Comorbidities (when someone is living with more than one condition) are common in MS and can affect people at the onset of their disease, and are even more prevalent in the aging MS population. Evidence presented at the 7th Joint ECTRIMS/ACTRIMS meeting in Paris, France on October 24-28, 2017 by Dr. Ruth Ann Marrie (University of Manitoba) suggests that comorbidities are associated with a negative impact on outcomes including an increase in disability progression, hospitalizations, mortality and a change in response to fatigue management. Aging is associated with certain comorbidities in the general population, and is no different in people living with chronic conditions such as MS. The most common comorbidities for people with MS were diabetes, heart disease, hypertension (high blood pressure), hyperlipidemia (high cholesterol) and peripheral vascular disease. In the aging MS population, comorbidities may appear at a time when disability progression is increasing and management of the disease is more challenging.
According to a separate Canadian study, the number of people living with MS over the age of 55 is increasing. It is postulated that this is due to improved quality of life of patients and the availability of more effective treatments for MS.
As people living with MS age, the risk of certain comorbidities increases. The need for multi-disciplinary, patient-centred care for prevention and treatment of comorbidity in people living with MS is critical in the overall management of the disease, especially within the aging MS population.
 Ploughman M, Beaulieu S, Harris C, et al. The Canadian survey of health, lifestyle and ageing with multiple sclerosis: methodology and initial results. BMJ Open 2014;4: e005718. doi:10.1136/ bmjopen-2014-005718
The McDonald criteria for MS was first established in 2001 by neurologist Ian McDonald and his team of researcher to diagnose individuals with MS with speed and sensitivity. The criteria include guidelines on Magnetic Resonance Imaging (MRI) evidence, clinical exams and the use of cerebrospinal fluid (fluid found in the brain and spinal cord, collectively called the central nervous system or CNS) to assist with the diagnosis of MS. Since then, it has undergone three separate revisions; the first took place in 2005, the second in 2010 and most recently, in 2017. The International Panel on Diagnosis of MS revised the 2010 McDonald criteria which was presented at the 7th Joint ECTRIMS/ACTRIMS meeting in Paris, France on October 24-28, 2017. The 2017 revisions were spurred by new data/research since the 2010 revision was released and now allow for an earlier and more efficient diagnosis of MS. The new data has lead to: a better understanding of MS including diagnostic strategies with more sensitivity, greater knowledge of conditions that mimic MS (which can result in misdiagnosis) and revised MRI criteria. The 2017 criteria lessen the risk of misdiagnosis, and most importantly, people can be diagnosed earlier and begin treatment right away.
The blood-brain barrier (BBB) was highlighted in a session at the #MSParis2017 conference where researchers presented their recent findings on the relationship between the BBB and MS. The BBB is a network of cells (called endothelial cells) that line all the blood vessels in the brain. These cells are so tightly connected that they prevent harmful substances such as bacteria and toxins from entering the brain and spinal cord (collectively called the central nervous system or CNS). In MS, the BBB is compromised and becomes leaky, allowing white blood cells from the immune system to pass through the barrier and enter the CNS. The white blood cells then attack myelin (the coating around the nerve cells in the CNS) which results in inflammation and lesions. Many research teams are examining what causes the BBB to weaken and ways to prevent this from happening.
The MS Society of Canada’s research team has arrived in the exciting city of Paris, France to attend the 7th Joint ACTRIMS/ECTRIMS meeting from October 25-28, 2017. Paris tidbit: Jean Martin Charcot, who identified and named multiple sclerosis (la sclérose en plaques), is from Paris, France. The ACTRIMS/ECTRIMS Congress is the largest international meeting devoted to scientific research and health management of multiple sclerosis, and each year the list of topics and number of participants grows.
A question I frequently receive is: “Are there supplements I can take to manage my MS?” MS impacts the day-to-day lives of those living with the disease, so it’s no surprise that many individuals explore complementary and alternative medications (CAMs) to take control of their MS. CAMs are approaches that come from a variety of traditions and practices, including exercise, natural health products, supplements and vitamins. In addition to helping in the management of MS, CAMs are used by Canadians to enhance their overall wellness.
There are a variety of small studies that have looked at the role of CAMs in MS, however their effects are unclear. One area that is growing in interest are the role of supplements as potential treatments. In this post, I will touch on three supplements that have recently gained some traction among the MS research community – vitamin D, biotin, and lipoic acid.
