Publications by authors named "Veronica Popescu"
Background: Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system (CNS), characterized by inflammation and neurodegeneration. The pathophysiology of MS, especially its progressive forms, involves various cellular components, including microglia, the primary resident immune cells of the CNS. This review discusses the role of microglia in neuroinflammation, tissue repair, and neural homeostasis, as well as their involvement in MS and explores potential therapeutic strategies targeting microglial function.
View Article and Find Full Text PDFBackground: Multiple sclerosis (MS) places substantial socioeconomic burden on patients due to its early onset and progressive nature, but healthcare systems are also impacted by the high costs of disease-modifying treatments (DMTs). The use of generics (for conventional drugs), biosimilars (for biologics) or follow-on versions of non-biologic complex drugs (NBCDs) can help to reduce the cost of MS care and improve patient access. This review describes the European regulatory processes for these DMT 'copies' and the available data in people with MS.
View Article and Find Full Text PDFArticle Synopsis
- * Machine learning models were applied to predict confirmed disability progression after two years, achieving a ROC-AUC score of 0.71, indicating moderate accuracy, while historical disability was found to be a stronger predictor than treatment or relapse history.
- * The research followed strict guidelines and made its coding accessible for others to facilitate future benchmarking in predicting disability progression in MS patients.
Article Synopsis
- Many patients with multiple sclerosis (MS) still show gradual deterioration of symptoms even when on treatment that prevents relapses, indicating the need for more comprehensive understanding beyond traditional views of MS progression.
- The authors introduce a new term, smouldering-associated-worsening (SAW), which refers to ongoing physical and cognitive decline caused by underlying pathological processes that haven’t been adequately addressed in therapy.
- They also suggest ways to monitor SAW using clinical, radiological, and biological markers, while emphasizing the importance of integrating findings on smouldering MS into both clinical practice and future research.
A metformin add-on clinical study in multiple sclerosis to evaluate brain remyelination and neurodegeneration (MACSiMiSE-BRAIN): study protocol for a multi-center randomized placebo controlled clinical trial.
Front Immunol
April 2024
Introduction: Despite advances in immunomodulatory treatments of multiple sclerosis (MS), patients with non-active progressive multiple sclerosis (PMS) continue to face a significant unmet need. Demyelination, smoldering inflammation and neurodegeneration are important drivers of disability progression that are insufficiently targeted by current treatment approaches. Promising preclinical data support repurposing of metformin for treatment of PMS.
View Article and Find Full Text PDFMultiple Sclerosis Multidisciplinary Care: A National Survey and Lessons for the Global Community.
Mult Scler Relat Disord
May 2024
Access to, standardization and reimbursement of multidisciplinary care for people with MS (PwMS) is lacking in many countries. Therefore, this study aims to describe the current multidisciplinary care for people with MS (PwMS) in Belgium and identify benefits, needs and future perspectives METHODS: A survey for PwMS questioned various aspects of MS and viewpoints on care. For MS nurses (MSN) and neurologists, employment, education, job-content, care organization and perspectives were inquired.
View Article and Find Full Text PDFArticle Synopsis
- FOXP3+ Tregs in autoimmune conditions lose their suppressive ability and become proinflammatory, complicating Treg therapy for diseases like multiple sclerosis (MS).
- Research using genetic fate-mapping shows that these dysfunctional Tregs accumulate in the central nervous system and lose their regenerative potential due to interactions with inflamed blood-brain barrier endothelial cells.
- Treatment with the mTORC1 inhibitor rapamycin can restore Treg function and enhance the effectiveness of autologous Treg therapy for MS patients.
Article Synopsis
- * Among 84 RMS patients analyzed, 72.6% maintained 'no evidence of disease activity' (NEDA-3) status after a mean follow-up of 22.6 months, while some experienced relapses or disability progression, especially those with a history of multiple treatments.
- * The safety profile was mostly acceptable, with 67.9% experiencing at least one adverse event, primarily fatigue and skin issues, reaffirming cladribine's
Article Synopsis
- Multiple sclerosis (MS) is a chronic illness that disrupts signal conduction in the central nervous system, affecting millions globally.
- The dataset provided includes motor evoked potential (MEP) measurements from 963 patients, with a total of 5586 visits over 6 years, capturing signals from hand and foot stimulation.
- This dataset can aid in MS research, assist in patient care, and serve as a benchmark for time series analysis and predictive modeling.
Background: Therapeutic inertia (TI) is a worldwide phenomenon that affects 60 to 90% of neurologists and up to 25% of daily treatment decisions during management of multiple sclerosis (MS) patients. A large volume of MS patients are women of childbearing age, and desire for pregnancy is a complex variable often affecting MS care. The objective of this study was to determine the effect of desire for pregnancy on decisions to escalate treatment during management of MS patients.
View Article and Find Full Text PDFArticle Synopsis
- * Evidence shows that relapses and MRI-detected focal activity are not strong predictors of long-term disability progression in MS, indicating that disability can accumulate independently of these events.
- * We propose that effective MS treatment should go beyond targeting inflammation and focus on broader brain and spinal cord processes, alongside managing other systemic health issues to improve patient outcomes.
Background: This retrospective study evaluates patient-reported outcomes in patients with multiple sclerosis (MS) spasticity who were treated with a cannabinoid oromucosal spray (Sativex®, USAN name: nabiximols) after not sufficiently responding to previous anti-spasticity medications.
