Researchers Reverse Aspects of Aging to Increase Myelin Repair in Rats

Researchers Reverse Aspects of Aging to Increase Myelin Repair in Rats

November 5, 2019

Researchers from the UK and Australia have found a way to make rat brain cells act more youthful, reversing some of the loss of healing capacity that normally comes with older age.

Multiple Sclerosis involves immune attacks that damage brain tissues, including the myelin coating on nerve fibers. The brain has its own resident stem cells, called OPCs, that can initiate myelin repair after damage. Robin Franklin, PhD, of the University of Cambridge, and others had previously shown that with greater age, OPCs lose the capacity to initiate myelin repair.

In a paper published in October 2019 in the journal Cell Stem Cell, Dr. Franklin and colleagues reported that in old rats, fasting made OPCs act more youthful, regaining capacity to repair myelin. The team also found that a diabetes drug called metformin, which can mimic some biological aspects of fasting, was able to reverse age-related changes to rat OPCs and increased their capacity to initiate myelin repair.
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How to Find the Right MS Treatment

How to Find the Right MS Treatment
Diane Kramer, 35, knows all too well the challenges of finding the right Multiple Sclerosis (MS) treatment. When she was diagnosed in her 20s, she tried several drugs, one after the other -- and has tried several more therapies since.

“My first disease-modifying treatment was completely dictated by insurance. I wasn’t part of the conversation,” Kramer says. “Then I changed insurance, so I had to change medications. I went from using an injectable once a week to using an injectable once every 3 days.”

The new drug left her covered in welts and flattened by flu-like symptoms. But perhaps even worse, she says, was the relationship she had with her new neurologist. “He told me I would be in a wheelchair in a year, so I should probably consider not working so I could spend more time with my family.”


After that, Kramer made it a priority to find a doctor who would fight for her health. “I’m in a very good place with my MS right now, and I attribute that hugely to having a great doctor who is ready with an answer about what’s next, no matter what issue I’m having.”

Joash T. Lazarus, MD, a neurologist at the Multiple Sclerosis Center of Atlanta, says finding the right treatment isn’t easy because the disease affects everyone differently. Having a good relationship with your doctor can make medication adherence more likely, especially when you need to experiment with different drugs to find a good fit.

Have the Awkward Conversation
When your MS doctor asks how you feel, you may find it easy to mention numbness, weakness, vision problems, loss of coordination, dizziness, and fatigue, which are all common symptoms in MS.

Would you also freely talk about more intimate concerns? These also are symptoms of MS:

Loss of bowel control
Painful constipation 
Inability to orgasm 
Peeing during sex
Forgetting what to do at work 

Sometimes people don’t bring such issues to their doctors’ attention, says Pavan Bhargava, MD, assistant professor of neurology at Johns Hopkins University Medical School. “I think embarrassment is a factor, or patients selectively leave out things they think aren’t related to MS,” he says. “Patients need to know that MS can affect a broad spectrum of things that have a huge impact of quality of life, and that there are ways to improve a lot of them.”

Lazarus agrees. “Sometimes it can be very uncomfortable for patients to talk about some of the more intimate ways MS affects you, but it’s the only way we can help,” he says.

Talk About Treatment Goals
Trying multiple therapies throughout the course of your disease is common. Doctors will recommend a switch if you’re on a disease-modifying drug that isn’t working well enough or if you find the side effects tough to handle.

Before you start taking a new drug, ask your doctor what to expect. Will you have different side effects? Will you start to feel better? How will you know if it’s working?

Bhargava says people with MS are often concerned when they don’t feel better because they don’t know that isn’t what the drugs are designed to do. “The goal is to prevent new lesions so that the disease does not get worse over time,” he says.

To feel better both physically and mentally, you’ll probably need to add treatments that improve your MS symptoms, not the course of the disease. Some examples include:
 Physical therapyMuscle relaxantsMedications to reduce fatigueAntidepressantsTreatments for bladder or bowel problemsPain relievers
If these approaches don’t give you enough relief, work with your doctor to find options that will. “I was in a lot of pain, and narcotics make my neuralgia worse,” Kramer says. “My current doctor suggested acupuncture could help. Now I’m not at all struggling with pain.”


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What to Know About MS and the JC Virus

This common virus is harmless to most of the population. But it can have serious effects for those with Multiple Sclerosis.

