MS

If it's on your mind and it has to do with multiple sclerosis in any way, post it here.
User avatar
Petr75
Family Elder
Posts: 1610
Joined: Sat Oct 19, 2013 10:17 am
Location: Czech Republic
Contact:

Re: MS

Post by Petr75 »

2020 Dec 9
Hospices Civils de Lyon, Laboratoire d'immunologie, Hôpital Édouard Herriot, Lyon, France
Clinical significance of a single cerebrospinal fluid immunoglobulin band: A retrospective study
https://pubmed.ncbi.nlm.nih.gov/33295240/

Abstract

Background: To demonstrate an inflammatory process in the central nervous system, the presence of at least two immunoglobulin (Ig) bands in the cerebrospinal fluid (CSF) is required. So far, the presence of a single abnormal Ig band is considered as negative.

Objective: The objective was to assess retrospectively the significance of a single CSF Ig band in clinical practice.

Methods and results: Out of 10,286 CSF analyses, we retained 214 results with single Ig. An inflammatory neurological disorder was diagnosed in 41% of patients.

Conclusion: Despite a modest sensitivity, the presence of a single CSF Ig band may be a biomarker of an inflammatory mechanism and, as such, may prompt the clinician to repeat the analysis when the clinical context remains suggestive.
https://www.eboro.cz
User avatar
Petr75
Family Elder
Posts: 1610
Joined: Sat Oct 19, 2013 10:17 am
Location: Czech Republic
Contact:

Re: MS

Post by Petr75 »

2021 Jan 12
Neuroscience Institute, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania, US
Real world prognosis in MS: does early versus late diagnosis matter?
https://pubmed.ncbi.nlm.nih.gov/33432877/

Abstract

Background: Multiple sclerosis (MS) often presents soon after the onset of a recognized clinically isolated syndrome (CIS). In order to interpret data from CIS trials, it is important to know whether patients presenting as classical CIS provide group data representative of RRMS.

Objective: We aimed to determine whether or not MS patients presenting soon after the onset of symptoms with clinically isolated syndromes have an identifiable clinical profile, including worse outcomes, versus MS patients presenting later.

Methods: Chart review of consecutive patients with newly diagnosed relapsing MS, diagnosed in our clinic between 1989 and 2005. We divided patients into an early presentation group (EP), versus the remaining late presenting group (LP), and analyzed the impact of delay in presentation on 10- and 15-year disability outcomes. We also sought to identify reasons for later presentation.

Results: The two groups were similar in terms of many demographics, clinical risk factors, and long-term disability outcomes (median EDSS 2.25 versus EDSS 2.0 at 10 years). Exceptionally, patients in the EP group had more frequent attacks in the first few years after onset and were diagnosed and treated earlier.

Conclusions: Patients in our MS clinic with EP versus LP were more likely to have multiple attacks in the first 2 years after onset and were treated earlier, but did not have a better 10- or 15-year outcome.
https://www.eboro.cz
User avatar
Petr75
Family Elder
Posts: 1610
Joined: Sat Oct 19, 2013 10:17 am
Location: Czech Republic
Contact:

Re: MS

Post by Petr75 »

2020 Dec 19
Department of Neurology, University of Campinas (UNICAMP), Brazil
Associations between cognitive and clinical disability across MS subtypes: The role of the underlying brain damage
https://pubmed.ncbi.nlm.nih.gov/33477004/

Abstract

Background: Cognitive impairment (CI) is present in all stages and subtypes of multiple sclerosis (MS). However, the majority of studies examined relapsing-remitting (RRMS) patients, and did not address cognitive phenotyping. Is still not clear whether patients with progressive MS (PMS) have a distinct pattern of CI compared to RRMS. In addition, there is conflicting data regarding the correlation between clinical and cognitive disability.

Objective: To investigate the differences of CI between PMS and RRMS patients, evaluating cognitive phenotypes. We also aimed to analyze the association between physical and cognitive disability with MRI measures of grey-matter atrophy and lesion burden.

