Spasticity is a condition in which there is an abnormal increase in muscle tone or stiffness of muscle, which might interfere with movement, speech, or be associated with discomfort or pain. Spasticity is usually caused by damage to nerve pathways within the brain or spinal cord that control muscle movement. [definition from NINDS] In MS, spasticity commonly affects the legs, but may also...
Your age matters in MS
Older age at onset is a poor prognostic feature in MS and according to this latest research you’re also less likely to see markers of inflammatory disease activity on brain scans as you get older. Figure 1. A) Age vs. presence of contrast-enhancing lesions (CELs) on baseline MRI. Scans with no contrast administered or missing results are categorized as ‘unknown’. B) Age at baseline vs...
Subtleties between benign and non-benign MS
Benign MS is defined in the literature as MS with an EDSS <3.0 for 10y or longer. Definitions are not perfect, but this one is a poor one. By definition the lack of walking limitation (which is EDSS 4.0) is not an indicator of disease progression in MS. There are other domains to consider, for example cognition, personality changes and fatigue; the invisible symptoms of MS. A shift in...
Does having MS increase your risk of infection?
A reader on my last post had not heard of MS increasing your risk of infections. TOM ANDERSON: Irrespective of DMT use, is this also saying that people with MS have a higher tendency for infection compared to their non-MS counterparts? I never heard that. “Individuals with multiple sclerosis (MS) are vulnerable to all types of infection, because MS itself involves immunodeficiency” Although...
Nutrition and fatigue in MS
We are told to watch what we eat when it comes to health. Nutritional status has fundamental links to a healthy metabolic function, which is responsible for the release of energy for your body. It is therefore not surprising that researchers want to investigate how nutritional status affects MS, in particular fatigue. In a sizable study conducted in France investigators looked at the influence of...
Can infections cause a relapse in MS?
Infections have not only been linked to worsening background MS symptoms (the pseudo-relapse), but also clinical relapses. The evidence behind it is ropy to say the least, comprised of retrospective case analysis and underpowered studies. Investigators in Naples, Italy therefore set about investigating prospectively whether infections in fact increased the risk of relapses in the short-long-term...
Safety of COVID-19 vaccines
It was only a matter of time before someone pooled together all of the publications on COVID-19 vaccine studies in MS. This pooled analysis includes data from 14755 MS patients who had received in total 23088 doses. Anecdotally, the popular press reports a significant risk of autoimmune related side effects from these vaccines. But according to the analysis presented here the proportion...
At what age should you stop MS treatments?
We often talk a lot about starting treatments in MS, but what about stopping them? Your age or to be more specific old age sits as the main consideration for stopping most treatments as a whole, particularly when there is no benefit to be had from the treatment or the risk of a serious side effect outweighs the benefit gained. One way to side step this issue is to use induction treatments...
Fampridine improves walking but not gait quality
In my mind there is no question that Fampridine improves walking speed in MS. It may not be long-lasting but works for that limited period that you want it to work. Fampridine works as a potassium channel blocker, increasing electrical propagation along axons leading to increased neurotransmitter release at neuromuscular junctions (NMJ) and improved walking. Here in small group of participants...
To acupuncture or not?
I know a lot of you have looked into acupuncture as another means of pain and spasticity control in MS. Let’s just say that the evidence out there is ropy, and this is the latest iteration of such research. Recruitment of a sufficient number of patients and the patients’ willingness to be randomizedare important indices of study feasibility. Unfortunately, alternative medicine trials tend...