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MS research update - How long to recover from a relapse? - 11 January 2012

Most people with MS are diagnosed with the relapsing remitting type. This is characterised by relapses (bad patches when symptoms get worse or new symptoms appear) followed by remission (when symptoms improve and may go away completely).

This study looked at how long people took to recover from a relapse and whether they recovered completely.

144 people with MS from Wales were assessed within one week of having a relapse and then followed up after two, six and 12 months using a variety of tests. If someone experienced another relapse before the 12 month point then they were assessed again following the same schedule.

85% were classed as having relapsing remitting MS but 15% had secondary progressive MS that still included relapses.

82 people (over a third) had no further relapse in the 12 month follow up period. The remaining participants experienced 226 relapses between them.

87% of those in the study showed an improvement in their EDSS score (mostly a measure of mobility) within two months including 50% who had recovered back to their initial EDSS score.

Arm function seemed slower to recover and could still be improving up to 6 months after the relapse.

30% of the relapses were classed as severe and, out of these, 11% failed to recover.

It was not generally possible to predict who would have a more severe relapse or who would not recover as quickly or so completely.

The researchers concluded that most improvement in physical symptoms occured within two months of the relapse and was largely complete within six months. However, further recovery could occur up to 12 months after the relapse in a small number of people.

They believe that these results are important in deciding what treatments should be used and when would be the best time to use them.

This study may also help people with MS to better understand the process of recovery after a relapse which can be confusing.

Hirst CL, Ingram G, Pickersgill TP, et al.
Temporal evolution of remission following multiple sclerosis relapse and predictors of outcome.
Mult Scler. 2012 Jan 4. [Epub ahead of print]


Research by topic areas...

Symptoms and symptom management

Sussman JE, Tjaden K.
Perceptual measures of speech from individuals with Parkinson's Disease and multiple sclerosis: intelligibility and beyond.
J Speech Lang Hear Res. 2012 Jan 9. [Epub ahead of print]

Wiedemann A, Kaeder M, Greulich W, et al.
Which clinical risk factors determine a pathological urodynamic evaluation in patients with multiple sclerosis? an analysis of 100 prospective cases.
World J Urol. 2012 Jan 7. [Epub ahead of print]

Amato MP, Portaccio E.
Management options in multiple sclerosis-associated fatigue.
Expert Opin Pharmacother. 2012 Jan 6. [Epub ahead of print]

Zakrzewska-Pniewska B, Gołębiowski M, Zajda M, et al.
Sex hormone patterns in women with multiple sclerosis as related to disease activity - a pilot study.
Neurol Neurochir Pol. 2011;45(6):536-542.

MS relapses

Naldi P, Collimedaglia L, Vecchio D, et al.
Predictors of attack severity and duration in multiple sclerosis: a prospective study.
Open Neurol J. 2011;5:75-82.

Disease modifying treatments

Weber MS, Menge T, Lehmann-Horn K, et al.
Current treatment strategies for multiple sclerosis - efficacy versus neurological adverse effects.
Curr Pharm Des. 2012 Jan 10. [Epub ahead of print]

Saidha S, Eckstein C, Calabresi PA.
New and emerging disease modifying therapies for multiple sclerosis.
Ann N Y Acad Sci. 2012 Jan 6. doi:10.1111/j.1749-6632.2011.06272.x. [Epub ahead of print]

Olival GS, Lima LC, Lima GP, et al.
Clinical predictors of response to immunomodulators for multiple sclerosis.
Arq Neuropsiquiatr. 2012 Jan;70(1):12-6.

Edan G, Comi G, Le Page E, et al.
Mitoxantrone prior to interferon beta-1b in aggressive relapsing multiple sclerosis: a 3-year randomised trial.
J Neurol Neurosurg Psychiatry. 2011 Dec;82(12):1344-50.

Fernández-Megía MJ, Casanova B, Magraner MJ, et al.
Assessment of the effectiveness and safety of natalizumab for treating relapsing-remitting multiple sclerosis.
Farm Hosp. 2011 Mar-Apr;35(2):75-9.

Drugs in development

Gorman MP, Tillema JM, Ciliax AM, et al.
Daclizumab use in patients with pediatric multiple sclerosis.
Arch Neurol. 2012 Jan;69(1):78-81.

Quality of life

Hwang JE, Cvitanovich DC, Doroski EK, et al.
Correlations between quality of life and adaptation factors among people with multiple sclerosis.
Am J Occup Ther. 2011 Nov-Dec;65(6):661-9.

Paediatric MS

Kerbrat A, Aubert-Broche B, Fonov V, et al.
Reduced head and brain size for age and disproportionately smaller thalami in child-onset MS.
Neurology. 2012 Jan 4. [Epub ahead of print]

Psychological aspects

O'Carroll CB, Woodruff BK, Locke DE, et al.
Is donepezil effective for multiple sclerosis-related cognitive dysfunction?: a critically appraised topic.
Neurologist. 2012 Jan;18(1):51-4.

Physical activity

Motl RW, Fernhall B.
Accurate prediction of cardiorespiratory fitness using cycle ergometry in minimally disabled persons with relapsing-remitting multiple sclerosis.
Arch Phys Med Rehabil. 2012 Jan 4. [Epub ahead of print]

Sandroff BM, Dlugonski D, Weikert M, et al.
Physical activity and multiple sclerosis: new insights regarding inactivity.
Acta Neurol Scand. 2012 Jan 3. doi: 10.1111/j.1600-0404.2011.01634.x. [Epub ahead of print]


Weinstock-Guttman B, Ramanathan M.
Multiple sclerosis in 2011: Advances in therapy, imaging and risk factors in MS.
Nat Rev Neurol. 2012 Jan 10. doi: 10.1038/nrneurol.2011.213. [Epub ahead of print]

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