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Saturday, October 26, 2019

Yoga and Non-Cardio Exercises: Your Allies in Managing MS Symptoms and Improving Overall Health

Presenters:
Sue Kushner, MS, PT - Physical Therapist
Lynn Stazzone, RN, BSN, MSN, NP - Neuroscience Nurse Practitioner


Non-cardio exercises, including yoga and seated stretches, can help positively manage your MS symptoms and promote your overall health. In particular, there is growing research on the disease-modifying effects of yoga, in addition to its profound impact on physical, mental, emotional, and spiritual well-being. Best of all, these activities are accessible to everyone of all abilities. With some creativity and adaptations, everyone can do something!

Download the recording and powerpoint now



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Exercise as Part of Everyday Life

Provided by #TheNationalMSSociety


Physical activity can be a regular part of staying healthy if you have MS. Includes tips on handling MS symptoms.

Exercise as part of daily life --  DOWNLOAD 



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Stretching for People with MS—An Illustrated Manual (.pdf)

Provided by #TheNationalMSSociety

Illustrated manual showing range of motion, stretching, and balance exercises for at-home program. By Beth E. Gibson, PT. (last updated October 2016)


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International MS Genetics Consortium Confirms 233 MS-Related Gene Variations in Largest Study to Date

September 26, 2019
SUMMARY:
  • The International MS Genetics Consortium (IMSGC) has published the largest MS genetics study to date, analyzing data from 47,429 people with MS and 68,374 individuals without MS.
  • They confirmed 233 variations in the human genome that contribute to the risk of developing MS. The variations were found to influence many different immune cell types and tissues, indicating that broad dysfunction in the immune system underlies the onset of MS.
  • The study also identifies a genetic variant for MS on chromosome X, the sex chromosome. Women have two X chromosomes while men have one; this is therefore an interesting lead to investigate why women are more likely to develop MS than men.
  • These results alone are not sufficient to pinpoint who will develop MS, but they contribute to an understanding of risk factors that may eventually be used to predict an individual’s risk of developing MS and point to ways to prevent it.
  • The IMSGC, a worldwide group of investigators collaborating to understand the genetic basis of MS, report this study in the magazine Science (365, eaav7188 [2019]).
 
“This study greatly expands our knowledge of the genetic variations that contribute to MS susceptibility, and establishes a roadmap to figure out what causes MS and how to prevent it,” said Bruce Bebo, PhD, Executive Vice President of Research at the Society. “This work would not be possible without the participation of people affected by MS, and the collective funding of agencies and MS Societies from around the world. It is an inspiring example of the collective power of patients, researchers, and funders coming together to accelerate vital research that brings us ever closer to a cure for MS,” he added.
 
DETAILS
Background: The cause of MS is not yet known, but it is thought be triggered by a combination of factors in people whose genetic makeup (genome) make them susceptible. The International MS Genetics Consortium comprises the world’s top neurologists and geneticists. This team was supported with many sources including research grants from the National Institutes of Health and the National MS Society (in part through the generous support of Richard and Rosalyn Slifka) to undertake a search for MS genes throughout the human genome. They assembled data from multiple prior studies and then worked to confirm (replicate) those results in a large number of independent subjects, analyzing genetic data from a total of 115, 803 individuals. This replication effort was needed to increase confidence of previous findings.
 
The Replication Study: In the largest MS genetic study to date, IMSGC researchers analyzed genetic data from 47,429 people with MS and 68,374 controls without MS. They confirmed 233 variations in the human genome that contribute to susceptibility to MS. These results confirm the initial results, representing a giant leap forward in understanding MS genetics.
These results alone are not sufficient to pinpoint who will develop MS, but they contribute to an understanding of risk factors that may eventually be used to predict an individual’s risk of developing MS and point to ways to prevent it.
 
The identified genetic variations influence the function of many immune cells types and tissues involved in initiating and carrying out immune attacks against the brain and spinal cord in MS. The team also found a link to the function of microglia, which are the immune cells of the brain, but not in other brain cells such as neurons or astrocytes. In addition, the study identified a genetic variation related to MS on chromosome X. Women have two X chromosomes (men have one), and this represents an intriguing lead to understanding part of the reason why women are more likely to develop MS than men.
 
