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This week on Sickboy we sit down with Ardra and dig into what it's like to live with MS, what it's like to rock a walker as a young woman, and how simple catheters can be, although, Taylor is still a little confused. Accessibility becomes a hot topic and we learn just how much of our society is constructed without it in mind. We had a really enlightening conversation and we want to give a huge shoutout to Ardra's blog, Tripping on Air, at trippingonair.com

Multiple sclerosis has affected millions of people worldwide - but there is now fresh evidence that it's triggered in part by the Epstein-Barr virus. Matt Galloway talks to Allison Markin, who has been living with MS for almost 20 years; and Dr. Jiwon Oh, medical director of the Barlo Multiple Sclerosis Program at St. Michael's Hospital in Toronto.

When Dr. Katherine Knox first arrived in Saskatchewan more than two decades ago, the province covered one prescription drug for patients with Multiple Sclerosis. Beyond that, patients had to pay for drugs out-of-pocket. Today, Knox said the province reimburses MS patients for 14 different drugs. \"MS is an expensive disease on many levels,\" said Knox, noting Saskatchewan's coverage is now the most favourable for MS patients anywhere in Canada. In Saskatchewan, three in 1,000 people have Multiple Sclerosis - one of the highest incidences of Multiple Sclerosis in the world. As treatments improve, the number of people living with this chronic autoimmune disease is rising. \"It's probably a combination of genetic and environmental factors that play a role,\" said Knox, who first learned about the disease as a student volunteer with the MS Society of Canada. \"Everyone had such a unique disease experience,\" Knox said. \"So I just became more curious.\" Her research these days focuses on non-drug approaches which prevent the onset of disability. After 15 years with the disease, it's estimated roughly half of MS patients need a cane or walking aid. \"Understandably many people don't want to use a walker for good reason,\" said Knox. \"It's bulky, it's awkward, it certainly lets people know that you have an issue with your walking.\" To delay that, Knox turned to researchers at the College of Kinesiology's Biomechanics of Balance and Movement Lab, to look at the power of a 'light touch'. The goal is to help people with MS regain - and keep - their balance and mobility. \"Patients would tell us you know when I walk the dog and hold the leash, my balance feels better. Or when I lightly touch the back of the chair I can be re-orientated,\" she said. By teaming up with Dr. Alison Oates, fourth-year resident Najala Orrell, and Pawan Kumar, an engineer and kinesiology research fellow, Knox studies patients' balance and stability, using various haptic inputs. \"Even just a light touch on a walker or perhaps a different object can help them regain their balance,\" said Knox. In this episode, she said keeping her patients moving and avoiding falls is crucial. \"We do need innovation and technology to come up with ways that can provide sensory feedback that would be discreet, socially acceptable, and easy to use,\" said Knox.

Dr. Robert Morse

Dr. Robert Morse

This scoping review aims to systematically map the existing literature on cognitive phenotypes in individuals with multiple sclerosis (MS). Cognitive impairment is recognized as a prevalent and debilitating symptom of MS, especially deficits in memory and processing speed, affecting a substantial proportion of individuals across different disease stages and clinical phenotypes. However, the identification and characterization of discrete cognitive phenotypes remain inconsistently defined across studies, posing a challenge for research, clinical assessment, and personalized treatment planning. The primary purpose of this scoping review is to identify and synthesize how cognitive phenotypes have been conceptualized, defined, and operationalized in the MS literature. Specifically, we aim to: (1) describe the number and types of phenotypes reported, including their core cognitive features and prevalence; and (2) summarize the methods used to identify cognitive phenotypes (e.g., clustering techniques, neuropsychological batteries, diagnostic thresholds). Expected outcomes include a comprehensive mapping of the current state of knowledge on cognitive phenotyping in MS, identification of consistent patterns across the literature, and recommendations for future research directions, with potential implications for clinical care and intervention development.

