Just recently I had my annual appointment with the MS consultant. He said it could only last 15 minutes. He did apologise for such a brief slot. Even so I couldn’t help but feel short changed. I could only discuss my 3 worst symptoms. Here is my own version of events at the MS review. He started “Has it got worse”? I thought to myself “This is a bit of a stupid question to ask anybody with...
Not All Data is Created Equal. Brain Atrophy
ProfG has put an interesting question about whether DMT are all born equal. Whilst the influence on relapse rates is much clearer in terms of the hierarchy, the effects on brain atrophy has led ProfG to ask a sensible question. It was suggested that HSCT and alemtuzumab are up there at the top of the pile in the atrophy states, leaving the B cell therapies in their wake. B cell therapies are...
MS in a snapshot: Global Burden of Disease study 2016
Trying to understand disease, especially rare disorders, at a global level is a Herculean task; not only from a resources perspective, but also from the cost and logistics involved. Before, the Global Burden of Disease study presented here, there was the Multiple Sclerosis International Federation that provided up to date figures on the global epidemiology of MS back in 2008. So, almost a decade...
Blood cells clearing up the myelin damage..
Zhou T, Zheng Y, Sun L, Badea SR, Jin Y, Liu Y, Rolfe AJ, Sun H, Wang X, Cheng Z, Huang Z, Zhao N, Sun X, Li J, Fan J, Lee C, Megraw TL, Wu W, Wang G, Ren Y. Microvascular endothelial cells engulf myelin debris and promote macrophage recruitment and fibrosis after neural injury. Nat Neurosci. 2019 Jan 21. doi: 10.1038/s41593-018-0324-9. [Epub ahead of print] The clearance of damaged...
Lumbar Puncture Headache…The answer is not age and sex…It’s your needle!
We have been talking about dinosaur neurologists and asking can they learn and change pratice? Prof G and DrRuth will be tearing their hair out with dispare on reading this. It will be disappointing that we are not listening and learning. Post-lumbar puncture headache: an adverse effect in multiple sclerosis work-up. Vecchio D, Naldi P, Ferro V, Comi C, Leone MA, Cantello R.Neurol Sci...
Think Hand but now see it
We have been talking about saving hand function, but can we get an understanding of why hand function. The imagers have been looking and they BACKGROUND:: Hand motor impairment has considerable effects on daily-life activities of patients with multiple sclerosis (pwMS). Understanding its anatomo-functional substrates is relevant to provide more specific therapeutic interventions...
Calculate your risk of developing MS from first presentation
We now understand that the early features of the condition matter; the more active the disease in the first five years the more likely you are to reaching the hard disability milestones (such as requiring a walking stick) that much sooner, than if the converse were true. But what about the development of MS (or CDMS, clinically definite MS) after the first clinical symptom (CIS, clinically...
Slowing conversion to SPMS, why we need Neurological Chicxulub for MS
Association of Initial Disease-Modifying Therapy With Later Conversion to Secondary Progressive Multiple Sclerosis. Brown JWL, Coles A, Horakova D, Havrdova E, Izquierdo G, Prat A, Girard M, Duquette P, Trojano M, Lugaresi A, Bergamaschi R, Grammond P, Alroughani R, Hupperts R, McCombe P, Van Pesch V, Sola P, Ferraro D, Grand’Maison F, Terzi M, Lechner-Scott J, Flechter S, Slee M...
MSexism 4: The gender pay gap
The gender pay gap is alive and thriving in neurology. That’s not only bad for women MS experts, but for all of us with the disease. One of my best moments of 2018 came at the end of a Thursday afternoon at the ECTRIMS October conference when dozens of women MS clinicians and scientists crowded into a room – and launched the International Women in Multiple Sclerosis group. Their aim is to...
HSCT is highly Effective
In this study the results of a randomisation non-ablative HSCT stem cell therapy compared to current DMT and it does better. Much better This is not surprising we know that immune depleteion is effective. Effect of Nonmyeloablative Hematopoietic Stem Cell Transplantation vs Continued Disease-Modifying Therapy on Disease Progression in Patients With Relapsing-Remitting Multiple Sclerosis A...