31 Aug 10

Imaging distribution and frequency of cortical lesions in patients with multiple sclerosis
Neurology. 2010 Aug 25. [Epub ahead of print]

The presence of cortical lesions (CLs) and their topographic distribution in the brains of patients with multiple sclerosis (MS) have been clearly shown by recent histopathologic studies. The authors studied 149 people with MS (103 relapsing-remitting [RR] and 46 primary progressive [PP]) with an MRI examination, which included a specific sequence for CL assessment. They concluded that people with RRMS and PPMS share more similarities than differences in terms of CL number, volume, topographic distribution, and frequency.
Source abstract

31 Aug 10

Appearance of Tissue Transglutaminase in Astrocytes in Multiple Sclerosis Lesions: A Role in Cell Adhesion and Migration?
Brain Pathol. 2010 Aug 20

A major pathological hallmark of multiple sclerosis (MS) is the presence of demyelinated lesions in the central nervous system. Specific cells, termed astrocyctes can become activated and migrate contributing to local damage. The authors studied this process and how some extracellular proteins can be involved. They found that a protein (Transglutaminase 2), localized on the surface of astrocytes, could play an important role in contributing to adhesion, migration and thus in tissue remodelling and glial scarring.
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31 Aug 10

Relevance of cognitive deterioration in early relapsing-remitting MS: a 3-year follow-up study
Mult Scler. 2010 Aug 20. [Epub ahead of print]

The aim of this study was to assess longitudinally cognitive functioning in people with relapsing-remitting multiple sclerosis (RRMS) and its relationship with clinical and MRI variables. Early RRMS patients and matched healthy controls were assessed in parallel in three testing sessions over 3 years, using a specific battery of neuropsychological tests. They also underwent an MRI analysis. The authors concluded that a cognitive deterioration could be expected in approximately one-third of MS patients with relatively short disease duration.
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31 Aug 10

A method for evaluating treatment switching criteria in multiple sclerosis
Mult Scler. 2010 Aug 24.

The authors investigated a method to evaluate a treatment switching approach, namely treatment change after one multiple sclerosis (MS) relapse. They studied patients who experienced a relapse while on a first-line disease-modifying therapy, glatiramer acetate and were divided into two groups: those who changed treatment and those who did not. No difference was observed between the two groups and the authors concluded that a single relapse may not be sufficient to indicate treatment failure. However, other studies should be done to better understand the role of confounding value.
Source abstract

24 Aug 10

Multiple sclerosis and risk of cancer: a meta-analysis
J Neurol Neurosurg Psychiatry doi:10.1136/jnnp.2009.195776

It was previously thought that patients with MS had a slightly reduced risk of developing cancer but a paper published earlier this year challenged the theory and concluded there was no difference in cancer risk between patients with MS and the general population. Here, the authors performed a meta-analysis, investigating all studies published in the last 15 years reporting measures of the risk of cancer for an MS cohort relative to population controls, including studies from the UK, Sweden, France, Denmark and Norway. By pooling the data from all available studies they found that there was a small, but significant decrease in risk of all cancers in patients with MS relative to controls (OR 0.92 (95% CI 0.87 to 0.97) p=0.004).
Source abstract

24 Aug 10

Magnetic resonance imaging features of the spinal cord in pediatric multiple sclerosis: a preliminary study
Neuroradiology. 2010 Aug 19. [Epub ahead of print]

In adults, MS lesions of the spinal cord are known to contribute significantly to disability. The authors investigated the radiological features of spinal cord lesions in 36 children with MS and found the majority of spinal cord lesions in paediatric-onset MS patients closely resemble those of adults with relapsing-remitting MS. However no association was found between spinal cord involvement in terms of lesion count and clinical disability. Their findings suggest that children recover well from MS attacks involving the spine, as they do from attacks involving the brain early in their disease. However, whether children with spinal lesions are at greater risk for future disability relative to paediatric-onset MS patients who do not experience early spinal cord involvement remains uncertain and further longitudinal observation into adulthood will be required.


