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Disclaimer: 'MS Views and News' DOES NOT endorse any products or services found on this blog. It is up to you to seek advice from your healthcare provider. The intent of this blog is to provide information on various medical conditions, medications, treatments, and procedures for your personal knowledge and to keep you informed of current health-related issues. It is not intended to be complete or exhaustive, nor is it a substitute for the advice of your physician. Should you or your family members have any specific medical problem, seek medical care promptly.

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Friday, December 29, 2017

Clomipramine, an Antidepressant, Shows Potential in Treating Progressive MS in Early Study

December 29, 2017

Clomipramine, an approved antidepressant, shows potential in treating people with progressive multiple sclerosis (MS)  — a disease form with few treatments — by protecting nerves from various processes thought to underly progressive MS, early research shows.
The lab and animal study, which focused on already-approved treatments, was titled “Systematic screening of generic drugs for progressive multiple sclerosis identifies clomipramine as a promising therapeutic” and published in the journal Nature Communications.
A variety of therapies exist for people with relapsing-remitting MS (RRMS), which is marked by exacerbations or flares. But fewer exist for people with progressive MS, and only one, Ocrevus (ocrelizumab), is approved for those with primary progressive disease. Among reasons for this are the markedly different underlying processes underlying these two types of MS.
“The mechanisms causing damage in progressive MS are not always the same as in relapsing-remitting MS. This is why the latter requires different therapeutic approaches,” Simon Faissner, a researchers with the Hotchkiss Brain Institute, University of Calgary, Canada and the study’s first author, said a press release.
Progressive MS involves severe aspects of neurodegeneration, accompanied by iron-mediated neurotoxicity, immune cell activity, and oxidative stress. An effective treatment essentially needs to address all these mechanisms.


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Zinbryta Fails to Prevent RRMS from Worsening After Patient Gets Off Tysabri, Case Study Shows

DECEMBER 28, 2017    Patricia Inacio, PhD

Zinbryta (daclizumab) may not be the best follow-up therapy for relapsing–remitting multiple sclerosis patients who stop taking Tysabri (natalizumab) for safety reasons, a case study suggests.
An article on the 25-year-old patient’s case, titled “Disease reactivation after switching from natalizumab to daclizumab,” was published in the Journal of Neurology.
Discontining Biogen’s Tysabri leads to many patients’ disease worsening. The question doctors face is what treatment to prescribe after Tysabri. One possibility is Zinbryta.
The U.S. Food and Drug Administration and European Union approved it as therapy for active RRMS cases in 2016.  Biogen and AbbVie market the monoclonal antibody, which targets the CD25 protein that scientists have linked to MS.
Researchers studied the 25-year-old patient’s case for clues about whether Zinbryta could benefit MS patients who discontinue Tysabri.
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Thursday, December 28, 2017

Spasticity in Multiple Sclerosis


Watch and Learn from this MS Expert, Aaron Boster, MD educate you




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Tuesday, December 26, 2017

Lifetime Cancer Risk Lower in MS Patients Than General Public, Study Reports

December 26, 2017


People with multiple sclerosis (MS) have a lower overall lifetime risk of cancer relative to a general population matched by area, age, sex and habits like tobacco use and alcohol consumption, new research reports, suggesting this lesser risk might be due to the nature of MS itself or to disease modifying therapies used by patients.

The study, “Decreased prevalence of cancer in patients with multiple sclerosis: A case-control study,” was published in the journal PLOS ONE.

The immune system is known to play a large role in both MS and cancer, leading some scientists to suggest that a disease like MS would modify the risk of cancer.

Some argue that the highly active immune system seen in MS patients works to improve cancer surveillance and decrease cancer risk. But others point to the disease-modifying treatments used by MS patients, particularly immunosuppressives, as increasing cancer risk in this population.

