Monday, May 12


Could Sleep Deprivation Aggravate Multiple Sclerosis?
 ABC News
Sleep Doubles Growth Of Brain Repair Cells. This explains why multiple sclerosis, an autoimmune disease that destroys myelin and kills oligodendrocytes, is so devastating. Hardened scars in the brain are the classic feature in the more than two million victims of the disease. Scientists at the University of Wisconsin-Madison (UoW) have discovered another reason why sleep is great! Resting boosts the growth of special cells — called oligodendrocytes — that repair the brain when it is injured, according to new findings reported in the Journal of Neuroscience.

High risk of cardiovascular diseases after diagnosis of multiple sclerosis
We recommend careful surveillance and preventive CVDs measures among MS patients, particularly among the women.

CAMPATH (Alemtuzumab) improves contrast sensitivity in patients with relapsing-remitting multiple sclerosis 
Alemtuzumab was associated with a greater chance of improved contrast sensitivity in patients with RRMS and may delay the worsening of visual function.

The impact of sexual dysfunction on health-related quality of life in people with multiple sclerosis
Sexual dysfunction is a prevalent symptom in multiple sclerosis (MS) that may affect patients’ health-related quality of life (HrQoL).  In patients with MS, sexual dysfunction has a much larger detrimental impact on the mental health aspects of HrQoL than severity of physical disability. The study population included 6183 persons (mean age: 50.6, SD = 9.6; 74.7% female, 42.3% currently employed. Participants were recruited from a large MS registry, the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry.

Click on "Read More" below to read 117 more Studies & Articles we posted the past week:

Interdependence and contributions of sun exposure and vitamin D to MRI measures in multiple sclerosis
Sun exposure may have direct effects on MRI measures of neurodegeneration in MS, independently of vitamin D. Multivitamin supplementation summer, sun exposure and darker eye color had the strongest associations with vitamin D metabolite levels in the MS group. Increased summer sun exposure was associated with increased grey matter volume and whole brain volume after correcting for Extended Disability Status Scale in the MS group. Inclusion of 25-hydroxy vitamin D3 levels did not substantially affect the positive associations of sun exposure with WBV and GMV...

Primary progressive multiple sclerosis: progress and challenges
Primary progressive multiple sclerosis (MS) has long been recognised as presenting great difficulties to our management of what is increasingly a treatable neurological disease...

The interface between neurology and psychiatry: the case of multiple sclerosis
There has been a surge in interest in the boundaries of psychiatry, both as a specialty in its own right and as a branch of medicine separate from neurology....

 Cocoa, neurovascular coupling, and neurodegeneration: The good, the bad, and the ugly
 Neurology September 3, 2013 81:863-864; published ahead of print August  7, 2013
Though the human brain is only ∼2% of body mass, it represents more than 20% of total body oxygen and energy consumption,1,2 and the supply of blood to the active neurons must match their metabolic demand. Fortunately, the tight coupling between capillary endothelial cells, astrocytes, pericytes, and neurons—dubbed the neurovascular unit—ensures precise modulation of regional blood flow in response to local metabolic demand. This integration of
supply and demand, termed neurovascular coupling (NVC), is critical to neurophysiologic health. Indeed, accumulating evidence shows an important role for cerebral vascular insufficiency in neurodegenerative diseases ranging from vascular cognitive impairment3 to Alzheimer disease.4 Therefore, targeting cerebral vascular pathology is a promising option for primary and secondary prevention of neurodegenerative diseases and subsequent cognitive impairments.

Spotting MS lesions

Evaluation of plaque detection and optimum time of enhancement in acute attack multiple sclerosis after contrast injection. Acta Radiology 2013 Aug. 

PURPOSE: To find the best time to detect MS plaques on MRI after Gadobutrol injection.

CONCLUSION: The maximum number of enhancing plaques in MS patients was detected 15 min after contrast agent administration and the size and signal intensity of the lesions also increased remarkably at this time. READ MORE 

Do any of your relatives have MS?
There have been a couple of mentions of a "slight" genetic link for multiple sclerosis, such as the subject of this older blog: Is Multiple Sclerosis Genetic?

CDC Details Use of Sleep Meds
Some 4% of American adults used prescription sleep medications in the past month, government survey data showed, with the highest rates among women, the elderly, whites, and the college-educated.

