APRIL 2019 MS NEWS : Diet Works, High Dose Biotin Pros And Cons, Robots/AI, Whole Body Vibration & More

 

Vitamins/ Herbs/Natural Supplements & Diet For Managing MS Symptoms

• A new Iranian study reviews herbs that can help manage MS symptoms. According to this study, there is clinical evidence for Cannabis sativa extract, cannabinoids, Ginkgo biloba, beta-phytosterol, and Lippia citriodora extract to improve MS symptoms. These plants and compounds help improve spasticity, muscle spasm, neuropathic pain, and urinary tract complications. Nanocurcumins and pomegranate peel extract showed anti-inflammatory effects in animal models.  

• Sesame oil may have beneficial effects for MS patients, (technical: via decreasing IFN-γ secretion and anti-inflammatory and anti-oxidant activities ), according to this study that compared the results of using interferon beta-1a versus interferon beta-1a+ sesame oil.

• Bushen recipe ( a herbal combination used by Traditional Chinses doctors) has a significant curative effect on MS,  can improve clinical symptoms and improve patients’ quality of life, according to this new randomized clinical trial.

• High dose biotin works in progressive MS and the benefits of this therapy persist over time, according to this new double-blind clinical trial. Patients on high dose biotin showed improvements in disability and some clinical markers (when compared with placebo group)  and these improvements are sustained over time (patient were evaluated again after 2 years).

• High dose biotin-cautions. This case study shows side effects (myopathy/symptoms affecting the muscles) from using high dose biotin for MS.  My thoughts: high dose biotin should not be used alone but in combination with small amounts other B vitamins and minerals. Taking one vitamin in high doses could cause a deficiency in other micronutrients (plus micronutrients work in synergy one with another). In addition, there are genetic variations that impair biotin absorption and recycling. Biotin was found beneficial to manage MS in clinical trials.  Bottom line: be aware of possible side effects.

• NAC (N-acetyl cysteine)  helps improve fatigue associated with progressive MS, increases antioxidant levels and is well tolerated, according to this new pilot randomized controlled trial. I wrote about NAC benefits in details here.

• Curcumin ameliorates the disease severity, in animal models of MS, suggests this new study.

• Vitamin D can effectively control MS when given very early (right when the disease develops), according to this new animal study (where MS was induced in the lab). Vitamin D increases the efficacy of glucocorticoids used for acute MS relapses (animal models, another new study)

 

Diet /Nutrition

• Diet is important, more and more researchers understand this “ Along with medication, it is known that a healthier diet/lifestyle can produce just as positive, if not a more positive outcome regarding this disease” according to the author of this new study.

• Have you her about immunonutrition ? It is nutrition targeting immune system health, based on the fact that researchers now understand the role of diet in autoimmunity and supplements like l- glutamine and omega 3 fatty acids. More details in this study.

• Keto diet. A modified ketgenic diet may be useful for people with RRMS, suggests this new study. Patients reported benefits such as weight loss (83%), improved fatigue (72%), improved exercise habits (55.5%), improved energy (50%), and reduced MS symptoms (45%). The most common side effects included constipation (28%), menstrual irregularities (22%), and diarrhea (17%). You will see more studies (some are in progress) evaluating the keto diet for MS.

• Nutrition and lifestyle factors do influence MS activity, according to this study based on the opinion of individuals with MS. A majority of the participants in this study perceived nutrition and lifestyle factors to have an effect on their multiple sclerosis, particularly stress, meat, fatty foods, and processed sugar.

• Mediterranean diet. A modified Mediterranean diet improves fatigue and decreases the impact of MS symptoms, according to this new pilot study.

On the other hand…

• Fast food consumption during adolescence is significantly associated with an increased risk of MS, according to this new study.

• Food allergies are associated with increased disease activity (more relapses) in MS, according to this new study that enrolled 1,349 patients with MS.

• Obesity might be an important factor, with significant impact on cognitive performance, says this new study conducted in people with MS. BMI (body mass index) did correlate with cognitive issues.

Other Natural Therapies: Whole Body Vibration, CryoTherapy, E-stimulation & More

• Whole body vibration (WBV): 2 new studies. WBV improves core muscle strength and endurance in people with MS, according to this new randomized trial. Improvements were assessed after 6 weeks. A second study this month also found whole body vibration effective, suggesting this therapy might alleviate neurodegeneration of postural control in people with MS. Note: You can find a whole-body vibration machine at a local gym or buy it and use it at home. Check out this short video to see get more details about this machine.

• Whole-body cryotherapy with physical exercise training is an effective therapy for patients with MS, according to this new study that noted improvements in mood and functional status. More details about this therapy in this article.

• Extracorporeal shockwave therapy (ESWT) can effectively reduce spasticity associated with MS, and its effects were maintained for 12 weeks, according to this new meta-analysis. Check out this short video to learn about this therapy.

• Vagus nerve stimulation to treat MS and other neurodegenerative conditions. A new patent application.

• Electric stimulation (abdominal functional electrical stimulation or ABFES) was found to be an effective alternative to standard therapies (ie laxatives) for treating MS-related constipation in this study.

• Manual cognitive rehabilitation is effective in improving the attention/information processing speed and the psychological state of women with MS, according to this new study.

• The most effective therapies to treat fatigue associated with MS include regular CBT (cognitive behavior therapy) plus exercise combo. Individual therapies: aerobic exercises, behavioral therapy, and medication also have positive effects, according to this new systematic review.

