MULTIPLE SCLEROSIS
The Gut Microbiome in Multiple Sclerosis: A Potential Therapeutic Avenue
Trevor O. Kirby andJavier Ochoa-Repáraz
Abstract
Recently, there has been a substantial increase in the number of studies focused upon connecting the gut microbiome with cases of central nervous system (CNS) autoimmunity. Multiple sclerosis (MS) is a neurodegenerative autoimmune disorder of the CNS. Recent experimental and clinical evidence suggests the presence of microbial imbalances in the gut of MS sufferers. The gut microbiome is defined as the summation of all the microbial entities as well as their genes, proteins, and metabolic products in a given space and time. Studies show the MS gut microbiome as having general alterations in specific taxa, some associated with the promotion of inflammatory cytokines and overall inflammation. In conjunction with these findings, experimental models of the disease have reported that T regulatory (Treg) cells have deficits in their function as a result of the aberrant gut microbiota composition. The findings suggest that the interactions between the host and the microbiota are reciprocal, although more extensive work is required to confirm this. Moreover, evidence indicates that changes in microbiota composition may result in imbalances that could result in disease, with the gut as a potential novel therapeutic avenue. By understanding the biological effects of aberrant gut microbiome composition, it is possible to contemplate current therapeutic options and their efficacy. Ultimately, more research is necessary in this field, but targeting the gut microbiota may lead to the development of novel therapeutic strategies
Source : Journal Medical Sciences
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Soda, Sugar-Sweetened Beverages Linked to More Severe Symptoms for People with MS
For people with multiple sclerosis (MS), drinking around 290 calories per day of soda or other sugar-sweetened beverages, or the equivalent of about two cans of non-diet soda, may be tied to more severe symptoms and a higher level of disability compared to people with MS who seldom consume sugar-sweetened beverages, according to a preliminary study released today that will be presented at the American Academy of Neurology’s 71st Annual Meeting in Philadelphia, May 4 to 10, 2019. People who seldom drank sugar-sweetened beverages consumed an average of seven calories in sugar-sweetened beverages per day, or the equivalent of one-and-a-half cans of non-diet soda per month. Soda and other sweet beverages were the only type of food that was related to MS symptoms in the study.
“MS patients often want to know how diet and specific foods can affect the progression of their disease,” said study author Elisa Meier-Gerdingh, MD, of St. Josef Hospital in Bochum, Germany, and a member of the American Academy of Neurology. “While we did not find a link with overall diet, interestingly, we did find a link with those who drank sodas, flavored juices and sweetened teas and coffees.”
The study involved 135 people with MS. Participants completed a questionnaire about their diet. Researchers then looked at how close each participants’ diet was to the Dietary Approaches to Stop Hypertension (DASH) diet. The DASH diet recommends whole grains, fruits and vegetables, low-fat dairy products, lean meats, poultry and fish, and nuts and legumes and limits foods that are high in saturated fat and sugar.
“We chose to study the DASH diet because adherence to the DASH diet is associated with lower risk of other chronic diseases like high blood pressure, diabetes and cardiovascular diseases,” said Meier-Gerdingh.
Researchers also measured the participants’ level of disability using the Expanded Disability Status Scale, a common method to quantify disability ranging from 0, no symptoms, to 10 points, death due to MS. A total of 30 participants had severe disability.
Overall, researchers did not find a link between what participants ate and their level of disability.
For soda and sugar-sweetened beverages, the participants were divided into five groups based on how much they drank. The people in the top group drank an average of 290 calories of sugar-sweetened beverages per day, while the lowest group seldom drank sugar-sweetened beverages.
The study found that participants who consumed the largest amounts of sugar-sweetened beverages were five times more likely to have severe disability than people who seldom drank sugar-sweetened beverages. Of the 34 people in the top group, 12 had severe disability, compared to 4 of the 34 people in the bottom group. The top group had on average a disability score of 4.1 points, while the bottom group had an average of 3.4 points.
“While these results need to be confirmed by larger studies that follow people over a long period of time, and the results do not show that soda and sugar-sweetened beverages cause more severe disability, we do know that sodas have no nutritional value and people with MS may want to consider reducing or eliminating them from their diet,” Meier-Gerdingh said.
Limitations of the study include the relatively small number of participants. The study also assessed participants’ diets and sugar-sweetened beverages at the same time as disability, so it is not possible to distinguish whether it is actually an aspect of diet, like sugar-sweetened beverages, that contributes to higher disability or whether more severe disease impacts a person’s ability to have a healthy diet.
Additional studies are needed to evaluate whether sugar-sweetened beverages affect the course of the disease
Source : American Academy of Neurology via Newswise
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Food allergies are associated with increased disease activity in multiple sclerosis
Rami Fakih, Camilo Diaz-Cruz, Alicia S Chua, Cindy Gonzalez, Brian C Healy, Neda Sattarnezhad, Bonnie I Glanz, Howard L Weiner,Tanuja Chitnis
Abstract
Objective The association between allergy and multiple sclerosis (MS) is still unclear. In our study, we assessed the association between a self-reported history of allergic conditions with MS clinical and MRI disease activity.
Methods A subset of 1349 patients enrolled in the Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women’s Hospital (CLIMB) study completed a self-administered questionnaire on environmental, food and drug allergies. Patients were distributed among four allergy groups: (1) environmental, (2) food, (3) drug, (4) no known allergies (NKA). Clinical (number of attacks, expanded disability status scale (EDSS), MS severity score (MSSS)) and radiological variables (presence of gadolinium-enhancing lesions and lesion count), and their associations with the different allergy groups or those with NKA, were assessed.
Results The food allergy group had a 1.38 times higher rate for cumulative number of attacks compared with the NKA group (P=0.0062); this difference remained significant in the adjusted analysis (relapse rate ratio 1.27, P=0.0305). The food allergy group showed more than twice the likelihood (OR 2.53, P=0.0096) of having gadolinium-enhancing lesions on MRI. The environmental and drug allergy groups did not show significant differences when compared with the NKA group. The EDSS and MSSS were not affected by any type of allergy.
Conclusions MS patients with food allergy had more relapses and a higher likelihood of gadolinium-enhancing lesions compared with patients with no known allergy. Future prospective studies are needed to confirm our findings and investigate underlying biological mechanisms, which may unveil new therapeutic and preventative strategies for MS.
Source : Journal of Neurology, Neurosurgery & Psychiatry
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[Effect of Chinese Herbs Used in Treating Multiple Sclerosis on T Subsets Using Association Rules].
[Article in Chinese]
Zhang Q, Li T, Xu YG, Yang XH
Abstract
OBJECTIVE:To analyze the effect of Chinese herbs used by Prof. LI Tao on peripheral blood T subsets in treating multiple sclerosis (MS) by using association rules and statistical methods, thereby providing evidence for optimizing prescriptions.
METHODS:Data of MS inpatients and outpatients recorded by data collecting system, Xiyuan Hospital, China Academy of Chinese Medical Sciences were resorted. The relationship between Chinese herbs and T cell subsets were analyzed using SPSS17.0 and Aprior module in SPSS Clementine 12.0.
