17 Nov 09

HLA-class I markers and multiple sclerosis susceptibility in the Italian population
Genes Immun. 2009 Nov 12

MS is a complex disease and it is believed that genes play a crucial role. However, the role played by genes in MS pathogenesis is still unclear. In this study, the authors aimed to investigate the role of different variants of genes previously related to MS in modulating MS risk. They found that the presence of a specific variant of one of the tested genes had a protective effect for MS, especially when a variant of another gene was present. Although more studies are needed, this may help us to better understand the complex relationship between genes and MS risk.
Source abstract

17 Nov 09

Optical coherence tomography in clinically isolated syndrome: no evidence of subclinical retinal axonal loss
Arch Neurol. 2009 Nov;66(11):1373-7

The authors compared a group of people who had experienced a first episode compatible with MS with a group of healthy controls, by means of a new tool for quantifying axonal loss, the optical coherence tomography (OCT). They found that OCT measurements were not significantly different between people with a first episode of MS and healthy controls and also that OCT parameters, when measured after a first episode of MS, did not predict the appearance of a second episode.
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17 Nov 09

Body size and risk of MS in two cohorts of US women
Neurology. 2009 Nov 10;73(19):1543-50

MS is a complex disease where both genetics and environment seem to play crucial and complementary roles in its development. In this article the authors have found that obesity in women during adolescence is associated with a higher risk of developing MS. However, the mechanisms of this association remain uncertain and more studies are needed to shed light on this issue.
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17 Nov 09

Magnetic resonance imaging predictors of conversion to multiple sclerosis in the BENEFIT study
Arch Neurol. 2009 Nov;66(11):1345-52

In this multicentre study the authors aimed to investigate the prognostic value of magnetic resonance imaging (MRI) performed shortly after a first episode suggestive of MS. They found that the current MRI criteria for MS had a moderate predictive value for presenting a second episode suggestive of MS, the number of lesions and the periventricular location of such lesions being the two criteria with the strongest predictive value.
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10 Nov 09

Vitamin D status is positively correlated with regulatory T cell function in patients with multiple sclerosis
PLoS One. 2009 Aug 13;4(8):e6635

: Many in vitro studies have shown that vitamin D is involved in the pathogenesis of MS. The aim of this work was to investigate a potential in vivo correlation between vitamin D status and the function of regulatory T-cells in people with relapsing-remitting MS. A positive correlation was found between serum levels of vitamin D and the regulatory T-cells function, suggesting that vitamin D is an important promoter of T cell regulation in vivo in people with MS.
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10 Nov 09

Integration of genetic risk factors into a clinical algorithm for multiple sclerosis susceptibility: a weighted genetic risk score
Lancet Neurol. 2009 Oct 28

In this large study the authors aimed to test the validity of a score called weighted genetic risk score (wGRS) to predict the risk of developing MS. The authors found that this score, which relies on the analysis of different genes that have been proven to be related to MS, can modestly predict MS risk. More interestingly, this score was enhanced when non-genetic risk factors were included into a more comprehensive algorithm to predict MS risk.
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10 Nov 09

IgG antibodies against measles, rubella, and varicella zoster virus predict conversion to multiple sclerosis in clinically isolated syndrome
PLoS One. 2009 Nov 5;4(11):e7638

In this article the authors aimed to investigate whether antibodies against measles, rubella and varicella zoster, which may be found in the cerebrospinal fluid (CSF) in people with MS, could be useful in predicting conversion to MS after a first episode suggestive of the disease. They found that people who had these antibodies in the CSF were more likely to develop relapsing-remitting MS after a first episode.
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10 Nov 09

Impact of multiple sclerosis relapses on progression diminishes with time
Neurology. 2009 Nov 4

In this article the authors aimed to investigate the impact of relapses on long-term disability in people with MS. They found that although relapses within the first five years of the disease had an impact on disease progression over the short term, the impact of relapses on long-term disability was minimal, either for early or later relapses.
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10 Nov 09

Effect of neutralizing antibodies on biomarker responses to interferon beta: the INSIGHT study
Neurology. 2009 Nov 3;73(18):1493-500

In this multicentre study the authors aimed to assess the in vivo impact of neutralising antibodies on interferon beta (IFNb) bioactivity, by studying biomarkers of the IFNb response. Their findings suggest that high titers of neutralising antibodies abolish the in vivo response to interferon beta.
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10 Nov 09

Magnetic resonance imaging characteristics of children and adults with paediatric-onset multiple sclerosis
Brain. 2009 Nov 5

In this study the authors compared two populations of paediatric-onset MS with two populations of adult onset MS, that had short and long disease evolution. They found that even though people with paediatric-onset MS had a similar lesion burden when compared to adult onset MS, the accrual of disability was slower in paediatric-onset than in adult-onset MS.
Source abstract