What is the JC virus?
The John Cunningham virus, known more commonly as the JC virus, is a very common virus in the United States. According to the World Journal of Neurosciences, between 70 and 90 percent of people in the world have the virus. The average person carrying the JC virus will never know and is unlikely to experience any side effects.
However, that’s not the case for a small percentage of individuals with multiple sclerosis (MS). The JC virus can be activated when a person’s immune system is compromised because of disease or immunosuppressive medication.
The virus can then be carried into the brain. It infects the white matter of the brain and attacks the cells responsible for making myelin, the protective coating that covers and protects nerve cells. This infection is called progressive multifocal leukoencephalopathy (PML). PML can be disabling, even fatal.

The role of immune-suppressing drugs

The JC virus often attacks when a person’s immune system is at its weakest. A weakened immune system can no longer fight off invading viruses. It’s the perfect opportunity for the JC virus to awaken, cross the blood-brain barrier, and begin attacking the brain. People with MS are at an increased risk for PML because their immune system is often compromised as a result of the condition.
Further compounding the problem, several medications used to treat the symptoms of MS can also compromise the immune system. Immunosuppressant medications can increase the likelihood that a person with MS will develop PML after exposure to the JC virus. These immunosuppressant medications may include:
azathioprine (Azasan, Imuran)cyclophosphamidedimethyl fumarate (Tecfidera)methotrexatemitoxantrone (Novantrone)mycophenolate mofetil (CellCept)corticosteroids
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Money Management in Multiple Sclerosis: The Role of Cognitive, Motor, and Affective Factors

Yael G1,2Nancy C2,3John D2,3.

Author information

1Department of Occupational Therapy, New York University, New York, NY, United States.2Kessler Foundation, West Orange, NJ, United States.3Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, NJ, United States.

Abstract

Introduction: Few studies have examined the motor, cognitive, and emotional factors involved in effective money management in persons with Multiple Sclerosis (MS). The aim of this study was to assess money management in persons MS and examine whether cognitive, motor, and emotional processes can predict money management. 
Methods: This study included 72 persons with MS and 26 healthy controls (HC). Using an a priori definition of efficient vs. inefficient money management skills, based on the money management questionnaire (self and others), and performance on Actual Reality™ (AR) money management items, MS participants were divided into two groups: efficient or inefficient money management (MS Efficient- MM, n = 34 vs. MS Inefficient-MM, n = 38). These groups were compared on cognitive, motor, and emotional variables. 
Results: Participants in the MS efficient MM group performed significantly better on executive function and processing speed measures, as well as performance on the 25WT. The MS Efficient -MM group also showed significantly less affective symptomatology (depressive and state anxiety). Importantly, HC performed similarly to the Efficient MM group on these tests. Good executive functioning and low depressive symptomatology predicted efficient money management. 
Conclusions: This study characterizes some of the major problems and underlying impairments persons with MS are encountering in money management. Practitioners working with persons with MS should be aware that executive function impairments together with depressive symptomatology could signal possible money management dysfunction. The early identification of at-risk persons for money management difficulties could have a profound impact on the quality of life for this subsample of the MS population.


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7T MRI offers new insights into multiple sclerosis

7T MRI offers new insights into multiple sclerosis
NEWS RELEASE 12-NOV-2019

Investigators use powerful imaging technology to reveal that a potential MRI marker of brain inflammation is common among patients with early MS and may be a sign of gray matter injury