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24 Aug 10

Brain Single Photon Emission Computed Tomography with Tc-99m MIBI or Tc-99m ECD in comparison to MRI in Multiple Sclerosis
Clin Nucl Med. 2010 Sep;35(9):682-6.

MRI is the imaging modality of preference in MS. The authors hypothesized that single photon emission computed tomography (SPECT) with Tc-99m MIBI or Tc-99m ECD (ethyl cysteinate dimer) may be a valuable assessment tool in MS because of the role of inflammation and disruption of blood-brain barrier in the disease pathophysiology. SPECT with Tc-99m MIBI or Tc-99m ECD was used to evaluate brain abnormalities identified using conventional MRI sequences in 16 patients with definite MS but failed to detect any abnormalities. The authors postulate that SPECT with Tc-99m MIBI or Tc-99m ECD may still be useful in differentiating between MS and connective tissue disorders affecting the brain which exhibit SPECT hyperperfusion.
Source abstract

24 Aug 10

Fatigue, sleepiness, and physical activity in patients with multiple sclerosis
J Neurol. 2010 Aug 18. [Epub ahead of print]

The study compares fatigue and sleepiness in 80 patients with MS and their relationship to physical activity. Interestingly, using a combination of clinical scores, scales and questionnaires, they found sleepiness varies to an appreciable extent independently from fatigue. Sleepiness and fatigue converge for situations that demand self-paced activation, while they differ for situations in which external cues contribute to the level of activation such as watching TV or driving a car. While fatigue correlated significantly with age, the same wasn’t true with sleepiness. The perceived overlapping of fatigue and sleepiness in MS as concepts and lack of clear demarcation has proven an obstacle for research in this field. This paper goes some way to improving our understanding of these overlapping but distinct symptoms.
Source abstract

16 Aug 10

The effect of core stability training on balance and mobility in ambulant individuals with multiple sclerosis: a multi-centre series of single case studies
Mult Scler. 2010 Aug 10.

Core stability training is popular in the management of people with multiple sclerosis (MS). The authors studied eight people with MS with this specific training and they found that an eight-week core stability training programme could improve the mobility in ambulant people with MS. However, they suggested that other studies may help us to confirm these findings and to identify who could benefit the most from this intervention.
Source abstract

16 Aug 10

No cerebrocervical venous congestion in patients with multiple sclerosis
Ann Neurol. 2010 Aug;68(2):173-83.

Multiple sclerosis (MS) is characterized by demyelination centered around cerebral veins. Recent studies suggested this topographic pattern may be caused by venous congestion, a condition termed chronic cerebrospinal venous insufficiency (CCSVI). The authors conducted an extended ultrasonography study with ecocolordoppler in 56 people with MS and 20 healthy volunteers. The authors found no difference between groups. They concluded that their results challenge the hypothesis that cerebral venous congestion may play a significant role in MS.
Source abstract

16 Aug 10

Venous and cerebrospinal fluid flow in multiple sclerosis: A case-control study
Ann Neurol. 2010 Aug;68(2):255-9.

Multiple Sclerosis (MS) etiopathogenesis has been challenged by the suggested new entity chronic cerebrospinal venous insufficiency. The authors studied 21 people with relapsing-remitting MS and 20 healthy volunteers with non conventional MRI. In addition, they performed magnetic resonance angiography in people with MS. They found no differences in internal jugular venous flow or cerebrospinal fluid flow. In conclusion, they found no evidence to confirm the suggested vascular multiple sclerosis hypothesis.
Source abstract

10 Aug 10

Meningeal T cells associate with diffuse axonal loss in multiple sclerosis spinal cords
Ann Neurol. 2010 Aug 4

