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Biomedical subjects

C Sfagos

Publications and source records attributed to C Sfagos.

13 recordsLinked to original sources

Associations of the Expanded Disability Status Scale with anxiety and depression in multiple sclerosis outpatients.

OBJECTIVES: We evaluated cross-sectionally the associations of depression and anxiety with age, sex, duration of illness, educational level, degree of disability and treatment with interferon-beta in outpatients with relapsing-remitting multiple sclerosis (RRMS) during a clinically stable phase of their illness. MATERIALS AND METHODS: The depression status scored on the Beck Depression Inventory (BDI), the symptoms of anxiety assessed using the State Trait Anxiety Inventory (STAI) and the level of disability measured by the Expanded Disability Status Scale (EDSS) were quantified in 86 consecutive RRMS patients. RESULTS: Linear regression analyses indicated that EDSS was independently (P < 0.001) associated with BDI and STAI and accounted for 15.7% and 18.5% of the variance in BDI and STAI respectively. The former association retained its statistical significance in multiple regression models adjusting for demographic and clinical characteristics. CONCLUSIONS: Disability status is an independent but moderate determinant of depression and anxiety in MS patients.

Adult↗

Brain MR post-gadolinium contrast in multiple sclerosis: the role of magnetization transfer and image subtraction in detecting more enhancing lesions.

Our purpose was to evaluate the role of magnetization transfer and image subtraction in detecting more enhancing lesions in brain MR imaging of patients with multiple sclerosis (MS). Thirty-one MS patients underwent MR imaging of the brain with T1-weighted spin echo sequences without and with magnetization transfer (MT) using a 1.5 T imager. Both sequences were acquired before and after intravenous injection of a paramagnetic contrast agent. Subtraction images in T1-weighted sequences were obtained by subtracting the pre-contrast images from the post-contrast ones. A significant difference was found between the numbers of enhanced areas in post-gadolinium T1-weighted images without and with MT (p=0.020). The post-gadolinium T1-weighted images with MT allowed the detection of an increased (13) number of enhancing lesions compared with post-gadolinium T1-weighted images without MT. A significant difference was also found between the numbers of enhanced areas in post-gadolinium T1-weighted images without MT and subtraction images without MT (p=0.020). The subtraction images without MT allowed the detection of an increased (10) number of enhancing lesions compared with post-gadolinium T1-weighted images without MT. Magnetization transfer contrast and subtraction techniques appear to be the simplest and least time-consuming applications to improve the conspicuity and detection of contrast-enhancing lesions in patients with MS.

Adult↗

Working memory deficits in multiple sclerosis: a controlled study with auditory P600 correlates.

BACKGROUND: Recently, the P600 component of event related potentials, a waveform that is conceived to be generated and/or modulated by basal ganglia and cingulate area has been considered an index of the completion of any synchronised operation after target detection, having much in common with working memory operation. Moreover, dysfunction of these brain structures as well as working memory deficits have been implicated in the pathophysiology of multiple sclerosis. The aim of this study was to investigate the patterns of P600 elicited during a working memory test in multiple sclerosis patients compared with healthy controls. METHODS: Twenty two definite, chronic progressive multiple sclerosis patients, with recent exacerbation of their illness, and 20 normal subjects matched for age, sex, and educational level, were studied with a computerised version of the digit span test of Wechsler batteries. Auditory P600 were measured during the anticipatory period of this test. RESULTS: The patient group, as compared with healthy controls, showed significantly reduced latencies of P600 at left frontal areas and reduced P600 amplitudes at left temporoparietal region. Moreover, memory performance of patients was significantly more impaired when compared with healthy controls. CONCLUSIONS: These findings may indicate that multiple sclerosis is associated with abnormal features of the completion of synchronised operation after target detection, as they are reflected by P600 amplitudes and latencies. Dysfunction of this mechanism may contribute to the identification of basic cognitive processes that could account for the cognitive deficits in multiple sclerosis.

Adult↗

Cognitive function in non-demented individuals complaining of short-term memory disturbances: a study with event-related potentials (P 300) and brain CT scan.

Event-related potentials (ERPs) were elicited in 30, non-consecutive, non-demented individuals, complaining of short-term memory disturbances. Fifteen of them had a moderate diffuse cerebral atrophy on their brain CT and the other 15 had a negative brain CT. ERPs were also elicited in 15 age-matched controls with no reported memory disturbances and negative brain CTs. The statistical analysis showed that the group of individuals with cerebral atrophy had a significantly prolonged P300 (P3) latency and a decreased P3 amplitude compared to controls. It is concluded that among persons complaining of short-term memory disturbances, the individuals who show cerebral atrophy, taken as a group, have a P3 latency prolongation and/or low P3 amplitude a finding which reflects an impaired information processing.

Adult↗

Platelet monoamine oxidase and plasma dopamine-beta-hydroxylase activities in patients with multiple sclerosis.

Platelet monoamine oxidase (MAO) and plasma dopamine-beta-hydroxylase (DBH) activities were determined in a large group of multiple sclerose patients in relapse (49 patients) and in remission (28 patients), and compared with an age- and sex-matched control group (52 normal subjects). The activities of both enzymes did not differ from normal in both patient groups. Women had higher MAO activities both in normal and in patient groups. Multiple linear regression analysis revealed an association of low platelet MAO to the score in the mental subscale in the Kurtzke Disability Status Scale. Both male and female patients with mental symptomatology had significantly (p = 0.02) lower platelet MAO activities compared to the patients without. The possibility of a relationship between MAO activity and psychiatric vulnerability in MS is considered.

