1
|
Mirzaii-Dizgah MH, Mirzaii-Dizgah MR, Mirzaii-Dizgah I. Serum and saliva total tau protein as a marker for relapsing-remitting multiple sclerosis. Med Hypotheses 2020; 135:109476. [DOI: 10.1016/j.mehy.2019.109476] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 10/29/2019] [Accepted: 11/08/2019] [Indexed: 01/06/2023]
|
2
|
Hessen E, Eckerström M, Nordlund A, Selseth Almdahl I, Stålhammar J, Bjerke M, Eckerström C, Göthlin M, Fladby T, Reinvang I, Wallin A. Subjective Cognitive Impairment Is a Predominantly Benign Condition in Memory Clinic Patients Followed for 6 Years: The Gothenburg-Oslo MCI Study. Dement Geriatr Cogn Dis Extra 2017; 7:1-14. [PMID: 28413412 PMCID: PMC5346963 DOI: 10.1159/000454676] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 11/15/2016] [Indexed: 12/21/2022] Open
Abstract
Background/Aims In the quest for prevention or treatment, there is a need to find early markers for preclinical dementia. This study observed memory clinic patients with subjective cognitive impairment (SCI) and normal cognitive function at baseline. The primary aim was to address SCI as a potential risk factor for cognitive decline. The secondary aim was to address a potential relation between (1) baseline cerebrospinal fluid biomarkers and (2) a decline in memory performance over the first 2 years of follow-up, with a possible cognitive decline after 6 years. Methods Eighty-one patients (mean age 61 years) were recruited from university memory clinics and followed up for 6 years. Results Eighty-six percent of the cohort remained cognitively stable or improved, 9% developed mild cognitive impairment, and only 5% (n = 4) developed dementia. Regression analysis revealed that low levels of Aβ42 at baseline and memory decline during the first 2 years predicted dementia. When combined, these variables were associated with a 50% risk of developing dementia. Conclusions Cognitive stability for 86% of the cohort suggests that SCI is predominantly a benign condition with regard to neuropathology. The low number of individuals who developed dementia limits the generalizability of the results and discussion of progression factors.
Collapse
Affiliation(s)
- Erik Hessen
- Department of Neurology, Akershus University Hospital, Oslo, Norway.,Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Oslo, Norway
| | - Marie Eckerström
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Arto Nordlund
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | | | - Jacob Stålhammar
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Maria Bjerke
- Reference Center for Biological Markers of Dementia, Department of Biomedical Sciences, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Carl Eckerström
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Mattias Göthlin
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Tormod Fladby
- Department of Neurology, Akershus University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ivar Reinvang
- Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Oslo, Norway
| | - Anders Wallin
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| |
Collapse
|
3
|
Hessen E, Nordlund A, Stålhammar J, Eckerström M, Bjerke M, Eckerström C, Göthlin M, Fladby T, Reinvang I, Wallin A. T-Tau is Associated with Objective Memory Decline Over Two Years in Persons Seeking Help for Subjective Cognitive Decline: A Report from the Gothenburg-Oslo MCI Study. J Alzheimers Dis 2016; 47:619-28. [PMID: 26401697 DOI: 10.3233/jad-150109] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is a need to find very early markers for pre-clinical Alzheimer's disease as interventions early in the disease process are thought to be most effective. OBJECTIVE The present study aimed to address the potential relation between cerebrospinal fluid (CSF) biomarkers and reduced cognitive function in a relatively young cohort of memory clinic patients with subjective cognitive decline. METHODS 122 patients (mean age 63 years) with subjective cognitive decline were recruited from two university memory clinics and followed for two years. RESULTS The main finding was that the subgroup with objective memory decline during the study period had significantly higher T-tau at baseline than the group with improved memory. Baseline CSF variables showed a trend toward more pathological values in the patients with memory decline compared to those who improved or remained stable. The baseline memory score of those who declined was significantly better than the baseline score of those who improved over two years. The general trend for the whole group was improved memory and executive test scores. There were no differences in cognitive scores based on CSF quartiles at baseline, nor were there differences in cognitive outcome for patients with early amnestic mild cognitive impairment versus average cognitive function at baseline. CONCLUSIONS The main finding that T-tau rather than amyloid-β was associated with memory decline do not support the prevailing opinion about the chain of events assumed to take place in Alzheimer's disease. In addition, memory decline was not associated with poor baseline memory score. Thus, a memory cut-off indicating low baseline memory would not would have identified the declining group.
