scholarly journals On the Correction of a Mental State in the Non-Drug Way at Multiple Sclerosis

2019 ◽  
Vol 8 (1) ◽  
pp. 177-199
Author(s):  
T. Reznikova ◽  
N. Seliverstova
Keyword(s):  
Multiple Sclerosis ◽  
Mental State ◽  
Psychological Assessment ◽  
Positive Effects ◽  
Functional Connections ◽  
Drug Influence

In this work the generalized results of clinical psychological assessment of 56 patients with multiple sclerosis in dynamics of non-drug influence by technique of formation and activation the artificial stable functional connections of a brain presented. Positive effects from activation, gnostic, emotional and personal components of a mental state, and also feature of psychological reorganizations at patients with multiple sclerosis during 10 sessions of activation by photostimulation of the set frequency are revealed.

scholarly journals Barriers and Facilitators Related to Rehabilitation Stays in Multiple Sclerosis

2015 ◽  
Vol 17 (3) ◽  
pp. 122-129 ◽  
Author(s):  
Caroline Bruun Helland ◽  
Trygve Holmøy ◽  
Pål Gulbrandsen
Keyword(s):  
Multiple Sclerosis ◽  
Information Overload ◽  
Treatment Options ◽  
Work And Family ◽  
University Hospital ◽  
Rehabilitation Service ◽  
Positive Effects ◽  
Information Giving ◽  
Rehabilitation Programs ◽  
Related Quality

Background: Studies have shown the positive effects of multidisciplinary rehabilitation on disability and health-related quality of life in multiple sclerosis (MS). However, many patients do not seek such treatment, even if it is available free of charge. The aim of this study was to identify facilitators and barriers related to use of such treatment options. Methods: Five focus group interviews with 27 MS patients were conducted. Three groups included patients who had been admitted to a multidisciplinary MS rehabilitation institution, and two groups included outpatients of a university hospital who had not applied for specialized rehabilitation. Interviews were audiotaped and transcribed, and were analyzed qualitatively by means of a modified form of systematic text condensation. Results: Important factors influencing the use of an MS rehabilitation service were 1) the availability and suitability of initial information about the disease and the service, 2) assumptions and expectations about such a service, and 3) practical barriers in the patient's life. The prospect of having a retreat from work and family was described as a motivational factor. Lack of reorientation after diagnosis, fears and perceptions of being labeled as an MS patient, or having information overload and being confronted with disabled individuals were identified as barriers. Conclusions: Communication skills, including information-giving skills, of neurologists in relation to newly diagnosed MS patients need improvement. Rehabilitation programs for MS patients should include stays of different durations and purposes to fit patients' needs. Health-care authorities should take measures to secure equal access to information about rehabilitation options across institutions and practicing physicians.

Depression is associated with disconnection of neurotransmitter-related nuclei in multiple sclerosis

2020 ◽  
pp. 135245852094821
Author(s):  
Matteo Martino ◽  
Paola Magioncalda ◽  
Mohamed Mounir El Mendili ◽  
Amgad Droby ◽  
Swetha Paduri ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Resting State ◽  
Depressive Symptomatology ◽  
Healthy Controls ◽  
Diffusion Weighted Mri ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Functional Connections ◽  
Brainstem Nuclei ◽  
And Diffusion