10 Nov 09

Effect of anti-IFN{beta} antibodies on MRI lesions of MS patients in the BECOME study
Neurology. 2009 Nov 3;73(18):1485-92

In this article the authors aimed to investigate the impact of neutralising antibodies against interferon beta (IFNb) on the efficacy of the drug. For this purpose they studied the MRI outcomes of those people who participated in the BECOME trial (IFNb 1b versus glatiramer acetate). They found that high levels of anti-IFNb correlated with reduced therapeutic efficacy of this drug.
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28 Oct 09

Modafinil for multiple sclerosis fatigue: does it work?
Clin Neurol Neurosurg. 2009 Oct 16

In this descriptive study (not a clinical trial) of 39 people with MS receiving Modafinil for MS-related fatigue, the authors found that this treatment is useful when fatigue is associated with excessive daytime sleepiness.
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28 Oct 09

Tract-based analysis of callosal, projection, and association pathways in pediatric patients with multiple sclerosis: a preliminary study
AJNR Am J Neuroradiol. 2009 Oct 22

Diffusion tensor imaging (DTI) is a relatively new MRI technique based on the diffusion of water molecules through brain tissue. In adults with MS, this has been proven to be useful in detecting abnormalities in the white matter pathways of the brain. In this study the authors found that DTI can be also useful in detecting such abnormalities in children with MS.
Source abstract

28 Oct 09

Replication of CD58 and CLEC16A as genome-wide significant risk genes for multiple sclerosis
J Hum Genet. 2009 Oct 16

Genes contribute to the risk of developing MS. Most genes associated with this disease are mainly related to the human leukocyte antigen (HLA), a vast family of proteins involved in the immune response. The authors studied the whole genome in a very large population and found that known HLA genes and non-HLA genes were associated with a higher risk of developing MS. Moreover, some of these genes were also associated with a higher risk of developing other autoimmune diseases, which could help explain the pathogenesis of MS and other diseases.
Source abstract

27 Oct 09

Real-life impact of early interferonbeta therapy in relapsing multiple sclerosis
Ann Neurol. 2009 May 28;66(4):513-520

Interferon beta is an accepted treatment for relapsing-remitting MS. It has been suggested that the earlier the IFN is given, the greater the benefit, although this view is controversial. This is a descriptive study where more than 2,500 people with MS treated with interferon beta have been followed for between seven to 15 years. The authors found that a reduced disability progression was observed for people who started IFN treatment within the first year after the onset of the disease.
Source abstract

27 Oct 09

Brainstem (1)H nuclear magnetic resonance (NMR) spectroscopy: marker of demyelination and repair in spinal cord
Ann Neurol. 2009 May 28;66(4):559-564

In this study, carried out in animal models of MS (mice), the authors found that magnetic resonance spectroscopy in the brainstem can be useful in predicting the degree of recovery of the spinal cord after demyelinating damage. Although the findings of this study need to be replicated in humans, they are important and may have interesting implications from the point of view of clinical practice in the future.
Source abstract

27 Oct 09

MicroRNA miR-326 regulates T(H)-17 differentiation and is associated with the pathogenesis of multiple sclerosis
MicroRNA miR-326 regulates T(H)-17 differentiation and is associated with the pathogenesis of multiple sclerosis

It is well known that the protein interleukin 17 (IL-17) plays a major role in MS and has been associated with clinical severity in animal models of MS. In this work, the authors found that the IL-17-related microRNA (a type of RNA with regulatory functions), promotes the production and differentiation (i.e. growth and development) of IL-17-producing T helper lymphocytes. These are involved in the pathogenesis of chronic autoimmune diseases, including MS. The authors also found that higher levels of the microRNA provoked the appearance of a more severe disease in animal models of MS. They concluded that this microRNA may serve as a new and valuable target for future treatments in MS.
Source abstract

27 Oct 09

Robot-based rehabilitation of the upper limbs in multiple sclerosis: feasibility and preliminary results
J Rehabil Med. 2009 Nov;41(12):966-70

In this study, the authors have found that a new, robot-based, rehabilitation protocol is effective in improving the coordination of the upper limb movements in people with MS. Although these are only preliminary results and the number of individuals tested is rather small (seven people), the authors suggest that the robot therapy may be a very useful tool for people with MS and coordination deficits.
Source abstract

27 Oct 09

Rituximab in patients with primary progressive multiple sclerosis: results of a randomized double-blind placebo-controlled multicenter trial
Ann Neurol. 2009 Sep 9;66(4):460-471