BRIGHAM AND WOMEN'S HOSPITAL

Boston, MA -- Increased immune system activity along the surface of the brain, or meningeal inflammation, may be important for understanding how Multiple Sclerosis (MS) progresses from the most common and earliest form of the disease known as Relapsing Remitting MS (RRMS) to a Secondary Progressive form. The meninges are a thin, protective tissue that covers the brain and spinal cord. One proposed way to more easily see evidence of inflammation at the meninges is by finding leptomeningeal enhancement (LME) on Magnetic Resonance Imaging (MRI) scans. This can appear early in the course of the disease and increases as the disease progresses, yet the most commonly available MRI technology -- 3 Tesla (3T) -- gives a limited view of this proposed marker. Investigators from Brigham and Women's Hospital have completed a new study using 7 Tesla (7T) MRI -- a far more powerful imaging technology -- to further examine LME in MS patients. With this new powerful tool, they have found that this proposed marker of brain inflammation in MS patients is more common than previously reported and is tied to lesions in the gray matter regions of the brain. The team's findings are published in the Multiple Sclerosis Journal.
"The 7T MRI scanner affords us new ways of viewing areas of damage in neurologic diseases such as MS that were not well seen using 3T MRI; it's capturing nuances that we would otherwise miss," said corresponding author Jonathan Zurawski, MD, a neurologist at the Brigham. "The 7T scanner reveals markers or signatures that were poorly characterized or overlooked and may allow us to better understand the disease process and ultimately better treat MS patients. As a clinician, I often hear from patients that they feel worse, even though the MRI may appear Stable. I've always thought that there is probably more to the story of that patient; 7T MRI is helping us fill in those details."
The Brigham's 7T MRI unit arrived at the hospital in 2017 and became the second in the country to be approved for clinical use. Since that time, it has been fully integrated into the MRI program at the Brigham. In addition to providing cutting-edge patient care, Brigham investigators are using the 7T to advance research and discovery.
To conduct their study, Zurawski and colleagues enrolled 30 participants with RRMS and 15 heathy control subjects. All participants underwent detailed 7T MRI scans to look for signs of LME and gray matter lesions.
The team found that two-thirds (20/30) of MS subjects had LME compared to only one of the 15 healthy people (6.7 percent), a tenfold increase. (Previous studies of patients with progressive MS using 3T MRI found signs of LME in only 20 to 50 percent of subjects.) MS patients with LME also had a four-to-five-fold increase in cortical lesions and thalamic lesions, telltale signs of gray matter injury seen in MS. Interestingly, these signs were independent of white matter lesions, which are the traditional marker of MS.
The team chose to study patients with RRMS to help address a gap in the current understanding of the disease. They note that their study was limited by its small sample size. While they cannot yet address how treatment of LME may affect disease progression, and whether their findings may apply to patients with the progressive form of the disease, plans are underway to continue following the patients in this study over time to see how LME and gray matter lesions may change over months and years. The team has also expanded the study's size to include more patients in the future.
"Gray matter injury is an important part of MS, which may be a key factor leading to disease progression," said Zurawski. "Our hope is that by finding new markers of this progression, it opens up the opportunity for developing treatments that can prevent progression before lesions become widespread."
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The study was supported by The Ann Romney Center for Neurologic diseases at the Brigham and The Watercove Foundation. Zurawski has received consulting fees from ERT Consulting.
Co-authors have received research support, personal fees and/or consulting fees from Bayer, Biogen, Celgene, EMD Serono, Genentech, Guerbet, Genzyme, IM Therapeutics, MedDay Pharmaceuticals, Merck Serono, the National Institutes of Health, National Multiple Sclerosis Society, Novartis, Sanofi, Sanofi Genzyme, Shire, Teva Neurosciences, Tilos Therapeutics, Tiziana Life Sciences, Verily Life Sciences and vTv Therapeutics.


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Potential genetic markers of multiple sclerosis severity

