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1.
Braz J Med Biol Res ; 54(3): e10428, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33470393

RESUMO

There is increasing evidence that neurofilament light chain (NF-L) can be considered as a biomarker for neuro-axonal damage. This polypeptide can be released into the cerebrospinal fluid (CSF) and the blood, where it can be quantified. The concentration of NF-L is elevated in patients with multiple sclerosis (MS) and psychiatric disorders. We aimed to investigate the NF-L levels in the CSF from treated MS patients and the relationship with depression or anxiety. The study involved three groups: control group (individuals without inflammation), the relapse-remitting multiple sclerosis (RRMS)-untreated group, and the RRMS-Fingo group (RRMS patients who were treated with fingolimod). MS disability was assessed by the Expanded Disability Status Scale, and depression and anxiety were evaluated by a neuropsychologist, using the Hospital Anxiety and Depression Scale, the Beck Depression Inventory-II, and the Beck Anxiety Inventory. Individual CSF samples were collected to measure NF-L levels. The results of the statistical analysis on levels of NF-L in the CSF of control subjects, RRMS-untreated patients, and RRMS-Fingo patients were significant. The relationship between depression and anxiety in RRMS-Fingo patients and NF-L levels was not statistically significant. In conclusion, MS events such as anxiety and depression appear to contribute to the onset of clinical relapses, subclinical cases, and neurodegeneration.


Assuntos
Transtornos de Ansiedade , Depressão , Esclerose Múltipla , Transtornos de Ansiedade/etiologia , Biomarcadores , Depressão/etiologia , Humanos , Filamentos Intermediários , Esclerose Múltipla/complicações , Proteínas de Neurofilamentos
2.
Nat Commun ; 12(1): 105, 2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-33397973

RESUMO

Environmental triggers have important functions in multiple sclerosis (MS) susceptibility, phenotype, and trajectory. Exposure to early life trauma (ELT) has been associated with higher relapse rates in MS patients; however, the underlying mechanisms are not well-defined. Here we show ELT induces mechanistic and phenotypical alterations during experimental autoimmune encephalitis (EAE). ELT sustains downregulation of immune cell adrenergic receptors, which can be attributed to chronic norepinephrine circulation. ELT-subjected mice exhibit interferon-ß resistance and neurodegeneration driven by lymphotoxin and CXCR2 involvement. These phenotypic changes are observed in control EAE mice treated with ß1 adrenergic receptor antagonist. Conversely, ß1 adrenergic receptor agonist treatment to ELT mice abrogates phenotype changes via restoration of immune cell ß1 adrenergic receptor function. Our results indicate that ELT alters EAE phenotype via downregulation of ß1 adrenergic signaling in immune cells. These results have implications for the effect of environmental factors in provoking disease heterogeneity and might enable prediction of long-term outcomes in MS.


Assuntos
Regulação para Baixo , Interferon beta/metabolismo , Esclerose Múltipla/complicações , Degeneração Neural/complicações , Receptores Adrenérgicos beta 1/metabolismo , Transdução de Sinais , Estresse Psicológico/complicações , Agonistas de Receptores Adrenérgicos beta 1/farmacologia , Antagonistas de Receptores Adrenérgicos beta 1/farmacologia , Animais , Biomarcadores/metabolismo , Encéfalo/imunologia , Encéfalo/patologia , Células Dendríticas/efeitos dos fármacos , Células Dendríticas/metabolismo , Modelos Animais de Doenças , Encefalomielite Autoimune Experimental/sangue , Encefalomielite Autoimune Experimental/patologia , Feminino , Complexo de Golgi/metabolismo , Masculino , Camundongos Endogâmicos C57BL , Esclerose Múltipla/sangue , Esclerose Múltipla/imunologia , Esclerose Múltipla/patologia , Degeneração Neural/sangue , Degeneração Neural/imunologia , Degeneração Neural/patologia , Neurônios/metabolismo , Neurônios/patologia , Norepinefrina/sangue , Fenótipo , Índice de Gravidade de Doença , Regulação para Cima/efeitos dos fármacos
3.
PLoS One ; 15(12): e0241459, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33378408

