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Wednesday, April 12, 2017

A Multimodal, Nonpharmacologic Intervention Improves Mood and Cognitive Function in People with Multiple Sclerosis


J Am Coll Nutr. 2017 Apr 10:1-19. doi: 10.1080/07315724.2016.1255160. [Epub ahead of print]

Author information



The objective of this study was to examine whether participation in a 12-month multimodal intervention would improve mood and cognitive function in adults with progressive multiple sclerosis (MS).


In this one-arm, open-label feasibility trial, participants were prescribed a home-based multimodal intervention, including (1) a modified Paleolithic diet; (2) an exercise program (stretching and strengthening of the trunk and lower limb muscles); (3) neuromuscular electrical stimulation (EStim) of trunk and lower limb muscles; and (4) stress management (meditation and self-massage). Individuals completed measures of mood (Beck Anxiety and Depression Inventories) and cognitive (Cognitive Stability Index, Cognitive Screening Test, Delis-Kaplan Executive Function System) and executive function (Wechsler Adult Intelligence Scale) at baseline and 3, 6, 9, and 12 months after the start of the intervention. Dosage of the multimodal intervention was assessed at 3, 6, 9, and 12 months.


The more individuals participated in the intervention activities, the greater improvements they had from baseline to 12 months on self-report measures of anxiety (Beck Anxiety Inventory [BAI]; ps = 0.001 to 0.02), depression (Beck Depression Inventory [BDI]; ps = <0.0001 to 0.09), cognitive function (Cognitive Stability Index [CSI/T], Delis-Kaplan Executive Function System [DKEFS]; ps = 0.001 to 0.06), and executive function (Wechsler Adult Intelligence Scale [WAIS]; ps = <0.0001 to 0.09). Mood and cognitive improvements were more closely related to a higher intake of the modified Paleolithic diet than to exercise and stress management dosage. Anxiety and depression changes were evident after just a few months, whereas changes in cognitive function were generally not observed until later in the intervention period. Mood and cognitive function changes from baseline to 12 months were significantly associated with fatigue improvements (ps = <0.0001 to 0.03).


A modified Paleolithic diet, exercise, EStim, and stress management intervention like this one has the potential to improve the mood and cognitive symptoms that can lead to considerable suffering in people with MS, potentially improving quality of life and function for people with progressive MS.


Multiple sclerosis; Wahl's Protocol; anxiety; cognitive function; depression; diet; electrical stimulation; exercise; mood; non-pharmacologic
PMID:  28394724

Terry Wahls, MD, MBA, IFMCP
Clinical Professor of Medicine
Department of Medicine
Carver College of Medicine
University of Iowa
200 Hawkins Drive
Iowa City, Iowa 52240

Sunday, April 9, 2017

LIVING WELL with MS - Round Table Discussion with Drs. Ben Thrower & Guy Buckle


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SSDI and SSI presented in Los Angeles

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Ocrevus (Ocrelizumab) Information Update

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Ocrevus - what is it?

What is it? Ocrelizumab is an antibody based medication that depletes the B cells in patients' circulation (largely in the blood). It is given via an infusion (intravenously) every 6 months. It was developed based on the promising results from trials of another B cell depleting medication called rituximab. The therapeutic benefits in relapsing remitting MS and in primary progressive MS were recently reported.

What are the steps involved in accessing this treatment? If you are interested in learning more about this medication, please schedule a follow-up with your neurologist to discuss Ocrevus in more detail and see if it is the right fit for you. If you and your neurologist decide to move forward with Ocrevus, our office will work with your insurance to see if it is covered. If the medication is covered and screening tests reveal no contraindications, our office will help you schedule the infusion at UCSF or at an alternate infusion center.

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MS Views and News is MAKING an IMPACT on those affected by Multiple Sclerosis

Genetics of primary progressive multiple sclerosis

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Multiple sclerosis (MS) patients are classified as either having relapsing onset or progressive onset disease, also known as primary progressive MS (PPMS). Relative to relapsing onset patients, PPMS patients are older at disease onset, are equally likely to be men or women, and have more rapid accumulation of disability that does not respond well to treatments used in relapsing onset MS. 
Although estimates vary, 5-15% of all MS patients have a PPMS disease course. Genetic variance is a proposed determinant of MS disease course. If distinct genes associated with PPMS were identified study of these genes might lead to an understanding of the biology underlying disease progression and neural degeneration that are the hallmarks of PPMS. These genes and their biological pathways might also represent therapeutic targets. This chapter systematically reviews the PPMS genetic literature. Despite the intuitively appealing notion that differences between PPMS and relapsing onset MS are due to genetics, definite differences associated with these phenotypes at the major histocompatibility complex or elsewhere in the genome have not been found. Recent large-scale genome wide screens identified multiple genes associated with MS susceptibility outside the MHC. 
The genetic variants identified thus far make only weak individual contributions to MS susceptibility. If the genetic effects that contribute to the differences between PPMS and relapsing MS are similar in magnitude to those that distinguish MS from healthy controls then, given the relative scarcity of the PPMS phenotype, very large datasets will be needed to identify PPMS associated genes. International collaborative efforts could provide the means to identify such genes. Alternately, it is possible that factors other than genetics underlie the differences between these clinical phenotypes.
Copyright © 2014 Bruce Cree. Published by Elsevier B.V. All rights reserved.

MS Views and News is MAKING an IMPACT on those affected by Multiple Sclerosis

Staying active and adaptive with Multiple Sclerosis

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Program Date: March 8, 2017
Location: Fort Myers, Florida

Think about Numbers 1440 and 168


Guest Speaker: Jeffrey Segal, BS, NSCA-CPT, CSCS, CPTS

To Discuss: Integrating healthy lifestyle choices into your daily life. Staying active and adaptive exercises for strengthening, balance and fighting fatigue. The impacts of incorporating physical fitness for those living with MS. – 40 minutes with Q&A

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Will Stem Cell Treatments soon become a reality for MS Patients?

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Experimental MS Treatment Offers Hope To Patients 

DALLAS (CBSDFW.COM) – Getting on the treadmill again, is a big step for Malia Litman.
“I’m doing heel to toe walking,” she says proudly as the belt moves underneath her feet.
But to understand what a big victory this is, you need to know Litman’s path.
Litman, a top trial attorney in Dallas, was diagnosed with multiple sclerosis 18 years ago. As time passed, the disease slowly robbed her of her balance, mobility and energy. She says even taking a shower wiped her out. The disease is the most widespread disabling neurological condition in the world.
“You can imagine how contracted my world had become, it that was the level of energy I had,” she explains.
After she fell and broke her leg, Litman depended on a wheelchair for weeks. She says expensive MS medicines weren’t really working. That’s when she started looking for alternative treatments. Her search led her to Dr. Dimitrios Karussis.
“I believe many answers for our diseases and medical problems are hidden inside our body,” Dr. Karussis explains.
WATCH a Video or Read MORE about a MS Patients' recent treatment, click here: