. Analysis of the MRI findings included detailed linear measurements of the ventricular and the subarachnoid spaces and reading of the intensity of the gray and white matter and intensity of the MS plaques. The plaques were sorted according to their number and size. The younger patients (20-40 years) had overall more plaques than the older ones (over 40 years). The small plaques were the most numerous and the large ones were the least common. Statistically significant association was found between the number of plaques and the calla media width. The intensity ratios between the nonplaque white matter/grey matter showed a significant correlation with the ventricular score. A significant negative correlation was found between the antero-posterior diameter of the spinal cord and the number of MS plaques in the brain. The plaque/white matter ratio had a significantly negative correlation with the cervical cord's width. (orig.)

  17. Pediatric multiple sclerosis: Escalation and emerging treatments.

    Chitnis, Tanuja; Ghezzi, Angelo; Bajer-Kornek, Barbara; Boyko, Alexey; Giovannoni, Gavin; Pohl, Daniela

    2016-08-30

    Over the last 20 years, there have been significant advances in multiple sclerosis (MS) therapeutics, with regulatory approval for 13 therapies in adults by the European Medicines Agency (EMA) and Food and Drug Administration. However, there is only limited approval for interferon-β and glatiramer acetate use in children 12 years and older by the EMA. Availability of disease-modifying therapies to children and adolescents with MS is variable by region, and is extremely limited in some regions of the world. Up to 30% of children experience breakthrough disease requiring therapies beyond traditional first-line agents. Recent legislation in both the United States and Europe has mandated clinical studies for all new therapeutics applicable to children. Several clinical trials in children are underway that will provide important information regarding the efficacy and safety of newer drugs. This review summarizes the current knowledge of breakthrough disease, escalation, and induction treatment approaches in children with MS, especially pertaining to disease course and disability outcomes in this group of patients. In addition, ongoing clinical trials and approaches and challenges in conducting clinical trials in the pediatric population are discussed. PMID:27572854

  18. Therapeutic Yoga: Symptom Management for Multiple Sclerosis.

    Rogers, Kim A; MacDonald, Megan

    2015-11-01

    Multiple sclerosis (MS) is the most common autoimmune inflammatory demyelinating disease of the central nervous system, affecting over 2.3 million people worldwide. According to the National Institute of Neurological Disorders and Stroke, the age of disease onset is typically between 20 and 40 years, with a higher incidence in women. Individuals with MS experience a wide range of symptoms, including declining physical, emotional, and psychological symptoms (e.g., fatigue, imbalance, spasticity, chronic pain, cognitive impairment, bladder and bowel dysfunction, visual and speech impairments, depression, sensory disturbance, and mobility impairment). To date, both the cause of and cure for MS remain unknown. In recent years, more individuals with MS have been pursuing alternative methods of treatment to manage symptoms of the disease, including mind-body therapies such as yoga, meditation, breathing, and relaxation techniques. It has been suggested that the practice of yoga may be a safe and effective way of managing symptoms of MS. Therefore, the purpose of this paper is to summarize the most relevant literature on exercise and mind-body modalities to treat MS symptoms and, more specifically, the benefits and potential role of yoga as an alternative treatment of symptom management for individuals with MS. The article also discusses future directions for research. PMID:26270955

  19. Gait termination in individuals with multiple sclerosis.

    Roeing, Kathleen L; Wajda, Douglas A; Motl, Robert W; Sosnoff, Jacob J

    2015-09-01

    Despite the ubiquitous nature of gait impairment in multiple sclerosis (MS), there is limited information concerning the control of gait termination in individuals with MS. The purpose of this investigation was to examine planned gait termination in individuals with MS and healthy controls with and without cognitive distractors. Individuals with MS and age matched controls completed a series of gait termination tasks over a pressure sensitive walkway under non-distracting and cognitively distracting conditions. As expected the MS group had a lower velocity (89.9±33.3 cm/s) than controls (142.8±22.4 cm/s) and there was a significant reduction in velocity in both groups under the cognitive distracting conditions (MS: 73.9±30.7 cm/s; control: 120.0±25.9 cm/s). Although individuals with MS walked slower, there was no difference between groups in the rate a participant failed to stop at the target (i.e. failure rate). Overall failure rate had a 10-fold increase in the cognitively distracting condition across groups. Individuals with MS were more unstable during termination. Future research examining the neuromuscular mechanisms contributing to gait termination is warranted. PMID:26228021

  20. Symptom overlap in anxiety and multiple sclerosis.

    O Donnchadha, Seán

    2013-02-14

    BACKGROUND: The validity of self-rated anxiety inventories in people with multiple sclerosis (pwMS) is unclear. However, the appropriateness of self-reported depression scales has been widely examined. Given somatic symptom overlap between depression and MS, research emphasises caution when using such scales. OBJECTIVE: This study evaluates symptom overlap between anxiety and MS in a group of 33 individuals with MS, using the Beck Anxiety Inventory (BAI). METHODS: Participants underwent a neurological examination and completed the BAI. RESULTS: A novel procedure using hierarchical cluster analysis revealed three distinct symptom clusters. Cluster one (\\'wobbliness\\' and \\'unsteady\\') grouped separately from all other BAI items. These symptoms are well-recognised MS-related symptoms and we question whether their endorsement in pwMS can be considered to reflect anxiety. A modified 19-item BAI (mBAI) was created which excludes cluster one items. This removal reduced the number of MS participants considered \\'anxious\\' by 21.21% (low threshold) and altered the level of anxiety severity for a further 27.27%. CONCLUSION: Based on these data, it is suggested that, as with depression measures, researchers and clinicians should exercise caution when using brief screening measures for anxiety in pwMS.

  1. Emerging injectable therapies for multiple sclerosis.

    Oh, Jiwon; Calabresi, Peter A

    2013-11-01

    Available treatment options for relapsing-remitting multiple sclerosis (MS) have expanded in recent years, and several injectable therapies are under development. In this Rapid Review, we summarise emerging injectable therapies for relapsing-remitting MS, and discuss pharmacological mechanisms, clinical trials, adverse events, and use in clinical practice. Many new potential treatments for MS are at an intermediate to advanced stage of development. Alemtuzumab is a monoclonal antibody that has shown efficacy in phase 3 trials but, because of serious adverse events associated with this drug, clinical monitoring is essential. Pegylated interferon beta-1a has shown efficacy in a phase 3 trial. Daclizumab and ocrelizumab are monoclonal antibodies that have shown efficacy and acceptable safety profiles in phase 2 trials; both are under investigation in ongoing phase 3 trials. Ofatumumab is a monoclonal antibody that has shown efficacy in a small phase 2 trial. Animal models suggest that anti-LINGO1 antibody has remyelinating potential, and phase 2 trials of the antibody are underway. Further clarification of purported mechanisms of action and continued surveillance will be essential to establish the safety and clinical efficacy of these drugs in patients with relapsing-remitting MS. PMID:24090587

  2. Female reproductive issues in multiple sclerosis.

    McCombe, Pamela A; Greer, Judith M

    2013-04-01

    Multiple sclerosis (MS) is more common in females than males and frequently affects women during their reproductive years. Thus, issues surrounding pregnancy and reproduction are of concern to women with MS. This review documents studies that shed light on reproductive issues in women with MS. The available literature was searched for papers relating to pregnancy and MS. Pregnancy is protective in MS in the short term, perhaps due to modulation of the immune system in pregnancy. It also possible that changes in the brain in pregnancy could protect against the effects of inflammation. The long-term effects of pregnancy also seem to be beneficial to MS, perhaps due to long-term epigenetic changes or possibly due to the effects of fetal microchimerism. Obstetric outcomes in women with MS are similar to those in the general population. In addition, there have been no reports of severe fetal abnormalities in babies exposed to first-line MS therapies. There is no good evidence that breast-feeding is protective in MS. There is no evidence that oral contraceptive pill use predisposes to MS, nor influences the clinical course of MS. After menopause, there is possible deterioration of MS, but it's difficult to disentangle this from the effects of aging and the natural progressive history of MS. The strong biological effect of pregnancy on MS deserves further study, so that these mechanisms can possibly be replicated as therapies for MS. PMID:22733837

  3. A toolbox for multiple sclerosis lesion segmentation

    Roura, Eloy; Oliver, Arnau; Valverde, Sergi; Llado, Xavier [University of Girona, Computer Vision and Robotics Group, Girona (Spain); Cabezas, Mariano; Pareto, Deborah; Rovira, Alex [Vall d' Hebron University Hospital, Magnetic Resonance Unit, Dept. of Radiology, Barcelona (Spain); Vilanova, Joan C. [Girona Magnetic Resonance Center, Girona (Spain); Ramio-Torrenta, Lluis [Dr. Josep Trueta University Hospital, Institut d' Investigacio Biomedica de Girona, Multiple Sclerosis and Neuroimmunology Unit, Girona (Spain)

    2015-10-15

    Lesion segmentation plays an important role in the diagnosis and follow-up of multiple sclerosis (MS). This task is very time-consuming and subject to intra- and inter-rater variability. In this paper, we present a new tool for automated MS lesion segmentation using T1w and fluid-attenuated inversion recovery (FLAIR) images. Our approach is based on two main steps, initial brain tissue segmentation according to the gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF) performed in T1w images, followed by a second step where the lesions are segmented as outliers to the normal apparent GM brain tissue on the FLAIR image. The tool has been validated using data from more than 100 MS patients acquired with different scanners and at different magnetic field strengths. Quantitative evaluation provided a better performance in terms of precision while maintaining similar results on sensitivity and Dice similarity measures compared with those of other approaches. Our tool is implemented as a publicly available SPM8/12 extension that can be used by both the medical and research communities. (orig.)

  4. Magnetic resonance tomography in confirmed multiple sclerosis

    The authors report on 21 cases of confirmed multiple sclerosis examined by both CT and magnetic resonance tomography. To safeguard the results, strict criteria were applied in accordance with the suggestions made by neurological work teams. Pathological lesons were seen in 20 patients; the MR image did not reveal anything abnormal in one case. On the average, 10.3 lesions were seen in the MR tomogram, whereas CT images showed on the average only 2.1 foci. The size and number of lesions in the MR tomogram were independent of the duration of the disease, the presented clinical symptoms, or the type of treatment at the time of examination. Evidently the sensitivity of MR tomography is very high in MS patients, but it has not yet been clarified to what extent this applies also to the specificity. Further research is mandatory. First experiences made by us show that lesions of a similar kind can also occur in diseases such as malignant lymphoma involving the brain, in vitamin B 12 deficiency syndrome, or encephalitis, and can become manifest in the MR tomogram. (orig.)

  5. Proton MR spectroscopic imaging in multiple sclerosis

    Tedeschi, G.; Bonavita, S. [Istituto di Scienze Neurologiche, Seconda Universita di Napoli (Italy); Department of Neuroimaging, National Institute of Neurological Disease and Stroke, National Institutes of Health, Bethesda, MD (United States); McFarland, H.F.; Richert, N. [Department of Neuroimmunology, National Institute of Neurological Disease and Stroke, National Institutes of Health, Bethesda, MD (United States); Duyn, J.H.; Frank, J.A. [Laboratory of Diagnostic Radiology Research, National Institutes of Health, Bethesda, MD (United States)

    2002-01-01

    We studied 24 patients with multiple sclerosis (MS) by proton magnetic resonance spectroscopic imaging (1H-MRSI) to assess the neurochemical pathology of the white-matter lesions (WML) and normal-appearing white matter (NAWM). Our 1H-MRSI technique allowed simultaneous measurement of N-acetylaspartate (NAA), choline-containing compounds (Cho), and creatine plus phosphocreatine (Cr) signal intensities from four 15-mm slices divided into 0.84 ml single-volume elements. In WML we found significantly lower NAA/Cr and NAA/Cho ratios and a significantly higher Cho/Cr ratio than in NAWM or control white matter. In NAWM, NAA/Cr and Cho/Cr were significantly lower than in control white matter. 1H-MRSI was compatible with damage to myelin in WML, and with axonal damage and/or dysfunction in WML and NAWM. These findings extend data on involvement of NAWM in MS beyond the abnormalities visible on MRI. (orig.)

  6. Proton MR spectroscopic imaging in multiple sclerosis

    We studied 24 patients with multiple sclerosis (MS) by proton magnetic resonance spectroscopic imaging (1H-MRSI) to assess the neurochemical pathology of the white-matter lesions (WML) and normal-appearing white matter (NAWM). Our 1H-MRSI technique allowed simultaneous measurement of N-acetylaspartate (NAA), choline-containing compounds (Cho), and creatine plus phosphocreatine (Cr) signal intensities from four 15-mm slices divided into 0.84 ml single-volume elements. In WML we found significantly lower NAA/Cr and NAA/Cho ratios and a significantly higher Cho/Cr ratio than in NAWM or control white matter. In NAWM, NAA/Cr and Cho/Cr were significantly lower than in control white matter. 1H-MRSI was compatible with damage to myelin in WML, and with axonal damage and/or dysfunction in WML and NAWM. These findings extend data on involvement of NAWM in MS beyond the abnormalities visible on MRI. (orig.)

  7. Magnetic resonance tomography in confirmed multiple sclerosis

    Uhlenbrock, D.; Dickmann, E.; Beyer, H.K.; Gehlen, W.

    1985-03-01

    The authors report on 21 cases of confirmed multiple sclerosis examined by both CT and magnetic resonance tomography. To safeguard the results, strict criteria were applied in accordance with the suggestions made by neurological work teams. Pathological lesions were seen in 20 patients; the MR image did not reveal anything abnormal in one case. On the average, 10.3 lesions were seen in the MR tomogram, whereas CT images showed on the average only 2.1 foci. The size and number of lesions in the MR tomogram were independent of the duration of the disease, the presented clinical symptoms, or the type of treatment at the time of examination. Evidently the sensitivity of MR tomography is very high in MS patients, but it has not yet been clarified to what extent this applies also to the specificity. Further research is mandatory. First experiences made by us show that lesions of a similar kind can also occur in diseases such as malignant lymphoma involving the brain, in vitamin B 12 deficiency syndrome, or encephalitis, and can become manifest in the MR tomogram.

  8. Cognitive impairment in relapsing remitting Multiple Sclerosis

    Saška Roškar

    2003-06-01

    Full Text Available The purpose of the study was to identify changes in cognitive abilities that affect patients with relapsing remitting form of multiple sclerosis (MS and to find out which instrument manifests them best. The performance of MS patients was compared to a matched group of healthy people using three neuropsychological tests: Wisconsin card sorting test (WCST, Stroop color and word test and Trail making test (TMT part B. Results on all three tests indicate general cognitive impairments in the group of patients. Compared to the group of healthy people patients with MS exhibited impaired ability of abstract reasoning (WCST, impaired cognitive flexibility and less resistance to irrelevant stimuli (Stroop color and word test, slowed information processing and impaired ability of shifting attention from one symbol to another (TMT. The largest differences between groups occured in Stroop color and word test as well as in TMT. The estimation of cognitive abilities of MS patients is of high importance and sistematicaly observing of changes in those abilities should be considered.

  9. B Cells and Autoantibodies in Multiple Sclerosis

    Anne-Katrin Pröbstel

    2015-07-01

    Full Text Available While over the past decades T cells have been considered key players in the pathogenesis of multiple sclerosis (MS, it has only recently become evident that B cells have a major contributing role. Our understanding of the role of B cells has evolved substantially following the clinical success of B cell-targeting therapies and increasing experimental evidence for significant B cell involvement. Rather than mere antibody-producing cells, it is becoming clear that they are team players with the capacity to prime and regulate T cells, and function both as pro- and anti-inflammatory mediators. However, despite tremendous efforts, the target antigen(s of B cells in MS have yet to be identified. The first part of this review summarizes the clinical evidence and results from animal studies pointing to the relevance of B cells in the pathogenesis of MS. The second part gives an overview of the currently known potential autoantigen targets. The third part recapitulates and critically appraises the currently available B cell-directed therapies.

  10. Connective tissue diseases mimicking multiple sclerosis

    Maryam Moghaddassi-Jahromi

    2011-11-01

    Full Text Available Background: Connective tissue diseases (CTD can involve nervous system. Diagnosis and differentiation from multiple sclerosis (MS can be difficult especially when the disease presented by symptoms and signs related to demyelinating process. The aim of this article is to review the variant forms of central nervous system involvement in CTD especially useful points for differentiation from demyelinating disorders. Materials and Method: We used the relevant articles in PUBMED, Scopus and other databases especially published in recent ten years. Results: Systemic lupus erythematosus (SLE, antiphospholipid syndrome (APS, Behcet’s disease (BD, Sjogren's syndrome (SS, and some vasculitides can involve nervous system. Patients may be present by demyelination areas in the white matter of the brain and spinal cord, which are difficult to differentiate from MS and other demyelinating processes, such as transverse myelitis and optic neuritis. On the other hand, autoantibodies such as antinuclear antibodies (ANA and antiphospholipid antibodies (aPL can also occur in MS. Treatment and prognosis of these diseases are quite different. In demyelinating diseases the diagnosis is established on the basis of clinical presentation, magnetic resonance imaging (MRI, cerebrospinal fluid (CSF examination, visual evoked potentials (VEP and autoantibody investigation.Conclusion: In many patients, distinction between different etiologies of demyelination can be made by considering clinical and paraclinical data, but in some cases, accurate diagnosis can only be made after long-term follow-up

  11. Sustained-release fampridine in Multiple Sclerosis.

    Hadavi, S; Baker, M D; Dobson, R

    2014-01-01

    Sustained-release fampridine, a slow release formulation of 4-aminopryridine, is a voltage-dependent potassium channel blocker licensed for the treatment of walking difficulties in multiple sclerosis (MS). Studies have demonstrated that approximately one-third of MS patients respond with a clear benefit to their walking speed. Sustained-release Fampridine is not currently available on the National Health Service (NHS), although it has been approved by the Food and Drug Administration (FDA) in the USA and European Medicine Agency (EMA). It appears to have an acceptable adverse event profile, with data from open-label extension studies now becoming available. Concerns have been raised that the use of fampridine may increase the risk of seizures, which were seen at higher rates in patients treated with high doses of sustained-release fampridine. The rate of seizures in those patients on lower doses has not been found to be significantly increased. There are significant barriers at present to the widespread use of fampridine in the UK, which have limited its use in clinical practice to date. Patients with MS are in need of interventions to improve walking and many clinicians feel that this drug may have a role in the symptomatic management of MS. PMID:25877967

  12. A toolbox for multiple sclerosis lesion segmentation

    Lesion segmentation plays an important role in the diagnosis and follow-up of multiple sclerosis (MS). This task is very time-consuming and subject to intra- and inter-rater variability. In this paper, we present a new tool for automated MS lesion segmentation using T1w and fluid-attenuated inversion recovery (FLAIR) images. Our approach is based on two main steps, initial brain tissue segmentation according to the gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF) performed in T1w images, followed by a second step where the lesions are segmented as outliers to the normal apparent GM brain tissue on the FLAIR image. The tool has been validated using data from more than 100 MS patients acquired with different scanners and at different magnetic field strengths. Quantitative evaluation provided a better performance in terms of precision while maintaining similar results on sensitivity and Dice similarity measures compared with those of other approaches. Our tool is implemented as a publicly available SPM8/12 extension that can be used by both the medical and research communities. (orig.)

