Tehran University Medical Journal

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Background: Multiples sclerosis is a common demyelinating disease of CNS and the main cause of disability in young adults all over the world so any research in different aspects of the disease has great value. researches in Iran are few in quantity and low in sample size. To determine clinical course and prognosis of the disease in Iranian MS patients we have studied these items in a considerable sample size.
Methods: Two hundred and three definite MS patients (according to MC’donalds 2001 criteria) included in this study and a planned questionnaire completed by visiting the patients or by degree of disability estimated according to EDSS (Expanded Disability Status Scale) score system. The results analyzed with SPSS software.
Results: Mean age of the patients was 35. All required examinations have been done by a neurologist and 60.6 percent were female. Mean duration of disease was 8.3 years. the main form of onset of symptoms was sensorimotor (mixed). Mean Attack rate was 5.5 times during the disease duration. Clinical course in 72.4 percent was relapsing-remitting type. Mean disability scale number according to EDSS was 5.2. Death rate was two percent. 69.3 percent of patients were able to work in the society. The degree of disability increased with increasing age, in lower educational state, in longer duration of the disease and in male gender.
Conclusion: The results of clinical course and type of MS, mean of disease duration from the onset and mean EDSS are compatible and comparable with similar studies in other countries though some results are different. For future large sample, multicenter studies recommended

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Background: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system resulting from demyelination and axonal loss. Although treatment of MS has progressed, patients continue to have attacks and treatment for such episodes remains a subject of ongoing study. The object of this study is to determine the effect of intravenous methylprednisolone (IVMP) on the degree of disability in MS patients.
Methods: This cross-sectional study involved 63 patients with a definite diagnosis of MS, based on the MacDonald criteria, at the Iranian Center for Neurological Research at Imam Khomeini Hospital, Tehran, Iran, from March 2004 through March 2005. After obtaining informed consent, investigators gathered data including each patient's age, gender, pyramidal activity status, cortical, cerebellar and brain stem activity status, sensory signals in the extremities, including vibration, touch, pain, position, visual status, as well as bladder and intestinal activity, and Expanded Disability Status Scale (EDSS) score. SPSS version 11 was used for data analysis.
Results: A five-day regimen of IVMP (5g) significantly reduced the immediate post-treatment score from 4.595 to 3.635, which represents a 96% improvement in the EDSS. The greatest change in functional system disability was seen in the pyramidal system with a mean score of 1.13. After treatment, the rate of disability reduction in the sensory system, cerebellum, vision, bladder and intestinal activity was 0.57, 0.49, 0.46, 0.4, and 0.38, respectively. Patients who had experienced fewer relapses responded better to treatment. There was no statistically significant relationship between patient age and the level of response to treatment. However, the rate of disability reduction after treatment was greater in males than females (p=0.05).
Conclusion: These results show that IVMP treatment induces an immediate post-treatment effect that could partly account for clinical and radiological improvement in MS patients. However, further study is required to determine the possible long-term, or even intermediate-term, effects of methylprednisolone treatment on the course of this disease.

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Background: Diagnosis of multiple sclerosis (MS), as a major cause of neurological disability in young adults, is difficult to establish, especially at the onset of the disease process, due to lack of reliable molecular markers.The goal of the present study was to evaluate serum and urinary concentrations of cystatin C and to find their relationship with patients' expanded disability status scale (EDSS).
Methods: Based on McDonald's criteria, 54 adult patients with M.S.(11 males and 43 females, with a mean age of 32.18±8.37 years) were enrolled as the case group and 24 age and sex-matched healthy, non-M.S. individuals (7 males and 17 females, with a mean age of 34.31±10.07 years) were recruited as the controls. Serum and urinary concentrations of cystatin C were measured in all the participants.
Results: The means of serum cystatin C concentrations (mg/Lit) in the case and control groups respectively were 0.90±0.01 and 0.89±0.02, (p=0.84) and the means for its urinary concentrations were 25.37±1.91 and 21.11±2.54 (p=0.18).The means of serum and urinary cystatin C concentrations were 0.90±0.01 and 25.11±2.33 in patients whose EDSS was ≤2.5 and 0.90±0.03 and 26.30±2.84 in patients whose EDSS was ≥2.5,respectively, although, the differences between the two groups of patients were not statistically significant (p=0.80 and 0.74,respectively for serum and urinary concentrations of cystatin C).
Conclusions: This study showed that serum and urinary cystatin C concentrations cannot be used for multiple sclerosis diagnosis or even as a marker in its treatment follow ups or for the determination of disease severity.