RESUMO

OBJECTIVE: The association between vitamin D deficiency and multiple sclerosis (MS) is well described. We set out to use remote sampling to ascertain vitamin D status and vitamin D supplementation in a cross-sectional study of people with MS across the UK. METHODS: People with MS and matched controls were recruited from across the UK. 1768 people with MS enrolled in the study; remote sampling kits were distributed to a subgroup. Dried blood spots (DBS) were used to assess serum 25(OH)D in people with MS and controls. RESULTS: 1768 MS participants completed the questionnaire; 388 MS participants and 309 controls provided biological samples. Serum 25(OH)D was higher in MS than controls (median 71nmol/L vs 49nmol/L). A higher proportion of MS participants than controls supplemented (72% vs 26%, p<0.001); people with MS supplemented at higher vD doses than controls (median 1600 vs 600 IU/day, p<0.001). People with MS who did not supplement had lower serum 25(OH)D levels than non-supplementing controls (median 38 nmol/L vs 44 nmol/L). Participants engaged well with remote sampling. CONCLUSIONS: The UK MS population have higher serum 25(OH)D than controls, mainly as a result of vitamin D supplementation. Remote sampling is a feasible way of carrying out large studies.


Assuntos
Suplementos Nutricionais , Esclerose Múltipla/sangue , Deficiência de Vitamina D/sangue , Vitamina D/sangue , Adulto , Idoso , Estudos de Casos e Controles , Estudos Transversais , Teste em Amostras de Sangue Seco , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Esclerose Múltipla/diagnóstico , Esclerose Múltipla/dietoterapia , Inquéritos e Questionários , Reino Unido , Vitamina D/administração & dosagem , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/dietoterapia
4.
BMC Psychol ; 8(1): 114, 2020 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-33129356

RESUMO

BACKGROUND: Multiple sclerosis (MS) is a neurodegenerative disease of the central nervous system. MS is significantly associated with a high rate of psychological, behavioral, and emotional consequences. Despite the frequent mental disorders, high rate of psychological comorbidities, and emotional problems in people with MS (PwMS), these conditions are often underdiagnosed and undertreated. This study aimed to examine the efficacy of a group format of the unified protocol for the transdiagnostic treatment of emotional disorders in adult PwMS associated with an emotional disorder. METHODS: Seventy adult PwMS were randomized using an internet-based computer system to either the unified protocol (n = 35) or treatment as usual condition. The assessment protocol included semi-structured clinical interviews and self-reports evaluating diagnostic criteria, depression, anxiety and worry symptoms, emotional dysregulation, and affectivity. RESULTS: The parametric test of analysis of covariance, followed the intent to treat analyses, revealed the unified protocol significantly changed depression symptoms (Cohen's d = 1.9), anxiety symptoms (Cohen's d = 2.16), worry symptoms (Cohen's d = 1.27), emotion dysregulation (Cohen's d = 0.44), positive affect (Cohen's d = 1.51), and negative affect (Cohen's d = 1.89) compared with the control group. The unified protocol also significantly improved outcome scores at the end of treatment relative to baseline (p < .001). CONCLUSION: The findings support that the unified protocol could be an additional efficient psychological treatment for PwMS. Trial registration IRCT, number: IRCT20190711044173N1. Registered 31october 2019, https://en.irct.ir/user/trial/40779/view .