RESULTS:Radix bupleuri, Radix Paeoniae alba, Fructus Aurantii, Atractylodes, and Radix Glycyrrhizae were most commonly used herbal combinations.Radix Aconiti lateralis preparata and Rhizoma Smilacis glabrae were often added. Radix Aconiti lateralis preparata was associated with decreased Th1 cells (confidence level 83.78%, supportive level 36.26%). Decreased Th1 cell was associated with Radix Aconiti lateralis preparata (confidence level 71.26%, supportive level 36.26%).Radix Aconiti lateralis preparata was obviously associated with decreased Th1 cells. Radix Bupleuri, Radix Paeoniae alba, bitter orange, Atractylodes , Radix glycyrrhizae, and Radix Aconiti lateralis preparata could reduce peripheral blood Th1 subsets of MS patients and elevate Th2 subsets (all P < 0.01).
CONCLUSIONS:The herbal combination of Radix Bupleuri, Radix Paeoniae alba, Fructus Aurantii, Atractylodes, Radix Glycyrrhizae, Rhizoma Smilacis glabrae, and Radix Aconiti lateralis preparata could lower peripheral blood Th1 cells and elevate Th2 cells, and prevent the relapse of MS possibly by reducing Th1 cells and elevating Th2 cells. Especially Radix Aconiti lateralis preparata played important roles in aforesaid changes of Th1 and Th2.
Source : US National Library of Medicine National Institutes of Health
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Association of Vitamin D Levels With Multiple Sclerosis Activity and Progression in Patients Receiving Interferon Beta-1b
Kathryn C. Fitzgerald, ScM1; Kassandra L. Munger, ScD1; Karl Köchert, MD2; Barry G. W. Arnason, MD3; Giancarlo Comi, MD4; Stuart Cook, MD5; Douglas S. Goodin, MD6; Massimo Filippi, MD7; Hans-Peter Hartung, MD, FRCP8; Douglas R. Jeffery, MD, PhD9; Paul O’Connor, MD10; Gustavo Suarez, MD11; Rupert Sandbrink, MD, PhD2,12; Ludwig Kappos, MD13; Christoph Pohl, MD†2,14; Alberto Ascherio, MD, DrPH1,1
Abstract
Importance Low serum 25-hydroxyvitamin D (25[OH]D) levels are associated with an increased risk of multiple sclerosis (MS) as well as with increased disease activity and rate of progression in clinically isolated syndromes and early MS.
Objective To assess the association between 25(OH)D and disease course and prognosis in patients with relapsing-remitting MS treated with interferon beta-1b.
Design, Setting, and Participants We conducted a prospective cohort study assessing 25(OH)D levels and subsequent MS disease course and progression characterized by magnetic resonance imaging (MRI) and clinical end points. The study took place between November 2003 and June 2005; data analysis was performed between June 2013 and December 2014. The study was conducted among participants in the Betaferon Efficacy Yielding Outcomes of a New Dose (BEYOND) study, a large, phase 3, prospective, multicenter, blinded, randomized clinical trial. Patients were monitored for at least 2 years. Clinic visits were scheduled every 3 months, and MRI was performed at baseline and annually thereafter. Eligible patients included 1482 participants randomized to receive 250 μg or 500 μg of interferon-1b with at least 2 measurements of 25(OH)D obtained 6 months apart.
Exposures Serum 25(OH)D measurements were performed at baseline, 6 months, and 12 months.
Main Outcomes and Measures Main outcomes included cumulative number of new active lesions (T2 lesions and gadolinium acetate–enhancing lesions), change in normalized brain volume, relapse rate, and progression determined by the Expanded Disability Status Scale (EDSS). Statistical analyses were adjusted for age, sex, randomized treatment, region, disease duration, and baseline EDSS score.
Results Overall, average 25(OH)D levels in 1482 patients were significantly inversely correlated with the cumulative number of new active lesions between baseline and the last MRI, with a 50.0-nmol/L increase in serum 25(OH)D levels associated with a 31% lower rate of new lesions (relative rate [RR], 0.69; 95% CI, 0.55-0.86; P = .001). The lowest rate of new lesions was observed among patients with 25(OH)D levels greater than 100.0 nmol/L (RR, 0.53; 95% CI, 0.37-0.78; P = .002). No significant associations were found between 25(OH)D levels and change in brain volume, relapse rates, or EDSS scores. Results were consistent following adjustment for HLA-DRB1*15 or vitamin D–binding protein status.
Conclusions and Relevance Among patients with MS treated with interferon beta-1b, higher 25(OH)D levels were associated with lower rates of MS activity observed on MRI. Results for brain atrophy and clinical progression were more equivocal.
Source : JAMA
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Effect of Tai Chi Chuan on Balance in Women with Multiple Sclerosis
Elaheh Azimzadeh, MSc. in Medical Surgical Nursing, MohammadAli Hosseini, Ph.D. in Higher Education Administration (Associatet Prof) , Kian Nourozi, Ph.D. in Nursing (Assistant Prof) , Patricia Mary Davidson, Ph.D. RN (Professor of Cardiovascular & Chronic Care)
Abstract
Objective To examine the effect of Tai Chi Chuan on balance in women with multiple sclerosis in Iran.
Design 36 women with multiple sclerosis who were members of the Iranian Multiple Sclerosis Society participated in this study. 18 participants were allocated to the intervention group and 18 allocated to the control group. The intervention consisted of Yang style Tai Chi Chuan exercise sessions twice a week for 12 weeks.
Main Outcome Measures This study used a demographic questionnaire and the Berg Balance Scale (BBS) to collect data.
Results After 12 weeks, the mean score of the BBS in the intervention group demonstrated a statistically significant improvement in comparison with baseline status.
Conclusions The results suggest that Tai Chi Chuan could be used as a safe complementary intervention to increase balance in patients with multiple sclerosis.
Source : Complementary Therapies in Clinical Practise
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Yoga Relieves Multiple Sclerosis Symptoms, Rutgers Study Finds
Specialized program improved quality of life, decreased pain and fatigue Paula Meltzer was only 38 when out of nowhere everything she looked at was blurry. For the single mother, who had a lucrative career as a gemologist and spent hours examining valuable pieces of jewelry, it seemed as if – in a split second – her life changed.
At first doctors thought Meltzer had a brain tumor. What they determined after further tests, however, was that she had multiple sclerosis, an autoimmune disease that affects the brain and central nervous system and was causing optic neuritis, an inflammation of the optic nerve that can cause a partial or complete loss of vision.
“I was living independently, doing my job, taking care of my child – and then I had to look to my parents to take care of me,” Meltzer said.
Almost two decades later, Meltzer, out of a wheelchair and walking without a cane, was one of 14 women with moderate disability due to MS who participated in a pilot trial conducted by the Rutgers School of Health Related Professions. A specially-designed yoga program for these MS patients not only improved their physical and mental well-being but also enhanced their overall quality of life.
“I felt like I became steadier and stronger in my core,” Meltzer said. Prior to yoga, she described herself as a “wall walker,” someone who felt safer holding onto the wall in order to get around. “To be able to stand on one leg and feel balanced is amazing.”
Susan Gould Fogerite, director of research for the Institute for Complementary and Alternative Medicine in the School of Health Related Professions, said that although there is widespread evidence that yoga is being used as a form of exercise by those with MS, much of the feedback has been anecdotal and there isn’t much empirical data regarding its safety and efficacy.
This is why she and her colleagues, Evan Cohen and David Kietrys, physical therapists and associate professors in the School of Health Related Professions at Stratford, decided to undertake the small pilot study, believing that a specialized yoga program for MS patients – which incorporates mind, body and spirit – would be beneficial to everyday living.