VIDEO: Software developer reveals challenges of living with multiple sclerosis
Alistair Farrugia walks out of the lift, leaning on the wheeled walker his company bought to assist his mobility at its offices. The young software developer ...

 Of Mice and Men: Problems with Animal Studies Highlighted in a New Light
John Ioannidis of Stanford and colleagues published an important paper in PLoS Biology, “Evaluation of Excess Significance Bias in Animal Studies of Neurological Diseases.”

Area man to bike 200 miles in multiple sclerosis fundraiser
Norman Eubank hadn't ridden a bicycle in 34 years when he decided he wanted to do a sprint triathlon. "I had turned 50, and I guess I needed to prove to myself ...»

Blair Underwood Makes Mom Proud
Actor Blair Underwood's mother was thrilled when he signed up to play disabled detective Ironside on Tv because she has been confined to a wheelchair with Multiple Sclerosis

Alzheimers, ALS and Multiple Sclerosis
Once I was diagnosed with multiple sclerosis, I became acutely aware of other chronic diseases, especially Alzheimer's disease and ALS (amyotrophic lateral ...

European Approval for Aubagio (Teriflunomide) in MS
Results of the TEriflunomide Multiple Sclerosis (TEMSO) trial, published in the New England Journal of Medicine in 2011, showed a significant reduction in ...

Cool cars cruise for cause
A&W Cruisin' for A Cause held a fundraiser last week in Maple Ridge for the Multiple Sclerosis Society of Canada. A&W restaurants in B.C. and the Yukon raised ...

Eleven-year-old completes run
For the past week, Tyler has been an 11-year-old fund- and awareness-raising machine for multiple sclerosis as he ran tip-to-tip across the Island along the ...

TYSABRI: The improvement of cognitive functions is associated with a decrease of plasma Osteopontin levels in Natalizumab treated Relapsing Multiple Sclerosis.

Risk factors for rare diseases can be risky to define: PML and Tysabri (natalizumab)
Neurology September 3, 2013 81:858-859
When rare neurologic diseases become topics of editorials in journals such as Nature Neuroscience,1 the New England Journal of Medicine,2 and Neurology®,3 there is usually something more of general interest than the rare disease itself. Such is the case for progressive multifocal leukoencephalopathy (PML), the JC virus–induced demyelinating disease that was once relegated for discussion to the back of the textbook, whether in microbiology or neurology. Not any longer. Incidence and publication of cases of PML have risen more than 50-fold within the last decade.

AUBAGIO (Teriflunomide) in relapsing multiple sclerosis: therapeutic utility.
Teriflunomide is an oral, once-daily disease-modifying therapy (DMT) approved in the USA, Australia, and Argentina for the treatment of relapsing forms of multiple sclerosis (RMS). Teriflunomide reversibly limits the expansion of activated T and B cells associated with the inflammatory process purportedly involved in multiple sclerosis pathogenesis, while preserving lymphocytes for routine immune surveillance. In an extensive clinical development program, teriflunomide demonstrated consistent benefits on both clinical and magnetic resonance imaging outcomes. In long-term studies, teriflunomide treatment was associated with low rates of relapse and disability progression for up to 8 years. The safety profile of teriflunomide has been well characterized, with adverse events generally mild to moderate in nature and infrequently leading to permanent treatment discontinuation. The evidence reviewed here indicates that teriflunomide is an effective addition to the current DMTs used to treat RMS....

Laquinimod for multiple sclerosis.
We found low-level evidence for the use of laquinimod as a disease-modifying therapy for MS because only one study with limited quality (high risk of attrition bias) was included. The published study suggests that laquinimod at a dose of 0.6 mg orally administered once daily may be safe and have potential benefits for most patients with RRMS in the short term. We are waiting for the publication of ongoing trials....

 Therapeutic Decisions in Multiple Sclerosis-Moving Beyond Efficacy
In this article, we focus primarily on the safety of DMTs in the context of understanding their pharmacological characteristics, including molecular targets, mechanism of action, chemical structure, and metabolism.  Recognizing the individual classes of DMTs described here may be valuable when considering use of such agents sequentially or possibly in combination....

L-Selectin is a possible biomarker for individual PML risk in natalizumab-treated MS patients
Objective: To find biomarkers identifying patients at risk for the development of progressive multifocal leukoencephalopathy (PML) during natalizumab treatment.
Conclusions: The cell-based assessment of the percentage of L-selectin-expressing CD4 T cells could provide an urgently needed biomarker for individual PML risk assessment....

