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3. Efficacy of satralizumab in subgroups of patients in SAkuraSky: A phase III double-blind, placebo-controlled, add-on study in patients with neuromyelitis optica spectrum disorder (NMOSD)

Author

Yamamura, T., primary, Kleiter, I., additional, Fujihara, K., additional, Palace, J., additional, Greenberg, J., additional, Zakrzewska-Pniewska, B., additional, Patti, F., additional, Tsai, C.P., additional, Saiz, A., additional, Haramura, M., additional, Terada, Y., additional, Kawata, Y., additional, and De Seze, J., additional

Published
2019
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5. Health-related quality of life in multiple sclerosis: Effects of natalizumab

Author

Rudick, R. A., Miller, D., Hass, S., Hutchinson, M, Calabresi, P. A., Confavreux, C., Galetta, S. L., Giovannoni, G., Havrdova, E., Kappos, L., Lublin, F. D., Miller, D. H., O'Connor, P. W., Phillips, J. T., Polman, C. H., Radue, Ew, Stuart, W. H., Wajgt, A., Weinstock Guttman, B., Wynn, D. R., Lynn, F., Panzara, M. A., Affirm, Macdonell, SENTINEL Investigators including: R., Hughes, A., Taylor, I., Lee, Y. C., Ma, H., King, J., Kilpatrick, T., Butzkueven, H., Marriott, M., Pollard, J., Spring, P., Spies, J., Barnett, M., Dehaene, I., Vanopdenbosch, L., D’Hooghe, M., Van Zandijcke, M., Derijck, O., Seeldrayers, P., Jacquy, J., Piette, T., De Cock, C., Medaer, R., Soors, P., Vanroose, E., Vanderhoven, L., Nagels, G., Dubois, B., Deville, M. C., D’Haene, R., Jacques, F., Hallé, D., Gagnon, S., Likavcan, E., Murray, T. J., Bhan, V., Mackelvey, R., Maxner, C. E., Christie, S., Giaccone, R., Guzman, D. A., Melanson, M., Esfahani, F., Gomori, A. J., Nagaria, M. H., Grand’Maison, F., Berger, L., Nasreddine, Z., Duplessis, M., Brunet, D., Jackson, A., Pari, G., O’Connor, P., Gray, T., Hohol, M., Marchetti, P., Lee, L., Murray, B., Sahlas, J., Perry, J., Devonshire, V., Hooge, J., Hashimoto, S., Oger, J., Smyth, P., Rice, G., Kremenchutzky, M., Stourac, P., Kadanka, Z., Benesova, Y., Niedermayerova, I., Meluzinova, E., Marusic, P., M, Bojar, Zarubova, K., Houzvicková, E., Piková, J., Talab, R., Faculty, Hospital Olomouc, Olomouc, B. Muchova, Urbánek, K, Kettnerova, Z., Mares, J., Otruba, P., Zapletalová, O., Hradilek, P., Ddolezil, D. Dolezil, Woznicova, I., Höfer, R., Ambler J. Fiedler, Z. Ambler J. Fiedler, Sucha, J., Matousek, V., Rektor, I., Dufek, M., Mikulik, R., Mastik, J., Tyrlikova, I., General, Teaching Hospital, Prague, E. Havrdová, Horakova, D., Kalistová, H., Týblová, M., Ehler, E., Novotná, A., Geier, P., Soelberg Sorensen, P., Ravnborg, M., Petersen, B., Blinkenberg, M., Färkkilä, M., Harno, H., Kallela, M., Häppölä, O., Elovaara, I., Kuusisto, H., Ukkonen, M., Peltola, J., Palmio, J., Pelletier, J., Feuillet, L., Suchet, L., Dalecky, A., Tammam, D., Edan, G., Le Page, E., Mérienne, M., Yaouanq, J., Clanet, M., Mekies, C., Azais Vuillemin, C., Senard, A., Lau, G., Steinmetz, G., Warter V. Wolff, J. Warter V. Wolff, Fleury, M., Tranchant, C., Stark, E., Buckpesch Heberer, U., Henn, K. H., Skoberne, T., Schimrigk, S., Hellwig, K., Brune, N., Weiller, C., Gbadamosi, J., Röther, J., Heesen, C., Buhmann, C., Karageorgiou, C., Korakaki, D., Giannoulis, D. r., Tsiara, S., Thomaides, T., Thomopoulos, I., Papageorgiou, H., Armakola, F., Komoly, S., Rózsa, C., Matolcsi, J., Szabó, G. y., Molnár, B., Lovas, G., Dioszeghy, P., Szulics, P., Magyar, Z., Incze, J., Farkas, J., Clemens, B., Kánya, J., Valicskó, Z. s., Bense, E., Nagy, Z. s., Geréby, G., Perényi, J., Simon, Z. s., Szapper, M., Gedeon, L., Csanyi, A., Rum, G., Lipóth, S., Szegedi, A., Jávor, L., Nagy, I., Adám, I., Szirmai, I., Simó, M., Ertsey, C., I, Amrein, Kamondi, A., Harcos, P., Dobos, E., Szabó, B., Balas, V., Guseo, A., Fodor, E., Jófejü, E., Eizler, K., Csiba, L., Csépány, T., Pallagi, E., Bereczki, D., Jakab, G., Juhász, M., Bszabó, B. Szabó I. Mayer, Katona, G., Hutchinson, M., O’Dwyer, J., O’Rourke, K., Sanders, E. A. C. M., Rijk van Andel, J. F., Bomhof, M. A. M., van Erven, P., Hintzen I. Hoppenbrouwers, R. Q. Hintzen I. Hoppenbrouwers, Neuteboom, R. F., Zemel, D., van Doorn, P. A., Jacobs, B. C., Munster, E. T. h. L. Van, ter Bruggen, J. P., Bernsen, R., Jongen, P. J. H., de Smet, E. A. A., Tacken, H. F. H., Polman, C., Zwemmer, J., Nielsen, J., Kalkers, N., Kragt, J., Jasperse, B., Willoughby, E., Anderson, N. E., Barber, A., Anderson, T., Parkin, P. J., Fink, J., Avery, S., Mason, D., Kwiecinski, H., Zakrzewska Pniewska, B., Kaminska, A., Podlecka, A., Nojszewska, M., Czlonkowska, A., Zaborski, J., Wicha, W., Kruszewska Ozimowska, J., Darda Ledzion, L., Selmaj, K., Mochecka Thoelke, A., Pentela Nowicka, J., Walczak, A., Stasiolek, M., Stelmasiak, Z., Bartosik Psujek, H., Mitosek Szewczyk, K., Belniak, E., Chyrchel, U., Maciejowski, M., Strzyzewska Lubos, L., Lubos, L., Matusik, E., Maciejek, Z., Niezgodzinska Maciejek, A., Sobczynska, D., Slotala, T., Wawrzyniak, S., Kochanowicz K. Kuczynski, J. Kochanowicz K. Kuczynski, Zimnoch, R., Pryszmont, M., Drozdowski, W., Baniukiewicz, E., Kulakowska, A., Borowik, H., Lewonowska, M., Szczudlik, A., Róg, T., Gryz Kurek, E., Pankiewicz, J., Furgal, J., Kimkowicz, A., Fryze, W., Wierbicki, T., Michalak, L., Kowalewska, J., Swiatkiewicz, J., Hillert, J., Åkesson, E, Fredrikson, S., Diener, P, Olsson, T., Wallström, E., Fpiehl, F. Piehl L. Hopia, Brundin, L., Marta, M., Andersson, M., Lycke, J., Runmarker, B., Malmeström, C., Vaghfeldt, P., Skoog, B., Schluep, M., Bogousslavskyr, J., Du Pasquier, R., Achtnichts, L., Kuhle, J., Buitrago Telez, C., Schläger, R., Naegelin, Y., Eraksoy, M., Bebek, N., Akman Demir, G., Topcuoglu, B., Kurtuncu, M., Istanbul, University, Istanbul:, A. Siva, Saip, S., Altintas, A., Kiyat, A., Sharief, M., Kasti, M., Lim, E. T., Rashid, W., Silber, E., Saldanha, G., Hawkins, C., Mamutse, G., Woolmore, J., Hawkes, C., Findley, L., Dasilva, R., Gunasekara, H., Palace, J., Cader, Z., Littleton, E., Burke, G., Sharrack O. Suliman, B. Sharrack O. Suliman, Klaffke, S., Swash, M., Dhillon, H., Bates, D., Westwood, M., Nichol, P., Barnes, D., Wren, D., Stoy, N., Robertson, N., Pickersgill, T., Pearson, O., Lawthom, C., Young, C., Mills, R., Lecky, B., Ford, C., Katzman, J., Rosenberg, G., Cooper, J., Wrubel, B., Richardson, B., Lynch, S., Ridings, L., Mcvey, A., Nowack, W., Rae Grant, A., Mackin, G. A., Castaldo, J. E., Spikol, L. J., Carter, J., Wingerchuk, D., Caselli, R., Dodick, D., Scarberry, S., Bailly, R., Garnaas, K., Haake, B., Rossman, H., Belkin, M., Boudouris, W. D., Pierce, R. P., Mass, M., Yadav, V., Bourdette, D., Whitham, R. H., Heitzman, D., Martin, A., Greenfield, C. F., Agius, M., Richman, D. P., Vijayan, N., Wheelock, V. L., Reder, A., Arnason, B., Noronha, A., Balabanov, R., Ray, A., Sheremata, W., Delgado, S., Shebert, B., Maldonado, J., Bowen, J., Garden, G. A., Distad, B. J., Carrithers, M., Rizzo, M., Vollmer, T., Reiningerova, J., Guarnaccia, J., Lo, A., Richardson, G. B., Fazekas, F., Enzinger, C., Seifert, T., Storch, M., Strasser Fuchs, S., Berger, T., Dilitz, E., Egg, R., Deisenhammer, F., Decoo, : D, Lampaert, J., Bartholome, E., Bier, J., Stenager, : E., Rasmussen, M., Binzer, M., Shorsh, K., Christensen, M., Soelberg Sørensen, P., Hansen, H. J., Bech, E., Petersen, T., Kirkegaard, M., Eralinna, : J., Ruutiainen, J., Soilu Hänninen, M., Säkö, E., Laaksonen, M., Reunanen, M., Remes, A., Keskinarkaus, I., Moreau, : T., Noblet, M., Rouaud, O., Couvreur, G., Lepage, E., Drapier, S., De Burghgraeve, V., Merienne, M., Cahagne, V., Gout, O., Deschamps, R., Le Canuet, P., Moulignier, A., Vermersch, P., De Seze, J., Stojkovic, T., Griffié, G., Engles, Ferriby, D., Debouverie, M., Pittion Vouyouvitch, S., Lacour, J. C., Lubetzki, C., Youssov, K., Mrejen, S., Charles, P., Yaici, S., Clavelou, P., Aufauvre, D., Renouil Guy, N., Cesaro, P., Degos, F., Benisty, S., Rumbach, L., Decavel, P., Blanc, S., Aubertin, P., Riche, G., Brochet, B., Ouallet, J. C., Anne, O., Menck, : S., Grupe, A., Gutmann, E., Lensch, E., Fucik, E., Heitmann, S., Hartung, H. P., Schröter, M., Kurz, F. M. W., Heidenreich, F., Trebst, C., Pul, R., Hohlfeld, R., Krumbholz, M., Pellkofer, H., Haas, J., Segert, A., Meyer, R., Anagnostou, P., Kabus, C., Poehlau, D., Schneider, K., Hoffmann, V., Zettl, U., Steinhagen, V., Adler, S., Steinbrecher E. Rothenfusser Körber, A. Steinbrecher E. Rothenfusser Körber, Zellner, R., Baum, K., Günther, A., Bläsing, H., Stoll, G., Gold, R., Bayas, A., Kleinschnitz, C., Limmroth, V., Katsarava, Z., Kastrup, O., Haller, P., Stoeve, S., Höbel, D., Oschmann, P., Voigt, K., Burger, C. V., Abramsky, : O., Karusiss, D., Achiron, A., Kishner, I., Stern, Y., Sarove Pinhas, I., Dolev, M., Magalashvili, D., Pozzili, : C., Lenzi, D., Scontrini, A., Millefiorini, E., Buttinelli, C., Gallo, P., Ranzato, F., Tiberio, M., Perini, P., Laroni, Alice, Marrosu, M., Cocco P. Marchi, E. Cocco P. Marchi, Spinicci, G., Massole, S., Mascia, M., Floris, G., Trojano, M., Bellacosa, A., Paolicelli, D., Bosco Zimatore, G., Simone, I. L., Giorelli, M., Di Monte, E., Mancardi, GIOVANNI LUIGI, Pizzorno, M., Murialdo, A., Narciso, E., Capello, A., Comi, G., Martinelli, V., Rodegher, M., Esposito, F., Colombo, B., Rossi, P., Polman, : C. H., Jasperse, M. M. S., Zwemmer, J. N. P., Kragt, J. J., De Smet, E., Tacken, H., Frequin, S. T. F. M., Siegers, H. P., Mauser, H. W., Fernandez Fernandez, : O., León, A., Romero, F., Alonso, A., Tamayo, J., Montalban, X., Nos, C., Pelayo, R., Tellez, N., Rio, J., Tintore, M., Arbizu, T., Romero, L., Moral, E., Martinez, S., Kappos, : L., Wilmes, S., Karabudak, : R., Kurne, A., Erdem, S., Siva, A., Atamer, A., Bilgili, F., Topcular, B., Giovannoni, : G., Lava, : N., Murnane, M., Dentinger, M., Zimmerman, E., Reiss, M., Gupta, V., Scott, T., Brillman, J., Kunschner, L., Wright, D., Perel, A., Babu, A., Rivera, V., Killian, J., Hutton, G., Lai, E., Picone, M., Cadivid, D., Kamin, S., Shanawani, M., Gauthier, S., Morgan, A., Buckle, G., Margolin, D., Kwen, P. L., Garg, N., Munschauer, F., Khatri, B., Rassouli, M., Saxena, V., Ahmed, A., Turner, A., Fox, E., Couch, C., Tyler, R., Horvit, A., Fodor, P., Humphries, S., Wynn, D., Nagar, C., O’Brien, D., Allen, N., Turel, A., Friedenberg, S., Carlson, J., Hosey, J., Crayton, H., Richert, J., Tornatore, C., Sirdofsky, M., Greenstein, J., Shpigel, Y., Mandel, S., Adbelhak, T., Schmerler, M., Zadikoff, C., Rorick, M., Reed, R., Elias, S., Feit, H., Angus, E., Sripathi, N., Herbert, J., Kiprovski, K., Qu, X., Del Bene, M., Mattson, D., Hingtgen, C., Fleck, J., Horak, H., Javerbaum, J., Elmore, R., Garcia, E., Tasch, E., Gruener, G., Celesia, G., Chawla, J., Miller, A., Drexler, E., Keilson, M., Wolintz, R., Drasby, E., Muscat, P., Belden, J., Sullivan, R., Cohen, J., Stone, L., Marrie, R. A., Fox, R., Hughes, B., Babikian, P., Jacoby, M., Doro, J., Puricelli, M., Boudoris, W., Pierce, R., Eggenberger, E., Birbeck, G., Martin, J., Kaufman, D., Stuart, W., English, J. B., Stuart, D. S., Gilbert, R. W., Kaufman, M., Putman, S., Diedrich, A., Follmer, R., Pelletier, D., Waubant, E., Cree, B., Genain, C., Goodin, D., Patwa, H., Rizo, M., Kitaj, M., Blevins, J., Smith, T., Mcgee, F., Honeycutt, W., Brown, M., Isa, A., Nieves Quinones, D., Krupp, L., Smiroldo, J., Zarif, M., Perkins, C., Sumner, A., Fisher, A., Gutierrez, A., Jacoby, R., Svoboda, S., Dorn, D., Groeschel, A., Steingo, B., Kishner, R., Cohen, B., Melen, O., Simuni, T., Zee, P., Cohan, S., Yerby, M., Hendin, B., Levine, T., Tamm, H., Travis, L. H., Freedman, S. M., Tim, R., Ferrell, W., Stefoski, D., Stevens, S., Katsamakis, G., Topel, J., Ko, M., Gelber, D., Fortin, C., Green, B., Logan, W., Carpenter, D., Temple, L., Sadiq, S., Sylvester, A., Sim, G., Mihai, C., Vertino, M., Jubelt, B., Mejico, L., Riskind, P., Cabo, A., Paskavitz, J., Moonis, M., Bashir J. Brockington, K. Bashir J. Brockington, Nicholas, A., Slaughter, R., Archer S. Harik, R. Archer S. Harik, Haddad, N., Pippenger, M. A., Van den Noort, S., Thai, G., Olek, M., Demetriou, M., Shin, R., Calabresi, P., Rus, H., Bever, C., Johnson, K., Sherbert, R., Herndon, R., Uschmann, H., Chandler, A., Markowitz, C., Jacobs, D., Balcer, L., Mitchell, G., Chakravorty, S., Heyman, R., Stauber, Z., Goodman, A., Segal, B., Schwid, S., Samkoff, L., Levin, M., Jacewicz, M., Menkes, D., Pulsinelli, W., Frohman, E., Racke, M., Hawker, K., Ulrich, R., Panitch, H., Hamill, R., Tandon, R., Dulaney, E., Simnad, V., Miller, J., Wooten, G. F., Harrison, M., Doherty, M., Wundes, A., Distad, J., Kachuck, N., Berkovich, R., Burnett, M., Sahai, S., Bandari, D., Weiner, L., Storey, J. R., Beesley, B., Hart, D., Moses, H., Sriram, S., Fang, J., O’Duffy, A., Kita, M., Taylor, L., Elliott, M., Roberts, J., Jeffery, D., Maxwell, S., Lefkowitz, D., Kumar, S., Sinclair, M., Radue, E. W., de Vera, A., Bacelar, O., and Kuster, P.

