Biomedical subjects

Nynke F Kalkers

Publications and source records attributed to Nynke F Kalkers.

3 recordsLinked to original sources

PubMed2002

A study validating changes in the multiple sclerosis functional composite.

OBJECTIVE: To prospectively characterize the relation between 1-year changes in neurologist ratings of abnormalities as measured by means of the Expanded Disability Status Scale (EDSS) and changes in observations of functional impairment as measured by means of the Multiple Sclerosis Functional Composite (MSFC) in the clinical assessment of multiple sclerosis (MS). METHODS: One hundred twenty patients with MS were recruited at our outpatient clinic. Impairment and disability at baseline and follow-up were assessed using the EDSS and MSFC. We studied correlations between change (Delta) in the EDSS, MSFC, and MSFC components for the total population and different subgroups and analyzed the contribution of change in MSFC components to change in the EDSS and MSFC. RESULTS: Median EDSS score at baseline was 4.5; at follow-up, 5.0. Mean MSFC score at baseline was -0.00; at follow-up, -0.04. Good cross-sectional correlations were found between the EDSS and MSFC at baseline (-0.72) and follow-up (-0.73). Only weak correlations were found between DeltaEDSS and DeltaMSFC. Although DeltaEDSS showed the strongest correlations with change in leg function and weak or no correlation with change in cognitive function or arm function, DeltaMSFC showed the highest correlation with change in arm function and cognitive function. CONCLUSION: Our longitudinal data indicate that the MSFC reflects change from different dimensions of neurologic functions, which is a favorable characteristic when compared with the EDSS.

Adult↗

PubMed2002

Longitudinal brain volume measurement in multiple sclerosis: rate of brain atrophy is independent of the disease subtype.

BACKGROUND: In multiple sclerosis (MS), brain atrophy depicted by magnetic resonance imaging reflects overall tissue loss, including axonal loss. OBJECTIVE: To determine the course of atrophy by studying the rate of development of brain atrophy in patients who have different subtypes of MS. METHODS: Eighty-three patients with MS (42 with relapsing-remitting, 21 with secondary progressive, and 20 with primary progressive) were studied longitudinally, with an interval of 2 to 4 years. Magnetic resonance imaging included T1- and T2-weighted images to obtain 2 brain volume measurements: (1) the parenchymal fraction as a marker of global brain atrophy and (2) the ventricular fraction as a marker of central atrophy. The annualized rate of global and central brain atrophy was compared between those with different subtypes of MS and related to clinical characteristics, including sex, age, disease duration, and disability. RESULTS: There was a significant decrease of the parenchymal fraction (-0.7% per year; SEM, 0.11% per year) and a significant increase of ventricular fraction (3.7% per year; SEM, 0.54% per year) in the total group. Significant tissue loss was also seen in all 3 subtypes of MS; the decrease in parenchymal fraction was not different between subtypes, whereas the increase in ventricular fraction tended to be larger in patients with secondary progressive MS compared with patients with primary progressive MS. Marginal associations were found between clinical determinants and the rate of brain atrophy. Annualized increase in the ventricular fraction was correlated with age (r = -0.26) and duration of symptoms (r = -0.22): younger patients (mainly patients with relapsing-remitting MS who have a limited disability) displayed a larger increase in ventricular fraction compared with older patients. CONCLUSIONS: The rate of development of brain atrophy is largely independent of the course of the disease and other clinical characteristics. The relentless loss of tissue occurring in MS is not restricted to later (progressive) phases of the disease, thereby stressing the need for early neuroprotective treatment in MS.

Adult↗

PubMed2002

Production of IL-1beta and IL-1Ra as risk factors for susceptibility and progression of relapse-onset multiple sclerosis.

Interleukin-1beta (IL-1beta) is present in multiple sclerosis (MS) lesions. Interleukin-1 receptor antagonist (IL-1Ra) moderates the induction of experimental autoimmune encephalomyelitis (EAE). Here, we show that families that are characterized by high IL-1beta over IL-1Ra production ratio are at 2.2-fold (95% CI, 1.0-4.8; p=0.05) increased risk to have a patient relative with relapse-onset MS than families with a low ratio. It is also related to the reduction of volumetric magnetization transfer ratio (MTR) histogram height, a measure of parenchymal integrity (p=0.04). Those families who combine a high IL-1beta over IL-1Ra ratio with a high tumor necrosis factor (TNF) over IL-10 production ratio have a 6.2-fold (95% CI, 1.8-21; p=0.002) increased risk. Innate production of IL-1beta and IL-1Ra is not related to the outcome of primary progressive MS. Taq1 polymorphism in the IL-1beta gene and the variable number of tandem repeats (VNTR) polymorphism of 86-base pairs within the IL-1Ra gene cannot explain these findings.

Adult↗