Potential genetic markers of multiple sclerosis severity
NEWS RELEASE 31-OCT-2019
In a bid to determine factors linked to the most debilitating forms of Multiple Sclerosis (MS), Johns Hopkins Medicine researchers say they have identified three so-called "complement system" genes that appear to play a role in MS-caused vision loss. The researchers were able to single out these genes -- known to be integral in the development of the brain and immune systems -- by using DNA from MS patients along with high-tech retinal scanning.
If further studies confirm the researcher's findings, reported in the September issue of Brain, the investigators say they could serve as markers for monitoring and predicting progression and severity of MS, an unpredictable disorder in which the immune system eats away at protective insulation around nerve cells. This approach, the researchers say, represents the beginning of precision medicine for MS and may ultimately allow designer therapies, as is being done for specific cancers.
In MS, nerve communication breaks down over time between the brain and the rest of the body, causing chronic and/or intermittent muscle spasms, tremors, imbalance, pain, numbness, depression, loss of bladder or bowel control and vision problems. MS is more common in women, and symptoms vary widely.
"Although we have treatments for the type of MS where symptoms come on in bursts -- called relapsing-remitting MS -- we don't have any way to stop the kind of MS in which the nerve cells start to die, known as progressive MS," says Peter Calabresi, M.D., professor of neurology and neuroscience at the Johns Hopkins University School of Medicine and co-director of the Johns Hopkins Precision Medicine Center of Excellence for Multiple Sclerosis. "We believe that our study opens up a new line of investigation targeting complement genes as a potential way to treat disease progression and nerve cell death."
For their study, the researchers used optical coherence tomography -- an imaging technique that allowed the researchers to look at the back of each patient's eyes and assess damage to the nerve cells in the retina -- in 374 patients with all types of MS. The patients were an average of 43 years old and mostly women (78%).
The investigators recruited these patients and performed imaging every few years from 2010 to 2017, yielding an average of 4.6 scans per participant over the course of the study. The scans were used to measure thinning of the layer of the nerve cells -- known as ganglion cells -- in the retina over time. The average rate of deterioration was a loss of 0.32 micrometers of tissue per year in each patient.
Then, using blood samples from the patients to collect their DNA, the researchers hunted for genetic mutations in those people with the fastest deterioration rates and identified 23 such DNA variations that mapped to the complement gene C3.
Next, to search for genes further linked to vision loss, they performed an analysis of an existing clinical trial group of another 835 people with MS, of whom 74% were women, and whose average age was 40. Each participant underwent periodic vision testing about every year to distinguish their ability to detect contrast -- finer and finer shades that distinguish light versus dark. The test requires the person to read five letters in a row as with a typical vision chart test, as well as separate vison charts with faint (low contrast) letters that simulate vision in low light (dusk or dark). However, in this one each row down gets fainter and fainter rather than smaller and smaller.
Using DNA from the blood samples of these 835 participants, the researchers identified specific genetic changes in two complement genes, C1QA and CR1, linked to those people with the most rapidly declining ability to distinguish letters with less contrast. Patients with genetic changes in the C1QA gene were 71% more likely to develop difficulty detecting visual contrast, whereas those with genetic changes in the CR1 gene were at 40% increased risk for developing a reduced ability to detect contrast.
These complement genes found to be linked with severity of MS vision loss hold the genetic instructions for making complement proteins.
"Complement proteins have traditionally been thought of as part of the immune system, binding to antibodies and helping them kill infected cells in the body," says Calabresi. "A decade ago, however, other researchers discovered that complement proteins bind to the connections between neurons and helps them grow in specific directions. But, too much complement was found to causes damage to the nerve cells, eventually killing them. Our findings fit well into this system."
"Our next step will be to repeat these studies in larger populations," says Kathryn Fitzgerald, Sc.D., assistant professor of neurology at the Johns Hopkins University School of Medicine and first author of the published report. "Next, animal studies looking further into the function of complement proteins will also need to be performed so we can figure out the mechanism behind their role in killing nerve cells in people with MS. From there we can possibly think about how to design new therapies."

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Four (4) Remedies for MS fatigue and Cog Fog - video by Aaron Boster, MD

Four (4) Remedies for MS fatigue and Cog Fog - video by Aaron Boster, MD
Got cog fog? MS fatigue? Well, stop these 4 things and improve your thinking, memory and energy levels! Learn to combat 2 of the most common Multiple Sclerosis symptoms!



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Aaron Boster, MD, Answering Viewers Questions: Fatigue & Depression in Multiple Sclerosis ·

Aaron Boster, MD, Answering Viewers Questions: Fatigue & Depression in Multiple Sclerosis ·
Aaron Boster MD

In this video I answer viewers questions about two of the most common and difficult symptoms of Multiple Sclerosis, fatigue and depression. To learn more, start watching this vid right now!




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How new gene discoveries could guide precision medicine in multiple sclerosis

How new gene discoveries could guide precision medicine in multiple sclerosis
by Arlene Weintraub | 
Oct 31, 2019 10:20am
Variants in three "complement" genes are closely associated with vision loss in Multiple Sclerosis, Johns Hopkins Medicine researchers discovered. (Pixabay)
The most severe form of Multiple Sclerosis, called progressive MS, causes the death of nerve cells, which often leads to vision loss and other neurological problems. Now, scientists at Johns Hopkins Medicine say they’ve identified gene variants that play a role in MS-related vision loss—a discovery that could help guide precision medicine for treating the disease as well as the development of new therapies, they believe.

The Johns Hopkins team tied vision loss in MS to three “complement system” genes, which make proteins that are normally associated with immune function. Using gene testing, advanced imaging and vision tests on MS patients over seven years, the researchers discovered that variants in the genes, called C1, CR1 and C1QA, were closely associated with vision loss. They published the findings in the journal Brain.

“We believe that our study opens up a new line of investigation targeting complement genes as a potential way to treat disease progression and nerve cell death,” said Peter Calabresi, M.D., professor of neurology and neuroscience and co-director of the Johns Hopkins Precision Medicine Center of Excellence for Multiple Sclerosis, in a statement.

he team started by using optical coherence tomography to examine nerve cells in the retinas of 374 patients with MS. The scans allowed them to measure the thinning of the layer of those cells, which are known as ganglion cells, over time. Then they used blood samples from the patients to look for genetic mutations, pinpointing 23 variants in C3 in patients with the fastest rates of deterioration in ganglion cells.

