ArchiveApril 2019

Fatigue in MS – what we don’t know?

Fatigue in MS is a strange duck, on many levels obvious and frequently described by PwMS (80-90%), but one that lacks sound medical explanation and science doesn’t even know how to test it yet. I was sure that the fatigue in MS, particularly exercise induced fatigue, was somehow related to the conduction block caused by the demyelination in the long tracts (corticospinal tract). It would...

Exercise, exercise, exercise ….

If you live in London it is impossible not to have gotten caught up in London-Marathon fever over the weekend. Eliud Kipchoge won the London marathon in the second fastest recorded time  (two hours two minutes 38 seconds). Interestingly, Kipchoge wears an electric blue band on his wrist, where four simple words are written: “No human is limited”. He has obviously not met someone with...

More evidence that myelin basic protein is unlikely to be a major target in MS.

Brain Citrullination Patterns and T Cell Reactivity of Cerebrospinal Fluid-Derived CD4+ T Cells in Multiple Sclerosis.Faigle W, Cruciani C, Wolski W, Roschitzki B, Puthenparampil M, Tomas-Ojer P, Sellés-Moreno C, Zeis T, Jelcic I, Schaeren-Wiemers N, Sospedra M, Martin R.Front Immunol. 2019 Apr 10;10:540 “Immune responses to citrullinated (or deimination is the conversion of the...

Extinction-Rebellion

If you live in London you may have had your life interrupted over the last two weeks by the Extinction Rebellion protests. This is a serious environmental movement that wants us to act now to save the planet from environmental catastrophe. As part of the protest, my daughters have been giving me a hard time about my carbon footprint. They want to know if I am offsetting my air miles, which I do...

You thought bassoon was a musical instrument. So did I. Let’s learn together and ask are we doing the right thing

Bassoon proteinopathy drives neurodegeneration in multiple sclerosis. Schattling B, Engler JB, Volkmann C, Rothammer N, Woo MS, Petersen M, Winkler I, Kaufmann M, Rosenkranz SC, Fejtova A, Thomas U, Bose A, Bauer S, Träger S, Miller KK, Brück W, Duncan KE, Salinas G, Soba P, Gundelfinger ED, Merkler D, Friese MA. Nat Neurosci. 2019 Apr 22. doi: 10.1038/s41593-019-0385-4. [Epub ahead of...

Old age; how is it going to affect me?

Is ageing a disease? It is if you have MS. We have been making the argument for moving our treatment target in MS to focus on old age; i.e. how do we your HCPs get you to old age with enough brain to deal with the ravages of age-related cognitive impairment? Mechanisms of neuronal loss in MS It is clear that your brain and cognitive reserves are what protects you from the ‘normal age-related...

Guest post: Social capital and social prescribing

I was having a chat with a friend a few days ago. He said “I have heard people talking about social capital and social prescribing. I don’t really know what they mean, do you?” “Umm, not too easy”, I said. “I know it’s nothing to do with money, it’s not measurable and it’s all to do with your quality of life”. “Sounds interesting”! He wanted to know more but I could not really help him right then...

Yellow Fever Vaccine Alert

In the past, I have made the claim that vaccinations, including vaccination with live attenuated viruses such as yellow fever, are relatively safe post-IRTs (immune reconstitution therapies) such as alemtuzumab, cladribine and HSCT. I even have two Alemtuzumabers on my books who have both had yellow fever vaccines before travelling to Ecuador and the Galapagos Islands. who I frequently mention in...

Guest post: Part three of choosing a DMT: Understanding risk

DMTs carry a much higher degree of risk than nothing at all and the reality of MS means that attitudes towards risk need adjusting. It is fine to come into the scenario assessing things in a pre-diagnosis manner, that is understandable. A patient needs educating about the whole post-diagnosis scenario now. The lens through which risk, regarding treatments, has changed. From the risks of opting...

Reminder: your chance to influence preventive research!

Here is a reminder to book your place on next week’s preventive neurology discussion: your chance to influence the direction of research taken by the Preventive Neurology group. Here are the details if you missed the last post: The Preventive Neurology Unit are hosting an afternoon of informal conversations on the 30th April with people who have a particular interest in MS, Parkinson’s...

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