scholarly journals Testing of urodynamic dysfunctions in patients with multiple sclerosis

2014 ◽  
Vol 71 (5) ◽  
pp. 446-450 ◽  
Author(s):  
Rade Babovic ◽  
Sasa Milicevic ◽  
Sasa Radovanovic ◽  
Jasna Jancic
Keyword(s):  
Multiple Sclerosis ◽  
Treatment Plan ◽  
Unknown Origin ◽  
Common Finding ◽  
Inflammatory Disorder ◽  
Urodynamic Testing ◽  
Ultrasound Computed Tomography ◽  
Appropriate Treatment ◽  
Detrusor Hyperreflexia ◽  
The Central Nervous System

Background/Aim. Multiple sclerosis (MS) is a chronic autoimmune inflammatory disorder of the unknown origin leading to multifocal demyelization, axonal damage and the loss of the nervous tissue in various parts of the central nervous system. Most MS patients have decreased functionality of the bladder leading to various dysuria disorders during the course of the illness. However, in 2% of the cases dysuric problems are the first symptoms of the disease. Urodynamic testing could help to diagnose functional disorders of the lower urinary tract, which might not be otherwise possible by performing the standard invasive procedures or noninvasive scans, such us ultrasound, computed tomography or functional magnetic resonance imaging (fMRI). Methods. Urodynamic testing - cystometry with electromyographic (EMG) potentials from the external anal sphincter (EAS), was performed in 34 patients (25 female and 9 male patients). Those patients fulfilled Mc Donald?s multiple sclerosis criteria. The urodynamic values were compared to neurological signs and the present disease symptoms. Results. The MS patients with (27) and without (7) miction problems were tested. Detrusor hyperreflexia is the most common finding, present in 58.8% of the cases. More than a half of the patients have detrusor sphincter dissynergia. Conclusions. Urodynamic testing helps us to determine neurological disorders characteristics and to prepare an appropriate treatment plan. During the course of the disease different urodynamic disfunctions may occur as well as changes in the urinating functionality. The rationale for urodynamic testing in patients suffering from MS before any other treatment procedure is to confirm the diagnosis of dysuric disorders and to secure appropriate treatment.

scholarly journals Multiple Sclerosis Biomarker Discoveries by Proteomics and Metabolomics Approaches

2021 ◽  
Vol 16 ◽  
pp. 117727192110133
Author(s):  
Ameneh Jafari ◽  
Amirhesam Babajani ◽  
Mostafa Rezaei-Tavirani
Keyword(s):  
Multiple Sclerosis ◽  
Complex Disease ◽  
Biomarker Discovery ◽  
Response To Treatment ◽  
Inflammatory Disorder ◽  
Protein Marker ◽  
Complex Disorders ◽  
New Information ◽  
The Central Nervous System ◽  
Monitoring Treatment

Multiple sclerosis (MS) is an autoimmune inflammatory disorder of the central nervous system (CNS) resulting in demyelination and axonal loss in the brain and spinal cord. The precise pathogenesis and etiology of this complex disease are still a mystery. Despite many studies that have been aimed to identify biomarkers, no protein marker has yet been approved for MS. There is urgently needed for biomarkers, which could clarify pathology, monitor disease progression, response to treatment, and prognosis in MS. Proteomics and metabolomics analysis are powerful tools to identify putative and novel candidate biomarkers. Different human compartments analysis using proteomics, metabolomics, and bioinformatics approaches has generated new information for further clarification of MS pathology, elucidating the mechanisms of the disease, finding new targets, and monitoring treatment response. Overall, omics approaches can develop different therapeutic and diagnostic aspects of complex disorders such as multiple sclerosis, from biomarker discovery to personalized medicine.

scholarly journals Impact of Multiple Sclerosis on Infertility and Impact of Infertility Treatments on Multiple Sclerosis Relapses in Slovenia: Medical Outline, Legal and Ethical Outcomes

2020 ◽  
Vol 13 (2) ◽  
pp. 153-172
Author(s):  
Eda Vrtačnik Bokal ◽  
Urban Vrtačnik
Keyword(s):  
Multiple Sclerosis ◽  
Detrimental Effect ◽  
Interdisciplinary Approach ◽  
Reproductive Period ◽  
Inflammatory Disorder ◽  
Infertility Treatments ◽  
Legal Outcomes ◽  
Significant Disability ◽  
The Central Nervous System

