Vertebral hemangiomas in the thoracic spine of multiple sclerosis patients are connected with fewer demyelinating lesions at the same level. Possible impact on pathophysiology and clinical course

2016 ◽  
Vol 38 (8) ◽  
pp. 655-662 ◽  
Author(s):  
Maria Anagnostouli ◽  
Serafeim Katsavos ◽  
Andreas Kyrozis ◽  
Maria Gontika ◽  
Konstantinos I. Voumvourakis ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Thoracic Spine ◽  
Clinical Course ◽  
Demyelinating Lesions ◽  
Multiple Sclerosis Patients ◽  
Vertebral Hemangiomas

Clinical and Radiologic Features, Pathology, and Treatment of Baló Concentric Sclerosis

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012230
Author(s):  
Evan A. Jolliffe ◽  
Yong Guo ◽  
Todd A Hardy ◽  
P. Pearse Morris ◽  
Eoin P. Flanagan ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Course ◽  
Tertiary Care ◽  
Demyelinating Diseases ◽  
Demyelinating Lesions ◽  
Tertiary Care Centers ◽  
Multiple Sclerosis Patients ◽  
Serial Mri ◽  
Distinct Subtype

Objective:To describe clinical, radiological and pathological features of patients with Baló’s concentric sclerosis (BCS) and assess overlap between BCS and other central nervous system inflammatory demyelinating diseases.Methods:Retrospective review of BCS cases from US and Australian tertiary care centers.Results:We identified 40 BCS cases with 38 available MRIs. Solitary MRI lesions were present in 26% (10/38). We saw >1 active concurrent BCS lesion in 45% (17/38). A third (13/38) had multiple sclerosis-suggestive lesions on the index MRI, of which 10 fulfilled Barkhof criteria. In patients with serial MRI performed within one month of the index MRI, lesions expanded radially with sequentially increased numbers of T2 hyperintense rings 52% (14/27). Initially non-enhancing or centrally enhancing lesions subsequently developed single or multiple enhancing rings (41%; 9/22) and incomplete enhancing rings (14%; 3/22). Discordance between rings as they appear on ADC, DWI, and gadolinium-enhanced imaging was observed in 67% (22/33). AQP4-IgG (n=26) and MOG-IgG (n=21) were negative in all patients with serum available. Clinical response to steroid treatment was seen in 46% (13/28). A monophasic clinical course was present in 56% (18/32) at last follow-up (median 27.5 months; range 3-100 months). The initial attack was fatal in 10% (4/40). Median time from symptom onset to death was 23 days (range 19-49 days). All 17 patients with pathology available demonstrated typical findings of multiple sclerosis. Patients with active demyelinating lesions all demonstrated oligodendrocytopathy (pattern III).Conclusions:BCS may be a distinct subtype of multiple sclerosis characterized by pattern III immunopathology.

Clinical course in multiple sclerosis patients presenting with a history of progressive disease

2014 ◽  
Vol 3 (1) ◽  
pp. 67-71 ◽  
Author(s):  
K.S. Pandey ◽  
S.C. Krieger ◽  
C. Farrell ◽  
C. Hannigan ◽  
T. DeAngelis ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Progressive Disease ◽  
Clinical Course ◽  
History Of ◽  
Multiple Sclerosis Patients

scholarly journals Dynamics of quality of life indicators at a multiple sclerosis

2010 ◽  
Vol 9 (4) ◽  
pp. 63-69
Author(s):  
V. N. Karnaukh ◽  
Yu. A. Lugovtsova ◽  
I. A. Barabash
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Clinical Course ◽  
Life Quality ◽  
Immunomodulatory Therapy ◽  
Quality Factors ◽  
Quality Of Life Indicators ◽  
Sf 36 ◽  
Multiple Sclerosis Patients

The study explored the life quality of 94 multiple sclerosis patients in comparison to healthy respondents and in dependence to different parameters of the disease with the use of SF-36 questionnaire. The study has discovered a decline of all the factors of life quality and their dependence on disablement intensity, clinical course and duration of the disease. Immunomodulatory therapy contributed to the improvement of life quality factors.

scholarly journals Polymorphisms in the CIITA −168A/G (rs3087456) and CIITA +1614G/C (rs4774) may influence severity in multiple sclerosis patients

2019 ◽  
Vol 77 (3) ◽  
pp. 166-173 ◽  
Author(s):  
Valéria Coelho Santa Rita Pereira ◽  
Fabrícia Lima Fontes-Dantas ◽  
Eduardo Ribeiro Paradela ◽  
Fabíola Rachid Malfetano ◽  
Simone de Souza Batista Scherpenhuijzen ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Course ◽  
Nucleotide Polymorphisms ◽  
Expanded Disability Status Scale ◽  
Disability Progression ◽  
Single Nucleotide ◽  
Disability Status ◽  
Multiple Sclerosis Patients ◽  
The Impact ◽  
Lower Odds Ratio