Studies have shown conflicting results, with some indicating a higher cancer risk and others a lower risk in MS patients.But most of these studies do not take into account lifestyle factors associated with cancer development, including alcohol and tobacco use.Lifetime Cancer Risk Lower in MS Patients Than General Public, Study Reports      READ MORE

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Monday, December 25, 2017

Tysabri-associated Progressive Multifocal Leukoencephalopathy (PML)


Discussed by Aaron Boster, MD

What is PML, what causes it, and the risk factors for infection associated with taking Tysabri











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What has Science taught us about Cann@bis and Multiple Sclerosis?

Created by Aaron Boster, MD
December 25, 2017

Dr. B reviews what we have learned from scientific studies as it relates to cann@bis and multiple sclerosis. There is good data that cann@bis does in fact help MS pain and MS spasticity. There is also good data that cann@bis worsens MS cognition. (Importantly people with MS who already have some cognitive impairment appear to be more affected as compared to those who do not already have problems with cognition). This is particularly important given that cognitive impairments and fatigue are the leading causes of loss of work among people with multiple sclerosis.







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Sunday, December 24, 2017

Primary Progressive MS: Myths vs. Facts

Primary progressive multiple sclerosis (PPMS) is a complex disease that varies between individuals. In other words, not everyone will have the same symptoms or experiences. The rates of progression also vary.
The mysteries surrounding PPMS have generated many myths about this condition. This can create a lot of confusion when you’re trying to research multiple sclerosis (MS) and its primary forms. Learn about some of the most common myths about PPMS here, as well as the real facts.

Myth: There will never be a cure for PPMS

Fact: Research is ongoing for medications

As of 2017, MS isn’t curable. Certain medications are approved by the U.S. Food and Drug Administration (FDA) for relapsing-remitting forms of MS, but but most of these don’t seem to work in PPMS. Recently, one new drug, Ocrevus (ocrelizumab), has been approved for PPMS.
This doesn’t mean that there will never be a cure. In fact, research is ongoing in terms of medications for PPMS, as well as possible cures for all forms of MS. Because genetics and environment are thought to contribute to MS development, research is looking into how to prevent some of these variables from affecting adults later in life.

Myth: PPMS primarily occurs in women

Fact: PPMS affects women and men at the same rate

Some forms of MS tend to occur more often in women than men — sometimes three times as much. Yet according to the National MS Society, PPMS seems to affect both women and men equally in number.
Diagnosing PPMS can be difficult, but you shouldn’t assume you have one specific form of MS just because of your sex.

Myth: PPMS is an elderly person’s disease

Fact: The condition may occur before middle age

The onset of PPMS tends to occur later than other forms of MS. However, there seems to be a misconception that it’s an elderly person’s disease. This may be in part due to the onset of disability being associated with age. According to the University of Rochester Medical Center, the average age of onset for PPMS is between 30 and 39 years of age.
Continue reading Myths and Facts about PPMS by clicking here

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Saturday, December 23, 2017

Listening to Dr Aaron Boster and Comprehensive Care by Brain Injury Radio







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Boster's Corner video: Why I don’t use narcotics in my Multiple Sclerosis practice

Published on Dec 23, 2017


Dr. B has never prescribed narcotics. In this video he explained his personal opinions on why he chooses not to use narcotics in his multiple sclerosis practice. There are many different types of chronic neuropathic pain that can occur in the setting of multiple sclerosis. We believe that using narcotics to treat these pains is not the right decision. Dr. B provides two reasons: One is the national opioid crisis. The other reason relates to the biologic mechanisms of narcotics and some of the long term problems that can arise when using narcotics to treat chronic neuropathic pain.