Multiple sclerosis (MS) is an autoimmune inflammatory disorder of the central nervous system. It is common in the reproductive period and can lead to infertility and significant disability. The treatment on multiple sclerosis is recently more successful and enables better quality of life, therefore rising hope and desire for future parents, also in terms of successful infertility treatments. In this context, the couples should be managed concerning the detrimental effect of the disease itself on fertility, detrimental effect of the drugs used for treatment on gonads and in terms of the implementation of drugs used for ovarian stimulation and their impact on the basic disease (MS). The article finds solutions on the legal outcomes in situations where infertility treatments may negatively impact the progress of MS, as well as the solutions on how to (successfully) provide infertility treatments to the patients with MS. It proposes interdisciplinary approach between gynaecologists and neurologists to perform required weighing of benefits and risks (burdens), deriving from specific action or treatment, whereas for the patients who shall not undergo infertility treatments due to their medical status, related to MS, it proposes storage of gametes under conditions, set by the law.

Neuromyelitis Optica

2017 ◽  
Author(s):  
Teri L. Schreiner ◽  
Jeffrey L. Bennett
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Optic Neuritis ◽  
Neuromyelitis Optica ◽  
Water Channel ◽  
Transverse Myelitis ◽  
Inflammatory Disorder ◽  
The Central Nervous System

Neuromyelitis optica (NMO), or Devic’s disease is an inflammatory disorder of the central nervous system that preferentially affects the optic nerves and spinal cord. Initially considered a variant of multiple sclerosis (MS), NMO is now clearly recognized to have distinct clinical, radiographic, and pathologic characteristics. Historically, the diagnosis of NMO required bilateral optic neuritis and transverse myelitis; however, the identification of a specific biomarker, NMO-IgG, an autoantibody against the aquaporin-4 (AQP4) water channel, has broadened NMO spectrum disease to include patients with diverse clinical and radiographic presentations. This chapter addresses the diagnosis, pathophysiology, and management of the disease.

Multiple sclerosis

2015 ◽  
Author(s):  
Alasdair Coles ◽  
Alastair Compston
Keyword(s):  
Multiple Sclerosis ◽  
Axonal Degeneration ◽  
Interferon Beta ◽  
Inflammatory Disorder ◽  
Resonance Imaging ◽  
Complex Interplay ◽  
Inflammatory Lesions ◽  
History Of ◽  
The Central Nervous System ◽  
Made In

The papers in this chapter illustrate the picture that has emerged of multiple sclerosis as an inflammatory disorder of the central nervous system, caused by a complex interplay of multiple genetic susceptibility alleles and unknown environmental triggers. Multiple sclerosis is a disease in which there is first demyelination of nerves, followed by axonal degeneration. Demyelination is caused by inflammation, as shown by the synthesis of immunoglobulins within the CNS, and magnetic resonance imaging has shown that only the minority of inflammatory lesions cause symptoms. All of these discoveries were made in the twentieth century, which ended with the first demonstration that a treatment—interferon-beta—could influence the natural history of the disease.

A Fundamentally New View of Multiple Sclerosis

2000 ◽  
Vol 2 (2) ◽  
pp. 2-8
Author(s):  
Richard Ransohoff
Keyword(s):  
Multiple Sclerosis ◽  
Imaging Techniques ◽  
Clinical State ◽  
Spinal Cord Atrophy ◽  
Axonal Pathology ◽  
Appropriate Treatment ◽  
The Us ◽  
Mri Scans ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri

Abstract The last decade has been an era of unprecedented progress in our understanding of multiple sclerosis (MS). MS is now considered a destructive process of the central nervous system, initiated by inflammatory demyelination but including prominent axonal pathology. This new knowledge has been acquired from new imaging techniques and traditional histopathologic study. New mechanisms of myelin destruction have been uncovered, and hypothetical new therapies for MS include neuroprotectants. Serial gadolinium-enhanced magnetic resonance imaging (MRI) scans reveal MS as a continuously active process. Brain and spinal cord atrophy, defined by MRI, correlate closely with clinical state. MR imaging techniques therefore are considered the standard tools for monitoring disease activity and severity. These efforts have produced improved therapy for patients with MS. Two classes of agents, interferon beta and glatiramer acetate, have been approved by the US Food and Drug Administration for use. A major challenge for clinicians is to provide early diagnosis and determine appropriate treatment. New neuroprotective and anti-inflammatory drugs are on the horizon.

