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From page 413... ... , 38, 39-40, 64 oligodendrocyte destruction, 350-351 Theiler's murine encephalomyelitis virus (TMEV) Read the entire page →
From page 414... ... , 42, 45 neutralizing antibodies, 51, 52, 97 Anxiety, 122, 123, 152, 200, 211, 217, 224 see also Depression side effects of treatment, 50, 125, 126, 127, 135, 388 treatment, 227, 229 Apoptosis, 7, 98, 243, 254, 255, 259, 269, 281, 284-285, 286, 287, 295, 351, 358-359, 392 Arthritis, 14, 44, 69, 122, 145, 152, 153, 297, 299, 328, 329, 337, 366 Asians, 48, 77, 79, 83, 85, 87 Assistive technology, ix, 199, 205-210, 385386 catheterization, 143, 206 cognitive impairment, 119, 209 cost and cost-effectiveness, 205, 206, 207, 210 defined, 205 employment, 193, 207-208 environmental control technology, 206, 207 health screening, 222-223 insurance coverage, 206, 209, 222 wheelchairs, 128, 188, 199, 206-207, 209, 220, 222, 386 Astrocytes, 3, 4 antigens, 244-245, 350 biological features of MS, 45, 62, 64, 71, 87 blood-brain barrier, 257 cytokines, 257, 258, 259, 350 disease mechanism research, 241, 245, 253, 257, 258, 259, 267 glial scars, 3, 241, 350 inflammation, 258 research recommendations, 241, 244-245, 253, 257, 258, 259, 267, 349, 350 treatment, 282, 284, 286, 294 Asymptomatic MS, 6, 30, 35-36, 88, 115, 177 Ataxia and tremor, 128, 138-140, 163 assistive technologies, 209 employment and, 191 experimental autoimmune encephalomyelitis (EAE) Read the entire page →
From page 415... ... , 42, 74, 265266 cloning, 42, 93 biomarkers, 265-266 experimental autoimmune encephalomyelitis (EAR) , 93 B lymphocytes, see B cells Back pain, 145, 160, 165 Baclofen, 132-133, 165, 289 Bacteria, 15, 67, 78, 283, 366 Barthel Index, 198, 200, 205, 215 Beck Depression Inventory, 121, 122 Bee venom, 408 Behavioral factors see also Functional status; Patient perspectives patient adherence to therapy, 51-52 measurement, 197 modification therapy, 123, 153 Social Security Administration disability criteria, 403 Bentyl, 144-145 Benzodiazapines, 133, 165 Beta-interferon, 35, 48-51, 60, 277, 284, 298, 307, 361, 392 animal studies, 92 Avonex/Rebif, 49, 50, 388, 396 Betaseron, 49, 51, 53, 388 cognitive impairment, 119 depression, 52, 123, 126-127 neutralizing antibodies, 51, 52, 97 side effects of, 49, 52, 123, 126-127, 388 Biological markers, 42, 44-45, 262-267, 308, 366-367 B cells, 265-266 cerebrospinal fluid (CSF) Read the entire page →
From page 416... ... 416 fatigue, 155 immune response, general, 42, 44, 45, 47, 263-266 oligoclonal bands, 42, 44, 46, 74, 87, 90, 164, 260, 266, 354 Biotechnology, 280, 289 see also Stem cell therapy private sector, 341-343 transgenic animals, 91, 93, 97, 100-104, 280, 355, 356-357 Black holes, see Tl-weighted hypointense lesions Bladder and bowel dysfunction, ix, 124, 140148 back pain, 165 catheterization, 143, 206 constipation, 125, 135, 140, 145, 146, 147, 154 diarrhea, 125, 135, 145, 154 measurement, 198, 199, 201, 202 relapses, 32, 34 research recommendations 143, 147 spasticity and, 142, 143, 144 treatment, 140, 142-145, 146-147, 400 as side effect, 135, 145, 154 Blood-brain barrier clinical factors, 37, 38, 45 depression, 126 disease mechanisms, 60, 63, 67, 70, 75, 76, 245, 257-258, 263 imaging, 37, 38, 356 research recommendations, 18, 350 treatment, 278, 288 Bone marrow transplants, 294, 296-298, 313, 314, 339 see also Stem cell therapy Botox, 134-135 Botulism A toxin, 133, 134, 149 Bowel dysfunction, see Bladder and bowel dysfunction Brain, vii, ix, 26, 283-284, 285, 350, 409 see also Alzheimer's disease; Blood-brain barrier; Brain stem; Cerebellum; Cerebral cortex; Cerebrospinal fluid; Cerebrum; Imaging technology; Parkinson's disease; Thalamus AMPA/kainate receptors, 243, 244, 287, 290 INDEX animal studies, 96, 103 encephalomyelitis, 7, 43, 72-73, 8486, 99; see also Experimental autoimmune encephalomyelitis asymptomatic MS, 35, 36 atrophy, 35, 38, 39, 122, 278, 356 banks, 316-318, 332, 339 depression, 122 employment and, 191 fatigue, 152-153, 155 hippocampus, 249, 293 laughing and crying, 119 N-acetyl aspartate, whole-brain, 39 optic neuritis, 148 self-repair mechanisms, 2, 26 spasticity, 129, 130 stroke, 115, 120-121, 130, 162, 200, 287, 291 surgery, 132, 134, 139-140, 147, 411, 412 T cells, brain-specific, 60, 70, 93, 252253, 254, 257-258, 260-261, 263265, 279, 280, 354, 355, 397 weakness, 130 Brain stem, 31, 34, 48, 201 evoked potentials, 47 lesions, general, 30 sexual dysfunction, 157 spasticity, 130 Tl-weighted hypointense lesions, 40 weakness, 130 British Society of Rehabilitation Medicine, 217-218 C Calcium, 45, 69, 134, 249, 253, 267, 288, 349, 407 Cambridge Multiple Sclerosis Basic Score, 202 Canaboids, see Marijuana Canada, 221, 339 CaP CURE, 13, 333, 339, 340, 345, 346, 365 Capsaicin, 144-145 Catheterization, 143, 206 Caucasians, 77, 82, 83-84 Read the entire page →
From page 417... ... , 277, 278, 304, 306, 307, 308, 309-311 marijuana, 229 measurement instruments, 203, 204 neuroplasticity, 247-248 optic neuritis, 148-149, 247-248 outcome measures, 194, 195 pain, 160, 162, 163, 165-166 primary prophylaxis, 277 progressive MS, altering, 278 racial/ethnic factors, 340-341 rehabilitation, 213, 214-216 relapse prevention, 277, 290-291 research recommendations, 4, 8-10, 24, 277-278, 352, 353, 359-361 standards, 20 stem cell therapy, 300-301 workshop agendas, 381 Clonazepam, 133, 134 Read the entire page →
From page 418... ... , 204-205 rehabilitation, 212 relapses, 32 research recommendations, 119- 120 Social Security Administration disability criteria, 402 treatment, 123 Communication, 191, 198, 201, 206, 216221, 386 see also Language skills; Patient education aids, 208-209 diagnosis, 12, 17, 179-180, 216-219 Internet, 12, 206, 208-209, 218, 221 physicians and other caregivers, 10, 25, 216-219, 223, 318, 363, 381 Computer applications see also Databases/registries assistive technology, 208, 209 ataxia and tremor, 138 bladder dysfunction, 143 cognitive impairment, 119 general information dissemination, 12 Internet, 12, 206, 208-209, 218, 221 Confidentiality, 361 Constipation, 125, 135, 140, 145, 146, 147, 154 Coordination loss, see Ataxia and tremor Copaxone, see Glatiramer acetate Cost and cost-effectiveness factors assistive technology, 205, 206, 207, 210 clinical trials, 8-9, 303-304, 365 INDEX erroneous research claims, 15, 306 health care modes, 210-211 quality-adjusted life years (QALYs) , 53-54 transgenic animal studies, 101 treatment, 52, 53-54, 210-211 Cramps, see Muscle spasms and cramps Crying, see Langhing and crying Cyclophosphamide, 390 Cylert, 154 Cytokines, 21, 42, 44, 60, 62, 64, 68, 74-76, 257-260, 264-265, 355 see also Beta-interferon; Tumor necrosis factor astrocytes, 257, 258, 259, 350 biomarkers, 259, 263-264 glia, 75, 76, 87 immune-based therapy, 259-260, 278-279, 281, 282, 285, 289, 290, 391, 392, 397 inflammatory/anti-inflammatory, 21, 75, 76, 87, 242, 257, 258, 259-260, 281, 391, 392 interleukin, 49, 60, 61, 103, 258, 259-260, 264-265, 392, 397, 398 neuropoietic, 74, 285 oligodendrocytes, 75, 259 transforming growth factor (T.F.) Read the entire page →
