Association Between Clinical Disease Activity And Epstein-Barr Virus Reactivation in MS
Wandinger K, Jabs W, Siekhaus A, Bubel S, Trillenberg P, Wagner H, Wessel K,
Kirchner H, Hennig H
Neurology 2000 Jul 25;55(2):178-84
Institute of Immunology and Transfusion Medicine, Depts of Univ of Lubeck School of Medicine, Germany
PMID# 10908887; UI# 20371001
To assess the potential significance of Epstein-Barr Virus (EBV) reactivation in disease activity in MS patients.
The prevalence of AntiBodies against Herpes Simplex Virus type 1 (HSV-1), HSV-2, EBV, and
CytoMegaloVirus was determined in a group of 108 MS patients and in 163 healthy control subjects.
Sera were analyzed using combinations of novel assay systems employing highly purified Viral and recombinant Antigens. In addition, PCR for the detection of EBV DNA was performed in serial samples.
In contrast to the control populations, AntiBodies against EBV were present in 100% of MS
patients. Among the tested Human HerpesViruses, this high extent of seropositivity was only found for EBV.
Primary infection was found exclusively in the control group (3.7%), whereas serologic evidence of EBV reactivation was seen in MS patients (13.9%) as well as control subjects (17.2%).
There was no temporal coincidence between EBV reactivation and disease activity in MS
However, in 19 patients followed monthly for 1 year, active Viral replication as measured by increased ImmunoGlobulin (Ig) M and IgA responses to EBV early Antigens (p54 + p138).
Positive Serum DNA was seen in 72.7% of patients with exacerbations during the study period and in none of the patients with clinically stable disease.
The results demonstrate an association between EBV reactivation and disease activity in MS patients over time, and suggest that EBV might play an indirect role in MS as an activator of the underlying disease process.
Cognitive Disorders In Multiple Sclerosis
Pelletier J, Benoit N, Montreuil M, Habib M
Pathol Biol (Paris) 2000 Mar;48(2):121-31
Service De Neurologie, CHU Timone, Marseille, France
PMID# 10815288; UI# 20274432
There is a lack of precise data concerning the natural history of Cognitive Disorders in Multiple Sclerosis (MS), but recent NeuroPsychological studies have demonstrated that the incidence of such disorders in MS appears to be frequent (40-65% of cases).
And have shown in particular that Recent Memory, Conceptual Reasoning, Attention, Executive Functions, VisuoSpatial Perception and Information Processing Speed are negatively affected.
In contrast, language functions, general intelligence and Implicit Memory appear to be relatively well preserved.
Although the presence and the degree of Cognitive Disorders does not seem to be directly linked to disease duration or to the extent of physical Disability, the relationship between Cognitive decline and Brain lesions detected by Magnetic Resonance Imaging (MRI) is still a subject of discussion.
The prevalence of Emotional and Affective Disorders is difficult to estimate.
Their frequency has only rarely been investigated, and the lack of data on the natural history of these disorders and those factors which they have in common (the PsychoSocial consequences of this chronic and disabling disease, Cognitive Impairment, and Brain lesions) further complicate the determination of treatment strategy.
The adoption of appropriate strategies could limit the negative impact of this disease on the social functioning of MS patients.
Brain MRI Lesions And Atrophy Are Related To Depression In Multiple Sclerosis
Bakshi R, Czarnecki D, Shaikh ZA, Priore RL, Janardhan V, Kaliszky Z, Kinkel PR
Neuroreport 2000 Apr 27;11(6):1153-8
Univat Buffalo (SUNY), School of Medicine and Biomedical Sciences and, Buffalo General Hospital, Dept of Neurology, Buffalo, NY 14203, USA
PMID# 10817583; UI# 20275284
It is unclear whether Brain MRI lesions are associated with Depression in Multiple Sclerosis (MS).
Neurological dysfunction in Depressed (n= 19) and non-Depressed (n = 29) MS patients was rated by Expanded Disability Status Scale (EDSS). EDSS was weakly predictive of the presence of (p = 0.03) and severity of (p = 0.01) Depression.
After correcting for EDSS, the presence of Depression was predicted by Superior Frontal and Superior Parietal HypoIntense T1 lesions (p<0.01);
The severity of Depression was predicted by Superior Frontal, Superior Parietal and Temporal T1 lesions, Lateral and Third Ventricular enlargement, and Frontal Atrophy (p<0.01).
Depression was not related to bright T2 lesions or enhancement.
We conclude that Atrophy and Cortical-SubCortical disconnection due to Frontal and Parietal White Matter destructive lesions may contribute to Depression in MS.