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Saturday, January 4, 2020

Multiple Sclerosis and Social Isolation: 10 Tips




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Social Isolation is all too common among people with Multiple Sclerosis (MS). I this video I offer 10 tips to combat social isolation: 10. participate in the online community. People who share your interests are out there on Twitter, Facebook, Instagram, YouTube and many many more. 9. Become a pen pal! 8. Set up a standing weekly phone date with a loved one or good friend 7. Complete some paperwork at a cafe instead of the home office 6. Take your workout outside of the home. Consider going to the park, taking group yoga or barre class, lifting at a rec center or joining a local gym. 5. Set up a standing monthly lunch date with a friend across town 4. Join a support group! Find a group right for you (ask your provider or check with the local NMSS chapter) 3. Sign up for a class at your community rec center! Underwater basket weaving at noon on Wednesdays! 2. Volunteer. It feels so good to give back. Usher at church, read to kids in a library, help with dinner at a soup kitchen. 1. The number one tip...GET A PET!

Say Howdy on Social: Twitter: https://twitter.com/AaronBosterMD Facebook: https://www.facebook.com/AaronBosterMD/ YouTube: https://www.youtube.com/c/AaronBosterMD Link To This Video: https://youtu.be/D5SdzaIj4nc


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"Ketogenic diet and fasting diet as Nutritional Approaches in Multiple Sclerosis (NAMS): protocol of a randomized controlled study"

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January 2020

Abstract

BACKGROUND:

Multiple sclerosis (MS) is the most common inflammatory disease of the central nervous system in young adults that may lead to progressive disability. Since pharmacological treatments may have substantial side effects, there is a need for complementary treatment options such as specific dietary approaches. Ketone bodies that are produced during fasting diets (FDs) and ketogenic diets (KDs) are an alternative and presumably more efficient energy source for the brain. Studies on mice with experimental autoimmune encephalomyelitis showed beneficial effects of KDs and FDs on disease progression, disability, cognition and inflammatory markers. However, clinical evidence on these diets is scarce. In the clinical study protocol presented here, we investigate whether a KD and a FD are superior to a standard diet (SD) in terms of therapeutic effects and disease progression.

METHODS:

This study is a single-center, randomized, controlled, parallel-group study. One hundred and eleven patients with relapsing-remitting MS with current disease activity and stable immunomodulatory therapy or no disease-modifying therapy will be randomized to one of three 18-month dietary interventions: a KD with a restricted carbohydrate intake of 20-40 g/day; a FD with a 7-day fast every 6 months and 14-h daily intermittent fasting in between; and a fat-modified SD as recommended by the German Nutrition Society. The primary outcome measure is the number of new T2-weighted MRI lesions after 18 months. Secondary endpoints are safety, changes in relapse rate, disability progression, fatigue, depression, cognition, quality of life, changes of gut microbiome as well as markers of inflammation, oxidative stress and autophagy. Safety and feasibility will also be assessed.

DISCUSSION:

Preclinical data suggest that a KD and a FD may modulate immunity, reduce disease severity and promote remyelination in the mouse model of MS. However, clinical evidence is lacking. This study is the first clinical study investigating the effects of a KD and a FD on disease progression of MS.

TRIAL REGISTRATION:

ClinicalTrials.gov, NCT03508414. Retrospectively registered on 25 April 2018.

KEYWORDS:

Anti-inflammatory diet; Dietary intervention; Intermittent fasting; Ketogenic diet; Multiple sclerosis
PMID:
 
31898518
 
DOI:
 
10.1186/s13063-019-3928-9

https://www.ncbi.nlm.nih.gov/pubmed/31898518

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Wednesday, January 1, 2020

As MS research evolves, a new focus on brain preservation comes to light


Dec 2019 - By MS Mindshift


Brain preservation starts with understanding the key role the brain plays when it comes to multiple sclerosis (MS). There are 4 key areas to focus on, including how you can preserve your brain and its function by making healthy lifestyle choices.

Brain preservation focuses on these four key areas

Brain lesions icon

Know all you can about brain lesions in white and grey matter

  • Lesions can happen in both white matter and grey matter in the brain
  • They interfere with the brain’s ability to communicate from one part of the brain to another, and from the brain to the rest of the body
  • These communication breakdowns, caused by lesions, can lead to MS symptoms and relapses
Grey matter lesions were recently identified as being closely associated with cognitive and physical changes related to MS. Cognitive changes caused by MS may include worsening of memory, difficulty concentrating, or trouble thinking of the right word.
Be sure to ask your neurologist about lesions that occur in both areas.

