MRI characteristics of familial and sporadic multiple sclerosis patients

2012 ◽  
Vol 19 (9) ◽  
pp. 1145-1152 ◽  
Author(s):  
Anita Tipirneni ◽  
Bianca Weinstock-Guttman ◽  
Murali Ramanathan ◽  
Nadir Abdelrahman ◽  
Sara Hussein ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Family History ◽  
Clinical Status ◽  
Positive Family History ◽  
Magnetization Transfer Ratio ◽  
Lesion Volume ◽  
Sporadic Group ◽  
History Of ◽  
Multiple Sclerosis Patients ◽  
Mri Characteristics

Purpose: To investigate the MRI characteristics in a large cohort of multiple sclerosis (MS) patients with and without a family history of MS. Methods: Enrolled in this prospective study were 758 consecutive MS patients (mean age 46.2 ± 10.1 years, disease duration 13.6 ± 9.2 years and EDSS 3.4 ± 2.1), of whom 477 had relapsing–remitting, 222 secondary-progressive, and 30 primary-progressive disease courses and 29 had clinically isolated syndrome. One hundred and ninety-six patients (25.9%) had a positive family history of MS. Patients were assessed using measurements of lesions, brain atrophy, magnetization transfer ratio (MTR) and diffusion-weighted imaging. Results: The familial MS group had greater T1-lesion volume ( p=0.009) and a trend for lower MTR of T1-lesion volume ( p=0.047) than the sporadic MS group. No clinical differences were found between familial versus sporadic group, or by a degree of affected relative subgroups. Conclusions: While familial MS was associated with more severe T1-lesion volume and its MTR characteristics, there were no clinical status differences between familial and sporadic MS patients. Therefore, a better understanding of the genetic and/or epigenetic influences causing these differences can advance the understanding and management of MS.

scholarly journals SAT-476 Alemtuzumab Induced Graves Disease

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Rafael C Caputi ◽  
Kavin Raj ◽  
Jose Nicolas Jimenez-Zuluaga ◽  
Sima Patel ◽  
Hongxiu Luo
Keyword(s):  
Multiple Sclerosis ◽  
Family History ◽  
Thyroid Function ◽  
Primary Care Physicians ◽  
Immune Reconstitution ◽  
Graves Disease ◽  
Consecutive Series ◽  
Thyroid Disorder ◽  
History Of ◽  
Multiple Sclerosis Patients

Abstract Introduction: Immune reconstitution therapy (IRT) with the monoclonal antibody alemtuzumab (anti-CD 52) has been shown to be superior to β-interferon in relapsing-remitting multiple sclerosis. It can cause early hyper-population of immature B cells which increases the risk of autoimmune disorders. The most common autoimmune adverse effect is autoimmune thyroid disorder (AITD) which has not been well recognized by internists, especially primary care physicians. We present a case of alemtuzumab-related hyperthyroidism. Most of these cases are mild and can be easily managed. Case presentation: A 44-year-old female with history of multiple sclerosis (MS) presented to the office with a two-month history of fatigue, palpitations, tremors, weight loss and pruritus after completing a course of Alemtuzumab. Her symptoms started 1 month after completing 2 years of a consecutive series with IRT. Her thyroid function panel was not checked before starting IRT. She had no previous history of thyroid disease. Family history is positive for goiter in her mother. She had no exposure to contrast dye, steroids, amiodarone, supplements or biotin use. On exam, she had tachycardia, dry skin, tremors on outstretched hands and a non-tender goiter with no palpable nodules. Her initial labs showed a suppressed TSH (<0.005 mIU/L), elevated FT4 (>7.77 ng/dL), elevated T3 (647 NG/dL) and TSI of 338% (<140%), consistent with Graves’ Disease. She was started on methimazole. Two months into treatment, she became clinical and biochemical euthyroid without medication side effects. Discussion: This patient might have Graves’ disease before IRT which can be easily treated if TFTs were routinely checked; or her Grave’s disease was induced by IRT later. Lack of TFTs checked before, during and after IRT put those patients at risk of unawareness of thyroid abnormalities. Based on this case, we strongly recommend doing routine TFTs (TSH, free T4) check before starting IRT to rule out existing thyroid function abnormalities and provide treatment accordingly. We also recommend checking TSI, TPO antibody for high-risk patients (positive family history, past history) and thyroid US for those who have nodules or goiters before starting IRT. For those found to have abnormal TFTs, TSI or TPO, routine follow up with an Endocrinologist should be recommended during, and even after therapy completion. References: 1. Alemtuzumab-induced thyroid events in multiple sclerosis: a systematic review and meta-analysis. L. Scappaticcio et al. 2. Thyroid disorders in alemtuzumab-treated multiple sclerosis patients: a Belgian consensus on diagnosis and management. Decallone B et al. 3. 2019 European Thyroid Association Guidelines on the Management of Thyroid dysfunction following immune reconstitution therapy. Muller et al.

