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MS research update - The future of research into progressive MS - 05 September 2012

Research into progressive forms of MS has not proceeded as rapidly as research into relapsing MS. An international group met to discuss this difference and to identify the priority areas for research.

The five priority areas highlighted were:

  • Experimental models of progressive MS
  • Targets for drug treatment and also opportunities to use treatments that are already well established for other forms of MS or other conditions
  • Markers of neurodegenerative processes for use in clinical trials
  • Valid clinical outcome measures for clinical trials
  • Better symptom management and rehabilitation

They concluded that an international, integrated, multi-disciplinary approach will be needed.

More about progressive forms of MS

You can read more about the different types of MS in the A-Z of MS.

Read the books - Secondary progressive MS and Primary progressive MS

Fox RJ, Thompson A, Baker D, et al.
Setting a research agenda for progressive multiple sclerosis: The International Collaborative on Progressive MS
Mult Scler. 2012 Aug 23. [Epub ahead of print]

MS can help in spotting the gorilla in the room

Inattentional blindness describes a situation where someone does not notice something even though it is plainly visible. It is probably experienced at times by everybody, including healthy people with no particular cognitive problems.

The "gorilla in the room" is a famous psychology experiment. Participants were asked to watch a video of people passing a basket ball around the group and to count the number of passes made by the players wearing white shirts. Half way through the video, someone wearing a gorilla suit strolls through the game, pauses to beat his chest, and moves on. A large proportion of the participants did not notice the gorilla even though he walked through the middle of the game. The explanation is that the participants were concentrating so hard on the ball and the people wearing white shirts that they did not register the gorilla. You can try this for yourself using the links below.

Many people with MS have cognitive problems including with concentration. This research project aimed to test whether this lack of concentration allowed people with MS to be better at detecting the gorilla in the room.

68 people with MS completed a series of psychological tests including the Gorilla in the Room and also the Stroop test. In the Stroop test, the name of each colour is written in a colour which is different from the colour which has been named. In the test, the participant has to name the colours shown in the display, rather than the actual words displayed. For example, if the word "green" is written in blue ink, then "blue" is the correct answer. However, there is a strong temptation to say the word "green" rather than naming the colour in which this word is displayed which, in this case, is blue. You can try this test, which can be surprisingly difficult, using the link below.

The researchers found that people with MS who scored poorly on the Stroop test and on another test called the 2-second Paced Auditory Serial Addition Test, were more likely to detect the gorilla but also more likely to detect fewer ball passes in the Gorilla in the Room test.

It was concluded that this group of people with MS had less inattentional blindness (they were better at spotting the gorilla than other people) but were more easily distracted from the task they had been set (they missed some of the ball passes).

This research has important implications for everyday life where concentrating on a task is important such as when driving, cooking or at work.

Feinstein A, Lapshin H, O'Connor P.
Looking anew at cognitive dysfunction in multiple sclerosis: The gorilla in the room.
Neurology. 2012 Aug 29. [Epub ahead of print]

Try the tests used in this research for yourself

An explanation of the Gorilla in the Room test. The video is 6 minutes long and you can choose to skip the advert.

A classic version of the Gorilla in the Room test. You are more likely to spot the gorilla as you already know that he is going to appear.

Another version of the Gorilla in the Room test. Can you see a gorilla?

Try the Stroop test. How many times can you correctly name the colour of the displayed text?

More about cognitive problems

About half of all people with MS have some 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. You can read more about cognitive problems in the A-Z of MS.There is also a link to an article by someone with MS about her experience of losing concentration.

StayingSmart is a website designed for people who want to know more about how MS can affect thinking. It takes a practical approach and includes tips for coping with day to day problems and video clips of people discussing their symptoms.  

Research by topic areas...

Symptoms and symptom management

Induruwa I, Constantinescu CS, Gran B.
Fatigue in multiple sclerosis - A brief review.
J Neurol Sci. 2012 Aug 27. [Epub ahead of print]

Côté I, Trojan D, Kaminska M, et al.
Impact of sleep disorder treatment on fatigue in multiple sclerosis.
Mult Scler. 2012 Aug 22. [Epub ahead of print]

Nick ST, Roberts C, Billiodeaux S, et al.
Multiple sclerosis and pain.
Neurol Res. 2012 Aug 21. [Epub ahead of print]

Disease modifying treatments

Abolfazli R, Hosseini A, Gholami KH, et al.
Quality of life assessment in patients with multiple sclerosis receiving interferon beta-1a: a comparative longitudinal study of Avonex and its biosimilar Cinnovex.
ISRN Neurol. 2012;2012:786526.

Grytten N, Aarseth JH, Espeset K, et al.
Stoppers and non-starters of disease-modifying treatment in multiple sclerosis.
Acta Neurol Scand. 2012 Aug 25. doi: 10.1111/j.1600-0404.2012.01708.x. [Epub ahead of print]

Ticha V, Kalincik T, Havrdova E.
Interferon-beta or azathioprine as add-on therapies in patients with active multiple sclerosis.
Neurol Res. 2012 Aug 21. [Epub ahead of print]

Lugaresi A, Florio C, Brescia-Morra V, et al.
Patient adherence to and tolerability of self-administered interferon β-1a using an electronic autoinjection device: a multicentre, open-label, phase IV study.
BMC Neurol. 2012 Mar 5;12:7.

Comabella M, Kakalacheva K, Río J, et al.
EBV-specific immune responses in patients with multiple sclerosis responding to IFNβ therapy.
Mult Scler. 2012 May;18(5):605-9.