  13. Olfactory dysfunction in patients with multiple sclerosis.

    Li, Li-Min; Yang, Li-Na; Zhang, Lin-Jie; Fu, Ying; Li, Ting; Qi, Yuan; Wang, Jing; Zhang, Da-Qi; Zhang, Ningnannan; Liu, Jingchun; Yang, Li

    2016-06-15

    Association of changes in olfactory-related structures with olfactory function in patients with multiple sclerosis (MS) is not well understood. We used a T&T olfactometer test kit to evaluate olfactory function in 26 patients with MS and 26 age- and sex-matched healthy controls (HC). Then, Brain MRI were performed and olfactory-related structures were analyzed in these subjects. Olfactory detection and recognition threshold were significantly higher in the MS group, interestingly olfactory recognition threshold positively correlated with expanded disability status scale scores in these patients. Olfactory bulb (OB) volume reduced in patients with olfactory dysfunction (ODF). At the same time, reductions in gray matter (GM) volume were observed in the parahippocampal gyrus (PCG), amygdala, piriform cortex, and inferior frontal gyrus in patients with MS compared to HC. Atrophy of the PCG was more obvious in patients with ODF than patients without ODF and the PCG volume correlated with the olfactory recognition threshold, while no difference was found in fractional anisotropy values of tract-based spatial statistics analysis in the two groups. Olfactory function in patients with MS tends to become gradually more impaired with disability aggravation. Decreases in the volume of the OB and olfactory-related GM might provide valuable information about disease status in patients with MS with olfactory impairment. PMID:27206870

  14. Husbands and wives living with multiple sclerosis.

    Courts, Nancy Fleming; Newton, Amanda N; McNeal, Linda J

    2005-02-01

    Multiple sclerosis (MS) frequently is diagnosed in young adults. Coping with symptoms of MS is challenging not only for the person with the disease, but also for his or her spouse. The well spouse often assumes the caregiving role. The purpose of this qualitative research was to investigate the experiences of persons whose spouses have MS. Twelve people participated in a 2-hour focus group: 8 men and 4 women. The husbands were, on average, 50 years old, and the wives averaged 55 years old. The length of time since diagnosis ranged from 2 to 11 years for the husbands and from 3 to 13 years for the wives. The focus group discussions were audiotaped and transcribed verbatim. Participants talked freely. Four major themes emerged: caregiver roles, need for information, relationship changes, and barriers. Men attempted to protect their wives' energy, intervening for them. Wives encouraged independence in their husbands. Spouses need information about MS, complementary interventions, and support. They want increased public awareness of invisible symptoms and awareness in the workplace of continuing capabilities of persons with MS. Role reversals were challenging for the women who felt that "MS is the third person in a marriage." Spouses need help to maintain appropriate boundaries. Limitations of the study include the small, economically homogeneous sample and the single encounter with the subjects. A longitudinal intervention study is needed. PMID:15794441

  15. Cognitive dysfunction in pediatric multiple sclerosis

    Suppiej A

    2014-07-01

    Full Text Available Agnese Suppiej,1 Elisa Cainelli1,2 1Child Neurology and Clinical Neurophysiology, Pediatric University Hospital, Padua, Italy; 2Lifespan Cognitive Neuroscience Laboratory (LCNL, Department of General Psychology, University of Padua, Italy Abstract: Cognitive and neuropsychological impairments are well documented in adult ­multiple sclerosis (MS. Research has only recently focused on cognitive disabilities in pediatric cases, highlighting some differences between pediatric and adult cases. Impairments in several functions have been reported in children, particularly in relation to attention, processing speed, visual–motor skills, and language. Language seems to be particularly vulnerable in pediatric MS, unlike in adults in whom it is usually preserved. Deficits in executive functions, which are considered MS-specific in adults, have been inconsistently reported in children. In children, as compared to adults, the relationship between cognitive dysfunctions and the two other main symptoms of MS, fatigue and psychiatric disorders, was poorly explored. Furthermore, data on the correlations of cognitive impairments with clinical and neuroimaging features are scarce in children, and the results are often incongruent; interestingly, involvement of corpus callosum and reduced thalamic volume differentiated patients identified as having a cognitive impairment from those without a cognitive impairment. Further studies about pediatric MS are needed in order to better understand the impact of the disease on brain development and the resulting effect on cognitive functions, particularly with respect to different therapeutic strategies. Keywords: central nervous system, child, deficit, IQ, inflammatory demyelination, neuropsychological

  16. Pain is associated with prospective memory dysfunction in multiple sclerosis.

    Miller, Ashley K; Basso, Michael R; Candilis, Philip J; Combs, Dennis R; Woods, Steven Paul

    2014-01-01

    Prospective memory (PM) pertains to the execution of a future goal or behavior. Initial research implies that people with multiple sclerosis (MS) are apt to show impaired prospective memory for activities of daily living. Yet, PM impairment does not occur in all people with MS. Thus, some other variable besides disease status alone may contribute to PM dysfunction in people with MS. Chronic pain may be such a variable. Approximately 50-70% of people with MS experience significant pain, and such pain has been thought to diminish memory function. To investigate this possibility, 96 patients with MS and 29 healthy subjects were administered the Memory for Intentions Screening Test (MIST; Woods, S. P., Iudicello, J. E., Moran, L. M, Carey, C. L., Dawson, M. S., & Grant, I. (2008). HIV-associated prospective memory impairment increases risk of dependence in everyday functioning. Neuropsychology, 22, 110-117.), a well-validated measure of prospective memory, and the Medical Outcomes Study Pain Effects Scale (PES; Fischer, J. S., Rudick, R. A., Cutter, G. R., & Reingold, S. C. (1999). The multiple sclerosis functional composite measure (MSFC): An integrated approach to MS clinical outcome assessment. National MS Society Clinical Outcomes Assessment Task Force. Multiple Sclerosis, 5, 244-250.) to assess chronic pain. After controlling for demographic variables and disability severity, subjective pain accounted for significant variance in PM, particularly for time-based intentions over sustained delay periods. These data accord well with assertions that pain may degrade ability to remember new intentions and suggests that pain is associated with PM dysfunction in people with MS. PMID:25338929

  17. The effectiveness of a self-management occupational therapy intervention on activity performance in individuals with multiple sclerosis-related fatigue: a randomized-controlled trial.

    Kos, Daphne; Duportail, Marijke; Meirte, Jill; Meeus, Mira; D'hooghe, Marie B; Nagels, Guy; Willekens, Barbara; Meurrens, Tom; Ilsbroukx, Stephan; Nijs, Jo

    2016-09-01

    Purpose to evaluate the effectiveness of an individual self-management occupational therapy intervention program (SMOoTh) versus relaxation on the performance of and satisfaction with relevant daily activities in individuals with multiple sclerosis (MS)-related fatigue. in a single-blind randomized-controlled trial, 31 patients with MS (SMOoTh: n=17, relaxation: n=14) were randomly allocated to three individual sessions focusing on pacing, prioritizing, ergonomics, and self-management (SMOoTh) or on stress management and relaxation (relaxation). Outcomes (blind assessor): Canadian Occupational Performance Measure (COPM) (primary), Modified Fatigue Impact Scale, Checklist Individual Strength and Short-Form Health Measure. COPM improved in the SMOoTh and relaxation group after the intervention and 3 months later (COPM performance: F=13.1, P=0.001 and COPM satisfaction: F=10.4, P=0.001); nonsignificant group differences showed a trend in favor of SMOoTh. Modified Fatigue Impact Scale, Checklist Individual Strength, and most of the Short-Form Health Measure subscales did not change. Clinically relevant changes in COPM performance scores were found in 71 and 27% of patients in the SMOoTh versus the relaxation group. Both interventions seem to be feasible approaches to improve performance of and satisfaction with relevant daily activities in people with MS, with a sustained effect after 3 months. Neither program altered change fatigue (impact) or quality of life. Future studies with larger sample sizes are needed. PMID:27182847

  18. Longitudinal changes in self-reported walking ability in multiple sclerosis.

    Robert W Motl

    Full Text Available Patient-reported outcomes are increasingly used to understand the clinical meaningfulness of multiple sclerosis disability and its treatments. For example, the 12-item Multiple Sclerosis Walking Scale (MSWS-12 measures the patient-reported impact of the disease on walking ability.We studied longitudinal changes in walking ability using the MSWS-12 in a cohort of 108 patients with relapsing-remitting multiple sclerosis and moderate-to-severe disability from a single US center cohort study investigating multiple sclerosis symptoms and physical activity.The MSWS-12 was completed every 6 months over 2 years together with self-reported measures of disease impact on daily life (Multiple Sclerosis Impact Scale and walking disability (Patient Determined Disease Steps scale.The results revealed a high frequency of self-reported changes in walking ability at the individual level, affecting approximately 80% of patients for all four time periods. MSWS-12 scores remained stable at the group level for all four time periods. The magnitude of observed changes at the individual level was higher than the proposed minimal clinically important differences of 4 or 6 points and correlated better with Multiple Sclerosis Impact Scale physical scores than psychological scores, but little with self-reported Patient Determined Disease Steps Scale scores.This novel finding of frequent fluctuations in self-reported walking ability is new and requires further investigation.

  19. Longitudinal Changes in Self-Reported Walking Ability in Multiple Sclerosis

    Motl, Robert W.; Putzki, Norman; Pilutti, Lara A.; Cadavid, Diego

    2015-01-01

    Background Patient-reported outcomes are increasingly used to understand the clinical meaningfulness of multiple sclerosis disability and its treatments. For example, the 12-item Multiple Sclerosis Walking Scale (MSWS-12) measures the patient-reported impact of the disease on walking ability. Objective We studied longitudinal changes in walking ability using the MSWS-12 in a cohort of 108 patients with relapsing-remitting multiple sclerosis and moderate-to-severe disability from a single US center cohort study investigating multiple sclerosis symptoms and physical activity. Methods The MSWS-12 was completed every 6 months over 2 years together with self-reported measures of disease impact on daily life (Multiple Sclerosis Impact Scale) and walking disability (Patient Determined Disease Steps scale). Results The results revealed a high frequency of self-reported changes in walking ability at the individual level, affecting approximately 80% of patients for all four time periods. MSWS-12 scores remained stable at the group level for all four time periods. The magnitude of observed changes at the individual level was higher than the proposed minimal clinically important differences of 4 or 6 points and correlated better with Multiple Sclerosis Impact Scale physical scores than psychological scores, but little with self-reported Patient Determined Disease Steps Scale scores. Conclusions This novel finding of frequent fluctuations in self-reported walking ability is new and requires further investigation. PMID:25932911

  20. Systemic Inflammation in Progressive Multiple Sclerosis Involves Follicular T-Helper, Th17- and Activated B-Cells and Correlates with Progression

    Romme Christensen, Jeppe; Börnsen, Lars; Ratzer, Rikke;

    2013-01-01

    Pathology studies of progressive multiple sclerosis (MS) indicate a major role of inflammation including Th17-cells and meningeal inflammation with ectopic lymphoid follicles, B-cells and plasma cells, the latter indicating a possible role of the newly identified subset of follicular T-helper (TF...... pathogenic role of systemic inflammation in progressive MS. These observations may have implications for the treatment of progressive MS....

  1. [Mitoxantrone role in treatment of primary progressive multiple sclerosis].

    Pastuszak, Żanna; Stępień, Adam; Tomczykiewicz, Kazimierz; Piusińska-Macoch, Renata; Durka-Kęsy, Marta

    2016-01-01

    Multiple sclerosis is a chronic, autoimmunological disease of central nervous system in which axonal damage in brain and spinal cord is observed. It is second most common cause of disability in young adults in West Europe and North America after injuries. There is 2.5 million people suffered from multiple sclerosis worldwide. The worse prognosis is connected with primary progressive MS in which recovery after first symptoms of central nervous system damage isn't observed. That subtype of disease is seen in case of 10-20% people with MS. MTX is a synthetic antracycline with antineoplastic, immunomodulatory and anti-inflammatory effects. Drug was allowed to treatment of leukemia. It is also used in treatment of breast, prostate, ovarian, stomach and liver cancer. Additionally MTX is used in treatment of secondary progressive SM and relapsing - remitting subtype of disease with no respond to treatment with interferon beta and glatiramer acetate. MTX inhibits topoisomerase II activity, matches to DNA molecule and damage her structure. Drug inhibits limphocyte T, B and macrophages activity and antibodies synthesis. The most dangerous side effects of MTX treatment are cardiotoxicity and induction of leukemia. There is lack of studies describing MTX effectiveness and safety in treatment of primary progressive SM. PMID:26891441

  2. Dimethyl fumarate: a new oral treatment option for multiple sclerosis

    Sarjana S. Atal

    2013-12-01

    Full Text Available Multiple Sclerosis (MS is a slowly progressive, immunologically mediated disease of the CNS. The recent years have witnessed great efforts in establishing new therapeutic options for multiple sclerosis. There is a clear need for more effective, safe and at the same time orally available treatment options. Here we review the recently approved drug Dimethyl fumarate (DMF, Tecfidera® as a new therapeutic option for MS and its role in context to the existing oral treatment options for MS. Dimethyl fumarate is the methyl ester of fumaric acid and has been claimed to possess immunomodulatory properties and is already in clinical use as Fumaderm for severe systemic psoriasis. In addition, Dimethyl fumarate was also shown to act on the blood-brain barrier and exert neuroprotective properties via activation of anti-oxidative pathways and displayed beneficial effects in experimental autoimmune encephalomyelitis (EAE, a model mimicking many aspects of MS. Based on two global phase III studies. Dimethyl fumarate has been clinically proven to significantly reduce important measures of disease activity, including relapses and development of brain lesions, as well as to slow disability progression over time, while demonstrating a favourable safety and tolerability profile. [Int J Basic Clin Pharmacol 2013; 2(6.000: 849-856

  3. Physical activity and quality of life in multiple sclerosis: Intermediary roles of disability, fatigue, mood, pain, self-efficacy and social support

    Motl, Robert W.; McAuley, Edward; Snook, Erin M.; Gliottoni, Rachael C.

    2009-01-01

    Physical activity has been associated with a small improvement in quality of life (QOL) among those with multiple sclerosis (MS). This relationship may be indirect and operate through factors such as disability, fatigue, mood, pain, self-efficacy and social support. The present study examined variables that might account for the relationship between physical activity and QOL in a sample (N = 292) of individuals with a definite diagnosis of MS. The participants wore an accelerometer for 7 days and then completed self-report measures of physical activity, QOL, disability, fatigue, mood, pain, self-efficacy and social support. The data were analysed using covariance modelling in Mplus 3.0. The model provided an excellent fit for the data (χ2 = 51.33, df = 18, p < 0.001, standardised root mean squared residual = 0.03, comparative fit index = 0.98). Those who were more physically active reported lower levels of disability (γ = -0.50), depression (γ = -0.31), fatigue (γ = -0.46) and pain (γ = -0.19) and higher levels of social support (γ = 0.20), self-efficacy for managing MS (γ = 0.41), and self-efficacy for regular physical activity (γ = 0.49). In turn, those who reported lower levels of depression (β = -0.37), anxiety (β = -0.15), fatigue (β = -0.16) and pain (β = -0.08) and higher levels of social support (β = 0.26) and self-efficacy for controlling MS (β = 0.17) reported higher levels of QOL. The observed pattern of relationships supports the possibility that physical activity is indirectly associated with improved QOL in individuals with MS via depression, fatigue, pain, social support and self-efficacy for managing MS. PMID:19085318

  4. [The Multiple Sclerosis Documentation System MSDS. Discussion of a documentation standard for multiple sclerosis].

