1,721,565 research outputs found
Multiple sclerosis in 2017: Progress in multiple sclerosis - from diagnosis to therapy
No full textIn 2017, extensive research into multiple sclerosis (MS) resulted in improved diagnostic criteria, development of biomarkers that enable monitoring of disease evolution and treatment response over time, and identification of novel genetic markers of disease susceptibility. In addition, 2017 saw the first successful clinical trials of remyelination strategies and treatments for progressive MS
The brief repeatable battery of neuropsychological test (BRB-N) version B: update of Italian normative data
No full textBackground: Cognitive impairment affects up to 70% of people with multiple sclerosis (PwMS), mainly impacting memory, processing speed and attention. The Brief Repeatable Battery of Neuropsychological Tests (BRB-N) is widely used to monitor these deficits and has two parallel versions, A and B, to minimize practice effects. The Italian norms for version B have been published years ago and may not reflect current demographic trends. Objectives: To revise and update normative data for the BRB-N version B in the Italian population and to harmonize these procedures with those used for other neuropsychological batteries used in MS. Methods: We recruited 224 healthy subjects (94 males, 130 females; mean age = 43.34, standard deviation [SD] = 14.41, range: 19-86 years; mean education = 13.89, SD = 4.05, range = 5-23) from two centers (Milan, Florence). Each raw BRB-N version B score was transformed into a scaled-score metric, then regressed on centered age, centered age2, education, and sex. Results: No significant differences were found in age and sex distribution between centers (all p ≥ 0.87), whereas Milan subjects showed a higher education compared to Florence subjects (p < 0.001). Age and education emerged as consistent predictors across nearly all tests, while sex showed only limited influence. Regression analysis provided normative data to calculate demographically adjusted z scores for each BRB-N version B test. Despite differing sample size and composition, regression coefficients mirrored those from BRB-N version A updated normative data. Conclusions: These updated, regression-based norms for BRB-N version B align with other major MS neuropsychological batteries in Italy, improving cognitive assessment accuracy in clinical and research settings
Conventional first-line treatment and general management
No full textMany disease-modifying therapies are currently available for adults with relapsing-remitting multiple sclerosis (MS) but none of them has been tested in pediatric MS in randomized placebo-controlled trials. At present, as suggested by observational studies and experts' guidelines, interferon-beta and glatiramer acetate continue to be the standard first-line treatments for pediatric MS. Observational studies and some controlled unblinded trials have shown a positive effect of these meditations in reducing relapse rate and delaying disease progression, with an acceptable safety profile. The goal of this article is to provide an overview of current knowledge with regard to safety, tolerability, and efficacy of first-line treatment options for MS in the pediatric age group, with the aim of providing guidance for planning first-line treatment of MS in children and adolescents
Secondary Prevention in Radiologically Isolated Syndromes and Prodromal Stages of Multiple Sclerosis
No full textFollowing the extraordinary progress in the treatment of multiple sclerosis (MS), two major unmet needs remain: understanding the etiology of the disease and, hence, designing definitive cures (this perspective is neither at hand, nor it can be taken for granted that the etiologic targets will be readily treatable); the prevention of an overt and disabling disease, which seems to be a more realistic and pragmatic perspective, as the integration of genetic data with endophenotypes, MRI, and other biomarkers ameliorates our ability to identify early neuroinflammation. Radiologically isolated syndrome (RIS; diagnosed when the unanticipated MRI finding of brain spatial dissemination of focal white matter lesions highly suggestive of MS occurs in subjects without symptoms of MS, and with normal neurological examinations) and the recently focused "prodromal MS" are conditions at risk of conversion toward overt disease. Here, we explore the possibility of secondary prevention approaches in these early stages of neuroinflammation. RIS and prodromal MS are rare conditions, which suggest the importance of Study Groups and Disease Registry to implement informative clinical trials. We summarize ongoing preventive approaches in the early stages of the demyelinating process, especially in RIS conditions. Moreover, we highlight the importance of the biomarkers and the predictors of evolution to overt disease, which may be useful to select the individuals at risk of conversion to clinically isolated syndrome (CIS) and/or clinically definite MS. Finally, we illustrate the importance of the endophenotypes to test the frontline immunomodulatory approach for preventive strategies. Future investigations, especially in relatives of patients, based on MRI techniques and biological studies (better with integrated approaches) may provide opportunities to understand the MS early causal cascade and may help to identify a "therapeutic window" to potentially reverse early disease processes
Pediatric multiple sclerosis: Clinical features and outcome
Full text linkMultiple sclerosis (MS) in children manifests with a relapsing-remitting MS (RRMS) disease course. Acute relapses consist of new neurologic deficits persisting greater than 24 hours, in the absence of intercurrent illness, and occur with a higher frequency early in the disease as compared to adult-onset RRMS. Most pediatric patients with MS recover well from these early relapses, and cumulative physical disability is rare in the first 10 years of disease. Brainstem attacks, poor recovery from a single attack, and a higher frequency of attacks portend a greater likelihood of future disability. Although prospective pediatric-onset MS cohorts have been established in recent years, there remains very limited prospective data detailing the longer-term clinical outcome of pediatric-onset MS into adulthood. Whether the advent of MS therapies, and the largely off-label access to such therapies in pediatric MS, has improved prognosis is unknown. MS onset during the key formative academic years, concurrent with active cognitive maturation, is an important determinant of long-term outcome, and is discussed in detail in another article in this supplement. Finally, increasing recognition of pediatric MS worldwide, recent launch of phase III trials for new agents in the pediatric MS population, and the clear imperative to more fully appreciate health-related quality of life in pediatric MS through adulthood highlight the need for standardized, validated, and robust outcome measures
Author response: Pregnancy decision-making in women with multiple sclerosis treated with natalizumab: I: Fetal risks
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Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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