Three Dimensional Brain Parameters of Multiple Sclerosis (MS) Patients.

BACKGROUND & OBJECTIVES: MS is not only a demyelinating disease of central nervous system, but it also affects cortical and deep gray matter (GM). Furthermore, it causes axonal damage in the brain and spinal cord through inflammation and axonal degeneration. It is mostly seen between the ages of 20 and 40 and prevalence of the disease is higher among females than males. In the present study, we measured different parameters in the brains of patients with multiple sclerosis (MS) and healthy controls in both genders to determine the amount of brain atrophy quantitatively in MS patients. METHODS: We used T2-weighted MRI scans of 40 MS patients (25 females + 15 males) with clinically definite relapsing-remitting multiple sclerosis that was determined according to Poser criteria in multiple parts of the brain, and we compared these data with those of sex-matched healthy controls in the same numbers. RESULTS: Wideness of the lateral and third ventricles and the volumes of cerebral sulci in MS patients were significantly increased compared to both male and female controls. Brain width, corpus callosum area and the total brain/cerebellum + brain stem volumes of MS patients were decreased considerably. INTERPRETATION & CONCLUSIONS: The present measurements indicated that MS caused parenchymal destruction in the cortex, axonal degeneration and myelin loss in the white matter of the brain. Consequently, the current observations correlate well with worsening disability in MS patients.

The effect of methylprednisolone treatment on cerebral reactivity in patients with multiple sclerosis.

We assessed the effect of intravenous high-dose methylprednisolone (IVMP) on cerebral reactivity in multiple sclerosis (MS) patients during exacerbations by means of functional transcranial Doppler imaging. Forty-eight clinically defined MS patients were evaluated with visual evoked potentials (VEP) and functional transcranial Doppler sonography (TCD) of both posterior cerebral arteries before and after 5 days of 1000 mg IVMP. After treatment, mean Expanded Disability Status Scale score, mean blood flow velocities and mean blood flow velocities at rest and at stimulation, significantly decreased (p < 0.0001, for each). The change in cerebral blood flow velocity ratio (CBFv) with visual stimulation after treatment increased slightly (p = 0.20). All TCD parameters were not significantly correlated with VEP changes. In conclusion, we observed significant changes in CBFv with a non-significant increase in vascular reactivity after treatment with IVMP in exacerbations of MS. Case-control studies are necessary to draw conclusions regarding the beneficial effects of IVMP treatment.

Plasma homocysteine levels in pergolide-treated Parkinson disease patients.

Hyperhomocysteinemia is as a risk factor for increased vascular disease in l-dopa-treated Parkinson disease (PD) patients. This effect of l-dopa is associated with the metabolism of l-dopa by methylation. This study aimed to assess the effect of pergolide on plasma homocysteine levels. Plasma homocysteine levels were compared between PD patients treated with pergolide as monotherapy, with l-dopa as monotherapy, or with an l-dopa and pergolide combination and compared with controls. Plasma homocysteine levels were significantly higher in the l-dopa monotherapy group, and there were no significant differences for the pergolide treatment groups. Pergolide can be beneficial for increased plasma homocysteine levels.