    Pette, M; Eulitz, M

    2002-02-01

    The MSDS (multiple sclerosis documentation system) has been developed at the Department of Neurology, Technical University of Dresden, Germany, during the last 4 years. The first version of this database application has been in use since October 2000. The MSDS manages information on MS patients, their treating physicians, patient history (symptoms, other diseases, biographical history, family history, habits, medication), clinical signs, results of laboratory examinations (blood chemistry, autoantibodies, borrelia serology, evoked potentials, cranial and spinal cord magnetic resonance imaging), clinical scores relevant for MS, and biosamples. In principle, MSDS allows online data input and semiautomatically generates reports to all general practitioners and neurologists treating the respective patient. Patient information sheets and internal treatment guidelines are part of the system. During a 3-month evaluation, the first version of MSDS was tested at eight university multiple sclerosis ambulatory care units and one general neurology hospital. The overall judgement was favorable. Suggestions for changes and improvements, as well as practical experiences, were considered when developing MSDS 2.0, which will be available by the end of 2001. PMID:11975090

  5. Development of Activity-Related Muscle Fatigue during Robot-Mediated Upper Limb Rehabilitation Training in Persons with Multiple Sclerosis: A Pilot Trial

    Johanna Renny Octavia

    2015-01-01

    Full Text Available Robot-assisted rehabilitation facilitates high-intensity training of the impaired upper limb in neurological rehabilitation. It has been clinically observed that persons with Multiple Sclerosis (MS have difficulties in sustaining the training intensity during a session due to the development of activity-related muscle fatigue. An experimental observational pilot study was conducted to examine whether or not the muscle fatigue develops in MS patients during one session of robot-assisted training within a virtual learning environment. Six MS patients with upper limb impairment (motricity index ranging from 50 to 91/100 and six healthy persons completed five training bouts of three minutes each performing lifting tasks, while EMG signals of anterior deltoid and lower trapezius muscles were measured and their subjective perceptions on muscle fatigue were registered. Decreased performance and higher subjective fatigue perception were present in the MS group. Increased mean EMG amplitudes and subjective perception levels on muscle fatigue were observed in both groups. Muscle fatigue development during 15′ training has been demonstrated in the arm of MS patients, which influences the sustainability of training intensity in MS patients. To optimize the training performance, adaptivity based on the detection of MS patient’s muscle fatigue could be provided by means of training program adjustment.

  6. Development of Activity-Related Muscle Fatigue during Robot-Mediated Upper Limb Rehabilitation Training in Persons with Multiple Sclerosis: A Pilot Trial

    2015-01-01

    Robot-assisted rehabilitation facilitates high-intensity training of the impaired upper limb in neurological rehabilitation. It has been clinically observed that persons with Multiple Sclerosis (MS) have difficulties in sustaining the training intensity during a session due to the development of activity-related muscle fatigue. An experimental observational pilot study was conducted to examine whether or not the muscle fatigue develops in MS patients during one session of robot-assisted training within a virtual learning environment. Six MS patients with upper limb impairment (motricity index ranging from 50 to 91/100) and six healthy persons completed five training bouts of three minutes each performing lifting tasks, while EMG signals of anterior deltoid and lower trapezius muscles were measured and their subjective perceptions on muscle fatigue were registered. Decreased performance and higher subjective fatigue perception were present in the MS group. Increased mean EMG amplitudes and subjective perception levels on muscle fatigue were observed in both groups. Muscle fatigue development during 15′ training has been demonstrated in the arm of MS patients, which influences the sustainability of training intensity in MS patients. To optimize the training performance, adaptivity based on the detection of MS patient's muscle fatigue could be provided by means of training program adjustment. PMID:26090229

  7. Serum antibodies to 25 myelin oligodendrocyte glycoprotein epitopes in multiple sclerosis and neuromyelitis optica: clinical value for diagnosis and disease activity

    XU Yan; ZHANG Yao; LIU Cai-yan; PENG Bin; WANG Jian-ming; ZHANG Xiao-jun; LI Hai-feng; CUI Li-ying

    2012-01-01

    Background Whether antibody to myelin oligodendrocyte glycoprotein (MOG) can be a diagnostic marker for multiple sclerosis (MS) is still controversial.Recent studies suggested that serum specific anti-MOG epitope antibody might be an MS specific marker.However,these studies did not include neuromyelitis optica (NMO) which might be proven to also have anti-MOG antibody.Hence,the present study was undertaken to investigate the clinical value of serum antibodies to 25 MOG epitopes in conventional MS (CMS) and NMO.Methods Serum anti-MOG epitope IgG was detected in 61 CMS patients,54 NMO patients,and 77 healthy controls,using enzyme-linked immunosorbent assay (ELISA).Results Anti-MOG27-38 IgG levels in both CMS and NMO patients were significantly higher than that in healthy controls (optical density (OD):0.64±0.38,0.48±0.23 vs.0.19±0.09; P=0.000).CMS and NMO patients in relapse stage had significantly higher anti-MOG27-38 IgG level than patients in remission stage (OD:0.55±0.14 vs.0.24±0.09,P=0.027).Conclusion Although serum anti-MOG epitope IgG could not differentiate MS from NMO,it may be a useful marker for monitoring disease activity.

  8. Early detection of multiple sclerosis: MR findings during the initial manifestations of multiple sclerosis

    The MR results in 21 patients showing the initial manifestations of multiple sclerosis (MS) were compared with those in 45 patients with a long history of MS. As in the old cases, MR proved a very sensitive technique during the early manifestations, with abnormal findings in 20 out of 21 patients. The relatively characteristic MR findings in long-standing MS (predominant peri-ventricular involvement with a relatively typical pattern) was seen in the early stages is only rare cases. The value of MR during the initial manifestations of MS is in cases where the clinical findings are not conclusive and laboratory diagnosis (evoked potentials, CSF findings) are indefinite. In these patients the finding of multiple lesions in the brain can confirm the suspected diagnosis of MS. (orig.)

  9. Altered thalamic functional connectivity in multiple sclerosis

    Highlights: •We demonstrated decreased connectivity between thalamus and cortical regions in MS. •Increased intra- and inter-thalamic connectivity was also observed in MS. •The increased functional connectivity is attenuated by increasing disease duration. -- Abstract: Objective: To compare thalamic functional connectivity (FC) in patients with multiple sclerosis (MS) and healthy controls (HC), and correlate these connectivity measures with other MRI and clinical variables. Methods: We employed resting-state functional MRI (fMRI) to examine changes in thalamic connectivity by comparing thirty-five patients with MS and 35 age- and sex-matched HC. Thalamic FC was investigated by correlating low frequency fMRI signal fluctuations in thalamic voxels with voxels in all other brain regions. Additionally thalamic volume fraction (TF), T2 lesion volume (T2LV), EDSS and disease duration were recorded and correlated with the FC changes. Results: MS patients were found to have a significantly lower TF than HC in bilateral thalami. Compared to HC, the MS group showed significantly decreased FC between thalamus and several brain regions including right middle frontal and parahippocampal gyri, and the left inferior parietal lobule. Increased intra- and inter-thalamic FC was observed in the MS group compared to HC. These FC alterations were not correlated with T2LV, thalamic volume or lesions. In the MS group, however, there was a negative correlation between disease duration and inter-thalamic connectivity (r = −0.59, p < 0.001). Conclusion: We demonstrated decreased FC between thalamus and several cortical regions, while increased intra- and inter-thalamic connectivity in MS patients. These complex functional changes reflect impairments and/or adaptations that are independent of T2LV, thalamic volume or presence of thalamic lesions. The negative correlation between disease duration and inter-thalamic connectivity could indicate an adaptive role of thalamus that is

  10. Dietary Pattern and Risk of Multiple Sclerosis

    Mahdi Aloosh

    2012-01-01

    Full Text Available Background:It has been suggested that nutrition might play a role in the etiology of multiple sclerosis (MS. However,dietary patterns associated with MS risk are unknown. This study was conducted to compare the dietary patterns of patients with MS and healthy controls to find the relationship between dietary patterns and MS.Methods:Usual dietary intake of 75 women with relapsing/remitting MS (RRMS and 75 healthy controls were assessed with a food frequency questionnaire consisting of 168 food items. To define major dietary patterns, we used factor analysis. Multivariate logistic regression was used to assess the relationship between dietary patterns and risk of MS.Results:Traditional pattern (high in low-fat dairy products,red meat, vegetable oil, onion, whole grain, soy, refined grains, organ meats, coffee, and legumes was inversely related to the risk of MS [odds ratio (OR = 0.15; 95%confidence interval (CI: 0.03-0.18; P = 0.028]. A similar inverse relationship was noted between MS risk andlacto-vegetarian (high in nuts, fruits, French fries, coffee,sweets and desserts, vegetables, and high-fat dairy products and vegetarian (high in green leafy vegetables, hydrogenated fats, tomato, yellow vegetables, fruit juices, onion, and other vegetablespatterns (OR = 0.31; 95% CI: 0.12-0.82; P = 0.018 and OR = 0.42; 95% CI: 0.19-0.90; P = 0.026, respectively. In contrast, the prevalence of MS was higher in those who had high animal fat dietary pattern (high in animal fats,potato, meat products, sugars, and hydrogenated fats and low in whole grains (OR = 1.99; 95% CI: 1.63-2.94;P < 0.005.Conclusion:Our findings showed that the risk of RRMS can be affected by major dietary patterns.

  11. Epigenetics of multiple sclerosis: an updated review.

    Küçükali, Cem İsmail; Kürtüncü, Murat; Çoban, Arzu; Çebi, Merve; Tüzün, Erdem

    2015-06-01

    Multiple sclerosis (MS) is an inflammatory and neurodegenerative disease characterized with autoimmune response against myelin proteins and progressive axonal loss. The heterogeneity of the clinical course and low concordance rates in monozygotic twins have indicated the involvement of complex heritable and environmental factors in MS pathogenesis. MS is more often transmitted to the next generation by mothers than fathers suggesting an epigenetic influence. One of the possible reasons of this parent-of-origin effect might be the human leukocyte antigen-DRB1*15 allele, which is the major risk factor for MS and regulated by epigenetic mechanisms such as DNA methylation and histone deacetylation. Moreover, major environmental risk factors for MS, vitamin D deficiency, smoking and Ebstein-Barr virus are all known to exert epigenetic changes. In the last few decades, compelling evidence implicating the role of epigenetics in MS has accumulated. Increased or decreased acetylation, methylation and citrullination of genes regulating the expression of inflammation and myelination factors appear to be particularly involved in the epigenetics of MS. Although much less is known about epigenetic factors causing neurodegeneration, epigenetic mechanisms regulating axonal loss, apoptosis and mitochondrial dysfunction in MS are in the process of identification. Additionally, expression levels of several microRNAs (miRNAs) (e.g., miR-155 and miR-326) are increased in MS brains and potential mechanisms by which these factors might influence MS pathogenesis have been described. Certain miRNAs may also be potentially used as diagnostic biomarkers in MS. Several reagents, especially histone deacetylase inhibitors have been shown to ameliorate the symptoms of experimental allergic encephalomyelitis. Ongoing efforts in this field are expected to result in characterization of epigenetic factors that can be used in prediction of treatment responsive MS patients, diagnostic screening panels

  12. Perceived Behavioral Changes in Early Multiple Sclerosis

    Fabiana Souza Lima

    2007-01-01

    Full Text Available Acquired behavioral changes have essentially been described in advanced multiple sclerosis (MS. The present study was designed to determine whether behavioral modifications specifically related to the MS pathological process could be identified in the initial phase of the disease, as compared to control patients with chronic, relapsing and progressive inflammatory disorders not involving the central nervous system (CNS. Eighty-eight early MS patients (Expanded Disability Status Scale score ≤ 2.5 and 48 controls were tested. Perceived changes by informants in behavioral control, goal-directed behavior, decision making, emotional expression, insight and interpersonal relationships were assessed using the Iowa Scale of Personality Change (ISPC. Executive behavioral disturbances were screened using the Dysexecutive Questionnaire (DEX. The mean change between the premorbid and postmorbid ISPC ratings was similar in the MS [12.2 (SD 15.6] and in the control [11.5 (SD 15.1] group. The perceived behavioral changes (PBCs most frequently reported in both groups were lack of stamina, lability/moodiness, anxiety, vulnerability to stress and irritability. Pathological scores in the DEX were also similar in both groups. Correlations between PBCs and DEX scores were different in MS and control groups. MS patients with cognitive impairment had a marginally higher number of PBCs than control patients (p = 0.056 and a significantly higher DEXp score (p = 0.04. These results suggest that (1 PBCs occurring in early MS patients were not different from those induced by comparable chronic non-CNS disorders, (2 qualitative differences in the relationship between behavioral symptoms and executive-behavioral changes may exist between MS and control groups, and (3 behavioral symptoms seem associated with cognitive deficits in MS. We further plan to assess these observations longitudinally.

  13. Altered thalamic functional connectivity in multiple sclerosis

    Liu, Yaou; Liang, Peipeng; Duan, Yunyun; Huang, Jing; Ren, Zhuoqiong; Jia, Xiuqin [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Dong, Huiqing; Ye, Jing [Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Shi, Fu-Dong [Department of Neurology and Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin 300052 (China); Butzkueven, Helmut [Department of Medicine, University of Melbourne, Parkville 3010 (Australia); Li, Kuncheng, E-mail: kunchengli55@gmail.com [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China)

    2015-04-15

    Highlights: •We demonstrated decreased connectivity between thalamus and cortical regions in MS. •Increased intra- and inter-thalamic connectivity was also observed in MS. •The increased functional connectivity is attenuated by increasing disease duration. -- Abstract: Objective: To compare thalamic functional connectivity (FC) in patients with multiple sclerosis (MS) and healthy controls (HC), and correlate these connectivity measures with other MRI and clinical variables. Methods: We employed resting-state functional MRI (fMRI) to examine changes in thalamic connectivity by comparing thirty-five patients with MS and 35 age- and sex-matched HC. Thalamic FC was investigated by correlating low frequency fMRI signal fluctuations in thalamic voxels with voxels in all other brain regions. Additionally thalamic volume fraction (TF), T2 lesion volume (T2LV), EDSS and disease duration were recorded and correlated with the FC changes. Results: MS patients were found to have a significantly lower TF than HC in bilateral thalami. Compared to HC, the MS group showed significantly decreased FC between thalamus and several brain regions including right middle frontal and parahippocampal gyri, and the left inferior parietal lobule. Increased intra- and inter-thalamic FC was observed in the MS group compared to HC. These FC alterations were not correlated with T2LV, thalamic volume or lesions. In the MS group, however, there was a negative correlation between disease duration and inter-thalamic connectivity (r = −0.59, p < 0.001). Conclusion: We demonstrated decreased FC between thalamus and several cortical regions, while increased intra- and inter-thalamic connectivity in MS patients. These complex functional changes reflect impairments and/or adaptations that are independent of T2LV, thalamic volume or presence of thalamic lesions. The negative correlation between disease duration and inter-thalamic connectivity could indicate an adaptive role of thalamus that is

  14. Modifiable factors influencing relapses and disability in multiple sclerosis.

    D'hooghe, M B; Nagels, G; Bissay, V; De Keyser, J

    2010-07-01

    A growing body of literature indicates that the natural course of multiple sclerosis can be influenced by a number of factors. Strong evidence suggests that relapses can be triggered by infections, the postpartum period and stressful life events. Vaccinations against influenza, hepatitis B and tetanus appear to be safe. Surgery, general and epidural anaesthesia, and physical trauma are not associated with an increased risk of relapses. Factors that have been associated with a reduced relapse rate are pregnancy, exclusive breastfeeding, sunlight exposure and higher vitamin D levels. A number of medications, including hormonal fertility treatment, seem to be able to trigger relapses. Factors that may worsen progression of disability include stressful life events, radiotherapy to the head, low levels of physical activity and low vitamin D levels. Strong evidence suggests that smoking promotes disease progression, both clinically and on brain magnetic resonance imaging. There is no evidence for an increased progression of disability following childbirth in women with multiple sclerosis. Moderate alcohol intake and exercise might have a neuroprotective effect, but this needs to be confirmed. PMID:20483884

  15. Magnetic resonance imaging of spinal lesions in multiple sclerosis

    We were able to detect spinal lesions by MRI (magnetic resonance imaging) in three cases of multiple sclerosis with suspected cervical spinal lesions. In two cases MRI was examined during relapse. MRI revealed marked swelling of the spinal cord. The lesions had low MRI-signal intensity in inversion-recovery images and high signal intensity in T2-weighted spin-echo images. As symptoms improved, a later MRI revealed that the spinal cord became thinner and signal intensity normalized. Prolongation of T1 relaxation time is said to be useful in evaluating lesion activity, but from our observations, T2-weighted images were more effective in detecting the earliest lesions of multiple sclerosis. We thought the MRI changes were due to edema because the time course of proton relaxation time resembled that in the experimental studies of brain edema reported previously and because in one case the swelling of the spinal cord and high signal areas on spin-echo image disappeared so rapidly in response to anti-edema therapy. In the last case MRI was examined in the remission phase. Although the spinal cord was almost normal in size, skip lesions of low signal intensity on the inversion-recovery image were detected, and we were still able to find high signal areas on spin-echo image. We supposed these might be lesions full of foamy cells, but further investigation is necessary to clarify the meaning of MRI in remission phase. (author)

  16. Clinical correlates of grey matter pathology in multiple sclerosis

    Horakova Dana

    2012-03-01

    Full Text Available Abstract Traditionally, multiple sclerosis has been viewed as a disease predominantly affecting white matter. However, this view has lately been subject to numerous changes, as new evidence of anatomical and histological changes as well as of molecular targets within the grey matter has arisen. This advance was driven mainly by novel imaging techniques, however, these have not yet been implemented in routine clinical practice. The changes in the grey matter are related to physical and cognitive disability seen in individuals with multiple sclerosis. Furthermore, damage to several grey matter structures can be associated with impairment of specific functions. Therefore, we conclude that grey matter damage - global and regional - has the potential to become a marker of disease activity, complementary to the currently used magnetic resonance markers (global brain atrophy and T2 hyperintense lesions. Furthermore, it may improve the prediction of the future disease course and response to therapy in individual patients and may also become a reliable additional surrogate marker of treatment effect.

  17. A Longitudinal Study of Disability, Cognition and Gray Matter Atrophy in Early Multiple Sclerosis Patients According to Evidence of Disease Activity.