What they discovered at the end of the eight-week trial was that those who participated were better able to walk for short distances and longer periods of time, had better balance while reaching backwards, fine motor coordination, and were better able to go from sitting to standing. Their quality of life also improved in perceived mental health, concentration, bladder control, walking, and vision, with a decrease in pain and fatigue.
“Yoga is not just exercise, it is a whole system of living,” said Fogerite, an associate professor, who, along with Kietrys, will present the results on September 26 at the Symposium on Yoga Research at the Kripalu Institute in Massachusetts. “The panel of experts who advised us on the trial wanted to make sure that we provided a fully integrated program that included philosophy, breathing practices, postures, relaxation and meditation.”
The yoga pilot trial was held at Still Point Yoga Center in Laurel Springs, a southern New Jersey town close to Philadelphia. Of the 72 individuals who were interested in participating, only 16 were eligible based on medical and other criteria and availability. Of those, 15 were enrolled and 14 completed the program after one person had to withdraw because of an unrelated health problem.
Meltzer and the other women who participated in the trial ranged in age from 34 to 64. Some had been diagnosed with MS within the last two years while others had been living with the illness for up to 26 years. For 90 minutes, twice a week for two months, they practiced techniques and exercises that would improve their posture, help to increase stamina, and teach them how to relax and focus.
“This study, I hope, is one of many that will give us the clinical information we need,” said Fogerite. “Yoga is not currently being widely prescribed for people with MS, although it might turn out to be a very helpful treatment.”
The yoga practices were done by the women in the study sitting, standing, or lying on yoga mats, and using metal folding chairs situated close to the wall to provide them with more support.
“What was so nice about this experience was that although everyone was at a different level of the disease, we felt like we were all together, so I think the camaraderie helped,” said Meltzer. “And it wasn’t just about gaining more mobility and balance in our legs but our arms and necks felt stronger as well.”
Fogerite said a larger randomized controlled trial would be needed to determine whether yoga could be used as a prescribed treatment for individuals with moderate disability due to MS. More than 2.3 million people – two to three times more women than men – throughout the world are diagnosed with this disease which can cause poor coordination, loss of balance, slurred speech, tremors, numbness, extreme fatigue and problems with memory and concentration.
“When I was first diagnosed I no longer felt safe in my own body,” Meltzer said. "I didn’t trust my body at all. What the program did was really bring that trust back.”
Source : University of New Jersey
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The Effects of Pranayama, Hatha and Raja Yoga on Physical Pain and the Quality of Life of Women with Multiple Sclerosis
Shahla Najafi Doulatabad, Khirollah Nooreyan, Ardavan Najafi Doulatabad, and Zinat Mohebbi Noubandegani
Abstract
In a clinical trial carried out on 60 women with multiple sclerosis, the researchers obtained data using survey questionnaires. In addition to demographic data, the Multiple Sclerosis Quality of Life-54 (MSQoL-54) instrument was used to determine how multiple sclerosis influences the quality of life of the studied women. Within the frame of this randomized controlled trial, the participants were divided into two equally sized groups (the case and the control group) in which the level of pain and the quality of life were evaluated. The case group exercised pain-managing Yoga methods for three months, keeping the pace of eight 90 minute - sessions per month. The control participants were subjected to no intervention. One month after the Yoga therapy, the level of pain and the quality of life were evaluated in both groups and compared to the baseline data. Data were analyzed using SPSS software and paired t-tests. After the Yoga therapy, the case group showed a significant improvement in physical pain management (P=0.007) and the quality of life (P=0.001) as compared to the control group. The results showed that Yoga techniques can alleviate physical pain and improve the quality of life of multiple sclerosis patients.
Source : Afr J Tradit Complement Altern Med. 2013; 10(1): 49–52.
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Mind-Body Medicine for Multiple Sclerosis: A Systematic Review
Angela Senders,1 Helané Wahbeh,1 Rebecca Spain,1,2 and Lynne Shinto1
1Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA
2Department of Neurology, Portland Veterans Affairs Medical Center, Portland, OR 97239, USA
Abstract
Background. Mind-body therapies are used to manage physical and psychological symptoms in many chronic health conditions. Objective. To assess the published evidence for using mind-body techniques for symptom management of multiple sclerosis.
Methods. MEDLINE, PsycINFO, and Cochrane Clinical Trials Register were searched from inception to March 24, 2012. Eleven mind-body studies were reviewed (meditation, yoga, biofeedback, hypnosis, relaxation, and imagery).
Results. Four high quality trials (yoga, mindfulness, relaxation, and biofeedback) were found helpful for a variety of MS symptoms.
Conclusions. The evidence for mind-body medicine in MS is limited, yet mind-body therapies are relatively safe and may provide a nonpharmacological benefit for MS symptoms.
Source : Autoimmune Diseases
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Faith as a Resource in Patients with Multiple Sclerosis Is Associated with a Positive Interpretation of Illness and Experience of Gratitude/Awe
Arndt Büssing,1,2 Anne-Gritli Wirth,1 Knut Humbroich,3 Kathrin Gerbershagen,4 Sebastian Schimrigk,5 Michael Haupts,6 Klaus Baumann,2,7 and Peter Heusser8
1Quality of Life, Spirituality and Coping, Institute of Integrative Medicine, Witten/Herdecke University, 58313 Herdecke, Germany
2Freiburg Institute for Advanced Studies (FRIAS), Universität Freiburg, 79098 Freiburg, Germany
3Department of Neurology, Communal Hospital Herdecke, 58313 Herdecke, Germany
4Department of Neurology and Palliative Care, Köln-Merheim Hospital, 51109 Cologne, Germany
5Neurological Hospital, Clinic of Lüdenscheid, 58515 Lüdenscheid, Germany
6Augusta Hospital Anholt, Neurological Hospital, 46419 Isselburg, Germany
7Caritas Science and Christian Social Work, Faculty of Theology, Albert-Ludwigs University, 79104 Freiburg, Germany
8Institute of Integrative Medicine, Witten/Herdecke University, 58313 Herdecke, Germany
Abstract
The aim of this cross-sectional anonymous survey with standardized questionnaires was to investigate which resources to cope were used by patients with multiple sclerosis (MS). We focussed on patients' conviction that their faith might be a strong hold in difficult times and on their engagement in different forms of spirituality. Consecutively 213 German patients (75% women; mean age 43 ± 11 years) were enrolled. Fifty-five percent regarded themselves as neither religious nor spiritual (R−S−), while 31% describe themselves as religious. For 29%, faith was a strong hold in difficult times. This resource was neither related to patients' EDSS scores, and life affections, fatigue, negative mood states, life satisfaction nor to Positive attitudes. Instead it was moderately associated with a Reappraisal strategy (i.e., and positive interpretation of illness) and experience of gratitude/awe. Compared to spiritual/religious patients, R−S− individuals had significantly ( ) lower Reappraisal scores and lower engagement in specific forms of spiritual practices. The ability to reflect on what is essential in life, to appreciate and value life, and also the conviction that illness may have meaning and could be regarded as a chance for development was low in R−S− individuals which either may have no specific interest or are less willing to reflect these issues.
Source : Evidence Based Complementary and Alternative Medicine
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High Vitamin D Levels in Pregnancy May Protect Mother More Than Baby Against Multiple Sclerosis
Pregnant women who have higher levels of vitamin D in their blood may have a lower risk of developing multiple sclerosis (MS) than women with lower levels, while their babies may not see the same protective effect, according to a study published in the November 20, 2012, online issue of Neurology®, the medical journal of the American Academy of Neurology. “In our study, pregnant women and women in general had a lower risk for MS with higher levels of the vitamin, as expected. However, a mother’s levels of vitamin D during early pregnancy did not have an effect on MS risk for her baby,” said study author Jonatan Salzer, MD, with Umeå University Hospital in Sweden.
