Posts tagged MS

ScienceDaily (July 2, 2012) — Botulinum toxin may help prevent shaking or tremor in the arms and hands of people with multiple sclerosis (MS), according to new research published in the July 3, 2012, print issue of Neurology®, the medical journal of the American Academy of Neurology.

"Treatments in use for tremor in MS are not sufficiently effective and new alternatives are needed," said study author Anneke van der Walt, MD, consultant neurologist at The Royal Melbourne Hospital and research fellow with the University of Melbourne in Australia.

For the study 23 people with MS were given botulinum toxin type A injections or a saline placebo for three months. Then they received the opposite treatment for the next three months. Scientists measured the tremor severity and their ability to write and draw before, during and after receiving the treatments. Video assessments were also taken every six weeks for six months.

The study found that people saw significant improvement in tremor severity, writing and drawing at six weeks and three months after the botulinum toxin treatment compared to after placebo. In tremor severity, the participants improved an average of two points on a 10-point scale, bringing their tremor from moderate to mild. In writing and drawing, participants improved by an average of one point on a 10-point scale.

"Our study suggests a new way to approach arm tremor related to MS where there are currently major treatment challenges and it also sets the framework for larger studies," said van der Walt.

Muscle weakness developed in 42 percent of people after treatment with botulinum toxin compared to six percent after placebo. The weakness was generally mild and went away within two weeks.

Source: Science Daily

ScienceDaily (June 28, 2012) — Mayo Clinic researchers have successfully used smaller, folded DNA molecules to stimulate regeneration and repair of nerve coatings in mice that mimic multiple sclerosis (MS). They say the finding, published June 28 in the journal PLoS ONE, suggests new possible therapies for MS patients.

Laboratory mouse. (Credit: iStockphoto)

"The problem has been to find a way to encourage the nervous system to regenerate its own myelin (the coating on the nerves) so nerve cells can recover from an MS attack," says L. James Maher III, Ph.D., Mayo Clinic biochemist and senior author on the paper. "We show here that these small molecules, called aptamers, can stimulate repair in the mice we are studying."

More than 200,000 people have multiple sclerosis. There is no cure and no effective therapy to stop progression or repair damage to the myelin sheath that surrounds and protects the nerves. Without that protection, nerve fibers will be damaged, leading to declining mobility and cognitive function, and other debilitating complications.

MS researchers, including Mayo neurologist Moses Rodriguez, M.D., a co-author on this paper, have focused on monoclonal antibodies in mice to stimulate myelin repair. The Rodriguez and Maher teams, working together, have determined that the aptamers are not only effective, but they are easy and cheap to synthesize — an important point for drug developers. They also are stable and not likely to cause an immune response. This new approach must be validated in other mouse models to see if it might be a candidate for human clinical trials.

The monoclonal antibodies used in earlier research are large and complex, but were shown to promote both cell signaling and remyelination of central nervous system lesions in mice. The aptamers used in this study are less than one-tenth the size of antibodies and are single-strands of DNA containing only 40 nucleotide units.

Source: Science Daily

June 15, 2012

The first large non-commercial study to investigate whether the main active constituent of cannabis (tetrahydrocannabinol or THC) is effective in slowing the course of progressive multiple sclerosis (MS) shows that there is no evidence to suggest this; although benefits were noted for those at the lower end of the disability scale.

The CUPID (Cannabinoid Use in Progressive Inflammatory brain Disease) study was carried out by researchers from the Peninsula College of Medicine and Dentistry (PCMD), Plymouth University. The study was funded by the Medical Research Council (MRC) and managed by the National Institute for Health Research (NIHR) on behalf of the MRC-NIHR partnership, the Multiple Sclerosis Society and the Multiple Sclerosis Trust.

The preliminary results of CUPID are to be presented by lead researcher Professor John Zajicek at the Association of British Neurologists’ Annual Meeting in Brighton on Tuesday 29th May.

CUPID enrolled nearly 500 people with MS from 27 centres around the UK, and has taken eight years to complete. People with progressive MS were randomised to receive either THC capsules or identical placebo capsules for three years, and were carefully followed to see how their MS changed over this period. The two main outcomes of the trial were a disability scale administered by neurologists (the Expanded Disability Status Scale), and a patient report scale of the impact of MS on people with the condition (the Multiple Sclerosis Impact Scale 29).

Overall the study found no evidence to support an effect of THC on MS progression in either of the main outcomes. However, there was some evidence to suggest a beneficial effect in participants who were at the lower end of the disability scale at the time of enrolment but, as the benefit was only found in a small group of people rather than the whole population, further studies will be needed to assess the robustness of this finding. One of the other findings of the trial was that MS in the study population as a whole progressed slowly, more slowly than expected. This makes it more challenging to find a treatment effect when the aim of the treatment is that of slow progression.

As well as evaluating the potential neuroprotective effects and safety of THC over the long-term, one of the aims of the CUPID study was to improve the way that clinical trial research is done by exploring newer methods of measuring MS and using the latest statistical methods to make the most of every piece of information collected. This analysis will continue for several months. The CUPID study will therefore provide important information about conducting further large scale clinical trials in MS.

