I looked at the attack ms trial… sounds great in theory, however I had optic neuritis in 2013, had lumbar puncture, no one ever checked the results. Had numbing in face in 2018 and following mri got diagnosis.
My point being, how many patients are diagnosed within 2 weeks of onset? Or will they just assume it is and treat as if it is?
Yes the idea is to start treatment during the diagnositc work up, if you have MS you are on treatment to stop that next attack to allow you the space to continue treatment with natalizumab or chose something else, if you don’t have MS you stop treatment drug disappears and there are essentially no-consequences as it only blocks white cell trafficking into a few sites
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) and in result it will have the same effect on repopulation?
Thank you.
You are correct that BMI can be used as a predictor of body volume, which is the issue here but as you say, if you are muscular then there will be a poor correlation.
I would like to hear more about Primary progressive MS. I have had it since I am 65 and I am battling to stay out the wheelchair and having care givers
ProfK/MD… Apologies I am pasting this the third (and definitely last) time (was an accidental double post earlier). Could you please confirm how long the average new lesion would be visible for on an MRI scan with contrast? E.g. if Joe Blogs had a relapse on 1/1/2022 then would an MRI with contrast on 1/5/2022 be unlikely to capture the enhancement of said lesion? Do you think the size of the lesion could have an impact on this as well?
Is there any data source showing excess deaths of pwms over past 2 years??? I desperately want concrete up to date data to reevaluate my risk of death from Covid to justify keeping up with my self isolation purgatory. Excess deaths tracked by a Rice University researcher shows significant excess deaths have continued in recent months. https://mfl.rice.edu/covid-19-excess-mortality-data-visualization (click green link and select state) and Houston Covid wastewater testing shows pattern of virus waves in Houston, which is so incredibly disparate from the public consensus of risk level. https://covidwwtp.spatialstudieslab.org/
Covid vaccine isn’t live, People with MS are best off to get jab, and antiviral should be given ASAP to people with MS on DMT because they are at severe risk of disease, and if pwms is Covid positive, steroids are generally counter indicated, correct??? .??!!, I can’t fully articulate the high level Ambivalence to me or to other pwms immune status here where I live. misinformation is all around me every day. Everything I do to protect my health is based on my own initiative. MS Society, Neurologists Groups, please do something!!! https://nypost.com/2022/01/28/california-mom-with-ms-dies-of-covid-19-after-being-denied-vaccine-lawsuit/
I’ve recently been diagnosed with a shoulder bone spur and mild inflammation. Was prescribed paracemtol which I cannot take due to taking Aubagio. Haven’t been able to consult my neuro about this but what NSAIDs can I take?
And now for something completely different.
I have always had cats in my life and would really love to have them again. However, I am taking Fingolimod since 2015 and am toxoplasmosis negative. My question is if it is a bad or very bad idea to consider getting kittens i.e. how high is the risk of catching toxoplasmosis? And would it be lethal?
This highly depends on whether you’re lymphocyte count is low or not and the quantity of parasitic load that you’re exposed to.
This is what is known by the CDC:
Kittens and cats can shed millions of oocysts in their faeces for as long as 3 weeks after infection. Mature cats are less likely to shed Toxoplasma if they have been previously infected. A Toxoplasma-infected cat that is shedding the parasite in its faeces contaminates the litter box. If the cat is allowed outside, it can contaminate the soil or water in the environment as well.
People can be infected by:-
-Accidental ingestion of oocysts after cleaning a cat’s litter box when the cat has shed Toxoplasma in its faeces
-Accidental ingestion of oocysts after touching or ingesting anything that has come into contact with a cat’s faeces that contain Toxoplasma
-Accidental ingestion of oocysts in contaminated soil (e.g., not washing hands after gardening or eating unwashed fruits or vegetables from a garden)
-Drinking water contaminated with the Toxoplasma parasite
mice running on a wheel for 30 days had a 40% increase in dopamine release in the dorsal stratium, the part of the brain involved in movement, compared to levels in mice that did not exercise. The runners also showed a nearly 60% increase in BDNF levels compared to their non-running counterparts. Notably, the increase in dopamine release remained elevated even after a week of rest. Additionally, when BDNF levels were artificially reduced, running did not lead to additional dopamine release.
