• Title/Summary/Keyword: multiple sclerosis

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Diagnosis of Multiple Sclerosis: 2017 McDonald Diagnostic Criteria (다발경화증의 진단: 2017 맥도널드진단기준)

  • Sohn, Eun Hee;Jeong, Seung-Hae
    • Journal of the Korean neurological association
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    • v.36 no.4
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    • pp.273-279
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    • 2018
  • Multiple sclerosis (MS) is a diagnosis of exclusion and the lesions or objective findings should disseminate in space and time to diagnose MS. The diagnostic criteria of MS have continuously evolved overtime. The McDonald criteria were originally proposed in 2001, and the revised 2010 McDonald criteria have been used widely. Scientific advances in the past 7 years since 2010 induced the revised 2017 McDonald criteria. All revisions relied entirely on the available evidences, and not expert opinion. In this review, we will provide an overview of the way to diagnose MS and the 2017 McDonald criteria.

Autonomic dysfunction in multiple sclerosis and neuromyelitis optica spectrum disorder

  • Soonwook Kwon;Ju-Hong Min
    • Annals of Clinical Neurophysiology
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    • v.25 no.1
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    • pp.19-26
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    • 2023
  • Autonomic dysfunction occurs frequently in multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). Patients with either condition may present with autonomic symptoms such as bladder, sexual, cardiovascular, thermoregulatory, and gastrointestinal dysfunction, and fatigue, but autonomic symptoms that affect quality of life are underrecognized in clinical practice. The immunopathogenesis of MS has been considered to be associated with autonomic dysfunction. Applying appropriate treatment strategies for autonomic dysfunction is important to improve the quality of life of patients. Here we review autonomic dysfunction and how this is managed in patients with MS and NMOSD.

Osteopathia striata in the mandible with cranial sclerosis: a case report and review of the literature

  • Jagtap, Rohan;Garrido, Michelle Briner;Hansen, Matthew
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.2
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    • pp.141-144
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    • 2021
  • Osteopathia striata with cranial sclerosis (OS-CS) is a bone dysplasia characterized by a linear striated pattern of sclerosis, especially in the long bones, and cranial sclerosis. It has variable clinical findings but distinctive radiological findings. Multiple oral and dental findings have been associated with this disease and can be seen during dental and/or medical imaging of the head and neck. Dentists and clinicians must be familiar with these signs to differentiate them from pathosis or erroneous radiographs. In the following case, we present a patient with OS-CS that presented at The University of Florida College of Dentistry with multiple craniofacial manifestations of this syndrome that were seen on a panoramic radiograph, which is one of the most commonly requested radiographs by dentists.

A case of childhood relapsing/remitting multiple sclerosis and interferon β-1b treatment in a Korean patient (소아 재발/완화형 다발성 경화증 환자에서 인터페론 베타 1b 치료 1례)

  • Kim, Hyun Seok;Lee, Won Deok;Lee, Jun Hwa;Cho, Kyung Lae
    • Clinical and Experimental Pediatrics
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    • v.50 no.6
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    • pp.580-584
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    • 2007
  • Multiple sclerosis (MS) is a demyelinating disorder that affects discrete areas of the CNS, including the optic nerves, in a quite variable relapsing-remitting fashion over a prolonged period of time. Although MS is usually considered to be a disease that affects peoples in early to middle adulthood, children do develop multiple sclerosis. The frequency of MS onset before the age of 15 years is 2.7-5% of all cases, while MS onset during infancy and early childhood was observed to be 0.2-0.7% of all cases. We report here on a Korean case of a relapsing-remitting MS female child who was treated with four rounds of intravenous methylpredinsolone pulse therapy and preventive Interferon-$\beta$-1b ($Betaferon^{(R)}$).

