symptoms

The levels of neurofilament light chain (NfL) and chitinase3-like1 (CHI3L1) in the cerebrospinal fluid — the liquid that surrounds the brain and spinal cord — serve as respective biomarkers of disease activity and progression in multiple sclerosis (MS), a study reports. Measuring levels of both proteins also helps to…

Endothelin-1 (ET-1) — a molecule with potent blood vessel-narrowing (vasoconstrictive) properties — may be used as a biomarker of severity for optic neuritis in people with multiple sclerosis (MS), a small Italian study suggests. The molecule also may be a potential indicator of patients’ failure to recover…

As I sit down (nothing unusual there — all I do these days is sit down!) and write this, I’m 62 years and one day old. On Saturday morning, it felt like I still had a few days to go before I reached the heady height of a 2-year-old. I’m…

Editor’s note: “Need to Know” is a series inspired by common forum questions and comments from readers. Have a comment or question about MS? Visit our forum. This week’s question is inspired by the forum topic “Is it the summer or winter weather that impacts your MS the most?”…

Several days ago, the headline “It’s All in Your Head” jumped out at me. The author of the Journal of the American Medical Association article, Matthew Burke, is a neurologist at Harvard Medical School who specializes in neuropsychiatry. According to Burke, the problem of physicians telling patients that unexplainable…

Editor’s note: “Need to Know” is a series inspired by common forum questions and comments from readers. Have a comment or question about MS? Visit our forum. This week’s question is inspired by the column,”Tips to Fend Off Invasion of the Common Cold” from Jan. 30, 2017.

For the last few months, urinary tract infections (UTIs) have been the main subject of this column. My current disease-modifying therapy, Ocrevus (ocrelizumab), has had a significant impact on my multiple sclerosis (MS). The only downside is that Ocrevus attacks B-cells in the body, increasing the risk…

Bladder and bowel problems, such as constipation and fecal incontinence, are associated with a higher level of fatigue in people with multiple sclerosis (MS), according to a study in Australia. The findings also showed that greater fatigue and experiencing bowel and bladder problems are associated with…

Acthar Gel (repository corticotropin injection) eased flare-up symptoms in patients with multiple sclerosis (MS) experiencing relapses, top-line data from an observational registry study shows. Acthar Gel, a medication developed and marketed by Mallinckrodt Pharmaceuticals, is a compound that enhances the production of steroids in the…

I have been fighting multiple sclerosis (MS) for seven years now. I’ve changed a lot since getting diagnosed. I’ve become more aware of my body and the ways MS has changed my life. Nothing stopped me from graduating from college, but I’ve still faced many challenges…

Careful profiling of inflammatory markers in cerebrospinal fluid (CSF) of multiple sclerosis patients, coupled with standard exams and scans, helps in understanding disease evolution and treatment response, a case report suggests. It followed a relapsing-remitting multiple sclerosis (RRMS) patient whose inflammatory markers in the CSF remained high over time, and…

Editor’s note: “Need to Know” is a series inspired by common forum questions and comments from readers. Have a comment or question about MS? Visit our forum. This week’s question is inspired by the forum topic “Is it an MS Diagnosis or is it something else? ” from July…

A diagnosis of multiple sclerosis (MS) often leaves patients and their families with many unanswered questions. It can be hard to find information, connect with other patients, and find support. Here are some frequently asked questions and answers about MS: What is MS? MS is an autoimmune disease —…

I saw a praying mantis this morning. The long, leaf-like oddity caught me off guard. I was transfixed by the beautiful specimen, its prayerful state contrasting starkly with its violent mating ritual. The female is known to eat the head of the male — a shift in temperament at…

Damage to nerve cells appears to occur years before people with multiple sclerosis (MS) begin to show symptoms and is evident in a likely biomarker, new data suggest. Researchers found raised levels of neurofilament light chain (NfL), a protein associated with nerve cell damage, in blood samples collected six years…

Serum neurofilament light chain (sNfL) in the blood — a proposed biomarker for multiple sclerosis (MS) — is linked with worse neurologic function at levels above a certain threshold, according to data from a large, real-world study. Kathryn Fitzgerald, assistant professor at the Johns Hopkins School of…

There’s always something. The trouble with a mélange of complex medical issues is that one good action often can lead to a bad secondary one. It’s like a game of consequences that unfortunately not only injures your psyche, but also leaves a mark on the body. In my case, it…

Feeling tired, depressed, or anxious? Maybe it has to do with your social cognition. Social cognition involves empathy and recognizing the emotions that are revealed by someone’s facial expression. That expression may show fear or disgust. Or it may warn us of danger. Social cognition also involves the…

Editor’s note: “Need to Know” is a series inspired by common forum questions and comments from readers. Have a comment or question about MS? Visit our forum. This week’s question is inspired by the forum topic “How do you feel about journaling? It’s a good way to keep track of…