The IMSGC report this study in the magazine Science (365, eaav7188 [2019]).
 
Source: a National MS Society publication


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Friday, October 25, 2019

Four-Year Study Confirms That Imaging the Eye with OCT Provides Window to MS Progression in the Brain and a Way to Track the Effects of Therapies

Optical coherence tomography (OCT) is a non-invasive imaging test. OCT uses light waves to take cross-section pictures of your retina.

So, what is OCT imaging?  Optical coherence tomography (OCT) is a non-invasive imaging test. OCT uses light waves to take cross-section pictures of your retina.
With OCT, your ophthalmologist can see each of the retina’s distinctive layers. This allows your ophthalmologist to map and measure their thickness. These measurements help with varying diagnosis. (source)

About The Study:

Summary
  • A recently published paper by a collaborative team used advanced Optical Coherence Tomography (OCT) and MRI brain scans of 107 people with MS over four years to track the impacts of MS and to determine whether changes in nerve layers at the back of the eye mirror changes in MRI-detected brain tissue integrity and degeneration.
  • The team reported that OCT findings reliably reflected overall brain degeneration, with a specific layer of the retina showing shrinkage at similar rates as specific brain regions seen with MRI. These similar rates of atrophy were more strongly associated in progressive MS for most areas of the brain.
  • OCT is a non-invasive, relatively inexpensive and well tolerated imaging method. These findings suggest that OCT findings reflect underlying disease progression, and further validate the usefulness of OCT as an important tool for tracking MS and the impacts in clinical trials.  
  • The paper, involving a collaboration of 15 researchers at 6 institutions, was published in the Annals of Neurology in November 2015 (2015;78:801-813).

Details
BackgroundMRI scans of the brain have typically been used to help diagnose MS and to observe disease activity and progression in people with MS. Typical clinical MRI scanning detects areas of damage or activity (lesions) in the white matter, areas of the brain that contain myelin-coated nerve fibers. Typical MRI doesn’t have the power to detect or track shrinkage of specific areas of the brain, or lesions that occur in the outer layers of the brain (cortex, gray matter) containing nerve cell bodies. Mounting evidence suggests that damage to nerve cells underlies long-term progressive disability in people with MS. So having easier ways to detect and track nerve degeneration would help speed the search for better therapies.
 
#OpticalCoherenceTomography (OCT) has been increasingly used as a research tool to detect damage that occurs to the nerves in the back of the eye. OCT is a scan of the nerves in the back of the eye. It is done with a small machine that can fit into an examining room, is relatively inexpensive, painless and well tolerated. Growing evidence has suggested that OCT findings can mirror MS-inflicted damage that occurs in the brain, but it has not been clear how or whether thinning of the nerve at the back of the eye reflects brain shrinkage (atrophy) and nerve degeneration overall or in specific areas of the brain. 
 
The Study: A collaborative team of 15 researchers at six institutions in the U.S. set out to track and compare changes in nerve layers at the back over four years with changes in brain tissue integrity and degeneration. The team conducted high-definition OCT scans twice annually and high-powered (3T) MRI brain scans annually in 107 people with relapsing-remitting, secondary progressive or primary progressive MS.
 
After four years, a comparison of the long-term MRI and OCT results suggested that the rate of tissue thinning seen on OCT reliably mirrored overall brain degeneration, with a specific layer of the retina (“ganglion cell and inner plexiform layer”) showing atrophy at similar rates as specific brain regions (whole brain, gray matter, white matter and the thalamus) seen with MRI. These similar rates of atrophy between OCT and MRI were more strongly associated in progressive MS for most areas of the brain.
 
These findings suggest that OCT findings reflect underlying disease progression, and further validate the usefulness of OCT as an important tool for tracking MS and the impacts in clinical trials.  
 
