Tehran University Medical Journal

Background: Multiple sclerosis (MS) is an inflammatory disease of the central nervous system with multifocal areas of demyelination. Despite an increased understanding of the mechanisms causing MS, immunological factors that indicate disease activity are only starting to be discovered. Chronic brain inflammation is often associated with an increase in production of IgG in the CSF as determined by the IgG index (normal ≤0.77) and oligoclonal bands (OCBs). Different studies have found variable correlations between these two factors and disease progression. We herein evaluate the correlation of IgG index and OCB with disease progression in Iranian MS patients.

Methods: The IgG index was measured in 54 patients with multiple sclerosis. The progression index (PI), type of disease course and the presence of OCBs were compared in patients with normal, high and very high IgG index.

Results: PI was higher in patients with very high IgG indexes (0.10±0.13) vs. patients with high (0.06±0.05) and normal IgG indexes (0.05±0.07 p>0.05). Secondary progressive (SP) patients had higher IgG indexes than those with relapsing-remitting (RR) courses (2.04±1.24 for SP vs. 1.78±1.45 for RR p>0.05). The PI was higher in OCB-positive MS patients (0.08±0.10) vs. OCB-negative patients (0.05±0.04) (p>0.05).

Conclusion: Although the findings of this study need to be treated with some caution since this is not a prospective evaluation, the results indicate a trend toward better prognosis of the disease in patients with lower IgG index values. We think that the IgG index is a useful marker of disease activity in MS. Patients with IgG indexes above 1.1 could have an increased risk of progression and they would benefit from early treatment with immunomodulator agents. Our results did not reveal statistically significant prognostic value for IgG index in patients with multiple sclerosis. Thus the results warrant prospective studies to verify the prognostic value of intrathecal IgG synthesis in multiple sclerosis.

Background: Many studies have shown that about 45-65% of multiple sclerosis (M.S) patients suffer from cognitive impairments. Semantic memory as one of the subcategories of cognition is quite important for effective communication. In the present study, category-semantic memory was studied in order to evaluate the semantic memory organization in normal individuals and MS patients.

Methods: Ninety voluntaries participated in this study. Participants comprise of 45 MS patients and 45 normal individuals. All participants were matched in terms of age, sex and education. Variables such as the reaction time and the number of correct responses for retrieval (recognition) of natural (animal and fruit) and artifact (object) words were measured in both groups by presentation software. Data analyzed by t-paired and One-Way ANOVA tests. Ethical committee of Tehran University of Medical sciences approved the study.

Results: The results of current study showed significant differences in reaction time and correct responses of artifact and natural categories between the MS and normal individuals (p<0.05). Furthermore, there was significant difference between reaction time and number of correct responses to natural and artifact categories in each group (p<0.05).

Conclusions: This study showed that the organization of semantic categorization as natural and artifact categories is still preserved in multiple sclerosis patients. However, the processing of semantic categorization was different in term of reaction time and number of correct responses between MS patients and normal subjects and the processing of semantic-memory is slower than normal individuals.

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Recent studies present a high prevalence of multiple sclerosis (MS) in Iran. Treatment with interferon is now the first choice in management of MS. CinnoVex^TM (an interferon beta 1-a) is available in Iran, with achievement of the technology of producing beta interferon. The aim of the present study is to evaluate the efficacy and safety of CinnoVex^TM in a national study named CINA study.

Methods: This study was conducted from 2007 to 2008 in cities of Tehran, Isfahan, Mashhad, Tabriz, and Shiraz. Patients with relapsing/remitting MS with 16-50 years of age and EDSS of <4 received CinnoVex^TM (30µg/week, IM) after diagnosis by a neurologist. EDSS, drug side effects, and frequency of relapse were evaluated for one year in four 3-month visits.

Results: A total of 1050 patients entered the study. Complete data were collected from 627 (60%) patients. Mean age was 30.7±8.6 year and 514 (82%) were female. The most common onset presentations were sensory symptoms (44%). Changes of EDSS through the study showed a significant decrease in the last 3-month of evaluation (p<0.05). Drug side effects were observed in 47%, 50%, 61%, and 61.4% (p>0.05) and relapse was occurred in 13.4%, 15.7%, 16.9%, and 2.4% of the patients in the first, second, third, and forth evaluation visits (p=0.001), respectively.

Conclusion: CinnoVex^TM prevents progression and improves clinical course of MS. The conventional side effects of beta interferon therapy, however, are observed with CinnoVex^TM.