19th meeting of the European Neurological Society: 20-24 June 2009.
Article Type: Conference news
Subject: Medical societies (Conferences, meetings and seminars)
Multiple sclerosis (Conferences, meetings and seminars)
Author: Milonas, Ioannis
Pub Date: 11/01/2009
Publication: Name: The International MS Journal Publisher: PAREXEL MMS Europe Ltd. Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2009 PAREXEL MMS Europe Ltd. ISSN: 1352-8963
Issue: Date: Nov, 2009 Source Volume: 16 Source Issue: 3
Product: Product Code: 8622000 Medical Associations NAICS Code: 81392 Professional Organizations SIC Code: 8621 Professional organizations
Geographic: Geographic Code: 4E Europe
Accession Number: 217847870
Full Text: Around 3000 delegates took part in the 19th Meeting of the European Neuroligical Society (ENS) and all sessions were well attended. All aspects of Neurology were covered in the comprehensive programme which included one presidential symposium on stroke, three main symposia on epilepsy, muscle disorders and multiple sclerosis (MS), 140 oral presentations, 654 posters, 23 workshops and 23 teaching courses. Multiple Sclerosis was well represented with one symposium, 20 oral presentations, 103 posters, two teaching courses and two workshops. Overall 23% of the submitted abstracts were rejected.

In the symposium entitled Critical issues on MS diagnosis and treatment, M Filippi (Italy) described the importance of magnetic resonance imaging (MRI) findings in the very early diagnosis of MS, presenting the recent application of quantitative MR techniques, such as magnetization transfer and diffusion-weighted, to the study of MS. He emphasized that in patients with clinical isolated syndrome (CIS) the risk of developing clinical definite MS (CDMS) is associated to the T2 lesion burden at onset. M Clanet (France) emphasized the importance of identifying MS from the large spectrum of idiopathic inflammatory demyelinating diseases in his presentation At the border of MS. He also summarized the characteristics of the radiologic isolated syndrome. M Tintore (Spain) in his presentation How to predict and monitor individual responses to treatment recommended that patients who present with clinical, MRI activity or disease progression in at least two of the three variables analyzed (relapses, MRI activity or increase of disability) after 12 months of treatment, are candidates for treatment change.

There were two presentations on the clinical efficacy of oral treatments from multicentre studies; the fingolimod Phase II extension by L Kappos (Switzerland) and the cladribine Phase III by G Giovannoni (UK). Both studies showed encouraging results. Additionally, a study on the MRI outcomes in patients treated with cladribine (from the CLARITY study group) was presented by G Comi (Italy) and showed considerable reduction of brain MRI activity following treatment with cladribine tablets.

With respect to the genetics of MS, a multicentre study of this in the progressive form of MS, presented by F Martinelli (Italy), showed correlation of progression with HLA Class II region, and additionally with markers in several genes including DPD6 and NRG1.

Furthermore, S Nischwitz (Germany) delineated a LD block of approximately 50 Kb within the CLEC16A gene that may play a pivotal role in the susceptibility to MS, and possibly other autoimmune diseases such as type-I diabetes.

J Sellner (Germany) reviewed the controversial topic of combination therapy, explaining that atorvastatin, which is assumed to attenuate Interferon beta (IFNB) immunomodulation, does not interfere with IFNB-induced alterations of soluble CD95/CD95L serum levels in MS.

Two studies on neuromyelitis optica (NMO; Devic's disease) were described; one from M Eraksoy, (Turkey) showed that childhood-onset cases were very similar to adult in terms of clinical and laboratory aspects, while N M Le (USA) indicated that there was a correlation between NMO onset and preceding infection, but not with any vaccinations. In addition, a poster from S Kurup (UK) reported the manifestation of NMO in a patient with systemic lymphoma treated with rituximab.

A vast amount of information was presented on posters. The highlights include the following:

* Joyeux (Switzerland) evaluated the time between the diagnosis of MS and the first prescription of disease-modifying drugs (DMDs) and found that 25.7% of patients did not receive their first DMD for ?180 days following their diagnosis, and they additionally found that the risk of an MS relapse was 50% lower when treatment was started early.

* Kieseier (Germany) reported that in a multicentre study, natalizumab improves quality of life in patients with highly active relapsing MS.

* Lonergan (Ireland) found inappropriate use of disease-modifying therapy in severely disabled patients with progressive MS.

* A study from Italy presented by Loraschi indicated that the use of herbal remedies is frequent among MS patients although limited information are provided to primary-healthcare givers and caring neurologists.

* Winston (UK) described a brief history of MRI mentioning that the clinical use is based on discoveries initially made 70 years ago, and over this period four Nobel prizes have been awarded.

* The group from San Raphaelle Hospital, Milan Italy, presented two MRI studies of paediatric MS, which showed that in these patients cortical grey matter is spared, but deep grey matter is not.

* Patanella (Italy) suggested that BDNF may have a neuroprotective affect on cognitive function in MS patients.

* Durelli presented an Italian multicentre study which showed that interleukin IL-17 and IL-22 were increased in MS relapses and their specificity for a myelin antigen suggests that it may be encephalitogenic.

* Oreja-Guevara (Spain) reported that optical coherence tomography showed affected retinal nerve fibre layer thickness in patients with CIS, but without optic neuritis.

* Derfuss (Germany) identified contactin 2 as a novel autoantigen targeted by T cells and autoantibodies in MS in a pathological study and these cells contribute in the development of grey matter pathology.

Unfortunately, the Association of British Neurologists meeting was held in Liverpool (UK) at the same time, so most of the British neurologists did not attend the ENS meeting this year.

Ioannis Milonas

Thessaloniki, Greece
Gale Copyright: Copyright 2009 Gale, Cengage Learning. All rights reserved.

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