Subjects
Adult, Male, medicine.medical_specialty, Multiple Sclerosis, Visual analogue scale, Health Status, Population, Pain, Comorbidity, Placebo, Antibodies, law.invention, Natalizumab, Randomized controlled trial, Quality of life, Double-Blind Method, law, Internal medicine, Surveys and Questionnaires, Monoclonal, medicine, Prevalence, Humans, Longitudinal Studies, education, Humanized, education.field_of_study, Expanded Disability Status Scale, Neuroscience (all), business.industry, Antibodies, Monoclonal, Antibodies, Monoclonal, Humanized, Female, Patient Satisfaction, Treatment Outcome, United States, Quality of Life, Multiple sclerosis, medicine.disease, Neurology, Physical therapy, Neurology (clinical), business, medicine.drug
Abstract

Objective To report the relationship between disease activity and health-related quality of life (HRQoL) in relapsing multiple sclerosis, and the impact of natalizumab. Methods HRQoL data were available from 2,113 multiple sclerosis patients in natalizumab clinical studies. In the Natalizumab Safety and Efficacy in Relapsing Remitting Multiple Sclerosis (AFFIRM) study, patients received natalizumab 300mg (n = 627) or placebo (n = 315); in the Safety and Efficacy of Natalizumab in Combination with Interferon Beta-1a in Patients with Relapsing Remitting Multiple Sclerosis (SENTINEL) study, patients received interferon beta-1a (IFN-β-1a) plus natalizumab 300mg (n = 589), or IFN-β-1a plus placebo (n = 582). The Short Form-36 (SF-36) and a subject global assessment visual analog scale were administered at baseline and weeks 24, 52, and 104. Prespecified analyses included changes from baseline to week 104 in SF-36 and visual analog scale scores. Odds ratios for clinically meaningful improvement or worsening on the SF-36 Physical Component Summary (PCS) and Mental Component Summary were calculated. Results Mean baseline SF-36 scores were significantly less than the general US population and correlated with Expanded Disability Status Scale scores, sustained disability progression, relapse number, and increased volume of brain magnetic resonance imaging lesions. Natalizumab significantly improved SF-36 PCS and Mental Component Summary scores at week 104 in AFFIRM. PCS changes were significantly improved by week 24 and at all subsequent time points. Natalizumab-treated patients in both studies were more likely to experience clinically important improvement and less likely to experience clinically important deterioration on the SF-36 PCS. The visual analog scale also showed significantly improved HRQoL with natalizumab. Interpretation HRQoL was impaired in relapsing multiple sclerosis patients, correlated with severity of disease as measured by neurological ratings or magnetic resonance imaging, and improved significantly with natalizumab. Ann Neurol 2007

Published
2007

7. [Uremic neuropathy is more frequent in male patients]

Author

Miroslaw Jedras, Zakrzewska-Pniewska B, Gellert R, Debowska M, Wojtaszek E, and Wardyn K

Subjects
Adult, Male, Sex Factors, Sympathetic Nervous System, Renal Dialysis, Risk Factors, Humans, Peripheral Nervous System Diseases, Female, Middle Aged, Aged, Skin, Uremia
Abstract

The aim of this study was to analyse the relationship between clinical and electrophysiological features of somatic and autonomic neuropathy and gender of 51 patients on chronic hemodialysis. Apart from basic neurological examination, conduction velocities in peripheral nerves were determined, and the function of the autonomic nervous system was assessed with the help of two tests: R-R interval variation (RRIV) and sympathetic skin response (SSR). The incidence and intensity of clinical and electrophysiological signs of sensomotor neuropathy were statistically significantly more prevalent among male patients, whereas the symptoms suggesting autonomic involvement were more frequent in women. Results of parasympathetic electrophysiological tests were similar in both groups, but abnormal SSR results prevailed in male patients.

Published
2002

8. [Uremic neuropathy--I. Is uremic neuropathy related to patient age, duration of nephropathy and dialysis treatment?]

Author

Miroslaw Jedras, Zakrzewska-Pniewska B, Wardyn K, and Switalski M

Subjects
Adult, Male, Age Factors, Neural Conduction, Peripheral Nervous System Diseases, Middle Aged, Autonomic Nervous System Diseases, Sural Nerve, Renal Dialysis, Risk Factors, Disease Progression, Humans, Female, Tibial Nerve, Aged, Uremia
Abstract

The aim of the study was to analyse the relationship between clinical and electrophysiological features of uremic neuropathy and age of patients, duration of kidney disease, renal failure and dialysis treatment. 51 patients with end-stage renal failure without diabetes were examined. Apart from a basic neurological examination, conduction velocities in the sural and tibial nerves were determined, and in order to assess the function of the autonomic nervous system, R-R interval variation and sympathetic skin response were tested. In majority of patients, symptoms and signs of sensorimotor neuropathy were found, and about 50% of them had dysautonomia. A negative correlation between age and R-R interval variation was observed. No relationship was found between neuropathy and the duration of nephropathy, duration of renal nor dialysis treatment.

