The CVLT-II provides standardized scores for each of the List A five learning trials, so that the clinician can compare the patient's raw trials 1&#x2013;5 scores with standardized ones. However, frequently, a patient's raw scores fluctuate making a proper interpretation difficult. The CVLT-II does not offer any other methods for classifying a patient's learning and memory status on the background of the learning curve. The main objective of this research is to illustrate that discriminant analysis provides an accurate assessment of the learning curve, if suitable predictor variables are selected. Normal controls were ninety-eight healthy volunteers (78 females and 20 males). A group of MS patients included 365 patients (266 females and 99 males) with clinically defined multiple sclerosis. We show that the best predictor variables are coefficients <svg style="vertical-align:-0.17555pt;width:18.8125px;" id="M1" height="10.9125" version="1.1" viewBox="0 0 18.8125 10.9125" width="18.8125"  xmlns="http://www.w3.org/2000/svg">
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</svg>, allow nearly 100&#x25; correct classification. These predictors allow identification of separate impairment of readiness to learn or ability to learn, or both.

Igor I. Stepanov

Charles I. Abramson

Marietta Hoogs

Ralph H. B. Benedict

Overall Memory Impairment Identification with Mathematical Modeling of the CVLT-II Learning Curve in Multiple Sclerosis

<i>Purpose</i>. This systematic review critically analyzes the literature on the effectiveness of treadmill training (TT), body-weight-supported TT (BWSTT), and robot-assisted TT (RATT) in persons with multiple sclerosis (MS), with focus on gait-related outcome measurements. <i>Method</i>. Electronic databases (Pubmed, Pedro, Web of Science, and Cochrane Library) and reference lists of articles and narrative reviews were searched. Pre-, quasi- and true-experimental studies were included if adult persons with MS were involved in TT, BWSTT, or RATT intervention studies published before 2012. Descriptive analysis was performed and two researchers scored the methodological quality of the studies. <i>Results</i>. 5 true- and 3 preexperimental studies (mean quality score: 66&#37;) have been included. In total 161 persons with MS were involved (TT, BWSTT, or RATT, 6–42 sessions; 2–5x/week; 3–21 weeks). Significant improvements in walking speed and endurance were reported. Furthermore, improvements of step length, double-support time, and Expanded Disability Status Scale were found. <i>Conclusions</i>. There is a limited number of published papers related to TT in persons with MS, concluding that TT, BWSTT, and RATT improve the walking speed and endurance. However, it is not clear what type of TT is most effective. RCTs with larger but more homogeneous populations are needed.

Eva Swinnen

David Beckw&#233;e

Droesja Pinte

Romain Meeusen

Jean-Pierre Baeyens

Eric Kerckhofs

Treadmill Training in Multiple Sclerosis: Can Body Weight Support or Robot Assistance Provide Added Value? A Systematic Review

The objective of this work was to investigate the effects of whole-body vibration on people with multiple sclerosis (MS). PubMed, CINAHL and Scopus databases were systematically searched for studies on the use of whole-body vibration (WBV) exercise in people with MS. These searches were supplemented with material identified in the references and in the authors’ personal files.  A qualitative analysis was performed to summarize the findings. Five studies with a total of seventy-one subjects were identified. All of these studies had small numbers of subjects (3&#8211;25), and two of the studies had no control groups. Some investigations have shown significant improvements of the muscle strength, of the functional mobility, and of the timed get up and go test in patients with MS. The number of publications found in the databanks searched is small, and in general, they have limitations in the design of protocols with a weakness to the interpretation of the findings. However, the analysis of the findings in these studies permits to conclude that some papers indicate that WBV exercises could benefit patients with MS. In addition, we suggest further larger scale investigations with controlled parameters and well-designed protocols into the effects of WBV exercises in people with MS.

Sebastião David Santos-Filho

Michelle H. Cameron

Mario Bernardo-Filho

Benefits of Whole-Body Vibration with an Oscillating Platform for People with Multiple Sclerosis: A Systematic Review

