scholarly journals Bedside Tested Ocular Motor Disorders in Multiple Sclerosis Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
G. Servillo ◽  
D. Renard ◽  
G. Taieb ◽  
P. Labauge ◽  
S. Bastide ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Duration ◽  
Clinically Isolated Syndrome ◽  
Motor Disorders ◽  
Ocular Motor ◽  
Mri Findings ◽  
Substantial Impact ◽  
Ocular Motor Disorders ◽  
Definition Of ◽  
Multiple Sclerosis Patients

Background/Aims. Ocular motor disorders (OMDs) are a common feature of multiple sclerosis (MS). In clinical practice, if not reported by patients, OMDs are often underdiagnosed and their prevalence is underestimated.Methods. We studied 163 patients (125 women, 76.7%, 38 men, 23.3%; median age 45.0 years; median disease duration 10 years; median EDSS 3.5) with definite MS (n=150, 92%) or clinically isolated syndrome (n=13, 8%) who underwent a thorough clinical examination of eye movements. Data on localization of previous relapses, MS subtype, and MRI findings were collected and analyzed.Results. Overall, 111/163 (68.1%) patients showed at least one abnormality of eye movement. Most frequent OMDs were impaired smooth pursuit (42.3%), saccadic dysmetria (41.7%), unilateral internuclear ophthalmoplegia (14.7%), slowing of saccades (14.7%), skew deviation (13.5%), and gaze evoked nystagmus (13.5%). Patients with OMDs had more severe disability(P=0.0005)and showed more frequently infratentorial MRI lesions(P=0.004). Localization of previous relapses was not associated with presence of OMDs.Conclusion. OMDs are frequent in patients with stable (no relapses) MS. A precise bedside examination of eye motility can disclose abnormalities that imply the presence of subclinical MS lesions and may have a substantial impact on definition of the diagnosis and on management of MS patients.

Ocular motor disorders

2014 ◽  
Vol 27 (1) ◽  
pp. 75-82 ◽  
Author(s):  
Anna Willard ◽  
Christian J. Lueck
Keyword(s):  
Motor Disorders ◽  
Ocular Motor ◽  
Ocular Motor Disorders

scholarly journals Perceptions of Health Status in Multiple Sclerosis Patients and Their Doctors

2013 ◽  
Vol 40 (2) ◽  
pp. 210-218 ◽  
Author(s):  
Marcelo Kremenchutzky ◽  
Len Walt
Keyword(s):  
Multiple Sclerosis ◽  
Health Status ◽  
Bodily Pain ◽  
Kappa Statistic ◽  
Patient Perceptions ◽  
Mean Values ◽  
Health Domains ◽  
Important Health ◽  
Definition Of ◽  
Multiple Sclerosis Patients

Objective:To compare neurologist and patient perceptions of multiple sclerosis (MS)-related health status.Methods:MS patients (n=99) were recruited from six sites in Canada. Following a consultation with their neurologist, patients estimated their relapse frequency, rated their general health and quality of life (QoL), reviewed descriptions of eight health domains and selected the three most important, and completed a utility assessment using the standard gamble (SG). Concurrently, neurologists independently used the same instruments to rate their patients' health status. Assessments were compared on the basis of paired mean values of both groups and the degree of exact agreement quantified by intraclass coefficient (ICC) and kappa analyses, which yield values of 1.0 with 100% agreement.Results:There were significant differences (p<0.001) between patient and neurologist ratings for relapses in the last year (0.86 vs. 0.4, respectively), QoL (61.2 vs. 69.7 (maximum score = 100) and utility (0.864 vs. 0.971); ICC analysis revealed moderate to poor levels of agreement (0.56 for QoL to 0.03 for SG). There was little concordance in identification of important health domain and the only significant associations were in bodily pain and social functioning (kappa statistic = 0.24, p = 0.026 for both). Neurologists identified physical functioning domains as important, while patients placed more emphasis on mental health domains.Conclusions:Discrepancies between neurologist and patient perceptions of MS were observed. The study identifies a need to educate neurologists on the recognition of MS health domains that are important in the definition of patient QoL.

scholarly journals Fatty acid binding protein-4 is associated with disability in multiple sclerosis patients