The paper was published in the Annals of Neurology in November 2015 (2015;78:801-813). The lead author is Dr. Shiv Saidha (Johns Hopkins University). Three members of this team – Drs. Laura Balcer, Peter Calabresi and Elliot Frohman – were the 2015 winners of the Barancik Prize for Innovation in MS Research for their pioneering work related to OCT. 

Read more

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Diagnosis and Symptoms of Secondary Progressive MS

If you have secondary progressive multiple sclerosis (#SPMS), you most likely started out with the relapsing-remitting type (#RRMS). The shift to SPMS often happens slowly, and it can be hard to know for sure if your condition has changed.
One way to tell the two MS types apart is that RRMS moves between periods of symptoms called relapses and symptom-free periods called remissions. In SPMS, symptoms and disability gradually increase over time without remissions.
Your doctor will examine you and do tests to find out whether you still have RRMS or you've moved on to SPMS. If you have made the shift to the new stage, a few changes to your treatment plan can help you better manage your symptoms.

Symptoms of SPMS (#SecondaryProgressiveMS)

Your symptoms offer the main clue that your disease has changed. With SPMS, you'll have fewer or no relapses. When you do have a relapse, you may not recover from it as fully as you once did. Instead, your symptoms may gradually get worse over a period of months.
Which symptoms you have depend on what areas of your brain and spinal cord the disease has damaged. The symptoms of SPMS aren't that different from those of RRMS, but they may be more severe.
Here are a few signs that you've developed SPMS:
  • More tiredness, #numbness, or #weakness
  • Double vision or other problems with your sight
  • Increasing trouble with walking, #balance, and coordination
  • #Bladder and bowel problems
  • A harder time thinking, remembering, and concentrating

How Your Doctor Diagnoses SPMS

Once you learn that you have RRMS, your doctor will track your disease to see if your symptoms change.
At regular visits, the doctor will ask how you're feeling. Expect to answer questions like:
  • Have you had any new symptoms?
  • When did they start?
  • Have your symptoms gotten worse or stayed the same?
Usually, doctors diagnose SPMS when your symptoms have steadily gotten worse for at least 6 months.

Tests for SPMS

No single test can confirm that you have SPMS. But your doctor can track the changes in your disease with tests that show how much nerve damage you have.
MRI (magnetic resonance imaging). In MS, the immune system -- your body's defense against germs -- attacks the myelin, the coating that surrounds and protects your nerves. This creates areas of damage called lesions in your brain and spinal cord.
An MRI uses powerful magnets and radio waves to make pictures of your brain and spinal cord. These images show how many lesions you have and where they are. Your doctor can look for these damaged areas to see if your disease has changed or if you have new lesions.
Cerebrospinal fluid (#CSF) test. CSF is a clear fluid that bathes and protects your brain and spinal cord. Your doctor will check for certain proteins and other substances in your CSF that can show whether your immune system is causing inflammation. That means your disease is active.
To take a sample of CSF, your doctor will do a lumbar puncture, also called a spinal tap. You'll lie on your side while they place a needle into your lower back below your spinal cord and remove some of the fluid for testing.
Evoked potentials (EP) test. This is a check of your electrical nerves to find out if MS has damaged those that help you see, hear, and feel. Your doctor places electrodes on your scalp to record electrical activity in your brain. He'll do this as you look at a pattern on a video screen, listen to a series of clicks, or get very tiny pulses in your arm or leg.
Optical coherence (#OCT scan). This scan takes a 3D image of your eye so your doctor can check your eye health and see what’s going on beneath the surface.
The above information was sourced from WebMD

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Thursday, October 24, 2019

About MRIs and Other Scans - How Does Radiology Help Diagnose MS?

How Does Radiology Help Diagnose MS?



