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Epstein-Barr and MS: meta-analysis

March 5, 2014

…3;8:e61110; free full text at www.ncbi.nlm.nih.gov/pmc/articles/PMC3621759/pdf/pone.0061110.pdf). Seroprevalence was determined for three anti-EBV antibodies: anti-EBV nuclear antigen 1 (anti-EBNA-1) or EBNA complex; antiviral capsid antigen (anti-VCA); and anti-Early Antigen (anti-EA). The median seroprevalence of anti-EBNA IgG was 98% in MS patients compared to 88% in controls (odds ratio 4.7). The median anti-VCA IgG seropositivity was 99% in M…

Depression and discrimination: the ASPEN/INDIGO study

February 19, 2014

…ree full text at www.ncbi.nlm.nih.gov/pmc/articles/PMC2623050/pdf/15640922.pdf). Comment Drs. Arun Ravindran and Nisha Ravindran: The last three decades have seen significant growth in the literature on psychiatric stigma. This recent publication, the result of a large collaborative European study focusing on patients with major depression, reports findings that are notable but not unexpected. It confirms that experiencing stigma as well as its an…

Subthalamic stimulation useful for early motor complications

February 19, 2014

…5:956-963. Deuschl et al. N Engl J Med 2006;355:896-908; free full text at www.nejm.org/doi/pdf/10.1056/NEJMoa060281). The EARLYSTIM study has now investigated the potential benefits of subthalamic stimulation at an earlier stage (Schuepbach et al. N Engl J Med 2013;368:610-622). The two-year study randomized 251 PD patients (mean age 52 years) with early motor complications to medical therapy with and without neurostimulation. Mean quality of lif…

MS treatment: What is Plan B?

December 5, 2013

…:1922-1930, free full text at www.ncbi.nlm.nih.gov/pmc/articles/PMC2690969/pdf/6636.pdf). In effect, natalizumab may keep the barbarians at the gate, but meanwhile the barbarians are proliferating. Maintaining control may be a challenge when natalizumab is withdrawn and the barbarians enter. De-escalation may not be the preferred strategy since many patients will have failed to respond to a prior injectable. Indeed, in the TY-STOP study, 17.8% of…

Zero tolerance for disease activity on treatment is near (but not yet)

November 30, 2013

…CF 2013). Tintoré et al. found that one clinical relapse, EDSS change or a combination of the two during the first 24 months of therapy was predictive of a poorer outcome. These results were similar to a recently published 15-year follow-up study, which reported that persistent disease activity (relapses, new T2 lesions or Gd-enhancing lesions) in the first two years on interferon-beta treatment was predictive of severe EDSS worsening (Bermel et a…