MS news notes: Spasticity, early treatment, pediatric onset

Columnist Ed Tobias comments on the week's top MS news

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by Ed Tobias |

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Welcome to “MS News Notes,” a column where I comment on multiple sclerosis (MS) news stories that caught my eye last week. Here’s a look at what’s been happening:

Can noninvasive brain stimulation reduce MS spasticity?

For a long time, I’ve had to deal with spasticity, a common MS symptom in which muscles become abnormally tight over time, making it hard to move and resulting in stiffness and pain. Medications, physical therapy, and exercise have helped a bit, but they haven’t been a complete or lasting solution.

The MS News Today story “Brain stimulation may offer promise for spasticity in MS: Study” reports on a review of various trials involving two types of brain stimulation, called repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS).

The trials indicated that rTMS, which is noninvasive and uses a magnetic field to stimulate brain cells, significantly eased spasticity in patients’ legs, ankles, and feet. This improvement was most pronounced when the rTMS was combined with physical therapy, researchers from the Middle East University in Jordan noted.

However, tDCS, which uses low levels of direct electrical current, “did not show meaningful effects,” they said, adding that “more research will be needed” to determine “whether these approaches are beneficial in the long-term.”

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Repeat after me: ‘Hit it hard and fast’

The story “Disability, older age at start of DMT linked to worse cognition in RRMS” provides more support for the belief that early diagnosis and treatment are important for holding MS symptoms at bay, particularly cognition decline.

The study emphasizes “the importance of early diagnosis and intervention to maintain cognitive functions in RRMS,” or relapsing-remitting MS, which is characterized by periods of new or worsening symptoms, called relapses, followed by periods of remission where symptoms ease.

I was given a battery of cognitive tests a little over a year ago, and the neuropsychologist described me as “extremely normal.” I think starting a disease-modifying therapy (DMT) at the earliest possible time played a role in that.

Aggressive treatment encouraged to treat pediatric-onset MS

Fast treatment with a high-efficacy therapy is recommended for children and adolescents with MS, according to research reported in a story titled “Using highly effective DMTs early linked to fewer relapses in children.” That’s similar to what studies show for adults.

The story notes that a moderately effective DMT is usually tried first with younger patients, whose doctors often switch them to a more effective one if the patient doesn’t respond well to treatment.

The study reports that only about 10.2% of the young patients who started with a moderate-efficacy DMT were still being treated with it about two years later, with most of those patients having switched to a high-efficacy treatment. The researchers wrote that “rapid initiation of more aggressive treatment shortly after the diagnosis may allow better disease control in [pediatric-onset MS].”

So why wait? A hit-it-hard-and-hit-it-fast treatment philosophy for pediatric MS patients makes sense to me.

Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to multiple sclerosis.


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