Cerebral palsy, cerebellar ataxia, AIDS, phacomatosis, neuromuscular disorders, and epilepsy
Jacques Corcos, David Ginsberg, Gilles Karsenty in Textbook of the Neurogenic Bladder, 2015
Infection with the other retroviruses such as human T-cell lymphotropic virus type 1 (HTLV-1) has also been associated with development of bladder symptoms, which would be expected due to its tendency to cause a myelopathy.34,36 Bladder symptoms in HTLV-1 infected patients are often attributed to UTIs, which are thought to occur more commonly in this condition. In a series of 21 HTLV-1 infected patients with urinary symptoms and negative urine cultures, urodynamic studies were abnormal in over 90%.43 In most cases, the findings were of detrusor overactivity and dyssynergia, and the strongest clinical predictor of urinary symptomatology was neurological disability as measured by the Expanded Disability Status Scale.43
AI and Autoimmunity
Louis J. Catania in AI for Immunology, 2021
Multiple sclerosis (MS): An algorithm was created that combines multiple machine-learning techniques to predict the expanded disability status scale (EDSS) score of patients with multiple sclerosis at two years solely based on age, sex, and fluid attenuated inversion recovery (FLAIR) MRI data. The algorithm combined several complementary predictors: a pure deep learning predictor based on a convolutional neural network (CNN) that learns from the images, as well as classical machine-learning predictors. The method predicted two-year clinical disability in patients with multiple sclerosis with a mean EDSS score error of 1.7. This supports the use of this model to predict EDSS score progression.27
Multiple Sclerosis and Related Conditions
John W. Scadding, Nicholas A. Losseff in Clinical Neurology, 2011
Less than 5 per cent of patients experience a rapidly fulminant course, and over 80 per cent of patients are alive 25 years after diagnosis. In a Canadian study, life table analysis revealed that life expectancy in MS patients at any given age was reduced by six or seven years compared to the general population. Severe disability, indicated by an expanded disability status scale (EDSS) of 7.5 or more (this equates to inability to take more than a few steps), was a major risk factor for premature death, with a case fatality ratio roughly four times the rate for controls.
Combination treatment of docosahexaenoic acid (DHA) and all-trans-retinoic acid (ATRA) inhibit IL-17 and RORγt gene expression in PBMCs of patients with relapsing-remitting multiple sclerosis
Published in Neurological Research, 2018
Ateke Mousavi Nasl-khameneh, Abbas Mirshafiey, Abdorreza Naser Moghadasi, Reza Chahardoli, Maryam Mahmoudi, Karim Parastouei, Mir Saeed Yekaninejad, Ali Akbar Saboor-Yaraghi
This in vitro study investigated the effects of ATRA and DHA treatments on peripheral blood mononuclear cells (PBMCs) extracted from RRMS patients. Participant ages ranged from 20 to 45 years. Patients were diagnosed based on a clinical examination conducted by neurologists, MRI imaging, and CSF laboratory data [18]. The diagnoses were confirmed by McDonald’s criteria [19], and patients were classified as having RRMS according to the standard disease course criteria for neurological disability [20]. At the time of blood sample collection, all patients had been treated with immunomodulatory therapy, IFN-β-1a, for at least one year according to international guidelines. Their Expanded Disability Status Scale (EDSS) scores were between zero and five. Patients with autoimmune diseases (lupus erythematosus, rheumatoid arthritis, etc.) and/or other conditions that may affect the immune system, such as type 1 diabetes, pregnancy, alcoholism, malnutrition, and overweight, and patients treated with immunosuppressive drugs were excluded from the study. Sixteen (13 female and 3 male) patients fulfilled the inclusion criteria and participated in this study. This study was approved by the Tehran University of Medical Sciences (TUMS) Ethics Committee. Written informed consent was obtained from all participants prior to the study and they were made aware of the aim of this study. All patients were treated by the MS clinic of Sina Hospital (Affiliated Hospital of TUMS).
Physical activity is associated with neuromuscular and physical function in patients with multiple sclerosis independent of disease severity
Published in Disability and Rehabilitation, 2021
Scott Rooney, Morten Riemenschneider, Ulrik Dalgas, Marie-Louise K. Jørgensen, Anne-Sophie Michelsen, Jan C. Brønd, Lars G. Hvid
Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system that manifests in whole/regional brain volume loss, impaired nerve conduction, and dysfunction of neural pathways including those of the descending motor tracts [1,2]. Consequently, neuromuscular function is impaired in patients with MS, as evidenced by reduced levels of lower-limb neuromuscular activity and muscle strength in comparison to healthy controls [3–6]. Furthermore, impaired lower-limb neuromuscular function has been shown to be associated with a decline in walking performance [7–9]. Therefore, reduced physical function is also a common feature of MS, with up to 68% of patients with MS experiencing difficulties with walking [10], and several studies reporting a decline in gait velocity and distance [11–14]. Ultimately, these impairments lead to disability – measured by the Expanded Disability Status Scale (EDSS) – which along with accumulation of disability over time (i.e., time since diagnosis [TSD] in years) provides a measure of disease severity [15]. As a consequence of the deleterious effects of MS on neuromuscular and physical function, identification of factors which influence these outcomes is an important priority of MS research.
Do pre-clinical multiple sclerosis models allow us to measure neurodegeneration and clinical progression?
Published in Expert Review of Neurotherapeutics, 2018
Tanja Hochstrasser, Zhan Jiangshan, Sebastian Rühling, Christoph Schmitz, Markus Kipp
To test for efficacy of any therapeutic intervention, one needs appropriate outcome measurements. One important point shall be highlighted here: preclinical studies apparently use other outcome measurements compared to those used in SPMS and PPMS clinical trials. In clinical trials, the two main primary outcome measurements are (i) progression of clinical disability and (ii) cerebral atrophy, measured by MRI [6,7]. The traditionally used primary clinical outcome measure is the Expanded Disability Status Scale (EDSS). Although the EDSS is still the mainstay for assessing treatment efficacy, nowadays several studies use much more sophisticated approaches such as the MS Functional Composite (MSFC). The MSFC comprises quantitative functional measures of three key clinical dimensions of MS: leg function/ambulation, arm/hand function, and cognitive function. Delay in time to sustained accumulated disability, and improvement of change in brain volume both indicate treatment success [8]. Both measurements, clinical disability and brain volume, are believed to depend on the extent of neurodegeneration.
Related Knowledge Centers
- Bladder
- Brainstem
- Cerebellum
- Gastrointestinal Tract
- Pyramidal Tracts
- Visual System
- Cerebrum
- Multiple Sclerosis
- Sensory Nervous System