How Does Radiology Help Diagnose MS?
Magnetic resonance imaging (MRI) has made it easier to diagnose MS and monitor disease progression. An MRI can provide different information, depending on how it’s done. Types of MRI and radiology tests that may be used for MS include:
  • T1-weighted brain MRI. Using contrast dye to detect active inflammation, this scan highlights new lesions or lesions that are growing. It can also show dark areas that indicate possible permanent damage.
  • T2-weighted brain MRI. This scan detects all old and new lesions and helps gauge total disease progression.
  • Fluid attenuated inversion recovery (FLAIR). As a more sensitive scan, this test can help identify brain lesions.
  • Spinal cord MRI. This test can detect lesions within your spinal cord.
  • Computed tomography (CT) scan. This scan, involving radiation, can also detect areas of demyelination, but with less detail than MRI.
Click here to read and understand 


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MS Symptoms: Fatigue, Numbness, Balance Problems, and More

By Joseph Bennington-Castro
Medically Reviewed by Samuel Mackenzie, MD, PhD
Last Updated: 10/10/2019

Dizziness, headache, and vision problems can all be symptoms of MS.
Ghislain & Marie David de Lossy/Alamy
In multiple sclerosis, or MS, your immune system attacks myelin, the fatty tissue that surrounds and protects nerve fibers.
This causes scar tissue (sclerosis, also called plaque or lesions) to form on nerve fibers, disrupting the flow of electrical impulses throughout the nervous system.
This nerve damage can lead to a broad range of MS symptoms, from blurred vision to numbness to weakness to loss of balance and more.
For people with relapsing-remitting MS, symptoms can worsen significantly, and new symptoms may arise, during relapses, or periods of acute inflammation in the central nervous system.
For people with primary-progressive MS, symptoms get steadily worse from the beginning, although how quickly they get worse varies from person to person.
Overheating, caused by fever, hot baths, or sun exposure, and stress can also trigger or temporarily worsen MS symptoms. When the body cools back down, or the stress is alleviated, the symptoms generally abate as well.

Continue




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What Is Trigeminal Neuralgia?

This severe, electric-shock-like facial pain affects about 2 to 5 percent of people with MS.
By Becky Upham
Medically Reviewed by Samuel Mackenzie, MD, PhD
Last Updated:  10/10/2019


The trigeminal nerve carries sensory information from the face to the brain and also makes chewing possible.
The trigeminal nerve carries sensory information from the face to the brain and also makes chewing possible.Shutterstock

Trigeminal neuralgia is a chronic pain disorder caused by dysfunction of the trigeminal nerve, the nerve that innervates the face, including the mouth and the teeth.

The trigeminal nerve provides sensory information to the brain about sensations like temperature and touch, says Devon Conway, MD, a neurologist at Cleveland Clinic Main Campus in Ohio.

About 150,000 people a year are diagnosed with trigeminal neuralgia, according to the American Association of Neurological Surgeons.

There are two kinds of trigeminal neuralgia, the most common being the typical or classic form, called TN1.

“The nerve starts to dysfunction for one reason or another, and it can cause very severe pain — typically described as a kind of electric-shock sensation — that can last from a few seconds to a few minutes,” says Dr. Conway.
In the “atypical” form, called TN2, the pain is more of a constant aching, burning, or stabbing pain that is somewhat less intense than in TN1, according to the Facial Pain Association.

What Are the Symptoms of Trigeminal Neuralgia?

The pain associated with trigeminal neuralgia is usually recurrent and happens on one side of the face, typically in areas of the face where the trigeminal nerve goes, says Conway. “There are three branches of the trigeminal nerve: One is mostly the forehead, one is between the chin and the forehead, and the other is from the chin down,” he says.

“Basically, the patient will have this bad, shocking sensation, which is often triggered by something, though in some situations the pain could be almost continuous,” says Conway. It’s a very severe pain that can sometimes be disabling for patients because of its intensity, he adds.

Who Is at Risk for Trigeminal Neuralgia?

Theoretically, anyone could develop trigeminal neuralgia, says Conway. One of the most common causes of pain is when the trigeminal nerve is being pushed on by a blood vessel, he says.

“It’s a very crowded area back around the brain stem, with a lot of blood vessels and exiting cranial nerves, including the trigeminal nerve,” he says. “If the vascular structure is pushing against the nerve it can cause this dysfunction and trigger the pain,” says Conway.


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