Resistance training for 8 weeks has useful anti-inflammatory effects in a study conducted in women with MS. (technical : it works by decrease in serum IL-17 production).
Total body resistance exercise is a functional and safe intervention that can improve the mobility and muscles strength of the knee in people with MS, reveals this study conducted over a 8 weeks period (3 sessions per week).
This new study emphasizes the benefits of exercise in MS and other conditions that involve increased blood brain barrier (BBB) permeability. Technical: There is a body of evidence that regular physical exercise regular exercise diminishes BBB permeability as it reinforces antioxidative capacity, decreases oxidative stress and has anti-inflammatory effects. It also improves endothelial function and might increase the density of brain capillaries.
Functional electrical stimulation plus cycling and cycling alone may be an effective intervention for improving walking endurance, sit-to-stand, and quality of life in individuals with MS, according to this new study.
A new systematic review and meta-analysis reveals that Pilates is a safe therapy for people with MS and can improve a number of symptoms (ie quality of life, balance, walking ability).
HIIT (High intensity interval training) aerobic exercise in people with MS improves cardiorespiratory and clinical outcomes, according to this new study. However, this form of exercise did cause one adverse reaction in one participant, who fainted.
Vitamins/ Herbs/Natural Supplements For Managing MS Symptoms
B12 plus folic acid. Supplementation with vitamin B12 and folic acid help correct homocysteine levels, anemia and also improve physical and mental aspects of quality of life in individuals with MS, according to this new study. Researchers also review here previous studies with similar findings and the importance of these key nutrients (including myelin repair).
Vitamin D deficiency is associated with depressive symptoms in people with RRMS and vitamin D supplementation was found to alleviate these depressive symptoms in this new study. Alfacalcidol (synthetic vitamin D derivate) is a safe and effective treatment strategy for treating fatigue in MS, is the conclusion of this new study. This drug also showed reduce risk of relapses.
Melatonin. Beyond the benefits of melatonin, this study looks at the links between the immune-pineal axis, neurodegenerative diseases and inflammation.
Medical Marijuana- A quick review of the benefits of marijuana for healthcare providers (including stats, clinical evidence, pharmacology, contraindications, routes of administration and more). Great resource to bring to your doctor when discussing whether medical marijuana may work for you. This new study reviews the importance of CB2 cannabinoid receptor and how it controls key cells involved in myelin repair. Technical : CB2 controls myeloid progenitor trafficking (animal models of MS) . Routes of administration and cannabis products with therapeutic purposes- a great review for physicians in this new article. This new study reviews the Cannabis, cannabinoid receptors, and endocannabinoid system, based on the latest research.
Curcumin. Nanocurcumin was found to decrease disability scores in a placebo controlled trial. Technical: mechanism of action: nanocurcumin increases frequency of Tregs and FoxP3.
Shikimic acid (SA) derived from star anise has potential to repair myelin, according to a study conducted in animal models of MS.
Multiple herbs. A review of scientific studies re: the benefits of herbal medicine for treating MS. The conclusion: “Medicinal plants and plant compounds caused decrease in the neurologic deficits due to MS. Clinical evidence has demonstrated the clinical potential of Cannabis sativa extract, cannabinoids, Ginkgo biloba, beta-phytosterol, and Lippia citriodora extract to improve MS symptoms” The symptoms improved by herbal preparations included: spasticity, muscle spasm, neuropathic pain, and urinary tract complications associated with MS.
Other Natural Therapies & More News
Osteopathy can help manage MS, especially anxiety and fatigue associated with this condition, according to this new pilot study.
Best drugs/supplements/therapies to repair myelin. This is an interesting study. Considering the fact that most MS approved drugs do not have a true potential to repair myelin, the researchers reviewed scientific literature to find out which drugs and supplements have the best potential. The effect of the seventy-eight different therapeutic approaches in 110 different comparisons for their remyelination potential is described here, including prescription drugs and natural supplements/therapies like electromagnetic field stimulation, electro acupuncture, vitamin E derivatives and melatonin (this is the summary/list) .
