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Cited by 818Multiple Sclerosis Research StudiesPeripheral Neuropathies and DisordersPolyomavirus and related diseases

The DOI matches its Crossref record; 96 of the 98 references it cites were found in a registry or an index.

Primary-progressive multiple sclerosis

Miller, David H, Leary, Siobhan M·2007·The Lancet Neurology
DOI 10.1016/s1474-4422(07)70243-0
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Abstract

About 10-15% of patients with multiple sclerosis (MS) present with gradually increasing neurological disability, a disorder known as primary-progressive multiple sclerosis (PPMS). Compared with relapse-onset multiple sclerosis, people with PPMS are older at onset and a higher proportion are men. Inflammatory white-matter lesions are less evident but diffuse axonal loss and microglial activation are seen in healthy-looking white matter, in addition to cortical demyelination, and quantitative MRI shows atrophy and intrinsic abnormalities in the grey matter and the white matter. Spinal cord atrophy corresponds to the usual clinical presentation of progressive spastic paraplegia. Although neuroaxonal degeneration seems to underlie PPMS, the pathogenesis and the extent to which immune-mediated mechanisms operate is unclear. MRI of the brain and spinal cord, and examination of the CSF, are important investigations for diagnosis; conventional immunomodulatory therapies, such as interferon beta and glatiramer acetate, are ineffective. Future research should focus on the clarification of the mechanisms of axonal loss, improvements to the design of clinical trials, and the development of effective neuroprotective treatments.

Overview

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Crossref · 10.1016/s1474-4422(07)70243-0

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Citations

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Research works printed but not linked: 1

  1. Kita, 2004, A phase II trial of mitoxantrone in patients with primary progressive multiple sclerosis, Neurology, 62, A99

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Metadata

Authors
Miller, D. H., & Leary, S. M.
Affiliations
  • UCL Queen Square Institute of Neurology (GB)
  • University College Hospital (GB)
ORCID
Leary, Siobhan M
Venue
The Lancet Neurology
Publisher
Elsevier BV
Published
2007-10
Volume
6
Issue
10
Pages
903-912
ISSN
1474-4422 (ISSN-L)
DOI
10.1016/s1474-4422(07)70243-0
OpenAlex
W1990040006
Cited by
818
References
98
Citations by year
2026: 18 · 2025: 23 · 2024: 30 · 2023: 32 · 2022: 74 · 2021: 74 · 2020: 29 · 2019: 26 · 2018: 32 · 2017: 33 · 2016: 161 · 2015: 66 · 2014: 33 · 2013: 71 · 2012: 19
FWCI
2.78
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • The Lancet Neurology (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Funders
Multiple Sclerosis Society
Topics
  • Health Sciences › Medicine › Clinical Neurology › Multiple Sclerosis Research Studies
  • Health Sciences › Medicine › Clinical Neurology › Peripheral Neuropathies and Disorders
  • Health Sciences › Medicine › Oncology › Polyomavirus and related diseases
Keywords
primary progressive multiple sclerosis, axonal loss, neuroaxonal degeneration, microglial activation, cortical demyelination, spinal cord atrophy, quantitative MRI, cerebrospinal fluid biomarkers, interferon-beta, glatiramer acetate, neuroprotection, pathogenesis
MeSH terms
Brain, Diagnosis, Differential, Humans, Magnetic Resonance Imaging, Multiple Sclerosis, Chronic Progressive

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