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Saturday, June 5, 2010

Low-dose quinidine in combination with dextromethorphan reduces the frequency of uncontrollable laughing or crying in multiple sclerosis

This report is part of a 12-month Clinical Context series.

By Richard Robinson, Contributing Writer, MedPage Today
Published: June 04, 2010
Reviewed by Ari Green, MD; Assistant Professor, University of California, San Francisco.


SAN ANTONIO -- Low-dose quinidine in combination with dextromethorphan reduces the frequency of uncontrollable laughing or crying in multiple sclerosis while improving patient safety, according to research presented here.


Using just a third of the quinidine dose contained in the current combination therapy, marketed as Zenvia, reduced those episodes by more than half, compared with a decrease of about one a day with placebo (P=0.0280), Daniel Wynn, MD, of Consultants in Neurology in Northbrook, Ill., and colleagues found.


Pseudobulbar affect (PBA), characterized by laughing or crying outbursts incongruent with the patient's emotional state, affects 15% of patients with MS, and is also seen in ALS, Alzheimer's disease, and other neurologic diseases.


"Pseudobulbar affect causes considerable distress for patients and caregivers," Wynn told attendees at the meeting of the Joint Consortium of Multiple Sclerosis Centers and America's Committee on Treatment and Research in Multiple Sclerosis. "It can be extremely socially disabling, and it is often under-recognized and undertreated."

 Continue Reading


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MS is very poorly misunderstood - Here, read more on the "Mysterious MS"

Chances are if you live in a northern state or Canada, you’re acquainted with someone who has multiple sclerosis. But that doesn’t necessarily mean you know they have been diagnosed with the disease.
By: Ann Bailey, Grand Forks Herald


Chances are if you live in a northern state or Canada, you’re acquainted with someone who has multiple sclerosis.

But that doesn’t necessarily mean you know they have been diagnosed with the disease.

“There are many patients walking down the street that you don’t know have it,” said Dr. Matthew Roller an Altru Health System neurologist,

He acknowledges that while a diagnosis of MS is frightening for people, the disease does not cause severe disability in most people and that it is not a death sentence.

“MS is very poorly misunderstood.”



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In Barrie Canada: MPP Lobbying for MS Fix

Posted By BOB BRUTON

Ontario multiple sclerosis patients should have access to a new treatment, says Barrie MPP Aileen Carroll, and she has asked the provincial health ministry to allow it.

Corrective angioplasty for chronic cerebro-spinal venous insufficiency (CCSVI) has been identified as a treatment for some sufferers of MS, a neurological disorder that eventually shuts down the human body.


"This procedure is low-cost and low-risk," said Dr. Sandy McDonald, a Barrie vascular surgeon.


"I'm not saying we can cure or treat MS, but it seems to be discriminatory that people are denied this treatment."

This procedure isn't universally accepted in the medical community.

The angioplasty opens a vein that prevents proper blood flow from the brain.

McDonald said the cost is about $1,500 per treatment.

Carroll says she isn't asking that OHIP cover this treatment's cost, only that MS patients have access to it in Ontario -- just as they do cosmetic surgery by doctors in accredited medical facilities.


Continue to read from the Barrie examiner

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MS patients push harder for controversial treatment: Chronic Cerebro Venous Insufficiency (CCSVI)

Updated: Sat Jun. 05 2010 12:39:47 PM

ctvtoronto.ca
TORONTO — Impatient multiple sclerosis patients are attempting to mount a quasi-coup, hoping to install two of their own on the M-S Society of Canada's board.
They are trying to elect representatives to the board who will push from inside for an unproven therapy M-S patients cannot currently get in Canada.
It's called the liberation procedure and it opens up blocked neck veins.
Italian Doctor Paolo Zamboni says that condition, which he calls C-C-S-V-I, is responsible for M-S and opening the blockages can restore some function to patients.
Five board seats are up for graps at the M-S Society's annual meeting June 12, but there are 5 incumbents seeking re-election.
M-S patient Janet Heisey (HI-zee) says the M-S community doesn't feel like the board is pushing hard enough for C-C-S-V-I treatment to be available in Canada.

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MS drug study on Teriflunomide shows

PARISJune 5, 2010 /PRNewswire/ -- Sanofi-aventis reported today new one-year data from a Phase II study with teriflunomide, a novel oral disease modifier being investigated for the treatment of relapsing multiple sclerosis (RMS). Study results demonstrated an improvement in outcomes, with a consistent safety profile with the data from a previous Phase II monotherapy study, in patients treated with interferon beta (IFN-[BETA]) - a standard therapy in RMS - and receiving teriflunomide 7mg or 14mg, compared with patients treated with IFN-[BETA] and receiving oral placebo.

