Optical coherence tomography angiography (OCTA) in differential diagnosis of aquaporin-4 antibody seronegative NMOSD and multiple sclerosis

Backround: Optic neuritis(ON) is a common feature of both relapsing-remitting multiple sclerosis(RRMS) and neuromyelitis optica spectrum disorders(NMOSD). It is crucial to early differentiate these two diseases, as they differ in pathophysiology and treatment.& nbsp;Objective: To compare NMOSD and RRMS patients using optical coherence tomography(OCT) and OCT angiography(OCTA) to assess retinal microvascular network differences.& nbsp;Methods: Fourteen RRMS (28 eyes) and 9 NMOSD patients(18 eyes), and 11 controls were enrolled. Seropositivity for aquaporin-4 antibody (anti-AQP4 Abs) was 44.4%. Peripapillary and macular retinal nerve fiber layer (RNFL) thickness, superficial peripapillary and macular vessel density(VD), area, perimeter and circularity of foveal avascular zone(FAZ) were analyzed.& nbsp;Results: OCTA showed reduction in peripapillary and macular VD and FAZ size in NMOSD+ON compared to RRMS+ON and controls (p = 0.001, p < 0.001 and p = 0.010, p < 0.001 respectively). Peripapillary VD was similar in RRMS +ON and controls. Peripapillary VD in monophasic seronegative NMOSD+ON eyes was significantly lower than monophasic RRMS+ON eyes (p = 0.030), which was no different from controls. FAZ area was smaller in unaffected eyes in NMOSD than RRMS and controls.& nbsp;Conclusions: Both OCT and OCTA revealed considerable differences between RRMS and NMOSD patients, providing promising results in favor of clinical utility of OCTA in differential diagnosis of ON, particularly in antiAQP4 antibody negative patients. OCTA might be a useful biomarker in differentiating NMOSD from MS

Optical coherence tomography angiography (OCTA) in differential diagnosis of aquaporin-4 antibody seronegative NMOSD and multiple sclerosis

Backround: Optic neuritis(ON) is a common feature of both relapsing-remitting multiple sclerosis(RRMS) and neuromyelitis optica spectrum disorders(NMOSD). It is crucial to early differentiate these two diseases, as they differ in pathophysiology and treatment.& nbsp;Objective: To compare NMOSD and RRMS patients using optical coherence tomography(OCT) and OCT angiography(OCTA) to assess retinal microvascular network differences.& nbsp;Methods: Fourteen RRMS (28 eyes) and 9 NMOSD patients(18 eyes), and 11 controls were enrolled. Seropositivity for aquaporin-4 antibody (anti-AQP4 Abs) was 44.4%. Peripapillary and macular retinal nerve fiber layer (RNFL) thickness, superficial peripapillary and macular vessel density(VD), area, perimeter and circularity of foveal avascular zone(FAZ) were analyzed.& nbsp;Results: OCTA showed reduction in peripapillary and macular VD and FAZ size in NMOSD+ON compared to RRMS+ON and controls (p = 0.001, p < 0.001 and p = 0.010, p < 0.001 respectively). Peripapillary VD was similar in RRMS +ON and controls. Peripapillary VD in monophasic seronegative NMOSD+ON eyes was significantly lower than monophasic RRMS+ON eyes (p = 0.030), which was no different from controls. FAZ area was smaller in unaffected eyes in NMOSD than RRMS and controls.& nbsp;Conclusions: Both OCT and OCTA revealed considerable differences between RRMS and NMOSD patients, providing promising results in favor of clinical utility of OCTA in differential diagnosis of ON, particularly in antiAQP4 antibody negative patients. OCTA might be a useful biomarker in differentiating NMOSD from MS

Autonomic Neuropathy and Endothelial Dysfunction in Patients With Impaired Glucose Tolerance or Type 2 Diabetes Mellitus

Autonomic neuropathy is one of the most common complications of diabetes mellitus (DM). The etiology of autonomic impairment is not well-understood, yet. There is need for studies to investigate the cause-effect relationships of inflammation and/or endothelial dysfunction and diabetic autonomic neuropathy. Only a few reports have mentioned autonomic neuropathy in individuals with impaired glucose tolerance (IGT), previously. Furthermore, the association between the plasma markers of endothelial dysfunction (von Willebrand factor (vWF), soluble E-selectin) and autonomic neuropathy in patients with IGT or DM has not been studied before. In this study, we aimed to investigate the correlation between plasma markers of endothelial dysfunction and autonomic neuropathy in patients with IGT or type 2 DM (T2DM)

Association between the Levels of IL-6, sE-Selectin and Distal Sensory Nerve Conduction Studies in Patients with Prediabetes

Aim:To determine the association between interleukin-6 (IL-6) and soluble E-selectin (sE-selectin) levels with the electrodiagnostic abnormalities in patients with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). Methods: Serum HbA1c, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen, IL-6 and sE-selectin levels were analyzed in 25 IFG patients, 22 IGT patients and 41 controls. Nerve conduction studies (NCS) of rural, dorsal sural (DS), medial dorsal cutaneous and medial plantar sensory nerves were conducted. Results: HbA1c and IL-6 levels were significantly higher in IFG and IGT patients than the controls. IGT patients had higher sE-selectin levels compared to controls and IFG patients. IL-6 levels were significantly correlated with levels of CRP, fibrinogen, ESR and sE-selectin in patients with prediabetes. Both IFG and IGT patients had substantial impairments in very distal sensory NCS. IL-6 levels were positively correlated with HbA1c and negatively correlated with DS NCS in prediabetic patients. Conclusions: Inflammation and endothelial dysfunction might be important in patients with IFG or IGT. Furthermore, our findings strengthen the idea that inflammation (increased levels of IL-6) might be associated with early electrophysiological impairments in patients with prediabetes. NCS of the most distal sensory nerves significantly enhanced the diagnosis of subclinical neuropathy in patients with prediabetes. Sub clinical peripheral sensory neuropathy should be investigated in prediabetes to lower the number of future outcomes they are associated with. (C) 2016 S. Karger AG, Base

