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Spotlight series: pivotal trials through today's knowledge--adrenocorticotrophic hormone. 聚焦系列:关键试验通过今天的知识-促肾上腺皮质激素。
International MS journal Pub Date : 2009-06-01
W A Sibley
{"title":"Spotlight series: pivotal trials through today's knowledge--adrenocorticotrophic hormone.","authors":"W A Sibley","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Forty-five years ago the first large multicentre, randomized, double-blinded, controlled trial of a potential therapy for multiple sclerosis (MS) was completed testing corticotrophin versus placebo. It demonstrated the feasibility of such a trial in an illness which is as variable, from patient to patient, as MS. Adrenocorticotrophic hormone was soon replaced by intravenous methylprednisolone (IVMP) as therapy for acute exacerbations, to control acute inflammatory responses. Long-term therapy with corticosteroids is fraught with complications. Pulsed IVMP has been widely used as an alternative, but few formal studies have been done. One, however, suggested that treated patients had less brain atrophy, and further study of this technique may be indicated.</p>","PeriodicalId":86075,"journal":{"name":"International MS journal","volume":"16 2","pages":"42-6"},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40026540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Magnetic resonance findings in leucodystrophies and MS. 脑白质营养不良和多发性硬化症的磁共振表现。
International MS journal Pub Date : 2009-06-01
P Labauge
{"title":"Magnetic resonance findings in leucodystrophies and MS.","authors":"P Labauge","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>White matter diseases are a frequent diagnosis problem in adult patients. They are divided into leucodystrophy, defined by abnormal white matter from the beginning, and leucoencephalopathy, with an initial normal white matter. In addition, two different natures have to be considered: vascular and non-vascular. Vascular diseases are mainly acquired and related to atherosclerosis. Genetic vascular disorders are mostly secondary to Notch3 mutations, defined as cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL). Occurrence of leucoaraiosis and lacunae on T2 sequences, and microbleeds on Gradient Echo sequences, strongly suggest this diagnosis. Some magnetic resonance (MR) patterns can help to identify genetic leucodystrophies, such as childhood ataxia with central nervous system hypomyelination/leucoencephalopathy with vanishing white matter disease (progressive rarefaction and cystic degeneration of the affected white matter, replaced by water); Alexander disease (hypointense signals on T2 sequences involving grey matter, brainstem and cervical cord, with marked atrophy); megalencephalic leucoencephalopathy with subcortical cysts (diffuse, symmetrical white matter lesions, with constant frontoparietal and anterotemporal subcortical cysts); leucoencephalopathy with brainstem and spinal cord involvement and high lactates syndrome (extensive demyelination, involvement of the brainstem, i.e. cerebellar peduncles, intraparenchymal and mesencephalic trigeminal nerves and spinal cord, mainly in the lateral corticospinal tracts and dorsal columns). Half of the genetic adult leucodystrophies remain without any precise diagnosis. This review describes MR in the adult leucoencephalopathies and in multiple sclerosis (MS). The first part will focus on MR patterns of vascular and nonvascular adult leucoencephalopathies, the second part on MR findings in MS and MS-related diseases. Specific MR patterns in both diseases will be summarized and compared.</p>","PeriodicalId":86075,"journal":{"name":"International MS journal","volume":"16 2","pages":"47-56"},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40026541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Plasticity in MS: from Functional Imaging to Rehabilitation. MS中的可塑性:从功能成像到康复。
International MS journal Pub Date : 2009-04-01
J Pelletier, B Audoin, F Reuter, Jp Ranjeva
{"title":"Plasticity in MS: from Functional Imaging to Rehabilitation.","authors":"J Pelletier,&nbsp;B Audoin,&nbsp;F Reuter,&nbsp;Jp Ranjeva","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>One of the main characteristics of multiple sclerosis (MS) is the existence of a \"clinico-radiological paradox\". The discrepancies observed between the clinical and radiological findings might be partly attributable to lack of specificity of the imaging measures, but also to functional reorganization mechanisms occurring at both the brain and spinal cord levels. These neuroplastic processes might provide a means of delaying the clinical expression of some functional symptoms. Functional MRI (fMRI) methods provide a useful means of determining whether functional reorganization mechanisms of this kind are at work. It has been established, for example, that these neuroplastic mechanisms occur right from the start of the disease and may contribute to reducing the expression of the symptoms resulting from pathological tissue damage. This functional reorganization may therefore constitute an important adaptive mechanism during the early stages of the disease. One potential practical application of the findings made on these neuroplastic processes is likely to be the development of specific rehabilitation methods, which can be used to enhance these reactive mechanisms in order to maintain MS patients functional abilities, and other specifically targeted approaches will also predictably be developed.