Published
1999

9. [Uremic neuropathy--II. Is pruritus in dialyzed patients related to neuropathy?]

Author

Miroslaw Jedras, Zakrzewska-Pniewska B, Wardyn K, and Switalski M

Subjects
Adult, Male, Renal Dialysis, Pruritus, Disease Progression, Humans, Peripheral Nervous System Diseases, Female, Middle Aged, Aged, Uremia
Abstract

The problem of pruritus in dialyzed patients remains unsolved. The aim of this study was to analyse the relationship between pruritus and clinical symptoms and signs, and electrophysiological aspects of peripheral neuropathy, both somatic and autonomic. 51 patients with end-stage renal failure undergoing hemodialysis were examined. Diabetics were excluded. Apart from taking history and physical examination, conduction velocities in peripheral nerves were determined, and R-R interval variation (RRIV: assessment of vagal function) and sympathetic skin response (SSR) tests were performed. Pruritus was present in about 63% of patients. In majority of them, symptoms and sings of neuropathy were also found. A significant relationship between pruritus and paresthesia was noted. This indicates a possible relationship between pruritus and secondary neuropathy.

Published
1999

10. Patient-reported quality of life in multiple sclerosis differs between cultures and countries: a cross-sectional Austrian–German–Polish study

Author

Pluta-Fuerst, A, primary, Petrovic, K, additional, Berger, T, additional, Fryze, W, additional, Fuchs, S, additional, Gold, R, additional, Kozubski, W, additional, Ladurner, G, additional, Petereit, H, additional, Potemkowski, A, additional, Rieckmann, P, additional, Sailer, M, additional, Szczudlik, A, additional, Vass, K, additional, Weber, T, additional, Zakrzewska-Pniewska, B, additional, and Fazekas, F, additional

Published
2010
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11. APOEepsilon variation in multiple sclerosis susceptibility and disease severity

Author

Burwick, R. M., primary, Ramsay, P. P., additional, Haines, J. L., additional, Hauser, S. L., additional, Oksenberg, J. R., additional, Pericak-Vance, M. A., additional, Schmidt, S., additional, Compston, A., additional, Sawcer, S., additional, Cittadella, R., additional, Savettieri, G., additional, Quattrone, A., additional, Polman, C. H., additional, Uitdehaag, B.M.J., additional, Zwemmer, J. N.P., additional, Hawkins, C. P., additional, Ollier, W. E.R., additional, Weatherby, S., additional, Enzinger, C., additional, Fazekas, F., additional, Schmidt, H., additional, Schmidt, R., additional, Hillert, J., additional, Masterman, T., additional, Hogh, P., additional, Niino, M., additional, Kikuchi, S., additional, Maciel, P., additional, Santos, M., additional, Rio, M. E., additional, Kwiecinski, H., additional, Zakrzewska-Pniewska, B., additional, Evangelou, N., additional, Palace, J., additional, and Barcellos, L. F., additional

Published
2006
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15. Patient-reported quality of life in multiple sclerosis differs between cultures and countries: a cross-sectional Austrian-German-Polish study.

Author

Pluta-Fuerst, A., Petrovic, K., Berger, T., Fryze, W., Fuchs, S., Gold, R., Kozubski, W., Ladurner, G., Petereit, H., Potemkowski, A., Rieckmann, P., Sailer, M., Szczudlik, A., Vass, K., Weber, T., Zakrzewska-Pniewska, B., and Fazekas, F.

Subjects
MULTIPLE sclerosis, QUALITY of life, CLINICAL trials, REGRESSION analysis, QUESTIONNAIRES, PATIENTS
Abstract

Background: Patient-reported quality of life (QOL) is an outcome measure in clinical trials in multiple sclerosis (MS), but translated QOL instruments may affect the actual comparability of data.Objectives: We aimed to investigate possible differences in QOL in MS between cultures and countries. We employed the Functional Assessment of Multiple Sclerosis (FAMS) Version 4 questionnaire, which is a state-of-the-art QOL instrument.Methods: Some 484 MS patients from Austria (145), Germany (144), and Poland (195) aged 20—60 years, and stratified for sex and disease severity as measured by the Expanded Disability Status Scale (EDSS) score completed the respective FAMS translation and a socio-demographic questionnaire.Results: Analysis of variance and post-hoc Scheffé-test showed that 64% of the FAMS items were answered significantly differently (p < 0.001) between the three countries. A multivariate regression analysis including all the available disease-related and socio-demographic variables revealed the factors age, EDSS score, employment, social contacts, MS course, and country to be significant predictors of both the total FAMS score and the score for items answered differently between the three countries.Conclusions: Differences exist in the QOL of MS patients from Austria, Germany, and Poland which seem to lie beyond the impact of disease severity. They appear to be related to culture or other country-specific factors, as country was an independent predictor of differently answered items of the FAMS and thus also of the whole FAMS. QOL instruments should consider this aspect to faithfully reflect subjective information such as patient-reported benefit of treatment in multinational clinical trials. [ABSTRACT FROM PUBLISHER]

Published
2011
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18. Extensive mixed vascular malformation clinically imitating multiple sclerosis -- case report.

Author

Rafalowska, J., Dziewulska, D., Podlecka, A., and Zakrzewska-Pniewska, B.

Subjects
MULTIPLE sclerosis, ONTOGENY, ANGIOMAS, VASCULAR endothelium, IMMUNOGLOBULINS
Abstract

Vascular malformations usually develop as a result of influence of teratogenic factor(s) acting in the defined embryonic/ fetal period. However, in the case examined by us, various types of vascular malformations formed in different periods of the ontogenic development were found. They were seen in all parts of the central nervous system and clinically mimicked multiple sclerosis. On the background of generalized ischemic lesions of the CNS, certain kinds of vascular malformations were seen: cavernous or fetallike vessels within meninges, superficially located capillary angioma penetrating into the brain and spinal cord white matter, and arterio-venous pathological conglomerates forming meningeal angiomatosis. In pathological Vessels, immunocytochemical assessment of vascular endothelium with antibodies against antigens CD31, CD34, von Willebrand factor and lectin Ulex europaeus was normal but examination of the vascular basal membrane compounds revealed poor immunoreactivity to laminin and fibronectin. There were no disturbances in expression of angiopoietin, platelet-derived growth factor, transforming growth factor β and vascular endothelial growth factor receptors Tie-1/2, PDGFR-α/β, endoglin and Flk-1, respectively. The presence of various types of pathological vessels originating from different ontogenic periods indicates remittent or prolonged influence of teratogenic factor(s) in all periods of fetal vessel development. [ABSTRACT FROM AUTHOR]

Published
2006

26. Trial of Satralizumab in Neuromyelitis Optica Spectrum Disorder.

Author

Yamamura, T., Kleiter, I., Fujihara, K., Palace, J., Greenberg, B., Zakrzewska-Pniewska, B., Patti, F., Tsai, C.-P., Saiz, A., Yamazaki, H., Kawata, Y., Wright, P., De Seze, j., Yamamura, Takashi, Kleiter, Ingo, Fujihara, Kazuo, Palace, Jacqueline, Greenberg, Benjamin, Zakrzewska-Pniewska, Beata, and Patti, Francesco

Subjects
*NEUROMYELITIS optica, *INTERLEUKIN-6 receptors, *IMMUNOADSORPTION, *CENTRAL nervous system diseases, *AUTOANTIBODY analysis, *PATHOLOGY
Abstract

Background: Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disease of the central nervous system and is associated with autoantibodies to anti-aquaporin-4 (AQP4-IgG) in approximately two thirds of patients. Interleukin-6 is involved in the pathogenesis of the disorder. Satralizumab is a humanized monoclonal antibody targeting the interleukin-6 receptor. The efficacy of satralizumab added to immunosuppressant treatment in patients with NMOSD is unclear.Methods: In a phase 3, randomized, double-blind, placebo-controlled trial, we randomly assigned, in a 1:1 ratio, patients with NMOSD who were seropositive or seronegative for AQP4-IgG to receive either satralizumab, at a dose of 120 mg, or placebo, administered subcutaneously at weeks 0, 2, and 4 and every 4 weeks thereafter, added to stable immunosuppressant treatment. The primary end point was the first protocol-defined relapse in a time-to-event analysis. Key secondary end points were the change from baseline to week 24 in the visual-analogue scale (VAS) pain score (range, 0 to 100, with higher scores indicating more pain) and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) score (range, 0 to 52, with lower scores indicating more fatigue). Safety was also assessed.Results: A total of 83 patients were enrolled, with 41 assigned to the satralizumab group and 42 to the placebo group. The median treatment duration with satralizumab in the double-blind period was 107.4 weeks. Relapse occurred in 8 patients (20%) receiving satralizumab and in 18 (43%) receiving placebo (hazard ratio, 0.38; 95% confidence interval [CI], 0.16 to 0.88). Multiple imputation for censored data resulted in hazard ratios ranging from 0.34 to 0.44 (with corresponding P values of 0.01 to 0.04). Among 55 AQP4-IgG-seropositive patients, relapse occurred in 11% of those in the satralizumab group and in 43% of those in the placebo group (hazard ratio, 0.21; 95% CI, 0.06 to 0.75); among 28 AQP4-IgG-seronegative patients, relapse occurred in 36% and 43%, respectively (hazard ratio, 0.66; 95% CI, 0.20 to 2.24). The between-group difference in the change in the mean VAS pain score was 4.08 (95% CI, -8.44 to 16.61); the between-group difference in the change in the mean FACIT-F score was -3.10 (95% CI, -8.38 to 2.18). The rates of serious adverse events and infections did not differ between groups.Conclusions: Among patients with NMOSD, satralizumab added to immunosuppressant treatment led to a lower risk of relapse than placebo but did not differ from placebo in its effect on pain or fatigue. (Funded by Chugai Pharmaceutical; ClinicalTrials.gov number, NCT02028884.). [ABSTRACT FROM AUTHOR]

Published
2019
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27. APOE epsilon variation in multiple sclerosis susceptibility and disease severity: some answers

Author

Reinhold Schmidt, Beata Zakrzewska-Pniewska, W. E. R. Ollier, Alastair Compston, Rita Cittadella, Helena Schmidt, Jonathan L. Haines, Stephen Sawcer, Richard M. Burwick, S. J. M. Weatherby, Hubert Kwieciński, Patricia P. Ramsay, Christian Enzinger, Lisa F. Barcellos, Masaaki Niino, Nikos Evangelou, Jacqueline Palace, Chris H. Polman, Seiji Kikuchi, Franz Fazekas, Aldo Quattrone, J. Zwemmer, Peter Høgh, Margaret A. Pericak-Vance, Jan Hillert, Bernard M. J. Uitdehaag, Stephen L. Hauser, Maria Edite Rio, Giovanni Savettieri, Silke Schmidt, Mónica Santos, Patrícia Maciel, Jorge R. Oksenberg, C. P. Hawkins, Thomas Masterman, [et al.], Universidade do Minho, Burwick, RM, Ramsay, PP, Haines, JL, Hauser, SL, Oksenberg, JR, Pericak-Vance, MA, Schmidt, S, Compston, A, Sawcer, S, Cittadella,R, Savettieri,G, Quattrone,A, Polman,CH, Uitdehaag, BM, Zwemmer, JN, Hawkins,CP, Ollier, WE, Weatherby, S, Enzinger, C, Fazekas, F, Schmidt, H, Schmidt, R, Hillert, J, Masterman, T, Hogh, P, Niino, M, Kikuchi,S, Maciel, P, Santos, M, Rio, ME, Kwiecinski, H, Zakrzewska-Pniewska, B, Evangelou, N, Palace, J, and Barcellos, LF.

