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Teriflunomide for multiple sclerosis.

BACKGROUND: Disease-modifying therapies (DMTs) for multiple sclerosis aim to specifically reduce inflammation in relapsing multiple sclerosis and promote neuroprotection and neurorepair in progressive multiple sclerosis (MS). Most of the currently available disease-modifying drugs (DMDs) require regular and frequent parenteral administration, which imposes a burden on patients and leads to reduced adherence. Not all MS patients respond adequately to current DMDs and, therefore, alternative MS treatments with less invasive routes of administration and new modes of action are required to expand …

Multislice brain myelin water fractions at 3T in multiple sclerosis.

PURPOSE: To evaluate a multislice nonlinearly-spaced 12-echo imaging sequence at 3T covering the supratentorial brain for the quantification of myelin water fraction (MWF) in multiple sclerosis (MS) patients. METHODS: Eighty-nine patients with, or at risk of, MS (69 relapsing remitting MS [RRMS], 7 secondary progressive MS [SPMS], 13 clinically isolated syndrome [CIS]) and 28 controls were studied. Twelve-echo datasets were acquired using a multislice T2 prep spiral imaging sequence and were fitted using a nonnegative least squares algorithm. The mean MWF within normal appearing white matter …

Enhancing patterns in multiple sclerosis: evolution and persistence.

BACKGROUND AND PURPOSE: Contrast enhancement on MR images of patients with multiple sclerosis (MS) is known to be associated with abnormalities of the blood-brain barrier (BBB). However, little is known about diagnostic patterns and common features of enhanced MS lesions. This study was designed to evaluate initial enhancement patterns, changes in these enhancing patterns, and duration of enhancement in a cohort of patients with MS. METHODS: Twenty-five patients with clinically definite MS were studied retrospectively. The appearance of enhancing lesions and sequential changes in the appearan…

Множественный склероз: молекулярный патогенез и терапевтическое вмешательство.

Множественный склероз — это хроническое иммунное расстройство центральной нервной системы, характеризующееся демиэлированием, аксонной потерей и нейронным воспалением, которое приводит к постепенной неврологической инвалидности. Несмотря на значительный прогресс в понимании иммунопатогенеза, нынешние иммунотерапии по-прежнему ограничены в их способности остановить прогрессию заболеваний, что делает множественный склероз неизлечимым и подчеркивает острую необходимость новых терапевтических стратегий. Иммунотерапия по антигенной специфике представляет собой новаторский подход, направленный на во

Совпадение в аннотации оригинала
Multiple sclerosis is a chronic immune-mediated disorder of the central nervous system characterized by demyelination, axonal loss, and neuroinflammation, culminating in progressive neurological disability. Despite significant advances in understanding its immunopathogenesis, current immunotherapies remain limited in their ability to halt disease progression…

Multiple sclerosis and Lyme borreliosis.

In a deductive approach the two disease entities of multiple sclerosis and chronic progressive neuroborreliosis are discussed. Various clinical features, seroepidemiology, neuroimaging, CSF findings, CSF serology, specific proteins within the CSF and antibodies against neuronal structures as well as the most recent findings of different dendritic cells within the CSF are discussed as a means of differentiating these two disease entities.

Respiratory complications of poliomyelitis and multiple sclerosis.

Years after suffering from poliomyelitis and completely recuperating from any of its acute complications, patients can develop postpolio syn … lem are discussed in the first part of this article. In the second part, pulmonary complications of multiple sclerosis are described. This common neurological disease affects young adults and often requires evaluation by a pulmonologist. This review centers on the acute respiratory manifestations of multiple sclerosis and also describes the chronic effects.

Optic neuritis and multiple sclerosis.

PURPOSE OF REVIEW: To discuss recent neuro-ophthalmic advances relevant to the management of optic neuritis and multiple sclerosis. RECENT FINDINGS: Major advances have occurred in the fields of autoimmunity in optic neuritis, and in imaging the retinal nerve fibre layer in both optic neuritis and multiple sclerosis. SUMMARY: A proportion of cases of optic neuritis occur in patients who do not develop multiple sclerosis; the optic neuritis may be monophasic illness or recurrent. In many recurrent cases who also have myelitis (neuromyelitis optica) a serum antibody to aquaporin-4 water channe…

A case of primary biliary cirrhosis associated with generalized morphea.

