Research news - May 2012
Open Door - May 2012 pages 4-5
- Planning takes longer with MS
- Who do you think you are?
- Sight problems in benign MS
- Barts and London Research Day
Planning takes longer with MS
This study looked at planning, problem solving and performance using the Tower of London test. This test has a board with three posts stacked with a small number of beads of different colours. The person being tested has to rearrange the beads, moving only one at a time, to get a target result set by the researcher. Successfully completing the test requires someone to plan all the moves before carrying out what they have planned.
In this study, three groups (people with relapsing remitting MS, people with secondary progressive MS and healthy controls) were tested. The researchers measured how long the person took in planning all their moves and whether they successfully completed the test.
They found that people with either type of MS took much longer to plan their moves than the healthy controls. They also showed a greater variation in how long they took to plan as the task was made harder. However, there was no difference between the three groups in how well they completed the task (whether they had all the coloured beads on the correct posts).
Denney DR, et al.
Deficits in planning time but not performance in patients with multiple sclerosis.
Archives of Clinical Neuropsychology 2012;27(2):148-158.
Problems with memory, concentration and planning are common in MS.
This research is relevant to tasks in everyday life, like making a meal which might involve planning all the stages before starting to cook. The conclusions are important as they suggest that, given enough time, people with MS can complete a task very well. What can be difficult is being rushed to finish something.StayingSmart is a web site that has tips for coping with day to day memory, concentration, planning and other cognitive problems.
Who do you think you are?
Someone's idea of themself as a person relies on a number of things which they think are important, such as their job, being a parent or being good at something. When life changes in a big way, it can affect someone's sense of who they are.
In this study of 12 people, the researchers found that having MS often altered the way someone saw themselves. However, this was not usually thought of as a loss but as a change to their identity.
Those who felt the strongest sense of loss were those whose symptoms had the most effect on their ability to fulfil the roles that they thought were important. For example, if someone was very physically fit before they had MS, then their identity was more likely to be affected by physical symptoms. This was then more likely to lead to anxiety or depression.
People with MS may be able to maintain their sense of self by reconnecting with the activities and roles that matter most to them, although this might be in a different way from before MS.
Mozo-Dutton L, et al.
MS and me: exploring the impact of multiple sclerosis on perceptions of self.
Disability and Rehabilitation 2011 Dec 13. [Epub ahead of print]
Adjusting to life with MS can be a challenge as it may be difficult to continue with some activities. This can be frustrating but some people find talents and interests that they had never explored before.
Later in this issue, Jennifer Willis describes how she developed an interest in photography, something she can do even when MS keeps her on the sofa.
More suggestions can be found in the Staying Active section of the website.
Sight problems in benign MS
About 15% of people with MS have very occasional relapses which are usually relatively mild with good recovery. In between are long periods with very few symptoms. This is sometimes called benign MS and can only be confirmed in hindsight.
Benign MS is defined in this study as an EDSS score of 3 or less after 15 years or more since symptoms first started. EDSS (Expanded Disability Status Scale) is a commonly used measure of disability, with 3 indicating that someone can walk without help but has moderate disability in other aspects of their MS, such as vision, sensation or continence.
The research looked at how nerves at the back of the eye (the retinal nerve fibre layer) might be affected in benign MS and how this related to sight problems.
13 out of 68 people (19%) already taking part in a long-term study of visual problems had benign MS. They had the same amount of thinning to the retinal nerve fibre layer as people with other types of MS. Both groups had significant difficulties in sight tests where they had to distinguish objects from backgrounds of a similar colour in low light conditions.
People with benign MS were more likely (69%) to have had optic neuritis than people with other types of MS (33%).
The researchers concluded that sight problems accounted for a large part of the disability of people with benign MS. However, their overall neurological symptoms were mild, giving a low EDSS score that might not fully reflect the impact of MS on their quality of life.
Galetta KM, et al.
Visual pathway axonal loss in benign multiple sclerosis: a longitudinal study.
Journal of Neuro-ophthalmology 2012 Jan 20. [Epub ahead of print]
Benign MS is a rather misleading name. This study shows that problems with eyesight are quite common in people with benign MS who can be seriously affected. However this is not always obvious to others, making this type of MS sometimes difficult to explain.
Barts and London Research Day
The Barts and The London Neuroimmunology Group held their third MS Research Day in January.
The Group is actively involved in MS research, from basic laboratory investigations through to clinical studies of new drugs. This event was an opportunity for people with MS, their family and friends to hear about the latest studies, talk to individual scientists and neurologists and feedback their own observations, frustrations and priorities for future research.
A ten minute alarm bell helped to keep talks short and to the point. Topics included:
- an update on new treatments being tested for relapsing remitting MS, including fingolimod, teriflunomide, BG-12 and alemtuzumab
- trials of treatments for progressive MS and difficulties of measuring the effectiveness of new treatments
- how MS affects white matter (myelinated nerve axons) and grey matter (nerve cell bodies). After demyelination there is damage to nerve axons and nerve cell bodies. Measuring brain volume incorporates all these changes and provides a better measure of progression in MS
- an overview of neuroinflammation in MS and the role of defence and repair mechanisms in the immune system
- how fampridine blocks potassium channels in nerve cell membranes to improve walking difficulties in some people with MS
- difficulties of predicting who will get MS and an update on a study comparing people with MS and their siblings who don't have MS
- drugs which prevent the breakdown of naturally occurring cannabinoids as potential treatments for spasticity
- launch of the Charcot Project, a new research programme looking at the role of the Epstein Barr virus (which causes glandular fever) and plans to test an antiviral drug to treat MS
- latest research on vitamin D, focussing on studies which found that genetic mutations that reduce vitamin D levels are more common in the MS population.
Watch videos from the day at
Shift.ms YouTube Playlist - Bart multiple sclerosis research day
Follow the Group's Multiple Sclerosis Research blog
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