02 Feb 10

Brain tissue sodium concentration in multiple sclerosis: a sodium imaging study at 3 tesla
Brain. 2010 Jan 27

The authors aimed to investigate the underlying mechanisms of neuro-axonal degeneration, which is thought to play an important part in determining the increase in irreversible disability in people with MS, by means of a new MRI technique which specifically assesses the amounts of sodium in the brain tissue. They found abnormally high values of tissue sodium concentration in people with MS compared to healthy controls, and also that such tissue sodium concentration correlated with clinical disability, in keeping with other studies which suggest that the accumulation of sodium in axons is an important cause of axonal damage in MS.
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02 Feb 10

Neurofilament light as a prognostic marker in multiple sclerosis
Mult Scler. 2010 Jan 19

The prognosis of MS may vary amongst people and as yet there are no significant markers which can predict a less favourable clinical evolution. The authors have found that, in people with relapsing-remitting MS (RRMS), higher levels of a protein called ‘neurofilament light’ (which supplies structural strength to neurons) in their cerebrospinal fluid were associated with a worse long-term prognosis. The authors suggest that elevated levels of neurofilament light could be used as a prognostic marker in early RRMS.
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02 Feb 10

Allelic variation in the Tyk2 and EGF genes as potential genetic determinants of CNS repair
Proc Natl Acad Sci U S A. 2010 Jan 12;107(2):792-7

Clinical evolution in people with MS may vary considerably amongst individuals. It is thought that this variability may be due, at least partly, to the fact that some people achieve good levels of tissue repair after a demyelinating insult. However, the mechanisms underlying this tissue repair are not well understood. The authors studied two strains of mice that differ significantly in their ability to repair damage in the central nervous system (CNS) after demyelination and they identified two regions in their DNA with a strong relationship to the ability to repair CNS tissue. Interestingly, these DNA regions contain genes related to proteins involved in cell growth and immune reactions. The findings of this study shed light on the complex processes underlying CNS repair in MS.
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02 Feb 10

Spinal cord repair in MS. Does mitochondrial metabolism play a role?
Neurology. 2010 Jan 27

The authors aimed to investigate the mechanisms of spinal cord repair and their contribution to clinical recovery in people with MS after a cervical cord relapse. They used new MRI techniques which explore metabolite concentrations and tissue volumes in the spinal cord. They found that people who had a greater increase of a specific metabolite called NAA, which mainly reflects mitochondrial activity in the axon, had a greater clinical recovery. This suggests that mitochondrial metabolism plays a role in the mechanism of cord repair after a cord relapse in people with MS. They also found that this possible repair mechanism seemed less efficient in patients with longer disease duration.
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26 Jan 10

A placebo-controlled trial of oral fingolimod in relapsing multiple sclerosis
N Engl J Med. 2010 Jan 20

In this 24-month, double-blind, randomised clinical trial, the efficacy of oral fingolimod relative to placebo in people with relapsing-remitting MS was investigated. As compared with placebo, oral fingolimod improved the relapse rate, the risk of disability progression, and MRI outcomes. However, further studies are needed to assess the safety and efficacy of oral fingolimod on the long term.
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26 Jan 10

Oral fingolimod or intramuscular interferon for relapsing multiple sclerosis
N Engl J Med. 2010 Jan 20

The authors report the results of a 12-month, double-blind clinical trial, where the efficacy of oral fingolimod relative to intramuscular interferon beta-1a (IFNb-1a, Avonex®) in people with relapsing-remitting MS was investigated. Oral fingolimod treatment was superior to intramuscular IFNb-1a in terms of relapse rate and MRI outcomes. However, two fatal infections occurred in the group of people who received fingolimod. Therefore, longer studies are needed to assess the safety and efficacy of treatment beyond one year.
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26 Jan 10

Early MRI in optic neuritis: the risk for clinically definite multiple sclerosis
Mult Scler. 2010 Jan 19

It is known that the time between the first and the second episodes suggestive of MS has proved to have long-term prognostic implications. Therefore, the authors aimed to investigate which factors, from the clinical and the MRI point of view, have the strongest influence in this time period between the first and the second episodes, when the first episode consists of optic neuritis. They found that the presence of new T2 lesions on an early follow-up scan was the strongest predictor of an earlier appearance of a second episode.
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26 Jan 10