A separate analysis of 835 patients who provided DNA samples and who underwent vision testing allowed the researchers to fine-tune their findings. They found that people with specific genetic variants in the complement gene C1QA were 71% more likely to lose their ability to detect visual contrasts over time, while those with changes in the CR1 gene faced a 40% risk of the same visual decline.

Several other research groups in MS are studying the role of genes and their variants in the progression and potential treatment of the disease. Early this year, a team at the University of Chicago found that a derivative of the hypertension drug Wytensin selectively inhibits a gene called PPP1R15A, which in turn seems to control inflammation in MS.

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Essential Oils: A Potential Way to Ease MS Stress

Essential Oils: A Potential Way to Ease MS Stress
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Last Updated: October 31, 2019

Do essential oils have a role in the treatment of MS? Maybe. While they haven’t yet been studied specifically in this population, they have been shown to improve mood and sleep quality in some people. Learn more about how to choose and use essential oils.

Essential oils are plant extracts designed to capture the “essence,” or scent, of the original plant.
Examples of popular essential oils include:

Chamomile
Jasmine
Lavender
Lemon
Peppermint
Rose
Sandalwood
Tea tree

These essences are typically compounded and sold as natural remedies for a variety of conditions. They are most often used in the practice of aromatherapy, which today is considered a form of complementary or alternative medicine with roots in ancient civilizations in Asia as well as in the Mediterranean region.

Scientific evidence for the medicinal benefits of these products is limited. But some studies have found that they may help manage symptoms relating to fatigue, anxiety, cognitive problems, skin disorders, digestive problems, and headaches, among others.

Although little if any research has been done on the possible benefits for people with Multiple Sclerosis (MS), some believe essential oils can help people with the condition manage some of its symptoms, like pain, fatigue, and digestive problems.

They may also be useful in treating other health conditions often linked with MS, like depression and anxiety.

“Anything natural that helps keep my MS monster in its cave is very useful,” says Mary Ellen Ciganovich, an author and educator who specializes in holistic healing and has MS herself. “I handle my own MS through diet, exercise, meditation, herbs, and essential oils, and I recommend these approaches to others with the condition.”

 

 
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So how can essential oils help you — if at all?

What Are Essential Oils?



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Biogen scores FDA nod for Tecfidera follow-up Vumerity as MS threats linger

Biogen scores FDA nod for Tecfidera follow-up Vumerity as MS threats linger
by Eric Sagonowsky | Oct 30, 2019

Biogen on Wednesday scored FDA approval for new MS offering Vumerity. (Biogen)

Biogen's Multiple Sclerosis business has been treading water and its best-selling med, Tecfidera, might just run up against early generics. But now, the company has its next launch—and, it hopes, Tecfidera replacement—in the newly FDA-approved MS med Vumerity.

The Tecfidera follow-up won approval Wednesday, and Biogen touted it as a just-as-effective, better-tolerated version of its multibillion-dollar predecessor—and pharma watchers can expect the company to use that advantage to push patients toward the newer drug.

Vumerity "offers the well-characterized efficacy” of Tecfidera and "has been studied for improved patient-reported gastrointestinal tolerability,” Chief Medical Officer Alfred Sandrock said in a statement

The nod comes as Tecfidera, Biogen’s top drug by sales, battles new competitors, including Roche's fast-launching MS star Ocrevus. And Tecfidera faces an intellectual property challenge from Mylan that could cut short its exclusivity. The key drug posted a 3% revenue increase in the third quarter to $1.12 billion.

As for the follow-up med, Bernstein analysts have said it will grow to $734 million by 2022 as Tecfidera sales shrink. 

With the approval, Biogen owes its partner Alkermes a $150 million milestone payment, and the biotech stands to collect a mid-teens royalty on global sales.  

