Vasylovskyi V. Progredient types of course of multiple sclerosis: clinical and pathogenetic characteristics of the course, prognosis and new approaches to the treatment strategy

In the dissertation, using clinical and neurological, neuroimaging, neuropsychological, immunopathological, biochemical, mathematical and statistical methods of research the clinical and pathogenetic characteristics were obtained in 200 patients with progressive types of multiple sclerosis (MS) and in 80 patients (comparison group) with relapsing course. We characterized clinical and neurological features of progredient and relapsing (comparison group) types of MS course. The disease time stages, consisting of clinical indicators that characterize different types of the MS coursewere also identified. We presented the generalized clinical characteristics of each stage, pointing both general patterns and individual differences, depending on the type of course - the secondary-progredient, primary-progredient, relapsing. Using clinical and mathematical analysis, we developed the differential diagnostic criteria for different prognosis variants (unfavorable and indefinite for progredient type course; favorable and indefinite for relapsing course). The features of MR-tomographic, neuropsychological, immunopathological, biochemical (the level of tau protein in serum, the content of different classes of albumin and immunoglobulin G in serum and cerebrospinal fluid) disorders in different types of course, were studied, considering the nature of the prognosis. New dexamethasone endolumbal introduction has been developed and traditional pathogenetic therapy complexes have been improved (courses of pulse therapy with glucocorticoids, betaferon, natalizumab (tizabri), mitoxantrone), considering the phasing, activity stage, prognosis nature of progredient types of MS course.