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Wednesday, December 20, 2017

Gadolinium-based Contrast Agents (GBCAs): Drug Safety Communication - Retained in Body; New Class Warnings

December 19, 2017

Audience: Radiology, Health Care Professional, Patient
ISSUE: FDA is requiring a new class warning and other safety measures for all gadolinium-based contrast agents (GBCAs) for magnetic resonance imaging (MRI) concerning gadolinium remaining in patients’ bodies, including the brain, for months to years after receiving these drugs. Gadolinium retention has not been directly linked to adverse health effects in patients with normal kidney function, and FDA has concluded that the benefit of all approved GBCAs continues to outweigh any potential risks.
However, after additional review and consultation with the Medical Imaging Drugs Advisory Committee, FDA is requiring several actions to alert health care professionals and patients about gadolinium retention after an MRI using a GBCA, and actions that can help minimize problems. These include requiring a new patient Medication Guide, providing educational information that every patient will be asked to read before receiving a GBCA. FDA is also requiring manufacturers of GBCAs to conduct human and animal studies to further assess the safety of these contrast agents. 
To date, the only known adverse health effect related to gadolinium retention is a rare condition called nephrogenic systemic fibrosis (NSF) that occurs in a small subgroup of patients with pre-existing kidney failure. FDA received reports of adverse events involving multiple organ systems in patients with normal kidney function. A causal association between these adverse events and gadolinium retention could not be established.
GBCAs are used with medical imaging devices called MRI scanners to examine the body for problems such as cancer, infections, or bleeding. GBCAs contain gadolinium, a heavy metal. These contrast agents are injected into a vein to improve visualization of internal organs, blood vessels, and tissues during an MRI, which helps health care professionals diagnose medical conditions. After being administered, GBCAs are mostly eliminated from the body through the kidneys. However, trace amounts of gadolinium may stay in the body long-term. Many GBCAs have been on the market for more than a decade.

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Tuesday, December 19, 2017

Novartis multiple sclerosis therapy Fingolimod granted FDA Breakthrough Therapy designation for pediatric MS

Breakthrough Therapy designation can expedite the development and review of therapies for serious conditions(1)

- In a pivotal Phase III study, oral fingolimod significantly reduced relapses by 82% in a pediatric patient population vs. interferon beta-1a intramuscular injection(2)

- Currently, no disease-modifying therapies are approved for pediatric patients with MS, who often have more frequent relapses than adults with early MS(3)

NEWS PROVIDED BY
Novartis 
Dec 18, 2017, 09:00 ET

EAST HANOVER, N.J., Dec. 18, 2017 /PRNewswire/ -- Novartis today announced that the US Food and Drug Administration (FDA) has granted Breakthrough Therapy designation for fingolimod for the treatment of children and adolescents 10 years of age or older with relapsing multiple sclerosis (MS). Fingolimod, also known as Gilenya® in the US, is approved to treat relapsing forms of MS in adults. Gilenya is not currently approved for children and adolescents with relapsing MS.

The Breakthrough Therapy designation is based on data from the Phase III PARADIGMS study, which evaluated the safety and efficacy of fingolimod vs. interferon beta-1a in children and adolescents (ages 10 or older) with relapsing MS4. PARADIGMS, the first completed randomized, controlled clinical trial specifically designed for pediatric relapsing MS, found that treatment with fingolimod resulted in an 82% reduction in the rate of relapses (annualized relapse rate) in this patient population over a period of up to two years, compared to interferon beta-1a intramuscular injection (p <0.001)2. The safety profile of fingolimod in this study was overall consistent with that seen in previous clinical trials in adults5.

"Despite the fact that children experience approximately two to three times as many relapses as a typical adult onset MS patient, there are currently no disease-modifying therapies approved for the pediatric population," said Dr. Tanuja Chitnis, Director of the Partners Pediatric Multiple Sclerosis Center, Massachusetts General Hospital, Boston, US, and Scientist, Ann Romney Center, Brigham and Women's Hospital, Boston, US. "Children with MS differ from adults in important ways and additional treatment options for pediatric patients are needed," added Dr. Chitnis, who also served as principal investigator for the PARADIGMS study.

The FDA grants Breakthrough Therapy designation for therapies that are intended to treat a serious condition and that have preliminary clinical evidence indicating that the treatment may demonstrate substantial improvement over available therapy on one or more clinically significant endpoints. This designation is a process designed to expedite the development and review of such therapies1.


