Primary-progressive multiple sclerosis

@article{Miller2007PrimaryprogressiveMS,
  title={Primary-progressive multiple sclerosis},
  author={David H. Miller and Siobhan M. Leary},
  journal={The Lancet Neurology},
  year={2007},
  volume={6},
  pages={903-912}
}
The role of advanced magnetic resonance imaging techniques in primary progressive MS
TLDR
Data from quantitative MRI studies suggest that the extent and topography of “diffuse” damage in different central nervous system (CNS) compartments is associated with the severity of disability in PPMS and can predict subsequent medium-term disease evolution.
Clinical and MRI features of primary progressive multiple sclerosis
TLDR
The specific question as to whether a distinct, early, inflammatory phase occurs in the condition is addressed by the use of triple dose Gadolinium in a subgroup of this cohort examined over six months and evidence for the possible existence of such a phase in some patients with PPMS is found.
Innate immunity in progressive multiple sclerosis
TLDR
The findings suggest that later stages of MS is characterized less of adaptive and innate cellular alterations in the periphery, also supported by the relative lack of efficacy of current therapies in MS directed mainly at modulating the adaptive immune defense.
Diagnostic modalities in multiple sclerosis: Perspectives in children
TLDR
Novel biomarkers are discussed, such as antibodies to aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG), which may help in making a diagnosis of pediatric multiple sclerosis.
Meningeal inflammation plays a role in the pathology of primary progressive multiple sclerosis.
TLDR
The data suggest that generalized diffuse meningeal inflammation and the associated inflammatory milieu in the subarachnoid compartment plays a role in the pathogenesis of cortical grey matter lesions and an increased rate of clinical progression in primary progressive multiple sclerosis.
CSF inflammation and axonal damage are increased and correlate in progressive multiple sclerosis
TLDR
CSF biomarkers of inflammation, axonal damage and demyelination are continuously increased in progressive MS patients and correlate, and these findings parallel pathology studies, emphasise a relationship between inflammation,AxonalDamage and demYelination and support the use of CSF biomarker in progressiveMS clinical trials.
Cervical cord atrophy and long-term disease progression in primary progressive multiple sclerosis patients
BACKGROUND AND OBJECTIVE: Cervical cord atrophy has been associated with clinical disability in multiple sclerosis and is proposed as an outcome measure of neurodegeneration. The aim of this study
Secondary Progressive Multiple Sclerosis: Definition and Measurement
TLDR
The definition(s) of SPMS is discussed and how it may vary, outcome measurements (current and emerging) and modern trial design are discussed, and the vast majority of clinical trials testing immunosuppressant and immunomodulating drugs in SPMS patients has so far yielded disappointing or mixed results.
Large-scale, multicentre, quantitative MRI study of brain and cord damage in primary progressive multiple sclerosis
TLDR
Sequence-related variability of measurements makes the standardization of MT MRI acquisition essential for the design of multicentre studies because of significant inter-centre heterogeneity.
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References

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Cord atrophy separates early primary progressive and relapsing remitting multiple sclerosis
TLDR
Grey matter and white matter of the brain are abnormal in both early RRMS and PPMS, but cord atrophy is present only in PPMS.
Natural history of multiple sclerosis
TLDR
Primary progressive MS may differ from relapsing‐remitting MS in MRI lesion frequency, immunogenetic profile, responsiveness to immunosuppressive treatment, and histology.
Imaging primary progressive multiple sclerosis: the contribution of structural, metabolic, and functional MRI techniques
TLDR
The results of these studies underpin that the main factors possibly explaining the clinical/MRI discrepancy observed in patients with PPMS include the presence of a diffuse tissue damage that is beyond the resolution of conventional imaging, the extent of cervical cord damage, and the impairment of the adaptive capacity of the cortex to limit the functional consequences of subcortical pathology.
Primary progressive multiple sclerosis: a 5-year clinical and MR study.
TLDR
Longer duration of follow-up demonstrates modest associations between change in clinical and MR measures and provides new insights into the pattern of change within and between individuals with PPMS.
The normal appearing grey matter in primary progressive multiple sclerosis
TLDR
There appear to be significant abnormalities in the NAGM in PP MS, and further investigation of the pathological basis and functional significance of grey matter abnormality in PPMS is warranted.
Cortical demyelination and diffuse white matter injury in multiple sclerosis.
TLDR
Global brain pathology in multiple sclerosis is analysed, focusing on the normal-appearing white matter (NAWM) and the cortex, to suggest that multiple sclerosis starts as a focal inflammatory disease of the CNS, which gives rise to circumscribed demyelinated plaques in the white matter.
A comparison of the pathology of primary and secondary progressive multiple sclerosis.
TLDR
There was significantly more inflammation in secondarygressive multiple sclerosis (as judged by the frequency of perivascular cuffing and cellularity of the parenchyma) than in primary progressive disease, which has implications for therapeutic strategies in progressive multiple sclerosis.
Axonal damage in acute multiple sclerosis lesions.
TLDR
The results show the expression of amyloid precursor protein in damaged axons within acute multiple sclerosis lesions, and in the active borders of less acute lesions, which may have implications for the design and timing of therapeutic intervention.
Multiple sclerosis: current and future treatment options.
  • S. Rizvi
  • Medicine
    Endocrine, metabolic & immune disorders drug targets
  • 2007
TLDR
The agents currently used in the treatment of MS are reviewed and the agents currently under development are discussed, which target the inflammatory component of the disease resulting in significant reduction in relapses, decrease in MRI lesion load and a modest effect on disability.
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