MS Research Spotlight: Telerehabilitation, Anesthesia, & More
MS Research Spotlight covers key research news from the last month.
Unique brain cells identified as targets for MS brain damage
“Cell types affected in brains of multiple sclerosis patients pinpointed”
JULY 17, 2019 || University of Cambridge
Not all brain cells are alike. In the case of people with MS, a specific brain cell type has been identified as central to changes in the brain unique to demyelinating disease.
The projection neuron is a brain cell which communicates information within areas of the brain. If damaged, these cells may fail to perform, leading to potential cognitive dysfunction and brain shrinkage.
The immune systems of people with MS target projection neurons. If scientists can identify therapies that protect projection cells, this could “provide a novel treatment for progressive MS,” said University of Cambridge professor David Rowitch.1
What is telerehabilitation, and how might it help people with MS?
“Telerehabilitation benefits patients with multiple sclerosis in an urban setting”
JULY 15, 2019 || Journal of Telemedicine and Telecare
Once an MS diagnosis comes to light, next steps include treatment as well as rehabilitation for symptoms. These might include problems with pain, poor sleep, mobility, continence, muscle spasticity, and MS’s most common symptom—fatigue.2,3
A new technology, transcranial direct current stimulation (tDCS), shows promise as an effective tool for managing MS-related fatigue.4 However, the time and resources required to travel to therapists trained in this procedure may make this form of rehabilitation less accessible.
This study (b) paired a remote tDCS telerehabilitation protocol with urban-based MS participants. It found that not only was this fatigue-management tool effective and easy to use at home (with supervision via videoconference), but it also saved MS patients significant time and money.2
New structure improves movement and balance in advanced MS
“Standing frame intervention improves life for people with multiple sclerosis, research shows”
JULY 10, 2019 || MedicalXPress
The Oswestry standing frame is a simple structure designed to enable people with MS to “regularly stand and carry out strengthening and balance exercises in a supported position,” according to the data collected from the Standing Up to MS (SUMS) research study recently published in The Lancet. It’s used as frequently as can be done so comfortably, and regular use can lead to strengthening of key muscle groups.5,6
Study participants who used the device found they were able to undertake important activities, such as walking a daughter down the aisle on her wedding day. One patient, who was not walking at all prior to using the frame, is now mobile (on foot) about 70 percent of the time.
The structure is more expensive than a wheelchair, but may be effective in reducing the need for a wheelchair. This is important, as mobility is a quality-of-life concern for many with severe or progressive forms of MS.5
Having surgery in the near future? No need to worry about a relapse
“Reviewing Medical Histories Reveals No Increase in MS Relapse Risk After Surgery, Anesthesia”
JULY 8, 2019 || National Multiple Sclerosis Society (NMSS)
By examining the medical charts of nearly 300 people with MS who’ve undergone operations, researchers at the University of Michigan found “no statistically significant increase in the risk of MS relapse within 90 days of the procedure,” according to the NMSS.7,8
This does not rule out relapses that might occur outside the 90-day window they observed. Also, the study mostly examined older adults with MS, whose relapses “can decrease in frequency with increasing age.”
The NMSS suggests that, for most, general anesthesia is not a relapse risk. However, those with “severe, advanced disease,” or with substantial weakness caused by MS, or respiratory issues, may face greater risk, not for relapse, but for anesthetic complications.7
Take a deep breath: A potential MS diagnostic assessment may be as simple as an exhale
“Researchers hope to develop a breath test to diagnose MS”
JULY 4, 2019 || MS Society
Researchers from the Centre for Biomarker Research (CeBioR) at the University of Huddersfield in West Yorkshire, England admit that the potential for a “breath biopsy test” is “futuristic,” but that’s not stopping them from developing it.
The test samples the presence of certain kinds of volatile organic compounds (VOCs) in your breath. They might reveal particular changes in the gut microbiome which could be unique to this with MS. These biomarker assessments might be helpful not only for the diagnosis of MS, but in its monitoring and as a way to check response to therapy.
The research team at CeBioR is working to arrange a large-scale study to develop and apply this potential breath sample collection tool. From it, they hope to observe people with MS at different stages as well as those who do not have MS to isolate potential compounds only present in MS.9
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