MS Patient’s Pick of the Week’s News: Tremors, Tecfidera, MRI, Progression, and Caregivers

There have been plenty of interesting stories on Multiple Sclerosis News Today over the last seven days. Here is my Pick of the Week’s news.

Tremors Linked to MS Poorly Treated with Symptomatic Medication, Study Finds

It will come as no surprise to those of us with MS that disabling tremors, which apparently can affect as many as half of all us, are inadequately treated. This is because of limited therapeutic options and because such tremors are not sufficiently being studied, researchers at the University of Alabama at Birmingham reported.

Their report, “Symptomatic Management of Multiple Sclerosis-Associated Tremor Among Participants in the NARCOMS Registry,” was published in the International Journal of MS Care.

We patients with MS are faced with a number of disabling symptoms that affect our capacity to do things, and our quality of life. Drugs approved in recent years improve some symptoms, such as gait or emotional responses, but other symptoms are often managed with drugs in an off-label manner, meaning the drug is not approved for such use. The researchers said their study revealed an urgent need for symptomatic treatments of tremors.

Latest Findings on RRMS Oral Therapy Tecfidera (Dimethyl Fumarate) Detailed in New Report

Since its approval by the U.S. Food and Drug Administration (FDA) in 2013, Tecfidera (dimethyl fumarate) seems to be emerging as a first-line treatment for relapsing multiple sclerosis – according to Biogen, the company that developed it. That’s good news, if the company’s claims are correct.

In a presentation at the 68th annual meeting of the American Academy of Neurology, the company announced positive results regarding the long-term effectiveness of Tecfidera. It said that newly diagnosed Relapsing MS patients receiving the treatment maintained consistently reduced relapse rates, and that over 50 percent of them exhibited no relapses in six years of treatment. The drug’s long-term safety profile was also supported, the company said.

Of Biogen’s three Phase 3 trials evaluating Tecfidera to treat Relapsing MS, one is continuing as an extension monotherapy study — ENDORSE (NCT00835770) — and will monitor the effectiveness and safety of the therapy through mid-2019.

New MRI Method Has Potential to Map MS Progression and Guide Treatment

A revolutionary development in magnetic resonance imaging (MRI) research that I find exciting is underway in Canada.

Researchers working with MRI are often faced with a problem: an average MRI brain scan produces a considerable amount of images (around 600 megabytes), but half carry distortions that make them unreadable. These “phase images,” as they are known, are usually discarded and their insights lost. Now, the work of researchers like Hongfu Sun in the field of quantitative susceptibility mapping (QSM) is revolutionizing the MRI field, and information within “phase images” is no longer a mystery.

This means that, for diseases such as multiple sclerosis, researchers could soon be much better equipped to track biomarkers in the brain that correspond with the severity of MS symptoms.

Dr. Sun, who received a T. Chen Fong Postdoctoral Fellowship for his innovative MRI methods targeting MS assessment, is now developing his research in Dr. Bruce Pike’s lab, part of The Hotchkiss Brain Institute (HBI) at the Cumming School of Medicine, Canada.

Now this is definitely one to watch.

MS Progression May Be Tied to Workings of Immune Complement System in Brain Lesions

Any progress into understanding primary progressive MS is very welcome.

The complement system, a part of our non-adaptable (innate) immune defenses, is activated in lesions inside the brain’s gray matter and may well contribute to the relentless progression of multiple sclerosis (MS), researchers report. The findings offer new insights into mechanisms driving the development of this disease — particularly its primary progressive forms.

The complement system is composed of an array of proteins that, by triggering a cascade of molecular signals, enhances (complements) the activity of other parts of the immune system, including antibodies and cells that clear microbes and cell debris.

Researchers at Swansea University School of Medicine in the U.K. analyzed a large set of complement factors, receptors, and regulatory molecules in the brains of 22 deceased MS patients and 23 control individuals, including 15 who did not have neurological disease and eight who had other types of inflammatory disease.

The study, “Complement is activated in progressive multiple sclerosis cortical grey matter lesions,“ published in the Journal of Neuroinflammation, found high levels of activated complement in gray matter lesions. Such lesions could be detected both in the surface layer of the brain, called the cortex, and in deeper brain regions.

MS Takes a Toll on Caregivers, Too, Especially on Their Mental Health

As an MS patient whose wife is my carer, I know the importance of looking after her needs as well as mine.

Caregivers of people with multiple sclerosis (MS) are often burdened by fatigue and depression, even anger, all of which can reduce the quality of care given — although they remain empathetic, according to a study. The research team at the University of Manitoba in Canada suggested that tending to the needs of people caring for MS patients would aid both the caregiver and the patient.

The study, “Examining the Relationship Between Family Caregivers’ Emotional States and Ability to Empathize with Patients with Multiple Sclerosis,“ published in the International Journal of MS Care, highlights that support to caregivers might require education, treatment of mood problems, access to respite care, and other interventions.

In the study, nearly one-third of caregivers showed signs of a negative impact on their mental health, scoring high or very high on a questionnaire measuring various mood-related behaviors. Fatigue was the most common negative feeling, present in 42 percent, with anger or hostility next, reported by 20 percent.

Family carers, in general, are perhaps the most often overlooked people in cases of chronic diseases, not just MS.

For anyone wondering why my articles never appear in my Pick of the Week’s news, it is because my column is not strictly news, as it includes my thoughts and opinions.

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.