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Prognostic value of kappa free light chain index in patients with primary progressive multiple sclerosis.

BACKGROUND: The kappa free light chain (κ-FLC) index is a well-established biomarker in multiple sclerosis (MS). While the prognostic value of the κ-FLC index has been demonstrated in early relapsing-remitting MS, its prognostic value in primary progressive MS (PPMS) has not yet been investigated. METHODS: In this multicenter, retrospective cohort study, patients diagnosed with PPMS with diagnostic lumbar puncture and clinical follow-up of at least 12 months were recruited from nine MS centers across five countries. At baseline, age, sex, disease duration, and the number of T2 hyperintense (T…

Blood biomarkers for predicting disability worsening in progressive multiple sclerosis: a multinational, individual participant-level analysis.

BACKGROUND AND OBJECTIVES: Biologically informative markers like glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) may help predict confirmed disability worsening (CDW) in multiple sclerosis (MS). However, data on the prognostic value of their blood concentrations in progressive MS (PMS) are limited, and there are substantial discrepancies in the published literature. This international collaboration uses individual participant data to define the prognostic value of serum GFAP and NfL in people with PMS (pwPMS). METHODS: Data were collected from BioMS-eu network centr…

Disability progression is a question of definition-A methodological reappraisal by example of primary progressive multiple sclerosis.

BACKGROUND: Different definitions of disability progression by Expanded Disability Status Scale (EDSS) may influence frequency and/or time to event. METHODS: In this multicenter cohort study, we included PPMS patients with follow-up ≥24 months and ≥3 available EDSS scores overall (≥1 per year). We applied 672 definitions of disability progression including different minimal EDSS increase, required confirmation and fixed/roving-baseline score. RESULTS: We analyzed follow-up periods from 131 PPMS patients (median age at baseline 53.0 years [45.0 - 63.0], 51.9 % female, median follow-up 3.9 yea

Imaging chronic active lesions in multiple sclerosis: a consensus statement.

Chronic active lesions (CAL) are an important manifestation of chronic inflammation in multiple sclerosis and have implications for non-relapsing biological progression. In recent years, the discovery of innovative MRI and PET-derived biomarkers has made it possible to detect CAL, and to some extent quantify them, in the brain of persons with multiple sclerosis, in vivo. Paramagnetic rim lesions on susceptibility-sensitive MRI sequences, MRI-defined slowly expanding lesions on T1-weighted and T2-weighted scans, and 18-kDa translocator protein-positive lesions on PET are promising candidate bio…

[Prognostic factors in the survival of patients with neuromuscular diseases after an episode of acute respiratory insufficiency].

We have studied the survival of 49 patients suffering from neuromuscular disease, who were hospitalised in the Respiratory Intensive Care Unit between 1981 and 1990 (29 males and 20 females with a mean age of 49.3 +/- 17 years with a range of 15 to 79). The neuromuscular diseases consisted of 8 with multiple sclerosis, 9 with amyotrophic lateral sclerosis, 8 with Steinert's disease, 11 myopathies, and 10 suffering from miscellaneous neurological diseases. Initially 27 of the 49 patients had been intubated and ventilated. During the hospital stay long-term ventilation was undertaken in 27 patie…

Роль изофлавонов в множественном склерозе.

Myelin дегенерация является отличительной чертой множественного склероза, хронического, аутоиммунного неврологического состояния, которое изменяет связь с центральной нервной системой. Несмотря на тот факт, что патофизиология множественного склероза является многофакторной и не вполне понятной, новые исследования показывают, что уменьшение окислительного стресса и воспаления может иметь терапевтические преимущества. Класс фитоэстрогенов, называемый изофалонами, которые в основном присутствуют в соях и других бобовых, вызвал интерес из-за их возможных противовоспалительных и нейрозащитных свойс

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Myelin degeneration is a hallmark of multiple sclerosis, a chronic, autoimmune neurological condition that alters Central Nervous System communication. Despite the fact that the pathophysiology of multiple sclerosis is multifactorial and not fully understood, new research indicates that reducing oxidative stress and inflammation may have therapeutic advantag…

[Good practice in prophylactic care: prophylactic care and professional activation of employees with multiple sclerosis].

Multiple sclerosis (sclerosis multiplex-SM) is a chronic inflammatory disease, characterized by disseminated damage of the nervous system. It is most commonly diagnosed between the ages of 20 and 40, which puts it at the top of the lits of disabling neurological diseases in young and middle-aged adults. The third and fourth decade of life is the period of high activity, thus the progressive impairment of many functions of the nervous system is not only a medical problem, but also social and economic issues. Educational actions addressed to occupational health services physicians are needed bec…

Midbrain cleft as a cause of chronic internuclear ophthalmoplegia, progressive ataxia, and facial weakness.