Adult↗

Prothymosin-alpha enhances HLA-DR antigen expression on monocytes from patients with multiple sclerosis.

Monocytes from patients with multiple sclerosis (MS) express decreased numbers of class II major histocompatibility complex (MHC) antigens in peripheral blood and are poor stimulators in the autologous mixed lymphocyte reaction (autoMLR). We assessed the effect of prothymosin-alpha (ProT alpha) on the expression of MHC class II antigens by monocytes. Immediately after isolation, monocytes were analyzed for MHC class II antigen expression using a radiolabelled monoclonal antibody specific for a monomorphic determinant on HLA-DR antigens. After incubation with ProT alpha we observed significant increases in HLA-DR antigens on MS monocytes (1.5- to 4-fold increase compared to freshly isolated monocytes). Kinetic analysis revealed that enhancement peaked after 2 days of incubation with ProT alpha. The increase in HLA-DR antigen on MS monocytes resulted in the restoration of the deficient autoMLR in MS patients. This is the first demonstration suggesting a link between HLA-DR antigen expression and cellular immune defects in MS. The significance of low autoMLR responses for T suppressor levels in MS patients is discussed.

Adult↗

Altered serotonin uptake kinetics in multiple sclerosis.

Platelet serotonin uptake was studied in 20 patients with multiple sclerosis (MS) in acute relapse and in 20 age- and sex-matched controls. While there was no difference in the maximum velocity of the uptake, Michaelis constants were significantly higher and correlated positively with the Disability Status Scale score. The results suggest a competitive block of the serotonin uptake sites in platelets of MS patients.

Adult↗

Low plasma cyclic nucleotides in multiple sclerosis.

The concentrations of cyclic AMP and cyclic GMP were estimated in plasma of 26 patients with definite multiple sclerosis (MS) in relapse, and compared to that of 26 sex- and age-matched healthy controls. MS patients had significantly lower levels of both nucleotides. The levels of c-GMP correlated negatively to the Disability Status Scale score.

Adult↗

Multiple sclerosis: I. Monocyte stimulatory defect in mixed lymphocyte reaction associated with clinical disease activity.

To investigate whether abnormalities of cellular immune responses are associated with multiple sclerosis (MS), we tested peripheral blood mononuclear cells (PBMC) or T cells, and monocytes from MS patients as responder and stimulatory cells respectively, in the allogeneic (allo-MLR) and autologous mixed lymphocyte reaction (auto-MLR). We found that PBMC or T cells from all MS patients were able to develop strong proliferation against allogeneic monocytes derived from normal individuals. Moreover, the capacity of monocytes from MS patients to act as accessory cells for autologous T cells in the allo-MLR was indistinguishable from that of normal donors. In contrast, monocytes from patients with active MS were not able to stimulate responder cell proliferation either in allo-MLR or in auto-MLR. This monocyte defect was partially restored in the inactive stage of the disease. In conclusion our results show that the stimulatory capacity of monocytes from MS patients in the MLR is closely associated with the clinical stage of MS. The observed monocyte defect may be helpful in understanding the pathogenesis of MS and can be used in evaluating the outcome of the disease activity.

Antigen-Presenting Cells↗

Multiple sclerosis: II. Effects of prothymosin alpha on the autologous and allogeneic MLR in patients with multiple sclerosis.

We have recently demonstrated that peripheral blood monocytes from patients with multiple sclerosis (MS) have a defect in stimulating autologous and allogeneic T lymphocytes. This defect was found to correlate with disease activity. In this report we demonstrate that prothymosin alpha (ProT alpha), a rat thymus fraction 5 polypeptide, restores the MS monocyte stimulatory defect. The concentrations of ProT alpha which induced optimal enhancement of the mixed lymphocyte responses (MLR) were significantly higher when monocytes from patients with active disease were used as stimulators than when monocytes from patients with inactive disease were used. T4+ cells tested with autologous stimulatory monocytes harvested from an inactive stage of MS exhibited considerably higher proliferative responses than when stimulated with autologous monocytes obtained from an acute relapse. The decreased autologous proliferation of T4+ cells in MS patients was restored to normal levels after preincubation with ProT alpha in the environment of autologous monocytes. Our results demonstrate that ProT alpha is capable of fully restoring the deficient stimulatory function of MS monocytes and monocyte-associated functional defects of MS-derived T4+ cells.

Humans↗

Normal plasma dopamine-beta-hydroxylase in non-treated and treated Parkinson patients.

Plasma dopamine-beta-hydroxylase activity (DBH) was estimated in 50 drug-free Parkinson patients, 30 of whom had never been treated, in 26 patients treated chronically with L-Dopa, and in 44 controls. 22 of the drug-free patients were examined again after two weeks treatment with L-Dopa plus decarboxylase inhibitor. In disagreement with other reports, no differences were found among the groups and no change in the enzyme activity occurred after treatment, although urinary homovanillic acid increased 20 fold. Low DBH activities could not be attributed to the age of onset or duration of illness, main symptom, depression, autonomic disturbances, or duration of drug treatment. The only difference was found in patients with dementia associated to their illness, who showed low enzyme activities.

Aged↗

Stargardt's disease with neurological involvement: case report.

The diagnosis of Stargardt's disease, in cases of macular degeneration associated with neurological symptomatology, has been questioned. A 23 year old man, suffering from well characterized Stargardt's disease since childhood, presented with progressive spastic tetraparesis and cerebellar involvement since the age of 18. The case is presented and the association between the two clinical pictures is discussed.

Adult↗