MS research update - 23 October 2009
- Computer-based training programme improves cognition in MS
- Foot massage as effective as reflexology in improving MS pain
- Modafinil effective for MS fatigue when accompanied by excessive day-time sleepiness
- Fatigue associated with low self-esteem in people with MS
Computer-based training programme improves cognition in MS
The term cognition refers to processes such as thinking, attention, concentration, judgment and reasoning. Many people with MS experience cognitive problems but they are most often mild and manageable. The present study investigated the effectiveness of a computer-based training programme in improving attention, information processing, and executive functions in people with MS. Preliminary neuropsychological tests (tests which measure thinking and levels of concentration) identified twenty people with relapsing remitting MS who scored below specified cut off measures. Ten of these were randomly chosen to receive the computer-based cognitive rehabilitation programme over three months whilst the other ten did not receive the treatment programme. At the end of three months, the group who had received the computer-based sessions scored significantly better in neuropsychological tests than the group who had not. Interestingly, the group that had taken part in the training programme also showed improvement in depression scores as gauged by a patient questionnaire.
Flavia M, Stampatori C, Zanotti D, et al.
Efficacy and specificity of intensive cognitive rehabilitation of attention and executive functions in multiple sclerosis.
Journal Neurological Sciences 2009 [Epub ahead of print].
Medline abstract
Foot massage as effective as reflexology in improving MS pain
The present study investigated the effectiveness of reflexology on pain in an MS population. Reflexology involves stimulating points on the soles of the feet to induce therapeutic effects in different parts of the body. 73 people with MS were randomly assigned to one of two groups; one group receiving reflexology; one group receiving placebo treatment (where sessions actually involved a general foot massage rather than reflexology) for a period of ten weeks. Interestingly, the pain intensity, as rated by the participants, significantly decreased in both groups after ten sessions. The conclusions that can be drawn from these results are twofold: either both treatments were effective and the results were due to the general rather than specific stimulatory effects of massage; or the improvements seen were the result of a 'placebo effect' in both groups.
Hughes CM, Smyth S, Lowe-Strong AS.
Relexology for the treatment of pain in people with multiple sclerosis: a double-blind randomised sham-controlled clinical trial.
Multiple Sclerosis 2009 [Epub ahead of print].
Medline abstract
Modafinil effective for MS fatigue when accompanied by excessive day-time sleepiness
Fatigue is one of the commonest symptoms experienced by people with MS and can have a significant impact on an individual's daily life. It can be a complex symptom to manage and there is no treatment strategy that will work for everyone. Previous studies investigating the effectiveness of the drug modafinil (brand name Provigil) in treating MS related fatigue have produced conflicting results. The present study investigates the benefit and long-term usefulness of modafinil in people with MS-related fatigue as reported by the people taking it.
Of the 39 people receiving modafinil, 12 reported fatigue without excessive day-time sleepiness, while 27 reported excessive day-time sleepiness as a component of their fatigue. In the group that experienced fatigue without sleepiness, only 3 reported an improvement with treatment. Of the group that experienced sleepiness as part of their fatigue, 21 experienced an improvement with treatment. Based on these results, the authors suggest that modafinil is more useful as a treatment for MS-related fatigue where excessive daytime sleepiness is a component of the individual's fatigue.
Littleton ET, Hobart JC, Palace J.
Modafinil for multiple sclerosis fatigue: does it work?
Neurorehabilitation and Neural Repair 2009; 23 (8):855-861.
Medline abstract
Fatigue associated with low self-esteem in people with MS
Multiple sclerosis is a complex condition which can cause a range of complex and sometimes interrelated symptoms. Fatigue is one of the most common symptoms reported by people with MS and can impact upon or be affected by other MS symptoms, daily routines and lifestyle choices. The present study sought to investigate whether levels of fatigue in MS are linked to self-esteem (an individuals' measure of self-worth). 30 people with MS were assessed for both levels of fatigue and levels of self-esteem. Low self-esteem was shown to be linked to greater levels of fatigue. It did not appear to be associated with any other factors such as age, gender, physical disability, length of MS duration, number of relapses, depression or anxiety. The authors conclude that chronic conditions such as MS can interfere with the way an individual views and values themselves.
Fragoso YD, da Silva EO, Finkelsztejn A, et al.
Correlation between fatigue and self-esteem in patients with multiple sclerosis.
Arquivos de Neuropsiquiatria 2009; 67(3b): 818-21.
Medline abstract