Luck or T cell protection ? I postponed Ocrevus infusion to get 4 th Pfizer Covid vaccine (3 primary + 1 immune compromised booster) 2nd week of April ( not 1st because no one would give it to me) , I then had my antibodies tested 2 weeks later via clinical study (because cdc doesn’t allow personal dr to order antibody testing for MS immune compromised) and learned I still have zero antibodies. Nevertheless , for sake of joy, I flew to a super spreader wedding with only my n95 protecting me from oblivious Typhoid Mary types in airports, shuttles, and on the dance floor. I removed mask at indoor reception in exchange for speaking unhindered with loved ones, sip champagne, eat and dance. Mostly everyone got Covid several days later, including my husband. But I didn’t. So much stress and anxiety to attend a family wedding. But so Thankful to be well. Did T cells help?
Probably but thanks for your story and the history lesson …..Mary Mallon, commonly known as Typhoid Mary, was an Irish-born American cook believed to have infected between 51 to 122 people with typhoid fever.
Wow, Intriguing article of a budding new science! Seems future studies could gather useful voluntary data from small scale communities such as college dormitories, conventions, or military bases.
Once again, Thanks To all of who keep this forum going. It has helped me stay informed and healthy.
These findings were in line with histological observations supporting a pivotal role for microglia and a marginal role for T cells in both retinal and cortical pathology in MS
The upshot: Learning to drum appeared to reduce hyperactive behavior and improve teens’ ability to focus and pay attention, she said. The activity also seemed to enhance communication “between brain regions responsible for inhibitory control, action-outcome monitoring, and self-regulation.”
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Hi Mouse Dr,
What trial would you like to see in the near future for the treatment of MS?
Attack MS… It’s ready to go can’t get much near future than that.
Cambridge started a Metformin trial in Marc-Feb
I looked at the attack ms trial… sounds great in theory, however I had optic neuritis in 2013, had lumbar puncture, no one ever checked the results. Had numbing in face in 2018 and following mri got diagnosis.
My point being, how many patients are diagnosed within 2 weeks of onset? Or will they just assume it is and treat as if it is?
Yes the idea is to start treatment during the diagnositc work up, if you have MS you are on treatment to stop that next attack to allow you the space to continue treatment with natalizumab or chose something else, if you don’t have MS you stop treatment drug disappears and there are essentially no-consequences as it only blocks white cell trafficking into a few sites
How to stay free of disease activity and progression following year 4 of Mavenclad?
«Wait and Watch» is by definition not a strategy for this, seeing how Mavenclad does not cure MS…
Please provide proof of your claim that Cladribine does not work. No one every said Clad was a “cure” for MS; however it is an effective drug.
Never said it didn’t work, nor that it isn’t effective. Just said it is not a cure (as proved by multiple studies).
I believe they tracked people down from oracle study reported 2010 and they are not on treatment. Ps I haven’t seen the data
Is it different to alemtuzumab etc….I don’t think the watch and wait approach is favoured by some, better to treat again and collect the cash.
Well we need studies for this. Neuros hesitate to do anything if it is not backed by studies.
Why is not Merck studying this?
What are the differences between the HSCT regimens they use in Mexico vs UK?
Profit will be the main one.
You can go to Mexico and pay with money or you can try to access it through the NHS and pay with brain and spinal cord 🙁
About £30,000 :-).
In Mexico there is post treatment rituximab
What benefit in terms of symptom management to sodium channel blockers potentially offer?
Anti pain, anti epilepsy etc
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) and in result it will have the same effect on repopulation?
Thank you.
You are correct that BMI can be used as a predictor of body volume, which is the issue here but as you say, if you are muscular then there will be a poor correlation.
How do you think valproic acid would compare as a neuroprotective to some of the other sodium channel blockers?
I would like to hear more about Primary progressive MS. I have had it since I am 65 and I am battling to stay out the wheelchair and having care givers
ProfK/MD… Apologies I am pasting this the third (and definitely last) time (was an accidental double post earlier). Could you please confirm how long the average new lesion would be visible for on an MRI scan with contrast? E.g. if Joe Blogs had a relapse on 1/1/2022 then would an MRI with contrast on 1/5/2022 be unlikely to capture the enhancement of said lesion? Do you think the size of the lesion could have an impact on this as well?