A 44-year-old man with progressive ataxia, facial weakness, bilateral adduction deficits, and abducting nystagmus was initially misdiagnosed and treated for multiple sclerosis because a midbrain anatomic cleft had been overlooked on brain MRI. Six cases of "midbrain (or mesencephalic) cleft" or "keyhole aqueduct syndrome" have been previously reported. This developmental anatomic abnormality always manifests bilateral internuclear ophthalmoplegia (INO), often together with ataxia, which may be progressive and debilitating. Because the INO is chronic, patients may have no visual symptoms. The c…

Parkinsonism in multiple sclerosis patients: A prospective observational study.

BACKGROUND: Rare cases of coexisting multiple sclerosis and parkinsonism have been reported in the literature. However, the true prevalence, clinical characteristics, and causal relation between the two entities have not been systematically evaluated. OBJECTIVE: To evaluate the prevalence of parkinsonism in patients with multiple sclerosis and examine the causal relationship, if any. METHODS: Consecutive patients referred to the multiple sclerosis clinic were evaluated by a neurologist with double training in both neuroimmunology and movement disorders. All patients were specifically screene…

Multiple sclerosis synaptic connectome: Insights from fluid biomarkers.

Multiple sclerosis is a chronic immune-mediated and degenerative disease of the central nervous system. Increasing evidence highlights the role of brain network disconnection in the pathogenesis of clinical progression and irreversible disability accumulation in people with multiple sclerosis. Several pathologic changes contribute to multiple sclerosis-related disconnection, ranging from focal areas of demyelination and axonal transection to atrophy of both cortical and subcortical gray matter structures. In the last years, increasing evidence also suggests a prominent role of synaptic dysfunc…

Challenges of persons with multiple sclerosis on ocrelizumab treatment during COVID-19 pandemic.

BACKGROUND: Coronavirus disease of the 2019 pandemic caused much fear among people with chronic diseases and those on immunosuppressant treatment because of spreading knowledge that the infection has a fatal course in these populations. People with Multiple Sclerosis on ocrelizumab treatment share this fear too. We aimed to investigate treatment and lifestyle changes of people with multiple sclerosis on ocrelizumab treatment during the lockdown. METHODS: We surveyed 199 of our registered multiple sclerosis patients on ocrelizumab treatment by phone. RESULTS: In this survey, delays in treatin…

Effects of Comorbid Fibromyalgia Syndrome on activities of daily living in multiple sclerosis patients.

OBJECTIVE: To investigate the frequency of Comorbid Fibromyalgia Syndrome and its effects on quality of life and activities of daily living without any known psychiatric problem (schizophrenia or bipolar disorder) or severe disability, other than depression, in patients with multiple sclerosis, which is known to be a chronic disease in young adults. METHODS: The study included 103 patients diagnosed with multiple sclerosis, following McDonald criteria, who had relapsing remitting disease. The Fibromyalgia Impact Questionnaire, Beck Anxiety Inventory, Beck Depression Inventory, Pittsburgh Slee…

Fingolimod-related atrioventricular block in paediatric age group with multiple sclerosis: two case reports.

Multiple sclerosis is a chronic inflammatory and demyelinating disease of the central nervous system, usually seen in young adults. Early onset of multiple sclerosis at age younger than 18 years is called paediatric multiple sclerosis. Unlike adult multiple sclerosis, paediatric multiple sclerosis causes morbidity at earlier ages and often progresses in a relapsing-remitting form. Although fingolimod is an effective drug used as a disease-modifiying therapy agent in relapsing-remitting paediatric multiple sclerosis patients, it can cause dysryhthmia in the early period after first dose. Our fi…

Neural stem cell transplantation in progressive multiple sclerosis: STEMS study long-term outcomes.

BACKGROUND: To evaluate the long-term safety and potential neuroprotective effects of human fetal neural precursor cell transplantation in individuals with progressive multiple sclerosis. METHODS: This retrospective observational study assessed long-term follow-up data (median 5.7 years) from participants in a first-in-human phase I trial (NCT03269071) investigating neural cell transplantation in progressive multiple sclerosis. Clinical and radiological available data were collected and compared to baseline values and reference populations. RESULTS: Long-term follow-up data were available fo…

Разработка временных итоговых мер для многоступенчатых клинических испытаний при многоразовом склерозе.