Mesenchymal Stem Cells (MSC) derived from mice with Experimental Autoimmune Encephalomyelitis (EAE) suppress EAE and have similar biological properties with MSC from healthy donors.

A Long-Term Follow-Up Study Using IPMSSG Criteria in Children With CNS Demyelination.

Comparison of BLADE and conventional T2-TSE sequences for the sagittal visualization of the cervical spinal cord in multiple sclerosis patients - A case report.

Inhibition of Endogenous Activated Protein C Attenuates Experimental Autoimmune Encephalomyelitis by Inducing Myeloid-Derived Suppressor Cells.

Autoantigens and Autoantibodies in Multiple Sclerosis.

Gene expression changes underlying cortical pathology: clues to understanding neurological disability in multiple sclerosis.

Chromosomal radiosensitivity in patients with multiple sclerosis.

Magnetic resonance monitoring of lesion evolution in multiple sclerosis.

Targeting ion channels for the treatment of autoimmune neuroinflammation.

Assessing humoral immunocompetence after alemtuzumab treatment  in MS

Immune competence after alemtuzumab treatment of multiple sclerosis
Neurology September 3, 2013 81:872-876; published ahead of print August 7, 2013 

 Retinal periphlebitis is associated with multiple sclerosis severity
 Neurology September 3, 2013 81:877-881; published ahead of print July 31,2013

Application and a proposed modification of the 2010 McDonald criteria for the diagnosis of multiple sclerosis in a Canadian cohort of patients with clinically isolated syndromes
The 2005 and 2010 McDonald criteria utilize magnetic resonance imaging (MRI) to provide evidence of disease dissemination in space (DIS) and time (DIT) for the diagnosis of multiple sclerosis (MS) in patients who have clinically isolated syndromes (CIS). Using 2010 McDonald criteria, 30% of the CIS patients could be diagnosed with MS using a single MRI scan. Inclusion of symptomatic lesions in the DIT criteria further increases this proportion to 33%...

Interferon beta failure predicted by EMA criteria or isolated MRI activity in multiple sclerosis
The objective of this paper is to investigate four-year outcomes of interferon beta (IFNB)-treated patients with multiple sclerosis (MS) according to their clinical or magnetic resonance imaging (MRI) activity status at first year of treatment.  The four-year outcomes of patients with isolated MRI activity did not differ from those fulfilling EMA criteria at first year of IFNB treatment...

Cytomegalovirus seropositivity is negatively associated with multiple sclerosis
Epidemiological data suggest a role for common viruses in the pathogenesis of multiple sclerosis (MS), and recent data showed a negative association of past cytomegalovirus (CMV) infection on pediatric MS risk.  CMV is negatively associated with adult-onset MS pathology, consistent with results from a study on pediatric MS cases. It remains to be shown whether this negative association is due to a true protective effect of CMV infection on MS risk.

Retinal periphlebitis is associated with multiple sclerosis severity
To assess the association of primary retinal inflammation, namely retinal periphlebitis (RP) and microcystic macular edema, with clinical, brain, and retinal imaging biomarkers of multiple sclerosis (MS) severity.  These results support the role of RP as a biomarker of MS severity.

Immune competence after alemtuzumab treatment of multiple sclerosis
To determine the immunocompetency of patients with multiple sclerosis treated with the lymphodepleting humanized monoclonal antibody alemtuzumab.  In this small historically controlled pilot study, we demonstrated i) retained humoral immunologic memory (in the form of antibodies against common viruses and response to recall antigens), and ii) the retained ability to mount a humoral immune response against a novel antigen after treatment with alemtuzumab.

A pragmatic parallel arm multi-centre randomised controlled trial to assess the effectiveness and cost-effectiveness of a group-based fatigue management programme (FACETS) for people with multiple sclerosis
To evaluate the effectiveness and cost-effectiveness of a six-session group-based program for managing MS-fatigue (Fatigue: Applying Cognitive behavioural and Energy effectiveness Techniques to lifeStyle (FACETS)).  FACETS is effective in reducing fatigue severity and increasing fatigue self-efficacy. However, it is difficult to assess the additional cost in terms of cost-effectiveness (ie, cost per QALY) as improvements in fatigue are not reflected in the QALY outcomes, with no significant differences between FACETS and CLP. The strengths of this trial are its pragmatic nature and high external validity.

