Treatment of multiple sclerosis patients after 24 Natalizumab doses: a prospective observational study: the TY-STOP

Subcutaneous interferon β-1a may protect against cognitive impairment in patients with relapsing-remitting multiple sclerosis: 5-year follow-up of the COGIMUS study

ObjectiveTo assess the effects of subcutaneous (sc) interferon (IFN) -1a on cognition over 5 years in mildly disabled patients with relapsing-remitting multiple sclerosis (RRMS).MethodsPatients aged 18-50 years with RRMS (Expanded Disability Status Scale score ≤4.0) who had completed the 3-year COGIMUS study underwent standardized magnetic resonance imaging, neurological examination, and neuropsychological testing at years 4 and 5. Predictors of cognitive impairment at year 5 were identified using multivariate analysis.ResultsOf 331 patients who completed the 3-year COGIMUS study, 265 participated in the 2-year extension study, 201 of whom (75.8%; sc IFN β-1a three times weekly: 44 µg, n = …

Is season of birth associated with multiple sclerosis?

Objective - To compare the monthly distribution of multiple sclerosis (MS) patients' births with that of the Sicilian population. Background - Studies on the association between season of birth and risk of MS are scanty and controversial. Design and methods - Archives of the Institute of Neuropsychiatry of the Universities of Palermo and Catania were searched up to 1995 for definite MS patients (McDonald and Halliday criteria). The monthly distribution of MS patients' births (N = 965) was compared with that of the Sicilian population (N = 5,608,307). Results - The distribution of births among MS patients compared with the general population was not different when tested by the χ2 statistic …

Effect of extracellular vesicles from CSF of multiple sclerosis patients and healthy controls on astrocytes in culture

INTRODUCTION Secretion of extracellular vesicles (EVs) and EV-mediated exchange of molecules among brain cells, under physiological conditions, has been described years ago. At the same time, ability of EVs to transfer proteins and nucleic acids to the surrounding cells, thus modifying their phenotypes, has been clearly demonstrated for tumor cells of different origins, including brain cancers. More recently, involvement of EVs in pathological processes affecting the Central Nervous System (CNS), and their capacity of transferring damaging cargoes have been also suggested. To explore these functions, we exposed primary cultures of astrocytes to EVs isolated from cerebral spinal fluid (CSF) …

No evidence of beneficial effects of plasmapheresis in natalizumab-associated PML

Objective:To examine retrospectively the effects of plasmapheresis (PLEX) on the survival and clinical outcomes of patients with multiple sclerosis (MS) and natalizumab (NTZ)–associated progressive multifocal leukoencephalopathy (PML).Methods:The medical literature was searched for the terms natalizumab and progressive multifocal leukoencephalopathy. A total of 193 international and 34 Italian NTZ-PML cases were included. Clinical outcome was determined by comparing the patients' clinical status at PML diagnosis with status after PML resolution. The effects on survival and clinical outcome of PLEX, sex, age, country, pre-PML Expanded Disability Status Scale score, NTZ infusion number, prior…

Post-marketing of disease modifying drugs in multiple sclerosis: an exploratory analysis of gender effect in interferon beta treatment.

Background: There are a few and conflicting results from randomised controlled trials (RCTs) pertaining to the influence of gender in response to currently used disease modifying drugs in Multiple Sclerosis (MS). Observational studies may be especially valuable for answering effectiveness questions in subgroups not studied in RCTs. Objective: To conduct a post-marketing analysis aimed to evaluate the gender effect on Interferon beta (IFN beta) treatment response in a cohort of relapsing (RR) MS patients. Methods: A cohort of 2570 IFN beta-treated RRMS was prospectively followed for Lip to 7 years in 15 Italian MS Centers. Cox proportional hazards regression models were used to assess gender…

Do patients' and referral centers' characteristics influence multiple sclerosis phenotypes? Results from the Italian multiple sclerosis and related disorders register

