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Latest MS research update - Can the HPV vaccination cause MS?- 12 January 2015

The MS Trust runs a weekly search for interesting and relevant research articles relating to multiple sclerosis using Medline, a specialised search engine for medical journals. The original abstracts to each of the articles can be accessed via the links provided.

For further information on any topic please contact the information team at info@mstrust.org.uk.


This week's highlighted research...

How common are tremors in people with MS?

Research by topic areas...

Assessment tools
Disease modifying treatments
Epidemiology
Genetics
Other
Other treatments
Paediatric MS
Physical activity
Pregnancy and childbirth
Prognosis
Psychological aspects
Stem cells
Symptoms and symptom management
Vitamin D


How common are tremors in people with MS?

Summary

Tremor is an involuntary, uncontrolled movement. Although it is commonly listed as a symptom that can occur in MS, little is known about how common it actually is or how severe tremors are. This study aimed to find out more about tremors in people with MS by surveying a large group of people in the USA.

People with MS who are on the NARCOMS (North American Research Committee on Multiple Sclerosis) registry complete two surveys a year. Between 2010 and 2011, participants were asked if they had tremor. If they did, they were asked to complete an extra survey to collect information about their tremor, including what part of the body it affected, what side of the body, any family history of tremors and if they were taking any treatments for it. 552 surveys were returned.

The study found that approximately 45% of people with MS reported having some level of tremor. A quarter (25%) said that the experienced a tremor that had an impact on their daily lives.

The study is the largest survey to examine MS tremors done to so far. The authors conclude that their survey helps to highlight that tremor is common in people with MS and it can have a major impact on some people, affecting their work and daily lives.


Background

Tremor is an involuntary, uncontrolled movement. Although it is commonly listed as a symptom that can occur in MS, little is known about how common it actually is or how severe tremors are. This study aimed to find out more about tremors in people with MS by surveying a large group of people with MS in the USA.


How this study was carried out

People with MS who are on the NARCOMS (North American Research Committee on Multiple Sclerosis) registry complete two surveys a year. In three surveys, in autumn 2010, spring 2011 and autumn 2011 (41,620 surveys returned), the participants were asked about if they had tremor using the Tremor and Coordination Scale (TACS). On this scale the person scores their tremor severity from 0 - no tremor to 5 - a totally disabling tremor.

The participants who had a score of 1 (minimal tremor) or more were asked to complete an extra survey to collect information about their tremor, including what part of the body it affected, what side of the body, any family history of tremors and if they were taking any treatments for it. 552 surveys were returned.


What was found

The study found that approximately 45% of people with MS reported having some level of tremor, which mostly affected the upper body, particularly the arms, although tremors were also reported to affect the legs, head, body and voice. A quarter (25%) said that the experienced a tremor that had an impact on their daily lives. Those reporting a mild tremor were mostly women and men were more likely to report severe or totally disabling tremors. The survey also found that as tremor severity increased, the participants were more likely to be unemployed.


What does it mean?

The study is the largest survey to examine MS tremors done to so far. It shows that tremor is common in people with MS and it can have a major impact on some people, affecting their work and daily lives. The authors conclude that their survey helps to highlight this is as an important MS symptom and will help health professionals to consider how it should be treated to best support people with MS tremor.


Rinker JR 2nd, Salter AR, Walker H , et al.
Prevalence and characteristics of tremor in the NARCOMS multiple sclerosis registry: a cross-sectional survey.
BMJ Open. 2015 Jan 8;5(1):e006714.
abstract
Read the full text of this paper

More about tremor

This study shows that tremor may be more common in people with MS than previously thought. In MS, the type of tremor that is most frequently experienced is intention tremor or cerebellar tremor. This is a tremor that worsens as the individual uses the affected limb, for instance the arm shaking as someone reaches for an object or tries to touch their nose. Some people may experience postural tremor, which occurs when a person is maintaining a posture, such as sitting up. For some people it can be a relatively mild problem with coordination (ataxia), but for others it can be one of the most disabling symptoms of MS.

There are a number of options for the management of tremor. There are no specific drug treatment s for tremor, but beta blockers and clonazepam are used and botulinum toxin has been used with some success to treat head tremor in people with MS, although most drug therapies have a limited effect on tremor.

Adaptation is a key element to coping with tremor and minimise its impact. One example is adapting how you do tasks, such as deliberately stopping before reaching a target object, such as a cup, and then sliding the hand forward to grasp it as this can reduce the effect of tremor. An occupational therapist can advise on these kinds of approaches.

Physiotherapy can also help as it can strengthen the core body muscles of the trunk and improve posture which may help with tremor. Splints or Lycra garments can be also helpful. These approaches are discussed by two physiotherapists in an article called Tremor in MS in the MS Trust newsletter, Open Door.

Keep up to date

You can sign up to receive an email alert for the MS Trust research update. The email provides links to this page so that you can see the latest published research in MS. You can read our blog on how we choose research to include in this update.

You can also sign up for our News alerts which cover reports about MS on our news page and in the media.