scholarly journals Higher EBV response is associated with more severe gray matter and lesion pathology in relapsing multiple sclerosis patients: A case-controlled magnetization transfer ratio study

2019 ◽  
Vol 26 (3) ◽  
pp. 322-332 ◽  
Author(s):  
Dejan Jakimovski ◽  
Murali Ramanathan ◽  
Bianca Weinstock-Guttman ◽  
Niels Bergsland ◽  
Deepa P Ramasamay ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Gray Matter ◽  
Magnetization Transfer ◽  
Humoral Response ◽  
Nuclear Antigen ◽  
Enzyme Linked Immunosorbent Assay ◽  
Magnetization Transfer Ratio ◽  
Lesion Volume ◽  
Transfer Ratio ◽  
Multiple Sclerosis Patients

Background: Epstein–Barr virus (EBV) infection has been associated with higher clinical activity and risk of multiple sclerosis (MS). Objective: To evaluate associations between EBV-specific humoral response and magnetization transfer ratio (MTR)-derived measure in MS patients and healthy controls (HCs). Methods: The study included 101 MS patients (69 relapsing-remitting multiple sclerosis (RRMS) and 32 secondary-progressive multiple sclerosis (SPMS)) and 41 HCs who underwent clinical, serological, and magnetic resonance imaging (MRI) investigations. MTR values of T1 or T2 lesion volume (LV), normal-appearing (NA) brain tissue (NABT), gray matter (NAGM), and white matter (NAWM) were obtained. Enzyme-linked immunosorbent assay was used to quantify EBV antibody levels. Partial correlations corrected for MRI strength were used, and Benjamini–Hochberg–adjusted p-values < 0.05 were considered significant. Results: MS patients had significantly higher anti-EBV nuclear antigen-1 (EBNA-1) titer when compared to HCs (107.9 U/mL vs 27.8 U/mL, p < 0.001). Within the MS group, higher serum anti-EBNA-1 titer was significantly correlated with lower T1-LV MTR ( r = –0.287, p = 0.035). Within the RRMS group, higher serum anti-EBNA-1 titer was associated with T1-LV MTR ( r = –0.524, p = 0.001) and NAGM MTR ( r = –0.308, p = 0.043). These associations were not present in HCs or SPMS patients. Conclusion: Greater EBV humoral response is associated with lower GM MTR changes and focal destructive lesion pathology in RRMS patients.

scholarly journals Quantitative MRI phenotypes capture biological heterogeneity in multiple sclerosis patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ide Smets ◽  
An Goris ◽  
Marijne Vandebergh ◽  
Jelle Demeestere ◽  
Stefan Sunaert ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Risk Score ◽  
Grey Matter ◽  
Quantitative Mri ◽  
Grey Matter Volume ◽  
Magnetization Transfer Ratio ◽  
Lesion Volume ◽  
Total Brain ◽  
Multiple Sclerosis Patients

