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.
Forty patients with aggressive relapsing remitting MS were randomly put into two groups. The first group underwent monthly plasma exchange for three successive months, followed by 12 mg/m(2) mitoxantrone at the end of each course and two more doses of 6 mg/m(2) mitoxantrone in 3-month intervals. The second group received the same doses of mitoxantrone only without plasma exchange. At the end of 8 months treatment course, clinical reassessment and neuroimaging was performed and treatment was continued with interferon-β.
At the end of induction therapy, Expanded Disability Status Scale score was significantly improved in both groups (P < 0.001). Number of demyelinating and gadolinium-enhancing plaques in brain magnetic resonance imaging (MRI) was prominently reduced in group 2(P ≤ 0.05), but the changes were not statistically significant in group 1, except for juxtacortical plaques.
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.
In adults, throughout life, uniqueness maintains the equivalent; but, it might be tailored in the track of neurological disarrays. As in the partition of cognitive function associated with multiple ...sclerosis (MS), numerous studies have been performed, but there are very few reports in this area of behavior. The aim of this study was to investigate the prevalence of personality types A and B in relation to individuals' behaviors with MS and type A behavior with demographic characteristics and the level of disability.
A cross-sectional descriptive study was performed between September 2010 and March 2011 on 50 patients who were referred to MS clinic (located at the Kashani hospital), Isfahan Neurosciences Research Centre (INRC). The subjects were evaluated using Friedman and Rosenman questioner and the Expanded Disability Status Scale (EDSS). The data were analyzed by SPSS software (version 17) based on Chi-square test and independent T-test.
Of the subjects, 65% were of personality type A and 35% were of personality type B (X2: 3.5, P < 0.05). There were no significant differences in individuals with type A behavior in relation to gender and marital status. In connection to EDSS (EDSS < 4.5 or EDSS > 4.5), patients with higher EDSS score, i.e., individuals with EDSS > 4.5 mostly had type A behavior pattern.
People with type A behavior pattern are reported to have more stress, nervousness, and anxiety. In this study, MS patients had more characteristics of type A than type B behavior. This behavior was increased in individuals with EDSS score > 4.5.
Background: The goal of this study was to determine the reliability of TCD in evaluation of vertebrobasilar arteries in comparison with brain MRA in patients suffering from acute vertebrobasilar ...stroke. Methods: Samples were patients with definite clinical diagnosis of vertebrobasilar stroke. For all patients brain MRI, MRA and TCD were performed during the first 48 hours of admission. Basilar artery was insonated at the depth of 75 to 85 mm and vertebral arteries were insonated at the depth of 45 to 55 mm. On brain MRA, the degree of stenosis in vertebrobasilar arteries was graded from I (normal) to IV (total stenosis) and the correlation between the grade of stenosis and TCD indices were studied. Results: Spearman correlation test revealed a significant correlation between mean flow velocity (MFV) and MRA grading (correlation coefficient = -0.486) as well as end diastolic velocity (EDV) and MRA grading (correlation coefficient = -0.323) with no significant correlation between pulsatility index, peak systolic velocity and MRA grading (p > 0.05). One way ANOVA analysis showed that there was only significant mean MFV and mean EDV difference between grade 1 and other grades. Conclusions: TCD was only able to differentiate between stenotic and normal pattern and could not assist in the grading of stenosis. On the other hand, in acute vertebrobasilar stroke that TCD performed blindly without visualization of arteries and in a fixed depth it might have limited value in the grading of vertebrobasilar system stenosis.
Working memory (WM) is one of the most affected cognitive domains in multiple sclerosis (MS), which is mainly studied by the previously established binary model for information storage (slot model). ...However, recent observations based on the continuous reproduction paradigms have shown that assuming dynamic allocation of WM resources (resource model) instead of the binary hypothesis will give more accurate predictions in WM assessment. Moreover, continuous reproduction paradigms allow for assessing the distribution of error in recalling information, providing new insights into the organization of the WM system. Hence, by utilizing two continuous reproduction paradigms, memory-guided localization (MGL) and analog recall task with sequential presentation, we investigated WM dysfunction in MS. Our results demonstrated an overall increase in recall error and decreased recall precision in MS. While sequential paradigms were better in distinguishing healthy control from relapsing-remitting MS, MGL were more accurate in discriminating MS subtypes (relapsing-remitting from secondary progressive), providing evidence about the underlying mechanisms of WM deficit in progressive states of the disease. Furthermore, computational modeling of the results from the sequential paradigm determined that imprecision in decoding information and swap error (mistakenly reporting the feature of other presented items) was responsible for WM dysfunction in MS. Overall, this study offered a sensitive measure for assessing WM deficit and provided new insight into the organization of the WM system in MS population.
Working memory is a system that temporarily stores and manipulates information used in tasks like decision-making and reasoning. Patients with multiple sclerosis – a condition that can affect the brain and spinal cord – often have impaired working memory, which can negatively affect their quality of life.
Traditionally, working memory has been evaluated using tests that determine whether a patient can recall an item or not. In this approach, an incorrect response implies a complete absence of information regarding the specific item, resulting in a binary evaluation. More recently, researchers have shown that the precision of the memories people recall degrades gradually as they are asked to remember more things and that focusing on an item negatively affects recall precision for other items. This implies that working memory is reorganised flexibly between memorised items, a so-called ‘resource model’.