The findings were the subject of the leading oral presentation at the American Committee for Treatment and Research in Multiple Sclerosis meeting (ACTRIMS) in San Antonio, TX, USA. This study is part of a comprehensive clinical development program for teriflunomide both in monotherapy and in adjunct therapy in MS patients.




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Friday, June 4, 2010

UK News : MS drugs scheme 'a costly failure' for the NHS

June 4, 2010
The multiple sclerosis risk sharing scheme is "a costly failure" and should not be continued, according to researchers in the British Medical Journal today.
 
They argue that the biggest losers are the other NHS patients who would otherwise have benefited from the money spent on the scheme, estimated to be around £50m per year since it was set up in 2002.
They also point out that, if an assessment had been completed after the first two years, the NHS could have already saved around £250m.
The risk sharing scheme was set up by the Department of Health to make sure disease-modifying drugs were available on the NHS after the National Institute of Health and Clinical Excellence (NICE) ruled that they were not cost effective.
Under the terms of the scheme, the government agreed to provide these drugs on the NHS while research was carried out to assess their long term . The NHS would then gradually stop paying for the drugs if patients did not appear to be benefiting.
In 2009, seven years after the scheme was set up, the first analysis of the data showed that patient outcomes were much worse than predicted, but the scheme's scientific advisory group judged that it was premature to reduce prices without further analysis.
Why did this happen and what can we do to prevent it recurring?



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Multiple Sclerosis from A to Z

Information provided by Marc Bloom of MSVN, who found this on the Research Channel





Description:
In partnership with the National Multiple Sclerosis Society, the University of Washington’s Multiple Sclerosis Rehabilitation Research and Training Center presents a lecture series about MS from A to Z. UW researchers as well as nationally- and internationally-renowned experts explore multiple sclerosis, from its history to pain management to employment for those living with the disease.

Subscribe to the Series Podcast (Help)


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Primary-Progressive MS: Perspectives on Moving Foward Parts 1-3

The National MS Society and MS Learn Online present:



A new Feature Presentation:

Parts one, two and three of a six-part video webcast series that explores:
  • What is primary-progressive MS?
  • Maintaining health and quality of life
  • Your health and MS
If you have a pop-up blocker, you will need to disable it prior to participating in a MS Learn Online webcast.
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Glatiramer acetate recovers microscopic tissue damage in patients with multiple sclerosis

Information provided by Hollie of the Accelerated Cure Project

Glatiramer acetate recovers microscopic tissue damage in patients with multiple sclerosis. A case-control diffusion imaging study.


Buffalo Neuroimaging Analysis Center, Department of Neurology, University of Buffalo, Buffalo, NY, United States; The Jacobs Neurological Institute, Department of Neurology, University of Buffalo, Buffalo, NY, United States.

Abstract

Traditional magnetic resonance imaging (MRI) techniques have contributed to the management of multiple sclerosis (MS) but are limited in their ability to detect neuronal damage. Advanced MRI metrics provide assessment of microscopic neuronal changes; however, few studies have examined the effects of MS therapies on these measures. 

This prospective, open-label, observational study evaluated the effect of subcutaneous glatiramer acetate (GA) 20mg/day on the 1- and 2-year changes in diffusion-weighted imaging (DWI) measures in patients with relapsing-remitting (RR) MS and in age- and sex-matched healthy controls (HC). Inclusion criteria were age 18-65, RR disease course, expanded disability status scale (EDSS) score <20 years. 

MS patients and HC underwent 1.5T MRI scans and clinical examinations at baseline and at 1- and 2-year follow-up. Nineteen RRMS patients and 16 HC completed the 1-year follow-up and 16 MS patients and 13 HC the 2-year follow-up of the study. In MS patients, treatment with GA promoted recovery of DWI mean parenchymal diffusivity (MPD) at year 1 (-7.1%, p=0.007) and at year 2 (-10.1%, p=0.028). 

The recovery of DWI MPD was significantly higher in MS patients compared to HC at year 1 (p=0.01) and year 2 (p<0.001). GA promoted recovery of DWI entropy at 2 years (-1.2%, p=0.018). No significant DWI MPD and entropy changes were observed in HC over the follow-up. No significant deterioration in magnetization transfer ratio occurred over the follow-up in MS patients and HC. 
Patients on GA and HC did not develop significant global or regional atrophy over 2 years. GA significantly improved microscopic tissue damage in the brain, as measured by DWI over the 1- and 2-year follow-up. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.



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