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Results for “MULTIPLE SCLEROSIS”

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PubMed1978

[Haptoglobin levels in the serum and the cerebrospinal fluid patients with multiple sclerosis].

In 47 patients with multiple sclerosis and 10 with other diseases of the nervous system determinations of haptoglobin were performed in the serum and cerebrospinal fluid by the method of Owen et al. The Hp level in the serum of multiple sclerosis patients was normal. Its level in the cerebrospinal fluid was higher in multiple sclerosis patients than in cases of other nervous system diseases (statistically significant difference, p less than 0.001). Raised value of the Hp/IgG index in the cerebrospinal fluid of multiple sclerosis patients points to increased permeability of the blood-brain barrier. The so called normal Hp/IgG index was found in multiple sclerosis patients with high Hp and IgG level. Low Hp/IgG index suggested the possibility of IgG synthesis in the brain of patients with this disease. The comparison of the protein level and protein indexes showed that raised IgG level in the cerebrospinal fluid was present in 80% of multiple sclerosis cases, raised Kabat index in 50%, and low Hp/IgG index in 48%.

Haptoglobins↗
PubMed2002

Multiple ring-enhancing lesions in a child with relapsing multiple sclerosis.

The presence of ring-enhancing lesions in brain magnetic resonance images (MRIs) often raises the concern of an infectious etiology, although this radiographic finding is also seen in patients with multiple sclerosis. Multiple ring-enhancing lesions have been reported in adult patients diagnosed with multiple sclerosis but have not yet been reported in childhood multiple sclerosis. We report here a 14-year-old girl with recurrent neurologic symptoms. Her initial brain MRI showed multiple ring-enhancing lesions involving numerous white-matter fiber tracts. An extensive investigation for infectious etiologies was unrevealing. Studies of cerebrospinal fluid showed an elevated myelin basic protein and the presence of an oligoclonal band not seen in the serum. The results of electrophysiologic studies suggested a demyelinating process. The patient responded rapidly to high-dose corticosteroid treatment. However, she suffered a clinical relapse 3 months later, presenting with dysesthesia and weakness of the right arm. Repeat MRI showed multiple new active lesions. This case report illustrates that multiple ring-enhancing lesions in the brain MRI can be seen in children with multiple sclerosis and that multiple sclerosis should be considered as part of the differential diagnosis when encountering a pediatric patient with similar radiographic findings.

Adolescent↗
PubMed2004

Pathogenesis of brain and spinal cord atrophy in multiple sclerosis.

For more than a century, multiple sclerosis was viewed as a disease process characterized by oligodendrocyte and myelin loss, and research into the pathogenesis of multiple sclerosis was mainly focused on the mechanisms of inflammation. However, with development of more sophisticated neuroimaging and molecular biology techniques, attention has shifted to new aspects of pathogenesis of multiple sclerosis: axonal loss and neurodegeneration. Evidence is increasing that tissue destruction, primarily axonal loss and neurodegeneration, is a key element in the pathogenesis of multiple sclerosis. In addition, it is now known that brain and spinal cord atrophy begins early in the disease process of multiple sclerosis and advances relentlessly throughout the course of the disease. Cumulative data suggest that axonal loss is the major determinant of progressive neurologic disability in patients with multiple sclerosis. Magnetic resonance imaging and magnetic resonance spectroscopy in patients with multiple sclerosis for < 5 years indicate brain atrophy and loss of axonal integrity. Neurodegeneration and axonal loss in patients with multiple sclerosis are initially accompanied by a local response from oligodendrocyte progenitor cells and some remyelination. However, these repair mechanisms eventually fail, and patients typically develop generalized brain atrophy, cognitive decline, and permanent disability. Although the exact mechanisms underlying central nervous system atrophy in patients with multiple sclerosis are largely unknown, evidence exists that atrophy may represent an epiphenomenon related to the effects of dynamic inflammation within the central nervous system, including demyelination, axonal injury, neuronal loss, Wallerian degeneration, and possibly iron deposition. This article summarizes the potential mechanisms involved in central nervous system atrophy in patients with multiple sclerosis.

Apoptosis↗
PubMedDate not supplied

[Experimental allergic encephalomyelitis as an animal model for multiple sclerosis].

