26 results on '"Garriga, J."'
Search Results
2. Epidemiology of NMOSD in Catalonia: Influence of the new 2015 criteria in incidence and prevalence estimates.
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Sepúlveda, Maria, Aldea, Marta, Escudero, Domingo, Llufriu, Sara, Arrambide, Georgina, Otero-Romero, Susana, Sastre-Garriga, J., Romero-Pinel, Lucía, Martínez-Yélamos, Sergio, Sola-Valls, N., Armangué, Thais, Sotoca, Javier, Escartín, Antonio, Robles-Cedeño, René, Ramió-Torrentà, Lluís, Presas-Rodríguez, Silvia, Ramo-Tello, Cristina, Munteis, Elvira, Pelayo, Raúl, and Gubieras, Laura
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NEUROMYELITIS optica ,MYELIN oligodendrocyte glycoprotein ,DEMYELINATION ,IMMUNOGLOBULINS ,AQUAPORINS - Abstract
Background: Population-based studies on neuromyelitis optica spectrum disorders (NMOSD) are limited, and it is unclear whether the rates have changed with the implementation of the new 2015 criteria. Objectives: To estimate the incidence and prevalence of NMOSD in Catalonia (Spain), using both the 2006 and the 2015 criteria. Methods: In this clinic-based retrospective study, patients diagnosed with NMOSD between 2006 and 2015 were identified using multiple sources, including direct contact to all Catalan hospitals, identification of cases through the Catalan Health Surveillance System, and registry of antibodies to aquaporin-4 (AQP4-IgG) and myelin oligodendrocyte glycoprotein (MOG-IgG) in a reference laboratory. The incidence rate was calculated for the period 1 January 2006–1 January 2016 and prevalence for the date 1 January 2016. Results: We identified 74 patients (by the 2015 criteria). Most patients were Caucasian (81%), and female (76%) with a median age at disease onset of 42 years (range, 10–76 years). In total, 54 (73%) patients were positive for AQP4-IgG, 11 (15%) double-seronegative, and 9 (12%) MOG-IgG-positive. Rates of incidence and prevalence (0.63/1,000,000 person-years and 0.89/100,000, respectively) were 1.5-fold higher than those reported by the 2006 criteria. Lowest rates were seen in children and elder people and highest in women and middle-aged people (40–59 years). The female predominance was lost in incident AQP4-IgG-seronegative children and AQP4-IgG-positive elder people. MOG-IgG and double-seronegativity contributed similarly but did not influence the long-term outcome. Conclusion: The new criteria increase the estimates, but NMOSD remains as a rare disease. The differences in age- and sex-specific estimates highlight the importance of the serologic classification. [ABSTRACT FROM AUTHOR]
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- 2018
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3. Significant clinical worsening after natalizumab withdrawal: Predictive factors
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Vidal-Jordana, A, primary, Tintoré, M, additional, Tur, C, additional, Pérez-Miralles, F, additional, Auger, C, additional, Río, J, additional, Nos, C, additional, Arrambide, G, additional, Comabella, M, additional, Galán, I, additional, Castilló, J, additional, Sastre-Garriga, J, additional, Rovira, A, additional, and Montalban, X, additional
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- 2014
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4. Brain atrophy in natalizumab-treated patients: A 3-year follow-up
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Sastre-Garriga, J, primary, Tur, C, additional, Pareto, D, additional, Vidal-Jordana, A, additional, Auger, C, additional, Río, J, additional, Huerga, E, additional, Tintoré, M, additional, Rovira, A, additional, and Montalban, X, additional
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- 2014
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5. Magnetic resonance imaging correlates of physical disability in relapse onset multiple sclerosis of long disease duration
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Kearney, H, primary, Rocca, MA, additional, Valsasina, P, additional, Balk, L, additional, Sastre-Garriga, J, additional, Reinhardt, J, additional, Ruggieri, S, additional, Rovira, A, additional, Stippich, C, additional, Kappos, L, additional, Sprenger, T, additional, Tortorella, P, additional, Rovaris, M, additional, Gasperini, C, additional, Montalban, X, additional, Geurts, JJG, additional, Polman, CH, additional, Barkhof, F, additional, Filippi, M, additional, Altmann, DR, additional, Ciccarelli, O, additional, Miller, DH, additional, and Chard, DT, additional
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- 2013
