Multiple Sclerosis (11) Flashcards
A chronic and progressive degenerative disease of the central nervous system characterized by lesions/plaques in the brain and spinal cord
Multiple sclerosis
What suggests that environmental factors are involved with MS?
Prevalence distribution varies greatly around the world - Temperate areas tend to have higher prevalence rates
compared to tropic areas
Why is the risk of MS said to be multifactorial?
No one cause appears to be sufficient on its own for the development of MS
What suggests that genetic predisposition is a risk factor?
Twin studies
Research on which gene complex is providing evidence of its involvement?
Human leukocyte antigen (HLA)
Why is geographic latitude a risk factor for MS?
Possibly Vitamin D exposure related
Why are infections a risk factor for MS?
Infectious agents may initiate or maintain the pathological immune response in MS
What is the relationship between mS and pregnancy?
Inflammation, relapse rates, and MS lesion activity typically
decline during pregnancy
What suggests that the gut microbiome influences MS?
Significant differences between the gut bacteria of people with MS vs. those without
What are the 6 main risk factors for MS?
Genetic predisposition, genographic latitude, infections, hormones/pregnancy/menstrual cycle, gut bicrobiome
What is the accepted pathogenic definition of MS?
Autoimmune-mediated inflammatory disorder
What is the target of the inflammatory response?
Myelin sheath of axons
How does the destruction of the myelin sheath generate MS symptoms?
Allows neurons to communicate more rapidly
Action potentials can “jump” over the myelin between each node of Ranvier
Demyelination leads to conduction becoming impaired, delaying the transmission of nerve impulses and creating MS symptoms
Patches of inflammation (scarring) as a result of the autoimmune processes/demyelination
Lesions (plaques)
Patches of inflammation (scarring) as a result of the autoimmune processes/demyelination
Lesions (plaques)
What do initial symptoms of MS often include?
Visual symptoms 9optic neuritis, loss/impaired visual
acuity)
Numbness/tingling/weakness
Vertigo
What are the four disease courses of MS?
Relapsing-remitting MS (RRMS)
Primary-progressive MS (PPMS)
Secondary-progressive MS (SPMS)
Progressive-relapsing MS (PRMS)
Clearly defined disease relapses with full recovery or with residual deficits upon recovery. The periods between relapses are characterized by a lack of disease progression
Relapsing-remitting MS
Steady disease progression from symptom onset with
possible occasional plateaus and possible minor improvements. A gradual, nearly continuous worsening of neurological function with, typically, no discrete relapses.
Primary-progressive MS
An initial RRMS presentation followed by a phase of progressive deterioration, with or without occasional relapses, or minor plateaus that is viewed as the inevitable long-term outcome for the majority of RRMS
patients
secondary-progressive MS
Progressive disease from symptom onset with clear, acute relapses, with or without full recovery. The periods between relapses are marked by continuing disease progression
Progressive-relapsing MS
What is McDonalds’s criteria for MS diagnosis with respect to neuroimaging?
Time: new lesions at follow-up scans
Space: new lesions across different regions
Refers to a first episode of neurological symptoms that lasts at least 24 hours and is caused by CNS inflammation or demyelination
Clinically isolated syndrome (CIS)
Refers to MRI findings suggestive of MS in
asymptomatic individuals
Radiologically isolated syndrome (RIS)
An evaluation of physical symptoms routinely used in both clinical and research settings to assess physical disability
Expanded Disability Status Scale (EDSS)
What are two cons of the Expanded Disability Status Scale (EDSS)?
Heavily weighted towards the physical aspects of the disease
Little consideration for cognitive functioning/mood
What has the degree of cognitive impairment in MS patients been linked to?
Degree of impairment has been linked to total brain volume affected by lesions, as well as total brain atrophy
Deficits in information processing speed underlie
deficits observed in all other cognitive domains, and impairments in a variety of cognitive processes are
simply a by-product of slowed IPS
Relative Consequence Model