Transcranial direct current stimulation (tc-DCS) was found to be clinically effective in improving neuropathic pain (tingling, numbness) in MS patients, according to this new randomized double-blind study.
Yoga. Based on the fact that yoga had been previously shown numerous benefits(i.e. improved posture control, improved flexibility of mind and body, relaxation and decreased anxiety and stress, this new study (systematic review) looked at the efficacy of yoga as a neuromuscular intervention in people with MS and other neurological conditions Conclusion : moderate evidence supports the use of yoga to decrease risk of falls in older people with stroke, MS, dementia and Alzheimer’s disease.
Antioxidants. Antioxidants have the potential to prevent neuronal loss in MS, according to this new study. Researcher emphasize in this study the oxidative stress related to iron metabolism impairments.
Targeting dopamine pathway to decrease inflammation and autoimmunity is revealed in this study. I wrote about dopamine deficiency and MS here and natural ways to improve dopamine pathways here.
Exploring the therapeutic benefits of PPARs and the Kynurenines for MS in this new study. I wrote about the benefits of natural PPAR gammas here. and about the tryptophan -kynurenine pathway (and natural treatments) here.
People with MS had significantly lower serum levels of orexin-A and BDNF than healthy controls, and SPMS patients had significantly lower levels of melatonin and orexin-A than RRMS patients, is the result of this new study. I wrote about orexins here and how to improve orexin levels naturally here.
Dirty electricity could increase the MS susceptibility, according to this new study. Specifically, the use of cell phones and satellite television dishes were significantly higher in MS patients. A correlation was observed between sleeping with cell phone and/or laptop under the pillow and MS disease.
Diet
The link between red meat consumption and risk of multiple sclerosis had been studied before and the results were inconclusive. This new study from Australia found that consuming unprocessed red meat reduces the risk of central nervous system demyelination.
MS misdiagnosis is common, almost 1 in 5 people diagnosed with MS likely have a different diagnosis, is the result of this study. This study found that MS was misdiagnosed in 18% of cases. Based on 271 patients from two US clinics: Cedars-Sinai and UCLA. The misdiagnosed patient received unnecessary MS disease modifying therapy for many years. Migraine was the most common alternate diagnosis (16%), followed by radiologically isolated syndrome (9%), spondylopathy (7%), and neuropathy (7%). Actually I found evidence that up to 1 in 3 people can be misdiagnosed as having MS. Check out “Hot Topics” section of this blog. This new study shows a case of Fabry’s disease misdiagnosed as MS.
History of MS- a review of this condition- how was considered in the Middle Ages, the contributions of Dr. Charcot and current therapies/research.
The Gut Microbiome
This new study explores the importance of gut-brain axis and gut microbiome and its involvement in MS, Parkinson’s and Alzheimer’s disease. Technical: The communication between brain and gut microbiome occurs through 3 systems: the vagus nerve, the systemic pathway (with the release of hormones, metabolites and neurotransmitters) and the immune system (by the action of cytokines).
Another new study suggesting that improving gut microbiota may represent future opportunities to treat and prevent MS and other neuroimmune conditions.
Other Symptoms/Conditions associated with MS
Carpal Tunnel Syndrome is prevalent in MS, affecting as many as 28%, according to this new study. It is important to get the right diagnosis (and treatment), as the symptoms of carpal tunnel syndrome are often misunderstood as MS symptoms.
Low bone mineral density, osteoporosis and osteoporotic fractures are more prevalent in those with MS compared with healthy population. This study also looked whether The Fracture Risk Assessment tool (FRAX®) is accurate to estimate the risk of fractures.
Headaches affect more than half of people with MS according to this new study. These headaches had been experienced before receiving the diagnosis of MS and MS meds appear to have little impact on headache occurrence.
Sexual dysfunction affects as many as 75% of people with MS. In fact, in 1-2% of patients, signs and symptoms of sexual dysfunction are the first symptom of MS. This new study further describes different types of sexual dysfunction, noted that affects women and men equally, and correlation with age and longer duration of the disease.
