Progressive Multifocal Leukoencephalopathy (PML) is an infectious, demyelinating disease of the central nervous system, which occurs in immunosuppressed individuals with AIDS, leukemia, or in organ transplant recipients. PML has also been reported in patients with inflammatory or auto-immune diseases treated with immunomodulatory medications. PML is caused by a reactivation of the polyomavirus JC (JCV), which destroys oligodendrocytes, the myelin-producing cells in the brain. JCV is a benign virus, which infects the majority of healthy individuals without causing any disease.
The goal of these NIH-sponsored, IRB-approved studies is to characterize the immunological, virological and radiological prognostic factors of disease evolution. HIV-positive or HIV-negative immunosuppressed individuals will qualify for these studies if they have neurological symptoms and brain lesions suggestive of PML, or if they have a positive brain biopsy or detectable JCV DNA in their cerebrospinal fluid.
Clinical studies are conducted in conjunction with the basic research laboratories within Division of Neuro-Virology. To learn more the Division of Neuro-Virology and its basic research work, please click here.
Study Title: Pathogenesis of Inflammation and seizures in PML
Purpose: To determine precisely which factors are associated with immune reconstitution inflammatory syndrome (IRIS) and the development of seizures in PML patients. One of our objective is to establish non-invasive markers of PML evolution by studying the brain metabolism in PML lesions using Magnetic Resonance Imaging (MRI), Magnetic Spectroscopy (MRS) and other advanced imaging modalities. Another objective is to predict the development of seizures in PML using high density array Electroencephalogram (EEG), which can then be used for preventive and therapeutic purposes. The goal of this study is to establish clear clinical guidelines for management of PML-IRIS patients as well as in developing therapeutic strategies for the treatment and prevention of IRIS and seizures.
If you are interested to refer a patient or if you have any questions about any of these studies, please feel free to contact Igor J. Koralnik, MD at 617-735-4460.