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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One in four children want better pain treatment

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A great need for better pain treatment

After an appendectomy, a quarter (24.8%) of all children wanted a stronger pain treatment in the first 24 hours after their operation. Among children who had a tonsillectomy, this was one-fifth (20.2%). Analysis of the data showed that this desire was primarily associated with sleep impairments and with movement pain. The lead author of the study, Prof. Ulrike M. Stamer, explained: “We are dealing with a large number of affected patients. Appendectomies and tonsillectomies are the most common operations performed on children overall. Just under a quarter of these cases strongly signal a desire for improvement”.

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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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Researchers identify barriers to use of surface electromyography in neurorehabilitation

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Kessler Foundation researchers have identified several practical and technical barriers to the widespread use of surface electromyography (sEMG) in clinical neurorehabilitation. Based on their holistic analysis of these factors, the researchers suggest a collaborative, interdisciplinary, and unified approach to enable rehabilitation professionals to routinely use sEMG. The article, “Use of Surface EMG in Clinical Rehabilitation of Individuals With SCI: Barriers and Future Considerations” (doi: 10.3389/fneur.2020.578559), was published December 18, 2020, in Frontiers in Neurology. It is available open access at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7780850/

The authors are Rakesh Pilkar, PhD, Kamyar Momeni, PhD, Arvind Ramanujam, Manikandan Ravi, Erica Garbarini, and Gail F. Forrest, PhD, affiliated with the Center for Mobility and Rehabilitation Engineering Research and the Tim and Caroline Reynolds Center for Spinal Stimulation at Kessler Foundation.

sEMG is a noninvasive technology that detects, records, and interprets the electrical activity of muscles. The quantifiable information on myoelectric output recorded by sEMG is extremely useful in assessing impairment and potentially determining patient-specific and effective interventions for individuals with spinal cord injury (SCI). However, while sEMG is commonly used in neurorehabilitation research, its integration into clinical practice has been limited, according to lead author Dr. Pilkar, senior research scientist at the Center for Mobility and Rehabilitation Engineering Research.

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Hope for children with bow hunter syndrome

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DALLAS – Feb. 11, 2021 – Fusing the neck’s top two vertebrae can prevent repeat strokes in children with bow hunter syndrome, a rare condition that affects a handful of U.S. pediatric patients each year, UT Southwestern researchers suggest in a recent study. The finding, published online in Child’s Nervous System, offers a new way to treat these children and protect them from potentially lifelong neurological consequences.

Bow hunter syndrome – so named because of the head’s position when a person is shooting an arrow – is a condition affecting children and adults in which turning the head compresses blood vessels supplying the back of the brain from the vertebral artery. In adults, this condition is usually caused by a bone spur on the neck and presents with temporary symptoms of fainting, dizziness, headache, or tinnitus that resolve when the head turns back to a neutral position.

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Link found between time perception, risk for developmental coordination disorder

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Neuroscientists at McMaster University have found a link between children who are at risk for developmental coordination disorder (DCD), a common condition that can cause clumsiness, and difficulties with time perception such as interpreting changes in rhythmic beats.

Accurate time perception is crucial for basic skills such as walking and processing speech and music.

“Many developmental disorders, including dyslexia or reading difficulties, autism and attention deficits have been linked to deficits in auditory time perception,” says Laurel Trainor, senior author of the study and founding director of the McMaster Institute for Music and the Mind.

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Study finds revised concussion guidelines shorten duration of symptoms

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The adoption of recommended changes in concussion management led to a reduction in the length of symptoms among 11- to 18-year-old athletes with first-time, sports-related concussions, according to new research in the Journal of Osteopathic Medicine. These outcomes support the widespread adoption of the updated concussion guidelines.

Researchers conducted a retrospective review of the medical records of athletes who sustained a concussion between 2016 and 2018 and were treated by a physician who used the revised approach to concussion management. They then compared the data with a previously published data set from athletes who sustained a concussion between 2011 and 2013 and whose physicians followed older guidelines for concussion management. A total of 110 male and 72 female athletes met the study’s eligibility criteria.

The recommended changes in care include advocating for early activity, recognizing pre-existing conditions, and educating athletes about concussion recovery. Following implementation of the guidelines at the clinic, athletes of both genders experienced a significantly shorter median duration of concussion symptoms. Male athletes reported a duration of symptoms that dropped from 11 days to 5 days, while female athletes’ symptom duration dropped from 28 to 7 days.

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Epilepsy research focused on astrocytes

Mariko Onodera and Jan Meyer perform an experiment with potassium-sensitive microelectrodes in the Institute of Neurobiology at HHU.

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During epileptic seizures, a large number of nerve cells in the brain fire excessively and in synchrony. This hyperactivity may lead to uncontrolled shaking of the body and involve periods of loss of consciousness. While about two thirds of patients respond to anti-epileptic medication, the remainder is refractory to medical treatment and shows drug-resistance. These patients are in urgent need for new therapeutic strategies.

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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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Increased risk of Parkinson’s disease in patients with schizophrenia

A new study conducted at the University of Turku, Finland, shows that patients with a schizophrenia spectrum disorder have an increased risk of Parkinson’s disease later in life. The increased risk may be due to alterations in the brain’s dopamine system caused by dopamine receptor antagonists or neurobiological effects of schizophrenia.

The record-based case-control study was carried out at the University of Turku in collaboration with the University of Eastern Finland. The study examined the occurrences of previously diagnosed psychotic disorders and schizophrenia in over 25,000 Finnish Parkinson’s disease (PD) patients treated in 1996-2019.

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