• 대한신경과학회지
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• 제36권4호
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• pp.273-279
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• 2018

Multiple sclerosis (MS) is a diagnosis of exclusion and the lesions or objective findings should disseminate in space and time to diagnose MS. The diagnostic criteria of MS have continuously evolved overtime. The McDonald criteria were originally proposed in 2001, and the revised 2010 McDonald criteria have been used widely. Scientific advances in the past 7 years since 2010 induced the revised 2017 McDonald criteria. All revisions relied entirely on the available evidences, and not expert opinion. In this review, we will provide an overview of the way to diagnose MS and the 2017 McDonald criteria.

• Annals of Clinical Neurophysiology
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• 제25권1호
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• pp.19-26
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• 2023

Autonomic dysfunction occurs frequently in multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). Patients with either condition may present with autonomic symptoms such as bladder, sexual, cardiovascular, thermoregulatory, and gastrointestinal dysfunction, and fatigue, but autonomic symptoms that affect quality of life are underrecognized in clinical practice. The immunopathogenesis of MS has been considered to be associated with autonomic dysfunction. Applying appropriate treatment strategies for autonomic dysfunction is important to improve the quality of life of patients. Here we review autonomic dysfunction and how this is managed in patients with MS and NMOSD.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권2호
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• pp.141-144
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• 2021

Osteopathia striata with cranial sclerosis (OS-CS) is a bone dysplasia characterized by a linear striated pattern of sclerosis, especially in the long bones, and cranial sclerosis. It has variable clinical findings but distinctive radiological findings. Multiple oral and dental findings have been associated with this disease and can be seen during dental and/or medical imaging of the head and neck. Dentists and clinicians must be familiar with these signs to differentiate them from pathosis or erroneous radiographs. In the following case, we present a patient with OS-CS that presented at The University of Florida College of Dentistry with multiple craniofacial manifestations of this syndrome that were seen on a panoramic radiograph, which is one of the most commonly requested radiographs by dentists.

• Clinical and Experimental Pediatrics
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• 제50권6호
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• pp.580-584
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• 2007

다발성 경화증은 중추신경계 백질의 여러 부위를 시간 간격을 두고 침범하는 만성재발성 질환이다. 주로 20세에서 40세 사이에 발병하며 15세 이하 소아에서도 3-5% 정도 발병하는 소아기에는 매우 드문 질환이다. 원인은 아직 정확히 밝혀지지 않았으나 유전적, 환경적 및 감염과 연관된 자가면역반응 등 여러요인이 복합적으로 작용하는 것으로 생각하고 있다. 임상증상은 침범된 백질 부위에 따라 다양한데 사지근력 약화나 저림, 시력장애, 감각장애, 운동실조 등 다양한 증세로 호전과 재발을 반복한다. 본 저자들은 경련, 왼쪽 편마비 등의 증상으로 6세에 첫 발병 후 메틸프레드니솔론(methylprednisolon) 치료 후 증상 완전 회복 있었으나 6개월 후 경련, 두통, 왼쪽 안와주위 통증 등으로 다시 입원하는 등 4년간 추적 관찰 중 4차례 메틸프레드니솔론 치료 실시하였으나 다른 양상의 신경학적 증상으로 재발하여 Interferon-${\beta}$-1b($Betaferon^{(R)}$, SheringAG, Germany) 예방 치료를 실시한 다발성 경화증 환자 1례를 경험 하였기에 문헌 고찰과 함께 보고하는 바이다.

• 한국멀티미디어학회논문지
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• 제24권8호
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• pp.979-987
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• 2021

Multiple Sclerosis (MS) can be early diagnosed by detecting lesions in brain magnetic resonance images (MRI). Unsupervised anomaly detection methods based on autoencoder have been recently proposed for automated detection of MS lesions. However, these autoencoder-based methods were developed only for 2D images (e.g. 2D cross-sectional slices) of MRI, so do not utilize the full 3D information of MRI. In this paper, therefore, we propose a novel 3D autoencoder-based framework for detection of the lesion volume of MS in MRI. We first define a 3D convolutional neural network (CNN) for full MRI volumes, and build each encoder and decoder layer of the 3D autoencoder based on 3D CNN. We also add a skip connection between the encoder and decoder layer for effective data reconstruction. In the experimental results, we compare the 3D autoencoder-based method with the 2D autoencoder models using the training datasets of 80 healthy subjects from the Human Connectome Project (HCP) and the testing datasets of 25 MS patients from the Longitudinal multiple sclerosis lesion segmentation challenge, and show that the proposed method achieves superior performance in prediction of MS lesion by up to 15%.

• The Journal of Korean Physical Therapy
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• 제27권1호
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• pp.61-67
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• 2015

Purpose: This study was conducted in order to investigate the effectiveness of an 8-week virtual reality exercise program designed around the Nintendo Wii (Wii), in improving balance among patients with Multiple Sclerosis (MS). Methods: The study included 16 patients with MS (10 female, 6 male) who were assigned randomly to experimental (n=8) or control group (n=8). Experimental group performed three 40-minute Wii balance-training sessions per week, for 8 weeks. The control group did not perform any of the training programs. A computerized dynamic posturography (Sensory Organizing Test, SOT) was used to evaluate all patients at baseline and at the end of the treatment protocol. Statistical significance was tested in between the patients before and after treatment by t-test. Results: After 24 training sessions, SOT showed significant difference on condition 5, 6, and vestibular ratios within the experimental group from baseline to post-intervention. By contrast, no significant difference was observed within the control groups. Conclusion: These findings demonstrated that the virtual reality training program could improve the outcomes in terms of balance in the MS population. Long term follow ups and the development of more efficient virtual reality training programs are needed.

