MS research update - 06 November 2009
- Relapses have minimal impact on long-term disability
- Neutralising antibodies reduce effectiveness of interferon beta
- Lower body resistance exercise improves muscle strength and functional capacity in MS
- People with MS more likely to suffer sleep disorders
Relapses have minimal impact on long-term disability
An MS relapse is usually defined as a temporary worsening of MS-related symptoms followed by a period of recovery. Whilst the immediate impact of a relapse is evident, what is less evident is the impact relapses might have on an individual's level of disability in the long-term.The present study investigated the relationship between relapses and long-term disability based on the medical records of 2, 477 people diagnosed with a relapsing onset of MS containing data that spanned over an average period of 20 years. The aim was to determine whether there was any link between early and later relapses and the time to reach point 6 on EDSS (a clinical scale used to measure an individual's level of disability). Point 6 on EDSS equates with the inability to walk without the support of a walking aid.
The study found that people who had a relapse within five years of onset had a significantly greater risk of needing to use a walking aid in the short-term, than those who did not experience a relapse within five years of onset. However, earlier relapses did not appear to have a significant impact over the long-term. Over a longer period of time, people who had experienced relapses earlier in the course of the condition were likely to experience a similar level of disability as those who had experienced relapses later in the course of the condition.
Tremlett H, Youselfi M, Devonshire V, et al.
Impact of multiple sclerosis relapses on progression diminishes with time.
Neurology 2009; Epub ahead of print.
Medline abstract
Neutralising antibodies reduce effectiveness of interferon beta
Antibodies are proteins produced by the immune system to fight foreign substances such as infections. As with drugs that are used in some other conditions such as diabetes, use of interferon over a long period of time may result in the production of what are known as 'neutralising antibodies'. A simple blood test can be used to check for the presence of neutralising antibodies. Previous studies have suggested that high levels of these antibodies reduce the effectiveness of the drugs.
The present study sought to determine whether there were any differences between the MRI scans produced for people who developed a high level of neutralising antibodies whilst receiving interferon beta treatment compared with those who did not develop neutralising antibodies. The MRI scans pointed to a higher level of disease activity in people with high levels of neutralising antibodies compared to the scans of those who did not develop neutralising antibodies. The findings confirm previous suggestions that the presence of neutralising antibodies reduces the effectiveness of interferon beta.
Pachner AR, Cadavid D, Wolansky L, et al.
Effect of anti-IFN (beta) antibodies on MRI lesions of MS patients in the BECOME study.
Neurology 2009; 73(18):1485-92.
Medline abstract
Lower body resistance exercise improves muscle strength and functional capacity in MS
The present study investigates the effectiveness of a 12-week programme of progressive resistance training (PRT) in improving muscle strength and functional capacity (ability to perform day-to-day activities) in a group of people with MS. Progressive resistance training is a strength training method in which weight-bearing movements are performed and the weight increases with each session to encourage adaptation and improvement.
38 people with MS with a moderate level of disability were randomly assigned to one of two groups: 19 people were assigned to receive a 12-week programme of progressive resistance training; 19 people were not assigned to any treatment programme. Following the 12-week (PRT) programme people were encouraged to continue training. Muscle strength and functional capacity were measured at the start of the study, and at 12 and 24 weeks. The group that had taken part in the PRT programme showed significant improvements in muscle strength and functional capacity at both 12 and 24 weeks compared to the group who had not been part of the training programme.
Dalgas U, Stenager E, Jakobsen J, et al.
Resistance training improves muscle strength and functional capacity in multiple sclerosis.
Neurology 2009; 73(18):1478-84.
Medline abstract
People with MS more likely to suffer sleep disorders
Though frequently unrecognized, sleep disorders are more prevalent in people with MS than the general population. This article reviews all the current evidence relating to sleep disorders in MS, identifying insomnia (inability to sleep), sleep disordered breathing (obstructed breathing during sleep), restless legs syndrome, and narcolepsy (excessive daytime sleepiness) amongst some of the disorders that have been reported. The article examines the link between sleep disorders and MS symptoms with particular focus on the relationship between sleep disorders and fatigue.
Brass SD, Duquette P, Proulx-Therien J, et al.
Sleep disorders in patients with multiple sclerosis.
Sleep Medicine Reviews 2009; Epub ahead of print.
Medline abstract