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Alcohol Consumption Linked to Lower MS Disability

Alcohol Consumption Linked to Lower MS Disability
By: Alicia Ciccone


Alcohol Consumption Linked to Lower MS disability
WASHINGTON — Multiple Sclerosis patients who consumed larger amounts of alcohol had lower rates of disability per the Expanded disability Status Score (EDSS) and Multiple Sclerosis Severity Score (MSSS), study findings indicate.
Consumption of beer also affected EDSS scores positively; however consumption of wine had no association with EDSS score, according to Camilio Diaz-Cruz, MD, of Brigham and Women’s Hospital in Boston, who reported the findings at the American Academy of Neurology 2015 Annual Meeting.
Camilio and colleagues measured alcohol/wine consumption in servings per week for 908 patients (73% females, mean age 47±11 years, mean disease duration 13±9 years) enrolled in the Comprehensive Longitudinal Investigation of Multiple Sclerosis (CLIMB) study. Drinking habits were also assessed, and influence of alcohol or wine consumption on clinical outcomes was assessed using regression models for relapse rate in the past year, and concurrent EDSS and MSSS outcomes. Associations with and changes in Symbol Digit Modality Tests (SDMT) were also assessed in a subset of patients.
There were 56 nondrinkers in the cohort; 98 of who preferred drinks with 80-proof liquor, 249 preferred beer, 283 preferred red wine, and 222 favored white wine. Median alcohol intake was 1.1 servings per week.
Those who had higher alcohol intake were significantly associated with lower EDSS (P=0.015) and MSSS (P=0.003.) Both red and white wine had a non-significant negative association with both EDSS and MSSS, and there was no significant association between alcohol or wine consumption and relapse rate in the past year, change in EDSS (P=0.57) or MSSS (P=0.64) over one year, current SDMT score, and change in SDMT score in the last year. Notably, beer drinkers tended to have lower EDSS, however the relationship was weaker compared to that of hard liquor (OR 0.94, 95% CI 0.88-0.99, for each serving/week versus each 1-point EDSS increment).
Although further data analyses are required to better understand the potential cause-effect relationship and underlying mechanism, the findings are complimentary to several previous but unconfirmed studies that suggest alcohol may be neuroprotective in the risk of developing Multiple Sclerosis.  

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Physical activity may help ease MS symptoms.

by Aviva Patz

“There are so many times when I wake up and everything hurts so bad—my knees are tight as a drum—and I force myself to do yoga,” he says. “Then I do it and I loosen up—everything relaxes, I relax. And I think, ‘how could I not want to do this?’”Dan Melfi was used to bicycling up and down mountains in his home state of Colorado when he was diagnosed with Multiple Sclerosis in 2009 at age 58. Now, he needs some assistance to walk—a walker, scooter, forearm crutches and, occasionally, a wheelchair. He’s a bigger advocate than ever of an active lifestyle. He goes to an MS swim class twice a week, which he enjoys because it helps him move all parts of his body without fear of falling, and he practices yoga.
Beyond the benefits for overall health—lowering heart disease risk and blood pressure, improving sleep, boosting bone health—research suggests that exercise helps people with MS improve aerobic capacity, muscle strength, balance and other factors that make it easier to get around, while also enhancing cognition, fatigue and mood. A 2010 study in the journal Brain Research suggests that exercise may even help stop MS from progressing.
“It’s the fountain of youth,” says Denis Avans, a wellness-fitness coordinator and certified personal trainer with Alabama Neurology. “If you could put the effects of exercise in a pill, it could be the most potent medicine of all.”
Here’s what you need to know to put physical activity to work for you.

New evidence for exercise






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SPMS and Diet: What Foods Can Help?

SPMS and Diet: What Foods Can Help?
Many treatments for Multiple Sclerosis (MS) are targeted at reducing inflammation, thereby slowing progression of the autoimmune disease. An anti-inflammatory diet also may slow disease progression, as well as enhance the positive effects of anti-inflammatory medications.
In MS, the immune system mistakenly attacks the protein coat that surrounds nerve fibers. That coating protects the nerves and facilitates the propagation of nervous signals.
Secondary Progressive Multiple Sclerosis (SPMS) is the second stage of MS, which follows relapsing-remitting Multiple Sclerosis (RRMS).
Appropriate exercise and healthy eating habits are important for all people with MS.
What is an anti-inflammatory diet?
An anti-inflammatory diet is a plan for healthy eating that does not contain foods that are high in saturated fats, refined carbohydrates — found in white bread — sugary desserts, soda, and red meat.
Foods that are part of an anti-inflammatory diet include tomatoes, olive oil, green leafy vegetables, nuts such as almonds and walnuts, fatty fish — including salmon, tuna, and sardines — and fruits such as strawberries, blueberries, cherries, and oranges.
How can an anti-inflammatory diet help me?
It has been proposed that an anti-inflammatory diet may be able to help slow disease progression in autoimmune disorders. Clinical trials are underway to test this hypothesis in patients with different types of MS.
Although several studies have been conducted, it is difficult for many reasons to draw broad conclusions as to the benefits of diet. For example, many studies have not included good controls and have relied on patient-reported information.
What has been shown, however, is that diets with inflammatory potential may be involved in the physiological processes associated with neurodegenerative diseases.
How should I start an anti-inflammatory diet?