From page 419... ... , 41 molecular plasticity of axons, 246-247, 349 myelin basic protein, 5-6, 42, 44, 50, 60, 66, 71, 72-73, 82, 257, 354, 389, 398 oligodendrocytes, 7-8 optic nerve, 115 pain, 163, 166 patient diagnosis information, 218 research recommendations, 268-269, 349, 354-355 spasticity, 130 T cells, 6, 21, 42, 66-76, 82, 86, 92, 93, 98, 99, 244, 251-257, 263, 279280, 354, 355, 388, 389, 395, 397, 398 animal models, 251-252, 355 419 suppressor cells, 17, 50, 73, 78, 257, 279-280 treatments, 49, 50, 257, 279-280, 303, 388, 389, 390, 391, 395, 397, 398 see also Major histocompatibility complex toxins, 84 virus-induced, 7, 88, 89, 90, 91, 95-98, 99-100, 357-358 Theiler's murine encephalomyelitis virus (TMEV) , 48, 91, 92, 95, 96, 99, 269, 357 Dental therapy, 15, 367, 411-412 Department of Defense, 314 Deporpanex, 408 Depression, ix, 120-128 see also Anxiety beta-interferon, 52, 123, 126-127 cognitive impairment and, 118, 122, 123 crying, 118-119 exercise and, 224 fatigue and, 153, 155 interferon therapy, 52 measurement, 121-122, 200, 202 sexual dysfunction and, 156 spousal attitudes, 186 suicide, 122-123, 388 treatment, 123-128, 153, 400 as side effect, 123, 125-127, 135, 150, 154, 388 Desipramine, 123 Deskar, 395 Desmopressin, 144-145 Detrol, 144-145 Dexamethasone, 150 Diabetes mellitus, 280, 328, 353 Diagnosis, 3, 42-48, 216-217, 357 see also Autopsies; Biological markers; Imaging technology; Symptoms atrophy, 39, 356 cerebrospinal fluid (CSF) Read the entire page →
From page 420... ... , 72, 74, 84, 86, 91-94, 102, 103 major histocompatibility complex, 61, 68, 76, 80-82, 83, 244, 251, 252, 256, 257, 260-261, 264, 268 research recommendations, 241-277, 348 spasticity, 130- 132 tumor necrosis factor (TNF) , 258, 259, 260, 264-265, 266, 268 Disease variants, 360, 363 see also Primary progressive MS; Progressive MS; Relapsingremitting MS; Secondary progressive MS asymptomatic MS, 6, 30, 35-36, 88, 115, 177 biological markers, 261, 262-267 magnetic resonance imaging, 261-262 monogenetic MS, 5, 269, 351 Ditropan XL, 144-145 Dizziness, 115, 125, 135, 145, 150, 154, 400 DNA, 316, 352 see also Genomics autoantigens, 253 B cells, 74 infectious agents, 260 magnetic resonance imaging (MRI) Read the entire page →
From page 421... ... INDEX microarrays, 256-257, 265, 269-271, 316, 354, 355 polymerase chain reaction, 5, 260, 265, 353, 354, 355 treatments, 50, 257 transgenic animals, 91, 93, 97, 100-104, 280, 355, 356-357 vaccines, 279 Dorsal column, 162, 248, 410-411 Drug treatment, see Pharmaceuticals Dysesthetic pain, 162-163, 165, 166, 250, 400 E EAR, see Experimental autoimmune encephalomyelitis Economic factors, see Cost and costeffectiveness factors; Employment; Funding; Socioeconomic status EDSS, see Expanded Disability Status Scale Education, see Information dissemination; Patient education; Professional education Educational attainment, patients, 189, 190, 191, 192, 199, 219, 221 Electromyocardiogram, 138 Electrophysiology, general, 8, 306 axons and myelin, general, 54-65, 246 electrical impulse conduction, 20, 56, 57, 58, 65, 242, 247, 255, 349, 350 dorsal column stimulation, 410-411 evoked potentials, 42, 43-47, 56, 130, 148, 157 weakness, 136 Elavil, 124-125 Eliprodil, 392, 393 Emotional impairment, 116, 119, 181-182, 183, 211 see also Anxiety; Depression assistive technology, 206-207 cognitiveimpairmentvs, 116, 119-120 diagnosis, emotional response, 17, 179180 exercise and, 224 laughing and crying, 118-119 measurement, 197, 198, 200, 202 rehabilitation, 215 side effect of treatment, 123, 125-127, 135, 150, 154, 388 421 Employment, 9, 14, 177, 178, 190-193, 197, 202 assistive technology, 193, 207-208 bladder and bowl dysfunction, 140 cognitive impairment, 115-116, 191, 404 depression, 122 fatigue, 191, 193, 205 gender factors, 191 researchers, 334-336 Social Security Administration disability criteria, 404 Encephalomyelitis, 7, 43, 72-73, 84-86, 99 see also Experimental autoimmune encephalomyelitis acute disseminated encephalomyelitis, 84, 85, 86 postinfectious encephalomyelitis, 86, 99 transverse myelitis, 30 Endothelial cells, 245, 257, 258, 265, 287, 391 Enolase, 42, 45 Environmental control technology, 206, 207 Environmental factors in causation, 67, 77, 78, 352 familial, 79 geographic, 76-77 toxins, 15, 84, 85 Environmental Status Scale, 202 Enzyme-linked immunosorbent assay, 265 Epidemiology, vii, 76-79, 190, 312, 352 see also Demographic factors; Incidence and prevalence functioning and quality of life studies, 10, 11, 362 infections, 77, 78-79, 86 Epilepsy, 1, 22, 328 Ethnicity, see Race/ethnicity Ethylenediamine tetraacetic acid, 410 Etiology and pathogenesis, 8, 54-76 see also Animal models; Clinical studies and trials; Demyelination; Diseases mechanisms; Immune response; Infections; Pain and pain management; Viruses committee task, 25, 26 erroneous research claims, 15, 306-367 infections, general, 33, 67, 78-79, 84, 85, 86, 87-90, 150, 252, 260-261 laughing and crying, 119 newly proposed pathogens, 14-15 research management, 14- 15 Read the entire page →
From page 422... ... , 40, 201, 202, 204-205, 211, 304, 306, 385-386 cognitive impairment, 117-118 depression, 121 outline of, 385-386 quality of life, 178 rehabilitation, 212-213, 214 sexual dysfunction, 157 Experimental autoimmune encephalomyelitis (EAR) disease management and measurement, 137, 163, 225-226 disease mechanisms, 72, 74, 84, 86, 9194, 102, 103 inflammation, 93-94 research strategies, 252, 253, 254-255, 257, 258, 260, 263, 268, 269, 270271, 278, 357 symptom characterization and management, 137, 163 treatment, 280, 285, 286, 288, 395 Eye pathologies, see Optical pathologies INDEX F Family factors, 178, 185-187, 190, 210, 362 assistive technology, 206 children, relations with, 187 cognitive impairments, 116 depression, 127 diagnosis, 217 genetic, 9, 11, 79, 80, 83 measurement, 197, 198, 199 monogenetic MS, 5, 269, 351 research recommendations, 351, 352 spouses, 185, 186 Fampridine, 394 Fatigue, viii, ix, 17, 149-155, 178 see also Weakness assistive technology, 207 clinician attitudes toward, 116 cognitive impairment and, 118 defined, 151 depression and, 121, 122 employment and, 191, 193, 205 functional MRI (fMRI) Read the entire page →
From page 423... ... , 200, 205, 211, 305 Impairment Scale for the European Database for Multiple Sclerosis, 202 Incapacity Status Scale, 201-202 Minimal Record of Disability, 201, 202 Multiple Depression Inventory, 121 Multiple Sclerosis Functional Composite Scale (MSFC) , 201, 203, 304, 306, 362 Multiple Sclerosis Impact Scale, 198 Multiple Sclerosis Quality-of-Life Inventory, 198 Sickness Impact Profile, 197, 198 standards, 194, 363 neuroplasticity, 246, 250 patient perspectives, 17, 179, 180, 194-195 remission, 246 research recommendations, 8, 10- 11, 362363 Social Security Administration disability criteria, 401 standards, 194, 363 workshop agendas, 382 423 Functional System Scales, 201 Funding, 325-333, 345, 362-363 assistive technology, 206 bone marrow transplant registries, 314 brain banks, 316, 317 clinical trials, 9, 50, 298, 300, 306, 310, 341 genetics and genomics, 268-269, 352 interdisciplinary research, 13, 365 MS Society, viii, 22, 23-24, 326-327, 329, 332, 338-339, 343-344, 362-363 NIH, vii, 22, 23, 314-315, 316, 325, 327, 332, 334 personal and social issues, 11 research centers, 322-333 researchers, 334-335, 364 G GABA (gama-aminobutyric acid) Read the entire page →
From page 424... ... , 5354 research recommendations, 361-363 Social Security Administration disability criteria, 401-404 Hepatitis virus, 95, 98-99, 100 Herpes virus, 89-90, 354 High-field strength magnetic resonance imaging, 38, 41 Hippocampus, 249, 293 Hiprex, 144-145 Read the entire page →