IL-1β, IL-6 and IL1Ra levels in temporal lobe epilepsy

© 2015 British Epilepsy Association.Purpose There is now extensive evidence to support the involvement of inflammation in the course of epileptic seizures. Seizure-induced changes in serum IL-1β, IL-6 and IL-1Ra levels are reported in several studies. Serum cytokine levels may also be disturbed in inter-ictal period due to seizure activity. Methods Twenty-one patients (12 women; mean age 35 ± 12.3) with temporal lobe epilepsy (TLE), 17 patients (8 women; mean age 31.8 ± 10.4) with extra-temporal lobe epilepsy (XLE) and 20 normal controls (10 women; mean age 35.6 ± 8.8) were included in the study. Serum levels of IL-1β, IL-6 and IL-1Ra of the TLE, XLE groups in inter-ictal period and of the normal control group were compared. Results All three cytokine levels are found to be significantly elevated in epilepsy patients when compared to controls (p < 0.05). In TLE group, IL-1β serum levels were significantly higher than in the XLE group (p < 0001). Conclusion The major findings in our study were increased levels of IL-1β, IL-6 and IL-1Ra in epileptic patients and high levels of IL-1β in TLE group. Our results support the existence of a chronic inflammatory state in epileptic patients

Effect of platelet-rich plasma on reconstruction with nerve autografts

WOS: 000394727100003PubMed ID: 28137414Despite advances in understanding of peripheral nerve injuries and regeneration and advances in surgical techniques, successful outcomes cannot be guaranteed after reconstructive surgery. Platelet-rich plasma (PRP) has been reported to have positive effects on nerve regeneration, as well as on tissue healing. The present study was designed to evaluate the effect of PRP on nerve-grafted defects. Sprague Dawley rats were divided into four surgery groups (n = 7 in each). A 1-cm long nerve defect was created in the upper thigh and then reconstructed using a nerve autograft in all groups. The wet muscle weights, electromyographic findings, and histomorphologic changes were evaluated 10 weeks later. As shown by both the electromyographic (p < 0.001) and histomorphologic findings (p < 0.001), PRP had more positive effects on nerve gap reconstruction in Group 3 then Group 4 as compared to the control groups. The present study is novel in that it evaluated the regeneration effect of PRP on a large nerve defect reconstructed with a nerve graft rather than primary repair. The results are encouraging for further experimental studies on the role of PRP in nerve healing. Copyright (C) 2016, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/)

Relapsing-Remitting Multiple Sclerosis diagnosis from cerebrospinal fluids via Fourier transform infrared spectroscopy coupled with multivariate analysis

Abstract Multiple sclerosis (MS) is a chronic, progressive, inflammatory and degenerative disease of central nervous system. Here, we aimed to develop a method for differential diagnosis of Relapsing-Remitting MS (RRMS) and clinically isolated syndrome (CIS) patients, as well as to identify CIS patients who will progress to RRMS, from cerebrospinal fluid (CSF) by infrared (IR) spectroscopy and multivariate analysis. Spectral analyses demonstrated significant differences in the molecular contents, especially in the lipids and Z conformation of DNA of CSF from CIS, CIS to RRMS transformed (TCIS) and RRMS groups. These changes enables the discrimination of diseased groups and controls (individuals with no neurological disease) from each other using hierarchical cluster and principal component analysis. Some CIS samples were consistently clustered in RRMS class, which may indicate that these CIS patients potentially will transform to RRMS over time. Z-DNA band at 795 cm−1 that is existent only in diseased groups and significant increase in carbonyl amount, decrease in amideI/amide II and lipid/protein ratios observed only for RRMS groups can be used as diagnostic biomarkers. The results of the present study shed light on the early diagnosis of RRMS by IR spectroscopy complemented with multivariate analysis tools

Effects of motor-motor and motor-cognitive tasks on balance in patients with multiple sclerosis

Background: Dual tasking is frequently impaired in Multiple Sclerosis (MS), substantially impairing quality of life (QoL). We aimed to examine the effects of motor-motor and motor-cognitive tasks on balance in highly mobile patients with relapsing-remitting MS (RRMS), with mild disability

Tongue myokymia presenting twelve years after radiation therapy

Objective: This case is a patient with tongue myokymia following radiation therapy 12 years earlier, documented using video and EMG. Case report: A 68-year-old woman with a history of nasopharyngeal carcinoma presented with subacute onset of difficulty in speaking and involuntary movements of her tongue approximately 12 years after radiation therapy to head and neck. Electromyography displayed myokymic discharges. There was no evidence of recurrent malignancy. Significance: Delayed effects of radiation therapy might be seen decades later. Myokymic discharges may reveal radiation-induced neuropathy. Keywords: Tongue myokymia, Radiation therapy, Long-term effect