A link between degeneration and diffuse inflammation has been established in the brain of people with progressive multiple sclerosis (MS). The authors sought to determine whether such a link could also be demonstrated in the spinal cord of patients with progressive MS. They carried out a neuropathological assessment of inflammation and axonal loss in the spinal cords of 18 people with progressive MS and five controls. They observed an involvement in the meninges (the system of membranes which envelops the central nervous system) of spinal cord in people with MS. The authors concluded that there could be a link between meningeal inflammation and spinal cord lesions.
Source abstract

10 Aug 10

OAS1: A multiple sclerosis susceptibility gene that influences disease severity
Neurology. 2010 Aug 3;75(5):411-418

Type 1 interferons upregulate oligoadenylate synthetase 1 (OAS1). The authors hypothesised that OAS1 genotypes can influence susceptibility to multiple sclerosis (MS) as well as disease activity, with the AA genotype being overrepresented and the GG genotype underrepresented in relapsing-remitting MS (RRMS) with increased disease activity. The authors studied the specific genotypes in 401 people with MS, 394 healthy controls and 178 people with MS receiving IFNbeta. They found that in people with MS on IFNbeta, the time to first relapse was 24 months with AA genotype and 33 with AG or GG genotype. They concluded that AA genotype may confer a susceptibility to MS and GG genotype may protect against increased disease activity.
Source abstract

10 Aug 10

Preclinical studies of methylthioadenosine for the treatment of multiple sclerosis
Mult Scler. 2010 Jul 29

Methylthioadenosine (MTA) is a natural metabolite with immunomodulatory properties which has been shown to improve the clinical course of an animal model of multiple sclerosis (MS). The authors studied this treatment in a preclinical trial comparing the efficacy with a first line MS treatment and developed an oral formulation. In this preclinical trial, treatment with MTA is more efficacious than first line therapies in an animal model of MS (EAE), with a dose-response effect and higher efficacy when combined with interferon-beta or glatiramer acetate.
Source abstract

03 Aug 10

Reciprocal Th1 and Th17 regulation by mesenchymal stem cells: Implication for multiple sclerosis
Ann Neurol. 2010 Jul 26.

Human mesenchymal stem cells (hMSCs) are being considered for clinical trials of multiple sclerosis (MS). The authors studied the effect of these stem cells in a specific subgroup of immune system cells. They found that soluble products from hMSCs inhibited the responses of some immune cells that are involved in the inflammatory process. They concluded that further preclinical work and immune-monitoring may define hMSC effects on disease under variable conditions.
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03 Aug 10

Emerging effects of comorbidities on multiple sclerosis
Lancet Neurol. 2010 Aug;9(8):820-8

The interaction between different diseases is strong but is not well studied in people with multiple sclerosis (MS). The authors observed that other diseases and lifestyle factors can have an influence in symptom onset, disability progression, and health-related quality of life. The authors concluded that future research is needed to answer many other questions about these associations with MS, including the best way to measure and analyse comorbidities to understand these associations.
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03 Aug 10

Natalizumab drug holiday in multiple sclerosis: Poorly Tolerated
Ann Neurol. 2010 Jul 26.

Natalizumab is a new therapy option for people with multiple sclerosis (MS). It has been suggested that natalizumab-associated progressive multifocal leukoencephalopathy may be prevented by structured interruptions of treatment. The authors studied this drug holiday effect in ten people with MS stringently followed up to six months after discontinuation of the infusions. Seven of ten people with MS suffered from a combination of clinical relapse and new and/or enhanced lesions on magnetic resonance imaging. Although numbers are small the authors concluded that a natalizumab drug holiday without reinstatement of alternate disease-modifying therapy is poorly tolerated.
Source abstract

03 Aug 10

Improvement in disability after alemtuzumab treatment of multiple sclerosis is associated with neuroprotective autoimmunity
Brain. 2010 Jul 21

