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Xavier S, Younesi S, Sominsky L, Spencer SJ. Inhibiting microglia exacerbates the early effects of cuprizone in males in a rat model of multiple sclerosis, with no effect in females. Front Neurol 2023; 14:989132. [PMID: 37745672 PMCID: PMC10516553 DOI: 10.3389/fneur.2023.989132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/28/2023] [Indexed: 09/26/2023] Open
Abstract
Hyper-activity of the brain's innate immune cells, microglia, is a hallmark of multiple sclerosis (MS). However, it is not clear whether this involvement of microglia is beneficial or detrimental or whether manipulating microglial activity may be therapeutic. We investigated if inhibiting microglial activity with minocycline prevents the early changes in oligodendrocyte and myelin-related markers associated with a demyelinating challenge in adult female and male rats. Cuprizone reduced the expression of myelin and oligodendrocyte genes in both females and males, reflective of cuprizone intoxication and the early phases demyelination, and reduced the number of oligodendrocytes in the corpus callosum. However, we see notable differences in the role for microglia in this response between females and males. In males, myelin and oligodendrocyte genes, as well as oligodendrocytes were also reduced by minocycline treatment; an effect that was not seen in females. In males, but not females, early changes in oligodendrocyte and myelin-related genes were associated with microglial proliferation in corpus callosum, and this increase was reversed by minocycline. These data indicate sex-specific effects of inhibiting microglia on the early changes leading to demyelination in an MS model and suggest microglia may play a key role in myelin stability in males but not in females. This highlights a strong need for sex-specific understanding of disease development in MS and suggest that treatments targeting microglia may be more effective in males than in females due to differing mechanisms of disease progression.
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Affiliation(s)
- Soniya Xavier
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Simin Younesi
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Luba Sominsky
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
- Barwon Health Laboratory, Barwon Health, University Hospital, Geelong, VIC, Australia
- School of Medicine, Institute for Physical and Mental Health and Clinical Transformation, Deakin University, Geelong, VIC, Australia
| | - Sarah J. Spencer
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
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Rashidbenam Z, Ozturk E, Pagnin M, Theotokis P, Grigoriadis N, Petratos S. How does Nogo receptor influence demyelination and remyelination in the context of multiple sclerosis? Front Cell Neurosci 2023; 17:1197492. [PMID: 37361998 PMCID: PMC10285164 DOI: 10.3389/fncel.2023.1197492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/15/2023] [Indexed: 06/28/2023] Open
Abstract
Multiple sclerosis (MS) can progress with neurodegeneration as a consequence of chronic inflammatory mechanisms that drive neural cell loss and/or neuroaxonal dystrophy in the central nervous system. Immune-mediated mechanisms can accumulate myelin debris in the disease extracellular milieu during chronic-active demyelination that can limit neurorepair/plasticity and experimental evidence suggests that potentiated removal of myelin debris can promote neurorepair in models of MS. The myelin-associated inhibitory factors (MAIFs) are integral contributors to neurodegenerative processes in models of trauma and experimental MS-like disease that can be targeted to promote neurorepair. This review highlights the molecular and cellular mechanisms that drive neurodegeneration as a consequence of chronic-active inflammation and outlines plausible therapeutic approaches to antagonize the MAIFs during the evolution of neuroinflammatory lesions. Moreover, investigative lines for translation of targeted therapies against these myelin inhibitors are defined with an emphasis on the chief MAIF, Nogo-A, that may demonstrate clinical efficacy of neurorepair during progressive MS.
