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Noteboom S, Strijbis EMM, Coerver EME, Colato E, van Kempen ZLE, Jasperse B, Vrenken H, Killestein J, Schoonheim MM, Steenwijk MD. Long-term neuroprotective effects of natalizumab and fingolimod in multiple sclerosis: Evidence from real-world clinical data. Mult Scler Relat Disord 2024; 87:105670. [PMID: 38772150 DOI: 10.1016/j.msard.2024.105670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/29/2024] [Accepted: 05/05/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND The long-term effect of high efficacy disease modifying therapy (DMT) on neurodegeneration in people with multiple sclerosis (pwMS) is largely unknown. The aim of this study was to evaluate the long-term effect of natalizumab (NTZ) or fingolimod (FTY) therapy on the evolution of brain atrophy compared to moderate efficacy DMT in a real-world clinical setting. METHODS A total of 438 pwMS with 2,439 MRI exams during treatment were analyzed: 252 pwMS treated with moderate efficacy DMT, 130 with NTZ and 56 with FTY. Evolution of brain atrophy was analyzed over an average follow-up of 6.6 years after treatment initiation. Brain segmentation was performed on clinical 3D-FLAIRs using SynthSeg and regional brain volume changes over time were compared between the treatment groups. RESULTS Total brain, white matter and deep gray matter atrophy rates did not differ between moderate efficacy DMTs, NTZ and FTY. Annualized ventricle growth rates were lower in pwMS treated with NTZ (1.1 %/year) compared with moderate efficacy DMT (2.4 %/year, p < 0.001) and similar to FTY (2.0 %/year, p = 0.051). Cortical atrophy rates were lower in NTZ (-0.08 %/year) compared with moderate efficacy DMT (-0.16 %/year, p = 0.048). CONCLUSION In a real-world clinical setting, pwMS treated with NTZ had slower ventricular expansion and cortical atrophy compared to those treated with moderate efficacy DMT.
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Affiliation(s)
- S Noteboom
- MS Center Amsterdam, Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmc, Amsterdam, the Netherlands.
| | - E M M Strijbis
- MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
| | - E M E Coerver
- MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
| | - E Colato
- MS Center Amsterdam, Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmc, Amsterdam, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing, University college London, UK
| | - Z L E van Kempen
- MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
| | - B Jasperse
- MS Center Amsterdam, Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
| | - H Vrenken
- MS Center Amsterdam, Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
| | - J Killestein
- MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
| | - M M Schoonheim
- MS Center Amsterdam, Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
| | - M D Steenwijk
- MS Center Amsterdam, Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
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Weeda MM, van Nederpelt DR, Twisk JWR, Brouwer I, Kuijer JPA, van Dam M, Hulst HE, Killestein J, Barkhof F, Vrenken H, Pouwels PJW. Multimodal MRI study on the relation between WM integrity and connected GM atrophy and its effect on disability in early multiple sclerosis. J Neurol 2024; 271:355-373. [PMID: 37716917 PMCID: PMC10769935 DOI: 10.1007/s00415-023-11937-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/09/2023] [Accepted: 08/11/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is characterized by pathology in white matter (WM) and atrophy of grey matter (GM), but it remains unclear how these processes are related, or how they influence clinical progression. OBJECTIVE To study the spatial and temporal relationship between GM atrophy and damage in connected WM in relapsing-remitting (RR) MS in relation to clinical progression. METHODS Healthy control (HC) and early RRMS subjects visited our center twice with a 1-year interval for MRI and clinical examinations, including the Expanded Disability Status Scale (EDSS) and Multiple Sclerosis Functional Composite (MSFC) scores. RRMS subjects were categorized as MSFC decliners or non-decliners based on ΔMSFC over time. Ten deep (D)GM and 62 cortical (C) GM structures were segmented and probabilistic tractography was performed to identify the connected WM. WM integrity was determined per tract with, amongst others, fractional anisotropy (FA), mean diffusivity (MD), neurite density index (NDI), and myelin water fraction (MWF). Linear mixed models (LMMs) were used to investigate GM and WM differences between HC and RRMS, and between MSFC decliners and non-decliners. LMM was also used to test associations between baseline WM z-scores and changes in connected GM z-scores, and between baseline GM z-scores and changes in connected WM z-scores, in HC/RRMS subjects and in MSFC decliners/non-decliners. RESULTS We included 13 HCs and 31 RRMS subjects with an average disease duration of 3.5 years and a median EDSS of 3.0. Fifteen RRMS subjects showed declining MSFC scores over time, and they showed higher atrophy rates and greater WM integrity loss compared to non-decliners. Lower baseline WM integrity was associated with increased CGM atrophy over time in RRMS, but not in HC subjects. This effect was only seen in MSFC decliners, especially when an extended WM z-score was used, which included FA, MD, NDI and MWF. Baseline GM measures were not significantly related to WM integrity changes over time in any of the groups. DISCUSSION Lower baseline WM integrity was related to more cortical atrophy in RRMS subjects that showed clinical progression over a 1-year follow-up, while baseline GM did not affect WM integrity changes over time. WM damage, therefore, seems to drive atrophy more than conversely.
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Affiliation(s)
- Merlin M Weeda
- MS Center Amsterdam, Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands.
| | - D R van Nederpelt
- MS Center Amsterdam, Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - J W R Twisk
- Epidemiology and Data Science, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - I Brouwer
- MS Center Amsterdam, Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - J P A Kuijer
- MS Center Amsterdam, Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - M van Dam
- MS Center Amsterdam, Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - H E Hulst
- Health-, Medical-, and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - J Killestein
- MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - F Barkhof
- MS Center Amsterdam, Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
- UCL Queen Square Institute of Neurology and Centre for Medical Image Computing, University College London, London, UK
| | - H Vrenken
- MS Center Amsterdam, Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - P J W Pouwels
- MS Center Amsterdam, Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
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Scherder RJ, van Dorp M, Prins A, van Klaveren C, Cornelisz I, Killestein J, Weinstein HC. Rest-Activity Rhythm, Pain, and Motor Activity in Multiple Sclerosis. Int J MS Care 2023; 25:157-162. [PMID: 37469337 PMCID: PMC10353695 DOI: 10.7224/1537-2073.2021-030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
BACKGROUND Although the relationships among physical disability, mood disorders, and pain are well described in multiple sclerosis (MS), little is known about whether those symptoms are associated with sleep disturbances. METHODS Forty-six patients with MS experiencing pain participated. Sleep was indirectly measured by assessing rest-activity rhythm via actigraphy: interdaily stability, intradaily variability, and relative amplitude. Pain was assessed using visual and verbal analog scales, mood by the Beck Depression Inventory and Symptom Checklist-90, and physical disability by the Expanded Disability Status Scale. RESULTS Incorporating mood, pain, and physical disability into 1 regression model resulted in a significant association with interdaily stability. CONCLUSIONS Compared with intradaily variability and relative amplitude, interdaily stability seems to be the most vulnerable actigraphy variable for mood disturbances, pain, and physical disabilities.
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Affiliation(s)
- Rogier J. Scherder
- From the Department of Clinical Neuropsychology, Free University, Amsterdam, the Netherlands (RJS, CvK, IC)
| | - M.J. van Dorp
- Tante Louise, Bergen op Zoom, the Netherlands (MJvD)
| | - A.J. Prins
- Atlant, Kuiltjesweg, Beekbergen, the Netherlands (AJP)
| | - C. van Klaveren
- From the Department of Clinical Neuropsychology, Free University, Amsterdam, the Netherlands (RJS, CvK, IC)
| | - I. Cornelisz
- From the Department of Clinical Neuropsychology, Free University, Amsterdam, the Netherlands (RJS, CvK, IC)
| | - J. Killestein
- Department of Neurology, Amsterdam University Medical Centers, Amsterdam, the Netherlands (JK)
| | - Henry C. Weinstein
- Department of Neurology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands (HW)
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Coerver E, Bourass A, Wessels M, van Kempen Z, Jasperse M, Tonino B, Barkhof F, Mostert J, Uitdehaag B, Killestein J, Strijbis E. Discontinuation of first-line disease-modifying therapy in relapse onset multiple sclerosis. Mult Scler Relat Disord 2023; 74:104706. [PMID: 37068370 DOI: 10.1016/j.msard.2023.104706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/22/2023] [Accepted: 04/02/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND It is not known if and when first-line disease modifying therapy (DMT) can safely be discontinued in relapse onset multiple sclerosis (MS) patients. OBJECTIVES To investigate the characteristics of patients who discontinued first-line DMT, and the occurrence of clinical and radiological inflammatory disease activity after discontinuation. METHODS We collected clinical and MRI parameters from patients with relapse onset MS in the MS Center Amsterdam and Rijnstate Hospital Arnhem who discontinued first-line DMT with no intention of restarting or switching treatment. RESULTS In total, 130 patients were included in the analyses. After discontinuation, 78 patients (60%) experienced disease activity. Sixty-three patients (48.5%) showed MRI activity after DMT discontinuation, 40 patients (30.8%) experienced relapse(s), and 29 patients (22.3%) restarted DMT. Higher age at DMT discontinuation was associated with a lower risk of MRI activity (45 -55 vs. <45 years: OR 0.301, p = 0.007, >55 vs. <45 years, OR: 0.296, p = 0.044), and with a lower risk of relapse(s) after discontinuation (45-55 vs. <45 years: OR=0.495, p = 0.106, >55 vs. <45 years: OR=0.081, p = 0.020). CONCLUSION Higher age at first-line DMT discontinuation is associated with lower risk and severity of radiological disease activity in MS, and a lower risk of relapse(s) after discontinuation.
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Olie SE, van Zeggeren IE, ter Horst L, Citroen J, van Geel BM, Heckenberg SGB, Jellema K, Kester MI, Killestein J, Mook BB, Titulaer MJ, van Veen KEB, Verschuur CVM, van de Beek D, Brouwer MC. Seizures in adults with suspected central nervous system infection. BMC Neurol 2022; 22:426. [PMID: 36376810 PMCID: PMC9661800 DOI: 10.1186/s12883-022-02927-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 10/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background Seizures can be part of the clinical presentation of central nervous system (CNS) infections. We describe patients suspected of a neurological infection who present with a seizure and study diagnostic accuracy of clinical and laboratory features predictive of CNS infection in this population. Methods We analyzed all consecutive patients presenting with a seizure from two prospective Dutch cohort studies, in which patients were included who underwent cerebrospinal fluid (CSF) examination because of the suspicion of a CNS infection. Results Of 900 episodes of suspected CNS infection, 124 (14%) presented with a seizure. The median age in these 124 episodes was 60 years (IQR 45–71) and 53% of patients was female. CSF examination showed a leukocyte count ≥ 5/mm3 in 41% of episodes. A CNS infection was diagnosed in 27 of 124 episodes (22%), a CNS inflammatory disorder in 8 (6%) episodes, a systemic infection in 10 (8%), other neurological disease in 77 (62%) and in 2 (2%) episodes another systemic disease was diagnosed. Diagnostic accuracy of clinical and laboratory characteristics for the diagnosis of CNS infection in this population was low. CSF leukocyte count was the best predictor for CNS infection in patients with suspected CNS infection presenting with a seizure (area under the curve 0.94, [95% CI 0.88 – 1.00]). Conclusions Clinical and laboratory features fail to distinguish CNS infections from other causes of seizures in patients with a suspected CNS infection. CSF leukocyte count is the best predictor for the diagnosis of CNS infection in this population.
