May, 2018: American Academy of Neurology
In the first update in 16 years, the American Academy of Neurology issues revised recommendations for starting, switching and stopping possible disease-modifying treatments (DMTs). Currently there are 17 approved DMTs available for all types of MS: clinically isolated syndromes, relapsing MS, and progressive MS. Most are for relapsing MS.
The guidelines are designed to help both patients and doctors make decisions that are more informed. It is believed that the new guidelines push to treat people earlier and to monitor them more carefully. By starting treatment early in disease detection, some people may be able to slow the progression and help maintain a quality of life.
April, 2018: Johns Hopkins University
Multiple Sclerosis progresses much faster in Afro-American patients than in Caucasian patients which suggests blacks would benefit from a more aggressive treatment approach. Examining brain lesion progression and retinal atrophy over years found progression in both significantly faster in black MS patients. Specifically, whole brain and gray and white matter atrophy occurred at a pace twice as fast along with faster atrophy of the thalamus, a brain region linked to cognitive impairment in MS, in African-American patients. Retinal layer atrophy were also found to be markedly faster with significantly reduced thickness in the retina’s nerve fiber and inner layer, common causes of visual impairment in MS
March, 2018: March is MS month – lots of interesting news generated this month.
Patent Related Outcome Measures published a study regarding comorbidities among MS sufferers, Comorbidities are other conditions present in patients which can be independent and may have negative consequences including a delay in MS diagnosis, greater disability progression, poorer quality of life, increased hospitalization rates and a higher risk of death.
The most common comorbidities are high cholesterol and high blood pressure, gastrointestinal disease, thyroid disease and anxiety. High cholesterol and hypertension were present in 25.9% to 29.7% of MS patients in a given year. A single vascular comorbidity was associated with a 51% increased risk of early gait disability, while two vascular comorbidities was associated with 228% increased risk.
What this suggests is that a more comprehensive care approach may yield better outcomes for MS patients.
Recent Research in Diets
The Wahls diet: Dr. Wahls credits her diet with reducing her MS symptoms. A modified Paleo diet, the plan advocated meant and fish, plenty of fruit and vegetables and fat from animal and plant sources with an emphasis on omega-3. Dairy products, eggs, grains such as wheat and rice, legumes, sugar, tomatoes, eggplant and peppers are not allowed. While more research is needed, it has been shown in many other studies that elements such as adding more fish and fruit and vegetables have a beneficial effect on everyone’s health, not only those with MS.
The Swank Diet: published in 1972, the diet’s main focus is to reduce saturated fat intake. No red meat is allowed in the first year but may be reintroduced. Poultry and fish are allowed as are dairy and eggs. Fruits, veggies and good fats from nuts and seeds are encouraged.
Low-fat Diet: Reduction of fat and adding more fruits and veggies may make a positive change. In a US study of children with MS it was found for every 10% increase in calories from fat, there was an associated 56% increased risk of relapse. The same study showed consuming more fruits and veggies may reduce the risk of relapse by 50%.
Johns Hopkins: Patients eating a diet rich in fruits, veggies, legumes and whole grains were less likely to have more severe physical disability and less likely to suffer severe depression.
Johns Hopkins University
Article published identifying the three most common cognitive effects of MS. Number one is Depression. Indications are that up to half of MS suffer from depression thought to be reactive – linked to frustrations with lifestyle changes or loss of function.
Anxiety is second particularly in those with depression but also in connection with the uncertainty of MS, its symptoms and its relapses.
Pseudobulbar Affect ranks third. This is a condition characterized by a disconnect between how you feel and how you express emotions. Patients may cry without being sad or upset. This condition is treated with antidepressants and other targeted therapies.
February, 2018: Icahn School of Medicine
Investigating how a modified Mediterranean diet – emphasizing plant-based food, healthy fats and fish - may help lessen the symptoms of MS. In previous studies, the gut microbiome of patients with MS was found to differ from healthy patients. Since bacteria communicate with immune cells in the gut, neurologists hypothesize that there is a link between diet and MS. The researcher believe that changes in the gut microbiome can lead to the development of MS and may impact the progression of the disease. The main component of changes to gut microbiome is diet.
Patients will be tracked for salt, fatty acids and carotenoids along with the effect of diet on body mass index, blood pressure, cholesterol and glucose. Other MS symptoms such as fatigue and depression will also be tracked for potential quality-of-life improvements.
January, 2018: From the FDA
The US Food and Drug Administration –FDA- has denied a request for use of a qualified health claim that taking vitamin D may reduce the risk for MS in healthy people. The FDA thoroughly reviewed 85 publications submitted on behalf of Bayer along with additional publications and determined that scientific conclusions could not be drawn about the relationship between vitamin D intake and reduction of MS risk.
The statement explains that qualified health claims are those supported by “credible” scientific evidence that do not meet the more rigorous “significant scientific agreement” standard required to support an authorized health claim.
