Objective Cognitive dysfunction is common in multiple sclerosis. The Brief Repeatable Battery of Neuropsychological Tests (BRB-N) was developed to assess cognitive functions most-frequently impaired ...in multiple sclerosis. However, normative values are lacking in Brazil. Therefore, we aimed to provide continuous and discrete normative values for the BRB-N in a Brazilian population sample. Methods We recruited 285 healthy individuals from the community at 10 Brazilian sites and applied the BRB-N version A in 237 participants and version B in 48 participants. Continuous norms were calculated with multiple-regression analysis. Results Mean raw scores and the 5th percentile for each neuropsychological measure are provided, stratified by age and educational level. Healthy participants' raw scores were converted to scaled scores, which were regressed on age, sex and education, yielding equations that can be used to calculate predicted scores. Conclusion Our normative data allow a more widespread use of the BRB-N in clinical practice and research.
Dissection of cervical arteries constitutes a medical emergency. Although relatively rarely, activities classified as sports and recreation may be a cause of arterial dissection independently of neck ...or head trauma. The purpose of the present paper was to present a series of cases of cerebrum-cervical arterial dissection in individuals during or soon after the practice of these sports activities.
Retrospective data on patients with arterial dissection related to sports and recreation.
Forty-one cases were identified. The most frequently affected vessel was the vertebral artery. A large variety of activities had a temporal relationship to arterial dissection, and jogging was the most frequent of these. This is the largest case series in the literature.
Arterial dissection may be a complication from practicing sports.
Series of cases collected from Brazilian centers.
We studied 13 cases of patients presenting with progressive histories of neurological dysfunction caused by SS-CNS. The most frequent clinical ...findings in these patients were progressive gait ataxia, hearing loss, hyperreflexia and cognitive dysfunction. The diagnoses of SS-CNS were made seven months to 30 years after the disease onset.
SS-CNS is a rare disease that may remain undiagnosed for long periods. Awareness of this condition is essential for the clinician.
To assess safety of the switch between natalizumab and fingolimod without a washout period.
Prospective data on 25 JCV positive patients who underwent this medication switch were collected and ...analyzed.
After a median period of nine months from the medication switch, there were no safety issues to report. The patients had good disease control and no adverse events were reported.
Washout may not be necessary in daily practice when switching from natalizumab to fingolimod. Expertise on multiple sclerosis management, however, is essential for drug switching.
ABSTRACT
Objectives:
The objectives of this study were to assess the prevalence of temporomandibular disorders (TMDs) in patients with relapsing-remitting multiple sclerosis (MS) and to investigate ...whether an association exists between the presence of TMD symptoms and the degree of MS-related disability.
Materials and Methods:
In all, 120 individuals were evaluated: 60 patients with a diagnosis of relapsing-remitting MS and 60 age- and sex-matched controls without neurological impairments. A questionnaire recommended by the European Academy of Craniomandibular Disorders for the assessment of TMD symptoms was administered. For those who answered affirmatively to at least one of the questions, the RDC/TMD Axis I instrument was used for a possible classification of TMD subtypes. The Expanded Disability Status Scale (EDSS) was the measure of the degree of MS-related disability.
Statistical Analysis Used:
Fisher’s exact test was used to analyze the data. ANOVA was used to detect significant differences between means and to assess whether the factors influenced any of the dependent variables by comparing means from the different groups.
Results:
The prevalence of TMD symptoms in patients with MS was 61.7% versus 18.3% in the control group (CG). A diagnosis of TMD was established for 36.7% in the MS group and 3.3% in the CG (
P
= 0.0001). There were statistically significant differences between degrees of MS-related disability and the prevalence of TMD (
P
= 0.0288).
Conclusions:
The prevalence of both TMD and TMD symptoms was significantly greater in the MS group. EDSS scores and TMD prevalence rates were inversely related.
Fingolimod is a new and efficient treatment for multiple sclerosis (MS). The drug administration requires special attention to the first dose, since cardiovascular adverse events can be observed ...during the initial six hours of fingolimod ingestion. The present study consisted of a review of cardiovascular data on 180 patients with MS receiving the first dose of fingolimod. The rate of bradycardia in these patients was higher than that observed in clinical trials with very strict inclusion criteria for patients. There were less than 10% of cases requiring special attention, but no fatal cases. All but one patient continued the treatment after this initial dose. This is the first report on real-life administration of fingolimod to Brazilian patients with MS, and one of the few studies with these characteristics in the world.
Multiple Sclerosis is a chronic inflammatory demyelinating disease that affects 2.5 million people in the world. NEDA (No evidence of disease Activity) -4 is a new concept related to absence of ...disease activity in the context of MS. It takes into account the following four parameters: relapses; disability progression; lesion load and brain atrophy. Areas covered: The purpose of this paper is to visit the new emerging concepts of NEDA. Although it is considered important and attractive, there is a lack of uniformity. Expert commentary: Although NEDA-4 embraces important markers of disease activity and degeneration, this definition is still evolving and other parameters apart from the loss of brain volume might be included, especially those related to disability, such as cognitive problems, visual function, fatigue and pain.
The study aims to investigate the presence of pain amongst multiple sclerosis (MS) patients.
One hundred MS patients responded to questionnaires evaluating neuropathic and nociceptive pain, ...depression and anxiety. Statistical analysis was performed using the Mann-Whitney U, Chi-Square and two-tailed Fisher's exact tests and multivariate logistic regression.
Women had a statistically higher prevalence of pain (p = 0.037), and chances of having pain after the age of 50 reduced. Women with pain had a statistically significant lower number of relapses (p = 0.003), restricting analysis to those patients with more than one relapse. After the second relapse, each relapse reduced the chance of having pain by 46%. Presence of pain was independent of Expanded Disability Status Scale (EDSS) anxiety, and depression.
Our findings suggest a strong inverse association between relapses and pain indicating a possible protective role of focal inflammation in the control of pain.
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