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Killestein J, van Kempen ZLE. Vaccination responses in B-cell depleted multiple sclerosis patients: the role of drug pharmacokinetics. Eur J Neurol 2022; 29:3137-3138. [PMID: 35997630 PMCID: PMC9538965 DOI: 10.1111/ene.15529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 08/16/2022] [Indexed: 12/01/2022]
Affiliation(s)
- J Killestein
- Amsterdam UMC, Vrije Universiteit, Department of Neurology, De Boelelaan 1117, 1081, HV, Amsterdam, the Netherlands
| | - Z L E van Kempen
- Amsterdam UMC, Vrije Universiteit, Department of Neurology, De Boelelaan 1117, 1081, HV, Amsterdam, the Netherlands
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Boekel L, Stalman E, Wieske L, Hooijberg F, Besten Y, Leeuw M, Atiqi S, Kummer L, van Dam K, Steenhuis M, van Kempen Z, Killestein J, Lems W, Tas S, van Vollenhoven R, Nurmohamed M, Boers M, van Ham M, Rispens T, Kuijpers T, Eftimov F, Wolbink GJ. OP0178 COVID-19 BREAKTHROUGH INFECTIONS IN VACCINATED PATIENTS WITH IMMUNE-MEDIATED INFLAMMATORY DISEASES AND CONTROLS – DATA FROM TWO PROSPECTIVE COHORT STUDIES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundConcerns have been raised regarding risks of COVID-19 breakthrough infections in vaccinated patients with immune-mediated inflammatory diseases (IMIDs) treated with immunosuppressants, but data on COVID-19 breakthrough infections in these patients are still scarce.ObjectivesThe primary objective was to compare the incidence and severity of COVID-19 breakthrough infections with the SARS-CoV-2 delta variant between fully vaccinated IMID patients with immunosuppressants, and controls (IMID patients without immunosuppressants and healthy controls). The secondary objective was to explore determinants of breakthrough infections.MethodsIn this study we pooled data collected from two large ongoing prospective multi-center cohort studies (Target to-B! [T2B!] study and ARC study). Clinical data were collected between February and December 2021, using digital questionnaires, standardized electronic case record forms and medical files. Post-vaccination serum samples were analyzed for anti-RBD antibodies (T2B! study only) and anti-nucleocapsid antibodies to identify asymptomatic breakthrough infections (ARC study only). Logistic regression analyses were used to assess associations with the incidence of breakthrough infections. Multivariable models were adjusted for age, sex, cardiovascular disease, chronic pulmonary disease, obesity and vaccine type.ResultsWe included 3207 IMID patients with immunosuppressants and 1810 controls (985 IMID patients without immunosuppressants and 825 healthy controls). The incidence of COVID-19 breakthrough infections was comparable between patients with immunosuppressants (5%) and controls (5%). The absence of SARS-CoV-2 IgG antibodies after COVID-19 vaccination was independently associated with an increased incidence of breakthrough infections (P 0.044). The proportion of asymptomatic COVID-19 breakthrough cases that were additionally identified serologically in the ARC cohort was comparable between IMID patients with immunosuppressants and controls; 66 (10%) of 695 patients vs. 64 (10%) of 647 controls. Hospitalization was required in 8 (5%) of 149 IMID patients with immunosuppressants and 5 (6%) of 86 controls with a COVID-19 breakthrough infection. Hospitalized cases were generally older, and had more comorbidities compared with non-hospitalized cases (Table 1). Hospitalization rates were significantly higher among IMID patients treated with anti-CD20 therapy compared to IMID patients using any other immunosuppressant (3 [23%] of 13 patients vs. 5 [4%] of 128 patients, P 0.041; Table 1).Table 1.Determinants of the severity of COVID-19 breakthrough infections.Ambulatory care (n = 222)Hospitalized (n = 13)Group - no. (%)IMID patients with immunosuppressants141(64)8(62)IMID patients without immunosuppressants49(22)3(23)Healthy controls32(14)2(15)Patient characteristicsAge, years – mean (SD)51(14)60(11)Female sex – no. (%)143(64)4(31)Comorbidities – no. (%)Cardiovascular disease17(8)5(39)Chronic pulmonary disease17(8)4(31)Diabetes15(7)3(23)Obesity34(15)5(39)Immunosuppressants– no. (%)Methotrexate36(16)2(15)TNF inhibitor48(22)2(15)Anti-CD20 therapy13(6)3(23)Mycophenolate mofetil3(1)0(0)S1P modulator5(2)0(0)Other immunosuppressants70(32)3(23)ConclusionThe incidence of COVID-19 breakthrough infections in IMID patients with immunosuppressants was comparable to controls, and infections were mostly mild. Anti-CD20 therapy might increase patients’ susceptibility to severe COVID-19 breakthrough infections, but traditional risk factors also continue to have a critical contribution to the disease course of COVID-19. Therefore, we argue that most patients with IMIDs should not necessarily be seen as a risk group for severe COVID-19, and that integrating other risk factors should become standard practice when discussing treatment options, COVID-19 vaccination, and adherence to infection prevention measures with patients.Disclosure of InterestsNone declared
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van Kempen ZLE, Wieske L, Stalman EW, Kummer LYL, van Dam PJ, Volkers AG, Boekel L, Toorop AA, Strijbis EMM, Tas SW, Wolbink GJ, Löwenberg M, van Sandt C, Ten Brinke A, Verstegen NJM, Steenhuis M, Kuijpers TW, van Ham SM, Rispens T, Eftimov F, Killestein J. Longitudinal humoral response after SARS-CoV-2 vaccination in ocrelizumab treated MS patients: To wait and repopulate? Mult Scler Relat Disord 2021; 57:103416. [PMID: 34847379 PMCID: PMC8608662 DOI: 10.1016/j.msard.2021.103416] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 11/19/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The objective of this study was to measure humoral responses after SARS-CoV-2 vaccination in MS patients treated with ocrelizumab (OCR) compared to MS patients without disease modifying therapies (DMTs) in relation to timing of vaccination and B-cell count. METHODS OCR treated patients were divided into an early and a late group (cut-off time 12 weeks between infusion and first vaccination). Patients were vaccinated with mRNA-1273 (Moderna). B-cells were measured at baseline (time of first vaccination) and SARS-CoV-2 antibodies were measured at baseline, day 28, 42, 52 and 70. RESULTS 87 patients were included (62 OCR patients, 29 patients without DMTs). At day 70, seroconversion occurred in 39.3% of OCR patients compared to 100% of MS patients without DMTs. In OCR patients, seroconversion varied between 26% (early group) to 50% (late group) and between 27% (low B-cells) to 56% (at least 1 detectable B-cell/µL). CONCLUSIONS Low B-cell counts prior to vaccination and shorter time between OCR infusion and vaccination may negatively influence humoral response but does not preclude seroconversion. We advise OCR treated patients to get their first vaccination as soon as possible. In case of an additional booster vaccination, timing of vaccination based on B-cell count and time after last infusion may be considered.
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Affiliation(s)
- Z L E van Kempen
- Department of Neurology, Amsterdam UMC, Vrije Universiteit, De Boelelaan 1117, 1081 HV Amsterdam, the Netherland.
| | - L Wieske
- Department of Neurology and Neurophysiology, Amsterdam Neuroscience, Amsterdam UMC, location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherland
| | - E W Stalman
- Department of Neurology and Neurophysiology, Amsterdam Neuroscience, Amsterdam UMC, location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherland
| | - L Y L Kummer
- Department of Neurology and Neurophysiology, Amsterdam Neuroscience, Amsterdam UMC, location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherland; Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Amsterdam UMC, Plesmanlaan 125, 1066 CX Amsterdam, the Netherland
| | - P J van Dam
- Department of Neurology and Neurophysiology, Amsterdam Neuroscience, Amsterdam UMC, location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherland
| | - A G Volkers
- Department of Gastroenterology and Hepatology, Amsterdam UMC, location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherland
| | - L Boekel
- Amsterdam Rheumatology and immunology Center, location Reade, Department of Rheumatology, Dr. Jan van Breemenstraat 2, 1056 AB Amsterdam, the Netherland
| | - A A Toorop
- Department of Neurology, Amsterdam UMC, Vrije Universiteit, De Boelelaan 1117, 1081 HV Amsterdam, the Netherland
| | - E M M Strijbis
- Department of Neurology, Amsterdam UMC, Vrije Universiteit, De Boelelaan 1117, 1081 HV Amsterdam, the Netherland
| | - S W Tas
- Amsterdam Rheumatology and immunology Center, Amsterdam UMC, Department of Rheumatology and Clinical Immunology, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherland
| | - G J Wolbink
- Amsterdam Rheumatology and immunology Center, location Reade, Department of Rheumatology, Dr. Jan van Breemenstraat 2, 1056 AB Amsterdam, the Netherland
| | - M Löwenberg
- Department of Gastroenterology and Hepatology, Amsterdam UMC, location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherland
| | - C van Sandt
- Department of Hematopoiesis, Sanquin Research and Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Plesmanlaan 125, 1066 CX Amsterdam, the Netherland; Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth, Melbourne, VIC 3000, USA
| | - A Ten Brinke
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Amsterdam UMC, Plesmanlaan 125, 1066 CX Amsterdam, the Netherland
| | - N J M Verstegen
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Amsterdam UMC, Plesmanlaan 125, 1066 CX Amsterdam, the Netherland
| | - M Steenhuis
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Amsterdam UMC, Plesmanlaan 125, 1066 CX Amsterdam, the Netherland
| | - T W Kuijpers
- Department of Pediatric Immunology, Rheumatology and Infectious Disease, Amsterdam UMC, location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherland
| | - S M van Ham
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Amsterdam UMC, Plesmanlaan 125, 1066 CX Amsterdam, the Netherland; Swammerdam Institute for Life Sciences, University of Amsterdam, the Netherland
| | - T Rispens
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Amsterdam UMC, Plesmanlaan 125, 1066 CX Amsterdam, the Netherland
| | - F Eftimov
- Department of Neurology and Neurophysiology, Amsterdam Neuroscience, Amsterdam UMC, location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherland
| | - J Killestein
- Department of Neurology, Amsterdam UMC, Vrije Universiteit, De Boelelaan 1117, 1081 HV Amsterdam, the Netherland
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Lam KH, van Oirschot P, den Teuling B, Hulst HE, de Jong BA, Uitdehaag BMJ, de Groot V, Killestein J. Reliability, construct and concurrent validity of a smartphone-based cognition test in multiple sclerosis. Mult Scler 2021; 28:300-308. [PMID: 34037472 PMCID: PMC8795217 DOI: 10.1177/13524585211018103] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background: Early detection and monitoring of cognitive dysfunction in multiple sclerosis (MS) may be enabled with smartphone-adapted tests that allow frequent measurements in the everyday environment. Objectives: The aim of this study was to determine the reliability, construct and concurrent validity of a smartphone-adapted Symbol Digit Modalities Test (sSDMT). Methods: During a 28-day follow-up, 102 patients with MS and 24 healthy controls (HC) used the MS sherpa® app to perform the sSDMT every 3 days on their own smartphone. Patients performed the Brief International Cognitive Assessment for MS at baseline. Test–retest reliability (intraclass correlation coefficients, ICC), construct validity (group analyses between cognitively impaired (CI), cognitively preserved (CP) and HC for differences) and concurrent validity (correlation coefficients) were assessed. Results: Patients with MS and HC completed an average of 23.2 (SD = 10.0) and 18.3 (SD = 10.2) sSDMT, respectively. sSDMT demonstrated high test–retest reliability (ICCs > 0.8) with a smallest detectable change of 7 points. sSDMT scores were different between CI patients, CP patients and HC (all ps < 0.05). sSDMT correlated modestly with the clinical SDMT (highest r = 0.690), verbal (highest r= 0.516) and visuospatial memory (highest r= 0.599). Conclusion: Self-administered smartphone-adapted SDMT scores were reliable and different between patients who were CI, CP and HC and demonstrated concurrent validity in assessing information processing speed.
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Affiliation(s)
- KH Lam
- KH Lam Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, De Boelelaan, 1117 Amsterdam, The Netherlands.
| | - P van Oirschot
- Orikami Digital Health Products, Nijmegen, The Netherlands
| | - B den Teuling
- Orikami Digital Health Products, Nijmegen, The Netherlands
| | - HE Hulst
- Department of Anatomy and Neurosciences, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - BA de Jong
- Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - BMJ Uitdehaag
- Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - V de Groot
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - J Killestein
- Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
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10
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Coerver EME, Wessels MHJ, van Lierop ZYG, van Kempen ZLE, Killestein J, Strijbis EMM. Natalizumab discontinuation in a Dutch real-world cohort. Mult Scler Relat Disord 2021; 52:102974. [PMID: 33990055 DOI: 10.1016/j.msard.2021.102974] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/12/2021] [Accepted: 04/18/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine characteristics of multiple sclerosis patients that discontinued natalizumab treatment in a real-world cohort. METHODS Data was collected from an ongoing observational cohort study of all natalizumab treated patients at the Amsterdam UMC. RESULTS Of 253 patients who ever received natalizumab treatment, 147 have discontinued treatment. The most frequent reason for treatment discontinuation was JC-virus (JCV) positivity. CONCLUSIONS JCV positivity seems the most frequent reason for natalizumab discontinuation. The heterogeneity in treatment switches reflects the advances made in treatment options, and underlines the need for adequate patient counselling.
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Affiliation(s)
- E M E Coerver
- Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands.
| | - M H J Wessels
- Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Z Y G van Lierop
- Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Z L E van Kempen
- Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - J Killestein
- Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - E M M Strijbis
- Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
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11
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van Lierop ZYGJ, Toorop AA, Coerver EME, Willemse EAJ, Strijbis EMM, Kalkers NF, Moraal B, Barkhof F, Teunissen CE, Killestein J, van Kempen ZLE. Ocrelizumab after natalizumab in JC-virus positive relapsing remitting multiple sclerosis patients. Mult Scler J Exp Transl Clin 2021; 7:20552173211013831. [PMID: 34123391 PMCID: PMC8175839 DOI: 10.1177/20552173211013831] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/06/2021] [Accepted: 04/12/2021] [Indexed: 11/16/2022] Open
Abstract
Ocrelizumab is often used as an alternative therapy in natalizumab-treated MS patients at risk for progressive multifocal leukoencephalopathy (PML). Our objective was to assess efficacy and safety of JC-virus positive patients switching (either directly or indirectly) from natalizumab to ocrelizumab. Forty-two patients were included from an observational cohort (median follow-up 21 months). No evidence of disease activity was found in 83% of direct switchers and 50% of indirect switchers. Two direct switchers were diagnosed with carry-over PML. Our data support a direct switch for adequate disease suppression, although carry-over PML illustrates the dilemma when choosing between a direct or indirect switch.
