Neurology

Does MS burn out?

 

‘Burned-out MS’ (BOMS) is a term that has arisen recently in the multiple sclerosis literature. An early definition of BOMS described patients with a high EDSS score after a prolonged course of illness who had atrophy but no inflammatory activity on MRI (Bhatia & Singh. Ann Indian Acad Neurol 2019;22:131-136). The MS Association of America described BOMS as a form of inactive MS in which disease progression slows dramatically later in life. This is not a new phenotype since these definitions overlap with that of stable disease (not active/without progression) in the 2013 revisions (Lublin et al. Neurology 2014;83:278-286). The key difference and controversy is that BOMS presumes that no further MS-related progression will occur. Read More

TOPICS:

What is the seizure risk after stopping antiseizure medications?

 

Most patients with epilepsy become seizure-free during treatment with antiseizure medications (ASM) and current guidelines by the American Academy of Neurology (AAN) support ASM discontinuation in some individuals to reduce the side effect burden and improve quality of life (Gloss et al. Neurology 2021;97:1072-1081). Read More

Utility of biomarkers in progressive MS

 

The German Emerging Blood Biomarkers in Progressive Multiple Sclerosis (EmBioProMS) study examined neurofilament-light chain (NfL) and glial fibrillary acidic protein (GFAP) levels in patients with primary or secondary progressive MS (Abdelhak et al. Ann Clin Transl Neurol 2024;11:477-485). Mean age was 55 years; one-third of patients had no DMT exposure at the time of enrollment. Read More

Protein biomarker panel useful for MS diagnosis, prognosis

 

A U.K. group has investigated 31 biomarkers for their potential utility in the diagnosis and prognosis of multiple sclerosis (Kodosaki et al. J Neuroinflamm 2024;21:52). The biomarkers examined included neurofilament-light chain (NfL), glial fibrillary acidic protein (GFAP), chitinase-3-like-1 protein (CHi3L1), pro-and anti-inflammatory cytokines (e.g. IL-6, IL-10), chemokines (e.g. CXCL12), complement proteins (e.g. C3, C5) and proteins in other pathways relevant to MS (e.g. vitamin D binding protein). CSF and serum samples were obtained from 77 people being investigated for a demyelinating condition and 80 controls. Read More