From page 425... ... , 6, 120, 356 relapsing-remitting MS, 37, 40 research recommendations, 4, 6, 349, 355358, 361 spinal cord, 1, 35-36, 43, 356 workshop agendas, 379-380 Imipramine, 144-145 Immune-based therapy, 48-54, 252, 257, 272, 279-280, 353, 392-398 see also Beta-interferon; Transplantation autoantigens, 253-254 clinical studies, 48, 50-51, 52 cost of, 52, 53-54 cytokines, 259-260, 278-279, 281, 282, 285, 289, 289, 290, 391, 392, 397 magnetic resonance imaging in evaluation of, 48, 50, 51 425 neuronal plasticity, 245-246 relapses, 50, 51-52, 277-278 T cell therapy, 49, 50, 257, 279-280, 303, 388, 389, 390, 391, 395, 397, 398 vaccines acute disseminated encephalomyelitis, 84 MS, 279, 280, 390, 397, 409 Immune response, vii, 4, 5-6, 17, 18, 21, 42, 65-76, 84, 242, 251-260 see also Antibodies; Antigens; B cells; Blood-brain barrier; Chemokines; Cytokines; Infections; Infectious agents; Inflammation; Major histocompatibility complex; Marcophages; T cells; Transplantation animal models, general, 7, 21, 48, 91, 97, 103 biomarkers, 42, 44, 45, 47, 263-266 cascade of events, 4, 5-6, 68, 70, 243, 278, 288, 354-355 gender factors, 23, 67 immunoglobulins, 42, 44, 47, 60, 73, 74, 83, 93, 260, 266, 354, 392, 393, 395, 410 macrophages, 45, 60, 64, 67, 71, 74, 75, 99, 103, 251, 253, 254, 263, 287, 392, 398 oligodendrocytes, 8, 65, 73, 253, 254, 359 postinfectious encephalomyelitis, 86 research recommendations, 268-269, 278, 350-351, 354-355 workshop agendas, 379-380 Immunobiological revitalization, 410 Immunoglobulins, 42, 44, 47, 60, 73, 74, 83, 93, 260, 266, 354, 392, 393, 395, 410 Impairment see also Assistive technology; Ataxia and tremor; Bladder and bowel dysfunction; Cognitive impairment; Depression; Emotional impairment; Expanded Disability Status Scale; Fatigue; Functional status; Language skills; Pain and pain Management; Rehabilitation; Spasticity; Visual impairments; Walking difficulties; Weakness defined, 204, 362 Read the entire page →
From page 426... ... , 95, 253, 255, 257, 258, 264, 268, 355, 391, 398 Theiler's murine encephalomyelitis virus (TMEV) , 95-96 Information dissemination, 11-12 see also Databases/registries; Internet; Patient education; Professional education committee task statement, 25 computers, general, 12 Informed consent, 51-52 Interdisciplinary approach care, 211 rehabilitation, 212 research, 13-14, 332-333, 364-367 Interferon, 20, 92, 260, 290, 392, 398 see also Beta-interferon depression as a side effect, 123, 126-127 Interleukin (IL) Read the entire page →
From page 427... ... , 35, 38, 40, 41, 61, 310, 356 T2-weighted hyperintense lesions, 38, 39, 40, 46, 310 Leukarrest, 395 Leukemia, 74, 87, 297 Leukodystrophies, 85 Leukoencephalopathy, see Progressive multifocal leukoencephalopathy Leustatin, 395 Life expectancy, 29, 223 quality-adjusted life years (QALYs) , 5354 Linomide, 392 Lioresal, 134 Longitudinal studies see also Databases/registries cytokines, 75, 259 functioning and quality of life, 10, 361 Lymphocytes, see B cells; T cells Read the entire page →
From page 428... ... disease mechanisms, 61, 68, 76, 80-82, 83, 244, 251, 252, 256, 257, 260261, 264, 268 animal models, 91, 103 racial/ethnic factors, 82, 83-84 INDEX research recommendations, 244, 251, 252, 256, 257, 260-261, 264, 268, 297, 351 -352 treatment, 297, 351, 390, 391, 394 Mandelamine, 144-145 Marijuana, 163, 228-229 Marital partners, see Spouses Medicaid, 222-223 Medical Outcomes Study, 197, 199, 200 Medicare, 222 Memory, 116-117, 119, 122, 178, 200, 209 Men, see Gender factors Menstrual cycles, 49, 353 Mental change, see Cognitive impairment Mental health, ix see also Anxiety; Depression; Emotional impairment; Psychological factors; Stress adaptation, 2, 9-12, 26, 177, 180-190, 193, 206, 207-208, 212-213, 218, 219, 221 patient attitude toward own, 115 rehabilitation, 212-213 Social Security Administration disability criteria, 403-404 suicide, 122-123, 388 Metabolic therapy, 407 Metalloproteins, 42, 45, 258, 265, 269, 392, 397 Methenamine infection, 144-145 Methotrexate, 390, 392 Methylprednisolone, 148, 150, 278 MHC, see Major histocompatibility complex Microglia, 64, 96, 97, 102, 103, 251, 258, 293, 294 Minimal Record of Disability, 201, 202 Mitoxantrone, 47, 50, 51, 390, 395 Mobility control technology, 206-207 wheelchairs, 128, 188, 199, 206-207, 209, 220, 222, 386 Modafinil, 154 Molecular biology, general, 6, 7 see also Amino acids; Biotechnology; Genetic factors; Genomics; Proteins axon plasticity, 246-247 demyelination, 65, 246-247 hyperexcitability, 8, 131, 166, 248, 359 neuronal plasticity, 245-246 research recommendations, 3, 6, 7, 8, 65, 278-279, 348, 349, 356 Read the entire page →
From page 429... ... , 201, 203, 304, 306, 362 Multiple Sclerosis Impact Scale, 198 Multiple Sclerosis Quality-of-Life Inventory, 198 Muscle spasms and cramps, 69, 135, 144, 145, 161, 163, 164-165 see also Spasticity; Weakness Muse, 159 Mutations, 6, 79, 80 B cells, 74 chemokine receptors, 82 cystic fibrosis, 6 T cells, 264 transgenic animals, 91, 93, 97, 100-104, 280, 355, 356-357 viruses, 97, 253 Myelin,3, 5-6, 8, 18, 19,20 see also Demyelinating diseases, general; Demylenation; Oligodendrocytes; Remyelination gene products, autoimmune agents, 21 myelin basic protein, 5-6, 42, 44, 50, 60, 66, 71, 72-73, 82, 257, 354, 389, 398 see also Glatiramer acetate MOG (myelin oligodendrocyte glycoprotein) , 73, 74, 93, 253, 255 oral, 392 physiology, 54-65, 242, 349 research recommendations, 65-70, 349 signs and symptoms of MS, 115 spasticity, 131 Myotrophin, 395 N N-acetyl aspartate, 38, 39-40, 64 National Center for Infectious Diseases, 367 429 National Institutes of Health brain banks, 316 funding, vii, 22, 23, 314-315, 316, 325, 327, 332, 334 researchers, 334, 335, 337 National Institute on Disability and Rehabilitation Research, 206 National Multiple Sclerosis Society, viii, 1, 2, 14, 15, 19, 23, 26, 348 beta-interferon, 50 brain banks, 316 clinical trials, 9, 50, 298, 300, 306, 310 cognitive impairment, 116 committee task statement, 25, 347 diagnostic criteria, 43, 50 everyday living, 11 functional measurement instruments, 201, 203, 306 funding, viii, 22, 23, 326-327, 329, 332, 338-339, 343-344, 362-363 research centers, 322 researchers, 335-336, 338-339 National Rehabilitation Information Center, 206 Nausea and vomiting, 49, 125, 135, 145, 150, 154, 159 Neopterin, 45 Nerve growth factor (NGF) Read the entire page →
From page 430... ... , 73, 74, 93, 253, 255 research recommendations, 241, 243-244, 253, 254, 266, 278, 349-351 toxins, 84 transgenic animal models, 102 treatment, 278, 282, 283, 284-285, 286, 287, 290, 294, 358-359, 393, 395 Optical pathologies, 148-149 see also Visual impairments neurotrophins, 285 Optic neuritis, 30, 32, 34, 48, 85, 148-149, 150, 160, 164, 247-248, 400 Orotein/Orgotein, 408 Orphan Drug Act, 49(n) , 342-343, 396, 399 Oxybutynin Chloride, 144 INDEX p Paclitaxel (Taxol) Read the entire page →
From page 431... ... , 75, 82, 92, 277, 290, 298, 360, 361, 389 glia, 281, 284, 285, 286, 290, 293, 294, 392 Internet, 221 major histocompatibility complex, 297, 351, 390, 391, 394 marijuana, 163, 228-229 neurons, 281, 283, 287, 392 oligodendrocytes, 278, 282, 283, 284-285, 286, 287, 290, 294, 358-359, 393, 395 optic neuritis, 148-149, 150 pain and sensory disturbance management, 8, 133, 138-139, 161-169 (passim) , 359 patient perspectives, 180 adherence to therapy, 51-52 polymorphisms, 272, 352 private sector, 341-343 relapse limiting, 278 remyelination, 65, 281-283, 286, 306, 358, 359, 393 research recommendations, 4, 8-9, 278, 299, 341-343, 347, 348, 353, 359360 sexual dysfunction, 158, 159, 400 sodium channels, 7, 288, 291, 358, 407 spasticity, 130, 132-135, 164-165, 289, 400 tumor necrosis factor (TNF) Read the entire page →