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Affiliation(s)
- ZYGJ van Lierop
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - AA Toorop
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - EME Coerver
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - EAJ Willemse
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - EMM Strijbis
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - NF Kalkers
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - B Moraal
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - F Barkhof
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - CE Teunissen
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - J Killestein
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - ZLE van Kempen
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
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12
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Bridel C, Verberk IMW, Heijst JJA, Killestein J, Teunissen CE. Variations in consecutive serum neurofilament light levels in healthy controls and multiple sclerosis patients. Mult Scler Relat Disord 2020; 47:102666. [PMID: 33291033 DOI: 10.1016/j.msard.2020.102666] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 11/28/2020] [Indexed: 10/22/2022]
Abstract
Background Neurofilament light is a neuronal protein detectable in serum (sNfL), with high potential as disease activity biomarker in multiple sclerosis (MS). To date, little is known about sNfL fluctuations between 2 consecutive measurements in healthy controls (HC) and MS patients. Yet this information is critical, as it will help define a clinically significant variation. Methods sNfL was measured at 2 consecutive time points in a cohort of 90 MS patients (untreated relapsing remitting MS (uRRMS), n=35; treated relapsing remitting MS (tRRMS), n= 21; secondary progressive MS, SPMS, n=21; primary progressive MS, PPMS, n=13), and 90 age-matched HC, using the Simoa NfL light® assay. Results Mean sNfL was elevated in all MS subtypes compared to HC (p<0.0001), and positively associated with age in HC (r=0.70, p<0.001), confirming previous reports. Mean sNfL was higher at follow-up compared to baseline in HC (p<0.001), and lower in uRRMS(p=0.036) and tRRMS (p=0.008). At follow-up, a similar proportion of HC (50.0%), untreated RRMS (51.4%), treated RRMS (33.3%), SPMS (45.0%) and PPMS (46.2%) had variations in sNfL levels exceeding 20% of baseline levels. Conclusions Our data suggest variations in sNfL occur both in HC and MS populations to a similar extent and magnitude. Variations between two consecutive sNfL measurements may reflect natural variations and not necessarily variations in inflammatory disease activity.
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Affiliation(s)
- C Bridel
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, University Medical Center (UMC), Amsterdam, The Netherlands; Department of Clinical Neurosciences, Neurology Unit, Geneva University Hospital, Geneva, Switzerland.
| | - I M W Verberk
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, University Medical Center (UMC), Amsterdam, The Netherlands
| | - J J A Heijst
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, University Medical Center (UMC), Amsterdam, The Netherlands
| | - J Killestein
- Department of Neurology, Amsterdam Neuroscience, MS Center, University Medical Center (UMC), Amsterdam, The Netherlands
| | - C E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, University Medical Center (UMC), Amsterdam, The Netherlands
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13
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Lam KH, Meijer KA, Loonstra FC, Coerver E, Twose J, Redeman E, Moraal B, Barkhof F, de Groot V, Uitdehaag B, Killestein J. Real-world keystroke dynamics are a potentially valid biomarker for clinical disability in multiple sclerosis. Mult Scler 2020; 27:1421-1431. [PMID: 33150823 PMCID: PMC8358561 DOI: 10.1177/1352458520968797] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Clinical measures in multiple sclerosis (MS) face limitations that may be overcome by utilising smartphone keyboard interactions acquired continuously and remotely during regular typing. Objective: The aim of this study was to determine the reliability and validity of keystroke dynamics to assess clinical aspects of MS. Methods: In total, 102 MS patients and 24 controls were included in this observational study. Keyboard interactions were obtained with the Neurokeys keyboard app. Eight timing-related keystroke features were assessed for reliability with intraclass correlation coefficients (ICCs); construct validity by analysing group differences (in fatigue, gadolinium-enhancing lesions on magnetic resonance imaging (MRI), and patients vs controls); and concurrent validity by correlating with disability measures. Results: Reliability was moderate in two (ICC = 0.601 and 0.742) and good to excellent in the remaining six features (ICC = 0.760–0.965). Patients had significantly higher keystroke latencies than controls. Latency between key presses correlated the highest with Expanded Disability Status Scale (r = 0.407) and latency between key releases with Nine-Hole Peg Test and Symbol Digit Modalities Test (ρ = 0.503 and r = −0.553, respectively), ps < 0.001. Conclusion: Keystroke dynamics were reliable, distinguished patients and controls, and were associated with clinical disability measures. Consequently, keystroke dynamics are a promising valid surrogate marker for clinical disability in MS.
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Affiliation(s)
- K H Lam
- Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam, The Netherlands
| | - K A Meijer
- Neurocast B.V., Amsterdam, The Netherlands
| | - F C Loonstra
- Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam, The Netherlands
| | - Eme Coerver
- Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam, The Netherlands
| | - J Twose
- Neurocast B.V., Amsterdam, The Netherlands
| | - E Redeman
- Neurocast B.V., Amsterdam, The Netherlands
| | - B Moraal
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam, The Netherlands
| | - F Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam, The Netherlands/Queen Square Institute of Neurology and Centre for Medical Image Computing, University College London, London, UK
| | - V de Groot
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Bmj Uitdehaag
- Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam, The Netherlands
| | - J Killestein
- Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam, The Netherlands
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Twose J, Licitra G, McConchie H, Lam KH, Killestein J. Early-warning signals for disease activity in patients diagnosed with multiple sclerosis based on keystroke dynamics. Chaos 2020; 30:113133. [PMID: 33261343 DOI: 10.1063/5.0022031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/21/2020] [Indexed: 06/12/2023]
Abstract
Within data gathered through passive monitoring of patients with Multiple Sclerosis (MS), there is a clear necessity for improved methodological approaches to match the emergence of continuous, objective, measuring technologies. As most gold standards measure infrequently and require clinician presence, fluctuations in the daily progression are not accounted for. Due to the underlying conditions of homogeneity and stationarity (the main tenets of ergodicity) not being met for the majority of the statistical methods employed in the clinical setting, alternative approaches should be investigated. A solution is to use a non-linear time series analysis approach. Here, Early-Warning Signals (EWS) in the form of critical fluctuations in Keystroke Dynamics (KD), collected using participant's smartphones, are investigated as indicators for a clinical change in three groups. These are patients with MS and changes in Magnetic Resonance Imaging (MRI), patients with MS but without changes in MRI, and healthy controls (HCs). Here, we report examples of EWS and changes in KD coinciding with clinically relevant changes in outcome measures in both patients with and without differences in the amount of MRI enhancing lesions. We also report no clinically relevant changes in EWS in the HC population. This study is a first promising step toward using EWS to identify periods of instability as measured by a continuous objective measure as a proxy for outcome measures in the field of MS.
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Affiliation(s)
- J Twose
- Neurocast B.V., Amsterdam 1097DN, The Netherlands
| | - G Licitra
- Neurocast B.V., Amsterdam 1097DN, The Netherlands
| | - H McConchie
- Neurocast B.V., Amsterdam 1097DN, The Netherlands
| | - K H Lam
- Department of Neurology, Amsterdam University Medical Centers, Amsterdam 1105AZ, The Netherlands
| | - J Killestein
- Department of Neurology, Amsterdam University Medical Centers, Amsterdam 1105AZ, The Netherlands
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15
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Weeda MM, Middelkoop SM, Steenwijk MD, Daams M, Amiri H, Brouwer I, Killestein J, Uitdehaag BMJ, Dekker I, Lukas C, Bellenberg B, Barkhof F, Pouwels PJW, Vrenken H. Validation of mean upper cervical cord area (MUCCA) measurement techniques in multiple sclerosis (MS): High reproducibility and robustness to lesions, but large software and scanner effects. Neuroimage Clin 2019; 24:101962. [PMID: 31416017 PMCID: PMC6704046 DOI: 10.1016/j.nicl.2019.101962] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 07/12/2019] [Accepted: 07/26/2019] [Indexed: 11/15/2022]
Abstract
Introduction Atrophy of the spinal cord is known to occur in multiple sclerosis (MS). The mean upper cervical cord area (MUCCA) can be used to measure this atrophy. Currently, several (semi-)automated methods for MUCCA measurement exist, but validation in clinical magnetic resonance (MR) images is lacking. Methods Five methods to measure MUCCA (SCT-PropSeg, SCT-DeepSeg, NeuroQLab, Xinapse JIM and ITK-SNAP) were investigated in a predefined upper cervical cord region. First, within-scanner reproducibility and between-scanner robustness were assessed using intra-class correlation coefficient (ICC) and Dice's similarity index (SI) in scan-rescan 3DT1-weighted images (brain, including cervical spine using a head coil) performed on three 3 T MR machines (GE MR750, Philips Ingenuity, Toshiba Vantage Titan) in 21 subjects with MS and 6 healthy controls (dataset A). Second, sensitivity of MUCCA measurement to lesions in the upper cervical cord was assessed with cervical 3D T1-weighted images (3 T GE HDxT using a head-neck-spine coil) in 7 subjects with MS without and 14 subjects with MS with cervical lesions (dataset B), using ICC and SI with manual reference segmentations. Results In dataset A, MUCCA differed between MR machines (p < 0.001) and methods (p < 0.001) used, but not between scan sessions. With respect to MUCCA values, Xinapse JIM showed the highest within-scanner reproducibility (ICC absolute agreement = 0.995) while Xinapse JIM and SCT-PropSeg showed the highest between-scanner robustness (ICC consistency = 0.981 and 0.976, respectively). Reproducibility of segmentations between scan sessions was highest in Xinapse JIM and SCT-PropSeg segmentations (median SI ≥ 0.921), with a significant main effect of method (p < 0.001), but not of MR machine or subject group. In dataset B, SI with manual outlines did not differ between patients with or without cervical lesions for any of the segmentation methods (p > 0.176). However, there was an effect of method for both volumetric and voxel wise agreement of the segmentations (both p < 0.001). Highest volumetric and voxel wise agreement was obtained with Xinapse JIM (ICC absolute agreement = 0.940 and median SI = 0.962). Conclusion Although MUCCA is highly reproducible within a scanner for each individual measurement method, MUCCA differs between scanners and between methods. Cervical cord lesions do not affect MUCCA measurement performance. Mean upper cervical cord area (MUCCA) was obtained with five different methods. MUCCA was determined in a unique scan-rescan multi-vendor MR study. Reproducibility: MUCCA did not differ between scan-rescan images for any method. Robustness: MUCCA differed between methods and between scanners. Performance of MUCCA methods was not affected by the presence of lesions.
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Affiliation(s)
- M M Weeda
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC-location VUmc, Amsterdam, the Netherlands.
| | - S M Middelkoop
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC-location VUmc, Amsterdam, the Netherlands
| | - M D Steenwijk
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC - location VUmc, Amsterdam, the Netherlands
| | - M Daams
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC-location VUmc, Amsterdam, the Netherlands
| | - H Amiri
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC-location VUmc, Amsterdam, the Netherlands
| | - I Brouwer
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC-location VUmc, Amsterdam, the Netherlands
| | - J Killestein
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC - location VUmc, Amsterdam, the Netherlands
| | - B M J Uitdehaag
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC - location VUmc, Amsterdam, the Netherlands
| | - I Dekker
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC-location VUmc, Amsterdam, the Netherlands; Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC - location VUmc, Amsterdam, the Netherlands
| | - C Lukas
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, St. Josef Hospital, Ruhr University, Bochum, Germany
| | - B Bellenberg
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, St. Josef Hospital, Ruhr University, Bochum, Germany
| | - F Barkhof
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC-location VUmc, Amsterdam, the Netherlands; Institutes of Neurology and Healthcare Engineering, UCL, London, UK
| | - P J W Pouwels
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC-location VUmc, Amsterdam, the Netherlands
| | - H Vrenken
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC-location VUmc, Amsterdam, the Netherlands
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16
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Dekker I, Leurs C, Hagens M, van Kempen Z, Kleerekooper I, Lissenberg-Witte B, Barkhof F, Uitdehaag B, Balk L, Wattjes M, Killestein J. Long-term disease activity and disability progression in relapsing-remitting multiple sclerosis patients on natalizumab. Mult Scler Relat Disord 2019; 33:82-87. [DOI: 10.1016/j.msard.2019.05.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 04/13/2019] [Accepted: 05/24/2019] [Indexed: 12/11/2022]
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17
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Leurs CE, Twaalfhoven H, Lissenberg-Witte BI, van Pesch V, Dujmovic I, Drulovic J, Castellazzi M, Bellini T, Pugliatti M, Kuhle J, Villar LM, Alvarez-Cermeño JC, Alvarez-Lafuente R, Hegen H, Deisenhammer F, Walchhofer LM, Thouvenot E, Comabella M, Montalban X, Vécsei L, Rajda C, Galimberti D, Scarpini E, Altintas A, Rejdak K, Frederiksen JL, Pihl-Jensen G, Jensen P, Khalil M, Voortman MM, Fazekas F, Saiz A, La Puma D, Vercammen M, Vanopdenbosch L, Uitdehaag B, Killestein J, Bridel C, Teunissen C. Kappa free light chains is a valid tool in the diagnostics of MS: A large multicenter study. Mult Scler 2019; 26:912-923. [PMID: 31066634 PMCID: PMC7350201 DOI: 10.1177/1352458519845844] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To validate kappa free light chain (KFLC) and lambda free light chain (LFLC) indices as a diagnostic biomarker in multiple sclerosis (MS). METHODS We performed a multicenter study including 745 patients from 18 centers (219 controls and 526 clinically isolated syndrome (CIS)/MS patients) with a known oligoclonal IgG band (OCB) status. KFLC and LFLC were measured in paired cerebrospinal fluid (CSF) and serum samples. Gaussian mixture modeling was used to define a cut-off for KFLC and LFLC indexes. RESULTS The cut-off for the KFLC index was 6.6 (95% confidence interval (CI) = 5.2-138.1). The cut-off for the LFLC index was 6.9 (95% CI = 4.5-22.2). For CIS/MS patients, sensitivity of the KFLC index (0.88; 95% CI = 0.85-0.90) was higher than OCB (0.82; 95%CI = 0.79-0.85; p < 0.001), but specificity (0.83; 95% CI = 0.78-0.88) was lower (OCB = 0.92; 95% CI = 0.89-0.96; p < 0.001). Both sensitivity and specificity for the LFLC index were lower than OCB. CONCLUSION Compared with OCB, the KFLC index is more sensitive but less specific for diagnosing CIS/MS. Lacking an elevated KFLC index is more powerful for excluding MS compared with OCB but the latter is more important for ruling in a diagnosis of CIS/MS.