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6. Clinical impact of early brain atrophy in clinically isolated syndromes
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Pérez-Miralles, F, primary, Sastre-Garriga, J, additional, Tintoré, M, additional, Arrambide, G, additional, Nos, C, additional, Perkal, H, additional, Río, J, additional, Edo, MC, additional, Horga, A, additional, Castilló, J, additional, Auger, C, additional, Huerga, E, additional, Rovira, A, additional, and Montalban, X, additional
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- 2013
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7. Increase in the prevalence of multiple sclerosis over a 17-year period in Osona, Catalonia, Spain
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Otero-Romero, S., primary, Roura, P., additional, Sola, J., additional, Altimiras, J., additional, Sastre-Garriga, J., additional, Nos, C., additional, Vaque, J., additional, Montalban, X., additional, and Bufill, E., additional
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- 2012
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8. A functional magnetic resonance proof of concept pilot trial of cognitive rehabilitation in multiple sclerosis
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Sastre-Garriga, J, primary, Alonso, J, additional, Renom, M, additional, Arévalo, MJ, additional, González, I, additional, Galán, I, additional, Montalban, X, additional, and Rovira, A, additional
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- 2010
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9. Primary progressive multiple sclerosis diagnostic criteria: a reappraisal
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Montalban, X., primary, Sastre-Garriga, J., additional, Filippi, M., additional, Khaleeli, Z., additional, Téllez, N., additional, Vellinga, MM, additional, Tur, C., additional, Brochet, B., additional, Barkhof, F., additional, Rovaris, M., additional, Miller, DH, additional, Polman, CH, additional, Rovira, A., additional, and Thompson, AJ, additional
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- 2009
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10. A single-center, randomized, double-blind, placebo-controlled study of interferon beta-1b on primary progressive and transitional multiple sclerosis
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Montalban, X., primary, Sastre-Garriga, J., additional, Tintoré, M., additional, Brieva, L., additional, Aymerich, FX, additional, Río, J., additional, Porcel, J., additional, Borràs, C., additional, Nos, C., additional, and Rovira, À., additional
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- 2009
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11. Measures in the first year of therapy predict the response to interferon β in MS
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Río, J, primary, Castilló, J, additional, Rovira, A, additional, Tintoré, M, additional, Sastre-Garriga, J, additional, Horga, A, additional, Nos, C, additional, Comabella, M, additional, Aymerich, X, additional, and Montalbán, X, additional
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- 2009
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12. Role of MRI criteria and OB for diagnosing multiple sclerosis in patients presenting with clinically isolated syndromes
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Tintore, M, primary and Sastre-Garriga, J, additional
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- 2009
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13. Brain atrophy in natalizumab-treated patients: A 3-year follow-up.
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Sastre-Garriga, J, Tur, C, Pareto, D, Vidal-Jordana, A, Auger, C, Río, J, Huerga, E, Tintoré, M, Rovira, A, and Montalban, X
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BRAIN physiology , *NATALIZUMAB , *MAGNETIC resonance imaging , *MULTIVARIATE analysis , *INFLAMMATION - Abstract
The article presents a study which investigates the volume dynamics of the brain in patients who are treated with natalizumab after the initiation of therapy. The study uses the magnetic resonance imaging scans and multivariate models for the investigation of the link between the baseline inflammation and the changes to the volume and disability of the brain. Results show that the measures of the volume of the brain is affected by the baseline inflammation after the initiation of natalizumab.
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- 2015
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14. Significant clinical worsening after natalizumab withdrawal: Predictive factors.