    Gro O Nygaard

    Full Text Available New treatment options may make "no evidence of disease activity" (NEDA: no relapses or disability progression and no new/enlarging MRI lesions, as opposed to "evidence of disease activity" (EDA with at least one of the former, an achievable goal in relapsing-remitting multiple sclerosis (RRMS. The objective of the present study was to determine whether early RRMS patients with EDA at one-year follow-up had different disability, cognition, treatment and gray matter (GM atrophy rates from NEDA patients and healthy controls (HC. RRMS patients (mean age 34 years, mean disease duration 2.2 years were examined at baseline and one-year follow-up with neurological (n = 72, neuropsychological (n = 56 and structural MRI (n = 57 examinations. Matched HC (n = 61 were retested after three years. EDA was found in 46% of RRMS patients at follow-up. EDA patients used more first line and less second line disease modifying treatment than NEDA (p = 0.004. While the patients groups had similar disability levels at baseline, they differed in disability at follow-up (p = 0.010; EDA patients progressed (EDSS: 1.8-2.2, p = 0.010, while NEDA patients improved (EDSS: 2.0-1.7, p<0.001. Cognitive function was stable in both patient groups. Subcortical GM atrophy rates were higher in EDA patients than HC (p<0.001. These results support the relevance of NEDA as outcome in RRMS and indicate that pathological neurodegeneration in RRMS mainly occur in patients with evidence of disease activity.

  18. Vision and vision-related outcome measures in multiple sclerosis

    Balcer, Laura J; Miller, David H; Reingold, Stephen C;

    2015-01-01

    to the afferent visual pathway. Abnormal eye movements also are common in multiple sclerosis, but quantitative assessment methods that can be applied in practice and clinical trials are not readily available. We summarize here a comprehensive literature search and the discussion at a recent international meeting......Visual impairment is a key manifestation of multiple sclerosis. Acute optic neuritis is a common, often presenting manifestation, but visual deficits and structural loss of retinal axonal and neuronal integrity can occur even without a history of optic neuritis. Interest in vision in multiple...... of investigators involved in the development and study of visual outcomes in multiple sclerosis, which had, as its overriding goals, to review the state of the field and identify areas for future research. We review data and principles to help us understand the importance of vision as a model for outcomes...

  19. Long-term effect of early treatment with interferon beta-1b after a first clinical event suggestive of multiple sclerosis: 5-year active treatment extension of the phase 3 BENEFIT trial

    Kappos, Ludwig; Freedman, Mark S; Polman, Chris H; Edan, Gilles; Hartung, Hans-Peter; Miller, David H; Montalbán, Xavier; Barkhof, Frederik; Radü, Ernst-Wilhelm; Metzig, Carola; Bauer, Lars; Lanius, Vivian; Sandbrink, Rupert; Pohl, Christoph; Battistini, Jette Lautrup

    2009-01-01

    BACKGROUND: The Betaferon/Betaseron in newly emerging multiple sclerosis for initial treatment (BENEFIT) trial investigated the effect of treatment with interferon beta-1b after a clinically isolated syndrome. The 5-year active treatment extension compares the effects of early and delayed treatme...... favourable long-term safety and tolerability profile support early initiation of treatment with interferon beta-1b, although a delay in treatment by up to 2 years did not affect long-term disability outcomes. FUNDING: Bayer Schering Pharma....... after randomisation. Patients and study personnel remained unaware of initial treatment allocation throughout the study. Primary endpoints were time to CDMS, time to confirmed disability progression measured with the expanded disability status scale, and the functional assessment of multiple sclerosis...

  20. Vision and vision-related outcome measures in multiple sclerosis.

    Balcer, Laura J; Miller, David H; Reingold, Stephen C; Cohen, Jeffrey A

    2015-01-01

    Visual impairment is a key manifestation of multiple sclerosis. Acute optic neuritis is a common, often presenting manifestation, but visual deficits and structural loss of retinal axonal and neuronal integrity can occur even without a history of optic neuritis. Interest in vision in multiple sclerosis is growing, partially in response to the development of sensitive visual function tests, structural markers such as optical coherence tomography and magnetic resonance imaging, and quality of life measures that give clinical meaning to the structure-function correlations that are unique to the afferent visual pathway. Abnormal eye movements also are common in multiple sclerosis, but quantitative assessment methods that can be applied in practice and clinical trials are not readily available. We summarize here a comprehensive literature search and the discussion at a recent international meeting of investigators involved in the development and study of visual outcomes in multiple sclerosis, which had, as its overriding goals, to review the state of the field and identify areas for future research. We review data and principles to help us understand the importance of vision as a model for outcomes assessment in clinical practice and therapeutic trials in multiple sclerosis. PMID:25433914

  1. Luteolin as a therapeutic option for multiple sclerosis

    Theoharides Theoharis C

    2009-10-01

    Full Text Available Abstract Multiple sclerosis (MS remains without an effective treatment in spite of intense research efforts. Interferon-beta (IFN-β reduces duration and severity of symptoms in many relapsing-remitting MS patients, but its mechanism of action is still not well understood. Moreover, IFN-β and other available treatments must be given parenterally and have a variety of adverse effects. Certain naturally occurring flavonoids, such as luteolin, have anti-oxidant and anti-inflammatory effects, including inhibition of activated peripheral blood leukocytes from MS patients. Luteolin also inhibits mast cells, as well as mast cell-dependent T cell activation, recently implicated in MS pathogenesis. Moreover, luteolin and structurally similar flavonoids can inhibit experimental allergic allergic encephalomyelitis (EAE, an animal model of MS in rodents. An appropriate luteolin formulation that permits sufficient absorption and reduces its metabolism could be a useful adjuvant to IFN-β for MS therapy.

  2. Association of celiac disease with multiple sclerosis

    Abolfazli.R

    2007-09-01

    Full Text Available   Background: Multiple sclerosis (MS and the gluten intolerance disease, celiac disease, (CD are immune-mediated diseases. Better testing for antibodies associated with CD, including anti-gliadin antibody [AGA], as well as anti-endomysial and anti-tissue transglutaminase antibodies, has improved the diagnosis of CD. Certain neurologic conditions have a reported association with CD. Previous researchers have investigated the role of a gluten-free diet in the treatment of MS and found no benefits. Here, we investigate the possible immunological association of CD with MS.Methods: Using ELISA, we estimated serum IgG and IgA anti-gliadin and IgA anti-endomysial antibodies in 34 MS patients, who were new or previous cases without immunosuppressant treatment for at least the last six months. The mean age was 29.6 years (range 15-46 years, with 30 patients relapsing-remitting, and four secondary-progressive MS. Thirty-four random anonymous blood donors were used as serologic controls (mean age 31.4 years, range 19-50 years. The individuals in both groups with elevated AGA (IgG or IgA or anti-endomysial antibody (IgA underwent duodenal biopsy.Results: In the MS group, high levels of IgG AGA were found in 5.9% of the subjects, and 5.9% had elevated IgA AGA. In the controls, elevated IgG AGA was detected in 5.9% of the subjects and IgA AGA in 2.9% (p=0.051 and 0.48, respectively. For IgG and IgA AGA levels, no significant differences were found between the patient and control groups. IgA anti-endomysial antibodies were not found in either group. Upon biopsy, the specific pathological features of celiac were absent.Conclusion: The same number of MS patients and controls had high levels of AGA, with normal levels of IgA anti-endomysial antibodies, which is more specific for CD, while the GI biopsies from both groups were not specific for CD. Therefore, AGA levels in any neurologic case should be interpreted with caution. The present study showed no

  3. MR in the diagnosis and monitoring of multiple sclerosis: An overview

    Multiple sclerosis is a chronic, persistent inflammatory-demyelinating disease of the central nervous system that typically presents as an acute clinically isolated syndrome attributable to a monofocal or multifocal demyelinating lesion, which usually affects the optic nerve, spinal cord, or brainstem and cerebellum. Although the diagnosis of multiple sclerosis is still based on clinical findings, magnetic resonance imaging is now integrated in the overall diagnostic scheme of the disease because of its unique sensitivity to demonstrate the spatial and temporal dissemination of demyelinating plaques in the brain and spinal cord. Conventional magnetic resonance imaging techniques, such as T2-weighted and gadolinium-enhanced T1-weighted sequences are highly sensitive in detecting multiple sclerosis plaques and provide a quantitative assessment of inflammatory activity and lesion load. However, there is a persisting mismatch between clinical and magnetic resonance imaging efficacy of approved treatments, which underlies the fact that this technique does not suffice to explain the entire spectrum of the disease process. In recent years, great effort has been dedicated to overcoming these limitations by using non-conventional magnetic resonance-derived metrics that can selectively measure the more destructive aspects of multiple sclerosis pathology and monitor the reparative mechanisms. These metrics, which include unenhanced T1-weighted imaging, measures of central nervous system atrophy, magnetization transfer imaging, proton magnetic resonance spectroscopy, diffusion-weighted imaging, and functional magnetic resonance imaging, provide a better approximation of the pathological substrate of the multiple sclerosis plaques, have increased our understanding of the pathogenesis of the disease, and have proven useful for studying the natural history of multiple sclerosis and monitoring the effects of new treatments. Therefore, magnetic resonance imaging not only plays an

  4. Sibship characteristics and risk of multiple sclerosis

    Bager, Peter; Nielsen, Nete Munk; Bihrmann, Kristine;

    2006-01-01

    Sclerosis Register. The cohort of 1.9 million Danes was followed for 28.1 million person-years; during that time, 1,036 persons developed MS. Overall, there was no association between number of older siblings, number of younger siblings, total number of siblings, age distance from the nearest younger...

  5. Activation of endogenous retrovirus reverse transcriptase in multiple sclerosis patient lymphocytes by inactivated HSV-1, HHV-6 and VZV

    Brudek, Tomasz; Luhdorf, P; Christensen, Tove;

    2007-01-01

    factors in HERV activation. We demonstrate the ability of HSV-1, HHV-6, and VZV antigens to induce higher RT activity in peripheral lymphocytes from MS patients vs. controls during the first 6 days post-antigen stimulation. On subsequent days, only VZV can sustain the increase in the RT expression in...

  6. Mechanisms and pharmacology of neuropathic pain in multiple sclerosis.

    Iannitti, T; Kerr, B J; Taylor, B K

    2014-01-01

    The neuropathic pain of multiple sclerosis is quite prevalent and severely impacts quality of life. A few randomized, placebo-controlled, blinded clinical trials suggest that cannabis- and anticonvulsant-based treatments provide partial pain relief, but at the expense of adverse events. An even smaller, but emerging, number of translational studies are using rodent models of experimental autoimmune encephalomyelitis (EAE), which exhibit pain-like behaviors resembling those of Multiple sclerosis (MS) patients. These studies not only support the possible effectiveness of anticonvulsants, but also compel further clinical trials with serotonin-norepinephrine reuptake inhibitors, the immunosuppressant drug rapamycin, or drugs which interfere with glutamatergic neurotransmission. Future behavioral studies in EAE models are essential toward a new pharmacotherapy of multiple sclerosis pain. PMID:24590824

  7. Non-invasive examination of multiple sclerosis patients

    Multiple sclerosis is characterized by a wide range of symptoms and, in many cases, by a highly erratic course. As a result diagnosis is often a problem. Two non-invasive examinations, Computer Tomography (CT scan) and the Evoked Response test (ER), are the subjects of this study which, according to available literature, both can play a role in the establishment of the diagnosis of multiple sclerosis. Clinical trials have been performed and both methods demonstrated abnormalities of the central nervous system which were not suspected on clinical grounds; as a result both methods of examination can contribute to the early establishment of the diagnosis of multiple sclerosis. In addition the diagnosis can be determined with greater certainty when the findings of the CT-scan and the evoked response test are taken into consideration. (Auth.)

  8. Spinal-cord swelling in acute multiple sclerosis

    Despite the frequent involvement of the spinal cord by multiple sclerosis, reports concerning neuroradiological findings regarding these lesions have been limited; most of them have demonstrated a normal or small spinal cord. Two cases of acute paraparesis showed evidence of spinal-cord swelling on myelography and CT myelography, initially suggesting the diagnosis of an intramedullary tumor. Spinal-cord swelling was demonstrated more clearly on CT myelography than on conventional myelography. The diagnosis of multiple sclerosis was made with the aid of the CSF findings, the clinical course, and the contracting-cord sign. The ''contracting-cord sign'' means the diminution of the spinal-cord diameter in the chronic stage. Since acute multiple sclerosis may produce spinal-cord swelling simulating a tumor, careful investigations are necessary to avoid unwarranted surgical interventions. (author)

  9. Molecular Approach to Targeted Therapy for Multiple Sclerosis.

    Sherbet, Gajanan V

    2016-01-01

    The development and evolution of targeted therapy to any disease require the identification of targets amenable to treatment of patients. Here the pathogenetic signalling systems involved in multiple sclerosis are scrutinised to locate nodes of deregulation and dysfunction in order to devise strategies of drug development for targeted intervention. Oliogoclonal bands (OCB) are isoelectric focusing profiles of immunoglobulins synthesised in the central nervous system. OCBs enable the diagnosis of multiple sclerosis with high sensitivity and specificity and are related to the course of the disease and progression. The OCB patterns can be linked with the expression of angiogenic molecular species. Angiogenic signalling which has also been implicated in demyelination provides the option of using angiogenesis inhibitors in disease control. The PI3K (phosphoinositide 3-kinase)/Akt axis has emerged with a key role in myelination with its demonstrable links with mTOR mediated transcription of downstream target genes. Inflammatory signals and innate and acquired immunity from the activation of NF-κB (nuclear factor κB) responsive genes are considered. NF-κB signalling could be implicated in myelination. The transcription factor STAT (signal transducers and activators of transcription) and the EBV (Epstein- Barr virus) transcription factor BZLF1 contributing significantly to the disease process are a major environmental factor linked to MS. EBV can activate TGF (transforming growth factor) and VEGF (vascular endothelial growth factor) signalling. EBV microRNAs are reviewed as signalling mediators of pathogenesis. Stem cell transplantation therapy has lately gained much credence, so the current status of mesenchymal and hematopoietic stem cell therapy is reviewed with emphasis on the differential expression immune-related genes and operation of signalling systems. PMID:26560895

  10. {sup 11}C-PBR28 imaging in multiple sclerosis patients and healthy controls: test-retest reproducibility and focal visualization of active white matter areas

    Park, Eunkyung; Gallezot, Jean-Dominique; Planeta, Beata; Lin, Shu-Fei; Lim, Keunpoong; Chen, Ming-Kai; Huang, Yiyun; Carson, Richard E. [Yale School of Medicine, PET Center, Department of Diagnostic Radiology, 801 Howard Avenue, PO Box 208048, New Haven, CT (United States); Delgadillo, Aracely; Liu, Shuang; O' Connor, Kevin C.; Lee, Jae-Yun; Chastre, Anne; Pelletier, Daniel [Yale School of Medicine, Department of Neurology, New Haven, CT (United States); Seneca, Nicholas; Leppert, David [Hoffmann-La Roche Ltd, Pharmaceuticals Division, Basel (Switzerland)

    2015-04-02

    Activated microglia play a key role in inflammatory demyelinating injury in multiple sclerosis (MS). Microglial activation can be measured in vivo using a positron emission tomography (PET) ligand {sup 11}C-PBR28. We evaluated the test-retest variability (TRV) and lesion detectability of {sup 11}C-PBR28 binding in MS subjects and healthy controls (HCs) with high-resolution PET. Four clinically and radiologically stable relapsing-remitting MS subjects (age 41 ± 7 years, two men/two women) and four HCs (age 42 ± 8 years, 2 two men/two women), matched for translocator protein genotype [two high- and two medium-affinity binders according to DNA polymorphism (rs6971) in each group], were studied for TRV. Another MS subject (age 41 years, male) with clinical and radiological activity was studied for lesion detectability. Dynamic data were acquired over 120 min after injection of 634 ± 101 MBq {sup 11}C-PBR28. For the TRV study, subjects were scanned twice, on average 1.4 weeks apart. Volume of distribution (V{sub T}) derived from multilinear analysis (MA1) modeling (t* = 30 min, using arterial input data) was the main outcome measure. Mean test V{sub T} values (ml cm{sup -3}) were 3.9 ± 1.4 in the whole brain gray matter (GM), 3.6 ± 1.2 in the whole brain white matter (WM) or normal-appearing white matter (NAWM), and 3.3 ± 0.6 in MS WM lesions; mean retest V{sub T} values were 3.7 ± 1.0 in GM, 3.3 ± 0.9 in WM/NAWM, and 3.3 ± 0.7 in MS lesions. Test-retest results showed a mean absolute TRV ranging from 7 to 9 % across GM, WM/NAWM, and MS lesions. High-affinity binders demonstrated 30 % higher V{sub T} than medium-affinity binders in GM. Focal {sup 11}C-PBR28 uptake was detected in two enhancing lesions of the active MS patient. High-resolution {sup 11}C-PBR28 PET can visualize focal areas where microglial activation is known to be present and has good test-retest reproducibility in the human brain. {sup 11}C-PBR28 PET is likely to be valuable for monitoring both

  11. 11C-PBR28 imaging in multiple sclerosis patients and healthy controls: test-retest reproducibility and focal visualization of active white matter areas

    Activated microglia play a key role in inflammatory demyelinating injury in multiple sclerosis (MS). Microglial activation can be measured in vivo using a positron emission tomography (PET) ligand 11C-PBR28. We evaluated the test-retest variability (TRV) and lesion detectability of 11C-PBR28 binding in MS subjects and healthy controls (HCs) with high-resolution PET. Four clinically and radiologically stable relapsing-remitting MS subjects (age 41 ± 7 years, two men/two women) and four HCs (age 42 ± 8 years, 2 two men/two women), matched for translocator protein genotype [two high- and two medium-affinity binders according to DNA polymorphism (rs6971) in each group], were studied for TRV. Another MS subject (age 41 years, male) with clinical and radiological activity was studied for lesion detectability. Dynamic data were acquired over 120 min after injection of 634 ± 101 MBq 11C-PBR28. For the TRV study, subjects were scanned twice, on average 1.4 weeks apart. Volume of distribution (VT) derived from multilinear analysis (MA1) modeling (t* = 30 min, using arterial input data) was the main outcome measure. Mean test VT values (ml cm-3) were 3.9 ± 1.4 in the whole brain gray matter (GM), 3.6 ± 1.2 in the whole brain white matter (WM) or normal-appearing white matter (NAWM), and 3.3 ± 0.6 in MS WM lesions; mean retest VT values were 3.7 ± 1.0 in GM, 3.3 ± 0.9 in WM/NAWM, and 3.3 ± 0.7 in MS lesions. Test-retest results showed a mean absolute TRV ranging from 7 to 9 % across GM, WM/NAWM, and MS lesions. High-affinity binders demonstrated 30 % higher VT than medium-affinity binders in GM. Focal 11C-PBR28 uptake was detected in two enhancing lesions of the active MS patient. High-resolution 11C-PBR28 PET can visualize focal areas where microglial activation is known to be present and has good test-retest reproducibility in the human brain. 11C-PBR28 PET is likely to be valuable for monitoring both MS disease evolution and response to therapeutic strategies that

  12. Complement component C3 and butyrylcholinesterase activity are associated with neurodegeneration and clinical disability in multiple sclerosis.

