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Mood and MS

Blog Summary

Those of us who have been involved in both the research and care of people with MS walk a tightrope sometimes between pointing out the severity of a problem and solving it. We want to alert our patients without overwhelming them. On Thursday, I attended a session on depression and other mood disorders at the Consortium of MS Centers meeting in Seattle that really brought home how prevalent these symptoms are in people with MS. While the numbers are sobering, the message is clear: bringing this information to light can only bring us closer to finding solutions.

Depression is two or more times more prevalent in people with MS than in the general population, says Dr. Scott Patten (from the University of Calgary) in his review of the studies (find his presentation here). When researchers try to find out what factors predict lower quality of life, depression gets high marks. Not surprising, since depression affects how you function at work, in school, in your social life and during recreational activities...

MS Symptoms: Researchers Look for Life-Changing Breakthroughs

Blog Summary

Stopping the effects of even one MS symptom can be a life-changing breakthrough for an individual with MS. I’m encouraged by the many strategies I heard about at ECTRIMS and its companion meeting, Rehabilitation in MS (RIMS), and am hopeful that they can soon be put into action to change the lives of people with MS.Fatigue – Dr. Vincent de Groot (Vu University Medical Center, Amsterdam) reported results from three clinical trials, each testing a different strategy to see if it could lessen fatigue over 16 weeks in approximately 90 people with MS: aerobic training, cognitive behavioral therapy, and energy conservation management.  Only cognitive behavioral therapy effectively reduced severe fatigue in this short-term study. We know that psychological interventions are a part of managing fatigue, and these results certainly support that...

Studies advance emotional and cognitive health in MS

Blog Summary

Finding solutions that advance emotional wellness and cognitive function can make every aspect of living with MS better. As a clinical psychologist who has treated people living with this disease, I find it heartening to see how researchers presenting this week at the American Academy of Neurology’s Annual Meeting are propelling this search forward. Here is just a small sample of their work. (Links are included to abstracts on the AAN site - access is free.) Let’s start with cognition – half or more of all people with MS will experience cognitive issues at some point. The fact that there is such a thing called “cognitive rehabilitation” rightfully suggests that there are options open to many that may help improve cognitive function. For example, Dr. Leigh Charvet and colleagues at New York University Langone Medical Center and the State University of New York at Stony Brook tested a computer-based cognitive training program in 135 people with MS. Of this group, 71 people used the training program – a series of brain-training games that are continuously adapted to keep the individual challenged – and 64 played regular video games for one hour per day, five days per week, over 12 weeks. Although the “placebo” video game group logged more playing time, those in the training group showed significantly greater improvement in cognitive function, as shown by a number of neuropsychological tests. I hope further testing makes this and similar programs easily accessible for improving cognition in MS...

ECTRIMS: Research Spotlight on Diet and Wellness Approaches

Blog Summary

A big part of my excitement at the ECTRIMS meeting is seeing so many researchers from around the world working hard to find the best solutions for people affected by MS. I found this to be especially true in the growing area of lifestyle and  wellness research  -exploring diet, exercise, physical activity and other approaches -  all of which people can manage themselves to improve how they feel and possibly how their MS evolves. 

The plot thickens on diet and MS

Blog Summary

To think that you might be able to change the course of disease, or at least relieve symptoms, by eating or not eating specific types of food is enticing. However, “the proof is in the pudding,” scientifically speaking, since studying diet is challenging. That’s why it’s been exciting to see how many researchers are trying to do just that at this week’s AAN Meeting. Diet and MS has been the subject of numerous platform talks and poster sessions, showing that clinicians and researchers are asking the same questions we hear so often from people living with MS. In a small study, Dr. Rocco Totaro and a team from the University of L’Aquila in Italy tested whether a six-week diet that was low in saturated animal fats, and high in antioxidants, would be associated with positive changes in body composition and fatigue in 17 people with relapsing-remitting MS. In their study, the percentage of body fat decreased, and fatigue as measured by a clinical scale lessened significantly as well. We need more and larger studies like this, to show how diet may impact symptoms that affect the lives of people with MS. What does it mean for you now? A healthy diet certainly can’t hurt, and it may even help both MS and general health. (Abstract P2.211) ...