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Vidal-Jordana, A, Tintoré, M, Tur, C, Pérez-Miralles, F, Auger, C, Río, J, Nos, C, Arrambide, G, Comabella, M, Galán, I, Castilló, J, Sastre-Garriga, J, Rovira, A, and Montalban, X
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DRUG withdrawal symptoms ,MAGNETIC resonance imaging ,MULTIPLE sclerosis ,NATALIZUMAB ,PREDICTIVE control systems - Abstract
We aimed to single out multiple sclerosis (MS) cases with poor outcome after natalizumab withdrawal and to identify predictive variables. We ascertained 47 withdrawals, and compared their pre- and post-natalizumab periods. We objectively defined significant clinical worsening after natalizumab withdrawal as a 2-step increase in Expanded Disability Status Scale (EDSS). We performed regression models. As a group, post-natalizumab annualized relapse rate (ARR) was lower in the post-natalizumab period, and there were no differences in the mean number of gadolinium (Gd)-enhancing lesions between pre- and post-natalizumab magnetic resonance imaging (MRI). Corticosteroid treatment did not change the outcomes. Eight patients (19%) presented significant clinical worsening after natalizumab withdrawal, which was predicted by a higher baseline EDSS and a 1-step EDSS increase while on natalizumab. [ABSTRACT FROM AUTHOR]
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- 2015
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15. Variations in chemokine receptor and cytokine expression during pregnancy in multiple sclerosis patients
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López, C, primary, Comabella, M, additional, Tintoré, M, additional, Sastre-Garriga, J, additional, and Montalban, X, additional
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- 2006
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16. Decreased MMP-9 production in primary progressive multiple sclerosis patients
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Sastre-Garriga, J, primary, Comabella, M, additional, Brieva, L, additional, Rovira, A, additional, Tintoré, M, additional, and Montalban, X, additional
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- 2004
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17. Myelopathy in seronegative Sjögren syndrome and/or primary progressive multiple sclerosis
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Pericot, I, primary, Brieva, L, additional, Tintoré, M, additional, Río, J, additional, Sastre-Garriga, J, additional, Nos, C, additional, and Montalban, X, additional
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- 2003
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18. C onversion to multiple sclerosis after a clinically isolated syndrome of the brainstem: cranial magnetic resonance imaging, cerebrospinal fl uid and neurophysiological findings
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Sastre-Garriga, J, primary, Tintoré, M, additional, Rovira, A, additional, Grivé, E, additional, Pericot, I, additional, Comabella, M, additional, Thompson, A J, additional, and Montalban, X, additional
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- 2003
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19. Magnetic resonance imaging correlates of physical disability in relapse onset multiple sclerosis of long disease duration.
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Kearney, H, Rocca, MA, Valsasina, P, Balk, L, Sastre-Garriga, J, Reinhardt, J, Ruggieri, S, Rovira, A, Stippich, C, Kappos, L, Sprenger, T, Tortorella, P, Rovaris, M, Gasperini, C, Montalban, X, Geurts, JJG, Polman, CH, Barkhof, F, Filippi, M, and Altmann, DR
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MULTIPLE sclerosis ,MAGNETIC resonance imaging ,CENTRAL nervous system ,LONG-term care of people with disabilities ,SPINAL cord - Abstract
The article discusses a study which was aimed to investigate the relationship of spinal cord and brain atrophy, and brain lesion load, with long-term physical disability in a large group of people with multiple scelrosis (MS). The study concluded that long-term physical disability was independently linked with atrophy of the spinal cord and brain T2 lesion load, and less consistently, with brain grey matter atrophy.
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- 2014
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20. Increase in the prevalence of multiple sclerosis over a 17-year period in Osona, Catalonia, Spain.