    Shahin Aeinehband

    Full Text Available Dysregulation of the complement system is evident in many CNS diseases but mechanisms regulating complement activation in the CNS remain unclear. In a recent large rat genome-wide expression profiling and linkage analysis we found co-regulation of complement C3 immediately downstream of butyrylcholinesterase (BuChE, an enzyme hydrolyzing acetylcholine (ACh, a classical neurotransmitter with immunoregulatory effects. We here determined levels of neurofilament-light (NFL, a marker for ongoing nerve injury, C3 and activity of the two main ACh hydrolyzing enzymes, acetylcholinesterase (AChE and BuChE, in cerebrospinal fluid (CSF from patients with MS (n = 48 and non-inflammatory controls (n = 18. C3 levels were elevated in MS patients compared to controls and correlated both to disability and NFL. C3 levels were not induced by relapses, but were increased in patients with ≥9 cerebral lesions on magnetic resonance imaging and in patients with progressive disease. BuChE activity did not differ at the group level, but was correlated to both C3 and NFL levels in individual samples. In conclusion, we show that CSF C3 correlates both to a marker for ongoing nerve injury and degree of disease disability. Moreover, our results also suggest a potential link between intrathecal cholinergic activity and complement activation. These results motivate further efforts directed at elucidating the regulation and effector functions of the complement system in MS, and its relation to cholinergic tone.

  13. Can multiple sclerosis as a cognitive disorder influence patients’ dreams?

    Abdorreza Naser Moghadasi; Mahsa Owji

    2013-01-01

    Dream should be considered as a kind of cognitive ability that is formed parallel to other cognitive capabilities like language. On the other hand, multiple sclerosis (MS) is a complex disease that can involve different aspects of our cognition. Therefore, MS may influence patients’ dreams. In fact, we do not know what the importance of dream is in MS, but further studies may introduce dream and dreaming as a sign of improvement or progression in MS disease.Multiple sclerosis (MS) is a diseas...

  14. New potent and selective inhibitors of anandamide reuptake with antispastic activity in a mouse model of multiple sclerosis

    Ligresti, Alessia; Cascio, Maria Grazia; Pryce, Gareth; Kulasegram, Sanjitha; Beletskaya, Irina; De Petrocellis, Luciano; Saha, Bijali; Mahadevan, Anu; Visintin, Cristina; Wiley, Jenny L.; Baker, David; Martin, Billy R.; Razdan, Raj K.; Di Marzo, Vincenzo

    2005-01-01

    We previously reported that the compound O-2093 is a selective inhibitor of the reuptake of the endocannabinoid anandamide (AEA). We have now re-examined the activity of O-2093 in vivo and synthesized four structural analogs (O-2247, O-2248, O-3246, and O-3262), whose activity was assessed in: (a) binding assays carried out with membranes from cells overexpressing the human CB1 and CB2 receptors; (b) assays of transient receptor potential of the vanilloid type-1 (TRPV1) channel functional act...

  15. Evaluation of the Needs of Patients with Multiple Sclerosis

    Ali Dehghani

    2012-09-01

    Full Text Available Background: Multiple sclerosis (MS is a demyelinating disease of the central nervous system that causes many problems in patients. Since training should be done in according to the educational needs, this study is performed to assess the educational needs of MS patients.Materials and Methods: This is a descriptive cross-sectional study, and its tool was a questionnaire on the educational needs of MS patients. Fifty patients referred to the MS society were selected through simple sampling.Results: Based on the obtained results, 60% of patients were female, 52% were single, and 16% were high school undergraduates. Seventy-eight percent of the patients needed training about disease nature, 82% about treatment and care, 46% about nutrition, and 32% about physical activity.Conclusion: The findings showed that patients need more education about treatment and self-care.

  16. High-throughput sequencing of immune repertoires in multiple sclerosis.

    Lossius, Andreas; Johansen, Jorunn N; Vartdal, Frode; Holmøy, Trygve

    2016-04-01

    T cells and B cells are crucial in the initiation and maintenance of multiple sclerosis (MS), and the activation of these cells is believed to be mediated through specific recognition of antigens by the T- and B-cell receptors. The antigen receptors are highly polymorphic due to recombination (T- and B-cell receptors) and mutation (B-cell receptors) of the encoding genes, which can therefore be used as fingerprints to track individual T- and B-cell clones. Such studies can shed light on mechanisms driving the immune responses and provide new insights into the pathogenesis. Here, we summarize studies that have explored the T- and B-cell receptor repertoires using earlier methodological approaches, and we focus on how high-throughput sequencing has provided new knowledge by surveying the immune repertoires in MS in even greater detail and with unprecedented depth. PMID:27081660

  17. Cladribine tablets for relapsing-remitting multiple sclerosis

    Rammohan, Kottil; Giovannoni, Gavin; Comi, Giancarlo; Cook, Stuart; Rieckmann, Peter; Soelberg Sørensen, Per; Vermersch, Patrick; Hamlett, Anthony; Kurukulasuriya, Nuwan

    2012-01-01

    BACKGROUND: In the phase III CLARITY study, treatment with cladribine tablets at cumulative doses of 3.5 or 5.25mg/kg over 96 weeks led to significant reductions in annualized relapse rates (ARR) versus placebo in patients with relapsing-remitting multiple sclerosis. Further post hoc analyses of...... CLARITY study data were conducted to determine the efficacy of cladribine tablets across patient subgroups stratified by baseline characteristics. METHODS: Relapse rates over the 96-week CLARITY study were analyzed in cohorts stratified by demographics; disease duration; treatment history and disease...... activity at baseline. RESULTS: In the intent-to-treat population (n=437, 433 and 456 in the placebo, cladribine 3.5 and 5.25mg/kg groups, respectively), treatment with cladribine tablets 3.5 and 5.25mg/kg led to consistent improvements in ARR versus placebo in patients stratified by gender; age (≤40...

  18. Extracellular vesicles in multiple sclerosis: what are they telling us?

    Matías eSáenz-Cuesta

    2014-03-01

    Full Text Available Extracellular vesicles (EVs are membrane-bound particles secreted by almost all cell types. They are classified depending on their biogenesis and size into exosomes and microvesicles or according to their cell origin. EVs play a role in cell-to-cell communication, including contact-free cell synapsis, carrying active membrane proteins, lipids, and genetic material both inside the particle and on their surface. They have been related to several physiological and pathological conditions. In particular, increasing concentrations of EVs have been found in many autoimmune diseases including multiple sclerosis (MS. MS is a central nervous system demyelinating disease characterized by relapsing of symptoms followed by periods of remission. Close interaction between endothelial cells, leukocytes, monocytes and cells from central nervous system is crucial for the development of MS. This review summarizes the pathological role of EVs in MS and the relationship of EVs with clinical characteristics, therapy and biomarkers of the disease.

  19. Mitochondrial dysfunction contributes to neurodegeneration in multiple sclerosis.

    Witte, Maarten E; Mahad, Don J; Lassmann, Hans; van Horssen, Jack

    2014-03-01

    Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. Current treatments are very effective in reducing the neuroinflammatory attack, but fail to significantly halt disease progression and associated loss of neuronal tissue. In recent years, it has become increasingly clear that dysfunctional mitochondria are important contributors to damage and loss of both axons and neurons. Observations in animal and histopathological studies suggest that infiltrating leukocytes and activated microglia play a central role in neuronal mitochondrial dysfunction. This review provides a comprehensive overview on the current knowledge regarding mitochondrial dysfunction in MS. Importantly, more insight into the cause and consequences of impaired mitochondrial function provide a basis for mitochondrial-targeted medicine to combat progressive MS. PMID:24369898

  20. Reduced brain functional reserve and altered functional connectivity in patients with multiple sclerosis.

    Cader, Sarah; Cifelli, Alberto; Abu-Omar, Yasir; Palace, Jacqueline; Matthews, Paul M

    2006-02-01

    Cognitive dysfunction (affecting particularly attention and working memory) occurs early in patients with multiple sclerosis. Previous studies have focused on identifying potentially adaptive functional reorganization through recruitment of new brain regions that could limit expression of these deficits. However, lesion studies remind us that functional specializations in the brain make certain brain regions necessary for a given task. We therefore have asked whether altered functional interactions between regions normally recruited provide an alternative adaptive mechanism with multiple sclerosis pathology. We used a version of the n-back task to probe working memory in patients with early multiple sclerosis. We applied a functional connectivity analysis to test whether relationships between relative activations in different brain regions change in potentially adaptive ways with multiple sclerosis. We studied 21 patients with relapsing-remitting multiple sclerosis and 16 age- and sex-matched healthy controls with 3T functional MRI. The two groups performed equally well on the task. Task-related activations were found in similar regions for patients and controls. However, patients showed relatively reduced activation in the superior frontal and anterior cingulate gyri (P > 0.01). Patients also showed a variable, but generally substantially smaller increase in activation than healthy controls with greater task complexity, depending on the specific brain region assessed (P memory. Functional connectivity analysis suggests that altered inter-hemispheric interactions between dorsal and lateral prefrontal regions may provide an adaptive mechanism that could limit clinical expression of the disease distinct from recruitment of novel processing regions. Together, these results suggest that therapeutic enhancement of the coherence of interactions between brain regions normally recruited (functional enhancement), as well as recruitment of alternative areas or use of

  1. Can we prevent or treat multiple sclerosis by individualised vitamin D supply?

    Dörr Jan

    2013-01-01

    Full Text Available Abstract Apart from its principal role in bone metabolism and calcium homeostasis, vitamin D has been attributed additional effects including an immunomodulatory, anti-inflammatory, and possibly even neuroprotective capacity which implicates a possible role of vitamin D in autoimmune diseases like multiple sclerosis (MS. Indeed, several lines of evidence including epidemiologic, preclinical, and clinical data suggest that reduced vitamin D levels and/or dysregulation of vitamin D homeostasis is a risk factor for the development of multiple sclerosis on the one hand, and that vitamin D serum levels are inversely associated with disease activity and progression on the other hand. However, these data are not undisputable, and many questions regarding the preventive and therapeutic capacity of vitamin D in multiple sclerosis remain to be answered. In particular, available clinical data derived from interventional trials using vitamin D supplementation as a therapeutic approach in MS are inconclusive and partly contradictory. In this review, we summarise and critically evaluate the existing data on the possible link between vitamin D and multiple sclerosis in light of the crucial question whether optimization of vitamin D status may impact the risk and/or the course of multiple sclerosis.

  2. Multiple Sclerosis: Hope Through Research | NIH MedlinePlus the Magazine

    ... of this page please turn Javascript on. Feature: Multiple Sclerosis Hope Through Research Past Issues / Spring 2012 Table ... that television journalist Neil Cavuto was diagnosed with multiple sclerosis (MS) more than 15 years ago. And that ...

  3. Blockade of Ca2+-activated K+ channels in T cells: an option for the treatment of multiple sclerosis?

    Madsen, Lars Siim; Christophersen, Palle; Olesen, Søren-Peter

    2005-01-01

    Voltage- and Ca(2+)-dependent K(+) channels in the membrane of both T and B lymphocytes are important for the cellular immune response. In the current issue of the European Journal of Immunology, Reich et al. demonstrate that selective blockade of the intermediate-conductance Ca(2+)-activated K(+...... of new immune-suppressant drugs for the treatment of autoimmune diseases.......(+) channel (the IK channel encoded by the KCNN4 gene) prevents cytokine production in the spinal chord and ameliorates the development of EAE caused by injection of myelin oligodendrocyte glycoprotein (MOG)(35-55) in mice. These data renew the focus on the IK channel as a potential target for the development...

  4. Drugs in development for relapsing multiple sclerosis.

    Ali, Rehiana; Nicholas, Richard St John; Muraro, Paolo Antonio

    2013-05-01

    Drug development for multiple sclerosis (MS), as with any other neurological disease, faces numerous challenges, with many drugs failing at various stages of development. The disease-modifying therapies (DMTs) first introduced for MS are only moderately effective, but given the lack of competition, they have been widely accepted in clinical practice. Although safety and efficacy continue to be the two main metrics by which drugs will be judged, the newer agents in the market also face challenges of a more comparative nature-are they more efficacious than the currently available drugs on the market? Are they safer or better tolerated? Do they offer any practical advantages over current treatments? Fingolimod represented a milestone following its approval as an oral drug for MS in 2010, offering patients a far more convenient administration route. However, association with cardiovascular complications has led to a more cautious approach in its initial prescribing, now requiring cardiac monitoring for the first 6 h as well as subsequent monitoring of blood pressure and for macular oedema. Natalizumab, amongst licensed drugs, represents the current benchmark for efficacy. The risk of progressive multifocal leukoencephalopathy during natalizumab treatment is now more quantifiable. Other monoclonal antibodies are in various phases of development. Marketing authorisation for alemtuzumab has been filed, and whilst trial data suggest that its efficacy outperforms both licensed drugs and others in development, there is a significant risk of secondary autoimmunity. Its once-yearly administration, however, seems particularly advantageous. Rituximab is unlikely to be developed further as its license will expire, but ocrelizumab, another monoclonal antibody directly targeting B cells, is currently in phase 2 development and looks promising. Daclizumab is also moderately efficacious but may struggle to establish itself given its monthly subcutaneous dosing. There are new oral

  5. Advances in the management of multiple sclerosis spasticity: multiple sclerosis spasticity guidelines.

    Gold, Ralf; Oreja-Guevara, Celia

    2013-12-01

    Symptomatic therapy of multiple sclerosis (MS) is an important part of a comprehensive treatment plan that aims to improve patients' quality of life. In the current era of medical progress, several factors have led to the development of guidelines for MS management. There is continued need for an evidence-based approach supported by high-quality data from controlled clinical trials. Most healthcare systems require this approach and include it in the reimbursement process. Guidelines are usually committed by national or continental neurological societies. The Spanish Society of Neurology demyelinating diseases working group has developed a consensus document on spasticity in patients with MS. MS experts from the group used the metaplan method to sum up the most important recommendations about spasticity for inclusion in the guidance. Recommendations were classified according to the Scottish Intercollegiate Guidelines Network system and approved by all members of the group. In Germany, the guideline panel of the German Neurological Society endorsed the national competence network for multiple sclerosis (Krankheitsbezogenes Kompetenznetz Multiple Sklerose) to update the existing recommendations. The most recent fifth edition of the guidelines (dated April 2012) now also includes recommendations for treatment of key symptoms such as spasticity. More than 30 MS neurologists contributed to the new edition reflecting the need for broad expertise. After a first round in which key topics were defined, a web-based decision process was undertaken to further develop individual topics such as symptomatic therapy. The draft manuscript was reviewed once again by the group prior to submission to the official review process. The aims of spasticity treatment are to improve mobility and dexterity, achieve physiological movement patterns, reduce pain, facilitate nursing measures and avoid complications such as contractures. Representative antispasticity medications include baclofen

  6. Effect of 12-Week Pilates Trainning on EDSS in Women Suffering fromMultiple Sclerosis

    Z Shanazari; SM Marandi; S Samie

    2013-01-01

    Abstract Background & aim: Multiple sclerosis is a debilitating disease that strikes the immune system. Multiple sclerosis is a chronic disease which debilitates the nervous system. The study was evaluated the effects of Pilates exercise on women with physical disabilities suffering from multiple sclerosis for 12 weeks .The aim of this study was to investigating the effects of Pilates trainning on EDSS of women suffering from Multiple Sclerosis (MS) for 12 weeks. Methods: In the pres...

  7. PPAR-γ: Therapeutic Potential for Multiple Sclerosis

    Michael K. Racke

    2008-06-01

    Full Text Available The role of peroxisome proliferator-activated receptors (PPARs in altering lipid and glucose metabolism is well established. More recent studies indicate that PPARs also play critical roles in controlling immune responses. We and others have previously demonstrated that PPAR-γ agonists modulate the development of experimental autoimmune encephalomyelitis (EAE, an animal model of multiple sclerosis (MS. This review will discuss the cellular and molecular mechanisms by which these agonists are believed to modulate disease. The therapeutic potential of PPAR-γ agonists in the treatment of multiple sclerosis will also be considered.