Severe depression, severe anxiety and sleep problems are more common in individuals with MS compared with healthy population (10.53% vs 6% for severe depression, 7.89% vs 5% for severe anxiety, 20.51% vs 11%), suggests this new study. Note: the percentage of people with MS affected by depression and anxiety is much higher, the numbers above relate to severe forms of depression and anxiety (not mild or moderate forms).
Sleep disorders affect as many as 60% of those with MS, according to this new study. Multiple mechanisms involved: circadian rhythm impairments, increased levels of pro-inflammatory cytokines, side effects from the meds, MS lesions.
Psoriasis increases the risk of MS. A review of multiple studies shows that psoriasis is significantly associated with an increased risk of developing MS.
The impact of menopause is explored in this study. The conclusion: Following menopause, there is a reduction in the relapse rate, but the disability progression continues at a similar rate, compared to the perimenopausal period.
Genetics
The interaction between nuclear and mitochondrial genome components in the risk of developing MS was demonstrated for the first time in this new Russian study.
This new study demonstrates a role of CYP2R1 in both risk and progression of MS, with sex-related differences. Researchers found that the minor allele A of rs10766197 in homozygosis was associated with MS progression, assessed by EDDS and MS Severity Score scores, only in men.
Genetic differences between PPMS and RRMS are reviewed in this new study, which reveals the following 1). HLA-DRB1*11, *15 and IL7RA, CXCR5, CLEC16A variants were associated with both MS forms.2). HLA-DRB1*07 and IL4, IRF5, IFNAR2 variants are putative PPMS-specific.3. HLA-DRB1*09 and IL6 variants are putative RRMS-specific.
This new study was the first report of the relationship between mir23a polymorphism and MS disease.
MS Conventional Therapies & Other Drugs (Including Side Effects)
Cladribine. Immune reconstitution therapies (IRT) for people with MS are used for short, intermittent treatment periods to induce immune resetting and allow subsequent treatment-free periods. The results of this new study suggest that cladribine tablets may be an immune reconstitution therapy.
Heart meds ACE inhibitors could be helpful to treat MS, according to this new study. Technical : they suppress Th17 cells. My note: while ACE inhibitors have a safer profile compared with newer meds approved for MS, they aren’t free from side effects.
Dimethyl fumarate. The good: Contrary to the old beliefs, dimethyl fumarate seem to influence both T and B cells. Furthermore, scientists suggest that this drug could reduce brain tissue damage, which may reduce long‐term disability in MS apart from its relapse‐reducing capacity. The bad: dimethyl fumarate -Too many digestive side effects, which are often the reason why people discontinue the drug. This study is actually looking at ways to manage these symptoms and allow patients to stay on this drug. Note: When I see a drug with many side effects affecting the GI tract, I always ask myself the question- if a drug hurts the gut, how come can be so great for the brain (considering the importance of gut microbiome and gut brain axis)?
Adverse Events MS Drugs and Vaccines
Dimethyl fumarate. Drug‐induced hemolytic anemia is a rare and potentially fatal complication of drug treatment. This case report describes a case of hemolytic anemia linked with dimethyl fumarate
Ocrelizumab. Late-onset neutropenia following ocrelizumab use reviewed in this new study.
Daclizumab-Sarcoidosis linked with daclizumab use (11 cases)
Natalizumab: erythroblast appearance in peripheral blood from natalizumab use (2 case reports).
Natalizumab linked (again) with increased risk of cervical dysplasia/cervical cancer in this new case study.
Interferon-Beta 1a- Bipolar Disorder with Psychotic Features induced by Interferon-Beta 1a. A case report.
Vaccines. “Influenza and acellular pertussis vaccines not only fail to protect, they increase susceptibility and severity of disease upon infection – benefits are overrated and the risks are being ignored “- a review of risks of these two vaccines in this research paper. T echnical: The influenza vaccines cause the development of IgE mediated allergy to the influenza virus. The reason for failure include antigenic mismatch between vaccine strain and wild virus, IgE mediated antigen neutralization, etc . For more details read the article here.
Fingolimod. pulmonary cryptococcosis with the use of fingolimod- a new case report.
