30 Jun 09

The development of patient-reported outcome indices for multiple sclerosis (PRIMUS)
Mult Scler. 2009 Jun 25

In MS the perception of symptoms and how they impact quality of life varies significantly from one person to another. The perceived response to treatment, including rehabilitation, may also differ. In this article the authors aimed to evaluate a newly developed set of tests (called PRIMUS) which takes into account MS symptoms in a holistic way, from the point of view of the person with MS. The authors concluded that scores obtained from PRIMUS are reliable and very useful in detecting how the disease impacts on the person with MS.
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30 Jun 09

A diffusion tensor imaging group study of the spinal cord in multiple sclerosis patients with and without T(2) spinal cord lesions
J Magn Reson Imaging. 2009 Jun 25;30(1):25-34

MS is an inflammatory-demyelinating disease of the central nervous system classically characterised by the presence of lesions in the white matter, seen with conventional MRI techniques. However, the presence of clinical disability does not always correlate with the presence of lesions on conventional MRI. The authors of this article compared the spinal cord of a group of healthy controls and a group of people with MS who did not have spinal cord lesions on the conventional MRI, by means of a new MRI technique called diffusion tensor imaging. This technique is based on the ability of water to move through the nervous tissue. They found that the spinal cord of people with MS showed abnormalities even in the absence of lesions, suggesting that these abnormalities could partially explain the accrual of disability in people with MS.
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30 Jun 09

Cognitive dysfunction in primary progressive multiple sclerosis: a neuropsychological and MRI study
Mult Scler. 2009 Jun 25

There are very few studies of cognitive dysfunction in people with primary progressive MS (PPMS). In this study the authors compared a group of people with primary progressive MS with a group of secondary progressive MS and a group of healthy volunteers. They found that (SPMS) people with MS scored lower than controls on some tests, such as those related to attention and information processing, verbal fluency and memory. However, people with PPMS and with SPMS performed tests similarly. Moreover, the authors found that people with a higher number of lesions performed worse than people with a lower lesion burden.
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30 Jun 09

Age of onset in concordant twins and other relative pairs with multiple sclerosis
Am J Epidemiol. 2009 Jun 22

Genes and environment seem to have an important role in the development of MS. Besides, the age of onset of MS may vary enormously amongst subjects and might have prognostic value. The authors of this article studied a large number of families where more than one family member had MS, in order to investigate how the percentage of genetic sharing may influence in the age of onset of the disease. Their results suggested that the higher the percentage of genetic sharing (i.e. twins), the more similar the age of onset of MS between the two members of the family. However, as identical (monozygotic) and non-identical (dizygotic) twins had similar behaviour in the concordance of age of onset, an effect of intrauterine hormonal environment was suggested. They also found that half-siblings from the same mother had more similar ages of onset of MS than half-siblings from the same father. This study may help us to to better understand the complexity of this disease, though further studies are needed.
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23 Jun 09

Grip force control in individuals with multiple sclerosis
Neurorehabil Neural Repair. 2009 Jun 16

In some neurological diseases including MS, and in elderly people, the grip force used for daily activities is excessively high, provoking an unnecessary waste of energy. In this study the authors aimed to investigate in a group of people with MS whether there was also an increased grip force compared to a group of controls. The grip force was measured by using a cylindrical object containing meters to measure acceleration in the three planes of space. As expected, they found an increased grip force in people with MS compared to controls. The authors suggested that impaired sensitivity and increased safety margins when holding objects (to avoid slippage) could be playing a role. The authors also suggested that including grip force control as an endpoint in neurorehabilitation therapy in people with MS may help them to avoid trauma disorders and fatigue.
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23 Jun 09

Coping strategy and anxiety evolution in multiple sclerosis patients initiating interferon-beta treatment
Eur Neurol. 2009 Jun 12;62(2):79-85

