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Fluid biomarker and electrophysiological outcome measures for progressive MS trials.

Progressive multiple sclerosis (MS) is characterized by insidious clinical worsening that is difficult to accurately quantify and predict. Biofluid markers and electrophysiological measures are potential candidate outcome measures in clinical trials, allowing the quantification of nervous damage occurring in the disease. Neurofilaments are highly specific neuronal proteins. They may have come closest to such applications by their higher concentrations repeatedly demonstrated in cerebrospinal fluid (CSF) in all stages of MS, during relapses, their responsiveness to disease-modifying treatments …

Autologous hematopoietic stem cell transplantation in progressive severe multiple sclerosis.

UNLABELLED: Multiple sclerosis (MS) is a chronic inflammatory disease of central nervous system (CNS), which is disabling and majorly involves younger population. Various available treatments in forms of immunomodulation are not very effective; however, stem cell transplantation seems to be promising in recent literature. The current case report is a novel evidence for autologous hematopoietic stem cell transplantation (HSCT) in progressive MS. CASE SUMMARY: A 33 year old male with secondary progressive MS (SPMS), after being failed and/or intolerance to standard approved interferon (IFN) and…

What makes a prognostic biomarker in CNS diseases: strategies for targeted biomarker discovery? Part 2: chronic progressive and relapsing disease.

INTRODUCTION: Compared with acute neurological conditions, biomarker discovery in chronic progressive and relapsing neurodegenerative diseas … AS COVERED: In this review, the authors cover chronic and relapsing neurological diseases including multiple sclerosis, neuromyelitis optica, motor neuron disease and a number of neurodegenerative dementias and movement disorders. In these entities, prognostic estimates depend, at least in part, on an accurate differential diagnosis. Therefore, the authors have give …

Mystery of chronic cerebrospinal venous insufficiency: identical venographic and ultrasound findings in patients with MS and controls.

BACKGROUND AND PURPOSE: Stenosis of the internal jugular, azygos, and other veins detected by using intracranial and neck Doppler and B-mode sonography and confirmed by venography has been reported in MS with a high degree of sensitivity. This article reports the results of sonographic findings in patients with MS and controls, looking for evidence of the controversial entity chronic cerebrospinal venous insufficiency. Furthermore, the venographic appearance in controls is documented. MATERIALS AND METHODS: Thirty consecutive patients with definite MS and 10 controls had TCD and high-resoluti

Role of early viral infections in development of multiple sclerosis.

INTRODUCTION: Multiple sclerosis is a chronic inflammatory, autoimmune, demyelinating, disease but also degeneration of axons, with mainly progressive course, causing greater or lesser degree of disability. In addition to genetic predisposition the environmental factors, with particular importance of early viral infection, have an essential role in the development of MS. These are called long-acting viruses that remain hidden in the body for years by encouraging latent immunological changes in the body, eventually resulting in autoimmune demyelination and the appearance of disease symptoms, wh…

Progressive Multiple Sclerosis Is Associated with Faster and Specific Retinal Layer Atrophy.

OBJECTIVE: Therapeutic development in progressive multiple sclerosis (PMS) has been hampered by a lack of reliable biomarkers to monitor neurodegeneration. Optical coherence tomography (OCT)-derived retinal measures have been proposed as promising biomarkers to fulfill this role. However, it is unclear whether retinal atrophy persists in PMS, exceeds normal aging, or can be distinguished from relapsing-remitting multiple sclerosis (RRMS). METHODS: 178 RRMS, 186 PMS, and 66 control participants were followed with serial OCT for a median follow-up of 3.7 years. RESULTS: The estimated proportio…

Unexpected additive effects of minocycline and hydroxychloroquine in models of multiple sclerosis: Prospective combination treatment for progressive disease?

