(Reuters) - Health insurer Centene Corp reported a better-than-expected quarterly profit as it added more states under its Medicaid contracts and expanded its coverage in existing ones.
The company raised its full-year forecast for premium and service revenue to $10.1 billion to $10.4 billion, and reiterated its profit forecast of $2.60 to $2.90 per share.
"We believe we are well positioned for profitable growth in 2014 and beyond," CEO Michael Neidorff said in a statement.
Net income fell marginally to $23 million, or 42 cents per share, in the first quarter from $24 million, or 45 cents per share, a year earlier.
Premium and service revenue rose 53 percent to $2.54 billion, mainly driven by the expansion of contracts in Texas, Mississippi and Louisiana, and contract additions in Kansas, Missouri and Washington, the company said.
Analysts were expecting a profit of 37 cents per share, on revenue of $2.46 billion, according to Thomson Reuters I/B/E/S.
Health benefits ratio, a measure of medical expenses expressed as a percentage of premium revenue, rose to 90.4 percent from 88.2 percent a year earlier.
The increase in medical expenses reflected a higher level of flu costs during the first quarter, and a higher level of medical costs in new business, the company said.
Insurers take a hit from the flu because of an increase in claims related to visits to doctors and hospitals.
Centene was hit by high costs at its Medicaid contracts in Texas and Kentucky last year as higher utilization of its services in the states ate into profit.
The insurer intends to exit Kentucky from July 5.
Several other health insurers providing Medicaid services in the two states had also experienced high medical costs.
Shares of the St. Louis, Missouri-based Centene closed at $45.35 on Monday on the New York Stock Exchange.
(Reporting by Esha Dey in Bangalore; Editing by Roshni Menon)
FILE- In this Wednesday, Dec. 14, 2011, file photo, a driver uses an iPhone while driving Wednesday, in Los Angeles. Traffic safety regulators are asking automakers to put stronger limits on how long drivers can use in-car touch screens in an effort to curb distracted driving. The voluntary guidelines unveiled Tuesday April 23, 2013, would restrict the amount of time it takes to perform a single function on the car's audio/visual systems to two seconds. (AP Photo/Damian Dovarganes, File)
FILE- In this Wednesday, Dec. 14, 2011, file photo, a driver uses an iPhone while driving Wednesday, in Los Angeles. Traffic safety regulators are asking automakers to put stronger limits on how long drivers can use in-car touch screens in an effort to curb distracted driving. The voluntary guidelines unveiled Tuesday April 23, 2013, would restrict the amount of time it takes to perform a single function on the car's audio/visual systems to two seconds. (AP Photo/Damian Dovarganes, File)
DETROIT (AP) ? The government is asking automakers to put stronger limits on drivers' interaction with in-car touch screens in an effort to curb distracted driving.
U.S. traffic safety regulators unveiled guidelines Tuesday that would restrict the amount of time it takes to perform both simple and complex functions on a car's entertainment and navigation systems.
Regulators also want to ban manual text entry and display of websites, social media, books and other text distractions while the car is moving.
"Distracted driving is unsafe, irresponsible. It can have devastating consequences," said Transportation Secretary Ray LaHood, who announced the guidelines along with National Highway Traffic Safety Administration Administrator David Strickland.
LaHood and Strickland told reporters on a conference call that NHTSA has determined that over 3,000 people were killed in crashes that involved distracted driving in 2011 and more than 387,000 were hurt.
The guidelines are voluntary for automakers and will be phased in over three years.
Strickland said NHTSA has had success with voluntary guidelines and would consider giving automakers incentives to comply.
But Clarence Ditlow, executive director of the Center for Auto Safety, a frequent NHTSA and auto industry critic, said the guidelines will do little to halt distracted driving.
"We've tried voluntary. Voluntary doesn't work," he said.