Unlike previous research, which favoured a binary model, Motahharynia et al. used a resource model to study visual working memory impairment in multiple sclerosis. The study participants consisted of healthy volunteers and patients with two subtypes of multiple sclerosis. Each participant completed one of two different types of test. In one, they were shown targets for short periods of time and then asked to pinpoint their position after they disappeared. In the other, participants were asked to memorise the orientation and colour of consecutively presented bars.
The findings confirmed that multiple sclerosis patients had worse memory recall than people without the disease. However, computer modelling provided insights into the sources of error in working memory dysfunction, showing that the memory deficiency was due to imprecision in recalling information and ‘swap errors’, the phenomenon of mistakenly reporting the property of other memorised items. This rise in swap errors is likely due to an increase in unwanted signals, or noise, in the brains of multiple sclerosis patients.
Motahharynia et al. have presented a sensitive way of measuring working memory deficiency. Importantly, the measurements were able to distinguish between different stages of multiple sclerosis. This could help doctors detect disease progression earlier, allowing for more timely and effective treatment interventions. This method could also be useful in the development and testing of drugs for therapy.
Background: Multiple sclerosis is an inflammatory and degenerative disease of central nerves, in which myelin appears as several large and small plaques in cerebrospinal white matter. The aim of this ...study was investigate the familial prevalence of Multiple Sclerosis. Methods: This cross- sectional study was performed from the beginning to the end of 2007 on 539 MS patients in Isfahan, Iran. The patients were selected among all of the MS people who referred to the MS clinics of Isfahan University of Medical Sciences by the simple random sampling. Finally 593 patients were studied; their disease was proved based on the McDonald values by 2 neurologists. Finding: The average of patients’ age was 33.44 ± 0.9. 493 patients (83.1%) were female. 85% had partial disability and 83.3%of them had Relapsing Remitting kind of this disease. 53.5% of them had 2 or more hospitalizations. 119 of them (20.1%) had familial history of MS which among them in 47 (40.5%) patients it was in first degree relatives, in 26 (22.6%) was in second degree relatives and in 46 (36%) was in third degree. Conclusion: According to the achieved results it seems the familial prevalence of MS in Isfahan, Iran is more than other regions, so it is recommended to do more etiologic studies based on the genetic and environmental factors.
The effect of nutrition in the course of multiple sclerosis (MS) is a topic of great interest. The present study was aimed to evaluate the immunoglobin E (IgE) against egg and fish in MS patients ...compared to healthy controls.
Between March 2012 and July 2012, 48 MS patients were selected and compared with 48 healthy subjects to assess the frequency of IgE against egg and fish in MS patients compared to healthy control. Fish and Egg specific IgE was determined by Immuno CAP. Sex and the frequency of specific IgE were compared between study groups by Chi-square test.
Total of 96 subjects was assessed (22% male and 78% female). The mean age of the study subjects was 30.8 ± 6.6 years. Mean age of case and control groups was 30.7 (±6.9) versus 30.9 ± 6.3, respectively (P = 0.83). There were no detection of egg and fish specific IgE in serum of MS patients and healthy subjects.
IgE allergy against fish and egg may be very unlikely to affect MS course.
This study aims to automatically detect multiple sclerosis (MS) in terms of the changes in retinal vessels using Scanning laser ophthalmoscopy (SLO) images. Although much research has been done to ...diagnose MS patients, these diagnostic techniques have always been based on using Magnetic resonance imaging (MRI) images which cannot be a complete technique in diagnosing this disease. Using SLO images and examining the condition of its vessels using computer technology, biomarkers in the vessel can be identified to help diagnose MS patients. However, in the first step, the color images are converted to gray and after that are improved using a combination of algorithm Tylor Coye and DWT, then, the images are segmented and retinal vessels are extracted. Besides, two different techniques are used in classification stage. In the first technique, classic Machine learning different features are extracted from the resulting regions and entered into several multiple classifiers, the results of which give us an accuracy of 72%, moreover in the second technique segmented images enter the transfer learning model and ultimately lead us to 98% accuracy in the distinction between MS patients and Healthy Controls (HCs).
Multiple sclerosis (MS) is a disease of young and middle aged individuals with a demyelinative axonal damage nature in central nervous system that causes various signs and symptoms. As color vision ...needs normal function of optic nerve and macula, it is proposed that MS can alter it via influencing optic nerve. In this survey, we evaluated color vision abnormalities and its relationship with history of optic neuritis and abnormal visual evoked potentials (VEPs) among MS patients.
The case group was included of clinically definitive MS patients and the same number of normal population was enrolled as the control group. Color vision of all the participants was evaluated by Ishihara test and then visual evoked potential (VEPs) and history of optic neuritis (ON) was assessed among them. Then, frequency of color blindness was compared between the case and the control group. Finally, color blinded patients were compared to those with the history of ON and abnormal VEPs.
63 MS patients and the same number of normal populations were enrolled in this study. 12 patients had color blindness based on the Ishihara test; only 3 of them were among the control group, which showed a significant different between the two groups (P = 0.013). There was a significant relationship between the color blindness and abnormal VEP (R = 0.53, P = 0.023) but not for the color blindness and ON (P = 0.67).
This study demonstrates a significant correlation between color blindness and multiple sclerosis including ones with abnormal prolonged VEP latencies. Therefore, in individuals with acquired color vision impairment, an evaluation for potentially serious underlying diseases like MS is essential.
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