Using smartphones and smartwatches to monitor disease course via the FLOODLIGHT app leads to high adherence and satisfaction among patients with multiple sclerosis (MS), results from a pilot study show. The research, “Adherence and Satisfaction of Smartphone- and Smartwatch-Based Remote Active Testing and Passive Monitoring in People With Multiple Sclerosis: Nonrandomized Interventional Feasibility Study,” was published in the Journal of Medical Internet Research. Assessing MS progression commonly requires periodic in-clinic visits, and doctors may miss subtle changes occurring between such visits. Smartphones may be a solution for real-time data collection and better patient monitoring outside the clinic. The Roche-sponsored FLOODLIGHT study assessed the feasibility of using smartphones and smartwatches to assess MS symptoms, including hand function, gait and posture, mood, and cognitive impairment. FLOODLIGHT primarily evaluated adherence and feedback to the smartphone- and smartwatch-based assessments, as well as the participants’ satisfaction, as determined by their impact on daily activities. The study included 76 MS patients (ages 20 to 57; 53 were women) and 25 healthy controls, who were recruited at the Multiple Sclerosis Centre of Catalonia in Barcelona, and the University of California, San Francisco. Most patients (91%) had relapsing-remitting MS. The mean time since symptom onset was 11.3 years, and the mean Expanded Disability Status Scale score was 2.4. The test battery included active tests performed daily, weekly, every two weeks, or on demand for 24 weeks, and passive monitoring, which analyzed sensor-based gait and mobility. Participants were instructed to complete the active tests at roughly the same time every day, and to carry the smartphone and smartwatch with them all the time. Adherence was assessed via the proportion of weeks with at least three days of completed testing, and four daily hours of passive monitoring. Satisfaction was determined through a questionnaire. Clinical evaluations were conducted at the study's start, after 12 weeks, and at the study's end. Brain magnetic resonance imaging scans were taken at the enrollment visit and at week 24 (study's end). Most participants finished the study – 92% of MS patients and 64% of the controls. Reasons for discontinuation included the burden of continuous monitoring and lack of availability for the three required in-clinic visits. Over an 18-month period, from November 2016 to April 2018, most participants performed five to seven active tests per week, including the Two-Minute Walk Test (2MWT). Adherence to both active tests and passive monitoring for the 24 weeks was good, and remained stable over time after week six. In the final week, participants had a minimum of four hours of passive monitoring data over an average of four days. Adherence was higher for passive monitoring than the tests. Data showed that 70% of participants completed all active tests, 75% did all active tests except the 2MWT, and 79% had data collected via smartphone- or smartwatch-based passive monitoring. The longer a person's disease duration, the lower was their adherence. In contrast, disease severity was not seen to impact adherence. Overall scores reflecting satisfaction was 73.7 out of 100 at week 24, having remained stable since week 12. Sixty-one patients reported that the test battery had an at least an acceptable impact on daily activities. Thirty-two had no issue with the active tests, while one-third would rather avoid the 2MWT. A majority, 60%, of the MS patients said they would like to continue using the FLOODLIGHT app to better understand their disease and improve its management. “Persons with multiple sclerosis were engaged and satisfied with the FLOODLIGHT test battery,” the scientists wrote. As such, “FLOODLIGHT sensor-based measures may enable continuous assessment of multiple sclerosis disease in clinical trials and real-world settings.” FLOODLIGHT tests are being assessed in long-term studies with larger patient groups in the CONSONANCE Phase 3b trial of Ocrevus (ocrelizumab, by Roche-owned Genentech) in people with progressive MS still enrolling, contact information is here), and in a global study open to all MS patients with a mobile device, called FLOODLIGHT Open.

Editor’s note: “Need to Know” is a series inspired by common forum questions and comments from readers. Have a comment or question about MS? Visit our forum.  This week’s question is inspired by the forum topic “How do you feel about journaling? It’s a good way to keep track…

When asleep, many people dream they can fly. Some dream about being naked in public, failing an exam, or (gasp!) about sex. Last night, I dreamed that I was walking. I have that walking dream a couple of times a year. I’m walking along and all of a sudden,…

Persistent fatigue in people with multiple sclerosis (MS) is associated with damage in specific areas of the brain, regardless of depression symptoms, a study shows. The study, “Microstructural fronto-striatal and temporo-insular alterations are associated with fatigue in patients with multiple sclerosis independent of white…

Editor’s note: “Need to Know” is a series inspired by common forum questions and comments from readers. Have a comment or question about MS? Visit our forum. This week’s question is inspired by the forum topic “Have you ever had an MS hug? What does it feel like?”…

Interleukin-17A (IL-17A), a molecule that mediates immune and inflammatory responses, likely promotes inflammation and tissue damage in relapsing-remitting multiple sclerosis (RRMS) and should be considered a potential target for treating the disease, a study reports. The findings of the study, “IL-17A is associated with the breakdown of the…

Dark Rimmed Brain Lesions May Be Signal of Aggressive Disease, NIH Study Says Researchers in this study found that specific brain lesions, notable for their dark rims, may indicate that a patient’s multiple sclerosis is likely to progress quickly. They suggest that early detection of these lesions can help…

The presence of chronic active lesions in the brain may provide a clue as to how quickly multiple sclerosis (MS) symptoms will progress. Researchers at the U.S. National Institutes of Health (NIH) call these lesions “smoldering inflammation.” Their study, just published in JAMA Neurology, indicates that the more lesions…

Brain lesions appearing as dark rimmed, “smoldering” spots on imaging scans, representing active inflammation, may be a hallmark of more aggressive and disabling forms of multiple sclerosis (MS), researchers at the National Institutes of Health (NIH) report. Using a powerful MRI brain scanner and a 3D printer, the…

Editor’s note: “Need to Know” is a series inspired by common forum questions and comments from readers. Have a comment or question about MS? Visit our forum. This week’s question is inspired by the forum topic “Have you had a lumbar puncture to help diagnose your MS?” from Jan. 29.

Testing for the types of fat (lipid) molecules present in the cerebrospinal fluid (CSF) of people with multiple sclerosis (MS) may be a very useful way to diagnose and monitor the disease, a study suggests. “MS patients present a different lipid profile at the time of diagnosis” than…