Before making any big changes, it's always a good idea to talk to your physician and a registered dietitian. They can help you figure out foods to include and avoid, while making sure you are getting the nutrition and vitamins you need.
article provided by: multiplesclerosisnewstoday.com



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Yoga and Non-Cardio Exercises: Your Allies in Managing MS Symptoms and Improving Overall Health

Presenters:
Sue Kushner, MS, PT - Physical Therapist
Lynn Stazzone, RN, BSN, MSN, NP - Neuroscience Nurse Practitioner


Non-cardio exercises, including yoga and seated stretches, can help positively manage your MS symptoms and promote your overall health. In particular, there is growing research on the disease-modifying effects of yoga, in addition to its profound impact on physical, mental, emotional, and spiritual well-being. Best of all, these activities are accessible to everyone of all abilities. With some creativity and adaptations, everyone can do something!

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Exercise as Part of Everyday Life

Provided by #TheNationalMSSociety


Physical activity can be a regular part of staying healthy if you have MS. Includes tips on handling MS symptoms.

Exercise as part of daily life --  DOWNLOAD 



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Stretching for People with MS—An Illustrated Manual (.pdf)

Stretching for People with MS—An Illustrated Manual (.pdf)
Provided by #TheNationalMSSociety

Illustrated manual showing range of motion, stretching, and balance exercises for at-home program. By Beth E. Gibson, PT. (last updated October 2016)


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International MS Genetics Consortium Confirms 233 MS-Related Gene Variations in Largest Study to Date

September 26, 2019
SUMMARY:The International MS Genetics Consortium (IMSGC) has published the largest MS genetics study to date, analyzing data from 47,429 people with MS and 68,374 individuals without MS.They confirmed 233 variations in the human genome that contribute to the risk of developing MS. The variations were found to influence many different immune cell types and tissues, indicating that broad dysfunction in the immune system underlies the onset of MS.The study also identifies a genetic variant for MS on chromosome X, the sex chromosome. Women have two X chromosomes while men have one; this is therefore an interesting lead to investigate why women are more likely to develop MS than men.These results alone are not sufficient to pinpoint who will develop MS, but they contribute to an understanding of risk factors that may eventually be used to predict an individual’s risk of developing MS and point to ways to prevent it.The IMSGC, a worldwide group of investigators collaborating to understand the genetic basis of MS, report this study in the magazine Science (365, eaav7188 [2019]). 
“This study greatly expands our knowledge of the genetic variations that contribute to MS susceptibility, and establishes a roadmap to figure out what causes MS and how to prevent it,” said Bruce Bebo, PhD, Executive Vice President of Research at the Society. “This work would not be possible without the participation of people affected by MS, and the collective funding of agencies and MS Societies from around the world. It is an inspiring example of the collective power of patients, researchers, and funders coming together to accelerate vital research that brings us ever closer to a cure for MS,” he added.
 
DETAILS
Background: The cause of MS is not yet known, but it is thought be triggered by a combination of factors in people whose genetic makeup (genome) make them susceptible. The International MS Genetics Consortium comprises the world’s top neurologists and geneticists. This team was supported with many sources including research grants from the National Institutes of Health and the National MS Society (in part through the generous support of Richard and Rosalyn Slifka) to undertake a search for MS genes throughout the human genome. They assembled data from multiple prior studies and then worked to confirm (replicate) those results in a large number of independent subjects, analyzing genetic data from a total of 115, 803 individuals. This replication effort was needed to increase confidence of previous findings.
 
The Replication Study: In the largest MS genetic study to date, IMSGC researchers analyzed genetic data from 47,429 people with MS and 68,374 controls without MS. They confirmed 233 variations in the human genome that contribute to susceptibility to MS. These results confirm the initial results, representing a giant leap forward in understanding MS genetics.
These results alone are not sufficient to pinpoint who will develop MS, but they contribute to an understanding of risk factors that may eventually be used to predict an individual’s risk of developing MS and point to ways to prevent it.
 