Methods: Thirty patients with PMS and twenty-four with RRMS underwent neurological, neuropsychological (BRB-N, Boston Naming, and Tower of London), and MRI assessments (3T). Brain volume evaluations were performed using FreeSurfer. Principal Components Analysis on neuropsychological yielded six principal cognitive domains. Cognitive deficits were classified according to three categories: no CI, impairment in isolated cognitive domain, or impairment in combined domains.

Results: In the overall sample, the most frequently impaired cognitive domains were information processing speed (IPS) and visual memory. PMS patients had a higher prevalence of verbal memory and verbal fluency deficits, and more frequent impairment in combined cognitive domains compared to RRMS individuals. After multivariable regression analysis with clinical variables, EDSS was associated with most cognitive domains. Nevertheless, after including T1-lesion volume in the model, it was the most consistent predictor of cognitive performance. To further analyze the interaction between EDSS and T1-lesions, we performed GLM analysis with EDSS and T1-hypointense lesion volume as covariates, and T1-lesion volume adjusted better the model for verbal memory (p = 0.013), IPS (p = 0.021) and total number of impaired cognitive domains (p = 0.021).

Conclusions: RRMS and PMS patients tend to have a similar neuropsychological profile in general, but the extent of CI was greater in PMS patients. Worse cognitive performance was associated with increased physical disability, but this correlation was no longer significant after controlling for T1-lesion volume, suggesting that the underlying MS pathology might be involved in this relationship. Thalamic and T1-lesion volumes were the most consistent MRI predictors associated with cognitive disability.
https://www.eboro.cz
User avatar
Petr75
Family Elder
Posts: 1610
Joined: Sat Oct 19, 2013 10:17 am
Location: Czech Republic
Contact:

Re: MS

Post by Petr75 »

2021 Feb 20
Centro de Esclerosis Múltiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
Menopause does not modify disability trajectories in a longitudinal cohort of women with CIS and MS followed from disease onset
https://pubmed.ncbi.nlm.nih.gov/33609298/

Abstract

Objective: to evaluate the effect of menopause on disability accumulation in women followed from their clinically isolated syndrome (CIS).

Methods: We examined the longitudinal changes in EDSS from CIS until the last follow-up in women belonging to the Barcelona CIS prospective cohort, followed through their menopausal transition. The analysis is based on 13,718 EDSS measurements with an average of 28 EDSS per patient. Differences in EDSS trajectories between menopausal and non-menopausal women, controlling for age and disease duration were evaluated. We performed two sensitivity analyses, in women with confirmed MS and in those experiencing and early menopause.

Results: from 764 eligible women, 496 (65%) responded to the questionnaire and 74 (14.9%) reached menopause over follow-up. We did not find a significant inflection point in EDSS trajectories around menopause (slope change -0.009 (95%CI -0.066; 0.046). The annual increase in EDSS over the complete course of the disease was significantly higher in menopausal women (0.049 IC 95% 0.026 - 0.074) versus non-menopausal (0.019 IC 95% 0.008 - 0.031, interaction p-value 0.025). This difference was lost once controlling for age and disease duration (EDSS annual increase of 0.059 95% CI 0.025- 0.094 vs 0.038 IC 95% 0.021 - 0.057 respectively, interaction p-value 0.321). No inflection point was detected when the analysis was restricted to women with confirmed MS or with earlier menopause.

Conclusion: menopause is not associated with an increased risk of disability in a CIS population, considering EDSS trajectories throughout the course of the disease, together with age and disease duration.
https://www.eboro.cz
User avatar
Petr75
Family Elder
Posts: 1610
Joined: Sat Oct 19, 2013 10:17 am
Location: Czech Republic
Contact:

Re: MS

Post by Petr75 »

2021 Mar 25
Department of Health & Exercise Science, Colorado State University, Fort Collins, Colorado, USA
Middle-age people with multiple sclerosis demonstrate similar mobility characteristics to neurotypical older adults
https://pubmed.ncbi.nlm.nih.gov/33813095/
Abstract

Background: Clinical trials often report significant mobility differences between neurotypical and atypical groups, however, these analyses often do not determine which measures are capable of discriminating between groups. Additionally, indirect evidence supports the notion that some mobility impaired populations demonstrate similar mobility deficits. Thus, the current study aimed to provide a comprehensive analysis of three distinct aspects of mobility (walking, turning, and balance) to determine which variables were significantly different and were also able to discriminate between neurotypical older adults (OA) and middle-aged people with multiple sclerosis (PwMS), and between middle-aged neurotypical adults and PwMS.

