Imaging Technology in the Diagnosis and Long-Term Management of MS

Jointly presented by The Johns Hopkins University School of Medicine
and The Institute for Johns Hopkins Nursing.

Summary
Recent models of the pathophysiology of multiple sclerosis (MS) have increasingly emphasized the importance of axonal loss and neurodegeneration, especially in the long-term progression of disability. As the importance of neurodegeneration in MS has received increasing attention, new imaging techniques have been developed to specifically assess axonal injury. The 2 cases presented here focus on the importance of conventional magnetic resonance imaging (MRI) and newer technologies in the diagnosis and management of MS. The first case considers evidence supporting the importance of neurodegeneration in MS and describes the use of optical coherence tomography in the assessment of optic neuritis and the diagnosis of MS. The second case describes the assessment and treatment of a patient with a history of relapsing-remitting MS who is currently symptom free but who has evidence of significant new disease activity on MRI. At the conclusion of this activity, participants should be better able to use radiographic findings in the diagnosis and long-term management of MS, and to select treatment options for patients with MRI evidence of ongoing disease activity.

Goal
To provide neurologists, nurses, and healthcare professionals who care for patients with MS with up-to-date information on the treatment and management of MS.

Target Audience
This activity is designed for neurologists, nurses, and healthcare professionals who care for patients with MS. No prerequisites required.

Learning Objectives
At the conclusion of this activity, the participant should be able to:

  • Discuss the biology of demyelination, axonal degeneration, and neuronal cell death in MS.
  • Identify noninvasive imaging techniques for the assessment and monitoring of neurodegeneration in patients with MS.
  • Summarize the clinical course and prognosis of patients with MS.
  • Describe current and emerging therapeutic strategies designed to promote neuroprotection in MS.

The Johns Hopkins University School of Medicine and The Institute for Johns Hopkins Nursing take responsibility for the content, quality, and scientific integrity of this CE activity.

CME Information
Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of The Johns Hopkins University School of Medicine and The Institute for Johns Hopkins Nursing. The Johns Hopkins University School of Medicine is accredited by the ACCME to provide CME for physicians.

The Institute for Johns Hopkins Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Credit Designation Statement
The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

This 1.6 contact hour Educational Activity is provided by The Institute for Johns Hopkins Nursing. Claim only those contact hours actually spent in the activity.

After reading this case module, participants may receive credit by completing the CE test, evaluation, and receiving a score of 70% or higher.

Release date: December 31, 2008. Expiration date: December 31, 2010.

Estimated time to complete activity: 1.6 hours

Full Disclosure Policy Affecting CME Activities
As a provider accredited by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of The Johns Hopkins University School of Medicine to require the disclosure of the existence of any relevant financial interest or any other relationship a faculty member or a sponsor has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. The participating faculty reported the following:

Course Directors
Benjamin Greenberg, MD, MHS
Assistant Professor
The Johns Hopkins University School of Medicine
Department of Neurology
Co-Director, The Johns Hopkins Transverse Myelitis Center
Director, The Johns Hopkins Encephalitis Center
Baltimore, Maryland
Dr Greenberg reports receiving grants/research support from the Accelerated Cure Project, the National Multiple Sclerosis Society, and Novartis Pharmaceuticals Corporation; serving as a consultant for DioGenix, Inc and Gene Logic Inc; and receiving honoraria from Biogen Idec and Teva Neuroscience.

Michael K. Racke, MD
Professor and Chairman of Neurology
The Helen C. Kurtz Chair in Neurology
The Ohio State University Medical Center
Columbus, Ohio
Dr Racke reports receiving grants/research support from the Bayer, National Institutes of Health, and National Multiple Sclerosis Society; serving as a consultant for Genentech, Inc, Peptimmune, and Teva Neuroscience; and serving on the speakers’ bureau for Bayer, Serono, and Teva Neuroscience.

Participating Faculty
Douglas Kerr, MD, PhD
Associate Professor, Neurology and Molecular Microbiology and Immunology
Director, The Johns Hopkins Transverse Myelitis Center
The Johns Hopkins Hospital
Baltimore, MD
Dr Kerr reports having no significant financial or advisory relationships with corporate organizations related to this activity.

Off-Label Product Discussion: All faculty have indicated that they have not referenced unlabeled or unapproved uses of drugs or devices.

This activity was reviewed by Barbara Fitzsimmons, MS, RN, CNRN, for the American Nurses Credentialing Center’s accreditation purposes.

Disclaimer Statement
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of The Johns Hopkins University School of Medicine and The Institute for Johns Hopkins Nursing names implies review of educational format, design, and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects, before administering pharmacologic therapy to patients.

Internet CME Policy
The Office of Continuing Medical Education (CME) at The Johns Hopkins University School of Medicine is committed to protect the privacy of its members and customers. Johns Hopkins University SOM CME maintains its Internet site as an information resource and service for physicians, other health professionals and the public. Continuing Medical Education at The Johns Hopkins University School of Medicine will keep your personal and credit information confidential when you participate in a CME Internet based program. Your information will never be given to anyone outside of The Johns Hopkins University School of Medicine’s CME program. CME collects only the information necessary to provide you with the services that you request.

References:

 

 

Supported by an educational grant from Novartis Pharmaceuticals Corporation. 

     
 
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