Effectiveness of alternative dose fingolimod for multiple sclerosis.

Background: Fingolimod is a daily oral medication used to treat relapsing multiple sclerosis (MS). Clinicians often adopt less frequent dosing for patients with profound drug-induced lymphopenia or other adverse events. Data on the effectiveness of alternate dose fingolimod are limited.

The contemporary spectrum of multiple sclerosis misdiagnosis: A multicenter study.

Objective: To characterize patients misdiagnosed with multiple sclerosis (MS).

Methods: Neurologists at 4 academic MS centers submitted data on patients determined to have been misdiagnosed with MS.

Results: Of 110 misdiagnosed patients, 51 (46%) were classified as "definite" and 59 (54%) "probable" misdiagnoses according to study definitions.

Predicting optimal response to B-cell depletion with rituximab in multiple sclerosis using CXCL13 index, magnetic resonance imaging and clinical measures.

Background: B-cell depleting drugs show promise for treating multiple sclerosis.

Objective: We sought predictors of optimal response to rituximab, a B-cell depleting antibody, to help guide therapy selection.

Methods: We performed a post hoc study of 30 relapsing multiple sclerosis patients with breakthrough disease while on beta-interferon or glatiramer acetate who were treated with add-on rituximab.

Dimethyl fumarate-associated lymphopenia: Risk factors and clinical significance.

Background: Dimethyl fumarate (DMF), a disease-modifying therapy for multiple sclerosis (MS), causes lymphopenia in a fraction of patients. The clinical significance of this is unknown. Several cases of progressive multifocal leukoencephalopathy in lymphopenic fumarate-treated patients have raised concerns about drug safety.

Decreased circulating miRNA levels in patients with primary progressive multiple sclerosis.

Emerging evidence underlines the importance of micro(mi)RNAs in the pathogenesis of multiple sclerosis (MS). Free-circulating miRNAs were investigated in serum from MS patients compared to controls. Statistically significant decreased levels of miR-15b, miR-23a and miR-223 were observed in MS patients (p < 0.

Monoclonal antibodies as disease modifying therapy in multiple sclerosis.

Multiple sclerosis (MS), a demyelinating disease of the central nervous system, was untreatable until the mid-1990s when beta-interferons and glatiramer acetate were introduced. These agents, while effective, were relatively nonspecific in action. Over the last 10 years, research has focused toward developing more targeted therapies for the disease.

CXCL13 is a biomarker of inflammation in multiple sclerosis, neuromyelitis optica, and other neurological conditions.

CXCL13, a B-cell chemokine, has been proposed as a biomarker in a variety of conditions, some of which can mimic multiple sclerosis and can have very high levels. In this case-control study, cerebrospinal fluid (CSF) CXCL13 was elevated in multiple sclerosis, neuromyelitis optica and other inflammatory neurological controls compared with noninflammatory controls. Levels did not differentiate disease groups.

Spinal cord ring enhancement in multiple sclerosis.

Objective: To describe the clinical and imaging characteristics of spinal cord ring enhancement in multiple sclerosis (MS).

Design: Clinical case series.

Setting: Academic referral center.

Changes in B- and T-lymphocyte and chemokine levels with rituximab treatment in multiple sclerosis.

Background: B cells are implicated in the pathogenesis of multiple sclerosis. A beneficial effect of B-cell depletion using rituximab has been shown, but the complete mechanism of action for this drug is unclear.

Objective: To determine the relationship between T and B cells and changes in cerebrospinal fluid (CSF) chemokine levels with rituximab, a monoclonal antibody that targets CD20.

Cerebrospinal fluid progranulin levels in patients with different multiple sclerosis subtypes.

Progranulin has recently attracted attention due to the discovery of mutations in its encoding gene (GRN) in several cases of frontotemporal lobar degeneration, but also for a possible role in inflammatory processes. In adult central nervous system, GRN mRNA is expressed in forebrain, olfactory bulbs and spinal cord. Progranulin cerebrospinal fluid (CSF) levels were evaluated in 55 patients with multiple sclerosis (MS) as well as in 35 subjects with non-inflammatory neurological diseases (NIND), 7 individuals with other inflammatory neurological disease (OIND) and 8 controls (CON), matched for ethnic background, gender and age.

A role for functional classification in the early identification of prognostic factors in ALS.

The aim of this study was to determine if the interval between onset of symptoms to initial electrodiagnostic studies indicates disease progression in amyotrophic lateral sclerosis (ALS). Fifty consecutive patients referred to our neurophysiology laboratory with clinical evidence of ALS were divided into two groups by outcome scores on the ALS Functional Rating Scale (ALSFRS) using 26 as a cut-off. Our results, which showed a median of four months (range 2-24 months) duration to initial electrodiagnostics for Group I (ALSFRS scores below 26) versus 10 months (range 1-24 months) for Group II (p = 0.

Spouses of Persian Gulf War I veterans: medical evaluation of a U.S. cohort.

Ten years after the 1991 Persian Gulf War (GW I), a comprehensive evaluation of a national cohort of deployed veterans (DV) demonstrated a higher prevalence of several medical conditions, in comparison to a similarly identified cohort of nondeployed veterans (NDV). The present study determined the prevalence of medical conditions among nonveteran spouses of these GW I DV and NDV. A cohort of 490 spouses of GW I DV and 537 spouses of GW I NDV underwent comprehensive face-to-face examinations.

Gulf War veterans' health: medical evaluation of a U.S. cohort.

Background: United States military personnel reported various symptoms after deployment to the Persian Gulf during the 1991 Gulf War. However, the symptoms' long-term prevalence and association with deployment remain controversial.

Objective: To assess and compare the prevalence of selected medical conditions in a national cohort of deployed and nondeployed Gulf War veterans who were evaluated by direct medical and teledermatologic examinations.