Includes bibliographical references (pages 446-452) and index

Includes bibliographical references (pages 446-452) and index

guest Shannon O'Donnell, Kelly Sterling, and Maggie Cosgrove

guest Shannon O'Donnell, Kelly Sterling, and Maggie Cosgrove

Joliet Junior College

Joliet Junior College

MS remyelination potential new treatments Dr.AriGreen

Aims: Direct effects of Multiple Sclerosis (MS) on the central nervous system, the stress of the disease itself, loss of functions, and side effects of the medications may have negative effects on patients’ psychology and quality of life (QOL). The aims of this study are to do psychiatric and quality of life measurements on relapsing remitting MS patients following a new attack, at baseline and following the first and sixth months of treatment with IFNβ-1b and to evaluate the effects of IFNβ-1b on psychiatric and quality of life parameters of these patients.  Material and Method: Thirty patients with relapsing remitting MS were recruited for this study. All patients received IFNβ-1b treatment for six months. Depression [(Beck Depression Inventory (BDI)], anxiety [State Anxiety Inventory (SAI)] and QOL (SF-36) measurements were prospectively obtained in these patients.  Results: The first and final results on the subscales of SF-36 such as physical role difficulty and pain scale showed a statistically significant difference for all patients in the study (p<.05, p<.05). We observed improvements on these variables. The baseline and sixth-month BDI did not show statistical significance (p>.05). However, the sixth-month SAI score was higher than the baseline SAI score and the difference is statistically significant (p<.007).  Discussion: We found that the interferon compounds administered when patients with relapsing remitting MS had a new attack improved the quality of life. There was no difference in depression scores while using interferon, while IFNβ-1b had a negative impact on the anxiety score.

Aims: Direct effects of Multiple Sclerosis (MS) on the central nervous system, the stress of the disease itself, loss of functions, and side effects of the medications may have negative effects on patients’ psychology and quality of life (QOL). The aims of this study are to do psychiatric and quality of life measurements on relapsing remitting MS patients following a new attack, at baseline and following the first and sixth months of treatment with IFNβ-1b and to evaluate the effects of IFNβ-1b on psychiatric and quality of life parameters of these patients.  Material and Method: Thirty patients with relapsing remitting MS were recruited for this study. All patients received IFNβ-1b treatment for six months. Depression [(Beck Depression Inventory (BDI)], anxiety [State Anxiety Inventory (SAI)] and QOL (SF-36) measurements were prospectively obtained in these patients.  Results: The first and final results on the subscales of SF-36 such as physical role difficulty and pain scale showed a statistically significant difference for all patients in the study (p<.05, p<.05). We observed improvements on these variables. The baseline and sixth-month BDI did not show statistical significance (p>.05). However, the sixth-month SAI score was higher than the baseline SAI score and the difference is statistically significant (p<.007).  Discussion: We found that the interferon compounds administered when patients with relapsing remitting MS had a new attack improved the quality of life. There was no difference in depression scores while using interferon, while IFNβ-1b had a negative impact on the anxiety score.

Aims: Direct effects of Multiple Sclerosis (MS) on the central nervous system, the stress of the disease itself, loss of functions, and side effects of the medications may have negative effects on patients’ psychology and quality of life (QOL). The aims of this study are to do psychiatric and quality of life measurements on relapsing remitting MS patients following a new attack, at baseline and following the first and sixth months of treatment with IFNβ-1b and to evaluate the effects of IFNβ-1b on psychiatric and quality of life parameters of these patients.  Material and Method: Thirty patients with relapsing remitting MS were recruited for this study. All patients received IFNβ-1b treatment for six months. Depression [(Beck Depression Inventory (BDI)], anxiety [State Anxiety Inventory (SAI)] and QOL (SF-36) measurements were prospectively obtained in these patients.  Results: The first and final results on the subscales of SF-36 such as physical role difficulty and pain scale showed a statistically significant difference for all patients in the study (p<.05, p<.05). We observed improvements on these variables. The baseline and sixth-month BDI did not show statistical significance (p>.05). However, the sixth-month SAI score was higher than the baseline SAI score and the difference is statistically significant (p<.007).  Discussion: We found that the interferon compounds administered when patients with relapsing remitting MS had a new attack improved the quality of life. There was no difference in depression scores while using interferon, while IFNβ-1b had a negative impact on the anxiety score.

