scholarly journals Rim lesions are demonstrated in early relapsing–remitting multiple sclerosis using 3 T-based susceptibility-weighted imaging in a multi-institutional setting

2021 ◽  
Author(s):  
Koy Chong Ng Kee Kwong ◽  
Daisy Mollison ◽  
Rozanna Meijboom ◽  
Elizabeth N. York ◽  
Agniete Kampaite ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Early Stage ◽  
Volumetric Analysis ◽  
Institutional Setting ◽  
Susceptibility Weighted Imaging ◽  
Planar Imaging ◽  
Random Factor ◽  
Multi Centre Study ◽  
Relapsing Remitting ◽  
The Difference

Abstract Purpose Rim lesions, characterised by a paramagnetic rim on susceptibility-based MRI, have been suggested to reflect chronic inflammatory demyelination in multiple sclerosis (MS) patients. Here, we assess, through susceptibility-weighted imaging (SWI), the prevalence, longitudinal volume evolution and clinical associations of rim lesions in subjects with early relapsing–remitting MS (RRMS). Methods Subjects (n = 44) with recently diagnosed RRMS underwent 3 T MRI at baseline (M0) and 1 year (M12) as part of a multi-centre study. SWI was acquired at M12 using a 3D segmented gradient-echo echo-planar imaging sequence. Rim lesions identified on SWI were manually segmented on FLAIR images at both time points for volumetric analysis. Results Twelve subjects (27%) had at least one rim lesion at M12. A linear mixed-effects model, with ‘subject’ as a random factor, revealed mixed evidence for the difference in longitudinal volume change between rim lesions and non-rim lesions (p = 0.0350 and p = 0.0556 for subjects with and without rim lesions, respectively). All 25 rim lesions identified showed T1-weighted hypointense signal. Subjects with and without rim lesions did not differ significantly with respect to age, disease duration or clinical measures of disability (p > 0.05). Conclusion We demonstrate that rim lesions are detectable in early-stage RRMS on 3 T MRI across multiple centres, although their relationship to lesion enlargement is equivocal in this small cohort. Identification of SWI rims was subjective. Agreed criteria for defining rim lesions and their further validation as a biomarker of chronic inflammation are required for translation of SWI into routine MS clinical practice.

Physical activity and multiple sclerosis: a meta-analysis

2005 ◽  
Vol 11 (4) ◽  
pp. 459-463 ◽  
Author(s):  
Robert W Motl ◽  
Edward McAuley ◽  
Erin M Snook
Keyword(s):  
Physical Activity ◽  
Multiple Sclerosis ◽  
Meta Analysis ◽  
Self Report ◽  
Weighted Mean ◽  
Physically Active ◽  
Manual Search ◽  
Relapsing Remitting ◽  
Quantitative Synthesis ◽  
The Difference

Using meta-analytic procedures, this study involved a quantitative synthesis of the difference in physical activity among individuals with multiple sclerosis (MS) compared with nondiseased and diseased populations and then examined factors (i.e., moderators) that explain variation in the overall difference in physical activity. We searched MEDLINE, PsycINFO and Current Contents Plus using the key words physical activity, exercise and physical fitness in conjunction with multiple sclerosis; conducted a manual search of bibliographies of the retrieved papers; and contacted study authors about additional studies. Overall, 53 effects were retrieved from 13 studies with 2360 MS participants and yielded a weighted mean effect size (ES) of -0.60 (95% CI= -0.44,-0.77). The weighted mean ES was heterogenous, Q=1164.11, df=52, p<0.0001. There were larger effects with objective versus self-report measures of physical activity, nondiseased versus diseased populations and primary progressive versus relapsing-remitting MS. The cumulative evidence suggests that individuals with MS are less physically active than nondiseased, but not diseased, populations.

scholarly journals The Role of Postpartum Intravenous Corticosteroids in the Prevention of Relapses in Multiple Sclerosis

2011 ◽  
Vol 13 (2) ◽  
pp. 91-93 ◽  
Author(s):  
Jose Avila-Ornelas ◽  
Mirla Avila ◽  
Milena Stosic ◽  
Liliana Robles ◽  
Pilar Guillermo Prieto ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Retrospective Study ◽  
Relapse Rate ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Intravenous Methylprednisolone ◽  
Secondary Progressive ◽  
Relapsing Remitting ◽  
The Difference