Burgers to Beat MS day raises funds to help improve the lives of Canadians living with multiple sclerosis. This fundraising campaign led the MS Society of Canada in partnership with A&W Food Services of Canada Inc has already raised over $9 million over the past 8 years, and this year A&W increased their donation to $2 from every Teen Burger® sold across the country on this day. Burgers to Beat MS creates an opportunity for people across the country to come together to support Canadian-led efforts to better understand MS and find a cure, while enjoying a delicious Teen Burger®.
The cause of MS is still a mystery and researchers continue to examine ways to prevent, diagnose and treat this highly unpredictable and often debilitating disease. Support from A&W allows the MS Society to invest in innovative research, support international research collaborations, and translate discoveries from ideas to new clinical tools and treatments.
Here are some projects that would not be possible without the amazing fundraising efforts of A&W and other dedicated partners and volunteers of the MS Society:
Team Roze at Hack4Health 2.0. Pictured (left to right): Lisa Loiselle (Co-chair), Lori-Ann Williams, Marium Kirmani, Rui Su, Karla Boluk (Co-chair)
I recently had the opportunity to interview Roze, a team of University of Waterloo students and the winners of last Fall’s annual Hack4Health competition hosted by the university. Hack4Health is a 36-hour innovation marathon bringing together students from multi-disciplinary fields working together to design a technology-based project on new wellness solutions for people living with multiple sclerosis and Alzheimer’s disease. Check out a previous blog post about the Hack4Health program and winners of the 2015 competition.
The members of team Roze – which include Lori-Ann Williams, Marium Kirmani, Rui Su and Tina Chan –bring experience from different areas: public health, pharmacy, software development and informatics. These talented ladies were excited about the opportunity to learn about MS and other neurodegenerative diseases as well as how they could contribute their skills of intersecting technology and health to make improvements in the quality of life for people living with MS. At Hack4Health, they pitched the idea of an app that promotes appropriate physical activity for women living with MS to help cope with and potentially reduce fatigue, one of the most common symptoms of MS. As the winners of the competition, they were selected to work with a supervisor to further develop their project with the help of a $15,000 grant from the MS Society of Canada.
In my interview with team Roze, I learned more about what motivated them to participate in Hack4Health, their fatigue-based technology, and a bit about the members of the team themselves.
Coordinated by the MS International Federation since 2009, each year the last Wednesday in May marks World Multiple Sclerosis Day. May is also MS awareness month, where the MS community unites to raise awareness of the challenges of today and rallies to find solutions for tomorrow. In fact the MS Society of Canada spent a few days in Ottawa, Ontario this month to meet with parliamentarians and make the voices of people with MS heard. Check out the news article highlighting our advocacy efforts around securing income and employment, improving access and accelerating research.
With the goal of helping better the lives of 2.3 million people living with MS world-wide, events around the world have highlighted what it means to live a #LifewithMS– the theme of this year’s World MS Day. The hashtag is being used around the world to share personal experiences and advice on how to improve life with MS.
Additionally, there is a great deal of research taking place around the world that has enormous potential to enhance #LifewithMS, whether it’s through the generation of new treatments, gathering insight into the risk factors for MS, or enabling the development of approaches that help people with MS manage symptoms.
How does multiple sclerosis begin? This is the million-dollar question and the answer to this question could lead to the ultimate goal of ending MS. Every year the MS Society of Canada invests millions in research to support scientists working to figure out the cause of MS. While factors contributing to MS development and progression are slowly being discovered, a single cause of MS remains elusive. Recently, there has been a lot of talk in the news about a protein that is believed to be linked to be the cause of MS, but what’s the hype all about? I had a chance to review the article published in Journal of Neuroinflammation and noted some interesting findings.
For people living with relapse-remitting MS, 1993 was a turning point. Before then, the only relief available to people living with MS was with the use of relapse-management therapies like steroids, which were used to decrease the severity and duration of an MS relapse by suppressing inflammation, as well as symptom management therapies. However, no options were available that could modify the underlying disease course and prevent relapses from happening in the first place. All that changed in 1993, when the U.S. Food and Drug Administration (FDA) approved the first disease-modifying therapy beta interferon 1-b (Betaseron) for the treatment of relapsing forms of MS, ushering in the era of modern MS therapy. Following Health Canada’s own regulatory approval process, Betaseron was marketed in Canada in 1995.