Subjects
Apolipoprotein E, Oncology, Risk, medicine.medical_specialty, Pathology, Multiple Sclerosis, Genotype, Apolipoprotein E2, Apolipoprotein E4, Polymorphism, Single Nucleotide, Severity of Illness Index, Linkage Disequilibrium, Primary progressive, Central nervous system disease, 03 medical and health sciences, 0302 clinical medicine, Apolipoproteins E, Disease severity, Polymorphism (computer science), Internal medicine, medicine, Humans, Genetic Predisposition to Disease, 10. No inequality, Alleles, 030304 developmental biology, 0303 health sciences, Expanded Disability Status Scale, Polymorphism, Genetic, Science & Technology, business.industry, Multiple sclerosis, medicine.disease, 3. Good health, Pedigree, Phenotype, Case-Control Studies, Settore MED/26 - Neurologia, Neurology (clinical), business, Multiple Sclerosis, APOE, disease severity, meta-analysis, 030217 neurology & neurosurgery
Abstract

Background: Previous studies have examined the role of APOE variation in multiple sclerosis (MS), but have lacked the statistical power to detect modest genetic influences on risk and disease severity. The meta- and pooled analyses presented here utilize the largest collection, to date, of MS cases, controls, and families genotyped for the APOE epsilon polymorphism. Methods: Studies of MS and APOE were identified by searches of PubMed, Biosis, Web of Science, Cochrane Review, and Embase. When possible, authors were contacted for individual genotype data. Meta-analyses of MS case-control data and family-based analyses were performed to assess the association of APOE epsilon genotype with disease risk. Pooled analyses of MS cases were also performed to assess the influence of APOE epsilon genotype on disease severity. Results: A total of 22 studies (3,299 MS cases and 2,532 controls) were available for meta-analysis. No effect of e2 or e4 status on MS risk was observed (summary OR 1.14, 95% CI 0.96–1.34 and OR 0.89, 95% CI 0.78–1.01). Results obtained from analyses of APOE genotypes in 1,279 MS families were also negative ( p = 0.61). Finally, results from pooled analyses of 4,048 MS cases also argue strongly that APOE epsilon status does not distinguish a relapsing-remitting from primary progressive disease course, or influence disease severity, as measured by the Expanded Disability Status Scale and disease duration. Conclusion: Overall, these findings do not support a role for APOE in multiple sclerosis, and underscore the importance of using large sample sizes to detect modest genetic effects, particularly in studies of genotype-phenotype relationships.

Published
2006

28. Patterns of cerebral damage in multiple sclerosis and aquaporin-4 antibody-positive neuromyelitis optica spectrum disorders-major differences revealed by non-conventional imaging.

Author

Jakuszyk P, Podlecka-Piętowska A, Kossowski B, Nojszewska M, Zakrzewska-Pniewska B, and Juryńczyk M

Abstract

Multiple sclerosis and aquaporin-4 antibody neuromyelitis optica spectrum disorders are distinct autoimmune CNS disorders with overlapping clinical features but differing pathology. Multiple sclerosis is primarily a demyelinating disease with the presence of widespread axonal damage, while neuromyelitis optica spectrum disorders is characterized by astrocyte injury with secondary demyelination. Diagnosis is typically based on lesion characteristics observed on standard MRI imaging and antibody testing but can be challenging in patients with in-between clinical presentations. Non-conventional MRI techniques can provide valuable diagnostic information by measuring disease processes at the microstructural level. We used non-conventional MRI to measure markers of axonal loss in specific white matter tracts in multiple sclerosis and neuromyelitis optica spectrum disorders, depending on their relationship with focal lesions. Patients with relapsing-remitting multiple sclerosis ( n = 20), aquaporin-4 antibody-associated neuromyelitis optica spectrum disorders ( n = 20) and healthy controls ( n = 20) underwent a 3T brain MRI, including T 1 -, T 2 - and diffusion-weighted sequences, quantitative susceptibility mapping and phase-sensitive inversion recovery sequence. Tractometry was used to differentiate tract fibres traversing through white matter lesions from those that did not. Neurite density index was assessed using neurite orientation dispersion and density imaging model. Cortical damage was evaluated using T 1 relaxation rates. Cortical lesions and paramagnetic rim lesions were identified using phase-sensitive inversion recovery and quantitative susceptibility mapping. In tracts traversing lesions, only one out of 50 tracts showed a decreased neurite density index in multiple sclerosis compared with neuromyelitis optica spectrum disorders. Among 50 tracts not traversing lesions, six showed reduced neurite density in multiple sclerosis (including three in the cerebellum and brainstem) compared to neuromyelitis optica spectrum disorders. In multiple sclerosis, reduced neurite density was found in the majority of fibres traversing (40/50) and not traversing (37/50) white matter lesions when compared to healthy controls. A negative correlation between neurite density in lesion-free fibres and cortical lesions, but not paramagnetic rim lesions, was observed in multiple sclerosis (39/50 tracts). In neuromyelitis optica spectrum disorders compared to healthy controls, decreased neurite density was observed in a subset of fibres traversing white matter lesions, but not in lesion-free fibres. In conclusion, we identified significant differences between multiple sclerosis and neuromyelitis optica spectrum disorders corresponding to their distinct pathologies. Specifically, in multiple sclerosis, neurite density reduction was widespread across fibres, regardless of their relationship to white matter lesions, while in neuromyelitis optica spectrum disorders, this reduction was limited to fibres passing through white matter lesions. Further studies are needed to evaluate the discriminatory potential of neurite density measures in white matter tracts for differentiating multiple sclerosis from neuromyelitis optica spectrum disorders., Competing Interests: The authors report no competing interests., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Guarantors of Brain.)

Published
2024
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29. Religious meaning system and life satisfaction: the mediating role of meaning in life among Polish people with multiple sclerosis.

Author

Wilski M, Wnuk M, Brola W, Szcześniak M, Żak M, Sobolewski P, Kapica-Topczewska K, Tarasiuk J, Czarnowska A, Kułakowska A, Zakrzewska-Pniewska B, Bartosik-Psujek H, Kubicka-Bączyk K, Morawiec N, Adamczyk-Sowa M, Stepien A, Jacek Z, Ratajczak A, Ratajczak M, Szałachowski R, Kroplewski Z, Lech B, Perenc A, Popiel M, and Potemkowski A

Abstract

Introduction: The complexity of the associations between religiosity and indicators of well-being suggests the presence of a mediating mechanism. Previous studies indicate that religion may influence subjective well-being because it helps to find meaning and purpose. Therefore, the aim of our study was to examine the mediating role of the presence and search dimensions of meaning in life in the relationship between religious meaning system and life satisfaction in patients with multiple sclerosis (MS)., Methods: This cross-sectional study included 600 MS patients recruited from Poland who completed the Satisfaction with Life Scale (SWLS), the Religious Meaning System Questionnaire (RMS) and the Meaning in Life Questionnaire (MLQ). Model 6 of Hayes PROCESS was used to test the hypotheses., Results: The results of our research indicate that there was a significant indirect effect of religious meaning system on life satisfaction through the presence of meaning in life. The specific indirect effect of religious meaning system on life satisfaction through searching for meaning in life was not significant., Discussion: The results of our study are relevant because they show that religion as a meaning system is positively related to the presence of meaning in life, which in turn positively predicts life satisfaction. This is particularly important in the case of incurable illness, where finding meaning in life is one of the natural stages of adaptation. By incorporating these findings into mental health practice, professionals can enhance the holistic well-being of people coping with MS and contribute to a more comprehensive and effective approach to mental health care., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Wilski, Wnuk, Brola, Szcześniak, Żak, Sobolewski, Kapica-Topczewska, Tarasiuk, Czarnowska, Kułakowska, Zakrzewska-Pniewska, Bartosik-Psujek, Kubicka-Bączyk, Morawiec, Adamczyk-Sowa, Stepien, Jacek, Ratajczak, Ratajczak, Szałachowski, Kroplewski, Lech, Perenc, Popiel and Potemkowski.)

Published
2024
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30. Analysis of seroconversion following COVID-19 vaccination among multiple sclerosis patients treated with disease-modifying therapies in Poland.

Author

Podlecka-Piętowska A, Sierdziński J, Nojszewska M, Stawicki J, Bartosik-Psujek H, Lech B, Popiel M, Perenc A, Kułakowska A, Czarnowska A, Kulikowska J, Kapica-Topczewska K, Jamróz-Wiśniewska A, Rejdak K, Zaborski J, Kubicka-Bączyk K, Niedziela N, Wierzbicki K, Adamczyk-Sowa M, Zwiernik J, Zwiernik B, Milewska-Jędrzejczak M, Głąbiński A, Jasińska E, Puz P, Krzystanek E, Stęposz A, Karuga A, Lasek-Bal A, Siuda J, Kściuk B, Walawska-Hrycek A, Patalong-Ogiewa M, Kaczmarczyk A, Siutka K, Brola W, and Zakrzewska-Pniewska B

Subjects
Female, Male, Humans, Poland, COVID-19 Vaccines, Seroconversion, SARS-CoV-2, Immunosuppressive Agents therapeutic use, Multiple Sclerosis drug therapy, COVID-19 prevention & control
Abstract

Clinical Rationale for the Study: The rapid spread of SARS-CoV-2 throughout the world has highlighted the importance of vaccinations to control the pandemic and to protect people at risk for severe disease courses. Disease-modifying therapies (DMT) in multiple sclerosis (MS), whether immunomodulatory or immunosuppressive, may affect the immune response. Therefore, the question arose as to whether these vaccinations would be effective., Aim of the Study: We planned a study to assess the immune response to SARS-CoV-2 vaccines by type of therapy., Material and Methods: Participants were recruited from 14 Polish MS centres. The data was obtained by neurologists using a questionnaire. We collected data on 353 MS patients (269 females, 84 males) who received complete primary SARS-CoV-2 vaccination. All persons with MS (PwMS) were treated with disease-modifying therapies., Results: 305 out of 353 PwMS (86.4%) were positive for IgG Abs against SARS-CoV-2 S domain S1 Ag after vaccination. A strong immune response was noted in 129 PwMS (36.5%). The rate of seroconversion after SARS-CoV-2 vaccination in PwMS who received immunomodulatory DMTs (interferon beta, glatiramer acetate, teriflunomide, dimethyl fumarate, natalizumab) was 91.5%, in PwMS receiving immune reconstruction therapy (alemtuzumab, cladribine) was 92%, and in immunosuppressive DMTs (fingolimod, ocrelizumab), the seroconversion rate was 59%., Conclusions and Clinical Implications: Our study shows that, in PwMS receiving immunomodulatory therapy, the immune response to vaccination is generally excellent. Even in immunosuppressive patients, seroconversion is satisfactory.