Assuntos
Transtornos do Humor/complicações , Transtornos do Humor/terapia , Esclerose Múltipla/complicações , Esclerose Múltipla/psicologia , Adulto , Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Depressão/complicações , Depressão/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/terapia , Resultado do Tratamento , Adulto Jovem
5.
Wiad Lek ; 73(9 cz. 2): 1950-1956, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33148839

RESUMO

OBJECTIVE: The aim: Is to conduct a comparative analysis of electroneuromyographic parameters in patients with myofascial pain syndrome with multiple sclerosis under the conditions of using various means of physical therapy. PATIENTS AND METHODS: Materials and methods: 105 patients aged 21 to 54 years were examined with MPS in MS. Neurological disorders were verified according to ENMG examinations. 64 patients were enrolled in an experimental group for which a specially designed program was included, which included reflexology and exercise for stretching muscles for 30 days. The control group included 41 patients who underwent a FT course based on therapeutic massage during the same time. Analysis of global ENMG was performed according to functional tests («muscle relaxation¼ and «maximum arbitrary muscle tension¼ with m. Tibialis anterior and m. Rectus femoris), M-responses and H-reflexes, polysynaptic responses (PSV) in withdrawal from these muscles during short-term stimulation n. plantaris (number of pulses in series 10, frequency - 20 Hz, duration of a separate stimulation signal - 1 ms, intensity - double threshold of contractile response of the muscles of the sole of the foot) and residual latency as the time of motor impulse on terminal non-myelinated nerve. Testing was performed on the same muscle groups on the left and righ. RESULTS: Results: Before physical therapy during electromyographic testing, a significant decrease in the amplitude of the maximum M response, a decrease in the speed of the impulse in the proximal and distal segments of the peripheral nerve, was found to be significant compared with the control, the ratio of the proximal-distal coefficient and the residual latency index significantly increased, which indicates a demyelinating character lesions of nerve conductors. After reflexotherapy with muscle stretching in 38.0% of the patients of the experimental group, the dynamics of the amplitude of the M-answers on the left and on the right has only a tendency to further increase, while in the other 62.0% of patients, the amplitude of the M-responses increases bilaterally and is 65.7% higher than in the control group. CONCLUSION: Conclusions: The use of reflexology in conjunction with stretching leads to a reduction in muscle spasticity and pain, as evidenced by electrophysiological indicators that substantiate their feasibility in the practice of physical therapy to improve the functional status of patients with MPS in MS.


Assuntos
Esclerose Múltipla , Síndromes da Dor Miofascial , Adulto , Humanos , Massagem , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Esclerose Múltipla/terapia , Contração Muscular , Síndromes da Dor Miofascial/terapia , Modalidades de Fisioterapia , Adulto Jovem
6.
Wiad Lek ; 73(8): 1780-1784, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33055351

RESUMO

OBJECTIVE: Multiple sclerosis (MS) is an inflammatory and demyelinating disease of the central nervous system of a chronic nature, most often with periods of exacerbation and remission, mainly affecting people between 20-40 years of age, with a slight prevalence of women. The aim of the study was to collect and analyze materials published in the literature regarding the prevalence and co-occurrence of mental disorders in patients with multiple sclerosis. Current reports show that as many as 75% of patients with this chronic disease experience various mental disorders, and the incidence of mental diseases - including mood disorders and anxiety disorders - is statistically higher than in the general population. CONCLUSION: Conclusions: Depending on the literature, depressive symptoms appear in 6.94% -70.1% of patients with MS. Diagnosis of anxiety disorders affects 11.1% of patients, while bipolar disorder affects up to 16.2%. Co-occurrence of MS with schizophrenia is estimated at 1.28%. The incidence of other psychoses is 2-4% in patients with MS. Only in the case of schizophrenia, men with MS are more likely to develop it, while other psychiatric disorders are more common among women. Co-occurrence of mental disorders in the course of multiple sclerosis adversely affects the treatment process and the functioning of patients and their families.