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Otero-Romero, S, Roura, P, Solà, J, Altimiras, J, Sastre-Garriga, J, Nos, C, Vaqué, J, Montalban, X, and Bufill, E
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MULTIPLE sclerosis ,DISEASE prevalence ,CROSS-sectional method - Abstract
The prevalence of multiple sclerosis in the south of Europe seems to be higher than previously considered. This study aimed to probe a possible increase in the prevalence of multiple sclerosis (MS) in Osona over the past 17 years. This was a cross-sectional study including MS-confirmed cases from several sources of information. Crude and adjusted prevalence rates were obtained. One hundred and twenty patients fulfilled the study criteria. The crude prevalence of MS was 79.9 (95% CI: 66.3–95.6) per 100,000 inhabitants and 91.2 (95% CI: 75.5–109.2) per 100,000 among Spanish born individuals. The prevalence of multiple sclerosis cases in Osona has increased over the past 17 years to being one of the highest reported in Spain. [ABSTRACT FROM PUBLISHER]
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- 2013
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21. A functional magnetic resonance proof of concept pilot trial of cognitive rehabilitation in multiple sclerosis.
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Sastre-Garriga, J., Alonso, J., Renom, M., Arévalo, M. J., González, I., Galán, I., Montalban, X., and Rovira, A.
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MULTIPLE sclerosis , *MAGNETIC resonance imaging of the brain , *COGNITION disorders , *NEUROPSYCHOLOGY , *REHABILITATION , *PILOT projects , *GAUSSIAN distribution - Abstract
Background: Cognitive impairment is frequent in multiple sclerosis (MS) and lacks effective treatment. Cognitive rehabilitation is widely applied in neurorehabilitation settings. Functional magnetic resonance imaging (fMRI) may help in investigating changes in brain activity and provide a tool to assess the efficacy of rehabilitation.Aim: To investigate the effect on brain activity as measured by fMRI of a cognitive rehabilitation programme in patients with MS and cognitive impairment.Method: Fifteen patients with MS and cognitive impairment and five healthy subjects were recruited. Neuropsychological assessments were performed in patients with MS at study entry and after rehabilitation to assess cognitive changes. fMRI scans were performed at week —5 (baseline), week 0 (immediately before rehabilitation) and week 5 (immediately after rehabilitation). The fMRI paradigm was the Paced Auditory Serial Addition Test (PASAT). The cognitive rehabilitation programme was composed of 15 computer-aided drill and practice sessions and five non-computer-aided cognitive stimulation group sessions (over 5 weeks). Strict guidelines ensured comparability of all rehabilitation interventions.Results: Patients had increased brain fMRI activity after rehabilitation in several cerebellar areas when compared with healthy subjects. After rehabilitation, patients had significantly improved their performance on the backward version of the Digit Span Test (p = 0.007) and on a composite score of neuropsychological outcomes (p = 0.009).Conclusion: The results of the present study indicate that this cognitive rehabilitation programme increases brain activity in the cerebellum of cognitively impaired patients with MS. The role of fMRI in the assessment of neurorehabilitation schemes warrants further investigation. [ABSTRACT FROM PUBLISHER]
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- 2011
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22. Characterizing 1-year development of cervical cord atrophy across different MS phenotypes
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Paola Valsasina, Claudio Gobbi, Chiara Zecca, Alex Rovira, Jaume Sastre-Garriga, Hugh Kearney, Marios Yiannakas, Lucy Matthews, Jacqueline Palace, Antonio Gallo, Alvino Bisecco, Achim Gass, Philipp Eisele, Massimo Filippi, Maria A Rocca, Frederik Barkhof, Olga Ciccarelli, Nicola De Stefano, Christian Enzinger, Claudio Gasperini, Ludwig Kappos, Hugo Vrenken, Tarek Yousry, Anatomy and neurosciences, Radiology and nuclear medicine, Amsterdam Neuroscience - Brain Imaging, Amsterdam Neuroscience - Neuroinfection & -inflammation, CCA - Cancer Treatment and quality of life, CCA - Imaging and biomarkers, Valsasina, P., Gobbi, C., Zecca, C., Rovira, A., Sastre-Garriga, J., Kearney, H., Yiannakas, M., Matthews, L., Palace, J., Gallo, A., Bisecco, A., Gass, A., Eisele, P., Filippi, M., Rocca, M. A., Barkhof, F., Ciccarelli, O., De Stefano, N., Enzinger, C., Gasperini, C., Kappos, L., Vrenken, H., and Yousry, T.