Background: Depression is frequently associated with multiple sclerosis (MS). However, the biological background underlying such association is poorly understood. Objective: Investigating the functional connections of neurotransmitter-related brainstem nuclei, along with their relationship with white matter (WM) microstructure, in MS patients with depressive symptomatology (MS-D) and without depressive symptomatology (MS-nD). Methods: Combined resting-state functional magnetic resonance imaging (fMRI) and diffusion-weighted MRI (dMRI) study on 50 MS patients, including 19 MS-D and 31 MS-nD patients, along with 37 healthy controls (HC). Main analyses performed are (1) comparison between groups of raphe nuclei (RN)-related functional connectivity (FC); (2) correlation between RN-related FC and whole brain dMRI-derived fractional anisotropy (FA) map; and (3) comparison between groups of FA in the RN-related WM area. Results: (1) RN-related FC was reduced in MS-D when compared to MS-nD and HC; (2) RN-related FC positively correlated with FA in a WM cluster mainly encompassing thalamic/basal ganglia regions, including the fornix; and (3) FA in such WM area was reduced in MS-D. Conclusion: Depressive symptomatology in MS is specifically associated to a functional disconnection of neurotransmitter-related nuclei, which in turn may be traced to a distinct spatial pattern of WM alterations mainly involving the limbic network.

Effect of drugs in secondary disease progression in patients with multiple sclerosis

2004 ◽  
Vol 10 (3_suppl) ◽  
pp. S46-S55 ◽  
Author(s):  
Ludwig Kappos
Keyword(s):  
Multiple Sclerosis ◽  
Disease Progression ◽  
Progressive Multiple Sclerosis ◽  
Positive Effects ◽  
Secondary Progressive ◽  
The North ◽  
Disability Status ◽  
Relapsing Remitting ◽  
Effect Of Therapy ◽  
Almost All

Secondary progressive multiple sclerosis (SPMS) is a form of MS characterized by continuously worsening disability with or without superimposed relapses that occurs after a variable period of relapsing remitting disease and results in limited ambulation for almost all patients. The use of interferon beta (IFN b) for immunomodulation in patients with SPMS has been evaluated in four recent clinical trials: The European multicentre trial on IFN b-1b in SPMS (EUSPMS), the Secondary Progressive Efficacy Trial of Rebif (IFN b-1a) in MS (SPEC TRIMS), the North A merican Study of IFN b-1b in SPMS (NA SPMS), and the Internatio nal MS Secondary Progressive Avonex C linical Trial (IMPAC T). EUSPMS was the only trial to demonstrate a significant positive effect of therapy on disease progression as measured by the expanded disability status scale (EDSS). However, results from all studies demonstrated significant positive effects of treatment on relapse, T2 lesion load, and gadolinium enhancement. Immunomodulation with IFN b has the potential to significantly slow disease progression and improve quality of life for patients with SPMS. While results with monthly IV Ig were disappointing, positive effects on disease progression have been reported with the applicatio n of immunosuppressants, especially Mitoxantrone. The risk-benefit ratio of these cytostatic agents remains controversial. New strategies addressing the important neurodegenerative aspects of the disease are urgently needed.

scholarly journals Randomized controlled trial of an e-learning designed behavioral intervention for increasing physical activity behavior in multiple sclerosis

2017 ◽  
Vol 3 (4) ◽  
pp. 205521731773488 ◽  
Author(s):  
Robert W Motl ◽  
Elizabeth A Hubbard ◽  
Rachel E Bollaert ◽  
Brynn C Adamson ◽  
Dominique Kinnett-Hopkins ◽  
...  
Keyword(s):  
Physical Activity ◽  
Multiple Sclerosis ◽  
Randomized Controlled Trial ◽  
Behavioral Intervention ◽  
Controlled Trial ◽  
Analysis Of Covariance ◽  
Learning Approaches ◽  
Positive Effects ◽  
Randomized Controlled ◽  
E Learning

