MS research update - 04 December 2009
- Oral and intravenous steroids have same effect as measured by MRI
- Effects of disease modifying drugs on parenthood studied
- Aspects of cognitive functioning linked to coping in MS
Oral and intravenous steroids have same effect as measured by MRI
Corticosteroids (steroids) are the standard treatment for a relapse in MS. They are thought to work by partly suppressing the immune system and by reducing fluid accumulation around the site of nerve damage. Many studies have shown that steroids are effective in speeding up recovery from relapse.
Steroids can be administered orally or intravenously. The present study compares the efficacy, tolerability, and safety of intravenous versus oral methylprednisolone in people with MS who had experienced a relapse in the previous two weeks and had at least one active lesion on MRI. 40 people with MS were randomly assigned to one of two groups to receive either a five day course of a daily 1g oral dose of methylprednisolone or a five day course of a daily 1g intravenous dose of methylprednisolone. The participants' level of disability and number of lesions on MRI were measured before the study and at weekly intervals for four weeks.
Both groups showed a reduction in active lesions and an improvement in level of disability over time, and both treatments were well tolerated.
Martinelli V, Rocca MA, Annovazzi P, et al.
A short-term randomized MRI study of high-does oral versus intravenous methylprednisolone in MS.
Neurology 2009; 73(22):1842-8.
Medline abstract
Effects of disease modifying drugs on parenthood studied
There is little data on the effects of disease modifying drugs on parenthood, particularly in relation to fathers with MS. The present study sought to determine whether there is any increased risk or complications associated with the outcomes of pregnancies fathered by individuals receiving disease modifying drugs.
A nationwide questionnaire was dispatched via a German outpatient MS clinic to capture information about pregnancy outcomes. Of 46 pregnancies fathered by individuals taking disease modifying drugs, there were 6 spontaneous abortions and 2 pre-term births. The average birth weight of babies born to fathers taking disease modifying drugs was not significantly reduced compared with the average birth weight of the general population.
The study also captured data relating to birth weight of babies mothered by people with MS and found that they tended to have a lower birth weight regardless of whether they were receiving disease modifying drug treatment or not.
The significance of this study is limited given that it involved only a small number of participants.
Hellwig K, Haghikia A, Gold R.
Parenthood and immunomodulation in patients with multiple sclerosis.
Journal of Neurology 2009; [Epub ahead of print].
View abstract
Aspects of cognitive functioning linked to coping in MS
The present study examined coping styles in people with MS and how they might be linked to different clinical or demographic variables, particularly cognitive functioning. 63 people with MS participated in the study and completed a series of assessments designed to capture individual coping styles. Neuropsychological assessments were used to identify cognitively impaired and cognitively preserved participants.
Overall, cognitive functioning did not appear to have any impact on the type of coping employed by the participants. However, some interesting correlations were drawn between specific cognitive deficits, particularly those related to sustained attention and aspects of executive functioning (a term that relates to functions such as planning) and poorer coping abilities.
The study authors conclude that aspects of cognitive functioning may play an important role in the success with which individuals are able to cope with long-term conditions such as MS.
Benedetta G, Portaccio E, Zipoli V, et al.
Impact of cognitive impairment on coping strategies in multiple sclerosis.
Clinical Neurology and Neurosurgey 2009; [Epub ahead of print].
View abstract