Progression Of Visual Evoked Potential Abnormalities In Multiple Sclerosis And Optic Neuritis
Electromyogr Clin NeuroPhysiol 2000 Jun;40(4):243-52
Kuwait University Faculty of Medicine, Physiology Dept
PMID# 10907603; UI# 20365047
To investigate Visual Signal Processing in patients with Optic Neuritis, suspected Multiple Sclerosis, confirmed Multiple Sclerosis (MS), and Optic Neuritis combined with MS, pattern reversal Visual Evoked Potentials (VEPs) were recorded in patients and normal subjects.
The amplitude and latency of the first positive peak, P100 were determined to assess Electrical Conduction in patients as compared to normal subjects. Suspected MS patients did not differ from normal subjects in peak latencies or amplitudes.
The P100 amplitude was reduced in Optic Neuritis, confirmed MS and Optic Neuritis combined with confirmed MS.
The P100 and N145 latencies were prolonged in Optic Neuritis patients and confirmed MS patients as compared to normal subjects.
The main characteristic of Optic Neuritis was P100 amplitude reduction, and of confirmed MS was P100 latency delay. There was a progression of the P100 latency delay and of the P100 amplitude decrement in Optic Neuritis, confirmed MS, and Optic Neuritis combined with confirmed MS.
These results indicate a progression of DeMyelination in Optic Neuritis, confirmed MS, and Optic Neuritis combined with confirmed MS.
Pain In Multiple Sclerosis: An Overview Of Its Nature And Management
J NeuroSci Nurs 2000 Jun;32(3):139-44, 152
Catholic Univ of America, Washington, DC, USA
PMID# 10907200; UI# 20364630
Pain is experienced by approximately two-thirds of all people with Multiple Sclerosis (MS) at some time during the course of their disease.
Pain in MS occurs as a consequence of both the disease and the disability that it produces.
Pain in MS is receiving more attention as clinical trials in the past decade have focused not solely on the Immune System modulators of disease but also on symptomatic management as well.
Nurses with their keen communication and assessment skills and their unique advocacy role are particularly equipped to effect Pain Management for people with Multiple Sclerosis.
Interferon-ß-1a Therapy Changes LipoProtein Metabolism In Multiple Sclerosis
Sena A, Pedrosa R, Ferret-Sena V, Almeida R, Andrade ML, Morais MG, Couderc R
Clin Chem Lab Med 2000 Mar;38(3):209-13
Universidade Nova de Lisboa, Faculdade de Ciencias Medicas, Departamento de Bioquimica, Lisboa, Portugal
PMID# 10905756; UI# 20361691
To assess whether Interferon beta1a (IFN-ß-1a) therapy affects Plasma LipoProtein metabolism, twelve patients with Relapsing/Remitting Multiple Sclerosis (MS) were studied during a two-year follow-up period.
High density LipoProtein (HDL2) Cholesterol and the HDL2/HDL3 ratio were increased at year 2 and LipoProtein (a) was transitorily increased at year 1, in comparison to baseline levels.
ApoLipoProtein A-I was lower and ApoLipoProtein E higher at year 1, only in a subgroup of patients who experienced relapses and/or progressed during therapy.
These findings suggest that IFN-ß-1a treatment is associated with changes in the LipoProtein Metabolism.
Alterations in this metabolism could be related to the ImmunoModulatory actions of the drug and the disease activity in Multiple Sclerosis patients.
Effect Of Baclofen On The Transmission In Spinal Pathways In Spastic Multiple Sclerosis
Orsnes G, Crone C, Krarup C, Petersen N, Nielsen J
Clin NeuroPhysiol 2000 Aug 1;111(8):1372-1379
Copenhagen Univ Hospital, Dept of Neurology, Rigshospitalet, Blegdamsvej 9, 2100 O., Copenhagen, Denmark
To measure the effect of Baclofen on the transmission in different Spinal Pathways to Soleus MotoNeurones in Spastic Multiple Sclerosis patients.
Baclofen was administered Orally in 14 and Intrathecally in 8 patients.
H(max)/M(max), PreSynaptic Inhibition by biceps femoris tendon tap of Femoral Nerve stimulation, depression of the Soleus H-reflex following previous activation of the Ia afferents from the Soleus Muscle (i.e. postactivation depression), DiSynaptic Reciprocal Ia Inhibition of the Soleus H-reflex and the number of backpropagating action potentials in primary afferents, which may be a sign of PreSynaptic Inhibition, were examined.