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Affiliation(s)
- C E Leurs
- Department of Neurology, MS Center Amsterdam, VU University Medical Center, De Boelelaan 1118, Amsterdam 1081 HZ, The Netherlands
| | - Ham Twaalfhoven
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - B I Lissenberg-Witte
- Department of Epidemiology and Biostatistics, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - V van Pesch
- Department of Neurology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Sint-Lambrechts-Woluwe, Belgium
| | - I Dujmovic
- Clinic of Neurology, Clinical Centre of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - J Drulovic
- Clinic of Neurology, Clinical Centre of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - M Castellazzi
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - T Bellini
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - M Pugliatti
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - J Kuhle
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - L M Villar
- Department of Immunology, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain/ Red Española de Esclerosis Múltiple (REEM), Madrid, Spain
| | - J C Alvarez-Cermeño
- Red Española de Esclerosis Múltiple (REEM), Madrid, Spain/Department of Neurology, Hospital Ramón y Cajal, IRYICIS, Madrid, Spain
| | - R Alvarez-Lafuente
- Red Española de Esclerosis Múltiple (REEM), Madrid, Spain/Grupo de Investigación de Esclerosis Múltiple, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - H Hegen
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - F Deisenhammer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - L M Walchhofer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - E Thouvenot
- Department of Neurology, CHU Nîmes, Hôpital Caremeau, Nîmes, France/Institut de Génomique Fonctionnelle, UMR5203, Université Montpellier, Montpellier, France
| | - M Comabella
- Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - X Montalban
- Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L Vécsei
- Department of Neurology, University of Szeged, Szeged, Hungary/MTA-SZTE Neuroscience Research Group, Szeged, Hungary
| | - C Rajda
- Department of Neurology, University of Szeged, Szeged, Hungary
| | - D Galimberti
- Multiple Sclerosis Centre, University of Milan, Dino Ferrari Centre, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - E Scarpini
- Multiple Sclerosis Centre, University of Milan, Dino Ferrari Centre, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - A Altintas
- Koc University, School of Medicine, Neurology Department, Istanbul, Turkey
| | - K Rejdak
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | - J L Frederiksen
- Department of Neurology, Rigshospitalet Glostrup and University of Copenhagen, Copenhagen, Denmark
| | - G Pihl-Jensen
- Department of Neurology, Rigshospitalet Glostrup and University of Copenhagen, Copenhagen, Denmark
| | - Peh Jensen
- Danish Multiple Sclerosis Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - M Khalil
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - M M Voortman
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - F Fazekas
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - A Saiz
- Center of Neuroimmunology, Service of Neurology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - D La Puma
- Center of Neuroimmunology, Service of Neurology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - M Vercammen
- Department of Laboratory Medicine, AZ Sint-Jan Brugge-Oostende, Brugge, Belgium
| | - L Vanopdenbosch
- Department of Neurology, AZ Sint-Jan Brugge-Oostende, Brugge, Belgium
| | - Bmj Uitdehaag
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - J Killestein
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - C Bridel
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - C Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
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18
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Dekker I, Eijlers AJC, Popescu V, Balk LJ, Vrenken H, Wattjes MP, Uitdehaag BMJ, Killestein J, Geurts JJG, Barkhof F, Schoonheim MM. Predicting clinical progression in multiple sclerosis after 6 and 12 years. Eur J Neurol 2019; 26:893-902. [PMID: 30629788 PMCID: PMC6590122 DOI: 10.1111/ene.13904] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 01/08/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE To predict disability and cognition in multiple sclerosis (MS) after 6 and 12 years, using early clinical and imaging measures. METHODS A total of 115 patients with MS were selected and followed up after 2 and 6 years, with 79 patients also being followed up after 12 years. Disability was measured using the Expanded Disability Status Scale (EDSS); cognition was measured only at follow-up using neuropsychological testing. Predictors of interest included EDSS score, baseline brain and lesion volumes and their changes over 2 years, baseline age, clinical phenotype, sex and educational level. RESULTS Higher 6-year EDSS score was predicted by early EDSS score and whole-brain volume changes and baseline diagnosis of primary progressive MS (adjusted R2 = 0.56). Predictors for 12-year EDSS score included larger EDSS score changes and higher T1-hypointense lesion volumes (adjusted R2 = 0.38). Year 6 cognition was predicted by primary progressive MS phenotype, lower educational level, male sex and early whole-brain atrophy (adjusted R2 = 0.26); year 12 predictors included male sex, lower educational level and higher baseline T1-hypointense lesion volumes (adjusted R2 = 0.14). CONCLUSIONS Patients with early signs of neurodegeneration and a progressive disease onset were more prone to develop both disability progression and cognitive dysfunction. Male sex and lower educational level only affected cognitive dysfunction, which remains difficult to predict and probably needs more advanced imaging measures.
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Affiliation(s)
- I Dekker
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - A J C Eijlers
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - V Popescu
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - L J Balk
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - H Vrenken
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M P Wattjes
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - B M J Uitdehaag
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - J Killestein
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - J J G Geurts
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - F Barkhof
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Institutes of Neurology and Healthcare Engineering, UCL, London, UK
| | - M M Schoonheim
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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19
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Leurs C, Lopes Pinheiro M, Wierts L, den Hoedt S, Mulder M, Eijlers A, Schoonheim M, Balk L, Uitdehaag B, Killestein J, de Vries H. Acid sphingomyelinase: No potential as a biomarker for multiple sclerosis. Mult Scler Relat Disord 2019; 28:44-49. [DOI: 10.1016/j.msard.2018.11.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 11/06/2018] [Accepted: 11/23/2018] [Indexed: 01/01/2023]
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20
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van Geest Q, Douw L, van 't Klooster S, Leurs CE, Genova HM, Wylie GR, Steenwijk MD, Killestein J, Geurts JJG, Hulst HE. Information processing speed in multiple sclerosis: Relevance of default mode network dynamics. Neuroimage Clin 2018; 19:507-515. [PMID: 29984159 PMCID: PMC6030565 DOI: 10.1016/j.nicl.2018.05.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 04/30/2018] [Accepted: 05/13/2018] [Indexed: 11/19/2022]
Abstract
Objective To explore the added value of dynamic functional connectivity (dFC) of the default mode network (DMN) during resting-state (RS), during an information processing speed (IPS) task, and the within-subject difference between these conditions, on top of conventional brain measures in explaining IPS in people with multiple sclerosis (pwMS). Methods In 29 pwMS and 18 healthy controls, IPS was assessed with the Letter Digit Substitution Test and Stroop Card I and combined into an IPS-composite score. White matter (WM), grey matter (GM) and lesion volume were measured using 3 T MRI. WM integrity was assessed with diffusion tensor imaging. During RS and task-state fMRI (i.e. symbol digit modalities task, IPS), stationary functional connectivity (sFC; average connectivity over the entire time series) and dFC (variation in connectivity using a sliding window approach) of the DMN was calculated, as well as the difference between both conditions (i.e. task-state minus RS; ΔsFC-DMN and ΔdFC-DMN). Regression analysis was performed to determine the most important predictors for IPS. Results Compared to controls, pwMS performed worse on IPS-composite (p = 0.022), had lower GM volume (p < 0.05) and WM integrity (p < 0.001), but no alterations in sFC and dFC at the group level. In pwMS, 52% of variance in IPS-composite could be predicted by cortical volume (β = 0.49, p = 0.01) and ΔdFC-DMN (β = 0.52, p < 0.01). After adding dFC of the DMN to the model, the explained variance in IPS increased with 26% (p < 0.01). Conclusion On top of conventional brain measures, dFC from RS to task-state explains additional variance in IPS. This highlights the potential importance of the DMN to adapt upon cognitive demands to maintain intact IPS in pwMS. Problems with information processing speed occur often in multiple sclerosis (MS) Dynamics in brain communication can reflect information transfer within the brain With fMRI, dynamic communication can be measured, which increases upon task demands This increase in dynamics explains information processing speed in MS
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Affiliation(s)
- Q van Geest
- Department of Anatomy & Neurosciences, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
| | - L Douw
- Department of Anatomy & Neurosciences, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands; Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - S van 't Klooster
- Department of Anatomy & Neurosciences, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - C E Leurs
- Department of Neurology, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - H M Genova
- Neuropsychology and Neuroscience Laboratory, Kessler Foundation, West Orange, NJ, USA; Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - G R Wylie
- Neuropsychology and Neuroscience Laboratory, Kessler Foundation, West Orange, NJ, USA; Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - M D Steenwijk
- Department of Anatomy & Neurosciences, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - J Killestein
- Department of Neurology, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - J J G Geurts
- Department of Anatomy & Neurosciences, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - H E Hulst
- Department of Anatomy & Neurosciences, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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21
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van Kempen ZLE, Leurs CE, de Vries A, Vennegoor A, Rispens T, Wattjes MP, Killestein J. John Cunningham virus conversion in relation to natalizumab concentration in multiple sclerosis patients. Eur J Neurol 2017; 24:1196-1199. [PMID: 28707781 DOI: 10.1111/ene.13355] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 06/01/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Infection with the John Cunningham virus (JCV) is required for the development of progressive multifocal leukoencephalopathy, the feared complication of natalizumab treatment in multiple sclerosis patients. The JCV seroconversion rate seems higher in natalizumab treated patients than in the normal population, with an unknown cause. METHODS Natalizumab concentration was correlated to JCV antibody status and seroconversion in a large cohort of multiple sclerosis patients. RESULTS One hundred and thirty-five patients were included. No correlation was found between natalizumab concentration and JCV status, JCV seroconversion or JCV index. CONCLUSIONS Higher natalizumab concentrations do not explain the increased JCV seroconversion rate in natalizumab treated patients.
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Affiliation(s)
- Z L E van Kempen
- Department of Neurology, Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - C E Leurs
- Department of Neurology, Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - A de Vries
- Biologicals Lab, Sanquin Diagnostic Services, Sanquin, Amsterdam, The Netherlands
| | - A Vennegoor
- Department of Neurology, Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - T Rispens
- Department of Immunology, Sanquin Research and Landsteiner Laboratory, Amsterdam, The Netherlands
| | - M P Wattjes
- Department of Radiology & Nuclear Medicine, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - J Killestein
- Department of Neurology, Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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22
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Bridel C, Koel-Simmelink MJA, Peferoen L, Derada Troletti C, Durieux S, Gorter R, Nutma E, Gami P, Iacobaeus E, Brundin L, Kuhle J, Vrenken H, Killestein J, Piersma SR, Pham TV, De Vries HE, Amor S, Jimenez CR, Teunissen CE. Brain endothelial cell expression of SPARCL-1 is specific to chronic multiple sclerosis lesions and is regulated by inflammatory mediators in vitro. Neuropathol Appl Neurobiol 2017; 44:404-416. [PMID: 28543098 DOI: 10.1111/nan.12412] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 05/18/2017] [Accepted: 05/24/2017] [Indexed: 02/05/2023]
Abstract
AIMS Cell matrix modulating protein SPARCL-1 is highly expressed by astrocytes during CNS development and following acute CNS damage. Applying NanoLC-MS/MS to CSF of RRMS and SPMS patients, we identified SPARCL-1 as differentially expressed between these two stages of MS, suggesting a potential as CSF biomarker to differentiate RRMS from SPMS and a role in MS pathogenesis. METHODS This study examines the potential of SPARCL-1 as CSF biomarker discriminating RRMS from SPMS in three independent cohorts (n = 249), analyses its expression pattern in MS lesions (n = 26), and studies its regulation in cultured human brain microvasculature endothelial cells (BEC) after exposure to MS-relevant inflammatory mediators. RESULTS SPARCL-1 expression in CSF was significantly higher in SPMS compared to RRMS in a Dutch cohort of 76 patients. This finding was not replicated in 2 additional cohorts of MS patients from Sweden (n = 81) and Switzerland (n = 92). In chronic MS lesions, but not active lesions or NAWM, a vessel expression pattern of SPARCL-1 was observed in addition to the expression by astrocytes. EC were found to express SPARCL-1 in chronic MS lesions, and SPARCL-1 expression was regulated by MS-relevant inflammatory mediators in cultured human BEC. CONCLUSIONS Conflicting results of SPARCL-1's differential expression in CSF of three independent cohorts of RRMS and SPMS patients precludes its use as biomarker for disease progression. The expression of SPARCL-1 by BEC in chronic MS lesions together with its regulation by inflammatory mediators in vitro suggest a role for SPARCL-1 in MS neuropathology, possibly at the brain vascular level.