Published
2024
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31. Sense of happiness in Polish patients with multiple sclerosis.

Author

Brola W, Szcześniak M, Wilski M, Żak M, Sobolewski P, Wnuk M, Szałachowski RR, Kapica-Topczewska K, Czarnowska A, Tarasiuk J, Kułakowska A, Zakrzewska-Pniewska B, Kubicka-Bączyk K, Morawiec N, Adamczyk-Sowa M, Stępień A, Zaborski J, Bartosik-Psujek H, Lech B, Perenc A, Popiel M, Ratajczak A, Ratajczak M, Kroplewski Z, and Potemkowski A

Subjects
Humans, Poland, Surveys and Questionnaires, Happiness, Multiple Sclerosis
Abstract

Introduction: Happiness is crucial to patient well-being and their acceptance of their disease. The aim of this study was to assess the sense of happiness in persons with multiple sclerosis (PwMS), compare it to the level of happiness in patients with other neurological conditions, and determine which factors affect the sense of happiness in PwMS., Material and Methods: Five hundred and eighty-nine PwMS and 145 control subjects (post-stroke patients with chronic pain syndromes and neuropathies) were included in the study. Due to the differences between the groups in terms of demographic variables, an adjusted group of PwMS (n = 145) was selected from the entire group of PwMS. All patients were assessed using the Oxford Happiness Questionnaire (OHQ), the Satisfaction with Life Scale (SLS), and the Family APGAR Questionnaire. Based on regression analysis, the study examined which variables affected the level of happiness in the groups., Results: Analysis of the OHQ scores showed that PwMS had a lower sense of happiness compared to the control group in the overall score [113.21 (25-42) vs. 119.88 (25-49), respectively; p = 0.031] and the subscales (OHQ subscale 1 - 54.52 vs. 57.84, respectively; p = 0.027; subscale 2 - 35.61 vs. 37.67; respectively; p = 0.044). Based on linear regression analysis, life satisfaction (β = 0.40; p < 0.001), positive orientation (β = 0.32; p < 0.001), and primary education (β = 0.08; p = 0.009) were the most significant predictors of a higher level of happiness in PwMS. Similar results were found in the control group., Conclusions: The sense of happiness in PwMS was lower than in patients with other conditions. The most important factors influencing happiness included life satisfaction and positive orientation. Influencing these predictors should be the aim of psychological interventions, especially in patients with a reduced sense of happiness.

Published
2023
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32. Analysis of Side Effects Following Vaccination Against COVID-19 Among Individuals With Multiple Sclerosis Treated With DMTs in Poland.

Author

Czarnowska A, Tarasiuk J, Zajkowska O, Wnuk M, Marona M, Nowak K, Słowik A, Jamroz-Wiśniewska A, Rejdak K, Lech B, Popiel M, Rościszewska-Żukowska I, Perenc A, Bartosik-Psujek H, Świderek-Matysiak M, Siger M, Ciach A, Walczak A, Jurewicz A, Stasiołek M, Kania K, Dyczkowska K, Kalinowska-Łyszczarz A, Galus W, Walawska-Hrycek A, Krzystanek E, Chojdak-Łukasiewicz J, Ubysz J, Pokryszko-Dragan A, Kapica-Topczewska K, Chorąży M, Bazylewicz M, Mirończuk A, Kulikowska J, Kochanowicz J, Białek M, Stolarz M, Kubicka-Bączyk K, Niedziela N, Warmus P, Adamczyk-Sowa M, Podlecka-Piçtowska A, Nojszewska M, Zakrzewska-Pniewska B, Jasińska E, Zaborski J, Milewska-Jȩdrzejczak M, Zwiernik J, Zwiernik B, Potemkowski A, Brola W, and Kułakowska A

Abstract

Background and Objectives: Since vaccination against COVID-19 is available for over a year and the population of immunized individuals with autoimmune disorders is higher than several months before, an evaluation of safety and registered adverse events can be made. We conducted a large study of side effects following the COVID-19 vaccine among patients with multiple (MS) sclerosis treated with disease-modifying therapies (DMTs) and analyzed factors predisposing for particular adverse events., Methods: We gathered data of individuals with MS treated with DMTs from 19 Polish MS Centers, who reported at least one adverse event following COVID-19 vaccination. The information was obtained by neurologists using a questionnaire. The same questionnaire was used at all MS Centers. To assess the relevance of reported adverse events, we used Fisher's exact test, t -test, and U -Menn-Whutney test., Results: A total of 1,668 patients with MS and reports of adverse events after COVID-19 vaccination were finally included in the study. Besides one case marked as "red flag", all adverse events were classified as mild. Pain at the injection site was the most common adverse event, with a greater frequency after the first dose. Pain at the injection site was significantly more frequent after the first dose among individuals with a lower disability (EDSS ≤2). The reported adverse events following immunization did not differ over sex. According to age, pain at the injection site was more common among individuals between 30 and 40 years old, only after the first vaccination dose. None of the DMTs predisposed for particular side effects., Conclusions: According to our findings, vaccination against COVID-19 among patients with MS treated with DMTs is safe. Our study can contribute to reducing hesitancy toward vaccination among patients with MS., Competing Interests: AK, WB, HB-P, AP-D, MA-S, EK, and KK received compensation for speaking and consulting services from Biogen, Bayer, Novartis, Roche, Merck, Teva, and Sanofi-Genzyme. MS received compensation for speaking from Roche, Novartis, Sanofi-Genzyme, and Biogen. MŚ-M received compensation for speaking and consulting services from Biogen, Novartis, Roche, Merck, and Sanofi-Genzyme. AJ received compensation for speaking services from Merck and SanofiGenzyme. MS received grant funding from Biogen and received compensation for speaking and consulting services from Biogen, Novartis, Roche, Merck, Sanofi-Genzyme, Bristol Myers Squibb, and Teva. AS, MM, KN, and MW received compensation for speaking and consulting services from Biogen, Bayer, Novartis, Roche, Merck, Teva, and Sanofi-Genzyme. They received also a grant from NCBIR (nr SZPITALE-JEDNOIMIENNE/18/2020). AK-L received grant funding from Novartis and received compensation for speaking and consulting services from Biogen, Bayer, Novartis, Roche, Merck, Teva, CSL Behring, Shire, and Sanofi-Genzyme. None of the agreements are relevant to the submitted work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Czarnowska, Tarasiuk, Zajkowska, Wnuk, Marona, Nowak, Słowik, Jamroz-Wiśniewska, Rejdak, Lech, Popiel, Rościszewska-Żukowska, Perenc, Bartosik-Psujek, Świderek-Matysiak, Siger, Ciach, Walczak, Jurewicz, Stasiołek, Kania, Dyczkowska, Kalinowska-Łyszczarz, Galus, Walawska-Hrycek, Krzystanek, Chojdak-Łukasiewicz, Ubysz, Pokryszko-Dragan, Kapica-Topczewska, Chorąży, Bazylewicz, Mirończuk, Kulikowska, Kochanowicz, Białek, Stolarz, Kubicka-Bączyk, Niedziela, Warmus, Adamczyk-Sowa, Podlecka-Piçtowska, Nojszewska, Zakrzewska-Pniewska, Jasińska, Zaborski, Milewska-Jȩdrzejczak, Zwiernik, Zwiernik, Potemkowski, Brola and Kułakowska.)

Published
2022
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33. Safety of Vaccines against SARS-CoV-2 among Polish Patients with Multiple Sclerosis Treated with Disease-Modifying Therapies.

Author

Czarnowska A, Tarasiuk J, Zajkowska O, Wnuk M, Marona M, Nowak K, Słowik A, Jamroz-Wiśniewska A, Rejdak K, Lech B, Popiel M, Rościszewska-Żukowska I, Perenc A, Bartosik-Psujek H, Świderek-Matysiak M, Siger M, Ciach A, Walczak A, Jurewicz A, Stasiołek M, Kania K, Dyczkowska K, Kalinowska-Łyszczarz A, Galus W, Walawska-Hrycek A, Krzystanek E, Chojdak-Łukasiewicz J, Ubysz J, Pokryszko-Dragan A, Kapica-Topczewska K, Chorąży M, Bazylewicz M, Mirończuk A, Kulikowska J, Kochanowicz J, Białek M, Stolarz M, Kubicka-Bączyk K, Niedziela N, Morawiec N, Adamczyk-Sowa M, Podlecka-Piętowska A, Nojszewska M, Zakrzewska-Pniewska B, Jasińska E, Zaborski J, Milewska-Jędrzejczak M, Zwiernik J, Zwiernik B, Potemkowski A, Brola W, and Kułakowska A

Abstract

(1) Background: The present study aims to report the side effects of vaccination against coronavirus disease 2019 (COVID-19) among patients with multiple sclerosis (MS) who were being treated with disease-modifying therapies (DMTs) in Poland. (2) Methods: The study included 2261 patients with MS who were being treated with DMTs, and who were vaccinated against COVID-19 in 16 Polish MS centers. The data collected were demographic information, specific MS characteristics, current DMTs, type of vaccine, side effects after vaccination, time of side-effect symptom onset and resolution, applied treatment, relapse occurrence, and incidence of COVID-19 after vaccination. The results were presented using maximum likelihood estimates of the odds ratio, t -test, Pearson's chi-squared test, Fisher's exact p , and logistic regression. The statistical analyses were performed using STATA 15 software. (3) Of the 2261 sampled patients, 1862 (82.4%) were vaccinated with nucleoside-modified messenger RNA (mRNA) vaccines. Mild symptoms after immunization, often after the first dose, were reported in 70.6% of individuals. Symptoms included arm pain (47.5% after the first dose and 38.7% after the second dose), fever/chills/flu-like symptoms (17.1% after the first dose and 20.5% after the second dose), and fatigue (10.3% after the first dose and 11.3% after the second dose). Only one individual presented with severe side effects (pro-thrombotic complications) after vaccination. None of the DMTs in the presented cohort were predisposed to the development of side effects. Nine patients (0.4%) had a SARS-CoV-2 infection confirmed despite vaccination. (4) Conclusions: Vaccination against SARS-CoV-2 is safe for people with MS who are being treated with DMTs. Most adverse events following vaccination are mild and the acute relapse incidence is low.

Published
2022
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34. The Big Five Personality Traits and Positive Orientation in Polish Adults with Multiple Sclerosis: The Role of Meaning in Life.

Author

Szcześniak M, Potemkowski A, Brola W, Kroplewski Z, Szałachowski RR, Zak M, Wilski M, Sobolewski P, Bartosik-Psujek H, Kapica-Topczewska K, Tarasiuk J, Czarnowska A, Kułakowska A, Zakrzewska-Pniewska B, Kubicka-Bączyk K, Morawiec N, Adamczyk-Sowa M, Stępień A, Zaborski J, Ratajczak A, and Ratajczak M

Subjects
Adult, Extraversion, Psychological, Humans, Personality Inventory, Poland, Multiple Sclerosis, Personality
Abstract

Scientific achievements concerning the direct relation between personality traits and positive orientation among patients with multiple sclerosis do not explain the role of potential mediators. In fact, some researchers argue that the traits-positivity association is much more complex than it seems to be. For this reason, we made an attempt to analyze the indirect relationship between the above-mentioned variables, including meaning in life as a mediator. In total, 618 patients with MS took part in the study. The NEO Five-Factor Inventory, the Positive Orientation Scale, and the Meaning in Life Questionnaire were used. The results showed that positive orientation/the presence of meaning/searching for meaning correlated positively with extraversion, openness to experience, agreeableness, and conscientiousness, and were negatively associated with neuroticism. Moreover, meaning in life in both its dimensions acted as a mediator in 9 of 10 models. It can be assumed that a propensity to establish interpersonal relationships (extraversion), use active imagination (openness), inspire confidence among others (agreeableness), and take responsibility (conscientiousness) can have an impact on someone's positive attitude toward oneself and the surrounding world (positive orientation) when people have meaning in life and when they are seeking it.