During the second year of this grant, we have finished characterizing the spontaneous form of Japanese macaque encephalomyelitis (JME) and published a manuscript in Annals of Neurology describing our results; we have characterized how intracranial injections of the Japanese macaque rhadinovirus (JMRV) induce demyelinating disease, as assessed by histopathology, MRI, and symptoms; we have demonstrated both in vitro and in vivo which cells are affected by JMRV infection; we have performed additional analyses characterizing the immune response to JMRV infection; and we have continued our genetic analyses. In the next year, we will continue to analyze the mechanisms by which JMRV triggers disease onset and immune responses and the role of the cytopathic effects of the virus in this process, which genes are linked to disease susceptibility, and how the virus influences cells in lesion microenvironments.

This article is from Multiple Sclerosis (Houndmills, Basingstoke, England) , volume 18 . Abstract Background:: Haematopoietic stem cell transplantation (HSCT) has been tried in the last 15 years as a therapeutic option in patients with poor-prognosis autoimmune disease who do not respond to conventional treatments. Worldwide, more than 600 patients with multiple sclerosis (MS) have been treated with HSCT, most of them having been recruited in small, single-centre, phase 1–2 uncontrolled trials. Clinical and magnetic resonance imaging outcomes from case series reports or Registry-based analyses suggest that a major response is achieved in most patients; quality and duration of response are better in patients transplanted during the relapsing–remitting phase than in those in the secondary progressive stage. Objectives:: An interdisciplinary group of neurologists and haematologists has been formed, following two international meetings supported by the European and American Blood and Marrow Transplantation Societies, for the purpose of discussing a controlled clinical trial, to be designed within the new scenarios of evolving MS treatments. Conclusions:: Objectives of the trial, patient selection, transplant technology and outcome assessment were extensively discussed. The outcome of this process is summarized in the present paper, with the goal of establishing the background and advancing the development of a prospective, randomized, controlled multicentre trial to assess the clinical efficacy of HSCT for the treatment of highly active MS.

This article is from Journal of Neuroinflammation , volume 9 . Abstract Background: Extracellular matrix metalloproteinase inducer (EMMPRIN; CD147, basigin) is an inducer of the expression of several matrix metalloproteinases (MMPs). We reported previously that blocking EMMPRIN activity reduced neuroinflammation and severity of disease in an animal model of multiple sclerosis (MS), experimental autoimmune encephalomyelitis (EAE). Methods: To improve upon EMMPRIN blockade, and to help unravel the biological functions of EMMPRIN in inflammatory disorders, we have developed several anti-EMMPRIN monoclonal antibodies. Results: Of these monoclonal antibodies, a particular one, clone 10, was efficient in binding mouse and human cells using several methods of detection. The specificity of clone 10 was demonstrated by its lack of staining of EMMPRIN-null embryos compared to heterozygous and wild-type mouse samples. Functionally, human T cells activated with anti-CD3 and anti-CD28 elevated their expression of EMMPRIN and the treatment of these T cells with clone 10 resulted in decreased proliferation and matrix metalloproteinase- 9 (MMP-9) production. Activated human T cells were toxic to human neurons in culture and clone 10 pretreatment reduced T cell cytotoxicity correspondent with decrease of granzyme B levels within T cells. In vivo, EAE mice treated with clone 10 had a markedly reduced disease score compared to mice treated with IgM isotype control. Conclusions: We have produced a novel anti-EMMPRIN monoclonal antibody that blocks several aspects of T cell activity, thus highlighting the multiple roles of EMMPRIN in T cell biology. Moreover, clone 10 reduces EAE scores in mice compared to controls, and has activity on human cells, potentially allowing for the testing of anti-EMMPRIN treatment not only in EAE, but conceivably also in MS.

This article is from Trials , volume 13 . Abstract Background: Maintenance of the blind-to-treatment allocation is one of the most important means of avoiding bias in randomised controlled clinical trials. Commonly used methodologies to determine whether patients have become unblinded to treatment allocation are imperfect. This may be of particular concern in studies where outcomes are patient-reported, and with products which have a characteristic adverse event profile. We report the results of an evidence-based statistical approach to exploring the possible impact of unblinding to a cannabis-based medicine (Sativex®) in people with muscle spasticity due to multiple sclerosis. Methods: All 666 patients included in three Phase III placebo-controlled studies were included in this analysis. The relationship between factors that might permit patients to identify their treatment allocation and the effect of treatment on the self-reported primary outcome measure was investigated using a general linear model where the dependent variable was the change from baseline in patient self-reported spasticity severity, and the various possible explanatory factors were regarded as fixed factors in the model. Results: There was no significant relationship between the effect of Sativex® on spasticity and the prior use of cannabis or the incidence of ‘typical’ adverse events. Nor was there any significant relationship between the prior use of cannabis and the incidence of ‘typical’ adverse events, nor between prior use of cannabis and dose of Sativex®. Conclusions: There is no evidence to suggest that there was widespread unblinding to treatment allocation in these three studies. If any patients did become unblinded, then there is no evidence that this led to bias in the assessment of the treatment difference between Sativex® and Placebo for efficacy, adverse events or study drug dosing. This methodology may be suitable for assessment of the integrity of the blind in other randomized clinical trials