Different coping strategies have been described in people dealing with stressful situations. Symptoms of anxiety and depression may occur in a high percentage of people recently diagnosed with MS, especially if they are about to start treatment. In this article the authors aimed to investigate whether the levels of anxiety and depression in people recently diagnosed with MS and who were due to start disease modifying drugs were different depending on the specific coping strategy they followed. They found that most people in the study chose a coping strategy consisting of obtaining information about the stressful situation (diagnosis and treatment) and dealing directly with the stressor (task-oriented strategy). Those people that chose a task-oriented strategy exhibited lower levels of anxiety compared to people who chose an emotion-oriented strategy (controlling all emotional issues related to the stressor) or an avoidance-oriented strategy (avoiding all kinds of confrontation). The authors concluded that understanding coping strategies may help health professionals to customise support and, in this case, increase adherence to treatment.
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23 Jun 09

Parent-of-origin effect in multiple sclerosis. Observations from interracial matings
Neurology. 2009 Jun 10

MS is a complex disease with a very clear geographical distribution. It is thought that both environment and genes play a role in this geographical distribution. This study involved people with MS from Canada of Caucasian-North American Aboriginal admixture. The authors found that among those siblings with MS born in families where the mother was Caucasian and the father was North American Aboriginal, the proportion of females with MS was higher than among those people with MS born from a Caucasian father and a North American Aboriginal mother. Moreover, the risk of recurrence of MS among these siblings was higher for those families where the mother was Caucasian and father was North American Aboriginal than the other way around. These findings suggest that the risk of MS conferred by one of the parents (the one of Caucasian origin) seems to be different depending on the sex of the parent that confers higher risk. This could mean that either the genetic influence on the risk of MS or the interaction between genetics and environment on the development of MS are different depending on the sex of the parent who confers the high risk for MS. This study helps us to better understand the pathogenesis of the disease, though further studies are needed.
Source abstract

23 Jun 09

Redefining functionality and treatment efficacy in multiple sclerosis
Neurology. 2009 Jun 9;72(23 Suppl 5):S1-11

MS is a disease in which various symptoms can seriously affect the quality of life (QoL) of people affected. However, scales and measurements used in clinical practice are mostly focused on mobility and ambulatory issues. The authors of this article describe the different tools used so far to assess QoL and expose the tools' lack of sensitivity to detect many problems related to QoL. Finally they propose new definitions of functionality and efficacy and highlight the important need to assess people with MS in a more comprehensive way, looking important issues such as cognitive function, emotional status, visual acuity, fatigue and pain as well as physical disability.
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23 Jun 09

Genome-wide association study identifies new multiple sclerosis susceptibility loci on chromosomes 12 and 20
Nat Genet. 2009 Jun 14

Predisposition to MS seems to be influenced by environmental and genetic factors. Certain variations of a number of genes have been associated with a higher risk of developing MS, most of them being related to the immune system. In this study, two previously unidentified regions of the DNA, located on chromosomes 12 and 20, have been associated with the risk of developing MS. These DNA regions have also been associated with the risk of developing other autoimmune diseases.
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16 Jun 09

Effect of statins on clinical and molecular responses to intramuscular interferon beta-1a
Neurology. 2009 Jun 9;72(23):1989-93

Statins have been used to reduce cholesterol levels in the general population and have recently also been shown to have anti-inflammatory properties. However, despite this anti-inflammatory effect, it had been suggested in previous studies that people with MS who were taking statins could have a higher risk of developing new MS lesions and relapses. Nevertheless, in this study the authors have demonstrated that treatment with statins in people receiving interferon beta is not causing a reduction of the therapeutic effect of the interferon.
Source abstract

16 Jun 09

Assessing the clinical efficacy of sildenafil for the treatment of female sexual dysfunction
Ann Pharmacother. 2009 Jun 9

