scholarly journals Prevalence of Autonomic Dysfunction in Patients with Multiple Sclerosis

2015 ◽  
Vol 28 (1) ◽  
pp. 51 ◽  
Author(s):  
Bitia Vieira ◽  
Andreia Costa ◽  
Gonçalo Videira ◽  
Maria José Sá ◽  
Pedro Abreu
Keyword(s):  
Multiple Sclerosis ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Symptom Score ◽  
Disease Duration ◽  
Statistical Significance ◽  
Confounding Factors ◽  
Autonomic Symptom ◽  
Autonomic Symptoms ◽  
Multiple Sclerosis Patients

<strong>Background:</strong> Autonomic nervous system dysfunction is commonly seen in multiple sclerosis patients and should be explored in the routine evaluation. Composite Autonomic Symptom Score questionnaire was validated as a self-assessment instrument of autonomic symptoms.<br /><strong>Objectives:</strong> Determine the frequency of autonomic symptoms in multiple sclerosis patients through a Portuguese version of Composite Autonomic Symptom Score; compare questionnaire results between patients and a control group; assess the feasibility of this questionnaire application in multiple sclerosis Portuguese patients.<br /><strong>Material and Methods:</strong> This case-control study used a Portuguese translated version of Composite Autonomic Symptom Score to determine the frequency of autonomic symptoms in multiple sclerosis patients.<br /><strong>Results:</strong> One-hundred and three relapsing-remitting multiple sclerosis patients – median age 41 years, median disease duration 6 years, median EDSS score 1 - and 80 healthy subjects were included. Alterations in autonomic function were reported in 97.1% of the cases, with statistical significance in orthostatic intolerance and gastrointestinal domain scores. Nevertheless, the difference between multiple sclerosis patients (41.7%) without confounding factors that could interfere with autonomic dysfunction (i.e. comorbidities or medications) and controls showed no statistical significance.<br /><strong>Discussion:</strong> Our results may be related to the short disease duration, young age and lowdisability status of our patients unaffected by confounding factors. The questionnaire was not designed specifically for multiple sclerosis and it may not be as sensible to early autonomic symptoms as to more severe manifestations.<br /><strong>Conclusions:</strong> Further studies are needed to achieve more robust results, validate this questionnaire and assess its application in multiple sclerosis patients in Portugal.<br /><strong>Keywords:</strong> Autonomic Nervous System; Multiple Sclerosis; Portugal; Questionnaires.<strong><br /><br /></strong>

Serum glial fibrillary acidic protein correlates with multiple sclerosis disease severity

2018 ◽  
Vol 26 (2) ◽  
pp. 210-219 ◽  
Author(s):  
Heidi Högel ◽  
Eero Rissanen ◽  
Christian Barro ◽  
Markus Matilainen ◽  
Marjo Nylund ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Nervous System ◽  
Glial Fibrillary Acidic Protein ◽  
Disease Progression ◽  
Disease Severity ◽  
Single Molecule ◽  
Progressive Disease ◽  
Disease Duration ◽  
Acidic Protein ◽  
Csf Levels

Background: Cerebrospinal fluid (CSF) levels of two soluble biomarkers, glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL), have been shown to associate with multiple sclerosis (MS) disease progression. Now, both biomarkers can be detected reliably in serum, and importantly, their serum levels correlate well with their CSF levels. Objective: To evaluate the usability of serum GFAP measurement as a biomarker of progressive disease and disease severity in MS. Methods: Clinical course, Expanded Disability Status Scale (EDSS), disease duration, patient age and magnetic resonance imaging (MRI) parameters were reviewed in 79 MS patients in this cross-sectional hospital-based study. Serum samples were collected for measurement of GFAP and NfL concentrations using single molecule array (Simoa) assay. A cohort of healthy controls was evaluated for comparison. Results: Higher serum concentrations of both GFAP and NfL were associated with higher EDSS, older age, longer disease duration, progressive disease course and MRI pathology. Conclusion: Earlier studies have demonstrated that GFAP, unlike NfL, is not increased in association with acute focal inflammation-related nervous system damage. Our work suggests that GFAP serum level associates with disease progression in MS and could potentially serve as an easily measurable biomarker of central nervous system (CNS) pathology related to disease progression in MS.

