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  • Do we know how long would it take for somatic mutations happen for returning B-cells? Does any antigen presenting process speed up this process? Is it possible to intervne this process?

  • Hello. Just read about prophylactic vaccine Evusheld against Covid which UK government has approved for severely immunosuppressed.

    Spoke to my MS nurse today but they hadn’t heard of it. I have no detectable antibody response after 4 Covid vaccines so am interested in a vaccine which helps immunosuppressed (am on ocrevus infusions)

    Does anyone know when it might be available and if it’s safe for MS patients?

    • I’m in the US but my neuro here says I’m not a candidate for Evusheld. I’m on Fingolimod – negative for antibodies after three vaccines.

    • I got Evusheld last Friday and have finished week 1 year 1 of Mavenclad. Was coming off of Ocrevus and had not had B cells for seroconverting from vaccine (3 full doses). Felt tired the day after Evusheld and now feel like my normal self. In the US the FDA recommended doubling the initial dose in order to be more effective against Omicron. You get a shot in each butt cheek and hang around for an hour to be sure there is no reaction.

  • What do you think about the possible effect of ursolic acid(-supplements) on remyelination (e.g. Zhang et al, A dual effect of ursolic acid to the treatment of multiple sclerosis through both immunomodulation and direct remyelination, PNAS 2020, April)?

  • Hi I have a weird/awkward question,
    I have lesions on my cervical spine, sometimes after having sex, my whole body could become paralyzed, then slowly recover in 1 hour or so. Sometimes its just my arms. This happened 3 times this month.

    My neuro said its fine and didnt even get me to do MRI but I’m quite concerned.

    Should I push for an MRI? Is this normal?

    Thank you!

    • Seems like a typical heat/exertion-triggered pseudo-exacerbation. This is exactly the kind of symptom that Fampyra can resolve, so you should ask your neurologist about it (insist actually, don’t just ask). And shame on him for dismissing your concerns, sexual function is a huge part of quality of life and needs to be taken seriously by MS clinics.

  • MD – I pay way too much attention to symptom triggers but feel like i have identified a couple over the last 2 years since my diagnosis.

    The first is working under a bright light. My office has poor natural light and the lights we do have are about 25 years old at least, probably more. If i dont work next to a window, my sensory symptoms go into overdrive. Is this me overthinking things or have you come across this phenomenon? i recall reading a paper about bank tellers in Israel or somewhere working in a room with no natural light where an abnormal number went on to develop MS.

    2nd one is coffee. After caffeine, my body wide twitches definitely ramp up. Is this damaging? i feel like perhaps i have just become more sensitive to the caffeine boost?


  • I’m all the studies on ALA and brain atrophy in MS. Have Neurofiliment light chain levels ever been tested in participants in these studies?

    The only biomarker seams MRI based

  • Oligodendrocytes

    Besides produding myelin what else can they do?

    Feeding neurons (axon part)

    Really did not know this

    Oligodendrocytes enhance axonal energy metabolism by deacetylation of mitochondrial proteins through transcellular delivery of SIRT2


    Now its simple to imagine when they get wasted ,neurons will starve a bit

  • Greetings

    Would you consider a ‘slightly more prominent’ t spine lesion (with new symptoms requiring steroids) evidence of inflammatory disease activity and a relapse for purpose of breakthrough disease on a dmt?

    Thanks 😊

    • I am not a neuro so I dont have to make such calls….do you want to switch?. This is where monitoring neurofilament levels can help is there a jump in the levels suggesting new damage, remeber in the brain there are many more lesional events than clinical events

  • Does research on long Covid symptom of brain fog potentially benefit pwms?? Long Covid cognitive changes such as slow processing speed are found by study to be related to a higher median CSF levels of C-reactive protein and serum amyloid A, as well as, higher activation markers interferon-gamma-inducible protein, interleukin (IL)-8), and immunovascular markers vascular endothelial growth factor-C, and VEGFR-1. https://www.medpagetoday.com/meetingcoverage/aan/98034 Is it possible such research leads to a breakthrough on identifying cognitive problems with CFS for pwms?!? Lab work to prove cognition issues! Wow that would be very big deal to pwms seeking understanding, help or disability support because of cognitive issues. !!!

  • There were studies which suggest quicker repopulation on Ocrevus for people with higher BMI.
    I always imagine overweight people, but what if someone has higher BMI because of muscles (e.g. bodybuilder).
    Do you think that it does not matter which factor produces higher BMI (fat, muscles) it will have the same effect on repopulation?
    Thank you.

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