Published
2022
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36. Complementary and alternative medicine in multiple sclerosis: a questionnaire-based study.

Author

Podlecka-Piętowska A, Sugalska M, Janiszewska K, Wall-Szczech A, Cyganek A, Szejko N, and Zakrzewska-Pniewska B

Subjects
Female, Male, Humans, Quality of Life, Surveys and Questionnaires, Poland, Multiple Sclerosis epidemiology, Complementary Therapies methods
Abstract

Aim of the Study: To assess the prevalence and characteristics of complementary and alternative medicine (CAM) use among multiple sclerosis (MS) patients in Poland., Clinical Rationale for the Study: Multiple sclerosis (MS) is a chronic, progressive and disabling neurological disease with significant impact on quality of life. Although the efficacy and safety of complementary and alternative medicine (CAM) has not been scientifically confirmed, many patients use CAM as a complement or an alternative to conventional therapy., Material and Methods: Data was collected via a self-designed survey consisting of 33 questions. The questionnaire was distributed among MS patients hospitalised during 2016 in the MS Unit at the Department of Neurology, Medical University of Warsaw, Poland. The study group consisted of 75 patients (47 females, 28 males, mean age 44.6 ± 12.5 years) with clinically defined MS., Results: According to the questionnaire, 48 patients (64%) had used CAM at least once. Most of the patients declared that CAM had a possible (58%) or a marked (43.7%) positive effect. 61.4% of CAM users reported reduced fatigue and 33.3% improved mood. There were significant correlations between CAM use and lower social and professional status (p < 0.04), disease progression (p < 0.03), and lack of efficacy of disease-modifying therapies (p < 0.04). There were no significant correlations between CAM usage and sex, habitation, education, marital or professional status. The most frequently used CAMs were vitamins (48%), and polyunsaturated fatty acids (36%); psychophysical methods (44%) included manual therapies (24%) and relaxation techniques (17.3%) as well as herbal medicine (29.3%). Physicians were considered to be the most reliable authority in both conventional treatment (97.3%) and CAM (67%). Complementary and alternative medicine users significantly more often discussed this issue with their doctors (56%) compared to patients who did not use alternative medicine (p < 0.05). However, 54% of patients did not inform their physician about CAM use. Responders said that physicians did not initiate discussion about it (55.9%), but 44% of patients would like to have the possibility of talking to a doctor about CAM., Conclusions and Clinical Implications: Although CAM efficacy and safety is not confirmed, one should keep in mind that most MS patients use alternative methods, especially those individuals with a more severe phenotype. Physicians are mostly perceived as reliable authorities and therefore they should discuss this issue with patients in order to eliminate drug interactions and to improve compliance.

Published
2022
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37. Impact of Immunoablation and Autologous Hematopoietic Stem Cell Transplantation on Treatment Cost of Multiple Sclerosis: Real-World Nationwide Study.

Author

Orlewska K, Bogusz K, Podlecka-Piętowska A, Nojszewska M, Markiewicz M, Liwoch R, Orlewski P, Śliwczyński A, Zakrzewska-Pniewska B, and Snarski E

Subjects
Health Care Costs, Humans, Transplantation, Autologous, Treatment Outcome, Hematopoietic Stem Cell Transplantation, Multiple Sclerosis therapy
Abstract

Objectives: To provide real-world data on the impact of autologous hematopoietic stem cell transplantation (AHSCT) on treatment costs of patients with multiple sclerosis (MS) in Poland., Methods: Medical data of 105 patients who underwent AHSCT in the years 2011 to 2016 were obtained from the National Health Fund (NHF) database. Treatment costs were calculated from the public payer's perspective per patient-year for the total available period as well as 12 months before and after AHSCT. The statistical analysis was performed using MATLAB 2016b., Results: Mean treatment-related costs covered by the NHF per patient-year before and after the transplantation were €4314.9 and €1188.8 , respectively. The average cost of disease-modifying drugs per patient was reduced from €2497.9/year before to €65.3/year after AHSCT., Conclusions: Although the initial cost of AHSCT is high, the costs involving AHSCT and post-AHSCT treatment could, according to our analysis, pay off in 3.9 years, when compared to the costs of disease-modifying drug therapy in aggressive MS. The study provides evidence that the AHSCT can lead to significant savings in treatment costs of aggressive MS from the public payer's perspective., (Copyright © 2021. Published by Elsevier Inc.)

Published
2021
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38. Clinical course and outcome of SARS-CoV-2 infection in multiple sclerosis patients treated with disease-modifying therapies - the Polish experience.

Author

Czarnowska A, Brola W, Zajkowska O, Rusek S, Adamczyk-Sowa M, Kubicka-Bączyk K, Kalinowska-Łyszczarz A, Kania K, Słowik A, Wnuk M, Marona M, Podlecka-Piętowska A, Nojszewska M, Zakrzewska-Pniewska B, Jasińska E, Gołuch K, Lech B, Noga M, Perenc A, Popiel M, Lasek-Bal A, Puz P, Maciejowska K, Kucharska-Lipowska M, Lipowski M, Kapica-Topczewska K, Chorąży M, Tarasiuk J, Kochanowicz J, Kulikowska J, Wawrzyniak S, Niezgodzińska-Maciejek A, Pokryszko-Dragan A, Gruszka E, Budrewicz S, Białek M, Kurkowska-Jastrzębska I, Kurowska K, Stępień A, Włodek A, Ptasznik V, Pawełczyk M, Sobolewski P, Lejmel H, Strzalińska K, Maciejowski M, Tutaj A, Zwiernik J, Litwin A, Lewańczyk B, Paprocka I, Zwiernik B, Pawlos A, Borysowicz A, Narożnik A, Michałowska A, Nosek K, Fudala M, Milewska-Jędrzejczak M, Kułakowska A, and Bartosik-Psujek H

Subjects
Adult, Female, Humans, Immunologic Factors, Immunosuppressive Agents, Male, Poland epidemiology, SARS-CoV-2, COVID-19, Multiple Sclerosis drug therapy, Multiple Sclerosis epidemiology, Multiple Sclerosis, Relapsing-Remitting
Abstract

Introduction: The aim of this study was to report the course and outcome of SARS-CoV-2 infection in multiple sclerosis (MS) patients treated with disease-modifying therapies (DMTs) in Poland. A major concern for neurologists worldwide is the course and outcome of SARS-CoV-2 infection in patients with MS treated with different DMTs. Although initial studies do not suggest an unfavourable course of infection in this group of patients, the data is limited., Materials and Methods: This study included 396 MS patients treated with DMTs and confirmed SARS-CoV-2 infection from 28 Polish MS centres. Information concerning patient demographics, comorbidities, clinical course of MS, current DMT use, as well as symptoms of SARS-CoV-2 infection, need for pharmacotherapy, oxygen therapy, and/or hospitalisation, and short-term outcomes was collected up to 30 January 2021. Additional data about COVID-19 cases in the general population in Poland was obtained from official reports of the Polish Ministry of Health., Results: There were 114 males (28.8%) and 282 females (71.2%). The median age was 39 years (IQR 13). The great majority of patients with MS exhibited relapsing-remitting course (372 patients; 93.9%). The median EDSS was 2 (SD 1.38), and the mean disease duration was 8.95 (IQR 8) years. Most of the MS patients were treated with dimethyl fumarate (164; 41.41%). Other DMTs were less frequently used: interferon beta (82; 20.70%), glatiramer acetate (42; 10.60%), natalizumab (35;8.84%), teriflunomide (25; 6.31%), ocrelizumab (20; 5.05%), fingolimod (16; 4.04), cladribine (5; 1.26%), mitoxantrone (3; 0.76%), ozanimod (3; 0.76%), and alemtuzumab (1; 0.25%). The overall hospitalisation rate due to COVID-19 in the cohort was 6.81% (27 patients). Only one patient (0.3%) died due to SARS-CoV-2 infection, and three (0.76%) patients were treated with mechanical ventilation; 106 (26.8%) patients had at least one comorbid condition. There were no significant differences in the severity of SARS-CoV-2 infection regarding patient age, duration of the disease, degree of disability (EDSS), lymphocyte count, or type of DMT used., Conclusions and Clinical Implications: Most MS patients included in this study had a favourable course of SARS-CoV-2 infection. The hospitalisation rate and the mortality rate were not higher in the MS cohort compared to the general Polish population. Continued multicentre data collection is needed to increase the understanding of SARS-CoV-2 infection impact on the course of MS in patients treated with DMTs.

Published
2021
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39. Search for viral agents in cerebrospinal fluid in patients with multiple sclerosis using real-time PCR and metagenomics.

Author

Perlejewski K, Bukowska-Ośko I, Rydzanicz M, Dzieciątkowski T, Zakrzewska-Pniewska B, Podlecka-Piętowska A, Filipiak A, Barć K, Caraballo Cortés K, Pawełczyk A, Radkowski M, and Laskus T

Subjects
Adolescent, Adult, Aged, Autoimmune Diseases immunology, Enterovirus isolation & purification, Enterovirus pathogenicity, Female, Herpesvirus 3, Human isolation & purification, Herpesvirus 3, Human pathogenicity, Herpesvirus 4, Human isolation & purification, Herpesvirus 4, Human pathogenicity, Herpesvirus 6, Human isolation & purification, Herpesvirus 6, Human pathogenicity, Humans, Male, Metagenomics, Middle Aged, Multiple Sclerosis genetics, Multiple Sclerosis immunology, Myelin Sheath genetics, Real-Time Polymerase Chain Reaction, Virus Diseases genetics, Virus Diseases immunology, Young Adult, Autoimmune Diseases virology, Multiple Sclerosis virology, Myelin Sheath immunology, Virus Diseases virology
Abstract

Multiple sclerosis (MS) is a chronic, immune-mediated demyelinating disease of the central nervous system of unclear etiology, but there is some evidence that viral infections could be responsible for triggering autoimmune mechanisms against myelin. We searched for viral RNA and DNA in cerebrospinal fluid (CSF) of 34 MS patients and 13 controls using RT-PCR/PCR against common neurotropic viruses. In addition, shotgun DNA- and RNA-based metagenomics were done in 13 MS patients and 4 controls. Specific quantitative real-time RT-PCR/PCR testing revealed the presence of viral nucleic acid in seven (20.59%) MS patients and in one (7.69%) control patient. In MS patients the most frequently detected was human herpesvirus type 6 (HHV-6; 3 cases; 8.82%); followed by Epstein-Barr virus (EBV; 2 cases; 5.88%), varicella zoster virus (VZV; 1 case; 2.94%) and Enterovirus (EV; 1 case; 2.94%). The single identified virus among controls was EBV (7.69%). DNA and RNA metagenomic assays did not identify any known eukaryotic viruses even though three of the analyzed samples were low-level positive by specific quantitative real-time PCR. In conclusion, we detected the presence of Herpesviridae and occasionally Enteroviridae in CSF from patients with MS but their prevalence was not significantly higher than among controls. Metagenomic analysis seems to be less sensitive than real-time RT-PCR/PCR and it did not detect any potential viral pathogens., Competing Interests: The authors have declared that no competing interests exist.

