Brain Awareness Week, happening this year from March 12 to 18, is a global campaign organized by Dana Alliance for Brain Initiatives to increase awareness of the benefits of brain research while promoting public interest in neuroscience research. In recognition of this week, I’m discussing brain health in multiple sclerosis with a focus on the MS Brain Health Report. Titled Brain Health: Time matters in multiple sclerosis, the report offers evidence-based recommendations focused on diagnostics, therapeutic strategies, and improving access to treatment. It was developed by a group of international experts in MS under the guidance of Dr. Gavin Giovannoni, Chair of Neurology at the Barts and The London School of Medicine and Dentistry. The MS Society of Canada was one of the many organizations to endorse the recommendations made in the report.
The MS Brain Health Report is divided into six key chapters focusing on: (1) the burden of MS; (2) speeding up diagnosis; (3) early interventions to maximize brain health; (4) monitoring and treating MS; (5) acting quickly on disease activity; and (6) approaches to understand cost-benefits of treatments. Together, these chapters make up an extensive summary! Below are some key points from each section to give a flavour of the Report.
For more than a century people around world have been celebrating International Women’s Day (IWD) on March 8th. The theme for this year’s IWD is #PressforProgress based on a need for gender parity. In addition to this year’s goal to #PressforProgres, IWD celebrates the achievements of women all around the world. When speaking of the achievements of women and bringing it locally, Dr. Pamela Valentine was appointed President and CEO of the Multiple Sclerosis Society of Canada this year. In Multiple Sclerosis (MS), more women than men are diagnosed with the disease that means more women are managing a disease while also juggling the everyday hurdles of life. So, in today’s post I wanted to highlight the research projects conducted by a couple of the female researchers we support that are working tirelessly to find ways to improve the quality of life of all people living with MS.
Presenters at the cutting-edge developments in MS session deliver the newest key findings of pivotal studies. At the session, we heard about a novel therapeutic involved in remyelination, pathways that inhibit remyelination, a genetic risk factor that may also target the cell functions in the central nervous system, and reduced adverse events with extended interval dosing of an approved disease-modifying therapy.
Read on for highlights from the #ACTRIMS2018 cutting edge developments in MS research session.
Happy New Year! It’s the time of year many of us make that list of New Year’s resolutions whether it’s being healthier, getting organized, being happier or something else. For many of you affected by MS, one hope you have is to stay well through your very personal journey.
Happily, 2018 seems promising for another year of discoveries. The MS Society continues to fund some of the world’s most groundbreaking MS research—research that has improved quality of life for people affected by MS. So here’s to another year of life-changing scientific advances like those we saw in 2017:
As per yearly tradition, the 7th joint ECTRIMS/ACTRIMS meeting ended with late-breaking research news. This year, we heard about discoveries related to human brain anatomy, a new biomarker for phase 2 clinical trials and a potential drug for progressive MS.
The trillions of bacteria that call the intestines home collectively make up the gut microbiome. Bacteria in the gut do much more than digest food and break it down into nutrients; they are involved in many biological functions including metabolic processes and regulating aspects of our immune system. Researchers are learning that these tiny creatures are important in the general maintenance of good health and are incredibly sensitive to change. Disruption of gut bacteria has been implicated in a host of health conditions including diabetes, obesity and autoimmune diseases like inflammatory bowel disorder and multiple sclerosis (MS). Studies have shown that certain strains of bacteria are elevated in individuals with MS but not in healthy individuals. We will be hearing more about the role the gut microbiome plays in the development, prevention, and treatment of MS in the coming years.
Already, the gut microbiome was an area of great interest at the #MSParis2017 conference this year. Here are highlights of the research discussed in the talks of Dr. Hartmut Wekerle and Dr. Helen Tremlett.
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.
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.