Multiple Sclerosis Research Today is a free monthly online journal that collates and summarizes the latest research about Multiple Sclerosis, including details on diagnosis, symptoms, treatment, prognosis.

Clinically isolated syndrome suggestive of multiple sclerosis: voxelwise regional investigation of white and gray matter.

Raz E, Cercignani M, Sbardella E, Totaro P, Pozzilli C, Bozzali M, Pantano P

Department of Neurological Sciences, Sapienza University of Rome, Viale dell' Università, 30, 00185 Rome, Italy. eytan.raz@uniroma1.it

PURPOSE: To quantify white matter (WM) and gray matter (GM) damage in patients who presented with clinically isolated syndrome (CIS), which is suggestive of multiple sclerosis (MS), by combining volume-based morphometry (VBM) and tract-based spatial statistics (TBSS). MATERIALS AND METHODS: This prospective HIPAA-compliant study was approved by the institutional review board. Written informed consent was obtained from all participants. In this study, 34 consecutive patients (21 women, 13 men; mean age, 31.7 years +/- 7.7 [standard deviation]) who presented with CIS were recruited. The magnetic resonance (MR) examination included dual-echo fast spin-echo, three-dimensional T1, and diffusion-tensor imaging. Sixteen matched healthy volunteers served as control subjects. T2 lesion volumes were assessed with a semiautomatic technique. VBM and TBSS were used for the GM and WM analyses, respectively, to compare regional GM volumes and fractional anisotropy (FA) values in the two groups. RESULTS: TBSS analysis revealed a pattern of diffuse FA reductions in patients with CIS at the cluster level (P < .05). Regions of decreased FA involved most of the WM pathways, including the corticospinal tracts, corpus callosum, and superior and inferior longitudinal fasciculi. There were no significant differences between the two groups in terms of global GM, WM, or cerebrospinal fluid volume or in terms of regional GM volume. CONCLUSION: Diffuse WM damage not accompanied by any change in GM or WM volume is observed in patients with CIS. This suggests that WM involvement plays a relevant role in the early phases of MS. Subsequently detected GM damage may be secondary to WM alterations.

Published 24 December 2009 in Radiology, 254(1): 227-34.
Full-text of this article is available online (may require subscription).

Articles on Multiple Sclerosis published 18 December 2009:

Neuromyelitis optica-IgG (aquaporin-4) autoantibodies in immune mediated optic neuritis.   J Neurol Neurosurg Psychiatry, 81(1): 109-11.

The clinical course of immune mediated optic neuritis (ON) will depend on the specific underlying inflammatory disease. These disorders have traditionally been classified according to clinical and MRI findings. Aquaporin-4 (AQP4) autoantibodies (neuromyelitis optica-IgG (NMO-IgG)) may have diagnostic and prognostic value in patients who present with isolated ON. In this prospective study, NMO-IgG was evaluated in 114 patients with ON in the following contexts: neuromyelitis optica (NMO), ... [Abstract] [Full-text]

HLA-DRB1 and month of birth in multiple sclerosis.   Neurology, 73(24): 2107-11.

BACKGROUND: Multiple sclerosis (MS) displays a month-of-birth effect, with an excess of individuals being born in the spring and a deficit in the winter. This effect was shown to be more pronounced in familial cases of MS. In the present study, we investigated whether this month-of-birth association has any relation to the principal MS susceptibility gene, HLA-DRB1. METHODS: A total of 4,834 patients with MS, 4,056 controls, and 659 unaffected siblings from Canada, Sweden, and Norway were ... [Abstract] [Full-text]

Long-term effects of childbirth in MS.   J Neurol Neurosurg Psychiatry, 81(1): 38-41.

BACKGROUND: The uncertainty about long-term effects of childbirth presents MS patients with dilemmas. METHODS: Based on clinical data of 330 female MS patients, the long-term effects of childbirth were analysed, using a cross-sectional study design. Four groups of patients were distinguished: (1) without children (n = 80), (2) with children born before MS onset (n = 170), (3) with children born after MS onset (n = 61) and (4) with children born before and after MS onset (n = 19). A ... [Abstract] [Full-text]

Effect of immigration on multiple sclerosis sex ratio in Canada: the Canadian Collaborative Study.   J Neurol Neurosurg Psychiatry, 81(1): 31-6.

BACKGROUND: The ratio of female to male (F:M) multiple sclerosis (MS) cases varies geographically, generally being greater in areas of high prevalence. In many regions, including Canada, rising MS incidence in women has been implied by the marked increase in F:M ratio. METHODS: We examined the F:M ratio over time in MS patients in the Canadian Collaborative Study born outside Canada, with onset postmigration (n = 2531). We compared the trends to native-born Canadians, by region of origin and ... [Abstract] [Full-text]

A diffusion tensor MRI study of cervical cord damage in benign and secondary progressive multiple sclerosis patients.   J Neurol Neurosurg Psychiatry, 81(1): 26-30.

BACKGROUND: Diffusion tensor (DT) MRI enables quantification of the severity of brain and cervical cord pathology in multiple sclerosis (MS). OBJECTIVE: To investigate DT MRI patterns of cervical cord damage in patients with benign MS (BMS) and secondary progressive MS (SPMS), in order to achieve a better understanding of the mechanisms underlying the development of irreversible disability in MS. METHODS: Conventional and DT MRI scans of the cervical cord and brain were acquired from 40 BMS ... [Abstract] [Full-text]

Articles on Multiple Sclerosis published 16 December 2009:

Symptomatic narcolepsy in patients with neuromyelitis optica and multiple sclerosis: new neurochemical and immunological implications.   Arch Neurol, 66(12): 1563-6.

OBJECTIVE: To characterize factors that contribute to symptomatic narcolepsy and excessive daytime sleepiness in neuromyelitis optica and multiple sclerosis. SETTING: Japanese university hospitals. DESIGN: Case study. PATIENTS: Seven Japanese patients whose initial diagnoses were multiple sclerosis and who were exhibiting excessive daytime sleepiness. MAIN OUTCOME MEASURES: Lesions on magnetic resonance imaging, cerebrospinal fluid hypocretin-1 levels, and serum anti-aquaporin 4 (AQP4) antibody ... [Abstract] [Full-text]

HLA-DRB1*1501 and spinal cord magnetic resonance imaging lesions in multiple sclerosis.   Arch Neurol, 66(12): 1531-6.

BACKGROUND: Multiple sclerosis (MS) is a heterogeneous neurologic disease with extensive variation with respect to the most affected central nervous system region (brain vs spinal cord). OBJECTIVE: To test the hypothesis that this variation in lesion location (brain vs spinal cord) might be (partially) genetically determined. DESIGN: Candidate gene study. SETTING: Academic research. PATIENTS: Patients were selected for the availability of DNA material, clinical variables, and brain and spinal ... [Abstract] [Full-text]

Cellular mechanisms of central nervous system repair by natural autoreactive monoclonal antibodies.   Arch Neurol, 66(12): 1456-9.

Natural autoreactive monoclonal IgM antibodies have demonstrated potential as therapeutic agents for central nervous system (CNS) disease. These antibodies bind surface antigens on specific CNS cells, activating intracellular repair-promoting signals. IgM antibodies that bind to surface antigens on oligodendrocytes enhanced remyelination in animal models of multiple sclerosis. IgM antibodies that bind to neurons stimulate neurite outgrowth and prevent neuron apoptosis. The neuron-binding IgM ... [Abstract] [Full-text]

© 2004-2010 Multiple Sclerosis Research Today. All Rights Reserved.