Tuesday, April 29, 2014

April 2014 Round-up of MS News and Research

Highlights of the evidence-based recommendations for complementary and alternative medicine (CAM) in MS issued by American Academy of Neurology (AAN) include possible effectiveness of different forms of cannabis extracts or synthetic cannabinoids for spasticity symptoms, pain, and urinary frequency; magnetic therapy and ginkgo biloba for fatigue; and reflexology for paresthesia.  Cannabinoids are likely ineffective for short-term spasticity, tremor, and urinary incontinence.  Magnetic therapy is probably ineffective for depression and ginko biloba is ineffective for cognition. Fish oil and bee sting therapies are probably ineffective for relapses, disability, fatigue, MRI lesions, and health-related quality of life (QOL).

A recent study shows that, for many individuals with MS, fatigue is associated with poor sleep quality.  Fatigue is among the most common symptoms of MS, affecting up to 80% of those diagnosed with the disease.  Several factors may contribute to the connection between poor sleep quality and fatigue.  Increased levels of inflammatory cytokines or lesions in the brain may disrupt pathways involved with sleep and daytime alertness.  Sleep apnea, which is common in people with MS, may also result in both fatigue and sleep disruption.  The use of MS disease modifying therapies, particularly beta interferons, may contribute to both fatigue and sleep disturbance. Although depression was associated with both sleep disturbance and fatigue in this study, authors note that exclusion of patients with severe depression and the low incidence of depression in the study participants limits their ability to evaluate a possible connection.

Neuromuscular electrical stimulation cycling benefits people with advanced MS according to a recent study.  Eight women with secondary progressive MS (SPMS) participated in a training program utilizing neuromuscular electrical stimulation (nMES) cycling that resulted in several real and perceived benefits.  Electrodes are placed on the quadriceps, hamstrings, and gluteal muscles of each leg which allows persons with paralyzed legs to exercise on a stationary recumbent bicycle.  The goal of this study was to investigate the feasibility of adapting nMES cycling to suit the needs of persons with MS. Adaptations included a slower pedaling cadence (at a speed of 10 revolutions/minute) which produces greater muscle forces and a slow, gradual increase in stimulation intensity (pulse amplitude) during the first 20 minutes of each exercise session as patients adjusted to the uncomfortable stimulation.  Study outcomes included the stimulation intensity tolerated, thigh circumference changes, and power output and cardiorespiratory response during cycling. 

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Hot Topics and MS Research News for April 2014

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