AbstractMagnetization transfer ratio (MTR) and brain volumetric imaging are (semi-)quantitative MRI markers capturing demyelination, axonal degeneration and/or inflammation. However, factors shaping variation in these traits are largely unknown. In this study, we collected a longitudinal cohort of 33 multiple sclerosis (MS) patients and extended it cross-sectionally to 213. We measured MTR in lesions, normal-appearing white matter (NAWM), normal-appearing grey matter (NAGM) and total brain, grey matter, white matter and lesion volume. We also calculated the polygenic MS risk score. Longitudinally, inter-patient differences at inclusion and intra-patient changes during follow-up together explained > 70% of variance in MRI, with inter-patient differences at inclusion being the predominant source of variance. Cross-sectionally, we observed a moderate correlation of MTR between NAGM and NAWM and, less pronounced, with lesions. Age and gender explained about 30% of variance in total brain and grey matter volume. However, they contributed less than 10% to variance in MTR measures. There were no significant associations between MRI traits and the genetic risk score. In conclusion, (semi-)quantitative MRI traits change with ongoing disease activity but this change is modest in comparison to pre-existing inter-patient differences. These traits reflect individual variation in biological processes, which appear different from those involved in genetic MS susceptibility.

Multiple sclerosis and alcohol: a study of problem drinking

2004 ◽  
Vol 10 (2) ◽  
pp. 197-201 ◽  
Author(s):  
Susan Quesnel ◽  
Anthony Feinstein
Keyword(s):  
Multiple Sclerosis ◽  
Mental Illness ◽  
Family History ◽  
Suicidal Ideation ◽  
Mood Disorders ◽  
Problem Drinking ◽  
Positive Family History ◽  
Lifetime Prevalence ◽  
Increased Risk ◽  
History Of

Multiple sclerosis (MS) patients are known to be at increased risk from mood disorders and suicidal ideation. A lthough these are often associated with alcohol disorders, the drinking habits of MS patients have not been well studied to date. O ur study assessed drinking patterns in 140 MS patients, focusing on a possible link between problem drinking and mood and anxiety disorders. Lifetime psychiatric diagnoses were ascertained using the Structured C linical Interview for DSM-IV disorders (SCID-IV). Results demonstrate that one in six MS patients drink to excess over the course of their lifetime. Those with a history of problem drinking display a higher lifetime prevalence of anxiety (P =0.006), but not mood disorders. There were also significant associations between problem drinking and a lifetime prevalence of suicidal ideation (P =0.006), substance abuse (P =0.001), and a family history of mental illness (P =0.008). C linicians should be aware of the possibility of problem drinking in MS patients, and how this may complicate the course of their disease. C lues to problem drinking in MS patients are the presence of a positive family history of mental illness and prominent anxiety.

scholarly journals The association between diabetes and thyroid cancer risk: a hospital-based case-control study in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Meng Wang ◽  
Wei-Wei Gong ◽  
Feng Lu ◽  
Ru-Ying Hu ◽  
Qing-Fang He ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Family History ◽  
Case Control Study ◽  
Positive Family History ◽  
Case Control ◽  
Diabetes Duration ◽  
Family History Of Diabetes ◽  
Thyroid Cancer Risk ◽  
History Of ◽  
Control Study