A 50-year-old female with primary biliary cirrhosis associated with generalized morphea is reported. She had suffered from multiple painful indurated plaques on the trunk which was diagnosed as generalized morphea; subsequently, primary biliary cirrhosis was diagnosed on the basis of her hepatic dysfunction. Although progressive systemic sclerosis has been reported to occur in patients with primary biliary cirrhosis, this localized form of cutaneous sclerosis has not previously been reported. Since generalized morphea is one of the most common manifestations of chronic graft-versus-host diseas

Fatigue characteristics in multiple sclerosis: the North American Research Committee on Multiple Sclerosis (NARCOMS) survey.

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 s…

Personalized Treatment Response in Progressive MS: Can the Patient's Profile Influence the Outcome?

BACKGROUND: Evidence from clinical trials providing average effects in populations is often used to forecast individualized patient outcomes similar to the trial patients. Multiple sclerosis (MS), known for notable heterogeneity in outcomes, makes the evaluation of potential heterogeneity of treatment effect (HTE) significant. Identifying factors that predict individual treatment response is crucial for optimizing patient care, and this study aimed to demonstrate the feasibility (proof of concept) of applying a statistical method to predict individual treatment response in MS trials. METHODS:…

Limb apraxia in individuals with multiple sclerosis: Is there a role of semi-immersive virtual reality in treating the Cinderella of neuropsychology?

BACKGROUND: Limb apraxia is an acquired cognitive-motor disorder characterized by spatial and temporal disorganization of limb movements, negatively affecting the quality of life of patients, including those with multiple sclerosis (MS). Although recent studies have shown the potential role of VR in increasing cognitive and motor functions, only a few studies have been carried out on the rehabilitation of upper limb apraxia. Hence, our study aims to evaluate the potential efficacy of VR training to improve upper limb ideomotor apraxia in patients with MS. METHODS: One hundred and six patients…

Disease activity in progressive multiple sclerosis can be effectively reduced by cladribine.

BACKGROUND: Evidence suggests people with non-relapsing deteriorating ("progressive") multiple sclerosis (pwPMS) may benefit from disease-modifying immune therapy (DMT). However, only one such treatment (ocrelizumab) has been licensed and is highly restricted to pwPMS suffering from the primary progressive phenotype. The difficulties assessing treatment outcome in pwPMS is one important reason for the lack of respective DMT. The concentration of neurofilaments in the cerebrospinal fluid (CSF) provides a biomarker of neuro-axonal damage, and both neurofilament light (NfL) and heavy chain (NfH) …

Efficacy of andrographolide in not active progressive multiple sclerosis: a prospective exploratory double-blind, parallel-group, randomized, placebo-controlled trial.

BACKGROUND: Multiple sclerosis (MS) is a chronic immune mediated disease and the progressive phase appears to have significant neurodegenerative mechanisms. The classification of the course of progressive MS (PMS) has been re-organized into categories of active vs. not active inflammatory disease and the presence vs. absence of gradual disease progression. Clinical trial experience to date in PMS with anti-inflammatory medications has shown limited effect. Andrographolide is a new class of anti-inflammatory agent, that has been proposed as a potential drug for autoimmune disorders, including M…

Evaluation of sexual function in women at two stages of multiple sclerosis.

PURPOSE: In the present study, we aimed to evaluate the sexual function in patients with multiple sclerosis (MS) who were examined in two subgroups and compare the results to the control group with a validated questionnaire. METHODS: A total of 23 consecutive female MS patients divided into groups with relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS) and 45 healthy control subjects were included into the study. The inclusion criteria were as follows: Definite MS, age between 18 and 60 years and an Expanded Disability Status Scale (EDSS) score of <8. The neurologic impairment,…

Перкутанная эпидуральная стимуляция спинного мозга немедленно уменьшает клонус у человека с множественным склерозом.