• Cognitive-behavioral therapy (CBT) based on mindfulness as an effective treatment to improve the psychological well-being of women with MS, suggests this new study.

• Mindfulness meditation helps reduce stress- particularly rumination in patients with MS, says this new study.

Robots/Virtual Reality/AI

• Virtual reality technology (VRT) has the potential as a useful tool for managing MS and other conditions, according to the review of over 100 studies, conducted from  2002 and 2017.

• Game-Based Virtual Reality Video works, according to this new study. Clinical improvements were found regarding the precision of movements, the execution times, and the efficiency of certain functional tasks in the MS group that combined occupational therapy plus virtual reality (a game based video ) versus those using occupation therapy alone.

• Virtual reality device helps improve mood and reduce pain, according to this new study.

• Artificial intelligence (AI) used for a test to assess cognitive function in people with MS. This new test was found to effective to asses and monitor cognitive performance in MS patients.

• A robotic device called Armeo-power can significantly improve brain networks and function (motor tasks), according to this new case study.Check out this short video to see how Armeo -power works.

More News

• The link between MS and fat metabolism. Improving cholesterol homeostasis, to be more specific could be a therapeutic target to treat MS, according to this new study. A second study evaluates a drug that inhibits cholesterol synthesis to help treat MS (by enhancing the formation of myelin-producing cells). Yes, impaired fat metabolism and specifically issues with cholesterol homeostasis is a key problem in MS. Bile Acid Metabolism is Altered in Multiple Sclerosis (in both adult and pediatric MS). In animal studies, supplementation with bile ameliorates brain inflammation, according to this new study. Note regarding diet: fat metabolism can be improved either by adopting a low-fat diet (ie Swank) or a high-fat diet ( ketogenic diet).

• Impaired iron metabolism is another big issue. This new study found a correlation between iron levels  (loss of brain iron) and disability in MS.

• This new research paper provides an in-depth review of the impact of Epstein Barr virus in the development of MS.

• Targeting dopamine-producing neurons to treat MS (specifically the impact of dopamine of the  T17 immune cells), is suggested in this new study. I wrote about dopamine deficiency and MS here and how to improve dopamine naturally here.

• The impact of interactions between astrocytes and white blood cells (lymphocytes) in the blood-brain barrier permeability and the development of MS. All these issues explored in this new study. I wrote about astrocytes, glymphatic system and MS here.

• Misdiagnosing MS is a big problem, suggests this study, which is a review of multiple studies. For example, one study conducted showed that over 50% of patients carried a misdiagnosis for at least 3 years, 70% had received disease-modifying therapy (DMTs), and 31% experienced unnecessary morbidity as a direct result. I wrote about this topic, check out the “hot topics” section.  

Genetics

• A genetic atlas of MS- see page 22 of this article. Plus a good review of the importance of diet, vitamins D and B12, gut microbiome, the glymphatic system, various therapies, and drugs, including nano-medicine, gene therapy, stem cell therapy.

• BIM gene plays a key role in the regulation of vital activity of human cells and overexpression of BIM was found to be associated with MS. Rseaecrhers of this new study suggest to use BIM gene as a biomarker to detect MS earlier. 

• This new study brings up an interesting theory: that MS is not one disease but rather multiple autoimmune demyelinating syndromes with genetic make-ups  (phenotypes) that share similar underlying mechanisms and genetic variants. Based on genome-wide association studies (GWAS), MS susceptibility is associated with  to than 230 genetic variants (especially related to T and B cells)

• Genetic variations may predict how MS progresses. This new study found that HLA-A*02 allele is linked with better MS outcomes and HLA-B*08, HLA-B*44 and HLA-B*07 have a potentially negative effect.

MS Conventional Therapies & Other Drugs

The good and the bad (ie serious warnings about Alemtuzumab )

• Cannabis-based drug Sativex shows long term efficacy for treating MS spasticity resistant to their treatments and the effects were sustained over time (evaluated at 18 months). Overall, patients did not increase the dosage (they had a relatively stable number of puffs/day). This is a large Italian study (observational) based on 1845 patients with MS.

• Metformin. The anti-diabetic drug metformin could help manage MS, according to this new study(in EAE, the animal model of MS). Note: I wrote about the link between diabetes and MS here.

• Cladribine. A review of the benefits of cladribine for MS in this new study. This drug was approved in 2017 for MS treatment by the  European Medicines Agency.

• Thyroid hormones- 2 new studies. Myelin can be repaired by a drug sobetirome, which is a selective agonist of thyroid hormone. This study is based on the fact that thyroid hormones are involved in myelination during early brain development and may help remyelination and limit neurodegeneration in MS. Liothyronine (synthetic thyroid hormone T3) was tested in this new (phase 1 clinical trial) and was found to be overall well tolerated.

 

• Alemtuzumab-serious warnings.  Serious issues with alemtuzumab published in “The Lancet”. Reports of stroke in patients having taken alemtuzumab for multiple sclerosis prompt a safety review by the European Medicines Agency. A few days earlier there was a case report showing multi-organ failure and adrenal problems from using this drug. Another new study showing 5 cases of brain (intracerebral) bleeding related to this drug. Many more serious adverse effects were found in past studies, check out my monthly reviews in the “latest research” section.I expressed my concerns about a year ago, here.