Methods: This study recruited 21 neurotypical OA, 19 middle-aged neurotypical adults, and 30 people with relapsing remitting MS. Participants came into the laboratory on two separate occasions to complete mobility testing while wearing wireless inertial sensors. Testing included a self-selected pace two-minute walk, a series of 180˚ and 360˚ turns, and a clinical balance test capturing a total of 99 distinct mobility characteristics. We determined significant differences for gait and turning measures through univariate analyses and a series of repeated measures analysis of variance in determining significance for balance conditions and measures. In determining discrimination between groups, the Area Under the Curve (AUC) was calculated for all individual mobility measures with a threshold of 0.80, denoting excellent discrimination. Additionally, a stepwise regression of the top five AUC producing variables was performed to determine whether a combination of variables could enhance discrimination while accounting for multicollinearity.

Results: The results between neurotypical OA and middle-aged PwMS demonstrated significant differences for three gait and one turning variable, with no variable or combination of variables able to provide excellent discrimination between groups. Between middle-age neurotypical adults and PwMS a variety of mean and variability gait measures demonstrated significant differences between groups; however, no variable or combination of variables met discriminatory threshold. For turning, five 360˚ turn variables demonstrated significant differences and furthermore, the combination of 360˚ mean turn duration and variability of peak turn velocity were able to discriminate between groups. Finally, the majority of postural sway measures demonstrated significant group differences and the ability to discriminate between groups, particularly during more challenging balance conditions where participants stood on a compliant surface.

Conclusion: These results offer a comprehensive analysis of mobility differences and measures capable of discriminating between middle-age neurotypical adults and PwMS. Additionally, these results provide evidence that OA and middle-age PwMS display similar movement characteristics and thus a potential indicator of advanced aging from a mobility perspective.
https://www.eboro.cz
User avatar
Petr75
Family Elder
Posts: 1610
Joined: Sat Oct 19, 2013 10:17 am
Location: Czech Republic
Contact:

Re: MS

Post by Petr75 »

2021 May 19
Université de Lyon, Université Claude Bernard Lyon 1, France
Effects of Age and Disease Duration on Excess Mortality in Patients With Multiple Sclerosis From a French Nationwide Cohort
https://pubmed.ncbi.nlm.nih.gov/34011577/


Abstract

Objective: To determine the effects of current age and disease duration on excess mortality in multiple sclerosis, we described the dynamics of excess deaths rates over these two time scales and studied the impact of age at multiple sclerosis clinical onset on these dynamics, separately in each initial phenotype.

Methods: We used data from 18 French multiple sclerosis expert centers participating in the Observatoire Français de la Sclérose en Plaques. Patients with multiple sclerosis living in metropolitan France and having a clinical onset between 1960 and 2014 were included. Vital status was updated on January 1st, 2016. For each multiple sclerosis phenotype separately (relapsing onset (R-MS) or primary progressive (PPMS)), we used an innovative statistical method to model the logarithm of excess death rates by a multidimensional penalized spline of age and disease duration.

Results: Among 37524 patients (71% women, mean age at multiple sclerosis onset ± standard deviation 33.0 ± 10.6 years), 2883 (7.7%) deaths were observed and 7.8% of patients were lost-to-follow-up. For R-MS patients, there was no excess mortality during the first 10 years after disease onset; afterwards, whatever age at onset, excess death rates increased with current age. From current age 70, the excess death rates values converged and became identical whatever the age at disease onset, which means that disease duration had no more impact. Excess death rates were higher in men with an excess hazard ratio of 1.46 (95% confidence interval 1.25-1.70). In contrast, in PPMS patients, excess death rates rapidly increased from disease onset, and were associated with age at onset, but not with sex.

