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  • Multiple sclerosis  (13)
  • Autoimmunity  (1)
  • Biological signal processing  (1)
  • 1
    Electronic Resource
    Electronic Resource
    Presence of T-cell subset abnormalities in newly diagnosed cases of multiple sclerosis and relationship with short-term clinical activity (1993)
    Springer
    Journal of neurology 240 (1993), S. 79-82 
    Details
    ISSN: 1432-1459
    Keywords: Multiple sclerosis ; T-cell subsets
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Abnormalities of T-cell subsets in patients with multiple sclerosis are well known; in order to assess whether immunological abnormalities are relevant in the pathogenesis of the disease after its clinical onset, peripheral blood lymphocyte subsets (CD3+, CD4+, CD4+ CD45RA+, CD4+CD45RA−, CD8+, CD8+CD57+, CD57+, CD25+) were analysed serially in 25 patients at the first clinical episode suggestive of inflammatory demyelinating disease and in an equal number of age- and sex-matched controls. During the follow-up period (12–18 months, mean 14) 6 of 25 patients presented new relapses: in this subgroup of patients, significant changes in CD4+ ratio (% CD4+CD45RA−/%CD4+CD45RA−) were detected in comparison both with healthy controls and with clinically stable patients. Patients clinically stable at follow-up did not display immunological abnormalities, regardless of the presence or absence of cerebrospinal fluid and/or magnetic resonance imaging alterations consistent with multiple sclerosis. These findings suggest a possible prognostic role of early T-cell subset imbalance in multiple sclerosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00858721
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  • 2
    Electronic Resource
    Electronic Resource
    Magnetisation transfer ratios of contrast-enhancing and nonenhancing lesions in multiple sclerosis (1996)
    Springer
    Neuroradiology 38 (1996), S. 115-119 
    Details
    ISSN: 1432-1920
    Keywords: Key words Magnetic resonance imaging ; Magnetisation transfer ; Magnetisation transfer ratio ; Multiple sclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Magnetisation transfer (MT) is a recently introduced technique for assessing the water content of tissues in vivo and its relationship to macromolecules or membranes. It has been suggested that MT could provide indirect evidence of the characteristics of multiple sclerosis (MS) lesions (oedema, demyelination, or gliosis). Our aims were to characterise brain MS lesions and to compare the magnetisation transfer ratio (MTR) values of lesions with different patterns of contrast enhancement. In patients with MS we measured the MTR of 65 gadolinium-enhancing and 292 nonenhancing lesions. Using the equation published by Dousset et al. we studied 29 patients with clinically definite MS and 10 healthy controls. Lesions had significantly lower MT than the normal-appearing white matter of the patients or the normal white matter of healthy controls. There was no difference in the MTR of enhancing and nonenhancing lesions. Enhancement was homogeneous in 45 and ring-like in 20 lesions; MTR values were lower in the latter. These findings are presumably related to the differences in pathological features of enhancing (different amounts of proteins and inflammatory cells, oedema and demyelination) and nonenhancing (gliosis, demyelination and axonal loss) lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00604792
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  • 3
    Electronic Resource
    Electronic Resource
    Acute myelopathy of unknown aetiology: a clinical, neurophysiological and MRI study of short-and long-term prognostic factors (1995)
    Springer
    Journal of neurology 242 (1995), S. 497-503 
    Details
    ISSN: 1432-1459