Hegen H, Schleiser M, Gneiss C, et al.
Persistency of neutralizing antibodies depends on titer and interferon-beta preparation.
Mult Scler. 2012 May;18(5):610-5.

Other treatments

Guillotreau J, Panicker JN, Castel-Lacanal E, et al.
Prospective evaluation of laparoscopic assisted cystectomy and ileal conduit in advanced multiple sclerosis.
Urology. 2012 Aug 28. [Epub ahead of print]

Schmidt S.
Fampridine improves severe dysarthria in secondary-progressive multiple sclerosis.
Mult Scler. 2012 Aug 30. [Epub ahead of print]

Pula JH, Macdonald CJ.
Current options for the treatment of optic neuritis.
Clin Ophthalmol. 2012;6:1211-23.

Assessment tools

Alschuler KN, Jensen MP, Ehde DM.
Defining mild, moderate, and severe pain in persons with multiple sclerosis.
Pain Med. 2012 Aug 23. doi: 10.1111/j.1526-4637.2012.01471.x. [Epub ahead of print]

Sormani M, Signori A, Siri P, et al.
Time to first relapse as an endpoint in multiple sclerosis clinical trials.
Mult Scler. 2012 Aug 22. [Epub ahead of print]

Bosma L, Kragt J, Polman C, et al.
Walking speed, rather than Expanded Disability Status Scale, relates to long-term patient-reported impact in progressive MS.
Mult Scler. 2012 Aug 20. [Epub ahead of print]

Quality of life

Roessler RT, Bishop M, Rumrill PD, et al.
Specialized housing and transportation needs of adults with multiple sclerosis.
Work. 2012 Jul 19. [Epub ahead of print]

Causes of MS

[No authors listed]
Proceedings of the European Charcot Foundation symposium: a reappraisal of nutrition and environment in multiple sclerosis, European Charcot Foundation Symposium, December 2-4, 2010, Fiuggi, Italy.
J Neurol Sci. 2011 Dec 15;311(1-2):1-106.

Boström I, Landtblom AM, Lauer K.
An ecological study of industry in a high-risk region of multiple sclerosis.
J Neurol Sci. 2011 Dec 15;311(1-2):50-7.

Vitamin D

Mowry EM, Waubant E, McCulloch CE, et al.
Vitamin D status predicts new brain magnetic resonance imaging activity in multiple sclerosis.
Ann Neurol. 2012 Aug;72(2):234-40.

Paediatric MS

Sadaka Y, Verhey LH, Shroff MM, et al.
2010 McDonald criteria for diagnosing pediatric multiple sclerosis.
Ann Neurol. 2012 Aug;72(2):211-223.

Yeh EA, Weinstock-Guttman B.
The management of pediatric multiple sclerosis.
J Child Neurol. 2012 Aug 21. [Epub ahead of print]

Bigi S, Banwell B.
Pediatric multiple sclerosis.
J Child Neurol. 2012 Aug 21. [Epub ahead of print]

Amato MP.
Cognitive and psychosocial issues in pediatric multiple sclerosis: where we are and where we need to go.
Neuropediatrics. 2012 Aug;43(4):174-5.

Physical activity

Bansi J, Bloch W, Gamper U, et al.
Training in MS: influence of two different endurance training protocols (aquatic versus overland) on cytokine and neurotrophin concentrations during three week randomized controlled trial.
Mult Scler. 2012 Aug 30. [Epub ahead of print]

Wurdeman SR, Huisinga JM, Filipi M, et al.
Multiple sclerosis alters the mechanical work performed on the body's center of mass during gait.
J Appl Biomech. 2012 Aug 23. [Epub ahead of print]

Huisinga JM, Schmid KK, Filipi ML, et al.
Gait mechanics are different between healthy controls and patients with multiple sclerosis.
J Appl Biomech. 2012 Aug 22. [Epub ahead of print]

Nilsagård Y, Carling A, Forsberg A., et al.
Activities-specific balance confidence in people with multiple sclerosis.
Mult Scler Int. 2012;2012:613925.

Sandroff BM, Motl RW.
Fitness and cognitive processing speed in persons with multiple sclerosis: A cross-sectional investigation.
J Clin Exp Neuropsychol. 2012 Aug 21. [Epub ahead of print]


Margaritella N, Mendozzi L, Garegnani M, et al.
Exploring the predictive value of the evoked potentials score in MS within an appropriate patient population: a hint for an early identification of benign MS?
BMC Neurol. 2012 Aug 22;12(1):80. [Epub ahead of print]


Choi SR, Howell OW, Carassiti D, et al.
Meningeal inflammation plays a role in the pathology of primary progressive multiple sclerosis.
Brain. 2012 Aug 20. [Epub ahead of print]

Pregnancy and childbirth

Lu E, Wang BW, Guimond C, et al.
Disease-modifying drugs for multiple sclerosis in pregnancy: a systematic review.
Neurology. 2012 Aug 29. [Epub ahead of print]

Houtchens MK, Kolb CM.
Multiple sclerosis and pregnancy: therapeutic considerations.
J Neurol. 2012 Aug 25. [Epub ahead of print]


Garaci FG, Marziali S, Meschini A, et al.
Brain hemodynamic changes associated with chronic cerebrospinal venous insufficiency are not specific to multiple sclerosis and do not increase its severity.
Radiology. 2012 Aug 21. [Epub ahead of print]


Rieckmann P, Boyko A, Centonze D, et al.
Future MS care: a consensus statement of the MS in the 21st Century Steering Group.
J Neurol. 2012 Aug 31. [Epub ahead of print]

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