Conclusions: In R-MS, current age has a stronger impact on multiple sclerosis mortality than disease duration while their respective effects are not so clear in PPMS.
https://www.eboro.cz
User avatar
Petr75
Family Elder
Posts: 1610
Joined: Sat Oct 19, 2013 10:17 am
Location: Czech Republic
Contact:

Re: MS

Post by Petr75 »

2021 May 30
Department of Neurology, Telemark Hospital Trust, Skien, Norway; Institute of Health and Society, University of Oslo, Norway
Maternal education has significant influence on progression in multiple sclerosis
https://pubmed.ncbi.nlm.nih.gov/34111658/

Abstract

Objective: The identification of potential risk factors for disease severity is of great importance in the treatment of multiple sclerosis. The influence of socioeconomic status on progression in multiple sclerosis (MS) is sparsely investigated. Our aim was to investigate how socioeconomic status in adolescence influences disease progression in later life.

Methods: A total of 1598 patients with multiple sclerosis from a well-defined population in Norway were included. Detailed information on disease progression, measured by expanded disability status scale (EDSS) and multiple sclerosis severity score (MSSS), were combined with data on socioeconomic factors. We used residency and parental level of education at patients' age 16 and exposure to second-hand smoking as a measure of socioeconomic status in adolescence, adjusting for the same variables as well as use of disease modifying treatments at prevalence date 01.01.18.

Results: High maternal level of education at patients' age 16 was significantly associated with less pronounced disease progression measured by MSSS (β-coefficient -0.58, p = 0.015), younger age and lower EDSS at disease onset, and shorter time from onset to diagnosis. No significant associations were found for paternal education level and MSSS. The use of any disease modifying treatment before prevalence date was significantly associated with disease progression (β-coefficient -0.49, p=0.004), while residence, current and second-hand smoking were not.

Conclusion: This study on a population-based, real-world cohort shows that the parental level of education has a significant impact on a timely diagnosis of MS. In addition to disease modifying treatment, maternal level of education also had an impact on disease progression in later life.
https://www.eboro.cz
User avatar
Petr75
Family Elder
Posts: 1610
Joined: Sat Oct 19, 2013 10:17 am
Location: Czech Republic
Contact:

Re: MS

Post by Petr75 »

2021 Oct 30
1st Department of Neurology, Faculty of Medicine, Comenius University, Slovakia
Autonomic Nervous System Function in Newly Diagnosed Multiple Sclerosis: Association With Lipid Levels and Insulin Resistance
https://pubmed.ncbi.nlm.nih.gov/34717060/


Abstract

Autonomic nervous system (ANS) disorders are common in multiple sclerosis (MS). Previous studies showed differences in insulin resistance (IR) and lipoprotein levels in MS subjects compared to controls. Lipolysis caused by increased sympathetic activity could be one of the possible linking mechanisms leading to dyslipidemia in MS. Our study aimed to evaluate ANS activity in the context of glucose and lipid metabolism in people with MS. We prospectively measured short-term heart rate variability (HRV), fasting lipoprotein concentrations, and calculated IR indices based on plasma glucose and insulin levels during oral glucose tolerance test (oGTT) in 32 patients with MS and 29 healthy controls matched for age, sex and body mass index in our study. There was no significant difference in HRV parameters and lipoprotein levels between MS and controls. A significant positive correlation was found between low/high-frequency power ratio (LF/HF) and triglycerides (r=0.413, p=0.021) in MS subjects but not in controls. A significantly lower whole-body insulin sensitivity index (ISIMat) was found in patients with MS compared to the control group (7.3±3.7 vs. 9.8±5.6, p=0.041). No significant correlations were found between LF/HF and IR parameters. In MS subjects, the positive correlation of LF/HF with triglycerides could reflect the effects of sympathetic activity on lipolysis. Positive correlations of sympathetic activity with increased lipoprotein levels could rather reflect processes associated with immune system activation/inflammation, than processes involved in glucose homeostasis maintenance.
https://www.eboro.cz
User avatar
Petr75
Family Elder
Posts: 1610
Joined: Sat Oct 19, 2013 10:17 am
Location: Czech Republic
Contact:

Re: MS

Post by Petr75 »

