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Saturday, January 21, 2017

Clearing Up Misconceptions about MS


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Sunday, January 15, 2017

HomeFeatured Our Senses Can’t Learn Under Stress


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Summary: Stress may impede perceptual learning and performance, a new study reports.
Source: RUB.

Stress is part of our everyday lives – while some thrive on it, it makes others sick. But what does stress do to our senses?
When we train them, we can sharpen our senses thereby improve our perceptual performance. The stress hormone cortisol completely blocks this important ability. In the current issue of “Psychoneuroendocrinology” neuroscientists of the Ruhr University Bochum (RUB) report on this finding.

“Previous research has already shown that stress can prevent the retrieval of memories. But now we have discovered that it also has a major effect on our perception and perceptual learning,” explains Dr Hubert Dinse, one of the authors of the study.

Tactile sense in training
In their study, researchers investigated how the sense of touch of 30 study participants could be changed after a training phase. Half of them received a medium dose of the stress hormone cortisol, while the other half received a placebo drug.

To make training comparable across all participants, the researchers employed the well-established approach of passive finger stimulation. Previous studies and several therapy approaches have shown that this method leads to an improved tactile acuity.
Image shows a hand and the chemical structure of cortisol.
To make training comparable across all participants, the researchers employed the well-established approach of passive finger stimulation. Previous studies and several therapy approaches have shown that this method leads to an improved tactile acuity. 
NeuroscienceNews.com image is for illustrative purposes only.
Tactile performance was assessed using the so-called “two-point discrimination threshold”. This marker indicates how far apart two stimuli need to be, to be discriminated as two separate sensations – the closer they are, the better the sense of touch.

No learning effect after cortisol
The placebo group improved their tactile acuity, as expected, by about 15 percent. In contrast, the cortisol given to the other group blocked almost all the stimulation-induced improvement. Cognitive psychologist Prof Dr Oliver T. Wolf explains:” Our data show that a single dose of cortisol not only disrupts memory in the hippocampus, but it also has a substantial effect on the plasticity of sensory areas of the brain.”

Cortisol blocks synaptic connections
In previous studies on a cellular level, neuroscientists have demonstrated that cortisol suppresses the strengthening of synaptic connections, and therefore the plasticity of the brain – its ability to learn. The team led by Hubert Dinse therefore suggests, their results could also explain by cortisol-induced suppression of synaptic plasticity.

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Journaling for MS: Why You Should Do It and How to Get Started


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Being diagnosed with multiple sclerosis (MS) is a jarring experience to say the least. Each of us is riddled with new experiences, physical symptoms and relationship changes. The duty of learning new versions of ourselves is bestowed upon us; we are left to deal with life and it’s a tendency to force us all into situations that stretch our understanding of the world and our place within it. Journaling for MS can help in sorting out these experiences.
When a person is first diagnosed with MS, everything is confusing. We have to see lots of doctors and go through countless procedures and tests. Our bodies are experiencing their own unique expressions of symptoms.
We realize how unpredictable and sneaky this disease is. And we begin to realize that our lives will never be laid out before us, as we once believed that they would be, again.

Keeping Grounded

Keeping a daily journal is a great way to keep ourselves grounded. There is so much thrust upon a person who is entering this community of ours, the challenges and changes can feel overwhelming and isolating.
A journal can be a safe space. A home base of sorts, where we can go, to remember who we are beyond this disease.
It is hard to be honest to even our closest allies about what we are experiencing. How do we form the words and share our deepest fears when they are so private and heavy?
A journal is always there, waiting to listen. Ready to keep everything locked and sealed from public view. A journal never gets tired. It never judges. It never speaks for you. A journal is always ready for more.
There are always empty pages ahead, begging to be filled. Page after page, day after day, a journal will keep your story sacred. It holds your value as a reminder that you cannot be silenced, erased or ignored.

Reflecting Upon Progress and Pitfalls

A journal can help us to reflect upon how far we have come on our journey. We can track our losses and our gains to see what therapies or treatments are most helpful.
Each one of us has a pattern or sweet spot we can find in our daily lives to help the days pass. For me, journaling has helped in seeing my triggers for fatigue.
Once I was able to look back and see the things that were most commonly causing fatigue, I could tweak my behavior and live with more energy.
Journaling can also aid in understanding our symptoms better. When I was first diagnosed, I had no idea how long my relapse was going to last.
I can still, very distinctly, remember all of the “I don’t knows” that came out of my neurologist’s mouth. I may never know for sure how my body is going to behave tomorrow, but after nine years with MS, I have a fairly good idea and that helps me sleep at night. Journaling has helped me to keep track of the symptoms that I have gained, the symptoms that have progressed and the symptoms that have healed.

Finding Your Groove

It is much easier to move through relapses and all of the days in between when we can understand the effectiveness of our medications. Journaling is a great way of keeping track of our changes and reactions to medications over time.
When we are in the thick of it, it is nice to have the ability to look back upon our last relapse to understand a basic timeline of our body’s reactions to steroids and physical therapy. A relapse can feel like an eternity, but a journal can show the incremental goal posts towards normalcy again.
Keeping track of disease-modifying drugs is better done with a journal as well. Many of us struggle with our meds in one way or another; remembering to take meds consistently, keeping track of injection sites and recognizing negative physical reactions to medications, are all important aspects when living a life with a chronic illness.
Making a habit of logging these details on a daily basis aids in protection from the negative consequences that can come from drug fatigue and complacency.