Baclofen depressed the Soleus H(max)/M(max) ratio significantly following Oral and Intrathecal Baclofen.
None of the two tests of PreSynaptic Inhibition, or the postactivation depression or the DiSynaptic Reciprocal Ia Inhibition of the Soleus H-reflex were affected by Baclofen administration.
Also the Action Potentials of the primary afferents were unchanged during Baclofen administration.
The AntiSpastic effect of Baclofen is not caused by an effect on the transmitter release from Ia afferents or on DiSynaptic Reciprocal Ia Inhibition.
One possible explanation of the depression of the H-reflex by Baclofen is suggested to be a direct depression of MotoNeuronal Excitability.
Stigma Of Visible And Invisible Chronic Conditions
Joachim G, Acorn S
J Adv Nurs 2000 Jul;32(1):243-8
Univ of British Columbia, School of Nursing, Vancouver, British Columbia, Canada
PMID# 10886457; UI# 20344848
Stigma of visible and invisible chronic conditions Nurses deliver care to people with various forms of chronic illnesses and conditions.
Some chronic conditions, such as Paraplegia, are visible while others, such as Diabetes, are invisible. Still others, such as Multiple Sclerosis, are both visible and invisible.
Having a chronic illness or condition and being different from the general population subjects a person to possible stigmatization by those who do not have the illness.
Coping with stigma involves a variety of strategies including the decision about whether to disclose the condition and suffer further stigma, or attempt to conceal the condition or aspects of the condition and pass for normal.
We present a beginning framework that describes the relationship between the elements of stigma and the decision to disclose or hide a chronic condition based on its visibility or invisibility.
The specific aims were to combine the results from a meta-study on qualitative research with a review of the quantitative literature, then develop a theoretical framework.
Although an understanding of how patients cope with stigmatizing conditions is essential for nurses who aim to deliver comprehensive individualized patient care, there is little current literature on this subject.
The relationship between visibility and invisibility and disclosure and non-disclosure remains poorly understood. A framework to facilitate a deeper understanding of the dynamics of chronic illnesses and conditions may prove useful for practice.
Repertoire Dynamics Of Autoreactive T-Cells In Multiple Sclerosis Patients And Healthy Subjects: Epitope Spreading Versus Clonal Persistence
Goebels N, Hofstetter H, Schmidt S, Brunner C, Wekerle H, Hohlfeld R
Brain 2000 Mar;123(Pt 3):508-518
Max Planck Institute for NeuroBiology, Dept of NeuroImmunology, Martinsried, Germany
PMID# 10686174; UI# 20153279
AutoAntigen-specific T-Lymphocytes are present in patients with AutoImmune Disease and in normal subjects. Little is currently known about the temporal variation (dynamics) of the Immune repertoire of these AutoReactive T-Cells.
We analyzed the long-term variation of the Immune repertoire of T-Cells specific for Myelin Basic Protein (MBP) in five untreated patients with Multiple Sclerosis and four normal control subjects over a mean observation period of 6 years.
MBP-specific CD4+ T-Cell lines were selected with purified human MBP, and their Epitope specificity was mapped with overlapping synthetic Peptides. Three distinct patterns of repertoire development were observed.
- Two patients and three control subjects maintained a broad Epitope response with fluctuations over time.
- Two patients initially showed a focused response that broadened over the course of 6 years; this finding could be described as intramolecular Epitope spreading.
- In one patient and one control subject, a strikingly focused response, which was directed to a cluster of nested Epitopes in the MBP region 83-102, persisted over time.
T-Cell receptor Vbeta sequence analysis allowed us to trace individual clones of MBP-specific T-Cells for up to 7 years in the peripheral circulation in four of the five patients and three of the four controls, suggesting that the long-term persistence of MBP-specific T-Cell clones is a common feature of the T-Cell repertoire not unique to Multiple Sclerosis.
The persisting MBP-specific T-Cell clones were not detectable in the blood of one of the patients by Complementarity-determining region (CDR)-3 spectratyping, indicating that their frequency does not exceed 1 in 5000 T-Cells.
The temporal characteristics of the MBP-specific T-Cell repertoire described here are relevant to therapeutic strategies targeting AutoAntigen-specific T-Cells in Multiple Sclerosis and other AutoImmune Diseases.