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Affiliation(s)
- C Bridel
- Department of Clinical Chemistry, Neurochemistry Lab and Biobank, VU Medical Centre, Amsterdam, The Netherlands
| | - M J A Koel-Simmelink
- Department of Clinical Chemistry, Neurochemistry Lab and Biobank, VU Medical Centre, Amsterdam, The Netherlands
| | - L Peferoen
- Department of Pathology, VU Medical Centre, Amsterdam, The Netherlands
| | - C Derada Troletti
- Department of Molecular Cell Biology and Immunology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands
| | - S Durieux
- Department of Clinical Chemistry, Neurochemistry Lab and Biobank, VU Medical Centre, Amsterdam, The Netherlands
| | - R Gorter
- Department of Pathology, VU Medical Centre, Amsterdam, The Netherlands
| | - E Nutma
- Department of Pathology, VU Medical Centre, Amsterdam, The Netherlands
| | - P Gami
- Department of Pathology, VU Medical Centre, Amsterdam, The Netherlands
| | - E Iacobaeus
- Department of Clinical Neuroscience, Neuroimmunology Unit, Karolinska Institute, Solna, Sweden.,Center for Molecular Medicine, Stockholm, Sweden
| | - L Brundin
- Department of Clinical Neuroscience, Neuroimmunology Unit, Karolinska Institute, Solna, Sweden.,Center for Molecular Medicine, Stockholm, Sweden
| | - J Kuhle
- Neurology, Department of Medicine, Biomedicine and Clinical Research, University Hospital Basel, Basel, Switzerland
| | - H Vrenken
- Department of Radiology and Nuclear Medicine and Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands
| | - J Killestein
- Department of Neurology, MS Centre Amsterdam, VU Medical Centre, Amsterdam, The Netherlands
| | - S R Piersma
- Department of Medical Oncology, OncoProteomics Laboratory, VU Medical Centre, Amsterdam, The Netherlands
| | - T V Pham
- Department of Medical Oncology, OncoProteomics Laboratory, VU Medical Centre, Amsterdam, The Netherlands
| | - H E De Vries
- Department of Molecular Cell Biology and Immunology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands
| | - S Amor
- Department of Pathology, VU Medical Centre, Amsterdam, The Netherlands.,Queen Mary University of London, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK
| | - C R Jimenez
- Department of Medical Oncology, OncoProteomics Laboratory, VU Medical Centre, Amsterdam, The Netherlands
| | - C E Teunissen
- Department of Clinical Chemistry, Neurochemistry Lab and Biobank, VU Medical Centre, Amsterdam, The Netherlands
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Abstract
Laboratory research including animal models of human disease suggests that cannabinoids might have therapeutic potential in multiple sclerosis (MS). We have recently seen a 46-year-old woman who developed MS after starting treatment with a cannabino id recepto r antagonist for obesity. The occurrence of MS several months after starting a cannabinoid receptor antagonist suggests that the cannabino id system might indeed be relevant to disease pathogenesis in MS.
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Affiliation(s)
- B W van Oosten
- Department of Neurology, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
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24
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Vennegoor A, van Rossum JA, Leurs C, Wattjes MP, Rispens T, Murk JLAN, Uitdehaag BMJ, Killestein J. High cumulative JC virus seroconversion rate during long-term use of natalizumab. Eur J Neurol 2016; 23:1079-85. [PMID: 27018481 DOI: 10.1111/ene.12988] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 02/02/2016] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND PURPOSE John Cunningham virus (JCV) seropositivity is a risk factor for the development of natalizumab-associated progressive multifocal leukoencephalopathy (PML) in multiple sclerosis (MS) patients. When JCV seronegative patients seroconvert, their risk of developing PML increases. Limited longitudinal data exist about the seroconversion rate amongst natalizumab-treated relapsing-remitting MS (RRMS) patients. Our objective was to evaluate the seroconversion rate in a large Dutch cohort of natalizumab-treated RRMS patients. Seroconversion was defined as at least two consecutive seropositive serum samples (or cessation of therapy after a single seropositive sample because of seropositivity) after initial seronegative testing. METHODS AND RESULTS In our study of 179 patients for whom longitudinal blood samples were available over a long period (median 4.2 years), anti-JCV antibody indices were measured in 933 available samples. Eighty-six patients (48.0%) tested seronegative initially. Of these 86 seronegative patients, 23 patients (26.7%) seroconverted during follow-up. The annualized seroconversion rate was 7.1%. Seroconversion occurred between 9 and 90 months (median 43 months) of treatment. The rate of seroconversion was independent of follow-up duration. No significant increase was seen in the anti-JCV antibody index in the non-converting patients during the follow-up. CONCLUSION The annualized seroconversion rate of 7.1% in patients using natalizumab, cumulatively leading to more than 25% of seronegative patients becoming seropositive in 4 years, is of clinical relevance and should be taken into account in the risk assessment when considering the start of natalizumab therapy.
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Affiliation(s)
- A Vennegoor
- Department of Neurology, MS Centre Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands
| | - J A van Rossum
- Department of Neurology, MS Centre Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands
| | - C Leurs
- Department of Neurology, MS Centre Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands
| | - M P Wattjes
- Department of Radiology, MS Centre Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands
| | - T Rispens
- Landsteiner Laboratory, Sanquin Research, Amsterdam, The Netherlands
| | - J L A N Murk
- Department of Medical Microbiology, UMC Utrecht, Utrecht, The Netherlands
| | - B M J Uitdehaag
- Department of Neurology, MS Centre Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands
| | - J Killestein
- Department of Neurology, MS Centre Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands
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25
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de Jong TD, Vosslamber S, Mantel E, de Ridder S, Wesseling JG, Kraan TCTMDP, Leurs C, Hegen H, Deisenhammer F, Killestein J, Lundberg IE, Vencovsky J, Nurmohamed MT, van Schaardenburg D, Bultink IEM, Voskuyl AE, Pegtel DM, van der Laken CJ, Bijlsma JW, Verweij CL. A6.12 Physiological evidence for diversification of IFNα- and IFNβ-mediated response programs in different autoimmune diseases. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-209124.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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26
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Murk J, Nieuwkamp D, Van Hecke W, Frijlink D, Killestein J, Wattjes M, Van Oosten B. Fatal PML in a patient treated with compounded dimethyl fumarate with only modest lymphocytopenia. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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27
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Balk LJ, Steenwijk MD, Tewarie P, Daams M, Killestein J, Wattjes MP, Vrenken H, Barkhof F, Polman CH, Uitdehaag BMJ, Petzold A. Bidirectional trans-synaptic axonal degeneration in the visual pathway in multiple sclerosis. J Neurol Neurosurg Psychiatry 2015; 86:419-24. [PMID: 24973342 DOI: 10.1136/jnnp-2014-308189] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To investigate the coexistence of anterograde and retrograde trans-synaptic axonal degeneration, and to explore the relationship between selective visual pathway damage and global brain involvement in longstanding multiple sclerosis (MS). METHODS In this single-centre, cross-sectional study, patients with longstanding MS (N=222) and healthy controls (HC, N=62) were included. We analysed thickness of retinal layers (optical coherence tomography), damage within optic radiations (OR) (lesion volume and fractional anisotropy and mean diffusivity by diffusion tensor imaging) and atrophy of the visual cortex and that of grey and white matter of the whole-brain (structural MRI). Linear regression analyses were used to assess associations between the different components and for comparing patients with and without optic neuritis and HC. RESULTS In patients with MS, an episode of optic neuritis (MSON) was significantly associated with decreased integrity of the ORs and thinning of the peripapillary retinal nerve fibre layer (pRNFL) and macular ganglion cell complex (GCC). Lesion volume in the OR was negatively associated with pRNFL and GCC thickness in patients without optic neuritis (MSNON). The pRNFL and GCC showed associations with integrity of the OR, thickness of the primary visual cortex (only in patients with MSON), and also with global white and grey matter atrophy. In HCs, no such relationships were demonstrated. INTERPRETATION This study provides evidence for presence of bidirectional (both anterograde and retrograde) trans-synaptic axonal degeneration in the visual pathway of patients with MS. Additionally, thinning of the retinal pRNFL and GCC are related to global white and grey matter atrophy in addition to pathology of the visual pathway.
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Affiliation(s)
- L J Balk
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - M D Steenwijk
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - P Tewarie
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - M Daams
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands Department of Anatomy and Neurosciences, Section of Clinical Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - J Killestein
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - M P Wattjes
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - H Vrenken
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands
| | - F Barkhof
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - C H Polman
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - B M J Uitdehaag
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - A Petzold
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
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28
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Kuhle J, Disanto G, Dobson R, Adiutori R, Bianchi L, Topping J, Bestwick JP, Meier UC, Marta M, Costa GD, Runia T, Evdoshenko E, Lazareva N, Thouvenot E, Iaffaldano P, Direnzo V, Khademi M, Piehl F, Comabella M, Sombekke M, Killestein J, Hegen H, Rauch S, D’Alfonso S, Alvarez-Cermeño JC, Kleinová P, Horáková D, Roesler R, Lauda F, Llufriu S, Avsar T, Uygunoglu U, Altintas A, Saip S, Menge T, Rajda C, Bergamaschi R, Moll N, Khalil M, Marignier R, Dujmovic I, Larsson H, Malmestrom C, Scarpini E, Fenoglio C, Wergeland S, Laroni A, Annibali V, Romano S, Martínez AD, Carra A, Salvetti M, Uccelli A, Torkildsen Ø, Myhr KM, Galimberti D, Rejdak K, Lycke J, Frederiksen JL, Drulovic J, Confavreux C, Brassat D, Enzinger C, Fuchs S, Bosca I, Pelletier J, Picard C, Colombo E, Franciotta D, Derfuss T, Lindberg RLP, Yaldizli Ö, Vécsei L, Kieseier BC, Hartung HP, Villoslada P, Siva A, Saiz A, Tumani H, Havrdová E, Villar LM, Leone M, Barizzone N, Deisenhammer F, Teunissen C, Montalban X, Tintoré M, Olsson T, Trojano M, Lehmann S, Castelnovo G, Lapin S, Hintzen R, Kappos L, Furlan R, Martinelli V, Comi G, Ramagopalan SV, Giovannoni G. Conversion from clinically isolated syndrome to multiple sclerosis: A large multicentre study. Mult Scler 2015; 21:1013-24. [DOI: 10.1177/1352458514568827] [Citation(s) in RCA: 196] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 11/19/2014] [Indexed: 11/15/2022]
Abstract
Background and objective: We explored which clinical and biochemical variables predict conversion from clinically isolated syndrome (CIS) to clinically definite multiple sclerosis (CDMS) in a large international cohort. Methods: Thirty-three centres provided serum samples from 1047 CIS cases with at least two years’ follow-up. Age, sex, clinical presentation, T2-hyperintense lesions, cerebrospinal fluid (CSF) oligoclonal bands (OCBs), CSF IgG index, CSF cell count, serum 25-hydroxyvitamin D3 (25-OH-D), cotinine and IgG titres against Epstein-Barr nuclear antigen 1 (EBNA-1) and cytomegalovirus were tested for association with risk of CDMS. Results: At median follow-up of 4.31 years, 623 CIS cases converted to CDMS. Predictors of conversion in multivariable analyses were OCB (HR = 2.18, 95% CI = 1.71–2.77, p < 0.001), number of T2 lesions (two to nine lesions vs 0/1 lesions: HR = 1.97, 95% CI = 1.52–2.55, p < 0.001; >9 lesions vs 0/1 lesions: HR = 2.74, 95% CI = 2.04–3.68, p < 0.001) and age at CIS (HR per year inversely increase = 0.98, 95% CI = 0.98–0.99, p < 0.001). Lower 25-OH-D levels were associated with CDMS in univariable analysis, but this was attenuated in the multivariable model. OCB positivity was associated with higher EBNA-1 IgG titres. Conclusions: We validated MRI lesion load, OCB and age at CIS as the strongest independent predictors of conversion to CDMS in this multicentre setting. A role for vitamin D is suggested but requires further investigation.