NHTSA based the new guidelines on a study it conducted on distracted driving. The results showed that tasks requiring drivers to look at touch screens or hand-held devices increase the risk of getting into a crash by three times. Texting, web browsing and dialing a phone were the tasks that kept drivers' eyes off the road the longest.
However, the study did not find an increased risk of a crash from just talking on a cellphone.
The new guidelines limit simple tasks to two seconds. They also restrict the time allowed for complex tasks to 12 seconds, but do not limit the number of times a driver can touch a screen. The decision on whether a screen would freeze or shut down after 12 seconds would be left to automakers based on their own research, NHTSA said.
The auto industry's current guidelines, which are a decade old, allow drivers to read text and perform other more complex tasks while cars are moving at less than 5 mph, Strickland said. Systems now are designed so multiple-step tasks take 10 or fewer screen touches for a total of 20 seconds with a driver's eyes off the road. But the devices won't turn off or stop a driver from doing something that takes longer than 20 seconds.
The new guidelines "will help us put an end to the dangerous practice of distracted driving by limiting the amount of time drivers take their eyes off the road," Strickland said.
The Alliance of Automobile Manufacturers, a group representing 12 large car makers, is worried that drivers will simply turn their eyes to something else: their mobile devices.
Gloria Bergquist, spokeswoman for the alliance, said a mobile device, with its smaller buttons and screens, "wasn't designed for use while driving a vehicle." She said guidelines for mobile devices should be proposed at the same time as those for in-car equipment, which is designed to be used while driving.
NHTSA said it will address mobile devices and voice-activation technology in the next phases of guidelines. But it encouraged mobile device makers to adopt recommendations from Tuesday's guidelines "that they believe are feasible and appropriate for their devices."
The guidelines cover any manufacturer-installed device that a driver can see or reach, but they do not affect video screens located behind the front seats.
Navigation maps that show movement as cars travel would still be allowed, as would the input of preset destinations, Strickland said. But a car would likely have to be stopped for a driver to manually type in an address.
NHTSA said more research is needed to decide if the guidelines should cover heavy trucks and buses.
Contact: Martin Sueess mmartin.sueess@emez.ethz.ch 41-446-336-408 ETH Zurich
Microprocessors communicating with light
Researchers from ETH Zurich, the Paul Scherrer Institute (PSI) and the Politec-nico di Milano have jointly developed a manufacturing technique to render the semiconductor germanium laser-compatible through high tensile strain. In their article recently published in "Nature Photonics", they reveal how they can gen-erate the necessary tensile strain efficiently. The scientists demonstrate how to use their method to effectively alter the optical properties of germanium, which is naturally unsuitable for lasing: "With a strain of three per cent, the material emits around twenty-five times more photons than in a relaxed state," explains Martin Sess, a doctoral student at the Laboratory for Nanometallurgy headed by Ralph Spolenak and the EMEZ at ETH Zurich. "That's enough to build lasers", adds his colleague Richard Geiger, a doctoral student at the Laboratory for Micro- and Nanotechnology at the PSI and the Institute for Quantum Electronics at ETH Zurich under Jrme Faist.
High tension through microbridges
With the new method, the researchers use the slight tension generated in ger-manium when it evaporates on silicon, to bring the germanium into a laser-compatible, strechted form. This prestrain is enhanced with so-called micro-bridges: the researchers centrally notch the sides of exposed germanium strips, which remain attached to the silicon layer at both ends. The two halves of the strip thus remain connected solely by an extremely narrow bridge, which is for physical reasons precisely where the strain in the germanium grows so intense that it becomes laser-compatible.
"The tensile strain applied to the germanium is comparable to the force exerted on a pencil as two lorries pull upon it in opposite directions," says Hans Sigg, the project manager at the PSI, explaining the feat on a micrometre scale in everyday proportions. Through the expansion of the material its properties change because the individual atoms slightly move apart, which enables the electrons within the material to reach energy levels that are favourable for the generation of light particles, so-called photons.
