Multiple Sclerosis Functional Composite

(MSFC) A three-part, standardized, quantitative assessment instrument for use in clinical trials in MS, that was developed by the Task Force on Clinical Outcomes Assessment appointed by the National MS Society's Advisory Committee on Clinical

Trials of New Agents in Multiple Sclerosis. The three components of the MSFC measure leg function/ambulation (Timed 25-Foot Walk), arm/hand function (9-Hole Peg Test), and cognitive function (Paced Auditory Serial Addition Test [PASAT]).

Muscle tone A characteristic of a muscle brought about by the constant flow of nerve stimuli to that muscle, which describes its resistance to stretching. Abnormal muscle tone can be defined as: hypertonus (increased muscle tone, as in spasticity); hypotonus (reduced muscle tone); flaccid (paralysis); and atony (loss of muscle tone). Muscle tone is evaluated as part of the standard neurologic exam in MS.

Myelin A soft, white coating of nerve fibers in the central nervous system, composed of lipids (fats) and protein. Myelin serves as insulation and as an aid to efficient nerve fiber conduction. When myelin is damaged in MS, nerve fiber conduction is faulty or absent. Impaired bodily functions or altered sensations associated with those demyeli-nated nerve fibers are identified as symptoms of MS in various parts of the body.

Myelin basic protein One of several proteins associated with the myelin of the central nervous system, which may be found in higher than normal concentrations in the cerebrospinal fluid of individuals with MS and other diseases that damage myelin.

Nerve A bundle of nerve fibers (axons). The fibers are either afferent (leading toward the brain and serving in the perception of sensory stimuli of the skin, joints, muscles, and inner organs) or efferent (leading away from the brain and mediating contractions of muscles or organs).

Nerve block A procedure used to relieve otherwise intractable spasticity, including painful flexor spasms. An injection of phenol into the affected nerve interferes with the function of that nerve for up to 3

months, potentially increasing a person's comfort and mobility.

Nervous system Includes all of the neural structures in the body: the central nervous system consists of the brain, optic nerves, and spinal cord; the peripheral nervous system consists of the nerve roots, nerve plexi, and nerves throughout the body; and the autonomic nervous system regulates the internal organs through a balance of the sympathetic and parasympathetic divisions.

Neurogenic Related to activity of the nervous system, as in "neurogenic bladder."

Neurogenic bladder Bladder dysfunction associated with neurologic malfunction in the spinal cord and characterized by a failure to empty, failure to store, or a combination of the two. Symptoms that result from these three types of dysfunction include urinary urgency, frequency, hesitancy, nocturia, and incontinence. See Nocturia.

Neurologist Physician who specializes in the diagnosis and treatment of conditions related to the nervous system.

Neurology Study of the central, peripheral, and autonomic nervous systems.

Neuron The basic nerve cell of the nervous system. A neuron consists of a nucleus within a cell body and one or more processes (extensions) called dendrites and axons.

Neuropsychologist A psychologist with specialized training in the evaluation of cognitive functions. Neuropsychologists use a battery of standardized tests to assess specific cognitive functions and identify areas of cognitive impairment. They also provide remediation for individuals with MS-related cognitive impairment. See Cognition and Cognitive impairment.

Nocturia The need to urinate during the night.

Nystagmus Rapid, involuntary movements of the eyes in the horizontal or, occasionally, the vertical direction.

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