This article is from PLoS ONE , volume 9 . Abstract The presence of Epstein-Barr Virus (EBV) DNA in cerebrospinal fluid (CSF) and peripheral blood (PB) samples collected from 55 patients with clinical and radiologically-active relapsing-remitting MS (RRMS) and 51 subjects with other neurological diseases was determined using standardized commercially available kits for viral nucleic acid extraction and quantitative EBV DNA detection. Both cell-free and cell-associated CSF and PB fractions were analyzed, to distinguish latent from lytic EBV infection. EBV DNA was detected in 5.5% and 18.2% of cell-free and cell-associated CSF fractions of patients with RRMS as compared to 7.8% and 7.8% of controls; plasma and peripheral blood mononuclear cells (PBMC) positivity rates were 7.3% and 47.3% versus 5.8% and 31.4%, respectively. No significant difference in median EBV viral loads of positive samples was found between RRMS and control patients in all tested samples. Absence of statistically significant differences in EBV positivity rates between RRMS and control patients, despite the use of highly sensitive standardized methods, points to the lack of association between EBV and MS disease activity.

This article is from Iranian Red Crescent Medical Journal , volume 16 . Abstract Background:: Multiple Sclerosis (MS) is a demyelinating disease of the nervous system which has numerous disabling effects on patients. Objectives:: This study aimed at investigating the short- and long-term effects of a period of combination exercise therapy on walking distance, balance, fatigue and quality of life in multiple sclerosis patients referred to the physiotherapy clinic of Iran's Multiple Sclerosis Society in 2013. Patients and Methods:: This study was a randomized controlled clinical trial on 59 patients divided into the intervention (n = 39) and control groups (n = 20). The intervention group received 10 weeks of combination therapy including aerobic, strengthening, balancing and stretching exercises. A week before, a week later and a year after the beginning of the exercises, both groups of patients received BBSS, six minute walking, Family Support Services (FSS), Expanded Disability Status Scale (EDSS) and quality of life tests. The scores of two groups were then compared using statistical tests such as repeated measures ANOVA test. Results:: The results indicated significant changes in the intervention group in comparison to the control group in the second phase of the study comparing to the first one for all tests except EDSS (Mean difference scores of EDSS: -0.13), P-value = 0.60; FSS: -6.9, P-value = 0.02, Mental Quality of Life (QOL): 16.36, P-value = 0.001; Physical QOL: 12.17, P-value = 0.001, six minute walking: 137.2, P-value < 0.0001; and Berg: 3.34, P-value < 0.0001. These changes were not significant in the second phase of the study comparing to the third one; however, they were again significant in the third phase comparing to the first phase of the study (P < 0.05). Conclusions:: Exercise has significant effect on improving symptoms of multiple sclerosis, and cessation of exercise may cause recurrence of symptoms in the intervention group with a slope similar to that of the control group. Therefore, continuous rather than short period exercises have valuable symptomatic and supportive relief effects in patients.

