Assess, compare and enhance the status of Persons with Multiple Sclerosis (MS) in Europe: a European Register for MS.

The hippocampus (HC) is a vulnerable brain area involved in learning and memory. Atrophy of the HC is common during normal aging, but in conditions like Alzheimer's disease (AD) or dementia, that volumetric decline becomes pathologic (Alzheimer's Association, 2012). Using high-resolution magnetic resonance imaging (MRI) it is possible to distinguish between single subfield of the HC, which have distinct morphological and functional properties. Single-subfield volumetry might be more meaningful than whole HC analysis, as some subfields might be more affected by dementia-like pathologies, age or by other risk factors than others (Raz, 2014). However, previous studies provided somewhat controversial results, and late-life trajectories have not been fully addressed. Therefore, this study's aim is to identify the effects of age independent from other known risk factors including apolipoprotein E ε4 (ApoE ε4), on HC shrinkage using 3T MRI in a large, well-characterized cohort of healthy older adults (≥ 60 years of age). Methods: SUBJECTS: 849 healthy older adults (60 - 80 years) from the Leipziger Research Center for Civilization Disease (LIFE)-cohort. EXCLUSION: severe untreated diseases, stroke, cardiac infarction, major brain pathologies, ineligibility to undergo MRI (e.g. metallic implants), medication (peripheral/central nervous system and immunosuppressive). OUTCOME MEASURES AND CONFOUNDERS: HC-volume (3T MRI), age, sex, systolic blood pressure, ApoE ε4 allele carrier status, education, body mass index (BMI), smoking behavior, depressive symptoms, anti-diabetes or anti-hypertensive medication, physical activity. IMAGE ACQUISITION AND ANALYSIS: High-resolution T1-weighted images assessed at 3T obtained with MPRAGE (ADNI): repetition time / echo time 2300 ms / 2.98 ms; flip angle 9°; slice / voxel size 1 mm / 1.0 × 1.0 × 1.0 mm (x × y × z); slices 176; field of view 256 mm; bandwidth 240 Hz / Px; base resolution 256; scanning time 5 min 10 s. Images were processed using FreeSurfer (www.freesurfer.net). HC volume was adjusted for total intracranial volume according to Raz (2005), Kerti (2013). STATISTICAL ANALYIS was performed using SPSS (IBM, Armonk, NY). Pearson's correlations were calculated for age and whole HC volume, as well as left and right HC and each subfield (CA1, CA2/3, CA4/DG and subiculum). To account for the effects of possible confounders, partial correlations were used including sex, physical activity, education (school years), systolic blood pressure, smoking (never, former, current smoker), BMI, depression score (CES-D), diabetes medication (yes / no) and vascular medication (yes / no) as covariates. In a subset of subjects (n = 645) we additionally adjusted for ApoE ε4-carrier status.

OBJECTIVES: Persons with multiple sclerosis (PwMS) experience health-related quality of life (HRQoL) problems greatly differing across Europe, and the European Union (EU) faces deep inequalities in MS management from country to country. Through the establishment of a European MS Register (EUReMS), an effective action is proposed to improve the overall knowledge on MS and support effective intervention programmes at EU and national political level. EUReMS aims to achieve consensus on its mission and vision, to define existing data providers, to develop models driving future MS health policies and research, to develop an information technology (IT) infrastructure for a data set, to develop a European shared governance and to secure providers' data provision into EUReMS. MATERIALS AND METHODS: EUReMS is meant to build on a minimum set of core data from existing national and regional population-based MS registries and from PwMS' perspectives. EUReMS' main partner is the European MS Platform (EMSP) acting in collaboration with associated and collaborating European partners. RESULTS: EUReMS was launched in July 2011. A Consensus Statement on purposes, vision, mission and strategies was produced in December 2011, and a comprehensive survey on existing MS data collections in Europe has been performed, and the EUReMS data mask is currently being discussed. CONCLUSIONS: EUReMS will represent a tool to provide up to date, comparable and sustainable MS data through an effective and credible register, which will encourage extensive knowledge building of MS, more equitable policies and higher standards in MS treatment and services.