CategorySymptoms and treatments

Spanner in the works for intrathecal rituximab

Figure: To-and-fro bi-directionality of CSF flow in the brainBy © Nevit Dilmen, CC BY-SA 3.0 I get a sinking feeling in the pit of my stomach when I read this article. Starting out in science, one is considered smart when following the trends of the populist. As a seasoned scientist, when one continues to work in this way, one is just not being too clever. I am not being disparaging of those who...

More B cell stuff. Don’t deal with the B cells…Don’t deal with disease?

Longitudinally persistent cerebrospinal fluid B-cells can resist treatment in multiple sclerosis.Greenfield AL, Dandekar R, Ramesh A, Eggers EL, Wu H, Laurent S, Harkin W, Pierson NS, Weber MS, Henry RG, Bischof A, Cree BA, Hauser SL, Wilson MR, von Büdingen HC. JCI Insight. 2019 Feb 12. pii: 126599. doi: 10.1172/jci.insight.126599. [Epub ahead of print] B-cells are key contributors to...

To B or Not to B..that’s is ProfG’s Atrophy Question

Effect of disease-modifying therapies on subcortical gray matter atrophy in multiple sclerosis.Sotirchos ES, Gonzalez-Caldito N, Dewey BE, Fitzgerald KC, Glaister J, Filippatou A, Ogbuokiri E, Feldman S, Kwakyi O, Risher H, Crainiceanu C, Pham DL, Van Zijl PC, Mowry EM, Reich DS, Prince JL, Calabresi PA, Saidha S. Mult Scler. 2019 Feb 11:1352458519826364. BACKGROUND:The effects of disease...

How Does Cladribine Work?

Here is a new offering from the CLAD lads :-), and follows on from the information that we got from the European Medicines Agency and from stuff in the public domain. This is not a pharma supported piece of work and they may have different views of how cladribine works or how they want to portray how they think this works, but as usual for us, it contains ideas of the unknown. Things we and...

We sincerely apologize, but you don’t have MS

The rate of misdiagnosis of MS around the globe is roughly a quarter. We are so focused in making an early diagnosis in MS that before we know it, it’s a runaway train. Sometimes, even the best of us need to eat our words, and admit to having a made a mistake. The diagnosis of MS is not easy; how many of you have googled non-specific symptoms and come up with MS as a potential cause? The...

Blocking Calcium, Should we listen to mouse studies or plough on regardless

Calcium Influx through Plasma-Membrane Nanoruptures Drives Axon Degeneration in a Model of Multiple Sclerosis. Witte ME, Schumacher AM, Mahler CF, Bewersdorf JP, Lehmitz J, Scheiter A, Sánchez P, Williams PR, Griesbeck O, Naumann R, Misgeld T, Kerschensteiner M. Neuron. 2019 Jan 6. pii: S0896-6273(18)31123-1. Axon loss determines persistent disability in multiple sclerosis patients...

Why some treatment is better than no treatment

For Relapsing-remitting MS we currently have option of highly active therapies, as well as first-line therapies that are less efficacious. You may question why anyone in their right mind would develop a treatment that was no good, then conversely ask yourself, why if there are treatments available, even not so good ones, are some people not any of it? This is not me pitching for the next...

Guest post: My annual visit

Just recently I had my annual appointment with the MS consultant. He said it could only last 15 minutes. He did apologise for such a brief slot. Even so I couldn’t help but feel short changed. I could only discuss my 3 worst symptoms. Here is my own version of events at the MS review. He started “Has it got worse”? I thought to myself “This is a bit of a stupid question to ask anybody with...

Not All Data is Created Equal. Brain Atrophy

ProfG has put an interesting question about whether DMT are all born equal. Whilst the influence on relapse rates is much clearer in terms of the hierarchy, the effects on brain atrophy has led ProfG to ask a sensible question. It was suggested that HSCT and alemtuzumab are up there at the top of the pile in the atrophy states, leaving the B cell therapies in their wake. B cell therapies are...

What is happening to my cortex?

A very common analogy is the comparison of MS to an iceberg. Why? Only one-eighth of an iceberg is visible above the water; to see what is below the water line requires specialised technology. The MS iceberg analogy refers to several observations: 1. For each clinical relapse, 10 or more MRI visible lesions are seen on MRI.2. For each visible white matter lesions on MRI, there are at least an...

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