de Seze J, Stojkovic T, Gauvrit JY, Saint Michel T, Ayachi M, Pruvo JP, Vermersch P
Muscle Nerve 2000 Aug;23(8):1284-6
Hopital R. Salengro, Dept of Neurology, CHRU de Lille, France
PMID# 10918270; UI# 20379344
Ventricular repolarization dysfunction has recently been reported in Multiple Sclerosis (MS).
We evaluated Ventricular repolarization dysfunction in 52 MS patients and looked for a relationship between corrected QT (QTc) abnormalities (i.e., abnormalities of QT intervals corrected for rate) and Spinal Cord Magnetic Resonance Imaging (MRI) findings.
QTc intervals were increased in MS patients compared with controls (P < 0.01) and were correlated with a reduction of Spinal Cord area (P < 0.01).
QTc abnormalities in MS were thus associated with Axonal loss, reflected by Spinal Cord Atrophy, rather than DeMyelination.
Copyright 2000 John Wiley & Sons, Inc.
Tumor Necrosis Factor-alpha Has Few Morphological Effects Within The Dorsal Columns Of The Spinal Cord, In Contrast To Its Effects In The Peripheral Nervous System
Hall SM, Redford EJ, Smith KJ
J NeuroImmunol 2000 Jul 1;106(1-2):130-136
NeuroInflammation Research Group, Division of Anatomy, Cell and Human Biology, Guy's, King's and St. Thomas' Schools of Medicine, Dentistry and Biomedical Sciences, Hodgkin Building, Guy's Campus, London, UK
There is circumstantial evidence implicating the Pro-Inflammatory Cytokine Tumor Necrosis Factor (TNF) in the PathoGenesis of Multiple Sclerosis (MS), but there is no direct evidence that TNF can produce DeMyelination in the Central Nervous System (CNS).
We demonstrate here that single injections of TNF into the Dorsal Columns of adult rats produced a mild Inflammatory response indistinguishable from that seen in control Cords, but did not induce DeMyelination.
A similar response was seen when TNF- was injected into Dorsal Columns where Central Axons had been ReMyelinated by Schwann cells.
In marked contrast, single IntraNeural injections of TNF into Sciatic Nerves produced acute changes in the EndoNeurial MicroVascular bed that were followed by DeMyelination and degeneration.
Ku YT, Montgomery LD, Lee HC, Luna B, Webbon BW
Am J Phys Med Rehabil 2000 Sep-Oct;79(5):427-34
Lockheed Martin Engineering & Sciences, Moffett Field, California, USA
PMID# 10994884; UI# 20448350
The objective of this study was to compare the responses of Multiple Sclerosis (MS) patients to short-term cooling therapy using three different vest configurations.
Each garment was used to cool 13 male and 13 female MS subjects (31-67 yr). Oral and right and left ear temperatures were logged manually every 5 min.
Arm, leg, chest, and rectal temperatures, heart rate, and respiration were recorded continuously on a Biolog ambulatory monitor.
Each subject was given a series of subjective and objective evaluation tests before and after cooling.
The Life Enhancement Technologies and Steele vests test groups had similar, significant (P < 0.01) cooling effects on oral and ear canal temperatures, which decreased approximately 0.4 degrees C and 0.3 degrees C, respectively.
The Life Enhancement Technologies active liquid cooling vest produced the coldest (P < 0.01) skin temperature and provided the most improvement on subjective and objective performance measures.
These results show that the various garment configurations tested do not produce similar thermal responses in all MS patients.
The circulating liquid cooling vest was found to be more effective than either of the two passive cooling garments tested.
Controlled High-Risk Subjects Avonex Multiple Sclerosis Prevention Study (CHAMPS)
Jacobs LD, Beck RW, Simon JH, Kinkel RP, Brownscheidle CM, Murray TJ, Simonian NA, Slasor PJ, Sandrock AW
N Engl J Med 2000 Sep 28;343(13):898-904
Buffalo General Hospital, Dept of Neurology, 100 High St., Buffalo, NY 14203
Treatment with Interferon-ß has been shown to help patients with established Multiple Sclerosis, but it is not known whether initiating treatment at the time of a first clinical DeMyelinating event is of value.
We conducted a randomized, double-blind trial of 383 patients who had a first acute clinical DeMyelinating event (Optic Neuritis, incomplete Transverse Myelitis, or a BrainStem or Cerebellar Syndrome) and evidence of prior subclinical DeMyelination on Magnetic Resonance Imaging (MRI) of the Brain.
After initial treatment with CorticoSteroids, 193 patients were randomly assigned to receive weekly intramuscular injections of 30 microg of Interferon-ß-1a and 190 were assigned to receive weekly injections of placebo.
The study end points were the development of Clinically Definite Multiple Sclerosis and changes in findings on MRI of the Brain. The trial was stopped after a preplanned interim efficacy analysis.
During three years of follow-up, the cumulative probability of the development of Clinically Definite Multiple Sclerosis was significantly lower in the Interferon-ß-1a group than in the placebo group (rate ratio, 0.56; 95 percent confidence interval, 0.38 to 0.81; P=0.002).
As compared with the patients in the placebo group, patients in the Interferon-ß-1a group had a relative reduction in the volume of Brain lesions (P<0.001), fewer new or enlarging lesions (P<0.001), and fewer Gadolinium-enhancing lesions (P<0.001) at 18 months.
Initiating treatment with Interferon-ß-1a at the time of a first DeMyelinating event is beneficial for patients with Brain lesions on MRI that indicate a high risk of Clinically Definite Multiple Sclerosis.