From page 432... ... , 6, 120, 356 Postinfectious encephalomyelitis, 86, 99 Posture, 128, 132, 138, 139, 192, 208 Potassium channels, 56-58, 147, 246, 394 Prednisome, 150 Pregnancy/postpartum period, 78, 409-410 Prevalence, see Incidence and prevalence Primary progressive MS, 35, 310 diagnostic criteria, 43 N-acetyl aspartate, 39 relapses, 32, 34 Privacy, see Confidentiality Pro-Banthine, 144-145 Procaine hydrochloride, 409 Professional education, 10, 25, 209, 210, 338 MS Society of Great Britain and Northern Ireland, 23-24 researchers, 12-13, 332-333, 338, 364 researchers, recruitment, 334-338, 364 Prognosis, 308, 351 Devic's pattern, 48 life expectancy, 29, 223 quality-adjusted life years (QALYs) , 53-54 progressive MS, 35 relapse features, 34 Progressive MS, 202 accumulated deficit, 29, 31 altering, 278 cognitive impairment, 117 disease progression, 31 immunomodulatory agents, 48, 394, 397 prevalence, 34 relapses, 32 see also Primary progressive MS; Secondary progressive MS INDEX Progressive multifocal leukoencephalopathy, 86-87 Promazine hydrochloride, 407 Proneut, 409 Propantheline bromide, 144-145 Prostin VR, 159 Proteins, 56, 265, 278, 282, 397 see also Cytokines; Ion channels; Neurotrophins and neurotrophic factors; Potassium channels; Sodium channels autoantigens, 6, 71, 253, 354 biomarkers, 42, 45 cerebrospinal fluid (CSF) Read the entire page →
From page 433... ... vs MS, 92, 93-94 imaging technology, 37, 40 inflammatory demyelination, 62 immunomodulatory agents, 48 lesions, 30, 37, 57 magnetization transfer imaging and, 40 N-acetyl aspartate, 39 prevalence, 30 T2-weighted hyperintense lesions, 39 Remissions, 290-291 functional recovery, 246 magnetic resonance imaging (MRI) , 38 sodium channels, 246-247 Remyelination, 3, 58, 64, 65, 246, 349, 350 see also Demylenation beta-interferon, 49 bladder and bowel dysfunction, 143 funding for research, 22 oligodendrocytes, 243-244 treatment, 65, 281-283, 286, 306, 358, 359, 393 Representational difference analysis, 5, 260, 353, 354 Research management, 12- 15, 22-24, 325346, 347-348, 362-367 see also Clinical studies and trials; Databases/registries; Funding erroneous research claims, 15, 306-367 interdisciplinary research, 13- 14, 332-333, 364-367 Researchers, 333-339, 344, 362 physician-scientists, 338, 345 recruitment, 334-338, 364 training, 13-14, 332-333, 338 Read the entire page →
From page 434... ... T-cell therapies, 49 nausea and vomiting, 49, 125, 135, 145, 150, 154, 159 optic neuritis and abnormal eye movements, 150 sexual dysfunction, 125, 145, 154, 156, 159 spasticity, 135 visual impairments, 145 Sildenafil citrate, 159 Snake venom, 408 Social factors, ix, 2, 178, 180-183, 185-190, 191 see also Employment; Family factors assistive technology, 205, 210 bladder and bowl dysfunction, 140 depression, 121, 127 disability defined, 203-204 disease management, 177 measurement, 197, 198, 200, 202, 204 rehabilitation, 212-213 research recommendations, 9, 10, 11, 14 support groups, 210 Social Security Administration, 193, 401-404 Society of Neuroscience, 13 Socioeconomic status, 191, 193 see also Employment Sodium channels, 56-57, 58, 65 astrocytes, 350 disease mechanisms, 242, 245, 246-247 remissions, 246-247 research recommendations, 7, 349, 350 symptoms and symptom management, 130, 147, 162-163 treatment, 7, 288, 291, 358, 407 Solu-Medrol, 150 Sparine, 407 Read the entire page →
From page 435... ... John's wart, 406-407 State law, 188 Stem cell therapy, 1, 20, 243, 358 bone marrow transplants, 294, 296-298, 313, 314, 339 clinical studies, 300-301 research recommendations, 4, 8, 65, 292298, 300, 332, 357, 359 transgenic animal models, 101 Steroids, 148-149, 290 Stress, 181-182, 184-185, 198, 199, 215, 220 see also Anxiety; Depression unpredictability/uncertainty, 9, 156, 177, 179, 180, 182, 193, 216, 217, 218, 220, 240, 348, 363 Stroke, 115, 120-121, 130, 162, 200, 287, 291 Subclinical MS, see Asymptomatic MS Suicide, 122-123, 388 Superantigens, 67, 92, 93, 95, 254 Superoxide dimutase, 408 Support groups, 210 Surgery, 132, 134, 147, 302, 318, 410-412 amputation, 247, 250 ataxia and tremor, 139- 140 Symmetrel, 154 Sympathectomy, 411 Symptoms, 2, 7, 26, 32, 43, 115-177, 198, 201, 281, 348 see also Ataxia and tremor; Bladder and bowel dysfunction; Cognitive impairment; Depression; Emotional impairment; Fatigue; Impairment; Nausea and vomiting; Pain and pain management; Seizures; Sensory impairment; Spasticity; Weakness asymptomatic MS, 6, 30, 35-36, 88, 115, 177 experimental autoimmune encephalomyelitis (EAE) vs MS, 92, 137, 163 management, 4, 8, 115-166, 359 monosymptomatic MS, 43, 277, 278 Parkinson's disease, 120, 139 patient perspectives, 17, 179, 220 sodium channels, 130, 147, 162-163 Synapses, 69, 71, 242, 249, 291 bowel dysfunction, 146 spasticity, 130-135 (passim) Read the entire page →
From page 436... ... , 95, 253, 255, 257, 258, 264, 268, 355, 391, 398 mutation, 264 receptors, 81, 82, 86 research recommendations, 6, 254, 350, 354, 355 superantigens, 67, 92, 93, 95, 254 treatments, 49, 50, 257, 279-280, 303, 388, 389, 390, 391, 395, 397, 398 vaccines, 279 Taxol (Paclitaxel) , 390, 396 Technology-Related Assistance for Individuals With Disabilities Act, 188 Thalamus ataxia and tremor, 139- 140 evoked potentials, 47 neuroplasticity, 248 thalamotomy/thalamic stimulation, 411 Thalidomide, 397 THC, see Marijuana Theiler's murine encephalomyelitis virus (TMEV) Read the entire page →
From page 437... ... , 359 Parkinson's disease, 139, 285, 287, 289, 292, 305 patient perspectives, 180 polymorphisms, 272, 352 remyelination, 65, 281-283, 286, 306, 358, 359, 393 research recommendations, 4, 8-9, 278, 299, 341-343, 347, 348, 351, 358361 sexual dysfunction, 158, 159, 400 sodium channels, 7, 288, 291, 358, 407 spasticity, 130, 132-135, 164-165, 289, 400 symptom-specific therapies, 2 T cells, 49, 50, 257, 279-280, 303, 388, 389, 390, 391, 395, 397, 398 tumor necrosis factor (TNF) , 281, 284, 286, 395 ultrasound, 411 weakness, 132, 133, 137 workshop agendas, 380, 381 Tremor, see Ataxia and tremor Trigeminal neuralgia, 161 Tl-weighted hypointense lesions (black holes) Read the entire page →
From page 438... ... side effects of drug treatment, 145 Social Security Administration disability criteria, 402-403 spasticity and, 130 spatial perception, 116 Vitamins, 225, 406, 409 Voluntary health organizations, 344, 346 Vomiting, see Nausea and vomiting W Walking difficulties, 32, 35 measurement, 199, 201, 204, 385-386 wheelchairs, 128, 188, 199, 206-207, 209, 220, 222, 386 INDEX Weakness, ix, 128-130, 136-138, 388 see also Fatigue relapses, 32 research recommendations, 137- 138 treatment, 132, 133, 137 Wellbutrin, 124-125 Wheelchairs, 128, 188, 199, 206-207, 209, 220, 222, 386 White persons, see Caucasians Women, see Gender factors World Federation of Neurology, 300 World Health Organization, 203-204, 212 World Wide Web, see Internet y Yeast, 407, 408 z Zanaflex (tizanidine) , 130, 132-133, 134-135 Zenapax, 397 Zoloft, 124-125 Zostrix, 144-145 Read the entire page →