  8. Advances in and Algorithms for the Treatment of Relapsing-Remitting Multiple Sclerosis.

    Ingwersen, Jens; Aktas, Orhan; Hartung, Hans-Peter

    2016-01-01

    Treatment options in relapsing-remitting multiple sclerosis have increased considerably in recent years; currently, a dozen different preparations of disease-modifying therapies are available and some more are expected to be marketed soon. For the treating neurologist this broad therapeutic repertoire not only greatly improves individualized management of the disease, but also makes choices more complex and difficult. A number of factors must be considered, including disease activity and severity, safety profile, and patient preference. We here discuss the currently existing options and suggest treatment algorithms for managing relapsing-remitting multiple sclerosis. PMID:26701666

  9. Disease-modifying therapies in relapsing–remitting multiple sclerosis

    Fabricio González-Andrade

    2010-07-01

    Full Text Available Fabricio González-Andrade1, José Luis Alcaraz-Alvarez21Department of Medicine, Metropolitan Hospital, Quito, Ecuador; 2School of Medicine, University of Mayab, Merida, MexicoClinical question: What is the best current disease-modifying therapy for relapsing–remitting multiple sclerosis?Results: The evidence shows that the most effective disease-modifying therapy for delaying short- to medium-term disability progression, prevention of relapses, reducing the area and activity of lesions on magnetic resonance imaging, with the least side effects, is high-dose, high-frequency subcutaneous interferon-β1a 44 μg three times per week.Implementation: The pitfalls in treatment of MS can be avoided by remembering the following points: • The most effective therapy to prevent or delay the appearance of permanent neurological disability with the fewest side effects should be chosen, and treatment should not be delayed.• Adherence to treatment should be monitored closely, and needs comprehensive patient information and education to establish long-term adherence, which is a critical determinant of long-term outcome.• The correct approach to the disease includes disease management, symptom management, and patient management. A combination of tools is necessary to ease the various symptoms, which fall into three broad categories, i.e. rehabilitation, pharmacological, and procedural.• It is important to understand that no treatment modality should be used alone, unless it is in itself sufficient to remedy the particular symptom/problem.Keywords: relapsing–remitting multiple sclerosis, interferon, disease-modifying therapy, relapse prevention

  10. Matrix Metalloproteinases in patients with Multiple Sclerosis. Metaloproteinasas de matriz en pacientes con esclerosis múltiple

    2007-01-01

    Fundament: The proteolitic rupture of the extracellular matrix due to metalloproteinase 2 and 9 is one of the aspects that can influence in the alteration of the permeability of the blood-brain barrier (BBB) in multiple sclerosis. Objective: To determine metalloproteinase activity with gelatinous activity in patients suffering from multiple sclerosis. Methods: the cerebrospinal fluid (CSF) samples taken fro...

  11. Cognitive-Linguistic Deficit and Speech Intelligibility in Chronic Progressive Multiple Sclerosis

    Mackenzie, Catherine; Green, Jan

    2009-01-01

    Background: Multiple sclerosis is a disabling neurological disease with varied symptoms, including dysarthria and cognitive and linguistic impairments. Association between dysarthria and cognitive-linguistic deficit has not been explored in clinical multiple sclerosis studies. Aims: In patients with chronic progressive multiple sclerosis, the…

  12. Protocol for the saMS trial (supportive adjustment for multiple sclerosis): a randomized controlled trial comparing cognitive behavioral therapy to supportive listening for adjustment to multiple sclerosis

    McCrone Paul; Roche Suzanne; Landau Sabine; Yardley Lucy; Dennison Laura; Moss-Morris Rona; Chalder Trudie

    2009-01-01

    Abstract Background Multiple Sclerosis (MS) is an incurable, chronic, potentially progressive and unpredictable disease of the central nervous system. The disease produces a range of unpleasant and debilitating symptoms, which can have a profound impact including disrupting activities of daily living, employment, income, relationships, social and leisure activities, and life goals. Adjusting to the illness is therefore particularly challenging. This trial tests the effectiveness of a Cognitiv...

  13. Fatigue characteristics in multiple sclerosis: the North American Research Committee on Multiple Sclerosis (NARCOMS survey

    Vollmer Timothy

    2008-11-01

    Full Text Available Abstract Background Fatigue is a common disabling symptom of multiple sclerosis (MS and has a significantly negative impact on quality of life. Persons with MS enrolled in the North American Research Committee on Multiple Sclerosis (NARCOMS Patient Registry are invited to complete follow-up surveys every six months to update their original registration information. One of these surveys was designed to focus on the severity and impact of fatigue, and its association with other clinical parameters of MS such as physical disability. Methods In addition to the usual data collected in Registry update surveys such as demographic characteristics, MS-related medical history, disability and handicap, immunomodulatory and symptomatic therapies taken, and healthcare services used, the survey for this study included two validated self-report fatigue scales, the Fatigue Severity Scale (FSS and the Modified Fatigue Impact Scale (MFIS and questions about the use of symptomatic management for fatigue, both pharmacologic and non-pharmacologic treatments. This Registry update survey was mailed to all NARCOMS registrants (n = 18,595 in November 2002. Information provided by registry participants was approved for research purposes by the Yale University Institutional Review Board. Results The response rate for the survey was 49.5% (9205/18,595. Severe fatigue as measured with the FSS using the developer's recommended severity cutpoint of ≥ 36 was reported by 6691 (74% of evaluable respondents (n = 9077. A higher prevalence of severe fatigue was observed in relapsing-worsening MS compared with relapsing-stable and primary progressive MS. A distinct pattern of fatigue was observed across the disability levels of the Patient-Determined Disease Steps (PDDS. Although there were no differences in the severity or impact of fatigue by immunomodulatory agents (IMA, respondents who recalled therapy changes in the prior six months reported different patterns of change in

  14. Selective association of multiple sclerosis with infectious mononucleosis

    Zaadstra, B.M.; Chorus, A.M.J.; Buuren, S. van; Kalsbeek, H.; Noort, J.M. van

    2008-01-01

    Previous studies have suggested an association between multiple sclerosis (MS) and infectious mononucleosis (IM) but data on the exact strength of this association or its selectivity have been conflicting. In this study we have evaluated the association between MS and a variety of common childhood i

  15. Modifiable factors influencing relapses and disability in multiple sclerosis

    D'hooghe, M. B.; Nagels, G.; Bissay, V.; De Keyser, J.

    2010-01-01

    A growing body of literature indicates that the natural course of multiple sclerosis can be influenced by a number of factors. Strong evidence suggests that relapses can be triggered by infections, the postpartum period and stressful life events. Vaccinations against influenza, hepatitis B and tetan

  16. Ocular flutter in suspected multiple sclerosis: a presenting paroxysmal manifestation.

    D. A. Francis; Heron, J. R.

    1985-01-01

    A patient with suspected multiple sclerosis is described who presented with attacks of blurring of vision and ocular flutter. This has not previously been reported as an isolated paroxysmal manifestation of brain stem demyelination. As with other paroxysmal disturbances ocular flutter may present as the first sign of the disease.

  17. Standardized cannabis in multiple sclerosis: a case report

    Hornby, Paul; Sharma, Manju

    2010-01-01

    A 52 year old female suffering from severe progressive multiple sclerosis was administered quantifiable amounts of standardized cannabis and monitored over the period of one year, while providing daily pain charts and records of her condition. An average daily intake of 500 mg of Tetrahydrocannabinol as cannabis was required to achieve a desired quality of life.

  18. Multiple sclerosis or neurological manifestations of Celiac disease

    Vahid Shaygannejad

    2013-01-01

    Full Text Available Multiple sclerosis (MS and celiac disease (CD are considered to be T-cell-mediated autoimmune disease. We discuss about a known case of CD-showed relapsing - remitting neurological symptoms compatible with MS. In this rare co-occurrence subject, MS-CD patient, the interaction between MS - and CD-related inflammatory processes is open to discussion.

  19. Selective association of multiple sclerosis with infectious monocleosis

    Zaadstra, B.; Chorus, A.M.J.; van Buuren, S.; Kalsbeek, H.; van Noort, J.M.

    2008-01-01

    Previous studies have suggested an association between multiple sclerosis (MS) and infectious mononucleosis (IM) but data on the exact strength of this association or its selectivity have been conflicting. In this study we have evaluated the association between MS and a variety of common childhood i

  20. Natalizumab plus interferon beta-1a for relapsing multiple sclerosis.

    Rudick, R.A.; Stuart, W.H.; Calabresi, P.A.; Confavreux, C.; Galetta, S.L.; Radue, E.W.; Lublin, F.D.; Weinstock-Guttman, B.; Wynn, D.R.; Lynn, F.; Panzara, M.A.; Sandrock, A.W.

    2006-01-01

    BACKGROUND: Interferon beta is used to modify the course of relapsing multiple sclerosis. Despite interferon beta therapy, many patients have relapses. Natalizumab, an alpha4 integrin antagonist, appeared to be safe and effective alone and when added to interferon beta-1a in preliminary studies. MET

  1. Conversion from clinically isolated syndrome to multiple sclerosis

    Kuhle, J; Disanto, G; Dobson, R;

    2015-01-01

    BACKGROUND AND OBJECTIVE: We explored which clinical and biochemical variables predict conversion from clinically isolated syndrome (CIS) to clinically definite multiple sclerosis (CDMS) in a large international cohort. METHODS: Thirty-three centres provided serum samples from 1047 CIS cases with...

  2. Risk for multiple sclerosis in dizygotic and monozygotic twins

    Hansen, Thomas; Skytthe, Axel; Stenager, Egon;

    2005-01-01

    We investigated the risks of twins for multiple sclerosis (MS). Our data are linked registers of all Danish twins and of all Danes born between 1920 and 1970 in whom MS was diagnosed before 1997. We compared differences in the risks for MS by Cox regression and standardized incidence ratios. Our ...

  3. Sun Exposure and Reduced Risk of Multiple Sclerosis

    J Gordon Millichap

    2008-09-01

    Full Text Available The association between red hair color (RHC melanocortin 1 receptor genotype, past environmental sun exposure, and risk of multiple sclerosis (MS was investigated in a population-based case-control study in Tasmania, Australia, involving 136 cases with MS and 272 controls.

  4. The role of the cerebellum in multiple sclerosis

    Weier, Katrin; Banwell, Brenda; Cerasa, Antonio;

    2015-01-01

    In multiple sclerosis (MS), cerebellar signs and symptoms as well as cognitive dysfunction are frequent and contribute to clinical disability with only poor response to symptomatic treatment. The current consensus paper highlights the broad range of clinical signs and symptoms of MS patients, which...

  5. The changing demographic pattern of multiple sclerosis epidemiology

    Koch-Henriksen, Nils; Sørensen, Per Soelberg

    2010-01-01

    The uneven distribution of multiple sclerosis (MS) across populations can be attributed to differences in genes and the environment and their interaction. Prevalence and incidence surveys could be affected by inaccuracy of diagnosis and ascertainment, and prevalence also depends on survival. These...

  6. Chronic cerebrospinal venous insufficiency and venous stenoses in multiple sclerosis

    Blinkenberg, M; Akeson, P; Sillesen, H;

    2012-01-01

    The traditional view that multiple sclerosis (MS) is an autoimmune disease has recently been challenged by the claim that MS is caused by chronic cerebrospinal venous insufficiency (CCSVI). Although several studies have questioned this vascular theory, the CCSVI controversy is still ongoing. Our...

  7. Survival of patients with multiple sclerosis in Denmark

    Brønnum-Hansen, Henrik; Koch-Henriksen, Nils; Hyllested, K

    1994-01-01

    We estimated survival probability and excess death rates for patients with MS on the basis of data from the Danish Multiple Sclerosis Registry, which includes virtually all patients diagnosed with MS in Denmark (population, five million) since 1948. We reviewed and reclassified all case records...

  8. The incidence and prevalence of psychiatric disorders in multiple sclerosis

    Marrie, Ruth Ann; Reingold, Stephen; Cohen, Jeffrey;

    2015-01-01

    BACKGROUND: Psychiatric comorbidity is associated with lower quality of life, more fatigue, and reduced adherence to disease-modifying therapy in multiple sclerosis (MS). OBJECTIVES: The objectives of this review are to estimate the incidence and prevalence of selected comorbid psychiatric...

  9. Monthly oral methylprednisolone pulse treatment in progressive multiple sclerosis

    Ratzer, Rikke; Iversen, Pernille; Börnsen, Lars;

    2016-01-01

    BACKGROUND: There is a large unmet need for treatments for patients with progressive multiple sclerosis (MS). Phase 2 studies with cerebrospinal fluid (CSF) biomarker outcomes may be well suited for the initial evaluation of efficacious treatments. OBJECTIVE: To evaluate the effect of monthly oral...

  10. Principles of a new treatment algorithm in multiple sclerosis

    Hartung, Hans-Peter; Montalban, Xavier; Sorensen, Per Soelberg;

    2011-01-01

    We are entering a new era in the management of patients with multiple sclerosis (MS). The first oral treatment (fingolimod) has now gained US FDA approval, addressing an unmet need for patients with MS who wish to avoid parenteral administration. A second agent (cladribine) is currently being...

  11. Clinical Relevance of Brain Volume Measures in Multiple Sclerosis

    De Stefano, Nicola; Airas, Laura; Grigoriadis, Nikolaos;

    2014-01-01

    Multiple sclerosis (MS) is a chronic disease with an inflammatory and neurodegenerative pathology. Axonal loss and neurodegeneration occurs early in the disease course and may lead to irreversible neurological impairment. Changes in brain volume, observed from the earliest stage of MS and...

  12. Statistical Analysis of Questionnaire on Physical Rehabilitation in Multiple Sclerosis

    Martinková, Patrícia; Řasová, K.

    -, č. 3 (2010), S340. ISSN 1210-7859. [Obnovené neuroimunologickjé a likvorologické dny. 21.05.2010-22.05.2010, Praha] R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : questionnaire * physical rehabilitation * multiple sclerosis Subject RIV: IN - Informatics, Computer Science

  13. Quantitative magnetic resonance imaging of cortical multiple sclerosis pathology

    Tardif, Christine L; Bedell, Barry J; Eskildsen, Simon Fristed;

    2012-01-01

    Although significant improvements have been made regarding the visualization and characterization of cortical multiple sclerosis (MS) lesions using magnetic resonance imaging (MRI), cortical lesions (CL) continue to be under-detected in vivo, and we have a limited understanding of the causes of GM...

  14. Permanent tremor reduction during thalamic stimulation in Multiple Sclerosis

    Thevathasan, Wesley; Schweder, Patrick; Joint, Carole; Ray, Nicola; Pretorius, Pieter; Gregory, Ralph; Aziz, Tipu

    2010-01-01

    Abstract Background: Unlike thalamic lesioning, thalamic stimulation is considered a reversible treatment for tremor. However, tremor in Multiple Sclerosis (MS) can sometimes permanently improve during thalamic stimulation. Such 'permanent tremor reduction' (PTR) has been attributed to limb weakness preventing tremor expression. In this study, eleven consecutive patients with MS tremor treated with thalamic stimulation were assessed for PTR. Eighteen upper limbs had tremor, of ...

  15. Reliability of Clinical Functioning Measures in Patients with Multiple Sclerosis

    Martinková, Patrícia; Šedová, Michaela; Řasová, K.

    Prague, 2009. s. 147-147. [ISCB 2009. Annual Conference /30./. 23.08.2009-27.08.2009, Prague] R&D Projects: GA MŠk(CZ) 1M06014 Grant ostatní: GA MZd(CZ) 1A8628 Institutional research plan: CEZ:AV0Z10300504 Keywords : multiple sclerosis * reliability * clinical functioning Subject RIV: IN - Informatics, Computer Science

  16. Exercise and Quality of Life in Women with Multiple Sclerosis

    Giacobbi, Peter R., Jr.; Dietrich, Frederick; Larson, Rebecca; White, Lesley J.

    2012-01-01

    The purpose of this study was to evaluate perceptions of quality of life after a 4-month progressive resistance training program for individuals with multiple sclerosis (MS). A second purpose was to examine participants' views about factors that facilitated or impeded exercise behavior. Qualitative interviews were conducted with eight females…

  17. Clinical Manifestations of Multiple Sclerosis in Taiwanese Children

    J Gordon Millichap

    2006-11-01

    Full Text Available Twenty-one patients with multiple sclerosis (MS and onset before 18 years were treated over the past 22 years and their records retrospectively analyzed at the National Taiwan University Hospital, Taipei, and Min-Sheng General Hospital, Taoyuan, Taiwan.

  18. Evaluating Functional Decline in Patients with Multiple Sclerosis

    Rosenblum, Sara; Weiss, Patrice L.

    2010-01-01

    Multiple Sclerosis (MS) is a disease with a wide-ranging impact on functional status. The aim of the study was to examine the added value of simultaneously evaluating fatigue, personal ADL and handwriting performance as indicators for functional decline among patients with MS. Participants were 50 outpatients with MS and 26 matched healthy…

  19. Childhood body mass index and multiple sclerosis risk

    Munger, Kassandra L; Bentzen, Joan; Laursen, Bjarne; Stenager, Egon; Koch-Henriksen, Nils Iørgen; Sørensen, Thorkild I. A.; Baker, Jennifer Lyn

    2013-01-01

    BACKGROUND: Obesity in late adolescence has been associated with an increased risk of multiple sclerosis (MS); however, it is not known if body size in childhood is associated with MS risk. METHODS: Using a prospective design we examined whether body mass index (BMI) at ages 7-13 years was...

  20. Intrathecal synthesis of free immunoglobulin light chains in multiple sclerosis

    Krakauer, M; Schaldemose Nielsen, H; Jensen, J; Sellebjerg, F

    1998-01-01

    OBJECTIVE: The detection of oligoclonal immunoglobulin free light chains (FLC) in the diagnosis of multiple sclerosis (MS) was compared to IgG isoelectric focusing. MATERIAL AND METHODS: Cerebrospinal fluid and serum samples from 69 patients with possible first attacks of MS, 50 patients with...