A Case of Intractable Vomiting

2018 ◽  
pp. 157-162
Author(s):  
Aaron E. Miller ◽  
Tracy M. DeAngelis ◽  
Michelle Fabian ◽  
Ilana Katz Sand
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Area Postrema ◽  
Inflammatory Disorder ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Clinical Imaging ◽  
Prompt Treatment ◽  
Disease Modifying Therapy ◽  
The Central Nervous System ◽  
Disease Modifying

Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disorder affecting the central nervous system, with clinical, imaging, and laboratory characteristics that are distinct from multiple sclerosis. It presents most commonly with optic neuritis, myelitis, or an area postrema syndrome consisting of intractable nausea, vomiting, or hiccups. Most patients are positive for serum antibodies to aquaporin 4. Prompt treatment with corticosteroids and/or plasma exchange is critical for recovery, as is the initiation of disease-modifying therapy with an immunomodulatory agent to prevent future attacks. First-line disease-modifying therapies for NMOSD include rituximab, mycophenolate mofetil, and azathioprine. Several additional agents are used less commonly, and others are currently in clinical trials.

scholarly journals T Helper Cells: The Modulators of Inflammation in Multiple Sclerosis

Cells ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. 482 ◽  
Author(s):  
Martina Kunkl ◽  
Simone Frascolla ◽  
Carola Amormino ◽  
Elisabetta Volpe ◽  
Loretta Tuosto
Keyword(s):  
Multiple Sclerosis ◽  
Inflammatory Responses ◽  
Clinical Symptoms ◽  
Inflammatory Disorder ◽  
T Helper ◽  
Th Cells ◽  
Cytokines And Chemokines ◽  
Th Cell ◽  
The Central Nervous System ◽  
Cell Subpopulations

Multiple sclerosis (MS) is a chronic neurodegenerative disease characterized by the progressive loss of axonal myelin in several areas of the central nervous system (CNS) that is responsible for clinical symptoms such as muscle spasms, optic neuritis, and paralysis. The progress made in more than one decade of research in animal models of MS for clarifying the pathophysiology of MS disease validated the concept that MS is an autoimmune inflammatory disorder caused by the recruitment in the CNS of self-reactive lymphocytes, mainly CD4+ T cells. Indeed, high levels of T helper (Th) cells and related cytokines and chemokines have been found in CNS lesions and in cerebrospinal fluid (CSF) of MS patients, thus contributing to the breakdown of the blood–brain barrier (BBB), the activation of resident astrocytes and microglia, and finally the outcome of neuroinflammation. To date, several types of Th cells have been discovered and designated according to the secreted lineage-defining cytokines. Interestingly, Th1, Th17, Th1-like Th17, Th9, and Th22 have been associated with MS. In this review, we discuss the role and interplay of different Th cell subpopulations and their lineage-defining cytokines in modulating the inflammatory responses in MS and the approved as well as the novel therapeutic approaches targeting T lymphocytes in the treatment of the disease.

Cold-induced reactivity in multiple sclerosis patients

2017 ◽  
pp. 56-62 ◽  
Author(s):  
Л.И. Герасимова-Мейгал ◽  
И.М. Сиренев
Keyword(s):  
Multiple Sclerosis ◽  
Cold Test ◽  
Typical Feature ◽  
Humid Climate ◽  
Ssr Analysis ◽  
Epidemiological Surveys ◽  
The Central Nervous System ◽  
The Individual ◽  
Hands And Feet ◽  
Multiple Sclerosis Patients