For the study, scientists reviewed information about 291,500 blood samples from 164,000 people collected since 1975 in the northern half of Sweden. Of those, 192 people developed MS an average of nine years after their blood sample was drawn, and there were 37 blood samples drawn during pregnancy from mothers whose children went on to develop MS later in life.
The research found that women who had high levels of vitamin D in their blood had a 61 percent lower risk of developing MS, compared to those who had low levels of vitamin D in their blood. Overall, few people had high levels of vitamin D. Only seven of the 192 people who developed MS, or four percent, had high vitamin D levels, compared to 30 of 384 controls without the disease, or eight percent.
No association was found between the mother’s vitamin D level and whether her child would later develop MS.
“Since we found no protective effect on the baby for women with higher levels of vitamin D in early pregnancy, our study suggests the protective effect may start in later pregnancy and beyond,” said Salzer. “Another interesting finding in our study was that the vitamin D levels became gradually lower with time from 1975 and onward. It is possible that this decline in vitamin D status is linked to the increasing numbers of MS cases seen worldwide.”
Sources of vitamin D are diet, supplements and the sun.
Source : Newswise
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Smoked Cannabis Reduces Some Symptoms of Multiple Sclerosis
A clinical study of 30 adult patients with multiple sclerosis (MS) at the University of California, San Diego School of Medicine has shown that smoked cannabis may be an effective treatment for spasticity – a common and disabling symptom of this neurological disease.The placebo-controlled trial also resulted in reduced perception of pain, although participants also reported short-term, adverse cognitive effects and increased fatigue. The study will be published in the Canadian Medical Association Journal on May 14.
Principal investigator Jody Corey-Bloom, MD, PhD, professor of neurosciences and director of the Multiple Sclerosis Center at UC San Diego, and colleagues randomly assigned participants to either the intervention group (which smoked cannabis once daily for three days) or the control group (which smoked identical placebo cigarettes, also once a day for three days). After an 11-day interval, the participants crossed over to the other group.
“We found that smoked cannabis was superior to placebo in reducing symptoms and pain in patients with treatment-resistant spasticity, or excessive muscle contractions,” said Corey-Bloom.
Earlier reports suggested that the active compounds of medical marijuana were potentially effective in treating neurologic conditions, but most studies focused on orally administered cannabinoids. There were also anecdotal reports of MS patients that endorsed smoking marijuana to relieve symptoms of spasticity.
However, this trial used a more objective measurement, a modified Ashford scale which graded the intensity of muscle tone by measuring such things as resistance in range of motion and rigidity. The secondary outcome, pain, was measured using a visual analogue scale. The researchers also looked at physical performance (using a timed walk) and cognitive function and – at the end of each visit – asked patients to assess their feeling of “highness.”
Although generally well tolerated, smoking cannabis did have mild effects on attention and concentration. The researchers noted that larger, long-terms studies are needed to confirm their findings and determine whether lower doses can result in beneficial effects with less cognitive impact.
The current study is the fifth clinical test of the possible efficacy of cannabis for clinical use reported by the University of California Center for Medicinal Cannabis Research (CMCR). Four other human studies on control of neuropathic pain also reported positive results.
“The study by Corey Bloom and her colleagues adds to a growing body of evidence that cannabis has therapeutic value for selected indications, and may be an adjunct or alternative for patients whose spasticity or pain is not optimally managed,” said Igor Grant, MD, director of the CMCR, which provided funding for the study.
Source : Newswise
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UV radiation, not vitamin D, might limit multiple sclerosis symptoms Sunshine effects on MS might be more complicated than previously thought, mouse study suggests
Ultraviolet radiation from sunshine seems to thwart multiple sclerosis, but perhaps not the way most researchers had assumed, a new study in mice suggests.If validated in further research, the finding could add a twist to a hypothesis that has gained credence in recent decades. The report appears online March 22 in the Proceedings of the National Academy of Sciences.
Scientists have hypothesized that MS is rare in the tropics because people synthesize ample vitamin D from exposure to the UV radiation in equatorial sunlight. What’s more, MS is more common in the high latitudes of northern parts of Europe and North America than in regions farther south. That pattern has led to the assumption that higher levels of vitamin D might prevent people from developing MS, what became known as the latitude hypothesis.
But a direct cause-and-effect relationship between vitamin D deficiency and MS has never been established. In past experiments, giving vitamin D supplements to mice with an MS-like disease required giving the animals harmful amounts of the nutrient, notes Hector DeLuca, a biochemist at the University of Wisconsin–Madison. “It just didn’t add up,” he says. “We decided to go back and see if maybe UV light by itself was doing something.”In MS, the fatty myelin sheaths that insulate nerves in the central nervous system are damaged by attacks by the immune system. In a series of experiments in mice, DeLuca and his team induced a condition comparable to human MS by injecting the animals with proteins that instigate similar myelin damage. The researchers exposed some mice to UV radiation before and after giving the animals the damaging injection. Another group of mice got the injection but not the UV exposure. The mice exposed to UV rays suppressed the effects of MS-like disease better than the control mice, the researchers found, even though the amount of radiation wasn’t enough to greatly increase the animals’ blood concentrations of vitamin D. In another test, the researchers gave injected mice varying doses of vitamin D supplements, but no UV radiation. The supplements failed to control the disease onset, severity or progression.“We concluded that UV light is doing something beyond [making] vitamin D,” DeLuca says. There’s no question that the latitude hypothesis has merit, says George Ebers, a neurologist at the University of Oxford in England. “MS risk is geographically related.” But that risk is more complicated than exposure to UV radiation during an MS attack, as this mouse model used. For example, previous research has shown that children in northern latitudes who are born in May, after their mothers had spent a winter with little sunshine, are more likely to develop MS than are kids born in November, he says.Ebers notes that mice in this study were exposed or not exposed to UV over a matter of weeks and were in the throes of an MS-like disease during the study. “That’s completely separate ... from the question of whether your risk is boosted or diminished by where your mother lived,” he says.Apart from the timing issue, MS risk might well be influenced by a biological mechanism apart from vitamin D blood levels, but many questions remain, Ebers says. Those include how UV radiation might inhibit MS and, more specifically, what is the effect of UV rays in suppressing the immune system. “It’s quite possible that UV exposure will have a number of other mechanisms and be involved in hormonal circuits,” he says.DeLuca and his colleagues speculate that UV radiation is playing a mysterious role in MS that is independent of vitamin D production. “We're doing experiments trying to find out what it is," he says. Suggested Reading:
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Trevor O. Kirby andJavier Ochoa-Repáraz
Abstract
Recently, there has been a substantial increase in the number of studies focused upon connecting the gut microbiome with cases of central nervous system (CNS) autoimmunity. Multiple sclerosis (MS) is a neurodegenerative autoimmune disorder of the CNS. Recent experimental and clinical evidence suggests the presence of microbial imbalances in the gut of MS sufferers. The gut microbiome is defined as the summation of all the microbial entities as well as their genes, proteins, and metabolic products in a given space and time. Studies show the MS gut microbiome as having general alterations in specific taxa, some associated with the promotion of inflammatory cytokines and overall inflammation. In conjunction with these findings, experimental models of the disease have reported that T regulatory (Treg) cells have deficits in their function as a result of the aberrant gut microbiota composition. The findings suggest that the interactions between the host and the microbiota are reciprocal, although more extensive work is required to confirm this. Moreover, evidence indicates that changes in microbiota composition may result in imbalances that could result in disease, with the gut as a potential novel therapeutic avenue. By understanding the biological effects of aberrant gut microbiome composition, it is possible to contemplate current therapeutic options and their efficacy. Ultimately, more research is necessary in this field, but targeting the gut microbiota may lead to the development of novel therapeutic strategies
Source : Journal Medical Sciences
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Soda, Sugar-Sweetened Beverages Linked to More Severe Symptoms for People with MS
For people with multiple sclerosis (MS), drinking around 290 calories per day of soda or other sugar-sweetened beverages, or the equivalent of about two cans of non-diet soda, may be tied to more severe symptoms and a higher level of disability compared to people with MS who seldom consume sugar-sweetened beverages, according to a preliminary study released today that will be presented at the American Academy of Neurology’s 71st Annual Meeting in Philadelphia, May 4 to 10, 2019. People who seldom drank sugar-sweetened beverages consumed an average of seven calories in sugar-sweetened beverages per day, or the equivalent of one-and-a-half cans of non-diet soda per month. Soda and other sweet beverages were the only type of food that was related to MS symptoms in the study.