  1. Principles of a new treatment algorithm in multiple sclerosis

    Hartung, Hans-Peter; Montalban, Xavier; Sorensen, Per Soelberg; Vermersch, Patrick; Olsson, Tomas

    2011-01-01

    We are entering a new era in the management of patients with multiple sclerosis (MS). The first oral treatment (fingolimod) has now gained US FDA approval, addressing an unmet need for patients with MS who wish to avoid parenteral administration. A second agent (cladribine) is currently being con...

  2. Motivational and Volitional Variables Associated with Stages of Change for Exercise in Multiple Sclerosis: A Multiple Discriminant Analysis

    Chiu, Chung-Yi; Fitzgerald, Sandra D.; Strand, David M.; Muller, Veronica; Brooks, Jessica; Chan, Fong

    2012-01-01

    The main objective of this study was to determine whether motivational and volitional variables identified in the health action process approach (HAPA) model can be used to successfully differentiate people with multiple sclerosis (MS) in different stages of change for exercise and physical activity. Ex-post-facto design using multiple…

  3. MRI in the evaluation of pediatric multiple sclerosis.

    Banwell, Brenda; Arnold, Douglas L; Tillema, Jan-Mendelt; Rocca, Maria A; Filippi, Massimo; Weinstock-Guttman, Bianca; Zivadinov, Robert; Sormani, Maria Pia

    2016-08-30

    MRI plays a pivotal role in the diagnosis of multiple sclerosis (MS) in children, as it does in adults. The presence of multiple lesions in CNS locations commonly affected by MS, along with the presence of both enhancing and nonenhancing lesions, can facilitate a diagnosis of MS at the time of a first attack, whereas the accrual of serial lesions or new clinical attacks over time confirms the diagnosis in patients not meeting such criteria at onset. T2 and enhancing lesion accrual could serve as a primary outcome metric for pediatric MS clinical trials of selected therapies with anti-inflammatory activity in order to facilitate feasible trial size numbers. More-advanced MRI techniques reveal the impact of MS on tissue integrity within both T2-bright and T1-hypointense lesions and regions of normal-appearing tissue. Volumetric MRI analyses quantify the impact of MS on age-expected brain growth, and fMRI reveals activation and resting-state functional connectivity patterns in patients with pediatric MS that differ from those seen in healthy age-matched youth. Such studies are of critical importance because MS onset during childhood may profoundly influence maturing and actively myelinating neural networks. High-field MRI visualizes MS pathology at a near-microscopic level and has the potential to more fully explain mechanisms for cognitive impairment, fatigue, and disability in patients with pediatric MS. PMID:27572868

  4. Geographical and seasonal correlation of multiple sclerosis to sporadic schizophrenia

    Fritzsche Markus

    2002-12-01

    Full Text Available Abstract Background Clusters by season and locality reveal a striking epidemiological overlap between sporadic schizophrenia and multiple sclerosis (MS. As the birth excesses of those individuals who later in life develop schizophrenia mirror the seasonal distribution of Ixodid ticks, a meta analysis has been performed between all neuropsychiatric birth excesses including MS and the epidemiology of spirochaetal infectious diseases. Results The prevalence of MS and schizophrenic birth excesses entirely spares the tropical belt where human treponematoses are endemic, whereas in more temperate climates infection rates of Borrelia garinii in ticks collected from seabirds match the global geographic distribution of MS. If the seasonal fluctuations of Lyme borreliosis in Europe are taken into account, the birth excesses of MS and those of schizophrenia are nine months apart, reflecting the activity of Ixodes ricinus at the time of embryonic implantation and birth. In America, this nine months' shift between MS and schizophrenic births is also reflected by the periodicity of Borrelia burgdorferi transmitting Ixodes pacificus ticks along the West Coast and the periodicity of Ixodes scapularis along the East Coast. With respect to Ixodid tick activity, amongst the neuropsychiatric birth excesses only amyotrophic lateral sclerosis (ALS shows a similar seasonal trend. Conclusion It cannot be excluded at present that maternal infection by Borrelia burgdorferi poses a risk to the unborn. The seasonal and geographical overlap between schizophrenia, MS and neuroborreliosis rather emphasises a causal relation that derives from exposure to a flagellar virulence factor at conception and delivery. It is hoped that the pathogenic correlation of spirochaetal virulence to temperature and heat shock proteins (HSP might encourage a new direction of research in molecular epidemiology.

  5. Self-reported health promotion and disability progression in multiple sclerosis

    D'hooghe, Marie Beatrice; Nagels, Guy; De Keyser, Jacques; Haentjens, Patrick

    2013-01-01

    Background: Health behavior may be associated with disability progression in multiple sclerosis (MS). Objectives: To investigate health-promoting behavior as measured by the Health-Promoting Lifestyle Profile II, which includes the subscales of health responsibility, physical activity, nutrition, sp

  6. Menarche, oral contraceptives, pregnancy and progression of disability in relapsing onset and progressive onset multiple sclerosis

    D'hooghe, M. B.; Haentjens, P.; Nagels, G.; D'Hooghe, T.; De Keyser, J.

    2012-01-01

    Female gender and hormones have been associated with disease activity in multiple sclerosis (MS). We investigated age at menarche, use of oral contraceptives and pregnancy in relation to progression of disability in relapsing onset and progressive onset MS. We conducted a cross-sectional survey amon

  7. COBALT-55 POSITRON EMISSION TOMOGRAPHY IN RELAPSING-PROGRESSIVE MULTIPLE-SCLEROSIS

    JANSEN, HML; WILLEMSEN, ATM; SINNIGE, LGF; PAANS, AMJ; HEW, JM; FRANSSEN, EJF; ZORGDRAGER, AM; PRUIM, J; MINDERHOUD, JM; KORF, J

    1995-01-01

    Multiple sclerosis (MS) is an immune-mediated disease of the white matter in the brain that can have a progressive course. However, the progression of relapsing-remitting (RR) MS into relapsing-progressive (RP) MS might represent a more fundamental change in disease activity, i.e. decay of vulnerabl

  8. Cognitive function and neurophysiological correlates in relapsing-remitting multiple sclerosis

    Sundgren, Mathias

    2016-01-01

    Impaired cognitive function is a frequent consequence of multiple sclerosis (MS). It negatively affects vocational status, treatment adherence, physical independence, competence in activities of daily life, rehabilitation potential, driving safety and quality of life. All papers in this thesis concern cognitive function in relapsing-remitting MS (RRMS), with emphasis on clinical and neurophysiological predictors, moderating factors and the effect of natalizumab (NZ) treatment. ...

  9. Alemtuzumab for patients with relapsing multiple sclerosis after disease-modifying therapy

    Coles, Alasdair J; Twyman, Cary L; Arnold, Douglas L;

    2012-01-01

    The anti-CD52 monoclonal antibody alemtuzumab reduces disease activity in previously untreated patients with relapsing-remitting multiple sclerosis. We aimed to assess efficacy and safety of alemtuzumab compared with interferon beta 1a in patients who have relapsed despite first-line treatment....

  10. Natalizumab treatment for multiple sclerosis: updated recommendations for patient selection and monitoring

    Kappos, Ludwig; Bates, David; Edan, Gilles;

    2011-01-01

    Natalizumab, a highly specific a4-integrin antagonist, is approved for treatment of patients with active relapsing-remitting multiple sclerosis (RRMS). It is generally recommended for individuals who have not responded to a currently available first-line disease-modifying therapy or who have very...

  11. Natalizumab treatment for multiple sclerosis: updated recommendations for patient selection and monitoring

    Kappos, Ludwig; Bates, David; Edan, Gilles;

    2011-01-01

    Natalizumab, a highly specific α4-integrin antagonist, is approved for treatment of patients with active relapsing-remitting multiple sclerosis (RRMS). It is generally recommended for individuals who have not responded to a currently available first-line disease-modifying therapy or who have very...

  12. Natalizumab plus interferon beta-1a reduces lesion formation in relapsing multiple sclerosis

    Radue, Ernst-Wilhelm; Stuart, William H; Calabresi, Peter A;

    2010-01-01

    The SENTINEL study showed that the addition of natalizumab improved outcomes for patients with relapsing multiple sclerosis (MS) who had experienced disease activity while receiving interferon beta-1a (IFNbeta-1a) alone. Previously unreported secondary and tertiary magnetic resonance imaging (MRI...

  13. Cognitive-Behavioral Classifications of Chronic Pain in Patients with Multiple Sclerosis

    Khan, Fary; Pallant, Julie F.; Amatya, Bhasker; Young, Kevin; Gibson, Steven

    2011-01-01

    The aim of this study was to replicate, in patients with multiple sclerosis (MS), the three-cluster cognitive-behavioral classification proposed by Turk and Rudy. Sixty-two patients attending a tertiary MS rehabilitation center completed the Pain Impact Rating questionnaire measuring activity interference, pain intensity, social support, and…

  14. Clinical and radiographic spectrum of pathologically confirmed tumefactive multiple sclerosis

    Lucchinetti, C.F.; Gavrilova, R. H.; Metz, I.; Parisi, J.E.; Scheithauer, B. W.; Weigand, S.; Thomsen, K.; Mandrekar, J.; Altintas, A.; Erickson, B. J.; König, F.; C. Giannini; Lassmann, H; Linbo, L.; Pittock, S.J.

    2008-01-01

    Atypical imaging features of multiple sclerosis lesions include size >2 cm, mass effect, oedema and/or ring enhancement. This constellation is often referred to as ‘tumefactive multiple sclerosis’. Previous series emphasize their unifocal and clinically isolated nature, however, evolution of these lesions is not well defined. Biopsy may be required for diagnosis. We describe clinical and radiographic features in 168 patients with biopsy confirmed CNS inflammatory demyelinating disease (IDD). ...

  15. Environmental Factors and Multiple Sclerosis Severity: A Descriptive Study

    Daniele Mandia; Ferraro, Ottavia E.; Guido Nosari; Cristina Montomoli; Elisabetta Zardini; Roberto Bergamaschi

    2014-01-01

    Growing evidence suggests that environmental factors play a key role in the onset of multiple sclerosis (MS). This study was conducted to examine whether environmental factors may also be associated with the evolution of the disease. We collected data on smoking habits, sunlight exposure and diet (particularly consumption of vitamin D-rich foods) from a sample of 131 MS patients. We also measured their serum vitamin D concentration. The clinical impact of MS was quantified using the Multiple ...

  16. The evaluation of focal lesions with diffusion MRI in multiple sclerosis attack

    Çubuk R et al.

    2010-09-01

    Full Text Available Objective: We aimed to determine if there are quantifiable diffusion differences among focal multiple sclerosis lesions that appear differently on T1-weighted Magnetic Resonance images in MS patients with acute attack. Methods: Average apparent diffusion coefficient was calculated for 153 lesions identified on T2-weighted images in 15 patients with acute multiple sclerosis attack. One hundred and thirty-tree nonenhancing lesions (78 isointense, 55 hypointense and 20 enhancing lesions (5 isointense, 15 hypointense were categorized on the basis of un-enhanced T1-weighted images. Results: In 18 of 20 active lesions, which were seen in 9 patients, the contrast enhancement was homogeneous. White matter of multiple sclerosis patients showed significantly higher ADC than normal white matter (p=0.01. Hypointense non-enhancing lesions showed higher ADC values than isointense non-enhancing lesions (p<0.05. Diffusion in enhancing portions of enhancing lesions was decreased when compared with non-enhanced hypointense lesions. Conclusion: The data of our patients showed that hipointense lesions of non-active ones had higher ADC than active lesions with homogeneous contrast enhancement. These quantitative differences may indicate another easy and useful measurement in documenting acute multiple sclerosis attack.

  17. Emotional change-associated T cell mobilization at the early stage of a mouse model of multiple sclerosis

    Giuseppa ePiras; Lorenza eRattazzi; Adam eMcDermott; Robert eDeacon; Fulvio eD'acquisto

    2013-01-01

    Autoimmune diseases like multiple sclerosis are known to be associated with debilitating emotional disorders that manifest long before the flaring of motor dysfunctions. Given the emerging role of T cells in controlling both emotions and autoimmunity, in this study we explored possible correlation between T cell activation and changes in emotional behavior in a mouse model of multiple sclerosis. Our results showed a significant increase in blood circulating T cells as soon as at day 4 post-im...

  18. Parenteral Treatment of Multiple Sclerosis: The Advent of Monoclonal Antibodies.

    Singer, Barry A

    2016-04-01

    Improved disease control is critical for enhancing the lives of those living with multiple sclerosis. With specific immunologic targets, monoclonal antibody (mAb) treatments are highly effective options for relapsing forms of multiple sclerosis. The mechanism, efficacy, and current safety profiles are detailed for the two mAb therapies, natalizumab and alemtuzumab, with regulatory approval in multiple countries. Daclizumab, which targets the interleukin-2 receptor, and ocrelizumab, which depletes B cells, have convincing phase 3 clinical trial data and may very well provide new options in the near future. Trial results of other B-cell-directed therapies, ofatumumab and rituximab, are reviewed. Less-frequent dosing of glatiramer acetate and interferon β-1a highlight developments in the first generation of parenteral immunomodulatory therapy. Remyelination using mAbs has moved into clinical trials with the first agents, anti-LINGO-1, rHIgM22, and anti-SEMA 4D. PMID:27116720

  19. [New therapeutic strategies for remyelination in multiple sclerosis].

    Kremer, D; Hartung, H-P; Stangel, M; Küry, P

    2015-08-01

    Multiple sclerosis (MS) is characterized by oligodendrocyte death and myelin sheath destruction of the central nervous system (CNS) in response to autoinflammatory processes. Besides demyelination axonal degeneration constitutes the second histopathological hallmark of this disease. A large number of immunomodulatory and targeted immunosuppression treatments have been approved for relapsing remitting (RR) MS where they effectively reduce relapse rates; however, currently no treatment options exist to repair injured axonal tracts or myelin damage that accumulates over time particularly in progressive MS. In light of the growing available therapeutic repertoire of highly potent immunomodulatory medications there is an increasing interest in the development of therapies aimed at neutralizing neurodegenerative damage. Endogenous remyelination processes occur mainly as a result of oligodendrocyte precursor cell (OPC) activation, recruitment and maturation; however, this repair activity appears to be limited and increasingly fails during disease progression. Based on these observations OPCs are considered as promising targets for the regenerative treatment of all stages of MS. This article presents an overview of approved medications with a suggested role in regeneration, regenerative treatments that are currently being tested in clinical trials, as well as promising future therapeutic approaches derived from basic glial cell research aiming at the promotion of the endogenous repair activity of the brain. PMID:26122637

  20. A passive exoskeleton can push your life up: application on multiple sclerosis patients.

    Di Russo, Francesco; Berchicci, Marika; Perri, Rinaldo Livio; Ripani, Francesca Romana; Ripani, Maurizio

    2013-01-01

    In the present study, we report the benefits of a passive and fully articulated exoskeleton on multiple sclerosis patients by means of behavioral and electrophysiological measures, paying particular attention to the prefrontal cortex activity. Multiple sclerosis is a neurological condition characterized by lesions of the myelin sheaths that encapsulate the neurons of the brain, spine and optic nerve, and it causes transient or progressive symptoms and impairments in gait and posture. Up to 50% of multiple sclerosis patients require walking aids and 10% are wheelchair-bound 15 years following the initial diagnosis. We tested the ability of a new orthosis, the "Human Body Posturizer", designed to improve the structural and functional symmetry of the body through proprioception, in multiple sclerosis patients. We observed that a single Human Body Posturizer application improved mobility, ambulation and response accuracy, in all of the tested patients. Most importantly, we associated these clinical observations and behavioral effects to changes in brain activity, particularly in the prefrontal cortex. PMID:24204814

  1. The Potential Negative Effects of Interleukin 1 B in Multiple Sclerosis Patients with MEFV Mutation

    Mahmut Alpayci

    2013-10-01

    Full Text Available Multiple sclerosis patients, who are carriers of MEditerranean FeVer (MEFV gene mutation, have faster progression than the non-carriers. However, its underlying mechanism is not well understood. This article proposes the potential role of interleukin-1β (IL-1β that may be responsible for this rapid progression. Mutations in MEFV, the gene encoding for protein pyrin, cause familial Mediterranean fever, lead to gain of pyrin function, resulting in inappropriate IL-1β release. Interleukin-1β is a major mediator of systemic inflammation and fever, and also it contributes to permeability of the blood-brain barrier in active lesions of multiple sclerosis. Moreover, IL-1β promotes apoptosis of neurons and oligodendrocytes that produce the myelin sheath, which insulates axons. Thus, inflammatory damage, the blood-brain barrier disfunction, effects of fever on the central nervous system (or Uhthoff’s phenomenon, and apoptosis of neurons and oligodendrocytes, which play an important role in the pathogenesis and clinical course of multiple sclerosis, can be induced by increased activation and release of IL-1β in the presence of MEFV gene mutations. Therefore, screening for MEFV mutations in patients with multiple sclerosis and treatment planning with IL-1β targeting drugs for the carriers, may be a logical idea that will be a source of inspiration for scientific studies.