Assuntos
Transtorno Bipolar , Esclerose Múltipla , Transtornos de Ansiedade , Transtorno Bipolar/epidemiologia , Comorbidade , Feminino , Humanos , Masculino , Esclerose Múltipla/complicações , Esclerose Múltipla/epidemiologia , Prevalência
7.
J Urol ; 204(6): 1284-1289, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32924823

RESUMO

PURPOSE: The relationship between fluid intake and lower urinary tract symptoms in individuals with neurogenic bladder is unknown. We investigated the association between fluid intake and urinary symptoms in patients with multiple sclerosis. MATERIALS AND METHODS: A prospective cross-sectional study of patients with multiple sclerosis presenting to the neurology office was conducted. Fluid intake and lower urinary tract symptoms were assessed by the questionnaire based voiding diary and the American Urological Association Symptom Score, respectively. The relationship between fluid intake and lower urinary tract symptoms was assessed using univariate and multivariate analyses. RESULTS: Among 200 individuals with multiple sclerosis the mean total daily fluid intake was 2,489 ml (SD 1,883) and did not differ according to severity (ie mild, moderate, severe) of lower urinary tract symptoms (F=0.30, p=0.74). Fluid restricting behavior to control urinary symptoms was reported by 47% of subjects. Subjects who reported fluid restricting were more likely to have worse urinary symptoms (OR 1.95, 95% CI 1.53-2.47, p <0.01). After accounting for fluid restricting behavior on multivariate analysis, there was a minimal relationship between caffeinated fluid intake and lower urinary tract symptom severity (OR 1.00, 95% CI 1.00-1.01, p=0.01), and there was no relationship between total fluid intake and lower urinary tract symptom severity (OR 1.00, 95% CI 1.00-1.00, p=0.07). CONCLUSIONS: Caffeinated fluid intake has a minimal effect on lower urinary tract symptoms in patients with multiple sclerosis. On average, patients with multiple sclerosis do not hydrate excessively and a considerable proportion restrict fluid intake to control urinary symptoms. Fluid intake may not contribute considerably to lower urinary tract symptoms in patients with multiple sclerosis.


Assuntos
Bebidas/estatística & dados numéricos , Ingestão de Líquidos/fisiologia , Sintomas do Trato Urinário Inferior/diagnóstico , Esclerose Múltipla/complicações , Bexiga Urinaria Neurogênica/etiologia , Adulto , Bebidas/efeitos adversos , Cafeína/efeitos adversos , Estudos Transversais , Feminino , Humanos , Sintomas do Trato Urinário Inferior/etiologia , Sintomas do Trato Urinário Inferior/prevenção & controle , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/fisiopatologia , Estudos Prospectivos , Índice de Gravidade de Doença , Bexiga Urinária/fisiopatologia , Bexiga Urinaria Neurogênica/fisiopatologia , Micção/fisiologia
8.
Mult Scler Relat Disord ; 45: 102442, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32777745

RESUMO

BACKGROUND: Recently SARS-CoV-2 has spread worldwide causing a pandemic. Little is known about disease severity in immunocompromised hosts and people receiving disease modifying therapies (DMTs). In the last decades DMTs have been widely employed, and ocrelizumab represents one of the newest therapies for the relapsing remitting and progressive forms of multiple sclerosis (MS). OBJECTIVES: to describe SARS-CoV-2 related pneumonia in two MS patients under ocrelizumab treatment. METHODS: Case series. RESULTS: Patients showed a mild clinical course of SARS-CoV-2 related pneumonia without complications or sequelae. CONCLUSION: Ocrelizumab treatment is not necessarily associated to increased severity in MS patients with SARS-CoV-2 infection.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Infecções por Coronavirus/complicações , Hospedeiro Imunocomprometido , Fatores Imunológicos/uso terapêutico , Esclerose Múltipla/complicações , Esclerose Múltipla/tratamento farmacológico , Pneumonia Viral/complicações , Adulto , Betacoronavirus , Infecções por Coronavirus/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia/imunologia , Pneumonia/virologia , Pneumonia Viral/imunologia
9.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(7. Vyp. 2): 61-66, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32844632

