MS Research Spotlight: Transcranial Therapy for Fatigue, Lemtrada Good News, and More
MS Research Spotlight covers key research news from the past two weeks.
Transcranial stimulation at home reduces fatigue
JANUARY 3, 2019 || MD Magazine
Recent research published in Multiple Sclerosis Journal supports the use of transcranial direct current stimulation (tDCS) as a fatigue-reduction therapy for people with MS. What’s more, the therapy is easy for patients to administer while at home.
tDCS involves the application of electrodes to specific areas on the scalp which, when activated, deliver low-amplitude electrical currents that alter nerve cell activity in a way that provides relief from fatigue.
Initial research on tDCS shows it to be safe to use, easy to tolerate, inexpensive to administer, and simple to activate. It can also be remotely supervised through a telemedicine platform, so patients can use the equipment safely on a regular basis without having to visit a medical facility.
Study author Leigh Charvet PhD, at Langone Medical Center, reported that, after trialing several placements, they found applying tDCS electrodes over the area of the dorsolateral prefrontal cortex—located on the frontal lobes of each of the brain’s hemispheres—generated “the most fatigue-specific improvements in multiple sclerosis.”
Correcting minority underrepresentation in MS clinical trials
JANUARY 2, 2019 || European Pharmaceutical Review
Neurologist Jay Avasarala, of UK Healthcare’s Kentucky Neuroscience Institute, recently called attention to inequities in the representation of minorities selected for participation in Phase III clinical trials that investigate potential MS treatments.
He found it worrisome that “not a single study” has compared how drugs for people with MS perform when comparing two clinically distinct phenotypes: patients who are Caucasian American and patients who are African American.
Avasarala points out that MS disease progression is markedly different between groups, and that for African Americans, it can be far more aggressive and disabling.
The FDA’s Center for Drug Evaluation and Research launched an initiative in 2014 to improve the numbers of minorities included in clinical trials.
However, Avasarala pointed out that companies developing MS therapies are not required to include efficacy statistics from minority populations, information he thinks would enable physicians to make more informed decisions regarding potential therapies for their patients.
“The scientific community has published reams of data, but all that matters to a patient is, ‘OK, doc, how can you treat me?’ [and] ‘What drugs would you recommend?’ And we fall short for African Americans, because we simply don’t have the data” he told CNS Spectrums last month.
“I feel powerless to help [these patients],” he said. “There needs to be a change. And change ought to begin in the form of a policy shift.”
SNUH finds cause for chronic relapsing inflammatory optic neuropathy
JANUARY 2, 2019 || Korea Biomedical Review
Seoul National University Hospital researchers think that myelin oligodendrocyte glycoprotein antibodies (MOG-Abs) are the main cause of a specific form of optic neuritis that is a frequent early symptom for people with MS.
CRION, or chronic relapsing inflammatory optic neuropathy, results in blurry vision, poor visual acuity, color vision deficits and eye pain. It is a feature of MS as well as other demyelinating conditions, including optic neuromyelitis.
The findings are important because doctors can now prevent visual impairment in patients with optic neuritis by confirming the presence of MOG-Abs, then treating the condition early with immunotherapy.
Myelin oligodendrocyte glycoprotein is a form of cellular protein said to assist in the myelination and stabilization of nerve cells in the central nervous system. MOG-Abs have been shown to induce or to contribute to demyelination.
Infratentorial lesions beneficial for differentiating Fabry Disease vs. MS
JANUARY 2, 2019 || Neurology Advisor
One of the bigger challenges with diagnosing MS relates to confidently ruling out other diseases which may mimic its symptoms.
One such disease is a rare condition known as Fabry disease, a genetic disorder traced to a defect on the X chromosome.
Investigators identified lesions appearing on the infratentorial region of the brain as indicative of MS activity, especially when lesions were also observed in the area known as the corpus callosum.
The infratentorial region in the brain houses the cerebellum, which regulates motor movement and processes information for the sensory systems and spinal cord. The corpus callosum describes the wide bed of nerve fibers which houses the two hemispheres of the brain.
The researchers concluded that MRI scans which show an absence of lesions in the infratentorial region suggest a diagnosis more compatible with Fabry disease and not MS.
Alemtuzumab linked to clinical and MRI disease remission
JANUARY 1, 2019 || Neurology Advisor
Good news for the new year came for patients using alemtuzumab (Lemtrada) to treat relapsing-remitting MS.
The Journal of Neurology reported results of new research, conducted over three years in a real-world, retrospective, multicenter study in Italy, that showed the use of the drug — a form of monoclonal antibody — to be linked to disease remission (measured in clinic and via MRI) as well as improvements in disability.
At follow-up, 45 percent of patients showed no sign of disease activity, 75 percent were considered relapse-free, and more than 62 percent showed no changes in MRI-measurable activity.
Also, more than 27 percent also reported improvements in areas of disability, and more than 82 percent did not report worsening of disability severity.
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