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Pathology ,medicine.medical_specialty ,Cord ,Multiple Sclerosis ,Cervical cord ,computer.software_genre ,Multiple sclerosis ,Atrophy ,Multiple Sclerosis, Relapsing-Remitting ,Voxel ,medicine ,Distribution (pharmacology) ,Humans ,Multiple sclerosi ,business.industry ,spinal cord ,Brain ,Cervical Cord ,Spinal cord ,medicine.disease ,Phenotype ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,disability ,Neurology ,Spinal Cord ,voxel-wise analysis ,Disease Progression ,Neurology (clinical) ,business ,computer ,MRI ,Demyelinating Diseases - Abstract
Background: Spatio-temporal evolution of cord atrophy in multiple sclerosis (MS) has not been investigated yet. Objective: To evaluate voxel-wise distribution and 1-year changes of cervical cord atrophy in a multicentre MS cohort. Methods: Baseline and 1-year 3D T1-weighted cervical cord scans and clinical evaluations of 54 healthy controls (HC) and 113 MS patients (14 clinically isolated syndromes (CIS), 77 relapsing-remitting (RR), 22 progressive (P)) were used to investigate voxel-wise cord volume loss in patients versus HC, 1-year volume changes and clinical correlations (SPM12). Results: MS patients exhibited baseline cord atrophy versus HC at anterior and posterior/lateral C1/C2 and C4–C6 ( p < 0.05, corrected). While CIS patients showed baseline volume increase at C4 versus HC ( p < 0.001, uncorrected), RRMS exhibited posterior/lateral C1/C2 atrophy versus CIS, and PMS showed widespread cord atrophy versus RRMS ( p < 0.05, corrected). At 1 year, 13 patients had clinically worsened. Cord atrophy progressed in MS, driven by RRMS, at posterior/lateral C2 and C3–C6 ( p < 0.05, corrected). CIS patients showed no volume changes, while PMS showed circumscribed atrophy progression. Baseline cord atrophy at posterior/lateral C1/C2 and C3–C6 correlated with concomitant and 1-year disability ( r = −0.40/–0.62, p < 0.05, corrected). Conclusions: Voxel-wise analysis characterized spinal cord neurodegeneration over 1 year across MS phenotypes and helped to explain baseline and 1-year disability.
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- 2022
23. Oral contraceptives do not modify the risk of a second attack and disability accrual in a prospective cohort of women with a clinically isolated syndrome and early multiple sclerosis
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Otero-Romero, Susana, Carbonell-Mirabent, Pere, Midaglia, Luciana, Zuluaga, María, Galan, Ingrid, Cobo-Calvo, Álvaro, Río, Jordi, Arrambide, Georgina, Vidal-Jordana, Angela, Castillo, Joaquín, Rodríguez Acevedo, Breogán, Comabella, Manuel, Rodríguez, Marta, Tur, Carmen, Auger, Cristina, Rovira, Alex, Sastre-Garriga, Jaume, Montalban, Xavier, Tintoré, Mar, Universitat Autònoma de Barcelona, Institut Català de la Salut, [Otero-Romero S] Centre d’Esclerosi Múltiple de Catalunya (CEMCAT), Barcelona, Spain. Servei de Neurologia-Neuroimmunologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. Servei de Medicina Preventiva i Epidemiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Carbonell-Mirabent P, Midaglia L, Zuluaga M, Galán I, Cobo-Calvo A, Rio J, Arrambide G, Vidal-Jordana A, Castillo J, Rodríguez-Acevedo B, Comabella M, Rodríguez M, Tur C, Sastre-Garriga J, Montalban X, Tintoré M] Centre d’Esclerosi Múltiple de Catalunya (CEMCAT), Barcelona, Spain. Servei de Neurologia-Neuroimmunologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Auger C, Rovira A] Secció de Neuroradiologia, Servei de Radiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain, and Vall d'Hebron Barcelona Hospital Campus