A placebo-controlled trial of oral cladribine for relapsing multiple sclerosis
Engl J Med. 2010 Jan 20

The authors of this article report the results of a 96-week clinical trial of a short-course oral tablet therapy with cladribine in people with relapsing-remitting MS. People who received cladribine tablets had a significantly lower rate of relapses, a higher relapse-free rate, and a lower risk of disability progression than the people who received the placebo. Furthermore, treatment with cladribine reduced MRI measures of disease activity. Since some adverse events related to cladribine treatment, such as decreased immune cell count and infection by herpes zoster, were observed, the benefits of this treatment need to be weighed against the risks.
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19 Jan 10

Preserved brain adaptive properties in patients with benign multiple sclerosis
Neurology. 2010 Jan 12;74(2):142-9

Clinical evolution may vary widely amongst people with MS and the reasons for this are not yet fully known. The authors observed, through the investigation of the sensorimotor network, that people with MS with a more benign evolution had patterns of brain activation very similar to healthy controls. The authors suggest that the long-term preservation of brain functional adaptive mechanisms play a key role in the development of a more favourable clinical evolution.
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19 Jan 10

Interferon-gamma-producing T cells, pregnancy, and postpartum relapses of multiple sclerosis
Arch Neurol. 2010 Jan;67(1):51-7

It is well known that in women with MS, the relapse rate decreases during pregnancy and can increase after delivery. The authors of this study propose that this increase of the relapse rate after pregnancy may be related to an immunological process (reflected by the decline in a specific type of immune cell) which starts during late pregnancy. They also suggest that this process can be interrupted by lactational amenorrhea (physiological suppression of menstruation while nursing) induced by exclusive breastfeeding.
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19 Jan 10

Regional brain atrophy in primary fatigued patients with multiple sclerosis
Neuroimage. 2010 Jan 5

Fatigue can be a very disabling symptom in MS and its pathogenesis is still poorly understood. The authors studied a group of people with MS with moderate levels of physical disability. They found that the people who suffered from fatigue had brain volume loss in specific areas of the cortical grey matter and the white matter nearby. No differences in the other MRI parameters were observed between fatigued and non-fatigued individuals. The findings of this study strongly suggest that the pathological substrate of primary fatigue (i.e. the fatigue not related to physical disability but to MS itself) in MS could be the interruption of the cortico-subcortical circuit.
Source abstract

19 Jan 10

Crucial role of interleukin-7 in T helper type 17 survival and expansion in autoimmune disease
Nat Med. 2010 Jan 10

It is well known that a specific type of immune cell (T helper TH17 lymphocyte) has a major role in the pathogenesis of MS. Furthermore, it is also known that the interleukin-7 receptor is amongst the genes whose abnormalities have been associated with the risk of MS. Through the study of an animal model of MS, the authors describe for the first time the relationship between these two factors. These findings may have important implications for future treatments of MS.
Source abstract

12 Jan 10

MRI criteria for MS in patients with clinically isolated syndromes
Neurology. 2010 Jan 6

The diagnostic criteria for MS have changed in recent years, notably after 2001, when MRI criteria were incorporated. These criteria have evolved towards a more accurate and prompt diagnosis. However, the criteria have become more complex and their use can be quite difficult in day-to-day practice. An international panel of MS specialists has been working to simplify the current criteria while maintaining a high level of specificity. The authors have integrated the results of all these processes, directed to simplify the current criteria for MS, and launch this new proposal.
Source abstract

12 Jan 10

No effect of parental age on risk of multiple sclerosis: a population-based study
Neuroepidemiology. 2009 Dec 24;34(2):106-109

It is known that advanced maternal or paternal age is associated with the appearance of different diseases in offspring, including chromosomal abnormalities and adult-onset disorders. In this paper the authors aimed to investigate whether a more advanced parental age was associated with a higher risk of MS in offspring. They found no association between parental age and the risk of MS.
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12 Jan 10