“MS patients often want to know how diet and specific foods can affect the progression of their disease,” said study author Elisa Meier-Gerdingh, MD, of St. Josef Hospital in Bochum, Germany, and a member of the American Academy of Neurology. “While we did not find a link with overall diet, interestingly, we did find a link with those who drank sodas, flavored juices and sweetened teas and coffees.”
The study involved 135 people with MS. Participants completed a questionnaire about their diet. Researchers then looked at how close each participants’ diet was to the Dietary Approaches to Stop Hypertension (DASH) diet. The DASH diet recommends whole grains, fruits and vegetables, low-fat dairy products, lean meats, poultry and fish, and nuts and legumes and limits foods that are high in saturated fat and sugar.
“We chose to study the DASH diet because adherence to the DASH diet is associated with lower risk of other chronic diseases like high blood pressure, diabetes and cardiovascular diseases,” said Meier-Gerdingh.
Researchers also measured the participants’ level of disability using the Expanded Disability Status Scale, a common method to quantify disability ranging from 0, no symptoms, to 10 points, death due to MS. A total of 30 participants had severe disability.
Overall, researchers did not find a link between what participants ate and their level of disability.
For soda and sugar-sweetened beverages, the participants were divided into five groups based on how much they drank. The people in the top group drank an average of 290 calories of sugar-sweetened beverages per day, while the lowest group seldom drank sugar-sweetened beverages.
The study found that participants who consumed the largest amounts of sugar-sweetened beverages were five times more likely to have severe disability than people who seldom drank sugar-sweetened beverages. Of the 34 people in the top group, 12 had severe disability, compared to 4 of the 34 people in the bottom group. The top group had on average a disability score of 4.1 points, while the bottom group had an average of 3.4 points.
“While these results need to be confirmed by larger studies that follow people over a long period of time, and the results do not show that soda and sugar-sweetened beverages cause more severe disability, we do know that sodas have no nutritional value and people with MS may want to consider reducing or eliminating them from their diet,” Meier-Gerdingh said.
Limitations of the study include the relatively small number of participants. The study also assessed participants’ diets and sugar-sweetened beverages at the same time as disability, so it is not possible to distinguish whether it is actually an aspect of diet, like sugar-sweetened beverages, that contributes to higher disability or whether more severe disease impacts a person’s ability to have a healthy diet.
Additional studies are needed to evaluate whether sugar-sweetened beverages affect the course of the disease
Source : American Academy of Neurology via Newswise
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Food allergies are associated with increased disease activity in multiple sclerosis
Rami Fakih, Camilo Diaz-Cruz, Alicia S Chua, Cindy Gonzalez, Brian C Healy, Neda Sattarnezhad, Bonnie I Glanz, Howard L Weiner,Tanuja Chitnis
Abstract
Objective The association between allergy and multiple sclerosis (MS) is still unclear. In our study, we assessed the association between a self-reported history of allergic conditions with MS clinical and MRI disease activity.
Methods A subset of 1349 patients enrolled in the Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women’s Hospital (CLIMB) study completed a self-administered questionnaire on environmental, food and drug allergies. Patients were distributed among four allergy groups: (1) environmental, (2) food, (3) drug, (4) no known allergies (NKA). Clinical (number of attacks, expanded disability status scale (EDSS), MS severity score (MSSS)) and radiological variables (presence of gadolinium-enhancing lesions and lesion count), and their associations with the different allergy groups or those with NKA, were assessed.
Results The food allergy group had a 1.38 times higher rate for cumulative number of attacks compared with the NKA group (P=0.0062); this difference remained significant in the adjusted analysis (relapse rate ratio 1.27, P=0.0305). The food allergy group showed more than twice the likelihood (OR 2.53, P=0.0096) of having gadolinium-enhancing lesions on MRI. The environmental and drug allergy groups did not show significant differences when compared with the NKA group. The EDSS and MSSS were not affected by any type of allergy.
Conclusions MS patients with food allergy had more relapses and a higher likelihood of gadolinium-enhancing lesions compared with patients with no known allergy. Future prospective studies are needed to confirm our findings and investigate underlying biological mechanisms, which may unveil new therapeutic and preventative strategies for MS.
Source : Journal of Neurology, Neurosurgery & Psychiatry
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[Effect of Chinese Herbs Used in Treating Multiple Sclerosis on T Subsets Using Association Rules].
[Article in Chinese]
Zhang Q, Li T, Xu YG, Yang XH
Abstract
OBJECTIVE:To analyze the effect of Chinese herbs used by Prof. LI Tao on peripheral blood T subsets in treating multiple sclerosis (MS) by using association rules and statistical methods, thereby providing evidence for optimizing prescriptions.
METHODS:Data of MS inpatients and outpatients recorded by data collecting system, Xiyuan Hospital, China Academy of Chinese Medical Sciences were resorted. The relationship between Chinese herbs and T cell subsets were analyzed using SPSS17.0 and Aprior module in SPSS Clementine 12.0.
RESULTS:Radix bupleuri, Radix Paeoniae alba, Fructus Aurantii, Atractylodes, and Radix Glycyrrhizae were most commonly used herbal combinations.Radix Aconiti lateralis preparata and Rhizoma Smilacis glabrae were often added. Radix Aconiti lateralis preparata was associated with decreased Th1 cells (confidence level 83.78%, supportive level 36.26%). Decreased Th1 cell was associated with Radix Aconiti lateralis preparata (confidence level 71.26%, supportive level 36.26%).Radix Aconiti lateralis preparata was obviously associated with decreased Th1 cells. Radix Bupleuri, Radix Paeoniae alba, bitter orange, Atractylodes , Radix glycyrrhizae, and Radix Aconiti lateralis preparata could reduce peripheral blood Th1 subsets of MS patients and elevate Th2 subsets (all P < 0.01).
CONCLUSIONS:The herbal combination of Radix Bupleuri, Radix Paeoniae alba, Fructus Aurantii, Atractylodes, Radix Glycyrrhizae, Rhizoma Smilacis glabrae, and Radix Aconiti lateralis preparata could lower peripheral blood Th1 cells and elevate Th2 cells, and prevent the relapse of MS possibly by reducing Th1 cells and elevating Th2 cells. Especially Radix Aconiti lateralis preparata played important roles in aforesaid changes of Th1 and Th2.