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Male ,medicine.medical_specialty ,Multiple Sclerosis ,acciones y usos químicos::acciones farmacológicas::efectos fisiológicos de los fármacos::sustancias para el control de la reproducción::anticonceptivos::anticonceptivos femeninos::anticonceptivos orales [COMPUESTOS QUÍMICOS Y DROGAS] ,Esclerosi múltiple ,Multiple sclerosis ,Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Reproductive Control Agents::Contraceptive Agents::Contraceptive Agents, Female::Contraceptives, Oral [CHEMICALS AND DRUGS] ,Nervous System Diseases::Demyelinating Diseases [DISEASES] ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,enfermedades del sistema nervioso::enfermedades desmielinizantes [ENFERMEDADES] ,Second relapse ,Disability ,Expanded Disability Status Scale ,Clinically isolated syndrome ,Oral contraceptives ,Mielina - Malalties ,Contraceptius orals ,Proportional hazards model ,business.industry ,Hazard ratio ,Confounding ,Nervous System Diseases::Autoimmune Diseases of the Nervous System::Demyelinating Autoimmune Diseases, CNS::Multiple Sclerosis [DISEASES] ,Confidence interval ,Cross-Sectional Studies ,Neurology ,enfermedades del sistema nervioso::enfermedades autoinmunitarias del sistema nervioso::enfermedades autoinmunes desmielinizantes del SNC::esclerosis múltiple [ENFERMEDADES] ,Disease Progression ,Female ,Neurology (clinical) ,Cohort study ,business ,Contraceptives, Oral ,Demyelinating Diseases - Abstract
Cohort study; Oral contraceptives; Second relapse Estudio de cohorte; Anticonceptivos orales; Segunda recaída Estudi de cohorts; Anticonceptius orals; Segona recaiguda Objective: To evaluate whether oral contraceptive (OC) use is associated with the risk of a second attack and disability accrual in women with a clinically isolated syndrome (CIS) and early multiple sclerosis (MS). Methods: Reproductive information from women included in the Barcelona CIS prospective cohort was collected through a self-reported cross-sectional survey. We examined the relationship of OC exposure with the risk of a second attack and confirmed Expanded Disability Status Scale of 3.0 using multivariate Cox regression models, adjusted by age, topography of CIS, oligoclonal bands, baseline brain T2 lesions, body size at menarche, smoking, and disease-modifying treatment (DMT). OC and DMT exposures were considered as time-varying variables. Findings were confirmed with sensitivity analyses using propensity score models. Results: A total of 495 women were included, 389 (78.6%) referred to ever use OC and 341 (68.9%) started OC before the CIS. Exposure to OC was not associated with a second attack (adjusted hazard ratio (aHR) = 0.73, 95% confidence interval (CI) = 0.33–1.61) or disability accrual (aHR = 0.81, 95% CI = 0.17–3.76). Sensitivity analyses confirmed these results. Conclusion: OC use does not modify the risk of second attack or disability accrual in patients with CIS and early MS, once considered as a time-dependent exposure and adjusted by other potential confounders. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This project was supported by FIS PI15/0070 from Ministry of Economy and Competitiveness of Spain.
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- 2021
24. Pharmacological management of spasticity in multiple sclerosis: Systematic review and consensus paper
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Alan J. Thompson, Xavier Montalban, Patrick Vermersch, Giancarlo Comi, Jaume Sastre-Garriga, Susana Otero-Romero, Per Soelberg Sørensen, Hans-Peter Hartung, Ralf Gold, Otero Romero, S, Sastre Garriga, J, Comi, Giancarlo, Hartung, Hp, Soelberg Sørensen, P, Thompson, Aj, Vermersch, P, Gold, R, and Montalban, X.