From page 413...

... , 38, 39-40, 64 oligodendrocyte destruction, 350-351 Theiler's murine encephalomyelitis virus (TMEV)

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From page 414...

... , 42, 45 neutralizing antibodies, 51, 52, 97 Anxiety, 122, 123, 152, 200, 211, 217, 224 see also Depression side effects of treatment, 50, 125, 126, 127, 135, 388 treatment, 227, 229 Apoptosis, 7, 98, 243, 254, 255, 259, 269, 281, 284-285, 286, 287, 295, 351, 358-359, 392 Arthritis, 14, 44, 69, 122, 145, 152, 153, 297, 299, 328, 329, 337, 366 Asians, 48, 77, 79, 83, 85, 87 Assistive technology, ix, 199, 205-210, 385386 catheterization, 143, 206 cognitive impairment, 119, 209 cost and cost-effectiveness, 205, 206, 207, 210 defined, 205 employment, 193, 207-208 environmental control technology, 206, 207 health screening, 222-223 insurance coverage, 206, 209, 222 wheelchairs, 128, 188, 199, 206-207, 209, 220, 222, 386 Astrocytes, 3, 4 antigens, 244-245, 350 biological features of MS, 45, 62, 64, 71, 87 blood-brain barrier, 257 cytokines, 257, 258, 259, 350 disease mechanism research, 241, 245, 253, 257, 258, 259, 267 glial scars, 3, 241, 350 inflammation, 258 research recommendations, 241, 244-245, 253, 257, 258, 259, 267, 349, 350 treatment, 282, 284, 286, 294 Asymptomatic MS, 6, 30, 35-36, 88, 115, 177 Ataxia and tremor, 128, 138-140, 163 assistive technologies, 209 employment and, 191 experimental autoimmune encephalomyelitis (EAE)

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From page 415...

... , 42, 74, 265266 cloning, 42, 93 biomarkers, 265-266 experimental autoimmune encephalomyelitis (EAR) , 93 B lymphocytes, see B cells Back pain, 145, 160, 165 Baclofen, 132-133, 165, 289 Bacteria, 15, 67, 78, 283, 366 Barthel Index, 198, 200, 205, 215 Beck Depression Inventory, 121, 122 Bee venom, 408 Behavioral factors see also Functional status; Patient perspectives patient adherence to therapy, 51-52 measurement, 197 modification therapy, 123, 153 Social Security Administration disability criteria, 403 Bentyl, 144-145 Benzodiazapines, 133, 165 Beta-interferon, 35, 48-51, 60, 277, 284, 298, 307, 361, 392 animal studies, 92 Avonex/Rebif, 49, 50, 388, 396 Betaseron, 49, 51, 53, 388 cognitive impairment, 119 depression, 52, 123, 126-127 neutralizing antibodies, 51, 52, 97 side effects of, 49, 52, 123, 126-127, 388 Biological markers, 42, 44-45, 262-267, 308, 366-367 B cells, 265-266 cerebrospinal fluid (CSF)

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From page 416...

... 416 fatigue, 155 immune response, general, 42, 44, 45, 47, 263-266 oligoclonal bands, 42, 44, 46, 74, 87, 90, 164, 260, 266, 354 Biotechnology, 280, 289 see also Stem cell therapy private sector, 341-343 transgenic animals, 91, 93, 97, 100-104, 280, 355, 356-357 Black holes, see Tl-weighted hypointense lesions Bladder and bowel dysfunction, ix, 124, 140148 back pain, 165 catheterization, 143, 206 constipation, 125, 135, 140, 145, 146, 147, 154 diarrhea, 125, 135, 145, 154 measurement, 198, 199, 201, 202 relapses, 32, 34 research recommendations 143, 147 spasticity and, 142, 143, 144 treatment, 140, 142-145, 146-147, 400 as side effect, 135, 145, 154 Blood-brain barrier clinical factors, 37, 38, 45 depression, 126 disease mechanisms, 60, 63, 67, 70, 75, 76, 245, 257-258, 263 imaging, 37, 38, 356 research recommendations, 18, 350 treatment, 278, 288 Bone marrow transplants, 294, 296-298, 313, 314, 339 see also Stem cell therapy Botox, 134-135 Botulism A toxin, 133, 134, 149 Bowel dysfunction, see Bladder and bowel dysfunction Brain, vii, ix, 26, 283-284, 285, 350, 409 see also Alzheimer's disease; Blood-brain barrier; Brain stem; Cerebellum; Cerebral cortex; Cerebrospinal fluid; Cerebrum; Imaging technology; Parkinson's disease; Thalamus AMPA/kainate receptors, 243, 244, 287, 290 INDEX animal studies, 96, 103 encephalomyelitis, 7, 43, 72-73, 8486, 99; see also Experimental autoimmune encephalomyelitis asymptomatic MS, 35, 36 atrophy, 35, 38, 39, 122, 278, 356 banks, 316-318, 332, 339 depression, 122 employment and, 191 fatigue, 152-153, 155 hippocampus, 249, 293 laughing and crying, 119 N-acetyl aspartate, whole-brain, 39 optic neuritis, 148 self-repair mechanisms, 2, 26 spasticity, 129, 130 stroke, 115, 120-121, 130, 162, 200, 287, 291 surgery, 132, 134, 139-140, 147, 411, 412 T cells, brain-specific, 60, 70, 93, 252253, 254, 257-258, 260-261, 263265, 279, 280, 354, 355, 397 weakness, 130 Brain stem, 31, 34, 48, 201 evoked potentials, 47 lesions, general, 30 sexual dysfunction, 157 spasticity, 130 Tl-weighted hypointense lesions, 40 weakness, 130 British Society of Rehabilitation Medicine, 217-218 C Calcium, 45, 69, 134, 249, 253, 267, 288, 349, 407 Cambridge Multiple Sclerosis Basic Score, 202 Canaboids, see Marijuana Canada, 221, 339 CaP CURE, 13, 333, 339, 340, 345, 346, 365 Capsaicin, 144-145 Catheterization, 143, 206 Caucasians, 77, 82, 83-84

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From page 417...

... , 277, 278, 304, 306, 307, 308, 309-311 marijuana, 229 measurement instruments, 203, 204 neuroplasticity, 247-248 optic neuritis, 148-149, 247-248 outcome measures, 194, 195 pain, 160, 162, 163, 165-166 primary prophylaxis, 277 progressive MS, altering, 278 racial/ethnic factors, 340-341 rehabilitation, 213, 214-216 relapse prevention, 277, 290-291 research recommendations, 4, 8-10, 24, 277-278, 352, 353, 359-361 standards, 20 stem cell therapy, 300-301 workshop agendas, 381 Clonazepam, 133, 134

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From page 418...

... , 204-205 rehabilitation, 212 relapses, 32 research recommendations, 119- 120 Social Security Administration disability criteria, 402 treatment, 123 Communication, 191, 198, 201, 206, 216221, 386 see also Language skills; Patient education aids, 208-209 diagnosis, 12, 17, 179-180, 216-219 Internet, 12, 206, 208-209, 218, 221 physicians and other caregivers, 10, 25, 216-219, 223, 318, 363, 381 Computer applications see also Databases/registries assistive technology, 208, 209 ataxia and tremor, 138 bladder dysfunction, 143 cognitive impairment, 119 general information dissemination, 12 Internet, 12, 206, 208-209, 218, 221 Confidentiality, 361 Constipation, 125, 135, 140, 145, 146, 147, 154 Coordination loss, see Ataxia and tremor Copaxone, see Glatiramer acetate Cost and cost-effectiveness factors assistive technology, 205, 206, 207, 210 clinical trials, 8-9, 303-304, 365 INDEX erroneous research claims, 15, 306 health care modes, 210-211 quality-adjusted life years (QALYs) , 53-54 transgenic animal studies, 101 treatment, 52, 53-54, 210-211 Cramps, see Muscle spasms and cramps Crying, see Langhing and crying Cyclophosphamide, 390 Cylert, 154 Cytokines, 21, 42, 44, 60, 62, 64, 68, 74-76, 257-260, 264-265, 355 see also Beta-interferon; Tumor necrosis factor astrocytes, 257, 258, 259, 350 biomarkers, 259, 263-264 glia, 75, 76, 87 immune-based therapy, 259-260, 278-279, 281, 282, 285, 289, 290, 391, 392, 397 inflammatory/anti-inflammatory, 21, 75, 76, 87, 242, 257, 258, 259-260, 281, 391, 392 interleukin, 49, 60, 61, 103, 258, 259-260, 264-265, 392, 397, 398 neuropoietic, 74, 285 oligodendrocytes, 75, 259 transforming growth factor (T.F.)

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From page 419...