  2. A passive exoskeleton can push your life up: application on multiple sclerosis patients.

    Francesco Di Russo

    Full Text Available In the present study, we report the benefits of a passive and fully articulated exoskeleton on multiple sclerosis patients by means of behavioral and electrophysiological measures, paying particular attention to the prefrontal cortex activity. Multiple sclerosis is a neurological condition characterized by lesions of the myelin sheaths that encapsulate the neurons of the brain, spine and optic nerve, and it causes transient or progressive symptoms and impairments in gait and posture. Up to 50% of multiple sclerosis patients require walking aids and 10% are wheelchair-bound 15 years following the initial diagnosis. We tested the ability of a new orthosis, the "Human Body Posturizer", designed to improve the structural and functional symmetry of the body through proprioception, in multiple sclerosis patients. We observed that a single Human Body Posturizer application improved mobility, ambulation and response accuracy, in all of the tested patients. Most importantly, we associated these clinical observations and behavioral effects to changes in brain activity, particularly in the prefrontal cortex.

  3. Black holes in multiple sclerosis: definition, evolution, and clinical correlations.

    Sahraian, M A; Radue, E-W; Haller, S; Kappos, L

    2010-07-01

    Magnetic resonance imaging (MRI) is a sensitive paraclinical test for diagnosis and assessment of disease progression in multiple sclerosis (MS) and is often used to evaluate therapeutic efficacy. The formation of new T2-hyperintense MRI lesions is commonly used to measure disease activity, but lacks specificity because edema, inflammation, gliosis, and axonal loss all contribute to T2 lesion formation. As the role of neurodegeneration in the pathophysiology of MS has become more prominent, the formation and evolution of chronic or persistent Tl-hypointense lesions (black holes) have been used as markers of axonal loss and neuronal destruction to measure disease activity. Despite the use of various detection methods, including advanced imaging techniques such as magnetization transfer imaging and magnetic resonance spectroscopy, correlation of persistent black holes with clinical outcomes in patients with MS remains uncertain. Furthermore, although axonal loss and neuronal tissue destruction are known to contribute to irreversible disability in patients with MS, there are limited data on the effect of therapy on longitudinal change in Tl-hypointense lesion volume. Measurement of black holes in clinical studies may elucidate the underlying pathophysiology of MS and may be an additional method of evaluating therapeutic efficacy. PMID:20003089

  4. Antiepileptic and Antidepressive Polypharmacy in Patients with Multiple Sclerosis

    Georg Anton Giæver Beiske

    2015-01-01

    Full Text Available Objective. Patients with multiple sclerosis (MS are often suffering from neuropathic pain. Antiepileptic drugs (AEDs and tricyclic antidepressants (TCAs are commonly used and are susceptible to be involved in drug interactions. The aim of this retrospective study was to investigate the prevalence of use of antiepileptic and antidepressive drugs in MS patients and to discuss the theoretical potential for interactions. Methods. Review of the medical records from all patients treated at a dedicated MS rehabilitation centre in Norway between 2009 and 2012. Results. In total 1090 patients attended a rehabilitation stay during the study period. Of these, 342 (31%; 249 females with mean age of 53 (±10 years and EDSS 4.8 (±1.7 used at least one AED (gabapentin 12.7%, pregabalin 7.7%, clonazepam 7.8%, and carbamazepine 2.6% or amitriptyline (9.7%. Polypharmacy was widespread (mean 5.4 drugs with 60% using additional CNS-active drugs with a propensity to be involved in interactions. Age, gender, and EDSS scores did not differ significantly between those using and not using AED/amitriptyline. Conclusion. One-third of MS patients attending a rehabilitation stay receive AED/amitriptyline treatment. The high prevalence of polypharmacy and use of CNS-active drugs calls for awareness of especially pharmacodynamic interactions and possible excessive adverse effects.

  5. Inflammation subverts hippocampal synaptic plasticity in experimental multiple sclerosis.

    Robert Nisticò

    Full Text Available Abnormal use-dependent synaptic plasticity is universally accepted as the main physiological correlate of memory deficits in neurodegenerative disorders. It is unclear whether synaptic plasticity deficits take place during neuroinflammatory diseases, such as multiple sclerosis (MS and its mouse model, experimental autoimmune encephalomyelitis (EAE. In EAE mice, we found significant alterations of synaptic plasticity rules in the hippocampus. When compared to control mice, in fact, hippocampal long-term potentiation (LTP induction was favored over long-term depression (LTD in EAE, as shown by a significant rightward shift in the frequency-synaptic response function. Notably, LTP induction was also enhanced in hippocampal slices from control mice following interleukin-1β (IL-1β perfusion, and both EAE and IL-1β inhibited GABAergic spontaneous inhibitory postsynaptic currents (sIPSC without affecting glutamatergic transmission and AMPA/NMDA ratio. EAE was also associated with selective loss of GABAergic interneurons and with reduced gamma-frequency oscillations in the CA1 region of the hippocampus. Finally, we provided evidence that microglial activation in the EAE hippocampus was associated with IL-1β expression, and hippocampal slices from control mice incubated with activated microglia displayed alterations of GABAergic transmission similar to those seen in EAE brains, through a mechanism dependent on enhanced IL-1β signaling. These data may yield novel insights into the basis of cognitive deficits in EAE and possibly of MS.

  6. Stage-specific immune dysregulation in multiple sclerosis.

    Segal, Benjamin M

    2014-08-01

    A large body of data indicates that multiple sclerosis (MS) is an autoimmune disease which is initiated by CD4(+) T-helper 1 (Th1) and Th17 cells that are reactive against proteins in the myelin sheath. MS typically begins with a relapsing-remitting course, punctuated by clinical exacerbations associated with the development of focal inflammatory lesions in central nervous system white matter, followed by a secondary progressive (SP) phase, characterized by a gradual accumulation of neurological disability associated with widespread microglial activation and axonal loss. The molecular and cellular basis for this transition is unclear, and the role of inflammation during the SP stage is a subject of active debate. As of now, no immunological biomarkers have been identified in MS that are predictive of the clinical course or therapeutic responsiveness to disease-modifying agents, or that correlate with new lesion development, cumulative lesion load, or degree of disability. The discovery of such biomarkers would greatly facilitate clinical management and provide power for smaller and shorter clinical trials. In this article, we discuss the literature on immunological biomarkers in MS with a focus on stage-specific differences and similarities. PMID:25084180

  7. Therapeutic strategies targeting B-cells in multiple sclerosis.

    Milo, Ron

    2016-07-01

    Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disease of the central nervous system (CNS) that traditionally has been considered to be mediated primarily by T-cells. Increasing evidence, however, suggests the fundamental role of B-cells in the pathogenesis of the disease. Recent strategies targeting B-cells in MS have demonstrated impressive and sometimes surprising results: B-cell depletion by monoclonal antibodies targeting the B-cell surface antigen CD20 (e.g. rituximab, ocrelizumab, ofatumumab) was shown to exert profound anti-inflammatory effect in MS with favorable risk-benefit ratio, with ocrelizumab demonstrating efficacy in both relapsing-remitting (RR) and primary-progressive (PP) MS in phase III clinical trials. Depletion of CD52 expressing T- and B-cells and monocytes by alemtuzumab resulted in impressive and durable suppression of disease activity in RRMS patients. On the other hand, strategies targeting B-cell cytokines such as atacicept resulted in increased disease activity. As our understanding of the biology of B-cells in MS is increasing, new compounds that target B-cells continue to be developed which promise to further expand the armamentarium of MS therapies and allow for more individualized therapy for patients with this complex disease. PMID:26970489

  8. An update of teriflunomide for treatment of multiple sclerosis

    Oh J

    2013-04-01

    Full Text Available Jiwon Oh,1,2 Paul W O’Connor2 1Department of Neurology, Johns Hopkins University, Baltimore, MD, USA; 2Division of Neurology, St Michael’s Hospital, Toronto, ON, Canada Abstract: There are a number of oral agents emerging as potential disease-modifying agents in multiple sclerosis (MS. Among these investigational agents, teriflunomide has shown promise in large, multicenter, phase III clinical trials with respect to safety and efficacy in relapsing MS patients, and is the latest disease-modifying agent approved for use in MS patients in the United States. This review will summarize teriflunomide's historical development, clinical pharmacology, studies in animals, clinical trials, and safety data, and will end with a discussion of the role of teriflunomide in MS in the context of existing treatment options. Keywords: teriflunomide, multiple sclerosis, clinical trials, review

  9. Theranostic Implications of Nanotechnology in Multiple Sclerosis: A Future Perspective

    Ajay Vikram Singh

    2012-01-01

    Full Text Available Multiple Sclerosis is a multifactorial disease with several pathogenic mechanisms and pathways. Successful MS management and medical care requires early accurate diagnosis along with specific treatment protocols based upon multifunctional nanotechnology approach. This paper highlights advances in nanotechnology that have enabled the clinician to target the brain and CNS in patient with multiple sclerosis with nanoparticles having therapeutic and imaging components. The multipartite theranostic (thera(py + (diagnostics approach puts forth strong implications for medical care and cure in MS. The current nanotheranostics utilize tamed drug vehicles and contain cargo, targeting ligands, and imaging labels for delivery to specific tissues, cells, or subcellular components. A brief overview of nonsurgical nanorepair advances as future perspective is also described. Considering the potential inflammatory triggers in MS pathogenesis, a multifunctional nanotechnology approach will be needed for the prognosis.

  10. T–CELL VACCINE PREPARATION FOR MULTIPLE SCLEROSIS TREATMENT

    I. P. Ivanova

    2014-07-01

    Full Text Available Abstract. A two–stage technology of preparation of T–cell vaccine designated for multiple sclerosis treatment is described. At the first stage myelin–specific lymphocytes undergoe antigen–dependent cultural selection, whereas at the second stage they are grown by means of non–specific stimulation. The vaccine prepared in this way was found to induce specific anti–idiotypic immune response, directed against myelin–reactive T–lymphocytes. The results of 1–year follow–up of 18 vaccinated patients with a cerebral–spinal type of multiple sclerosis indicated the absence of side effects of T–cell vaccination, and suggest the possibility of effective application of this treatment within early stages of disease. (Med. Immunol., 2005, vol.7, № 1, pp 27532

  11.  Potential pathogens in multiple sclerosis (MS

    Mariola Zawada

    2012-10-01

    Full Text Available  Multiple sclerosis is a neuroimmunological disease in which etiologic agents have not been identified yet. The etiology of MS is complex in its nature and may involve many different agents acting simultaneously or in a cascade manner leading to the development of the disease. The causes of MS development were sought among the factors associated with HLA and TCR genes and human endogenous retroviruses (HERV. Environmental factors such as bacterial, fungal and viral infections as well as potential participation of vitamin D in the pathogenesis of the disease have also been examined. The current state of knowledge concerning potential factors participating in the etiopathogenesis of multiple sclerosis has been reviewed in this paper.

  12. Magnetic resonance imaging in clinically-definite multiple sclerosis

    Forty-two patients with clinically-definite multiple sclerosis were examined by magnetic resonance imaging using a 1.5-T instrument. Magnetic resonance imaging detected an abnormality in 90% of patients. In four patients, no lesions were demonstrated. The number, size and site of the lesions by magnetic resonance imaging were compared with the patients' clinical status and other variables. The Kurtzke disability status scale score increased in patients with corpus callosum atrophy, brainstem and basal ganglia lesions, and correlated with the total number of lesions. No correlation was shown between the findings of magnetic resonance imaging and disease duration, age, sex or pattern-reversal visual-evoked potentials. The variety of magnetic resonance images that could be obtained in patients with clinically-definite multiple sclerosis is highlighted. 24 refs., 8 figs., 1 tab

  13. Increasing Benefit of Magnetic Resonance Imaging in Multiple Sclerosis

    Magnetic resonance imaging (MRI) has emerged as an essential tool of multiple sclerosis (MS) diagnosis and has opened up completely new prospects in MS research and treatment trials. It is a sensitive method that gives direct evidence of tissue pathology and has greatly increased our knowledge of MS. In clinical work, MRI is used to confirm and exclude the diagnosis of MS. The international recommendation is that every suspected MS patient should undergo at least one brain MRI. T2-weighted images are the standard tool in clinical work, and functional imaging methods are mainly used in MS research. The subtypes and the course of the disease cause variation in MRI findings. Here, we present a general overview of MR findings in MS. Brain, magnetic resonance imaging, multiple sclerosis, spinal cord

  14. Magnetic resonance imaging abnormalities in multiple sclerosis: A review

    :During the last two decades, magnetic resonance imaging has been widely used In the diagnosis and treatment monitoring of multiple sclerosis. MRI, both conventional and non conventional methods, has transformed all aspects of M S research and clinical practice in recent years. Although advanced imaging methods have added much more to our knowledge about pathogenesis and natural history of the disease but their cost, availability, complexity and lack of validation have limited their use in routine clinical practice. Conventional MR techniques including proton density, T1/T2-Weighted images and fluid- attenuated inversion recovery sequences are now accepted in standard protocols for diagnosis and treatment outcome measures in clinical trials of multiple sclerosis. This review will focus on the type, morphology and evolution of M S lesions regarding conventional MRI and their use for treatment monitoring in daily clinical practice

  15. Clinical Characteristics of Pediatric-Onset and Adult-Onset Multiple Sclerosis in Hispanic Americans.

    Langille, Megan M; Islam, Talat; Burnett, Margaret; Amezcua, Lilyana

    2016-07-01

    Multiple sclerosis can affect pediatric patients. Our aim was to compare characteristics between pediatric-onset multiple sclerosis and adult-onset multiple sclerosis in Hispanic Americans. This was a cross-sectional analysis of 363 Hispanic American multiple scleroses cases; demographic and clinical characteristics were analyzed. A total of 110 Hispanic patients presented with multiple sclerosis before age 18 and 253 as adult multiple sclerosis. The most common presenting symptoms for both was optic neuritis. Polyfocal symptoms, seizures, and cognitive symptoms at presentation were more prevalent in pediatric-onset multiple sclerosis (P ≤ .001). Transverse myelitis was more frequent in adult-onset multiple sclerosis (P ≤ .001). Using multivariable analysis, pediatric-onset multiple sclerosis (adjusted odds ratio, 0.3OR 95% confidence interval 0.16-0.71, P = .004) and being US born (adjusted odds ratio, 0.553, 95% confidence interval 0.3-1.03, P = .006) were less likely to have severe ambulatory disability. Results suggest that pediatric-onset multiple sclerosis and adult-onset multiple sclerosis in Hispanics have differences that could be important for treatment and prognosis. PMID:27021143

  16. Differential micro RNA expression in PBMC from multiple sclerosis patients.

    David Otaegui

    Full Text Available Differences in gene expression patterns have been documented not only in Multiple Sclerosis patients versus healthy controls but also in the relapse of the disease. Recently a new gene expression modulator has been identified: the microRNA or miRNA. The aim of this work is to analyze the possible role of miRNAs in multiple sclerosis, focusing on the relapse stage. We have analyzed the expression patterns of 364 miRNAs in PBMC obtained from multiple sclerosis patients in relapse status, in remission status and healthy controls. The expression patterns of the miRNAs with significantly different expression were validated in an independent set of samples. In order to determine the effect of the miRNAs, the expression of some predicted target genes of these were studied by qPCR. Gene interaction networks were constructed in order to obtain a co-expression and multivariate view of the experimental data. The data analysis and later validation reveal that two miRNAs (hsa-miR-18b and hsa-miR-599 may be relevant at the time of relapse and that another miRNA (hsa-miR-96 may be involved in remission. The genes targeted by hsa-miR-96 are involved in immunological pathways as Interleukin signaling and in other pathways as wnt signaling. This work highlights the importance of miRNA expression in the molecular mechanisms implicated in the disease. Moreover, the proposed involvement of these small molecules in multiple sclerosis opens up a new therapeutic approach to explore and highlight some candidate biomarker targets in MS.

  17. Psychometric Evaluation of the Perceived Stress Scale in Multiple Sclerosis

    Wu, Salene M.; Dagmar Amtmann

    2013-01-01

    Multiple sclerosis (MS) is a progressive disease characterized by neurological symptoms and sometimes heightened levels of distress. The Perceived Stress Scale (PSS) is often used in MS samples to measure stress but has not been validated in this population. Participants (n=446) completed the PSS as well as measure of depression, anxiety, and mental and physical health. Factor analyses indicated that the general factor of a bifactor model accounted for a large amount of the variance in the 14...

  18. Multiple Sclerosis Increases Fracture Risk: A Meta-Analysis

    Guixian Dong; Ning Zhang; Zhanpo Wu; Yumin Liu; Litao Wang

    2015-01-01

    Purpose. The association between multiple sclerosis (MS) and fracture risk has been reported, but results of previous studies remain controversial and ambiguous. To assess the association between MS and fracture risk, a meta-analysis was performed. Method. Based on comprehensive searches of the PubMed, Embase, and Web of Science, we identified outcome data from all articles estimating the association between MS and fracture risk. The pooled risk ratios (RRs) with 95% confidence intervals (CIs...

  19. Cannabinoid control of neuroinflammation related to multiple sclerosis

    Baker, D.; Jackson, S. J.; Pryce, G.

    2007-01-01

    The cannabis plant (Cannabis sativa) has been known by many names but the question remains ‘Can we call it medicine?' There has been renewed interest in the value of cannabis for the control of neuroinflammatory conditions such as multiple sclerosis, where it has been shown to have some effect on spasticity and pain both experimentally and in clinical trials in humans. However, in addition to symptom control potential, the question remains whether cannabinoids can modify the neuroinflammatory...

  20. Mechanisms and Pharmacology of Neuropathic Pain in Multiple Sclerosis

    Iannitti, T; Kerr, B.J.; Taylor, BK

    2014-01-01

    The neuropathic pain of multiple sclerosis is quite prevalent and severely impacts quality of life. A few randomized, placebo-controlled, blinded clinical trials suggest that cannabis- and anticonvulsant-based treatments provide partial pain relief, but at the expense of adverse events. An even smaller, but emerging, number of translational studies are using rodent models of experimental autoimmune encephalomyelitis (EAE), which exhibit pain-like behaviors resembling those of MS patients. The...