Multiple Sclerosis Lesion Detection using 3D Autoencoder in Brain Magnetic Resonance Images (3D 오토인코더 기반의 뇌 자기공명영상에서 다발성 경화증 병변 검출)

  • Choi, Wonjune;Park, Seongsu;Kim, Yunsoo;Gahm, Jin Kyu
    • Journal of Korea Multimedia Society
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    • v.24 no.8
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    • pp.979-987
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    • 2021
  • Multiple Sclerosis (MS) can be early diagnosed by detecting lesions in brain magnetic resonance images (MRI). Unsupervised anomaly detection methods based on autoencoder have been recently proposed for automated detection of MS lesions. However, these autoencoder-based methods were developed only for 2D images (e.g. 2D cross-sectional slices) of MRI, so do not utilize the full 3D information of MRI. In this paper, therefore, we propose a novel 3D autoencoder-based framework for detection of the lesion volume of MS in MRI. We first define a 3D convolutional neural network (CNN) for full MRI volumes, and build each encoder and decoder layer of the 3D autoencoder based on 3D CNN. We also add a skip connection between the encoder and decoder layer for effective data reconstruction. In the experimental results, we compare the 3D autoencoder-based method with the 2D autoencoder models using the training datasets of 80 healthy subjects from the Human Connectome Project (HCP) and the testing datasets of 25 MS patients from the Longitudinal multiple sclerosis lesion segmentation challenge, and show that the proposed method achieves superior performance in prediction of MS lesion by up to 15%.

Effects of Virtual Reality Exercise Program on Balance in Multiple Sclerosis Patients

  • Lee, Geun-Ho
    • The Journal of Korean Physical Therapy
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    • v.27 no.1
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    • pp.61-67
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    • 2015
  • Purpose: This study was conducted in order to investigate the effectiveness of an 8-week virtual reality exercise program designed around the Nintendo Wii (Wii), in improving balance among patients with Multiple Sclerosis (MS). Methods: The study included 16 patients with MS (10 female, 6 male) who were assigned randomly to experimental (n=8) or control group (n=8). Experimental group performed three 40-minute Wii balance-training sessions per week, for 8 weeks. The control group did not perform any of the training programs. A computerized dynamic posturography (Sensory Organizing Test, SOT) was used to evaluate all patients at baseline and at the end of the treatment protocol. Statistical significance was tested in between the patients before and after treatment by t-test. Results: After 24 training sessions, SOT showed significant difference on condition 5, 6, and vestibular ratios within the experimental group from baseline to post-intervention. By contrast, no significant difference was observed within the control groups. Conclusion: These findings demonstrated that the virtual reality training program could improve the outcomes in terms of balance in the MS population. Long term follow ups and the development of more efficient virtual reality training programs are needed.

Neuroprotective Effects of 6-Shogaol and Its Metabolite, 6-Paradol, in a Mouse Model of Multiple Sclerosis

  • Sapkota, Arjun;Park, Se Jin;Choi, Ji Woong
    • Biomolecules & Therapeutics
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    • v.27 no.2
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    • pp.152-159
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    • 2019
  • Multiple sclerosis (MS) is an autoimmune disease characterized by progressive neuronal loss, neuroinflammation, axonal degeneration, and demyelination. Previous studies have reported that 6-shogaol, a major constituent of ginger (Zingiber officinale rhizome), and its biological metabolite, 6-paradol, have anti-inflammatory and anti-oxidative properties in the central nervous system (CNS). In the present study, we investigated whether 6-shogaol and 6-paradol could ameliorate against experimental autoimmune encephalomyelitis (EAE), a mouse model of MS elicited by myelin oligodendrocyte glycoprotein ($MOG_{35-55}$) peptide immunization with injection of pertussis toxin. Once-daily administration of 6-shogaol and 6-paradol (5 mg/kg/day, p.o.) to symptomatic EAE mice significantly alleviated clinical signs of the disease along with remyelination and reduced cell accumulation in the white matter of spinal cord. Administration of 6-shogaol and 6-paradol into EAE mice markedly reduced astrogliosis and microglial activation as key features of immune responses inside the CNS. Furthermore, administration of these two molecules significantly suppressed expression level of tumor necrosis $factor-{\alpha}$, a major proinflammatory cytokine, in EAE spinal cord. Collectively, these results demonstrate therapeutic efficacy of 6-shogaol or 6-paradol for EAE by reducing neuroinflammatory responses, further indicating the therapeutic potential of these two active ingredients of ginger for MS.