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Who’s Willing to Accept More DMT Risk, You or Your Neuro?

Dec 20, 2019 - By Ed Tobias

As more high-efficacy disease-modifying therapies (DMTs) are being made available, people with multiple sclerosis have to decide how much risk they’re willing to accept in exchange for the treatment’s potential benefits. It’s a tough decision not made any easier if a patient’s neurologist is unwilling to accept much risk.

According to researchers at the University Medical Center Hamburg-Eppendorf in Germany, when it comes to one highly effective DMT, neurologists are willing to accept less risk than their patients are.
The DMT is Tysabri (natalizumab). One of its risks is progressive multifocal leukoencephalopathy (PML), a rare and potentially fatal brain disease. In the study, 69 patients treated with Tysabri and 66 neurologists were given a three-page leaflet about the association between Tysabri and PML. After reading it, they were asked whether they thought the Tysabri treatment should continue. Unsurprisingly to me, significantly more patients were willing to accept the risk than the neurologists. Forty-nine percent of the doctors reported that if told that Tysabri’s PML risk was two people in 10,000 or lower, they would stop treatment. But only 17 percent of the patients would.

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The researchers believe that one reason the patients’ risk acceptance was higher was that they had a significantly worse perception of the harm that MS could cause them. But the report also notes that both patients and doctors had higher-than-warranted expectations of Tysabri’s effects.
Tysabri was good to me. I was treated with it for about seven years, and it seemed to be more effective than my first DMT, Avonex (interferon beta-1a). I don’t remember any adverse side effects, and its monthly infusion schedule fit my lifestyle. However, when I was using Avonex, I quickly developed needle fatigue from the weekly injections.
Was I concerned about the possibility of PML? Sure. Fortunately, though, I was on the same page as my neurologist concerning benefits versus risks. She told me that I would be carefully monitored for PML. That meant blood tests and a brain MRI every six months. She assured me that if those tests spotted early signs of PML, I would have the Tysabri flushed from my system and be moved to another DMT.
My neuro told me that PML becomes more of a risk after two years of Tysabri treatments. It was at around that time that she cut back my infusions from monthly to every eight weeks. Increasing the time between infusions to as much as 8 1/2 weeks is not believed to diminish the efficacy of Tysabri, but it does reduce the PML risk.
After seven years on Tysabri, my blood tests showed that my titer score was rising to a concerning level. The titer score measures the level of the John Cunningham (JC) virus in the blood. The higher the titer level, the greater the risk that a dormant JC virus will reactivate and trigger a PML infection. It was at that point that I was taken off Tysabri and switched to Aubagio (teriflunomide).

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Einstein Researchers Receive Grant to Study Brain Activity Related to Fall Risk in MS Patients

December 17, 2019

Einstein Researchers Receive Grant to Study Brain Activity Related to Fall Risk in MS Patients

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grant awarded recently by the National Institutes of Health (NIH) will fund research to explore how brain changes in multiple sclerosis (MS) patients affect mobility.
The five-year grant (1R01NS109023-01A1), totaling $3.5 million, was awarded by the National Institute of Neurological Disorders and Stroke, part of the NIH, to a team led by Roee Holtzer, PhD, professor of neurology at Albert Einstein College of Medicine in the Bronx, New York.
Impaired mobility is one of the most common symptoms of MS, leading to frequent falls. According to the research team, not enough is known about mobility problems and falls in people with MS — issues that can affect patients’ quality of life significantly.
Previous research by Holtzer and colleagues suggested that motor problems in MS are due to abnormal functioning in the brain, particularly in a region called the prefrontal cortex, which is believed to play a critical role in orchestrating complex thoughts and actions.
The new project aims to determine whether changes in brain activity during walking can be used to predict fall risk in people with MS. To do this, the team will measure prefrontal cortex activity in 120 people with MS, and 120 people without (the control group), while they are walking.
Prefrontal cortex activity will be assessed through functional near-infrared spectroscopy, a non-invasive technique that measures how much oxygen-carrying blood is in certain parts of the brain. It can be used to estimate brain activity because when a part of the brain is more active, it requires more oxygen.
In addition, other traditional brain imaging techniques, such as magnetic resonance imaging (MRI), will be used to assess the structural integrity of participants’ brains.

Researchers hope findings from this study will allow the identification of biological targets that can be manipulated to minimize fall risk.
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Tuesday, December 31, 2019

Video: Reducing MS Spasticity: Toes & Foot


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