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Affiliation(s)
- Zahra Rashidbenam
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Ezgi Ozturk
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Maurice Pagnin
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Paschalis Theotokis
- Laboratory of Experimental Neurology and Neuroimmunology, Department of Neurology, AHEPA University Hospital, Thessaloniki, Greece
| | - Nikolaos Grigoriadis
- Laboratory of Experimental Neurology and Neuroimmunology, Department of Neurology, AHEPA University Hospital, Thessaloniki, Greece
| | - Steven Petratos
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
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Propper RE, Wylie GR, Villafana M. An internet-based survey of synesthesia in multiple sclerosis: Incidence, characteristics and implications. Mult Scler Relat Disord 2021; 54:103121. [PMID: 34246021 DOI: 10.1016/j.msard.2021.103121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/11/2021] [Accepted: 06/25/2021] [Indexed: 10/21/2022]
Abstract
Objective Prior work raises the interesting possibility that both multiple sclerosis and synesthesia share a common etiology, that being immune system dysfunction, as well as neuroanatomical and neurochemical abnormalities, including those involving white matter and serotonergic pathways, respectively. Given these links between these two syndromes, we examined the possibility that prevalence of synesthesia would be elevated in a population of individuals with MS, relative to what is thought to be the prevalence in the neurotypical population. It was not known whether synesthesia might be a marker for subsequent development of MS, or if synesthesia might reflect neurological damage resulting from MS disease progression. Method Individuals with self- reported clinically definite MS were recruited online via the internet and social media using sites specifically relevant to the MS community. Data from 147 individuals who completed several questionnaires related to synesthesia were analyzed. Results Depending on criteria, between approximately 7 and 16% of individuals with MS reported synesthesia here. This is an estimated 1.57 to 3.55 times increased incidence of synesthesia here relative to previous findings in neurotypical samples. Limitations of the study include that this was an internet survey, and that synesthesia was not directly assessed in this sample. Conclusions Results suggest a link between the syndromes, primarily indicating that synesthesia may be a marker for subsequent MS development, and the implications and directions for future study are discussed.
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Affiliation(s)
- Ruth E Propper
- Department of Psychology, Montclair State University, 1 Normal Avenue, Montclair, NJ, USA.
| | - Glenn R Wylie
- Kessler Foundation, Department of Veterans' Affairs, Rutgers University, USA
| | - Melissa Villafana
- Department of Psychology, Montclair State University, 1 Normal Avenue, Montclair, NJ, USA
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Pirttisalo AL, Sipilä JOT, Viitala M, Soilu-Hänninen M. Trends and characteristics of infection-related hospital admissions in multiple sclerosis patients in Southwest Finland in 2009-2018. Mult Scler Relat Disord 2020; 44:102328. [PMID: 32619965 DOI: 10.1016/j.msard.2020.102328] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/20/2020] [Accepted: 06/21/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) patients are at increased risk for infections. The aim of this study was to investigate the trends in hospital admissions of patients with MS and to identify the factors predisposing to infection-related admissions. METHODS Hospital admissions with MS as a primary or an auxiliary diagnosis in the hospital district of Southwest Finland in 2009-2018 were searched and MS patients with infection admissions compared with other MS patients in the hospital district. Data were derived from hospital registries, patient charts and the Finnish MS register. Group comparisons were performed using Pearson´s chi-squared test, Fisher´s exact test or Wilcoxon rank sum test. Overdispersion-adjusted Poisson regression was used to analyze the annual admission numbers and multivariable logistic regression to examine the predictors of infection-related admissions. RESULTS 1380 hospital admissions for 532 patients were identified. The annual number of admissions decreased by 8.9% annually (p<0.001). Proportion of infection-related admissions declined from 26.5% to 19.5% (p = 0.049). The patients with infection admissions were on average 8.2 years older (p<0.001), more often male (p<0.001), had on average 5.3 years longer disease duration (p<0.001), more disability (median EDSS 5.0 vs. 2.0; p<0.001), more often progressive disease (p<0.001) and more comorbidities (p = 0.006) than other MS patients. Disease modifying therapies (DMTs) were used less often by patients with infection admissions (p<0.001). Infection admissions were not associated with the number of recent relapses. In-hospital mortality was higher in the infection-related admissions (3.57% vs 0.29%; p<0.001). Only 14.3% of patients with over two infection admissions had a DMT during the study period. CONCLUSION Hospital admissions, with or without an infection, have become more infrequent in MS patients of Southwest Finland over the decade from 2009 to 2018. Infection-related admissions were associated with lesser use of DMTs, older age, male gender and disability.
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Affiliation(s)
- Anna-Leena Pirttisalo
- Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland; Department of Clinical Neurosciences, University of Turku, Turku, Finland.