This article is from PLoS ONE , volume 9 . Abstract Brain lesions in patients with multiple sclerosis may lead to abnormal excitability of brainstem reflex circuits because of impairment of descending control pathways. We hypothesized that such abnormality should show in the analysis of blink reflex responses in the form of asymmetries in response size. The study was done in 20 patients with relapsing-remitting multiple sclerosis and 12 matched healthy subjects. We identified first patients with latency abnormalities (AbLat). Then, we analyzed response size by calculating the R2c/R2 ratio to stimulation of either side and the mean area of the R2 responses obtained in the same side. Patients with significantly larger response size with respect to healthy subjects in at least one side were considered to have abnormal response excitability (AbEx). We also examined the blink reflex excitability recovery (BRER) and prepulse inhibition (BRIP) of either side in search for additional indices of asymmetry in response excitability. Neurophysiological data were correlated with MRI-determined brain lesion-load and volume. Eight patients were identified as AbLat (median Expanded Disability Status Scale–EDSS = 2.75) and 7 of them had ponto-medullary lesions. Nine patients were identified as AbEx (EDSS = 1.5) and only 2 of them, who also were AbLat, had ponto-medullary lesions. In AbEx patients, the abnormalities in response size were confined to one side, with a similar tendency in most variables (significantly asymmetric R1 amplitude, BRER index and BRIP percentage). AbEx patients had asymmetric distribution of hemispheral lesions, in contrast with the symmetric pattern observed in AbLat. The brainstem lesion load was significantly lower in AbEx than in AbLat patients (p = 0.04). Asymmetric abnormalities in blink reflex response excitability in patients with multiple sclerosis are associated with lesser disability and lower tissue loss than abnormalities in response latency. Testing response excitability could provide a reliable neurophysiological index of dysfunction in early stages of multiple sclerosis.

This article is from Frontiers in Aging Neuroscience , volume 6 . Abstract Despite a strong correlation to outcome, the measurement of gray matter (GM) atrophy is not being used in daily clinical practice as a prognostic factor and monitor the effect of treatments in Multiple Sclerosis (MS). This is mainly because the volumetric methods available to date are sophisticated and difficult to implement for routine use in most hospitals. In addition, the meanings of raw results from volumetric studies on regions of interest are not always easy to understand. Thus, there is a huge need of a methodology suitable to be applied in daily clinical practice in order to estimate GM atrophy in a convenient and comprehensive way. Given the thalamus is the brain structure found to be more consistently implied in MS both in terms of extent of atrophy and in terms of prognostic value, we propose a solution based in this structure. In particular, we propose to compare the extent of thalamus atrophy with the extent of unspecific, global brain atrophy, represented by ventricular enlargement. We name this ratio the “yearly rate of Relative Thalamic Atrophy” (yrRTA). In this report we aim to describe the concept of yrRTA and the guidelines for computing it under 2D and 3D approaches and explain the rationale behind this method. We have also conducted a very short crossectional retrospective study to proof the concept of yrRTA. However, we do not seek to describe here the validity of this parameter since these researches are being conducted currently and results will be addressed in future publications.

This article is from Frontiers in Neurology , volume 5 . Abstract None

This article is from Frontiers in Neurology , volume 5 . Abstract None

This article is from Frontiers in Neurology , volume 5 . Abstract None

This article is from Frontiers in Neurology , volume 5 . Abstract None

Councilmember Roger Berliner presents a proclamation recognizing Multiple Sclerosis to local activists dedicated to raising awareness on the health condition.

This scoping review will review what scientific evidence is available so far pertaining to functional connectivity perturbations in brain fog in multiple sclerosis patients.

I am visiting Gandhamardan Hills since year 1990 for Ethnobotanical surveys and collected information worth several TBs in these years. The present series is an effort to bring all aspects of Biodiversity rich Gandhamardan Hills among world community. For details please visit pankajoudhia.com Related References Oudhia, P. (2014). Medicinal Rice Baisur with Red, Brown and Black Rice based Traditional Herbal Formulations (Gandhamardan Hills Series) for Guttate psoriasis. Medicinal Rice Formulations (1990-2014) in Encyclopedia of Tribal Medicines by Pankaj Oudhia at pankajoudhia.com Oudhia, P. (2014). Medicinal Rice Baisur with Red, Brown and Black Rice based Traditional Herbal Formulations (Gandhamardan Hills Series) for Hürthle cell carcinoma. Medicinal Rice Formulations (1990-2014) in Encyclopedia of Tribal Medicines by Pankaj Oudhia at pankajoudhia.com Oudhia, P. (2014). Medicinal Rice Baisur with Red, Brown and Black Rice based Traditional Herbal Formulations (Gandhamardan Hills Series) for H1N1 Flu. Medicinal Rice Formulations (1990-2014) in Encyclopedia of Tribal Medicines by Pankaj Oudhia at pankajoudhia.com Oudhia, P. (2014). Medicinal Rice Baisur with Red, Brown and Black Rice based Traditional Herbal Formulations (Gandhamardan Hills Series) for Hair Loss. Medicinal Rice Formulations (1990-2014) in Encyclopedia of Tribal Medicines by Pankaj Oudhia at pankajoudhia.com Oudhia, P. (2014). Medicinal Rice Baisur with Red, Brown and Black Rice based Traditional Herbal Formulations (Gandhamardan Hills Series) for Head and neck cancers. Medicinal Rice Formulations (1990-2014) in Encyclopedia of Tribal Medicines by Pankaj Oudhia at pankajoudhia.com Oudhia, P. (2014). Medicinal Rice Baisur with Red, Brown and Black Rice based Traditional Herbal Formulations (Gandhamardan Hills Series) for Hearing Loss. Medicinal Rice Formulations (1990-2014) in Encyclopedia of Tribal Medicines by Pankaj Oudhia at pankajoudhia.com

