MS research update - 27 November 2009
- Giving birth may delay MS progression
- MS may impair social skills and emotional recognition
- People with MS more likely to direct anger inwards
- Interferon beta improves health related quality of life
Giving birth may delay MS progression
Existing research has failed to draw any firm conclusions about the long-term effects of childbirth on the course of MS. Researchers in Belgium studied the progression of disability in 330 females with MS over a period of 18 years. Participants were divided into four groups: women who had given birth before the onset of MS; women who had given birth after the onset of MS; women who had given birth both before and after the onset of MS; and women who had never had children.
The time taken from onset of MS to reach point 6 on EDSS (a clinical scale used to measure an individual's level of disability) was the measure used to define MS progression. Point 6 on EDSS equates with the inability to walk without the support of a walking aid.
Analysis of the data revealed that women who had given birth at any point in time - either before or after the onset of MS - were 34% less likely to reach EDSS 6 than childless women with MS.
The study authors acknowledge the limitations of their findings, such as lack of consideration for timing and duration of disease modifying drug therapy and the imprecision of the time of MS onset. In spite of these limitations, it is an interesting study which may invite further investigation into the long-term effects of childbirth in MS.
D'hooghe MB, Nagels G, Uitdehaag BMJ.
Long-term effects of childbirth in MS.
Journal of Neurology Neurosurgery and Psychiatry 2009; [Epub ahead of print].
View article
MS may impair social skills and emotional recognition
Social cognition refers to the skills that are needed to properly engage in different social situations and interpersonal contexts. In order to respond appropriately in different social interactions, we need to be able to perceive and interpret other people's beliefs, emotions, and intentions. This ability is often referred to as emotional recognition.
The present study investigated these skills in 40 people with MS and 35 healthy individuals. A series of tests were used to measure the participants' ability to recognise different emotions. One of these tests consisted of 20 photographs of the same actress portraying different mental states. For each expression, participants were asked to choose one of two phrases that best described the thoughts expressed by the face. A similar test used photographs showing only the eyes.
The results of these tests showed that people with MS made more mistakes than the healthy participants. Based on these findings the study authors conclude that non-verbal social skills and emotional recognition are affected by MS. They suggest that such impairment is due to the presence of lesions in parts of the brain that are involved in emotional recognition.
Banati M, Sandor J, Mike A, et al.
Social cognition and theory of mind in patients with relapsing remitting multiple sclerosis.
European Journal of Neurology 2009 [Epub ahead of print].
Medline abstract
People with MS more likely to direct anger inwards
Research suggests that emotional disorders such as anxiety and depression are more common among the MS population compared with the general population. The present research studied the anger profile of people with MS and compared it against the anger profile of the general population to determine whether there is anything unique to the anger characteristics of people with MS.
The study involved 195 people with MS; 150 with relapsing remitting MS; and 45 with progressive forms of MS. 140 healthy individuals were used for comparison. Three different aspects of anger expression were measured, nominally: Anger Out - anger that is directed towards other people or objects; Anger In - anger that is withheld or directed towards oneself; and Anger Control - anger that is expressed or dissolved in a controlled manner.
The findings showed that people with MS expressed a similar level of anger overall to healthy individuals. However, there was significant variation in the mode of this expression. The findings demonstrated that people with MS experienced twice the normal level of withheld anger (anger that is directed inwards) and significantly lower levels of controlled anger (anger that is released in a controlled manner) compared to the other study participants.
Levels of anger were not linked to disease severity or other demographic factors such as age or education and there was no significant association between anger and anxiety or depression. The study authors hypothesise that the unique anger characteristics of people with MS is due to central nervous system damage rather than an emotional reaction to the stress of the condition.
Nocentini U, Tedeschi G, Migliaccio R, et al.
An exploration of anger phenomenology in multiple sclerosis.
European Journal of Neurology 2009; 16 1312-1317.
Medline abstract
Interferon beta improves health related quality of life
Health-related quality of life (HRQoL) refers to an individual's satisfaction or happiness with areas of their life that affect or are affected by health. To date, most research into the effects of the disease modifying drugs that are used in MS have focused on their impact on relapses and MRI findings. The present study investigated the effect of 2 years treatment with interferon beta 1a on health related quality of life in 284 people with relapsing remitting MS.
An MS-specific questionnaire designed to capture the aspects of health status most relevant to people with MS, was completed before treatment and after two years of treatment with interferon beta 1a. 204 people completed two years of treatment. The questionnaires were analysed and revealed that health related quality of life improved for people who completed two years of treatment on interferon beta 1a. The improvements were more pronounced in younger people who had lower levels of disability.
Jongen PJ, Sindic C, Carton H, et al.
Improvement in health-related quality of life in relapsing remitting multiple sclerosis patients after 2 years of treatment with intramuscular interferon beta 1a.
Journal of Neurology 2009; [Epub ahead of print].
Medline abstract
