Cold-induced reactivity in multiple sclerosis patients

Author(s):  
Л.И. Герасимова-Мейгал ◽  
И.М. Сиренев

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.

2018 ◽  
Vol 28 (2) ◽  
pp. 519-523
Author(s):  
Inna Mincheva Ivanova

Multiple sclerosis (MS) is one of the most common diseases of the central nervous system (CNS), one of the biggest puzzles in medicine. A number of drugs and therapies have been developed that affect the symptoms or change the severity and frequency of the seizures. Multiple sclerosis is of great social and economic importance to the world, due to the great invasion at early age. It affects the "young adults" in their creatively active period - between 10 and 50 years of age. Contrary to most allegations that pain is absent in MS patients, this is not the case. In the first periods of the disease, pain is almost absent, apart from the periodic manifestation of cramps, perceptions and all types of pain in the body, which at night interfere with sleep, provoke chronic fatigue and irritability (as they themselves have other mechanisms leading to the event their). However, some studies show that pain persists more frequently in women than in men. In most cases, disabling and immobilizing patients is exalted by their attempts to avoid pain. Physiotherapy is a basic tool for maintaining and improving the general condition of the patient. The study involved 22 patients with relapsing-remitting MS. The survey was conducted on the territory of Sofia - NSA "Vasil Levski", in the period from 01.09.2013 to 30.10.2015. The pain syndrome was evaluated in multiple sclerosis patients, at the beginning, the 10th procedure and the last procedure. For each patient in the experimental group, 20 procedures were performed within 10 weeks. The duration of the individual activity was 1 hour. The procedures for hippotherapy were a total of 16, each lasting 30 minutes. After the completion of the 10-week Physiotherapy program, each of the patients continues the hippotherapy courses on the Khan Asparuh horse base. The therapeutic program we have prepared and tested includes the following: Exercise with a large therapeutic ball (fitball); proprioceptive neuromuscular facilitation (PNF); myofascial techniques (MFT); autogenous training (AT); hippo therapy (HT). During the study, the subsequent results showed a significant decrease in pain in the tested group. At the end of the study, the improvement of the indicators from the initial to the final study were seen. The statistical significance is less than or equal to 0.01, with the possibility of error being minimal. From the conclusions, it can be said that the methodology thus performed brings great positives in terms of pain reduction in women with multiple sclerosis who participated in the study.


2018 ◽  
Vol 28 (2) ◽  
pp. 525-530
Author(s):  
Inna Mincheva Ivanova

Multiple sclerosis (MS) is one of the most common diseases of the central nervous system (CNS), one of the biggest puzzles in medicine. A number of drugs and therapies have been developed that affect the symptoms or change the severity and frequency of the seizures. Multiple sclerosis is of great social and economic importance to the world, due to the great invasion at early age. It affects the "young adults" in their creatively active period - between 10 and 50 years of age. Contrary to most allegations that pain is absent in MS patients, this is not the case. In the first periods of the disease, pain is almost absent, apart from the periodic manifestation of cramps, perceptions and all types of pain in the body, which at night interfere with sleep, provoke chronic fatigue and irritability (as they themselves have other mechanisms leading to the event their). However, some studies show that pain persists more frequently in women than in men. In most cases, disabling and immobilizing patients is exalted by their attempts to avoid pain. Physiotherapy is a basic tool for maintaining and improving the general condition of the patient. The study involved 18 male patients with relapsing-remitting MS. The survey was conducted on the territory of Sofia - NSA "Vasil Levski", in the period from 01.09.2013 to 30.10.2015. The pain syndrome was evaluated in multiple sclerosis patients, at the beginning, the 10th procedure and the last procedure. For each patient in the experimental group, 20 procedures were performed within 10 weeks. The duration of the individual activity was 1 hour. The procedures for hippotherapy were a total of 16, each lasting 30 minutes. After the completion of the 10-week Physiotherapy program, each of the patients continues the hippotherapy courses on the Khan Asparuh horse base. The therapeutic program we have prepared and tested includes the following: Exercise with a large therapeutic ball (fitball); proprioceptive neuromuscular facilitation (PNF); myofascial techniques (MFT); autogenous training (AT); hippo therapy (HT). During the study, the subsequent results showed a significant decrease in pain in the tested group. At the end of the study, the improvement of the indicators from the initial to the final study were seen. The statistical significance is less than or equal to 0.01, with the possibility of error being minimal. From the conclusions, it can be said that the methodology thus performed brings great positives in terms of pain reduction in women with multiple sclerosis who participated in the study.


2018 ◽  
Vol 19 (11) ◽  
pp. 3589 ◽  
Author(s):  
Claudia Rossi ◽  
Ilaria Cicalini ◽  
Mirco Zucchelli ◽  
Maria di Ioia ◽  
Marco Onofrj ◽  
...  

Multiple sclerosis (MuS) is an autoimmune disease of the central nervous system characterized by neuroinflammation, neurodegeneration, and degradation of the myelin sheath. Epidemiological studies have shown that the female gender is more susceptible than the male gender to MuS development, with a female-to-male ratio of 2:1. Despite this high onset, women have a better prognosis than men, and the frequency of the relapsing phase decreases during pregnancy, while it increases soon after birth. Therefore, it is interesting to investigate hormonal fluctuations during pregnancy and whether they correlate with metabolic signatures. To gain a deeper inside into the biochemical mechanism of such a multifactorial disease, we adopted targeted metabolomics approaches for the determination of many serum metabolites in 12 pregnant women affected by MuS by mass spectrometry analysis. Our data show a characteristic hormonal fluctuation for estrogens and progesterone, as expected. They also highlight other interesting hormonal alterations for cortisol, corticosterone, 11-deoxycortisol, 4-androstene-3,17-dione, testosterone, and 17α-hydroxyprogesterone. Furthermore, a negative correlation with progesterone levels was observed for amino acids and for acylcarnitines, while an imbalance of different sphingolipids pathways was found during pregnancy. In conclusion, these data are in agreement with the characteristic clinical signs of MuS patients during pregnancy and, if confirmed, they may add an important tessera in the complex mosaic of maternal neuroprotection.