Bottom Line 'Understanding Parkinson's & Multiple Sclerosis'

artykuł w: Annales Universitatis Mariae Curie-Skłodowska. Sectio D, Medicina. Vol. 60, N2, 193 (2005), strony 987-990. ; Bibliografia na stronie 989.

256 pages : 24 cm

256 pages : 24 cm

Multiple Sclerosis • Language: Hebrew • Author: Ashur Cherry (Toronto, Canada) Hebrew Language Publications are Dedicated in Honour of Professor Binyamin Geva

Wisconsin has one of the highest incidences of MS in the United States - one in 500. Multiple Sclerosis is a progressive disease for which no cure has yet been found. UW professor Colleen Hayes shares her research on Vitamin D's role in MS. Shelley Peterman Schwartz describes the path her life has taken since her MS diagnosis over 30 years ago. For more information, go to www.wisMS.org, or call 800-242-3358 (toll free in Wisconsin)

Wisconsin has one of the highest incidences of MS in the United States - one in 500. Multiple Sclerosis is a progressive disease for which no cure has yet been found. UW professor Colleen Hayes shares her research on Vitamin D's role in MS. Shelley Peterman Schwartz describes the path her life has taken since her MS diagnosis over 30 years ago. For more information, go to www.wisMS.org, or call 800-242-3358 (toll free in Wisconsin)

Wisconsin has one of the highest incidences of MS in the United States - one in 500. Multiple Sclerosis is a progressive disease for which no cure has yet been found. UW professor Colleen Hayes shares her research on Vitamin D's role in MS. Shelley Peterman Schwartz describes the path her life has taken since her MS diagnosis over 30 years ago. For more information, go to www.wisMS.org, or call 800-242-3358 (toll free in Wisconsin)

Wisconsin has one of the highest incidences of MS in the United States - one in 500. Multiple Sclerosis is a progressive disease for which no cure has yet been found. UW professor Colleen Hayes shares her research on Vitamin D's role in MS. Shelley Peterman Schwartz describes the path her life has taken since her MS diagnosis over 30 years ago. For more information, go to www.wisMS.org, or call 800-242-3358 (toll free in Wisconsin)

Wisconsin has one of the highest incidences of MS in the United States - one in 500. Multiple Sclerosis is a progressive disease for which no cure has yet been found. UW professor Colleen Hayes shares her research on Vitamin D's role in MS. Shelley Peterman Schwartz describes the path her life has taken since her MS diagnosis over 30 years ago. For more information, go to www.wisMS.org, or call 800-242-3358 (toll free in Wisconsin)

Wisconsin has one of the highest incidences of MS in the United States - one in 500. Multiple Sclerosis is a progressive disease for which no cure has yet been found. UW professor Colleen Hayes shares her research on Vitamin D's role in MS. Shelley Peterman Schwartz describes the path her life has taken since her MS diagnosis over 30 years ago. For more information, go to www.wisMS.org, or call 800-242-3358 (toll free in Wisconsin)

