Multiple sclerosis and related disorders
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Mult Scler Relat Disord · Jul 2015
Association between soluble L-selectin and anti-JCV antibodies in natalizumab-treated relapsing-remitting MS patients.
In relapsing-remitting MS (RRMS) patients treated with natalizumab, the low level of L-selectin-expressing CD4+ T cells has been associated with the risk of progressive multifocal leukoencephalopathy (PML). In this study, our aim was to correlate the levels of soluble L-selectin and the anti-JCV antibody index in the sera of RRMS patients treated with natalizumab. ⋯ The results support the hypothesis of sL-selectin being connected to the anti-JCV antibody index values and possibly cellular L-selectin. Measurement of serum sL-selectin should be evaluated further as a potential biomarker for predicting the risk of developing PML.
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Mult Scler Relat Disord · Jul 2015
Health care utilization before and after intensive care unit admission in multiple sclerosis.
The incidence of intensive care unit (ICU) admission is elevated in the multiple sclerosis (MS) population but the reasons for this are incompletely understood, as are outcomes post-ICU admission. Among MS patients we examined the association between ICU admission and health care utilization in the year preceding admission, and compared health care utilization following ICU admission among persons with MS and persons from the general population. ⋯ The incidence of ICU admission is higher among persons with MS who have higher prior health care utilization. Health care utilization remains high after ICU admission. Efforts to prevent ICU admission in this population are needed.
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Mult Scler Relat Disord · May 2015
Cervical cord area is associated with infratentorial grey and white matter volume predominantly in relapsing-remitting multiple sclerosis: A study using semi-automated cord volumetry and voxel-based morphometry.
Atrophy of the brain and the upper cervical cord, which both have major impact on the severity of clinical symptoms in multiple sclerosis (MS), may be interrelated by neuraxonal degeneration. Aiming to identify possible spatially remote effects of neuraxonal brain damage on spinal cord atrophy, we studied regional and global brain volumes and the upper cervical cord area (UCCA) in a large group of MS patients and a healthy control group. ⋯ Cervical cord and brain atrophy were present in both, RRMS and even more severe in SPMS. Still, spatial associations between cervical cord area and remote cerebellar and brainstem volume, possibly driven by neuraxonal degeneration, were detected mostly in RRMS patients with predominantly short disease durations. Future longitudinal studies may elucidate the interplay between affection of spinal cord and infratentorial structures in MS, and contribute to the understanding of the conversion processes from relapsing-remitting to secondary progressive MS.
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Mult Scler Relat Disord · Mar 2015
Randomized Controlled Trial Multicenter StudyRegional gray matter atrophy in relapsing remitting multiple sclerosis: baseline analysis of multi-center data.
Regional gray matter (GM) atrophy in multiple sclerosis (MS) at disease onset and its temporal variation can provide objective information regarding disease evolution. An automated pipeline for estimating atrophy of various GM structures was developed using tensor based morphometry (TBM) and implemented on a multi-center sub-cohort of 1008 relapsing remitting MS (RRMS) patients enrolled in a Phase 3 clinical trial. Four hundred age and gender matched healthy controls were used for comparison. ⋯ Thalamic atrophy observed in MS patients compared to healthy controls remained consistent within subgroups based on gender and scanner field strength. Weak correlations between thalamic volume and EDSS (r=-0.133; p<0.001) and DD (r=-0.098; p=0.003) were observed. Of all the structures, thalamic volume moderately correlated with T2 LL (r=-0.492; P-value<0.001), T1 LL (r=-0.473; P-value<0.001) and nCSF (r=-0.367; P-value<0.001).
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Mult Scler Relat Disord · Mar 2015
Subclinical MRI disease activity influences cognitive performance in MS patients.
The pathological mechanisms underlying cognitive dysfunction in multiple sclerosis (MS) are not yet fully understood and, in addition to demyelinating lesions and gray-matter atrophy, subclinical disease activity may play a role. ⋯ Cognitive dysfunction was especially related to high burden of cortical lesions and subclinical disease activity. Cognitive studies in MS should look over subclinical disease activity as a potential contributor to cognitive impairment.