Цель исследования - изучение особенностей восприимчивости пациентов с рассеянным склерозом (РС) к холодовому воздействию с помощью функциональных тестов, характеризующих функцию терморегуляции. Как известно, РС - хроническое прогрессирующее аутоиммунное заболевание центральной нервной системы мультифакториальной природы, более часто встречающееся в регионах с холодным и влажным климатом. Нарушения терморегуляции вследствие автономной дисфункции являются характерным признаком РС, вместе с тем участию холодового фактора в развитии заболевания не придается существенного значения. Методика. Обследовано 32 пациента (17 мужчин и 15 женщин, средний возраст 29,6 ± 4,2 года) с установленным диагнозом: РС ремиттирующе-рецидивирующая форма течения (средняя продолжительность заболевания - 4,2 ± 2,7 года) и 18 практически здоровых лиц группы сравнения. Восприятие холода оценивали с помощью визуально-аналоговой шкалы. Продолжительность холод-индуцированной вазоконстрикции после локального холодового теста изучали по данным инфракрасной термометрии. Вегетативную регуляцию вазомоторных реакций оценивали по результатам анализа вызванных кожных вегетативных потенциалов (ВКВП). Результаты. На основе анализа самооценки восприятия холода у пациентов с РС показана низкая переносимость холодового фактора. При проведении локального холодового теста отмечено замедление восстановления температуры кожи кисти, что характерно для усиления холод-индуцированной вазоконстрикции. В группе пациентов с РС выявлено снижение параметров ВКВП ладоней и стоп, свидетельствующее о дефиците нейрогенного контроля терморегуляционных сосудистых реакций. Заключение. У пациентов с РС выявлены нарушения механизмов терморегуляции при действии холода, что обусловливает высокую индивидуальную восприимчивость к холоду у данной категории лиц. Сопоставление результатов анализа механизмов индивидуальной холод-индуцированной реактивности у пациентов с РС с данными эпидемиологических исследований приводит к заключению о потенциальном модулирующем влиянии холодового фактора на течение РС. The purpose of the present study was focused on the evaluation of the sensitivity to cold in multiple sclerosis (MS) patients by means of functional thermoregulatory based tests. MS is known to be a chronic autoimmune progressive disease of the central nervous system of multifactor origin that is very common in regions with cold and humid climate. Disorder of thermoregulation caused by autonomic dysfunction is a typical feature of MS, however the role of the cold in the disease development is still underestimated. Methods. Thirty two MS patients (17 males, 15 females, mean age 29,6 ± 4,2 years) with the remittent form of the disease (mean disease duration 4,2 ± 2,7 years) and 18 age-matched healthy controls volunteered to participate in this study. Susceptibility to cold was analyzed with the use of visual-analogous scale. The duration of cold-induced vasoconstriction after local cold test was estimated using by infrared thermometry. Autonomic regulation of vasomotor reactions was investigated with the help of the skin sympathetic response (SSR) analysis. Results. The analysis of self-reported perception of the cold in MS patients showed their low tolerance to cold. Slow recovery of the skin temperature of the hand in the local cold test observed in MS patients was considered as the aggravated cold-induced vasoconstriction. The decreased SSR in the hands and feet in MS patients was found that indicates the deficit of the neurogenic control of thermoregulatory vasomotor reactions. Conclusion. The results obtained demonstrate the impairment of thermoregulation under cold in MS patients that leads to higher individual susceptibility to cold of this group. Comparing of the data found in this study on the mechanisms of the individual cold-induced reactivity in MS patients with epidemiological surveys enable to conclude that cold environment has potential modulating effect of on the course of MS.

Immunomodulation in Multiple Sclerosis by Phytotherapy

2020 ◽  
Vol 16 (1) ◽  
pp. 28-36
Author(s):  
Maryam Bahrami ◽  
Ghasem Mosayebi ◽  
Ali Ghazavi ◽  
Ali Ganji
Keyword(s):  
Multiple Sclerosis ◽  
Nigella Sativa ◽  
Boswellia Serrata ◽  
Immunomodulatory Agents ◽  
Therapeutic Benefits ◽  
Demyelinating Disorder ◽  
Sensory Impairments ◽  
The Central Nervous System ◽  
Pomegranate Peel Extract ◽  
Peel Extract

Multiple sclerosis is a chronic inflammatory and demyelinating disorder of the central nervous system (CNS) that can cause cognition, mobility, and sensory impairments. Studies have shown that the immune system through inflammation and autoreactive T cells are involved in the progression of MS. The present article aimed to review the potent anti-inflammatory, antioxidant, and immunomodulatory agents that could modulate the immune response in MS. In herbal medicine, various medicinal plants including Olive, Silybum marianum, Grape, Pomegranate peel extract, Nigella sativa, Turmeric, Green tea, Aloysia citrodora, Boswellia papyrifera, Boswellia serrata, Ruta graveolens, and Andrographis paniculata are known with therapeutic benefits in MS patients through immunoregulation and reduction of major symptoms.

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