2021 Dec 3
Neuroimaging Unit, Neuro-immunology Division, Department of Neurology, Vanderbilt University Medical Center, Nashville
White matter tracts that overlap with the thalamus and the putamen are protected against multiple sclerosis pathology
https://pubmed.ncbi.nlm.nih.gov/34922252/


Abstract

Background: The thalamus and the putamen are highly connected hubs implicated in multiple sclerosis (MS) pathology. It remains unclear if white matter (WM) tracts, which pass through them, have a different susceptibility to MS pathology, and if so, if their impact on disability predominates over that exerted by disease in other WM tracts. We hypothesized that WM tracts connected to and passing through these hubs (subsequently termed hub+ tracts) would be more susceptible to MS-related pathology than tracts that do not pass through them (hub- tracts) due to retrograde and anterograde distant degeneration. Thus, we compared the lesion load and neurite orientation dispersion and density imaging (NODDI) derived metrics between hub+ and hub- tracts and assessed the relationship between these MRI metrics and those of physical impairment.

Methods: Eighteen patients (mean age of 45.5 years, 12 females) had 3 Tesla MRI consisting of T1-weighted and T2-weighted Fluid Attenuated Inversion recovery (FLAIR), and NODDI from which the orientation dispersion index (ODI), neurite density index (NDI), and isotropic volume fraction (IVF) were derived. Forty-nine WM tracts, i.e., 12 hub+ and 37 hub- tracts, were segmented out. Exploratory analyses of the differences in lesion burden, whole tract and normal appearing WM (NAWM) NODDI metrics were carried out between the two types of tracts using a Mann-Whitney U test. Correlations with physical impairment, assessed using the expanded disability status scale (EDSS) and timed 25-foot walk (T25FW)were assessed using Spearman correlation analyses.

Results: Hub- tracts had larger T1- (p<0.001) and T2-lesion (p<0.001) volumes; lower ODI (p<0.001), NDI (p<0.001) and higher IVF (p = 0.020) in comparison to hub+ tracts. Measures of tissue injury in hub+ tracts correlated with those of clinical disability, though less strongly than in hub- tracts.

Conclusions: Contrary to our hypothesis, our exploratory pilot study results suggest that WM tracts that overlap with the thalamus and the putamen have a lower degree of lesional and non-lesional tissue injury, suggesting a protective role of the hubs against MS pathology or a higher degree of vulnerability of those not passing through hub stations. We also show a weaker association between disability impairment and hub+ pathology, compared to that in hub- tracts. Our findings point to a potential role of disease location in relation to hubs as guidance for treatment personalization in MS.
https://www.eboro.cz
User avatar
Petr75
Family Elder
Posts: 1610
Joined: Sat Oct 19, 2013 10:17 am
Location: Czech Republic
Contact:

Re: MS

Post by Petr75 »

2022 Jan 19
The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
High or increasing serum NfL is predictive of impending multiple sclerosis relapses
https://pubmed.ncbi.nlm.nih.gov/35078125/

Abstract

Background: One-off serum levels of neurofilament light chain (sNfL) is an established predictor of emerging disease activity in multiple sclerosis (MS). However, the importance of longitudinal increases in sNfL is yet to be enumerated, an important consideration as this test is translated for serial monitoring. Glial Fibrillary Acidic Protein (sGFAP) is another biomarker of predictive interest. Our objective was to assess the association between longitudinal changes sNfL and prediction of future relapses, as well as a possible role for sGFAP.

Methods: Participants with active MS were prospectively monitored for one year as part of a clinical trial testing mesenchymal stem cells. Visits every three months or less included clinical assessments, MRI scans and serum draws. sNfL and sGFAP concentrations were quantified with Single Molecule Array immunoassay. We used Kaplan-Meier estimates and Anderson-Gill Cox regression models with and without adjustment for age, sex, disease subtype, disease duration and expanded disability status score (EDSS) to estimate the rate of relapse predicted by baseline and longitudinal changes in biomarker.