Germanium laser for the computer of the future
The interdisciplinary research team's method could increase the performance of future computer generations considerably. After all, in order to improve comput-er performance, computer chips have constantly been made smaller and more densely packed. However, this approach will eventually reach its limits in the foreseeable future. "In order to further increase performance and speed, the individual components need to be linked more closely and communicate with each other more efficiently," explains Sess. This requires new transmission paths that are faster than today, where the signals are still transmitted via elec-tricity and copper cables.
"The future way to go is light," says Geiger. However, in order to be able to use light to transfer data, first of all light sources are needed that are so small as to fit onto a chip and react well to silicon, the base material of all computer chips. Silicon itself is not suitable for the emission of laser light, which is also the reason why it is so important for the researchers to make germanium laser-compatible: "Germanium is perfectly compatible with silicon and already used in the computer industry for the production of silicon chips," explains Geiger. If it is possible to build tiny lasers out of germanium using the new method, a system change is within reach. "We're on the right track," says Sess. The international team of researchers is currently in the process of actually constructing a germa-nium laser with the new method.
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Contact: Martin Sueess mmartin.sueess@emez.ethz.ch 41-446-336-408 ETH Zurich
Microprocessors communicating with light
Researchers from ETH Zurich, the Paul Scherrer Institute (PSI) and the Politec-nico di Milano have jointly developed a manufacturing technique to render the semiconductor germanium laser-compatible through high tensile strain. In their article recently published in "Nature Photonics", they reveal how they can gen-erate the necessary tensile strain efficiently. The scientists demonstrate how to use their method to effectively alter the optical properties of germanium, which is naturally unsuitable for lasing: "With a strain of three per cent, the material emits around twenty-five times more photons than in a relaxed state," explains Martin Sess, a doctoral student at the Laboratory for Nanometallurgy headed by Ralph Spolenak and the EMEZ at ETH Zurich. "That's enough to build lasers", adds his colleague Richard Geiger, a doctoral student at the Laboratory for Micro- and Nanotechnology at the PSI and the Institute for Quantum Electronics at ETH Zurich under Jrme Faist.
High tension through microbridges
With the new method, the researchers use the slight tension generated in ger-manium when it evaporates on silicon, to bring the germanium into a laser-compatible, strechted form. This prestrain is enhanced with so-called micro-bridges: the researchers centrally notch the sides of exposed germanium strips, which remain attached to the silicon layer at both ends. The two halves of the strip thus remain connected solely by an extremely narrow bridge, which is for physical reasons precisely where the strain in the germanium grows so intense that it becomes laser-compatible.
"The tensile strain applied to the germanium is comparable to the force exerted on a pencil as two lorries pull upon it in opposite directions," says Hans Sigg, the project manager at the PSI, explaining the feat on a micrometre scale in everyday proportions. Through the expansion of the material its properties change because the individual atoms slightly move apart, which enables the electrons within the material to reach energy levels that are favourable for the generation of light particles, so-called photons.
Germanium laser for the computer of the future
The interdisciplinary research team's method could increase the performance of future computer generations considerably. After all, in order to improve comput-er performance, computer chips have constantly been made smaller and more densely packed. However, this approach will eventually reach its limits in the foreseeable future. "In order to further increase performance and speed, the individual components need to be linked more closely and communicate with each other more efficiently," explains Sess. This requires new transmission paths that are faster than today, where the signals are still transmitted via elec-tricity and copper cables.
"The future way to go is light," says Geiger. However, in order to be able to use light to transfer data, first of all light sources are needed that are so small as to fit onto a chip and react well to silicon, the base material of all computer chips. Silicon itself is not suitable for the emission of laser light, which is also the reason why it is so important for the researchers to make germanium laser-compatible: "Germanium is perfectly compatible with silicon and already used in the computer industry for the production of silicon chips," explains Geiger. If it is possible to build tiny lasers out of germanium using the new method, a system change is within reach. "We're on the right track," says Sess. The international team of researchers is currently in the process of actually constructing a germa-nium laser with the new method.