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Affiliation(s)
- J Kuhle
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK/ Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland
| | - G Disanto
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - R Dobson
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - R Adiutori
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - L Bianchi
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - J Topping
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - JP Bestwick
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, Barts and the London School for Medicine and Dentistry, UK
| | - U-C Meier
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - M Marta
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - G Dalla Costa
- Department of Neurology and INSPE, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Italy
| | - T Runia
- Department of Neurology, Erasmus MC University Medical Center, The Netherlands
| | - E Evdoshenko
- Centre of Multiple Sclerosis, City Clinical Hospital#31, Russia
| | - N Lazareva
- Centre of Multiple Sclerosis, City Clinical Hospital#31, Russia
| | - E Thouvenot
- Institut de Génomique Fonctionelle, CNRS UMR5203, INSERM U661, Université Montpellier 1, Université Montpellier, France, and Hôpital Carémeau, France
| | - P Iaffaldano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Italy
| | - V Direnzo
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Italy
| | - M Khademi
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - F Piehl
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - M Comabella
- Servei de Neurologia-Neuroimmunologia, Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Institut de Receca Vall d’Hebron (VHIR), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Spain
| | - M Sombekke
- Departments of Neurology and Clinical Chemistry, MS Center, Neurocampus Amsterdam, VU University Medical Centre Amsterdam, The Netherlands and BioMS-eu network
| | - J Killestein
- Departments of Neurology and Clinical Chemistry, MS Center, Neurocampus Amsterdam, VU University Medical Centre Amsterdam, The Netherlands and BioMS-eu network
| | - H Hegen
- Department of Neurology, Innsbruck Medical University, Austria
| | - S Rauch
- Department of Radiology, Innsbruck Medical University, Austria
| | - S D’Alfonso
- Department of Health Sciences and IRCAD, Eastern Piedmont University, Italy
| | | | - P Kleinová
- Department of Neurology, Charles University in Prague, Czech Republic
| | - D Horáková
- Department of Neurology, Charles University in Prague, Czech Republic
| | - R Roesler
- Department of Neurology, CSF Laboratory and MS Outpatient Unit, University of Ulm, Germany
| | - F Lauda
- Department of Neurology, CSF Laboratory and MS Outpatient Unit, University of Ulm, Germany
| | - S Llufriu
- Center for Neuroimmunology and Department of Neurology. Institut d’investigacions Biomèdiques August Pi Sunyer (IDIBAPS) – Hospital Clinic of Barcelona, Spain
| | - T Avsar
- Dr Orhan Öcalgiray Molecular Biology-Biotechnology and Genetics Research Centre, Istanbul Technical University, Turkey
| | - U Uygunoglu
- Department of Neurology, Istanbul University, Turkey
| | - A Altintas
- Department of Neurology, Istanbul University, Turkey
| | - S Saip
- Department of Neurology, Istanbul University, Turkey
| | - T Menge
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Germany
| | - C Rajda
- Department of Neurology, University of Szeged, Hungary
| | | | - N Moll
- Pôle de Neurosciences Cliniques, Service de Neurologie, Centre de Résonance Magnétique Biologique et Médicale, Centre Hospitalier Universitaire Timone, Laboratoire d’histocompatibilité, Etablissement Français du Sang Alpes Méditerrannée, Aix Marseille Université, France
| | - M Khalil
- Department of Neurology, Medical University of Graz, Austria
| | - R Marignier
- Department of Neurology, Université de Lyon, Université Claude Bernard-Lyon 1, France
| | - I Dujmovic
- Clinic of Neurology, Belgrade University School of Medicine, Serbia
| | - H Larsson
- Unit of Functional Imaging, Glostrup Hospital, University of Copenhagen, Denmark
| | - C Malmestrom
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - E Scarpini
- Neurology Unit, Dept. of Pathophysiology and Transplantation, University of Milan, Fondazione Cà Granda, IRCCS Policlinico
| | - C Fenoglio
- Neurology Unit, Dept. of Pathophysiology and Transplantation, University of Milan, Fondazione Cà Granda, IRCCS Policlinico
| | - S Wergeland
- KG Jebsen Centre for MS-Research, Department of Clinical Medicine, Haukeland University Hospital, University of Bergen, Norway
| | - A Laroni
- Department of Neurology, University of Genoa, Italy
| | - V Annibali
- Centre for Experimental Neurological Therapies, S. Andrea Hospital-site, Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Italy
| | - S Romano
- Centre for Experimental Neurological Therapies, S. Andrea Hospital-site, Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Italy
| | - AD Martínez
- Department of Neurology of Hospital Británico of Buenos Aires, Argentina
| | - A Carra
- Department of Neurology of Hospital Británico of Buenos Aires, Argentina
| | - M Salvetti
- Centre for Experimental Neurological Therapies, S. Andrea Hospital-site, Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Italy
| | - A Uccelli
- Department of Neurology, University of Genoa, Italy
| | - Ø Torkildsen
- KG Jebsen Centre for MS-Research, Department of Clinical Medicine, Haukeland University Hospital, University of Bergen, Norway
| | - KM Myhr
- Department of Neurology, University of Genoa, Italy
| | - D Galimberti
- Neurology Unit, Dept. of Pathophysiology and Transplantation, University of Milan, Fondazione Cà Granda, IRCCS Policlinico
| | - K Rejdak
- Department of Neurology, Medical University of Lublin, Poland
| | - J Lycke
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - JL Frederiksen
- Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark
| | - J Drulovic
- Clinic of Neurology, Belgrade University School of Medicine, Serbia
| | - C Confavreux
- Department of Neurology, Université de Lyon, Université Claude Bernard-Lyon 1, France
| | - D Brassat
- Department of Neurology, University of Toulouse, France
| | - C Enzinger
- Department of Neurology, Medical University of Graz, Austria
| | - S Fuchs
- Department of Neurology, Medical University of Graz, Austria
| | - I Bosca
- MS Unit, Neurology Department, La Fe University and Polytechnic Hospital, Instituto de investigación Sanitaria La Fe, Spain
| | - J Pelletier
- Pôle de Neurosciences Cliniques, Service de Neurologie, Centre de Résonance Magnétique Biologique et Médicale, Centre Hospitalier Universitaire Timone, Laboratoire d’histocompatibilité, Etablissement Français du Sang Alpes Méditerrannée, Aix Marseille Université, France
| | - C Picard
- Pôle de Neurosciences Cliniques, Service de Neurologie, Centre de Résonance Magnétique Biologique et Médicale, Centre Hospitalier Universitaire Timone, Laboratoire d’histocompatibilité, Etablissement Français du Sang Alpes Méditerrannée, Aix Marseille Université, France
| | - E Colombo
- C. Mondino National Neurological Institute, Italy
| | - D Franciotta
- C. Mondino National Neurological Institute, Italy
| | - T Derfuss
- Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland
| | - RLP Lindberg
- Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland
| | - Ö Yaldizli
- Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland
| | - L Vécsei
- Department of Neurology, University of Szeged, Hungary
| | - BC Kieseier
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Germany
| | - HP Hartung
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Germany
| | - P Villoslada
- Center for Neuroimmunology and Department of Neurology. Institut d’investigacions Biomèdiques August Pi Sunyer (IDIBAPS) – Hospital Clinic of Barcelona, Spain
| | - A Siva
- Department of Neurology, Istanbul University, Turkey
| | - A Saiz
- Center for Neuroimmunology and Department of Neurology. Institut d’investigacions Biomèdiques August Pi Sunyer (IDIBAPS) – Hospital Clinic of Barcelona, Spain
| | - H Tumani
- Department of Neurology, CSF Laboratory and MS Outpatient Unit, University of Ulm, Germany
| | - E Havrdová
- Department of Neurology, Charles University in Prague, Czech Republic
| | - LM Villar
- Department of Neurology and Immunology, Hospital Ramón y Cajal, Spain
| | - M Leone
- MS Centre, SCDU Neurology, Head and Neck Department, AOU Maggiore della Carità, Italy
| | - N Barizzone
- Department of Health Sciences and IRCAD, Eastern Piedmont University, Italy
| | - F Deisenhammer
- Department of Neurology, Innsbruck Medical University, Austria
| | - C Teunissen
- Departments of Neurology and Clinical Chemistry, MS Center, Neurocampus Amsterdam, VU University Medical Centre Amsterdam, The Netherlands and BioMS-eu network
| | - X Montalban
- Servei de Neurologia-Neuroimmunologia, Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Institut de Receca Vall d’Hebron (VHIR), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Spain
| | - M Tintoré
- Servei de Neurologia-Neuroimmunologia, Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Institut de Receca Vall d’Hebron (VHIR), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Spain
| | - T Olsson
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - M Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Italy
| | - S Lehmann
- Institut de Génomique Fonctionelle, CNRS UMR5203, INSERM U661, Université Montpellier 1, Université Montpellier, France, and Hôpital Carémeau, France
| | - G Castelnovo
- Institut de Génomique Fonctionelle, CNRS UMR5203, INSERM U661, Université Montpellier 1, Université Montpellier, France, and Hôpital Carémeau, France
| | - S Lapin
- Centre of Multiple Sclerosis, City Clinical Hospital#31, Russia
| | - R Hintzen
- Department of Neurology, Erasmus MC University Medical Center, The Netherlands
| | - L Kappos
- Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland
| | - R Furlan
- Department of Neurology and INSPE, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Italy
| | - V Martinelli
- Department of Neurology and INSPE, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Italy
| | - G Comi
- Department of Neurology and INSPE, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Italy
| | - SV Ramagopalan
- Department of Physiology, Anatomy and Genetics and Medical Research Council Functional Genomics Unit, University of Oxford, UK
| | - G Giovannoni
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
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Vennegoor A, Rispens T, Van Oosten BW, Wattjes MP, Wondergem MJ, Teunissen CE, Van der Kleij D, Uitdehaag BMJ, Polman CH, Killestein J. Application of serum natalizumab levels during plasma exchange in MS patients with progressive multifocal leukoencephalopathy. Mult Scler 2014; 21:481-4. [DOI: 10.1177/1352458514541507] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Progressive multifocal leukoencephalopathy (PML) is a severe complication of natalizumab treatment. Restoring immune function by plasmapheresis/immunoadsorption (PLEX/IA) is important for the outcome of PML. We report on four multiple sclerosis (MS) patients whom developed PML during natalizumab treatment, in whom we measured serum natalizumab concentrations before and during PLEX. Depending on the serum natalizumab concentration at the time of PML diagnosis, the number of PLEX treatments necessary to reach subtherapeutic serum natalizumab concentrations is variable. Measuring serum natalizumab concentrations before and during PLEX is helpful to determine the optimum number of PLEX treatments in individual MS patients with PML.
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Affiliation(s)
- A Vennegoor
- VU University Medical Center, Amsterdam, The Netherlands
| | - T Rispens
- Landsteiner Laboratory, Sanquin Research, Amsterdam, The Netherlands
| | - BW Van Oosten
- VU University Medical Center, Amsterdam, The Netherlands
| | - MP Wattjes
- VU University Medical Center, Amsterdam, The Netherlands
| | - MJ Wondergem
- VU University Medical Center, Amsterdam, The Netherlands
| | - CE Teunissen
- VU University Medical Center, Amsterdam, The Netherlands
| | - D Van der Kleij
- Landsteiner Laboratory, Sanquin Research, Amsterdam, The Netherlands
| | - BMJ Uitdehaag
- VU University Medical Center, Amsterdam, The Netherlands
| | - CH Polman
- VU University Medical Center, Amsterdam, The Netherlands
| | - J Killestein
- VU University Medical Center, Amsterdam, The Netherlands
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Balk LJ, Twisk JWR, Steenwijk MD, Daams M, Tewarie P, Killestein J, Uitdehaag BMJ, Polman CH, Petzold A. A dam for retrograde axonal degeneration in multiple sclerosis? J Neurol Neurosurg Psychiatry 2014; 85:782-9. [PMID: 24474822 DOI: 10.1136/jnnp-2013-306902] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Trans-synaptic axonal degeneration is a mechanism by which neurodegeneration can spread from a sick to a healthy neuron in the central nervous system. This study investigated to what extent trans-synaptic axonal degeneration takes place within the visual pathway in multiple sclerosis (MS). METHODS A single-centre study, including patients with long-standing MS and healthy controls. Structural imaging of the brain (MRI) and retina (spectral-domain optical coherence tomography) were used to quantify the extent of atrophy of individual retinal layers and the primary and secondary visual cortex. Generalised estimation equations and multivariable regression analyses were used for comparisons. RESULTS Following rigorous quality control (OSCAR-IB), data from 549 eyes of 293 subjects (230 MS, 63 healthy controls) were included. Compared with control data, there was a significant amount of atrophy of the inner retinal layers in MS following optic neuritis (ON) and also in absence of ON. For both scenarios, atrophy stopped at the level of the inner nuclear layer. In contrast, there was significant localised atrophy of the primary visual cortex and secondary visual cortex in MS following ON, but not in MS in absence of ON. INTERPRETATION These data suggest that retrograde (trans-synaptic) axonal degeneration stops at the inner nuclear layer, a neuronal network capable of plasticity. In contrast, there seems to be no neuroplasticity of the primary visual cortex, rendering the structure vulnerable to anterograde (trans-synaptic) degeneration.
