MS Research Spotlight: Pregnancy Relapse Rebound, Cocoa for Fatigue & More
MS Research Spotlight covers key research news from the past two weeks.
No increased risk of relapses in the postpartum period
MARCH 12, 2019 || American Academy of Neurology
A preliminary study, supported by the National Multiple Sclerosis Society, delivers potential hope for women with MS who want to have children.
Study lead author Annette Langer-Gould, MD, Ph.D. shared findings in a recent press release which suggest that “most women diagnosed with MS today can have children, breastfeed and resume modestly effective DMTs per their preferences without incurring an increased risk of relapses during the postpartum period.”
Previous data from more than two decades prior has suggested that relapse rates tended to rebound in the postpartum period, but Langer-Gould’s research dismisses this data in favor of new findings that take DMTs and early diagnosis more into account than was typical during earlier research.
Her team also found that “exclusive breastfeeding” reduced the risk of postpartum relapses. Data from the study will be released at the American Academy of Neurology meeting in Philadelphia in May 2019.1
Pediatric onset MS study
MARCH 7, 2019 || University of Illinois at Urbana-Champaign
Pediatric onset multiple sclerosis (POMS) constitutes between 2.7 to 10.5 percent of all MS cases.2
The demands of managing a child with MS are considerable. Parents of children with POMS were recruited by Boston Children's Hospital in recent efforts to better understand how MS impacts these families.3
The parents shared ongoing stress due to uncertainty, fear of progression, and anxiety regarding symptoms, what the researchers described as a "long and demanding diagnostic odyssey."
Multiple procedures and clinical visits, and the complexities of working with a team of healthcare providers, have complicated their lives. So, too, has keeping track of "voluminous amounts of information, paperwork and treatment costs." They've struggled with DMTs, especially the delivery of injectables, which can be an overwhelming burden.
While they, overall, felt that MS placed extra demands on their family life, most parents interviewed found support from specialists, the National Multiple Sclerosis Society, and the greater MS community and reported success in adapting to new family realities.
Cocoa may help curb MS fatigue
MARCH 4, 2019 || BMJ
A small feasibility trial in the Journal of Neurology Neurosurgery & Psychiatry found that consuming cocoa —a treat high in anti-inflammatory substances known as flavonoids— might help with MS fatigue.
Forty adults with RRMS were given a daily cup of either a high-flavonoid hot cocoa drink or a similar, but low-flavonoid version, over a six-week period. Fatigue levels in both groups were measured prior to the test, at the study’s midpoint, and at trial’s end.
Those who drank the high-flavonoid cocoa enjoyed a 45 percent improvement in subjective fatigue and an 80 percent improvement in walking speed. Pain levels, though not objectively measured, seemed also to be reduced in the high-flavonoid group.
"A full evaluation, including wider geography, longer follow-up and cost-effectiveness is now indicated," the researchers concluded. Flavonoids are linked to longevity and heart health as well as healthy gut bacteria, says study author, Dr. Paolo Ragonese, who suggested there might be “possible positive effects of flavonoid intake on the management of fatigue in patients with MS.’4
Association between MS and pain medications
FEBRUARY 28, 2019 || PAIN: The Journal of the International Association for the Study of Pain
New research characterizing pain among people with MS showed neuropathic pain to be the main driver for increased complaints in patients with MS.
Patients with MS, recruited for three separate studies in Sweden, were matched with similar individuals who did not have MS to determine whether people with MS are at a greater risk for experiencing pain than their healthy cohorts.
“Pain and prescription of pain medication in patients with MS will not only be due to MS itself,” write the study authors, “but by comparing with a general population cohort, it is possible to identify an excess of pain medication use among this patient group, with the possibility to identify some more specific subtypes of pain.”
Subytpes of MS pain
To identify instances of neuropathic pain, they collected data on prescriptions for pregabalin, gabapentin, amitriptyline, capsaicin, and nortriptyline. To identify migraine complaints, they looked for anti-migraine medication requests, and they identified the presence of musculoskeletal pain through the request and use of muscle relaxants.
They found that their MS subjects were more likely to ask for and receive pain treatment for chronic concerns, with neuropathic pain being the most common pain complaint. Meanwhile, the data suggested that people with MS are at a greater risk of suffering from chronic pain but are less likely to be diagnosed with sporadic pain.
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