Multiple sclerosis and related disorders
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Mult Scler Relat Disord · Sep 2019
Observational StudyDisease course, progression and activity of neuromyelitis optica (NMOSD) in patients who were treated with Rituximab, 6 and 12 months after receiving the first dose of drug, in Isfahan city.
Neuromyelitis optica spectrum disease (NMOSD) is a chronic inflammatory and usually relapsing demyelinating disease which mainly involves optic nerve and spinal cord and also other parts of the central nervous system. Rituximab has been used for some neurological disorders with a probable autoimmune basis. Early and aggressive immunosuppression therapy is necessary to prevent clinical relapses and permanent disability in NMOSD. Rituximab, a monoclonal antibody against B cells, has been found effective in several recent studies. The objective of this study is to evaluate the clinical efficacy of Rituximab as a newly introduced treatment to NMOSD in Iran. ⋯ In the current study, we found that Rituximab can significantly improve disability state and also can markedly reduce relapse rate in NMOSD patients.
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Mult Scler Relat Disord · Aug 2019
Meta AnalysisEfficacy and tolerability of azathioprine for neuromyelitis optica spectrum disorder: A systematic review and meta-analysis.
Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory and autoimmune disorder of the central nervous system that typically presents with optic neuritis and myelitis. Azathioprine (AZA) is one of the available immunotherapies with purported beneficial effects for patients with NMOSD. At present, there are no systematic reviews that extensively pooled the effects of AZA compared to other interventions for this condition. The objective of this study, therefore, is to determine the efficacy and safety of AZA in patients with NMOSD using systematic review of relevant studies. ⋯ AZA improves relapses and disability in patients with NMOSD but this regimen is associated with relatively frequent adverse events based on limited published evidences. More well-conducted clinical trials are necessary to establish with certainty the beneficial and harmful effects of AZA in patients with NMOSD.
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Mult Scler Relat Disord · Aug 2019
Five year iron changes in relapsing-remitting multiple sclerosis deep gray matter compared to healthy controls.
Relapsing-Remitting MS (RRMS) Deep Grey Matter (DGM) 5 year changes were examined using MRI measures of volume, transverse relaxation rate (R2*) and quantitative magnetic susceptibility (QS). By applying Discriminative Analysis of Regional Evolution (DARE), R2* and QS changes from iron and non-iron sources were separated. ⋯ Thalamic atrophy was the only bulk effect that demonstrated different rates of changes over 5 years compared to age-matched controls. DARE Iron decrease in regions of the caudate, putamen, and thalamus were prominent features in stable RRMS over 5 years.
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Mult Scler Relat Disord · Jun 2019
Transorbital ultrasonography in acute optic neuritis: Can it be a supportive diagnostic tool?
Because of limitations of conventional tools for diagnosing optic neuritis (ON), transorbital ultrasonography (TOUS) was introduced as a promising tool to evaluate the optic nerve. However, studies demonstrating its utility are scarce. ⋯ TOUS could be a cost-effective tool for morphologically evaluating acute ON showing a significant thickening of the optic nerve and sheath, although only a limited retrobulbar area could be explored.
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Mult Scler Relat Disord · Jun 2019
Characterization of gray-matter multiple sclerosis lesions using double inversion recovery, diffusion, contrast-enhanced, and volumetric MRI.
To investigate gray-matter (GM) lesions in relapsing-remitting multiple sclerosis (MS) using double-inversion recovery (DIR) MRI, determine GM lesions prevalence, spatial distribution and characterize their contrast-enhancement, diffusion characteristics and compare them to white-matter (WM) lesions. This is the first study, to our knowledge, to investigate GM MS lesions using double-inversion recovery MRI, to determine GM lesion prevalence and location, and characterize contrast-enhancement and diffusion characteristics, compared to WM lesion characteristics in the same patients. We also correlated GM lesion counts, volume and apparent diffusion coefficient (ADC) with total brain, WM, and GM volumes, as well as 25-foot walk test as a clinical disability. ⋯ This study characterized GM MS lesions using double-inversion recovery, contrast-enhanced and diffusion MRI. Understanding GM lesion pathophysiology using MRI in vivo, may prove useful for improving targeted therapy and monitoring disease progression.