Multiple sclerosis and related disorders
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Mult Scler Relat Disord · Sep 2020
The relationship between aquaporin-4 antibody status and visual tract integrity in neuromyelitis optica spectrum disorders: A visual evoked potential study.
Optic neuritis (ON) is one of the hallmark symptomatic features of neuromyelitis optica spectrum disorders (NMOSD). The majority of patients with NMOSD present highly specific autoantibodies against aquaporin-4 (AQP4). A number of studies have reported poor visual acuity outcomes in individuals with AQP4 seropositive NMOSD, but no such relationship has been found with regard to visual evoked potentials (VEP) parameters such as the amplitude and latency of the P100 component. In this paper, we aimed (i) to describe VEP responses in patients with NMOSD; (ii) to analyze those results based on a scoring system; and (iii) to investigate the association between the VEPs and AQP4 antibody status. ⋯ VEP study remains a useful tool in the assessment of NMOSD patients. Due to the high prevalence of absent VEPs in NMOSD patients, the scoring system appears to be more applicable for the precise analysis of VEP recordings. There is a positive association between the AQP-positive serostatus and the poorer outcome in VEP responses, especially in patients with severe impairment of the optic nerve(s).
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Mult Scler Relat Disord · Aug 2020
Review Meta AnalysisAdherence and drop-out in randomized controlled trials of exercise interventions in people with multiple sclerosis: A systematic review and meta-analyses.
The short-term benefits of exercise in people with multiple sclerosis (MS) are well established. To sustain benefits exercise needs to continue long-term. Despite important clinical implications, no systematic reviews have synthesized evidence on adherence and drop-out in MS exercise interventions. ⋯ Little consensus existed on definition of adherence or determination of drop-out in MS exercise studies, with reporting generally of poor quality, if done at all. Hence it is largely unknown what can moderate adherence and whether exercise continued following an exercise intervention. Researchers should ensure clear transparent measurement and reporting of adherence and drop-out data in future trials.
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Mult Scler Relat Disord · Aug 2020
Altered resting-state functional connectivity density in patients with neuromyelitis optica-spectrum disorders.
Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune, demyelinating disorder, accompanied by abnormal spontaneous activity of the brain and impairment of the retina and optic nerve. Functional connectivity density (FCD) map, a graph theory method, was applied to explore the functional connectivity alterations of brian in NMOSD patients and investigate the alterations of FCD to the structural and microvascular changes around the optic nerve head (ONH). ⋯ Our study demonstrates that patients with NMOSD have widespread brain dysfunction after optic neuritis attacks which shows as impairment of widespread spatial distribution in long- and short-range FCD. Structural and microvascular changes around the ONH are associated with neural changes in the brain.
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Mult Scler Relat Disord · Aug 2020
ReviewThe underpinning biology relating to multiple sclerosis disease modifying treatments during the COVID-19 pandemic.
SARS-CoV-2 viral infection causes COVID-19 that can result in severe acute respiratory distress syndrome (ARDS), which can cause significant mortality, leading to concern that immunosuppressive treatments for multiple sclerosis and other disorders have significant risks for both infection and ARDS. ⋯ In contrast to ablative haematopoietic stem cell therapy, most multiple-sclerosis-related disease modifying therapies do not particularly target the innate immune system and few have any major long-term impact on CD8 T cells to limit protection against COVID-19. In addition, few block the formation of immature B cells within lymphoid tissue that will provide antibody-mediated protection from (re)infection. However, adjustments to dosing schedules may help de-risk the chance of infection further and reduce the concerns of people with MS being treated during the COVID-19 pandemic.