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Baclofen ,medicine.medical_specialty ,Multiple Sclerosis ,Cyclohexanecarboxylic Acids ,Gabapentin ,Nabiximols ,Clonidine ,Dantrolene ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Physical medicine and rehabilitation ,medicine ,Cannabidiol ,Humans ,Dronabinol ,030212 general & internal medicine ,Spasticity ,Amines ,Injections, Spinal ,gamma-Aminobutyric Acid ,Analgesics ,Diazepam ,Phenol ,Muscle Relaxants, Central ,business.industry ,Multiple sclerosis ,medicine.disease ,Drug Combinations ,Neurology ,chemistry ,Muscle Spasticity ,Tizanidine ,Observational study ,Neurology (clinical) ,medicine.symptom ,business ,Excitatory Amino Acid Antagonists ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Background and objectives: Treatment of spasticity poses a major challenge given the complex clinical presentation and variable efficacy and safety profiles of available drugs. We present a systematic review of the pharmacological treatment of spasticity in multiple sclerosis (MS) patients. Methods: Controlled trials and observational studies were identified. Scientific evidence was evaluated according to pre-specified levels of certainty. Results: The evidence supports the use of baclofen, tizanidine and gabapentin as first-line options. Diazepam or dantrolene could be considered if no clinical improvement is seen with the previous drugs. Nabiximols has a positive effect when used as add-on therapy in patients with poor response and/or tolerance to first-line oral treatments. Despite limited evidence, intrathecal baclofen and intrathecal phenol show a positive effect in severe spasticity and suboptimal response to oral drugs. Conclusion: The available studies on spasticity treatment offer some insight to guide clinical practice but are of variable methodological quality. Large, well-designed trials are needed to confirm the effectiveness of antispasticity agents and to produce evidence-based treatment algorithms.
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- 2016
25. Primary progressive multiple sclerosis diagnostic criteria: a reappraisal
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Carmen Tur, Alan J. Thompson, Bruno Brochet, Frederik Barkhof, Xavier Montalban, David Miller, Ana Rovira, Chris H. Polman, M.M. Vellinga, Massimo Filippi, Jaume Sastre-Garriga, Z Khaleeli, Marco Rovaris, N. Téllez, Neurology, Radiology and nuclear medicine, NCA - Multiple Sclerosis and Other Neuroinflammatory Diseases, Montalban, X, Sastre Garriga, J, Filippi, Massimo, Khaleeli, Z, Tellez, N, Vellinga, Mm, Tur, C, Brochet, B, Barkhof, F, Rovaris, M, Miller, Dh, Polman, Ch, Rovira, A, and Thompson, Aj
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Adult ,Male ,medicine.medical_specialty ,Pediatrics ,Time Factors ,Primary Progressive Multiple Sclerosis ,Severity of Illness Index ,Primary progressive ,Young Adult ,Multiple Sclerosis, Relapsing-Remitting ,Predictive Value of Tests ,Severity of illness ,medicine ,Humans ,Visual Pathways ,Aged ,Retrospective Studies ,business.industry ,Multiple sclerosis ,Oligoclonal Bands ,Brain ,Retrospective cohort study ,McDonald criteria ,Middle Aged ,Multiple Sclerosis, Chronic Progressive ,medicine.disease ,Magnetic Resonance Imaging ,Surgery ,Europe ,Cross-Sectional Studies ,Spinal Cord ,Neurology ,Predictive value of tests ,Cohort ,Evoked Potentials, Visual ,Female ,Neurology (clinical) ,business ,Algorithms - Abstract
The diagnostic criteria used in primary progressive (PP) and relapsing—remitting (RR) multiple sclerosis (MS) show substantial differences. This introduces complexity in the diagnosis of MS which could be resolved if these criteria could be unified in terms of the requirements for dissemination in space (DIS). The aim of this study was to assess whether a single algorithm may be used to demonstrate DIS in all forms of MS. Five sets of RRMS criteria for DIS were applied to a cohort of 145 patients with established PPMS (mean disease duration: 11 years — PPMS-1): C1: Barkhof—Tintoré (as in 2005 McDonald’s criteria); C2: Swanton et al. (as in JNNP 2006); C3: presence of oligoclonal bands plus two lesions (as in McDonald’s criteria); C4 and C5: a two-step approach was also followed (patients not fulfilling C1 or C2 were then assessed for C3). Two sets of PPMS criteria for DIS were applied: C6: Thompson et al. (as in 2001 McDonald’s criteria); C7: 2005 McDonald criteria. A second sample of 55 patients with less than 5 years of disease duration (PPMS-2) was also analysed using an identical approach. For PPMS-1/PPMS-2, fulfilment was: C1:73.8%/66.7%; C2:72.1%/59.3%; C3:89%/79.2%; C4:96%/92.3%; C5:96%/85.7%; C6:85.8%/78.7%; C7:91%/80.4%. Levels of fulfilment suggest that the use of a single set of criteria for DIS in RRMS and PPMS might be feasible, and reinforce the added value of cerebrospinal fluid (CSF) findings to increase fulfilment in PPMS. Unification of the DIS criteria for both RRMS and PPMS could be considered in further revisions of the MS diagnostic criteria.