... , 41 molecular plasticity of axons, 246-247, 349 myelin basic protein, 5-6, 42, 44, 50, 60, 66, 71, 72-73, 82, 257, 354, 389, 398 oligodendrocytes, 7-8 optic nerve, 115 pain, 163, 166 patient diagnosis information, 218 research recommendations, 268-269, 349, 354-355 spasticity, 130 T cells, 6, 21, 42, 66-76, 82, 86, 92, 93, 98, 99, 244, 251-257, 263, 279280, 354, 355, 388, 389, 395, 397, 398 animal models, 251-252, 355 419 suppressor cells, 17, 50, 73, 78, 257, 279-280 treatments, 49, 50, 257, 279-280, 303, 388, 389, 390, 391, 395, 397, 398 see also Major histocompatibility complex toxins, 84 virus-induced, 7, 88, 89, 90, 91, 95-98, 99-100, 357-358 Theiler's murine encephalomyelitis virus (TMEV) , 48, 91, 92, 95, 96, 99, 269, 357 Dental therapy, 15, 367, 411-412 Department of Defense, 314 Deporpanex, 408 Depression, ix, 120-128 see also Anxiety beta-interferon, 52, 123, 126-127 cognitive impairment and, 118, 122, 123 crying, 118-119 exercise and, 224 fatigue and, 153, 155 interferon therapy, 52 measurement, 121-122, 200, 202 sexual dysfunction and, 156 spousal attitudes, 186 suicide, 122-123, 388 treatment, 123-128, 153, 400 as side effect, 123, 125-127, 135, 150, 154, 388 Desipramine, 123 Deskar, 395 Desmopressin, 144-145 Detrol, 144-145 Dexamethasone, 150 Diabetes mellitus, 280, 328, 353 Diagnosis, 3, 42-48, 216-217, 357 see also Autopsies; Biological markers; Imaging technology; Symptoms atrophy, 39, 356 cerebrospinal fluid (CSF)

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From page 420...

... , 72, 74, 84, 86, 91-94, 102, 103 major histocompatibility complex, 61, 68, 76, 80-82, 83, 244, 251, 252, 256, 257, 260-261, 264, 268 research recommendations, 241-277, 348 spasticity, 130- 132 tumor necrosis factor (TNF) , 258, 259, 260, 264-265, 266, 268 Disease variants, 360, 363 see also Primary progressive MS; Progressive MS; Relapsingremitting MS; Secondary progressive MS asymptomatic MS, 6, 30, 35-36, 88, 115, 177 biological markers, 261, 262-267 magnetic resonance imaging, 261-262 monogenetic MS, 5, 269, 351 Ditropan XL, 144-145 Dizziness, 115, 125, 135, 145, 150, 154, 400 DNA, 316, 352 see also Genomics autoantigens, 253 B cells, 74 infectious agents, 260 magnetic resonance imaging (MRI)

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From page 421...

... INDEX microarrays, 256-257, 265, 269-271, 316, 354, 355 polymerase chain reaction, 5, 260, 265, 353, 354, 355 treatments, 50, 257 transgenic animals, 91, 93, 97, 100-104, 280, 355, 356-357 vaccines, 279 Dorsal column, 162, 248, 410-411 Drug treatment, see Pharmaceuticals Dysesthetic pain, 162-163, 165, 166, 250, 400 E EAR, see Experimental autoimmune encephalomyelitis Economic factors, see Cost and costeffectiveness factors; Employment; Funding; Socioeconomic status EDSS, see Expanded Disability Status Scale Education, see Information dissemination; Patient education; Professional education Educational attainment, patients, 189, 190, 191, 192, 199, 219, 221 Electromyocardiogram, 138 Electrophysiology, general, 8, 306 axons and myelin, general, 54-65, 246 electrical impulse conduction, 20, 56, 57, 58, 65, 242, 247, 255, 349, 350 dorsal column stimulation, 410-411 evoked potentials, 42, 43-47, 56, 130, 148, 157 weakness, 136 Elavil, 124-125 Eliprodil, 392, 393 Emotional impairment, 116, 119, 181-182, 183, 211 see also Anxiety; Depression assistive technology, 206-207 cognitiveimpairmentvs, 116, 119-120 diagnosis, emotional response, 17, 179180 exercise and, 224 laughing and crying, 118-119 measurement, 197, 198, 200, 202 rehabilitation, 215 side effect of treatment, 123, 125-127, 135, 150, 154, 388 421 Employment, 9, 14, 177, 178, 190-193, 197, 202 assistive technology, 193, 207-208 bladder and bowl dysfunction, 140 cognitive impairment, 115-116, 191, 404 depression, 122 fatigue, 191, 193, 205 gender factors, 191 researchers, 334-336 Social Security Administration disability criteria, 404 Encephalomyelitis, 7, 43, 72-73, 84-86, 99 see also Experimental autoimmune encephalomyelitis acute disseminated encephalomyelitis, 84, 85, 86 postinfectious encephalomyelitis, 86, 99 transverse myelitis, 30 Endothelial cells, 245, 257, 258, 265, 287, 391 Enolase, 42, 45 Environmental control technology, 206, 207 Environmental factors in causation, 67, 77, 78, 352 familial, 79 geographic, 76-77 toxins, 15, 84, 85 Environmental Status Scale, 202 Enzyme-linked immunosorbent assay, 265 Epidemiology, vii, 76-79, 190, 312, 352 see also Demographic factors; Incidence and prevalence functioning and quality of life studies, 10, 11, 362 infections, 77, 78-79, 86 Epilepsy, 1, 22, 328 Ethnicity, see Race/ethnicity Ethylenediamine tetraacetic acid, 410 Etiology and pathogenesis, 8, 54-76 see also Animal models; Clinical studies and trials; Demyelination; Diseases mechanisms; Immune response; Infections; Pain and pain management; Viruses committee task, 25, 26 erroneous research claims, 15, 306-367 infections, general, 33, 67, 78-79, 84, 85, 86, 87-90, 150, 252, 260-261 laughing and crying, 119 newly proposed pathogens, 14-15 research management, 14- 15

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From page 422...

... , 40, 201, 202, 204-205, 211, 304, 306, 385-386 cognitive impairment, 117-118 depression, 121 outline of, 385-386 quality of life, 178 rehabilitation, 212-213, 214 sexual dysfunction, 157 Experimental autoimmune encephalomyelitis (EAR) disease management and measurement, 137, 163, 225-226 disease mechanisms, 72, 74, 84, 86, 9194, 102, 103 inflammation, 93-94 research strategies, 252, 253, 254-255, 257, 258, 260, 263, 268, 269, 270271, 278, 357 symptom characterization and management, 137, 163 treatment, 280, 285, 286, 288, 395 Eye pathologies, see Optical pathologies INDEX F Family factors, 178, 185-187, 190, 210, 362 assistive technology, 206 children, relations with, 187 cognitive impairments, 116 depression, 127 diagnosis, 217 genetic, 9, 11, 79, 80, 83 measurement, 197, 198, 199 monogenetic MS, 5, 269, 351 research recommendations, 351, 352 spouses, 185, 186 Fampridine, 394 Fatigue, viii, ix, 17, 149-155, 178 see also Weakness assistive technology, 207 clinician attitudes toward, 116 cognitive impairment and, 118 defined, 151 depression and, 121, 122 employment and, 191, 193, 205 functional MRI (fMRI)

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From page 423...

... , 200, 205, 211, 305 Impairment Scale for the European Database for Multiple Sclerosis, 202 Incapacity Status Scale, 201-202 Minimal Record of Disability, 201, 202 Multiple Depression Inventory, 121 Multiple Sclerosis Functional Composite Scale (MSFC) , 201, 203, 304, 306, 362 Multiple Sclerosis Impact Scale, 198 Multiple Sclerosis Quality-of-Life Inventory, 198 Sickness Impact Profile, 197, 198 standards, 194, 363 neuroplasticity, 246, 250 patient perspectives, 17, 179, 180, 194-195 remission, 246 research recommendations, 8, 10- 11, 362363 Social Security Administration disability criteria, 401 standards, 194, 363 workshop agendas, 382 423 Functional System Scales, 201 Funding, 325-333, 345, 362-363 assistive technology, 206 bone marrow transplant registries, 314 brain banks, 316, 317 clinical trials, 9, 50, 298, 300, 306, 310, 341 genetics and genomics, 268-269, 352 interdisciplinary research, 13, 365 MS Society, viii, 22, 23-24, 326-327, 329, 332, 338-339, 343-344, 362-363 NIH, vii, 22, 23, 314-315, 316, 325, 327, 332, 334 personal and social issues, 11 research centers, 322-333 researchers, 334-335, 364 G GABA (gama-aminobutyric acid)

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From page 424...

... , 5354 research recommendations, 361-363 Social Security Administration disability criteria, 401-404 Hepatitis virus, 95, 98-99, 100 Herpes virus, 89-90, 354 High-field strength magnetic resonance imaging, 38, 41 Hippocampus, 249, 293 Hiprex, 144-145

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From page 425...