    Keywords: Acute myelopathy ; Magnetic resonance imaging ; Evoked potentials ; Multiple sclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Brain and spinal cord magnetic resonance imaging (MRI), multimodal evoked potentials (EPs) and cerebrospinal fluid (CSF) analysis were performed in 27 patients with acute myelopathy of unknown aetiology (AMUA), to detect the diagnostic and prognostic values of paraclinical tests at presentation. Spinal cord MRI was abnormal in 56% and brain MRI in 33% of the patients. Visual EPs were abnormal in 7%, median somatosensory EPs in 17%, tibial somatosensory EPs in 56% and motor EPs in 35% of the cases examined. Brain-stem acoustic EPs were normal in all the patients. CSF oligoclonal bands (OBs) were detected in 30% of cases. The patients were divided into subgroups according to the short-term clinical outcome (complete, partial or absent recovery). There were no significant differences among the three groups as regards MRI findings. Patients with complete recovery showed a significantly lower frequency of tibial somatosensory EP and motor EP abnormalities. According to the paraclinical findings at onset and on the basis of a long-term clinical follow-up (mean duration 24 months), 6 patients were diagnosed as having clinically definite multiple sclerosis, while 21 did not develop further neurological disturbances. Only the presence of CSF OBs was significantly more frequent in patients with definite multiple sclerosis. Our study indicates that EPs exploring spinal cord function are more powerful than spinal MRI for predicting the short-term outcome of AMUA, while the combined use of brain MRI and CSF OBs has the highest negative predictive value for the subsequent development of clinically definite multiple sclerosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00867419
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  • 4
    Electronic Resource
    Electronic Resource
    Long-term follow-up of isolated optic neuritis: the risk of developing multiple sclerosis, its outcome, and the prognostic role of paraclinical tests (1999)
    Springer
    Journal of neurology 246 (1999), S. 770-775 
    Details
    ISSN: 1432-1459
    Keywords: Key words Optic neuritis ; Multiple sclerosis ; Magnetic resonance ; imaging ; CSF examination ; Oligoclonal bands ; Evoked ; potentials
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We evaluated the risk of developing clinically definite multiple sclerosis (CDMS) after an acute attack of isolated optic neuritis (ON) in 112 patients, in relation to demographic and paraclinical findings. Patients were examined by brain MRI, CSF analysis, and multiple evoked potentials (EPs); 10 were lost to follow-up, and the other 102 were enrolled in a prospective study (follow-up duration 6.3 ± 2.2 years). Of these, 37 (36.3%) developed CDMS after a mean interval of 2.3 ± 1.6 years. The risk of developing CDMS was 13% after 2 years, 30% after 4, 37% after 6, and 42% after 8 and 10 years. Gender, age, and season of ON onset did not affect the risk. MS occurred in 37 of 71 patients (52.1%) with one MRI lesion or more; no patient with a normal MRI developed the disease. MS developed more frequently in patients with intrathecal IgG synthesis than in those without (43% vs. 28%), but the difference was not statistically significant. Multiple EPs showed a slight predictive value only including somatosensory EPs of the lower limb. Multiple sclerosis was mild in most cases (EDSS 2.2 ± 1.9). The EDSS was less than 4 in 32 cases (86%), between 4 and 6 in 2 (5%), higher than 6.5 in 3 (8%).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004150050453
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  • 5
    Electronic Resource
    Electronic Resource
    Acute- and insidious-onset myelopathy of undetermined aetiology: contribution of paraclinical tests to the diagnosis of multiple sclerosis (1990)
    Springer
    Journal of neurology 237 (1990), S. 171-176 
    Details
    ISSN: 1432-1459
    Keywords: Multiple sclerosis ; Myelopathy ; Magnetic resonance imaging ; Evoked potentials
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Brain magnetic resonance imaging (MRI), multimodality evoked potentials (EPs) and cerebrospinal fluid examination were performed in 42 patients with myelopathy of undetermined aetiology in order to detect abnormalities usually related to multiple sclerosis (MS). Patients were divided into three groups: insidious-onset myelopathy with only motor signs (group A; 11 patients), with both motor and sensory signs (group B; 18 patients) and acute-onset myelopathy (group C; 13 patients). Multiple brain MRI lesions were found in 18 patients (2 of group A, 13 of group B and 3 of group C). Another 7 patients had a single white-matter lesion. Visual EPs were abnormal in 21 and brain-stem auditory EPs in 12 patients. Paraclinical tests supported the diagnosis of MS in 25 patients (60%) by showing subclinical brain abnormalities. Oligoclonal bands were found in 16 of these 25 patients. The findings strongly suggest a diagnosis of MS in the patients of group B.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00314590