###
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?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
FILE - In this April 26, 2012, file photo, North Carolina defensive end Quinton Coples, right, hugs NFL Commissioner Roger Goodell after being selected as the 16th pick overall by the New York Jets in the first round of the NFL football draft in New York. How many hugs can Roger Goodell endure from all the burly offensive and defensive players expected to be selected in the first round? Last year, he embraced many first-round picks who took the stage and was nearly hugged into submission_one of the things to watch for during the three-day NFL draft beginning Thursday, April 25, 2013. (AP Photo/Jason DeCrow, File)
FILE - In this April 26, 2012, file photo, North Carolina defensive end Quinton Coples, right, hugs NFL Commissioner Roger Goodell after being selected as the 16th pick overall by the New York Jets in the first round of the NFL football draft in New York. How many hugs can Roger Goodell endure from all the burly offensive and defensive players expected to be selected in the first round? Last year, he embraced many first-round picks who took the stage and was nearly hugged into submission_one of the things to watch for during the three-day NFL draft beginning Thursday, April 25, 2013. (AP Photo/Jason DeCrow, File)
FILE- This combo image of March 2013 file photos shows quarterbacks, from top, Geno Smith, E.J. Manuel and Matt Barkley during their respective NFL football pro days. Will any quarterbacks be taken in the first round? Possibilities include Geno Smith, Matt Barkley and E.J. Manuel_one of the things to watch for during the three-day NFL draft beginning Thursday, April 25, 2013. (AP Photos/File)
FILE - In this April 26, 2012, file photo, quarterback Robert Griffin III, right, poses for photographs with NFL Commissioner Roger Goodell after he was selected as the second pick overall by the Washington Redskins in the first round of the NFL football draft in New York. Fashionistas surely will be tracking the expensive, colorful designer suits, hairstyles (think dreadlocks) and even socks of the draftees as they take the stage after being selected. (Think Robert Griffin III, the Redskins' top pick in 2012, who wore a baby blue jacket, checkered-patterned shirt, purplish tie with horizontal stripes, and burgundy and gold socks. Fashion is one of the things to watch for during the three-day NFL draft beginning Thursday, April 25, 2013. (AP Photo/Jason DeCrow, File)
FILE - In this March 26, 2013, file photo, linebacker Manti Te'o runs the 40 yard sprint during Notre Dame's NFL football pro day in South Bend, Ind. Some analysts have Notre Dame's All-American linebacker Mante Te'o back to being a first-round cinch, even after a great season was marred by a poor game against Alabama followed by the hoax involving a deceased "girlfriend." He did not perform well at the NFL combine but did better at pro day in South Bend. Te'o is one of the people to watch for during the three-day NFL draft beginning Thursday, April 25, 2013. (AP Photo/Joe Raymond, File)
NEW YORK (AP) ? Since 1936, the NFL has picked the best of college football to join the pro league. From the very first pick ? Jay Berwanger, who also was the first bust, never playing a down in the NFL ? to last year's No. 1, Andrew Luck, the draft has always offered plenty of intrigue for teams and fans.
Here are 10 things to watch for during the three-day NFL draft beginning Thursday night:
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COMMISSIONER HUGGY BEAR
How many hugs can Roger Goodell endure from all the burly offensive and defensive players expected to be selected in the first round? Last year, he embraced many first-round picks who took the stage and was nearly hugged into submission by the likes of Fletcher Cox, Dontari Poe and Melvin Ingram.
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SHOW ME A QUARTERBACK
Will any quarterbacks be taken in the first round? Possibilities include Geno Smith, Matt Barkley and EJ Manuel, but this is far from the glamour year of 2012, when QBs were huge: Luck, No. 1; Robert Griffin III, No. 2; Ryan Tannehill (No. 8); Brandon Weeden (No. 22). The last time no quarterback was taken in round one was 1996 (Tony Banks was a second-rounder, No. 42, by the Rams); the last time only one was taken was 2001 (Michael Vick, first overall) and the last time two were taken was 2010 (Sam Bradford and Tim Tebow).