B-cell-depleting Therapies May Increase Risk of Psoriasis
https://multiplesclerosisnewstoday.com/news-posts/2022/05/06/disproportional-increase-in-psoriasis-reports-in-association-with-b-cell-depleting-therapies-in-patients-with-multiple-sclerosis/?utm_source=MS&utm_campaign=e4f9df1127-RSS_EMAIL_CAMPAIGN&utm_medium=email&utm_term=0_b5fb7a3dae-e4f9df1127-71699829&cn-reloaded=1
Walking
Study finds that the brain searches for the best way to move the body
https://medicalxpress.com/news/2022-05-brain-body.html
Is there any data source showing excess deaths of pwms over past 2 years??? I desperately want concrete up to date data to reevaluate my risk of death from Covid to justify keeping up with my self isolation purgatory. Excess deaths tracked by a Rice University researcher shows significant excess deaths have continued in recent months. https://mfl.rice.edu/covid-19-excess-mortality-data-visualization (click green link and select state) and Houston Covid wastewater testing shows pattern of virus waves in Houston, which is so incredibly disparate from the public consensus of risk level. https://covidwwtp.spatialstudieslab.org/
Covid vaccine isn’t live, People with MS are best off to get jab, and antiviral should be given ASAP to people with MS on DMT because they are at severe risk of disease, and if pwms is Covid positive, steroids are generally counter indicated, correct??? .??!!, I can’t fully articulate the high level Ambivalence to me or to other pwms immune status here where I live. misinformation is all around me every day. Everything I do to protect my health is based on my own initiative. MS Society, Neurologists Groups, please do something!!! https://nypost.com/2022/01/28/california-mom-with-ms-dies-of-covid-19-after-being-denied-vaccine-lawsuit/
Low cost pharma
https://youtu.be/qw2nx-I-jAA
Listen to Doc Mouse he has been saing this for a lonnnnng time
Multiple sclerosis patients with higher B cell counts found to have a better vaccine response
https://medicalxpress.com/news/2022-05-multiple-sclerosis-patients-higher-cell.html
I’ve recently been diagnosed with a shoulder bone spur and mild inflammation. Was prescribed paracemtol which I cannot take due to taking Aubagio. Haven’t been able to consult my neuro about this but what NSAIDs can I take?
No restrictions for NSAIDs, e.g. ibuprofen
Similarities and differences of human and rodent neocortical synapses, neurons and networks
Well i think its the first i see this
Nk cells in the brain
Single-cell profiling reveals periventricular CD56bright NK cell accumulation in multiple sclerosis
https://elifesciences.org/articles/73849
And now for something completely different.
I have always had cats in my life and would really love to have them again. However, I am taking Fingolimod since 2015 and am toxoplasmosis negative. My question is if it is a bad or very bad idea to consider getting kittens i.e. how high is the risk of catching toxoplasmosis? And would it be lethal?
This highly depends on whether you’re lymphocyte count is low or not and the quantity of parasitic load that you’re exposed to.
This is what is known by the CDC:
Kittens and cats can shed millions of oocysts in their faeces for as long as 3 weeks after infection. Mature cats are less likely to shed Toxoplasma if they have been previously infected. A Toxoplasma-infected cat that is shedding the parasite in its faeces contaminates the litter box. If the cat is allowed outside, it can contaminate the soil or water in the environment as well.
People can be infected by:-
-Accidental ingestion of oocysts after cleaning a cat’s litter box when the cat has shed Toxoplasma in its faeces
-Accidental ingestion of oocysts after touching or ingesting anything that has come into contact with a cat’s faeces that contain Toxoplasma
-Accidental ingestion of oocysts in contaminated soil (e.g., not washing hands after gardening or eating unwashed fruits or vegetables from a garden)
-Drinking water contaminated with the Toxoplasma parasite
Association of Brain Atrophy With Disease Progression Independent of Relapse Activity in Patients With Relapsing Multiple Sclerosis
https://jamanetwork.com/journals/jamaneurology/fullarticle/2792415?guestAccessKey=28c67026-8692-43b3-b6e8-b803e7243c95&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamaneurology&utm_content=olf&utm_term=051622
Move
🙂
mice running on a wheel for 30 days had a 40% increase in dopamine release in the dorsal stratium, the part of the brain involved in movement, compared to levels in mice that did not exercise. The runners also showed a nearly 60% increase in BDNF levels compared to their non-running counterparts. Notably, the increase in dopamine release remained elevated even after a week of rest. Additionally, when BDNF levels were artificially reduced, running did not lead to additional dopamine release.
https://medicalxpress.com/news/2022-05-boost-nerve-growth-protein-brain-health.html
Just read this – https://www.theguardian.com/film/2022/may/16/selma-blair-on-living-with-ms-multiple-sclerosis
It’s probably a story that many of us can relate to in some form or another.
