Brain atrophy in multiple sclerosis: mechanisms, clinical relevance and treatment options

AbstractMultiple sclerosis (MS) is an immune-mediated disease of the central nervous system characterized by focal or diffuse inflammation, demyelination, axonal loss and neurodegeneration. Brain atrophy can be seen in the earliest stages of MS, progresses faster compared to healthy adults, and is a reliable predictor of future physical and  cognitive disability. In addition, it is widely accepted to be a valid, sensitive and reproducible measure of neurodegeneration in MS. Reducing the rate of brain atrophy has only recently been incorporated as a critical endpoint into the clinical trials of new or emerging disease modifying drug s (DMDs) in MS. With the advent of easily accessible neuroimaging softwares along with the accumulating evidence, clinicians may be able to use brain atrophy measures in their everyday clinical practice to monitor disease course and response to DMDs. In this review, we will describe the differe nt mechanisms contributing to brain atrophy, their clinical relevance on disease presentation and course and the effect of current or emergent DMDs on brain atrophy and neuroprotection.
Source: Autoimmunity Highlights - Category: Allergy & Immunology Source Type: research

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Authors: Goodman A, Anadani N, Gerwitz L Abstract Introduction: Multiple sclerosis (MS) causes focal lesions of immune-mediated demyelinating events followed by slow progressive accumulation of disability. Over the past 2 decades, multiple medications have been studied and approved for use in MS. Most of these agents work by modulating or suppressing the peripheral immune system. Siponimod is a newer-generation sphingosine 1 phosphate (S1P) receptor modulator which internalizes S1P1 receptors thereby inhibiting efflux of lymphocytes from lymph nodes and thymus. There are promising data suggesting that it may also h...
Source: Expert Opinion on Investigational Drugs - Category: Drugs & Pharmacology Tags: Expert Opin Investig Drugs Source Type: research
FRIDAY, Oct. 11, 2019 -- Reduction in peripapillary retinal nerve fiber layer (pRNFL) thickness is significantly associated with physical and cognitive disability in patients with multiple sclerosis (MS), according to a study published in the...
Source: Drugs.com - Pharma News - Category: Pharmaceuticals Source Type: news
CONCLUSION: disease duration was strongly correlated with a higher number of disabilities and better socioeconomic and educational profiles showed to be protective factors for functionality. Care planning should consider the needs observed by the multidisciplinary team, stimulating the development of self-care, functionality and sociability. PMID: 31596417 [PubMed - in process]
Source: Revista Latino-Americana de Enfermagem - Category: Nursing Authors: Tags: Rev Lat Am Enfermagem Source Type: research
THURSDAY, Oct. 10, 2019 -- Physical disability, depressive symptoms, and reduced information processing affect work-related disability and vocational status among patients with multiple sclerosis, according to a study published in the November issue...
Source: Drugs.com - Pharma News - Category: Pharmaceuticals Source Type: news
Conclusions: The serum level of pNF-H, EDSS score-correlated, might stand for a potential biomarker of disability in RRMS reflecting progressive axonal damage and cumulative neurological deterioration. The novelty of these results warrants conducting a larger confirmatory trial.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusion. Even with lack of marked cognitive decline and disability in individuals with MS and lack of differences between groups in pragmatic tasks, the MS group showed lower performance in making inferences and interpreting implicit and social situations. This study highlights the link between pragmatic language and ToM difficulties in MS.
Source: Annals of Physical and Rehabilitation Medicine - Category: Rehabilitation Source Type: research
Publication date: Available online 3 October 2019Source: Multiple Sclerosis and Related DisordersAuthor(s): Magnus Spangsberg Boesen, Annika Langkilde, Alfred Peter Born, Melinda Magyari, Morten Blinkenberg, Tanuja Chitnis, Lau Caspar Thygesen, Frank ErikssonAbstractBackgroundAcute disseminated encephalomyelitis (ADEM) can cause cognitive impairment in children. However, long-term consequences for school performance and psychiatric morbidity have never been characterized. Our aim was to investigate long-term school performance and psychiatric morbidity after pediatric ADEM (
Source: Multiple Sclerosis and Related Disorders - Category: Neurology Source Type: research
ConclusionsIn this cohort of patients with newly diagnosed CIS and RRMS, fatigue scores were associated with mood, disease impact on daily life and quality of life as well as with alterations of attentive functions. Study results indicate that subjective fatigue scores are not well reflected by some commonly used and objectively measurable disease parameters like EDSS, T2 lesions and NFL levels.
Source: Multiple Sclerosis and Related Disorders - Category: Neurology Source Type: research
Publication date: Available online 1 October 2019Source: Multiple Sclerosis and Related DisordersAuthor(s): Xiaodong Song, Dawei Li, Zhandong Qiu, Shengyao Su, Yan Wu, Jingsi Wang, Zheng Liu, Huiqing DongAbstractBackgroundCervical spinal cord atrophy (CSCA), which partly reflects the axonal loss in the spinal cord, is increasingly recognized as a valuable predictor of disease outcome. However, inconsistent results have been reported regarding the correlation of CSCA and clinical disability in multiple sclerosis (MS). The aim of this meta-analysis was to synthesize the available data obtained from 3.0-Tesla (3T) MRI scanner...
Source: Multiple Sclerosis and Related Disorders - Category: Neurology Source Type: research
Condition:   Nutrition Habits in Multiple Sclerosis Intervention:   Sponsor:   Assiut University Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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