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Multiple Sclerosis and related Disorders

Jan Kolcava, Monika Hulova, Yvonne Benesova, Josef Bednarik, Pavel Stourac
BACKGROUND: Natalizumab-related progressive multifocal leukoencephalopathy (PML) is associated with the presence of anti-John Cunningham virus (JCV) antibodies. The aim of this investigation was to evaluate the long-term stability of anti-JCV antibody serum levels and their relation to various demographic, clinical and radiological characteristics in patients suffering from multiple sclerosis (MS). METHODS: Seventy-eight relapsing-remitting MS patients treated with natalizumab and evaluated for the presence of serum anti-JCV antibodies over a time period of 1-6 years (3-11 samples) were included in the study...
February 14, 2019: Multiple Sclerosis and related Disorders
David Baker, Gareth Pryce, Samuel S Herrod, Klaus Schmierer
Oral cladribine is a novel treatment for relapsing multiple sclerosis (MS). This appears to be a semi-selective immune-reconstitution therapy that induces long-term therapy from short treatment cycles. It has a relatively good safety profile that currently does not require extensive monitoring associated with some continuous immunosuppressive and relatively non-selective immune reconstitution therapies. The efficacy and safety of cladribine relates to its particular physicochemical properties, the function of the lymphocyte subsets that are selectively targeted by the drug and the repopulation kinetics of these subsets...
February 14, 2019: Multiple Sclerosis and related Disorders
S Anis, K Regev, S J Pittock, E P Flanagan, Y Alcalay, A Gadoth
MOG-Ab positive CNS demyelination typically involves the optic nerve and spinal cord. Recurrent episodes of myelitis without optic neuritis are very rare and according to current literature review represent about 3-5% of positive MOG-Ab cases. We report a 30-year-old woman with positive serum MOG-Ab suffering two discrete episodes of transverse myelitis without ophthalmic involvement. Repeated serum MOG-Ab test after the second relapse was positive, correlating with high likelihood of relapsing disease. Of note, our patient relapsed under Rituximab therapy, which does not seem to be uncommon for MOG-Ab patients...
February 13, 2019: Multiple Sclerosis and related Disorders
Steve Simpson, Keryn L Taylor, George A Jelinek, Alysha M De Livera, Chelsea R Brown, Emily O'Kearney, Sandra L Neate, William Bevens, Tracey J Weiland
BACKGROUND: Depression is highly prevalent among people with MS, and determinants thereof would be useful. OBJECTIVES: We examined the relationship of demographic and clinical factors with positive depression-screen and change in depression over 2.5 years in people with MS. METHODS: Positive depression-screen assessed by Patient Health Questionnaire (PHQ)-2 and PHQ-9. Associations of demographic and clinical factors with depression-screen and change thereof assessed using multivariable regression models, adjusted for age, sex, disability, fatigue, antidepressant use, and baseline PHQ-2, as appropriate...
February 11, 2019: Multiple Sclerosis and related Disorders
Pavan Bhargava, Cassie Wicken, Matthew D Smith, Roy E Strowd, Irene Cortese, Daniel S Reich, Peter A Calabresi, Ellen M Mowry
BACKGROUND: Leptomeningeal inflammation is associated with increased cortical damage and worse clinical outcomes in MS. It may be detected on contrast-enhanced T2-FLAIR imaging as focal leptomeningeal contrast-enhancement (LME). OBJECTIVE: To assess the safety of intrathecal (IT) rituximab in progressive MS (PMS) and to assess its effects on LME and CSF biomarkers. METHODS: PMS patients had a screening MRI to detect LME. Participants satisfying eligibility criteria underwent two IT administrations of 25 mg rituximab 2 weeks apart...
February 11, 2019: Multiple Sclerosis and related Disorders
Anas Bennis, Hicham El Otmani, Nada Benkirane, Ilham Harrizi, Bouchra El Moutawakil, Mohammed Abdoh Rafai, Ilham Slassi
BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) was suggested to be more frequent and have specific features among populations from Africa or North Africa. However, we could not find any large study about NMOSD in an African population in the medical literature. OBJECTIVES: To describe the characteristics of NMOSD in a Moroccan monocenter population. PATIENTS AND METHODS: A retrospective study was conducted. Patients fromJanuary 1999 to December 2015 fulfilling the 2015 International Consensus Criteria for NMOSD were included...
February 10, 2019: Multiple Sclerosis and related Disorders
Lijun Peng, Chongfeng Bi, Deyu Xia, Linling Mao, Hairong Qian
BACKGROUND: Central nervous system (CNS) inflammatory demyelinating disease (IDD) is an immune-mediated disease that is pathologically characterized by demyelination and inflammatory infiltration in the CNS and includes clinically isolated syndrome (CIS), multiple sclerosis (MS), and neuromyelitis optica spectrum disorders (NMOSD). IDD is usually characterized by variable symptoms, multivariate imaging, uncertain reactions to treatment, and a variable prognosis, which makes it difficult to diagnose early...