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The objective of this project was to determine whether a controlled period of head and torso cooling would enhance the cognitive performance of multiple sclerosis patients. Nineteen MS patients (11 men and 8 women) participated in the study. Control data were taken from nineteen healthy volunteers (12 men and 7 women). All but six of nineteen MS patients tested improved their cognitive performance, as measured by their scores on the Rao test battery. A second objective was to gain insight into the neurological effects of cooling. Visual evoked potentials (VEPs) stimulated by a reversing checkerboard pattern were recorded before and after cooling. We found that cooling selectively benefited the cognitive performance of those MS patients whose pre-cooling VEPs were abnormally shaped (which is an indication of visual pathway impairment due to demyelinization). Moreover, for female MS patients, the degree of cognitive performance improvement following cooling was correlated with a change in the shape of their VEPs toward a more normal shape following cooling.

This article is from Patient preference and adherence , volume 8 . Abstract This article discusses the many ways that nurses can address the factors that lead to treatment fatigue in patients with multiple sclerosis (MS) on long-term disease-modifying therapy, ultimately helping to preserve the patient’s health and quality of life. Patients with MS on long-term therapy may suffer from treatment fatigue and poor adherence due to a variety of different factors, including difficulties with injections, anxiety/depression, financial problems, and inaccurate beliefs about the MS disease process. Because MS nurses have regular interactions with patients, they are ideally situated to help patients cope with these and other factors that may limit adherence.

This article is from Neuropsychiatric Disease and Treatment , volume 10 . Abstract Cognitive and neuropsychological impairments are well documented in adult multiple sclerosis (MS). Research has only recently focused on cognitive disabilities in pediatric cases, highlighting some differences between pediatric and adult cases. Impairments in several functions have been reported in children, particularly in relation to attention, processing speed, visual–motor skills, and language. Language seems to be particularly vulnerable in pediatric MS, unlike in adults in whom it is usually preserved. Deficits in executive functions, which are considered MS-specific in adults, have been inconsistently reported in children. In children, as compared to adults, the relationship between cognitive dysfunctions and the two other main symptoms of MS, fatigue and psychiatric disorders, was poorly explored. Furthermore, data on the correlations of cognitive impairments with clinical and neuroimaging features are scarce in children, and the results are often incongruent; interestingly, involvement of corpus callosum and reduced thalamic volume differentiated patients identified as having a cognitive impairment from those without a cognitive impairment. Further studies about pediatric MS are needed in order to better understand the impact of the disease on brain development and the resulting effect on cognitive functions, particularly with respect to different therapeutic strategies.

This article is from Health and Quality of Life Outcomes , volume 12 . Abstract Background: Limited data define what constitutes a minimal clinically important difference (MCID) on the EuroQol 5-Dimension (EQ-5D) health status index in persons with multiple sclerosis (PwMS). We sought to estimate the MCID for the EQ-5D health index in North American PwMS. Methods: PwMS completing the Patient Determined Disease Steps (PDDS) scale, 12-Item Multiple Sclerosis Walking Scale (MSWS-12) and EQ-5D as part of the North American Research Committee on Multiple Sclerosis (NARCOMS) registry’s spring 2011 update and supplemental survey were included in this retrospective, cross-sectional study. Distribution-based (standard error of measurement [SEM], 0.50 standard deviation [SD] and 0.33 SD unit) approaches were used to estimate a range of MCIDs for the EQ-5D based upon disease severity groups determined by the PDDS and MSWS-12 tertiles. Results: A total of 3,044 participants were included. Moderately strong correlations between the EQ-5D and the PDDS and MSWS-12 were observed (Spearman’s r = -0.56 and -0.59, respectively, p 