BACKGROUND: Most multiple sclerosis (MS) patients succumb to a progressive phenotype. Continued lymphocyte activity in the brain, microglia-mediated injury, iron deposition, and oxidative stress are characteristics of progressive MS. OBJECTIVE: As minocycline and hydroxychloroquine have been shown to inhibit microglia, we evaluated their effects on other outcomes relevant for progression. METHODS: Medications were evaluated in culture and in mice with acute and chronic experimental autoimmune encephalomyelitis (EAE). RESULTS: Both medications individually reduced iron neurotoxicity and a co…

The X factor.

A 45-year-old white woman presented with chronic bilateral, painless, progressive, peripheral vision loss. She was found to have bilateral optic atrophy and nonenhancing multifocal white matter lesions on magnetic resonance imaging of the brain. Cerebrospinal fluid analysis showed an elevated level of myelin basic protein. She was diagnosed as having the carrier state of X-linked adrenoleukodystrophy. X-linked adrenoleukodystrophy can mimic the clinical and radiographic features of multiple sclerosis in a female carrier. To our knowledge, this is the first case report of bilateral optic atroph…

THE IMPACT OF ESTABLISHING A SPECIALIZED MULTIPLE SCLEROSIS CLINIC ON PATIENTS' QUALITY OF LIFE: EXPERIENCE FROM THE REGIONAL HEALTHCARE SYSTEM (THE KOMI REPUBLIC, 2020-2024)

Significance. Multiple sclerosis is a chronic progressive disease that significantly affects physical and mental health. Effectiveness of the multiple sclerosis management is determined not only by the availability of modern treatments but also by the organization of specialized medical care delivery. The evaluation of such organizational reforms through the lens of patient-reported outcomes, such as quality of life, is of significant practical interest. Purpose. To assess the impact of organizational changes in the neurological care system on the quality of life and key clinical-therapeutic i…

The potential of optical coherence tomography angiography in progressive multiple sclerosis.

Early detection and monitoring of neurodegenerative processes in persons with multiple sclerosis (PwMS) is currently a major challenge. Optical coherence tomography angiography (OCTA) is an emerging method to visualize retinal vascular architecture. However, its use has mainly been investigated in relapsing MS. We evaluated OCTA as a possible complementary method in progressive MS (PMS) in a monocentric, retrospective, cross-sectional study. Eyes with evidence of optic neuritis were excluded from analysis. OCTA images acquired using a Spectralis OCT (Heidelberg Engineering) were analyzed with …

Изучение влияния различных дихотомических определений когнитивных нарушений на функциональную связь в вторичных прогрессивных MS.

СВЯЗЬ С ПЕРЕСМОТРЕННОЙ Сетевой функцией мозга связана с когнитивной дисфункцией при множественном склерозе (MS), однако недавние исследования указывают на отсутствие консенсуса на местах. Эти различия могут касаться стадии MS или различных определений когнитивных нарушений. ЦЕЛЬ: Мы изучили когнитивные нарушения и функциональные связи (FC), в частности в СМПС (вторичное прогрессивное MS) с использованием функционального MRI (rs-fMRI) в состоянии отдыха, и провели оценку изменений в FC с использованием двух широко используемых дихотомных критериев для когнитивных нарушений. МЕТОДЫ: 65 субъектов

Совпадение в аннотации оригинала
BACKGROUND: Altered brain network function is associated with cognitive impairment in multiple sclerosis (MS), but recent studies highlight a lack of consensus in the field. These differences may relate to the stage of MS, or different definitions for cognitive impairment. OBJECTIVE: We investigated cognitive impairment and functional connectivity (FC) spec…

Subcortical plaques and inflammation reflect cortical and meningeal pathologies in progressive multiple sclerosis.

It remains elusive whether lesions and inflammation in the sub/juxtacortical white matter reflect cortical and/or meningeal pathologies. Elu … ters in a false discovery rate-corrected analysis. We compared 12 patients with primary progressive multiple sclerosis (PPMS) and 15 with secondary progressive MS to 22 controls. Fifteen patients and 11 controls contributed with hemispheric sections. Sections were stained with haematoxylin-eosin, for myelin and for microglia/macrophages. B cells and T cells were con …

Effect of Short-term Integrated Palliative Care on Patient-Reported Outcomes Among Patients Severely Affected With Long-term Neurological Conditions: A Randomized Clinical Trial.