RESUMO

Multiple sclerosis (MS) is often accompanied by a deficiency of vitamin D, the causes of which are not exactly clear how. It is suggested that this may be due to genetically determined characteristics of enzymes of vitamin D3 metabolism in patients with MS. OBJECTIVE: To evaluate the relationship between vitamin D status and polymorphisms of the genes encoding enzymes of the vitamin D metabolism CYP27B1 (rs703842) and CYP24A1 (rs2248359) in patients with MS. MATERIAL AND METHODS: Caucasians born and living in the Altai region of the Russian Federation, 90 patients with relapsing-remitting MS and 87 volunteers without MS took part in the study. The level of 25-hydroxyvitamin D (25(OH)D) in the blood serum was measured by enzyme immunoassay. Genotyping was carried out using the TaqMan probe method. RESULTS: A level of 25(OH)D of less than 30 ng/ml was more common among patients with MS compared with the control. A relationship between the MS risk and the TC genotype CYP27B1 (rs703842) was identified. In patients with MS and in the control, the GA genotype CYP24A1 (rs2248359) was associated with a 25(OH)D level of less than 30 ng/ml. CONCLUSION: The high prevalence of vitamin D deficiency in patients with MS may be associated with the genetically determined features of CYP27B1.


Assuntos
25-Hidroxivitamina D3 1-alfa-Hidroxilase/genética , Esclerose Múltipla , Deficiência de Vitamina D , Humanos , Esclerose Múltipla/complicações , Polimorfismo Genético , Federação Russa , Vitamina D , Deficiência de Vitamina D/genética , Vitamina D3 24-Hidroxilase/genética
11.
Praxis (Bern 1994) ; 109(10): 794-800, 2020 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-32752967

RESUMO

Treatment and Management of Spasticity Abstract. In the care of neurological patients with a lesion of the first motor neuron, for example after stroke or multiple sclerosis, spasticity is a common problem with considerable impairment of quality of life. The treatment is based in the first place on therapeutic and nursing interventions. In addition, a systemic antispastic medication or, depending on the distribution of the spasticity, local injections with botulinum neurotoxin can be applied. If this is insufficient, surgical procedures may be considered.


Assuntos
Toxinas Botulínicas Tipo A , Espasticidade Muscular , Acidente Vascular Cerebral , Humanos , Esclerose Múltipla/complicações , Espasticidade Muscular/etiologia , Espasticidade Muscular/terapia , Qualidade de Vida , Acidente Vascular Cerebral/complicações
12.
Medicine (Baltimore) ; 99(31): e21238, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756102

RESUMO

Anti-N-methyl-D-aspartate receptor encephalitis (NMDARe) can coexist with myelin oligodendrocyte glycoprotein antibody (MOG-ab) disease.To characterize MOG-ab disease during NMDARe, we analyzed all the patients with MOG-ab disease and NMDARe from our hospital from December 2018 to December 2019 and data from a systematical review of previously published reports. Details of the patients identified were summarized and literature was reviewed.Four of thirty (14.2%) patients with anti-NMDARe had overlapping MOG-ab disease in our department. Analyze together with previously reported cases. Thirty-two NMDARe patients had overlapping MOG-ab disease. The onset age ranged from 3 to 48 years. Twenty-four patients (74%) developed abnormal behavior or cognitive dysfunction during the episodes of anti-NMDARe. None of these patients had tumors. 84% (27/32) patients received high doses of steroids as first-line immunotherapy and 28% (9/32) received mycophenolate mofetil (MMF) to prevent relapse. Twenty-six of twenty-seven (96%) had a good outcome.Steroids are the most common first-line immunotherapies in NMDARe overlapping MOG-ab disease. Most of the NMDARe patients overlapping MOG-ab disease have a good prognosis.