This article is from Trials , volume 13 . Abstract Background: Multiple sclerosis is the most common chronic inflammatory disease of the central nervous system in young adults. Despite the fact that numerous lines of evidence link both the risk of disease development and the disease course to the serum level of 25-hydroxyvitamin D it still remains elusive whether multiple sclerosis patients benefit from boosting the serum level of 25-hydroxyvitamin D, mainly because interventional clinical trials that directly address the therapeutic effects of vitamin D in multiple sclerosis are sparse. We here present the protocol of an interventional clinical phase II study to test the hypothesis, that high-dose vitamin D supplementation of multiple sclerosis patients is safe and superior to low-dose supplementation with respect to beneficial therapeutic effects. Methods/Design: The EVIDIMS trial is a German multi-center, stratified, randomized, controlled and double-blind clinical phase II pilot study. Eighty patients with the diagnosis of definite multiple sclerosis or clinically isolated syndrome who are on a stable immunomodulatory treatment with interferon-β1b will be randomized to additionally receive either high-dose (average daily dose 10.200 IU) or low-dose (average daily dose 200 IU) cholecalciferol for a total period of 18 months. The primary outcome measure is the number of new lesions detected on T2-weighted cranial MRI at 3 tesla. Secondary endpoints include additional magnetic resonance imaging and optical coherence tomography parameters for neuroinflammation and -degeneration, clinical parameters for disease activity, as well as cognition, fatigue, depression, and quality of life. Safety and tolerability of high-dose vitamin D supplementation are further outcome parameters. Discussion: In light of the discrepancy between existing epidemiological and preclinical data on the one hand and available clinical data on the other the EVIDIMS trial will substantially contribute to the evaluation of the efficacy of high-dose vitamin D supplementation in MS patients. The study design presented here fulfills the criteria of a high-quality clinical phase II trial in MS. Trial Registration: ClinicalTrials.gov Identifier: NCT01440062

This article is from Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences , volume 19 . Abstract Background:: Sexual dysfunction (SD) is a common reported problem in patients with multiple sclerosis (MS). Aims:: to examine frequency and distribution of SD dimensions and to determine whether SD is related to various clinical and demographic variables in female patients. Materials and Methods:: A total of 271 MS women (age: 19-50 years) participated in this cross-sectional study. We used a structured demographic and clinical interview and Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19). Disability was rated by Expanded Disability Status Score (EDSS). Results:: 63.5% (n = 173) of women had SD included 142 (52.4%) women with primary SD, 102 (37.5%) women with secondary SD and 120 (41%) women with tertiary SD. The most common SD-related complaint was orgasmic problem (41.2%). Women with primary SD were significantly older and had higher EDSS score. No significant relationship was found between primary SD and disease duration. Fatigue (OR = 2.69, 95% CI: 1.352-5.385, P = 0.005), memory and concentration complaints (OR = 1.915, 95% CI: 1.034-3.546, P = 0.039) and some of urinary symptoms such as frequency (OR = 2.108, 95% CI: 1.015-4.375, P = 0.045) were seem to be the significant predictors. Fatigue was also found to be the most powerful predicting factor for tertiary SD (OR = 2.793, 95% CI: 1.358-5.744 P = 0.005). Conclusion:: SD, a common multifactorial problem among MS women, can arise at any time during the disease and with any level of disability. However, we found relationships between SD and some of clinical variables and symptoms. Understanding these relationships would help us to develop practical approach and treatment for SD.

This article is from Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences , volume 19 . Abstract Background:: Sexual dysfunction (SD) is a common reported problem in patients with multiple sclerosis (MS). Aims:: to examine frequency and distribution of SD dimensions and to determine whether SD is related to various clinical and demographic variables in female patients. Materials and Methods:: A total of 271 MS women (age: 19-50 years) participated in this cross-sectional study. We used a structured demographic and clinical interview and Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19). Disability was rated by Expanded Disability Status Score (EDSS). Results:: 63.5% (n = 173) of women had SD included 142 (52.4%) women with primary SD, 102 (37.5%) women with secondary SD and 120 (41%) women with tertiary SD. The most common SD-related complaint was orgasmic problem (41.2%). Women with primary SD were significantly older and had higher EDSS score. No significant relationship was found between primary SD and disease duration. Fatigue (OR = 2.69, 95% CI: 1.352-5.385, P = 0.005), memory and concentration complaints (OR = 1.915, 95% CI: 1.034-3.546, P = 0.039) and some of urinary symptoms such as frequency (OR = 2.108, 95% CI: 1.015-4.375, P = 0.045) were seem to be the significant predictors. Fatigue was also found to be the most powerful predicting factor for tertiary SD (OR = 2.793, 95% CI: 1.358-5.744 P = 0.005). Conclusion:: SD, a common multifactorial problem among MS women, can arise at any time during the disease and with any level of disability. However, we found relationships between SD and some of clinical variables and symptoms. Understanding these relationships would help us to develop practical approach and treatment for SD.