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- 2009
26. Large-scale, multicentre, quantitative MRI study of brain and cord damage in primary progressive multiple sclerosis
- Author
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Jaume Sastre-Garriga, T Korteweg, Frederik Barkhof, Maria Pia Sormani, Nicola De Stefano, Chris H. Polman, Z Khaleeli, Alan J. Thompson, Marco Rovaris, Alex Rovira, Massimo Filippi, E. Judica, Xavier Montalban, B. Benedetti, David Miller, Rovaris, M, Judica, E, Sastre Garriga, J, Rovira, A, Sormani, Mp, Benedetti, B, Korteweg, T, De Stefano, N, Khaleeli, Z, Montalban, X, Barkhof, F, Miller, Dh, Polman, C, Thompson, Aj, Filippi, Massimo, Radiology and nuclear medicine, Neurology, and Neuroscience Campus Amsterdam 2008
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,primary progressive multiple sclerosis ,grey matter ,Grey matter ,Severity of Illness Index ,Central nervous system disease ,White matter ,Disability Evaluation ,medicine ,Humans ,Magnetization transfer ,Aged ,Retrospective Studies ,Expanded Disability Status Scale ,business.industry ,Multiple sclerosis ,Brain ,Middle Aged ,Multiple Sclerosis, Chronic Progressive ,medicine.disease ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,Spinal Cord ,Neurology ,atrophy, MRI, primary progressive multiple sclerosis, grey matter ,Brain size ,Female ,Neurology (clinical) ,Atrophy ,business ,Nuclear medicine ,MRI ,Diffusion MRI - Abstract
Although the mechanisms underlying the accumulation of disability in primary progressive (PP) multiple sclerosis (MS) are still unclear, a major role seems to be played by `occult' tissue damage. We investigated whether conventional and magnetization transfer (MT) MRI may provide complementary information for the assessment of PPMS severity. Conventional and MT MRI scans from 226 PPMS patients and 84 healthy controls were collected for centralized analysis. The expanded disability status scale (EDSS) score was rated at the time of MRI acquisition. T2 lesion volume, normalized brain volume (NBV) and cervical cord cross-sectional area (CSA) were measured. Magnetization transfer ratio (MTR) histograms from whole brain tissue, normal-appearing white matter and grey matter (NAGM) were also obtained. Mean NBV, CSA and MTR histogram-derived metrics showed significant inter-centre heterogeneity. After correcting for the acquisition centre, pooled average MTR and histogram peak height values were different between PPMS patients and controls for all tissue classes ( P-values between 0.03 and 0.0001). More severe brain and cord atrophy and MT MRI-detectable NAGM damage were found in patients who required walking aids than in those who did not ( P-values: 0.03, 0.001 and 0.016). A composite score of NBV, CSA, whole brain and NAGM MTR histogram peak height z-scores was correlated with patients' EDSS ( r = 0.37, P 0.001). Magnetization transfer MRI might provide information complementary to that given by conventional MRI when assessing PPMS severity. Sequence-related variability of measurements makes the standardization of MT MRI acquisition essential for the design of multicentre studies. Multiple Sclerosis 2008; 14: 455—464. http://msj.sagepub.com
- Published
- 2008
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