Thanks for link Ian – I’ve shared with family and friends
Cns and rheumatoid arthritis
https://medicalxpress.com/news/2022-05-atp-sensory-neuron-interneuron-crosstalk-key.html
Study in mice suggests that COVID-19 increases risk of developing Parkinson’s disease
https://medicalxpress.com/news/2022-05-mice-covid-parkinson-disease.html
T cell biology
Killer T vs. memory: DNA isn’t destiny for T cells
https://medicalxpress.com/news/2022-05-killer-memory-dna-isnt-destiny.html
Luck or T cell protection ? I postponed Ocrevus infusion to get 4 th Pfizer Covid vaccine (3 primary + 1 immune compromised booster) 2nd week of April ( not 1st because no one would give it to me) , I then had my antibodies tested 2 weeks later via clinical study (because cdc doesn’t allow personal dr to order antibody testing for MS immune compromised) and learned I still have zero antibodies. Nevertheless , for sake of joy, I flew to a super spreader wedding with only my n95 protecting me from oblivious Typhoid Mary types in airports, shuttles, and on the dance floor. I removed mask at indoor reception in exchange for speaking unhindered with loved ones, sip champagne, eat and dance. Mostly everyone got Covid several days later, including my husband. But I didn’t. So much stress and anxiety to attend a family wedding. But so Thankful to be well. Did T cells help?
Probably but thanks for your story and the history lesson …..Mary Mallon, commonly known as Typhoid Mary, was an Irish-born American cook believed to have infected between 51 to 122 people with typhoid fever.
Remember 80 % of infection are done by 20% of the positive cases
This is also true with other viruses
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7674790/
Wow, Intriguing article of a budding new science! Seems future studies could gather useful voluntary data from small scale communities such as college dormitories, conventions, or military bases.
Once again, Thanks To all of who keep this forum going. It has helped me stay informed and healthy.
🙂
Never heard about autoimmunity to type I IFNs
No good if you are old and get covid 19
The risk of COVID-19 death is much greater and age dependent with type I IFN autoantibodies
https://www.pnas.org/doi/abs/10.1073/pnas.2200413119?af=R
Well you know what to do
Type 2 diabetes accelerates brain aging and cognitive decline
https://medicalxpress.com/news/2022-05-diabetes-brain-aging-cognitive-decline.html
So many people there would be on metformin. Does this bode well for trials?
Guess not
Not covid not ms
Experiment :
Take healthy alpha synuclein put it on a test tube at 34 ,35 celsius stir it up for a week
Injected in a mouse duodenum ,wait a couple of week
The mouse get parkinson disease
Transneuronal Propagation of Pathologic α-Synuclein from the Gut to the Brain Models Parkinson’s Disease
https://www.cell.com/neuron/fulltext/S0896-6273(19)30488-X?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS089662731930488X%3Fshowall%3Dtrue
For all the science nerds
Egg cell development
Pain
Studies indicate that pain and anxiety should be dealt with soon after MS diagnosis
https://medicalxpress.com/news/2022-05-pain-anxiety-dealt-ms-diagnosis.html
Microglia
Today the bad guys
Hyper-Reflecting Foci in Multiple Sclerosis Retina Associate With Macrophage/Microglia-Derived Cytokines in Cerebrospinal Fluid
https://www.frontiersin.org/articles/10.3389/fimmu.2022.852183/full
Doc Mouse will like this bit 🙂
These findings were in line with histological observations supporting a pivotal role for microglia and a marginal role for T cells in both retinal and cortical pathology in MS
This is a good one 🙂
Could beating drums help beat autism?
https://medicalxpress.com/news/2022-06-autism.html
The upshot: Learning to drum appeared to reduce hyperactive behavior and improve teens’ ability to focus and pay attention, she said. The activity also seemed to enhance communication “between brain regions responsible for inhibitory control, action-outcome monitoring, and self-regulation.”
Ps: I teach drums
🙂