Handbook of Multiple Sclerosis, Fourth Edition

by Cook; Stuart D.

• ISBN13: 9781574448276
• ISBN10: 1574448277
• Edition: 4th
• Format: Hardcover
• Copyright: 2006-03-13
• Publisher: CRC Press

Summary

Univ. of Medicine and Dentistry of New Jersey, Newark. Text spans the etiology, epidemiology, clinical features, diagnosis, pathology, and treatment of multiple sclerosis. Provides recommendations and research updates on genetics, neuroimaging, and more. Previous edition: c2001. For clinicians. DNLM: Multiple sclerosis.

Table of Contents

Preface	v
Acknowledgment	vii
Contributors	xvii
PART I: ETIOPATHOGENESIS
1. Etiopathogenesis and Epidemiology: Clues to Etiology	1	(40)
William Pryse-Phillips and Scott Sloka
Introduction	1	(1)
Familial Factors and Genetic Susceptibility	2	(4)
Prevalence and Incidence Studies	6	(7)
Intercurrent Factors with Possible Association	13	(9)
Natural History and Clinical Variability	22	(3)
Clues to Etiology	25	(5)
References	30	(11)
2. Genetics: Susceptibility and Expressivity	41	(24)
Thomas Masterman and Jan Hillert
Susceptibility	41	(8)
Expressivity	49	(1)
Prospects	50	(6)
References	56	(9)
3. Evidence for an Infectious Etiology of Multiple Sclerosis	65	(30)
Stuart D. Cook
Introduction	65	(1)
Historical Perspective	65	(2)
Evidence for an Infectious Etiology	67	(3)
Possible Mechanisms of Virus-Induced Demyelination	70	(3)
Candidate Agents in MS	73	(12)
Conclusion	85	(1)
References	85	(10)
4. Multiple Sclerosis: An Autoimmune Disease of the Central Nervous System?	95	(18)
John R. Rinker II, Robert T. Naismith, and Anne H. Cross
Introduction	95	(1)
Epidemiology	96	(1)
Pathology Suggests an Autoimmune Etiology	96	(1)
Genetic Evidence Supporting Autoimmunity in MS	97	(1)
Evidence for T-Cell Mediated Autoimmunity in MS	98	(3)
Humoral Immunity as Indirect Evidence for Autoimmunity in MS	101	(2)
Response to Immunosuppressive Therapies Suggests an Autoimmune Etiology	103	(1)
The Autoimmune Hypothesis Is Supported by Animal Models	103	(1)
Summary	104	(1)
References	105	(8)
PART II: CLINICAL–PATHOLOGIC CHARACTERISTICS
5. Pathology: What May It Tell Us?	113	(40)
Claudia F. Lucchinetti and Joseph E. Parisi
Introduction	113	(1)
How Does Stage of Demyelinating Activity Relate to Clinical Phase of the Disease?	114	(5)
What Is the Pathogenic Role of Inflammation in MS?	119	(2)
What Is the Fate of the Oligodendrocyte and Extent of Remyelination in MS Lesions?	121	(2)
Is There Evidence for Pathologic Heterogeneity in MS?	123	(5)
Does Pathologic Heterogeneity Reflect Pathogenic Heterogeneity in MS?	128	(2)
What Is the Substrate of Irreversible Disability in MS?	130	(1)
The Inflammatory Demyelination/Neurodegeneration Paradox	130	(6)
What Is the Spectrum of Idiopathic Inflammatory Demyelinating Diseases?	136	(5)
What Do New Molecular Studies Tell Us About the MS Lesion?	141	(2)
Conclusion	143	(1)
References	143	(10)
6. Clinical Features	153	(26)
Aaron E. Miller
Introduction	153	(1)
Diagnosis	153	(5)
Age of Onset	158	(1)
Clinical Manifestations	158	(8)
Course	166	(2)
Pregnancy	168	(1)
References	169	(10)
7. MRI Techniques in Multiple Sclerosis: Role in Diagnosis, Pathophysiology, and Therapy	179	(44)
Massimo Filippi, Federica Agosta, Beatrice Benedetti, and Maria A. Rocca
Introduction	179	(3)
A Brief Review of Basic Aspects of Nonconventional MRI Techniques	182	(3)
The Role of MRI in the Diagnosis and Prognosis of MS	185	(9)
The Role of MRI in Understanding MS Pathophysiology	194	(10)
MRI in Monitoring Treatment Efficacy in MS Trials	204	(3)
Conclusions	207	(1)
References	208	(15)
8. Multiple Sclerosis Biomarkers	223	(20)
P.K. Coyle
Introduction	223	(3)
Potential Biomarkers	226	(9)
Neuroimaging	235	(1)
Conclusion	236	(1)
References	236	(7)
9. Evoked Potentials	243
Marc R. Nuwer
Introduction	243	(1)
Visual Evoked Potentials	244	(3)
Brainstem Auditory Evoked Potentials	247	(2)
Somatosensory Evoked Potentials	249	(3)
Motor EPs	252	(1)
Event-Related Potentials	253	(1)
Multimodality EP Testing	253	(3)
Use of EPs in MS Therapeutic Trials	256	(4)
References	260	(11)
PART III: THERAPIES—CURRENT AND FUTURE
10. Managing the Symptoms of Multiple Sclerosis	271	(10)
Randall T. Schapiro
Introduction	271	(1)
Fatigue	271	(1)
Spasticity	272	(1)
Weakness	273	(1)
Urinary Dysfunction	274	(1)
Bowel Dysfunction	274	(1)
Sexual Dysfunction	275	(1)
Pain	275	(1)
Tremor	276	(1)
Visual Dysfunction	276	(1)