Source : US National Library of Medicine National Institutes of Health
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Association of Vitamin D Levels With Multiple Sclerosis Activity and Progression in Patients Receiving Interferon Beta-1b
Kathryn C. Fitzgerald, ScM1; Kassandra L. Munger, ScD1; Karl Köchert, MD2; Barry G. W. Arnason, MD3; Giancarlo Comi, MD4; Stuart Cook, MD5; Douglas S. Goodin, MD6; Massimo Filippi, MD7; Hans-Peter Hartung, MD, FRCP8; Douglas R. Jeffery, MD, PhD9; Paul O’Connor, MD10; Gustavo Suarez, MD11; Rupert Sandbrink, MD, PhD2,12; Ludwig Kappos, MD13; Christoph Pohl, MD†2,14; Alberto Ascherio, MD, DrPH1,1
Abstract
Importance Low serum 25-hydroxyvitamin D (25[OH]D) levels are associated with an increased risk of multiple sclerosis (MS) as well as with increased disease activity and rate of progression in clinically isolated syndromes and early MS.
Objective To assess the association between 25(OH)D and disease course and prognosis in patients with relapsing-remitting MS treated with interferon beta-1b.
Design, Setting, and Participants We conducted a prospective cohort study assessing 25(OH)D levels and subsequent MS disease course and progression characterized by magnetic resonance imaging (MRI) and clinical end points. The study took place between November 2003 and June 2005; data analysis was performed between June 2013 and December 2014. The study was conducted among participants in the Betaferon Efficacy Yielding Outcomes of a New Dose (BEYOND) study, a large, phase 3, prospective, multicenter, blinded, randomized clinical trial. Patients were monitored for at least 2 years. Clinic visits were scheduled every 3 months, and MRI was performed at baseline and annually thereafter. Eligible patients included 1482 participants randomized to receive 250 μg or 500 μg of interferon-1b with at least 2 measurements of 25(OH)D obtained 6 months apart.
Exposures Serum 25(OH)D measurements were performed at baseline, 6 months, and 12 months.
Main Outcomes and Measures Main outcomes included cumulative number of new active lesions (T2 lesions and gadolinium acetate–enhancing lesions), change in normalized brain volume, relapse rate, and progression determined by the Expanded Disability Status Scale (EDSS). Statistical analyses were adjusted for age, sex, randomized treatment, region, disease duration, and baseline EDSS score.
Results Overall, average 25(OH)D levels in 1482 patients were significantly inversely correlated with the cumulative number of new active lesions between baseline and the last MRI, with a 50.0-nmol/L increase in serum 25(OH)D levels associated with a 31% lower rate of new lesions (relative rate [RR], 0.69; 95% CI, 0.55-0.86; P = .001). The lowest rate of new lesions was observed among patients with 25(OH)D levels greater than 100.0 nmol/L (RR, 0.53; 95% CI, 0.37-0.78; P = .002). No significant associations were found between 25(OH)D levels and change in brain volume, relapse rates, or EDSS scores. Results were consistent following adjustment for HLA-DRB1*15 or vitamin D–binding protein status.
Conclusions and Relevance Among patients with MS treated with interferon beta-1b, higher 25(OH)D levels were associated with lower rates of MS activity observed on MRI. Results for brain atrophy and clinical progression were more equivocal.
Source : JAMA
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Effect of Tai Chi Chuan on Balance in Women with Multiple Sclerosis
Elaheh Azimzadeh, MSc. in Medical Surgical Nursing, MohammadAli Hosseini, Ph.D. in Higher Education Administration (Associatet Prof) , Kian Nourozi, Ph.D. in Nursing (Assistant Prof) , Patricia Mary Davidson, Ph.D. RN (Professor of Cardiovascular & Chronic Care)
Abstract
Objective To examine the effect of Tai Chi Chuan on balance in women with multiple sclerosis in Iran.
Design 36 women with multiple sclerosis who were members of the Iranian Multiple Sclerosis Society participated in this study. 18 participants were allocated to the intervention group and 18 allocated to the control group. The intervention consisted of Yang style Tai Chi Chuan exercise sessions twice a week for 12 weeks.
Main Outcome Measures This study used a demographic questionnaire and the Berg Balance Scale (BBS) to collect data.
Results After 12 weeks, the mean score of the BBS in the intervention group demonstrated a statistically significant improvement in comparison with baseline status.
Conclusions The results suggest that Tai Chi Chuan could be used as a safe complementary intervention to increase balance in patients with multiple sclerosis.
Source : Complementary Therapies in Clinical Practise
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Yoga Relieves Multiple Sclerosis Symptoms, Rutgers Study Finds
Specialized program improved quality of life, decreased pain and fatigue Paula Meltzer was only 38 when out of nowhere everything she looked at was blurry. For the single mother, who had a lucrative career as a gemologist and spent hours examining valuable pieces of jewelry, it seemed as if – in a split second – her life changed.
At first doctors thought Meltzer had a brain tumor. What they determined after further tests, however, was that she had multiple sclerosis, an autoimmune disease that affects the brain and central nervous system and was causing optic neuritis, an inflammation of the optic nerve that can cause a partial or complete loss of vision.
“I was living independently, doing my job, taking care of my child – and then I had to look to my parents to take care of me,” Meltzer said.
Almost two decades later, Meltzer, out of a wheelchair and walking without a cane, was one of 14 women with moderate disability due to MS who participated in a pilot trial conducted by the Rutgers School of Health Related Professions. A specially-designed yoga program for these MS patients not only improved their physical and mental well-being but also enhanced their overall quality of life.
“I felt like I became steadier and stronger in my core,” Meltzer said. Prior to yoga, she described herself as a “wall walker,” someone who felt safer holding onto the wall in order to get around. “To be able to stand on one leg and feel balanced is amazing.”
Susan Gould Fogerite, director of research for the Institute for Complementary and Alternative Medicine in the School of Health Related Professions, said that although there is widespread evidence that yoga is being used as a form of exercise by those with MS, much of the feedback has been anecdotal and there isn’t much empirical data regarding its safety and efficacy.
This is why she and her colleagues, Evan Cohen and David Kietrys, physical therapists and associate professors in the School of Health Related Professions at Stratford, decided to undertake the small pilot study, believing that a specialized yoga program for MS patients – which incorporates mind, body and spirit – would be beneficial to everyday living.
What they discovered at the end of the eight-week trial was that those who participated were better able to walk for short distances and longer periods of time, had better balance while reaching backwards, fine motor coordination, and were better able to go from sitting to standing. Their quality of life also improved in perceived mental health, concentration, bladder control, walking, and vision, with a decrease in pain and fatigue.
“Yoga is not just exercise, it is a whole system of living,” said Fogerite, an associate professor, who, along with Kietrys, will present the results on September 26 at the Symposium on Yoga Research at the Kripalu Institute in Massachusetts. “The panel of experts who advised us on the trial wanted to make sure that we provided a fully integrated program that included philosophy, breathing practices, postures, relaxation and meditation.”
The yoga pilot trial was held at Still Point Yoga Center in Laurel Springs, a southern New Jersey town close to Philadelphia. Of the 72 individuals who were interested in participating, only 16 were eligible based on medical and other criteria and availability. Of those, 15 were enrolled and 14 completed the program after one person had to withdraw because of an unrelated health problem.