| | - Jussi O T Sipilä
- Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland; Department of Clinical Neurosciences, University of Turku, Turku, Finland; Department of Neurology, Siun sote, North Karelia Central Hospital, Joensuu, Finland
| | - Matias Viitala
- Department of Mathematics and Statistics, University of Turku, Turku, Finland; StellarQ LTD, Turku, Finland
| | - Merja Soilu-Hänninen
- Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland; Department of Clinical Neurosciences, University of Turku, Turku, Finland
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Murtonen A, Sumelahti M. Multiple sclerosis prevalence in 2000 and 2010 in Western Finland. Acta Neurol Scand 2020; 141:311-318. [PMID: 31838739 DOI: 10.1111/ane.13203] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 12/09/2019] [Accepted: 12/11/2019] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To study ten-year change in MS prevalence in the Province of Western Finland in Tampere University Hospital District located in 62.7°N, 23.7°E. METHODS Age-standardized prevalence/105 by using direct standardization in European Standard Population (ESP2013) and crude prevalence/105 with 95% confidence interval (95% CI) were assessed among resident MS cases fulfilling Poser criteria by sex and disease course in 31.12.2000 and 31.12.2010. MS-related disability and disease-modifying treatment (DMT) use were estimated in 31.12.2010. RESULTS Crude prevalence increased 49% from 129/105 (95% CI 121-137) in 2000 (N 1080) to 196/105 (187-203) in 2010 (N 1666). Age-standardized prevalence increased 45% from 133/105 (127-140) to 192/105 (184-200) and peaked in 40- to 49-year age-group. Age-standardized prevalence increased 58% among women from 176/105 (171-176) to 277/105 (270-284) and 31% among men from 91/105 (87-95) to 119/105 (115-124). Increase in RRMS was 61% from 111/105 (105-117) to 179/105 (171-186), and decrease in PPMS was 14% from 21/105 (19-24) to 18/105 (15-21). In 2010 among the 52% RRMS cases on DMT, MS-related disability was mild in 50%. In total, cohort disability was mild in 46%, moderate to severe in 47%, and information was not available in 14%. CONCLUSION A significant increase in prevalence was observed in Western Finland. Increase was higher among women and in relapsing-remitting onset MS. Disability showed age- and disease course-specific variation.
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Affiliation(s)
- Annukka Murtonen
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
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Pirttisalo AL, Soilu-Hänninen M, Sipilä JOT. Multiple sclerosis epidemiology in Finland: Regional differences and high incidence. Acta Neurol Scand 2019; 139:353-359. [PMID: 30480315 DOI: 10.1111/ane.13057] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 11/07/2018] [Accepted: 11/20/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Studies on the east-west gradient of multiple sclerosis (MS) are scarce. In Finland, epidemiological differences have been only partially elucidated, but the MS risk is high, and it has been claimed that the occurrence follows a longitudinal gradient. In this register-based study, we updated the MS epidemiology in southwest Finland (SwF) and compared it to the easternmost hospital district, North Karelia (NK), for which no previous data exist. MATERIALS AND METHODS Patients with ICD-10 code G35 were identified from hospital district administrative data. Patient records were reviewed to include only cases with a definitive diagnosis. Incidence period covered 5 years (2012-2016), and the prevalence date was December 31, 2016. Results were standardized using the direct method. RESULTS A total of 1184 persons had MS in SwF and 253 persons in NK at the end of 2016. The prevalence was 280/100 000 (95% CI 264-296) in SwF and 168/100 000 (95% CI 148-190) in NK (age-standardized for the European standard population 2013). During the incidence period, 211 new MS diagnoses were made in SwF and 49 in NK. The annual age-standardized (ESP 2013) incidence was 12.1/100 000 person-years (95% CI 10.5-13.8) in SwF and 8.6/100 000 person-years (95% CI 6.4-11.2) in NK in the age-group 10-69 years. CONCLUSIONS There are regional differences in MS epidemiology in Finland, possibly related to demographic, social, and genetic circumstances, but the retrospective nature and limited sample size of this study might introduce some uncertainty to the calculations. SwF is a region with a globally very high risk for MS.