Paroxysmal Spasms	277	(1)
Pathological Laughing/Crying	277	(1)
Depression	277	(1)
Conclusion	277	(1)
References	278	(3)
11. Rehabilitation: Its Role in Multiple Sclerosis	281	(20)
George H. Kraft and Anjali N. Shah
Introduction	281	(1)
Fatigue	282	(2)
Weakness and Spasticity	284	(5)
Body Cooling	289	(2)
Ataxia and Tremor	291	(1)
Sensory Loss and Pain	292	(1)
Depression	293	(1)
Cognitive Impairment	293	(1)
General Fitness	294	(1)
Assistive Technology	295	(1)
Vocational Issues	296	(1)
Conclusion	296	(1)
References	297	(4)
12. Acute Treatments	301	(16)
Brian G. Weinshenker and Nima Mowzoon
Introduction	301	(3)
Treatment with Corticosteroids	304	(2)
Intravenous Immunoglobulin	306	(2)
Therapeutic Plasma Exchange	308	(2)
Mitoxantrone	310	(1)
Cyclophosphamide	311	(1)
Conclusions	312	(1)
References	313	(4)
13. Treatment of the Clinically Isolated Syndromes	317	(16)
Giancarlo Comi
Introduction	317	(1)
Rationale for Early Treatment	317	(10)
Conclusion	327	(1)
References	327	(6)
14. The Use of Interferon Beta in the Treatment of Multiple Sclerosis	333	(18)
Douglas S. Goodin
Introduction	333	(2)
Biological Consequences of IFNβ Administration	335	(1)
Assessing the Clinical and MRI Effects of IFNβ in MS Patients	336	(10)
Conclusions	346	(1)
References	347	(4)
15. Glatiramer Acetate (Copaxone®)	351	(22)
Yang Mao-Draayer and Hillel S. Panitch
Introduction	351	(1)
Clinical Studies of GA	351	(10)
Immunological Activity of GA	361	(4)
The Place of GA in MS Therapy	365	(1)
Conclusion	366	(1)
References	366	(7)
16. Mitoxantrone	373	(12)
Oliver Neuhaus, Bernd C. Kieseier, and Hans-Peter Hartung
Introduction	373	(1)
Evidence Leading to the Approval of Mitoxantrone for Use in Multiple Sclerosis	373	(3)
Current Clinical Aspects of Mitoxantrone	376	(3)
Putative Mechanisms of Action of Mitoxantrone	379	(2)
Conclusions	381	(1)
References	381	(4)
17. Monoclonal Antibodies, T-Cell Receptors, and T-Cell Vaccines	385	(24)
Flavia Nelson and Jerry S. Wolinsky
Introduction	385	(1)
Monoclonal Antibodies	385	(13)
T-Cell Vaccines	398	(3)
Conclusion	401	(1)
References	402	(7)
18. Immune Therapy for Multiple Sclerosis: Altered Peptide Ligands and Statins	409	(14)
Fu-Dong Shi, Denise I. Campagnolo, and Timothy L. Vollmer
Introduction	409	(1)
Is the Use of APLs Still a Viable Approach for Treatment of MS?	409	(4)
Are Statins a Treatment Option for MS?	413	(6)
References	419	(4)
19. Immunosuppression	423	(20)
Harold Atkins and Mark Freedman
Introduction	423	(1)
Cyclophosphamide	424	(2)
Complete Immunoablation and Autologous Stem Cell Transplantation	426	(1)
Transplant Studies in MS	427	(2)
Stem Cell Transplantation	429	(4)
MS Outcomes Following Transplantation	433	(1)
Patient Selection	434	(1)
Future Directions—Beyond Cytotoxic Immunosuppression	434	(1)
Future Directions—Beyond Repair of the Immune System	435	(1)
Conclusion	435	(1)
References	435	(8)
20. Combination Therapy in Multiple Sclerosis	443	(10)
Mark J. Tullman and Fred D. Lublin
Introduction	443	(1)
Selecting Agents for Combination Therapy	443	(2)
IFNβ and GA	445	(2)
IFN, Methylprednisolone, and Methotrexate	447	(1)
Mitoxantrone and Methylprednisolone	448	(1)
Conclusions	449	(1)
References	450	(3)
21. Regeneration Strategies for Multiple Sclerosis	453	(24)
Arthur E. Warrington and Moses Rodriguez
Introduction	453	(1)
Remyelination as a Normal Reparative Response	454	(1)
Present Treatments for MS Target Inflammation, Not Repair	454	(1)
Inflammation Hinders as well as Facilitates CNS Repair	455	(1)
Growth Factors for MS Lesion Repair and Regeneration	456	(1)
Cell Transplantation for MS Lesion Repair and Regeneration	457	(2)
Pathogenic Antibodies Directed Against CNS Antigens	459	(1)
Reparative Antibodies Directed Against CNS Antigens	459	(4)
Glatiramer Acetate, an Established Treatment for MS, May Act via a Humoral Immune Response	463	(1)
Mechanism of Antibody-Mediated CNS Repair	464	(2)
Remyelination Promoting mAbs Target the Damaged CNS	466	(1)
The Challenge of Balancing Inflammation for Regeneration	467	(1)
References	467	(10)
22. Axonal Injury in Multiple Sclerosis	477	(30)
Gerson A. Criste and Bruce D. Trapp
Introduction	477	(1)
Axonal Pathology in MS Lesions	477	(4)
Mechanism of Axonal Injury in MS	481	(5)
Strategies for Axonal Protection	486	(3)
Surrogate Markers of Axonal Loss	489	(6)
Clinical Implications	495	(1)
Conclusion	496	(1)
References	497	(10)
Index	507