Methods: Of 276 patients from eight centers in Belgium who began treatment prior to 31 December 2017, effectiveness assessment data were available for 238 patients during the test period of 4 to 8/12 weeks, and for smaller patient cohorts with continued treatment for 6/12 months.
Results: Mean 0-10 spasticity Numerical Rating Scale (NRS) scores improved from 8.
Article Synopsis
- Motor Evoked Potentials (MEPs) are used to track the progression of disability in multiple sclerosis (MS), but there is no agreed-upon definition for what constitutes normal or abnormal MEP morphology.
- Five experts labeled MEP morphology as normal or abnormal, revealing consistent concepts but differing thresholds for classification; an automated analysis identified approximate entropy (ApEn) as a strong predictor of these classifications.
- Using ApEn, researchers created an objective and reproducible score for MEP morphology that could streamline data analysis and improve the integration of MEPs in clinical practice and large-scale research.
Article Synopsis
- * A large dataset was obtained from the Rehabilitation & MS Center in Belgium, allowing for a more robust evaluation of the machine learning models, which included random forests (RF) and logistic regression (LR), to predict long-term outcomes for MS patients.
- * The study found that incorporating additional time series features from motor EPs significantly enhances predictive performance, particularly when using random forests, which achieved an area under the curve (AUC) of 0.75, indicating
Background/objective: Endurance exercise can improve memory function in persons with multiple sclerosis (pwMS), but the effects on hippocampal functioning are currently unknown. We investigated the effects of a running intervention on memory and hippocampal functional connectivity in pwMS.
Methods/results: Memory and resting-state functional magnetic resonance imaging (fMRI) data were collected in a running intervention ( = 15) and waitlist group ( = 14).
Personalized treatment is highly desirable in multiple sclerosis (MS). We believe that multidisciplinary measurements including clinical, functional and patient-reported outcome measures in combination with extensive patient profiling can enhance personalized treatment and rehabilitation strategies. We elaborate on four reasons behind this statement: (1) MS disease activity and progression are complex and multidimensional concepts in nature and thereby defy a one-size-fits-all description, (2) functioning, progression, treatment, and rehabilitation effects are interdependent and should be investigated together, (3) personalized healthcare is based on the dynamics of system biology and on technology that confirms a patient's fundamental biology and (4) inclusion of patient-reported outcome measures can facilitate patient-relevant healthcare.
View Article and Find Full Text PDFBackground: Exercise therapy studies in persons with multiple sclerosis (pwMS) primarily focused on motor outcomes in mid disease stage, while cognitive function and neural correlates were only limitedly addressed.
Objectives: This pragmatic randomized controlled study investigated the effects of a remotely supervised community-located "start-to-run" program on physical and cognitive function, fatigue, quality of life, brain volume, and connectivity.
Method: In all, 42 pwMS were randomized to either experimental (EXP) or waiting list control (WLC) group.
Grey matter (GM) atrophy is a prominent aspect of multiple sclerosis pathology and an important outcome in studies. GM atrophy measurement requires accurate GM segmentation. Several methods are used in vivo for measuring GM volumes in MS, but assessing their validity in vivo remains challenging.
View Article and Find Full Text PDFBackground: Studies disagree on the location of grey matter (GM) atrophy in the multiple sclerosis (MS) brain.
Aim: To examine the consistency between FSL, FreeSurfer, SPM for GM atrophy measurement (for volumes, patient/control discrimination, and correlations with cognition).
Materials And Methods: 127 MS patients and 50 controls were included and cortical and deep grey matter (DGM) volumetrics were performed.
Neuronal and axonal loss in normal-appearing gray matter and subpial lesions in multiple sclerosis.
J Neuropathol Exp Neurol
May 2015
Multiple sclerosis (MS) is a demyelinating and neurodegenerative disease of the CNS. Multiple sclerosis lesions include significant demyelination of the gray matter, which is thought to be a major contributor to both physical and cognitive impairment. Subpial (Type III) lesions are the most common demyelinated cortical lesions.
View Article and Find Full Text PDFThe back-to-back (BTB) acquisition of MP-RAGE MRI scans of the Alzheimer׳s Disease Neuroimaging Initiative (ADNI1) provides an excellent data set with which to check the reproducibility of brain atrophy measures. As part of ADNI1, 131 subjects received BTB MP-RAGEs at multiple time points and two field strengths of 3T and 1.5 T.
View Article and Find Full Text PDFCervical spinal cord volume loss is related to clinical disability progression in multiple sclerosis.
J Neurol Neurosurg Psychiatry
April 2015
Objective: To examine the temporal evolution of spinal cord (SC) atrophy in multiple sclerosis (MS), and its association with clinical progression in a large MS cohort.
Methods: A total of 352 patients from two centres with MS (relapsing remitting MS (RRMS): 256, secondary progressive MS (SPMS): 73, primary progressive MS (PPMS): 23) were included. Clinical and MRI parameters were obtained at baseline, after 12 months and 24 months of follow-up.
Article Synopsis
- The study aimed to investigate differences in spinal cord atrophy among multiple sclerosis (MS) subtypes and its potential as a diagnostic tool alongside other MRI markers.
- The study involved analyzing the upper cervical cord cross-sectional area (UCCA) and correlating it with clinical disability in 440 MS patients from two centers, categorized into relapsing-remitting (RR), secondary-progressive (SP), and primary-progressive (PP) MS.
- Results showed that patients with SP and PP MS had significantly smaller UCCA compared to RR MS, and UCCA correlated inversely with disability scores, suggesting its importance in assessing clinical status in MS.