Why do women develop multiple sclerosis almost twice as often as men?
The report from collaborators in Minnesota, Northern Ireland, Belgium and Italy appears in the Jan. 27 online publication of the journal Genes & Immunity
"In practical terms, this is what our findings suggest: How much of the protein known as 'interferon gamma' you produce appears to be a new key variable in understanding who gets MS and who doesn't, and especially why women develop MS more often than men," explains the study's lead author, Mayo Clinic neurologist Brian Weinshenker, M.D.
"If you have a gene that produces high levels of interferon gamma, it may predispose you to developing MS. Under this scenario, men get MS less often because they have a lower frequency of a gene variant that is related to higher secretion of interferon gamma."
To researchers looking for a cure for MS -- where currently there is none -- the finding is helpful for three main reasons:
1) it provides a target at which to direct future investigations into ways to stop MS,
2) it provides leads on ways to improve treatments that can minimize the tissue and nerve damage the disease causes,
and 3) it may advance the search for new treatments for other diseases.
Notes Dr. Weinshenker, "Our finding isn't the whole genetic cause, but it's a helpful step that could lead us to a more complete understanding of MS -- and ultimately, effective treatment. It's also a very promising lead about gender differences that may pertain to susceptibility of other diseases, too, such as rheumatoid arthritis."
The original news release can be found here.
Pharmacology of vertigo/nystagmus/oscillopsia
Current Opinion in Neurology. 18(1):11-14, February 2005
Recent findings: In the last 2 years several studies have been published on possible pharmacological treatment options for nystagmus and oscillopsia.
In the treatment of vestibular neuritis two studies showed that cortisone treatment was effective for restoring labyrinthine function. This benefit seems more likely if treatment is started within the first 2 days of onset.
For recurrent vertigo attacks due to Meniere's disease, the titration technique with daily or weekly doses of intratympanic gentamicin until onset of vestibular symptoms, change in vertigo or hearing loss rated best for complete vertigo control.
A new pharmacological treatment option for downbeat nystagmus is the administration of potassium channel blockers (e.g. 4-aminopyridine). They are thought to reinforce the inhibitory action of cerebellar Purkinje cells.
Several case reports have proven the beneficial effect of baclofen on periodic alternating nystagmus, of gabapentin and memantine on acquired pendular nystagmus, and of carbamazepine and gabapentin on superior oblique myokymia.
Physical activity and the association with sporadic ALS
NEUROLOGY 2005;64:241-245
Objective: To assess whether lifetime physical activity during work and leisure time is associated with an increased risk of developing ALS and to determine the association between physical activity and duration or age at onset of disease.
Methods: Patients referred to our clinic during the 1-year period 2001 to 2002 who had definite, probable, or possible ALS according to El Escorial criteria, without a familial history of ALS, were asked to participate in the study. A case-control study was performed taking into account all occupational and leisure time activities of patients (n = 219) and controls (n = 254). Multivariate analysis included confounding factors (sex, age, level of education, body mass index, alcohol use, and smoking). Three quantitative measures of cumulative physical activity were calculated: until 1 year before the onset of disease (total physical activity), the last 10 years before the onset of disease (late physical activity), and until the age of 25 (early physical activity). In addition, a systematic review of all published data is presented.
Results: Smoking and alcohol use were independently associated with ALS (current smoking increased risk, OR = 1.8, 95% CI = 1.0 to 3.0, p = 0.03, ever/current alcohol use decreased risk, OR = 0.6, 95% CI = 0.3 to 0.9, p = 0.04). No significant association with occupational or leisure time physical activity was found (all ORs 1.7), which was in agreement with most studies with the highest level of evidence in the systematic review. Higher leisure time activities were associated with an earlier age at onset: activity levels before age of 25 (p <>
Conclusions: There is no association between physical activity and the risk of developing ALS.