Abstract Background Previous studies have indicated inconsistent relationships of diabetes with thyroid cancer risk, yet little is known in China. In this study, we aimed to investigate the associations between diabetes, diabetes duration and the risk of thyroid cancer in Chinese population. Methods A 1:1 matched case-control study was performed between 2015 and 2017 in Zhejiang Province including 2,937 thyroid cancer cases and 2,937 healthy controls. Odds ratios (ORs) with 95 % confidence intervals (CIs) for thyroid cancer were estimated in logistic regression models. Specific effects stratified by age, as well as sex, body mass index (BMI) and family history of diabetes were also examined. Results Overall, neither diabetes (OR = 0.75, 95 % CI: 0.21–2.73) nor diabetes duration (OR = 0.14, 95 % CI: 0.02–1.22 for diabetes duration ≦ 5 years; OR = 2.10, 95 % CI: 0.32–13.94 for diabetes duration > 5 years) was significantly associated with thyroid cancer. In stratified analyses, significant lower risk of thyroid cancer was observed among subjects with diabetes and shorter diabetes duration ( ≦ 5 years), but limited to those who were aged more than 40 years, female, overweight/obese and had positive family history of diabetes. Conclusions Diabetes and shorter diabetes duration were significantly associated with decreased risk of thyroid cancer in individuals characterized by older age, female sex, higher BMI and positive family history of diabetes.

scholarly journals Changes in Cerebrospinal Fluid Balance of TNF and TNF Receptors in Naïve Multiple Sclerosis Patients: Early Involvement in Compartmentalised Intrathecal Inflammation

Cells ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 1712
Author(s):  
Roberta Magliozzi ◽  
Francesco Pezzini ◽  
Mairi Pucci ◽  
Stefania Rossi ◽  
Francesco Facchiano ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Immune Cell ◽  
Protein Pattern ◽  
Fold Change ◽  
Cortical Lesion ◽  
Control Group ◽  
Lesion Volume ◽  
Mri Features ◽  
Csf Levels ◽  
Multiple Sclerosis Patients

An imbalance of TNF signalling in the inflammatory milieu generated by meningeal immune cell infiltrates in the subarachnoid space in multiple sclerosis (MS), and its animal model may lead to increased cortical pathology. In order to explore whether this feature may be present from the early stages of MS and may be associated with the clinical outcome, the protein levels of TNF, sTNF-R1 and sTNF-R2 were assayed in CSF collected from 122 treatment-naïve MS patients and 36 subjects with other neurological conditions at diagnosis. Potential correlations with other CSF cytokines/chemokines and with clinical and imaging parameters at diagnosis (T0) and after 2 years of follow-up (T24) were evaluated. Significantly increased levels of TNF (fold change: 7.739; p < 0.001), sTNF-R1 (fold change: 1.693; p < 0.001) and sTNF-R2 (fold change: 2.189; p < 0.001) were detected in CSF of MS patients compared to the control group at T0. Increased TNF levels in CSF were significantly (p < 0.01) associated with increased EDSS change (r = 0.43), relapses (r = 0.48) and the appearance of white matter lesions (r = 0.49). CSF levels of TNFR1 were associated with cortical lesion volume (r = 0.41) at T0, as well as with new cortical lesions (r = 0.56), whilst no correlation could be found between TNFR2 levels in CSF and clinical or MRI features. Combined correlation and pathway analysis (ingenuity) of the CSF protein pattern associated with TNF expression (encompassing elevated levels of BAFF, IFN-γ, IL-1β, IL-10, IL-8, IL-16, CCL21, haptoglobin and fibrinogen) showed a particular relationship to the interaction between innate and adaptive immune response. The CSF sTNF-R1-associated pattern (encompassing high levels of CXCL13, TWEAK, LIGHT, IL-35, osteopontin, pentraxin-3, sCD163 and chitinase-3-L1) was mainly related to altered T cell and B cell signalling. Finally, the CSF TNFR2-associated pattern (encompassing high CSF levels of IFN-β, IFN-λ2, sIL-6Rα) was linked to Th cell differentiation and regulatory cytokine signalling. In conclusion, dysregulation of TNF and TNF-R1/2 pathways associates with specific clinical/MRI profiles and can be identified at a very early stage in MS patients, at the time of diagnosis, contributing to the prediction of the disease outcome.

scholarly journals Differential expression of micro RNA-29 family in non-diabetic adults of diabetic and non-diabetic parents