Results: 58 Canadian and Italian participants with MS were enrolled in this study. Higher baseline sNfL was future relapse (Log-rank p = 0.0068), MRI lesions (p=0.0096), composite-relapse associated worsening (p=0.01) and progression independent of relapse activity (p=0.0096). Conversely, baseline sGFAP was only weakly associated with MRI lesions (0.044). Cross-sectional analyses of baseline sNfL revealed that a two-fold difference in baseline sNfL, e.g. from 10 to 20 pg/mL, was associated with a 2.3-fold increased risk of relapse during follow-up (95% confidence interval 1.65-3.17). Longitudinally, a two-fold increase in sNfL level from the first measurement was associated with an additional 1.46 times increased risk of relapse (1.07-2.00). The impact of longitudinal increases in sNfL on the risk of relapse were most pronounced for patients with lower baseline values of sNfL (<10 pg/mL: HR = 1.54, 1.06-2.24). These associations remained significant after adjustment for potential confounders.

Conclusion: We enumerate the risk of relapse associated with dynamic changes in sNfL. Both baseline and longitudinal change in sNfL may help identify patients who would benefit from early treatment optimisation.
https://www.eboro.cz
User avatar
1eye
Family Elder
Posts: 3780
Joined: Wed Mar 17, 2010 3:00 pm
Location: Kanata, Ontario, Canada
Contact:

Re: MS

Post by 1eye »

I was diagnosed in 1997-8, denied DMT because I was supposedly relapsing-remitting, then told I was secondary progressive, so it was 'too late' for DMTs, finally treated myself with biotin (later prescribed by a neurologist) which I have done for about ten years, never got my walking back (yet), and I'm told by people who should know that I'm doing better than anybody else who has had it this long.

Retired in about 2002. I'm 68.
This unit of entertainment not brought to you by FREMULON.
Not a doctor.
"I'm still here, how 'bout that? I may have lost my lunchbox, but I'm still here." John Cowan Hartford (December 30, 1937 – June 4, 2001)
User avatar
NHE
Volunteer Moderator
Posts: 6221
Joined: Sat Nov 20, 2004 3:00 pm
Contact:

Re: MS

Post by NHE »

Hi @1eye,
MedDay’s phase 3 trial of high dose biotin failed to prove helpful.

viewtopic.php?t=32061

Have you ever tried Na-R-Lipoate, a more absorbable form of Lipoic acid? Lipoic acid was found to reduce brain atrophy better than Ocrevus.

Reduction in atrophy:
Lipoic acid, 600mg/day = 68%
Ocrevus = 18%

https://www.medicalnewstoday.com/articles/318225

User avatar
Petr75
Family Elder
Posts: 1610
Joined: Sat Oct 19, 2013 10:17 am
Location: Czech Republic
Contact:

Re: MS

Post by Petr75 »

2022 Mar 24
University of Florence, Department of NEUROFARBA, Florence, Italy
Progression is independent of relapse activity in early multiple sclerosis: a real-life cohort study
https://pubmed.ncbi.nlm.nih.gov/35325059/

Abstract

Disability accrual in multiple sclerosis may occur as relapse-associated worsening or progression independent of relapse activity. The role of progression independent of relapse activity in early MS is yet to be established. The objective of this multicentre, observational, retrospective cohort study was to investigate the contribution of relapse-associated worsening and progression independent of relapse activity to confirmed disability accumulation in patients with clinically isolated syndrome and early relapsing-remitting multiple sclerosis, assessed within one year from onset and with follow-up >/= 5 years (n = 5169). Data were extracted from the Italian Multiple Sclerosis Register. Confirmed disability accumulation was defined by an increase in Expanded Disability Status Scale score confirmed at 6 months, and classified per temporal association with relapses. Factors associated with progression independent of relapse activity and relapse-associated worsening were assessed using multivariable Cox regression models. Over a follow-up period of 11.5 ± 5.5 years, progression independent of relapse activity occurred in 1427 (27.6%) and relapse-associated worsening in 922 (17.8%) patients. Progression independent of relapse activity was associated with older age at baseline (HR = 1.19; 95CI 1.13-1.25, p < 0.001), having a relapsing-remitting course at baseline (HR = 1.44; 95CI 1.28-1.61, p < 0.001), longer disease duration at baseline (HR = 1.56; 95%CI 1.28-1.90, p < 0.001), lower Expanded Disability Status Scale at baseline (HR = 0.92; 95CI 0.88-0.96, p < 0.001), lower number of relapses before the event (HR = 0.76; 95CI 0.73-0.80, p < 0.001). Relapse-associated worsening was associated with younger age at baseline (HR = 0.87; 95CI 0.81-0.93, p < 0.001), having a relapsing-remitting course at baseline (HR = 1.55; 95CI 1.35-1.79, p < 0.001), lower Expanded Disability Status Scale at baseline (HR = 0.94; 95CI 0.89-0.99, p = 0.017), higher number of relapses before the event (HR = 1.04; 95CI 1.01-1.07, p < 0.001). Longer exposure to disease modifying drugs was associated with a lower risk of both progression independent of relapse activity and relapse-associated worsening (p < 0.001). This study provides evidence that in early relapsing-onset multiple sclerosis cohort, progression independent of relapse activity was an important contributor to confirmed disability accumulation. Our findings indicate that insidious progression appears even in the earliest phases of the disease, suggesting that inflammation and neurodegeneration can represent a single disease continuum, in which age is one of the main determinants of disease phenomenology.
https://www.eboro.cz
User avatar
Petr75
Family Elder
Posts: 1610
Joined: Sat Oct 19, 2013 10:17 am
Location: Czech Republic
Contact:

Re: MS

Post by Petr75 »

2022 May 26
Department of Pediatrics, 5447Nicklaus Children's Hospital, Miami, FL, USA
Multifocal and Multiphasic Demyelinating Lesions After Radiation for Ependymoma in a Pediatric Population
https://pubmed.ncbi.nlm.nih.gov/35619552/

Abstract

Radiation treatment is widely used to address unresectable intracranial tumors. Owing to the nature of therapy, healthy tissue and diseased regions will be affected. New insights have shown that not only does this impact brain parenchyma but it causes changes in fluid status, myelination, and the integrity of the blood-brain barrier. This alters how peripheral and central immune systems interact, perpetuating neuroinflammation. Rare case reports in the adult literature have described multifocal, multiphasic demyelinating lesions after radiation. Here we describe 2 pediatric cases of relapsing demyelination after and in conjunction with radiation therapy for ependymoma, consistent with a multiple sclerosis phenotype. Insights into the underpinnings of multiple sclerosis show peripheral inflammation, blood-brain barrier disruption, and antigenic mimicry stimulate neuroinflammation. Here we investigate the roll that radiation, tumor burden, and systemic inflammation may play in creating demyelinating disorders. We strive to elucidate common pathophysiology between radiation-induced brain injury and multiple sclerosis.
https://www.eboro.cz
User avatar
Petr75
Family Elder
Posts: 1610
Joined: Sat Oct 19, 2013 10:17 am
Location: Czech Republic
Contact:

Re: MS

Post by Petr75 »

2022 Jun 25
University of Michigan, School of Nursing, Ann Arbor, United States
Relationships between childhood trauma and multiple sclerosis: A systematic review
https://pubmed.ncbi.nlm.nih.gov/35779440/

Abstract

Objective: Adverse Childhood Experiences (ACEs), such as physical, emotional, and sexual abuse trigger inflammatory changes and have been associated with many causes of morbidity and mortality, including autoimmune diseases. Although Multiple Sclerosis (MS) is a debilitating neurological autoimmune disease, literature linking ACEs and MS is understudied. The aim of this review was to examine the 1) state of the literature, and 2) relationships between childhood adversity and the prevalence and physical clinical features of MS (e.g., age at onset, relapses, pain, fatigue, disability).

Methods: A comprehensive search was preformed through five databases and by hand using the ancestry and descendancy approach for connections to papers published through January 20th, 2022. Studies were screened by independent reviewers using Rayyan.ai, and critically appraised for both quality and reporting transparency.

Results: Twelve studies examined relationships between any ACE(s) and the prevalence or physical clinical features of MS. There was considerable variance in the measurement of stressors, confounders, and categorization of MS; however most studies (n = 10) demonstrated an association between ACEs and MS (alone or grouped with other similar diagnoses), or physical clinical features.
https://www.eboro.cz
Post Reply

Return to “General Discussion”