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Pure spinal multiple sclerosis: A possible novel entity within the multiple sclerosis disease spectrum

Schee JP, Viswanathan S

Mult Scler, 2019 07;25(8):1189-1195.
PMID: 29771191 DOI: 10.1177/1352458518775912

We identified five female patients retrospectively with relapsing short-segment partial myelitis whose clinical and paraclinical features were suggestive of cord involvement of multiple sclerosis (MS)-type albeit not rigidly fulfilling the 2017 McDonald criteria. Notably, these patients had not developed any typical MS-like brain lesions despite repeated neuroimaging assessments over years. Comprehensive work-up for differential diagnoses of MS and other causes of transverse myelitis particularly neuromyelitis optica spectrum disorders had been consistently negative on longitudinal follow-up. Thus, we postulate a possible entity of pure spinal MS which may represent a novel forme fruste within the MS disease spectrum.

Matched MeSH terms: Multiple Sclerosis/drug therapy
A call for more research and global collaboration in South-East Asia to address challenges of DMT access and MS management in the region

Vijayasingham L, Viswanathan S

Mult Scler, 2019 01;25(1):130-131.
PMID: 30132396 DOI: 10.1177/1352458518797290
Matched MeSH terms: Multiple Sclerosis/drug therapy*
High mobility group box 1 (HMGB1) protein in Multiple Sclerosis (MS): Mechanisms and therapeutic potential

Paudel YN, Angelopoulou E, C BK, Piperi C, Othman I

Life Sci, 2019 Dec 01;238:116924.
PMID: 31606383 DOI: 10.1016/j.lfs.2019.116924

Multiple sclerosis (MS) is an autoimmune chronic inflammatory disease with distinctive features of focal demyelination, axonal loss, activation of glial cells, and immune cells infiltration. The precise molecular mechanism underlying the disease progression remains enigmatic despite of the rapid progression on experimental and clinical MS research. The focus of MS therapy relies on the repression of the pathogenic autoimmune response without compromising an adaptive immune response. High mobility group box-1 (HMGB1) protein is a ubiquitous nuclear protein driving pro-inflammatory responses as well as targeting innate immune signaling that initiates and mediates autoimmunity as well as sterile injury. A considerable amount of experimental and human studies suggests the contribution of HMGB1 in the pathogenesis of MS/experimental autoimmune encephalitis (EAE). In this regard, HMGB1 protein has gained increased attention, as an emerging possible therapeutic target against MS. This is more strengthened by the promising therapeutic outcome demonstrated by HMGB1 neutralizing agents in the experimental EAE model. Herein, we attempt to shed more light on the molecular crosstalk of HMGB1 protein in the pathogenesis of MS/EAE suggesting that HMGB1 blockade could impede the pro-inflammatory loop that drives MS autoimmunity.

Matched MeSH terms: Multiple Sclerosis/drug therapy*
Asian adaptation and validation of an English version of the multiple sclerosis international quality of life questionnaire (MusiQoL)

Thumboo J, Seah A, Tan CT, Singhal BS, Ong B

Ann Acad Med Singap, 2011 Feb;40(2):67-73.
PMID: 21468459

INTRODUCTION: The Multiple Sclerosis International Quality of Life questionnaire (MusiQoL) is a self-administered, multi-dimensional, patient-based health-related quality of life (HRQoL) instrument. With increasing prevalence of multiple sclerosis (MS) in Asian countries, a valid tool to assess HRQoL in those patients is needed. The aim of this study was to evaluate patient acceptability, content validity and psychometric properties of an Asian version of the English MusiQoL in Singapore, Malaysia and India.
MATERIALS AND METHODS: English speaking patients older than 18 years of age with a defi nite diagnosis of MS were included. The self-administered survey material included the adapted HRQoL questionnaire, a validated generic HRQoL questionnaire: the short-form 36 (SF-36), as well as a checklist of 14 symptoms. We assessed the internal and external validity of the adapted MusiQoL.
RESULTS: A total of 81 patients with MS were included in the study. The questionnaire was generally well accepted. In the samples from Malaysia and Singapore, all scales exhibited good internal consistency (Cronbach's alpha >0.70). Correlation to SF-36 was generally good, demonstrating high construct validity (P <0.001) in some aspects of the MusiQoL.
CONCLUSION: The Asian adaptation of the English version of the MusiQoL in evaluating HRQoL seems to be a valid, reliable tool with adequate patient acceptability and internal consistency.

Matched MeSH terms: Multiple Sclerosis/drug therapy