Computer-Aided Diagnosis of Multiple Sclerosis

The study aims to develop a computer-assisted decision support based on cerebrospinal fluid (CSF) and blood findings to improve their value and ease the diagnostic procedure of chronic inflammatory diseases (CIDs) of central nervous system (CNS). Data were collected from patients suffering from multiple sclerosis (MS,n = 73), from another CID of the CNS (n = 22), or a psychiatric disease (control group, CTRL,n = 12). Univariate and multivariate analyses were performed using multiple logistic regression and artificial neural networks. Differentiating between MS and CID, no parameter could be disclosed that could provide a meaningful decision support. However, multivariate analysis obtained a statistically significant classification (sensitivity = 84.9%, specificity = 54.5%,p < 0.001). On the contrary, multivariate analysis based on the differentiation between MS vs. CTRL, gave good results (sensitivity = 95.9%, specificity = 83.3%,p < 0.001). It became evident from standard laboratory findings that there is a significant potential for computer-aided decision support.

Mathematical Identification of a Neuronal Network Consisting of GABA and DA in Striatal Slices of the Rat Brain

High frequency stimulation (HFS) has been used to treat various neurological and psychiatric diseases. Although further disorders are under investigation to extend the clinical application of HFS, the complex effect of HFS within a neuronal network is still unknown. Thus, it would be desirable to find a theoretical model that allows an estimation of the expected effect of applied HFS. Based on the neurochemical analysis of effects of the γ-aminobutyric acid (GABA)Areceptor antagonist bicuculline, the D2-like receptor antagonist sulpiride and the D1-like receptor antagonist SCH-23390 on HFS evoked GABA and dopamine (DA) release from striatal slices of the rat brain, a mathematical network model is proposed including the neurotransmitters GABA, DA and glutamate (GLU). The model reflects inhibitory and excitatory interactions of the neurotransmitters outflow in the presence of HFS. Under the assumption of linear interactions and static measurements, the model is expressed analytically. Numerical identification of inhibition and excitation is performed on a basis of real outflow levels of GABA and DA in the rat striatum. Results validate the nature of the proposed model. Therefore, this leads to an analytical model of the interactions within distinct neural network components of the rat striatum.

Why do cannabinoids not show consistent effects as analgetic drugs in multiple sclerosis?

The effectiveness of cannabinoids (CB) in the treatment of pain in patients with multiple sclerosis (MS) varies. The pathogenesis of pain in MS is diverse as are the possible effects of CB at different sites of CB receptors in the peripheral and central nervous system, this may explain the variable impact on individual patients. The aim of this review is to summarize pre-clinical and clinical studies to explain this variability from a neuropharmacological point of view. Future studies are needed to examine specific effects on distinct symptoms in homogenous groups of patients.

Myeloradiculitis: a rare event in schistosoma infection

Schistosomiasis a parasitic disease caused by trematodes is widely distributed in (sub-)tropical countries. Depending on the species the infection manifests clinically as gastrointestinal (preferentially Schistosoma mansoni and S. japonicum) or urinary (preferentially S. haematobium) disorders. Here we present an uncommon case of myeloradiculitis leading to bladder palsy and sensory loss at the lower limbs.

Multianalyte profiling of serum cytokines for detection of pancreatic cancer

Early detection of pancreatic cancer might improve clinical outcome. Significant alterations in the levels of individual serum cytokines have been reported in pancreatic cancer. We hypothesized that a multicytokine panel could serve as biomarkers for pancreatic cancer. To evaluate the diagnostic utility of such a panel, we have utilized a novel multianalyte LabMAP profiling technology that allows simultaneous measurement of multiple markers. In this study, a panel of 31 serological markers including cytokines, chemokines, growth and angiogenic factors in combination with CA 19-9 was analyzed in sera of pancreatic cancer patients, patients with chronic pancreatitis, and matched control healthy subjects. Statistical analysis identified a multicytokine panel that was able to distinguish pancreatic cancer from healthy controls with a sensitivity of 85.7% and specificity of 92.3%, which was superior to performance of CA 19-9 alone. Importantly, a multicytokine panel allowed the discrimination of pancreatic cancer from chronic pancreatitis with high sensitivity of 98% and specificity of 96.4%. In conclusion, we demonstrated that analysis of multiple serum cytokines using a novel LabMAP technology is a promising approach for development of a diagnostic assay for pancreatic cancer.

Electrical high frequency stimulation of the caudate nucleus induces local GABA outflow in freely moving rats

Electrical high frequency stimulation of the globus pallidus internus or the subthalamic nucleus has beneficial motor effects in advanced Parkinson's disease. The mechanisms underlying these clinical results remain, however, unclear. From previous in vitro studies it is proposed that the gamma-aminobutyric acid (GABA) system is involved in the effectiveness of electrical high frequency stimulation (HFS). In these experiments, we developed an in vivo model that allows for simultaneous and collocated microdialysis and HFS by electrical pulses of 124 Hz in the caudate nucleus of freely moving rats. GABA and glutamate outflow were sampled by microdialysis technique and quantified after pre-column o-phthaldialdehyde sulphite derivatization using HPLC with electrochemical detection. As the most outstanding result, we could demonstrate that high frequency stimulation significantly increased basal GABA outflow without affecting glutamate levels in freely moving rats.

Late-onset metachromatic leukodystrophy: genotype strongly influences phenotype

BACKGROUND

P426L and I179S are the two most frequent mutations in juvenile and adult metachromatic leukodystrophy (late-onset MLD), which, in contrast to infantile MLD, show marked phenotypic heterogeneity.

OBJECTIVE

To search for genotype-phenotype correlations in late-onset MLD.

METHODS

The authors reviewed the clinical course of 22 patients homozygous for mutation P426L vs 20 patients heterozygous for mutation I179S, in which the second arylsulfatase A (ASA) mutation had also been determined.

RESULTS

P426L homozygotes principally presented with progressive gait disturbance caused by spastic paraparesis or cerebellar ataxia; mental disturbance was absent or insignificant at the onset of disease but became more apparent as the disease evolved. In contrast, compound heterozygotes for I179S presented with schizophrenia-like behavioral abnormalities, social dysfunction, and mental decline, but motor deficits were scarce. Reduced peripheral nerve conduction velocities and less residual ASA activity were present in P426L homozygotes vs I179S heterozygotes.

CONCLUSION

The characteristic clinical differences between homozygous P426L and compound heterozygous I179S patients establish a distinct genotype-phenotype correlation in late-onset metachromatic leukodystrophy.

Neuronal electrical high frequency stimulation enhances GABA outflow from human neocortical slices

Electrical high frequency stimulation of the globus pallidus internus or the subthalamic nucleus has beneficial motor effects in advanced Parkinson's disease. The mechanisms underlying these clinical results remain, however, unclear. From previous studies it is proposed that the gamma-aminobutyric acid (GABA) system is involved in the effectiveness of electrical high frequency stimulation. In these experiments, human neocortical slices were stimulated electrically (130 Hz) in vitro, and GABA outflow was measured after o-phthaldialdehyde sulphite derivatization using HPLC with electrochemical detection. Our results could demonstrate that high frequency stimulation (HFS) significantly increased basal GABA outflow in the presence of submaximal concentrations of the voltage-gated sodium channel opener veratridine. This effect could be abolished by the GABA antagonists bicuculline or picrotoxin. These results suggest that HFS has an activating effect on GABAergic neuronal terminals in human neocortical slices, depending on sodium and chloride influx. Since GABA plays a role in CNS disorders of basal ganglia, anxiety and epilepsy, its neocortical modulation by HFS may be (patho)physiologically relevant.