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Medicina
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Disease Progression in Multiple Sclerosis: Latest Therapeutic Developments and Future...
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Disease Progression in Multiple Sclerosis: Latest Therapeutic Developments and Future Directions

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Neurology".

Deadline for manuscript submissions: closed (14 February 2023) | Viewed by 3528

Special Issue Editors

Dr. Matteo Lucchini

E-Mail Website
Guest Editor
1. UOC Neurologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
2. Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, CERSM, 00168 Rome, Italy
Interests: multiple sclerosis; demyelinating disorders; neuroimmunology; neuroimaging; CSF biomarkers; real-world study; disease modifying treatment (DMT)
Dr. Serena Ruggieri

E-Mail Website
Guest Editor
Department of Human Neurosciences, Sapienza University, Rome, Italy
Interests: multiple sclerosis; demyelinating disorders; neuroimmunology; neuroimaging; CSF biomarkers; real-world study; disease modifying treatment (DMT)

Special Issue Information

Dear Colleagues,

Multiple Sclerosis (MS) is the second leading cause of neurological disability in young adults after traumatic injuries. Clinically, MS can present as relapsing, remitting, or being characterized by a progressive disease course.

In the last 30 years, numerous therapies (disease-modifying therapies, DMTs) have been approved for MS treatment. These therapeutic approaches proved to be highly effective in reducing clinical relapses, as well as neuroradiological burden. However, DMTs have shown only partial efficacy in slowing the clinical deterioration in progressive forms of the disease. Indeed, in the MS research field, a major challenge is represented by the prediction of disease progression and accumulation. Disability accrual can occur as relapse-associated worsening (RAW) or steady progression independent of relapse activity (PIRA), with PIRA considered to be a feature of progressive MS.

This Special Issue aims to collect recent evidence (in form of original paper or as review) on the physiopathology of disease progression, treatment strategies for transitional and progressive forms of the disease, and biomarkers of progression in MS.

We are soliciting studies that explore potential pathological mechanisms of disease progression from in vivo approaches (such as studies on EAE model) to neurophysiological evaluations of patients. We also give priority to original papers evaluating potential markers of disease progression and disability accumulation, encompassing serum, cerebrospinal fluid, and neuroradiological biomarkers. We include a clinical study investigating potential predictors (both clinical and radiological ones) of long-term risk of disease progression. Finally, we intend to collect pharmacological studies, including both transitional (from relapsing-remitting to progressive) and progressive MS.

Dr. Matteo Lucchini
Dr. Serena Ruggieri
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • multiple sclerosis
  • disease modifying treatment (DMT)
  • magnetic resonance imaging
  • progressive multipla sclerosis
  • relapse-associated worsening (RAW)
  • progression independent of relapse activity (PIRA)
  • biomarkers
  • cerebrospinal fluid (CSF)

Published Papers (2 papers)