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Affiliation(s)
- L J Balk
- Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands
| | - J W R Twisk
- Department of Clinical Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands
| | - M D Steenwijk
- Department of Radiology and Nuclear Medicine, VU University Medical Centre, Amsterdam, The Netherlands
| | - M Daams
- Department of Radiology and Nuclear Medicine, VU University Medical Centre, Amsterdam, The Netherlands Department of Anatomy and Neurosciences, Section of Clinical Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - P Tewarie
- Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands
| | - J Killestein
- Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands
| | - B M J Uitdehaag
- Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands
| | - C H Polman
- Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands
| | - A Petzold
- Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands
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van Rossum JA, Looysen EE, Daniels JMA, Killestein J. Fingolimod-induced asthma deterioration in a patient with relapsing-remitting multiple sclerosis. Mult Scler 2014; 20:1792-3. [PMID: 24866203 DOI: 10.1177/1352458514531844] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- J A van Rossum
- VU University Medical Center, Amsterdam, The Netherlands
| | - E E Looysen
- VU University Medical Center, Amsterdam, The Netherlands
| | - J M A Daniels
- VU University Medical Center, Amsterdam, The Netherlands
| | - J Killestein
- MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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Balk LJ, Tewarie P, Killestein J, Polman CH, Uitdehaag BMJ, Petzold A. Disease course heterogeneity and OCT in multiple sclerosis. Mult Scler 2014; 20:1198-206. [DOI: 10.1177/1352458513518626] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 12/08/2013] [Indexed: 11/16/2022]
Abstract
Background: The heterogeneity of the disease course in multiple sclerosis (MS) remains a challenge for patient management and clinical trials. Objective: The objective of this paper is to investigate the relationship between disease course heterogeneity and retinal layer thicknesses in MS. Methods: A total of 230 MS patients and 63 healthy control subjects were included. Spectral-domain OCT scanning of the peripapillary and macular regions was performed, followed by automated eight-layer segmentation. Generalised estimation equations were used for comparisons. Receiver operating characteristic (ROC) curves were calculated for distinguishing a benign from a typical disease course. Results: Primary progressive patients showed relative preservation of inner retinal layers, compared to the relapsing onset MS types. Only in MS eyes without optic neuritis did patients with typical MS show more severe thinning of the inner retinal layers (RNFL to INL) compared to patients with a benign disease course, even after an average disease course of 20 years. Conclusion: The thicknesses, particularly of the innermost retinal layers (RNFL, GCC), were significantly related to the heterogeneous disease course in MS. The relative preservation of these layers in primary progressive and benign MS suggests rather limited susceptibility of the retina to neurodegeneration, which may be relevant for future neurodegenerative treatment trials employing OCT as a secondary outcome measure in primary progressive MS.
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Affiliation(s)
- LJ Balk
- Department of Neurology, VU University Medical Centre, the Netherlands
| | - P Tewarie
- Department of Neurology, VU University Medical Centre, the Netherlands
| | - J Killestein
- Department of Neurology, VU University Medical Centre, the Netherlands
| | - CH Polman
- Department of Neurology, VU University Medical Centre, the Netherlands
| | - BMJ Uitdehaag
- Department of Neurology, VU University Medical Centre, the Netherlands
| | - A Petzold
- Department of Neurology, VU University Medical Centre, the Netherlands
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Hegen H, Millonig A, Bertolotto A, Comabella M, Giovanonni G, Guger M, Hoelzl M, Khalil M, Killestein J, Lindberg R, Malucchi S, Mehling M, Montalban X, Polman CH, Rudzki D, Schautzer F, Sellebjerg F, Sørensen PS, Deisenhammer F. Early detection of neutralizing antibodies to interferon-beta in multiple sclerosis patients: binding antibodies predict neutralizing antibody development. Mult Scler 2013; 20:577-87. [PMID: 24009164 DOI: 10.1177/1352458513503597] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Neutralizing antibodies (NAb) affect efficacy of interferon-beta (IFN-b) treatment in multiple sclerosis (MS) patients. NAbs evolve in up to 44% of treated patients, usually between 6-18 months on therapy. OBJECTIVES To investigate whether early binding antibody (BAb) titers or different IFN-b biomarkers predict NAb evolution. METHODS We included patients with MS or clinically isolated syndrome (CIS) receiving de novo IFN-b treatment in this prospective European multicenter study. Blood samples were collected at baseline, before and after the first IFN-b administration, and again after 3, 12 and 24 months on that therapy; for determination of NAbs, BAbs, gene expression of MxA and protein concentrations of MMP-9, TIMP-1, sTRAIL, CXCL-10 and CCL-2. RESULTS We found that 22 of 164 (13.4%) patients developed NAbs during a median time of 23.8 months on IFN-b treatment. Of these patients, 78.9% were BAb-positive after 3 months. BAb titers ≥ 1:2400 predicted NAb evolution with a sensitivity of 74.7% and a specificity of 98.5%. Cross-sectionally, MxA levels were significantly diminished in the BAb/NAb-positive samples; similarly, CXCL-10 and sTRAIL concentrations in BAb/NAb-positive and BAb-positive/NAb-negative samples, respectively, were also diminished compared to BAb/NAb-negative samples. CONCLUSIONS BAb titers reliably predict NAbs. CXCL-10 is a promising sensitive biomarker for IFN-b response and its abrogation by anti-IFN-b antibodies.
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Affiliation(s)
- H Hegen
- Department of Neurology, Innsbruck Medical University, Austria
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van de Kraats C, Killestein J, Popescu V, Rijkers E, Vrenken H, Lütjohann D, Barkhof F, Polman CH, Teunissen CE. Oxysterols and cholesterol precursors correlate to magnetic resonance imaging measures of neurodegeneration in multiple sclerosis. Mult Scler 2013; 20:412-7. [PMID: 23959711 DOI: 10.1177/1352458513499421] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cholesterol homeostasis is important for formation and maintenance of myelin and axonal membranes in the central nervous system (CNS). The concentrations of the brain specific cholesterol metabolite 24S-hydroxycholesterol (24OHC) and cholesterol precursors have been shown to be altered in multiple sclerosis (MS). However, how changes in sterol levels relate to the pathological processes in MS is not clear. METHODS In this study, we compared serum and cerebrospinal fluid (CSF) sterol levels between 105 MS (51 relapsing-remitting (RR); 39 secondary progressive (SP) and 15 primary progressive (PP)) and 49 control patients. Sterol levels were correlated to magnetic resonance imaging (MRI) markers of disease activity. RESULTS We found decreased serum 24OHC and 27-hydroxycholesterol (27OHC) and increased CSF lathosterol in MS patients compared to control patients (p=0.018, p=0.002 and p=0.002, respectively). Subgroup analysis showed that serum 24OHC levels were negatively correlated to normalized brain volume measurements in relapse-onset MS patients (r= -0.326, p=0.004). CONCLUSIONS These results confirm that cholesterol homeostasis is disturbed in MS and suggest that changes in cholesterol synthesis are related to neurodegenerative pathological processes as seen on the MRI. The data seem to be in line with the recently reported observation that high dose statins may have a positive effect on clinical disability in secondary progressive MS.
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Affiliation(s)
- C van de Kraats
- Department of Neurology, MS Center Amsterdam, VU University Medical Center, The Netherlands
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35
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Teunissen CE, Sombekke M, van Winsen L, Killestein J, Barkhof F, Polman CH, Dijkstra CD, Blankenstein MA, Pratico D. Increased plasma 8,12-iso-iPF2alpha- VI levels in relapsing multiple sclerosis patients are not predictive of disease progression. Mult Scler 2012; 18:1092-8. [DOI: 10.1177/1352458511433306] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Oxidative stress plays an important role in multiple sclerosis (MS). Isoprostanes are biomarkers for oxidative stress and have been related to neurological disease progression. Objective: To study whether plasma isoprostane levels were related to disease progression in MS. Methods: Plasma levels of 8,12-iso-iPF2alpha-VI were determined in 17 patients with clinically isolated syndrome (CIS), 41 relapsing–remitting MS (RRMS) patients and 5 primary progressive MS (PPMS) patients and related to MRI and clinical disease parameters. Results: Isoprostane levels were similar in CIS (60.9, interquartile range (IQR): 47.7–77.7 pg/ml) and RRMS patients (65.3, IQR: 51.9–82.8 pg/ml). The plasma levels were lower in PPMS patients (42.5, IQR: 37.1–49.9) pg/ml, p<0.05) compared to CIS and RRMS patients in this cohort, which was not confirmed in a second cohort. Baseline isoprostane levels were not related to clinical progression defined by conversion form CIS to RRMS or change in Expanded Disability Status Scale (EDSS) or MS Functional Composite (MSFC) scores during six years of follow-up (CIS + RRMS), nor to change in volume of gadolinium enhancing lesions, T2 lesion load or T1 hypointense lesion load during 2.8 years of follow-up (CIS + RRMS). Conclusion: These results do not support a strong role of 8,12-iso-iPF2alpha-VI in the prediction of disease progression in MS.
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Affiliation(s)
- CE Teunissen
- Department of Clinical Chemistry, VU University Medical Center, The Netherlands
| | - M Sombekke
- Department of Neurology, VU University Medical Center, The Netherlands
| | - L van Winsen
- Department of Neurology, VU University Medical Center, The Netherlands
| | - J Killestein
- Department of Neurology, VU University Medical Center, The Netherlands
| | - F Barkhof
- Department of Radiology, VU University Medical Center, The Netherlands
| | - CH Polman
- Department of Neurology, VU University Medical Center, The Netherlands
| | - CD Dijkstra
- Department of Clinical Chemistry, VU University Medical Center, The Netherlands
| | - MA Blankenstein
- Department of Clinical Chemistry, VU University Medical Center, The Netherlands
| | - D Pratico
- Department of Pharmacology, Temple University, USA
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36
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Grimaldi L, Barkhof F, Beelke M, Burton J, Holmoy T, Hupperts R, Killestein J, Rieckmann P, Schluep M, Smolders J. A randomized trial of high-dose vitamin D2 in relapsing-remitting multiple sclerosis. Neurology 2012; 78:841. [PMID: 22411961 DOI: 10.1212/01.wnl.0000413180.13413.ce] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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37
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Wiebenga OT, Hulst HE, Kooi EJ, Killestein J, Geurts JJG. Multicenter randomized clinical trial of donepezil for memory impairment in multiple sclerosis. Neurology 2012; 77:1998; author reply1999-2000. [PMID: 22123783 DOI: 10.1212/wnl.0b013e318239c242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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39
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Sombekke MH, van der Voort LF, Kragt JJ, Nielsen JM, Guzel H, Visser A, Oudejans CBM, Crusius JBA, Peña AS, Vrenken H, Polman CH, Killestein J. Relevance of IL7R genotype and mRNA expression in Dutch patients with multiple sclerosis. Mult Scler 2011; 17:922-30. [DOI: 10.1177/1352458511402411] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The interleukin 7 receptor (IL7R) has been recognized as a susceptibility gene for Multiple Sclerosis (MS). Analysis of rs6897932 (the most strongly MS-associated single nucleotide polymorphism (SNP)), showed effects of genotype on the relative expression of membrane-bound to total amount of IL7R mRNA. Objective: We assessed the relevance of IL7R on MS phenotype (including clinical and magnetic resonance imaging (MRI) parameters) at DNA and mRNA level in Dutch patients with MS. Methods: The genotype of rs6897932 was analyzed in 697 patients with MS and 174 healthy controls. The relevance of genotype and carriership of the C allele on MS phenotype (disease activity and severity, using clinical and MRI parameters) was assessed. In addition, relative gene expression of membrane-bound to total IL7R mRNA was analyzed with respect to disease phenotype in a subgroup of 95 patients with early relapsing MS. Results: In particular, homozygosity for the risk allele is a risk factor for MS in our population (ORCC vs CT and TT = 1.65 (95% CI: 1.18–2.30), two-sided p = 0.004). However, no effect of genotype or the relative expression of membrane-bound IL7R (presence of exon 6–7) to total amount of IL7R mRNA (presence of exon 4–5) was found on MS phenotype. Discussion: Homozygosity for the IL7R exon 6 rs6897932 C allele is associated with a higher risk for MS in our Dutch population. No effect was found of genotype or mRNA expression on disease phenotype.
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Affiliation(s)
- MH Sombekke
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - LF van der Voort
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - JJ Kragt
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - JM Nielsen
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - H Guzel
- Image Analysis Center, VU University Medical Center, Amsterdam, The Netherlands
| | - A Visser
- Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
| | - CBM Oudejans
- Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
| | - JBA Crusius
- Department of Pathology (Laboratory of Immunogenetics), VU University Medical Center, Amsterdam, The Netherlands
| | - A Salvador Peña
- Department of Pathology (Laboratory of Immunogenetics), VU University Medical Center, Amsterdam, The Netherlands
| | - H Vrenken
- Department of Radiology and Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands
| | - CH Polman
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - J Killestein
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
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Teunissen CE, Koel-Simmelink MJA, Pham TV, Knol JC, Khalil M, Trentini A, Killestein J, Nielsen J, Vrenken H, Popescu V, Dijkstra CD, Jimenez CR. Identification of biomarkers for diagnosis and progression of MS by MALDI-TOF mass spectrometry. Mult Scler 2011; 17:838-50. [PMID: 21505015 DOI: 10.1177/1352458511399614] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Body fluid biomarkers for clinical subtyping and monitoring of disease progression are of considerable interest in multiple sclerosis (MS). Proteomics tools are optimal for the unbiased simultaneous detection of large series of peptides and proteins. OBJECTIVES To identify novel candidate biomarkers discriminating patients with MS from patients with other neurological diseases (OND), and for subtyping of relapsing-remitting (RR), secondary progressive (SP) and primary progressive (PP) MS patients using a high-throughput MALDI-TOF-based mass spectrometry method. METHODS Paired cerebrospinal fluid (CSF) and serum samples of 41 RRMS, 30 SPMS, 13 PPMS patients and 25 patients with OND were analysed. RESULTS Out of a total of 100 detected peptides in CSF and 200 peptides in serum, 11 peptides were differentially regulated in serum and two in CSF between patients with MS and the OND control group. Eleven peptides were differentially regulated in both serum and CSF between relapse-onset MS and PPMS patients. Lastly, four peptides were differentially regulated in serum and two in CSF between RRMS and SPMS patients. Specific peaks regulated in MS were tentatively identified as fragments of secretogranin III and complement C3. The peak intensity of the CSF peptide ion with m/z value 8607.7 correlated to atrophy (r = -0.27, p < 0.005), black hole volumes (r = 0.31, p < 0.008) and total lesion load (r = 0.34, p < 0.003). A serum peptide with m/z value of 872.4 elevated in SPMS correlated to Expanded Disability Status Scale (r = 0.341, p < 0.005) and atrophy (r = -0.286, p < 0.028). CONCLUSIONS Using high-throughput body fluid profiling by MALDI-TOF mass spectrometry, small proteins and peptides were detected as promising candidate biomarkers for diagnosis and disease progression of MS.
