Hickman SJ, Brierley CM, Silver NC, Moseley IF, Scolding NJ, Compston DA, Miller DH
J Neurol Sci 2001 Jun 15;187(1-2):35-9
NMR Research Unit, Institute of Neurology,
Univ, College London, Queen Square, WC1N 3BG, London, UK
PMID# 11440742; UI# 21334443
In Multiple Sclerosis (MS), HypoIntense lesions on T1-weighted Magnetic Resonance Imaging are thought to represent areas of tissue disruption and Axonal loss.
In previous studies of MS patients, InfraTentorial T1 HypoIntense lesions were found to be rare.
In MS patients selected to have chronic Cerebellar Ataxia, we have determined the extent of InfraTentorial T1 HypoIntense lesions and their relationship with Disability.
We recruited nine patients with chronic Cerebellar Ataxia due to MS. An Expanded Disability Status Scale (EDSS) assessment was performed on each.
The patients' Brains were then imaged with Axial-oblique Dual-Echo Fast Spin-Echo and contrast-enhanced T1-weighted conventional Spin-Echo sequences.
The number and total volume of InfraTentorial high-signal Lesions on T2-weighted images and InfraTentorial HypoIntense lesions on T1-weighted images were calculated by a blinded observer using a computer-assisted contouring technique.
A total of 96 InfraTentorial high-signal lesions were present, of which 62 (64.6%) appeared IsoIntense and 34 (35.4%) HypoIntense with respect to the surrounding Brain substance on the T1-weighted images.
There was a median of 3 (range 0-10) and median volume of 0.43 ml (range 0-0.85 ml) InfraTentorial T1 HypoIntense lesions per patient.
The EDSS score correlated with both the number (r=0.68, p=0.043) and the volume per patient (r=0.89, p=0.001) of InfraTentorial T1 HypoIntense but not T2 high-signal lesions.
InfraTentorial T1 HypoIntense lesions are often seen in patients with MS and chronic Cerebellar Ataxia. They may play a significant role in the Disability suffered by these patients.
Sexual Dysfunction In Multiple Sclerosis: A 2-Year Follow-Up Study
Zorzon M, Zivadinov R, Monti Bragadin L, Moretti R, De Masi R, Nasuelli D, Cazzato G
J Neurol Sci 2001 Jun 15;187(1-2):1-5
Cattinara Hospital, Dept of Neurology, Strada di Fiume, 447-34149, Trieste, Italy
PMID# 11440738; UI# 21334439
Background And Objective
Sexual dysfunction severely affects the quality of life of patients, but longitudinal studies of sexual function in Multiple Sclerosis are lacking.
We performed a study on a group of patients with Multiple Sclerosis to evaluate the change in sexual function and to examine the relationship between sexual dysfunction and other clinical variables over time.
A 2-year follow-up study on 99 patients with definite Multiple Sclerosis. Information on sexual and Sphincteric disturbances have been collected through face-to-face structured interviews.
Disability, independence, Cognitive performances and psychological functioning have also been assessed.
Spearman rank correlation analysis corrected for multiple comparisons, and linear regression analysis have been performed to test variables relationship and remove the effect of potential confounding covariates.
The proportion of patients with sexual dysfunction remained over 70% and did not change during the 2-year follow-up, but the extent and number of symptoms increased significantly.
The number of symptoms of sexual dysfunction did not change significantly after an exacerbation. Significantly, more patients than before the study resorted to counseling and discussed with doctors of sexual matters.
In the univariate analysis, changes in sexual function over time correlated with changes in Bladder function (r=0.47, p<0.0001) and EDSS score (r=0.41, p<0.0001).
But the multivariate analysis demonstrated that only Bladder dysfunction was independently related to sexual dysfunction (R=0.36, p=0.003) when the effect of psychological factors were removed.
Symptoms of sexual dysfunction increase in significance and number over time in patients with Multiple Sclerosis.
Relapses did not influence the number of symptoms of sexual dysfunction, but a worsening of pre-existing symptoms cannot be excluded.
The change of sexual function appears to be independently associated to Bladder dysfunction.
Pars Planitis: Epidemiology, Treatment, And Association With Multiple Sclerosis
Prieto JF, Dios E, Gutierrez JM, Mayo A, Calonge M, Herreras JM
Ocul Immunol Inflamm 2001 Jun;9(2):93-102
Instituto de Oftalmobiologia Aplicada (IOBA), Valladolid, Spain
PMID# 11449325; UI# 21342440
During retrospective and prospective studies, we attempted to determine the clinical characteristics, treatment, and Visual outcome of patients with Pars Planitis.
And to evaluate the association between Pars Planitis and Multiple Sclerosis (MS).
The retrospective study included 44 patients with Pars Planitis, who had been examined between October 1986 and January 1999.
We analyzed age, sex, Visual Acuity (VA), median follow-up time, and medical and surgical treatments.
The prospective study, which included 21 consecutive patients with Pars Planitis, was performed to determine the presence of MS. In the retrospective study, the mean patient age was 22.4 years (SD +/- 11.5) and the median follow-up was 34.9 months (SD +/- 27.2).
Complications included Macular Edema (47.7%), Vitreous Opacities (38.6%), Papillitis (38.6%), Vasculitis (36.4%), and Cataract (20.5%). Forty patients (90.9%) had a final bilateral VA better than 20/40.
In the prospective study, Magnetic Resonance Imaging (MRI) was performed. DeMyelinating lesions were found in 10 (47.6%) of the 21 patients and Relapsing/Remitting Clinically Definite MS was diagnosed in seven (33.3%).
With the exception of age, no significantly statistical differences were observed.
When the Visual prognosis and the clinical and Epidemiologic characteristics were compared between the two groups of patients with and without associated MS.
A diagnosis of MS was more frequently made in patients over 25 years of age. With appropriate treatment, patients with Pars Planitis have a good Visual prognosis.
Because the presence of DeMyelinating Lesions seems to be high among patients with Pars Planitis, MRI should be considered, especially in patients over 25 years of age.