Collapse
Affiliation(s)
- Erik Hessen
- Department of Neurology, Akershus University Hospital, Oslo, Norway.,Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Oslo, Norway
| | - Arto Nordlund
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg, University, Mölndal, Sweden
| | - Jacob Stålhammar
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg, University, Mölndal, Sweden
| | - Marie Eckerström
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg, University, Mölndal, Sweden
| | - Maria Bjerke
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg, University, Mölndal, Sweden
| | - Carl Eckerström
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg, University, Mölndal, Sweden
| | - Mattias Göthlin
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg, University, Mölndal, Sweden
| | - Tormod Fladby
- Department of Neurology, Akershus University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ivar Reinvang
- Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Oslo, Norway
| | - Anders Wallin
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg, University, Mölndal, Sweden
| |
Collapse
|
4
|
Lee DH, Steinacker P, Seubert S, Turnescu T, Melms A, Manzel A, Otto M, Linker RA. Role of glial 14-3-3 gamma protein in autoimmune demyelination. J Neuroinflammation 2015; 12:187. [PMID: 26438180 PMCID: PMC4595275 DOI: 10.1186/s12974-015-0381-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 08/18/2015] [Indexed: 02/06/2023] Open
Abstract
Background The family of 14-3-3 proteins plays an important role in the regulation of cell survival and death. Here, we investigate the role of the 14-3-3 gamma (14-3-3 γ) subunit for glial responses in autoimmune demyelination. Methods Expression of 14-3-3 γ in glial cell culture was investigated by reverse transcription polymerase chain reaction (RT-PCR) and immunocytochemistry. 14-3-3 γ knockout mice were subjected to murine myelin oligodendrocyte-induced experimental autoimmune encephalomyelitis (MOG-EAE), an animal model mimicking inflammatory features and neurodegenerative aspects of multiple sclerosis (MS). Results Expression studies in cell culture confined expression of 14-3-3 γ to both, oligodendrocytes (OL) and astrocytes. RT-PCR analysis revealed an increased expression of 14-3-3 γ mRNA in the spinal cord during the late chronic phase of MOG-EAE. At that stage, EAE was more severe in 14-3-3 γ knockout mice as compared to age- and gender-matched controls. Histopathological analyses on day 56 post immunization (p.i.) revealed significantly enhanced myelin damage as well as OL injury and secondary, an increase in axonal injury and gliosis in 14-3-3 γ −/− mice. At the same time, deficiency in 14-3-3 γ protein did not influence the immune response. Further histological studies revealed an increased susceptibility towards apoptosis in 14-3-3 γ-deficient OL in the inflamed spinal cord. Conclusion These data argue for a pivotal role of 14-3-3 γ-mediated signalling pathways for OL protection in neuroinflammation. Electronic supplementary material The online version of this article (doi:10.1186/s12974-015-0381-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- De-Hyung Lee
- Department of Neurology, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, D-91054, Erlangen, Germany
| | - Petra Steinacker
- Department of Neurology, Universitäts- und Rehabilitationskliniken Ulm (RKU), Oberer Eselsberg 45, D-89081, Ulm, Germany
| | - Silvia Seubert
- Department of Neurology, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, D-91054, Erlangen, Germany
| | - Tanja Turnescu
- Department of Neurology, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, D-91054, Erlangen, Germany
| | - Arthur Melms
- Neurological Rehabilitation, Department of Neurology, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, D-91054, Erlangen, Germany
| | - Arndt Manzel
- Department of Neurology, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, D-91054, Erlangen, Germany
| | - Markus Otto
- Department of Neurology, Universitäts- und Rehabilitationskliniken Ulm (RKU), Oberer Eselsberg 45, D-89081, Ulm, Germany
| | - Ralf A Linker
- Department of Neurology, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, D-91054, Erlangen, Germany.