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Research

11 pages, 1902 KiB  
Article
Annual Plasma Neurofilament Dynamics Is a Sensitive Biomarker of Disease Activity in Patients with Multiple Sclerosis
by Miriam Fedičová, Pavol Mikula, Zuzana Gdovinová, Marianna Vitková, Norbert Žilka, Jozef Hanes, Lýdia Frigová and Jarmila Szilasiová
Medicina 2023, 59(5), 865; https://doi.org/10.3390/medicina59050865 - 29 Apr 2023
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Abstract
Background and Objectives: Neurofilament light chain (NfL) is a sensitive biomarker of neuroaxonal damage. This study aimed to assess the relationship between the annual change in plasma NfL (pNfL) and disease activity in the past year, as defined by the concept no [...] Read more.
Background and Objectives: Neurofilament light chain (NfL) is a sensitive biomarker of neuroaxonal damage. This study aimed to assess the relationship between the annual change in plasma NfL (pNfL) and disease activity in the past year, as defined by the concept no evidence of disease activity (NEDA) in a cohort of multiple sclerosis (MS) patients. Materials and Methods: Levels of pNfL (SIMOA) were examined in 141 MS patients and analyzed in relationship to the NEDA-3 status (absence of relapse, disability worsening, and MRI activity) and NEDA-4 (NEDA-3 extended by brain volume loss ≤ 0.4%) during the last 12 months. Patients were divided into two groups: annual pNfL change with an increase of less than 10% (group 1), and pNfL increases of more than 10% (group 2). Results: The mean age of the study participants (n = 141, 61% females) was 42.33 years (SD, 10.17), and the median disability score was 4.0 (3.5–5.0). The ROC analysis showed that a pNfL annual change ≥ 10% correlates with the absence of the NEDA-3 status (p < 0.001; AUC: 0.92), and the absence of the NEDA-4 status (p < 0.001; AUC: 0.839). Conclusions: Annual plasma NfL increases of more than 10% appear to be a useful tool for assessing disease activity in treated MS patients. Full article
(This article belongs to the Special Issue Disease Progression in Multiple Sclerosis: Latest Therapeutic Developments and Future Directions)
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10 pages, 717 KiB  
Article
Factors Related to the Progression of Clinically Isolated Syndrome to Multiple Sclerosis: A Retrospective Study in Lithuania
by Renata Balnytė, Vaidas Matijošaitis, Ieva Čelpačenko, Miglė Malciūtė, Radvilė Stankevičiūtė and Ovidijus Laucius
Medicina 2022, 58(9), 1178; https://doi.org/10.3390/medicina58091178 - 30 Aug 2022
Cited by 2 | Viewed by 1617
Abstract
Background and Objectives: Multiple sclerosis (MS) is a demyelinating disease which usually manifests as clinically isolated syndrome (CIS). Approximately 70% of patients with CIS progress to MS. Therefore, there is a pressing need to identify the most accurate predictive factors of CIS [...] Read more.
Background and Objectives: Multiple sclerosis (MS) is a demyelinating disease which usually manifests as clinically isolated syndrome (CIS). Approximately 70% of patients with CIS progress to MS. Therefore, there is a pressing need to identify the most accurate predictive factors of CIS developing into MS, some of which could be a clear clinical phenotype of early MS as well as lesions in magnetic resonance imaging (MRI), pathological findings in cerebrospinal fluid (CSF) and evoked potentials (EP) tests. The problem is of outstanding importance since early MS diagnosis and treatment prevents long-term disability. The aim of our study is to analyze the factors that could influence the progression of CIS to MS. Materials and Methods: This study is a retrospective data analysis which included patients with their primary CIS diagnosis between 1st January 2015 and 1st January 2020. The prevalence and predictive value of clinical symptoms, MRI lesions, pathological CSF and EP findings were evaluated in accordance with the final diagnosis and compared between the sexes and age groups. Results: Out of 138 CIS patients, 49 (35.5%) patients progressed to MS. MS patients were more likely to have a diminished sense of vibration and proprioception (χ2 = 9.033, p = 0.003) as well as spinal cord MRI lesions (χ2 = 7.209, p = 0.007) in comparison with the non-MS group. Positive oligoclonal bands (OCBs) in CSF (χ2 = 34.859, p ≤ 0.001) and pathological brainstem auditory evoked potential (BAEP) test findings (χ2 = 10.924, p ≤ 0.001) were more prevalent in the MS group. Diminished sense of vibration and proprioception increased the risk for developing MS by 13 times (p = 0.028), whereas positive OCBs in CSF increased the risk by 100 times (p < 0.001). MS patients that were older than 50 years were more likely to exhibit positive Babinski’s reflex (χ2 = 6.993, p = 0.03), decreased muscle strength (χ2 = 13.481, p = 0.001), ataxia (χ2 = 8.135, p = 0.017), and diminished sense of vibration and proprioception (χ2 = 7.918, p = 0.019) in comparison with both younger age groups. Conclusions: Diminished sense of vibration and proprioception, spinal cord MRI lesions, positive OCBs and pathological BAEP test findings were more common among patients that developed MS. Diminished sense of vibration and proprioception along with positive CSF OCBs are predictors of CIS progressing to MS. Older patients that develop MS have more symptoms in general, such as positive Babinski’s reflex, decreased muscle strength, ataxia, and diminished sense of vibration and proprioception. Full article
(This article belongs to the Special Issue Disease Progression in Multiple Sclerosis: Latest Therapeutic Developments and Future Directions)
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