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MS research update - Memory training changes brain wiring - 21 June 2012

About half of all people with multiple sclerosis have some degree of problem at some time with aspects of thinking - memory, attention span or concentration. Cognition is the term that covers all aspects of thinking and these symptoms are referred to as cognitive problems.

Memory is most often affected which can have consequences for both work and private life, so effective techniques to improve memory are an important aim or cognitive rehabilitation.

A team of researchers in the States has been testing the Story Memory Technique as a means to remember lists and actions in a group of people with MS. Using this method, you develop a story that includes all the items to remember. Improvements in memory and increased brain activity were shown after using this technique.

Brain activity was studied in more detail in a subset of the participants. Using advanced MRI techniques, increased connectivity was found between key areas of the brain involved in memory. The researchers state that this is the first evidence that a behavioural treatment can alter the nerve networks involved in memory in people with MS.

Leavitt VM, Wylie GR, Girgis PA, et al.
Increased functional connectivity within memory networks following memory rehabilitation in multiple sclerosis.
Brain Imaging Behav. 2012 Jun 16. [Epub ahead of print]

Vitamin D and MS disease activity

There is some evidence to suggest that low levels of vitamin D contribute to the risk of developing MS and can affect the number of relapses and the disease course. Three new studies suggest an association between low levels of vitamin D and MS disease activity but also highlight the problems of interpreting findings in this type of research.

All of these studies measured blood vitamin D levels at regular intervals; supplements were not given.

A Norwegian study of 88 people found that when vitamin D levels increased by 10 nmol/L there was a reduction of approximately 10% in the likelihood of new lesions as visible on MRI scans. This effect was apparent in the six months before treatment with beta interferon but not in the 18 months after treatment had started.

An Australian study of 178 people found a similar increase in vitamin D levels reduced the relapse rate by 10%, but only saw this effect in people on beta interferon. They concluded that beta interferon treatment was associated with an increased production of vitamin D and that part of the effect of beta interferon on relapse rates may be though effects on vitamin D metabolism.

A Dutch study of 73 people found that when vitamin D levels doubled the risk of relapse fell by 27%.

The accompanying editorial draws attention to the difficulties of interpreting these results. The trials do not give enough information to indicate whether the effects seen are caused by vitamin D levels, the relatively small number of people in trials and the fluctuating levels of vitamin D throughout the year due to season, time spent outdoors and use of sun block or other protection.

The editorial also raises the unanswered question of whether the nature of MS means that what are adequate vitamin D levels for the general population might be too low for people with MS.

Stewart N, Simpson S Jr, van der Mei I, et al.
Interferon-β and serum 25-hydroxyvitamin D interact to modulate relapse risk in MS.
Neurology. 2012 Jun 13. [Epub ahead of print]

Runia TF, Hop WC, de Rijke YB, et al.
Lower serum vitamin D levels are associated with a higher relapse risk in multiple sclerosis.
Neurology. 2012 Jun 13. [Epub ahead of print]

Løken-Amsrud KI, Holmøy T, Bakke SJ, et al.
Vitamin D and disease activity in multiple sclerosis before and during interferon-β treatment.
Neurology. 2012 Jun 13. [Epub ahead of print]

Ascherio A, Marrie RA.
Editorial: Vitamin D in MS: A vitamin for 4 seasons.
Neurology. 2012 Jun 13. [Epub ahead of print]

Research by topic areas...

Symptoms and symptom management

Panou T, Mastorodemos V, Papadaki E, et al.
Early signs of memory impairment among multiple sclerosis patients with clinically isolated syndrome.
Behav Neurol. 2012 Feb 15. [Epub ahead of print]

Firdolas F, Ozan T, Onur R, et al.
Evaluation of sexual function in women at two stages of multiple sclerosis.
World J Urol. 2012 Jun 6. [Epub ahead of print]

MS relapses

Clavelou P, Ouallet JC, Brochet B, et al.
Increased risk of multiple sclerosis relapse after in vitro fertilisation.
J Neurol Neurosurg Psychiatry. 2012 Jun 11. [Epub ahead of print]

Disease modifying treatments

[No authors listed]
Multiple sclerosis: Natalizumab reduces cortical pathology in relapsing-remitting multiple sclerosis.
Nat Rev Neurol. 2012 Jun 19. doi: 10.1038/nrneurol.2012.109. [Epub ahead of print]

Vågberg M, Kumlin U, Svenningsson A.
Humoral immune response to influenza vaccine in natalizumab-treated MS patients.
Neurol Res. 2012 Jun 16. [Epub ahead of print]

Drugs in development

Brück W, Zamvil SS.
Laquinimod, a once-daily oral drug in development for the treatment of relapsing-remitting multiple sclerosis.
Expert Rev Clin Pharmacol. 2012 May;5(3):245-56.

Vermersch P, Benrabah R, Schmidt N, et al.
Masitinib treatment in patients with progressive multiple sclerosis: a randomized pilot study.
BMC Neurol. 2012 Jun 12;12(1):36. [Epub ahead of print]

Costelloe L, Jones J, Coles A.
Secondary autoimmune diseases following alemtuzumab therapy for multiple sclerosis.
Expert Rev Neurother. 2012 Mar;12(3):335-41.