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Affiliation(s)
- C E Teunissen
- NUBIN, Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands.
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41
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Vosslamber S, van der Voort LF, van den Elskamp IJ, Heijmans R, Aubin C, Uitdehaag BMJ, Crusius JBA, van der Pouw Kraan TCTM, van der PouwKraan TCTM, Comabella M, Montalban X, Hafler DA, De Jager PL, Killestein J, Polman CH, Verweij CL. Interferon regulatory factor 5 gene variants and pharmacological and clinical outcome of Interferonβ therapy in multiple sclerosis. Genes Immun 2011; 12:466-72. [PMID: 21471993 DOI: 10.1038/gene.2011.18] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Interferon-β (IFNβ) therapy is effective in approximately half of the patients with relapsing-remitting multiple sclerosis (RRMS). Clinical non-responders were characterized by an increased expression of IFN response genes before the start of therapy, and a lack of a pharmacologically induced increase in IFN response gene activity. Because Interferon Regulatory Factor 5 (IRF5) is a master regulator of IFN-activity, we carried out a candidate gene study of IRF5 gene variants in relation to the pharmacological and clinical response upon IFNβ treatment. We found that patients with the IRF5 rs2004640-TT and rs47281420-AA genotype exerted a poor pharmacological response to IFNβ compared with patients carrying the respective G-alleles (P=0.0006 and P=0.0023, respectively). Moreover, patients with the rs2004640-TT genotype developed more magnetic resonance imaging (MRI)-based T2 lesions during IFNβ treatment (P=0.003). Accordingly, an association between MRI-based non-responder status and rs2004640-TT genotype was observed (P=0.010). For the rs4728142-AA genotype a trend of an association with more T2 lesions during IFNβ treatment and MRI-based non-responder status was observed (P=0.103 and P=0.154, respectively). The clinical relevance of the rs2004640-TT genotype was validated in an independent cohort wherein a shorter time to first relapse was found (P=0.037). These findings suggest a role for IRF5 gene variation in the pharmacological and clinical outcome of IFNβ therapy that might have relevance as biomarker to predict the response to IFNβ in multiple sclerosis.
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Affiliation(s)
- S Vosslamber
- VU University Medical Center, Department of Pathology, Amsterdam, The Netherlands.
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42
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Vennegoor A, Wattjes MP, van Munster ETL, Kriekaart RL, van Oosten BW, Barkhof F, Killestein J, Polman CH. Indolent course of progressive multifocal leukoencephalopathy during natalizumab treatment in MS. Neurology 2011; 76:574-6. [DOI: 10.1212/wnl.0b013e31820b7644] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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van der Voort LF, Vennegoor A, Visser A, Knol DL, Uitdehaag BMJ, Barkhof F, Oudejans CBM, Polman CH, Killestein J. Spontaneous MxA mRNA level predicts relapses in patients with recently diagnosed MS. Neurology 2010; 75:1228-33. [PMID: 20921509 DOI: 10.1212/wnl.0b013e3181f6c556] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine if myxovirus resistance protein A (MxA) mRNA is related to clinical disease activity in multiple sclerosis (MS). METHODS Baseline MxA mRNA levels were measured in a prospective cohort of 116 untreated patients with early MS and were related to clinical relapses and MRI at baseline and at follow-up. RESULTS Low levels of MxA mRNA were associated with the occurrence of relapses (p = 0.002) and contrast-enhancing lesions (CELs) on baseline MRI (p = 0.045). In addition, high baseline MxA mRNA levels were related to a longer time to a first new relapse (hazard ratio [HR] 0.59; 95% confidence interval [CI] 0.35-1.00; p = 0.044). Adding the absence of CELs to high MxA mRNA, the predictive value increased (HR 0.35; 95% CI 0.17-0.74; p = 0.006), clearly showing a cumulative value for combining both factors. CONCLUSIONS MxA mRNA is related to clinical exacerbations, the number of CELs on MRI, and is indicative for the time to a subsequent relapse. If confirmed, MxA mRNA has potential as a biomarker for clinical disease activity in MS.
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Affiliation(s)
- L F van der Voort
- VU Medical Center, Department of Neurology, de Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam, the Netherlands.
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44
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Worthington V, Killestein J, Eikelenboom MJ, Teunissen CE, Barkhof F, Polman CH, Uitdehaag BMJ, Petzold A. Normal CSF ferritin levels in MS suggest against etiologic role of chronic venous insufficiency. Neurology 2010; 75:1617-22. [PMID: 20881272 DOI: 10.1212/wnl.0b013e3181fb449e] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Chronic cerebrospinal venous insufficiency (CCSVI) has been suggested to be a possible cause of multiple sclerosis (MS). If the presumed mechanism of venous stasis-related parenchymal iron deposition and neurodegeneration were true, then upregulation of intrathecal iron transport proteins may be expected. METHODS This was a cross-sectional (n = 1,408) and longitudinal (n = 29) study on CSF ferritin levels in patients with MS and a range of neurologic disorders. RESULTS Pathologic (>12 ng/mL) CSF ferritin levels were observed in 4% of the control patients (median 4 ng/mL), 91% of patients with superficial siderosis (75 ng/mL), 73% of patients with a subarachnoid hemorrhage (59 ng/mL), 10% of patients with relapsing-remitting MS (5 ng/mL), 11% of patients with primary progressive MS (6 ng/mL), 23% of patients with secondary progressive MS (5 ng/mL), and 23% of patients with meningoencephalitis (5 ng/mL). In MS, there was no significant change of CSF ferritin levels over the 3-year follow-up period. CONCLUSION These data do not support an etiologic role for CCSVI-related parenchymal iron deposition in MS.
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Affiliation(s)
- V Worthington
- Department of Neuroimmunology, UCL Institute of Neurology, University College London, Queen Square, London, UK
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45
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Killestein J, van der Meer ML, Regelink JC, Huijgens PC, Polman CH. SEVERE CARDIAC FAILURE IN A PATIENT WITH MULTIPLE SCLEROSIS FOLLOWING LOW-DOSE MITOXANTRONE TREATMENT. Neurology 2010; 74:934; author reply 934. [DOI: 10.1212/wnl.0b013e3181d2b7de] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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46
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Lazzarino G, Amorini AM, Eikelenboom MJ, Killestein J, Belli A, Di Pietro V, Tavazzi B, Barkhof F, Polman CH, Uitdehaag BMJ, Petzold A. Cerebrospinal fluid ATP metabolites in multiple sclerosis. Mult Scler 2010; 16:549-54. [PMID: 20194579 DOI: 10.1177/1352458510364196] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Increased axonal energy demand and mitochondrial failure have been suggested as possible causes for axonal degeneration and disability in multiple sclerosis. Our objective was to test whether ATP depletion precedes clinical, imaging and biomarker evidence for axonal degeneration in multiple sclerosis. The method consisted of a longitudinal study which included 21 patients with multiple sclerosis. High performance liquid chromatography was used to quantify biomarkers of the ATP metabolism (oxypurines and purines) from the cerebrospinal fluid at baseline. The Expanded Disability Status Scale, MRI brain imaging measures for brain atrophy (ventricular and parenchymal fractions), and cerebrospinal fluid biomarkers for axonal damage (phosphorylated and hyperphosphorylated neurofilaments) were quantified at baseline and 3-year follow-up. Central ATP depletion (sum of ATP metabolites >19.7 micromol/litre) was followed by more severe progression of disability if compared to normal ATP metabolites (median 1.5 versus 0, p< 0.05). Baseline ATP metabolite levels correlated with change of Expanded Disability Status Scale in the pooled cohort (r= 0.66, p= 0.001) and subgroups (relapsing-remitting patients: r= 0.79, p< 0.05 and secondary progressive/primary progressive patients: r= 0.69, p< 0.01). There was no relationship between central ATP metabolites and either biomarker or MRI evidence for axonal degeneration. The data suggests that an increased energy demand in multiple sclerosis may cause a quantifiable degree of central ATP depletion. We speculate that the observed clinical disability may be related to depolarisation associated conduction block.
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Affiliation(s)
- G Lazzarino
- Department of Chemical Sciences, Laboratory of Biochemistry, University of Catania, Italy
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Vogt MHJ, Teunissen CE, Iacobaeus E, Heijnen DAM, Breij ECW, Olsson T, Brundin L, Killestein J, Dijkstra CD. Cerebrospinal fluid anti-myelin antibodies are related to magnetic resonance measures of disease activity in multiple sclerosis. J Neurol Neurosurg Psychiatry 2009; 80:1110-5. [PMID: 18931010 DOI: 10.1136/jnnp.2008.146357] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Recent studies reported contrasting results with respect to the presence of anti-myelin protein antibodies in multiple sclerosis (MS) and their relation with disease activity. This may be due to the heterogeneous specificity of autoantibodies in MS and the inability of most methods to detect pathogenically relevant antibodies. Here, myelin particles were used to detect anti-myelin antibodies in the CSF of MS patients. Subsequently, their relation with MRI parameters was evaluated. METHODS Anti-myelin IgG antibody reactivity was determined in the CSF of patients with MS (n = 65) and clinically isolated syndrome (CIS, n = 37) using a novel flow cytometry based assay. In addition, the CSF of patients with other neurological diseases (OND, n = 17), inflammatory neurological diseases (IND, n = 33) and controls (n = 22) was tested. RESULTS Compared with controls, increased anti-myelin IgG antibody reactivity was most frequently found in the CSF of patients with CIS (46%, p = 0.002), relapsing-remitting MS (56%, p<0.001) and secondary progressive MS (55%, p<0.001), together constituting 85% of all positive CSF samples. In contrast, elevated anti-myelin IgG antibody reactivity was present in a minority of IND patients (21%), marginally present in controls (5%) and absent in OND patients (0%). Most strikingly, anti-myelin IgG antibody reactivity was related to the number of T2 lesions (r = 0.31, p = 0.041) and gadolinium enhancing T1 lesions (r = 0.37, p = 0.016) on brain MRI in CIS and relapse onset MS patients. CONCLUSION CSF anti-myelin IgG antibodies are promising specific biomarkers in CIS and relapse onset MS and correlate with MR measures of disease activity.
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Affiliation(s)
- M H J Vogt
- Department of Molecular Cell Biology and Immunology, VU University Medical Centre, Amsterdam, The Netherlands
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48
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van der Voort LF, Visser A, Knol DL, Oudejans CBM, Polman CH, Killestein J. Lack of interferon-beta bioactivity is associated with the occurrence of relapses in multiple sclerosis. Eur J Neurol 2009; 16:1049-52. [DOI: 10.1111/j.1468-1331.2009.02649.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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49
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Eikelenboom MJ, Killestein J, Kragt JJ, Uitdehaag BMJ, Polman CH. Gender differences in multiple sclerosis: cytokines and vitamin D. J Neurol Sci 2009; 286:40-2. [PMID: 19656528 DOI: 10.1016/j.jns.2009.06.025] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2009] [Revised: 05/15/2009] [Accepted: 06/16/2009] [Indexed: 10/20/2022]
Abstract
The disproportional increase of the female:male ratio in relapse-onset (relapsing remitting (RR) and secondary progressive (SP)) multiple sclerosis (MS) patients in the last 20 years has further raised scientific interest in gender difference in MS. It has been suggested that the immune system, especially cytokines, plays an important role in the gender issue, as can also be seen in other autoimmune diseases. The immune system is influenced by different factors including hormones and seasonal fluctuations (vitamin D). This overview will highlight the gender differences in MS, with emphasis on the cytokines and vitamin D.
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Affiliation(s)
- M J Eikelenboom
- Department of Neurology, VU University Medical Center, 1007MB Amsterdam, The Netherlands.
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50
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Killestein J, Jasperse B, Liedorp M, Seewann A, Polman CH. Very late delayed-allergic reaction to natalizumab not associated with neutralizing antibodies. Mult Scler 2009; 15:525-6. [DOI: 10.1177/1352458508101322] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- J Killestein
- VU University Medical Center, Department of Neurology, MS Center Amsterdam, The Netherlands
| | - B Jasperse
- VU University Medical Center, Department of Neurology, MS Center Amsterdam, The Netherlands
| | - M Liedorp
- VU University Medical Center, Department of Neurology, MS Center Amsterdam, The Netherlands
| | - A Seewann
- VU University Medical Center, Department of Neurology, MS Center Amsterdam, The Netherlands
| | - CH Polman
- VU University Medical Center, Department of Neurology, MS Center Amsterdam, The Netherlands
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