Meltzer and the other women who participated in the trial ranged in age from 34 to 64. Some had been diagnosed with MS within the last two years while others had been living with the illness for up to 26 years. For 90 minutes, twice a week for two months, they practiced techniques and exercises that would improve their posture, help to increase stamina, and teach them how to relax and focus.
“This study, I hope, is one of many that will give us the clinical information we need,” said Fogerite. “Yoga is not currently being widely prescribed for people with MS, although it might turn out to be a very helpful treatment.”
The yoga practices were done by the women in the study sitting, standing, or lying on yoga mats, and using metal folding chairs situated close to the wall to provide them with more support.
“What was so nice about this experience was that although everyone was at a different level of the disease, we felt like we were all together, so I think the camaraderie helped,” said Meltzer. “And it wasn’t just about gaining more mobility and balance in our legs but our arms and necks felt stronger as well.”
Fogerite said a larger randomized controlled trial would be needed to determine whether yoga could be used as a prescribed treatment for individuals with moderate disability due to MS. More than 2.3 million people – two to three times more women than men – throughout the world are diagnosed with this disease which can cause poor coordination, loss of balance, slurred speech, tremors, numbness, extreme fatigue and problems with memory and concentration.
“When I was first diagnosed I no longer felt safe in my own body,” Meltzer said. "I didn’t trust my body at all. What the program did was really bring that trust back.”
Source : University of New Jersey
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The Effects of Pranayama, Hatha and Raja Yoga on Physical Pain and the Quality of Life of Women with Multiple Sclerosis
Shahla Najafi Doulatabad, Khirollah Nooreyan, Ardavan Najafi Doulatabad, and Zinat Mohebbi Noubandegani
Abstract
In a clinical trial carried out on 60 women with multiple sclerosis, the researchers obtained data using survey questionnaires. In addition to demographic data, the Multiple Sclerosis Quality of Life-54 (MSQoL-54) instrument was used to determine how multiple sclerosis influences the quality of life of the studied women. Within the frame of this randomized controlled trial, the participants were divided into two equally sized groups (the case and the control group) in which the level of pain and the quality of life were evaluated. The case group exercised pain-managing Yoga methods for three months, keeping the pace of eight 90 minute - sessions per month. The control participants were subjected to no intervention. One month after the Yoga therapy, the level of pain and the quality of life were evaluated in both groups and compared to the baseline data. Data were analyzed using SPSS software and paired t-tests. After the Yoga therapy, the case group showed a significant improvement in physical pain management (P=0.007) and the quality of life (P=0.001) as compared to the control group. The results showed that Yoga techniques can alleviate physical pain and improve the quality of life of multiple sclerosis patients.
Source : Afr J Tradit Complement Altern Med. 2013; 10(1): 49–52.
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Mind-Body Medicine for Multiple Sclerosis: A Systematic Review
Angela Senders,1 Helané Wahbeh,1 Rebecca Spain,1,2 and Lynne Shinto1
1Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA
2Department of Neurology, Portland Veterans Affairs Medical Center, Portland, OR 97239, USA
Abstract
Background. Mind-body therapies are used to manage physical and psychological symptoms in many chronic health conditions. Objective. To assess the published evidence for using mind-body techniques for symptom management of multiple sclerosis.
Methods. MEDLINE, PsycINFO, and Cochrane Clinical Trials Register were searched from inception to March 24, 2012. Eleven mind-body studies were reviewed (meditation, yoga, biofeedback, hypnosis, relaxation, and imagery).
Results. Four high quality trials (yoga, mindfulness, relaxation, and biofeedback) were found helpful for a variety of MS symptoms.
Conclusions. The evidence for mind-body medicine in MS is limited, yet mind-body therapies are relatively safe and may provide a nonpharmacological benefit for MS symptoms.
Source : Autoimmune Diseases
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Faith as a Resource in Patients with Multiple Sclerosis Is Associated with a Positive Interpretation of Illness and Experience of Gratitude/Awe
Arndt Büssing,1,2 Anne-Gritli Wirth,1 Knut Humbroich,3 Kathrin Gerbershagen,4 Sebastian Schimrigk,5 Michael Haupts,6 Klaus Baumann,2,7 and Peter Heusser8
1Quality of Life, Spirituality and Coping, Institute of Integrative Medicine, Witten/Herdecke University, 58313 Herdecke, Germany
2Freiburg Institute for Advanced Studies (FRIAS), Universität Freiburg, 79098 Freiburg, Germany
3Department of Neurology, Communal Hospital Herdecke, 58313 Herdecke, Germany
4Department of Neurology and Palliative Care, Köln-Merheim Hospital, 51109 Cologne, Germany
5Neurological Hospital, Clinic of Lüdenscheid, 58515 Lüdenscheid, Germany
6Augusta Hospital Anholt, Neurological Hospital, 46419 Isselburg, Germany
7Caritas Science and Christian Social Work, Faculty of Theology, Albert-Ludwigs University, 79104 Freiburg, Germany
8Institute of Integrative Medicine, Witten/Herdecke University, 58313 Herdecke, Germany
Abstract
The aim of this cross-sectional anonymous survey with standardized questionnaires was to investigate which resources to cope were used by patients with multiple sclerosis (MS). We focussed on patients' conviction that their faith might be a strong hold in difficult times and on their engagement in different forms of spirituality. Consecutively 213 German patients (75% women; mean age 43 ± 11 years) were enrolled. Fifty-five percent regarded themselves as neither religious nor spiritual (R−S−), while 31% describe themselves as religious. For 29%, faith was a strong hold in difficult times. This resource was neither related to patients' EDSS scores, and life affections, fatigue, negative mood states, life satisfaction nor to Positive attitudes. Instead it was moderately associated with a Reappraisal strategy (i.e., and positive interpretation of illness) and experience of gratitude/awe. Compared to spiritual/religious patients, R−S− individuals had significantly ( ) lower Reappraisal scores and lower engagement in specific forms of spiritual practices. The ability to reflect on what is essential in life, to appreciate and value life, and also the conviction that illness may have meaning and could be regarded as a chance for development was low in R−S− individuals which either may have no specific interest or are less willing to reflect these issues.
Source : Evidence Based Complementary and Alternative Medicine
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High Vitamin D Levels in Pregnancy May Protect Mother More Than Baby Against Multiple Sclerosis
Pregnant women who have higher levels of vitamin D in their blood may have a lower risk of developing multiple sclerosis (MS) than women with lower levels, while their babies may not see the same protective effect, according to a study published in the November 20, 2012, online issue of Neurology®, the medical journal of the American Academy of Neurology. “In our study, pregnant women and women in general had a lower risk for MS with higher levels of the vitamin, as expected. However, a mother’s levels of vitamin D during early pregnancy did not have an effect on MS risk for her baby,” said study author Jonatan Salzer, MD, with Umeå University Hospital in Sweden.
For the study, scientists reviewed information about 291,500 blood samples from 164,000 people collected since 1975 in the northern half of Sweden. Of those, 192 people developed MS an average of nine years after their blood sample was drawn, and there were 37 blood samples drawn during pregnancy from mothers whose children went on to develop MS later in life.
The research found that women who had high levels of vitamin D in their blood had a 61 percent lower risk of developing MS, compared to those who had low levels of vitamin D in their blood. Overall, few people had high levels of vitamin D. Only seven of the 192 people who developed MS, or four percent, had high vitamin D levels, compared to 30 of 384 controls without the disease, or eight percent.