Other treatments

Haut SR, Bienen EJ, Miller A.
Clinical overview of the seizure risk of dalfampridine.
Expert Opin Drug Saf. 2012 Jun 18. [Epub ahead of print]

Slof J, Gras A.
Sativex(®) in multiple sclerosis spasticity: a cost-effectiveness model.
Expert Rev Pharmacoecon Outcomes Res. 2012 Jun 8. [Epub ahead of print]


Boström I, Stawiarz L, Landtblom AM.
Sex ratio of multiple sclerosis in the National Swedish MS Register (SMSreg).
Mult Scler. 2012 Jun 18. [Epub ahead of print]

Boström I, Riise T, Landtblom AM.
Mortality Statistics for Multiple Sclerosis and Amyotrophic Lateral Sclerosis in Sweden.
Neuroepidemiology. 2012 Jun 5;38(4):245-249. [Epub ahead of print]


Swinnen E, Beckwée D, Pinte D, et al.
Treadmill training in multiple sclerosis: can body weight support or robot assistance provide added value? A systematic review.
Mult Scler Int. 2012;2012:240274. Epub 2012 May 30.
free full paper

Santos-Filho SD, Cameron MH, Bernardo-Filho M.
Benefits of whole-body vibration with an oscillating platform for people with multiple sclerosis: a systematic review.
Mult Scler Int. 2012;2012:274728.
free full paper

Nilsagård YE, Forsberg AS, von Koch L.
Balance exercise for persons with multiple sclerosis using Wii games: a randomised, controlled multi-centre study.
Mult Scler. 2012 Jun 6. [Epub ahead of print]

Co-existing conditions

Christiansen CF.
Risk of vascular disease in patients with multiple sclerosis: a review.
Neurol Res. 2012 Jun 16. [Epub ahead of print]

Assessment tools

Wicks P, Vaughan TE, Massagli MP.
The multiple sclerosis rating scale, revised (MSRS-R): Development, refinement, and psychometric validation using an online community.
Health Qual Life Outcomes. 2012 Jun 18;10(1):70. [Epub ahead of print]

Causes of MS

Stys PK, Zamponi GW, van Minnen J, et al.
Will the real multiple sclerosis please stand up?
Nat Rev Neurosci. 2012 Jun 20;13(7):507-14. doi: 10.1038/nrn3275.

Owens GP, Bennett JL.
Trigger, pathogen, or bystander: the complex nexus linking Epstein- Barr virus and multiple sclerosis.
Mult Scler. 2012 Jun 8. [Epub ahead of print]

Psychological aspects

Pakenham KI, Samios C.
Couples coping with multiple sclerosis: a dyadic perspective on the roles of mindfulness and acceptance.
J Behav Med. 2012 Jun 12. [Epub ahead of print]

Schumann R, Adamaszek M, Sommer N, et al.
Stress, Depression and Antidepressant Treatment Options in Patients Suffering from Multiple Sclerosis.
Curr Pharm Des. 2012 Jun 6. [Epub ahead of print]


Hutchinson M.
In assessing multiple sclerosis disease activity patient report measures are a waste of time: cut to the MRI scan!--Commentary.
Mult Scler. 2012 Mar;18(3):269-70.

Miller D.
In assessing multiple sclerosis disease activity patient report measures are a waste of time: cut to the MRI scan!--No.
Mult Scler. 2012 Mar;18(3):266-8.

Miller DH.
In assessing multiple sclerosis disease activity patient report measures are a waste of time: cut to the MRI scan!--Yes.
Mult Scler. 2012 Mar;18(3):264-5.


Ceccarelli A, Bakshi R, Neema M.
MRI in multiple sclerosis: a review of the current literature.
Curr Opin Neurol. 2012 Jun 11. [Epub ahead of print]

Kipp M, Amor S.
FTY720 on the way from the base camp to the summit of the mountain: relevance for remyelination.
Mult Scler. 2012 Mar;18(3):258-63.


Lejbkowicz I, Caspi O, Miller A.
Participatory medicine and patient empowerment towards personalized healthcare in multiple sclerosis.
Expert Rev Neurother. 2012 Mar;12(3):343-52.

Chronic cerebrovascular venous insufficiency

Machan L, Murphy K, Traboulsee T.
Multiple Sclerosis and Venous Abnormalities: Medicine in the Age of Social Media.
Can Assoc Radiol J. 2012 Jun 16. [Epub ahead of print]

Salvi F, Bartolomei I, Buccellato E, et al.
Venous angioplasty in multiple sclerosis: neurological outcome at two years in a cohort of relapsing-remitting patients.
Funct Neurol. 2012 Jan-Mar;27(1):55-9.

Bone health

Zikán V, Týblová M, Raška I Jr, et al.
Bone mineral density and body composition in men with multiple sclerosis chronically treated with low-dose glucocorticoids.
Physiol Res. 2012 Jun 6. [Epub ahead of print]


Turner LG.
Beyond 'medical tourism': Canadian companies marketing medical travel.
Global Health. 2012 Jun 15;8(1):16. [Epub ahead of print]

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