Study may show why MS patients develop progressive disability

Pree release:

Did you know multiple sclerosis (MS) means multiple scars? New research shows that the brain and spinal cord scars in people with MS may offer clues to why they developprogressive disability but those with related diseases where the immune system attacks the central nervous system do not.

In a study published in Neurology, Mayo Clinic researchers and colleagues assessed if inflammation leads to permanent scarring in these three diseases:

MS.
Aquaporin-4 antibody positive neuromyelitis optica spectrum disorder (AQP4-NMOSD).
Myelin oligodendrocyte glycoprotein antibody associated disorder (MOGAD).

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In many cases, MS starts long before the diagnosis

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Persons suffering from the autoimmune disease multiple sclerosis can develop various neurological symptoms caused by damage to the nervous system. Especially in early stages, these may include sensory dysfunction such as numbness or visual disturbances. In most patients, MS starts with recurring episodes of neurological disability, called relapses or demyelinating events. These clinical events are followed by a partial or complete remission. Especially in the beginning, the symptoms vary widely, so that it is often difficult even for experienced doctors to interpret them correctly to arrive at a diagnosis of MS.

Above-average numbers of medical appointments

It has been evident for some time, however, that patients with MS show significantly higher numbers of physician visits and hospital admissions even years before the first diagnosis as compared to healthy control persons. In recent years, specialists have seen this pre-diagnosis period as a possible prodromal phase of the disease.

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Pandemic led to profound changes in multiple sclerosis clinical practice

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A survey of U.S. multiple sclerosis, or MS, specialist clinicians reveals the COVID-19 pandemic has created major changes in how they deliver care.

“Since the pandemic began, more than 95% of our survey respondents reported using telehealth platforms to provide care for their patients,” said Dr. Elizabeth Morrison-Banks, a health sciences clinical professor of neurology in the School of Medicine at the University of California, Riverside, who led the survey reported in the journal Multiple Sclerosis and Related Disorders. “Approximately one half of the respondents were MS specialist neurologists, four out of five of whom indicated that COVID-19 had changed how they were recommending and prescribing MS disease-modifying therapies.”

During the pandemic, the MS specialist neurologists tended to prescribe fewer immunosuppressive agents. Survey respondents also commented on their perceived level of safety and support in the workplace during the pandemic. Most indicated they had access to adequate personal protective equipment, but fewer than 50% reported they had adequate ability to physically distance themselves at work. Nearly 10% of respondents reported they had been redeployed, most commonly to the front lines of COVID-19 care.

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Machine learning helps spot gait problems in individuals with multiple sclerosis

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Monitoring the progression of multiple sclerosis-related gait issues can be challenging in adults over 50 years old, requiring a clinician to differentiate between problems related to MS and other age-related issues. To address this problem, researchers are integrating gait data and machine learning to advance the tools used to monitor and predict disease progression.

A new study of this approach led by University of Illinois Urbana Champaign graduate student Rachneet Kaur, kinesiology and community health professor Manuel Hernandez and industrial and enterprise engineering and mathematics professor Richard Sowers is published in the journal Institute of Electrical and Electronics Engineers Transactions on Biomedical Engineering.

Multiple sclerosis can present itself in many ways in the approximately 2 million people that it affects globally, and walking problems are a common symptom. About half of the patients need walking assistance within 15 years of onset, the study reports.

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Fatty acid may help combat multiple sclerosis

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The abnormal immune system response that causes multiple sclerosis (MS) by attacking and damaging the central nervous system can be triggered by the lack of a specific fatty acid in fat tissue, according to a new Yale study. The finding suggests that dietary change might help treat some people with the autoimmune disease.

The study was published Jan. 19 in The Journal of Clinical Investigation.

Fat tissue in patients diagnosed with MS lack normal levels of oleic acid, a monounsaturated fatty acid found at high levels in, for instance, cooking oils, meats (beef, chicken, and pork), cheese, nuts, sunflower seeds, eggs, pasta, milk, olives, and avocados, according to the study.

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More than half of American adults with advanced MS report mistreatment by caregivers

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Four in 10 people with advanced multiple sclerosis, or MS, are emotionally abused by someone responsible for caring for them, reports a study led by the University of California, Riverside.

Further, the study finds one quarter are financially exploited, one in six are neglected, one in nine are battered, and one in 12 are sexually assaulted by a caregiver.

“We knew we would find some level of abuse and neglect, but we were surprised by how prevalent it is,” said Dr. Elizabeth Morrison-Banks, a health sciences clinical professor at the UC Riverside School of Medicine, who led the study. “The findings of this study represent a collective cry for help from so many families affected by multiple sclerosis across the United States.”

MS is an autoimmune disease that affects more than 2.3 million people worldwide. This chronic, degenerative neurological condition periodically shutters communication between the brain and other parts of the body, resulting in symptoms that include numbness and tingling in the arms and legs, as well as blindness and paralysis.

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Childhood obesity could increase the risk of multiple sclerosis

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Childhood and adolescent obesity is projected to contribute up to 14 per cent of overall risk of Multiple Sclerosis (MS) in 2035, according to research led by Queen Mary University of London.

Previous studies have estimated that 53 per cent of MS risk is directly attributable to environmental factors, and that up to one in five MS cases could be attributable to smoking. Smoking and high body mass index (BMI) are leading global drivers of many non-communicable diseases and cause significant premature morbidity and mortality.

The study, part-funded by Barts Charity and involving researchers from Queen Mary University of London, Barts Health NHS Trust and the University of Oxford, used published literature from the UK, USA, Russia and Australia, to estimate and project the proportion of MS incidence that could be attributed to two modifiable risk factors: smoking, and childhood and adolescent high BMI.

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