Making Connections

Research News


	Summaries of all the latest research findings on MS selected by a team based at the Institute of Neurology, London.

Prior suggestive symptoms in one-third of patients consulting for a "first" demyelinating event

The authors used a patient administered health questionnaire to evaluate the incidence of prior antecedent neurological symptoms in patients consulting for a “first” demyelinating event across 14 French neurology departments.

The questionnaire comprised 72 questions regarding previous symptoms lasting >24 h and the cohort included 178 patients. The questionnaire, which was subsequently validated by a neurologist, demonstrated that 33% of patients consulting for a first demyelinating event had had prior symptoms suggestive of central nervous system demyelination that had gone unnoticed, and almost 70% had either sequelae of prior demyelination or McDonald criteria for dissemination in space.

The self-administered questionnaire showed an overall sensitivity of 93% and specificity of 80% for identifying patients with prior symptoms suggestive of demyelination. The authors suggest that such a questionnaire could be a useful tool for earlier diagnosis of multiple sclerosis.

authors: Gout O, Lebrun-Frenay C, Labauge P, Le Page GE, Clavelou P, Allouche S; PEDIAS Group

source: J Neurol Neurosurg Psychiatry. 2010 Nov 19. [Epub ahead of print]

Trends in the epidemiology of multiple sclerosis in Greater Hobart, Tasmania: 1951 to 2009

This is the third population-based epidemiological study of MS from Hobart, Australia, and describes the evolution of MS within the population over the last six decades following collation of the most recent epidemiological data from 2001-2009.

Key observations were of a threefold increase in the age-standardised prevalence of MS from 1961 to 2009, during which time the incidence nearly doubled. However, encouragingly, mortality fell by half from 2.4/100,000 in 1951-1959 to 1.0/100,000 in 2001–2009. The authors comment that part of the increase in prevalence was due to an increased longevity and decreased mortality seen over the last six decades.

Overall the study points to a rising prevalence of MS, particularly when the analysis is restricted to Australian-born members of the cohort. Changing trends in prevalence amongst non-Australian born citizens have been linked to changing migration patterns and a shift from migrants moving to Australia from higher latitude/prevalence countries to migrants from low latitude countries in Asia/Oceania.

authors: Simpson S Jr, Pittas F, van der Mei I, Blizzard L, Ponsonby AL, Taylor B.

source: J Neurol Neurosurg Psychiatry. 2010 Nov 20. [Epub ahead of print]

TGF-beta signalling is altered in the peripheral blood of subjects with multiple sclerosis

The pleiotropic cytokine TGF-beta is thought to play a role in suppressing autoreactive T cell responses in MS. The authors studied 25 subjects with untreated MS and 23 healthy donors and found changes in the transcriptional activity of multiple elements of the TGF-beta signalling pathway. Low levels of SMAD7 and p21 expression reflect reduced TGF-beta transcriptional control and increased TGF-beta RII and SMAD4 likely representing compensatory upregulation. The authors suggest that changes are most likely explained by reduced TGF-beta signalling in MS although response to exogenous TGF-beta1 was intact, arguing against an intrinsic defect or inhibition of TGF-beta signal transduction. The authors have gone on to suggest that the impaired regulation of TGF-beta1 might be an important factor in the loss of immune tolerance seen in MS.

authors: Meoli EM, Oh U, Grant CW, Jacobson S.

source: J Neuroimmunol. 2010 Nov 18. [Epub ahead of print]

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