| |
Collapse
|
5
|
Becker M, Latarche C, Roman E, Debouverie M, Malaplate-Armand C, Guillemin F. No prognostic value of routine cerebrospinal fluid biomarkers in a population-based cohort of 407 multiple sclerosis patients. BMC Neurol 2015; 15:79. [PMID: 25966681 PMCID: PMC4430897 DOI: 10.1186/s12883-015-0330-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 04/22/2015] [Indexed: 12/20/2022] Open
Abstract
Background We aimed to determine the association of clinical and routine cerebrospinal fluid biochemical markers (total protein, IgG index and oligoclonal bands) with disability in multiple sclerosis and whether these biomarkers assessed at diagnosis add prognostic value. Methods We followed a cohort of patients included in the Multiple Sclerosis Lorraine Register (eastern France) who had a diagnosis of multiple sclerosis for at least 5 years, as well as biological markers values and MRI findings (Barkhof’s criteria). In a Cox regression model, endpoint was time to score of 4 on the Expanded Disability Status Scale (EDSS) (i.e., limited time walking without aid or rest for more than 500 m). Results For 407 patients included, the median time from multiple sclerosis onset to EDSS score 4 was 4.5 years [2.2–7.2]. Cerebrospinal fluid total protein factor < 500 mg/L was associated with EDSS score 4 on bivariate analysis (hazard ratio 0.66, 95% confidence interval 0.46–0.95, p = 0.02). On multivariate analysis, older age at disease onset (≥50 years) and initial primary progressive course of MS but not biological markers predicted worse prognosis. Conclusion Routine cerebrospinal fluid biological markers at diagnosis were not prognostic factors of multiple sclerosis progression.
Collapse
Affiliation(s)
- Madlyne Becker
- INSERM, CIC-EC, CIC 1433, F-54 000, Nancy, France. .,Departement of Clinical Epidemiology and Evaluation, Nancy University Hospital, F-54 000, Nancy, France. .,Université de Lorraine, Université Paris Descartes, EA 4360 Apemac, F-54 000, Nancy, France.
| | - Clotilde Latarche
- INSERM, CIC-EC, CIC 1433, F-54 000, Nancy, France. .,Departement of Clinical Epidemiology and Evaluation, Nancy University Hospital, F-54 000, Nancy, France. .,Université de Lorraine, Université Paris Descartes, EA 4360 Apemac, F-54 000, Nancy, France.
| | - Emilie Roman
- Metz-Thionville Hospital, Bel Air Hospital, Departement of Biology, F-57 100, Thionville, France.
| | - Marc Debouverie
- INSERM, CIC-EC, CIC 1433, F-54 000, Nancy, France. .,Université de Lorraine, Université Paris Descartes, EA 4360 Apemac, F-54 000, Nancy, France. .,Department of Neurology, Nancy University Hospital, F-54 000, Nancy, France.
| | | | - Francis Guillemin
- INSERM, CIC-EC, CIC 1433, F-54 000, Nancy, France. .,Departement of Clinical Epidemiology and Evaluation, Nancy University Hospital, F-54 000, Nancy, France. .,Université de Lorraine, Université Paris Descartes, EA 4360 Apemac, F-54 000, Nancy, France. .,Department of Clinical Epidemiology and Evaluation, CHU de Nancy, Hôpitaux de Brabois, Allée du Morvan, 54500 Vandoeuvre Les, Nancy, France.
| |
Collapse
|
6
|
Sriramoju B, Kanwar RK, Kanwar JR. Neurobehavioral burden of multiple sclerosis with nanotheranostics. Neuropsychiatr Dis Treat 2015; 11:2675-89. [PMID: 26508863 PMCID: PMC4610886 DOI: 10.2147/ndt.s82768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic demyelinating neurological disorder affecting people worldwide; women are affected more than men. MS results in serious neurological deficits along with behavioral compromise, the mechanisms of which still remain unclear. Behavioral disturbances such as depression, anxiety, cognitive impairment, psychosis, euphoria, sleep disturbances, and fatigue affect the quality of life in MS patients. Among these, depression and psychosis are more common than any other neurological disorders. In addition, depression is associated with other comorbidities. Although anxiety is often misdiagnosed in MS patients, it can induce suicidal ideation if it coexists with depression. An interrelation between sleep abnormalities and fatigue is also reported among MS patients. In addition, therapeutics for MS is always a challenge because of the presence of the blood-brain barrier, adding to the lack of detailed understanding of the disease pathology. In this review, we tried to summarize various behavioral pathologies and their association with MS, followed by its conventional treatment and nanotheranostics.