"We're proud of this regulatory milestone, which represents part of our commitment to advance treatment options for young people with MS," said Fabrice Chouraqui, President of Novartis Pharmaceuticals Corporation. "Novartis is looking forward to working with the FDA to bring a therapy with a long track record in adults with relapsing MS to this younger patient population as soon as possible."

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Evaluating Near-Fallers and Fallers with MS

Mult Scler Relat Disord; ePub 2017 Nov 21; Fritz, et al

December 19, 2017


Near-fallers and fallers with multiple sclerosis (MS) reported similar circumstances surrounding fall events and demonstrated similar performance on standard timed walking tests, a recent study found. To that end, clinicians monitoring individuals with MS should consider evaluation of the circumstances surrounding falls in combination with quantitative walking measures to improve determination of fall risk and appropriate rehabilitation interventions. In a single visit, 135 MS participants completed the Hopkins Falls Grading Scale, a custom questionnaire investigating circumstances surrounding falls and near-falls, and performed the Timed Up and Go and Timed 25-Foot Walk tests.

Researchers found:

30% of individuals reported falls, while 44% reported near-falls over a 1-year period.
Non-fallers completed the walking tests more quickly than near-fallers and fallers; near-fallers and fallers demonstrated similar motor profiles.

Individuals were more likely to sustain a fall rather than a near-fall under the following circumstances: transferring outside the home and tripping over an obstacle.
Performing 1-second slower on the walking tests increased the odds of a history of a fall by 6–20%.

Citation:
Fritz NE, Eloyan A, Baynes M, Newsome SD, Calabresi PA, Zachowski KM. Distinguishing among multiple sclerosis fallers, near-fallers and non-fallers. [Published online ahead of print November 21, 2017]. Mult Scler Relat Disord. doi:10.1016/j.msard.2017.11.019.

Source



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Physical, Cognitive Functions in Elderly with MS

J Geriatr Phys Ther; ePub 2017 Dec 1; Bollaert, Motl
December 19, 2017

A recent study points to evidence of reduced function in older adults with multiple sclerosis (MS), and this might be partially managed by behavioral interventions that target physical activity and sedentary behavior for the promotion of healthy aging in this population. Participants initially underwent the cognitive assessments, followed by the physical function assessments. They were then instructed to wear an accelerometer and document wear time in a log book for a 7-day period after the testing session. Researchers found:

Older adults with MS (n=40) performed worse on all measures of physical function, and 1 measure of cognitive function (ie, information-processing speed), compared with healthy controls (n=40).
Older adults with MS engaged in less moderate-to-vigorous physical activity, more sedentary behavior, and longer duration of long sedentary bouts than healthy controls.

Levels and patterns of physical activity were significantly associated with a majority of physical function variables but not cognitive function variables in both older adults with MS and healthy controls but to a greater extent in older adults with MS.

Citation:
Bollaert RA, Motl RW. Physical and cognitive functions, physical activity, and sedentary behavior in older adults with multiple sclerosis. [Published online ahead of print December 1, 2017]. J Geriatr Phys Ther. doi:10.1519/JPT.0000000000000163.

Article source

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Healthy Diet, Lifestyle Linked with Less Disability

Neurology; ePub 2017 Dec 6; Fitzgerald, et al
December 19, 2017

A healthy diet and a composite healthy lifestyle are associated with lesser disability and symptom burden in multiple sclerosis (MS), according to a recent study. In 2015, participants in the North American Research Committee on MS (NARCOMS) Registry completed a dietary screener questionnaire that estimates intake of fruits, vegetables and legumes, whole grains, added sugars, and red/processed meats. Researchers constructed an overall diet quality score for each individual based on these food groups; higher scores denoted a healthier diet. They assessed whether a composite healthy lifestyle measure, a healthier diet, healthy weight (body mass index <25), routine physical activity, and abstinence from smoking was associated with symptom severity. They found:

Of the 7,639 (68%) responders, 6,989 reported physician-diagnosed MS and provided dietary information.