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  • 6
    Electronic Resource
    Electronic Resource
    Correlation between multimodal evoked potentials and magnetic resonance imaging in multiple sclerosis (1989)
    Springer
    Journal of neurology 236 (1989), S. 4-8 
    Details
    ISSN: 1432-1459
    Keywords: Multiple sclerosis ; Diagnosis ; Electrophysiological tests ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Sixty multiple sclerosis (MS) patients (33 definite, 13 probale and 14 suspected were investigated by computed tomography (CT), magnetic resonance imaging (MRI), multimodality evoked potentials (EPs) and cerebrospinal fluid (CSF) electrophoresis. MRI abnormalities were found in 50 cases, while at least one abnormal evoked potential was detected in each of 52 cases. Brain-stem auditory evoked potentials were more sensitive than MRI for the detection of brainstem involvement. All the patients with oligoclonal bands had abnormal MRI and none of the patients with normal MRI had oligoclonal bands in the CSF. The number and the extent of MRI lesions were significantly correlated with the duration of disease and with the degree of disability. Our observations stress the importance of the combined use of MRI and EPs in detecting silent CNS lesions in MS patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00314209
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  • 7
    Electronic Resource
    Electronic Resource
    Multiple sclerosis and mitochondrial myopathy: An unusual combination of diseases (1994)
    Springer
    Journal of neurology 241 (1994), S. 511-516 
    Details
    ISSN: 1432-1459
    Keywords: Multiple sclerosis ; Mitochondrial DNA (muscle) ; Mitochondrial myopathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A woman with definite multiple sclerosis (MS) and mitochondrial myopathy is described. There were widespread white matter lesions on magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) abnormalities and evoked response changes. Muscle biopsy showed ragged red fibres (RRFs) and cytochrome c oxidase (CoX) deficiency. Southern blot analysis revealed a large deletion of mitochondrial DNA (mtDNA). The patient may be affected by two unrelated diseases, MS and mitochondrial myopathy, but this combination has never previously been reported.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00919714
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  • 8
    Electronic Resource
    Electronic Resource
    ERPs in multiple sclerosis (1998)
    Springer
    Neurological sciences 19 (1998), S. S408 
    Details
    ISSN: 1590-3478
    Keywords: Multiple sclerosis ; Cognitive impairment ; Event-related potentials
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Nella comprensione dei meccanismi fisiopatogenetici del disturbo cognitivo nella sclerosi multipla (SM), i potenziali evento correlati (ERPs) sono in grado di fornire informazioni sul timing dei processi cognitivi con risoluzione temporale dell'ordine dei millisecondi. La componente P300, da paradigma odd-ball visivo o acustico, costituisce l'ERP più ampiamente utilizzato nelle demenze di varia natura. Esiste concordanza della letteratura nel rilevare nei pazienti con SM, incrementi di latenza e riduzioni di ampiezza della P300, correlate con l'entità dei deficit cognitivi. In linea con tali risultati, in un studio su 54 pazienti, abbiamo riscontrato alterazioni di latenza della P300 strettamente correlate al grado di compromissione cognitiva e al grado di demielinizzazione della sostanza bianca. La valutazione della distribuzione topografica dell'onda aumentava la sensibilitd della metodica, con significativa riduzione del gradiente di attività nei settori cerebrali centro-anteriori, anche quando latenza e ampiezza risultavano normali. Considerando gli aspetti funzionali, la tomografia ad emissione di positroni (PET) è in grado di evidenziare un ridotto metabolismo correlato con la gravità del deterioramento cognitivo. Nel confronto con gli ERPs condotto su 30 pazienti e emerso un significativo ipometabolismo nel talamo e nelle regioni temporo-parieto-occipitali nel gruppo dei pazienti con P300 ] alterata rispetto al gruppo con P300 normale, suggerendo che la compromissione di aree specifiche, quali il talamo, è di fondamentale importanza per la genesi dell'onda.