New treatments are available for early relapsing-remitting multiple sclerosis (MS). The authors studied the effect of a humanised monoclonal antibody, alemtuzumab, in people with early relapsing-remitting MS and found that it significantly reduced the risk of relapse and accumulation of disability compared with interferon beta-1a in a phase 2 trial. They analysed specific and advanced clinical laboratory findings and concluded that improvement in disability after alemtuzumab may result from a specific neuroprotection effect.
Source abstract

26 Jul 10

Reduced NAA-Levels in the NAWM of Patients with MS Is a Feature of Progression. A Study with Quantitative Magnetic Resonance Spectroscopy at 3 Tesla
PLoS One. 2010 Jul 20;5(7):e11625.

The authors used an advanced magnetic imaging technique, called spectroscopy, to assess the neuronal damage in the brain white matter outside visible lesions (the so called “normal appearing white matter”), in people with relapsing-remitting and secondary progressive MS and in a group of healthy controls. They found that people with secondary progressive MS, but not those with relapsing-remitting MS, had lower levels of N-acetyl-aspartate, a marker of neuronal damage, compared with controls. They concluded that lower levels of N-acetyl-aspartate in the normal appearing white matter may be a typical feature of progression in MS.
Source abstract

26 Jul 10

B-cell activation influences T-cell polarization and outcome of anti-CD20 B-cell depletion in central nervous system autoimmunity
Ann Neurol. 2010 Jul 16. [Epub ahead of print]

In this study in animal models of MS, the authors examined two possible mechanisms through which medications able to reduce the effect of B-cells that are implicated in generating the inflammatory response in the body, could be effective in reducing inflammation in MS. They found that medications able to block a molecule called CD-20 that is localised on B-cells, are effective in reducing the inflammatory power of B-cells. However, they stress that a non-selective elimination of B cells could be dangerous, as these cells also have a beneficial anti-inflammatory influence on other immune cells.


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26 Jul 10

Differential expression of SOCS1 in macrophages in relapsing-remitting and chronic EAE and its role in disease severity
Glia. 2010 Jul 19.

Macrophages are cells that play a very important role in the body’s immune response. In this study, the authors looked at a molecule called SOCS1, whose role is to control the inflammation process, in an animal model of relapsing-remitting and chronic MS. They found that SOCS1 was present in greater quantity in the macrophages of animals with the relapsing-remitting form of disease, compared with those with the chronic form. They concluded that the presence of this molecule in macrophages may be important in determining the course of the disease.
Source abstract

26 Jul 10

Rapid disease course in African Americans with multiple sclerosis
Neurology. 2010 Jul 20;75 (3):217-23.

The authors employed the Multiple Sclerosis Severity Scale, a scale to measure disability in MS based on combining the level of disability with the disease duration, to compare the disease course of African Americans and White Americans in a large population of people with MS in the USA. They found that African Americans tended to progress more rapidly towards a greater level of disability, and suggested that Multiple Sclerosis Severity Scale is a useful tool to compare rates of progression between groups of patients with MS.
Source abstract

20 Jul 10

T2 lesion location really matters: a 10 year follow-up study in primary progressive multiple sclerosis
J Neurol Neurosurg Psychiatry. 2010 Jul 13. [Epub ahead of print]

In this magnetic resonance imaging study, the authors investigated whether the spatial location of brain lesions at study entry was a significant predictor of long-term clinical disability in a large population of people with primary progressive MS followed up for ten years. They found that patients who presented at study entry brain lesions localised within the motor and the associative tracts (pathways connecting different brain regions) were more likely to progress more quickly towards a significant level of disability, independently of their spinal cord damage.
Source abstract

20 Jul 10

Hippocampal atrophy in relapsing-remitting and primary progressive MS: a comparative study
Mult Scler. 2010 Jul 14. [Epub ahead of print]

In this magnetic resonance imaging study, the authors assessed the volume of the hippocampus, a brain area that is specifically involved in memory function, in people with relapsing-remitting and primary-progressive MS, comparing them with healthy controls, and looked at clinical association with memory dysfunction. They found that the volume of the hippocampus was reduced in people with MS compared with controls, but the correlation between the volume loss in this specific area and the memory performance was rather weak. This suggests that there may be additional factors to hippocampal volume loss in contributing to memory dysfunction in MS.