СПРАВОЧНАЯ ИНФОРМАЦИЯ И ЦЕЛИ: В ходе многоэтапных клинических испытаний с применением различных видов оружия (MAMS) используются промежуточные итоговые анализы для проверки нескольких методов лечения кандидатов, которые должны перейти к следующему этапу испытаний. Сокращение времени, расходов и числа участников по сравнению с нынешними отдельными этапами 2 и 3 Клинические испытания могли бы ускорить разработку методов лечения нейродегенеративных заболеваний, таких, как прогрессивный множественный склероз (ПМС). Промежуточные результаты испытаний МУПМ должны отражать конечный результат этапа и

Совпадение в аннотации оригинала
BACKGROUND AND OBJECTIVES: Multi-arm multistage (MAMS) clinical trials use interim outcome stage analyses to test multiple candidate treatme … ls, could expedite the development of treatments in neurodegenerative diseases, such as progressive multiple sclerosis (PMS). MAMS trial interim outcomes must reflect the final stage outcome and be able to detect treatment effects with high power at interim stages. Patient-reported outcomes (PROMs) are cost-effective and highly accessible, making them promising MAMS …

Clean intermittent self-catheterization in persons with multiple sclerosis: the influence of cognitive dysfunction.

BACKGROUND: Bladder problems are very common in persons with multiple sclerosis (PwMS). OBJECTIVE: The aim of this study was to investigate the ability of PwMS to learn clean intermittent self-catheterization (CISC). METHODS: The physical disability of 23 PwMS was evaluated with the Expanded Disability Status Scale (EDSS), and cognitive status was evaluated with the Brief Repeatable Battery of Neuropsychological Tests (BRB-N). CISC was taught by the same continence advisor who was blinded to the cognitive test results. The ability to learn CISC was evaluated immediately after sessions and 3 …

The role of iron dysregulation in the pathogenesis of multiple sclerosis: an Egyptian study.

BACKGROUND: Iron is essential for virtually all types of cells and organisms. The significance of iron for brain function is reflected by the presence of receptors for transferrin on brain capillary endothelial cells. Iron imbalance is associated with proinflammatory cytokines and oxidative stress, which have been implicated in the pathogenesis of multiple sclerosis (MS). Transferrin receptor (TfR) is the major mediator of iron uptake. Its expression is increased to facilitate iron entrance into the cell. The increased serum level of soluble transferrin receptor (sTfR) may indicate an abnormal…

Визуальные последствия лекарств от множественного склероза: хорошее, плохое, уродливое и неизвестное.

Множественный склероз (MS) связан с изменениями зрения как из-за воздействия MS на визуальные пути, так и из-за воздействия лекарств на визуальные пути. Определение причин изменения видения имеет решающее значение для надлежащей диагностики и управления. Изучаются частотность, показ и лечение макулярного отёка, связанного с фенолимодом, алемтузумбовой орбитопатии щитовидной железы и прогрессивной многофукальной лейкоэнцефалопатии у пациентов, страдающих НР. Приводится информация о благоприятном воздействии на зрение острых, хронических и симптоматических препаратов MS.

Совпадение в аннотации оригинала
Multiple sclerosis (MS) is associated with vision changes both due to MS effects on visual pathways and due to medication effects on the visual pathways. Distinguishing the causes of vision change are critical to appropriate diagnosis and management. The incidence, presentation, and treatment of fingolimod-associated macular edema, alemtuzumab-associated thy…

Neurofilament light chain and glial fibrillary acidic protein as biomarkers of peripheral nervous system involvement in multiple sclerosis: diagnostic and prognostic evaluation.

BACKGROUND: Multiple sclerosis is a chronic demyelinating disease of the central nervous system caused by an immune-mediated inflammatory process. Its aetiology remains unclear, and numerous pathogenetic theories have been proposed. The diversity of clinical manifestations and the lack of reliable biomarkers make diagnosis challenging. Serum neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) have been investigated as potential biomarkers for disease progression and response to disease-modifying therapies; however, their specificity and sensitivity remain variable, parti…

[Retinal atrophy using optical coherence tomography (OCT) in 15 patients with multiple sclerosis and comparison with healthy subjects].

INTRODUCTION: Multiple sclerosis is a common disabling progressive neurological disorder. Axonal loss is thought to be a likely cause of persistent disability after a multiple sclerosis relapse. Retinal nerve fiber layer (RNFL) imaging by optical coherence tomography (OCT) seems to be a non-invasive way of detecting optical axonal loss following optic neuritis. OBJECTIVE: To determine whether multiple sclerosis affects retinal nerve fiber layer measurements obtained with optical coherence tomography (OCT3-Carl Zeiss Meditec, Dublin, California, USA). MATERIAL AND METHODS: Diagnosis of MS was…