2018 ◽  
Vol 25 (3) ◽  
pp. 344-351 ◽  
Author(s):  
Riley Bove ◽  
Brain C Healy ◽  
Alexander Musallam ◽  
Pejvak Soltany ◽  
Camilo Diaz-Cruz ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Fatty Acid ◽  
Fatty Acid Binding Protein ◽  
Disease Duration ◽  
Binding Protein ◽  
Longitudinal Models ◽  
Cross Sectional ◽  
Fatty Acid Binding ◽  
Acid Binding Protein ◽  
Multiple Sclerosis Patients

Background: Increased adiposity is a risk factor for multiple sclerosis (MS) and is associated with increased disability scores. Adipokines may mediate the effects of adiposity on MS disease course. Objective: The objective of this study is to examine the association between the adipokines (leptin and fatty acid binding protein-4, FABP4) and clinical course in individuals with MS. Methods: Subjects (18–65 years) with relapsing-remitting MS or clinically isolated syndrome and <10 year disease duration were selected from a longitudinal clinical study. Cross-sectional and longitudinal models assessed the relationship between two adipokines (leptin and FABP4) and disease severity in women and men, adjusting for age, disease duration and disease type, Vitamin D level, testosterone level, and as well by body mass index (BMI). Results: Mean age of subjects ( N = 163, 56% women) was 39.3 years. Higher FABP4 levels were associated with higher Expanded Disability Status Scale (EDSS) scores in women in both univariate and multivariate analyses (odds ratio: 1.30; p = 0.005). In men, higher FABP4 level was significantly associated with change in EDSS over time (estimate: 0.0062; p = 0.035). We found no association of FABP4 levels with time to next relapse or a measure of processing speed. Conclusion: FABP4 levels may be associated with increased disability in both men and women with MS independent of effects of BMI and other hormones. Future studies should expand these analyses and further explore downstream mechanisms of adiposity-related effects in MS.

Fatigue in multiple sclerosis: a comparison of different rating scales and correlation to clinical parameters

2002 ◽  
Vol 8 (6) ◽  
pp. 523-526 ◽  
Author(s):  
P Flachenecker ◽  
T Kümpfel ◽  
B Kallmann ◽  
M Gottschalk ◽  
O Grauer ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Physical Disability ◽  
Rating Scales ◽  
Disease Duration ◽  
Correlation Coefficients ◽  
Clinical Activity ◽  
Impact Scale ◽  
Fatigue Severity ◽  
Underlying Mechanisms ◽  
Definition Of

Objectives: Fatigue is one of the most common, yet poorly defined, disabling symptoms in patients with multiple sclerosis (MS). To delineate more clearly the frequency and type of fatigue, we first compared four widely used fatigue scales in consecutive MS patients. Secondly, to further clarify the nature of fatigue, we investigated its relation to physical disability, course of the disease, immunotherapy, and depression. Patients and Methods: Between February and September 2000, 151 consecutive MS patients entering our outpatient clinic (94 relapsing-remitting, 50 secondary progressive, and 7 primary progressive patients; mean age 29.0-7.3 years, mean disease duration 9.9-6.7 years, median EDSS 3.5) filled in a standardized questionnaire including four fatigue scales - Fatigue Severity Scale (FSS), MS-specific FSS (MFSS), Modified Fatigue Impact Scale (MFIS), and Visual Analogue Scale (VAS). Patients were included in the ‘MS-related fatigue group’ (MS-F) when they stated in the questionnaire that fatigue: 1) is one of their three most disabling symptoms; 2) occurs daily or on most of the days; and 3) limits their activities at home or at work. Patients fulfilling none of these criteria were classified as ‘MS-related nonfatigue group’ (MS-NF). Depression was measured by Beck’s Depression Inventory (BDI). Results: Although all scales showed significant differences between MS-F and MS-NF, correlation between these scales was, at best, moderate (correlation coefficients ranging from 0.06 to 0.56). The most discriminative scales were FSS and MFIS, showing no overlap of the 10th and 90th percentiles for the MS-F and MS-NF groups, with cut-off values of 4.6 and 38, respectively. Depression (BDI≥18) was present in 24 of 148 patients who filled in the BDI (16%). FSS was significantly correlated with physical disability (r =0.33, p <0.0001) and BDI (r =0.41, p<0.0001), but not with age, disease duration, clinical activity, and treatment with interferon-b. In multivariate analysis, however, only BDI independently predicted fatigue. Conclusions: The association of fatigue and depression suggests that there might be either common underlying mechanisms or interdependence by a cause-and-effect relationship that requires further investigation. The weak correlation within various fatigue scales is best explained by the fact that fatigue is a multidimensional symptom and, therefore, the available tests measure and weight different aspects of fatigue. Our findings underline the necessity for a more exact definition of fatigue and the development of more valid tools if these are to be used to evaluate treatments.