<i  >Objectives</i>. To investigate the properties of the strength-duration time constant (SDTC) in multiple sclerosis (MS) patients. <i  >Methods</i>. The SDTC and rheobase in 16&#x2009;MS patients and 19 healthy controls were obtained following stimulation of the right median nerve at the wrist. <i  >Results</i>. SDTC and rheobase values were <svg style="vertical-align:-1.09097pt;width:80.287498px;" id="M1" height="12.175" version="1.1" viewBox="0 0 80.287498 12.175" width="80.287498"  xmlns="http://www.w3.org/2000/svg">
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				<tspan style="font-size: 12.50px; " x="0" y="0">4</tspan>
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				<tspan style="font-size: 12.50px; " x="42.247639" y="0">6</tspan>
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				<tspan style="font-size: 12.50px; " x="57.876389" y="0">0</tspan>
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</svg>&#x2009;<i  >&#x3bc;</i>s and <svg style="vertical-align:-1.09097pt;width:56.849998px;" id="M2" height="12.05" version="1.1" viewBox="0 0 56.849998 12.05" width="56.849998"  xmlns="http://www.w3.org/2000/svg">
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				<tspan style="font-size: 12.50px; " x="39.121887" y="0">8</tspan>
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</svg>&#x2009;mA in MS patients, versus <svg style="vertical-align:-1.09097pt;width:80.287498px;" id="M3" height="12.175" version="1.1" viewBox="0 0 80.287498 12.175" width="80.287498"  xmlns="http://www.w3.org/2000/svg">
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				<tspan style="font-size: 12.50px; " x="42.247639" y="0">6</tspan>
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				<tspan style="font-size: 12.50px; " x="57.876389" y="0">4</tspan>
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</svg>&#x2009;<i  >&#x3bc;</i>s and <svg style="vertical-align:-1.09097pt;width:56.849998px;" id="M4" height="12.05" version="1.1" viewBox="0 0 56.849998 12.05" width="56.849998"  xmlns="http://www.w3.org/2000/svg">
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				<tspan style="font-size: 12.50px; " x="39.121887" y="0">1</tspan>
			</text>

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</svg>&#x2009;mA in controls. The differences were not significant in SDTC or rheobase values between the patients and controls (<svg style="vertical-align:-0.27588pt;width:63.962502px;" id="M5" height="11.0375" version="1.1" viewBox="0 0 63.962502 11.0375" width="63.962502"  xmlns="http://www.w3.org/2000/svg">
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				<tspan style="font-size: 12.50px; " x="0" y="0">𝑃</tspan>
				<tspan style="font-size: 12.50px; " x="10.890113" y="0">=</tspan>
				<tspan style="font-size: 12.50px; " x="22.930502" y="0">0</tspan>
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				<tspan style="font-size: 12.50px; " x="32.307751" y="0">9</tspan>
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				<tspan style="font-size: 12.50px; " x="44.810753" y="0">8</tspan>
			</text>

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	</g>
</svg> for SDTC and <svg style="vertical-align:-0.17555pt;width:63.962502px;" id="M6" height="10.9125" version="1.1" viewBox="0 0 63.962502 10.9125" width="63.962502"  xmlns="http://www.w3.org/2000/svg">
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				<tspan style="font-size: 12.50px; " x="0" y="0">𝑃</tspan>
				<tspan style="font-size: 12.50px; " x="10.890113" y="0">=</tspan>
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				<tspan style="font-size: 12.50px; " x="32.307751" y="0">7</tspan>
				<tspan style="font-size: 12.50px; " x="38.559254" y="0">2</tspan>
				<tspan style="font-size: 12.50px; " x="44.810753" y="0">2</tspan>
			</text>

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	</g>
</svg> for rheobase). <i  >Conclusion</i>. Our study showed no abnormality in relapsing remitting MS patients in terms of SDTC, which gives some indirect information about peripheral Na<sup  >+</sup> channel function. This may indicate that alterations in the Na<sup  >+</sup> channel pattern in central nervous system (CNS) couldnot be shown in the peripheral nervous system (PNS) in the MS patients by SDTC. The opinion that MS can be a kind of channelopathy might be proven by performing other axonal excitability tests or SDTC in progressive forms of MS.

Gençer Genç

Semai Bek

Tayfun Kasikci

Umit Hidir Ulas

 Seref Demirkaya

Zeki Odabasi

Strength-Duration Time Constant in Peripheral Nerve:  No Abnormality in Multiple Sclerosis

The aim of this preliminary study was to evaluate the effect of low-dose oral vitamin D in combination with current disease-modifying therapy on the prevention of progression of relapsing-remitting multiple sclerosis (RRMS). A phase II double-blind placebo-controlled randomized clinical trial conducted between October 2007 and October 2008 included 50 patients with confirmed RRMS aged 25 to 57 years and normal serum 25-hydroxyvitamin D. They were randomly allocated to receive 12 months of treatment with either escalating calcitriol doses up to 0.5 μg/day or placebo combined with disease-modifying therapy. Response to treatment was assessed at eight-week intervals. In both groups, the mean relapse rate decreased significantly (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>P</mml:mi><mml:mo>&lt;</mml:mo><mml:mn>0.001</mml:mn></mml:math>). In the 25 patients treated with placebo, the mean (SD) Expanded Disability Status Scale (EDSS) increased from 1.70 (1.21) at baseline to 1.94 (1.41) at the end of study period (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>P</mml:mi><mml:mo>&lt;</mml:mo><mml:mn>0.01</mml:mn></mml:math>). Average EDSS and relapse rate at the end of trial did not differ between groups. Adding low-dose vitamin D to routine disease-modifying therapy had no significant effect on the EDSS score or relapse rate. A larger phase III multicenter study of vitamin D in RRMS is warranted to more assess the efficacy of this intervention.