Abstract Background Multiple sclerosis (MS) is characterized by phenotypical heterogeneity, partly resulting from demographic and environmental risk factors. Socio-economic factors and the characteristics of local MS facilities might also play a part. Methods This study included patients with a confirmed MS diagnosis enrolled in the Italian MS and Related Disorders Register in 2000–2021. Patients at first visit were classified as having a clinically isolated syndrome (CIS), relapsing–remitting (RR), primary progressive (PP), progressive-relapsing (PR), or secondary progressive MS (SP). Demographic and clinical characteristics were analyzed, with centers’ characteristics, geographic macro-ar…

Application of tRNS to improve Multiple Sclerosis Fatigue: a sham-controlled study

Background and aims: Fatigue is one of the most common, early, and disabling symptom in Multiple Sclerosis (MS). tDCS on Dorso-Lateral Prefrontal Cortex seems to give positive results on MS fatigue. Recently, a new stimulation protocol, transcranial Random Noise Stimulation (tRNS), showed powerful facilitatory effects on motor cortex in healthy subjects and ameliorated pain in MS patients. Here we aimed to explore effects of motor cortex tRNS in MS fatigue.Methods: 13 MS fatigued patients were enrolled in a blind, sham controlled tRNS study. 7 patients received 1.5 mA, 101-640 Hz tRNS stimulation and 6 patient received sham stimulation, both stimulations applied daily over M1 for 15 minutes…

Door-to-door prevalence survey of epilepsy in three Sicilian municipalities

A door-to-door prevalence survey of epilepsy was conducted in 3 Sicilian municipalities, as of November 1, 1987. In phase 1, the screening by questionnaire of 24,496 eligible subjects (participation = 92%) identified 544 suspected to have epilepsy. In phase 2, neurological evaluation of the 544 subjects yielded 111 with epilepsy. Of the 111 subjects, 103 (93%) had been previously diagnosed, 68 (61%) were taking antiepileptic medication, and 81 (73%) had active epilepsy. Referring to the 81 subjects with active epilepsy, the seizure type was generalized in 60 (74%), partial in 19 (23%) and undetermined in 2 (3%). The prevalence of active epilepsy (per 1,000 population) was 3.3 overall, 3.5 f…

The Italian multiple sclerosis register

The past decade has seen extraordinary increase in worldwide availability of and access to several large multiple sclerosis (MS) databases and registries. MS registries represent powerful tools to provide meaningful information on the burden, natural history, and long-term safety and effectiveness of treatments. Moreover, patients, physicians, industry, and policy makers have an active interest in real-world observational studies based on register data, as they have the potential to answer the questions that are most relevant to daily treatment decision-making. In 2014, the Italian MS Foundation, in collaboration with the Italian MS clinical centers, promoted and funded the creation of the …

GREY MATTER ATROPHY AND FATIGUE IN MULTIPLE SCLEROSIS: A CORRELATION EVIDENT ONLY IN PATIENTS WITH LOW DISABILITY

Regional Partnerships for Living Labs: the Case of Sicily and the MedLab Project

Abstract: This paper addresses the issue of how the Living Lab model can be integrated into regional development policy, through a “demand-pull” approach to innovation in which institutional innovation plays a key role in the form of bottom-up partnerships between a range of actors. The MedLab project, funded by the ERDF in the MED programme, addresses this issue with eight partners in seven Mediterranean regions. The paper first discusses the case of a concrete experience in building a regional Living Lab partnership in the Sicilian region and how the lessons learned shaped the MedLab approach and workplan. The first activities in MedLab are then presented as a more structured attempt at l…

Cognitive impairment and its relation with disease measures in mildly disabled patients with relapsing-remitting multiple sclerosis: baseline results from the Cognitive Impairment in Multiple Sclerosis (COGIMUS) study.

Background Cognitive impairment is a common symptom of multiple sclerosis (MS), but the association between cognitive impairment and magnetic resonance imaging (MRI) disease measures in patients with relapsing–remitting (RR) MS is unclear. Objectives To study the prevalence of cognitive impairment and its relation with MRI disease measures in mildly disabled patients with RRMS. Methods Patients aged 18–50 years with RRMS (McDonald criteria) and an Expanded Disability Status Scale (EDSS) score ≤4.0, who were enrolled in the Cognitive Impairment in Multiple Sclerosis (COGIMUS) study, underwent baseline standardized MRI complete neurological examination and neuropsychological testing. Results…