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FASHION STATEMENT
Fashionistas surely will be tracking the expensive, colorful designer suits, hairstyles (think dreadlocks) and even socks of the draftees as they take the stage after being selected. (Think Griffin, the Redskins' top pick in 2012, who wore a baby blue jacket, checkered-patterned shirt, purplish tie with horizontal stripes, and burgundy and gold socks with the words "GO CATCH YOUR DREAM."
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TE'O TIME
When that will be exactly is anyone's guess. Some analysts have Notre Dame's All-American linebacker Manti Te'o back to being a first-round cinch, even after a great season was marred by a poor game against Alabama followed by the hoax involving a deceased "girlfriend." He did not perform well at the NFL combine, but did better at pro day in South Bend.
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BEEFING UP EARLY
Watch for all the beef early in the first round. There's a chance seven of the first 10 picks could be really big fellas. Among them are offensive linemen Luke Joeckel (306 pounds), Eric Fisher (306), Chance Warmack (317), Lane Johnson (303) and Jonathan Cooper (311); and defensive linemen Sharrif Floyd (297) and Ziggy Ansah (271).
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WILL TIDE ROLL AGAIN IN 1ST ROUND?
A year ago, the national champions had four players picked: RB Trent Richardson (No. 3), SS Mark Barron (No. 7), CB Dre Kirkpatrick (No.17) and LB Dont'a Hightower (No. 25). National champs again, there are five that could end up as first-rounders: Warmack, cornerback Dee Milliner, offensive tackle D.J. Fluker, defensive tackle Jesse Williams, and running back Eddie Lacy.
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FAMILY TIES
Every year, a slew of players with family ties to the NFL are draft eligible. This year is no exception, with a few dozen all-in-the-family connections. Among them are QBs Nate Montana (son of Joe Montana) and Jordan Rodgers (brother of Aaron Rodgers), Jake Ryan (son of Pat Ryan), Duron Carter (son of Cris Carter), Luke Tasker (son of Steve Tasker), Kyle Long (son of Howie Long, brother of Chris Long) and Baker Steinkuhler (son of Dean Steinkuhler).
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HALL OF FAME PICKERS
A total of 32 former NFL players will be announcing second- and third-round picks for teams, including newly elected Hall of Famers Jonathan Ogden (Ravens), Warren Sapp (Buccaneers) and Dave Robinson (Packers). Others making picks for their former teams include Deion Sanders (Falcons) and Larry Little (Dolphins).
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BEST STORYLINES
Houston cornerback D.J. Hayden and South Carolina running back Marcus Lattimore.
Hayden was moments from death last November after an on-field collision with a teammate tore a blood vessel off the back of his heart. He was taken to a hospital, underwent lifesaving surgery, and now could be a first-round pick. He ran a 4.33 40-yard dash at Houston's pro day in March, and now he'll wait to see if a team believes his talent and speed is worth the risk.
In 2011, Lattimore tore the ACL in his left knee midway through the season. He returned last year, and in October, the star running back suffered a horrific injury to his right knee against Tennessee ? it was dislocated and ligaments were damaged as he was tackled. He had surgery a month later, continued rehabbing, and at South Carolina's pro day recently he impressed NFL scouts so much they applauded after his workout. He says he's confident he'll be ready to play when the 2013 season starts.
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MR. IRRELEVANT
As the draft draws to a close Saturday, the fun revs up with the final pick, aka Mr. Irrelevant. As they did last year, the Colts have the honor at pick No. 254. Last year, they went for Northern Illinois quarterback Chandler Harnish (Andrew Luck was the Colts' other QB pick ? at No. 1 overall). The last pick will be awarded the Lowsman (opposite of Heisman) Trophy during a weeklong celebration at the Balboa Bay Club in Newport Beach, Calif. In 2012, Harnish's first trip to California included golf at Big Canyon Country Club, a visit to Disneyland and parties galore. The founder of Irrelevant Week is Paul Salata, a former USC and NFL receiver. The first Mr. Irrelevant was WR Kelvin Kirk in 1976.
