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MS research update - Keeping cool - 03 May 2012

Many people with MS find that heat makes their symptoms significantly worse. A study in Australia looked at how much people are affected by heat and at ways of keeping cool especially using air conditioning. The climate in different parts of Australia varies from tropical to quite similar to the UK.

Over 90% reported increased symptoms due to heat. The most common issue was fatigue for 84%, followed by an increase in other symptoms for 62%. Just under half also reported reduced capacity for social, household and work activities, and self-care. Some people with MS also reported impact on their use of medication (9%), doctor or other health professional visits (7%), and hospitalisation (3%).

People were also asked about the ways that they tried to keep their homes cool. Air conditioners were used by 82% of respondents but there were 10% who could not afford an air conditioner. 40% used external window coverings such as blinds and awnings, 80% used internal window coverings, 70% had ceiling insulation, 19% had roof vents and 27% had wall insulation.

There was a financial cost, as well as a personal cost, as people with MS in Australia spend between 4 and 12 times more on running their air conditioners than other households.

Summers MP, Simmons RD, Verikios G.
Keeping cool: use of air conditioning by Australians with multiple sclerosis.
Mult Scler Int. 2012;2012:794310.

Keeping on DMTs

Disease modifying treatments (DMTs) have been shown to reduce relapse rates and improve markers of disease activity seen on MRI scans. However, these treatments have to be given by injection and taken over the long term, possibly life long, because interruption of treatment can lead to an increase in disease activity.

A number of previous studies have shown that many people find it difficult to keep to the required schedule of injections. This study looked at the reasons behind this.

202 people with relapsing remitting MS completed a questionnaire. The average age was 41 and three quarters were women. All had an EDSS score of less than 5.5 and had been on a DMT for at least three months, although the average was 3 years. Most were being treated with interferon but 18% had been prescribed glatiramer acetate.

42% reported missing their injections from time to time including 26% who had missed at least one injection in the previous 3 months. 18% admitted to taking a "drug holiday".

The most common reason given was forgetting (39%). People who considered themselves well informed about MS were more likely to keep to the treatment regime. Younger people were more likely to miss an injection.

The majority of patients (87%) intended continuing their treatment and 50% believed that their current treatment might reduce relapses.

de Seze J, Borgel F, Brudon F, et al.
Patient perceptions of multiple sclerosis and its treatment.
Patient Prefer Adherence. 2012;6:263-73.


Research by topic areas...

Symptoms and symptom management

Li Y, Munger KL, Batool-Anwar S, et al.
Association of multiple sclerosis with restless legs syndrome and other sleep disorders in women.
Neurology. 2012 Apr 25. [Epub ahead of print]

MS relapses

Morrow SA, McEwan L, Alikhani K, et al.
MS patients report excellent compliance with oral prednisone for acute relapses.
Can J Neurol Sci. 2012 May;39(3):352-4.

Disease modifying treatments

Castrop F, Kowarik MC, Albrecht H, et al.
Severe multiple sclerosis relapse under fingolimod therapy: incident or coincidence?
Neurology. 2012 Mar 20;78(12):928-30.

Other treatments

Koziolek MJ, Tampe D, Bähr M, et al.
Immunoadsorption therapy in patients with multiple sclerosis with steroid-refractory optical neuritis.
J Neuroinflammation. 2012 Apr 26;9(1):80. [Epub ahead of print]

Geffard M, Duleu S, Bessede A, et al.
GEMSP: a new therapeutic approach to multiple sclerosis.
Cent Nerv Syst Agents Med Chem. 2012 Apr 25. [Epub ahead of print]

Assessment tools

Tewarie P, Balk L, Costello F, et al.
The OSCAR-IB consensus criteria for retinal OCT quality assessment.
PLoS One. 2012;7(4):e34823.

Vitamin D

Simon KC, Munger KL, Ascherio A.
Vitamin D and multiple sclerosis: epidemiology, immunology, and genetics.
Curr Opin Neurol. 2012 Jun;25(3):246-51.

Psychological aspects

Schwartz CE, Snook E, Quaranto B, et al.
Cognitive reserve and patient-reported outcomes in multiple sclerosis.
Mult Scler. 2012 Apr 30. [Epub ahead of print]

Aviv RI, Francis PL, Tenenbein R, et al.
Decreased frontal lobe gray matter perfusion in cognitively impaired patients with secondary-progressive multiple sclerosis detected by the bookend technique.
AJNR Am J Neuroradiol. 2012 Apr 26. [Epub ahead of print]

Physical activity

Dlugonski D, Joyce RJ, Motl RW.
Meanings, motivations, and strategies for engaging in physical activity among women with multiple sclerosis.
Disabil Rehabil. 2012 Apr 25. [Epub ahead of print]


Caloyeras JP, Zhang B, Wang C, et al.
Cost-effectiveness analysis of interferon beta-1b for the treatment of patients with a first clinical event suggestive of multiple sclerosis.
Clin Ther. 2012 Apr 26. [Epub ahead of print]


Gelfand JM, Nolan R, Schwartz DM, et al.
Microcystic macular oedema in multiple sclerosis is associated with disease severity.
Brain. 2012 Apr 25. [Epub ahead of print]

Al-Saeed O, Athyal R, Ismail M, et al.
Significance of Virchow-Robin spaces in patients newly diagnosed with multiple sclerosis: a case-control study in an Arab population.
Med Princ Pract. 2012 Apr 25. [Epub ahead of print]

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