Rituximab is a monoclonal antibody which selectively targets CD20, a specific antigen (i.e. protein) present on the surface of B cells, a type of immune cell. This treatment has been proven to be effective in reducing disease activity in relapsing-remitting MS. Since no treatment has been shown to be effective in delaying the progression of primary progressive MS (PPMS), the authors aimed to investigate the efficacy of rituximab in people with PPMS. In this multicentre, double blind, placebo controlled, clinical trial, people were randomised to receive either rituximab or a placebo. The main aim of the study was to investigate whether rituximab could delay the time to confirmed progression compared to placebo. Although the time to confirmed progression was not different between the two groups, some efficacy was observed for people with high inflammatory activity in their MRI and/or people younger than 51 years old.
Source abstract

20 Oct 09

Cognitive aging in patients with multiple sclerosis: a cross-sectional analysis of speeded processing
Arch Clin Neuropsychol. 2009 Oct 9

In people with MS, it may be possible that some degree of cognitive dysfunction appears some years after disease onset. However, some degree of cognitive dysfunction may also appear in a healthy population over time, as a result of normal aging, and this "aging effect" can be seen in people with MS. The authors of this study aimed to investigate whether the decline in cognitive function due to the increasing age ("aging effect") was different between people with MS and healthy controls. They found that, despite people with MS having lower scores in cognitive performance tests than healthy people, the rate of cognitive deterioration over time was similar in both groups, indicating that general cognitive aging occurs similarly in both groups, with and without MS.
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20 Oct 09

Revision of the risk of secondary leukemia after mitoxantrone in multiple sclerosis populations is required
Mult Scler. 2009 Oct 13

Mitoxantrone is one of the accepted treatments for MS, although its use is restricted to people who do not have a good response to first line therapies such as interferon beta and glatiramer acetate, because of its potentially life threatening side effects including acute leukaemia. The risk of acute leukaemia after mitoxantrone treatment is not yet fully understood. The authors therefore aimed to evaluate the real incidence of this life threatening event in two cohorts of people with MS who received this treatment. After a mean follow-up of between three and four years after treatment discontinuation, they found that, the accumulated incidence of acute leukaemia was higher than 2%. This percentage was higher than what had been reported in previous studies. They did not find any relation between the appearance of acute leukaemia and the dose administered, age at disease onset or at the beginning of mitoxantrone treatment, disease duration, sex or the presence of other treatments. The authors concluded that people who received mitoxantrone should be monitored for at least five years after treatment discontinuation.
Source abstract

20 Oct 09

A single-centre, randomized, double-blind, placebo-controlled study of interferon beta-1b on primary progressive and transitional multiple sclerosis
Mult Scler. 2009 Sep 29

Interferon beta (IFNb) is one of the accepted treatments for relapsing-remitting MS. No treatment has yet been proven to be effective for primary progressive MS in delaying the progression of disability. The authors aimed to investigate whether IFNb treatment given for two years was effective in provoking such delay in accumulation of disability over time, in a double blind, placebo-controlled, clinical trial. They found that, despite having some positive effects on some clinical scales (within the MS functional composite, MSFC) and on magnetic resonance parameters, the drug was not effective in delaying progression of disability when measured by, the Expanded Disability Status Scale (EDSS), the most common clinical scale.
Source abstract

20 Oct 09

Efficacy and specificity of intensive cognitive rehabilitation of attention and executive functions in multiple sclerosis
J Neurol Sci. 2009 Oct 12

In this double-blind, placebo controlled, clinical trial the authors investigated the efficacy of intensive cognitive treatment given to people with MS with a degree of cognitive dysfunction. The 20 people in this study were divided into two groups. One group received intensive neuropsychological treatment consisting of one hour sessions of computer-assisted training of attention, information processing and planning exercises for executive functions. The other group received no training. The sessions took place three times a week over a three month period. The authors found that the people who received intensive cognitive rehabilitation scored significantly higher in all cognitive tests than people who did not receive any rehabilitation treatment. They also found that cognitive rehabilitation improved depression scale scores. Despite the small number of participants, this study highlights the importance of cognitive rehabilitation for people with MS and cognitive dysfunction.
Source abstract

20 Oct 09

Reflexology for the treatment of pain in people with multiple sclerosis: a double-blind randomised sham-controlled clinical trial
Mult Scler. 2009 Oct 13

Despite not being a cardinal clinical feature of MS, pain can appear in a non-negligible percentage of people with this disease. Currently available pharmacological treatments often fail to control this symptom, which can have a major effect on quality of life. Using a randomised, placebo-controlled, clinical trial, the authors investigated whether reflexology, was effective in treating pain in people with MS. They compared precision reflexology treatment, where the massage of zones on the feet corresponded to different parts of the body, with sham reflexology treatment, using a standardised foot massage applying less pressure on the reflex points and avoiding the representative points of common areas of pain associated with MS. They found that both groups significantly improved after ten weeks of treatment and that this improvement continued after 12 weeks of follow-up. However, no differences were seen between the precision reflexology and sham treatments.
Source abstract