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Affiliation(s)
- Anna-Leena Pirttisalo
- Division of Clinical Neurosciences; Turku University Hospital; Turku Finland
- Department of Neurology; University of Turku; Turku Finland
| | - Merja Soilu-Hänninen
- Division of Clinical Neurosciences; Turku University Hospital; Turku Finland
- Department of Neurology; University of Turku; Turku Finland
| | - Jussi O. T. Sipilä
- Division of Clinical Neurosciences; Turku University Hospital; Turku Finland
- Department of Neurology; University of Turku; Turku Finland
- Department of Neurology, Siun sote; North Karelia Central Hospital; Joensuu Finland
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Validating the portal population of the United Kingdom Multiple Sclerosis Register. Mult Scler Relat Disord 2018; 24:3-10. [DOI: 10.1016/j.msard.2018.05.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 05/17/2018] [Accepted: 05/22/2018] [Indexed: 11/17/2022]
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Exome and regulatory element sequencing of neuromyelitis optica patients. J Neuroimmunol 2015; 289:139-42. [DOI: 10.1016/j.jneuroim.2015.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 10/30/2015] [Accepted: 11/02/2015] [Indexed: 11/19/2022]
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Braverman ER, Blum K, Hussman KL, Han D, Dushaj K, Li M, Marin G, Badgaiyan RD, Smayda R, Gold MS. Evoked Potentials and Memory/Cognition Tests Validate Brain Atrophy as Measured by 3T MRI (NeuroQuant) in Cognitively Impaired Patients. PLoS One 2015; 10:e0133609. [PMID: 26244349 PMCID: PMC4526533 DOI: 10.1371/journal.pone.0133609] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 06/29/2015] [Indexed: 11/30/2022] Open
Abstract
To our knowledge, this is the largest study evaluating relationships between 3T Magnetic Resonance Imaging (MRI) and P300 and memory/cognitive tests in the literature. The 3T MRI using NeuroQuant has an increased resolution 15 times that of 1.5T MRI. Utilizing NeuroQuant 3T MRI as a diagnostic tool in primary care, subjects (N=169; 19–90 years) displayed increased areas of anatomical atrophy: 34.62% hippocampal atrophy (N=54), 57.14% central atrophy (N=88), and 44.52% temporal atrophy (N=69). A majority of these patients exhibited overlap in measured areas of atrophy and were cognitively impaired. These results positively correlated with decreased P300 values and WMS-III (WMS-III) scores differentially across various brain loci. Delayed latency (p=0.0740) was marginally associated with temporal atrophy; reduced fractional anisotropy (FA) in frontal lobes correlated with aging, delayed P300 latency, and decreased visual and working memory (p=0.0115). Aging and delayed P300 latency correlated with lower FA. The correlation between working memory and reduced FA in frontal lobes is marginally significant (p=0.0787). In the centrum semiovale (CS), reduced FA correlated with visual memory (p=0.0622). Lower demyelination correlated with higher P300 amplitude (p=0.0002). Compared to males, females have higher demyelination (p=0.0064). Along these lines, the higher the P300 amplitude, the lower the bilateral atrophy (p=0.0165). Hippocampal atrophy correlated with increased auditory memory and gender, especially in males (p=0.0087). In considering temporal lobe atrophy correlations: delayed P300 latency and high temporal atrophy (p=0.0740); high auditory memory and low temporal atrophy (p=0.0417); and high working memory and low temporal atrophy (p=0.0166). Central atrophy correlated with aging and immediate memory (p=0.0294): the higher the immediate memory, the lower the central atrophy. Generally, the validation of brain atrophy by P300 and WMS-III could lead to cost-effective methods utilizable in primary care medicine following further confirmation.
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Affiliation(s)
- Eric R. Braverman
- Department of Psychiatry, McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida, United States of America
- Department of Clinical Neurology, PATH Foundation NY, New York, New York, United States of America
- * E-mail:
| | - Kenneth Blum
- Department of Psychiatry, McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida, United States of America
- Department of Clinical Neurology, PATH Foundation NY, New York, New York, United States of America
- Human Integrated Services, University of Vermont, Center for Clinical and Translational Science, College of Medicine, Burlington, Vermont, United States of America
- Department of Addiction Services, Dominion Diagnostics, LLC., North Kingstown, Rhode Island, United States of America
| | - Karl L. Hussman
- Alpha 3T MRI & Diagnostic Imaging, New York, New York, United States of America
| | - David Han
- Department of Management Science and Statistics, University of Texas at San Antonio, San Antonio, Texas, United States of America
| | - Kristina Dushaj
- Department of Clinical Neurology, PATH Foundation NY, New York, New York, United States of America
| | - Mona Li
- Department of Clinical Neurology, PATH Foundation NY, New York, New York, United States of America
| | - Gabriela Marin
- Department of Clinical Neurology, PATH Foundation NY, New York, New York, United States of America
| | - Rajendra D. Badgaiyan
- Department of Psychiatry, Neuroimaging Center, University Of Minnesota School of Medicine, Minneapolis, Minnesota, United States of America
| | - Richard Smayda
- Department of Clinical Neurology, PATH Foundation NY, New York, New York, United States of America
| | - Mark S. Gold
- Department of Psychiatry, McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida, United States of America
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