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MS research update - Increased risk of breaking bones - 21 March 2012

52,960 women were followed for two years to see how many had fractures (broken bones) and whether this was more likely in people with certain conditions.

Overall, 6% (about 1 in 17) broke a bone in the two years of the study. This was much more likely if the woman had another medical condition and particularly common if they had Parkinson's Disease or MS.

This research adds to the existing evidence that people with MS have a lower bone density and are more prone to fractures. Problems with mobility and weight bearing, long term exposure to steroids, increasing age and lack of both vitamin D and calcium in the diet can all increase the risk of osteoporosis. This, together with the higher risk of falls, makes it important for people with MS to be aware of bone health. Being as active as possible and having a balanced diet can reduce the risk of osteoporosis and breaking bones.

Dennison EM, Compston JE, Flahive J, et al.
Effect of co-morbidities on fracture risk: Findings from the Global Longitudinal Study of Osteoporosis in Women (GLOW).
Bone. 2012 Mar 9. [Epub ahead of print]

Assessing speech changes in MS

Speaking involves the complicated coordination of the lungs, diaphragm, vocal cords, lips, tongue and nasal cavity. Damage caused by MS to the areas of the central nervous system that control any of these elements can have an effect on speech. Similarly, fatigue or weakness can affect any part of the process. Weakness or lack of coordination in the muscles used in speaking is known as dysarthria.

Speech problems can include slurred speech or difficulty in controlling volume, articulation or intonation. Swallowing difficulties or problems with remembering specific words (dysphasia) can contribute to speech problems.

This study compared people with MS, people with Parkinson's disease and people with no neurological condition. They each read a text at their normal speed and then at a slower than normal speed. The researchers measured how fast they spoke overall, the articulation rate (a measure of speaking in which all pauses are excluded from the calculation), how long and how often they paused in their speech.

All the groups adjusted articulation time and increased the time of their pauses so that the overall rate of their speech was slower. Speech runs were shorter, included fewer syllables and had longer, more frequent pauses.

The results may help speech and language therapists to deliver better help for people with MS who experience speech difficulties.

Tjaden K, Wilding G.
Speech and pause characteristics associated with voluntary rate reduction in Parkinson's disease and Multiple Sclerosis.
J Commun Disord. 2011 Nov-Dec;44(6):655-65. 

Research by topic areas...

MS relapses

Nicholas R, Straube S, Schmidli H, et al.
Time-patterns of annualized relapse rates in randomized placebo-controlled clinical trials in relapsing multiple sclerosis: A systematic review and meta-analysis.
Mult Scler. 2012 Mar 15. [Epub ahead of print]

Disease modifying treatments

Nafissi S, Azimi A, Amini-Harandi A, et al.
Comparing efficacy and side effects of a weekly intramuscular biogeneric/biosimilar interferon beta-1a with Avonex in relapsing remitting multiple sclerosis: A double blind randomized clinical trial.
Clin Neurol Neurosurg. 2012 Mar 17. [Epub ahead of print]

Horakova D, Kalincik T, Dolezal O, et al.
Early predictors of non-response to interferon in multiple sclerosis.
Acta Neurol Scand. 2012 Mar 16. doi: 10.1111/j.1600-0404.2012.01662.x. [Epub ahead of print]

Perumal J, Khan O.
Emerging disease-modifying therapies in multiple sclerosis.
Curr Treat Options Neurol. 2012 Mar 18. [Epub ahead of print]

Drugs in development

Kitsos DK, Tsiodras S, Stamboulis E, et al.
Rituximab and multiple sclerosis.
Clin Neuropharmacol. 2012 Mar;35(2):90-6.

Comi G, Jeffery D, Kappos L, et al.
Placebo-controlled trial of oral laquinimod for multiple sclerosis.
N Engl J Med. 2012 Mar 15;366(11):1000-9.

Other treatments

Stroet A, Gold R, Chan A, et al.
Acute myeloid leukemia in italian patients with multiple sclerosis treated with mitoxantrone.
Neurology. 2012 Mar 20;78(12):933-4.


Gaber TA, Oo WW, Gautam V, Smith L.
Outcomes of inpatient rehabilitation of patients with multiple sclerosis.
NeuroRehabilitation. 2012 Jan 1;30(2):97-100.

Assessment tools

Conrad A, Coenen M, Schmalz H, et al.
Validation of the Comprehensive ICF Core Set for Multiple Sclerosis from the perspective of occupational therapists.
Scand J Occup Ther. 2012 Mar 20. [Epub ahead of print]

Quaranta D, Marra C, Zinno M, et al.
Presentation and validation of the multiple sclerosis depression rating scale: a test specifically devised to investigate affective disorders in multiple sclerosis patients.
Clin Neuropsychol. 2012 Mar 20. [Epub ahead of print]

Vitamin D

Ozerlat I.
Multiple sclerosis: Multiple sclerosis therapy-vitamin D under spotlight.
Nat Rev Neurol. 2012 Mar 20. doi: 10.1038/nrneurol.2012.37. [Epub ahead of print]


Roshanisefat H, Bahmanyar S, Hillert J, et al.
Shared genetic factors may not explain the raised risk of comorbid inflammatory diseases in multiple sclerosis.
Mult Scler. 2012 Mar 14. [Epub ahead of print]

Psychological aspects

das Nair R, Ferguson H, Stark DL, et al.
Memory rehabilitation for people with multiple sclerosis.
Cochrane Database Syst Rev. 2012 Mar 14;3:CD008754.

Physical activity

Sosnoff JJ, Sandroff BM, Motl RW.
Quantifying gait abnormalities in persons with multiple sclerosis with minimal disability.
Gait Posture. 2012 Mar 17. [Epub ahead of print]

Dalgas U, Severinsen K, Overgaard K.
Relations between 6 min walking distance and 10 m walking speed in patients with multiple sclerosis and stroke.
Arch Phys Med Rehabil. 2012 Mar 12. [Epub ahead of print]


Gartzen K, Katzarava Z, Diener HC, et al.
Peripheral nervous system involvement in multiple sclerosis.
Eur J Neurol. 2011 May;18(5):789-91.

Bone health

Batista S, Teter B, Sequeira K, et al.
Cognitive impairment is associated with reduced bone mass in multiple sclerosis.
Mult Scler. 2012 Mar 14. [Epub ahead of print]


Hill S, Filippini G, Synnot A, et al.
Presenting evidence-based health information for people with multiple sclerosis: The IN-DEEP project protocol.
BMC Med Inform Decis Mak. 2012 Mar 16;12(1):20. [Epub ahead of print]

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