Background Internet-delivered, behavioral interventions represent a cost-effective, broadly disseminable approach for teaching persons with multiple sclerosis (MS) the theory-based skills, techniques, and strategies for changing physical activity. Objectives This pilot, randomized controlled trial examined the efficacy of a newly developed Internet website based on e-learning approaches that delivered a theory-based behavior intervention for increasing physical activity and improving symptoms, walking impairment, and neurological disability. Methods Participants with MS ( N = 47) were randomly assigned into behavioral intervention ( n = 23) or waitlist control ( n = 24) conditions delivered over a six-month period. Outcomes were administered before and after the six-month period using blinded assessors, and data were analyzed using analysis of covariance in SPSS. Results There was a significant, positive intervention effect on self-reported physical activity ( P = 0.05, [Formula: see text] = 0.10), and non-significant improvement in objectively measured physical activity ( P = 0.24, [Formula: see text] = 0.04). There were significant, positive effects of the intervention on overall ( P = 0.018, [Formula: see text] = 0.13) and physical impact of fatigue ( P = 0.003, [Formula: see text] = 0.20), self-reported walking impairment ( P = 0.047, [Formula: see text] = 0.10), and disability status ( P = 0.033, [Formula: see text] = 0.11). There were non-significant improvements in fatigue severity ( P = 0.10, [Formula: see text] = 0.06), depression ( P = 0.10, [Formula: see text] = 0.07) and anxiety ( P = 0.06, [Formula: see text] = 0.09) symptoms, and self-reported disability ( P = 0.10, [Formula: see text] = 0.07). Conclusions We provide evidence for the efficacy of an Internet-based behavioral intervention with content delivered through interactive video courses grounded in e-learning principles for increasing physical activity and possibly improving secondary outcomes of fatigue, depression, anxiety, and walking impairment/disability in persons with MS.

scholarly journals Microglia-targeted dendrimer-2PMPA therapy robustly inhibits GCPII and improves cognition in a mouse model of multiple sclerosis

2020 ◽  
Author(s):  
Kristen Hollinger ◽  
Anjali Sharma ◽  
Carolyn Tallon ◽  
Lyndah Lovell ◽  
Ajit G. Thomas ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Pamam Dendrimers ◽  
Inflammatory Activity ◽  
List Type ◽  
Brain Delivery ◽  
Brain Penetration ◽  
Positive Effects ◽  
Anti Inflammatory

AbstractRoughly half of all individuals with multiple sclerosis (MS) experience cognitive impairment, but there are no approved treatments that target this aspect of the disease. Recent studies link reduced brain N-acetylaspartylglutamate (NAAG) levels to impaired cognition in various neurological diseases, including MS. NAAG levels are regulated by glutamate carboxypeptidase II (GCPII), which hydrolyzes the neuropeptide to N-acetyl-aspartate (NAA) and glutamate. Although several GCPII inhibitors, such as 2-(phosphonomethyl)-pentanedioic acid (2-PMPA), elevate brain NAAG levels and restore cognitive function in preclinical studies when given at high systemic doses or via direct brain injection, no GCPII inhibitors are clinically available due to poor bioavailability and limited brain penetration. Systemic hydroxyl dendrimers (~4 nm) have been successfully used to enhance brain delivery of drugs selectively to activated glia. We recently discovered that GCPII is highly upregulated in activated microglia after brain injury. To determine if dendrimer conjugation could enhance the brain delivery of GCPII inhibitors, specifically in the context of MS, we attached 2-PMPA to hydroxyl polyamidoamicne (PAMAM) dendrimers (D-2PMPA) using a highly efficient click chemistry approach. Targeted uptake of D-2PMPA into activated glia was subsequently confirmed in glial cultures where it showed robust anti-inflammatory activity, including an elevation in TGFβ and a reduction in TNFα. Given these positive effects, D-2PMPA (20mg/kg) or vehicle dendrimer were dosed twice weekly to experimental autoimmune encephalomyelitis (EAE)-immunized mice starting at disease onset (therapeutic paradigm). D-2PMPA significantly improved cognition in EAE as assessed by Barnes maze performance, even though physical severity was not impacted. Glial target engagement was confirmed, as CD11b+ enriched cells isolated from hippocampi in D-2PMPA-treated mice exhibited almost complete loss of GCPII activity. These data demonstrate the utility of hydroxyl dendrimers to enhance brain penetration and support the development of D-2PMPA to treat cognitive impairment in MS.FundingThis work was funded by the National Multiple Sclerosis Society (RG-1507-05403 to BSS), the National Institute of Health NINDS (R01NS093416 to SK, RM and BSS), and Ashvattha Therapeutics. We would also like to acknowledge support for the statistical analysis from the National Center for Research Resources and NIH NCATS (1UL1TR001079).HighlightsThe GCPII inhibitor 2-PMPA was conjugated to hydroxyl PAMAM dendrimers (D-2PMPA)D-2PMPA targeted activated glia in culture and displayed anti-inflammatory activityWhen dosed systemically to EAE mice, D-2PMPA inhibited CD11b+ cell GCPII activityWhen dosed systemically to EAE mice, D-2PMPA improved cognitive function

