Multiple Sclerosis: Etiology, Diagnosis, and New Treatment Strategies (Current Clinical Neurology)

The recent explosion of new information about the pathology, pathophysiology, clinical classification, imaging, and treatment of multiple sclerosis (MS) has dramatically opened the way to a deeper understanding of the disease and a more effective therapeutic landscape for patients. In Multiple Sclerosis: Etiology, Diagnosis, and New Treatment Strategies, leading MS physicians synthesize current concepts about the evaluation, treatment, and future directions in MS. On the evaluation side, the authors review the use of magnetic resonance imaging (MRI), magnetic resonance spectroscopy, functional MRI, and three-dimensional MRI, and consider the rapidly developing body of pathologic information they have yielded. On the treatment side, the focus is on recently approved medications (Novantrone), new indications for medications (CHAMPS Trial), medications in development (Oral Interferon Tau, Oral Copaxone, and Oral Cellcept), immunosuppressive therapy for both progressive disease and symptomatic therapy; the current medications for treating relapsing-remitting MS (Avonex, Betaseron, and Copaxone) are also discussed. For future directions, the authors present the current best thinking, as well as the latest discoveries in immunology relating to MS, including groundbreaking B-cell research, its applications to specific immunotherapies, and the use of immune markers for tracking the disease. Additional chapters cover the mechanism and application of myelin repair, bone marrow transplantation, combination therapy, and specific immunomodulatory treatments. Comprehensive and up-to-date, Multiple Sclerosis: Etiology, Diagnosis, and New Treatment Strategies reviews all the current immunological, neuropsychological, imaging, and pregnancy issues associated with MS and shows how each is contributing to the still ongoing development of more efficacious therapies. Doody Review Services Reviewer: Tanuja Chitnis, MD(Brigham & Women's Hospital) Description: This is an updated review of the diagnosis, prognosis, and current therapeutic strategies in multiple sclerosis (MS). Purpose: The author's objectives are to provide an update on current concepts for the evaluation, treatment, and future directions in MS. This book meets the author's listed objectives, but in some areas, particularly immunopathogenesis, a more thorough overview should be provided. The chapter on treatment of progressive MS fails to differentiate between the various forms of progressive MS, and its subsequent implications for treatment decisions. Also, a more structured organization of chapters outlining treatment is desired. Audience: The targeted audience includes primary care physicians and neurologists caring for MS patients. The author is a reasonable authority in the field. Features: The main topics covered in this book include clinical manifestations, prognostic factors, and diagnosis of MS and therapy. There is an in-depth chapter on the role of MRI in diagnosis and prognosis, and a description of cognitive dysfunction in MS. Immunopathology and genetics are briefly discussed, and a detailed chapter on the role of B cells in MS autoimmunity is provided. Sections outline treatment of early MS, treatment during pregnancy, and progressive MS with a focus on the use of cyclophosphamide. Immunologic mechanisms of new therapeutic strategies are discussed and highlight the future directions of MS immunotherapy. Synopsis of neuroprotection and CNS repair provides insight into this emerging research area. Assessment: In contrast to comparable publications, this book offers a practical, management-oriented approach to MS and interpretation of current clinical literature. Unique to this publication is the review of pregnancy and cognitive issues. The treatment sections are fairly complete, but would benefit from a more structured organization. Inclusion of a chapter on mitoxantrone and further detail about the immunopathogenesis of the disease are required. Incorporating these changes into future editions would significantly improve the book. This review was prepared by Tanuja Chitnis, MD, Susan Gauthier, DO, and Samia J. Khoury MD (Brigham & Women's Hospital and Harvard Medical School). Signs and symptoms of multiple sclerosis / Stanley van den Noort Differential diagnosis, clinical features, and prognosis of multiple sclerosis / Michael J. Olek Role of magnetic resonance imaging in the diagnosis and prognosis of multiple sclerosis / Robert Zivadinov and Rohit Bakshi Cognitive dysfunction in multiple sclerosis / Darcy Cox and Laura Julian Multiple sclerosis, genetics, and autoimmunity / Michael Demetriou B-cell immunology in multiple sclerosis / Yufen Qin and Pierre Duquette Multiple sclerosis : a case for early treatment / Alex C. Tselis and Omar A. Khan Pregnancy and multiple sclerosis / Christina Caon Treatment of progressive multiple sclerosis / Norman Wang Cyclophosphamide therapy for multiple sclerosis / Derek R. Smith Repair and neuroprotective strategies in multiple sclerosis / Fernando Dangond Future therapies / Michael J. Olek. Front Matter....Pages i-xv Signs and Symptoms of Multiple Sclerosis....Pages 1-14 Differential Diagnosis, Clinical Features, and Prognosis of Multiple Sclerosis....Pages 15-53 Role of Magnetic Resonance Imaging in the Diagnosis and Prognosis of Multiple Sclerosis....Pages 55-89 Cognitive Dysfunction in Multiple Sclerosis....Pages 91-102 Multiple Sclerosis, Genetics, and Autoimmunity....Pages 103-112 B-Cell Immunity in Multiple Sclerosis....Pages 113-130 Multiple Sclerosis....Pages 131-143 Pregnancy and Multiple Sclerosis....Pages 145-159 Treatment of Progressive Multiple Sclerosis....Pages 161-170 Cyclophosphamide Therapy for Multiple Sclerosis....Pages 171-191 Repair and Neuroprotective Strategies in Multiple Sclerosis....Pages 193-207 Future Therapies for Multiple Sclerosis....Pages 209-234 Back Matter....Pages 235-245 "Comprehensive and up-to-date, Multiple Sclerosis: Etiology, Diagnosis, and New Treatment Strategies reviews all the current immunological, neuropsychological, imaging, and pregnancy issues associated with MS and shows how each is contributing to the still ongoing development of more efficacious therapies." --Résumé de l'éditeur