The identified genetic variations influence the function of many immune cells types and tissues involved in initiating and carrying out immune attacks against the brain and spinal cord in MS. The team also found a link to the function of microglia, which are the immune cells of the brain, but not in other brain cells such as neurons or astrocytes. In addition, the study identified a genetic variation related to MS on chromosome X. Women have two X chromosomes (men have one), and this represents an intriguing lead to understanding part of the reason why women are more likely to develop MS than men.
 
The IMSGC report this study in the magazine Science (365, eaav7188 [2019]).
 
Source: a National MS Society publication


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Four-Year Study Confirms That Imaging the Eye with OCT Provides Window to MS Progression in the Brain and a Way to Track the Effects of Therapies

Four-Year Study Confirms That Imaging the Eye with OCT Provides Window to MS Progression in the Brain and a Way to Track the Effects of Therapies
Optical coherence tomography (OCT) is a non-invasive imaging test. OCT uses light waves to take cross-section pictures of your retina.

So, what is OCT imaging?  Optical coherence tomography (OCT) is a non-invasive imaging test. OCT uses light waves to take cross-section pictures of your retina.
With OCT, your ophthalmologist can see each of the retina’s distinctive layers. This allows your ophthalmologist to map and measure their thickness. These measurements help with varying diagnosis. (source)

About The Study:

Summary
A recently published paper by a collaborative team used advanced Optical Coherence Tomography (OCT) and MRI brain scans of 107 people with MS over four years to track the impacts of MS and to determine whether changes in nerve layers at the back of the eye mirror changes in MRI-detected brain tissue integrity and degeneration.The team reported that OCT findings reliably reflected overall brain degeneration, with a specific layer of the retina showing shrinkage at similar rates as specific brain regions seen with MRI. These similar rates of atrophy were more strongly associated in progressive MS for most areas of the brain.OCT is a non-invasive, relatively inexpensive and well tolerated imaging method. These findings suggest that OCT findings reflect underlying disease progression, and further validate the usefulness of OCT as an important tool for tracking MS and the impacts in clinical trials.  The paper, involving a collaboration of 15 researchers at 6 institutions, was published in the Annals of Neurology in November 2015 (2015;78:801-813).
Details
BackgroundMRI scans of the brain have typically been used to help diagnose MS and to observe disease activity and progression in people with MS. Typical clinical MRI scanning detects areas of damage or activity (lesions) in the white matter, areas of the brain that contain myelin-coated nerve fibers. Typical MRI doesn’t have the power to detect or track shrinkage of specific areas of the brain, or lesions that occur in the outer layers of the brain (cortex, gray matter) containing nerve cell bodies. Mounting evidence suggests that damage to nerve cells underlies long-term progressive disability in people with MS. So having easier ways to detect and track nerve degeneration would help speed the search for better therapies.
 
#OpticalCoherenceTomography (OCT) has been increasingly used as a research tool to detect damage that occurs to the nerves in the back of the eye. OCT is a scan of the nerves in the back of the eye. It is done with a small machine that can fit into an examining room, is relatively inexpensive, painless and well tolerated. Growing evidence has suggested that OCT findings can mirror MS-inflicted damage that occurs in the brain, but it has not been clear how or whether thinning of the nerve at the back of the eye reflects brain shrinkage (atrophy) and nerve degeneration overall or in specific areas of the brain. 
 
The Study: A collaborative team of 15 researchers at six institutions in the U.S. set out to track and compare changes in nerve layers at the back over four years with changes in brain tissue integrity and degeneration. The team conducted high-definition OCT scans twice annually and high-powered (3T) MRI brain scans annually in 107 people with relapsing-remitting, Secondary Progressive or Primary Progressive MS.
 
After four years, a comparison of the long-term MRI and OCT results suggested that the rate of tissue thinning seen on OCT reliably mirrored overall brain degeneration, with a specific layer of the retina (“ganglion cell and inner plexiform layer”) showing atrophy at similar rates as specific brain regions (whole brain, gray matter, white matter and the thalamus) seen with MRI. These similar rates of atrophy between OCT and MRI were more strongly associated in progressive MS for most areas of the brain.
 
These findings suggest that OCT findings reflect underlying disease progression, and further validate the usefulness of OCT as an important tool for tracking MS and the impacts in clinical trials.  
 
The paper was published in the Annals of Neurology in November 2015 (2015;78:801-813). The lead author is Dr. Shiv Saidha (Johns Hopkins University). Three members of this team – Drs. Laura Balcer, Peter Calabresi and Elliot Frohman – were the 2015 winners of the Barancik Prize for Innovation in MS Research for their pioneering work related to OCT. 

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