Collapse
Affiliation(s)
- Bhasker Sriramoju
- Nanomedicine-Laboratory of Immunology and Molecular Biomedical Research (NLIMBR), School of Medicine, Molecular and Medical Research, Faculty of Health, Deakin University, VIC, Australia
| | - Rupinder K Kanwar
- Nanomedicine-Laboratory of Immunology and Molecular Biomedical Research (NLIMBR), School of Medicine, Molecular and Medical Research, Faculty of Health, Deakin University, VIC, Australia
| | - Jagat R Kanwar
- Nanomedicine-Laboratory of Immunology and Molecular Biomedical Research (NLIMBR), School of Medicine, Molecular and Medical Research, Faculty of Health, Deakin University, VIC, Australia
| |
Collapse
|
7
|
Raphael I, Webb J, Stuve O, Haskins W, Forsthuber T. Body fluid biomarkers in multiple sclerosis: how far we have come and how they could affect the clinic now and in the future. Expert Rev Clin Immunol 2014; 11:69-91. [PMID: 25523168 DOI: 10.1586/1744666x.2015.991315] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Multiple sclerosis (MS) is an autoimmune inflammatory disease of the central nervous system, which affects over 2.5 million people worldwide. Although MS has been extensively studied, many challenges still remain in regards to treatment, diagnosis and prognosis. Typically, prognosis and individual responses to treatment are evaluated by clinical tests such as the expanded disability status scale, MRI and presence of oligoclonal bands in the cerebrospinal fluid. However, none of these measures correlates strongly with treatment efficacy or disease progression across heterogeneous patient populations and subtypes of MS. Numerous studies over the past decades have attempted to identify sensitive and specific biomarkers for diagnosis, prognosis and treatment efficacy of MS. The objective of this article is to review and discuss the current literature on body fluid biomarkers in MS, including research on potential biomarker candidates in the areas of miRNA, mRNA, lipids and proteins.
Collapse
Affiliation(s)
- Itay Raphael
- University of Texas San Antonio - Biology, San Antonio, TX, USA
| | | | | | | | | |
Collapse
|
8
|
Salvisberg C, Tajouri N, Hainard A, Burkhard PR, Lalive PH, Turck N. Exploring the human tear fluid: discovery of new biomarkers in multiple sclerosis. Proteomics Clin Appl 2014; 8:185-94. [PMID: 24488530 DOI: 10.1002/prca.201300053] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 12/19/2013] [Accepted: 01/22/2014] [Indexed: 12/19/2022]
Abstract
PURPOSE Multiple sclerosis is the first cause of progressive neurological disability among young adults living in Western countries. Its diagnosis is mostly based on clinical evaluation, neuroimaging, and in some cases cerebrospinal fluid (CSF) analysis, but no definitive diagnostic test exists. We proposed here that the exploration of tears from multiple sclerosis patients could lead to the discovery of new biomarkers. EXPERIMENTAL DESIGN Thirty multiple sclerosis patients (20% men) recruited to the Geneva University Hospitals were included in our study (mean age ± SD [years]: 42.4 ± 15.9). Twenty-five control patients (32% men) were also enrolled (mean age ± SD [years]: 42.7±15.1). Tears, CSF or blood was collected for each patient. Three independent quantitative (tandem mass tag) experiments were carried out between tears from multiple sclerosis and control patients. Protein verification was performed by Western blot on tears and CSF and by ELISA on serum samples. RESULTS Combined proteomics analyses provided 185 identified tear proteins. Among the differential proteins, alpha-1 antichymotrypsin was the only one to be significantly increased in the three experiments with similar ratios (ratios 1.6 to 2.5, p < 0.05). Its tear, CSF and serum elevation were further confirmed by Western blot and ELISA, respectively. CONCLUSIONS AND CLINICAL RELEVANCE This study supports the concept that modifications of the tear proteome can reflect biological abnormalities associated with multiple sclerosis and perhaps other inflammatory conditions affecting the CNS. In addition, alpha-1 antichymotrypsin elevation in tear fluid emerges as a promising biomarker for the diagnosis of multiple sclerosis.