Keeping Healthy and Fit


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Selection of first-line therapy in multiple sclerosis using risk-benefit decision analysis.


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Bargiela D, et al. Neurology. 2017.


OBJECTIVE: To integrate long-term measures of disease-modifying drug efficacy and risk to guide selection of first-line treatment of multiple sclerosis.
METHODS: We created a Markov decision model to evaluate disability worsening and progressive multifocal leukoencephalopathy (PML) risk in patients receiving natalizumab (NTZ), fingolimod (FGL), or glatiramer acetate (GA) over 30 years. Leveraging publicly available data, we integrated treatment utility, disability worsening, and risk of PML into quality-adjusted life-years (QALYs). We performed sensitivity analyses varying PML risk, mortality and morbidity, and relative risk of disease worsening across clinically relevant ranges.
RESULTS: Over the entire reported range of NTZ-associated PML risk, NTZ as first-line therapy is predicted to provide a greater net benefit (15.06 QALYs) than FGL (13.99 QALYs) or GA (12.71 QALYs) treatment over 30 years, after accounting for loss of QALYs due to PML or death (resulting from all causes). NTZ treatment is associated with delayed worsening to an Expanded Disability Status Scale score ≥6.0 vs FGL or GA (22.7, 17.0, and 12.4 years, respectively). Compared to untreated patients, NTZ-treated patients have a greater relative risk of death in the early years of treatment that varies according to PML risk profile.
CONCLUSIONS: NTZ as a first-line treatment is associated with the highest net benefit across full ranges of PML risk, mortality, and morbidity compared to FGL or GA. Integrated modeling of long-term treatment risks and benefits informs stratified clinical decision-making and can support patient counseling on selection of first-line treatment options.
© 2017 American Academy of Neurology.


 28087821 [PubMed - as supplied by publisher]

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Subjective and objective assessment of physical activity in multiple sclerosis and their relation to health-related quality of life


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Krüger T, et al. BMC Neurol. 2017.


BACKGROUND: Physical activity (PA) is frequently restricted in people with multiple sclerosis (PwMS) and aiming to enhance PA is considered beneficial in this population. We here aimed to explore two standard methods (subjective plus objective) to assess PA reduction in PwMS and to describe the relation of PA to health-related quality of life (hrQoL).
METHODS: PA was objectively measured over a 7-day period in 26 PwMS (EDSS 1.5-6.0) and 30 matched healthy controls (HC) using SenseWear mini® armband (SWAmini) and reported as step count, mean total and activity related energy expenditure (EE) as well as time spent in PA of different intensities. Measures of EE were also derived from self-assessment with IPAQ (International Physical Activity Questionnaire) long version, which additionally yielded information on the context of PA and a classification into subjects' PA levels. To explore the convergence between both types of assessment, IPAQ categories (low, moderate, high) were related to selected PA parameters from objective assessment using ANOVA. Group differences and associated effect sizes for all PA parameters as well as their relation to clinical and hrQoL measures were determined.
RESULTS: Both, SWAmini and IPAQ assessment, captured differences in PA between PwMS and HC. IPAQ categories fit well with common cut-offs for step count (p = 0.002) and mean METs (p = 0.004) to determine PA levels with objective devices. Correlations between specifically matched pairs of IPAQ and SWAmini parameters ranged between r .288 and r .507. Concerning hrQoL, the lower limb mobility subscore was related to four PA measures, while a relation with patients' report of general contentment was only seen for one.
CONCLUSIONS: Both methods of assessment seem applicable in PwMS and able to describe reductions in daily PA at group level. Whether they can be used to track individual effects of interventions to enhance PA levels needs further exploration. The relation of PA measures with hrQoL seen with lower limb mobility suggests lower limb function not only as a major target for intervention to increase PA but also as a possible surrogate for PA changes.


 28086828 [PubMed - in process]


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Understanding Comprehensive Care -


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Information showing below was written by The National Multiple Sclerosis Society

Understand the importance of comprehensive MS care and meet the healthcare professionals who will partner with you to manage the disease and your health.

Comprehensive Care

 IN THIS National MS SOciety ARTICLE

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 The Edward M. Dowd Personal Advocate Program aims to increase independent living capabilities and quality of life for people affected by MS whose health and safety are compromised by limited knowledge, understanding, and/or ability to access programs and benefits. Individuals in need of this service are identified by:
  • Multiple, urgent issues and significant MS-related symptoms and/or disability
  • Significant changes in physical or mental health, or cognition
  • Inability of family or caregiver(s) to provide care or cope
  • Isolation (including being homebound), living alone, or other health or safety risks
  • Lack of home care, adequate housing, or other vital services
  • Inability to identify needs, e.g., scattered assistance requests or signs of being overwhelmed
  • Imminent potential of admission to a long-term care facility

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International Progressive MS Alliance


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Learn more about Collaborative Network Award leader Dr. Francisco Quintana’s breakthrough research during a live webcast on February 13.

International Progressive MS Alliance Webinar Registration

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