THE TECFIDERA CHANNEL: 15 STUDIES IN WEDNESDAY'S NEWS

PLUS: 336 new Studies we posted from 11/1 to Tuesday 11/25 Start at the Bottom!

Stress as Provoking Factor for the First and Repeated Multiple Sclerosis Seizures

Multiple sclerosis is an inflammatory, autoimmune, disease of the white mass of the brain, which sometimes may involve the gray matter (subcortical and ones in the anterior horns of the spinal cord) with the chronic nature and generally with progressive course. As a possible cause of this disease state are listed genetic predisposition, early viral infections and environmental factors, with special effects of stress as a provoking factor in first episode of the disease and relapses because stress leads to modulation of the immune system and immune response to various causes. An intensive stressor is certainly one of the triggers for the development of Multiple Sclerosis, as the first episode and worsening of previously established disease.

Study provides first class 1 evidence for cognitive rehabilitation in MS
Although disabling cognitive problems that affect functional performance and employment are common in persons with MS, there are very few evidence-based protocols for cognitive rehabilitation in MS.

New understanding, warning signs, and potential treatments for multiple sclerosis
Scientists are gaining a new level of understanding of multiple sclerosis (MS) that may lead to new treatments and approaches to controlling the chronic disease, according to new research released at Neuroscience 2013, the annual meeting of the Society for Neuroscience and the world's largest source of emerging news about brain science and health.

Neuroimaging study sheds light on mechanisms of cognitive fatigue in multiple sclerosis
A new study by Kessler Foundation scientists sheds light on the mechanisms underlying cognitive fatigue in individuals with multiple sclerosis. Cognitive fatigue is fatigue resulting from mental work rather than from physical labor. Genova H et al: Examination of cognitive fatigue in multiple sclerosis using functional magnetic resonance imaging and diffusion tensor imaging" was published in PlosOne. This is the first study to use neuroimaging to investigate aspects of cognitive fatigue. The study was funded by grants from the National MS Society and Kessler Foundation.

Aerobic Exercise Benefits Memory in Persons With MS

A research study headed by Victoria Leavitt, Ph.D. and James Sumowski, Ph.D., of Kessler Foundation, provides the first evidence for beneficial effects of aerobic exercise on brain and memory in individuals with multiple sclerosis (MS). The article, "Aerobic exercise increases hippocampal volume and improves memory in multiple sclerosis: Preliminary findings," was released as an epub ahead of print on October 4 by Neurocase: The Neural Basis of Cognition.

Variation Within DNA Repair Pathway Genes and Risk of Multiple Sclerosis

Multiple sclerosis (MS) is a complex autoimmune disease of the central nervous system with a prominent genetic component. The primary genetic risk factor is the human leukocyte antigen (HLA)-DRB1*1501 allele; however, much of the remaining genetic contribution to MS has not been elucidated. The authors investigated the relation between variation in DNA repair pathway genes and risk of MS. Single-locus association testing, epistatic tests of interactions, logistic regression modeling, and nonparametric Random Forests analyses were performed by using genotypes from 1,343 MS cases and 1,379 healthy controls of European ancestry. A total of 485 single nucleotide polymorphisms within 72 genes related to DNA repair pathways were investigated, including base excision repair, nucleotide excision repair, and double-strand breaks repair.

Mortality following a brain tumour diagnosis in patients with multiple sclerosis

As brain tumours and their treatment may theoretically have a poorer prognosis in inflammatory central nervous system diseases such as multiple sclerosis (MS), all-cause mortality following a brain tumour diagnosis was compared between patients with and without MS. The potential role of age at tumour diagnosis was also examined. Younger age at tumour diagnosis may contribute to mortality reduction in those with high-grade and uncertain-grade brain tumours. Survival following a brain tumour is not worse in patients with MS; even after age at brain tumour diagnosis and grade of malignancy are taken into account.

Evaluation of the Effect of Progressive Relaxation Exercises on Fatigue and Sleep Quality in Patients with Multiple Sclerosis

Fatigue and sleep problems are very commonly observed in patients with multiple sclerosis (MS). The Progressive Muscle Relaxation Technique (PMRT), used as one of the alternative methods in recent years, is reported to have benefits such as facilitating sleep and reducing sensitivity against fatigue. This research was conducted to investigate the effect of PMRT on fatigue and sleep quality in patients with MS. This study supports the effect of PMRT on fatigue and sleep quality in patients with MS, and it is recommended that further studies be conducted on this subject in the future.

Responsiveness of walking-based outcome measures after multiple sclerosis relapses following steroid pulses

The aim of this study was to examine the impact of intravenous methylprednisolone therapy (IVMP) on the recovery of walking ability in patients experiencing multiple sclerosis (MS) relapses, to compare the responsiveness of walking-based measures, and to estimate the impact of different walking-based measures responsiveness on clinical trials. All applied walking-based measures showed significant improvement of walking ability 1 month after the IVMP. Responsiveness of various walking-based measures notably differ, thus affecting sample size calculations.

Cognitive impairment and “invisible symptoms” are not associated with CCSVI in MS

We investigated the association between chronic cerebrospinal venous insufficiency (CCSVI) and cognitive impairment (CI) in multiple sclerosis (MS). Moreover, we evaluated the association between CCSVI and other frequent self-reported MS symptoms. Our findings suggest a lack of association between CCSVI and CI in MS patients. Fatigue, depressive, bladder/sexual symptoms and self-reported quality of life are not associated with CCSVI.

Combination therapy with mitoxantrone and plasma exchange in aggressive relapsing remitting multiple sclerosis: A preliminary clinical study

The efficacy of mitoxantrone induction therapy in rapidly worsening multiple sclerosis (MS) is well established. Plasma exchange is also applied as an adjuvant in exacerbations of relapsing MS. The aim of this study was to compare the efficacy of combination therapy with mitoxantrone and plasma exchange versus mitoxantrone alone in patients with aggressive MS. Administration of mitoxantrone as an induction therapy in patients of aggressive relapsing remitting MS results in significant improvement of their clinical state and MRI activity. However, combination of plasma exchange with mitoxantrone gives no more benefits than mitoxantrone alone and sometimes worsens the situation possibly by reduction of mitoxantrone efficacy as a result of plasma exchange.

The Clinical Relevance of Force Platform Measures in Multiple Sclerosis: A Review

Disease-specific molecular events in cortical multiple sclerosis lesions

Tobacco smoking and disability progression in multiple sclerosis: United Kingdom cohort study

Adding to the Burden: Gastrointestinal Symptoms and Syndromes in Multiple Sclerosis

336 STUDIES FROM 11/1 to Tuesday 11/26 are below:

A passive exoskeleton can push your life up: application on multiple sclerosis patients.
n the present study, we report the benefits of a passive and fully articulated exoskeleton on multiple sclerosis patients by means of behavioral and electrophysiological measures, paying particular attention to the prefrontal cortex activity.

Pupillary response to sparse multifocal stimuli in multiple sclerosis patients.
The objective of this paper is to investigate the pattern of abnormalities and establish the diagnostic power of multifocal objective pupil perimetry (mfPOP) in multiple sclerosis (MS).
mfPOP is well tolerated and potentially has a role in the diagnosis and assessment of patients with MS.

Long-term effects of whole body cryostimulation on uric acid concentration in plasma of secondary progressive multiple sclerosis patients.
Uric acid (UA) has been suggested to be a marker of multiple sclerosis (MS) activity. Whole body cryostimulation (WBCT) is a new form of additional treatment and becoming popular in medicine. Objectives. The aims of this study were to determine the long-term effects of WBCT on the level of plasma UA in selected group of MS patients only with secondary progressive (SPMS) clinical form and verify results with functional state of patients assessed by expanded disability status scale (EDSS).

An RCT to treat learning impairment in multiple sclerosis: The MEMREHAB trial.
To examine the efficacy of the modified Story Memory Technique (mSMT), a 10-session behavioral intervention teaching context and imagery to facilitate learning, to improve learning and memory abilities in persons with multiple sclerosis (MS). The mSMT is effective for improving learning and memory in MS.

Body Mass Index in Multiple Sclerosis: Associations with CSF Neurotransmitter Metabolite Levels.
Body weight and height of patients with relapsing-remitting multiple sclerosis (RRMS) or clinically isolated syndrome suggesting MS (CIS) in the age range 18 to 60 years (154 males and 315 females) were compared with those of subjects (146 males and 212 females) free of any major neurological disease. In drug-free patients, CSF levels of the metabolites of noradrenaline (MHPG), serotonin (5-HIAA), and dopamine (HVA), neurotransmitters involved in eating behavior, were estimated in searching for associations with body mass index (BMI).

Treatment of pediatric multiple sclerosis.
Multiple sclerosis (MS) in children and adolescents has received increased attention during the past decade. Although not tested in randomized placebo-controlled trials, first-line disease-modifying therapies are widely used in patients with MS who are younger than 18 years.

Accuracy of Postcontrast 3D Turbo Spin Echo MR Sequence for the Detection of Enhanced Inflammatory Lesions in Patients with Multiple Sclerosis.

MicroRNA Profiling May Provide Biomarkers for Monitoring MS

Shorter Washout Reduces MS Relapse Switching Off Natalizumab

Sodium May Make MS Worse
OPENHAGEN, Denmark — A study for the first time links higher sodium intake with increased clinical and radiologic disease activity in people with multiple sclerosis (MS).
A high-sodium diet has recently been shown to worsen disease in the animal model of MS, experimental autoimmune encephalomyelitis. "Our study adds some evidence that this effect might be also present in humans as individuals that consume high amounts of sodium have a higher number of lesions on MRI and also more clinical bouts," Mauricio Farez, MD, from the Institute for Neurological Research, Buenos Aires, Argentina, told Medscape Medical News.

Cholesterol Transport Protein Implicated in MS

Don't Freeze Medicare Rates, Docs Tell Congress

Doctors Complain They Will Be Paid Less by Exchange Plans

Cognitive Therapy, Meds Equal in Curbing Depression Relapse

EU patent call sets stage for Tecfidera launch in Europe

Omega-3 Fatty Acids of No Benefit in Multiple Sclerosis
The finding, from the 4-year Omega-3 Fatty Acid Treatment in Multiple Sclerosis (OFAMS) trial, goes against those of preliminary studies that suggested omega-3 supplementation would have a protective effect in MS, lead author Øivind Torkildsen, MD, PhD, from Haukeland University Hospital, Bergen, Norway, told Medscape Medical News.

Masitinib Treatment in Patients With Progressive Multiple Sclerosis

Plasmacytoid Dendritic Cells and Immunotherapy in Multiple Sclerosis

Influence of multiple sclerosis, age and degree of disability, in the position of the contrast sensitivity curve peak.

A polymorphism in the resistin gene promoter and the risk of multiple sclerosis.

The Evaluation of the Retinal Nerve Fiber Layer in Multiple Sclerosis with Special-Domain Optical Coherence Tomography.

Y-39983, a Selective Rho-Kinase Inhibitor, Attenuates Experimental Autoimmune Encephalomyelitis via Inhibition of Demyelination.

Nuclear factor kappa B (NF-κB) in multiple sclerosis pathology.

Discovery of peptoid ligands for anti-aquaporin 4 antibodies.

A pragmatic parallel arm multi-centre randomised controlled trial to assess the effectiveness and cost-effectiveness of a group-based fatigue management programme (FACETS) for people with multiple sclerosis

Immune competence after alemtuzumab treatment of multiple sclerosis

Retinal periphlebitis is associated with multiple sclerosis severity

Cytomegalovirus seropositivity is negatively associated with multiple sclerosis

Endogenous Retroviruses and Multiple Sclerosis

Interdependence and Contributions of Sun Exposure and Vitamin D to MRI Measures in Multiple Sclerosis

Exercise and Disease Progression in Multiple Sclerosis
It has been suggested that exercise (or physical activity) might have the potential to have an impact on multiple sclerosis (MS) pathology and thereby slow down the disease process in MS patients. The objective of this literature review was to identify the literature linking physical exercise (or activity) and MS disease progression.

Revisiting Statins in Multiple Sclerosis

A Role in Monitoring Multiple Sclerosis?

Possible Immune Target Identified in Multiple Sclerosis
t is assumed that in MS, the immune system recognizes proteins of the myelin sheath as antigenic, setting in motion an inflammatory reaction resulting in demyelination of the axons, breakdown of the blood-brain barrier, and the formation of lesions. However, the exact target of the immune response involved in MS has continually eluded researchers.

Smoking: Effects on Multiple Sclerosis Susceptibility and Disease Progression
Multiple sclerosis (MS) is associated with both genetic and environmental factors that influence disease susceptibility. Exposure to cigarette smoke is emerging as a viable environmental risk factor for MS that contributes to both increased disease susceptibility and more rapid disease advancement. The relative risk for MS development is approximately 1.5 for smokers compared with nonsmokers. Furthermore, there may be important interactions between smoking, an individual's genetic background, and other environmental risk exposures. This review summarizes the current evidence supporting the association of smoking with MS risk and disease course, with additional comments on causation.

Behavioral Interventions in Multiple Sclerosis
Managing uncertainty is a major challenge associated with the diagnosis of multiple sclerosis (MS). In addition to physical symptoms, neuropsychiatric symptoms are highly prevalent in this disease. Depression in particular is more common in MS than in other chronic diseases. While substantial achievements have been made in the therapy of MS and an increasing number of immunomodulatory treatments are now available, the long-term benefits of these are still a matter of debate. Importantly, while the approved therapies show good efficacy on inflammatory lesions and relapse rate, and may slow certain aspects of disease progression, improvements in function have rarely been reported.

Neurogenesis In The Chronic Lesions Of Multiple Sclerosis
Subcortical white matter in the adult human brain contains a population of interneurons that helps regulate cerebral blood flow. We investigated the fate of these neurons following subcortical white matter demyelination. Immunohistochemistry was used to examine neurons in normal-appearing subcortical white matter and seven acute and 59 chronic demyelinated lesions in brains from nine patients with multiple sclerosis and four controls.

Women With Multiple Sclerosis Have High Rate of Migraine

Lung Volume Recruitment in Multiple Sclerosis

Prevalence of fatigue in patients with multiple sclerosis and its effect on the quality of life

Multiple Sclerosis Cases Hit 2.3 Million Worldwide

Multiple Sclerosis: Autoimmune or Neurodegenerative?

Therapeutic Decision Making in a New Drug Era in Multiple Sclerosis

Cortical Lesions in Multiple Sclerosis

Studies Show Promise for Angioplasty in Multiple Sclerosis

Plasmacytoid Dendritic Cells and Immunotherapy in Multiple Sclerosis
Plasmacytoid dendritic cells (pDCs) are specialized APCs implicated in the pathogenesis of many human diseases.

Jacobian integration method increases the statistical power to measure gray matter atrophy in multiple sclerosis.

Brain atrophy: an in-vivo measure of disease activity in multiple sclerosis.

Exercise therapy and multiple sclerosis: a systematic review.
Multiple sclerosis (MS) is an incurable disease, and despite current pharmacologic treatment being effective in reducing relapse rates and lesion burden, there is little evidence that these treatments work as effectively in preventing disability progression. In such cases, non-pharmacologic techniques such as exercise therapy with rehabilitation purposes may play an important role.

Using magnetic resonance imaging in animal models to guide drug development in multiple sclerosis.
Major advances are taking place in the development of therapeutics for multiple sclerosis (MS), with a move past traditional immunomodulatory/immunosuppressive therapies toward medications aimed at promoting remyelination or neuroprotection. With an increase in diversity of MS therapies comes the need to assess the effectiveness of such therapies.

Cortical plasticity predicts recovery from relapse in multiple sclerosis.
Relapsing-remitting multiple sclerosis (RRMS) is characterized by the occurrence of clinical relapses, followed by remitting phases of a neurological deficit. Clinical remission after a relapse can be complete, with a return to baseline function that was present before, but is sometimes only partial or absent. Remyelination and repair of the neuronal damage do contribute to recovery, but they are usually incomplete. Synaptic plasticity may contribute to symptom recovery after a relapse in MS; and PAS, measured during a relapse, may be used as a predictor of recovery.

Disclosure of diagnosis of multiple sclerosis in the workplace positively affects employment status and job tenure.
For many employees with multiple sclerosis (MS), disclosure of their diagnosis at work is seen as a high-risk strategy that might lead to diminished perceptions of their capabilities by supervisors and colleagues, if not outright discrimination. The consequence of this mistrust surrounding the disclosure process is that employees with MS may leave it until too late to effectively manage symptoms at work. This study provides the first empirical support for the positive role of disclosure in maintaining employment status, measured both as job retention and tenure in current employment.

Extending technology-aided leisure and communication programs to persons with spinal cord injury and post-coma multiple disabilities.

Clinical and demographic factors affecting disease severity in patients with multiple sclerosis.
The clinical course of multiple sclerosis (MS) evolves over many years. Its prognosis is highly variable among affected individuals, i.e. while some suffer from early severe disabilities, others remain ambulatory and functional for many years. We used Multiple Sclerosis Severity Score (MSSS) and the new classification for MS severity Herbert et al. introduced in 2006 according to MSSS, to investigate some clinical and demographic factors as potential indicators of disease severity in in MS. Early prediction of disease severity by demographic and clinical features is currently impossible. We need to determine stronger predictors, possibly a combination of demographic, clinical, biomarkers, and imaging findings.

Magnetic Resonance Monitoring of Lesion Evolution in Multiple Sclerosis
Disease activity in multiple sclerosis (MS) is strongly linked to the formation of new lesions, which involves a complex sequence of inflammatory, degenerative, and reparative processes. Conventional magnetic resonance imaging (MRI) techniques, such as T2-weighted and gadolinium-enhanced T1-weighted sequences, are highly sensitive in demonstrating the spatial and temporal dissemination of demyelinating plaques in the brain and spinal cord. Hence, these techniques can provide quantitative assessment of disease activity in patients with MS, and they are commonly used in monitoring treatment efficacy in clinical trials and in individual cases. However, the correlation between conventional MRI measures of disease activity and the clinical manifestations of the disease, particularly irreversible disability, is weak.

Employment and multiple sclerosis in new zealand.

A preliminary path analysis: Effect of psychopathological symptoms, mental and physical dysfunctions related to quality of life and body mass index on fatigue severity of Iranian patients with multiple sclerosis.
Multiple sclerosis (MS) is a neurological disease with fatigue as most prevalent symptom. Psychopathological symptoms, physical and mental dysfunctions and body mass abnormalities potentially could deteriorate fatigue. Thus, in this study, we aimed at evaluating the effect of these factors on fatigue severity of MS patients. Present study made the role of psychopathological symptoms and physical and mental dysfunctions prominent in exacerbation of fatigue severity. Moreover, we can refer to more sensible effect of physical dysfunction related to life on fatigue.

Growth Hormone and Disease Severity in Early Stage of Multiple Sclerosis.

The Fluctuating Natural Course of CCSVI in MS Patients and Controls, a Prospective Follow-Up.
OBJECTIVES: A new treatable venous disorder, chronic cerebrospinal venous insufficiency (CCSVI), has been proposed in patients with multiple sclerosis. The natural course of CCSVI has not been examined yet. This is crucial given the fact that surgical procedures are increasingly offered to MS patients to treat venous stenosis.
CONCLUSIONS: ECD examination shows a fluctuating natural course of the extracranial venous haemodynamics, which makes determination of CCSVI by ECD examination unreliable.

Evolutive Study of Relapsing-Remitting Multiple Sclerosis with Cervical Proton Magnetic Resonance Spectroscopy. A Case Report.

Spasticity in patients with multiple sclerosis - clinical characteristics, treatment and quality of life.
Aims: To gain real-life data on demographic and clinical characteristics, treatment patterns, treatment satisfaction and quality-of-life of multiple sclerosis-related spasticity (MSS) in Germany.
Conclusions: Spasticity and its symptoms impair personal well-being and quality-of-life. Treatment of spasticity with drugs and physiotherapy is common, but satisfaction with the currently available anti-spastic pharmacotherapy is low.

The molecular study of IFNβ pleiotropic roles in MS treatment.
MS) is one of the most important autoimmune diseases recognized by demyelination and axonal lesion. It is the most common cause of disability in the young population. Various immunomodulatory and immunosuppressive therapies, including different formulations of interferon beta (IFNβ), glatiramer acetate (GA), mitoxantrone, and natalizumab are available for this disease. However, interferon has been the best prescribed.

Dietary pattern and risk of multiple sclerosis.
It has been suggested that nutrition might play a role in the etiology of multiple sclerosis (MS). However, dietary patterns associated with MS risk are unknown. This study was conducted to compare the dietary patterns of patients with MS and healthy controls to find the relationship between dietary patterns and MS. Our findings showed that the risk of RRMS can be affected by major dietary patterns.

Optical coherence tomography versus visual evoked potential in multiple sclerosis patients.
Optical coherence tomography (OCT) is a non-invasive instrument, which can be used to estimate the thickness of the retinal nerve fibre layer (RNFL) and provides an indirect measurement of axonal destruction in multiple sclerosis (MS). The main aim of this study was to find out any correlations between P100 latency in visual evoked potential (VEP) and RNFL thickness.
OCT does have good correlations with P100 latency, indicating retinal non-myelinated axonal involvement in early stages in addition to the myelinated axonal involvement. However, it cannot be used as the sole test in evaluating visual pathway in optic neuritis and complementary tests as VEPs are recommended.

Reversible therapy-related dysplastic hematopoiesis following Beta Interferon Therapy in Multiple Sclerosis Patients: Report of 2 Cases.
Interferon beta-la and -1b have been increasingly used for the treatment of multiple sclerosis (MS). The most frequent systemic adverse effects are flu-like symptoms. Laboratory abnormalities include asymptomatic leukopenia and elevated hepatic transaminases. Myelodysplastic Syndrome (MDS) refers to a spectrum of hematological disorders which can occur in different situations. Several hematological abnormalities have been reported following interferon therapy. Both of our cases were reversible; although treatment with IFNβ-1a and-1b is safe and well tolerated in the majority of population, we should be careful about this premalignant hematological disorder.

Effect of honey bee venom on lewis rats with experimental allergic encephalomyelitis, a model for multiple sclerosis.
(MS) is a progressive and autoimmune neurodegenerative disease of the central nervous system (CNS). This disease is recognized through symptoms like inflammation, demyelination and the destruction of neurological actions. Experimental allergic encephalomyelitis (EAE) is a widely accepted animal model for MS. EAE is created in animals by injecting the tissue of myelin basic protein (MBP), CNS, or myelin oligodendrocyte glycoprotein (MOG) along with the adjuvant. EAE and MS are similar diseases. Honey Bee venom (Apis mellifera) contains a variety of low and high molecular weight peptides and proteins, including melittin, apamin, adolapin, mast cell degranulating peptide and phospholipase A2.

Neuroprotection in a novel mouse model of multiple sclerosis.

Mortality following a brain tumour diagnosis in patients with multiple sclerosis.
As brain tumours and their treatment may theoretically have a poorer prognosis in inflammatory central nervous system diseases such as multiple sclerosis (MS), all-cause mortality following a brain tumour diagnosis was compared between patients with and without MS. The potential role of age at tumour diagnosis was also examined. Younger age at tumour diagnosis may contribute to mortality reduction in those with high-grade and uncertain-grade brain tumours. Survival following a brain tumour is not worse in patients with MS; even after age at brain tumour diagnosis and grade of malignancy are taken into account.

Let's rehabilitate cognitive rehabilitation in multiple sclerosis.
Up to 60% of patients with multiple sclerosis (MS) experience cognitive dysfunction, with prominent involvement of complex attention, information processing speed, executive functions, episodic memory, and visuospatial abilities. Since MS-related cognitive deficits can substantially affect a wide range of daily life activities (e.g., work, driving, social integration, and adherence to medication regimens), it is imperative that we identify and develop strategies to alleviate them.

Efficacy and safety of BG-12 (dimethyl fumarate) and other disease modifying therapies for the treatment of relapsing-remitting multiple sclerosis: a systematic review and mixed treatment comparison.
Currently, direct comparative evidence or head-to-head data between BG-12 (dimethyl fumarate) and other disease-modifying treatments (DMTs) is limited. This study is a systematic review and data synthesis of published randomized clinical trials comparing the efficacy and safety of existing DMTs to BG-12 for Relapsing-Remitting Multiple Sclerosis (RRMS). Based on indirect comparison, BG-12 offers an effective oral treatment option for patients with RRMS with an overall promising efficacy and safety profile compared to currently approved DMTs. Key limitations of the systematic review were the large heterogeneity in patients enrolled, and the variability in the definition of outcomes in included trials.

Prevalence of joint contractures and muscle weakness in people with multiple sclerosis.
Abstract Objectives: To investigate the prevalence of joint contracture (limited passive range of joint motion) and muscle weakness in a population with multiple sclerosis (MS). A secondary aim was to establish normative data of functional tests of mobility and balance of people with MS who are still ambulant. These data show that in addition to muscle weakness joint contractures are highly prevalent among people with MS, especially in the ankle joint. This implicates that prevention of contracture is crucial in providing rehabilitation to people with MS. Implications for Rehabilitation Joint contractures are highly prevalent of people with MS, especially in the lower limb, even at an early stage. While many interventions such as stretching and serial casting have been implemented to reduce contractures, there is not yet strong evidence for their effectiveness. Further research is required.

Relating relapse and T2 lesion changes to disability progression in multiple sclerosis: a systematic literature review and regression analysis.
In the treatment of multiple sclerosis (MS), the most important therapeutic aim of disease-modifying treatments (DMTs) is to prevent or postpone long-term disability. Given the typically slow progression observed in the majority of relapsing-remitting MS (RRMS) patients, the primary endpoint for most randomized clinical trials (RCTs) is a reduction in relapse rate. It is widely assumed that reducing relapse rate will slow disability progression. Similarly, MRI studies suggest that reducing T2 lesions will be associated with slowing long-term disability in MS. The objective of this study was to evaluate the relationship between treatment effects on relapse rates and active T2 lesions to differences in disease progression (as measured by the Expanded Disability Status Scale [EDSS]) in trials evaluating patients with clinically isolated syndrome (CIS), RRMS, and secondary progressive MS (SPMS). Treatment differences in relapse reduction and T2 lesions are positively related to differences in disease progression over the first two years of treatment.

Treatment options for patients with multiple sclerosis who have a suboptimal response to interferon-β therapy.
Although the first-line disease-modifying therapies (DMTs) interferon beta and glatiramer acetate have a favourable benefit-to-risk profile, they are only partially effective for treating relapsing-remitting multiple sclerosis (RRMS). The optimization of treatment in patients who do not show a maximum response to first-line therapy is critical for achieving the best long-term outcomes. Treatment strategies for patients with a suboptimal response include switching to another first-line DMT or a second-line DMT. Natalizumab and fingolimod are approved for RRMS with high disease activity in the European Union and Canada. A descriptive comparison of fingolimod and natalizumab is provided in the context of the decision-making process of how and when to switch patients who have a suboptimal response to first-line therapy.

Patient-related factors may affect the outcome of neuropsychological rehabilitation in multiple sclerosis.
The aim of this study was to identify factors associated with neuropsychological rehabilitation outcome in patients with multiple sclerosis (MS). Patient-related factors may affect neuropsychological rehabilitation outcome in MS.

Low contrast visual acuity testing is associated with cognitive performance in multiple sclerosis: a cross-sectional pilot study.

Effect of treadmill training on fatigue in multiple sclerosis: a pilot study.
People with multiple sclerosis (PwMS) tend to be less physically active than the general population. Limited physical activity increases fatigue, possibly affecting other functions such as balance. Treadmill training is a promising method to ameliorate these symptoms. The aim of this study was to assess the effect of treadmill training on fatigue and balance.

Multiple Sclerosis International Federation: Stimulating international cooperation in researc.

A novel pH-sensitive interferon-β (INF-β) oral delivery system for application in multiple sclerosis.

Lower Serum Levels of Th2-Related Chemokine CCL22 in Women Patients with Multiple Sclerosis: A Comparison Between Patients and Healthy Women.

The glutathione S-transferase T1 deletion is associated with susceptibility to multiple sclerosis.

The influence of disease duration, clinical course, and immunosuppressive therapy on the synthesis of intrathecal oligoclonal IgG bands in multiple sclerosis.

Metabolomic approach to human brain spectroscopy identifies associations between clinical features and the frontal lobe metabolome in multiple sclerosis.

Muscle-specific kinase antibody positive myaesthenia gravis and multiple sclerosis co-presentation: A case report and literature review.

Electroconvulsive therapy in patient with psychotic depression and multiple sclerosis.

Fatigue and sleep-disordered breathing in multiple sclerosis: a clinically relevant association?
Objective. To evaluate the importance of routine respirography in MS patients with severe fatigue and to explore the effects of treatment with continuous positive airway pressure (CPAP).
Conclusion. Respirography in MS patients with severe fatigue should be considered in daily medical practice, because SDB frequency is high and CPAP therapy reduces fatigue severity.

Factors affecting bone mineral density in multiple sclerosis patients.
BACKGROUND: Multiple sclerosis (MS) is a demyelinating disease which can cause many disabilities for the patient. Recent data suggests that MS patients have higher risk for osteoporosis. This study was performed to investigate if the osteoporosis prevalence is higher in MS patients and to determine the possible factors affecting bone mineral density (BMD).
CONCLUSION: As a result of this study, bone loss inevitably occurs in MS patients. The major factor of BMD loss is immobility. Osteoporosis should be managed as part of MS patients' treatment protocols.

Comparison of serum levels of copper and zinc among multiple sclerosis patients and control group.

Can multiple sclerosis as a cognitive disorder influence patients' dreams?
Dream should be considered as a kind of cognitive ability that is formed parallel to other cognitive capabilities like language. On the other hand, multiple sclerosis (MS) is a complex disease that can involve different aspects of our cognition. Therefore, MS may influence patients' dreams. In fact, we do not know what the importance of dream is in MS, but further studies may introduce dream and dreaming as a sign of improvement or progression in MS disease.

The relation between peptide hormones and sex hormone in patients with multiple sclerosis.
BACKGROUND: Hormones can play a significant role in the pathogenesis of multiple sclerosis (MS). The aim of this study was to compare levels of ghrelin, leptin, and testosterone hormones of MS patients with healthy subjects, and assess the relationship between levels of peptide hormone and sex hormones in MS patients.
CONCLUSION: According to the results, there was no significant difference between peptide and sex hormones of MS patients and healthy persons. Furthermore, there was no significant relationship between peptide and sex hormones of MS patients and healthy persons.

Is serum vitamin D levels associated with disability in patients with newly diagnosed multiple sclerosis?
BACKGROUND: Although the precise etiology of multiple sclerosis (MS) is unknown, it seems that both genetic and environmental factors are important. Recent studies suggest that low serum vitamin D levels are important environmental factor in MS. The aim of this study was to compare the serum levels of vitamin D between MS patients and healthy subjects, and to determine its association with disability in MS patients.
CONCLUSION: Our findings did not suggest a protective association for serum vitamin D levels against disability in MS patients.

Prevalence of fatigue in patients with multiple sclerosis and its effect on the quality of life.
OBJECTIVE: This prospective study was carried out to observe the prevalence of fatigue in patients with multiple sclerosis (MS) and its effect on quality-of-life (QoL).
CONCLUSION: Prevalence of fatigue was found to be high in the MS patients in the study. All four domains of QoL were significantly more impaired in the group with fatigue than in those without fatigue.

Baló's concentric sclerosis in a girl with interesting presentation.

Neurological manifestations in patients with antiphospholipid syndrome.

Physical trauma and risk of multiple sclerosis: A systematic review and meta-analysis of observational studies.

Relating relapse and T2 lesion changes to disability progression in multiple sclerosis: a systematic literature review and regression analysis.

Anesthetic technique in a patient with multiple sclerosis scheduled for laparoscopic nephrectomy for a renal tumor: a case report.

Prevalence of chronic cerebrospinal venous insufficiency in multiple sclerosis: a blinded sonographic evaluation.

Cladribine interferes with IL-1β synaptic effects in experimental multiple sclerosis.

Elevated and dysregulated bone morphogenic proteins in immune cells of patients with relapsing-remitting multiple sclerosis.

Promoting Remyelination in Multiple Sclerosis-Recent Advances.

Anesthetic technique in a patient with multiple sclerosis scheduled for laparoscopic nephrectomy for a renal tumor: a case report.

Modeling disease severity in multiple sclerosis using electronic health records.

Prevalence of chronic cerebrospinal venous insufficiency in multiple sclerosis: a blinded sonographic evaluation.
Chronic cerebrospinal venous insufficiency is a haemodynamic condition strongly associated with multiple sclerosis and is not found in normal controls. The addition of M-mode ultrasound to the diagnostic protocol allows improved observation of venous valve abnormalities.

Clinical Outcomes Following Surgical Management of Coexistent Cervical Stenosis and Multiple Sclerosis: A Cohort Controlled Analysis.
Myelopathic patients with coexisting MS and CS improve after surgery, although at a lower rate and to a lesser degree than those without MS. Therefore, surgery should be considered for these patients. MS patients should be informed that 1) myelopathy symptoms are less likely to be alleviated completely or may only be alleviated temporarily due to progression of MS, and 2) that surgery can help alleviate neck pain and radicular symptoms.

[Impact of physical activity level on alexithymia and coping strategies in an over-40 multiple sclerosis population: A pilot study.]
This study provides insight for future research about the impact of physical activity on multiple sclerosis.

What do multiple sclerosis patients and their caregivers perceive as unmet needs?
A better understanding of MS patient needs, starting from the point of view of patients and caregivers, could have a great impact on quality of life and on management of the disease.

Treatment options for patients with multiple sclerosis who have a suboptimal response to interferon-β therapy.

A descriptive comparison of fingolimod and natalizumab is provided in the context of the decision-making process of how and when to switch patients who have a suboptimal response to first-line therapy.

Prolonged-release fampridine improves walking in a proportion of patients with multiple sclerosis.
Fampridine is indicated to improve walking in adult multiple sclerosis (MS) patients. Indications vary between countries and the prescribing neurologist should be aware of the labeling and indication in his own country.

Prevalence of joint contractures and muscle weakness in people with multiple sclerosis.
Abstract Objectives: To investigate the prevalence of joint contracture (limited passive range of joint motion) and muscle weakness in a population with multiple sclerosis (MS). A secondary aim was to establish normative data of functional tests of mobility and balance of people with MS who are still ambulant. Design: Cross-sectional study.

Myalgic encephalomyelitis/chronic fatigue syndrome and encephalomyelitis disseminata/multiple sclerosis show remarkable levels of similarity in phenomenology and neuroimmune characteristics.

Examination of Cognitive Fatigue in Multiple Sclerosis using Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging.

Preserved Antigen-Specific Immune Response in Patients with Multiple Sclerosis Responding to IFNβ-Therapy.

Care ethics for guiding the process of multiple sclerosis diagnosis.

Assessment of cardiac safety during fingolimod treatment initiation in a real-world relapsing multiple sclerosis population: a phase 3b, open-label study.

Is There Extra Cost of Institutional Care for MS Patients?
hroughout life, patients with multiple sclerosis (MS) require increasing levels of support, rehabilitative services, and eventual skilled nursing facility (SNF) care. There are concerns that access to SNF care for MS patients is limited because of perceived higher costs of their care. This study compares costs of caring for an MS patient versus those of a typical SNF patient. We merged SNF cost report data with the 2001-2006 Nursing Home Minimum Data Set (MDS) to calculate percentage of MS residents-days and facility case-mix indices (CMIs).

Cost minimisation analysis of fingolimod vs natalizumab as a second line of treatment for relapsing-remitting multiple sclerosis.
Fingolimod is more efficient than natalizumab as a second-line treatment option for relapsing-remitting multiple sclerosis and it generates savings for the Spanish national health system.

[Need for creating Polish registry of multiple sclerosis patients].

Predictors of effectiveness of multidisciplinary rehabilitation treatment on motor dysfunction in multiple sclerosis.
These data confirm that an intensive inpatient rehabilitation program is able to produce a short-term relevant improvement on clinical and functional outcome measures and suggest some clinical features which can be considered as potential predictors of the outcome of rehabilitative intervention.

The Promoter SNP, but not the Alternative Splicing SNP, is Linked to Multiple Sclerosis Among Jordanian Patients.

Rare Inflammatory Diseases of the White Matter and Mimics of Multiple Sclerosis and Related Disorders.

Effects of a 4-month Ananda Yoga Program on Physical and Mental Health Outcomes for Persons With Multiple Sclerosis.

Adding to the burden: gastrointestinal symptoms and syndromes in multiple sclerosis.

Retinal Nerve Fiber Layer Thickness, Brain Atrophy, and Disability in Multiple Sclerosis Patients.
This study shows that RNFL thickness correlates with BCR and with MS subtypes. Additionally, our study indicates that OCT is better suited for MS assessment than GDx. We conclude that the damage of retinal axons appears related to brain damage in patients with MS.

Functional brain network analysis using minimum spanning trees in Multiple Sclerosis: An MEG source-space study.

Impact of delayed diagnosis and treatment in clinically isolated syndrome and multiple sclerosis.

Multiple sclerosis research: diagnostics, disease-modifying treatments, and emerging therapies.
Multiple sclerosis (MS) is a complex disease that affects the central nervous system. It is believed to be an immune mediated disease, and although the etiology remains unknown, it is believed to occur from a combination of genetic risk factors and environmental risk factors. There is no single diagnostic test for MS, and diagnostic criteria have been developed to aid the provider in making an accurate and timely diagnosis.

Regional brain atrophy and functional connectivity changes related to fatigue in multiple sclerosis.
Fatigue is one of the most frequent symptoms in multiple sclerosis (MS), and recent studies have described a relationship between the sensorimotor cortex and its afferent and efferent pathways as a substrate of fatigue. The objectives of this study were to assess the neural correlates of fatigue in MS through gray matter (GM) and white matter (WM) atrophy, and resting state functional connectivity (rs-FC) of the sensorimotor network (SMN). Efficacy and safety of laquinimod in multiple sclerosis: current status.

Voxel-Wise Displacement as Independent Features in Classification of Multiple Sclerosis.

Activation of MSRV-Type Endogenous Retroviruses during Infectious Mononucleosis and Epstein-Barr Virus Latency: The Missing Link with Multiple Sclerosis?

A Mathematical Framework for the Registration and Analysis of Multi-Fascicle Models for Population Studies of the Brain Microstructure.

Percutaneous sclerotherapy with ethanolamine oleate for venous malformations of the head and neck.
Percutaneous sclerotherapy with ethanolamine oleate appears to be safe and effective for the treatment of venous malformations and should be considered when treating these complex lesions. The efficacy of this agent appears to match or exceed that of other sclerosants used for such treatment, and further investigation in prospective controlled research is warranted.

No evidence for shared genetic basis of common variants in multiple sclerosis and amyotrophic lateral sclerosis.

Multiple sclerosis-induced neuropathic pain: pharmacological management and pathophysiological insights from rodent EAE models.
In patients with multiple sclerosis (MS), pain is a frequent and disabling symptom. The prevalence is in the range 29-86 % depending upon the assessment protocols utilised and the definition of pain applied. Neuropathic pain that develops secondary to demyelination, neuroinflammation and axonal damage in the central nervous system is the most distressing and difficult type of pain to treat.

Risk of multiple sclerosis after optic neuritis in patients with normal baseline brain MRI.
When assessing and managing a patient with optic neuritis (ON), the risk of future development of multiple sclerosis (MS) is an important issue, as this can be the first presentation of the disease. Although the presence of lesions on baseline brain MRI is the strongest predictor of MS conversion, some patients with normal imaging also develop MS.

Characteristics of multiple sclerosis in the Middle East with special reference to the applicability of international guidelines to the region.
Abstract We have reviewed the clinical literature with reference to the local applicability of guidelines for the diagnosis and management of multiple sclerosis (MS) in the Middle East.

Quantitative MRI analysis in children with multiple sclerosis: a multicenter feasibility pilot study.
Assessment of MRI lesion LV characteristics is feasible in a multicenter cohort of children with MS.

Assessments of nursing home guidelines for quality of care provided to residents with multiple sclerosis.

IL-12, but not IL-23, induces the expression of IL-7 in microglia and macrophages: Implications for multiple sclerosis.

TNFRSF1A in multiple sclerosis: A tale of soluble receptors and signaling cascades
   Pentti J. Tienari and Reinhard Hohlfeld
   Neurology. published 30 October 2013,
   10.1212/01.wnl.0000436624.56026.eb
   http://www.neurology.org/cgi/content/abstract/01.wnl.0000436624.56026.ebv1?ct=ct

Clinical relevance and functional consequences of the TNFRSF1A multiple sclerosis locus
   Linda Ottoboni, Irene Y. Frohlich, Michelle Lee, Brian C. Healy,
   Brendan T. Keenan, Zongqi Xia, Tanuja Chitnis, Charles R. Guttmann,
   Samia J. Khoury, Howard L. Weiner, David A. Hafler, and Philip L. De
   Jager
   Neurology. published 30 October 2013,
   10.1212/01.wnl.0000436612.66328.8a
   http://www.neurology.org/cgi/content/abstract/01.wnl.0000436612.66328.8av1?ct=ct

Early pathological alterations of lower lumbar cords detected by ultrahigh-field MRI in a mouse multiple sclerosis model   Yuki Mori, Masaaki Murakami, Yasunobu Arima, Dasong Zhu, Yasuo
   Terayama, Yutaka Komai, Yuji Nakatsuji, Daisuke Kamimura, and
   Yoshichika Yoshioka
   Int. Immunol. published 29 October 2013, 10.1093/intimm/dxt044
   http://intimm.oxfordjournals.org/cgi/content/abstract/dxt044v2?ct=ct

Alemtuzumab-Related Thyroid Dysfunction in a Phase 2 Trial of Patients with
Relapsing-Remitting Multiple Sclerosis   Gilbert H. Daniels, Anton Vladic, Vesna Brinar, Igor Zavalishin,
   William Valente, Pedro Oyuela, Jeffrey Palmer, and David H. Margolin
   J. Clin. Endocrinol. Metab. published 29 October 2013,
   10.1210/jc.2013-2201
   http://jcem.endojournals.org/cgi/content/abstract/jc.2013-2201v1?ct=ct

Assessments of nursing home guidelines for quality of care provided to residents with multiple sclerosis.