Participants with diet quality scores in the highest quintile had lower levels of disability and lower depression scores.

Individuals reporting a composite healthy lifestyle had lower odds of reporting severe fatigue, depression, pain, or cognitive impairment.

Citation:
Fitzgerald KC, Tyry T, Salter A, et al. Diet quality is associated with disability and symptom severity in multiple sclera. [Published online ahead of print December 6, 2017]. Neurology. doi:10.1212/WNL.0000000000004768.

Source



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Black Hole Assessment Method in Multiple Sclerosis

Mult Scler Relat Disord; ePub 2017 Dec 2; Adusumilli, et al
December 19, 2017


A method designed to classify and estimate the severity of T1-weighted hypointensities (persistent black and gray holes) within multiple sclerosis (MS) can add information to conventional imaging, a recent study found. 38 MS patients contributed images to the study. Intensities of lesions on T1-weighted scans were assessed relative to cerebrospinal fluid intensity using commercial software. Magnetization transfer imaging, diffusion tensor imaging, and clinical testing were performed to assess associations with T1w intensity-based measures. Researchers found:
  • Intensity-based assessments of T1w hypointensities were reproducible and achieved >90% concordance with expert rater determinations of “black” and “gray” holes.
  • Intensity ratio values correlated with magnetization transfer ratios (R=0.473) and diffusion tensor imaging metrics (R values ranging from 0.283 to −0.531) that have been associated with demyelination and axon loss.
  • Intensity ratio values incorporated into T1w hypointensity volumes correlated with clinical measures of cognition.
Citation:
Adusumilli G, Trinkaus K, Sun P, et al. Intensity ratio to improve black hole assessment in multiple sclerosis. [Published online ahead of print December 2, 2017]. Mult Scler Relat Disord. doi:10.1016/j.msard.2017.11.020.
Source



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Age Is Essential Modifier of Drug Efficacy in MS

Front Neuro; ePub 2017 Nov 10; Weideman, et al
December 19, 2017

Progressive multiple sclerosis (MS) is simply a later stage of the MS disease process and age is an essential modifier of a drug efficacy, according to a recent meta-analysis. Furthermore, higher efficacy treatments exert their benefit over lower efficacy treatments only during early stages of MS, and, after age 53, the model suggests that there is no predicted benefit to receiving immunomodulatory disease-modifying therapies (DMTs) for the average MS patient. Researchers performed a literature search with pre-defined criteria and extracted relevant features from 38 clinical trials that assessed efficacy of DMTs on disability progression. They found:

>28,000 MS subjects participating in trials of 13 categories of immunomodulatory drugs were included in the meta-analysis.
The efficacy of immunomodulatory DMTs on MS disability strongly decreased with advancing age.
Inclusion of baseline Expanded Disability Status Scale did not significantly improve the model.
The regression predicts 0 efficacy beyond approximately age 53 years.
The comparative efficacy rank derived from the regression residuals differentiates high- and low-efficacy drugs.
High-efficacy drugs outperform low-efficacy drugs in inhibiting MS disability only for patients aged <40.5 years.

Citation:
Weideman AM, Tapia-Maltos MA, Johnson K, Greenwood M, Bielekova B. Meta-analysis of the age-dependent efficacy of multiple sclerosis treatments. [Published online ahead of print November 10, 2017]. Front Neuro. doi:10.3389/fneur.2017.00577.

Source



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Monday, December 18, 2017

University of Huddersfield Team Develops Blood Test for Diagnosing MS

December 18, 2017

University of Huddersfield researchers have developed a blood test for diagnosing multiple sclerosis that avoids the invasive, painful process of collecting fluid from the brain and spine.