Assuntos
Encefalite Antirreceptor de N-Metil-D-Aspartato/diagnóstico , Esclerose Múltipla/diagnóstico , Glicoproteína Mielina-Oligodendrócito/sangue , Adulto , Encefalite Antirreceptor de N-Metil-D-Aspartato/sangue , Encefalite Antirreceptor de N-Metil-D-Aspartato/complicações , Encefalite Antirreceptor de N-Metil-D-Aspartato/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Registros Médicos , Pessoa de Meia-Idade , Esclerose Múltipla/sangue , Esclerose Múltipla/complicações , Estudos Retrospectivos , Convulsões/etiologia , Adulto Jovem
15.
Neurol Sci ; 41(7): 1647-1650, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32617741

RESUMO

We assessed the prevalence and impact of COVID-19 among multiple sclerosis (MS) patients across Europe by leveraging participant data collected as part of the ongoing EU IMI2 RADAR-CNS major programme aimed at finding new ways of monitoring neurological disorders using wearable devices and smartphone technology. In the present study, 399 patients of RADAR-MS have been included (mean age 43.9 years, 60.7% females) with 87/399 patients (21.8%) reporting major symptoms suggestive of COVID-19. A trend for an increased risk of COVID-19 symptoms under alemtuzumab and cladribine treatments in comparison to injectables was observed. Remote monitoring technologies may support health authorities in monitoring and containing the ongoing pandemic.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Esclerose Múltipla/epidemiologia , Esclerose Múltipla/virologia , Pneumonia Viral/epidemiologia , Adulto , Alemtuzumab/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Europa (Continente) , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Pandemias , Pneumonia Viral/tratamento farmacológico , Prevalência
16.
Mult Scler Relat Disord ; 45: 102338, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32629402

RESUMO

BACKGROUND AND OBJECTIVE: The global COVID-19 pandemic creates an obvious acute health care resourcing and response problem. The different timing of pandemic peak in geographically distinct locations creates a short window of response opportunity. Rapid dissemination of medical information from early affected areas to later ones is therefore crucial to optimise planning. Formulating the best system response for at-risk patient populations is especially complex. People with multiple sclerosis (pwMS) are exposed to long-term immunosuppressive disease modifying treatments (DMTs) and, in theory, could be at increased risk of contracting the virus and developing complications. Social media, such as Twitter, can provide a global platform to rapidly share information and individual experiences. METHODS AND RESULTS: This report summarizes the case experience of pwMS with COVID-19 infection in the first month of the pandemic as reported on Twitter using the #MSCOVID19 hashtag. 26 individual cases of COVID-19 in pwMS were reported from Europe and the United States of America. The cases involved a combination of relapsing and progressive MS phenotypes treated with a range of DMT (5 anti CD20 therapy, 4 cladribine, 4 fingolimod, 4 injectables, 3 alemtuzumab, 2 dimethyl fumarate, 2 untreated, 1 teriflunomide, 1 natalizumab). The cases shared present the earliest reported data on outcomes of COVID-19 infection in pwMS. Whilst limited, the cautiously reassuring nature of these early cases assisted in clinical management by allowing neurologists to continuously reassess their approach to DMT management.


Assuntos
Infecções por Coronavirus/complicações , Infecções por Coronavirus/imunologia , Hospedeiro Imunocomprometido , Esclerose Múltipla/complicações , Pneumonia Viral/complicações , Pneumonia Viral/imunologia , Mídias Sociais , Adulto , Betacoronavirus , Infecções por Coronavirus/mortalidade , Feminino , Humanos , Imunossupressores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/tratamento farmacológico , Esclerose Múltipla/mortalidade , Pandemias , Pneumonia Viral/mortalidade
17.
Arch Clin Neuropsychol ; 35(5): 506-510, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32619239

RESUMO

BACKGROUND: Obesity is linked to greater physical disability and increased comorbidities among patients with multiple sclerosis (MS). Its contribution to cognition in this group is unclear. This observational study examines the link between obesity and processing speed in a large sample of patients with MS (PwMS). METHODS: As part of routine clinical care at our center, PwMS completed the Processing Speed Test (PST), an electronic implementation of the Symbol Digit Modalities Test (SDMT). Height and weight were used to calculate body mass index (BMI). Bivariate correlations were conducted to examine the association between PST and BMI in the group overall and in subgroups based on demographic and clinical variables. A one-way ANOVA examined differences in PST by BMI categories (normal weight, overweight, obese). RESULTS: The sample included 8,713 patients. No association between PST and BMI was found in the entire sample (r = .01), nor within subgroups based on demographic and disease variables. No difference in PST score was found between BMI categories. CONCLUSIONS: No association between BMI and processing speed was found among PwMS regardless of demographic or disease-specific patient characteristics.