Multiple sclerosis: distribution of inflammatory cells in newly forming lesions
Ann Neurol. 2009 Jul 13;66(6):739-753

It is thought that T cells, a specific type of immune cell, are crucial in the mechanisms underlying myelin destruction in MS. However, the authors of this study suggest that other mechanisms independent of T cells may also play an important role in the formation of MS plaques.
Source abstract

12 Jan 10

Cognitive impairment after three decades of multiple sclerosis
Eur J Neurol. 2009 Dec 29

In some people with MS, some degree of cognitive dysfunction may appear eventually. In this paper the authors investigated long-term physical and cognitive outcome and the predictors of cognitive impairment in a group of people with MS. They found that after 30 years of disease duration almost a half of the population had some degree of cognitive impairment. They also found that a younger age at onset was associated with a higher prevalence of cognitive impairment.
Source abstract

05 Jan 10

Intellectual enrichment is linked to cerebral efficiency in multiple sclerosis: functional magnetic resonance imaging evidence for cognitive reserve
Brain. 2009 Dec 28

People with MS may occasionally develop some degree of cognitive dysfunction, although the mechanisms by which this dysfunction appears are not yet fully understood. This study shows that intellectual enrichment protects against cognitive decline secondarily to MS, supporting the cognitive reserve hypothesis, which says that lifetime intellectual enrichment lessens the negative impact of brain disease on cognition.
Source abstract

05 Jan 10

A randomized trial of memantine as treatment for spasticity in multiple sclerosis
Mult Scler. 2009 Dec 22

In this article the authors report the results of a single center randomized, double-blind, placebo-controlled, parallel group trial of memantine in people with MS and spasticity conducted over 12 weeks. Unfortunately, memantine treatment did not demonstrate efficacy in treatment of spasticity.
Source abstract

05 Jan 10

Quantitative diffusion tensor deterministic and probabilistic fiber tractography in relapsing-remitting multiple sclerosis
Eur J Radiol. 2009 Dec 28

It is well known that multiple sclerosis (MS) is an inflammatory-demyelinating disease of the central nervous system. The authors of this study have studied the brain of people with relapsing remitting MS by a new magnetic resonance technique that investigates the white matter tracts. They found not only that people with MS showed changes in the brain that were not observed in healthy controls, but also that those changes correlated with clinical impairment.
Source abstract

05 Jan 10

Phase II study of oral fingolimod (FTY720) in multiple sclerosis: 3-year results
Mult Scler. 2009 Dec 22

In 2006, the results of a six-month clinical trial with oral fingolimod for people with relapsing-remitting MS were published. This treatment proved to be effective in reducing the relapse rate and the MRI inflammatory activity compared with placebo. The authors of this article report the results of the 36-month interim analysis of the extension of the clinical trial, where all participants have been on treatment with fingolimod either since the beginning of the trial or since the seventh month. They found that fingolimod was generally well tolerated by most of the patients, and that the low MRI and clinical disease activity observed at six months were maintained at 36 months.
Source abstract

22 Dec 09

HLA-DRB1 and month of birth in multiple sclerosis
Neurology. 2009 Dec 15;73(24):2107-11

MS is a complex disease where both genetics and environment seem to play a role. The results of this study show an association between the month of birth, the presence of a specific genetic variant (associated with a higher risk of MS) and the risk of developing MS, suggesting a possible interaction of a seasonal risk factor with a genetic risk factor in the development of this disease.
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22 Dec 09

Do multimodal evoked potentials add information to MRI in clinically isolated syndromes?
Mult Scler. 2009 Dec 7

People with MS may develop a certain degree of disability over time. However it is very difficult, after a first episode suggestive of MS, to identify the people who will have a faster accrual of disability. With this work, the authors suggest that carrying out complete neurophysiological tests, which investigate the integrity of the main pathways of the central nervous system, after a first episode of MS may help identify people with a higher risk of developing disability.
Source abstract

22 Dec 09

Transplanted neural precursors enhance host brain-derived myelin regeneration
J Neurosci. 2009 Dec 16;29(50):15694-