Professor John Zajicek, Professor of Clinical Neuroscience at PCMD, Plymouth University, said: “To put this study into context: current treatments for MS are limited, either being targeted at the immune system in the early stages of the disease or aimed at easing specific symptoms such as muscle spasms, fatigue or bladder problems. At present there is no treatment available to slow MS when it becomes progressive. Progression of MS is thought to be due to death of nerve cells, and researchers around the world are desperately searching for treatments that may be ‘neuroprotective’. Laboratory experiments have suggested that certain cannabis derivatives may be neuroprotective.”

He added: “Overall our research has not supported laboratory based findings and shown that, although there is a suggestion of benefit to those at the lower end of the disability scale when they joined CUPID, there is little evidence to suggest that THC has a long term impact on the slowing of progressive MS.”

Dr Doug Brown, Head of Biomedical Research at the MS Society, said: “There are currently no treatments for people with progressive MS to slow or stop the worsening of disability. The MS Society is committed to supporting research in this area and this was an important study for us to fund. While this study sadly suggests THC is ineffective at slowing the course of progressive MS, we will not stop our search for effective treatments. We are encouraged by the possibility shown by this study that THC may have potential benefits for some people with MS and we welcome further investigation in this area.”

Provided by The Peninsula College of Medicine and Dentistry

Source: medicalxpress.com

June 13, 2012

(HealthDay) — Women with multiple sclerosis (MS) who undergo in vitro fertilization (IVF) are at greater risk of relapse after treatment, particularly if they receive gonadotrophin releasing hormone (GnRH) agonists or if IVF fails, according to a study published online June 11 in the Journal of Neurology, Neurosurgery & Psychiatry.

Women with multiple sclerosis who undergo in vitro fertilization (IVF) are at greater risk of relapse after treatment, particularly if they receive gonadotrophin releasing hormone agonists or if IVF fails, according to a study published online June 11 in the Journal of Neurology, Neurosurgery & Psychiatry.

Noting that pregnancy and treatment with sex steroids can affect the relapse rate in patients with MS, Laure Michel, M.D., from Hôpital Laennec in Nantes, France, and colleagues analyzed data from 32 women with MS who had undergone 70 IVF treatments during an 11-year study period: 48 with GnRH agonists and 19 with GnRH antagonists.

The researchers found that there were significantly more relapses in the three months after IVF (annualized relapse rate [ARR], 1.60), compared with one year before (ARR, 0.68) or three months before (ARR, 0.80). The increase in relapses was significantly associated with GnRH agonist use (P = 0.025) and failed IVF (P = 0.019).

"MS patients should be aware of a possible increased risk of MS relapse after IVF, particularly if the procedure does not result in a pregnancy," Michel and colleagues conclude. "Furthermore, because there is a reasonable doubt that GnRH agonists may make patients more prone to such an increase in relapse rate, GnRH antagonists might be preferred for IVF protocols.”

Source: medicalxpress.com

March 13, 2012

Warm weather may hinder cognitive performance in people with multiple sclerosis (MS), according to results of a Kessler Foundation study e-published online ahead of print by Neurology. An accompanying editorial by Meier & Christodoulou, MS and heat: The smoke and the fire, details the study’s unique aspects, ie, longitudinal followup in a cohort with apparently quiescent disease.

Victoria M. Leavitt, Ph.D., research scientist at Kessler Foundation, is principal investigator for the study, which for the first time, shows a link between warm weather and cognition in people with MS. With more research, this information might help guide people with MS in making life decisions and assist their clinicians in choosing clinical treatment. Scientists may also want to consider the effect of warmer weather on cognition when designing and conducting clinical trials.

Kessler Foundation co-investigators are James F. Sumowski, Ph.D., Research Scientist, Nancy Chiaravalloti, Ph.D., Director of Neuropsychology & Neuroscience Research, and John DeLuca, Ph.D., Vice President for Research. All also have faculty appointments at UMDNJ-New Jersey Medical School.

Memory and processing speed were measured in 40 individuals with MS and 40 healthy people without MS. The study was conducted throughout the calendar year, and the daily temperature at the time of testing was recorded. The results showed that people with MS scored 70 percent higher on the tests on cooler days. There was no connection between daily temperature and cognitive performance for individuals without MS.

To confirm the effect of outdoor temperature, the group examined a separate sample of 45 persons with MS for whom cognitive tests were given at two sessions separated by a 6-month interval. For each person, cognitive performance was worse for testing during the warmer temperature. This finding is particularly important for researchers planning clinical trials with cognitive outcomes, especially since such trials frequently span a 6-month period. If baseline measurements of cognitive function are taken during warm months, the effect of the treatment may be inflated by the temperature effect. Cognitive performance may be a more sensitive indicator of subclinical disease activity than traditional assessments based on sensorimotor or EDSS (Expanded Disability Status score).

Provided by Kessler Foundation

Source: medicalxpress.com