Experimental allergic encephalomyelitis is an animal model for demyelinating autoimmune disease of central nervous system, whose clinical and pathological characteristics resemble those in human disease multiple sclerosis. Multiple sclerosis is a chronic inflammatory disease followed by central nervous system demyelination, which is the result of an autoimmune process followed by central nervous system infiltration with autoreactive lymphocytes, activated macrophages and by local production of proinflammatory cytokines. Finally, the destruction of oligodendrocytes and myelin sheath occurs, caused by immunologic effector mechanisms. In this paper we reviewed fundamental and new facts about the most used models, induction, clinical and immunological characteristics of the experimental allergic encephalomyelitis in comparison with multiple sclerosis. Aethology and pathogenesis of multiple sclerosis are still unknown, but experiments on its animal models have improved our knowledge, not only about multiple sclerosis, but autoimmune diseases in general.

Animals↗
PubMed1991

[Multiple sclerosis--an immunological disease].

Multiple sclerosis is a chronic inflammatory demyelinating disease of the central nervous system. Although the cause(s) of multiple sclerosis is not known, an immunological process is considered to be a significant element in the pathogenesis of the disease. The paper describes important immunological features in multiple sclerosis and how immunological mechanisms can mediate demyelination.

Antibody Formation↗
PubMed1977

Multiple sclerosis in Asia.

Cases of multiple sclerosis were collected by Asian neurologists from recognized medical centers, using standardized formats similar to those used for the Japan nationwide multiple sclerosis survey. As a result, information on a total of 61 cases was collected from six neurologic centers in five Asian countries excluding Japan. Multiple sclerosis appears to be a rare disease throughout Asia. Certain clinical characteristics that had been previously noted in Japanese and other individual Asian series were again observed in the present Asian series. When compared with Western multiple sclerosis, the Asian multiple sclerosis cases showed a relatively higher frequency of optic nerve involvement, frequently bilateral and severe, at the onset, as well as during the course of illness, and no rare occurrence of Devic's syndrome.

Asia↗
PubMedDate not supplied

MR imaging of multiple sclerosis simulating brain tumor.

Multiple sclerosis may sometimes present as a mass lesion that is indistinguishable from brain tumor both clinically and radiologically. We describe two cases of multiple sclerosis simulating brain tumor on computed tomography (CT) scans and magnetic resonance (MR) images, one of which was proved and another was suggestive to be demyelinating disease by biopsy. Steroid therapy produced regression of the lesions of MR images and CT scans. Our cases and others in the literature suggest strategies for detecting multiple sclerosis presenting as a mass lesion.

Adult↗
PubMed1999

[Environment, genetics and immunology in multiple sclerosis].

The cause of multiple sclerosis remains unknown. Epidemiological studies indicate that it is a multi-factorial disease. The environmental factors are still unknown. No virus has been yet demonstrated to play a role in multiple sclerosis. The role of HLA in the genetic susceptibility has been known since the seventies; the detailed analysis is underway. Immunological factors playing a role in the course of multiple sclerosis are better known and may serve as basis to new therapeutical approaches.

Environment↗
PubMed2001

Investigating chemokines and chemokine receptors in patients with multiple sclerosis: opportunities and challenges.

Multiple sclerosis is an autoimmune demyelinating disease of the human central nervous system with an unknown etiology. Crucial to its pathogenesis is the accumulation and activation of mononuclear cells in the central nervous system. Chemokines and their receptors are proposed to play a major role in the inflammatory recruitment of leukocytes. Besides analyses of relationships between chemokine or chemokine receptor gene polymorphisms and multiple sclerosis susceptibility and severity, analyses of chemokines and their receptors in patients with multiple sclerosis remain descriptive. In clinical material, chemokines and chemokine receptors can be examined in body fluids (blood and cerebrospinal fluid) and in brain tissues obtained via biopsy or autopsy. Research results will be summarized in this review, and a general model of leukocyte migration into the central nervous system under normal and inflammatory conditions will be proposed. Furthermore, opportunities and challenges for future investigations will be identified.

Brain Chemistry↗
PubMed2002

Evaluation of cognitive assessment and cognitive intervention for people with multiple sclerosis.