Collapse
Affiliation(s)
- Cindy Salvisberg
- Translational Biomarker Group, Department of Human Protein Sciences, Medical University Center, Geneva, Switzerland
| | | | | | | | | | | |
Collapse
|
9
|
Kisic Tepavcevic D, Pekmezovic T, Stojsavljevic N, Kostic J, Dujmovic Basuroski I, Mesaros S, Drulovic J. Predictive value of health-related quality of life in progression of disability and depression in persons with multiple sclerosis: a 3-year study. Acta Neurol Belg 2013; 113:403-9. [PMID: 23460394 DOI: 10.1007/s13760-013-0191-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Accepted: 02/15/2013] [Indexed: 11/29/2022]
Abstract
In our study, we examined whether health-related quality of life (HRQoL) could predict changes in disability, depression, and fatigue in patients with multiple sclerosis (MS) over a 3-year follow-up period. A group of 109 consecutive MS patients (McDonald's criteria) referring to the Institute of Neurology, Belgrade were enrolled in the study. At two time points during the study (baseline, and after a 3-year period) an HRQoL (measured by MSQoL-54), EDSS, Hamilton Rating Scale for Depression (HDRS) and Fatigue Severity Scale (FSS) were assessed. At the end of a 3-year follow-up, 12 out of 109 patients (11%) had dropped out. Multiple linear regression analysis showed that Physical Health scale of MSQoL-54 is significant independent predictor of change in EDSS after 3 years (p = 0.035). Mental health composite score of MSQoL-54 was predictor of change in HDRS score (p = 0.049). In separate regression analysis, only social function was independent predictor of the development of depression (p = 0.041). None of the HRQoL domains had predictive effect on the change of FSS. Our study suggests that baseline HRQoL scores, measured by MSQoL-54, could be applied as a prognostic marker for progression of both, disability, and severity of depressive symptoms in MS.
Collapse
Affiliation(s)
- Darija Kisic Tepavcevic
- Faculty of Medicine, Institute of Epidemiology, University of Belgrade, Visegradska 26, 11000, Belgrade, Serbia
| | | | | | | | | | | | | |
Collapse
|
10
|
Clinical, MRI, and CSF markers of disability progression in multiple sclerosis. DISEASE MARKERS 2013; 35:687-99. [PMID: 24324285 PMCID: PMC3842089 DOI: 10.1155/2013/484959] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Revised: 09/12/2013] [Accepted: 10/09/2013] [Indexed: 11/17/2022]
Abstract
Multiple sclerosis (MS) is a chronic disorder of the central nervous system (CNS) in which the complex interplay between inflammation and neurodegeneration determines varying degrees of neurological disability. For this reason, it is very difficult to express an accurate prognosis based on purely clinical information in the individual patient at an early disease stage. Magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) biomarkers are promising sources of prognostic information with a good potential of quantitative measure, sensitivity, and reliability. However, a comprehensive MS outcome prediction model combining multiple parameters is still lacking. Current relevant literature addressing the topic of clinical, MRI, and CSF markers as predictors of MS disability progression is reviewed here.
Collapse
|
11
|
Gajofatto A, Bongianni M, Zanusso G, Bianchi MR, Turatti M, Benedetti MD, Monaco S. Clinical and biomarker assessment of demyelinating events suggesting multiple sclerosis. Acta Neurol Scand 2013; 128:336-44. [PMID: 23550839 DOI: 10.1111/ane.12123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Initial demyelinating event (IDE) diagnosis and prognosis are not straightforward. OBJECTIVE To identify potential diagnostic markers and outcome predictors of IDEs suggestive of multiple sclerosis (MS), that is, clinically isolated syndromes (CISs). METHODS Clinically isolated syndrome cases (i.e., subjects with an IDE compatible with MS onset and no alternative explanation) with at least 1.5 years' follow-up were retrospectively identified. All cases underwent clinical, neurophysiological, MRI, and cerebrospinal fluid (CSF) assessment, including exploratory tau, 14-3-3, and cystatin C testing. CIS recovery, conversion to MS, and long-term neurological disability were used as outcome measures. Patients with neuromyelitis optica spectrum disorders, idiopathic acute transverse myelitis (IATM), Creutzfeldt-Jacob disease, and non-inflammatory/non-neurodegenerative disorders served as controls for CSF analysis. RESULTS Forty-six CIS cases were included. Severe presentation was associated with incomplete recovery, while presence of at least 3 periventricular lesions on baseline MRI correlated with MS conversion. Initial pyramidal tract involvement, incomplete CIS recovery, and number of relapses predicted neurological disability. CSF tau, 14-3-3, and cystatin C did not correlate with any outcome measure. CIS cases had significantly lower tau and cystatin C levels compared to IATM. CONCLUSIONS An extensive diagnostic evaluation of patients with an IDE is worthwhile to make prognostic predictions. More robust molecular biomarkers are needed.