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Uzair Abbas ◽  
Bushra Imdad ◽  
Sikander Adil Mughal ◽  
Israr Ahmed Baloch ◽  
Afshan Mehboob Khan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Family History ◽  
Positive Family History ◽  
Cross Sectional Study ◽  
Vital Role ◽  
Micro Rna ◽  
Cross Sectional ◽  
Family History Of Diabetes ◽  
History Of

Abstract Objective MicroRNAs are known to regulate 60% of genes at post translational level. MicroRNAs including Micro RNA-29 family play a vital role in cellular activities and have validate role in numerous metabolic disorders inclusive of diabetes mellitus and its complications. While micro RNA profile changes years before the occurrence of disease. This cross-sectional study was conducted in non-diabetic adults of diabetic and non-diabetic parents to explore the early changes in expression of micro RNA-29 family as it can be served as early biomarker of type 2 diabetes in non-diabetic adults. This study was conducted from January 2019 to January 2021. Micro RNA was extracted from plasma of 50 participants and expression was compared through qPCR. While data was analyzed through SPSS version 21.0. Results 29a and 29b had lower expression in participants with family history of DM compared to those having no family history of DM (P < 0.0001). While micro RNA 29c was found to be significantly higher in participants with positive family history of type 2 diabetes as compared to those without family history of diabetes (P = 0.001).

A Group Therapy Approach to Facilitate Integration of Risk Information for Women at Risk for Breast Cancer

1998 ◽  
Vol 43 (4) ◽  
pp. 375-380 ◽  
Author(s):  
Mary Jane Esplen ◽  
Brenda Toner ◽  
Jonathan Hunter ◽  
Gordon Glendon ◽  
Kate Butler ◽  
...  
Keyword(s):  
Breast Cancer ◽  
At Risk ◽  
Family History ◽  
Group Therapy ◽  
Perceived Risk ◽  
Positive Family History ◽  
Risk Information ◽  
Degree Relative ◽  
Therapy Approach ◽  
History Of

Objective: To describe and illustrate elements of a group counselling approach designed to enhance the communication of risk information on breast cancer (BC) to women with a family history of this disease. Breast cancer is a leading cause of female cancer death. The most important risk factor for BC is a positive family history in at least 1 first-degree relative, and approximately one-third of women with BC have a family history of the disease. Recent evidence suggests that there is a significant psychological impact associated with having a family history of BC, and this may influence the psychological adjustment and response to being counselled for personal risk. New counselling approaches are required. Method: This paper describes a group therapy approach that incorporates principles of supportive-expressive therapy designed to address the emotional impact of being at risk for BC and to promote accuracy of perceived risk. The key elements of the intervention are described along with clinical illustrations from groups that are part of an ongoing study to develop and standardize the group therapy. Conclusion: Qualitative data from the groups suggest that this model of therapy is both feasible and effective.

Levels of anxiety, depression and denial in patients with myocardial infarction

1997 ◽  
Vol 12 (3) ◽  
pp. 149-151 ◽  
Author(s):  
D Sarantidis ◽  
A Thomas ◽  
K Iphantis ◽  
N Katsaros ◽  
J Tripodianakis ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Intensive Care Unit ◽  
Family History ◽  
Positive Family History ◽  
Anxiety And Depression ◽  
Previous Myocardial Infarction ◽  
History Of ◽  
Seeking Help ◽  
Anxiety Depression

SummaryIn this study we investigated 1) the changes in anxiety, depression and denial from admission to discharge in patients admitted to the intensive care unit following an acute myocardial infarction and 2) the effect of smoking habits, time lapsed from the appearance of symptoms to seeking help behavior, presence of a person that motivated the patient to seek help, previous myocardial infarction (MI) and family history of MI, on these changes. The results indicated that 1) the levels of both anxiety and depression increased from admission to discharge, while denial decreased; 2) positive family history of MI was associated with lower difference of denial between admission and discharge.

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