February 8, 2019: Multiple Sclerosis and related Disorders
Weijing Liao, Cheng Li, Yulan Tang, Fan Huang, Huimin Kuang, Shuolin Liang, Yi Yang
Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory demyelinating disease of the central nervous system (CNS). A typical finding on spinal magnetic resonance imaging (MRI) of NMOSD is longitudinally extensive transverse myelitis (LETM). However, patients with NMOSD presenting with short-segment transverse myelitis (STM) during myelitis attacks associated with breast cancer are uncommon. We report a case of a 35-year-old woman with STM and left eye optic neuritis. The patient was positive for serum aquaporin-4 antibodies (AQP4-IgG), and a biopsy of the left breast showed invasive ductal carcinoma...
February 8, 2019: Multiple Sclerosis and related Disorders
Ricardo Alonso, Edgar Carnero Contentti, Gaston Imhoff, Pablo A Lopez, Adrian Rubstein, Santiago Tizio
Current multiple sclerosis (MS) therapeutic options have significantly increased treatment algorithm complexity. This urges physicians to take into account multiple factors in the decision-making process and make an even more thorough analysis of the risk-benefit balance. We carried out a descriptive review aiming to assess some factors that endanger the proper MS treatment fulfillment, focusing mainly on Latin American countries. Firstly, it is paramount to warrant the correct, fair and timely treatment access...
February 7, 2019: Multiple Sclerosis and related Disorders
Chiara Zecca, Zbyšek Pavelek, Kateřina Přikrylová, Mascia Ghielmetti, Andreas Beeler, Claudio Gobbi
BACKGROUND: Interferon beta (IFNB) and Glatiramer acetate, long-term first line disease modifying treatments (DMTs) for multiple sclerosis (MS), have different injection frequencies crucial for injection site related side effects. We aimed at investigating whether switching to intramuscular IFNB-1a injected once/week with the Avonex®Pen™ device improves treatment tolerability and quality of life in stable MS patients. METHODS: Clinically stable MS patients, whom their treating neurologist switched from high frequency injectable DMTs to weekly intramuscular IFNB-1a because of bothersome injection site reactions, were included...
February 6, 2019: Multiple Sclerosis and related Disorders
José Manuel Sánchez-Villalobos, Amaya Jimeno-Almazán, Carmen López-Peña, Esther Hernández-Hortelano, Antonio Martínez-Francés, José Antonio Pérez-Vicente
Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis that presents potential impairment of the central nervous system (CNS). Frequent CNS impairment makes ECD a disease worth considering in the differential diagnosis of multiple sclerosis (MS). We report the case of a patient initially diagnosed with relapsing-remitting MS with an atypical course who developed ECD during the disease progression. Given the patient's clinical-radiological characteristics, two diagnostic possibilities were proposed: the coexistence of both diseases or a new presentation of ECD mimicking MS...
February 6, 2019: Multiple Sclerosis and related Disorders
Alfredo Damasceno, Rafael Paterno C Dias-Carneiro, Adriel Santos Moraes, Vinícius O Boldrini, Raphael Patrício S Quintiliano, Verônica Almeida de Paula Galdino da Silva, Alessandro S Farias, Carlos Otavio Brandão, Benito Pereira Damasceno, Leonilda Maria Barbosa Dos Santos, Fernando Cendes
BACKGOUND: A major aim in MS field has been the search for biomarkers that enable accurate detection of neuronal damage. Besides MRI, recent studies have shown that neuroaxonal damage can also be tracked by neurofilament detection. Nevertheless, before widespread implementation, a better understanding of the principal contributors for this biomarker is of paramount importance. Therefore, we analyzed neurofilament light chain (NfL) in relapsing (RMS) and progressive MS (PMS), addressing which MRI and clinical variables are better related to this biomarker...
February 5, 2019: Multiple Sclerosis and related Disorders
Jeong Hee Cho, Yoonseon Park, Naeun Woo
There have been reports of central nervous systemic inflammatory disease associated with vaccination. We describe a female patient who developed longitudinally extensive transverse myelitis following seasonal influenza vaccination. A 38-year-old woman had severe neck and back pain with urinary retention. She received influenza vaccine 3 days before symptom onset. Examination revealed mild quadriparesis with diffuse hyperreflexia. Magnetic resonance imaging (MRI) of the spine showed a T2 hyperintense lesion with gadolinium enhancement in the spinal cord extending from the cervicomedullary junction to the level of T10...
