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Last chance to have your say on complementary and alternative therapies

source: MSIF

You have until 12 October 2009 to inform the next issue of MS in focus, on complementary and alternative medicines (CAMs) and MS, by taking part in our survey.

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Profile of the Month : January 2010

Pavel Zlobin

Country: Russia
Age: 37
Type of MS: Secondary progressive
Year of Diagnosis: 1999

"MS is still neglected as people think it is a minor problem."

Deutsch English French Italiano Русский

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Long-term effect of early treatment with interferon beta-1b after a first clinical event suggestive of multiple sclerosis: 5-year active treatment extension of the phase 3 BENEFIT trial

In relapsing-remitting MS, people can experience a period which can last for several years, characterised by the presence of acute relapses. Following this, a period of slow progression of disability may appear. Interferon (IFN) beta is one of the accepted drugs for MS, as it has been proven to reduce the relapse rate in people with MS and delay the appearance of a second relapse, when given after a first attack suggestive of MS. The authors aimed to investigate whether treatment with IFN beta, when administered after a first relapse, could also delay the progression of disability in people with MS. The authors followed two groups of people with MS for five years. One of these groups started IFN beta immediately after the first relapse and the other started the treatment after the second clinical relapse. They found that the risk for confirmed progression of disability was not lower in people who had started the treatment after the first relapse than in people who had started this treatment later, suggesting that IFN beta does not seem to delay the appearance of long-term disability.

authors: Kappos L, Freedman MS, Polman CH, Edan G, Hartung HP, Miller DH, Montalbán X, Barkhof F, Radü EW, Metzig C, Bauer L, Lanius V, Sandbrink R, Pohl C; for the BENEFIT Study Group

source: Lancet Neurol. 2009 Sep 10

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Cortical lesions and atrophy associated with cognitive impairment in relapsing-remitting multiple sclerosis

Although MS has traditionally been considered an inflammatory-demyelinating disease mainly affecting the white matter, the involvement of the grey matter in MS is increasingly recognised. It is well known that some people with MS may develop a degree of cognitive decline, which can considerably diminish their quality of life. However, the causes of cognitive symptoms are not yet known. The authors of this study found that there is a clear association between the appearance of cognitive dysfunction and the presence of lesions in the cortical grey matter and cortical grey matter volume loss. These findings stress the importance of grey matter involvement in MS, which may help explain the presence of cognitive symptoms more than the involvement of the white matter.

authors: Calabrese M, Agosta F, Rinaldi F, Mattisi I, Grossi P, Favaretto A, Atzori M, Bernardi V, Barachino L, Rinaldi L, Perini P, Gallo P, Filippi M

source: Arch Neurol. 2009 Sep;66(9):1144-50

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Multiple sclerosis with predominant, severe cognitive impairment

Although the presence of severe symptoms of cognitive dysfunction in MS is not frequent or typical, the identification of those with a high risk of developing these symptoms may be crucial. The authors studied 23 people with MS with severe cognitive dysfunction. They found that the clinical feature most frequently observed amongst them was the presence of psychiatric symptoms and the presence of signs denoting involvement of the brain cortex. With this study, the authors pinpoint the importance of the grey matter involvement in MS, especially when cognitive dysfunction appears, as many authors have already suggested.

authors: Staff NP, Lucchinetti CF, Keegan BM

source: Arch Neurol. 2009 Sep;66(9):1139-43

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Diffuse white matter damage is absent in neuromyelitis optica

Neuromyelitis optica (NMO) and MS and are both inflammatory-demyelinating diseases of the central nervous system, with NMO mainly affecting the spinal cord and the optic nerve. It is not clear whether MS and NMO are different diseases or different versions of the same disease. Since both prognosis and treatment may be very different for the two diseases, the correct and early differentiation between them is of great importance in clinical practice. However, clinical and MRI data are not always sufficient for making this differentiation. With MS it is well known that typical brain lesions and damage in the brain tissue, which seems normal when studied by conventional MRI techniques play a role in the development of disability. Whilst the white matter of people with MS appears normal when examined with conventional MRI techniques, it shows abnormalities when non-conventional MRI techniques are used. With NMO it is not clear whether there is also significant and meaningful damage in brains that appear normal using conventional MRI techniques. The authors studied whether white matter in the brains of a group of people with NMO showed abnormalities using spectroscopic MRI, a new technique which can detect abnormalities in the chemical composition of the brain tissue. When the authors compared the spectroscopic MRI scans of people with NMO with a group of healthy controls no differences were found. These findings are very important because they suggest that the study of brain tissue that appears normal may be a tool to differentiate people with MS and with NMO in clinical practice, when conventional MRI and clinical data are insufficient.

authors: Aboul-Enein F, Krssák M, Höftberger R, Prayer D, Kristoferitsch W

source: AJNR Am J Neuroradiol. 2009 Sep 12

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An electrophysiological approach to the diagnosis of neurogenic dysphagia; implications for botulinum toxin treatment

In advanced stages of MS dysfunction of the pharyngeal muscles may sometimes appear, causing difficulty in swallowing which can be potentially life threatening. Despite a lack of clinical trials, botulinum toxin is an accepted treatment for this symptom. Not all people with pharyngeal dysfunction respond to this treatment and no tools currently exist to predict who will respond successfully. The authors studied the value of electrophysiological methods (i.e. electromyogram of pharyngeal muscles) for monitoring botulinum toxin treatment response in a group of people with neurological diseases, including MS. The results of the study showed that electrophysiological methods can be a potentially useful tool for these purposes.

authors: Alfonsi E, Merlo IM, Ponzio M, Montomoli C, Tassorelli C, Biancardi C, Lozza A, Martignoni E

source: J Neurol Neurosurg Psychiatry. 2009 Sep 16

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MS Society of Canada marks one year anniversary of endMS campaign

source: MS Society of Canada

With over CA$41 million raised, five regional research and training centres launched and a growing number of educational events aimed at MS researchers and trainees, the MS Society of Canada has proudly marked one year since the launch of its endMS campaign.

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Update on Tysabri and PML

source: US National MS Society

According to the US Food and Drug Administration, there have been 13 confirmed cases of progressive multifocal leukoencephalopathy (PML, a viral infection of the brain that usually leads to death or severe disability) among people who have used Tysabri (natalizumab) after it became available for prescription in July 2006.

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MS pioneer and first Chief Medical Officer of the US National MS Society, Dr Stanley van den Noort passes away

source: US National MS Society

Dr Stanley van den Noort, an internationally acclaimed leader in the field of neuroscience and one of the most distinguished researchers and clinicians in the field of MS, died on 16 September 2009.

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Scientists discover clues about how the immune system works

source: UK MS Society

UK researchers have made a new discovery about how the immune system works.

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