... , 6, 120, 356 relapsing-remitting MS, 37, 40 research recommendations, 4, 6, 349, 355358, 361 spinal cord, 1, 35-36, 43, 356 workshop agendas, 379-380 Imipramine, 144-145 Immune-based therapy, 48-54, 252, 257, 272, 279-280, 353, 392-398 see also Beta-interferon; Transplantation autoantigens, 253-254 clinical studies, 48, 50-51, 52 cost of, 52, 53-54 cytokines, 259-260, 278-279, 281, 282, 285, 289, 289, 290, 391, 392, 397 magnetic resonance imaging in evaluation of, 48, 50, 51 425 neuronal plasticity, 245-246 relapses, 50, 51-52, 277-278 T cell therapy, 49, 50, 257, 279-280, 303, 388, 389, 390, 391, 395, 397, 398 vaccines acute disseminated encephalomyelitis, 84 MS, 279, 280, 390, 397, 409 Immune response, vii, 4, 5-6, 17, 18, 21, 42, 65-76, 84, 242, 251-260 see also Antibodies; Antigens; B cells; Blood-brain barrier; Chemokines; Cytokines; Infections; Infectious agents; Inflammation; Major histocompatibility complex; Marcophages; T cells; Transplantation animal models, general, 7, 21, 48, 91, 97, 103 biomarkers, 42, 44, 45, 47, 263-266 cascade of events, 4, 5-6, 68, 70, 243, 278, 288, 354-355 gender factors, 23, 67 immunoglobulins, 42, 44, 47, 60, 73, 74, 83, 93, 260, 266, 354, 392, 393, 395, 410 macrophages, 45, 60, 64, 67, 71, 74, 75, 99, 103, 251, 253, 254, 263, 287, 392, 398 oligodendrocytes, 8, 65, 73, 253, 254, 359 postinfectious encephalomyelitis, 86 research recommendations, 268-269, 278, 350-351, 354-355 workshop agendas, 379-380 Immunobiological revitalization, 410 Immunoglobulins, 42, 44, 47, 60, 73, 74, 83, 93, 260, 266, 354, 392, 393, 395, 410 Impairment see also Assistive technology; Ataxia and tremor; Bladder and bowel dysfunction; Cognitive impairment; Depression; Emotional impairment; Expanded Disability Status Scale; Fatigue; Functional status; Language skills; Pain and pain Management; Rehabilitation; Spasticity; Visual impairments; Walking difficulties; Weakness defined, 204, 362

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From page 426...

... , 95, 253, 255, 257, 258, 264, 268, 355, 391, 398 Theiler's murine encephalomyelitis virus (TMEV) , 95-96 Information dissemination, 11-12 see also Databases/registries; Internet; Patient education; Professional education committee task statement, 25 computers, general, 12 Informed consent, 51-52 Interdisciplinary approach care, 211 rehabilitation, 212 research, 13-14, 332-333, 364-367 Interferon, 20, 92, 260, 290, 392, 398 see also Beta-interferon depression as a side effect, 123, 126-127 Interleukin (IL)

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From page 427...

... , 35, 38, 40, 41, 61, 310, 356 T2-weighted hyperintense lesions, 38, 39, 40, 46, 310 Leukarrest, 395 Leukemia, 74, 87, 297 Leukodystrophies, 85 Leukoencephalopathy, see Progressive multifocal leukoencephalopathy Leustatin, 395 Life expectancy, 29, 223 quality-adjusted life years (QALYs) , 5354 Linomide, 392 Lioresal, 134 Longitudinal studies see also Databases/registries cytokines, 75, 259 functioning and quality of life, 10, 361 Lymphocytes, see B cells; T cells

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From page 428...

... disease mechanisms, 61, 68, 76, 80-82, 83, 244, 251, 252, 256, 257, 260261, 264, 268 animal models, 91, 103 racial/ethnic factors, 82, 83-84 INDEX research recommendations, 244, 251, 252, 256, 257, 260-261, 264, 268, 297, 351 -352 treatment, 297, 351, 390, 391, 394 Mandelamine, 144-145 Marijuana, 163, 228-229 Marital partners, see Spouses Medicaid, 222-223 Medical Outcomes Study, 197, 199, 200 Medicare, 222 Memory, 116-117, 119, 122, 178, 200, 209 Men, see Gender factors Menstrual cycles, 49, 353 Mental change, see Cognitive impairment Mental health, ix see also Anxiety; Depression; Emotional impairment; Psychological factors; Stress adaptation, 2, 9-12, 26, 177, 180-190, 193, 206, 207-208, 212-213, 218, 219, 221 patient attitude toward own, 115 rehabilitation, 212-213 Social Security Administration disability criteria, 403-404 suicide, 122-123, 388 Metabolic therapy, 407 Metalloproteins, 42, 45, 258, 265, 269, 392, 397 Methenamine infection, 144-145 Methotrexate, 390, 392 Methylprednisolone, 148, 150, 278 MHC, see Major histocompatibility complex Microglia, 64, 96, 97, 102, 103, 251, 258, 293, 294 Minimal Record of Disability, 201, 202 Mitoxantrone, 47, 50, 51, 390, 395 Mobility control technology, 206-207 wheelchairs, 128, 188, 199, 206-207, 209, 220, 222, 386 Modafinil, 154 Molecular biology, general, 6, 7 see also Amino acids; Biotechnology; Genetic factors; Genomics; Proteins axon plasticity, 246-247 demyelination, 65, 246-247 hyperexcitability, 8, 131, 166, 248, 359 neuronal plasticity, 245-246 research recommendations, 3, 6, 7, 8, 65, 278-279, 348, 349, 356

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From page 429...

... , 201, 203, 304, 306, 362 Multiple Sclerosis Impact Scale, 198 Multiple Sclerosis Quality-of-Life Inventory, 198 Muscle spasms and cramps, 69, 135, 144, 145, 161, 163, 164-165 see also Spasticity; Weakness Muse, 159 Mutations, 6, 79, 80 B cells, 74 chemokine receptors, 82 cystic fibrosis, 6 T cells, 264 transgenic animals, 91, 93, 97, 100-104, 280, 355, 356-357 viruses, 97, 253 Myelin,3, 5-6, 8, 18, 19,20 see also Demyelinating diseases, general; Demylenation; Oligodendrocytes; Remyelination gene products, autoimmune agents, 21 myelin basic protein, 5-6, 42, 44, 50, 60, 66, 71, 72-73, 82, 257, 354, 389, 398 see also Glatiramer acetate MOG (myelin oligodendrocyte glycoprotein) , 73, 74, 93, 253, 255 oral, 392 physiology, 54-65, 242, 349 research recommendations, 65-70, 349 signs and symptoms of MS, 115 spasticity, 131 Myotrophin, 395 N N-acetyl aspartate, 38, 39-40, 64 National Center for Infectious Diseases, 367 429 National Institutes of Health brain banks, 316 funding, vii, 22, 23, 314-315, 316, 325, 327, 332, 334 researchers, 334, 335, 337 National Institute on Disability and Rehabilitation Research, 206 National Multiple Sclerosis Society, viii, 1, 2, 14, 15, 19, 23, 26, 348 beta-interferon, 50 brain banks, 316 clinical trials, 9, 50, 298, 300, 306, 310 cognitive impairment, 116 committee task statement, 25, 347 diagnostic criteria, 43, 50 everyday living, 11 functional measurement instruments, 201, 203, 306 funding, viii, 22, 23, 326-327, 329, 332, 338-339, 343-344, 362-363 research centers, 322 researchers, 335-336, 338-339 National Rehabilitation Information Center, 206 Nausea and vomiting, 49, 125, 135, 145, 150, 154, 159 Neopterin, 45 Nerve growth factor (NGF)

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From page 430...

... , 73, 74, 93, 253, 255 research recommendations, 241, 243-244, 253, 254, 266, 278, 349-351 toxins, 84 transgenic animal models, 102 treatment, 278, 282, 283, 284-285, 286, 287, 290, 294, 358-359, 393, 395 Optical pathologies, 148-149 see also Visual impairments neurotrophins, 285 Optic neuritis, 30, 32, 34, 48, 85, 148-149, 150, 160, 164, 247-248, 400 Orotein/Orgotein, 408 Orphan Drug Act, 49(n) , 342-343, 396, 399 Oxybutynin Chloride, 144 INDEX p Paclitaxel (Taxol)

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From page 431...

