May 27, 2009

Multiple sclerosis (MS) is more frequent in women than in men, suggesting that sex hormones could play a role in the development of MS. For this reason, several studies have assessed whether use of oral contraceptives modifies the risk of MS.

In this article, the methodology and results of published epidemiologic studies addressing this issue are reviewed. On the whole, the existing epidemiologic evidence does not support an important effect of oral contraceptive use on the risk of MS, though it does suggest that oral contraceptives might delay the onset of the disease.

As we learn that MS is more than an attack on the white-matter, it has become apparent that we need to focus on neuroprotection as treatment avenue. This means we need to be able to tell when a treatment is having a neuroprotective effect to tell if it is working. A review of the literature on imaging techniques that can indicate neuroprotection and repair has some suggestions.

They conclude that: At present, the three most promising primary outcomes in phase II trials of neuroprotective and/or reparative strategies in MS are: changes in whole-brain volume to gauge general cerebral atrophy; T1 hypointensity and magnetization transfer ratio to monitor the evolution of lesion damage; and optical coherence tomography findings to evaluate the anterior visual pathway.