scholarly journals Diverse mechanisms and treatment strategies to confront fatigue in multiple sclerosis: A systematic review

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 563
Author(s):  
Sumanth Khadke ◽  
tehmina siddique
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Reviews ◽  
Observational Studies ◽  
Behavioral Therapy ◽  
Combined Treatment ◽  
Cochrane Review ◽  
Treatment Strategies ◽  
Individual Treatment ◽  
Positive Effects ◽  
Positive Effect

Background: Firm conclusions about the applicability of treatment methods other than pharmacotherapy in treating fatigue in multiple sclerosis (MS) remain elusive. Our objective is to synthesize and review the epidemiological literature systematically and find an effective therapeutic plan for fatigue. The effect of individual treatment and combined treatment strategies are studied. Methods: An electronic database search included EBSCO, PubMed, SCIENCE DIRECT and Scopus from January 1, 2013, to September 30, 2018. Search terms used are “Fatigue AND Multiple sclerosis AND therapy”. The articles included in the study are open access, published in last five years, not restricted to region and language. The search included randomized controlled trials (RCTs), observational studies, and systematic reviews. Results: We included 13 systematic reviews, 10 RCTs and 7 observational studies. A Cochrane review on 3206 patients showed exercise therapy to have a positive effect on fatigue in RRMS patients. The EPOC trial showed switching interferon therapy or glatiramer to fingolimod showed improved fatigue levels. The FACETS trial showed incorporating behavioral therapy to ongoing recommended therapy is beneficial. Few observational studies demonstrated that fatigue is influenced by pain, mood problems, and depression. Conclusions: The diverse pathology of fatigue related to MS is important in understanding and quantifying the role of each causal factor. Evidence reveals a positive effect on fatigue levels of RRMS patients with regular CBT and exercise-based combination therapy. Progressive forms of the disease have the worst prognosis. Individually aerobic exercises, behavioral therapy and pharmacotherapy have positive effects. A modified amalgamation of the same is a better hope for MS patients.

scholarly journals Motor Imagery: A Resource in the Fatigue Rehabilitation for Return-to-Work in Multiple Sclerosis Patients—A Mini Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Francesco Agostini ◽  
Letizia Pezzi ◽  
Marco Paoloni ◽  
Roberta Insabella ◽  
Carmine Attanasi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Return To Work ◽  
Motor Imagery ◽  
Cognitive Processing ◽  
Cochrane Collaboration ◽  
Qualitative Synthesis ◽  
Auditory Cues ◽  
Positive Effects ◽  
Internal Stimulus ◽  
Multiple Sclerosis Patients

Fatigue is a multidimensional symptom with both physical and cognitive aspects, which can affect the quality of daily and working life activities. Motor Imagery (MI) represents an important resource for use during the rehabilitation processes, useful, among others, for job integration/reintegration, of neurological pathologies, such as Multiple Sclerosis (MS). To define the effective rehabilitation protocols that integrate MI for the reduction of fatigue in patients with MS (PwMS), a literary review was performed through August 2020. Five articles were included in the qualitative synthesis, including two feasibility pilot randomized control trials (RCTs) and 3 RCTs with good quality according to the PEDro score and a low risk of bias according to the Cochrane Collaboration tool. The literature suggested that MI, in association with rhythmic-auditory cues, may be an effective rehabilitation resource for reducing fatigue. Positive effects were observed on perceived cognitive and psychological fatigue. PwMS require greater compensatory strategies than healthy individuals, and the use of rhythmic-auditory cues may be useful for optimizing the cognitive processing of MI, which acts as an internal stimulus that is enhanced and made more vivid by outside cues. These findings provide evidence that MI is a promising rehabilitation tool for reducing fatigue in PwMS and return to work strategies.