13 Oct 09

Effect of glatiramer acetate on conversion to clinically definite multiple sclerosis in patients with clinically isolated syndrome (PreCISe study): a randomised, double-blind, placebo-controlled trial
Lancet. 2009 Oct 6

Glatiramer acetate is one of the accepted treatments for relapsing-remitting MS (RRMS), but its efficacy after a first relapse has not yet been demonstrated. With a randomised, multicentre, double-blind placebo-controlled clinical trial, the authors demonstrated that GA significantly delays the appearance of a second relapse when given after a first episode. These results may have important consequences from the point of view of clinical practice.
Source abstract

13 Oct 09

Hypothalamic stimulation for trigeminal neuralgia in multiple sclerosis patients: efficacy on the paroxysmal ophthalmic pain
Mult Scler. 2009 Oct 7

In a study of people with MS-related trigeminal neuralgia (TN), the authors aimed to evaluate the efficacy of a specific treatment for TN called hypothalamic stimulation (HS). Existing treatments for TN are pharmaceutical (which are often insufficient), and surgical (whose potential local adverse events derived from the physical disruption of the affected nerve are not negligible). Although this is a small study with only five people, the authors found that the HS was effective for people that have TN in the first branch (i.e. ophthalmic branch) of the trigeminal nerve. Therefore, they conclude that HS should be considered as a therapeutic option especially for those with an ophthalmic branch TN, taking into account that the local adverse events occurring after surgery may be especially serious when the first branch is involved.
Source abstract

13 Oct 09

25-Hydroxyvitamin D in cerebrospinal fluid during relapse and remission of multiple sclerosis
Mult Scler. 2009 Oct 6

It has been suggested that vitamin D may play an important role in the pathogenesis of MS, and that its immunomodulatory effects might be carried out by the vitamin D present within the central nervous system. However, the authors did not find differences in vitamin D levels of the cerebrospinal fluid (CSF) between people with MS and people with other neurological, inflammatory and non-inflammatory diseases. Also, they did not find differences in vitamin D levels of the CSF between people with MS, with or without clinical or MRI inflammatory activity, suggesting that vitamin D does not have a major impact on disease activity.
Source abstract

13 Oct 09

Gamma knife radiosurgery for multiple sclerosis-related trigeminal neuralgia
Neurology. 2009 Oct 6;73(14):1149-54

Trigeminal neuralgia (TN, a severe and disabling pain disorder) can appear in people with MS in a higher percentage than in the general population. Pharmaceutical treatment for this is not always satisfactory. The authors aimed to evaluate the long term outcome of 37 people with MS with TN who received a specific surgical treatment called gamma knife. Because of the reasonable pain control and the low morbidity associated with the treatment, the authors suggest that gamma knife could be a therapeutic option for MS-related trigeminal neuralgia.
Source abstract

13 Oct 09

Calprotectin levels in the cerebrospinal fluid reflect disease activity in multiple sclerosis
J Neuroimmunol. 2009 Oct 1

Calprotectin has been considered as a marker of inflammation in a number of inflammatory diseases. Therefore, the authors aimed to investigate the role of calprotectin as a possible marker of inflammation in MS. They found that the levels of this molecule in the CSF were associated with the presence of clinical activity, reinforcing the possibility of its future use as a marker of inflammation in MS.
Source abstract

06 Oct 09

Human neural stem cells ameliorate autoimmune encephalomyelitis in non-human primates
Ann Neurol. 2009 May 11;66(3):343-354

In chronic phases of MS, after a first period characterised by inflammatory-demyelinating changes, a slow, progressive and irreversible damage of the central nervous system (CNS) is a predominant feature of the disease, being possibly responsible for the accrual of disability. Current MS drugs are only able to reduce the inflammatory-demyelinating component. They do not have a clear effect on the progressive damage occurring in the CNS nor do they have an effect as regenerative agents of the damaged tissue of the brain or spinal cord. For this reason, stem cell therapy could be an appealing therapeutic approach, as it seems able to promote regeneration of this permanent damage. Neural stem cells have been shown to provoke a significant amelioration of damaged neural tissue in mice with experimental autoimmune encephalomyelitis (EAE), the animal model of MS. However, neural stem cells have not yet been tested in humans with MS, in contrast with haematopoietic stem cells, whose efficacy as treatment for people with MS is still a matter of controversy. In this study the authors compared two groups of common marmosets (primates) with EAE. One group was treated with human neural stem cells and the other received a placebo. They found that the group treated with neural stem cells had significantly better outcomes in terms of accumulated disability and survival. This study represents a major step towards a future use of neural stem cells for people with MS.
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