Sildenafil citrate (sold as Viagra and various other trade names) is a drug commonly used to treat erectile dysfunction. The authors of this study reviewed the clinical data regarding the efficacy and safety of sildenafil for the treatment of sexual dysfunction in diverse neurological diseases. They concluded that, although there is some evidence coming from different clinical trials favouring sildenafil treatment in women with neurological disorders including MS, this data should be considered with caution and further studies were needed to assess sildenafil’s beneficial effects.
Source abstract

16 Jun 09

Exclusive breastfeeding and the risk of postpartum relapses in women with multiple sclerosis
Arch Neurol. 2009 Jun 8

It is well known that women are more frequently affected by MS, suggesting that sexual hormones play a part in the development of inflammatory-demyelinating reactions occurring in the central nervous system of people with MS. It is also known that during pregnancy, the rate of relapses tends to be strongly reduced in women with MS, again suggesting an important role of sexual hormones in this condition. The authors of this work have shown that exclusive breastfeeding for at least the first two months after giving birth would protect against further relapses in at least the following year postpartum. The authors suggest that this protection against relapses may be due to the lack of menstruation while breastfeeding.

To read the full research article on Pub Med click here.
Source abstract

16 Jun 09

Genetic association between polymorphisms in the BTG1 gene and multiple sclerosis
J Neuroimmunol. 2009 Jun 8

MS is a chronic inflammatory-demyelinating disease of the central nervous system. It is a complex disease where genes may play a role. The authors of this study have found that certain variations of a specific gene related to inflammatory processes in the brain may confer a higher risk of developing MS.
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08 Jun 09

Efficacy of intramuscular interferon beta-1a in patients with clinically isolated syndrome: analysis of subgroups based on new risk criteria
Mult Scler. 2009 Jun;15(6):728-34

Some years ago interferon (IFN) beta was tested in people with a first episode suggestive of MS. It was proven to be effective in delaying the appearance of a second MS relapse. In the current study the authors have re-analysed the data from the former trial and have concluded that IFN beta was especially beneficial in delaying the second attack for those people whose first episode showed involvement of only one anatomical area. This finding reinforces the need for early disease modifying treatment after a first episode suggestive of MS, even when only mild anatomical involvement is observed.
Source abstract

08 Jun 09

Twin studies and the heritability of MS: a conclusion
Mult Scler. 2009 Jun;15(6):661-7

MS is a complex disease in which genes may play a role. In this study the authors aimed to investigate the relative contribution of genes and the environment to the appearance of MS by re-analysing six published studies from six countries, on people with MS who were twins. The authors found that the different methodologies and the huge variability in the results of the different studies prevented them from obtaining robust conclusions. They also suggested that further twin studies with improved methodology should be undertaken in people with MS, to more thoroughly investigate the genetic influence in the appearance of MS.
Source abstract

08 Jun 09

Remyelination capacity of the MS brain decreases with disease chronicity
Neurology. 2009 Jun 2;72(22):1914-21

MS is an inflammatory-demyelinating disease of the central nervous system. It is known that demyelinated areas can recover the myelin by an internal repair mechanism of the damaged neural tissue by a process called remyelination. However, little is known about the characteristics of this protective process. The authors of this study aimed to investigate the frequency of remyelination in people with MS with different disease durations and the areas where this protective phenomenon was more prominent. They finally conclude that remyelination was more prominent in earlier stages of the disease and also that the location of the lesion may influence the extent of the remyelination.
Source abstract

08 Jun 09

Effect of parenteral cladribine on relapse rates in patients with relapsing forms of multiple sclerosis: results of a 2-year, double-blind, placebo-controlled, crossover study
Mult Scler. 2009 Jun;15(6):767-70

The aim of this placebo-controlled clinical trial was to investigate the beneficial effects of cladribine given subcutaneously in people with MS compared to placebo. The 84 patients in the study were divided into two groups. One group received cladribine first and a placebo afterwards and the other group received a placebo first and the cladribine afterwards. The results showed that cladribine was effective in people with MS mainly because it provoked a reduction in the relapse rate.
Source abstract

