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MS research update - Men and women: why the difference in MS? - 29 March 2012

A review published this week looks at the differences between MS in men and women. The idea is that, if scientists can work out why MS is different, it might suggest new paths for developing treatments or even allow strategies to decrease the chances of developing MS in the first place.

MS occurs about three times more frequently in women than in men so sex-related factors must have an effect on susceptibility to MS. These factors are hormonal, genetic and environmental but there are other, more complex effects involving the interactions between genes and the environment or changes to genes that affect how much they are used at a particular time (known as epigenetic changes).

Even though women get MS more often, they are not more severely affected than men so it is important to know why this is. However, pregnancy and all the hormonal and other changes that it brings, can affect a woman's MS. Often the chance of a relapse decreases in the last three months of pregnancy but increases in the months just after giving birth. However, these changes during pregnancy do not make a difference to the longer term level of disability.

The review concludes that it will be important to work out what is going on in the bodies of men and women that gives rise to these differences. This, in turn, will help the development of new strategies for the treatment of MS.

Voskuhl RR, Gold SM.
Sex-related factors in multiple sclerosis susceptibility and progression.
Nat Rev Neurol. 2012 Mar 27. doi: 10.1038/nrneurol.2012.43. [Epub ahead of print]

Horse riding helps with balance and walking

Many people find that being active and taking exercise, as far as possible, helps their MS. However, as for the general population, a big question can be finding a kind of exercise that is enjoyable, that you can do regularly and which is beneficial.

There are two forms of horse riding which can help people with MS. Hippotherapy uses the motion of the walking horse to provide therapeutic movement to the rider. The horse is led by a handler and the person receiving treatment may carry out a series of exercises or just gain benefit from the movement of the horse. The participant does not actively ride the horse but still benefits from the exercise. Sessions are under the direction of a physiotherapist specifically trained in this method of treatment.

Therapeutic horse riding, which was the focus of this study, involves the participant actively riding the horse. 27 people with MS were divided into two groups; one group undertook therapeutic horse riding while the other group did traditional physiotherapy. Both groups did two series of 10 weekly sessions. Their ability to balance and various aspects of walking were measured before and after the study.

The researchers found that the group who undertook therapeutic horse riding improved both their balance and some measures of walking. The same improvements were not seen in those who did the physiotherapy programme. They concluded that this form of exercise is good for people with MS.

Muñoz-Lasa S, Ferriero G, Valero R, et al.
Effect of therapeutic horseback riding on balance and gait of people with multiple sclerosis.
G Ital Med Lav Ergon. 2011 Oct-Dec;33(4):462-7.


Research by topic areas...


Oreja-Guevara C, Noval S, Alvarez-Linera J, et al.
Clinically isolated syndromes suggestive of multiple sclerosis: an optical coherence tomography study.
PLoS One. 2012;7(3):e33907.

Symptoms and symptom management

Guo ZN, He SY, Zhang HL, et al.
Multiple sclerosis and sexual dysfunction.
Asian J Androl. 2012 Mar 26. doi: 10.1038/aja.2011.110. [Epub ahead of print]

Disease modifying treatments

Johnson KP.
Glatiramer acetate for treatment of relapsing-remitting multiple sclerosis.
Expert Rev Neurother. 2012 Apr;12(4):371-84.

Zintzaras E, Doxani C, Mprotsis T, et al.
Network analysis of randomized controlled trials in multiple sclerosis.
Clin Ther. 2012 Mar 21. [Epub ahead of print]

Coles AJ, Fox E, Vladic A, et al.
Alemtuzumab more effective than interferon β-1a at 5-year follow-up of CAMMS223 Clinical Trial.
Neurology. 2012 Mar 21. [Epub ahead of print]

Other treatments

Stroet A, Hemmelmann C, Starck M, et al.
Incidence of therapy-related acute leukaemia in mitoxantrone-treated multiple sclerosis patients in Germany.
Ther Adv Neurol Disord. 2012 Mar;5(2):75-9.

Assessment tools

Schwartz CE, Bode RK, Vollmer T.
The symptom inventory disability-specific short forms for multiple sclerosis: reliability and factor structure.
Arch Phys Med Rehabil. 2012 Mar 21. [Epub ahead of print]

Hughes S, Spelman T, Trojano M, et al.
The Kurtzke EDSS rank stability increases 4 years after the onset of multiple sclerosis: results from the MSBase Registry.
J Neurol Neurosurg Psychiatry. 2012 Mar;83(3):305-10.

Vitamin D

Munger KL, Ascherio A.
Prevention and treatment of MS: studying the effects of vitamin D.
Mult Scler. 2011 Dec;17(12):1405-11.

Physical activity

Kempen JC, de Groot V, Knol DL, et al.
Self-reported fatigue and energy cost during walking are not related in patients with multiple sclerosis.
Arch Phys Med Rehabil. 2012 Mar 20. [Epub ahead of print]

Dalgas U, Stenager E.
Exercise and disease progression in multiple sclerosis: can exercise slow down the progression of multiple sclerosis?
Ther Adv Neurol Disord. 2012 Mar;5(2):81-95.


McClurg D, Irshad T.
Intermittent self-catheterisation in MS.
Nurs Times. 2012 Jan 31-Feb 6;108(5):16-8.

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