The team at the British discussed the test in an article titled “Sphingosine and dihydrosphingosine as biomarkers for multiple sclerosis identified by metabolomic profiling using coupled UPLC-MS.” It appeared in the journal Analytical Methods.
Medical technicians check the blood sample for two biomarkers of MS — sphingosine and dihydrosphingosine. Scientists have discovered that levels of the compounds are significantly lower in MS patients’ blood.
In addition to offering a new diagnostic tool, the discovery may help scientists learn more about the compounds’ role in the disease, potentially leading to therapies.
“Sphingosine and dihydrosphingosine have been previously found to be at lower concentrations in the brain tissue of patients with multiple sclerosis,” the researchers wrote said in a news release. “The detection of these sphingolipids in blood plasma allows the non-invasive monitoring of these and related compounds.”

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Cell Recycling Process Helps Trigger Immune Attack on Protective Nerve Cell Protein Myelin


December 18, 2017

A cell recycling process helps trigger an immune response against myelin, the protein that protects nerve cells, a multiple sclerosis study indicates.
When University of Zurich researchers eliminated the process, mice developed much milder forms of an MS-like disease. Loss of myelin is the hallmark of MS.
Cell Recycling Process Helps Trigger Immune Attack on Protective Nerve Cell Protein Myelin

In addition to providing key insights into the events leading to MS, the study suggested that there may be other ways to treat the disease than targeting immune cells. MS is an autoimmune disease, or one in which the immune system attacks healthy tissue instead of invaders.
Before the University of Zurich study, scientists knew little about the signals that tell immune T-cells to attack myelin in the brain. The Swiss researchers discovered that a protein that is active in cell material recycling is involved in the signaling.
Cells digest old or unwanted components so they can reuse their building blocks. The recycling process, known as autophagy, is crucial to cells’ health.

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Saturday, December 16, 2017

See how your Amazon Purchases benefit what we do to provide information, resources and services to the MS Community


Wrap-up your holiday shopping at smile.amazon.com/ch/26-3323427 and Amazon donates to MS Views And News. This holiday, give the gifts that give back.

Here’s how you can help: go to smile.amazon.com (smile.amazon.com/ch/26-3323427).
Log in with your same Amazon account info, and then, please select MS Views and News. That's it.

Amazon will donate .5 percent of your purchase to MS Views and News. Believe me when I tell you that every dollar helps.



Thus far in 2017 we raised money through Amazon that allowed us to provide a new educational program to patients and caregivers and so we are hoping to be able to raise more dollars this holiday season that will allow us to provide this kind of educational event to an area of need in 2018, as well. Help support what we do to educate MS Patients and Caregivers with needed information and resources

By using Amazon Smile, there is no additional cost to you. Something cool that I just learned is that if you’re ever on the site and forget to use Amazon Smile, just delete the “www” on your address bar and type “smile” in its place. It works the same way.

MS Views and News as well as all whom we educate, do very much thank you for using our www.smile.amazon.com/ch/26-3323427 link.

Happy Holidays!

Best Wishes,

Stuart Schlossman and the MS Views and News team

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Symptom Management and Lifestyle Modifications in Multiple Sclerosis

This article was selected as a need to know for those affetced by MS

by Lori Mayer, DNP, MSN, RN, MSCN

Why is this important to me?
MS is a chronic disease that is typically diagnosed in early adulthood and lasts for decades. Symptoms are different in each person and change over time. Symptom management and lifestyle modification can improve symptoms and lead to a healthier and longer life.

Who will benefit from reading this study/article?
This article addresses a variety of symptoms, and thus, all people with MS will benefit from reading this article.

What is the objective of this study?
Symptoms of MS may produce a variety of levels of discomfort, pain, and disability and may decrease quality of life and interfere with activities of daily living. Managing your symptoms will improve your overall health and well-being. Managing your symptoms accompanies the use of disease-modifying therapies and is just as important. Because you may experience more than one symptom and because symptoms change over time, you should periodically review your symptoms with your healthcare provider to determine which symptoms concern you most. It is also important to be aware that certain symptoms may simultaneously present, and therefore become more intensified. For example, pain, spasticity, and gait problems may occur together. The following symptoms are common in MS and can be effectively managed:

Fatigue: Fatigue can affect employment, quality of life, and cognitive abilities. By addressing those things that tend to cause fatigue, a healthcare provider can often assist at reducing fatigue levels. Fatigue may also be reduced with exercise, strategies to conserve energy, and behavioral and drug therapy.

