Multiple sclerosis patients who improve in their disability over time develop less brain atrophy compared to those who remain stable or progress

Objective To assess whole brain and central brain atrophy as well as their differential relation to memory, cognitive performance, fatigue, depression and quality of life in patients with relapsingremitting multiple sclerosis (RRMS). Methods A 3D flow compensated gradient recalled T1-weighted MRI was acquired in 45 RRMS patients. An automated analysis tool was used to calculate brain parenchymal fraction (BPF) and ventricular brain fraction (VF). All patients were assessed with neuropsychological tests focusing on memory and self-rating scales for depression, fatigue and quality of life. Age corrected partial correlations between brain atrophy, motor performance, psychological scales and test scores were calculated. Results BPF correlated moderately (0.35≤r<0.5) with duration of symptoms and disease, the Expanded Disability Status Scale (EDSS), the upper extremity motor performance, and with mental aspects of quality of life. VF correlated moderately with EDSS, upper and lower extremity motor performance and memory functions. Neither BPF nor VF correlated with fatigue and depression. Results of several cognitive tests correlated moderately with depression and fatigue, the Paced Auditory Serial Addition Test (PASAT) showing the largest correlation. Conclusions Memory performance shows a correlation with relative ventricular size in RRMS patients, indicating the strategic location of the ventricle system along the structures of the limbic system and its vulnerability in MS. The PASAT and several other cognitive tests show moderate correlations with depression and fatigue, arguing for an inter relation between the cognitive functioning and the emotional state of patients. However, this relation is independent of measurable brain atrophy.

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Brain atrophy and disability progression in multiple sclerosis patients: a 10-year follow-up study

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2013-306906 ◽

2014 ◽

Vol 85 (10) ◽

pp. 1109-1115 ◽

Cited By ~ 94

Author(s):

Cecilie Jacobsen ◽

Jesper Hagemeier ◽

Kjell-Morten Myhr ◽

Harald Nyland ◽

Kirsten Lode ◽

...

Keyword(s):

Multiple Sclerosis ◽

Brain Atrophy ◽

Disability Progression ◽

Follow Up Study ◽

Multiple Sclerosis Patients

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The long-term effect of AHSCT on MRI measures of MS evolution: a five-year follow-up study

Multiple Sclerosis Journal ◽

10.1177/1352458507076982 ◽

2007 ◽

Vol 13 (8) ◽

pp. 1068-1070 ◽

Cited By ~ 37

Author(s):

L. Roccatagliata ◽

MA Rocca ◽

P. Valsasina ◽

L. Bonzano ◽

MP Sormani ◽

...

Keyword(s):

Multiple Sclerosis ◽

Brain Atrophy ◽

Marked Decrease ◽

Hematopoietic Stem ◽

Follow Up Study ◽

Long Term Effect ◽

Second Year ◽

Multiple Sclerosis Patients

Using MRI, we measured disease activity and brain atrophy in nine multiple sclerosis patients treated with autologous hematopoietic stem cell transplantation (AHSCT) for a mean follow up of 63 months. We show that AHSCT is associated to a longlasting suppression of inflammation and to a marked decrease of the rate of brain atrophy after the second year following treatment. Multiple Sclerosis 2007; 13 : 1068—1070. http://msj.sagepub.com

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Early Cognitive Impairment in Multiple Sclerosis Patients In Relation To Brain Atrophy, Egyptian Sample

QJM ◽

10.1093/qjmed/hcaa054.008 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

M F Zakaria ◽

T A Abdo ◽

A A Abdelaziz ◽

D A Zamzam ◽

Y A Abdullah ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Brain Atrophy ◽

General Medicine ◽

Economic Consequences ◽

University Hospitals ◽

Cross Sectional ◽

Significant Difference ◽

Multiple Sclerosis Patients

Abstract Background Approximately half of all patients with multiple sclerosis (MS) experience cognitive impairment, most commonly with regard to new learning and memory. Cognitive dysfunction is a leading cause of disability in MS and it can have profound social and economic consequences for patients and their families. Objective This study was conducted to discover the early cognitive domains affected in multiple sclerosis patients concomitant with the postulated brain atrophy in an Egyptian sample of multiple sclerosis patients. Patients and Methods A cross-sectional observational case-control study conducted on seventy (60) patients who came for follow-up in Ain Shams University hospitals. 40 patients were taken as cases that followed up in MS unit in Ain-Shams university hospitals. 20 participants were taken as controls taken from the general medicine clinics age and sex matched to our patient group. An informed written consent was taken from parents of each person included in the study. Results There was a statistically significant difference between the two groups in brain volumetric changes and in the parameters of cognitive assessment Conclusion Early detection and examination of cognitive functions is important for patient evaluation, follow up and treatment regimen used.

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Longitudinal single-cell cytokine responses reveal recurrent autoimmune myelin reactivity in relapsing-remitting multiple sclerosis patients

Multiple Sclerosis Journal ◽

10.1191/1352458505ms1165oa ◽

2005 ◽

Vol 11 (3) ◽

pp. 251-260 ◽

Cited By ~ 5

Author(s):

I R Moldovan ◽

R A Rudick ◽

A C Cotleur ◽

S E Born ◽

J-C Lee ◽

...

Keyword(s):

Multiple Sclerosis ◽

Amino Acid ◽

Ex Vivo ◽

Proteolipid Protein ◽

Myelin Proteins ◽

Immune Reactivity ◽

Cytokine Responses ◽

Relapsing Remitting ◽

Multiple Sclerosis Patients ◽

Over Time

The relationship between multiple sclerosis (MS) disease activity and myelin protein-induced cytokine responses over time is not elucidated. We addressed this relationship by examining longitudinal cytokine responses to myelin proteins every three months for one year, in the context of gadolinium (gad)-enhancing brain lesions and of clinical relapses. The ELISPOT assay was used to determine the ex vivo cytokine production in response to nine amino acid long peptides spanning the entire proteolipid protein (PLP) and myelin basic protein (MBP) molecules in relapsing—remitting (RR) MS patients and matched healthy controls. We identified three longitudinal levels of myelin-induced cytokine secretion by adding up the positive responses for all PLP or MBP peptides obtained for five timepoints, at three- month intervals: low reactivity (<200 cumulative cytokine-secreting cells), isolated peptide reactivity (201-450 cumulative cytokine- secreting cells) and recurrent protein-wide bursts of cytokine reactivity (> 451 cumulative cytokine-secreting cells). The majority of MS patients showed recurrent bursts to PLP and MBP. In contrast, controls showed a more even distribution between all levels of cytokine reactivity. The majority of patients with gad-enhancing lesions showed PLP/IFNg and MBP/IFNg recurrent burst responses. This is the first longitudinal study on MS patients in which nine amino acid long myelin peptides are used to reveal the broad range of PLP- and MBP- peptide cytokine reactivity across the whole molecule of these two major myelin proteins. This study also reveals the extremely dynamic nature of the immune reactivity to numerous regions of myelin, which can fluctuate dramatically over time. Such fluctuation could hamper the efficacy of antigen-based therapies for MS.

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