Source abstract

20 Jul 10

Disability Progression in a Clinical Trial of Relapsing-Remitting Multiple Sclerosis
Arch Neurol. Published online July 12, 2010. doi:10.1001/archneurol.2010.150

In this retrospective study, the authors evaluated after eight years the level of disability of patients with relapsing-remitting MS who had been previously included in a two-year clinical trial with intramuscular interferon beta-1a or placebo, to determine the most relevant predictive factors of long-term clinical disability. They found that a sustained clinical deterioration during the clinical trial (as measured by an increase of at least one point or more on the disability status scale compared with the clinical picture at study entry) was the strongest significant predictor of clinical disability eight years afterwards.
Source abstract

20 Jul 10

Lamotrigine for neuroprotection in secondary progressive multiple sclerosis: a randomised, double-blind, placebo-controlled, parallel-group
Lancet Neurol. 2010 Jul;9(7):681-8. Epub 2010 Jun 8

In this clinical trial, the authors have looked at the role of lamotrigine, a drug that has proved effective in protecting neurons in animal models of MS, in protecting neurons in people with secondary progressive MS. In particular, they studied the effects of this drug compared with placebo on brain volume, and also its impact on the clinical deterioration of the patients over two years. They found that lamotrigine did not have a significant protective effect compared with placebo in terms of brain volume; also, they found that it reduced the clinical deterioration as measured by the walking speed, but did not affect other clinical measures. Further studies are needed to further evaluate the potential effects of this drug.
Source abstract

12 Jul 10

Reconstitution of circulating lymphocyte counts in FTY720-treated MS patients
Clin Immunol. 2010 Jul 2

FTY720 (Fingolimod) is a new therapy that reduces disease activity by decreasing numbers of a specific immune system cell. The authors investigated patients who discontinued therapy during clinical investigation and they found that the reconstitution of this specific cell-type after prolonged FTY720 therapy can be significantly greater than predicted.
Source abstract

12 Jul 10

Impact on activities of daily living using a functional electrical stimulation device to improve dropped foot in people with multiple sclerosis, measured by the Canadian Occupational Performance Measure
Mult Scler. 2010 Jul 2

Dropped foot is a common problem following multiple sclerosis. In a randomised controlled trial, the authors studied 64 people with unilateral dropped foot who were assigned to either a group using a specific electrical stimulator or receiving physiotherapy exercises. They found that people with multiple sclerosis using this specific stimulator increased walking performance, compared to the exercise group and also experienced fewer falls.
Source abstract

12 Jul 10

Polymorphisms of innate pattern recognition receptors, response to interferon-beta and development of neutralizing antibodies in multiple sclerosis patients
Mult Scler. 2010 Jul 1

Interferon-beta therapy can be correlated with development of specific neutralising antibodies. Innate pattern recognition receptors play an important role in immune responses towards foreign substances and could be related to treatment outcome. The authors studied genetic variations in selected pattern receptors and determined the antibody formation in 567 prospectively followed Relapsing Remitting Multiple Sclerosis patients. They found an association between specific genetic loci and increase in interferon-beta neutralising antibodies.
Source abstract

12 Jul 10

Evidence for VAV2 and ZNF433 as susceptibility genes for multiple sclerosis
J Neuroimmunol. 2010 Jun 30

Several studies are emerging to better understand the individual genetic susceptibility in people with multiple sclerosis (MS). The authors studied 592 people with MS and 825 healthy volunteers with a genome-wide specific genetic analysis. They were able to replicate the association of the HLA region with MS and also found evidence suggestive of an association of two new gene variants with MS.
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