Atrophy in key region of brain associated with multiple sclerosisPublic release date: 23-Apr-2013 [ | E-mail | Share ]
Contact: Linda Brooks lbrooks@rsna.org 630-590-7762 Radiological Society of North America
OAK BROOK, Ill. Magnetic resonance imaging (MRI) measurements of atrophy in an important area of the brain are an accurate predictor of multiple sclerosis (MS), according to a new study published online in the journal Radiology. According to the researchers, these atrophy measurements offer an improvement over current methods for evaluating patients at risk for MS.
MS develops as the body's immune system attacks and damages myelin, the protective layer of fatty tissue that surrounds nerve cells within the brain and spinal cord. Symptoms include visual disturbances, muscle weakness and trouble with coordination and balance. People with severe cases can lose the ability to speak or walk.
Approximately 85 percent of people with MS suffer an initial, short-term neurological episode known as clinically isolated syndrome (CIS). A definitive MS diagnosis is based on a combination of factors, including medical history, neurological exams, development of a second clinical attack and detection of new and enlarging lesions with contrast-enhanced or T2-weighted MRI.
"For some time we've been trying to understand MRI biomarkers that predict MS development from the first onset of the disease," said Robert Zivadinov, M.D., Ph.D., FAAN, from the Buffalo Neuroimaging Analysis Center of the University at Buffalo in Buffalo, N.Y. "In the last couple of years, research has become much more focused on the thalamus."
The thalamus is a structure of gray matter deep within the brain that acts as a kind of relay center for nervous impulses. Recent studies found atrophy of the thalamus in all different MS disease types and detected thalamic volume loss in pediatric MS patients.
"Thalamic atrophy may become a hallmark of how we look at the disease and how we develop drugs to treat it," Dr. Zivadinov said.
For this study, Dr. Zivadinov and colleagues investigated the association between the development of thalamic atrophy and conversion to clinically definite MS.
"One of the most important reasons for the study was to understand which regions of the brain are most predictive of a second clinical attack," he said. "No one has really looked at this over the long term in a clinical trial."
The researchers used contrast-enhanced MRI for initial assessment of 216 CIS patients. They performed follow-up scans at six months, one year and two years. Over two years, 92 of 216 patients, or 42.6 percent, converted to clinically definite MS. Decreases in thalamic volume and increase in lateral ventricle volumes were the only MRI measures independently associated with the development of clinically definite MS.
"First, these results show that atrophy of the thalamus is associated with MS," Dr. Zivadinov said. "Second, they show that thalamic atrophy is a better predictor of clinically definite MS than accumulation of T2-weighted and contrast-enhanced lesions."
The findings suggest that measurement of thalamic atrophy and increase in ventricular size may help identify patients at high risk for conversion to clinically definite MS in future clinical trials involving CIS patients.
"Thalamic atrophy is an ideal MRI biomarker because it's detectable at very early stage," Dr. Zivadinov said. "It has very good predictive value, and you will see it used more and more in the future."
The research team continues to follow the study group, with plans to publish results from the four-year follow-up next summer. They are also trying to learn more about the physiology of the thalamic involvement in MS.
"The next step is to look at where the lesions develop over two years with respect to the location of the atrophy," Dr. Zivadinov said. "Thalamic atrophy cannot be explained entirely by accumulation of lesions; there must be an independent component that leads to loss of thalamus."
MS affects more than 2 million people worldwide, according to the Multiple Sclerosis International Foundation. There is no cure, but early diagnosis and treatment can slow development of the disease.
