AuthorProf G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

Does MS exile you from the everyday of life?

Barts-MS rose-tinted-odometer: ★★★★★ (Sunday or Summer orange #f99f00) Exercise has emerged as a safe, effective, low-cost, non-pharmacological intervention for managing disability experienced by pwMS. Despite the evidence, it is the most under-prescribed and under-utilised disease-modifying therapy we have at our disposal.  Exercise promotes improvements in aerobic capacity, muscular strength...

Mortality: what risk would you be prepared to take?

Barts-MS rose-tinted-odometer: ZERO-★’S (Black Tuesday – a tear for my beloved country #000000) As you are aware by now I am a proponent of flipping the pyramid and using high-efficacy DMTs first-line including immune-reconstitution therapies (IRTs) such as alemtuzumab and AHSCT. I justify the latter two options based on the fact that given sufficient time the vast majority of pwMS will...

Don’t walk and talk

Barts-MS rose-tinted-odometer: zero-★s (Blue Monday; Italian or Azzurri blue  #0A36AF) Have you noticed that you battle with multitasking? As MS progresses and damages the brain people with MS develop cognitive problems and have difficulty multitasking. This is because MS reduces your brain reserve and hence you have to concentrate on doing one task at a time. This is why pwMS have problems in...

Please, please, please #GetVaccinatedASAP

Barts-MS rose-tinted-odometer: ★ (Black & White Friday) As the delta variant of SARS-CoV-2 is surging it is putting residents of Whitechapel at serious risk of getting COVID-19. This is important because the vaccination rate in Whitechapel is so low; less than 30% of adults have both dose of the COVID-19 vaccine. Why is the uptake of vaccines so low in our local community? Vaccine hesitancy...

Clash of the Titans: the HILO study

Barts-MS rose-tinted-odometer: ★★★ (I am seeing blue and Spanish yellow today) Roche blue (#0066CC) & Novartis Spanish Yellow (#F7B516) Yes, I really do think that intrathecal (within the meninges that cover the brain and spinal cord) or CNS resident B-cells and plasma cells are pathogenic in MS. In other words, the cytokine or chemicals B-cells and plasma cells produce, in particular their...

Smouldering MS – not all bad news

Barts-MS rose-tinted-odometer: ★★★★★ (today’s colour is Delta Red Iron Oxide #9b2f1c) One of the smouldering MS dogmas that have entered the MS lexicon is that the iron-rimmed slowly expanding MS lesions (SELs) go on enlarging and destroying or shredding the brain tissue around it forever. Another dogma states these SELs don’t respond to current DMTs. The good news is that both of these...

73 tomorrow – some achievement

Barts-MS rose-tinted-odometer: ★★★★★ (Today’s colours are NHS blue & yellow #005EB8 & #FAE100) Tomorrow the NHS turns 73. If you love the NHS and want to give it and its staff a present please have your COVID-19 vaccine. Barts Health NHS Trust and many other NHS services are running walk-in vaccine centres. 📣Roll-up, roll-up! Or should we say ‘walk-in, walk-in’! 🚶🏽 🚶🏼‍♀️ 🚶🏿‍♀️ 🚶...

To HITT or not to HITT?

Barts-MS rose-tinted-odometer: ★★★★★ (Saturday – a red-hot poker day #f54303) There is little doubt that exercise is good for you and is a form of disease modification. However, there is a big debate about whether high-intensity interval (HIIT) or moderate continuous training (MCT) (aerobic) is best for you. This study below suggests HIIT is best.  Positive changes in cardiorespiratory...

Hey doc what’s my NFL level?

Barts-MS rose-tinted-odometer: ★★★★★ (it’s a Red & White Wednesday, as in the flag of St George, #cf2e2e) The reason why rheumatologists are so way ahead of us in treating rheumatoid arthritis (RA) and protecting joints (the RA end-organ) is that they have an inflammatory biomarker that is closely linked to outcome, it is called the C-reactive protein (CRP), which they include as part of...

Laura’s story

Barts-MS rose-tinted-odometer: ★ (a very Black & Red Monday) I received an email from Laura, a young woman with very active MS, who had been on natalizumab (Tysabri) for 7 years and had recently seroconverted to being high-index JCV seropositive. She was put onto natalizumab extended interval dosing (EID), i.e an infusion every 8 weeks, to derisk PML and to reduced the number of infusions she...

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