Multiple Sclerosis International Federation: Stimulating international cooperation in research.The MS International Federation (MSIF), established in 1967, links the activities of over 85 national multiple sclerosis (MS) societies worldwide. Over those 45 years, and particularly in the last 20, it has seen dramatic changes in our understanding, treatment, and multidisciplinary management of people with MS.

Multiple sclerosis research: diagnostics, disease-modifying treatments, and emerging therapies.

Effects of walking direction and cognitive challenges on gait in persons with multiple sclerosis.

Long-term impact of interferon beta-1b in patients with CIS: 8-year follow-up of BENEFIT.

No evidence for shared genetic basis of common variants in multiple sclerosis and amyotrophic lateral sclerosis.

Dalfampridine improves walking speed, walking endurance, and
Neuroimaging biomarkers of neurodegenerative diseases and dementia.

community participation in veterans with multiple sclerosis: a longitudinal cohort study.

Efficacy and safety of BG-12 (dimethyl fumarate) and other disease modifying therapies for the treatment of relapsing-remitting multiple sclerosis: a systematic review and mixed treatment comparison.

Low contrast visual acuity testing is associated with cognitive performance in multiple sclerosis: a cross-sectional pilot study.
Our data show that: a) cognitive impairment and performance in visual function tests such as low contrast sensitivity testing are associated; b) the main cognitive domains correlating with visual test performance are information processing speed and, to a lesser degree, memory; This preliminary data needs to be substantiated in further studies investigating patients with a higher cognitive burden, healthy controls and in longitudinal settings.

Retinal Nerve Fiber Layer Thickness, Brain Atrophy, and Disability in Multiple Sclerosis Patients.

Review of laquinimod and its therapeutic potential in multiple sclerosis.

Teriflunomide: A Review of Its Use in Relapsing Multiple Sclerosis.

Effect of treadmill training on fatigue in multiple sclerosis: a pilot study.

The Regulation of Reactive Changes Around Multiple Sclerosis Lesions by Phosphorylated Signal Transducer and Activator of Transcription.

Evidence for a two-stage disability progression in multiple sclerosis

It is well documented that disability accumulation in multiple sclerosis is correlated with axonal injury and that the extent of axonal injury is correlated with the degree of inflammation. However, the interdependence between focal inflammation, diffuse inflammation and neurodegeneration, and their relative contribution to clinical deficits, remains ambiguous.

Impact of natalizumab on patient-reported outcomes in multiple sclerosis: a longitudinal study

PRO measures were improved with natalizumab in a real-world setting. The improvements were observed as early as after 3 months and sustained over a 12-month period. The improvements in PROs show that, in clinical practice, the clinical benefits of natalizumab are translated into patient-reported benefits.

Human endogenous retrovirus type W envelope expression in blood and brain cells provides new insights into multiple sclerosis disease

The association between MS disease and the MSRV-type HERV-W element now appears quite strong, as evidenced ex-vivo from serum and PBMC with post-mortem confirmation in brain lesions. Chronic progressive MS, RRMS and clinically isolated syndrome show different ELISA (Enzyme-Linked Immunosorbent Assay) and/or PCR profiles suggestive of an increase with disease evolution, and amplicon sequencing confirms the association with particular HERV-W elements.

Differential diagnosis of suspected multiple sclerosis: a consensus approach

Differential diagnosis leading to MS or alternatives is complex and a strong evidence base is lacking. Consensus-determined guidelines provide a practical path for diagnosis and will be useful for the non-MS specialist neurologist. Recommendations are made for future research to validate and support these guidelines. Guidance on the differential diagnosis process when MS is under consideration will enhance diagnostic accuracy and precision.

The clinical potential of blood-proteomics in multiple sclerosis

We demonstrated for the first time, albeit only with preliminary data, the aprioristic possibility of distinguishing naive and IFN-treated MS groups from controls, and naive from IFN-treated MS patients using a blood sample-based methodology (i.e. proteomics) alone. The functional profile of the identified molecules provides new pathophysiological insight into MS. Future development of these techniques could open up novel applications in terms of molecular diagnosis and therapy monitoring in MS patients.

Stress and the risk of multiple sclerosis

These results do not support a major role of stress in the development of the disease, but repeated and more focused measures of stress are needed to firmly exclude stress as a potential risk factor for MS.

Randomized controlled trial of a teleconference fatigue management plus physical activity intervention in adults with multiple sclerosis: rationale and research protocol

Poor Sleep in Patients with Multiple Sclerosis

Poor sleep is common in patients with MS. Early identification and treatment of modifiable risk factors may improve sleep and quality of life in MS.

Estrogen Treatment in Multiple Sclerosis

Epidural analgesia and cesarean delivery in multiple sclerosis post-partum relapses: the Italian cohort study

Our findings, show no correlation between EA, CD and postpartum relapses and disability. Therefore these procedures can safely be applied in MS patients. On the other hand, post-partum relapses are significantly associated with increased disability, which calls for the need of preventive therapies after delivery.

Increased mitochondrial content in remyelinated axons: implications for multiple sclerosis

A combined post-mortem magnetic resonance imaging and quantitative histological study of multiple sclerosis pathology

Vitamin D in African Americans with multiple sclerosis

Retinal Axonal Loss Begins Early in the Course of Multiple Sclerosis and Is Similar between Progressive Phenotypes

No sex-specific difference in disease trajectory in multiple sclerosis patients before and after age 50