In MS, a chronic demyelinating disease of the central nervous system, the cells in charge of promoting the formation of new myelin in regions where myelin has been damaged fail to produce this remyelination. In this study the authors found that the transplantation of neural precursor cells, (cells that are due to become neural cells) into the brains of mice with the animal model of MS can facilitate remyelination in their brains.
Source abstract

22 Dec 09

Primary progressive multiple sclerosis diagnostic criteria: a reappraisal
Mult Scler. 2009 Dec;15(12):1459-65

Diagnosis of MS consists of the demonstration of dissemination in space and time of the characteristic demyelinating process occurring in the central nervous system. Current diagnostic criteria that consider dissemination in space for relapsing-remitting MS (RRMS) and primary progressive MS (PPMS) show significant differences. This means that the diagnostic process may become very difficult, especially for people suffering from PPMS. The results of this study suggest that the unification of the current criteria for dissemination in space for RRMS and PPMS should be seriously considered in future revisions of the diagnostic criteria for MS.
Source abstract

14 Dec 09

Cervical cord functional MRI changes in relapse-onset MS patients
J Neurol Neurosurg Psychiatry. 2009 Dec 3

In MS, conventional MRI techniques are not always sufficient to differentiate between people with a mild or severe clinical course. In this study, the authors found that functional MRI of the spinal cord may be helpful, not only in differentiating between controls and people with MS, but also in detecting people with a more severe disease course. People with a higher level of disability seemed to have higher activations in the functional MRI scan, revealing underlying pathological changes that maybe associated with the accrual of disability in MS.
Source abstract

14 Dec 09

A consensus protocol for the standardization of cerebrospinal fluid collection and biobanking
Neurology. 2009 Dec 1;73(22):1914-22

MS is an inflammatory-demyelinating disease of the central nervous system, where the study of cerebrospinal fluid (CSF) can be of great help in the diagnosis of the disease and may be crucial for research studies. In this paper, the authors describe a consensus protocol on recommendations for CSF collection procedures obtaining high-quality clinical and paraclinical data, to be able to establish large banks of reliable and well-defined samples in the future.
Source abstract

14 Dec 09

Fatigue and quality of life in pediatric multiple sclerosis
Mult Scler. 2009 Nov 13

MS generally affects young adults but sometimes children can also be affected. In this study carried out on 51 children with MS, the authors specifically examined the factors related to fatigue and quality of life in this population. They conclude that fatigue and poorer quality of life seem to be related to overall physical disability and that they are of great concern in paediatric MS.
Source abstract

14 Dec 09

Magnetic resonance evidence of cerebellar cortical pathology in multiple sclerosis
J Neurol Neurosurg Psychiatry. 2009 Dec 3

MS is an inflammatory-demyelinating disease of the central nervous system and studies suggest that the cerebellar cortex is a major site of demyelination. In this study, the authors investigated the involvement of the cerebellar cortex in MS and found that it is severely affected at an early stage in people with MS. Also, they suggest that monitoring of both volume and lesions in the cerebellar cortex may be of great help in understanding the mechanisms underlying disease progression.
Source abstract

08 Dec 09

Evaluation of optic neuropathy in multiple sclerosis using low-contrast visual evoked potentials
Neurology. 2009 Dec 1;73(22):1849-57

In this article the authors compared two methods of obtaining visual evoked potentials (VEP), depending on the stimuli used. Their results suggest that VEP obtained using low-contrast stimuli was more sensitive in detecting demyelinating optic neuropathy.
Source abstract

08 Dec 09

Callosal lesion predicts future attacks after clinically isolated syndrome
Neurology. 2009 Dec 1;73(22):1837-41

MS is diagnosed by the demonstration of lesions disseminated in space and in time. The so-called Barkhof criteria, which are based on the number and location of the lesions seen in the brain of people with MS, have been extensively used to determine dissemination in space and they have proved to be useful in predicting the appearance of a second relapse after a first episode suggestive of MS. The authors of this study have found that not only the Barkhof criteria but also the lesions in the corpus callosum can predict the appearance of the second relapse. Further more, when both Barkhof criteria and lesions in the corpus callosum were combined, the predictive value was stronger.
Source abstract