Published
2020
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40. The relationship between aquaporin-4 antibody status and visual tract integrity in neuromyelitis optica spectrum disorders: A visual evoked potential study.

Author

Barć K, Gospodarczyk-Szot K, Nojszewska M, Podlecka-Piętowska A, and Zakrzewska-Pniewska B

Subjects
Autoantibodies, Humans, Infant, Neoplasm Recurrence, Local, Retrospective Studies, Aquaporin 4, Evoked Potentials, Visual, Neuromyelitis Optica
Abstract

Background: Optic neuritis (ON) is one of the hallmark symptomatic features of neuromyelitis optica spectrum disorders (NMOSD). The majority of patients with NMOSD present highly specific autoantibodies against aquaporin-4 (AQP4). A number of studies have reported poor visual acuity outcomes in individuals with AQP4 seropositive NMOSD, but no such relationship has been found with regard to visual evoked potentials (VEP) parameters such as the amplitude and latency of the P100 component. In this paper, we aimed (i) to describe VEP responses in patients with NMOSD; (ii) to analyze those results based on a scoring system; and (iii) to investigate the association between the VEPs and AQP4 antibody status., Methods: We retrospectively analysed the VEP responses of 40 patients with a diagnosis of NMOSD (according to the 2015 IPND criteria), including 16 with AQP4-postive status (AQP4[+]) and 24 with AQP4-negative status (AQP4[-]). In the first step, we measured the P100 peak latency and P100-N2 peak-to-peak amplitude in each patient. In the second, we converted these measures to the VEP score (0-10) using the scoring proposed by Jung et al. (2008). All recordings were performed using the same VEP device and testing protocol., Results: Abnormal VEPs were recorded in 25 of 40 patients (62.6%). Of these, 17 (42.5%) had prolonged P100 latency, and 8 (20%) had no response detected in at least one eye. The patients with ON as the initial relapse symptom had significantly higher median VEP scores than those who experienced the longitudinally extensive transverse myelitis (LETM) at the disease onset (7.0 [in-terquar-tile range (IQR), 2.0-8.0] vs. 0.0 [IQR, 0.0-4.0], p<0.001). A lack of VEP response in at least one eye was detected more frequently in the AQP4[+] group than the AQP4[-] group (7/16 vs. 1/24, p<0.005). Logistic regression model controlling for age, gender, disease duration, and the type of relapse at onset showed an independent impact of AQP4[+] status (OR=35.45, p = 0.018) on the higher rate of absent VEP responses. In the entire group of patients (n = 40), those with AQP4[+] showed a small tendency towards a higher median VEP score (4.0 [IQR, 0.0-7.8] vs. 1.0 [IQR, 0.0-4.0], p = 0.304). Among individuals with abnormal responses (n = 25), the patients with AQP4[+] had significantly higher median VEP scores (7.0 [IQR, 4.0-8.5] vs. 3.0 [IQR, 1.0-7.0], p = 0.034) and more common bilateral involvement of the optic tracts (80% vs. 40%, p = 0.048) than those who were seronegative for anti-AQP4 antibody. A median regression analysis model controlling for age, gender, disease duration, type of onset, and number of relapses in last 12 months showed an independent association between the AQP4-positive status and a higher VEP score in patients with NMOSD (t = 2.882, df=2, p = 0.007)., Conclusion: VEP study remains a useful tool in the assessment of NMOSD patients. Due to the high prevalence of absent VEPs in NMOSD patients, the scoring system appears to be more applicable for the precise analysis of VEP recordings. There is a positive association between the AQP-positive serostatus and the poorer outcome in VEP responses, especially in patients with severe impairment of the optic nerve(s)., (Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.)

Published
2020
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41. Real-world effectiveness of fingolimod in Polish group of patients with relapsing-remitting multiple sclerosis.

Author

Walczak A, Kurkowska-Jastrzebska I, Zakrzewska-Pniewska B, Dorobek M, Brola W, Zajdel R, Bartosik-Psujek H, Stasiolek M, Kulakowska A, Rusek S, Tutaj A, Glabinski A, Wlodek A, Kochanowski J, Ciach A, Siger M, Kurowska K, Wicha W, Nojszewska M, Podlecka-Pietowska A, Czajka A, Kapica-Topczewska K, Bielecki B, Maciagowska-Terela M, and Stepien A

Subjects
Adult, Disabled Persons rehabilitation, Disease Progression, Female, Humans, Male, Middle Aged, Poland, Recurrence, Fingolimod Hydrochloride therapeutic use, Immunosuppressive Agents therapeutic use, Multiple Sclerosis, Relapsing-Remitting drug therapy
Abstract

Objectives: Fingolimod is indicated for the treatment of relapsing-remitting multiple sclerosis (RRMS) patients with highly aggressive disease characterized by frequent relapses and active magnetic resonance imaging. Its efficacy has been demonstrated in three large phase III trials, used in the regulatory submissions throughout the world. Fingolimod in licensed in Europe since 2011 but with a growing number of disease-modifying drugs (DMD) becoming available for RRMS, it is important to gather real-world evidence data regarding long-term effectiveness in treated patients with MS. The aim of this study was to assess fingolimod effectiveness in a real life Polish group of RRMS patients receiving fingolimod as second line treatment., Patients and Methods: The observational study with retrospective data collection was performed at 13 sites that were asked to document eligible patients in consecutive chronological order to avoid selection bias. Demographic and clinical data from 253 adult patients with RRMS treated with fingolimod were analyzed., Results: Mean treatment time with fingolimod was 42 months. Relapses reduction during 3 years treatment period was observed (2.0 v 0.2) and majority of patients were free of relapses. Mean EDSS score was stable during the time of observation. The proportion of patients who were free from any clinical disease activity, i.e. without relapses and disability progression, was over 70%. During the first and second year of observation significant reduction of new MRI lesions was observed., Conclusion: In the Polish group of patients with RRMS treated with fingolimod, the majority of them showed freedom from relapses, disability progression and reduction of new MRI lesions. Switching from injectable immunomodulatory drugs to fingolimod is associated with fewer relapses and lower disability progression., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Published
2019
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42. Electrophysiological and clinical assessment of dysautonomia in multiple system atrophy (MSA) and progressive supranuclear palsy (PSP): a comparative study.

Author

Nojszewska M, Potulska-Chromik A, Jamrozik Z, Janik P, and Zakrzewska-Pniewska B

Subjects
Aged, Electrophysiological Phenomena, Female, Humans, Male, Middle Aged, Pneumothorax, Multiple System Atrophy, Parkinson Disease, Parkinsonian Disorders, Primary Dysautonomias, Supranuclear Palsy, Progressive
Abstract

Clinical Rationale for the Study: Autonomic nervous system (ANS) involvement in different parkinsonian syndromes has been frequently discussed. It is well established in multiple system atrophy (MSA), whereas it is less evident in progressive supranuclear palsy (PSP)., Aims of the Study: The aims were to assess the presence and pattern of ANS involvement in MSA and PSP using noninvasive tests i.e. the sympathetic skin response (SSR) test and the R-R interval variation (RRIV) test; to analyse the relationship between clinical and electrophysiological abnormalities in both disorders; and to assess whether an autonomic profile might help to differentiate them., Materials and Methods: Clinical and electrophysiological assessments of dysautonomia were performed in 59 patients with MSA (24 cases of MSA-C and 35 cases of MSA-P), these 59 cases including 31 females, mean disease duration 4.2 ± 2.7 years, mean age 60.3 ± 8.4 years, and in 37 patients with PSP (12 females, mean disease duration 4.6 ± 3.6 years, mean age 67.5 ± 6.1 years) and the results were compared to the results obtained from 23 healthy controls matched for age and sex., Results: Clinical dysautonomia assessed by an Autonomic Symptoms Questionnaire was observed in 97% of the MSA patients and in 84% of the PSP patients. SSR was abnormal in 64% and RRIV was abnormal in 73% of MSA cases. In PSP cases, these figures were 78% and 81% respectively. Dysautonomia was clinically more pronounced in MSA compared to PSP (p < 0.05), whereas electrophysiological testing revealed frequently subclinical ANS damage in PSP patients., Conclusions and Clinical Implications: Our results point to the complementary role of electrophysiological tests in the diagnostic work-up of dysautonomia in parkinsonian syndromes.

Published
2019
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43. Evaluation of reproductive health in female patients with multiple sclerosis in Polish population.

Author

Bartnik P, Wielgoś A, Kacperczyk-Bartnik J, Szymusik I, Podlecka-Piętowska A, Zakrzewska-Pniewska B, and Wielgoś M

Subjects
Adult, Comorbidity, Cross-Sectional Studies, Female, Humans, Middle Aged, Poland, Pregnancy, Quality of Life, Surveys and Questionnaires, Multiple Sclerosis, Relapsing-Remitting, Reproductive Health
Abstract

Multiple sclerosis (MS) is a chronic disease, which affects mostly women and has an early onset. Due to progress in treatment patients maintain a high quality of life for a long period and participate in all of its fields. One of them is reproductive health with all of its aspects. The aim of the study was to evaluate the reproductive health of female MS patients with regard to various features of MS. It was a cross-sectional study. The data was collected via anonymous survey distributed among patients with MS hospitalized at the Department of Neurology, Medical University of Warsaw and online. The study group consisted of 218 women diagnosed with MS. The survey consisted of demographic questions, questions assessing features of MS, reproductive health, sexual performance and psychological comorbidities, including depression and fatigue. 53.01% of MS patients declared interest in maternity. Patients interested in pregnancy were significantly younger (p < .01), often nulliparous (p < .001), had lower EDSS score (p < .006) and lower motor deficit (p < .001). History of at least one labour (p < .02) had a negative impact on the frequency of gynaecologic admissions. More advanced age (p < .003), unemployment (p < .01), at least one labour (p < .043), stronger balance problems (p < .003) and more intense motor deficit (p < .002) were related to less frequent Pap smears. Reproductive health of women with MS is similar to that of background population. Therefore, the general gynaecological care in those women should not be neglected., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Published
2018
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44. Sexual dysfunction in female patients with relapsing-remitting multiple sclerosis.

