MS News Notes: aHSCT, Iron Rim Lesions, Smell Test, Electrical Brain Stimulation

The following multiple sclerosis (MS) news stories caught my eye last week:

Stem cell transplant and nerve fiber damage

This small study of 43 people with relapsing-remitting multiple sclerosis who underwent autologous hematopoietic stem cell transplant (aHSCT) in Sweden reports that their disability during the period of study — about seven years, plus a four-year follow-up — was generally stable or their impairment was reduced. To me, this is additional evidence that we should make aHSCT available to more people with MS.

Autologous hematopoietic stem cell transplant (aHSCT) reduces markers of nerve fiber and myelin damage in people with relapsing-remitting MS (RRMS), according to a small study done in Sweden.

“We investigated if therapeutic intervention with aHSCT could halt the injurious process leading to tissue damage in MS,” researchers wrote. “Our main finding is that a majority of patients reach that goal with time, regardless of subsequent disease activity.”

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Iron rim lesions and disease severity

Some people call iron rim lesions “smouldering MS.” The lesions are active, but their growth is slow. It’s been thought for some time that they indicate a more aggressive MS course. But this is the first study that I know of to suggest that tracking these lesions with MRIs could lead to a more accurate MS prognosis.

The presence of iron rim lesions, which are regions of chronic inflammation seen on MRI scans, may be linked to a more severe disease course in people with multiple sclerosis, according to a recent study.

The findings suggest the presence and number of iron rim lesions could serve “as an imaging biomarker for disease severity, which could be easily implemented in clinical practice,” researchers wrote.

Smell test

My wife smells everything, but I smell very little. She thinks I have no nose, while I think hers is oversensitive. We’re probably both right. Maybe now I can blame my MS for having no nose.

Evaluating a person’s sense of smell may help monitor disease progression in people with MS, according to a recent study.

Almost a third of MS patients studied showed signs of smell loss in clinical evaluations and the degree of impairment correlated with clinical measures of disease, such as disability, MS duration, and cognitive performance.

Electrical brain stimulation

Easing MS spasticity with direct electrical stimulation of the brain is an interesting concept, but it’s just that — a concept. The subjects of this small study in Egypt underwent five 20-minute electrical brain stimulation treatments that resulted in improvement in some, but not all, of three test measures of spasticity. There also was no indication of how long the improvement lasted. I expect I’ll be sticking to my baclofen prescription to treat my leg spasticity for some time to come.

Electrical stimulation of the brain through electrodes placed on the scalp may ease some measures of spasticity for people with relapsing-remitting MS, according to results from a small clinical trial.

Using this novel route of brain stimulation was shown to impact muscle contractions in patients with spasticity in at least one leg.

The procedure, called transcranial direct current stimulation (tDCS), “is non-invasive, easily applicable and could [reduce] spasticity in MS,” the researchers wrote.

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