ArchiveJanuary 2018

The interpretation of results can depend on the way you look at things.

Look at this picture. What do you see? Do you see an old woment (you see a nose) or a young women (you see a jaw)? Now Look at this. What do you see? Don’t know what this is?. An educational comment for pwMS and researchers It is interleukin 10. It maybe doesn’t mean much to you, but it may help you understand papers a bit better and questions whether you should accept dogma...

Smoking a potential drug interaction in IFNB

Are you a smoker? This is an important post if you are. Neurology. 2018 Jan 17. pii: 10.1212/WNL.0000000000004949. doi: 10.1212/WNL.0000000000004949. [Epub ahead of print] Smoking affects the interferon beta treatment response in multiple sclerosis. Petersen ER, Oturai AB, Koch-Henriksen N, Magyari M, Sørensen PS, Sellebjerg F, Søndergaard HB. Abstract OBJECTIVE: To investigate whether smoking in...

Comorbidties and smoking, what can we do about them?

The elephant in the room is comorbidities such as hypertension, diabetes, obesity, metabolic syndrome and smoking. How can we get pwMS to take their general health seriously?  In the study below physical comorbidity was not only associated with disability but with each additional comorbidity, there was a mean increase in the EDSS score of 0.18. By optimising your general health you will...

Has NICE got it wrong this time?

As you are probably aware NICE, true to past form, chose the Christmas period to toss a small grenade into the MS space. I assume they thought that by tossing it on Wednesday 20 December when most people were either away, or about to go away, on Christmas holidays the perceived explosion would be smaller than expected and the shrapnel would cause no collateral damage. NICE was wrong. They are...

What is causing the MS pandemic?

Is it not the time to do something about the obesity pandemic? What has obesity got to do with MS?  The latest data from Canada indicates that the prevalence and incidence of MS continues to increase; this is a trend across the world. Importantly, Canada may have just surpassed Scotland as the highest prevalence region of the world. Why is this happening? Why has MS become a pandemic? Is...

Imaging grey matter atrophy to find the roots of disability

How do we measure nerve loss? The imagers tell us it is grey matter loss that holds the key. So what’s new here? About ten years ago I was at a meeting where a very distinguished MRI expert was saying that ‘whole brain volume’ was not a good outcome measure to monitor progression and that grey matter volume was a much more responsive outcome measure. However, we (the neuros...

Fingolimod affects white blood cells, but really targets all B cells

Is Fingolimod really B cell non-selective depletor? Angerer IC, Hecker M, Koczan D, Roch L, Friess J, Rüge A, Fitzner B, Boxberger N, Schröder I, Flechtner K, Thiesen HJ, Winkelmann A, Meister S, Zettl UK. Transcriptome profiling of peripheral blood immune cell populations in multiple sclerosis patients before and during treatment with a sphingosine-1-phosphate receptor modulator. CNS Neurosci...

Is HSCT for everyone, or not?

The HSCT zealots would want you to believe that HSCT is the solution to MS and that we the neurologists are preventing you from accessing this curative treatment. Are they correct? Or do we need evidence from randomised trials? I saw a patient for a third opinion late last year. She was in her mid-20s and had just failed alemtuzumab with a severe spinal cord relapse 19 months into her 2-year...

Circadian rhythm the subconscious mystery

What have clock genes got to do with MS? PLoS One. 2018 Jan 11;13(1):e0190601. doi: 10.1371/journal.pone.0190601. eCollection 2018. Association of circadian rhythm genes ARNTL/BMAL1 and CLOCK with multiple sclerosis. Lavtar P1, Rudolf G1, Maver A1, Hodžić A1, Starčević Čizmarević N2, Živković M3, Šega Jazbec S4, Klemenc Ketiš Z5,6, Kapović M2, Dinčić E7, Raičević R7, Sepčić J8, Lovrečić L1...

Imaging Demyelination, but am I being a bit thick?

A new report suggests that there is a new imaging agent for demyelination. If we can image demyelination, remyelination trials get a whole lot easier. However you asked, Has this study in animals cracked the nut? Updated Brugarolas P, Sánchez-Rodríguez JE, Tsai HM, Basuli F, Cheng SH, Zhang X, Caprariello AV, Lacroix JJ, Freifelder R, Murali D, DeJesus O, Miller RH, Swenson RE, Chen CT...

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