Finding Solutions at the World’s Largest MS Meeting

Blog Summary

I’m pleased to be reporting from the 2014 Joint ACTRIMS-ECTRIMS Meeting in Boston. This is the largest gathering of MS professionals – more than 7,000 attendees from 90 countries. What a fantastic place to learn about how researchers around the globe are finding solutions to help everyone with MS live their best lives. Take Dr. Laura De Giglio and her team from Rome, Italy, who are studying how “brain training” may help people with MS to restore cognitive function. At last year’s meeting, this team showed that Nintendo’s Dr. Kawashima Brain Training™ improved attention, processing speed and working memory in people with MS. What they report this year is even better news. The team used functional magnetic resonance imaging (fMRI), which allows researchers to take active images of the brain while a person is performing certain tasks. The idea is that it helps researchers to see how a particular treatment is affecting the way specific parts of the brain are functioning...

Tackling MS symptoms to restore function

Blog Summary

I am truly amazed at the breadth of research I am seeing at the AAN on restoring function to people with MS. Scientists are looking virtually everywhere for answers about how to manage symptoms and improve function through novel treatments and rehabilitation techniques. One great aspect of attending the AAN is hearing about exciting advances in neurology in general – Dr. Albert Lo (we talked about his salsa dance program) presented promising research on rehabilitation robotics at a plenary session to thousands of neurologists. Robots can do heavy lifting for tasks like supporting a person’s weight while they walk on a treadmill, and they can be programmed to provide precise resistance and “dosages” of an exercise. A core concept of rehab is the necessity to do repetitive work. And robots are masters of repetition – an occupational therapy session may require 50 repetitions of an exercise, and robots can guide a person’s arm to do those precise repetitions. We need more proper trials, says Dr. Lo, but it was exciting to see this new frontier of rehabilitation research, which is just beginning to be applied to improving function for people with MS...

Live from AAN: Research to improve wellness

Blog Summary

I am blogging from the 66th Annual Meeting of the American Academy of Neurology in Philadelphia, otherwise known as the AAN meeting. The AAN features thousands of presentations on neurological diseases. I am increasingly impressed with how many of these address wellness and lifestyle in people with MS. Entire sessions are dedicated to topics such as “Diet and Hormonal Influences in MS” and “Cognition and Fatigue in MS.” We are becoming more aware of the diverse paths toward finding solutions for everyone with MS. And even salsa dancing! Mandelbaum, Lo and colleagues (Providence, RI) reported here on a study in which they enrolled eight people with MS in a four-week salsa dance program. Individuals participated in dance sessions twice a week. Dancing resulted in significant improvements in gait and balance both right after the program and after three months of follow up. The National MS Society is now funding Dr. Lo of this team to conduct a larger study that may lead to more widespread use of dance as physical therapy for MS...

More on Exercise and Rehabilitation

Blog Summary

It’s getting clearer that exercise and rehabilitation can help many levels of function and quality of life for people living with MS. This year, ECTRIMS is being held in conjunction with the 18th Annual Conference of Rehabilitation in MS, and I’ve been impressed by the extent to which researchers are applying creative strategies to study and maximize the potential benefits of rehab and exercise to address MS.   Some of these strategies were described by Dr. Dalgas (Aarhus, Denmark), who reminded the audience that for many years people with MS were advised against exercising because it seemed to make fatigue and other symptoms worse. Thanks to research, we now know that this worsening is usually temporary and outweighed by the benefits.

ECTRIMS: Risks and Triggers for MS

Blog Summary

There’s a lot of progress being reported this week at ECTRIMS on the topic of MS risk factors and triggers. I think this is really important because if we knew exactly what causes MS, we might be able to prevent anyone from ever getting the disease again. But even more relevant to people who already live with MS is new evidence for risk factors that are within a person’s control and which may make their disease worse – or better.   For example, in a large population study by Dr. A.K. Hedström and team from Stockholm, Sweden, they confirmed that cigarette smoking increased the risk for developing MS at any age, and climbed with the amount smoked. They also found that quitting smoking completely flattened out that risk back to normal within a decade.