02 Jun 09

Fatigued patients with multiple sclerosis have impaired central muscle activation
Mult Scler. 2009 May 22

Fatigue can be a major problem in people with MS. Its cause and mechanisms are still unknown. In this study the authors aimed to investigate whether this fatigue could be caused by a dysfunction in some of the parts of the central nervous system in charge of sending the signal for the muscles being able to move. They finally concluded that some degree of this specific part of the central nervous system could be involved in fatigue in MS.
Source abstract

02 Jun 09

MRI measures show significant cerebellar gray matter volume loss in multiple sclerosis and are associated with cerebellar dysfunction
Mult Scler. 2009 May 22 [Epub ahead of print]

In people with MS, some degree of loss of brain volume can sometimes be seen and it has been suggested that the loss of brain volume could be related to disability. In this study the authors aimed to investigate the presence of volume loss specifically in the cerebellum, a part of the brain especially involved in coordination skills, and its relationship to specific symptoms denoting impaired coordination. They found that loss of cerebellum tissue was clinically relevant, especially when this loss of volume was affecting the grey matter.
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02 Jun 09

Use of neuromuscular electrostimulation in the treatment of dysphagia in patients with multiple sclerosis
Ann Otol Rhinol Laryngol. 2009 Apr;118(4):241-6

Swallowing problems are sometimes present in people with MS and they can cause other further complications if the situation is not addressed properly. In this study the authors aimed to investigate the beneficial effects of neuromuscular stimulation as a treatment for swallowing dysfunction. Beneficial effects were observed, suggesting that this could be considered as a treatment for swallowing problems in MS.
Source abstract

02 Jun 09

Randomized Clinical Trial of Balance-Based Torso Weighting for Improving Upright Mobility in People With Multiple Sclerosis
Neurorehabil Neural Repair. 2009 May 26. [Epub ahead of print]

Balance problems can affect people with MS. In previous studies and in clinical practice it has been shown that the mobility and postural control in people with MS with balance problems could be improved by placing small amounts of weight on the torso. In this study the authors found beneficial effects of the treatment and they suggested that this would be a useful tool to improve balance problems in people with MS.
Source abstract

26 May 09

Humoral immune response to EBV in multiple sclerosis is associated with disease activity on MRI
Neurology. 2009 May 20

The pathogenesis of MS is complex and it is well established that viral infections may play a role. Evidence suggests that Epstein-Barr virus (EBV) could be involved in triggering or perpetuating disease activity in MS, as EBV can be reactivated under certain circumstances, even years after the first infection. In this study the authors aimed to investigate whether reactivation of EBV was related to the presence of high MRI inflammatory activity (new, active lesions) in people with MS. Though the authors found some correlation between past EBV infection and active brain lesions, they failed to demonstrate that reactivation of EBV was related to a higher presence of such active lesions.
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26 May 09

Prognostic implications of a carefully performed neurological assessment in patients with a first event suggestive of multiple sclerosis
BMC Neurol. 2009 May 20;9(1):19

To diagnose MS, evidence for dissemination in time and space is required. In this article the authors have demonstrated that a precise neurological examination after a first episode suggestive of MS is indispensable, as the prognostic value of certain MRI features indicating higher severity of the disease seems be different depending on the neurological examination.
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26 May 09

A pilot test of pioglitazone as an add-on in patients with relapsing remitting multiple sclerosis
J Neuroimmunol. 2009 May 14

In this study the authors aimed to investigate the effects of oral pioglitazone, a drug that has been shown to have anti-inflammatory and neuroprotective effects, in people with relapsing-remitting MS, when added to IFN beta. After one year of treatment, though no differences were observed between the two groups of treatment (IFN+pioglitazone and IFN+placebo) from the clinical point of view, some differences were observed in terms of MRI parameters. These findings would suggest hints of efficacy favouring the pioglitazone treatment. Further studies are needed to establish clinical efficacy of pioglitazone.
Source abstract