scholarly journals Polymorphism of chemokine receptor gene CCR5 in multiple sclerosis patients and in healthy subjects in the Siberian region

2006 ◽  
Vol 5 (3) ◽  
pp. 98-104
Author(s):  
Yu. Yu. Orlova ◽  
V. M. Alifirova ◽  
N. V. Cherdyntseva ◽  
P. A. Gervas
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Nervous System ◽  
Chemokine Receptor ◽  
Healthy Subjects ◽  
Receptor Gene ◽  
Chronic Inflammatory Disease ◽  
Leading Role ◽  
Multiple Sclerosis Patients ◽  
Chemokine Receptor Gene

Multiple sclerosis is chronic inflammatory disease of the central nervous system in the development of which chemokines of the type Tx1 play the leading role. Chemokines and their receptors participate in the development of multiple sclerosis as a result of drawing immune cells into central nervous system. Mutation of CCR5 delta32 decreases functional activity of the appropriate receptor on cellular surface and thus can reduce migration of leucocytes into foci of injury. Aimed at studying the role of mutation in multiple sclerosis, we compared frequency of gene type CCR5 in peripheral mononuclears of 102 multiple sclerosis patients and in 136 healthy subjects. The results obtained allow to conclude that polymorphism of chemokine receptor gene CCR5del32 is not a leading factor in the susceptibility to multiple sclerosis in the studied population.

scholarly journals Clinical and neurophysiological findings in oligoclonal band negative multiple sclerosis patients

2003 ◽  
Vol 131 (3-4) ◽  
pp. 122-126 ◽  
Author(s):  
Sarlota Mesaros ◽  
Jelena Drulovic ◽  
Zvonimir Levic
Keyword(s):  
Multiple Sclerosis ◽  
Statistical Significance ◽  
Progression Rate ◽  
Positive Group ◽  
Clinical Difference ◽  
Initial Symptoms ◽  
Significant Difference ◽  
Intrathecal Igg Synthesis ◽  
Edss Score ◽  
Multiple Sclerosis Patients

Besides magnetic resonance imaging, the presence of locally produced oligoclonal IgG bands (OCB) in the cerebrospinal fluid (CSF) is the most consistent laboratory abnormality in patients with multiple sclerosis (MS). The most sensitive method for the detection of CSF OCB is isoelectric focusing (IEF) [6]. Occasional patients with clinically definite MS lack evidence for intrathecal IgG synthesis [7, 8]. This study was designed to compare clinical data and evoked potential (EP) findings between CSF OCB positive and OCB negative MS patients. The study comprised 22 OCB negative patients with clinically definite MS [11] and 22 OCB positive controls matched for age, disease duration, activity and course of MS. In both groups clinical assessment was performed by using Expanded Disability Status Scale (EDSS) score [12] and progression rate (PR). All patients underwent multimodal EP: visual (VEPs), brainstem auditory (BAEPs) and median somatosensory (mSEPs). The VEPa were considered abnormal if the P100 latency exceeded 117 ms or inter-ocular difference greater than 8 ms was detected. The BAEPs were considered abnormal if waves III or V were absent or the interpeak latencies I-III, III-V, or I-V were increased. The mSEPs were considerd abnormal when N9, N13 and N20 potentials were absent or when increased interpeak latencies were recorded. The severity of the neurophysiological abnormalities was scored for each modality as follows normal EP score 0; every other EP abnormality except the absence of one of the main waves, score 1; absence of one or more of the main waves, score 2 [13]. Both mean EDSS score (4.0 vs. 3.5) and PR (0.6 vs. 0.5) were similar in OCB positive and OCB negative group, (p>0.05). In the first group males were predominant, but without statistical significance (Table 1). Disease started more often with the brainstem symptoms in the OCB positive than in OCB negative MS group (p=0.028), while there was no differences in other initial symptoms between the groups (Graph 2). The frequency of (multimodal) EP abnormalities was higher in the OCB positive group but the differences were not statistically significant, except for bilateral SEP abnormalities (p=0.012). The severity of the AEPs abnormalities was similar in both groups while for the VEPs and SEPs abnormalities were more pronounced in the OCB positive group but not significantly (Table 2). The male preponderance of OCB negative MS patients in our study is in accordance with previous studies [14, 15]. This finding could be potentially ascribed to the well known gender-related differences in both humoral and cellular immune responses [17]. We found no statistically significant differences in either disability or PR between the two patient groups, although OCB negative MS patients had lower EDSS score and PR than OCB positive cases. In accordance with these findings, Fukazawa et al. also failed to show differences in disability between OCB negative and positive MS patients. On the other hand, few studies reported that OCB negative MS patients have a better prognosis [16 18]. The only clinical difference between two groups of patients that we found was that the disease more often started with brainstem symptoms in OCB positive MS patients (p=0.028). OCB positive MS patients had more often bilateral SEPs abnormalities (p=0.012). There was no statistically significant differences between two groups of patients in the severity of trimodal EPs abnormalities and the frequency of BAEPs and VEPs abnormalities although OCB negative patients had trend towards less pronounced EP disturbancies. In conclusion, our results did not reveal significant difference in clinical and neurophysiological(y) parameters between two groups of patients. However, they indicate a trend towards better prognosis of the disease in OCB negative MS patients.