Клонус — симптом дисфункции верхних моторных нейронов у пациентов с множественным склерозом (MS). Мы сообщаем о немедленном прекращении механического клонуса с помощью эпидуральной блюбозакаральной стимуляции спинного мозга (ES) у 58-летнего мужчины со вторичным прогрессивным MS. Это наблюдение было снято в ходе тренировок с использованием видео- и поверхностной электромиографии мышечной активности солью. ES немедленно сократила механическую продолжительность клонуса и число циклов по сравнению с испытаниями без стимулирования, как это определено испытанием Kruskal-Wallis (p < 0,05, n = 2-3 ис

Совпадение в аннотации оригинала
Clonus is a disabling symptom of upper motor neuron dysfunction in patients with multiple sclerosis (MS). We report immediate termination of mechanically evoked clonus by epidural lumbosacral spinal cord stimulation (ES) in a 58-year-old man with secondary progressive MS. This observation was captured during training using video and skin surface electromyogr…

Siponimod following Alemtuzumab in secondary progressive MS: investigating sequential therapy-A case series.

Alemtuzumab, a humanized anti-CD52 monoclonal antibody, is approved for treatment of highly active relapsing multiple sclerosis (MS) but requires vigilant post-treatment monitoring due to associated risks. The prescription of subsequent therapies following Alemtuzumab, as mandated by label guidance for a treatment-free period of at least 5 years, presents a complex challenge, particularly if there is concurrent conversion to secondary progressive disease course. We described a case-series of five patients starting therapy with Siponimod and followed up for 12 months period converted to seconda…

Dimethyl Fumarate Treatment in Patients With Primary Progressive Multiple Sclerosis: A Randomized, Controlled Trial.

BACKGROUND AND OBJECTIVE: To study whether dimethyl fumarate is superior to placebo in decreasing CSF concentrations of neurofilament light chain (NFL) in patients with primary progressive MS (PPMS). METHODS: In the double-blind, placebo-controlled phase 2 study dimethyl FUMArate treatment in Progressive Multiple Sclerosis (FUMAPMS), patients with PPMS were randomly assigned to treatment with 240 mg dimethyl fumarate or placebo in a 1:1 ratio for 48 weeks. The primary endpoint was change in concentration of NFL in the CSF. Secondary endpoints included other CSF biomarkers and clinical and MRI…

Association of Serum Neurofilament Light Chain With Inner Retinal Layer Thinning in Multiple Sclerosis.

BACKGROUND AND OBJECTIVES: Serum neurofilament light chain (sNfL) and optical coherence tomography (OCT)-derived retinal measures (including peripapillary retinal nerve fiber layer [pRNFL] and macular ganglion cell layer/inner plexiform layer [GCIPL] thickness) have been proposed as biomarkers of neurodegeneration in multiple sclerosis (MS). However, studies evaluating the associations between sNfL and OCT-derived retinal measures in MS are limited. METHODS: In this retrospective analysis of a longitudinal, observational, single-center cohort study, sNfL levels were measured in people with MS…

Which clinical risk factors determine a pathological urodynamic evaluation in patients with multiple sclerosis? an analysis of 100 prospective cases.

BACKGROUND: Urinary tract symptoms are an underestimated problem in multiple sclerosis (MS). OBJECTIVE: Hundred urodynamics of MS patients have been evaluated prospectively. DESIGN, SETTING AND PARTICIPANTS: In an inpatient rehabilitation, all persons with MS who also suffered from urinary tract symptoms received a voiding diary, post-void sonography and an urodynamic examination according to International Continence-Society-Standard. RESULTS AND LIMITATIONS: Between 10/2009 and 3/2011, 100 patients (79 women; 21 men; mean EDSS, 4.52 ± 2.26) were examined who had primary progressive MS (9×)…

Relationship of acute axonal damage, Wallerian degeneration, and clinical disability in multiple sclerosis.

BACKGROUND: Axonal damage and loss substantially contribute to the incremental accumulation of clinical disability in progressive multiple sclerosis. Here, we assessed the amount of Wallerian degeneration in brain tissue of multiple sclerosis patients in relation to demyelinating lesion activity and asked whether a transient blockade of Wallerian degeneration decreases axonal loss and clinical disability in a mouse model of inflammatory demyelination. METHODS: Wallerian degeneration and acute axonal damage were determined immunohistochemically in the periplaque white matter of multiple sclero…