Vahid Shaygannejad

Mohsen Janghorbani

Fereshteh Ashtari

Hamed Dehghan

Effects of Adjunct Low-Dose Vitamin D on Relapsing-Remitting Multiple Sclerosis Progression: Preliminary Findings of a Randomized Placebo-Controlled Trial

Despite the known difficulties many people with MS have with high ambient temperatures, there are no reported studies of air conditioning use and MS.  This study systematically examined air conditioner use by Australians with MS.  A short survey was sent to all participants in the Australian MS Longitudinal Study cohort with a response rate of 76&#x25; (<svg style="vertical-align:-1.76814pt;width:65.050003px;" id="M1" height="13.075" version="1.1" viewBox="0 0 65.050003 13.075" width="65.050003"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,13.075)">
		<g transform="translate(72,-61.54)">
			<text transform="matrix(1,0,0,-1,-71.95,63.35)">
				<tspan style="font-size: 12.50px; " x="0" y="0">𝑛</tspan>
				<tspan style="font-size: 12.50px; " x="9.6773224" y="0">=</tspan>
				<tspan style="font-size: 12.50px; " x="21.71771" y="0">2</tspan>
				<tspan style="font-size: 12.50px; " x="27.969212" y="0">,</tspan>
				<tspan style="font-size: 12.50px; " x="33.182961" y="0">3</tspan>
				<tspan style="font-size: 12.50px; " x="39.434464" y="0">8</tspan>
				<tspan style="font-size: 12.50px; " x="45.685963" y="0">5</tspan>
			</text>

		</g>
	</g>
</svg>).  Questions included hours of air-conditioner use, areas cooled, type and age of equipment, and the personal effects of overheating.  Air conditioners were used by 81.9&#x25; of respondents, with an additional 9.6&#x25; who could not afford an air conditioner.  Regional and seasonal variation in air conditioning use was reported, with a national annual mean of 1,557 hours running time.  90.7&#x25; reported negative effects from overheating including increased fatigue, an increase in other MS symptoms, reduced household and social activities, and reduced work capacity.  Households that include people with MS spend between 4 and 12 times more on keeping cool than average Australian households.

Michael P. Summers

Rex D. Simmons

George Verikios

Keeping Cool: Use of Air Conditioning by Australians with Multiple Sclerosis

Recent advances in the field of neuromyelitis optica (NMO) research provided convincing evidence that anti-AQP4 antibody (AQP4-Ab) not only serves as a highly specific disease marker, but also plays an essential role in the pathogenesis of the disease. Although it is now widely recognized that AQP4-Ab induces astrocytic necrosis in a complement-dependent manner, additional triggers are also suspected as a prerequisite for the development of the disease. Unraveling these unresolved aspects of the disease will provide substantial insight into still controversial issues in the pathogenesis of NMO.

Makoto Kinoshita

Yuji Nakatsuji

Where Do AQP4 Antibodies Fit in the Pathogenesis of NMO?

<i>Background</i>. Neuromyelitis optica (NMO) attacks are poorly controlled by steroids and evolve in stepwise neurological impairments. Assuming the strong humoral response underlying NMO attacks, plasma exchange (PLEX) is an appropriate technique in severe NMO attacks. <i>Objective</i>. Presenting an up-to-date review of the literature of PLEX in NMO. <i>Methods</i>. We summarize the rationale of PLEX in relation with the physiology of NMO, the main technical aspects, and the available studies. <i>Results</i>. PLEX in severe attacks from myelitis or optic neuritis are associated with a better outcome, depending on PLEX delay (&#8220;time is cord and eyes&#8221;). NMO-IgG status has no influence. Finally, we build up an original concept linking the inner dynamic of the lesion, the timing of PLEX onset and the expected clinical results. <i>Conclusion</i>. PLEX is a safe and efficient add-on therapy in NMO, in synergy with steroids. Large therapeutic trials are required to definitely assess the procedure and define the time opportunity window.

Mickael Bonnan

Philippe Cabre

Plasma Exchange in Severe Attacks of Neuromyelitis Optica

About this journal

<p><em>Multiple Sclerosis International</em> publishes articles related to all aspects of multiple sclerosis, such as clinical neurology, neuroimaging, neuropathology, neuroimmunology, biomarkers, psychology and neurorehabilitation.</p>


Journal profile

Meet the editorial board

<p><em>Multiple Sclerosis International&nbsp;</em>maintains an Editorial Board of practicing researchers from around the world, to ensure manuscripts are handled by editors who are experts in the field of study.</p>


Editor spotlight

Submit your proposal

Do you think there is an emerging area of research that really needs to be highlighted? Or an existing research area that has been overlooked or would benefit from deeper investigation? Raise the profile of a research area by leading a Special Issue.

Special Issues

Author guidelines

Editorial board

Databases and indexing

Multiple Sclerosis International - Table of contents 2012

Multiple Sclerosis International | Hindawi

title

Multiple Sclerosis International publishes articles related to all aspects of multiple sclerosis, such as clinical neurology, neuroimaging, neuropathology, neuroimmunology, biomarkers, psychology and neurorehabilitation.

Multiple Sclerosis International