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.

HLA-DRB1*1501 intensifies the impact of IL-6 promoter polymorphism on the susceptibility to multiple sclerosis in an Iranian population

2010 ◽  
Vol 16 (10) ◽  
pp. 1173-1177 ◽  
Author(s):  
M. Shahbazi ◽  
H. Ebadi ◽  
D. Fathi ◽  
D. Roshandel ◽  
M. Mohamadhosseni ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Nervous System ◽  
Promoter Polymorphism ◽  
Exact Test ◽  
Inflammatory Processes ◽  
The Central Nervous System ◽  
Pcr Method ◽  
Multiple Sclerosis Patients ◽  
The Impact

Background: The multifunctional cytokine interleukin-6 (IL-6) is involved in inflammatory processes in the central nervous system. It is well documented that amount of IL-6 is increased in serum, cerebrospinal fluid and central nervous system lesions of patients with multiple sclerosis. A single nucleotide polymorphism at position -174 in the IL-6 gene promotor appears to influence IL-6 expression. Recently, several researchers have focused on HLA-DRB alleles, specifically HLA-DRB1*1501, as a potential risk allele in the pathogenesis of multiple sclerosis. Objective: To investigate the possible influence of IL-6/-174 polymorphisms on susceptibility to multiple sclerosis and its integration with HLA-DRB1*1501. Genomic DNA was extracted from whole blood of 345 patients with multiple sclerosis and 426 control subjects. Method: The SSP-PCR method was used to determine genotypes and Fisher’s exact test was applied to determine differences between groups. HLA-DRB1*1501 was observed more frequently among multiple sclerosis patients compared with healthy subjects (45% and 34%, respectively; OR = 1.6, 95% CI = 1.2—2.2, p = 0.0018). At the IL-6/-174 position, the G allele had higher frequency among multiple sclerosis patients compared with controls (77% and 70%, respectively; OR = 1.4, 95% CI = 1.1—1.8, p = 0.0038). This difference was more significant among HLA-DRB1*1501-positive patients and controls (81% and 67%, respectively; OR = 1.9, 95% CI = 1.5—2.5, p < 0.0001). Results: Our results have shown that the G allele at the IL-6/-174 promoter polymorphism may be associated with development of multiple sclerosis in this population, and may be strengthened by HLA-DRB1*1501. Conclusions: We suggest more studies to confirm these results in other populations.

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