MS research update - 15 January 2010
- Fatigue related to damage in specific areas of the brain
- TENS improves touch sensitivity in hands of people with MS
- Lack of effectiveness and side effects are main reasons for stopping or switching therapy
Fatigue related to damage in specific areas of the brain
Two types of fatigue are described in MS - primary fatigue and secondary fatigue. Primary fatigue is thought to be caused by the processes and changes that occur in MS itself, while secondary fatigue is thought to be caused by other factors that affect the person with MS more significantly than those without the condition.
The present study recruited 34 people with MS; 17 with primary-fatigue on assessment, and 17 non-fatigued on assessment. All participants underwent an MRI scan and the results of the two groups were compared. The results of the MRI scans revealed a greater loss of brain volume in specific regions of the brain in people with primary fatigue compared with non-fatigued people.
The authors suggest that primary fatigue is directly related to the damage that occurs in specific regions of the brain in people with MS.
Andreasan AK, Jakobsen J, Soerensen L, et al.
Regional brain atrophy in primary fatigued patients with multiple sclerosis.
Neuroimage 2010; [Epub ahead of print].
Medline abstract
TENS improves touch sensitivity in hands of people with MS
Transcutaneous Electrical Nerve Stimulation (TENS) is the application of a small electric current, usually used in the treatment of pain. Loss of touch or sensation is sometimes seen in people with MS as damage to nerves in the central nervous system disrupts the signals that are sent between different parts of the body and the brain. As a result, people with MS can become less sensitive to touch in particular parts of the body, such as the hands.
The present study investigated the long-term effects of sensory stimulation using a TENS machine on hand sensitivity of people with MS. TENS was applied an hour a day for three weeks on the median nerve region (found in the heel of the palm) of their dominant hand. Touch sensitivity tests were conducted prior to the treatment; twelve hours after each session; and three weeks after the very last session. The results of the tests showed that long-lasting increases in touch sensitivity were achieved in people with MS, but not in the healthy comparator group participants. The improved touch sensitivity was also seen in parts of the hands and fingers where the TENS device had not been directly applied.
Cuypers K, Levin O, Thijs H, et al.
Long-term TENS treatment improves tactile sensitivity in MS patients.
Neurorehabilitation and Neural Repair 2010; [Epub ahead of print].
Medline abstract
Lack of effectiveness and side effects are main reasons for stopping or switching therapy
A significant number of people with MS discontinue or switch disease modifying drugs. When taken out of context the statistics relating to the number of people who stop or switch from the disease modifying drug that was originally prescribed are somewhat bewildering. The present study explored the occurrence and reasons for stopping, switching or continuing first prescribed interferon-beta therapy in people with MS in Sweden.
The records of 259 people with MS were reviewed comparing people who continued treatment for at least three years with those who either stopped or switched. Of this number, 69% of people either stopped (15%) or switched (54%) from interferon-beta within three years. People who stopped drug treatment tended to have had longer disease duration before starting; be less likely to be in the relapsing remitting stage of the condition; and to have a higher level of physical disability compared to the people who switched. The two most common reasons for switching or stopping treatment were a perceived lack of effectiveness and intolerable side-effects.
Cunningham A, Gottberg K, von Koch L, et al.
Non-adherence to interferon-beta therapy in Swedish patients with multiple sclerosis.
Acta Neurologica Scandinavica 2010; [Epub ahead of print].
Medline abstract