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This interventional study provides class 1 evidence that dalfampridine extended-release tablets produce clinically meaningful improvement in walking ability in a subset of people with MS, with the effect maintained between doses.

Context.-Pain is the most disturbing symptom of diabetic peripheral neuropathy. As many as 45% of patients with diabetes mellitus develop peripheral neuropathies.Objective.-To evaluate the effect of gabapentin monotherapy on pain associated with diabetic peripheral neuropathy.Design.-Randomized, double-blind, placebo-controlled, 8-week trial conducted between July 1996 and March 1997. Setting.-Outpatient clinics at 20 sites. Patients.-The 165 patients enrolled had a 1-to 5-year history of pain attributed to diabetic neuropathy and a minimum 40-mm pain score on the Short-Form Mc-Gill Pain Questionnaire visual analogue scale. Intervention.-Gabapentin (titrated from 900 to 3600 mg/d or maximum tolerated dosage) or placebo. Main Outcome Measures.-The primary efficacy measure was daily pain severity as measured on an 11-point Likert scale (0, no pain; 10, worst possible pain). Secondary measures included sleep interference scores, the Short-Form McGill Pain Questionnaire scores, Patient Global Impression of Change and Clinical Global Impression of Change, the Short Form-36 Quality of Life Questionnaire scores, and the Profile of Mood States results.Results.-Eighty-four patients received gabapentin and 70 (83%) completed the study; 81 received placebo and 65 (80%) completed the study. By intent-to-treat analysis, gabapentin-treated patients' mean daily pain score at the study end point (baseline, 6.4; end point, 3.9; n = 82) was significantly lower (PϽ.001) compared with the placebo-treated patients' end-point score (baseline, 6.5; end point, 5.1; n = 80). All secondary outcome measures of pain were significantly better in the gabapentin group than in the placebo group. Additional statistically significant differences favoring gabapentin treatment were observed in measures of quality of life (Short Form-36 Quality of Life Questionnaire and Profile of Mood States). Adverse events experienced significantly more frequently in the gabapentin group were dizziness (20 [24%] in the gabapentin group vs 4 [4.9%] in the control group; PϽ.001) and somnolence (19 [23%] in the gabapentin group vs 5 [6%] in the control group; P = .003). Confusion was also more frequent in the gabapentin group (7 [8%] vs 1 [1.2%]; P = .06).Conclusion.-Gabapentin monotherapy appears to be efficacious for the treatment of pain and sleep interference associated with diabetic peripheral neuropathy and exhibits positive effects on mood and quality of life.

Colonization, growth, and clonal morphology differ with genotype and are influenced by elevation. Local adaptation of Spartina alterniflora to environmental conditions may lead to dominance by different suites of genotypes in different locations within a marsh. In a constructed marsh, we found reduced colonization in terms of density of clones with increasing distance from edge in a 200‐ha mudflat created in 1996; however, growth in diameter was not different among three 100‐m‐long zones that differed in distance from site edge. Distance from edge was confounded by elevation in this comparison of natural colonization. The rate of clonal expansion in diameter was 3.1 m/yr, and clonal growth was linear over the 28 mo of the study. The area dominated by S. alterniflora in the three distance zones increased concomitantly with clonal growth. However, the lower initial clonal densities and colonization by other plant species resulted in reduced overall dominance by S. alterniflora in the two more‐interior locations. Seedling recruitment was an important component of S. alterniflora colonization at all elevations and distances from edge two years after site creation. Seedlings were spatially very patchy and tended to occur near clones that probably produced them. A field experiment revealed that S. alterniflora height and total stem length varied with genotype, while stem density and flowering stem density did not. Differences between edge and center of clonal patches also occurred for some response variables, and there were also significant interactions with genotype. Differences between edge and center are interpreted as differences in clone morphology. Elevation differences over distances of a few meters influenced total stem length and flowering stem density but not other response variables. Clones that were larger in diameter also tended to have greater stem heights and total stem lengths. A number of plant morphological measures were found to vary significantly among the five genotypes and had broad‐sense heritabilities ranging up to 0.71. These results indicate that S. alterniflora populations developing on new substrata colonize broadly, but growth and reproduction vary with genotype and are influenced by changes in elevation (range: 11.8 cm), and probably other environmental factors, over relatively small distances. Differences in growth and clone morphology of different genets, and the frequent occurrence of seedlings throughout the site, underscore the importance of genetic variability in natural and created populations. Corresponding Editor: J. B. Zedler.

Summary1 Genetically based phenotypic and ecotypic variation in a dominant plant species can influence ecological functions and patterns of recruitment by other species in plant communities. However, the nature and degree of importance of genotypic differences is poorly understood in most systems. 2 The dominant salt marsh species, Spartina alterniflora , is known to induce facilitative and competitive effects in different plant species, and the outcomes of interactions can be affected by nutrients and flooding stress. Clonal genotypes, which maintained their different plant architecture phenotypes throughout 31 months of a field experiment, underwent considerable genet-specific senescence in their centres over the last 12 months. 3 Different clonal genotypes and different locations (robust edges vs. senescent centres) permitted significantly different levels of light penetration of the canopy (14.8-77.6%), thus establishing spatial heterogeneity for this important environmental factor. 4 S. alterniflora clonal genotype influenced the degree of suppression of the previously dominant Salicornia bigelovii as well as facilitation of recruitment and growth by other plant species. Aster subulatus and Atriplex patula performed better in Spartina clone centres, and experienced reduced growth in Salicornia -dominated areas. 5 Four other high marsh species ( Borrichia frutescens , Aster tenuifolius , Iva frutescens and Limonium carolinianum ) colonized only into Spartina clones but not into the Salicornia -dominated area. 6 These results suggest that differences in clone size, centre senescence, stem density, height, total stem length and biomass in different genotypes of a dominant marsh plant species can influence recruitment and growth of other plant species. The spatial pattern of habitat heterogeneity is, at least in part, dependent on the genotypic diversity, and possibly the genetic diversity, of such foundation species. 7 We hypothesize that as genotypic diversity increases in populations of a dominant plant species like S. alterniflora , the number and diversity of interactions with other species will increase as well.

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was not peer-reviewed) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity.The copyright holder for this preprint (which . http://dx.doi.org/10.1101/143933 doi: bioRxiv preprint first posted online Jul. 13, 2017; 2 Abstract:We assembled and analyzed genetic data of 47,351 multiple sclerosis (MS) subjects and 68,284 control subjects and establish a reference map of the genetic architecture of MS that includes 200 autosomal susceptibility variants outside the major histocompatibility complex (MHC), one chromosome X variant, and 32 independent associations within the extended MHC. We used an ensemble of methods to prioritize up to 551 potentially associated MS susceptibility genes, that implicate multiple innate and adaptive pathways distributed across the cellular components of the immune system. Using expression profiles from purified human microglia, we do find enrichment for MS genes in these brain-resident immune cells. Thus, while MS is most likely initially triggered by perturbation of peripheral immune responses the functional responses of microglia and other brain cells are also altered and may have a role in targeting an autoimmune process to the central nervous system.