OBJECTIVES: Cognitive problems in multiple sclerosis are common but any possible benefits of treatment remain uncertain. The aim of the study was to evaluate the benefits of providing a psychology service, including cognitive assessment and intervention, to patients with multiple sclerosis. METHOD: The study was a single blind randomised controlled trial. A total of 240 patients with clinically definite, laboratory supported, or clinically probable multiple sclerosis were recruited from an multiple sclerosis management clinic and assessed on a brief screening battery. They were randomised into three groups. The control group received no further intervention. The assessment group received a detailed cognitive assessment, the result of which was fed back to staff involved in the patients' care. The treatment group received the same detailed cognitive assessment and a treatment programme designed to help reduce the impact of their cognitive problems. Patients were followed up 4 and 8 months later on the general health questionnaire (GHQ-28), extended activities of daily living scale, SF-36, everyday memory questionnaire, dysexecutive syndrome questionnaire, and memory aids questionnaire. RESULTS: The three groups were compared on the outcome measures at 4 and 8 months after recruitment. There were few significant differences between the groups and those that occurred favoured the control group. Overall, the results showed no effect of the interventions on mood, quality of life, subjective cognitive impairment or independence. CONCLUSIONS: The study failed to detect any significant effects of cognitive assessment or cognitive intervention in this cohort of people with multiple sclerosis.

Adult↗
PubMed2001

Analysis of MTR histograms in multiple sclerosis using principal components and multiple discriminant analysis.

Magnetization transfer ratio (MTR) histograms have the potential to characterize subtle diffuse changes in multiple sclerosis (MS) and other white matter disease. A new method is described which gives improved correlation with the Expanded Disability Status Scale (EDSS). Classification of individual subjects into normal and MS subgroups is shown. Principal component analysis (PCA) and multiple discriminant analysis (MDA) are shown to give results superior to methods of MTR histogram analysis using traditional features such as peak height and peak location. Scatterplots confirm the improved separation between groups achieved using the MDA score. The histogram analysis provides a comparison of two classification approaches, based on PCA and MDA, to recognize differences between normal controls and the four different subgroups of MS disease (and all MS patients). Multiple linear regression of these PCs vs. EDSS established an MR-based measure of disease. Using a central 60-mm slab of brain tissue, the success rate of binary classification between control and MS subgroups using MDA was 75-95%, depending on which two groups were being compared. Multiple regression analysis of EDSS with the first three PCs as independent variables was significant (r = 0.83 for secondary progressive MS, and r = 0.80 for all MS patients).

Brain↗
PubMed1977

Subclinical optic neuropathy in multiple sclerosis.

Optic neuropathy in multiple sclerosis is often not detectable by conventional clinical assessment. Temporal resolution of vision was measured at localized retinal sites by a simple perceptual test of double light-flash discrimination. Nine of 11 multiple sclerosis patients with normal fundi and no prior history of optic neuritis displayed abnormal temporal resolution. Double-flash discrimination was consistently more sensitive than any of the clinical variables measured and in some cases complementary to them. The more advanced the disease, the more spatially widespread was the double-flash impairment in the central visual field. There was a significantly increased level of double-flash impairment in advanced multiple sclerosis patients compared with patients with spinal forms of the disease and with unilateral retrobulbar neuritis.

Adult↗
PubMed1990

Do nurses or doctors have an increased risk of developing multiple sclerosis?

A cluster of multiple sclerosis (MS) patients has been reported in seven of 307 nurses in Key West, Florida. The MS death rates in British nurses and qualified medical practitioners were looked at and no increased mortality from multiple sclerosis was found. Neither was there an increase in mortality from motor neuron disease (amyotrophic lateral sclerosis), the control disease. Death rates from MS vary with social class, being highest in social class IIIN (skilled non-manual) and lowest in social class II (intermediate). These different rates may be due to MS causing health related occupational mobility. Allowance for the inter-class variability in MS death rates did not materially affect the conclusion that death from MS appears to be no more common than expected among nurses and doctors than in the general population. Possible explanations for the cluster of multiple sclerosis among nurses in Key West are discussed.

Adult↗
PubMedDate not supplied

[T-lymphocytes with a receptor for the immunoglobulin Fc fragment in the blood of multiple sclerosis patients].

In 12 multiple sclerosis patients and 15 healthy subjects the suppressor activity in vitro by the method of Shou et al. was determined parallelly with the number of T-lymphocytes with the receptor for the Fc fragment of immunoglobulin G (TG lymphocytes). In healthy subjects a correlation (p less than 0.05) was demonstrated between the suppressor activity of lymphocytes in vitro and the number of TG lymphocytes in the peripheral blood. On the other hand, in multiple sclerosis patients a decrease was observed frequently in the suppressor activity of these cells in vitro (especially during exacerbation of the disease) while the number of TG lymphocytes in the peripheral blood was normal or raised sometimes. Different causes of the this phenomenon in multiple sclerosis are discussed.