</p>","PeriodicalId":86075,"journal":{"name":"International MS journal","volume":"16 1","pages":"26-31"},"PeriodicalIF":0.0,"publicationDate":"2009-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28149953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The World Congress on Treatment and Research in Multiple Sclerosis (joint meeting of ECTRIMS, ACTRIMS, LACTRIMS). 世界多发性硬化症治疗与研究大会(ECTRIMS, ACTRIMS, LACTRIMS联合会议)。
International MS journal Pub Date : 2009-04-01
M Clanet
{"title":"The World Congress on Treatment and Research in Multiple Sclerosis (joint meeting of ECTRIMS, ACTRIMS, LACTRIMS).","authors":"M Clanet","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This congress was the first joint meeting for European, North and South American neurologists and neuroscientists to discuss 1 year of progress in treatment and research on multiple sclerosis (MS). More than 4500 delegates attended and with 83 oral presentations and 909 posters, it is difficult to select the highlights from this large amount of information. Probably the most interesting topic for neurologists and patients was new treatments.</p>","PeriodicalId":86075,"journal":{"name":"International MS journal","volume":"16 1","pages":"31-2"},"PeriodicalIF":0.0,"publicationDate":"2009-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28149954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The 2nd world congress on controversies in neurology. 第二届世界神经病学争议大会。
International MS journal Pub Date : 2009-04-01
D Goodin
{"title":"The 2nd world congress on controversies in neurology.","authors":"D Goodin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The 2nd World Congress in Controversies in Neurology (CONy) attracted over 1200 delegates worldwide. The congress covered a wide range of neurological issues in dementia, epilepsy, neurodegeneration, Parkinsons disease, stroke and multiple sclerosis (MS). The part of the programme on MS included sessions on clinical aspects, epidemiology, therapy and clinical trials of novel treatments. The focus of each session was a debate between two invited neurologists who presented opposing views on current controversial issues in MS.</p>","PeriodicalId":86075,"journal":{"name":"International MS journal","volume":"16 1","pages":"33-4"},"PeriodicalIF":0.0,"publicationDate":"2009-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28149955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Physical Exercise and MS Recommendations. 体育锻炼和MS建议。
International MS journal Pub Date : 2009-04-01
U Dalgas, T Ingemann-Hansen, E Stenager
{"title":"Physical Exercise and MS Recommendations.","authors":"U Dalgas,&nbsp;T Ingemann-Hansen,&nbsp;E Stenager","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The use of physical exercise programmes in the rehabilitation of patients with multiple sclerosis (MS) has been a controversial issue for many years. During the last decade, however, evidence from a number of studies has suggested that exercise is a safe and efficient way to induce improvements in a number of physiological functions, which ultimately can lead to functional improvements that have a positive effect on a patients daily life. The purpose of this review is, based on the existing research, to provide clinicians with some easily administrable recommendations for the application of exercise in the rehabilitation strategy of MS.</p>","PeriodicalId":86075,"journal":{"name":"International MS journal","volume":"16 1","pages":"5-11"},"PeriodicalIF":0.0,"publicationDate":"2009-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28149950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The emperors new clothiers. 皇帝的新衣。
International MS journal Pub Date : 2009-04-01
Gc Ebers
{"title":"The emperors new clothiers.","authors":"Gc Ebers","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There can be few situations in all of science which invite or reward the reporting of chance associations, yet the nature of surveillance for potential adverse events in clinical medicine demands it. We excuse the usual rigour of proof in these ordinarily as their purpose is to trigger an alarm which alerts observers to similar occurrences.</p>","PeriodicalId":86075,"journal":{"name":"International MS journal","volume":"16 1","pages":"3-4"},"PeriodicalIF":0.0,"publicationDate":"2009-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28149999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Th17 Cells in MS and Experimental Autoimmune Encephalomyelitis. Th17细胞在MS和实验性自身免疫性脑脊髓炎中的作用。