• Biomolecules & Therapeutics
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• 제27권2호
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• pp.152-159
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• 2019

Multiple sclerosis (MS) is an autoimmune disease characterized by progressive neuronal loss, neuroinflammation, axonal degeneration, and demyelination. Previous studies have reported that 6-shogaol, a major constituent of ginger (Zingiber officinale rhizome), and its biological metabolite, 6-paradol, have anti-inflammatory and anti-oxidative properties in the central nervous system (CNS). In the present study, we investigated whether 6-shogaol and 6-paradol could ameliorate against experimental autoimmune encephalomyelitis (EAE), a mouse model of MS elicited by myelin oligodendrocyte glycoprotein ($MOG_{35-55}$) peptide immunization with injection of pertussis toxin. Once-daily administration of 6-shogaol and 6-paradol (5 mg/kg/day, p.o.) to symptomatic EAE mice significantly alleviated clinical signs of the disease along with remyelination and reduced cell accumulation in the white matter of spinal cord. Administration of 6-shogaol and 6-paradol into EAE mice markedly reduced astrogliosis and microglial activation as key features of immune responses inside the CNS. Furthermore, administration of these two molecules significantly suppressed expression level of tumor necrosis $factor-{\alpha}$, a major proinflammatory cytokine, in EAE spinal cord. Collectively, these results demonstrate therapeutic efficacy of 6-shogaol or 6-paradol for EAE by reducing neuroinflammatory responses, further indicating the therapeutic potential of these two active ingredients of ginger for MS.

• 대한청각학회지
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• 제24권1호
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• pp.48-52
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• 2020

Lateralization for central auditory processing (CAP) with dichotic digits recognition (DDR) test is believed expression of hemispheric dominance. Multiple sclerosis (MS) is considered an inflammatory and autoimmune alteration of central nervous system (CNS). Hearing alterations in MS and their role in CAP has not been well studied. A patient with MS and new kind of alteration in lateralization of CAP with DDR test is presented. A 53 year of age female with MS of 16 years of evolution, nine of them remained asymptomatic. She has a persistent advantage of the right ear for DDR test; but other monaural tests showed predominance of the left afferent pathway. Brainstem auditory evoked potentials (BAEPs) and long latency auditory evoked potentials (LLAEPs) showed adequate right response with deficits in organization of left response in BAEP, and N2 wave. In the contrary direction of previous publication, we disclosed advantage for DDR test, BAEP, and LLAEP in the right ear. We observed no left ear suppression; with predominance of correct left percentages in monaural psychoacoustics tests. We must keep on searching to find pathophysiological meaning of predominant of right or left auditory laterality as a CAP disorder in patients with MS.

• Journal of Audiology & Otology
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• 제24권1호
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• pp.48-52
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• 2020

Lateralization for central auditory processing (CAP) with dichotic digits recognition (DDR) test is believed expression of hemispheric dominance. Multiple sclerosis (MS) is considered an inflammatory and autoimmune alteration of central nervous system (CNS). Hearing alterations in MS and their role in CAP has not been well studied. A patient with MS and new kind of alteration in lateralization of CAP with DDR test is presented. A 53 year of age female with MS of 16 years of evolution, nine of them remained asymptomatic. She has a persistent advantage of the right ear for DDR test; but other monaural tests showed predominance of the left afferent pathway. Brainstem auditory evoked potentials (BAEPs) and long latency auditory evoked potentials (LLAEPs) showed adequate right response with deficits in organization of left response in BAEP, and N2 wave. In the contrary direction of previous publication, we disclosed advantage for DDR test, BAEP, and LLAEP in the right ear. We observed no left ear suppression; with predominance of correct left percentages in monaural psychoacoustics tests. We must keep on searching to find pathophysiological meaning of predominant of right or left auditory laterality as a CAP disorder in patients with MS.

• Korean Journal of Radiology
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• 제24권12호
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• pp.1260-1283
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• 2023

Magnetic resonance imaging (MRI) has been extensively applied in the study of multiple sclerosis (MS), substantially contributing to diagnosis, differential diagnosis, and disease monitoring. MRI studies have significantly contributed to the understanding of MS through the characterization of typical radiological features and their clinical or prognostic implications using conventional MRI pulse sequences and further with the application of advanced imaging techniques sensitive to microstructural damage. Interpretation of results has often been validated by MRI-pathology studies. However, the application of MRI techniques in the study of neuromyelitis optica spectrum disorders (NMOSD) remains an emerging field, and MRI studies have focused on radiological correlates of NMOSD and its pathophysiology to aid in diagnosis, improve monitoring, and identify relevant prognostic factors. In this review, we discuss the main contributions of MRI to the understanding of MS and NMOSD, focusing on the most novel discoveries to clarify differences in the pathophysiology of focal inflammation initiation and perpetuation, involvement of normal-appearing tissue, potential entry routes of pathogenic elements into the CNS, and existence of primary or secondary mechanisms of neurodegeneration.