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"Thalamic Atrophy is Associated with Development of Clinically Definite Multiple Sclerosis." Collaborating with Dr. Zivadinov were Eva Havrdov, M.D., Ph.D., Niels Bergsland, M.S., Michaela Tyblova, M.D., Jesper Hagemeier, M.S., Zdenek Seidl, M.D., Ph.D., Michael G. Dwyer, M.S., Manuela Vaneckova, M.D., Ph.D., Jan Krasensky, M.Sc., Ellen Carl, Ph.D., Tomas Kalincik, M.D., Ph.D., Dana Horkov, M.D., Ph.D.
Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc.
RSNA is an association of more than 51,000 radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill. (RSNA.org)
For patient-friendly information on MRI, visit RadiologyInfo.org.
[ | E-mail | Share ]
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Atrophy in key region of brain associated with multiple sclerosisPublic release date: 23-Apr-2013 [ | E-mail | Share ]
Contact: Linda Brooks lbrooks@rsna.org 630-590-7762 Radiological Society of North America
OAK BROOK, Ill. Magnetic resonance imaging (MRI) measurements of atrophy in an important area of the brain are an accurate predictor of multiple sclerosis (MS), according to a new study published online in the journal Radiology. According to the researchers, these atrophy measurements offer an improvement over current methods for evaluating patients at risk for MS.
MS develops as the body's immune system attacks and damages myelin, the protective layer of fatty tissue that surrounds nerve cells within the brain and spinal cord. Symptoms include visual disturbances, muscle weakness and trouble with coordination and balance. People with severe cases can lose the ability to speak or walk.
Approximately 85 percent of people with MS suffer an initial, short-term neurological episode known as clinically isolated syndrome (CIS). A definitive MS diagnosis is based on a combination of factors, including medical history, neurological exams, development of a second clinical attack and detection of new and enlarging lesions with contrast-enhanced or T2-weighted MRI.
"For some time we've been trying to understand MRI biomarkers that predict MS development from the first onset of the disease," said Robert Zivadinov, M.D., Ph.D., FAAN, from the Buffalo Neuroimaging Analysis Center of the University at Buffalo in Buffalo, N.Y. "In the last couple of years, research has become much more focused on the thalamus."
The thalamus is a structure of gray matter deep within the brain that acts as a kind of relay center for nervous impulses. Recent studies found atrophy of the thalamus in all different MS disease types and detected thalamic volume loss in pediatric MS patients.
"Thalamic atrophy may become a hallmark of how we look at the disease and how we develop drugs to treat it," Dr. Zivadinov said.
For this study, Dr. Zivadinov and colleagues investigated the association between the development of thalamic atrophy and conversion to clinically definite MS.
"One of the most important reasons for the study was to understand which regions of the brain are most predictive of a second clinical attack," he said. "No one has really looked at this over the long term in a clinical trial."
The researchers used contrast-enhanced MRI for initial assessment of 216 CIS patients. They performed follow-up scans at six months, one year and two years. Over two years, 92 of 216 patients, or 42.6 percent, converted to clinically definite MS. Decreases in thalamic volume and increase in lateral ventricle volumes were the only MRI measures independently associated with the development of clinically definite MS.
"First, these results show that atrophy of the thalamus is associated with MS," Dr. Zivadinov said. "Second, they show that thalamic atrophy is a better predictor of clinically definite MS than accumulation of T2-weighted and contrast-enhanced lesions."
The findings suggest that measurement of thalamic atrophy and increase in ventricular size may help identify patients at high risk for conversion to clinically definite MS in future clinical trials involving CIS patients.
"Thalamic atrophy is an ideal MRI biomarker because it's detectable at very early stage," Dr. Zivadinov said. "It has very good predictive value, and you will see it used more and more in the future."
The research team continues to follow the study group, with plans to publish results from the four-year follow-up next summer. They are also trying to learn more about the physiology of the thalamic involvement in MS.