Brain atrophy and lesion load predict long term disability in multiple sclerosis
To determine whether brain atrophy and lesion volumes predict subsequent 10 year clinical evolution in multiple sclerosis (MS).  This large multicentre study points to the complementary predictive value of atrophy and lesion volumes for predicting long term disability in MS.

Chronic Headache: Is a CAM Therapy Worth a Try?

Trophos Completes Patient Enrolment in a First Study of Olesoxime in Relapsing Remitting Multiple Sclerosis

Living with MS can be Hell
There’s never been a more deserving time to treat yourself to your favourite Hell pizza. The irreverent company’s 25 Auckland outlets are throwing their support behind Multiple Sclerosis Auckland’s annual Street Appeal, donating $1 for every double-size pizza and 50 cents for every snack pizza sold from 6-12 September.

Novartis' MS Drug Gilenya Under FDA Investigation for PML Case
FDA has issued a safety alert after a patient with multiple sclerosis (MS) in Europe developed a rare and serious brain infection known as progressive multifocal leukoencephalopathy (PML) following treatment with Gilenya (fingolimod).

If Amy Winehouse was here, she'd be jumping out the plane too
Janis Winehouse's fierce fight with multiple sclerosis means she struggles to walk — but she reckons Amy would be doing the charity parachute jump beside her if she were alive! Janis, 58, will perform a parachute jump on September 29 to raise money for the Amy Winehouse Foundation and create awareness about multiple sclerosis (MS), which she suffers from.

MS and Elevated Liver Enzymes: A Genetic Connection?
Elevated liver enzymes are a regrettably common complication of multiple sclerosis and its treatments. A new study at the University of British Columbia (UBC) is ...

No Consensus on Crowded MS Drug field
Pharmacy Practice News
“This is an oversimplified recommendation that we strongly feel needs to be more nuanced,” argued representatives of the AAN's Multiple Sclerosis Working ...

Sunshine and multiple sclerosis

Are Your Personal Assets at Risk if You're Sued?

“Amazing Race” host Phil Keoghan leads the cyclists of the No Opportunity Wasted team which advocates for multiple sclerosis research. More than 2,000 Puget Sound cyclists will be joining Keoghan in the Washington Bike MS Ride Sept. 7-8 in Skagit and Island counties. 

Disabled Sartell man finds chair that he thought was stolen Mark Demars has multiple sclerosis, and thought a new office chair he had delivered to his apartment was taken by thieves. He lives at Hope Village, an apartment complex that caters to people with disabilities. 

Cerebral venous thrombosis in a patient with clinically isolated spinal cord syndrome.
The association between cerebral venous thrombosis (CVT) and multiple sclerosis (MS) has already been reported in patients with clinically definite MS in relation to intravenous methylprednisolone (IVMP) or previously performed lumbar puncture (LP).

The impact of sexual dysfunction on health-related quality of life in people with multiple sclerosis.
Participants were recruited from a large MS registry, the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry. Participants self-reported demographic information and completed the Patient Determined Disease Steps (PDDS), MSISQ-19, and the Short Form-12 (SF-12). 
In patients with MS, sexual dysfunction has a much larger detrimental impact on the mental health aspects of HrQoL than severity of physical disability.

Need for differentiation of real and clinical important change in research on responsiveness of walking outcome measures in multiple sclerosis.

Interferon beta failure predicted by EMA criteria or isolated MRI activity in multiple sclerosis.
The objective of this paper is to investigate four-year outcomes of interferon beta (IFNB)-treated patients with multiple sclerosis (MS) according to their clinical or magnetic resonance imaging (MRI) activity status at first year of treatment.  The four-year outcomes of patients with isolated MRI activity did not differ from those fulfilling EMA criteria at first year of IFNB treatment.

Genzyme's Aubagio approved by European Commission for Multiple Sclerosis treatment
Sep 02, 2013 (Menafn - M2 EQUITYBITES via COMTEX) --Genzyme, a division of Sanofi SNY, announced on Friday the grant of marketing authorisation by the European Commission for Aubagio (teriflunomide) 14 mg, a once-daily, oral therapy indicated for the treatment of adult patients with relapsing remitting multiple sclerosis (RRMS)

Treating Rare Neurologic Diseases
Although neurologists are frequently faced with the management of rare diseases, there is little generic guidance for the approach to management. There are complexities with respect to diagnosis, counselling, treatment and monitoring which are idiosyncratic to rare diseases. Here we use a case report as the basis for discussion of the management of rare neurological diseases. We discuss current issues, guidance from regulatory bodies, and offer practical tips for diagnosis, treatment and monitoring, including the use of decision tree analysis. We offer a generic algorithm to aid neurologists when facing rare conditions.