Open Door, the MS Trust's free quarterly newsletter is available both by post and by email. It contains information on all the publications and support that the MS Trust provides, articles on a wide range of topics written by health professionals and people with MS as well as news about MS and recent research. Sign up for Open Door here or call us on 0800 032 38 39 or 01462 476700

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Assessment tools

Dicianno BE, Mahajan H, Cooper RA.
Advanced joystick algorithms for computer access tasks.
PM R. 2015 Jan 13. [Epub ahead of print]
abstract

LeBouthillier DM, Thibodeau MA, Alberts NM, et al.
Do people with and without medical conditions respond similarly to the short health anxiety inventory? An assessment of differential item functioning using item response theory.
J Psychosom Res. 2015 Jan 2. [Epub ahead of print]
abstract

Moore F, Vickrey B, Fortin K, et al.
Two multiple sclerosis quality-of-life measures: comparison in a national sample.
Can J Neurol Sci. 2015 Jan 14:1-9. [Epub ahead of print]
abstract

Patten SB, Burton JM, Fiest KM, et al.
Validity of four screening scales for major depression in MS.
Mult Scler. 2015 Jan 12. [Epub ahead of print]
abstract

Settle JR, Robinson SA, Kane R, et al.
Remote cognitive assessments for patients with multiple sclerosis: a feasibility study.
Mult Scler. 2015 Jan 12. [Epub ahead of print]
abstract

Barrett L, Cano S, Zajicek J, et al.
Lending a hand: Can DASH items help ABILHAND improve manual ability measurement in multiple sclerosis?
Mult Scler. 2015 Jan 12. [Epub ahead of print]
abstract

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Disease modifying treatments

Pandit L, Mustafa S, Malli C, et al.
Mycophenolate mofetil in the treatment of multiple sclerosis: a preliminary report.
Neurol India. 2014 Nov-Dec;62(6):646-8.
abstract

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Epidemiology

Solaro C, Ponzio M, Moran E, et al.
The changing face of multiple sclerosis: prevalence and incidence in an aging population.
Mult Scler. 2015 Jan 12. [Epub ahead of print]
abstract

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Genetics

Fagnani C, Neale MC, Nisticò L, et al.
Twin studies in multiple sclerosis: a meta-estimation of heritability and environmentality.
Mult Scler. 2015 Jan 12. [Epub ahead of print]
abstract

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Other

Razaz N, Tremlett H, Boyce WT, et al.
Impact of parental multiple sclerosis on early childhood development: a retrospective cohort study.
Mult Scler. 2015 Jan 12. [Epub ahead of print]
abstract

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Other treatments

Melo PL, Silva MT, Martins JM, et al.
Technical developments of functional electrical stimulation to correct drop foot: sensing, actuation and control strategies.
Clin Biomech (Bristol, Avon). 2014 Nov 20. [Epub ahead of print]
abstract

Goodman AD, Bethoux F, Brown TR, et al.
Long-term safety and efficacy of dalfampridine for walking impairment in patients with multiple sclerosis: results of open-label extensions of two phase 3 clinical trials.
Mult Scler. 2015 Jan 12. [Epub ahead of print]
abstract

Read the full text of this paper

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Paediatric MS

Sandvig I, Barlinn J, Nedregaard B, et al.
Multiple sclerosis in children and adolescents. An important differential diagnosis of acute neurological disease.
Eur J Paediatr Neurol. 2014 Dec 30. [Epub ahead of print]
abstract

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Physical activity

Kersten S, Mahli M, Drosselmeyer J, et al.
A pilot study of an exercise-based patient education program in people with multiple sclerosis.
Mult Scler Int. 2014;2014:306878.
abstract

Read the full text of this paper

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Pregnancy and childbirth

Strijbos E, Coenradie S, Touw D, et al.
High-dose methylprednisolone for multiple sclerosis during lactation: concentrations in breast milk.
Mult Scler. 2015 Jan 12. [Epub ahead of print]
abstract

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Prognosis

Stangel M, Penner IK, Kallmann BA, et al.
Towards the implementation of 'no evidence of disease activity' in multiple sclerosis treatment: the multiple sclerosis decision model.
Ther Adv Neurol Disord. 2015 Jan;8(1):3-13.
abstract

Read the full text of this paper

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Psychological aspects

Adamson BC, Ensari I, Motl RW.
The effect of exercise on depressive symptoms in adults with neurological disorders: a systematic review and meta-analysis.
Arch Phys Med Rehabil. 2015 Jan 13. [Epub ahead of print]
abstract

Tan-Kristanto S, Kiropoulos LA.
Resilience, self-efficacy, coping styles and depressive and anxiety symptoms in those newly diagnosed with multiple sclerosis.
Psychol Health Med. 2015 Jan 14:1-11. [Epub ahead of print]
abstract

Marrie RA, Reingold S, Cohen J, et al.
The incidence and prevalence of psychiatric disorders in multiple sclerosis: a systematic review.
Mult Scler. 2015 Jan 12. [Epub ahead of print]
abstract

Read the full text of this paper

Bogart KR.
Disability identity predicts lower anxiety and depression in multiple sclerosis.
Rehabil Psychol. 2015 Jan 12. [Epub ahead of print]
abstract

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Stem cells

Curro' D, Vuolo L, Gualandi F, et al.
Low intensity lympho-ablative regimen followed by autologous hematopoietic stem cell transplantation in severe forms of multiple sclerosis: a mri-based clinical study.
Mult Scler. 2015 Jan 12. [Epub ahead of print]
abstract

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Symptoms and symptom management

Gandolfi M, Munari D, Geroin C, et al.
Sensory integration balance training in patients with multiple sclerosis: a randomized, controlled trial.
Mult Scler. 2015 Jan 12. [Epub ahead of print]
abstract

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Vitamin D

Rinaldi AO, Sanseverino I, Purificato C, et al.
Increased circulating levels of vitamin D binding protein in MS patients.
Toxins (Basel). 2015 Jan 13;7(1):129-37.
abstract

Read the full text of this paper