Assessment Of Optic Nerve Damage
In Multiple Sclerosis Using MRI
Simon JH, McDonald WI
J Neurol Sci 2000 Jan 15;172 Suppl 1:S23-S26
Univ of Colorado Health Sciences Center, Dept of Radiology/MRI, 4200 E Ninth Ave, Denver, CO, USA
The MR imaging-based assessment of the Optic Nerve in Optic Neuritisand Multiple Sclerosis provides information that is complementary to clinical and electrophysiological methods.
The standard and more tissue destruction specific methods can be used in strategies to measure treatment efficacy and for understanding the mechanisms of relapse, recovery, and failure of recovery.
The Role Of Magnetic Resonance In The Assessment Of Multiple Sclerosis
Rovaris M, Filippi M
J Neurol Sci 2000 Jan 15;172 Suppl 1:S3-S12
Univ of Milan, Scientific Institute, Ospedale San Raffaele, NeuroImaging Research Unit, Dept of NeuroScience, via Olgettina 60, 20132, Milan, Italy
Although the correlations between Magnetic Resonance Imaging (MRI) findings and long-term disease evolution range from poor to moderate, conventional pre- and post-contrast MRI provides sensitive and reliable measures to monitor Multiple Sclerosis (MS) activity over time.
MRI pulse sequences that have been recently introduced have shorter acquisition times and their use in large-scale studies can significantly decrease their costs in terms of both working load and patients' discomfort.
The application of non-conventional techniques can increase the pathological specificity of MRI findings and, as a consequence, improve the relationship with the clinical evolution of the disease.
These techniques also enable us to quantify the subtle abnormalities occuring in the so-called Normal-Appearing White Matter, thus allowing a more accurate assessment of MS burden to be achieved.
Some of these techniques have already shown their value for assessing MS dynamics, whereas other still need to go through a more complete validation process prior to any extensive clinical application in MS.
Partial Synergy Of Bisindolylmaleimide With Apoptotic Stimulus In Antigen-Specific T-Cells Implications For Multiple Sclerosis
Wendling U, Aktas O, Schmierer K, Zschenderlein R, Zipp F
J NeuroImmunol 2000 Feb 1;103(1):69-75
Univ Hospital Charite, Dept of Neurology, Schumannstr, Berlin, Germany
PMID# 10674991; UI# 20137456
In Multiple Sclerosis (MS), induction of T-Cell Apoptosis constitutes a promising therapeutic strategy.
Recently, Bisindolylmaleimide has been shown to be an effective treatment of Experimental AutoImmune EncephaloMyelitis, presumably due to enhancement of CD95-mediated T-Cell Apoptosis.
Therefore, we studied the effects of Bisindolylmaleimide on human (auto)Antigen-specific T-Cells.
We observed a synergistic effect of Bisindolylmaleimide with Apoptotic stimulus assessed via caspase activity and annexin V-binding, but no potentiation of DNA fragmentation or cell death.
Thus, Bisindolylmaleimide might be useful for modulating T-Cell Apoptosis, yet more potent substances have to be generated re-establishing Immunological control over auto-reactive T-Cells.
The Effect Of Apoptosis Inhibitors On Experimental AutoImmune EncephaloMyelitis: Apoptosis As A Regulatory Factor
Okuda Y, Sakoda S, Fujimura H, Yanagihara T
Biochem Biophys Res Commun 2000 Jan 27;267(3):826-30
La Trobe University, NeuroImmunology Laboratory, Bundoora, Victoria, 3083, Australia
PMID# 10673376; UI# 20139735
The effect of Apoptosis inhibitors on Experimental AutoImmune EncephaloMyelitis (EAE), a model for Multiple Sclerosis, was investigated by intraperitoneal or intracisternal administration of Apoptosis inhibitors Ac-YVAD-cmk and zVAD-fmk.
After onset of the disease, these agents had no suppressive effect on EAE and resulted in impaired recovery or earlier relapse.
Histological examination revealed that administration of zVAD-fmk suppressed the Apoptotic death of Inflammatory cells in the Central Nervous System (CNS) of mice with EAE.
The results indicated that the Apoptotic elimination of infiltrated cells in the CNS might be one of the recovery mechanisms in EAE.
Copyright 2000 Academic Press.
Clinical Appropriateness: A Key Factor In Outcome Measure Selection: The 36 Item Short Form Health Survey In Multiple Sclerosis
Freeman JA, Hobart JC, Langdon DW, Thompson AJ
J Neurol NeuroSurg Psychiatry 2000 Feb;68(2):150-156
Institute of Neurology, Dept of Clinical Neurology, Queen Square, London WC1 N3BG, UK
Understanding the properties of an outcome measure is essential in choosing the appropriate instrument and interpreting the information it generates.
The MOS 36 item short form health survey questionnaire (SF-36) is widely acknowledged as the gold standard generic measure of health status; few studies however have evaluated its use for clinical trials in Multiple Sclerosis.
Its clinical appropriateness, internal consistency reliability, validity, and responsiveness was investigated across a broad range of patients with Multiple Sclerosis.
A prospective study in which 150 adults with clinically definite Multiple Sclerosis completed a battery of questionnaires evaluating generic health status, disability, handicap, and emotional wellbeing.
Of these, 44 patients undergoing inpatient rehabilitation completed the questionnaires before and after intervention to evaluate responsiveness.
Score distributions demonstrated significant floor and ceiling effects in four of the eight dimensions which were particularly marked when patient selection was restricted to a narrow band of disease severity (as is the case in most clinical trials).
Internal consistency exceeded the standard for group comparisons for all dimensions. Convergent and discriminant construct validity was supported by the direction, magnitude, and pattern of correlations with other health measures.
In comparison with instruments measuring associated constructs, the responsiveness of the SF-36 was poor in evaluating change in moderate to severely disabled patients participating in a programme of inpatient rehabilitation.
The SF-36 has some limitations as an outcome measure in Multiple Sclerosis.
The results highlight the need for all instruments to be examined in the specific sample population under question and for the specific research question being investigated.
In Multiple Sclerosis clinical trials, the SF-36 should be supplemented with other relevant measures.