Determining Disability

Tortorella P, Laganà MM, Saresella M, Tavazzi E, Preti MG, Ricci C, Baglio F, Marventano I, Piancone F, Baselli G, Cecconi P, Caputo D, Clerici M, Rovaris M. Determinants of disability in multiple sclerosis: an immunological and MRI study. Biomed Res Int. 2014;2014:875768. doi: 10.1155/2014/875768. Epub 2014

Multiple sclerosis (MS) is characterized by a wide interpatient clinical variability and available biomarkers of disease severity still have suboptimal reliability. We aimed to assess immunological and MRI-derived measures of brain tissue damage in patients with different motor impairment degrees, for in vivo investigating the pathogenesis of MS-related disability. Twenty-two benign (B), 26 secondary progressive (SP), and 11 early, non-disabled relapsing-remitting (RR) MS patients and 37 healthy controls (HC) underwent conventional and diffusion tensor brain MRI and, as regards MS patients, immunotyping of white blood cell responses by functional analysis of stimulated peripheral blood mononuclear cells (PBMC). Corticospinal tract (CST) fractional anisotropy and grey matter volume were lower and CST diffusivity was higher in SPMS compared to RRMS and BMS patients. CD14+IL6+ and CD4+IL25+ (activated T cells or regulatory T cells) cell percentages were higher in BMS than in SPMS patients.  In patients without motor impairment after long-lasting MS, the grey matter and CST damage degree seem to remain as low as in the earlier disease stages and an immunological pattern suggestive of balanced pro- and anti-inflammatory activity is observed. 

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