Multiple sclerosis relapse phenotype is an important, neglected, determinant of disease outcome – YES

Scott, Thomas F.

doi:10.1177/1352458515608263

Cited by 5 publications

(5 citation statements)

References 16 publications

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“…Neu ro bo re lio zë kar tais ga li kli nið kai imi tuo ti de mie li nizuo jan èius CNS su sir gi mus ir IS. Tiek neu ro bo re lio zei, tiek IS bû din gi ávai rûs ir dau gi niai neu ro lo gi niai simp tomai, ku rie ap sun ki na di fe ren ci nae diag nos ti kà [1,5,[11][12][13]. Abiems li goms bû din gi pa ra ly þiai, gal vi niø ner vø pa þei di mai, neu ro pa ti niai ga lû niø skaus mai, lie mens ap tirpi mas, gal vos svai gi mas ir kt.…”

Section: Aptarimasunclassified

“…Abiems li goms bû din gi pa ra ly þiai, gal vi niø ner vø pa þei di mai, neu ro pa ti niai ga lû niø skaus mai, lie mens ap tirpi mas, gal vos svai gi mas ir kt. [5,11,13]. Mû sø ap ra ðy ti kli ni ki niai at ve jai iliust ruo ja te ori nius ir at lik tø kli ni ki niø ty ri mø duo me nis apie neu ro bo re lio zës ir de mie li ni zuo janèiø CNS su sir gi mø simp to mus, ga lin èius imi tuo ti vie nas ki tà.…”

Section: Aptarimasunclassified

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Neuroborreliosis mimicking demyelinating disease of the central nervous system: case reports

Giedraitienė

Lisinskaitė

Klimašauskienė

2018

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Straipsnyje pristatomi du pacientai, sergantys neuroborelioze, kuriems kliniškai ir radiologiškai buvo įtariama demielinizuojanti centrinės nervų sistemos liga. Pirmoji pacientė skundėsi dešinės veido pusės nutirpimu, dvejinimusi akyse, galvos svaigimu, kurie truko apie pusę metų. Galvos smegenų magnetinio rezonanso tomografijos (MRT) tyrime nustatyti hiperintensiniai susiliejantys židiniai, o regos sukeltųjų potencialų tyrime – prailgėjęs nervinio impulso perdavimas. Antrasis pacientas skundėsi kairės rankos nutirpimu, skausmu ir silpnumu, kurie truko kelias savaites. Stuburo kaklinės dalies MRT tyrime nustatyti demielinizacijos procesą primenantys hiperintensiniai židiniai, o galvos smegenų MRT – keli smulkūs hiperintensiniai židinukai. Abiem atvejais bendras smegenų skysčio tyrimas parodė limfocitinę citozę, padidėjusį baltymo kiekį. Serologiškai teigiami Borrelia burgdorferi antikūnų rezultatai nurodė persirgtą infekciją, tačiau likvore nustatyti IgM ir IgG klasės antikūnai patvirtino neuroboreliozės diagnozę. Klinikinių simptomų visuma, citologiniai, biocheminiai ir imunologiniai pokyčiai likvoro tyrime bei antibiotikoterapinio gydymo veiksmingumas abiems pacientams patvirtino neuroboreliozės diagnozę.

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Section: Aptarimasunclassified

Neuroborreliosis mimicking demyelinating disease of the central nervous system: case reports

Giedraitienė

Lisinskaitė

Klimašauskienė

2018

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“…Evidence points out that myelin loss in inflammatory white matter lesion can induce axonal degeneration locally and that neuronal and axonal loss happen outside areas of inflammation, making neurodegeneration an independent event as a possible explanation. They theorize that neurodegeneration could evolve independent of inflammation, being influenced by genetic and metabolic backgrounds and that there is a need to develop animal models of MS neurodegenerative pathology and an in vivo biomarker of neuronal function to test for neuroprotective agents in progressive MS [118].…”

Section: Other Hypothesis and Controversiesmentioning

confidence: 99%

Multiple sclerosis: Enigmatic factors and new controversies

Vila¹,

Casabella²,

Baig³

et al. 2016

Clin Case Rep Rev

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“…The degree to which relapses with incomplete recovery (RW) contribute to the overall picture of worsening disability in relapse‐onset multiple sclerosis (RMS) remains unclear . Clarification of this issue may determine the extent to which elimination of relapses through immunotherapy can result in long‐term benefits.…”

Section: Introductionmentioning

confidence: 99%

Multiple sclerosis relapses contribute to long‐term disability

et al. 2019

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The degree to which relapses with incomplete recovery (RW) contribute to the overall picture of worsening disability in relapse-onset multiple sclerosis (RMS) remains unclear. 1,2 Clarification of this issue may determine the extent to which elimination of relapses through immunotherapy can result in long-term benefits. Incomplete recovery from relapses implies a contribution of these circumscribed events to the irreversible process of tissue destruction. 3,4 Better understanding of the impact of relapses vs slow progression may also help us understand the complex relationship between inflammation vs degeneration, which evolves over a lifetime of RMS. Some epidemiologists opine that the majority of disability accumulated in MS over time results from a more or less degenerative process involving slow progression, whereas relapses contribute little to the long-term picture. 5 This view is challenged in more recent studies. 6,7 We sought to calculate the frequency of RW in the first 15 years of longitudinally followed RMS patients, using a clinical definition of incomplete recovery from relapse, and to compare the frequency of year-to-year slow progressive worsening (PW). Furthermore, we Background: Treatments affect both relapse-related disability and short-term disability change, but measurements of their impact on long-term outcomes remain a challenge.Objective: To ascertain the contribution of relapse-associated disability to overall disability in relapse-onset multiple sclerosis (RMS) using long-term data collected in our clinic. Materials and Methods: Retrospective study of a cohort of newly diagnosed patients with RMS, (n = 176) was undertaken, measuring all confirmed changes in disability up to 15 years after onset. Worsening was assessed yearly and in 5-year epochs and was attributed to either relapse (RW) or slow progression (PW). Results: At data lock, 139/176 (81%) of patients were still actively followed, with Expanded Disability Status Scale (EDSS) available for 10 years post-onset in 145/176 (82%) patients and 15 years post-onset EDSS in 83 patients (mean follow-up entire group 12.7 years post-onset). RW accounted for a large amount of worsening seen in the first 15 years of RMS. RW was less frequent over time, but accounted for most EDSS changes in the first decade of MS (167/267, 63% of EDSS changes), and remained important even in years 11-15 (17/50, 34% of EDSS changes). Median change in disability due to RW vs PW was similar over the entire 15 years.Conclusions: Worsening of treated MS was associated with relapses in many RMS patients throughout the first 15 years after onset, suggesting an opportunity for long-term benefit through relapse reduction. K E Y W O R D S expanded disability status scale, MS, progression, relapse | 337 SCOTT eT al.

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Multiple sclerosis relapse phenotype is an important, neglected, determinant of disease outcome – YES

Cited by 5 publications

References 16 publications

Neuroborreliosis mimicking demyelinating disease of the central nervous system: case reports

Neuroborreliosis mimicking demyelinating disease of the central nervous system: case reports

Multiple sclerosis: Enigmatic factors and new controversies

Multiple sclerosis relapses contribute to long‐term disability

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