    Notes: Abstract Involvement of cognitive functions is detectable in about 50% of patients with multiple sclerosis (MS). One important element seems to be the interruption or temporal distortion of the cross-talk among cortical associative areas and between cortical and subcortical structures as a consequence of demyelination and axonal degeneration, as occurs in the so-called subcortical dementias. There is a general agreement among recent studies that P300 latency is prolonged and amplitude is reduced in MS. Altered scalp topographic distribution is also frequent. Similar results were found in 54 MS patients. Both early and late components resulted prolonged as observed in subcortical dementia. P300 abnormalities were correlated with neuropsychological findings and magnetic resonance imaging evidence of confluent periventricular lesions. Topographically, P300 was significantly decreased in amplitude over central-anterior regions. Considering the functional aspects of cognitive dysfunction, 30 definite MS patients were studied by positron emission tomography. All patients with metabolic thalamic involvement had P300 abnormalities. Moreover, in the abnormal P300 group, significant hypometabolism was found in thalamic and in temporo-parieto-occipital regions. These results suggest that impairment of specific areas such as the thalamus is fundamental in the correct genesis of this wave.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00539597
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  • 9
    Electronic Resource
    Electronic Resource
    EEG correlates of cognitive impairment in MS (1998)
    Springer
    Neurological sciences 19 (1998), S. S413 
    Details
    ISSN: 1590-3478
    Keywords: Multiple sclerosis ; EEG ; Coherence Movement-related potentials ; Reaction time ; Cognitive impairment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Il coinvolgimento cognitivo è una frequente complicanza della sclerosi multipla (SM), generalmente come demenza sottocorticale. Al fine di valutare le connessioni funzionali cortico-corticali nella SM, abbiamo studiato la coerenza dell'elettroencefalogramma (EEG) in un gruppo di 21 pazienti con SM clinicamente deftnita. I pazienti sono stati inoltre sottoposti a risonanza magnetica (RM) e valutazione neuropsicologica. I pazienti con deficit cognitivi presentavano, rispetto ai pazienti senza deficit, una riduzione della coerenza di banda alfa e theta, nelle derivazioni a breve e a lunga distanza. La coerenza anteroposteriore ed interemisferica era significativamente correlata col cortco lesionale RM immediatamente sottostante la corteccia e non con le lesioni periventricolari. Questi dati supportano l'ipotesi the il coinvolgimento cognitivo nella sclerosi multipla sia principalmente correlato a demielinizzazione o perdita assonale delle connessioni cortico-corticali. In un altro studio abbiamo valutato i correaaai neuropsicologici dei deficit frontali. I lobi frontali hanno un ruolo fondamentale nella programmazione ed esecuzione del movimento. Abbiamo valutato il potenziale movimento-correlato (MRP) in pazienti SM con e senza deficit frontali. Il tempo di reazione manuale al test di Stroop, the valuta le funzioni esecutive, e le componenti del MRP erano ritardate in entrambi i gruppi di pazienti rispetto ai soggetti normali e nei pazienti frontali rispetto ai non frontali. Questi dati suggeriscono the il coinvolgimento cognitivo frontale nella SM corrisponde a un'alterazione dell'attività bioelettrica anche durante un compito motorio semplice.