December,2017: Johns Hopkins School of Medicine
Providing a link between a healthy lifestyle and a reduction in MS symptoms, the University studied 6989 persons with MS. A healthy lifestyle was defined as having a healthy weight, getting regular exercise, eating a better than average diet and not smoking. A healthy diet was defined as one focused on eating more fruits, vegetables, legumes and whole grains with less processed meat, less sugar from desserts and less sweetened beverages.MS symptoms and relapses were reported in areas of fatigue, mobility, pain and depression.
Results indicated those with the healthiest diet were 20% less likely to have more severe physical disability and around 20% less likely to have more severe depression. Those with healthy lifestyles overall were nearly 50% less likely to have depression, 30% less likely to have severe fatigue and more than 40% less likely to have pain. Also taken into account were age and how long persons had had MS.
Evidence to support specific diets such as the Wahls Paleo diet, remains unclear at this time.
November 2017: Reported in Harvard Health
Reporting on studies regarding the cause of MS, there is a suggestion that head injuries may be a risk factor. Examining 7000 people with MS and comparing them to more than 70,000 who were similar but did not have MS, investigators looked for a history of physician-diagnosed concussion prior to the age of 20. They also assed if the subject had ever broken bones in the upper or lower extremities prior to the age of 20. Findings showed that those who had suffered a single concussion between the ages of 10 and 20 had a 22% higher rate of MS. The rate of MS was doubled for those with more than one concussion. There was no connections between broken bones and MS. This suggests a possible link with this type of injury. Further study may find some other factor more common among head injuries may be the connection but this doe warrant additional study.
National MS Society
The prevalence of MS is more than double the previously reported number now project to be an estimated 975,000. Women are more than 3 times more likely to develop MS with the single highest prevalence found among women in the 55-64 age bracket. Regionally the Northeast leads with the Mid west second.
October, 2017: News from BMC Neurology
A summary of relevant guidelines detailed the effectiveness of regular physical activity as a means of rehabilitation for MS patients. In MS patients affected by mild or moderate disability, appropriate exercise can cause noteworthy and important improvements in aerobic fitness, muscle strength, flexibility, balance, fatigue, cognition, quality of life and respiratory function. Patients may also positively adapt to resistance training which may result in improved fatigue and movement. Flexibility exercises such as stretching the muscles may diminish spasticity and prevent future painful contractions. Balance exercises result in fewer falls and better overall balance. Exercise should be considered as an effective means for optimizing physical functioning and mental health without concern of triggering the onset or exacerbation of disease symptoms or relapse.
News from University of British Columbia
Examining 1250 patients, 49% of whom had a psychiatric disorder identified a link between a psychiatric comorbidity and disability progression of MS. Interestingly, the link held true only for women. The findings indicate that optimizing management of psychiatric comorbidities should be explored as a means of potentially mitigating disability progression in MS.
News from the Philippines
Medical Marijuana was approved by the legislature for use in treating symptoms for 10 different disease including MS.
News from Sweden
Teenagers who suffer concussions have a 22% higher risk of developing MS a study at Orebro University found. Between 1964 and 2012, 7292 patients were diagnosed with autoimmune disease.
September, 2017: In Neurology
The latest study from Finland examining the relationship of Vitamin D to risk of MS. While the study failed to adjust for MS risk factors such as bodymass index, smoking, or presence of Epstein-Barr virus infection or that the study was primarily white subjects, the investigators concluded that correcting vitamin D deficiency among reproductive age women may reduce their future risk of developing MS.
Study out of Denmark
Led researchers to conclude that resistance training may slow down the progression of MS by enhancing brain volume. The initial study included mostly high-functioning people. They are not sure if exercise works for those in a more progressed stage of the disease. Studies have also shown that exercise reduces depression and fatigue as well as improving cognitive function and learning.
July, 2017: 5 Areas of research that could change the Future of MS Treatment
The MS Society in the UK reports movement in a number of areas in the search for better treatment and cure for MS.
Stem Cell therapy – A greater understanding of the myelin-producing stem cells in the brain could lead the way to treatment promoting myelin repair.
Genetics – Although not the only contributing factor, genetics do play a role in the development of MS. Understanding more about inheritance factors may help develop strategies to prevent MS or tailor treatments depending upon a person’s genes.
Vitamin D – MS is more common in countries further from the equator meaning fewer hours of sunshine and lower levels of Vitamin D. Research is need to determine the link between vitamin D and MS and if supplements could be an effective method of treatment .
Myelin repair – There are a number of myelin research projects to develop treatment that could stop the progression of the disease.
Neuroprotection – Latest research has indicated that protecting nerve cells from damage could be a potential strategy to prevent of slow down the progression of MS.
The idea is to develop drugs to protect nerve cells from damage.
Tips for Managing Cognitive Health
According to the National Multiple Sclerosis Society, around 65% of people living with MS suffer from some cognitive issues – most notably memory, concentration and speed of processing information. Cognitive health can be improved by participating in activities such as painting or drawing, jigsaw puzzles, crosswords and sudokus, learning a new language, creative writing, watching game shows and playing cards and board games – all enjoyable ways to keep your mind active. Also consider taking part in groups – a good way to exercise your mind while enjoying the company of others.
LATEST NEWS IN Multiple Sclerosis
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