Anti-GAD antibody ocular flutter: expanding the spectrum of autoimmune ocular motor disorders

2013 ◽  
Vol 260 (10) ◽  
pp. 2675-2677 ◽  
Author(s):  
Raffaele Dubbioso ◽  
Vincenzo Marcelli ◽  
Fiore Manganelli ◽  
Rosa Iodice ◽  
Marcello Esposito ◽  
...  
Keyword(s):  
Motor Disorders ◽  
Ocular Motor ◽  
Ocular Flutter ◽  
Ocular Motor Disorders

Ocular motor disorders

2011 ◽  
Author(s):  
Christopher Kennard
Keyword(s):  
Eye Movement ◽  
Movement Disorders ◽  
Motor Disorder ◽  
Motor Disorders ◽  
Ocular Motor ◽  
Idiopathic Orbital Inflammation ◽  
Pupillary Light ◽  
Ocular Motor Disorders ◽  
The Central Nervous System ◽  
Eye Movement Disorders

This chapter discusses motor disorders of the eye. The first part of the chapter describes the proper examination of eye movements to facilitate identification of ocular motor disorder pathology. The effects of nerve palsies on ocular motor function are then described.Eye movement disorders can also have their cause in the central nervous system; both the brainstem, and cerebellum have been implicated as causal factors in some eye movement disorders. Disorders of the pupil, which affect the pupillary light reflex, can be caused by lesions to central, afferent and efferent pupillary pathways as well as sympathetic pathways lesions.Finally, this chapter describes diseases of the eye orbits, including dysthyroid eye disease, idiopathic orbital inflammation, orbital tumours, vascular disorders and orbital infections.

scholarly journals Elevated Concentrations of Soluble Fas and FasL in Multiple Sclerosis Patients with Antinuclear Antibodies

2020 ◽  
Vol 9 (12) ◽  
pp. 3845
Author(s):  
Josip Sremec ◽  
Sanja Tomasović ◽  
Nada Tomić Sremec ◽  
Alan Šućur ◽  
Jelena Košćak Lukač ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Antinuclear Antibodies ◽  
Disease Duration ◽  
Immunofluorescence Assay ◽  
Peripheral Lymphocyte ◽  
Effective Control ◽  
Lymphocyte Apoptosis ◽  
Soluble Fas ◽  
Potential Link ◽  
Multiple Sclerosis Patients

Antinuclear antibodies (ANA) are currently considered as an epiphenomenon of apoptotic processes, possibly in control of autoreactivity in patients with multiple sclerosis (MS). Apoptosis of reactive lymphocytes by the Fas/FasL system is described as an effective control mechanism for autoreactivity in MS. We aimed to provide a context to the potential link between ANA and peripheral lymphocyte apoptosis in MS. The presence of ANA was detected in sera by immunofluorescence assay, and concentrations of sFas and sFasL were determined in the sera of 44 and cerebrospinal fluid (CSF) of 11 relapsing-remitting (RR) MS patients using cytometric bead-based array, and their association with the disease characteristics was determined. ANA were detected in the sera of 43.2% of RRMS patients, and their frequency was the highest in patients with disease duration of less than one year (88,89%). In addition, the number of experienced relapses was lower in ANA-positive patients. Concentrations of sFasL were inversely associated with patients’ expanded disability status scale (EDSS) scores. Low concentrations of both soluble factors strongly discriminated patients with moderate to severe disability, from patients with mild or absent disability only in a group of patients with prolonged disease duration (>10 years). Both soluble mediators were significantly higher in ANA-positive patients. FasL concentrations were inversely associated with the number of relapses. There is a potential link between the presence of ANA and peripheral lymphocyte apoptosis mediated by Fas/FasL system in MS, whose precise role and significance needs to be determined by future mechanistic studies.

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