Jack Osbourne 'Dancing With the Stars' to Shine Light on Multiple ...
ABC News
Just over a year ago, Jack Osbourne was a new father finding out he had multiple sclerosis. "The Osbournes" star was admittedly angry and frustrated. Now ...

Apitope releases positive results from Phase I clinical study of ...
Pharmaceutical Business Review
When patients with relapsing multiple sclerosis were treated with intradermal injection of ATX-MS-1467, the MRI results showed a decrease in the number of ...

First study to investigate the human genome in multiple sclerosis
EurekAlert (press release)
The National Institutes of Health (NIH) awarded Benaroya Research Institute at Virginia Mason (BRI) a $1.9 million grant to find marks in the human genome ...

The invisible side of MS and preview On-Line Training for Caregivers, Social ...

Glendale eatery fundraiser to benefit those with MS
Arizona Republic
The fundraiser, which benefits the National Multiple Sclerosis Society, was created to honor Denise Anderson, who is the mother of one of The Shout House's ...

Business RadioX®'s Eugeria! Radio™ Addresses the Invisible Side of Multiple Sclerosis

FDA Alert for Multiple Sclerosis Drug
The Food and Drug Administration has issued an alert concerning the multiple sclerosis drug fingolimod, after a patient in Europe developed a rare and serious brain infection while taking the medication. Fingolimod is sold under the brand name Gilenya by Novartis (NYSE:NVS).

Surveyed U.S. Neurologists Are More Likely Than Payers to Consider Biogen Idec's Tecfidera to be a Breakthrough in the Treatment of Multiple Sclerosis
BURLINGTON, Mass., Sept. 3, 2013 /PRNewswire/ --  more than half of surveyed neurologists consider Biogen Idec's Tecfidera to be a breakthrough in the treatment of multiple sclerosis (MS), slightly greater than those who feel the same about Novartis's Gilenya and nearly twice as many as for Genzyme's Aubagio. 

Contribution of cortical and white matter lesions to cognitive impairment in multiple sclerosis

Symptom overlap in anxiety and multiple sclerosis

Cerebral white matter blood flow and energy metabolism in multiple sclerosis
Our results suggest that in MS patients there is no relationship between reduced CBF in NAWM and impaired axonal mitochondrial metabolism or astrocytic PCr metabolism.

Altered expression of the plasminogen activation pathway in peripheral blood mononuclear cells in multiple sclerosis: possible pathomechanism of matrix metalloproteinase activation

Assessing interactions between HLA-DRB1*15 and infectious mononucleosis on the risk of multiple sclerosis

Perceived and actual arm performance in multiple sclerosis: relationship with clinical tests according to hand dominance
This study aimed to determine the relation between real-life arm performance and clinical tests in MS.  Real-life arm performance is decreased in wheelchair-bound MS patients and can be best predicted by measures on ‘body functions & structures’ level and fine motor control.

Retinal nerve fiber layer thickness in benign multiple sclerosis

International Pediatric Multiple Sclerosis Study Group criteria for pediatric multiple sclerosis and immune-mediated central nervous system demyelinating disorders: revisions to the 2007 definitions

Pediatric onset multiple sclerosis: McDonald criteria 2010 and the contribution of spinal cord MRI

Application of the McDonald 2010 criteria for the diagnosis of multiple sclerosis in an Argentinean cohort of patients with clinically isolated syndromes

Childhood body mass index and multiple sclerosis risk: a long-term cohort study
Obesity in late adolescence has been associated with an increased risk of multiple sclerosis (MS); however, it is not known if body size in childhood is associated with MS risk.  Having a high BMI in early life is a risk factor for MS, but the mechanisms underlying the association remain to be elucidated.

A guide to facilitate the early treatment of patients with idiopathic demyelinating disease (multiple sclerosis and neuromyelitis optica)
Definite diagnosis of inflammatory demyelinating disease (multiple sclerosis (MS) and neuromyelitis optica (NMO)) may require time, but early treatment offers the opportunity to maximize patient outcomes.