26 May 09

Quality of life in multiple sclerosis is associated with lesion burden and brain volume measures
Neurology. 2009 May 19;72(20):1760-5

In MS, health-related quality of life (HRQOL) is reduced. However, it is not yet well established that measures related to quality of life are to be taken into account as outcome measures in clinical trials. In this study the authors have shown that there is a significant association between MRI characteristics such as lesion burden and brain volume loss and HRQOL. These findings strengthen the argument for the use of HRQOL outcome measures in clinical trials.
Source abstract

26 May 09

Parity and secondary progression in multiple sclerosis
J Neurol Neurosurg Psychiatry. 2009 Jun;80(6):676-8

It is known that MS more frequently affects women than men. It is also known that relapses occur less frequently during pregnancy, and that there is a rebound effect with an increase in relapse frequency after delivery. All these facts indicate a hormonal involvement in the pathogenesis of the disease, especially in the appearance of relapses. The authors of this study aimed to investigate the influence of the number of births in the risk of development of secondary progression. They found no evidence that parity (the number of times a woman has given birth) could influence the risk of such progression after the relapsing-remitting phase.
Source abstract

19 May 09

Glatiramer acetate treatment in PPMS: Why males appear to respond favorably
J Neurol Sci. 2009 May 7

In 2007, a clinical trial of glatiramer acetate (GA, Copaxone®) in primary progressive MS (PPMS) was carried out. Though GA did not turn out to be effective in PPMS, when only the male population was observed, some hints of efficacy of GA were suggested. In this article the authors aimed to investigate whether the effect of GA during the clinical trial could have caused different effects in men and in women. However, the authors finally concluded that GA would seem to have caused the same (not significant) clinical effects in men and women. Then, if some differences between both sexes were observed during the trial, these should be attributed to other incidental clinical factors apart from gender.
Source abstract

19 May 09

Diffusely abnormal white matter in chronic multiple sclerosis: imaging and histopathologic analysis
Arch Neurol. 2009 May;66(5):601-9

In MS, a disease characterised by the appearance of inflammatory-demyelinating lesions in the white matter, some abnormalities, generally diffuse and not well-defined, in the brain tissue which does not contain the typical lesions can also be seen with the conventional MRI techniques. The meaning of these diffuse abnormalities is not fully understood. In this article the authors have studied the brains (post-mortem) of people with MS and have looked at these regions containing diffuse abnormalities. They concluded that these regions reflect the chronic loss of myelin and axons. As these regions are likely to be contributing to disability in MS, the authors proposed that these abnormalities could be considered as MRI markers of disease progression.
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19 May 09

Accumulation of cortical lesions in MS: relation with cognitive impairment
Mult Scler. 2009 May 12

The grey matter involvement in MS has been proven to be important. In this study the authors have studied the behaviour of grey matter lesions over time and their relationship with cognitive function. They concluded that the number of lesions appearing in the cortical grey matter seems to increase over time and, more interestingly, that these cortical lesions are related to cognitive decline.
Source abstract

19 May 09

A single, early magnetic resonance imaging study in the diagnosis of multiple sclerosis
Arch Neurol. 2009 May;66(5):587-92

The diagnosis of MS is based on the demonstration of dissemination in space and time of the inflammatory-demyelinating processes characteristic of MS. Over the recent years the diagnostic procedure has evolved and has been simplified, but still at present is quite complex. While before 2001 at least two relapses were required to diagnose MS, since then, the demonstration that new lesions have appeared on the MRI, by comparing two different scans performed in different moments after the first relapse, was enough to have the diagnosis of MS. The authors of this study have demonstrated that with just a single MRI scan of the brain, even performed very early after the first episode, the diagnosis of MS can be made, when certain features indicating dissemination in space and time are present. The results of this work are very important because they might lead to a simplification of the current diagnostic criteria for MS.
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