Multiple sclerosis (MS) is most prevalent in women of childbearing age. It is well established that the relapse rate decreases during pregnancy but increases significantly during the first postpartum trimester. The objective of this retrospective study was to evaluate the effectiveness of the administration of 1 g of intravenous methylprednisolone (IVMP) after delivery in the prevention of MS relapses. The study involved 47 women with one or more documented pregnancies; each pregnancy was treated as a separate case. There were 50 cases with relapsing-remitting MS and 2 with secondary progressive MS. The cases were divided into two groups: the IVMP group (those who received 1 g of IVMP after delivery) and the no-IVMP group (those who did not receive IVMP after delivery). There were 39 cases in the IVMP group and 13 in the no-IVMP group. During the first postpartum trimester, relapses occurred in 17.9% of the IVMP group, compared with 46.2% of the no-IVMP group (P = .0448). The difference in relapse percentage between the two groups during the second and third postpartum trimesters was not statistically significant. Our study shows a statistically significant benefit of postpartum IVMP administration in reducing MS relapses.

Isoprostanes in clinically isolated syndrome and early multiple sclerosis as biomarkers of tissue damage and predictors of clinical course

2012 ◽  
Vol 19 (4) ◽  
pp. 411-417 ◽  
Author(s):  
Emilia Sbardella ◽  
Anita Greco ◽  
Maria L Stromillo ◽  
Luca Prosperini ◽  
Maria Puopolo ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Tissue Damage ◽  
Roc Analysis ◽  
Brain Volume ◽  
Clinical Symptoms ◽  
Early Stage ◽  
Relapsing Remitting ◽  
Neurological Conditions ◽  
Magnetic Resonance Imaging Mri ◽  
Biomarkers Of Oxidative Stress

Background: Isoprostanes (IsoP) are sensitive biomarkers of oxidative stress. Their cerebrospinal-fluid (CSF) level is increased in several neurological conditions, including multiple sclerosis (MS). In particular, in relapsing–remitting MS, IsoP have been proposed as an index of neurodegenerative processes. The mechanisms leading to neuroaxonal damage in MS are not fully understood but oxidative mechanisms play a substantial role. Although axonal loss is present in MS patients since their first clinical symptoms, IsoP levels at this early stage have not been evaluated yet. Objectives: The objectives of this study were (a) to assess IsoP levels in CSF of patients with a first clinical attack suggestive of MS; (b) to correlate IsoP levels with magnetic resonance imaging (MRI) measures of brain damage and (c) to assess IsoP value in predicting disease clinical evolution. Methods: Thirty-nine patients with a first clinical attack suggestive of MS underwent neurological examination, lumbar puncture with IsoP levels quantification and conventional/spectroscopic-MRI. Patients were followed up for 24 months. Results: CSF IsoP levels were higher in patients than controls (mean±standard deviation (SD) 123.4±185.8 vs 4.5±2.9 pg/ml; p<0.0001) and inversely correlated to normalized brain volume ( p=0.04) and N-acetylaspartate/choline (NAA/Cho) ( p=0.01). The risk of experiencing clinical relapses differed according to IsoP level: subjects with levels higher than 95 pg/ml (a cut-off value resulting from ROC analysis) were more likely to relapse than patients with levels equal or lower than 95 pg/ml (59% vs 27% respectively; p=0.03). Conclusions: CSF IsoP might be useful biomarkers of tissue damage in MS with a predictive value of disease course.

Drugs used in the treatment of multiple sclerosis during COVID-19 pandemic: a critical viewpoint

2021 ◽  
Vol 19 ◽  
Author(s):  
Marika Alborghetti ◽  
Gianmarco Bellucci ◽  
Antonietta Gentile ◽  
Chiara Calderoni ◽  
Ferdinando Nicoletti ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Antiviral Activity ◽  
Early Stage ◽  
Public Health Problem ◽  
Dimethyl Fumarate ◽  
Disease Recurrence ◽  
Oral Drug ◽  
First Line ◽  
Relapsing Remitting ◽  
Disease Modifying Agents