... , 75, 82, 92, 277, 290, 298, 360, 361, 389 glia, 281, 284, 285, 286, 290, 293, 294, 392 Internet, 221 major histocompatibility complex, 297, 351, 390, 391, 394 marijuana, 163, 228-229 neurons, 281, 283, 287, 392 oligodendrocytes, 278, 282, 283, 284-285, 286, 287, 290, 294, 358-359, 393, 395 optic neuritis, 148-149, 150 pain and sensory disturbance management, 8, 133, 138-139, 161-169 (passim) , 359 patient perspectives, 180 adherence to therapy, 51-52 polymorphisms, 272, 352 private sector, 341-343 relapse limiting, 278 remyelination, 65, 281-283, 286, 306, 358, 359, 393 research recommendations, 4, 8-9, 278, 299, 341-343, 347, 348, 353, 359360 sexual dysfunction, 158, 159, 400 sodium channels, 7, 288, 291, 358, 407 spasticity, 130, 132-135, 164-165, 289, 400 tumor necrosis factor (TNF)

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From page 432...

... , 6, 120, 356 Postinfectious encephalomyelitis, 86, 99 Posture, 128, 132, 138, 139, 192, 208 Potassium channels, 56-58, 147, 246, 394 Prednisome, 150 Pregnancy/postpartum period, 78, 409-410 Prevalence, see Incidence and prevalence Primary progressive MS, 35, 310 diagnostic criteria, 43 N-acetyl aspartate, 39 relapses, 32, 34 Privacy, see Confidentiality Pro-Banthine, 144-145 Procaine hydrochloride, 409 Professional education, 10, 25, 209, 210, 338 MS Society of Great Britain and Northern Ireland, 23-24 researchers, 12-13, 332-333, 338, 364 researchers, recruitment, 334-338, 364 Prognosis, 308, 351 Devic's pattern, 48 life expectancy, 29, 223 quality-adjusted life years (QALYs) , 53-54 progressive MS, 35 relapse features, 34 Progressive MS, 202 accumulated deficit, 29, 31 altering, 278 cognitive impairment, 117 disease progression, 31 immunomodulatory agents, 48, 394, 397 prevalence, 34 relapses, 32 see also Primary progressive MS; Secondary progressive MS INDEX Progressive multifocal leukoencephalopathy, 86-87 Promazine hydrochloride, 407 Proneut, 409 Propantheline bromide, 144-145 Prostin VR, 159 Proteins, 56, 265, 278, 282, 397 see also Cytokines; Ion channels; Neurotrophins and neurotrophic factors; Potassium channels; Sodium channels autoantigens, 6, 71, 253, 354 biomarkers, 42, 45 cerebrospinal fluid (CSF)

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From page 433...

... vs MS, 92, 93-94 imaging technology, 37, 40 inflammatory demyelination, 62 immunomodulatory agents, 48 lesions, 30, 37, 57 magnetization transfer imaging and, 40 N-acetyl aspartate, 39 prevalence, 30 T2-weighted hyperintense lesions, 39 Remissions, 290-291 functional recovery, 246 magnetic resonance imaging (MRI) , 38 sodium channels, 246-247 Remyelination, 3, 58, 64, 65, 246, 349, 350 see also Demylenation beta-interferon, 49 bladder and bowel dysfunction, 143 funding for research, 22 oligodendrocytes, 243-244 treatment, 65, 281-283, 286, 306, 358, 359, 393 Representational difference analysis, 5, 260, 353, 354 Research management, 12- 15, 22-24, 325346, 347-348, 362-367 see also Clinical studies and trials; Databases/registries; Funding erroneous research claims, 15, 306-367 interdisciplinary research, 13- 14, 332-333, 364-367 Researchers, 333-339, 344, 362 physician-scientists, 338, 345 recruitment, 334-338, 364 training, 13-14, 332-333, 338

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From page 434...

... T-cell therapies, 49 nausea and vomiting, 49, 125, 135, 145, 150, 154, 159 optic neuritis and abnormal eye movements, 150 sexual dysfunction, 125, 145, 154, 156, 159 spasticity, 135 visual impairments, 145 Sildenafil citrate, 159 Snake venom, 408 Social factors, ix, 2, 178, 180-183, 185-190, 191 see also Employment; Family factors assistive technology, 205, 210 bladder and bowl dysfunction, 140 depression, 121, 127 disability defined, 203-204 disease management, 177 measurement, 197, 198, 200, 202, 204 rehabilitation, 212-213 research recommendations, 9, 10, 11, 14 support groups, 210 Social Security Administration, 193, 401-404 Society of Neuroscience, 13 Socioeconomic status, 191, 193 see also Employment Sodium channels, 56-57, 58, 65 astrocytes, 350 disease mechanisms, 242, 245, 246-247 remissions, 246-247 research recommendations, 7, 349, 350 symptoms and symptom management, 130, 147, 162-163 treatment, 7, 288, 291, 358, 407 Solu-Medrol, 150 Sparine, 407

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From page 435...

... John's wart, 406-407 State law, 188 Stem cell therapy, 1, 20, 243, 358 bone marrow transplants, 294, 296-298, 313, 314, 339 clinical studies, 300-301 research recommendations, 4, 8, 65, 292298, 300, 332, 357, 359 transgenic animal models, 101 Steroids, 148-149, 290 Stress, 181-182, 184-185, 198, 199, 215, 220 see also Anxiety; Depression unpredictability/uncertainty, 9, 156, 177, 179, 180, 182, 193, 216, 217, 218, 220, 240, 348, 363 Stroke, 115, 120-121, 130, 162, 200, 287, 291 Subclinical MS, see Asymptomatic MS Suicide, 122-123, 388 Superantigens, 67, 92, 93, 95, 254 Superoxide dimutase, 408 Support groups, 210 Surgery, 132, 134, 147, 302, 318, 410-412 amputation, 247, 250 ataxia and tremor, 139- 140 Symmetrel, 154 Sympathectomy, 411 Symptoms, 2, 7, 26, 32, 43, 115-177, 198, 201, 281, 348 see also Ataxia and tremor; Bladder and bowel dysfunction; Cognitive impairment; Depression; Emotional impairment; Fatigue; Impairment; Nausea and vomiting; Pain and pain management; Seizures; Sensory impairment; Spasticity; Weakness asymptomatic MS, 6, 30, 35-36, 88, 115, 177 experimental autoimmune encephalomyelitis (EAE) vs MS, 92, 137, 163 management, 4, 8, 115-166, 359 monosymptomatic MS, 43, 277, 278 Parkinson's disease, 120, 139 patient perspectives, 17, 179, 220 sodium channels, 130, 147, 162-163 Synapses, 69, 71, 242, 249, 291 bowel dysfunction, 146 spasticity, 130-135 (passim)

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From page 436...

... , 95, 253, 255, 257, 258, 264, 268, 355, 391, 398 mutation, 264 receptors, 81, 82, 86 research recommendations, 6, 254, 350, 354, 355 superantigens, 67, 92, 93, 95, 254 treatments, 49, 50, 257, 279-280, 303, 388, 389, 390, 391, 395, 397, 398 vaccines, 279 Taxol (Paclitaxel) , 390, 396 Technology-Related Assistance for Individuals With Disabilities Act, 188 Thalamus ataxia and tremor, 139- 140 evoked potentials, 47 neuroplasticity, 248 thalamotomy/thalamic stimulation, 411 Thalidomide, 397 THC, see Marijuana Theiler's murine encephalomyelitis virus (TMEV)

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From page 437...

... , 359 Parkinson's disease, 139, 285, 287, 289, 292, 305 patient perspectives, 180 polymorphisms, 272, 352 remyelination, 65, 281-283, 286, 306, 358, 359, 393 research recommendations, 4, 8-9, 278, 299, 341-343, 347, 348, 351, 358361 sexual dysfunction, 158, 159, 400 sodium channels, 7, 288, 291, 358, 407 spasticity, 130, 132-135, 164-165, 289, 400 symptom-specific therapies, 2 T cells, 49, 50, 257, 279-280, 303, 388, 389, 390, 391, 395, 397, 398 tumor necrosis factor (TNF) , 281, 284, 286, 395 ultrasound, 411 weakness, 132, 133, 137 workshop agendas, 380, 381 Tremor, see Ataxia and tremor Trigeminal neuralgia, 161 Tl-weighted hypointense lesions (black holes)

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From page 438...

... side effects of drug treatment, 145 Social Security Administration disability criteria, 402-403 spasticity and, 130 spatial perception, 116 Vitamins, 225, 406, 409 Voluntary health organizations, 344, 346 Vomiting, see Nausea and vomiting W Walking difficulties, 32, 35 measurement, 199, 201, 204, 385-386 wheelchairs, 128, 188, 199, 206-207, 209, 220, 222, 386 INDEX Weakness, ix, 128-130, 136-138, 388 see also Fatigue relapses, 32 research recommendations, 137- 138 treatment, 132, 133, 137 Wellbutrin, 124-125 Wheelchairs, 128, 188, 199, 206-207, 209, 220, 222, 386 White persons, see Caucasians Women, see Gender factors World Federation of Neurology, 300 World Health Organization, 203-204, 212 World Wide Web, see Internet y Yeast, 407, 408 z Zanaflex (tizanidine) , 130, 132-133, 134-135 Zenapax, 397 Zoloft, 124-125 Zostrix, 144-145

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Index Pages 413-438

Index
Pages 413-438