Collapse
Affiliation(s)
- A. Gajofatto
- Section of Clinical Neurology; Department of Neurological, Neuropsychological, Morphological and Movement Sciences; University of Verona; Italy
| | - M. Bongianni
- Section of Neuropathology; Department of Neurological, Neuropsychological, Morphological and Movement Sciences; University of Verona; Italy
| | - G. Zanusso
- Section of Neuropathology; Department of Neurological, Neuropsychological, Morphological and Movement Sciences; University of Verona; Italy
| | - M. R. Bianchi
- Section of Clinical Neurology; Department of Neurological, Neuropsychological, Morphological and Movement Sciences; University of Verona; Italy
| | - M. Turatti
- Section of Clinical Neurology; Department of Neurological, Neuropsychological, Morphological and Movement Sciences; University of Verona; Italy
| | - M. D. Benedetti
- Section of Clinical Neurology; Department of Neurological, Neuropsychological, Morphological and Movement Sciences; University of Verona; Italy
| | - S. Monaco
- Section of Neuropathology; Department of Neurological, Neuropsychological, Morphological and Movement Sciences; University of Verona; Italy
| |
Collapse
|
12
|
Szalardy L, Zadori D, Simu M, Bencsik K, Vecsei L, Klivenyi P. Evaluating biomarkers of neuronal degeneration and neuroinflammation in CSF of patients with multiple sclerosis–osteopontin as a potential marker of clinical severity. J Neurol Sci 2013; 331:38-42. [DOI: 10.1016/j.jns.2013.04.024] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 03/31/2013] [Accepted: 04/22/2013] [Indexed: 01/26/2023]
|
13
|
Kirbas A, Kirbas S, Anlar O, Efe H, Yilmaz A. Serum paraoxonase and arylesterase activity and oxidative status in patients with multiple sclerosis. J Clin Neurosci 2013; 20:1106-9. [DOI: 10.1016/j.jocn.2012.09.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Revised: 09/24/2012] [Accepted: 09/29/2012] [Indexed: 10/26/2022]
|
14
|
Sbardella E, Greco A, Stromillo ML, Prosperini L, Puopolo M, Cefaro LA, Pantano P, De Stefano N, Minghetti L, Pozzilli C. Isoprostanes in clinically isolated syndrome and early multiple sclerosis as biomarkers of tissue damage and predictors of clinical course. Mult Scler 2012; 19:411-7. [PMID: 22917691 DOI: 10.1177/1352458512457721] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Isoprostanes (IsoP) are sensitive biomarkers of oxidative stress. Their cerebrospinal-fluid (CSF) level is increased in several neurological conditions, including multiple sclerosis (MS). In particular, in relapsing-remitting MS, IsoP have been proposed as an index of neurodegenerative processes. The mechanisms leading to neuroaxonal damage in MS are not fully understood but oxidative mechanisms play a substantial role. Although axonal loss is present in MS patients since their first clinical symptoms, IsoP levels at this early stage have not been evaluated yet. OBJECTIVES The objectives of this study were (a) to assess IsoP levels in CSF of patients with a first clinical attack suggestive of MS; (b) to correlate IsoP levels with magnetic resonance imaging (MRI) measures of brain damage and (c) to assess IsoP value in predicting disease clinical evolution. METHODS Thirty-nine patients with a first clinical attack suggestive of MS underwent neurological examination, lumbar puncture with IsoP levels quantification and conventional/spectroscopic-MRI. Patients were followed up for 24 months. RESULTS CSF IsoP levels were higher in patients than controls (mean ± standard deviation (SD) 123.4 ± 185.8 vs 4.5 ± 2.9 pg/ml; p<0.0001) and inversely correlated to normalized brain volume (p=0.04) and N-acetylaspartate/choline (NAA/Cho) (p=0.01). The risk of experiencing clinical relapses differed according to IsoP level: subjects with levels higher than 95 pg/ml (a cut-off value resulting from ROC analysis) were more likely to relapse than patients with levels equal or lower than 95 pg/ml (59% vs 27% respectively; p=0.03). CONCLUSIONS CSF IsoP might be useful biomarkers of tissue damage in MS with a predictive value of disease course.
Collapse
Affiliation(s)
- Emilia Sbardella
- Department of Neurology and Psychiatry, Sapienza University, Rome, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|