Multiple sclerosis : clinical and laboratory research
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Multiple sclerosis (MS) is generally considered as an autoimmune disease of the central nervous system. This concept has led to the idea that profound immunosuppression followed by transplantation of stem cell grafts would stop, or at least slow down, disease activity. Supported by the positive effects of hematopoietic stem cell transplantation (HSCT) on experimental autoimmune encephalomyelitis and by anecdotal reports on the beneficial effect of HSCT on MS patients with concomitant malignant disease, HSCT programs for MS have been initiated worldwide. ⋯ However, there is ample evidence that HSCT is a technically feasible approach in MS, not more dangerous than in the hemato-oncological diseases. For every step in the HSCT procedure, there are many different options. The time has come for a systematic analysis of the safety and efficacy associated with the different methodologies.
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Randomized Controlled Trial Clinical Trial
Effects of a short-term exercise training program on aerobic fitness, fatigue, health perception and activity level of subjects with multiple sclerosis.
Multiple sclerosis (MS) patients of an inpatient rehabilitation program have been randomly assigned to an exercise training (MS-ET) or nontraining group (MS-NI). Before and after 4 weeks of aerobic exercise training, a graded maximal exercise test with measurement of gas exchange and a lung function test was administered to all 26 patients fulfilling the inclusion criteria. Activity level, fatigue and health perception were measured by means of questionnaires. ⋯ No changes were observed for the MS-NI group and the control groups. Maximal aerobic capacity and lung function were not changed by either training or nontraining in all four groups. Overall compliance to the training program was quite low (65%), whereas incidence of symptom exacerbation by physical activity has been lower than expected (6%).
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The aim of this study was to investigate changes of brain volume as measured by magnetic resonance imaging (MRI) in relapsing-remitting multiple sclerosis (MS) patients under treatment with interferon beta-1a. Moreover, the relationship between brain volume changes and standard MR or clinical outcome variables was determined. After a 6-month pretreatment period, 52 patients with relapsing-remitting MS were assigned to receive interferon beta-1a (Rebif-Serono) during a 24-month treatment period MRI scans were performed monthly during the 6-month pretreatment period and for the first 9 months of the treatment period. ⋯ Of the group in whom was detected a significant decrease of brain volume, 13 out of 26 (50%) had a sustained change in EDSS while in the group that did not have a significant decrease of brain volume, only 3 out of 26 (11.5%) had a sustained EDSS change (p=0.02). In this study a decrease of brain volume was found in relapsing-remitting MS patients treated with IFNbeta-1a over 2 years. The only parameter that predicted brain volume decrease by 2 years of IFNbeta-1a treatment was the mean volume of enhancing lesions over the 6-month pretreatment period.