A 1H Magnetic Resonance Spectroscopy Study Of Aging In Parietal White Matter: Implications For Trials In Multiple Sclerosis
Leary SM, Brex PA, MacManus DG, Parker GJ, Barker GJ, Miller DH, Thompson AJ
Magn Reson Imaging 2000 May;18(4):455-9
Institute of Neurology, NMR Research Unit, Queen Square, London, UK
PMID# 10788723; UI# 20251119
1H Magnetic Resonance Spectroscopy (MRS) provides a unique tool to detect and quantify Brain metabolites.
In Multiple Sclerosis it can be used to investigate Axonal Loss or dysfunction through measurement of N-AcetylAspartate (NAA), a Neuronal marker.
Previous studies in adults have reported variable effects of aging on metabolite concentrations but have predominantly focused on changes in the elderly.
This study has examined a younger adult age group to provide a reference database more applicable to the Multiple Sclerosis population. Single Voxel (volume element) 1H MRS was carried out in 44 subjects between 22 and 62 years of age.
Sixteen subjects underwent repeat examination after one year. Absolute concentrations of NA (the sum of NAA and N-AcetylAspartate Glutamate), NAA, Creatine/PhosphoCreatine (Cr), Choline containing compounds (Cho) and Myo-Inositol (MI) were measured.
NA, NAA and MI concentrations did not correlate with age but there were significant correlations between age and Cr (r = 0.43, p = 0.004) and Cho (r = 0.38, p = 0. 011) concentrations.
No significant differences in metabolite concentrations were seen over one year. This study provides evidence that age-related changes of metabolite concentrations occur even in a young to middle aged adult population.
This emphasizes the need to perform absolute quantification of metabolite concentrations rather than ratios and the importance of age-matching in 1H MRS studies of Multiple Sclerosis.
Baclofen Increases The Soleus Stretch Reflex Threshold In The Early Swing Phase During Walking In Spastic Multiple Sclerosis
Nielsen JF, Anderson JB, Sinkjaer T
Mult Scler 2000 Apr;6(2):105-114
Aalborg University, Center for Sensory-Motor Interaction, Dept of Medical Informatics and Image Analysis, Denmark
The effect of Baclofen on walking performance was examined in nine Spastic Multiple Sclerosis patients. In addition, nine healthy subjects were tested as controls.
The modulation of the short latency Soleus stretch reflex was closer to normal with Baclofen compared to the recordings without Baclofen.
The modulation index being 74% (range: 60 - 100) with Baclofen and 62% (range: 20 - 100) without Baclofen, P=0.03. In healthy subjects the modulation index was 100% (range: 52 - 100).
In the early swing phase the threshold of the Soleus stretch reflex was significantly higher during Baclofen medication being 139 deg/s (range: 63 - 302) compared with 93 deg/s (range: 37 - 187) without Baclofen, P=0.004.
The relation between the stretch velocity (input) and the amplitude of the stretch reflex (output) in early swing phase was unchanged.
Being 0.27 muVs/deg (range: 0.1 - 1.51) in patients with Baclofen and 0.24 muVs/deg (range: 0.08 - 0.79) without Baclofen, P=0.25.
Baclofen induced no change in input - output properties of the stretch reflex during walking compared with findings in a sitting position at matched EMG activity.
There was a significant correlation between clinical Spasticity score and stretch reflex threshold in the early swing phase (rho=-0.61, P=0.04).
And, between clinical Spasticity score and the slope of the best linear fit in the early swing phase (rho=0.72, P=0.009).
Multiple Sclerosis (2000) 6, 105 - 114
MRI And Clinical Activity In MS After Terminating Treatment With Interferon-ß-1b
Richert ND, Zierak MC, Bash CN, Lewis BK, McFarland HF, Frank JA
Mult Scler 2000 Apr;6(2):86-90
NIH, Laboratory of Diagnostic Radiology Research, Clinical Center, Bethesda, Maryland, MD 20892, USA
Monthly MRI activity and clinical disability were evaluated in two Relapsing/Remitting Multiple Sclerosis (RRMS) patients for 4 years during a cross-over treatment trial with IFN-ß-1b.
And, for a mean of 21 months after terminating treatment with IFN-ß-1b.
Post-treatment MRI activity was compared to baseline activity in these patients.
Although Contrast Enhancing Lesions (CEL) and the Bulk White Matter lesion load (BWMLL) on T2-weighted images eventually returned to baseline values.
There was a refractory period of 6 - 10 months after terminating treatment, before baseline MRI activity was restored.
Although the mechanism for a sustained effect of IFN-ß-1b is unclear at this time, these results have important implications for enrollment of such patients into new treatment protocols that rely on contrast enhancing lesion frequency as an outcome measure.
Kremenchutzky M, Lee D, Rice GP, Ebers GC
Mult Scler 2000 Apr;6(2):81-85
London Health Sciences Centre-UC, Dept of Clinical Neurological Sciences, 339 Windermere Road, London, Ontario N6A 5A5, Canada
The clinical course of Multiple Sclerosis can be classified as Relapsing from onset (Relapsing/Remitting), or Progressive from onset (Primary/Progressive - PPMS).
These clinical phenotypes have been based on historical and clinical observations.
It has been reported that PPMS patients tend to have quantitatively less MRI activity and disease burden.
We evaluated the sensitivity and diagnostic value of conventional Brain MRI scan in 143 PPMS patients.
Brain MRIs were blindly evaluated to determine if they satisfied Paty and/or Fazekas diagnostic criteria.
Patients were divided into those with typical, atypical or normal scans. They satisfied Brain MRI criteria in 92% cases.
Findings included: 131 typical, four atypical, and eight normal scans.
All 12 non-typical scans' subjects had Spinal onset; Spinal MRI scans were positive in four of seven cases.
Sex, age of onset, site and number of symptoms involved at onset among those groups were not significantly different.
But, accumulation of disability had a tendency to be slower in these few individuals with normal or atypical head MRI's.
Although there may be quantitative differences in lesion activity/burden, MRI scanning in PPMS unexpectedly has diagnostic sensitivity very similar to that seen in RRMS.
A normal Brain MRI is unusual in PPMS patients.
TNF- PolyMorphisms In Multiple Sclerosis: No Association With -238 And -308 Promoter Alleles, But The MicroSatellite Allele A11 Is Associated With The Disease In French Patients
Lucotte G, Bathelier C, Mercier G
Mult Scler 2000 Apr;6(2):78-80
Center of Molecular Neurogenetics, Faculty of Medicine, Rheims, France
Tumor Necrosis Factor-alpha (TNF-), a ProInflammatory Cytokine, is believed to play an important role in Multiple Sclerosis (MS) PathoGenesis.
The objective of this study was to determine whether sequence variation in the TNF- Gene is associated with MS.
Bi-allelic PolyMorphisms in the TNF- -238 and -308) and microsatellite TNF- were previously reported.
We investigated these PolyMorphisms in 74 French patients with MS, compared with 75 controls.
No significant differences regarding the TNF- -238 and -308 PolyMorphisms were observed between MS patients and controls.
Allele frequency for the a11 allele is in very significant association (P<0.0001) with MS, due in part to the association of the a11 allele with the HLA-DRB1*15 allele in patients.