ABSTRACT It is currently unknown how genetic factors may influence the clinical course of multiple sclerosis (MS). Objective: We examined the impact of CIITA polymorphisms −168A/G (rs3087456) and +1614G/C (rs4774) on the risk of disability progression, severity and on responses to first-line immunomodulator treatments. Methods: Genomic DNA was extracted from blood samples. We used ABI3730xl and GeneMapper v.4.0 software to identify genotype variations. All patients were followed up and clinically reassessed at three-month intervals. Disability progression was measured by the Expanded Disability Status Scale and disease severity by the Multiple Sclerosis Spasticity Scale (MSSS). Results: We included 37 men and 80 women. We found no evidence regarding the influence of the single nucleotide polymorphisms studied in the Expanded Disability Status Scale or therapeutic response of the evaluated drugs. We performed a logistic regression analysis with the MSSS and found that a less severe MS course was associated with wild type CIITA −168AA and CIITA +1614GG, as the chance of the patient progressing to MSSS2 and MSSS3 decreased in 61% and 75% with CIITA −168AA and 66% and 75% with CIITA +1614GG, respectively (p < 0.0001). Although less significant, the CIITA +1614 GC also pointed to a less severe MS course and the chance of the patient progressing to MSSS3 decreased 79% (p = 0.015). We also observed that the CIITA −168GG genotype was more frequent in MSSS2 and MSSS3 and had 40% lower odds ratio to becoming more severe MS. Conclusion: These data suggest that CIITA −168AA, CIITA +1614GG and CIITA +1614 GC polymorphisms may be associated with a better MS clinical course. This knowledge may be useful for a better understanding of MS and its therapeutic management.

scholarly journals Adhesion molecules and proinflammatory cytokines in cerebrospinal fluid of multiple sclerosis patients

2009 ◽  
Vol 8 (1(2)) ◽  
pp. 23-26
Author(s):  
S. A. Yelchaninova ◽  
I. V. Smagina ◽  
V. A. Sidorenko ◽  
Yu. N. Lichenko ◽  
A. V. Popovtseva ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Adhesion Molecules ◽  
Cell Adhesion Molecules ◽  
Tumor Necrosis ◽  
Clinical Course ◽  
Cerebral Tissue ◽  
Tnf Α ◽  
Multiple Sclerosis Patients ◽  
Necrosis Factor

In liquor 30 multiple sclerosis patients with remittent kind of clinical course the concentration of cell-cell adhesion molecules (sPECAM-1, sVCAM-1) and tumor necrosis factor (TNF) α, not interleukin-1β, was higher during the period of exacerbation compared to the period of remission. These changes are supposed to display the activity of pathogenesis important processes multiple sclerosis in cerebral tissue of multiple sclerosis patients.

Half-dose fingolimod for treating relapsing-remitting multiple sclerosis: Observational study

2017 ◽  
Vol 24 (2) ◽  
pp. 167-174 ◽  
Author(s):  
Chiara Zecca ◽  
Arianna Merlini ◽  
Giulio Disanto ◽  
Mariaemma Rodegher ◽  
Letizia Panicari ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Observational Study ◽  
Clinical Laboratory ◽  
Significant Proportion ◽  
Lower Baseline ◽  
Neuroimaging Data ◽  
Demyelinating Lesions ◽  
Magnetic Resonance Imaging Mri ◽  
Multiple Sclerosis Patients ◽  
Relapsing Remitting Multiple Sclerosis

Objectives: To investigate the efficacy and safety of fingolimod (FTY) 0.5 mg administered every other day (FTY-EOD) compared to every day (FTY-ED) in multiple sclerosis patients. Methods: Multicentre retrospective observational study. Clinical, laboratory and neuroimaging data were consecutively collected from 60 FTY-EOD and 63 FTY-ED patients. Baseline characteristics were compared using logistic regression. Efficacy in preventing occurrence of relapses and demyelinating lesions was tested using propensity score–adjusted Cox and linear regressions. Results: Weight was inversely associated with risk of switch to FTY-EOD because of any reason (odds ratio (OR) = 0.94, 95% confidence interval (95% CI) = 0.89–0.99, p = 0.026), and female sex and lower baseline lymphocyte count were positively associated with switch because of lymphopenia. Compared to FTY-ED patients, FTY-EOD patients were at higher risk of developing relapses (hazard ratio (HR) = 2.98, 95% CI = 1.07–8.27, p  = 0.036) and either relapses or new magnetic resonance imaging (MRI) demyelinating lesions (combined outcome, HR = 2.07, 95% CI = 1.06–4.08, p  = 0.034). Within FTY-EOD, treatment with natalizumab before FTY and lower age were positively associated with risk of developing relapses and combined outcome, respectively (HR = 25.71, 95% CI = 3.03–217.57, p = 0.002 and HR = 0.85, 95% CI = 0.77–0.96, p  = 0.005). FTY-EOD was overall well tolerated. Conclusion: Disease reactivation was observed in a significant proportion of patients treated with FTY-EOD. Neurologists should be cautious when reducing FTY administration to every other day, especially in younger patients and those previously treated with natalizumab.