: Since COVID-19 has emerged as a word public health problem, attention has been focused on how immune suppressive drugs used for the treatment of autoimmune disorders influence the risk for SARS-CoV-2 infection and the development of the acute respiratory distress syndrome (ARDS). Here we discuss the disease-modifying agents approved for the treatment of multiple sclerosis (MS) within this context. Interferon (IFN)-1a and -1b, which display antiviral activity, could be protective in the early stage of COVID-19 infection, although SARS-CoV-2 may have developed resistance to IFNs. However, in the hyper inflammation stage, IFNs may become detrimental by facilitating macrophage invasion in the lung and other organs. Glatiramer acetate and its analogues should not interfere with the development of COVID-19 and may be considered safe. Teriflunomide, a first-line oral drug used in the treatment of relapsing-remitting MS (RRMS) may display antiviral activity by depleting cellular nucleotides necessary for viral replication. The other first-line drug, dimethyl fumarate, may afford protection against SARS-CoV-2 by activating the Nrf-2 pathway and reinforcing the cellular defences against oxidative stress. Concern has been raised on the use of second-line treatments for MS during COVID-19 pandemic. However, this concern is not always justified. For example, fingolimod, might be highly beneficial during the hyperinflammatory stage of COVID-19 for a number of mechanisms including the reinforcement of the endothelial barrier. Caution is suggested for the use of natalizumab, cladribine, alemtuzumab, and ocrelizumab, although MS disease recurrence after discontinuation of these drugs may overcome a potential risk for COVID-19 infection.

Axonal Degeneration Independent of Inflammatory Activity: Is It More Intense in the Early Stages of Relapsing-Remitting Multiple Sclerosis Disease?

2020 ◽  
Vol 83 (5) ◽  
pp. 508-516
Author(s):  
Vedat Cilingir ◽  
Muhammed Batur
Keyword(s):  
Multiple Sclerosis ◽  
Axonal Degeneration ◽  
Early Stage ◽  
Early Years ◽  
Inflammatory Activity ◽  
Control Group ◽  
Relapsing Remitting ◽  
Duration Of Disease ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

<b><i>Background:</i></b> This study aimed to investigate whether there are differences in the axonal degeneration rate between patients in the early years of relapsing-remitting multiple sclerosis (RRMS) disease and RRMS patients in their later years. <b><i>Methods:</i></b> The early-stage RRMS patients (EMS) group had 65 patients whose duration of disease was within 3 years from the date of the first attack. The late-stage RRMS patients (LMS) group had 69 patients whose duration of disease was within the range of 3–10 years from the date of the first attack. In addition, a control group was composed of 32 healthy subjects. Peripapillary retinal nerve fiber layer (RNFL) thickness was monitored with spectral-domain OCT in all included patients for approximately 3 years. <b><i>Results:</i></b> The annual RNFL atrophy rate (aRNFLr) in the EMS group was −1.246 ± 0.778 μm/year, the aRNFLr in the LMS group was −0.898 ± 0.536 μm/year, and the aRNFLr was −0.234 ± 0.154 μm/year in the control group (<i>p</i> &#x3c; 0.001). The aRNFLr in the EMS group was significantly higher than the aRNFLr in the LMS group (<i>p</i> = 0.01). The aRNFLr was not associated with MRI activity or the condition of having an attack. There was a correlation between Expanded Disability Status Scale (EDSS) progression and aRNFLr in both the EMS and LMS patient groups (<i>r</i> = −0.471, <i>p</i> &#x3c; 0.001, and <i>r</i> = −0.567, <i>p</i> &#x3c; 0.001, respectively). <b><i>Conclusion:</i></b> The axonal degeneration rate is faster in RRMS patients in the first years of the disease than in later years. In addition, axonal degeneration occurs independently of inflammatory activity. Axonal degeneration is correlated with disability progression, but not with inflammatory findings, such as clinical episodes and MRI activity.

Perception of affective prosody in patients at an early stage of relapsing-remitting multiple sclerosis

2012 ◽  
Vol 7 (1) ◽  
pp. 91-106 ◽  
Author(s):  
Markus Kraemer ◽  
Michele Herold ◽  
Jennifer Uekermann ◽  
Bernhard Kis ◽  
Irene Daum ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Early Stage ◽  
Affective Prosody ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis
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