REPORT FROM THE EUROPEAN CHARCOT FOUNDATION ANNUAL MEETING – BAVENO, ITALY, NOVEMBER 28-30, 2013 – The optimal strategy for managing patients with an inadequate response to an initial disease-modifying therapy (DMT) was the focus of discussion at a session of the ECF annual meeting and two somewhat different approaches were presented.
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Prognostic value of CSF analysis
November 30, 2013REPORT FROM THE EUROPEAN CHARCOT FOUNDATION ANNUAL MEETING – BAVENO, ITALY, NOVEMBER 28-30, 2013 – Lumbar puncture was once part of the routine work-up of MS patients but the usefulness of CSF oligoclonal bands (OCB) in the diagnosis of MS was de-emphasized following the publication of the revised McDonald criteria (Polman et al. Ann Neurol 2005;58:840-846).
Zero tolerance for disease activity on treatment is near (but not yet)
November 30, 2013REPORT FROM THE EUROPEAN CHARCOT FOUNDATION ANNUAL MEETING – BAVENO, ITALY, NOVEMBER 28-30, 2013 – Recent studies have attempted to identify baseline disease characteristics that would predict response to a given treatment, but no factors have been determined thus far. However, markers of disease activity during treatment can be useful for identifying treatment failure.
Characterizing demyelinating lesion formation and neurodegeneration
November 29, 2013REPORT FROM THE EUROPEAN CHARCOT FOUNDATION ANNUAL MEETING – BAVENO, ITALY, NOVEMBER 28-30, 2013 – A decade ago, four immunopathological patterns of demyelination were described for MS lesions (Lucchinetti et al. Ann Neurol 2000;47:707-717). Patterns I and II resembled a T-cell-mediated and T-cell plus antibody-mediated autoimmune encephalomyelitis, while patterns III and IV were suggestive of a virus- or toxin-mediated demyelination rather than autoimmune processes. This lesion heterogeneity is evident early in MS; patterns converge to one of T cell, macrophage and microglia involvement later in the disease course (Lassmann H. ECF 2013).