2010 ◽  
Vol 16 (10) ◽  
pp. 1173-1177 ◽  
Author(s):  
M. Shahbazi ◽  
H. Ebadi ◽  
D. Fathi ◽  
D. Roshandel ◽  
M. Mohamadhosseni ◽  
...  

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.


2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Suyan Tian ◽  
Lei Zhang

Multiple sclerosis (MS) is a common neurological disability of the central nervous system. Immune-modulatory therapy with interferon-β (IFN-β) has been used as a first-line treatment to prevent relapses in MS patients. While the therapeutic mechanism of IFN-β has not been fully elucidated, the data of microarray experiments that collected longitudinal gene expression profiles to evaluate the long-term response of IFN-β treatment have been analyzed using statistical methods that were incapable of dealing with such data. In this study, the GeneRank method was applied to generate weighted gene expression values and the monotonically expressed genes (MEGs) for both IFN-β treatment responders and nonresponders were identified. The proposed procedure identified 13 MEGs for the responders and 2 MEGs for the nonresponders, most of which are biologically relevant to MS. Our work here provides some useful insight into the mechanism of IFN-β treatment for MS patients. A full understanding of the therapeutic mechanism will enable a more personalized treatment strategy possible.


2017 ◽  
Vol 24 (9) ◽  
pp. 1151-1156 ◽  
Author(s):  
Liesbet M Peeters

Multiple sclerosis (MS) is a progressive demyelinating and degenerative disease of the central nervous system with symptoms depending on the disease type and the site of lesions and is featured by heterogeneity of clinical expressions and responses to treatment strategies. An individualized clinical follow-up and multidisciplinary treatment is required. Transforming the population-based management of today into an individualized, personalized and precision-level management is a major goal in research. Indeed, a complex and unique interplay between genetic background and environmental exposure in each case likely determines clinical heterogeneity. To reach insights at the individual level, extensive amount of data are required. Many databases have been developed over the last few decades, but access to them is limited, and data are acquired in different ways and differences in definitions and indexing and software platforms preclude direct integration. Most existing (inter)national registers and IT platforms are strictly observational or focus on disease epidemiology or access to new disease modifying drugs. Here, a method to revolutionize management of MS to a personalized, individualized and precision level is outlined. The key to achieve this next level is FAIR data.


2011 ◽  
Vol 18 (7) ◽  
pp. 1038-1041 ◽  
Author(s):  
Felipe von Glehn ◽  
Alessandro S Farias ◽  
Augusto C Penalva de Oliveira ◽  
Alfredo Damasceno ◽  
Ana Leda F Longhini ◽  
...  

Intrathecal immunoglobulin synthesis in an oligoclonal pattern is the most common immunologic abnormality detected in MS patients. Various treatments, such as immunomodulators and immunosuppressors, have not been found to modify it. Natalizumab hinders migration of encephalitogenic T-cells into the central nervous system (CNS), reducing inflammatory response. Its impact on CSF oligoclonal bands (OCBs) has not been demonstrated. This report describes its effect in four out of six patients with multiple sclerosis after a mean of 10 infusions: the CSF was negative for OCBs at the second lumbar puncture. In conclusion, natalizumab treatment can reduce CSF OCBs to undetectable levels, although the clinical significance of this observation is not yet known.


2008 ◽  
Vol 9 (2) ◽  
pp. 109-114
Author(s):  
Viola Sacchi

Multiple sclerosis (MS) is an autoimmune disease where dysregulated immune system elements (i.e. leucocytes) react against different components of the central nervous system (CNS), in particular myelin structures, causing several physical and mental symptoms,often progressing to total disability. While some treatments for MS provide only symptom relief, the most commonly drugs administered for altering the course of the disease are DMTs (disease-modifying therapies); nevertheless for more than ten years the only DMTs available were interferon β, glatiramer acetate (two immunomodulating drugs) and mitoxantrone (an immunosuppressant).


10.12737/5911 ◽  
2014 ◽  
Vol 21 (3) ◽  
pp. 104-108
Author(s):  
Молчанова ◽  
Zh. Molchanova

Multiple sclerosis is the most frequent disease of the central nervous system. An increase in multiple sclerosis frequency was registered in several countries including Russia. This may be associated with better multiple sclerosis diagnosis and treatment, better data collection and real increase in multiple sclerosis incidence. Early disability and its rapid progression emphasize the medico-social importance of multiple sclerosis. Neuropsychological disturbances are often observed in multiple sclerosis, being one of the important components in the formation of clinical disease. 43 patients living in the North region with definite multiple sclerosis and mild or moderate disability were tested with expended neuropsychological, neurological and study of quality of life. The purpose of the study was to analyze the role of cognitive, emotional and personal peculiarities at multiple sclerosis on quality of life. To assess quality of life the authors used SF-36. The results of this study of quality of life revealed significant differences in the physical, role and social components depending on the cognitive peculiarities.


2000 ◽  
Vol 48 (3) ◽  
pp. 399-399 ◽  
Author(s):  
Servaas A. Morré ◽  
Corline J. A. De Groot ◽  
Joep Killestein ◽  
Chris J. L. M. Meijer ◽  
Chris H. Polman ◽  
...  

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