Early Indicators Early Treatments Neuroprotection in Multiple Sclerosis

1. Front Matter

   Pages I-XV

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2. Evidence for an Early Treatment of Multiple Sclerosis

   • G. Comi, L. Moiola

   Pages 1-13

3. Inflammation, Demyelination, and Axonal Degeneration: Three Aspects of the Pathogenesis of Multiple Sclerosis Revealed by Campath-1H Treatment

   • A. J. Coles, M. G. Wing, P. Molyneux, A. Paolillo, C. M. Davie, G. Hale et al.

   Pages 15-25

4. Genetic Regulation of Nerve Cell Death/Glial Activation and Protective Effects of Myelin Basic Protein Autoimmune Neurotrophin Production in Mechanically Induced Neurodegeneration

   • F. Piehl, O. Lidman, T. Olsson

   Pages 27-39

5. Neuroprotective Treatment in Primary Progressive Multiple Sclerosis: a Phase I/II Study with Riluzole

   • N. Kalkers, F. Barkhof, L. Bergers, R. Van Schijndel, C. Polman

   Pages 41-47

6. Neuropathology and Disease Progression in Multiple Sclerosis

   • C. Bjartmar, B. D. Trapp

   Pages 49-61

7. Autoimmune Inflammation and Multiple Sclerosis

   • I. R. Cohen

   Pages 63-66

8. Early Treatment of Progression in Multiple Sclerosis

   • R. E. Gonsette

   Pages 67-81

9. Imaging for Tissue Characterization in Multiple Sclerosis and Other White Matter Diseases

   • M. Filippi, N. De Stefano

   Pages 83-95

10. Monounsaturated Fatty Acids and Neuroprotection. The Results of a Study of Cognitive Decline in Old Age. Is There a Case for this Treatment in Multiple Sclerosis?

    • A. Capurso, F. Panza, V. Solfrizzi, C. Capurso, A. D’Introno, S. Capurso et al.

    Pages 97-107

11. Neuroprotection in Acute Ischemic Stroke: Lessons for Early Treatment in Multiple Sclerosis

    • J. De Keyser, G. Ramsaransing, E. Zeinstra, N. Wilczak

    Pages 109-114

12. Soluble VCAM-1 Release Indicates Inflammatory Blood-Brain Barrier Pathology and Further Modulates Adhesion

    • B. A. Kallmann, V. Hummel, K. V. Toyka, P. Rieckmann

    Pages 115-117

13. Early Treatment in Multiple Sclerosis with Intravenous Immunoglobulin: Rationale and Study Design

    • A. Achiron, Y. Barak, M. Faibel, S. Miron, I. Kishner, M. Chen et al.

    Pages 119-128

14. Serial Magnetic Resonance Imaging in Patients with a First Clinical Episode Suggestive of Multiple Sclerosis: Outline of a Research Protocol

    • C. Pozzilli, P. Pantano, S. Di Legge, F. Caramia, M. C. Piattella, I. Pestalozza et al.

    Pages 129-133

15. T1-Hypointense Lesions (T1 Black Holes) in Mild-to-Moderate Disability Relapsing Multiple Sclerosis

    • J. H. Simon, L. Jacobs, N. Simonian, The MS Collaborative Research Group

    Pages 135-139

16. Acute Monosymptomatic Optic Neuritis: Potential Clues to Early Therapy in Multiple Sclerosis

    • D. I. Kaufman

    Pages 141-153

17. Antibody Mediated Demyelination

    • A. Van Der Goes, E. C. W. Breij, M. Kortekaas, K. Hoekstra, P. J. H. Jongen, C. D. Dijkstra et al.

    Pages 155-161

18. Anti-MOG Antibodies as Early Predictors for Conversion to Relapsing-Remitting Disease Course in Patients Suggestive of Multiple Sclerosis

    • T. Berger, P. Rubner, R. Egg, E. Dilitz, D. Stadlbauer, F. Deisenhammer et al.

    Pages 163-166

19. Sunlight, Vitamin D, and Multiple Sclerosis

    • C. E. Hayes

    Pages 167-179

20. The Yin and Yang of Inflammation in Multiple Sclerosis

    • G. Giovannoni

    Pages 181-189

There is now evidence that irreversible brain damage accumulates very early in the course of multiple sclerosis. This book reviews the main neurobiological, magnetic resonance imaging, and clinical aspects of the early phases of the dis­ ease. Mechanisms ofirreversible axonal damage and the role played by the inter­ action of glia and the axon are highlighted. In contrast to what was believed for a long time, the sufficient availability of oligodendrocyte precursor cells to promote remyelination in acute lesions has now been demonstrated. For reasons not understood, this remyelination process fails or does not start, particularly in the chronic stages ofthe disease. These findings emphasize the importance of the "milieu" changes induced by an inflammatory process in limiting remyelination. However, first indications are that part of this inflammatory process may have a neuroprotective effect. Pathological studies in multiple sclerosis have now clearly demonstrated that destructive processes may be followed by recovery phases in such a way that myelin may be morphologically and functionally reconstituted. These findings provide the rationale for early treatment and emphasize the importance of clinical trials in early multiple sclerosis. Early treatment is one of the most important aspects in multiple sclerosis today.

• brain
• magnetic resonance
• magnetic resonance imaging
• magnetic resonance imaging (MRI)
• neuropathology
• neuroprotection

• European Charcot Foundation, Nijmegen, The Netherlands

  Otto R. Hommes

• Department of Neurology, Scientific Institute and University Ospedale San Raffaele, Milan, Italy

  Giancarlo Comi

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