    Notes: Abstract Cognitive impairment is a frequent complication of multiple sclerosis (MS), generally reflecting subcortical dementia. In order to explore functional cortico-cortical connections in MS, we studied electroencephalogram (EEG) coherence in a group of 21 clinically defined MS patients. Patients also underwent magnetic resonance imaging (MRI) and neuropsychological examinations. Compared to unimpaired MS patients, cognitively involved patients had reduced short-distance and long-distance theta and alpha band coherencies. Anteroposterior and interhemispheric coherencies were significantly correlated with MRI lesion load immediately underlying cortex but not were exclusively associated with periventricular lesions. These data support the hypothesis that cognitive impairment in MS is mostly related to demyelination or axonal loss of cortico-cortical connections. In a second study, we evaluated the neurophysiological correlates of frontal lobe dysfunction. Frontal lobes are also involved in motor planning and execution. We evaluated the EEG movement-related potential (MRP) in MS patients with and without frontal neuropsychological deficits. Reaction times to the Stroop test, which evaluates frontal functions, and MRP components were delayed in both MS groups compared to normal subjects and in frontal compared to nonfrontal MS patients. These data suggest that frontal cognitive involvement in MS corresponds to abnormal bioelectrical activity also during simple motor tasks.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00539598
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  • 10
    Electronic Resource
    Electronic Resource
    Pathophysiology of cognitive impairment in multiple sclerosis (1998)
    Springer
    Neurological sciences 19 (1998), S. S443 
    Details
    ISSN: 1590-3478
    Keywords: Multiple sclerosis ; Cognitive dysfunction PET ; Event-related potentials
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Solo negli ultimi anni sono stati raggiunti significativi risultati nella conoscenza della fisiopatologia dei disturbi cognitivi nella sclerosi multipla (SM). La risonanza magnetica ha consentito di rilevare correlazioni tra disturbi cognitivi ed entità del carico lesionale globale e regionale oltre che con indici di atrofia cerebrale. Più recenti studi neurofisiologici (potenziali evento correlati, studio della coerenza dell'elettroencefalogramma) e l'uso di tecniche non convenzionali di risonanza magnetica hanno inoltre permesso di definire con più precisione il substrato patologico e funzionale delle lesioni macroscopiche. La interruzione o disfunzione parziale delle connessioni tra diverse aree corticali o tra strutture corticali e sottocorticali é alla base della cosiddetta demenza sottocorticale, irreveribile e progressiva, osservata generalmente nei pazienti con SM di una certa durata e gravità, associata principalmente a perdita assonale e a grave demielinizzazione. È comunque sempre più frequente l'osservazione di pazienti SM con disturbi cognitivi, selettivi o globali, ad esordio acuto e transitori, nei quali può essere ipotizzato un coinvolgimento diretto del processo infiammatorio. Anticorpi contro antigeni neuronali, citochine proinfiammatorie e neurotossine possono infatti, con diversi meccanismi, interferire sia sul funzionamento cellulare sia sulla conduzione nervosa delle strutture coinvolte nelle funzioni cognitive.
    Notes: Abstract Only in the last decade has significant progress been reached in understanding the pathophysiology of cognitive impairment in multiple sclerosis (MS). Edema, inflammation, demyelination and axonal loss may have different consequences on nerve fiber conduction, causing temporal disorganization or disruption of the inputs travelling along the intrahemispheric and interhemispheric connections among associative areas as well as between cortical and subcortical structures involved in mental functions. Neuropsychological, electrophysiological, metabolic and magnetic resonance imaging (MRI) studies have provided converging evidence that the most common type of cognitive dysfunction observed in MS patients, the so-called subcortical dementia, is an almost invariable complication of the advanced phases of the disease. In these phases, large amounts of brain white matter may be affected by microscopic and macroscopic lesions characterized by pronounced axonal loss. However, the acute occurence of transitory and isolated selective cognitive deficits or reversible dementia has been observed in a few patients. In these cases a pathogenetic role of the inflammatory process in cognitive changes is to be considered. In fact, antineural antibodies, proinflammatory cytokines and other neurotoxic substances may induce or regulate several critical cellular and electrophysiologic functions. Understan-ding how the cellular and humoral responses may be differently associated with acute or chronic disease evolution and with macroscopic and microscopic brain changes is essential for the formulation of a unifying pathogenetic model of cognitive impairment in MS.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00539603
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