scholarly journals T196. THERAPEUTIC MANAGEMENT IN MULTIPLE SCLEROSIS AND SCHIZOPHRENIA SPECTRUM DISORDERS DUAL DIAGNOSIS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S306-S306
Author(s):  
Octavian Vasiliu
Keyword(s):  
Multiple Sclerosis ◽  
Dual Diagnosis ◽  
Atypical Antipsychotics ◽  
Psychotic Disorders ◽  
Complement Factor ◽  
Schizophrenia Spectrum Disorders ◽  
Positive Effects ◽  
Schizophrenia Spectrum ◽  
Baseline Values ◽  
Spectrum Disorders

Abstract Background Multiple sclerosis has been suggested as a potential vulnerability factor for schizophrenia and other psychotic disorders, and there is a hypothesis about a common etiology in a subgroup of schizophrenia and multiple sclerosis [1]. Immune-related single-nucleotide polymorphisms have been associated with schizophrenia and genetic pleiotropy between schizophrenia and multiple sclerosis has been reported, but not between bipolar disorder and multiple sclerosis (at the level of major histocompatibility complex) [2]. As new data about the involvement of genetically-determined immune factors in the susceptibility to schizophrenia appear (e.g., variants of complement factor 4 possibly linked to synaptic pruning during brain development) [3] the interest for finding therapeutic targets within the immune system for psychotic disorders is also increasing. Methods Three patients diagnosed with both schizophrenia spectrum disorders (schizophrenia n=2, or schizoaffective disorder, depressive type n=1), female, mean age 43.7, with a history of psychotic disorder for at least one year, were monitored during 6 months using Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning (GAF), Clinical Global Impressions – Severity (CGI-S), Columbia-Suicide Scale for Schizophrenia (CSSRS), Calgary Depression Scale (CDS), Multiple Sclerosis Severity Scale (MSSS), and the Extrapyramidal Symptom Rating Scale (ESRS). None of these patients presented other organic or psychiatric co-morbidity, and they were on active treatment for their multiple sclerosis throughout the 6-month duration of psychiatric evaluation. All patients were initiated on a new antipsychotic, because of the lack of efficacy of the previous agents, or due to their lack of therapeutic adherence. A patient was initiated on olanzapine 15 mg/day, while the other two received risperidone 4 mg/day. The antipsychotic doses were flexible during the 6 months of the treatment, with olanzapine between 10 and 20 mg daily, and risperidone between 3–6 mg daily. The initial PANSS mean score was 92.2, with a GAF of 35.3 and a CGI-S of 5.1. Results All patients reached the week 24 visit of their evaluation, and the overall tolerablity of the antipsychotic treatment was good. All patients had lower PANSS scores at week 24 (the mean decrease was -25.6 points compared to baseline), higher GAF scores (+27.7 points), and lower CGI-S (-2.5 points). CSSRS did not change significantly during the 6 months, the score remained at minimum value, and the CDS scores also remained constantly under 3. ESRS recorded transient increments, but at week 12 they were not significantly increased reported at the baseline values, and no corrective medication was recommended throughout the 6 months for extrapyramidal symptoms. MSSS mean score did not change significantly at week 12 compared to its baseline values. Discussion Atypical antipsychotics are efficient and well tolerated in patients with schizophrenia and multiple sclerosis dual diagnosis. The positive effects of atypical antipsychotics maintained during the 6 months of monitoring and they had no significant impact over the multiple sclerosis symptoms. References

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