Bøger i Topics in Neuroscience serien

Recent years have witnessed dramatic advances in the development and use of magnetic resonance imaging (MRI) techniques that can provide quantitative measures with some degree of pathological specificity for the heterogeneous substrates of multiple sclerosis (MS).

The coverage of the issues involved in the use of magnetic resonance techniques in assessing therapeutic effect is comprehensive and, though the field is chan ging rapidly, the principles and much of the detail in the book are likely to have lasting value.

Written by world-renowned scientists, the volume provides a state-of-the-art on the most recent MRI techniques related to MS, and it is an indispensable tool for all those working in this field.

This work covers the immunological and clinical aspects of immune-mediated diseases of the central and peripheral nervous system, excluding multiple sclerosis. It also discusses the immune mechanisms in the growing number of recognized paraneoplastic conditions, amongst other topics.

There is now evidence that irreversible brain damage accumulates very early in the course of multiple sclerosis. These findings provide the rationale for early treatment and emphasize the importance of clinical trials in early multiple sclerosis.

This variant, often in the guise of a chronic progressive myelopathy or, less commonly, progressive cerebellar or bulbar dysfunction, usually responds poorly to corticosteroids and rarely seems to benefit to a significant degree from intensive immunosuppressive treatments.

In the last few years, increasing effort has been devoted to better define the characteristics of tissue damage occurring outside MRI-visible lesions in patients with multiple sclerosis (MS) and, as a consequence, to improve our understanding of the disease pathobiology and of the mechanisms leading to the accumulation of irreversible disability. This book provides an updated review of the results obtained by leading research groups in this field. The potential clinical applications of what has been shown so far, as well as the areas for future research in the study of normal-appearing white and gray matter damage in MS are extensively discussed, making this book a valuable tool for clinical neurologists who are involved in the daily-life care of MS patients and for neuroscientists involved in MS research.

There is now evidence that irreversible brain damage accumulates very early in the course of multiple sclerosis. This book reviews the main neurobiological, magnetic resonance imaging, and clinical aspects of the early phases of the dis­ ease. Mechanisms ofirreversible axonal damage and the role played by the inter­ action of glia and the axon are highlighted. In contrast to what was believed for a long time, the sufficient availability of oligodendrocyte precursor cells to promote remyelination in acute lesions has now been demonstrated. For reasons not understood, this remyelination process fails or does not start, particularly in the chronic stages ofthe disease. These findings emphasize the importance of the "milieu" changes induced by an inflammatory process in limiting remyelination. However, first indications are that part of this inflammatory process may have a neuroprotective effect. Pathological studies in multiple sclerosis have now clearly demonstrated that destructive processes may be followed by recovery phases in such a way that myelin may be morphologically and functionally reconstituted. These findings provide the rationale for early treatment and emphasize the importance of clinical trials in early multiple sclerosis. Early treatment is one of the most important aspects in multiple sclerosis today.

In multiple sclerosis (MS), conventional magnetic resonance imaging (cMRI) has proved to be a valuable tool to increase diagnostic confidence and for monitoring the efficacy of experimental treatment. However, cMRI has limited specificity and accuracy of cMRI to the most disabling aspects of the MS pathology, known to occur in and outside macroscopic lesions. Modern quantitative MR techniques have the potential to overcome the limitations of cMRI, and their application is changing dramatically our understanding of how MS causes irreversible disability. In detail, there is an increasing body of MR evidence that MS is not only a white matter disease and does not only cause focal lesions, as well as that neurodegeneration is an important aspect of the disease (since the earliest clinical phases), which is only partially related to inflammatory changes. There is also increasing perception that modern MR methodologies should be more extensively employed in clinical trials to derive innovative information.Written by world-renowned scientists, the volume provides a state-of-the-art on the most recent MRI techniques related to MS, and it will bi and indispensable tool for all those working in this field.