Half of new MS patients may soon get Biogen’s Tecfidera
Boston-based financial services group Cowen Group Inc. said Friday morning that based on patient data, Biogen Idec Inc.’s new drug, Tecfidera, may soon be getting more than half of all new multiple sclerosis patients. The Weston, Mass. biotech launched Tecfidera in March and has managed to outdo already-high expectations ever since. During its first three months on the market, the drug accounted for more than 10 percent of the Weston, Mass.-based drug company’s second-quarter revenues of $1.7 billion, which was up 21 percent year-over-year.

Therapeutic potential of cannabinoid medicines.
Cannabis was extensively used as a medicine throughout the developed world in the nineteenth century but went into decline early in the twentieth century ahead of its emergence as the most widely used illicit recreational drug later that century. This paper will then go on to review clinical research exploring the potential of cannabinoid medicines in the following indications: symptomatic relief in multiple sclerosis, chronic neuropathic pain, intractable nausea and vomiting, loss of appetite and weight in the context of cancer or AIDS, psychosis, epilepsy, addiction, and metabolic disorders.

Post-Tysabri (natalizumab) clinical and radiological findings in a cohort of multiple sclerosis patients: 12-month follow-up.
There is an urgent need to identify the best strategies to prevent the loss of natalizumab (N) beneficial effects after its suspension. The objective is to evaluate the clinical and radiological disease activity and to test the efficacy of immunomodulatory/immunosuppressive drugs (IT) after N suspension.

Quality of life and employment in persons with multiple sclerosis.
Results of the study emphasize the need for the provision of quality vocational services to persons with MS. Issues such as quality vocational services, timeliness, and the importance of continued work are discussed.

The experience of being grounded: a phenomenological study of living with a wheelchair.
The purpose of this existential-phenomenological study was to investigate the experience of being in a wheelchair. It was a prelude to a pilot study examining the effect of "seated" Tai Chi.  The accommodations from the ADA Act have greatly facilitated the independence for those who are disabled, yet many obstacles remain.

 Epstein-Barr virus in oral shedding of children with multiple sclerosis

Notre Dame Men's Tennis Set To Host "Smash MS" Clinic Saturday

Evaluation of an electronic diary for improvement of adherence to interferon beta-1b in patients with multiple sclerosis: design and baseline results of an observational cohort study

Tour de South Shore ride to benefit Alzheiemer's, MS research

Monoclonal antibodies in targeted therapy.

What sample sizes for reliability and validity studies in neurology?

Improved operator agreement and efficiency using the minimum area contour change method for delineation of hyperintense multiple sclerosis lesions on FLAIR MRI.

A Novel pH-Sensitive Interferon-β (INF-β) Oral Delivery System for Application in Multiple Sclerosis.

Neuromyelitis optica: atipic clinic presentation.

Evaluation of circulating osteopontin levels in an unselected cohort of patients with multiple sclerosis: relevance for biomarker development.

Connexin 43 astrocytopathy linked to rapidly progressive multiple sclerosis and neuromyelitis optica.
Impairment of JCV-specific T-cell response by corticotherapy: effect on PML-IRIS management?
Matrix metalloproteinases and their pathological upregulation in multiple sclerosis: an overview.

Meta-Analysis of the Correlation Between Chronic Cerebrospinal Venous Insufficiency and Multiple Sclerosis.
To determine whether a correlation exists between chronic cerebrospinal venous insufficiency (CCSVI) and multiple sclerosis (MS).

Dry Eyes Tied to Lower Pain Threshold
Women with dry eye disease had a greater overall sensitivity to pain and lower pain tolerance compared with women without the condition, researchers found.

Cognitive functions in multiple sclerosis: impact of gray matter integrity.
Our aim was to investigate the impact of gray matter (GM) integrity on cognitive performance in multiple sclerosis (MS), and its relationship with white matter (WM) integrity and presence of lesions.  GM and WM integrity of specific networks influences cognitive performance in MS. However, GM damage assessed by DTI only adds a small increment to the explained variance by WM in predicting cognitive functioning.

(CCVI) Chronic cerebrospinal venous insufficiency--pathophysiology and treament
Multiple sclerosis (sclerosis multiplex--SM) is a chronic nervous sytem disease, which through formation of demyenilisation focus in the central nervous system leads to deterioration of its various functions. In the consequence it may cause invalidity of patient.