Assuntos
Cognição , Esclerose Múltipla , Obesidade , Índice de Massa Corporal , Humanos , Esclerose Múltipla/complicações , Testes Neuropsicológicos , Obesidade/complicações
19.
Nervenarzt ; 91(10): 926-935, 2020 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-32696077

RESUMO

The relationship between headache and multiple sclerosis (MS) has been a matter of controversy for over 60 years. Headaches are still rated as a "red flag", indicating alternative diagnoses to MS, although in the last few years numerous studies have shown a frequent association between headache and MS. In recent studies on MS patients, a link was found between lower age/shorter disease duration of MS and frequent headaches. A study of 50 patients manifesting MS for the first time showed the highest headache prevalence in MS of 78% reported so far.Headaches can also be a possible side effect of most disease-modifying MS drugs. In many cases, however, the headache appears to be a symptom of MS in terms of secondary headache. This is also supported by pathophysiological implications, for example, by detecting B cell follicles in the meninges of MS patients.Migraine is the most common type of headache in MS. In some cases, this is a comorbidity of two diseases with many similarities, but headaches caused by inflammatory MS lesions also appear to be phenomenologically very similar to classic migraines; thus, distinguishing between them is often only successful with the help of thorough differential diagnostics (cerebrospinal fluid, MRI etc.).The task of future studies must be to specify the phenomenology of headache in MS even more precisely, in order to, to gain knowledge in, among others, patients with radiologically isolated syndrome, who often suffer from headache, because in these patients a considerable differential diagnostic and therapeutic uncertainty exists.


Assuntos
Transtornos de Enxaqueca , Esclerose Múltipla , Cefaleia/diagnóstico , Cefaleia/epidemiologia , Cefaleia/etiologia , Humanos , Imagem por Ressonância Magnética , Esclerose Múltipla/complicações , Esclerose Múltipla/diagnóstico , Prevalência
20.
Mult Scler ; 26(10): 1157-1162, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32662757

RESUMO

BACKGROUND: We need high-quality data to assess the determinants for COVID-19 severity in people with MS (PwMS). Several studies have recently emerged but there is great benefit in aligning data collection efforts at a global scale. OBJECTIVES: Our mission is to scale-up COVID-19 data collection efforts and provide the MS community with data-driven insights as soon as possible. METHODS: Numerous stakeholders were brought together. Small dedicated interdisciplinary task forces were created to speed-up the formulation of the study design and work plan. First step was to agree upon a COVID-19 MS core data set. Second, we worked on providing a user-friendly and rapid pipeline to share COVID-19 data at a global scale. RESULTS: The COVID-19 MS core data set was agreed within 48 hours. To date, 23 data collection partners are involved and the first data imports have been performed successfully. Data processing and analysis is an on-going process. CONCLUSIONS: We reached a consensus on a core data set and established data sharing processes with multiple partners to address an urgent need for information to guide clinical practice. First results show that partners are motivated to share data to attain the ultimate joint goal: better understand the effect of COVID-19 in PwMS.


Assuntos
Infecções por Coronavirus/fisiopatologia , Esclerose Múltipla/terapia , Pneumonia Viral/fisiopatologia , Sistema de Registros , Betacoronavirus , Infecções por Coronavirus/complicações , Infecções por Coronavirus/terapia , Coleta de Dados , Humanos , Disseminação de Informação , Cooperação Internacional , Esclerose Múltipla/complicações , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/terapia , Fatores de Risco , Resultado do Tratamento
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