Adult↗
PubMed1981

Intrathecal interferon reduces exacerbations of multiple sclerosis.

Ten patients with multiple sclerosis who were treated with human fibroblast interferon (IFN-B) for 6 months showed a significant reduction in their exacerbation rates compared with their rates before treatment (P < .01). The IFN-B was administered intrathecally by serial lumbar punctures. There was no significant change in the exacerbation rates of ten multiple sclerosis control patients before and during the period of observation. The IFN-B recipients have now been on the study a mean of 1.5 years, the controls, 1.2 years. The clinical condition of five of the IFN-B recipients and one of the control patients has improved, whereas the condition of five of the controls and one of the IFN-B recipients has deteriorated (P < .036). These findings warrant cautious optimism about the efficacy of intrathecal IFN-B in altering the course of multiple sclerosis and support concepts of a viral or dysimmune etiology of the disease.

Adolescent↗
PubMed2001

In vivo assessment of the brain and cervical cord pathology of patients with primary progressive multiple sclerosis.

In patients with primary progressive (PP) multiple sclerosis, brain MRI lesion activity and burden are low, despite the presence of severe neurological impairment. On the contrary, the degree of cord atrophy and diffuse tissue damage in the brain and cervical cord have been found to be associated with clinical disability. Against this background, this study aimed at providing an in vivo indirect assessment of brain and cervical cord pathology in a large cohort of PP multiple sclerosis patients, using conventional MRI and magnetization transfer imaging (MTI). Ninety-one PP multiple sclerosis patients, 36 secondary progressive (SP) multiple sclerosis patients and 30 healthy controls underwent brain and cervical cord MRI scans, using dual echo (brain) or fast short-tau inversion recovery (cervical cord) MTI and T(1)-weighted sequences. For the brain, T(2) hyperintense and T(1) hypointense lesion volumes were calculated and the volume of the whole of the brain tissue measured. For the cervical cord, the number and burden of lesions and the cross-sectional area were assessed. MTI scans were post-processed and analysed to obtain magnetization transfer ratio (MTR) histograms from the whole of the brain and cervical cord tissue and from the normal-appearing brain tissue in isolation. In PP multiple sclerosis patients, brain, normal-appearing brain tissue and cervical cord MTR histogram-derived metrics revealed the presence of diffuse tissue damage whose characteristics did not significantly differ from those of SP multiple sclerosis patients, even though SP multiple sclerosis patients had higher MRI-visible lesion burdens. None of the correlations between MRI or MTI measures obtained from the brain and the cord were significant. PP multiple sclerosis patients' disability was significantly, albeit weakly associated with a composite MR model including measures of loss and intrinsic damage of cervical cord tissue. Our data indicate the presence of a diffuse tissue damage undetectable by conventional MRI in PP multiple sclerosis patients, whose extent seems to match that of SP multiple sclerosis patients with similar levels of disability. They also suggest that the severity of multiple sclerosis pathology in the cervical cord is one of the factors contributing to neurological impairment in PP multiple sclerosis.

Adult↗
PubMed1981

Clinico-electroencephalographic studies of multiple sclerosis.

57 cases of multiple sclerosis was seen from 1949-1979, an incidence of 935 per 100,000 neurological admissions, and 0.04 per 100,000 inpatient admissions. There was a sex ratio of 1:1.1, and a mean age of 33 years. The mean duration of illness was 31 months. It is striking that in 47% the initial affliction was visual impairment (62% being bilateral). Motor paralysis, chiefly paraplegia (37%) was also frequent. However, initial diplopia, vertigo and ataxia were uncommon. Aside from these variations the clinical picture of multiple sclerosis is essentially the same as seen in the West. The EEG changes were nonspecific without definite correlations with age, sex, occupation, birthplace, age at admission, age at onset, duration of illness, mode of onset and clinical manifestations. Active cases presented more abnormal records thant quiescent cases. More abnormal records were obtained in cases with remissions and relapses than those running a progressive course. The EEG, especially with serial studies, is helpful in depicting cortical dysfunction in multiple sclerosis at an early stage of the disease. A normal tracing does not exclude structural damage inasmuch as submicroscopic and substructural physiochemical changes might not be sufficiently severe to cause alteration in electrical activity recorded from the convexity of the cerebral hemispheres.

Adolescent↗