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MS research update - Planning takes longer with MS - 04 January 2012

MS can affect all aspects of thinking, including memory, concentration and planning.

This study looked at how MS might affect planning, problem solving and performance using a test called the Tower of London test. This test has many varieties but they are all similar to the following.

There is usually a board with a few posts stacked with a small number of beads of different colours. These have been arranged by the researcher to show what the target result is.

The person being tested is given an identical board with beads but arranged in a different order on the posts. They have to rearrange the beads, moving only one at a time from one post to another, to get the target result. This requires thinking ahead to move some of the beads to the "wrong" post so that others can then be moved. Finally, beads can be moved from the "wrong" post to the correct post to complete the task.

Successfully completing the test requires someone to plan all the moves before carrying out what they have planned. You can see one version of the Tower of London test on YouTube.

In this study, three groups (people with relapsing remitting MS or secondary progressive MS and healthy controls) were tested on a difficult version of the Tower of London test. The researchers measured how long the person took in planning all their moves as well as whether they were successful in completing the test.

They found that people with both types of MS took much longer to plan their moves than the healthy controls. They also showed a greater variation in how long they took to plan as the task was made harder.

However, there was no difference between the three groups in how well they completed the task (whether they had all the coloured beads on the correct posts), it just took people with MS longer to think ahead and make their plan.

The researchers suggest that imposing a time limit, as has been done in many other studies, would affect how well someone seemed to complete the task when, in fact, it was just more time for planning that was needed to be successful.

Denney DR, Hughes AJ, Owens EM, et al.
Deficits in planning time but not performance in patients with multiple sclerosis.
Arch Clin Neuropsychol. 2011 Dec 15. [Epub ahead of print]


Bladder problems helped by pelvic floor exercises

Bladder problems are common in MS and can be very distressing. They include urgency (a desperate urge to go to the toilet with little or no warning), frequency (needing the toilet more than eight times a day), hesitancy (difficulty in emptying the bladder) and retention (a feeling of incomplete bladder emptying).

The pelvic floor muscles are located between the legs, and run from the pubic bone at the front to the base of the spine at the back. They help in controlling the bladder and are used to urinate.

Older people and women who have had children can have weaker pelvic floor muscles. Pelvic floor exercises have been used successfully to strengthen these muscles and stop any urinary incontinence.

In this study, 35 women with MS were divided into two groups, either doing pelvic floor exercises or a sham (control) procedure. Both groups were trained for 12 weeks, twice a week, and encouraged to practice every day at home.

At the end of the study, those who had done the pelvic floor exercises had fewer bladder problems and said that their quality of life had improved.

Lúcio AC, Perissinoto MC, Natalin RA, et al.
A comparative study of pelvic floor muscle training in women with multiple sclerosis: its impact on lower urinary tract symptoms and quality of life.
Clinics (Sao Paulo). 2011;66(9):1563-8.


Research by topic areas...

Symptoms and symptom management

Fanchamps MH, Gensicke H, Kuhle J, et al.
Screening for balance disorders in mildly affected multiple sclerosis patients.
J Neurol. 2011 Dec 21. [Epub ahead of print]

Kaminska M, Kimoff R, Benedetti A, et al.
Obstructive sleep apnea is associated with fatigue in multiple sclerosis.
Mult Scler. 2011 Dec 19. [Epub ahead of print]

Disease modifying treatments

Goodin DS, Traboulsee A, Knappertz V, et al.
Relationship between early clinical characteristics and long term disability outcomes: 16 year cohort study (follow-up) of the pivotal interferon β-1b trial in multiple sclerosis.
J Neurol Neurosurg Psychiatry. 2011 Dec 21. [Epub ahead of print]

Fernandez-Fernandez O, Garcia-Trujillo L, Guerrero-Fernandez M, et al.
The effectiveness of glatiramer acetate in clinical practice: an observational study.
Rev Neurol. 2012 Jan 1;54(1):1-9. Spanish, English.

Rispens T, Vennegoor A, Wolbink GJ, et al.
Natalizumab remains detectable in patients with multiple sclerosis long after treatment is stopped.
Mult Scler. 2011 Dec 19. [Epub ahead of print]


Ahlgren C, Odén A, Lycke J.
A nationwide survey of the prevalence of multiple sclerosis in immigrant populations of Sweden.
Mult Scler. 2011 Dec 29. [Epub ahead of print]

Assessment tools

Langdon D, Amato M, Boringa J, et al.
Recommendations for a brief international cognitive assessment for multiple sclerosis (BICAMS).
Mult Scler. 2011 Dec 21. [Epub ahead of print]

Paediatric MS

Fay AJ, Mowry EM, Strober J, et al.
Relapse severity and recovery in early pediatric multiple sclerosis.
Mult Scler. 2011 Dec 19. [Epub ahead of print]

Psychological aspects

Reade JW, White MB, White CP, et al.
What would you say? Expressing the difficulties of living with multiple sclerosis.
J Neurosci Nurs. 2012 Feb;44(1):54-63.

Holmes JM, Ford E, Yuill F, et al.
Attendance at a psychological support group for people with multiple sclerosis and low mood.
Disabil Rehabil. 2011 Dec 28. [Epub ahead of print]

Strober LB, Christodoulou C, Benedict RH, et al.
Unemployment in multiple sclerosis: the contribution of personality and disease.
Mult Scler. 2011 Dec 19. [Epub ahead of print]

Cooper CL, Hind D, Parry GD, et al.
Computerised cognitive behavioural therapy for the treatment of depression in people with multiple sclerosis: external pilot trial.
Trials. 2011 Dec 14;12(1):259. [Epub ahead of print]


Olesen J, Gustavsson A, Svensson M, et al.
The economic cost of brain disorders in Europe.
Eur J Neurol. 2012 Jan;19(1):155-162.


Ertl-Wagner B, Koerte I, Kuempfel T, et al.
Non-specific alterations of craniocervical venous drainage in multiple sclerosis revealed by cardiac-gated phase-contrast MRI.
Mult Scler. 2011 Dec 22. [Epub ahead of print]

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