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Friday, August 5, 2016

Advanced Structural and Functional Brain MRI in Multiple Sclerosis


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Antonio Giorgio, MD, PhD; Nicola De Stefano, MD, PhD
Disclosures  --- Semin Neurol. 2016;36(2):163-176. 


Conventional magnetic resonance imaging (MRI) of the central nervous system is crucial for an early and reliable diagnosis and monitoring of patients with multiple sclerosis (MS). Focal white matter (WM) lesions, as detected by MRI, are the pathological hallmark of the disease and show some relation to clinical disability, especially in the long run. Gray matter (GM) involvement is evident from disease onset and includes focal (i.e., cortical lesions) and diffuse pathology (i.e., atrophy). Both accumulate over time and show close relation to physical disability and cognitive impairment. Using advanced quantitative MRI techniques such as magnetization transfer imaging (MTI), diffusion tensor imaging (DTI), proton MR spectroscopy (1H-MRS), and iron imaging, subtle MS pathology has been demonstrated from early stages outside focal WM lesions in the form of widespread abnormalities of the normal appearing WM and GM. In addition, studies using functional MRI have demonstrated that brain plasticity is driven by MS pathology, playing adaptive or maladaptive roles to neurologic and cognitive status and explaining, at least in part, the clinicoradiological paradox of MS.


Given its sensitivity in revealing focal white matter (WM) abnormalities, magnetic resonance imaging (MRI) has become an indispensable tool for the assessment of patients with multiple sclerosis (MS) in the diagnostic workup. It is also extensively used in monitoring of abnormalities over time and elucidating the mechanisms of disease progression and disability.
There are established MRI guidelines that incorporate WM lesions into the diagnosis of patients with a clinically isolated syndrome (CIS) suggestive of MS,[1] and specific MRI acquisition protocols have been suggested for longitudinally monitoring WM lesion changes in patients with established disease.[2]Moreover, in MS research, conventional MRI has been significantly improved by quantitative and advanced MRI techniques, which have shown greater sensitivity and specificity to the heterogeneous pathological substrates of the disease, not only in focal T2-visible WM lesions, but also in normal-appearing white matter (NAWM) and gray matter (GM).[3]
Efficiency or dysfunction of brain cortical reorganization in the different stages of MS might play an important role in explaining heterogeneity of the clinical manifestations across patients, and several studies have used functional MRI (FMRI) to evaluate functions of brain network in patients with MS.[4,5]
More recently, new MRI methods capable of measuring pathological processes that have been overlooked in the past (e.g., iron deposition) and the advent of high- and ultrahigh-field magnets, have provided further insight into the pathophysiology of MS.[2]

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Multiple sclerosis: 15 signs you might have MS


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New Delhi, India: Multiple sclerosis (MS) is a nervous system disease which affects the brain and spinal cord. MS is a lifelong condition that can sometimes cause serious disability.
The exact cause of multiple sclerosis is unknown. However, the underlying mechanism is thought to be either destruction by the immune system or failure of the myelin-producing cells. It can also be caused by a combination of genetic and environmental factors.
Although MS can occur in young children and older adults, the condition most commonly affects people between the ages of 20 and 50
While the symptoms of multiple sclerosis may vary from person to person, some of the common warning signs include:
  • Vision problems
  • Numbness and tingling in the arms and legs
  • Fatigue
  • Headache
  • Dizziness
  • Muscle spasms, stiffness and weakness
  • Balance difficulties
  • Bladder or bowel problems
  • Pain in parts of the body
  • Tremor
  • Breathing problems
  • Problems with thinking, learning and planning
  • Depression and anxiety
  • Speech problems
  • Sexual problems
Unfortunately, there's no cure for multiple sclerosis, but treatments can help control the condition. It's important to recognize the early signs of the condition and pay attention to them. Early detection may help prevent multiple sclerosis from progressing quickly as well as have a positive impact on the treatment.

First Published: Monday, July 25, 2016 -HERE

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The Neurological Aspects of MS and BEYOND - Annual MS Symposium- South Florida


The Neurological Aspects of MS and BEYOND
2016 MS Symposium in South Florida

Featuring Guest Multiple Sclerosis Neurologists from Ohio, Alabama and South Florida.

Free Admission, Free Parking, Continental Breakfast and Lunch


Event includes presentations from a Social Security Disability attorney

and a PT from Ohio to discuss Bladder and Bowel care for the MS Patient


See full program information showing below and then:

RSVP required to attend this event

at the Signature Grand in Davie, Fl.  

To Register, click here: www.events.msvn.org

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777 NW 72nd Ave - Suite 3005
Miami, Fl. 33126


Legislature aware part of Ohio pot law legally questionable


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ADVANCE FOR SUNDAY, JULY 24 – FILE – In this Oct. 20, 2015, file photo, Shamay Flaharty of Lewiston, Ill., who has multiple sclerosis and is hoping cannabis will help ease her pain and headaches, meets with Eric Sweatt, partner and manager of Salveo Health and Wellness, a licensed medical cannabis dispensary in Canton, Ill. Ohio's medical marijuana law takes effect Sept. 8, 2016, and Republican Ohio state Sen. Bill Seitz says changes may be required to part of the law that sets aside a piece of the state's future pot business for minorities, provisions that The Associated Press reported may be unconstitutional. Photo: Seth Perlman, AP / Copyright 2016 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistribu

 SUNDAY, JULY 24 – FILE – In this Oct. 20, 2015, file photo, Shamay Flaharty of Lewiston, Ill., who has multiple sclerosis and is hoping cannabis will help ease her pain and headaches, meets with ... more

COLUMBUS, Ohio (AP) — Apparently unconstitutional portions of Ohio's medical marijuana law, which set aside a percentage of the state's pot licenses for minorities, were spotted during legislative debate but left in the bill to gain needed votes, a key lawmaker says.
State Sen. Bill Seitz, a Cincinnati Republican, said legally prickly provisions exposed by The Associated Press in June may require changes. The law takes effect Sept. 8, at which point a new panel will begin laying out a blueprint for how the new industry will work.
"I certainly think it's something the (Medical) Marijuana Advisory Committee ought to take a look at," Seitz said. "Because we're not just talking about government contracts, but government licenses." Changes may wind up in a marijuana corrective bill that emerges in the lame duck session.
The benchmarks are contained in legislation that was fast-tracked by the Republican-controlled Legislature to head off a medical marijuana proposal that was on its way to Ohio's fall ballot. Ohio is the 25th state to legalize medicinal cannabis.

They require at least 15 percent of Ohio's cultivator, processor, retail dispensary and laboratory licenses to go to the businesses of one of four economically disadvantaged minority groups — blacks, Hispanics, Asians or Native Americans — so long as an adequate number apply.

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Thursday, August 4, 2016



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