No association was found between the mother’s vitamin D level and whether her child would later develop MS.
“Since we found no protective effect on the baby for women with higher levels of vitamin D in early pregnancy, our study suggests the protective effect may start in later pregnancy and beyond,” said Salzer. “Another interesting finding in our study was that the vitamin D levels became gradually lower with time from 1975 and onward. It is possible that this decline in vitamin D status is linked to the increasing numbers of MS cases seen worldwide.”
Sources of vitamin D are diet, supplements and the sun.
Source : Newswise
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Smoked Cannabis Reduces Some Symptoms of Multiple Sclerosis
A clinical study of 30 adult patients with multiple sclerosis (MS) at the University of California, San Diego School of Medicine has shown that smoked cannabis may be an effective treatment for spasticity – a common and disabling symptom of this neurological disease.The placebo-controlled trial also resulted in reduced perception of pain, although participants also reported short-term, adverse cognitive effects and increased fatigue. The study will be published in the Canadian Medical Association Journal on May 14.
Principal investigator Jody Corey-Bloom, MD, PhD, professor of neurosciences and director of the Multiple Sclerosis Center at UC San Diego, and colleagues randomly assigned participants to either the intervention group (which smoked cannabis once daily for three days) or the control group (which smoked identical placebo cigarettes, also once a day for three days). After an 11-day interval, the participants crossed over to the other group.
“We found that smoked cannabis was superior to placebo in reducing symptoms and pain in patients with treatment-resistant spasticity, or excessive muscle contractions,” said Corey-Bloom.
Earlier reports suggested that the active compounds of medical marijuana were potentially effective in treating neurologic conditions, but most studies focused on orally administered cannabinoids. There were also anecdotal reports of MS patients that endorsed smoking marijuana to relieve symptoms of spasticity.
However, this trial used a more objective measurement, a modified Ashford scale which graded the intensity of muscle tone by measuring such things as resistance in range of motion and rigidity. The secondary outcome, pain, was measured using a visual analogue scale. The researchers also looked at physical performance (using a timed walk) and cognitive function and – at the end of each visit – asked patients to assess their feeling of “highness.”
Although generally well tolerated, smoking cannabis did have mild effects on attention and concentration. The researchers noted that larger, long-terms studies are needed to confirm their findings and determine whether lower doses can result in beneficial effects with less cognitive impact.
The current study is the fifth clinical test of the possible efficacy of cannabis for clinical use reported by the University of California Center for Medicinal Cannabis Research (CMCR). Four other human studies on control of neuropathic pain also reported positive results.
“The study by Corey Bloom and her colleagues adds to a growing body of evidence that cannabis has therapeutic value for selected indications, and may be an adjunct or alternative for patients whose spasticity or pain is not optimally managed,” said Igor Grant, MD, director of the CMCR, which provided funding for the study.
Source : Newswise
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UV radiation, not vitamin D, might limit multiple sclerosis symptoms Sunshine effects on MS might be more complicated than previously thought, mouse study suggests
Ultraviolet radiation from sunshine seems to thwart multiple sclerosis, but perhaps not the way most researchers had assumed, a new study in mice suggests.If validated in further research, the finding could add a twist to a hypothesis that has gained credence in recent decades. The report appears online March 22 in the Proceedings of the National Academy of Sciences.
Scientists have hypothesized that MS is rare in the tropics because people synthesize ample vitamin D from exposure to the UV radiation in equatorial sunlight. What’s more, MS is more common in the high latitudes of northern parts of Europe and North America than in regions farther south. That pattern has led to the assumption that higher levels of vitamin D might prevent people from developing MS, what became known as the latitude hypothesis.
But a direct cause-and-effect relationship between vitamin D deficiency and MS has never been established. In past experiments, giving vitamin D supplements to mice with an MS-like disease required giving the animals harmful amounts of the nutrient, notes Hector DeLuca, a biochemist at the University of Wisconsin–Madison. “It just didn’t add up,” he says. “We decided to go back and see if maybe UV light by itself was doing something.”In MS, the fatty myelin sheaths that insulate nerves in the central nervous system are damaged by attacks by the immune system. In a series of experiments in mice, DeLuca and his team induced a condition comparable to human MS by injecting the animals with proteins that instigate similar myelin damage. The researchers exposed some mice to UV radiation before and after giving the animals the damaging injection. Another group of mice got the injection but not the UV exposure. The mice exposed to UV rays suppressed the effects of MS-like disease better than the control mice, the researchers found, even though the amount of radiation wasn’t enough to greatly increase the animals’ blood concentrations of vitamin D. In another test, the researchers gave injected mice varying doses of vitamin D supplements, but no UV radiation. The supplements failed to control the disease onset, severity or progression.“We concluded that UV light is doing something beyond [making] vitamin D,” DeLuca says. There’s no question that the latitude hypothesis has merit, says George Ebers, a neurologist at the University of Oxford in England. “MS risk is geographically related.” But that risk is more complicated than exposure to UV radiation during an MS attack, as this mouse model used. For example, previous research has shown that children in northern latitudes who are born in May, after their mothers had spent a winter with little sunshine, are more likely to develop MS than are kids born in November, he says.Ebers notes that mice in this study were exposed or not exposed to UV over a matter of weeks and were in the throes of an MS-like disease during the study. “That’s completely separate ... from the question of whether your risk is boosted or diminished by where your mother lived,” he says.Apart from the timing issue, MS risk might well be influenced by a biological mechanism apart from vitamin D blood levels, but many questions remain, Ebers says. Those include how UV radiation might inhibit MS and, more specifically, what is the effect of UV rays in suppressing the immune system. “It’s quite possible that UV exposure will have a number of other mechanisms and be involved in hormonal circuits,” he says.DeLuca and his colleagues speculate that UV radiation is playing a mysterious role in MS that is independent of vitamin D production. “We're doing experiments trying to find out what it is," he says. Suggested Reading:
- Timonen, T.T. 1999. A hypothesis concerning deficiency of sunlight, cold temperature, and influenza epidemics associated with the onset of acute lymphoblastic leukemia in northern Finland. Annals of Hemotology, 78 (Sept.): 408-414.
- Goldberg, P. 1974. Multiple Sclerosis: Vitamin D and calcium as environmental determinants of prevalence (a viewpoint). Part 1: Sunlight, dietary factors, and epidemiology. International Journal of Environmental Studies, Vol. 6:19–27.
- Ebers, G.C. and Sadovnick, A.D. 1993. The geographic distribution of multiple sclerosis: a review. Neuroepidemiology, 12:1–5.
- Francisco, E. 2004. Vitamin D and multiple sclerosis. Science News 165(Jan. 31):77. Available online to subscribers only at [Go to]
- Seppa, Nathan. 2007. New clues: Gene variations may contribute to MS risk. Science News 172(August 4): 70. Available online to subscribers only at [Go to]
- Seppa, Nathan. 2007. Good light: Sun early in life could protect against MS. Science News 172(July 28): 51. Available online to subscribers only at [Go to]
- Wille, C.J. et al. 2005. Timing of birth and risk of multiple sclerosis: population based study .
British Medical Journal, 330:(Jan. 15)120.
doi:10.1136/bmj.38301.686030.63
- Becklund, B.R. et al. 2010. UV radiation suppresses experimental autoimmune encephalomyelitis independent of vitamin D production. PNAS, online March 22. Doi: 10.1073/pnas.1001119107
http:www.pnas.org/cgi/doi/10.1073/pnas.1001119107
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