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Long-term potentiation, or LTP, is one of the ways by which synaptic plasticity—changes in the strength of chemical synapses—can occur in the brain. LTP is the process of synaptic strengthening that occurs over time between pre- and postsynaptic neuronal connections. The synaptic strengthening of LTP works in opposition to the synaptic weakening of long-term depression (LTD) and together are the main mechanisms that underlie learning and memory.
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Late onset multiple sclerosis: Is it really late onset?

Pezhman Roohani1, Tenbit Emiru1, Adam Carpenter1

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Multiple Sclerosis and Related Disorders
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Summary

Late onset multiple sclerosis (MS) is rare, with relapsing-remitting MS (RRMS) being the most common clinical course. Reclassification revealed secondary-progressive MS (SPMS) is more common than primary progressive MS (PPMS) in this population.

Keywords:
Demyelinating disease in the elderlyLate onset multiple sclerosisMultiple sclerosis

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Area of Science:

  • Neurology
  • Immunology
  • Demyelinating Diseases

Background:

  • Multiple sclerosis (MS) is a leading cause of demyelinating disease.
  • Late onset MS (LOMS), defined as onset over 50 years, is less common.
  • LOMS was previously thought to predominantly present as primary progressive MS (PPMS).

Purpose of the Study:

  • To investigate the clinical characteristics of demyelinating diseases in patients over 50 years old.
  • To determine the prevalence and clinical course of late onset MS (LOMS).
  • To re-evaluate the initial clinical course diagnosis in LOMS patients.

Main Methods:

  • Retrospective review of medical records from four MS centers in the Northern Midwest USA.
  • Inclusion of patients aged 50+ at symptom onset diagnosed with MS or clinically isolated syndrome (CIS).
  • Reclassification of clinical course based on detailed patient history of prior neurological events.

Main Results:

  • LOMS accounted for 3.4% of the MS population studied (124/3700 patients).
  • After reclassification, relapsing-remitting MS (RRMS) was the most common course (44%), followed by secondary-progressive MS (SPMS) (28%) and primary progressive MS (PPMS) (20%).
  • Transverse myelitis was the most frequent clinical presentation for both acute (32%) and chronic (51%) syndromes.

Conclusions:

  • LOMS is a rare form of MS, with RRMS being the most common initial clinical course.
  • Reclassification highlights that SPMS may be more prevalent than previously assumed in LOMS.
  • Transverse myelitis is the predominant clinical presentation in LOMS.