February 5, 2019: Multiple Sclerosis and related Disorders
Jonathan Zurawski, Bonnie I Glanz, Alicia Chua, Hrishikesh Lokhande, Dalia Rotstein, Howard Weiner, David Engler, Tanuja Chitnis, Brian C Healy
BACKGROUND: Although the expanded disability status scale (EDSS) is the most commonly used measure of disability for multiple sclerosis, measurement of disability accumulation is complex due to the unequal steps of the scale. OBJECTIVE: To estimate the time between EDSS scores in a large MS cohort from a single center and determine the impact of functional system scores on EDSS transitions. METHODS: 31,394 clinical visits with EDSS scores from 2054 subjects in the CLIMB longitudinal cohort study were included in our analysis...
February 5, 2019: Multiple Sclerosis and related Disorders
D Vecchio, I Crespi, E Virgilio, P Naldi, M P Campisi, R Serino, U Dianzani, G Bellomo, R Cantello, C Comi
BACKGROUND: Cerebrospinal fluid (CSF) kappa free light chains (KFLC) have been suggested as quantitative alternative to oligoclonal bands (OB) in multiple sclerosis (MS) diagnosis. Despite OB have been associated to poor disease prognosis, little is known on KFLC in predicting MS early progression. Our aim is to evaluate the prognostic value of KFLC in a cohort of Italian MS patients. METHODS: 100 patients (64 females) underwent CSF analysis during their diagnostic MS work-up...
February 5, 2019: Multiple Sclerosis and related Disorders
Murat Çakır, Seda Sabah-Özcan, Hikmet Saçmacı
BACKGROUND: Multiple Sclerosis (MS) is a potentially progressive autoimmune disorder of the central nervous system. The pathology of MS is characterized by inflammation, demyelination, reactive gliosis and neuronal damage. Salusin-α and salusin-β have been shown to be widely expressed in many tissues, including the central nervous system. In our study, we investigated whether salusin-α and salusin-β peptides had a relation with inflammation and whether it is related to Relapsing-Remitting Multiple Sclerosis (RRMS) disease...
February 5, 2019: Multiple Sclerosis and related Disorders
Youngran Kim, Trudy Millard Krause, Philip Blum, Léorah Freeman
BACKGROUND: Multiple sclerosis (MS) is a leading cause of disability in adults and requires lifelong treatment. Specialty drugs referred to as disease-modifying therapies (DMTs) have become the standard for multiple sclerosis treatment since the 1990s as they have been shown to reduce the risk of relapses and to delay disease progression. While more DMTs became available, prices of DMTs including existing drugs continue to rise and remain very expensive. This study is to estimate recent drug costs for DMTs and examine its impact on overall health care costs among individuals with MS enrolled in commercial insurance...
February 5, 2019: Multiple Sclerosis and related Disorders
M Netravathi, B Hari Krishna, B Maya, V H Ganaraja, P Shwetha, M Anita, L K Nitish, A Nalini, R Yadav, P K Pal, P Satishchandra
BACKGROUND: Neuromyelitis Optica (NMO) is an autoimmune astrocytopathic disorder due to AQP4 antibodies. OBJECTIVES: To analyse clinical, neuroimaging features in NMO patients and assess the efficacy of various therapeutics. METHODS: AQP4+ve NMO patients were diagnosed based on consensus diagnostic criteria. RESULTS: 101 AQP4+ve NMO patients were seen with female (90) predominance. Adult population (71.3%) formed the larger group followed by pediatric (19...
February 4, 2019: Multiple Sclerosis and related Disorders
Felipe Balistieri Santinelli, Richard E A van Emmerik, Fabiana Araújo Silva, Luis Felipe Itikawa Imaizumi, Tiago Penedo, Ana Maria Canzonieri, Sérgio Tosi Rodrigues, Paula Favaro Polastri Zago, Fabio Augusto Barbieri
BACKGROUND: Multiple Sclerosis (MS) is a neurodegenerative and inflammatory disease that impacts both visual and postural control. It is currently unknown how the integration between visual and postural control is affected in people with MS (PwMS). It has been shown in healthy individuals that saccadic eye movements can decrease body sway as result as the integration of eye and postural movements. OBJECTIVE: Investigate the effect of saccadic eye movement on postural control in PwMS and compare with neurologically healthy people...
February 4, 2019: Multiple Sclerosis and related Disorders
Jun-Jun Lee, Meng-Han Tsai, Chia-Yi Lien, Yu-Ju Huang, Wen-Neng Chang
BACKGROUND: The aim of the current study was to examine intra-family phenotype variations in familial neuromyelitis optica (NMO) spectrum disorder. METHODS: The clinical presentation and neuroimaging features of two family members (mother and daughter) from a NMO spectrum disorder family (index family) were analyzed. Multiplex polymerase chain reaction was performed based on targeted re-sequencing on the AQP4 gene and the human leukocyte antigen (HLA) loci. The clinical and neuroimaging features of the members of six other previously reported NMO spectrum disorder families were also included for analysis...
February 4, 2019: Multiple Sclerosis and related Disorders
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