COMPARATIVE ANALYSIS OF THE RESULTS RECEIVED IN THE PAIN EFFECTS SCALE IN MEN WITH MULTIPLE SCULPROSIS

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 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.


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.


1970 ◽  
Vol 24 (1) ◽  
pp. 9-16
Author(s):  
Md Bahadur Ali Miah ◽  
Abdul Kader Sheikh ◽  
Akhlaque Hosain Khan ◽  
Md Rafiqul Islam ◽  
AKM Anwar Ullah ◽  
...  

This study was undertaken in the Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from January 2002 to December 2003. The objective of this study was to determine the initial neurologic symptoms of multiple sclerosis among Bangladeshi patients. A total of 25 respondents of multiple sclerosis patients as cases selected by McDonald et al. (2001) diagnostic criteria for multiple sclerosis were enlisted during the study period. The clinical details, investigations of the respondents were reviewed. Data were recorded in predesigned data collection sheet. Out of 25 cases, male patients were 12 (48%) and females were 13 (52%), ratio being 1:1.08. Majority of the patients presented at second, third and fourth decades of life. Most of the patients (56%) had acute onset, followed by subacute (28%) and insidious (16%). Certain clinical characteristics among Bangladeshi multiple sclerosis patients are noteworthy, namely, number of male and female patients almost equal (48% vs 52%), a higher rate of impaired vision (optic nerve involvement, 64%), motor weakness (92%), sphincteric disturbances (92%) and a lower rate of brainstem and cerebellar involvement. Painful tonic spasm was a prominent feature among Bangladeshi patients with multiple sclerosis (8 out of 25, 32%). Out of 25 patients, one (4%) expired due to aspiration pneumonia. Twenty four (96%) survived. Among them 9 (36%) has restricted activity, 7 (28%) were bedridden, 5 (20%) were chairbound, 2 (8%) had minor disability and were in work and 1 (4%) was completely normal. DOI: http://dx.doi.org/10.3329/bjn.v24i1.3035 Bangladesh Journal of Neuroscience 2008; Vol. 24 (1) :9-16


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.


2021 ◽  
Vol 21 (1) ◽  
pp. 36-40
Author(s):  
Justyna Wiśniowska ◽  
◽  
Kamilla Puławska ◽  

Fatigue is one of the most common symptoms seen in patients with multiple sclerosis. Cognitive-behavioural psychotherapy can be a non-pharmacological approach for these patients. Van Kessel and Moss-Morris developed a cognitive-behavioural model to explain multiple sclerosis-related fatigue (2006). According to this model, inflammatory and demyelinating factors present in the central nervous system trigger fatigue, while cognitive interpretation, anxiety, or depressive symptoms and resting lifestyle are maintaining factors. Based on the cognitive-behavioural model of fatigue in multiple sclerosis, a protocol encompassing 8 treatment sessions was developed. For over 10 years, studies have been conducted to verify the effectiveness of cognitive-behavioural psychotherapy in the treatment of fatigue in patients with multiple sclerosis. The so far obtained results show that cognitive-behavioural psychotherapy has a moderate short-term effect on reducing fatigue, while the effect size in the long-term is small. The obtained results were undoubtedly influenced by several factors: the heterogeneity of the procedures used, the size of the research groups, and the large number of disease-related intermediary variables. Further research should be conducted to identify specific factors responsible for the effectiveness of cognitive-behavioural psychotherapy in the treatment of fatigue and to assess the long-term effects of therapy.


2021 ◽  
Vol 27 (1-2) ◽  
pp. 36-45
Author(s):  
M.I. Bozhenko ◽  

Aim of the research is to analyze the patterns of pain syndromes and their characteristics in multiple sclerosis patients. Materials and Methods. A total of 104 multiple sclerosis patients complaining of pain during the last month were examined in Lviv Regional Multiple Sclerosis Center. We analyzed medical records, performed general medical and neurological examinations and compiled history of lifestyle, illness and pain. The VAS and PainDetect questionnaires were used to assess the characteristics of pain syndromes. The patients were asked to choose one of the 4 typical patterns of pain, which best described their feelings. Then the analysis of pain syndrome patterns and their characteristics was carried out. Results and Discussions. All 4 typical patterns of pain syndromes were registered in multiple sclerosis patients. However, only 26.92% of the participants experienced an intermittent pain pattern. The rest of patients suffered from patterns characterized by persistent pain. The evaluation of the patterns and their characteristics revealed typical features. The highest intensity of the severest and average pain during the last month was present in the patients suffering from constant pain with distinct attacks: 8.0 [7.0; 9.0] points (p<0.05) and 7.0 [5.0; 8.0] points (p<0.05), respectively. Persistent paroxysmal pain was more common in the multiple sclerosis patients with neuropathic pain (43.8±8.8% vs 20.4±5.8%, p<0.05). Irradiating pain is also characteristic to this pattern in 52.9±8.6% of patients (p<0.05). The head is the most common pain localization in the patients experiencing persistent pain with severe attacks - 82.4±9.2% of cases (p<0.05). Conclusions. Pain is a permanent symptom in a significant number of multiple sclerosis patients. It can have different patterns of progression. However, it has typical characteristics and their understanding will aid in the diagnosis, prognosis and treatment of pain syndromes in multiple sclerosis patients


2003 ◽  
Vol 131 (3-4) ◽  
pp. 122-126 ◽  
Author(s):  
Sarlota Mesaros ◽  
Jelena Drulovic ◽  
Zvonimir Levic

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.


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.


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