Biomarkers in Monitoring Medication Treatment in Relapsing-Remitting Multiple Sclerosis
Biomarkers in Monitoring Medication Treatment in Relapsing-Remitting Multiple Sclerosis
Transcranial magnetic stimulation (TMS) studies reported consistent and substantial
 impairments in the central nervous system (CNS) in multiple sclerosis (MS). Studies of
 peripheral nervous system (PNS) function comprising electromyoneurography (EMNG) reported
 impairments of the PNS in MS that were less pronounced and inconsistent. Neurophysiological
 studies are generally small and cross-sectional and with the poor grouping of MS patients
 according to MS type.

 The objective of the study is to investigate clinical, neurophysiological and immunological
 markers prior to and after the initiation of medication treatment with corticosteroids in
 relapsing-remitting MS patients. The results of the study may contribute to a better
 understanding of the pathophysiology of multiple sclerosis and can provide guidance in the
 diagnosis and treatment of patients with relapsing-remitting MS.
The following techniques will be applied:

 -  Neurophysiological testing will be performed with navigated transcranial magnetic
 stimulation (nTMS) incorporating an individual MRI of each subject's brain performed on
 1,5 MRI scanner using a series of neuropsychological protocols;

 -  Electromyoneurography (EMNG) assessment of lower and upper extremities for motor and
 sensory nerves;

 -  Neuropsychological assessment will include the general questionnaire and battery of
 cognitive and psychological tests;

 -  Immunoassays on blood samples include testing with four antibodies to monocyte markers;

 -  Clinical examinations include neurological, biochemical, neuroradiological and
 neuropsychological testing.

 The participants with relapsing-remitting MS will be tested in 3 phases: before the intake of
 steroids, 5 weeks after taking the steroids and 6 months after taking the steroids. In each
 phase, the overall testings will be accomplished in three days.
Inclusion Criteria:

 -  Subjects with a documented diagnosis of relapsing-remitting MS according to the Mc
 Donald criteria (2005) and with EDSS achievement of 0-3.5 according to the modified
 Kurtzke's EDSS (Expanded disability status scale) for the assessment of neurological
 function and incapacity of patients with multiple sclerosis

 Exclusion Criteria:

 -  Patients in whom the clinical course of the disease is characterized by disease
 progression

 -  Patients with relapsing-remitting MS who have started drug therapy with
 corticosteroids

 -  Patients with metals in the body (e.g. pacemaker, dentures)

 -  Patients with new pregnancies (verbally confirmed)

 -  Patients with new head trauma

 -  Subjects unwilling to sign a consent or follow study procedures