Lateralization of the Dichotic Digits Test, Central Auditory Processes, and Evoked Potentials in Multiple Sclerosis

  • Penaloza, Yolanda;Valdivia, Martha;Poblano, Adrian
    • Korean Journal of Audiology
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    • v.24 no.1
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    • pp.48-52
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    • 2020
  • Lateralization for central auditory processing (CAP) with dichotic digits recognition (DDR) test is believed expression of hemispheric dominance. Multiple sclerosis (MS) is considered an inflammatory and autoimmune alteration of central nervous system (CNS). Hearing alterations in MS and their role in CAP has not been well studied. A patient with MS and new kind of alteration in lateralization of CAP with DDR test is presented. A 53 year of age female with MS of 16 years of evolution, nine of them remained asymptomatic. She has a persistent advantage of the right ear for DDR test; but other monaural tests showed predominance of the left afferent pathway. Brainstem auditory evoked potentials (BAEPs) and long latency auditory evoked potentials (LLAEPs) showed adequate right response with deficits in organization of left response in BAEP, and N2 wave. In the contrary direction of previous publication, we disclosed advantage for DDR test, BAEP, and LLAEP in the right ear. We observed no left ear suppression; with predominance of correct left percentages in monaural psychoacoustics tests. We must keep on searching to find pathophysiological meaning of predominant of right or left auditory laterality as a CAP disorder in patients with MS.

Lateralization of the Dichotic Digits Test, Central Auditory Processes, and Evoked Potentials in Multiple Sclerosis

  • Penaloza, Yolanda;Valdivia, Martha;Poblano, Adrian
    • Journal of Audiology & Otology
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    • v.24 no.1
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    • pp.48-52
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    • 2020
  • Lateralization for central auditory processing (CAP) with dichotic digits recognition (DDR) test is believed expression of hemispheric dominance. Multiple sclerosis (MS) is considered an inflammatory and autoimmune alteration of central nervous system (CNS). Hearing alterations in MS and their role in CAP has not been well studied. A patient with MS and new kind of alteration in lateralization of CAP with DDR test is presented. A 53 year of age female with MS of 16 years of evolution, nine of them remained asymptomatic. She has a persistent advantage of the right ear for DDR test; but other monaural tests showed predominance of the left afferent pathway. Brainstem auditory evoked potentials (BAEPs) and long latency auditory evoked potentials (LLAEPs) showed adequate right response with deficits in organization of left response in BAEP, and N2 wave. In the contrary direction of previous publication, we disclosed advantage for DDR test, BAEP, and LLAEP in the right ear. We observed no left ear suppression; with predominance of correct left percentages in monaural psychoacoustics tests. We must keep on searching to find pathophysiological meaning of predominant of right or left auditory laterality as a CAP disorder in patients with MS.

Understanding the Pathophysiology and Magnetic Resonance Imaging of Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders

  • Laura Cacciaguerra;Maria A. Rocca;Massimo Filippi
    • Korean Journal of Radiology
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    • v.24 no.12
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    • pp.1260-1283
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    • 2023
  • Magnetic resonance imaging (MRI) has been extensively applied in the study of multiple sclerosis (MS), substantially contributing to diagnosis, differential diagnosis, and disease monitoring. MRI studies have significantly contributed to the understanding of MS through the characterization of typical radiological features and their clinical or prognostic implications using conventional MRI pulse sequences and further with the application of advanced imaging techniques sensitive to microstructural damage. Interpretation of results has often been validated by MRI-pathology studies. However, the application of MRI techniques in the study of neuromyelitis optica spectrum disorders (NMOSD) remains an emerging field, and MRI studies have focused on radiological correlates of NMOSD and its pathophysiology to aid in diagnosis, improve monitoring, and identify relevant prognostic factors. In this review, we discuss the main contributions of MRI to the understanding of MS and NMOSD, focusing on the most novel discoveries to clarify differences in the pathophysiology of focal inflammation initiation and perpetuation, involvement of normal-appearing tissue, potential entry routes of pathogenic elements into the CNS, and existence of primary or secondary mechanisms of neurodegeneration.