IMPORTANCE: Palliative care has shown benefits in reducing symptom intensity and quality of life in patients with advanced cancer. However, … 350 were randomized. Inclusion criteria were patients 18 years or older with any advanced stage of multiple sclerosis, motor neuron disease, idiopathic Parkinson disease multiple system atrophy, or progressive supranuclear palsy. Data were analyzed from November 2018 to March 2019. INTERVENTIONS: Patients were randomized 1:1 using minimization method to receive SI …

A novel mitochondrial DNA deletion producing progressive external ophthalmoplegia associated with multiple sclerosis.

We report a previously undescribed 7676 base pair mitochondrial (mt)DNA deletion involving genes of complex I, complex IV subunits 2 and 3 (cytochrome oxidase [Cox] II, III), adenosine triphosphatase 8 and 6, cytochrome b and 8 transfer (t)RNA genes producing myopathy and progressive external ophthalmoplegia (PEO) in a 44-year-old right-handed Caucasian man with features of multiple sclerosis (MS). We performed complete mtDNA sequencing and deletion analysis, spectrophotometric analysis of muscle and platelet respiratory chain activity, measurement of platelet mitochondrial membrane potential …

Electroconvulsive Therapy in Multiple Sclerosis: A Review of Current Evidence.

OBJECTIVE: To review the published literature over the last 5 years on the use of electroconvulsive therapy (ECT) in multiple sclerosis (MS), focusing on efficacy, safety, and tolerability. MS commonly has neuropsychiatric comorbidity. ECT is used in MS for severe and life-threatening forms of mental illness when other treatment options have failed or when a rapid response is required. DATA SOURCES: English-language literature published in the last 5 years (January 2015-June 2, 2020) was searched using the terms: ECT, electroconvulsive therapy, shock therapy, electroshock therapy, electroconv…

LAMA2-related muscular dystrophy mimicking multiple sclerosis.

Laminin-alpha2-related muscular dystrophy (LAMA2-MD) is a genetic condition due to reduced LAMA2, a protein found throughout the nervous system. Late-onset LAMA2-MD may present with proximal muscle weakness, joint contractures, neuropathy, epilepsy and/or cardiorespiratory issues, and is less common than the neonatal form. We describe a novel phenotype of LAMA2-MD with progressive myelopathy and spinal cord abnormalities.A woman was referred for evaluation of multiple sclerosis (MS) with progressive gait difficulty and abnormal neuroimaging showing white matter abnormalities in the brain and s…

Self-assessments and determinants of HRQoL in a German MS population.

OBJECTIVES: The importance of health-related quality of life (HRQoL) in multiple sclerosis (MS) is widely acknowledged. In 2015, a multicenter study was launched to assess the HRQoL and coping styles of chronically ill persons in Germany. The aims of this paper were (i) to describe how persons affected by MS assess their HRQoL and (ii) find out sociodemographic and disease-specific determinants of HRQoL. MATERIALS AND METHODS: A quantitative survey (optionally per paper-pencil or online) was conducted between March and October 2015 in Germany. Recruitment ways were as follows: Associations of…

CD133-Positive Membrane Particles in Cerebrospinal Fluid of Patients with Inflammatory and Degenerative Neurological Diseases.

Background: Analysis of cerebrospinal fluid (CSF) is a frequently used diagnostic tool in a variety of neurological diseases. Recent studies … mmatory diseases demonstrated significantly elevated levels in individuals with relapsing-remitting multiple sclerosis (p = 0.023) and secondary progressive multiple sclerosis (SPMS; p = 0.010). Conclusion: Collectively, our study revealed elevated levels of membrane particle-associated CD133 in patients with normal pressure hydrocephalus, parkinsonism as well as re …