Pregnancy in multiple sclerosis patients treated with immunomodulators prior to or during part of the pregnancy: a descriptive study in the Spanish population

2007 ◽  
Vol 13 (8) ◽  
pp. 981-984 ◽  
Author(s):  
V. De las Heras ◽  
C. De Andrés ◽  
N. Téllez ◽  
M. Tintoré ◽  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Practice ◽  
Relapse Rate ◽  
Pregnancy Outcomes ◽  
Medical Records ◽  
Clinical Course ◽  
Post Partum ◽  
Accidental Exposure ◽  
Multicentric Study ◽  
Multiple Sclerosis Patients

Objectives To study the management of pregnancy in multiple sclerosis (MS) patients on immunomodulatory therapy (IMT) in routine clinical practice and to analyze pregnancy outcomes and the clinical course of MS around pregnancy. Methods Retrospective, multicentric study in Spain in MS patients receiving IMT before conception and followed for at least three months post-partum. Results A total of 1286 medical records were reviewed. Eighty-eight pregnancies were identified in 74 (6%) women, 66% of which were unexposed and 34% exposed pregnancies. In most cases, IMT was discontinued before conception and resumed shortly after delivery. Accidental exposure to IMT did not lead to higher rates of abortions ( P = 0.76) or malformations. The relapse rate was decreased during pregnancy (0.31 versus 0.61 in the pre-pregnancy year) and increased after delivery (0.87 on month 3), returning to pre-conception values on month 12. The median EDSS score was not increased during the study. Conclusions Discontinuation of IMT before conception, and resumption shortly after delivery was the most frequent clinical practice procedure. Accidental exposure to IMT did not affect pregnancy outcomes or increased malformation rates. Pregnancy was associated with a reduced relapse rate. No factor was found to predict the risk of relapses during or after pregnancy. Multiple Sclerosis 2007; 13: 981—984. http://msj.sagepub.com

P4136Neurogenic stunned myoacardium in multiple sclerosis patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E Gialafos ◽  
E Tsougos ◽  
E Andreadou ◽  
D Tzanetakos ◽  
I Tzartos ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Wide Spectrum ◽  
Coronary Artery Spasm ◽  
Stunned Myocardium ◽  
Common Finding ◽  
Demyelinating Lesions ◽  
Neurogenic Stunned Myocardium ◽  
Thoracic Part ◽  
Multiple Sclerosis Patients ◽  
Upper Thoracic

Abstract A wide spectrum of topics regarding Multiple Sclerosis (MS) have been thoroughly studied, like immunology, nature of demyelinating lesions (DL's), therapeutics, etc. However, little is known about the influence of MS DL's on the cardiovascular system and especially in the coronary vasculature although few reports mention coronary vasospasm due to autonomic nervous system (ANS) abnormalities. Aim of this study was the detection the presence of Neurogenic Stunned Myocardium (NSM) through perfusion test. Method We enrolled 50 asymptomatic fulfilling the criteria MS patients, aged 45±7 years old and disease in our study duration of 6±13 years with EDSS= 2,5. After echocardiography and clinical examination as primary screening, pharmacologic stress thallium 201 scintigraphy and/or coronary angiography were performed to identify the incidence of NSM. Clinical characteristics of MS, type of disease, treatments as well as localization of demyelinating plaques (DP) were noted. Results 13 patients (26%) had abnormal scintigraphy test although clinical profile was not indicative. Cardiac ultrasound showed that 2 patients from this group had a critical ejection fraction (around 50%). All positive patients that underwent for coronary angiogram were negative implying coronary artery spasm as a potential mechanism for the stress positive result. A common finding of all positive patients was the localization of DP which was in the lateral horn of the lower cervical part (C5–7) and upper thoracic part (Th1–4). No correlation seems to have the presence of CAD with disease duration, EDSS and treatment approaches. Discussion Our study shows a high incidence of NSM. This finding due to the location of the DP seems to correlate with ANS disturbance and might help to distinguish patients at higher risk.

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