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MS research update - Use of complementary and alternative medicine - 08 February 2012

This study in the USA looked at what treatments were used by people with MS, apart from the disease modifying treatments (DMTs). The researchers sent out a 13 question survey which asked about mainstream treatments, such as physiotherapy and osteopathy, and also complementary and alternative treatments, such as acupuncture, chiropractic and massage. In addition, they asked about any dietary supplements and exercise.

People were asked to say if they were currently using any of these treatments and to rate their level of disability on a scale of 1 to 10 (with 10 being most severe). This scale was not the same as the commonly used EDSS scale. All participants were over the age of 18 and already had a diagnosis of MS.

111 people completed the survey and 100% of them used other treatments apart from any DMTs. It is unlikely that everyone in the MS community was using such treatments and very likely that only people using these treatments decided to complete the survey.

A fifth of those completing the survey did not use a DMT. More than half (58%) reported doing exercise every week but three quarters of those doing exercise were on the lower half of the disability scale.

More than half (58%) used complementary or alternative therapies such as acupuncture and massage, or other treatments as osteopathy and psychotherapy.

The researchers concluded that many people with MS seek out other treatments apart from the DMTs. The researchers believe that it is important that health professionals are aware of this and provide guidance and monitoring to enable the best outcomes for people with MS. The researchers did not comment on what evidence there was on how well each treatment might work.

Stoll SS, Nieves C, Tabby DS, et al.
Use of therapies other than disease-modifying agents, including complementary and alternative medicine, by patients with multiple sclerosis: a survey study.
J Am Osteopath Assoc. 2012 Jan;112(1):22-8.

Multiple sclerosis 200 years ago?

MS is not a new disease but it must have been very difficult to diagnose before the days of MRI scans and lumbar punctures.

Augustus d'Este is usually said to be the first recorded person for whom a definite diagnosis of MS can be made. He lived from 1794 until 1848. He was not diagnosed during his lifetime but he kept a detailed diary for 22 years which described what it was like to live with his condition.

His symptoms began at the age of 28 with visual problems. He later developed weakness of the legs, clumsiness of the hands, numbness, dizziness, bladder problems and erectile dysfunction. This was followed by tremor and spasms at night. At the age of 50 he began to use a wheelchair.

Augustus was the grandson of George III who suffered from porphyria. Some people have suggested that Augustus may also have had porphyria and this could explain his symptoms.

This study used an online computer application to compare Augustus's symptoms and family history to a large database of genetic, neurological and metabolic disorders. It then produced a list of the most likely diagnoses.

The research confirmed that multiple sclerosis was the most likely diagnosis but that neuromyelitis optica was also a strong possibility. There was no evidence using this software that Augustus suffered from one of the acute porphyrias.

Garrard P, Peters TJ.
Multiple sclerosis or neuromyelitis optica? Re-evaluating an 18th-century illness using 21st-century software.
JRSM Short Rep. 2012 Jan;3(1):1.


Research by topic areas...


Kelly SB, Chaila E, Kinsella K, et al.
Using atypical symptoms and red flags to identify non-demyelinating disease.
J Neurol Neurosurg Psychiatry. 2012 Jan;83(1):44-8.

Symptoms and symptom management

Kessler N, Ganança MM, Ganança CF, et al.
Balance Rehabilitation Unit (BRU™) posturography in relapsing-remitting multiple sclerosis
Arq Neuropsiquiatr. 2011 Jun;69(3):485-90.

Disease modifying treatments

Confavreux C, Li DK, Freedman MS, et al.
Long-term follow-up of a phase 2 study of oral teriflunomide in relapsing multiple sclerosis: safety and efficacy results up to 8.5 years.
Mult Scler. 2012 Feb 3. [Epub ahead of print]

D'Arcy C, Thomas D, Stoneman D, et al.
Patient assessment of an electronic device for subcutaneous self-injection of interferon β-1a for multiple sclerosis: an observational study in the UK and Ireland.
Patient Prefer Adherence. 2012;6:55-61.

Evans C, Tam J, Kingwell E, et al.
Long-term persistence with the immunomodulatory drugs for multiple sclerosis: a retrospective database study .
Clin Ther. 2012 Jan 31.[Epub ahead of print]


Fromont A, Binquet C, Sauleau E, et al.
National estimate of multiple sclerosis incidence in France (2001-2007).
Mult Scler. 2012 Feb 1. [Epub ahead of print]

Assessment tools

Gafson AR, Giovannoni G.
Towards the incorporation of lumbar puncture into clinical trials for multiple sclerosis.
Mult Scler. 2012 Feb 1. [Epub ahead of print]

Vitamin D

Disanto G, Meier U, Giovannoni G, et al.
Vitamin D: a link between Epstein-Barr virus and multiple sclerosis development?
Expert Rev Neurother. 2011 Sep;11(9):1221-4.


Kaliszewska A, De Jager PL.
Exploring the role of the epigenome in multiple sclerosis: A window onto cell-specific transcriptional potential.
J Neuroimmunol. 2012 Jan 30. [Epub ahead of print]

Psychological aspects

Stuifbergen AK, Becker H, Perez F, et al.
A randomized controlled trial of a cognitive rehabilitation intervention for persons with multiple sclerosis.
Clin Rehabil. 2012 Feb 2. [Epub ahead of print]

Anhoque CF, Domingues SC, Carvalho T, et al.
Anxiety and depressive symptoms in clinically isolated syndrome and multiple sclerosis.
Arq Neuropsiquiatr. 2011 Dec;69(6):882-6.

Pregnancy and childbirth

Lebrun C, Le Page E, Kantarci O, et al.
Impact of pregnancy on conversion to clinically isolated syndrome in a radiologically isolated syndrome cohort.
Mult Scler. 2012 Feb 2. [Epub ahead of print]


Fragoso YD.
The internet racing ahead of the scientific evidence: the case of "liberation treatment" for multiple sclerosis.
Arq Neuropsiquiatr. 2011 Jun;69(3):525-7.

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