Author

Bartnik P, Wielgoś A, Kacperczyk J, Pisarz K, Szymusik I, Podlecka-Piętowska A, Zakrzewska-Pniewska B, and Wielgoś M

Subjects
Adult, China epidemiology, Demography, Fatigue etiology, Fatigue psychology, Female, Humans, Middle Aged, Neurologic Examination methods, Neuropsychological Tests, Sexual Behavior, Surveys and Questionnaires, Depression etiology, Depression physiopathology, Multiple Sclerosis, Relapsing-Remitting complications, Multiple Sclerosis, Relapsing-Remitting diagnosis, Multiple Sclerosis, Relapsing-Remitting epidemiology, Multiple Sclerosis, Relapsing-Remitting physiopathology, Sexual Dysfunction, Physiological etiology, Sexual Dysfunction, Physiological psychology
Abstract

Introduction: Sexual dysfunction (SD) is one of the common symptoms of multiple sclerosis (MS) and is often underdiagnosed, especially in women. Relapsing-remitting multiple sclerosis (RRMS) is the most widespread form of the disease, but the data on SD occurrence in this particular group of patients is limited. The aim of the study was to analyze the associations between demographic factors, symptoms and signs of MS, psychiatric comorbidities and SD in female patients with RRMS., Material & Methods: A subgroup of 86 sexually active women with RRMS out of 218 total MS respondents was analyzed. Exclusion criteria included active relapse, EDSS score equal or higher than 6.5, and current pregnancy. All patients completed questionnaires including demographic data, questions about symptoms and signs of MS, Female Sexual Function Index (FSFI) for sexual performance, Patient Health Questionnaire 9 (PHQ-9) for depression, and Fatigue Severity Scale (FSS) for fatigue evaluation., Results: According to FSFI, SD occurred in 21 (27.27%) of the respondents. SD occurrence was associated with depression ( p  < .05) and speech disturbances ( p  < .04). A negative effect on sexual performance was associated with depression intensity ( p  < .003), fatigue intensity ( p  < .05), more advanced age at diagnosis ( p  < .02), lower education level ( p  < .05), and smaller area of residence ( p  < .002)., Conclusions: SD in women with RRMS is mostly associated with psychosocial parameters. Patients who are more depressed, presenting speech problems, less educated, and from smaller towns, should be considered high-risk for sexual dysfunction.

Published
2017
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45. Bone metabolism and vitamin D status in patients with multiple sclerosis.

Author

Kępczyńska K, Zajda M, Lewandowski Z, Przedlacki J, and Zakrzewska-Pniewska B

Subjects
Absorptiometry, Photon, Adult, Bone Diseases, Metabolic blood, Bone Diseases, Metabolic complications, Calcium blood, Female, Femur Neck diagnostic imaging, Humans, Lumbar Vertebrae diagnostic imaging, Male, Middle Aged, Multiple Sclerosis, Chronic Progressive blood, Multiple Sclerosis, Chronic Progressive complications, Multiple Sclerosis, Relapsing-Remitting blood, Multiple Sclerosis, Relapsing-Remitting complications, Osteoporosis blood, Osteoporosis complications, Parathyroid Hormone blood, Phosphates blood, Vitamin D Deficiency blood, Vitamin D Deficiency complications, Bone Density physiology, Bone Diseases, Metabolic metabolism, Multiple Sclerosis, Chronic Progressive metabolism, Multiple Sclerosis, Relapsing-Remitting metabolism, Osteoporosis metabolism, Vitamin D blood, Vitamin D Deficiency metabolism
Abstract

Background: Vitamin D (VD), an important factor for bone health immobilization and immune regulation, has been shown to have low serum concentration in multiple sclerosis (MS) patients. Those patients have also multiple fracture risk factors, including progressive immobilization and long-term glucocorticoids treatment. The aim of the study was to analyze bone health (osteopenia or osteoporosis prevalence) and VD serum concentration in MS patients as well as the influence of disease activity and treatment on bone health., Materials and Methods: The study involved 72 MS patients: 52 women and 20 men. Mean age was 40.3±10.5 yrs, mean EDSS (Expanded Disability Status Scale) 3.3±1.9. Bone health was analyzed using standard densitometry in the lumbar spine and femoral neck. Serum levels of VD, calcium, phosphate and parathormone were assessed. We compared two groups of patients with multiple sclerosis: relapsing - remitting MS (RRMS) and progressive relapsing MS (PRMS)., Results: Densitometry revealed osteopenia in twenty-six (36.1%) patients and osteoporosis in eleven (15.3%), no bone fractures were presented. Sixty-eight MS patients (94.4%) had lower VD serum level if compared to population referential values. Thirteen patients (18.1%) had severe VD deficiency. Densitometry parameter (T-score of the lumbar spine) worsened with EDSS increase (r=-0.43, P=0.001). There was a statistically significant negative correlation between VD concentration and EDSS score (r=-0.31; P=0.009)., Conclusions: Our study indicates that patients with MS have high incidence of osteopenia and osteoporosis and vitamin D deficiency. Bone health disturbances studied by densitometry are related to the disability caused by MS., (Copyright © 2016 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.)

Published
2016
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47. Metagenomic Analysis of Cerebrospinal Fluid from Patients with Multiple Sclerosis.

Author

Perlejewski K, Bukowska-Ośko I, Nakamura S, Motooka D, Stokowy T, Płoski R, Rydzanicz M, Zakrzewska-Pniewska B, Podlecka-Piętowska A, Nojszewska M, Gogol A, Caraballo Cortés K, Demkow U, Stępień A, Laskus T, and Radkowski M

Subjects
Adult, Female, Herpes Zoster cerebrospinal fluid, Herpes Zoster virology, High-Throughput Nucleotide Sequencing methods, Humans, Male, Middle Aged, Multiple Sclerosis cerebrospinal fluid, Young Adult, Herpes Zoster epidemiology, Herpesvirus 3, Human genetics, Metagenomics methods, Multiple Sclerosis genetics, Multiple Sclerosis virology, RNA, Viral cerebrospinal fluid
Abstract

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of central nervous system of unknown etiology. However, some infectious agents have been suggested to play a significant role in its pathogenesis. Next-generation sequencing (NGS) and metagenomics can be employed to characterize microbiome of MS patients and to identify potential causative pathogens. In this study, 12 patients with idiopathic inflammatory demyelinating disorders (IIDD) of the central nervous system were studied: one patient had clinically isolated syndrome, one patient had recurrent optic neuritis, and ten patients had multiple sclerosis (MS). In addition, there was one patient with other non-inflammatory neurological disease. Cerebrospinal fluid (CSF) was sampled from all patients. RNA was extracted from CSF and subjected to a single-primer isothermal amplification followed by NGS and comprehensive data analysis. Altogether 441,608,474 reads were obtained and mapped using blastn. In a CSF sample from the patient with clinically isolated syndrome, 11 varicella-zoster virus reads were found. Other than that similar bacterial, fungal, parasitic, and protozoan reads were identified in all samples, indicating a common presence of contamination in metagenomics. In conclusion, we identified varicella zoster virus sequences in one out of the 12 patients with IIDD, which suggests that this virus could be occasionally related to the MS pathogenesis. A widespread bacterial contamination seems inherent to NGS and complicates the interpretation of results.

Published
2016
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48. Multiple metastatic intracranial lesions associated with left atrial myxoma.

Author

Kierdaszuk B, Gogol P, Kolasa A, Maj E, Zakrzewska-Pniewska B, Gołębiowski M, and Kamińska AM

Abstract

Background: One of the most common cardiac tumors is myxoma. Despite its predominantly benign course, diverse cardiological, systemic as well as neurological complications have been reported., Case Report: We are the first from Poland to present the case of a patient with multiple central nervous system metastases associated with the left atrial myxoma. Various diagnostic, neuroradiological and histopathological procedures were described. The patient underwent cardiac surgery., Conclusions: Follow-up studies excluded the recurrence of the heart tumor and confirmed partial resolution of brain metastases. Nevertheless, subsequent neurological assessment was advised according to the literature data and possible late relapses mainly due to cerebral emboli.

Published
2014
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49. Clinical and neuroimaging correlation of movement disorders in multiple sclerosis: case series and review of the literature.

Author

Potulska-Chromik A, Rudzinska M, Nojszewska M, Podlecka-Piętowska A, Szczudlik A, Zakrzewska-Pniewska B, and Gołębiowski M

Subjects
Adult, Aged, Female, Humans, Male, Middle Aged, Multiple Sclerosis pathology, Neuroimaging, Movement Disorders etiology, Multiple Sclerosis complications
Abstract

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system, in which movement disorders (MD) have been reported very rarely. Anatomopathological studies of MS indicate two main processes: inflammation and neurodegeneration. The occurrence of the movement disorders symptoms in MS revises the question of aetiology of these two diseases. During the 10 years of observation in our out-patient clinic and MS units we examined about 2500 patients with clinically definite MS diagnosed according to the revised McDonald's criteria. Only in 10 cases we found coexistence of MS and MD signs. Below we present rare cases of patients with coexistence of MS and chorea, pseudoathetosis, dystonia and parkinsonism. Searching for the strategic focal lesion in our case series showed demyelinating plaques placed in the thalamus most often. Detailed analysis of the clinical, pharmacological and neuroimaging correlations may help to explain the character of movement disorders in MS.

Published
2014
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50. The N-terminal pro-brain natriuretic peptide as a marker of mitoxantrone-induced cardiotoxicity in multiple sclerosis patients.

Author

Podlecka-Piętowska A, Kochanowski J, Zakrzewska-Pniewska B, Opolski G, Kwieciński H, and Kamińska AM

Subjects
Adult, Antineoplastic Agents administration & dosage, Antineoplastic Agents toxicity, Biomarkers blood, Cardiomyopathies blood, Cardiomyopathies chemically induced, Cardiomyopathies diagnosis, Female, Heart Diseases blood, Heart Diseases chemically induced, Heart Failure blood, Heart Failure chemically induced, Heart Failure diagnosis, Humans, Male, Middle Aged, Mitoxantrone administration & dosage, Mitoxantrone toxicity, Ventricular Dysfunction, Left blood, Ventricular Dysfunction, Left chemically induced, Ventricular Dysfunction, Left diagnosis, Antineoplastic Agents adverse effects, Heart Diseases diagnosis, Mitoxantrone adverse effects, Multiple Sclerosis drug therapy, Natriuretic Peptide, Brain blood, Peptide Fragments blood
Abstract

Background and Purpose: Mitoxantrone (MTX) has been shown to reduce progression of disability and number of clinical exacerbations in patients with progressive multiple sclerosis (MS). Prolonged administration of MTX, however, is limited by the risk of cardiotoxicity. Cardiac monitoring in MTX-treated patients includes usually measurement of left ventricular ejection fraction (LVEF) by means of echocardiography. The N-terminal pro-brain natriuretic peptide (NT-proBNP) represents a novel diagnostic tool in the assessment of heart failure. This study was aimed to evaluate the usefulness of NT-proBNP for early detection of MTX-induced cardiotoxicity in MS patients., Materials and Methods: We measured the NT-proBNP plasma levels in 45 MS patients who completed 24-month MTX therapy and in 37 MS patients of control group., Results: The median NT-proBNP plasma value was 15.12pg/mL. In 12 MTX-treated patients (27%), NT-proBNP plasma values were elevated, though this subgroup of patients neither clinical showed evidence of myocardial damage nor had the LVEF value <50%. In five patients with normal NT-proBNP, we observed LVEF decline >10%. We did not observe correlations between the NT-proBNP levels and patient age, MS duration, relapses index, Extended Disability Status Scale (EDSS), MTX single dose and the total cumulative dose of MTX. In 8 patients (22%) from control group, NT-proBNP plasma levels were also elevated., Conclusions: The results of our study confirm that MTX therapy is safe for carefully selected and closely monitored MS patients. We believe that serial evaluation of NT-proBNP levels (before, during and after MTX therapy) can identify MS patients at high risk for MTX-induced cardiotoxicity., (Copyright © 2014 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.)

Published
2014
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