Sensory problems: These include numbness and pain. Pain, which may cluster with cognitive problems, can be neuropathic (caused by damage to the nervous system), inflammatory, secondary to other MS problems, or unrelated to MS. Treatment is guided by the cause of pain.
Cognitive problems: These problems typically occur later in MS and include difficulties with information-processing speed, memory, and executive function (planning, attention, managing multiple tasks, etc.). Cognitive problems can affect employment, activities of daily living, and adherence to prescribed medications and rehabilitation activities. Treatment involves ruling out other factors that affect cognition and then creating a coping plan that may involve behavioral therapy, physical and mental exercise, and drug therapy.

Mood disorders: Major depressive disorder and anxiety are common and occur early in the disease course. Therapy may include drug treatment, psychotherapy, and exercise.
Bladder problems: These are common in later stages of MS and can lead to social isolation. Treatments include proper hydration, antibiotics, bladder training, medication, nerve stimulation, and sometimes catheterization, which are all aimed at achieving continence, improving quality of life, preventing infection, and protecting the kidneys.

Spasticity: Spasticity can cause pain, posture problems, limited mobility, and other problems. Management of spasticity includes physical therapy and certain medications.

Modifying your lifestyle choices to achieve wellness and reduce vascular risk factors is important for everyone, especially those with a neurological disease such as MS, because such modifications can improve brain health. Brain weight and volume change over time in everyone, however, the loss of brain volume occurs faster in people with MS. Proper diet, exercise, and avoiding smoking contribute to better brain health and are particularly important if you have MS. The following lifestyle considerations are important:

  • Weight: Obesity creates chronic, low-grade inflammation and can cause some degree of damage to the brain. Thus, maintaining optimal body weight if you have MS is important.
  • Smoking and alcohol use: Tobacco use can decrease the effectiveness of some MS drugs. More studies are needed to understand the interaction between alcohol use and MS, but if you have MS, you are urged to not smoke or consume excessive amounts of alcohol.
  • Vitamin D: Low vitamin D is a risk factor for developing MS. Vitamin D supplements can be useful.
    • Diet: The digestive system contains many types of helpful bacteria. The bacterial make-up of your digestive system is influenced by what you eat, vitamin D, smoking, and alcohol consumption. A healthy diet that includes vegetables, fish, vitamins A and D, and certain elements is anti-inflammatory and leads to the presence of healthy bacteria in your digestive system. In contrast, unhealthy fats, red meat, high salt, and high sugar can increase inflammation and have a harmful effect on gut bacteria. Thus, consuming a healthy diet creates a state of healthy bacteria and low inflammation that will benefit brain health. A healthy diet is especially important if you have MS.
    • Exercise: Exercise improves many MS symptoms, and people with MS should exercise a few times a week if possible.
    • Sleep: Sleep disorders are common in MS and can cause fatigue. Good quality sleep is important for brain health, especially if you have MS.
    • Temperature control: MS symptoms can worsen in hot or humid weather, and thus, temperature control can improve MS symptoms.
    • Stress: People with MS appear to respond abnormally to stress. Although stress cannot be completely eliminated, steps to reduce stress will benefit you if you have MS.
    • Medical marijuana: Medical marijuana may improve some MS symptoms. This topic is controversial, and more studies are needed to assess the risks and benefits.
    • Mental and social engagement: If you have MS, you should try to be mentally and socially active, which may improve brain health.
    • Vascular risk factors: Heart disease, high blood pressure, high cholesterol, and diabetes negatively impact brain health and should be identified and treated if you have MS.


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