"The next step is to look at where the lesions develop over two years with respect to the location of the atrophy," Dr. Zivadinov said. "Thalamic atrophy cannot be explained entirely by accumulation of lesions; there must be an independent component that leads to loss of thalamus."
MS affects more than 2 million people worldwide, according to the Multiple Sclerosis International Foundation. There is no cure, but early diagnosis and treatment can slow development of the disease.
###
"Thalamic Atrophy is Associated with Development of Clinically Definite Multiple Sclerosis." Collaborating with Dr. Zivadinov were Eva Havrdov, M.D., Ph.D., Niels Bergsland, M.S., Michaela Tyblova, M.D., Jesper Hagemeier, M.S., Zdenek Seidl, M.D., Ph.D., Michael G. Dwyer, M.S., Manuela Vaneckova, M.D., Ph.D., Jan Krasensky, M.Sc., Ellen Carl, Ph.D., Tomas Kalincik, M.D., Ph.D., Dana Horkov, M.D., Ph.D.
Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc.
RSNA is an association of more than 51,000 radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill. (RSNA.org)
For patient-friendly information on MRI, visit RadiologyInfo.org.
[ | E-mail | Share ]
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Apr. 21, 2013 ? Researchers at Northeastern University in Boston have developed a gene therapy approach that may one day stop Parkinson's disease (PD) in it tracks, preventing disease progression and reversing its symptoms. The novelty of the approach lies in the nasal route of administration and nanoparticles containing a gene capable of rescuing dying neurons in the brain. Parkinson's is a devastating neurodegenerative disorder caused by the death of dopamine neurons in a key motor area of the brain, the substantia nigra (SN). Loss of these neurons leads to the characteristic tremor and slowed movements of PD, which get increasingly worse with time. Currently, more than 1% of the population over age 60 has PD and approximately 60,000 Americans are newly diagnosed every year. The available drugs on the market for PD mimic or replace the lost dopamine but do not get to the heart of the problem, which is the progressive loss of the dopamine neurons.
The focus of Dr. Barbara Waszczak's lab at Northeastern University in Boston is to find a way to harvest the potential of glial cell line-derived neurotrophic factor (GDNF) as a treatment for PD. GDNF is a protein known to nourish dopamine neurons by activating survival and growth-promoting pathways inside the cells. Not surprisingly, GDNF is able to protect dopamine neurons from injury and restore the function of damaged and dying neurons in many animal models of PD. However, the action of GDNF is limited by its inability to cross the blood-brain barrier (BBB), thus requiring direct surgical injection into the brain. To circumvent this problem, Waszczak's lab is investigating intranasal delivery as a way to bypass the BBB. Their previous work showed that intranasal delivery of GDNF protects dopamine neurons from damage by the neurotoxin, 6-hydroxydopamine (6-OHDA), a standard rat model of PD.
Taking this work a step further, Brendan Harmon, working in Waszczak's lab, has adapted the intranasal approach so that cells in the brain can continuously produce GDNF. His work utilized nanoparticles, developed by Copernicus Therapeutics, Inc., which are able to transfect brain cells with an expression plasmid carrying the gene for GDNF (pGDNF). When given intranasally to rats, these pGDNF nanoparticles increase GDNF production throughout the brain for long periods, avoiding the need for frequent re-dosing. Now, in new research presented on April 20 at 12:30 pm during Experimental Biology 2013 in Boston, MA, Harmon reports that intranasal administration of Copernicus' pGDNF nanoparticles results in GDNF expression sufficient to protect SN dopamine neurons in the 6-OHDA model of PD.
Waszczak and Harmon believe that intranasal delivery of Copernicus' nanoparticles may provide an effective and non-invasive means of GDNF gene therapy for PD, and an avenue for transporting other gene therapy vectors to the brain. This work, which was funded in part by the Michael J. Fox Foundation for Parkinson's Research and Northeastern University, has the potential to greatly expand treatment options for PD and many other central nervous system disorders.
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Public release date: 22-Apr-2013
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