scholarly journals Recommendations for the Diagnosis and Treatment of Multiple Sclerosis Relapses

2021 ◽  
Vol 12 (1) ◽  
pp. 6
Author(s):  
Cristina Ramo-Tello ◽  
Yolanda Blanco ◽  
Luis Brieva ◽  
Bonaventura Casanova ◽  
Eva Martínez Cáceres ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Classification Criteria ◽  
Imaging Biomarkers ◽  
Special Populations ◽  
Improve Quality ◽  
Resonance Imaging ◽  
Key Concepts ◽  
Women And Children ◽  
Risk Of Relapse

Minimizing the risk of relapse is essential in multiple sclerosis (MS). As none of the treatments currently available are capable of completely preventing relapses, treatment of these episodes remains a cornerstone of MS care. The objective of this manuscript is to reduce uncertainty and improve quality of care of this neurological process. This article addresses definitions of key concepts, recommendations for clinical examination, classification criteria, magnetic resonance imaging, biomarkers, and specific therapeutic counsels including special populations such as pregnant and breastfeeding women, and children. An algorithm for treating MS relapses is also provided.

ANALYSIS OF THE TOPIC STUDY USING 2010 MCDONALD CRITERIA

2015 ◽  
Vol 86 (11) ◽  
pp. e4.27-e4
Author(s):  
David Rog ◽  
Jerry Wolinsky ◽  
Philippe Truffinet ◽  
Karthinathan Thangavelu ◽  
Aaron Miller
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Resonance Imaging ◽  
Mcdonald Criteria ◽  
Clinical Episode ◽  
Magnetic Resonance Imaging Lesion ◽  
Consistent Treatment ◽  
Post Hoc ◽  
Reduced Risk ◽  
Risk Of Relapse

IntroductionTOPIC (NCT00622700) was designed to evaluate teriflunomide in patients with a first clinical episode suggestive of multiple sclerosis (MS). Teriflunomide 14 mg reduced risk of relapse determining conversion to clinically definite MS by 42.6%, and of new relapse or magnetic resonance imaging lesion by 34.9% vs placebo. After study initiation, the 2005 McDonald criteria were revised, potentially allowing earlier MS diagnosis.MethodsThe 2010 McDonald criteria were applied retrospectively. Patients who received teriflunomide 14 mg or placebo for ≤108 weeks were grouped according to fulfilment of 2010 criteria at baseline. Time to MS was analysed for those not fulfilling the 2010 criteria at baseline. Additional post hoc analyses will evaluate differences in outcomes based on baseline radiological characteristics of reclassified patients.ResultsPatients receiving teriflunomide 14mg (n=214) or placebo (n=197) were analysed. For those not meeting the 2010 criteria (n=163), probability of conversion to MS was 54.1% (14 mg) and 74.4% (placebo). Teriflunomide 14mg reduced the probability of conversion to MS by 39.1% vs placebo. Data regarding time to MS based upon baseline radiological characteristics will be presented.ConclusionsTeriflunomide demonstrates a consistent treatment effect in patients with MS diagnosed according to differing diagnostic criteria. (Study supported by Genzyme, a Sanofi company).

scholarly journals Musical identity of patients with multiple sclerosis

2009 ◽  
Vol 67 (1) ◽  
pp. 46-49 ◽  
Author(s):  
Shirlene Vianna Moreira ◽  
Cecília Cavalieri França ◽  
Marcos Aurélio Moreira ◽  
Marco Aurélio Lana-Peixoto
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Body Awareness ◽  
Adult Patients ◽  
Improve Quality ◽  
Therapeutic Tool ◽  
Musical Identity ◽  
Musical History

Musical autobiographies consist of a powerful therapeutic tool by which individuals define themselves. The use of this technique may help (re)construction personal identities and improve quality of life of patients with multiple sclerosis (MS). Eight adult patients on treatment at CIEM Multiple Sclerosis Investigation Center after selecting 10 to 15 pieces of music most significant in their lives were interviewed. The data collected were classified according to Even Rudd categories, which reveal how a person expresses his personal, social, temporal and transpersonal identities. We observed that recall of musical history makes MS patients get better perception both of their feelings and body awareness, as well as provide them with an alternative way to express themselves, activate and contextualize affective memories, and achieving a sense of life continuity in spite of the disease.

scholarly journals The Role of Molecular Imaging as a Marker of Remyelination and Repair in Multiple Sclerosis

2021 ◽  
Vol 23 (1) ◽  
pp. 474
Author(s):  
Ido Ben-Shalom ◽  
Arnon Karni ◽  
Hadar Kolb
Keyword(s):  
Multiple Sclerosis ◽  
Molecular Imaging ◽  
Disease Progression ◽  
Acute Inflammation ◽  
Imaging Biomarkers ◽  
Underlying Mechanisms

The appearance of new disease-modifying therapies in multiple sclerosis (MS) has revolutionized our ability to fight inflammatory relapses and has immensely improved patients’ quality of life. Although remarkable, this achievement has not carried over into reducing long-term disability. In MS, clinical disability progression can continue relentlessly irrespective of acute inflammation. This “silent” disease progression is the main contributor to long-term clinical disability in MS and results from chronic inflammation, neurodegeneration, and repair failure. Investigating silent disease progression and its underlying mechanisms is a challenge. Standard MRI excels in depicting acute inflammation but lacks the pathophysiological lens required for a more targeted exploration of molecular-based processes. Novel modalities that utilize nuclear magnetic resonance’s ability to display in vivo information on imaging look to bridge this gap. Displaying the CNS through a molecular prism is becoming an undeniable reality. This review will focus on “molecular imaging biomarkers” of disease progression, modalities that can harmoniously depict anatomy and pathophysiology, making them attractive candidates to become the first valid biomarkers of neuroprotection and remyelination.

scholarly journals Can a stress management programme reduce stress and improve quality of life in people diagnosed with multiple sclerosis?

2018 ◽  
Vol 4 (4) ◽  
pp. 205521731881317
Author(s):  
Susan Agland ◽  
Amanda Lydon ◽  
Sally Shaw ◽  
Rodney Lea ◽  
Sheila Mortimer-Jones ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Stress Management ◽  
Perceived Stress ◽  
Intervention Group ◽  
Secondary Analysis ◽  
Management Programme ◽  
Progressive Muscle Relaxation ◽  
Improve Quality

Background Despite evidence of perceived stress as a risk factor for multiple sclerosis activity, the evidence for managing stress is limited. Objective To evaluate a stress management programme on perceived stress and quality of life, over 6 months. Methods One hundred people with multiple sclerosis were randomly assigned to either a stress management programme of mindfulness, meditation and progressive muscle relaxation, or wait list. Perceived stress and quality of life were assessed at three intervals across 6 months. Salivary cortisol levels were assessed at two intervals: baseline and first follow-up. Results The stress management programme did not significantly reduce perceived stress, when comparing mean scores. Secondary analysis using median scores found a significant improvement for quality of life, favouring the intervention group. Conclusion Stress management had no significant effect on the primary outcome of perceived stress but did improve quality of life in a secondary analysis of median scores.

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