International MS journal Pub Date : 2009-04-01
Hh Hofstetter, R Gold, H-P Hartung
{"title":"Th17 Cells in MS and Experimental Autoimmune Encephalomyelitis.","authors":"Hh Hofstetter,&nbsp;R Gold,&nbsp;H-P Hartung","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Multiple sclerosis (MS) is regarded as a Tcell mediated autoimmune disease of the central nervous system (CNS). It has been traditionally seen as a Th1-mediated autoimmune disease, a notion which has been largely supported by studies in its animal model, experimental autoimmune encephalomyelitis (EAE). However, evidence has accumulated in recent years that a newly described lineage of (autoantigen-specific) T-cells, which are characterized by the production of the inflammatory cytokine interleukin 17 (Th17) cells, might be the relevant effector cell population instead. This is supported by studies both in MS patients and in the EAE mouse model. Research in this field currently centres on the endogenous factors which are required for the priming and expansion of CNS autoantigen specific Th17 cells as well as on exogenous factors which trigger Th17 differentiation and activation. This review tries to provide an overview of the relevant literature and to summarize the current body of evidence on the role of Th17 cells in CNS autoimmune disease.</p>","PeriodicalId":86075,"journal":{"name":"International MS journal","volume":"16 1","pages":"12-8"},"PeriodicalIF":0.0,"publicationDate":"2009-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28149951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Diagnosis of MS. MS的诊断。
International MS journal Pub Date : 2009-04-01
E Mallam, N Scolding
{"title":"The Diagnosis of MS.","authors":"E Mallam,&nbsp;N Scolding","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Diagnosing multiple sclerosis (MS) is not always straightforward. The very nature of this disease means that it can manifest in multiple varied clinical presentations. Diagnosis is further confounded by the lack of a single diagnostic test and a gargantuan list of differential diagnoses. Traditionally the diagnosis of MS is a clinical one: with the history and/or examination revealing the separation in time and space of neurological episodes. In some cases, however, a diagnosis of \"possible MS\" might have to be made, for example, when the patient presents after a single event. Paraclinical investigations and diagnostic criteria may be of help in these situations. It is recommended that any diagnostic uncertainty is discussed openly with patients.</p>","PeriodicalId":86075,"journal":{"name":"International MS journal","volume":"16 1","pages":"19-25"},"PeriodicalIF":0.0,"publicationDate":"2009-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28149952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anti-aquaporin-4 antibodies in neuromyelitis optica: how to prove their pathogenetic relevance? 抗水通道蛋白-4抗体在视神经脊髓炎中的作用:如何证明其病理相关性?
International MS journal Pub Date : 2008-09-01
M Bradl, Dr Hans Lassmann
{"title":"Anti-aquaporin-4 antibodies in neuromyelitis optica: how to prove their pathogenetic relevance?","authors":"M Bradl,&nbsp;Dr Hans Lassmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The discovery of a specific autoantibody response in neuromyelitis optica (NMO) patients, which selectively targets astrocytic end feet at the glia limitans1 and which is directed against the water channel aquaporin-4 (AQP-4)2 was a milestone in defining this disease entity and profoundly changed our view regarding its pathogenesis.3 Indirect evidence, coming from clinical observations and pathology strongly suggest that these autoantibodies play a major role in driving the disease process. The pathological hallmark of NMO lesions is a very selective and characteristic deposition of immunoglobulins and complement on astrocytes at the glia limitans, which is associated with destruction and loss of glial fibrillary acidic protein and AQP-4 positive astrocytes in fresh lesions4 to 6 followed by demyelination and global tissue destruction. As in other antibody-mediated diseases, granulocytes, and in particular eosinophils, are a major component of the inflammatory infiltrates.4 Furthermore, the distribution of the lesions in the brain and spinal cord of NMO patients correlates with the extent of regional AQP-4 expression.6,7 Most importantly, therapies, which eliminate antibodies (plasma exchange),8 or which target Blymphocytes (anti-CD20 antibodies),9 are at least in part effective in NMO patients. Based on this evidence NMO is now considered an antibody-mediated autoimmune disease, however, direct proof of the pathogenic potential of AQP-4 antibodies is so far lacking.</p>","PeriodicalId":86075,"journal":{"name":"International MS journal","volume":"15 3","pages":"75-8"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27692076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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